CHPW Medicaid Formulary - Community Health Plan of Washington

Transcription

2016 Drug Formulary
CHPW_RX_02_2016_Medicaid_Formulary
COMMUNITY HEALTH PLAN of WASHINGTON 2016 DRUG FORMULARY The Community Health Plan of Washington Drug Formulary was developed by the Pharmacy and Therapeutics (P&T) Committee of the Community Health Plan of Washington (CHPW). This Committee is composed of Washington state providers and pharmacists from various medical specialties. They have performed evidence-‐based reviews on medications in all therapeutic categories based on safety, effectiveness and cost, selecting the products showing the most value in each class. The P&T Committee will regularly review new and existing medications to ensure the Formulary remains responsive to the needs of our members and providers. For updates regarding periodic changes to the Formulary and other pharmaceutical management programs please check our website at www.chpw.org. This Drug Formulary is intended for use by our providers and pharmacies and applies only to medications prescribed to our members and dispensed by participating pharmacies. The Formulary does not apply to inpatient medications. Requesting Changes to the Formulary If a provider would like to request that a new or existing medication be added to the Drug Formulary, a letter (including copies of relevant research articles and journal citations) indicating the significant evidence-‐based advantages of the drug product over current Formulary medications should be mailed to the following address: Community Health Plan Director of Pharmacy 720 Olive Way, Suite 300 Seattle, WA 98101 Non-‐Formulary and Prior Authorization Request Process The health care professionals consulted in the development of this Formulary attempted to include medications for all therapeutic needs. Providers are expected to comply with the Drug Formulary when prescribing medications for plan members. If a patient requires a medication that is not covered, the provider may request an exception to allow payment for the non-‐covered medication. It is anticipated that such exceptions will be rare, and that most of the time, providers should be able to find a Formulary medication for the vast majority of therapeutic needs. However, if providers desire a non-‐
covered product for members, they must call or submit a request explaining the necessity, past therapeutic failures and patient identification (name, address and Community Health Plan of Washington member number). Updated on 3/30/2016
Generic Drug Policy Community Health Plan utilizes a mandatory generic policy. This means that unless specified, the brand product won’t be covered without adequate trial and documented failure of the formulary generic product. Only when generic substitution conflicts with state regulations or restrictions, the pharmacist must gain approval from the prescriber to use the generic equivalent. OTC Medication Policy Some Over-‐The-‐Counter (OTC) products are covered with a written prescription. If a prescription product is available in the identical strength, dosage form, and active ingredient(s) as an OTC product, the prescription product will not be covered. In these instances, providers and pharmacists should refer members to the OTC equivalent product. If the member or provider insists on the prescription equivalent product, the member must pay the entire cost of the prescription. Age Restrictions Age restrictions apply to selected drugs. These drugs are covered without prior authorization for specific age ranges but otherwise require prior authorization. -‐budesonide inhalation suspension – covered for members under 7 years old -‐insulin pens-‐ covered for members under 21 years old or pregnant -‐tretinoin-‐ covered for members under 30 years old Second Opinion Network Community Health Plan of Washington has adopte4d Washington Health Care Authority (HCA) age/dose limits for certain psychotropic medications for children under 18 years old. Clients currently receiving medications outside of these age/dose guidelines will be allowed to continue, regardless of previous payer (whether HCA FFS, the plan themselves, or a previous payer prior to the client becoming a Medicaid enrollee). Clients being prescribed medications for the first time, or receiving prescriptions for dose escalations which exceed thresholds will have those prescriptions denied by the managed care plans, and referred to HCA for initiation of the second opinion review process. After completion of the second opinion review, the managed care plan will receive a copy of the SON written recommendation, and approve or deny future prescriptions accordingly. DOCTORS and PHARMACISTS ONLY: Non-‐Formulary and Prior Authorization requests must be directed to: Express Scripts, Inc. Attn: Prior Authorization Mail Stop B401-‐03 8640 Evans Road St. Louis, MO 63134 Phone: 1-‐888-‐256-‐6132 Prior Authorization To promote the most appropriate utilization, selected high-‐risk or high-‐cost medications require prior authorization to be eligible for coverage. Prior authorization criteria have been developed using current, published, peer-‐reviewed, medical literature, as well as input from local providers. The prior authorization criteria are approved by the P&T Committee. The Formulary medications that require prior authorization are identified by a “PA” following their name. Most authorizations are good for one year; after that, the drugs listed here will need to be re-‐authorized. Drugs may be added or deleted from this list as deemed necessary by Community Health Plan. Step-‐Therapy Step-‐therapy promotes appropriate utilization of first line drugs and/or therapeutic categories. Step-‐therapy requires that participants receive one or more first-‐line drug(s), as defined by program criteria, before prescriptions are covered for second-‐line drugs. All step-‐therapy programs are supported by prior authorization criteria to determine coverage in the event that a participant does not meet the automated, on-‐line step-‐therapy criteria and coverage of a second line product is medically necessary. Benefit Exclusions Drugs in the following categories are not available as benefits of the plan: • Non-‐FDA approved drug products: Medications will be eligible for coverage only if they are FDA-‐approved prescription medications used for non-‐experimental indications. • Experimental and Investigational (E & I) drugs: These are drugs that do not have FDA-‐
approved indication(s) for use, or other indications that are considered effective based on published scientific evidence. • Compounded drugs with non-‐FDA approved ingredients: (e.g. Estriol used in Bi-‐Est and Tri-‐Est) • Samples: Members started on samples of a non-‐formulary drug are not guaranteed coverage for that drug. • Drugs for weight loss or appetite suppression: (e.g. Xenical) • Drugs for impotence or sexual dysfunction: (e.g. Viagra) • Drugs to treat cosmetic issues: (e.g. Rogaine) • Infertility drugs • Prescription drugs that are equivalent to OTC medications or with an OTC add on: Some OTC medications are covered for Apple Health. Please Note: Generic drugs are listed in lower case BRAND drugs are listed in UPPER case Tier 1: Formulary Tier 2: Formulary Non-‐Preferred (PA Required) Tier 3: Non-Formulary Tier 4: Medical benefit
PA: Prior Authorization. The Plan requires you or your physician to get prior authorization for certain drugs. This means that you will need to get approval before you fill your prescriptions. If you don’t get approval, we may not cover the drug. QL: Quantity Limit. For certain drugs, there are limits on the amount of the drug that we will cover. ST: Step Therapy. In some cases, the Plan requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, we may not cover Drug B unless you try Drug A first. If Drug A does not work for you, we will then cover Drug B. Retail Pharmacy days supply 30 days supply is allowed at the retail pharmacy for all Community Health Plans. Mail Order Pharmacy Apple Health has no mail order benefit. Copay Determinations There is no copay or deductible for formulary products for Apple Health. OTC products: Only certain OTC products are covered for Community Health Plan members Community Health Plan of Washington
2016 Drug Formulary
Formulary Detail
Contents
of
Table
Table of Contents
ALTERNATIVE THERAPY .................................................................................................................................................................................................................................................................. 8
ANALGESIC, ANTI-INFLAMMATORY OR ANTIPYRETIC ........................................................................................................................................... 20
ANESTHETICS ......................................................................................................................................................................................................................................................................................................... 34
ANORECTAL PREPARATIONS .............................................................................................................................................................................................................................................. 37
ANTIDOTES AND OTHER REVERSAL AGENTS ................................................................................................................................................................................ 38
ANTI-INFECTIVE AGENTS ............................................................................................................................................................................................................................................................ 41
ANTINEOPLASTICS ..................................................................................................................................................................................................................................................................................... 55
ANTISEPTICS & DISINFECTANTS ................................................................................................................................................................................................................................. 64
BIOLOGICALS ......................................................................................................................................................................................................................................................................................................... 67
CARDIOVASCULAR THERAPY AGENTS ......................................................................................................................................................................................................... 71
CENTRAL NERVOUS SYSTEM AGENTS ............................................................................................................................................................................................................ 87
CHEMICAL DEPENDENCY, AGENTS TO TREAT ....................................................................................................................................................................... 105
CHEMICALS-PHARMACEUTICAL ADJUVANTS ......................................................................................................................................................................... 106
COGNITIVE DISORDER THERAPY .......................................................................................................................................................................................................................... 151
CONTRACEPTIVES ................................................................................................................................................................................................................................................................................... 151
DERMATOLOGICAL .............................................................................................................................................................................................................................................................................. 155
DIAGNOSTIC AGENTS ....................................................................................................................................................................................................................................................................... 204
DRUGS TO TREAT ERECTILE DYSFUNCTION ............................................................................................................................................................................... 208
EATING DISORDER THERAPY ......................................................................................................................................................................................................................................... 209
ELECTROLYTE BALANCE-NUTRITIONAL PRODUCTS .............................................................................................................................................. 209
ENDOCRINE ............................................................................................................................................................................................................................................................................................................. 267
ENZYMES ...................................................................................................................................................................................................................................................................................................................... 279
GASTROINTESTINAL THERAPY AGENTS ............................................................................................................................................................................................... 279
GENITOURINARY THERAPY ............................................................................................................................................................................................................................................... 299
GOUT AND HYPERURICEMIA THERAPY .................................................................................................................................................................................................. 303
HEMATOLOGICAL AGENTS ................................................................................................................................................................................................................................................. 303
HISTAMINE PREPARATIONS FOR DESENSITIZATION ............................................................................................................................................... 310
IMMUNOSUPPRESSIVE AGENTS ................................................................................................................................................................................................................................. 310
LOCOMOTOR SYSTEM .................................................................................................................................................................................................................................................................... 311
MEDICAL SUPPLIES AND DURABLE MEDICAL EQUIPMENT (DME) ............................................................................................. 314
MEDICAL SUPPLY, FDB SUPERSET ....................................................................................................................................................................................................................... 385
METABOLIC DISEASE ENZYME REPLACEMENT AGENTS ................................................................................................................................ 455
METABOLIC MODIFIERS ............................................................................................................................................................................................................................................................ 456
MOUTH-THROAT-DENTAL - PREPARATIONS ................................................................................................................................................................................ 457
MULTIPLE SCLEROSIS AGENTS ................................................................................................................................................................................................................................. 463
OPHTHALMIC AGENTS .................................................................................................................................................................................................................................................................. 464
ORGAN PRESERVATION SOLUTIONS .............................................................................................................................................................................................................. 474
OTIC ......................................................................................................................................................................................................................................................................................................................................... 474
PROSTAGLANDINS ................................................................................................................................................................................................................................................................................... 475
RENAL REPLACEMENT THERAPY ........................................................................................................................................................................................................................ 475
RESPIRATORY THERAPY AGENTS ........................................................................................................................................................................................................................ 475
VAGINAL PRODUCTS .......................................................................................................................................................................................................................................................................... 512
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7
Drug Name
Community Health Plan of Washington
2016 Drug Formulary
Formulary Detail
Drug Name
Drug Tier Requirements
/Limits
ALTERNATIVE
THERAPY
ALTERNATIVE
THERAPY ANDROGENIC
AGENTS
/Limits
COSAMIN DS (WITH
MANGANESE) ORAL
CAPSULE
500-400-2-0.33 MG
3
DONA ORAL
POWDER IN PACKET
3
DONA ORAL
TABLET
1
DURAFLEX ORAL
3
FLEXI JOINT
3
GENICIN
3
gluc-chon-msm#1-c-ma
ng-bos-bor oral tablet
500-416.6-20 mg
3
1
DEHYDROEPIANDR
OSTERONE (MICRO)
1
gluc-chon-msm#1-c-ma
ng-bos-bor oral tablet
750-625-30 mg
DHEA ORAL
CAPSULE
3
gluc-chon-msm#1-vit
c-mang-bor
3
gluc-chon-msm#3-mang
-bosw-bor
1
gluc-msm-chon-bos-hya
l
3
3
DHEA ORAL TABLET
10 MG-47 MG
CALCIUM, 25 MG, 25
MG-52 MG CALCIUM,
50 MG-60 MG
CALCIUM
3
prasterone (dhea)
3
GLUCOS CHOND
CPLX ADVANCED
prasterone (dhea),
micro(bulk)
1
glucosam su
dip-chondroit-c-mn
3
pregnenolone
3
3
pregnenolone,
micronized(bulk)
glucosam-chon-collag-h
yalur ac
3
glucosam-chond
su-collag-hy ac
3
GLUCOSAM-CHONDMSM(WITH BORON)
ORAL TABLET
750-625-30-1 MG
3
GLUCOSAM-CHOND
R-MSM WITH VIT D
3
glucosam-chondr-vit
c-mn-boron
3
GLUCOSAMINE
1
ALTERNATIVE
THERAPY ANTIARTHRITICS
ARTHRI-FLEX
3
CARTIVISC
3
CIDAFLEX
1
CIDATRINE
1
CONDROLITE
1
COSAMIN DS
1
You can find information on what the symbols andabbreviations on this table mean by going to the beginning of
this table.
8
Drug Name
glucosamine
2kcl-msm-chondroit
oral tablet
500-166.6-400 mg
GLUCOSAMINE
CHONDROITIN PLUS
/Limits
3
3
GLUCOSAMINE
COMPLEX-MSM
1
glucosamine hcl
3
glucosamine hcl-msm
3
glucosamine
hcl-msm-chondroitn
oral tablet 400-200-333
mg, 500-167-400 mg,
500-300-400 mg,
500-83-400 mg
3
Drug Name
/Limits
glucosamine sulfate 2kcl
oral capsule 1,000 mg,
750 mg
3
oral capsule 500 mg
1
oral tablet
3
glucosamine sulfate
nacl(bulk)
3
glucosamine sulfate oral
capsule
3
glucosamine sulfate oral
tablet
1
glucosamine
sulfate-msm
3
GLUCOSAMINE
SULF-CHONDROITIN
1
glucosamine
sulf-chondroitinsa oral
capsule 250-200 mg
3
glucosamine
hcl-msm-chondroitn
mg
1
glucosamine
hcl-msm-chondroitn
oral tablet extended
release
3
GLUCOSAMINE-CHO
ND-MSM COMPLEX
3
3
GLUCOSAMINE MSM
3
GLUCOSAMINE-CHO
NDR-D3 (C-MANG)
GLUCOSAMINE-CHO
NDROITIN 3X ORAL
TABLET 750-625-30
MG
1
GLUCOSAMINE
RELIEF ORAL
CAPSULE
3
GLUCOSAMINE
RELIEF ORAL
TABLET
1
1
glucosamine su 2kcl
(bulk)
GLUCOSAMINE-CHO
NDROITIN COMPLX
ORAL CAPSULE
3
glucosamine su
2kcl-chondroit oral
tablet
3
3
glucosamine
sul-chondroitn-msm
oral capsule
3
GLUCOSAMINE-CHO
NDROITIN COMPLX
ORAL TABLET
250-200-30-2.5 MG,
500-416.6-20 MG,
750-625-1,000
MG-MG-UNIT
glucosamine
sul-chondroitn-msm
mg
1
3
GLUCOSAMINE-CHO
NDROITIN COMPLX
ORAL TABLET
750-625-30 MG
this table.
9
Drug Name
GLUCOSAMINE-CHO
NDROITIN DS ORAL
CAPSULE
GLUCOSAMINE-CHO
NDROITIN DS ORAL
TABLET
GLUCOSAMINE-CHO
NDROITIN MAX ST
/Limits
1
3
1
glucosamine-chondroiti
n oral capsule 167-133
mg
3
n oral capsule 500-400
mg
1
n oral liquid
3
n oral tablet 250-200
mg, 500-400 mg,
750-600 mg
1
Drug Name
/Limits
GLUCOSAMINE-MS
M COMPLEX ORAL
CAPSULE
3
glucosam-msm-chond-h
rb149-hyal
3
glucosam-msm-chondro
it-vit d3
3
GLUCOS-CHOND-MS
M (WITH ANTIOX)
3
GLUCOTEN
3
JOINT SUPPORT
3
LIMBREL
3
LIMBREL250
3
LIMBREL500
3
MEDI-FLEXX
3
methylsulfonylmethane
(bulk)
3
oral tablet
3
MSM
3
OPTIFLEX
COMPLETE
3
OPTIFLEX-G
3
OSTEO BI-FLEX
1
GLUCOSAMINE-CHO
NDROITIN ORAL
TABLET 750 MG-100
MG- 125 MG-1.65 MG,
750-60-150-1 MG,
750-600-99-5 MG, 900
MG
3
n oral tablet,chewable
3
OSTEO BI-FLEX
(5-LOXIN)
3
GLUCOSAMINE-CHO
NDROITIN-MSM
3
OSTEO BI-FLEX
TRIPLE STRENGTH
3
n-vit d3
SYNOVACIN
3
3
3
glucosamine-chondroitn
sulf.na
TREPADONE (WITH
BROMELAIN)
1
TRIPLEFLEX
1
glucosamine-chondroitvit c-mn oral tablet
1
glucosamine-d3-boswell
ia serr
3
GLUCOSAMINE-FISH
OIL
3
ALTERNATIVE
THERAPY ANTIDEPRESSANT
S
st. john's wort
3
st. john's wort (bulk)
3
this table.
10
Drug Name
/Limits
ALTERNATIVE
THERAPY ANTIOXIDANT
Drug Name
/Limits
lutein oral capsule 40
mg
3
lutein oral tablet 10 mg
1
50+ ADULT EYE
HEALTH
3
lutein oral tablet 20 mg,
6 mg
3
alpha lipoic acid (bulk)
1
lutein-zeaxanthin
3
alpha lipoic acid oral
capsule 100 mg, 200 mg
3
MACUVITE WITH
LUTEIN
3
capsule 300 mg, 50 mg,
600 mg
MULTI-BETIC
3
1
OCUVITE
3
tablet
3
OCUVITE LUTEIN
AND ZEAXANTHIN
3
alpha-ketoglutaric acid
(bulk)
3
OCUVITE WITH
LUTEIN
3
ANTIOXIDANT
A/C/E/SELENIUM
OPTI-VITAMINS
3
3
3
ANTIOXIDANT
FORMULA
(SELENIUM)
PRESERVISION
AREDS
3
PRESERVISION
AREDS 2
3
PROSIGHT
3
SAVISION
3
SUPER
ANTIOXIDANT
3
ULTRA
ANTIOXIDANT
FORMULA
3
VISION FORMULA
(WITH LUTEIN)
3
VISION-VITE + ZINC
3
ANTIOXIDANT
VITAMINS ORAL
TABLET 1,000
UNIT-200 MG-60
UNIT-2 MG
3
astaxanthin
3
E-400 C-500 AND
BETA CAROTENE
3
EYE-VITE EXTRA +
LUTEIN
3
HEALTHY EYES
3
HEALTHY EYES
SUPERVISION
3
ICAPS AREDS
3
I-VITE
3
I-VITE PROTECT
3
LIPOIC ACID
1
lutein (bulk)
3
lutein oral capsule 20
mg, 6 mg
1
ALTERNATIVE
THERAPY COUGH AND
COLD AGENTS
LITTLE REMEDIES
HONEY COUGH
3
this table.
11
Drug Name
/Limits
ALTERNATIVE
THERAPY DIETARY
SUPPLEMENT,
STEROID
STRUCTURE
7-KETO DHEA
3
7-KETO DHEA,
MICRONIZED
1
ALTERNATIVE
THERAPY DIURETICS
Drug Name
/Limits
SOY MENOPAUSE
3
STAY COOL
3
VP-GSTN
3
ALTERNATIVE
THERAPY PINEAL
HORMONE
AGENTS
MELADOX
3
MELATIN
3
melatonin (bulk)
3
DIURETIC
3
melatonin oral drops
3
NATURAL HERBAL
DIURETIC
3
melatonin oral tablet 1
mg, 3 mg
3
melatonin oral tablet
extended release
3
melatonin sublingual
tablet 1 mg, 5 mg
3
melatonin-chamomile
flower
3
TOPROPHAN
1
ALTERNATIVE
THERAPY ESTROGENIC
AGENTS
ESTRO SUPPORT ES
3
ESTROMINERAL
3
ESTROVEN
3
ESTROVEN ENERGY
3
ESTROVEN
MAXIMUM
STRENGTH
3
FOSTEUM
3
FOSTEUM PLUS
ALTERNATIVE
THERAPY SEDATIVE/HYPNO
TICS
3
3
LYDIA PINKHAM
HERBAL ORAL
ELIXIR
I-COOL
3
tryptophan
3
ISOREL
3
MENOPAUSE RELIEF
3
MENOPAUSE
SUPPORT ORAL
TABLET 30-400-80
UNIT-MCG-MG, 55-30
MG-UNIT
3
ALTERNATIVE
THERAPY TOPICAL
ANTI-INFLAMMA
TORY AGENTS
NEWPHASE
COMPLETE
3
ALTERNATIVE
THERAPY UNCLASSIFIED
soy isoflavone
3
5-HTP
SOY ISOFLAVONES
3
MSM/GLUCOSAMINE
3
3
this table.
12
Drug Name
/Limits
5-hydroxytryptophan
(5-htp)
3
ABATRACE
3
acai berry extract
3
ACAI WEIGHT
CONTROL
3
acetylcarnitin hcl-a
lipoic ac
3
acetylcarnitine (bulk)
3
ACTIVE Q
Drug Name
/Limits
AZO CRANBERRY
3
AZO CRANBERRY +
PROBIOTIC
1
AZO CRANBERRY
PLUS VIT C
3
balsam peru (bulk)
1
BASE, PCCA
PRACAMAC OIL
3
3
3
BEAUTY AND SKIN
THERAPY
ADRENOID
3
bee pollen
3
AIRBORNE (WITH
LYSINE ACETATE)
betaine hcl
3
3
bilberry
3
alfalfa
3
BILBERRY EXTRACT
3
aloe vera oral
3
bilberry fruit extract
3
american ginseng root
(bulk)
3
BIO-IMMUNEX
3
ANAMU
3
bitter melon extract
(bulk)
3
ANTI-NAUSEA
GINGER
3
black cohosh
3
APPETITE CONTROL
3
3
apple cider vinegar
3
BLACK COHOSH
MENOPAUSE
COMPLEX
APPLE CIDER
VINEGAR PLUS
3
black cohosh root
extract
3
APPTRIM
3
APPTRIM-D
3
BLACK
COHOSH-FLAXSEEDSOY
3
ARGIMENT AT
3
ARGITEIN
3
blue-green algae
(spirulina)
3
arnica
3
3
arnica flower (bulk)
3
boswellia serrata xt
(bulk)
ashwagandha root
extract(bulk)
broccoli flower
3
3
BURN CALORIES
3
astragalus root (bulk)
3
CALMME
3
astragalus root extract
(bulk)
3
CARB INTERCEPT
3
cardamom oil (bulk)
3
avocado oil (bulk)
3
CARDIOPRESS
3
AZO BLADDER
CONTROL
3
CARNI Q-GEL FORTE
3
this table.
13
Drug Name
/Limits
cat's claw (uncaria
tomentosa)
3
celery seed oil (bulk)
3
CHEW Q
Drug Name
/Limits
coenzyme q10 oral
400 mg
3
1
3
chia seed oil-omega
3-6-9 oral capsule 1,000
mg (580 mg), 1,000 mg
(630 mg-210 mg-72mg)
coenzyme q10 oral
liquid
3
coenzyme q10 oral
tablet
3
CHLOROPHYLL
(WITH ALFALFA)
3
3
coenzyme q10 oral
tablet extended release
24 hr
CHOLASE CONTROL
3
3
CHOLEST OFF
3
coenzyme q10 oral
tablet,chewable
CHOLEST OFF PLUS
3
coenzyme
q10-l-carnitine-vit e
3
CHONDROITIN
SULFATE ORAL
3
1
CINNAMON
3
coenzyme q10-vitamin e
oral capsule 100-5
mg-unit
cinnamon bark
3
3
cinnamon bark (bulk)
3
COLD AND FLU
FIGHTER
cinnamon
bark-chromium picolin
3
COLON HERBAL
CLEANSER
3
cinnamon
bark-chromium-ala
colostrum, bovine
3
3
3
CLA
3
CONCEPTIONXR
MOTILITY
CO Q-10 (WITH VIT
E)
1
CONCEPTIONXR
REPRODUCTIVE
3
COQ-10
3
coq10 (ubiquinol)
3
cranberry
3
cranberry conc-ascorbic
acid
3
cranberry
conc-c-bacillus coag
3
CRANBERRY
CONCENTRATE
3
cranberry extract (bulk)
3
CO Q-10 ORAL
CAPSULE 10 MG, 150
MG, 200 MG, 50 MG
1
CO Q-10 ORAL
CAPSULE 100 MG, 30
MG, 300 MG, 400 MG,
75 MG
3
co q10-red yeast rice
3
CO Q-10-VITAMIN
E-FISH OIL
3
coenzyme q10 (bulk)
powder 100 %
1
3
coenzyme q10 oral
50 mg, 60 mg
cranberry extract oral
capsule
1
cranberry extract oral
tablet 300 mg
3
this table.
14
Drug Name
/Limits
Drug Name
/Limits
cranberry fruit
concentrate
3
echinacea angust-purpr
root xt
3
cranberry fruit oral
tablet 400 mg
1
echinacea oral capsule
380 mg, 500 mg
3
cranberry fruit oral
tablet,chewable
3
echinacea oral capsule
400 mg
1
CRANBERRY JUICE
POWDER
3
ECHINACEA ORAL
TABLET 125 MG
3
CRANBERRY PLUS
VITAMIN C
3
echinacea purp leaf-ang
rt ext
3
CRANBERRY-PROBI
OTICS-VITAMIN C
3
echinacea purpurea
aerial
3
CRAN-MAX
3
3
CRAN-MAX 500 MG
3
echinacea purpurea
extract
creatine (bulk)
3
3
creatine monohydrate
(bulk)
echinacea purpurea
root
3
CYTO-Q
3
echinacea-golden seal
oral capsule , 350-100
mg
3
CYTO-Q MAX
3
CYTO-Q T-F
3
EFFERVESCENT
FORMULA
3
DAILY GARLIC
ONCE-A-DAY
3
ELLURA
3
ENTERAGAM
3
DERMANIC
3
DETOX DIETARY
3
epigallocatechin
gallate(bulk)
3
DETOXAREX
3
ESTROMINERAL
3
devil's claw extract
(bulk)
3
ESTROVEN MOOD
AND MEMORY
3
DIETER'S DETOX
3
3
DIETEX FORTE
3
ESTROVEN WEIGHT
MANAGEMENT
DIGAZ
3
EVENING PRIMROSE
1
diindolylmethane (bulk)
3
evening primrose oil
1
dong quai (angelica
sinensis)
3
EVENING PRIMROSE
OIL-CRANBERRY
3
EAR DROPS
HOMEOPATHIC
fenugreek seed extract
3
3
flaxseed
3
EARACHE RELIEF
3
1
ECHINACEA AND
GOLDENSEAL ORAL
CAPSULE
flaxseed oil oral capsule
1,000 mg
3
flaxseed oil-omega 3,6,9
3
this table.
15
Drug Name
/Limits
flaxseed-omega3,6,9-fat
ty acid
3
FRUIT AND
VEGETABLE DAILY
3
GABADONE
3
GARCINIA
CAMBOGIA
3
GARLIC OIL
3
Drug Name
/Limits
ginseng oral capsule
250 mg, 520 mg
3
GLUCOLESS
1
GLUCOSAMINE-MS
M COMPLEX ORAL
TABLET
3
golden seal (goldenseal)
oral capsule 535 mg
3
golden seal root
3
GRAPE SEED
3
grape seed extract
3
garlic oral capsule ,
1,000 mg, 2,000 mg, 3
mg, 580 mg
3
garlic oral capsule
1,500 mg, 500 mg
1
grape seed oil (bulk)
3
garlic oral tablet
3
grape seed
xt-bioflav,citrus
3
garlic-parsley
3
GARLIC-X
3
3
GARLIQUE
3
GREEN COFFEE
BEAN ORAL
CAPSULE
GASTRACE
3
gelatin oral capsule 600
mg
3
3
GREEN TEA
(W/MET.ENHAN.BLE
ND)
gelatin oral capsule 650
mg
1
GREEN TEA
COMPLEX ORAL
TABLET 1,000 MG
3
geranium oil (bulk)
3
GREEN TEA
EXTRACT
3
green tea extract (bulk)
3
3
ginger (zingiber
officinalis)
3
GINGER EXTRACT
3
ginger root (bulk)
3
green tea leaf ext-green
tea
ginkgo biloba (bulk)
3
green tea leaf extract
3
ginkgo biloba leaf
extract oral capsule
3
green tea oil (bulk)
3
GREEN TEA ORAL
CAPSULE , 250 MG
3
green tea-hoodia
gordonii
3
ginkgo biloba oral
500 mg, 60 mg
3
ginkgo biloba oral
tablet 40 mg
3
GRIPE WATER
3
ginkgo biloba-ginkgo
biloba ex
3
GUANIDINEACETIC
ACID
3
GINSENG KOREAN
3
GUARANA
3
ginseng oral capsule
100 mg
1
guarana seed extract
(bulk)
3
this table.
16
Drug Name
/Limits
Drug Name
/Limits
H2Q
3
linoleic acid (bulk)
3
hawthorn
3
LIQ-10
3
HAWTHORN BERRY
3
LIQSORB
3
HEALTHY HEART
COMPLEX
3
LITTLE REMEDIES
GRIPE WATER
3
HELIOCARE
3
3
horse chestnut
3
LIVER-KIDNEY
CLEANSER
hyaluronate sodium-vit
c
L-METHYL-MC NAC
3
3
lutein (bulk)
3
HYALURONIC ACID
(CHOND-COLLGN)
3
lycopene
3
lycopene (bulk)
3
HYPERTENSA
3
maca extract
3
IMMUNE SUPPORT
COMPLEX
3
mag oxide-d3-turmeric
rt xt
3
IMMUNICARE
3
MAXIMUM ENERGY
3
IMUHANCE
3
MEDI-10
3
INNERMOST
NATURE FOR MEN
3
MELATONEX
3
jojoba oil (bulk)
3
MELATONIN (WITH
B6)
3
KAVA KAVA ORAL
CAPSULE 250 MG,
500 MG
3
melatonin-pyridoxine
(vit b6) oral tablet 3-2
mg
3
kava root extract
3
KELP
3
hcl (b6)
3
KIDNEY BEAN
EXTRACT (BULK)
3
MEMORY COMPLEX
3
KOREAN GINSENG
3
MENS POTENT
FORMULA
3
KOREAN GINSENG
COMPLEX
3
METAFOLBIC PLUS
1
korean ginseng root
(bulk)
3
3
METHACHOLINE
WITH LIVER
MG-PLUS-PROTEIN
1
korean ginseng root
extract
3
MIGRELIEF
3
kudzu root (bulk)
3
milk thistle (bulk)
3
LECITHIN-KELP-B6
3
MILK THISTLE
EXTRACT
1
LECITHIN-KELP-B6
(100-8.3)
3
milk thistle oral capsule
150 mg, 500 mg
3
licorice,deglycyrrhizin
(bulk)
3
milk thistle oral tablet
1
this table.
17
Drug Name
/Limits
Drug Name
/Limits
milk thistle seed extract
oral capsule 140 mg,
200 mg, 87.5 mg
peppermint spirit oral
3
3
PERCURA
3
milk thistle seed extract
oral capsule 175 mg
1
PEUCEDANUM
OSTRUTHIUM
3
MISEFLEX
1
phenylalanine,dl- (bulk)
3
MISEFLEX-C
3
PHYTOFUSION
3
MYOFIBEX
1
pomegranate fruit
extract
3
NATROL 5-HTP
3
NATURAL HERBAL
DIURETIC
3
3
POMEGRANATE-EGC
G-GRAPE SEED
PONARIS
1
NEOQ10
3
PREGNITUDE
3
nettle leaf (bulk)
3
PRIMROSE OIL
3
NICOTINAMIDE
ADENINE DINUC.
3
PROSTATE 2.4
3
NONI
3
PROSTATE SR
3
NUMOISYN MUCOUS
MEMBRANE LIQUID
3
PROSTATE
THERAPY
3
ODOR FREE GARLIC
ORAL TABLET 100
MG
PROTEOLIN
3
3
PROTEOLIN DS
3
Q-GEL
3
ODOR FREE
GARLIC-X
3
Q-GEL FORTE
3
Q-GEL MEGA
1
ODORLESS GARLIC
ORAL CAPSULE
1
Q-GEL ULTRA
3
ODORLESS GARLIC
ORAL TABLET
QH LIQUID
3
3
olive leaf extract
3
Q-SORB CO Q-10
ORAL CAPSULE 100
MG, 200 MG
3
OPTIFLEX-C
3
oregano oil
3
Q-SORB CO Q-10
PLUS
3
origanum oil (bulk)
3
3
ORTHODIET
1
quercetin dihydrate
(bulk)
OVASITOL
3
Q-UP
3
PANAX GINSENG
ORAL CAPSULE
raspberry ketone
3
1
RE:IIMMUNE
3
PANAX GINSENG
ORAL TABLET
3
red yeast rice
3
papain
3
red yeast rice extract
(bulk)
3
peppermint oil
3
REFEX
1
this table.
18
Drug Name
/Limits
RELAX AND SLEEP
3
REMEPRIN
3
resveratrol
3
RHEUMATE
3
royal jelly
3
s-adenosylmeth sulf tos
(bulk)
3
sage leaf (bulk)
Drug Name
/Limits
SUPER ENERGY
HERBAL COMPLEX
3
SUPER POTENT
YOHIMBE
3
SUPER-D3+
3
SYNERTROPIN
3
SYSTANE VITAMIN
1
3
tea tree oil topical oil
1
SAM-E
3
3
SAM-E (ENTERIC
COATED)
TEARS AGAIN
HYDRATE
3
THE ELIMINATOR
3
saw palmetto
1
THERACRAN
3
SAW PALMETTO
COMPLEX(PUMPK-Z
N)
3
3
THERACRAN HP FOR
KIDS
THERALITH XR
3
SAW PALMETTO
EXTRACT, MAX-STR
1
THERAMINE
3
THERAMINE PLUS
3
saw palmetto fruit
1
saw palmetto fruit
(bulk)
3
3
TOTAL BODY
CLEANSE
TUMERSAID
3
saw palmetto-pumpkin
seed oil
1
turmeric (bulk)
3
saw palmto frt xtr-zinc
picoli
turmeric root extract
3
1
ubiquinol (bulk)
3
selenium yeast (bulk)
3
ULTRA DIET AID
3
SENTRA AM
3
ULTRA ENERGY
3
SENTRA PM
3
UTYMAX
3
shark cartilage (bulk)
3
valerian root (bulk)
3
shark cartilage oral
capsule 500 mg
3
3
SHARK FIN
CARTILAGE
valerian root oral
capsule 100 mg, 250
mg, 450 mg, 500 mg
3
VALINEX
1
shea butter (bulk)
3
VASOHA
3
siberian ginseng (bulk)
3
VAYACOG
3
sodium gluconate (bulk)
3
VAYARIN
3
SOMNICIN
3
VEINERECT
3
SPIRULINA
3
VITAMELTS RELAX
3
SUPER CRANBERRY
3
VITAMENT
3
VP-PRECIP
3
this table.
19
Drug Name
/Limits
WHOLE BODY JOINT
SUPPORT
3
WITEPSOL H-15
3
xanthium fruit
3
yohimbe bark
3
YOHIMBE ORAL
CAPSULE
3
ANALGESIC,
ANTI-INFLAMM
ATORY OR
ANTIPYRETIC
ANALGESIC CENTRAL
ALPHA-2
RECEPTOR
AGONISTS
clonidine (pf)
3
DURACLON (PF)
3
ANALGESIC NEUROLYSIS
AGENTS
DEHYDRATED
ALCOHOL
3
ethanol (ethyl alcohol)
3
ANALGESIC NEURONAL
(N)-TYPE
CALCIUM
CHANNEL
BLOCKERS
(NCCBS)
PRIALT
3
ANALGESIC
NARCOTIC
AGONISTS
Drug Name
/Limits
ASTRAMORPH-PF
3
codeine phosphate
(bulk)
1
codeine sulfate oral
tablet
1
CONZIP
3
DEMEROL
3
DEMEROL (PF)
3
DILAUDID
3
DILAUDID (PF)
INJECTION
SOLUTION 4 MG/ML
1
DILAUDID-HP (PF)
INJECTION
SOLUTION
3
DISKETS
1
DOLOPHINE ORAL
TABLET 10 MG
3
DOLOPHINE ORAL
TABLET 5 MG
1
DURAGESIC
3
DURAMORPH (PF)
3
EMBEDA ORAL
CAPSULE,ORAL
ONLY,EXT.REL PELL
2
EXALGO ER
3
fentanyl citrate
3
fentanyl citrate (pf)
intravenous syringe 100
mcg/2 ml (50 mcg/ml)
4
fentanyl transdermal
patch 72 hour 100
mcg/hr, 12 mcg/hr, 25
mcg/hr, 50 mcg/hr, 75
mcg/hr
2
3
3
ABSTRAL
3
ACTIQ
3
ALFENTA
3
fentanyl transdermal
patch 72 hour 37.5
mcg/hour, 62.5
mcg/hour, 87.5
mcg/hour
alfentanil
1
FENTORA
PA
PA
this table.
20
Drug Name
/Limits
hydrocodone bitartrate
(bulk) powder
3
hydromorphone (bulk)
1
hydromorphone (pf)
1
hydromorphone
injection solution
1
hydromorphone
injection syringe 0.5
mg/0.5 ml
3
hydromorphone
injection syringe 1
mg/ml, 2 mg/ml, 4
mg/ml
1
hydromorphone oral
liquid
3
hydromorphone oral
tablet
1
hydromorphone oral
24 hr
2
hydromorphone rectal
1
HYSINGLA ER
3
INFUMORPH P/F
1
IONSYS
3
PA
Drug Name
/Limits
methadone (bulk)
2
PA
methadone injection
2
PA
METHADONE
INTENSOL
2
PA
methadone oral
concentrate
2
PA
methadone oral solution
2
PA
methadone oral tablet
2
PA
methadone oral
tablet,soluble
2
PA
METHADOSE ORAL
CONCENTRATE
3
METHADOSE ORAL
TABLET,SOLUBLE
1
morphine (bulk)
1
morphine (pf) in
dextrose 5 %
4
morphine (pf) injection
solution 0.5 mg/ml, 1
mg/ml
1
morphine (pf)
intravenous patient
control.analgesia soln
4
morphine concentrate
oral solution
1
1
KADIAN ORAL
CAPSULE,EXTEND.R
ELEASE PELLETS 10
MG, 100 MG, 20 MG,
200 MG, 30 MG, 40
MG, 50 MG, 60 MG, 80
MG
3
morphine injection
solution 15 mg/ml, 8
mg/ml
1
LAZANDA
3
morphine injection
syringe 10 mg/ml, 2
mg/ml, 4 mg/ml, 8
mg/ml
levorphanol tartrate
2
meperidine (bulk)
3
morphine injection
syringe 5 mg/ml
3
morphine intramuscular
3
PA
meperidine (pf)
injection solution 100
mg/ml, 25 mg/ml, 50
mg/ml
1
morphine intravenous
cartridge
4
meperidine injection
cartridge
1
morphine intravenous pt
controlled analgesia
syring
4
meperidine oral
3
this table.
21
Drug Name
solution 100 mg/4 ml,
25 mg/ml, 250 mg/10
ml, 50 mg/ml
/Limits
4
Drug Name
/Limits
ROXICODONE ORAL
TABLET 15 MG, 30
MG
3
ROXICODONE ORAL
TABLET 5 MG
1
SUBSYS
3
syringe
4
morphine oral capsule,
er multiphase 24 hr
3
tramadol hydrochloride
(bulk)
3
morphine oral
capsule,extend.release
pellets
3
tramadol oral
capsule,er biphase 24 hr
17-83
3
morphine oral solution
1
morphine oral tablet
1
3
morphine oral tablet
extended release
tramadol oral
capsule,er biphase 24 hr
25-75
1
tramadol oral tablet
1
morphine rectal
1
1
MS CONTIN
3
tramadol oral tablet
extended release 24 hr
NUCYNTA
2
3
NUCYNTA ER
3
tramadol oral tablet, er
multiphase 24 hr
OPANA
3
ULTRAM
3
OPANA ER ORAL
TABLET,ORAL
ONLY,EXT.REL.12
HR
ULTRAM ER
3
3
ZOHYDRO ER ORAL
CAPSULE, ORAL
ONLY, ER 12HR
3
oxycodone oral capsule
1
oxycodone oral
concentrate
1
oxycodone oral solution
1
oxycodone oral tablet
1
oxycodone oral
tablet,oral
only,ext.rel.12 hr 10 mg,
20 mg, 40 mg, 80 mg
2
PA
ANALGESIC
NARCOTIC
CODEINE
COMBINATIONS
PA
OXYCONTIN ORAL
TABLET,ORAL
ONLY,EXT.REL.12
HR
3
oxymorphone oral tablet
2
PA
oxymorphone oral tablet
3
PA
acetaminophen-codeine
oral solution 120-12
mg/5 ml, 240 mg-24 mg
/10 ml (10 ml), 300
mg-30 mg /12.5 ml
1
acetaminophen-codeine
oral tablet
1
ASCOMP WITH
CODEINE
1
BUTALBITAL
COMPOUND
W/CODEINE
1
butalbital-acetaminop-c
af-cod
2
PA
this table.
22
Drug Name
/Limits
CAPITAL WITH
CODEINE
1
FIORICET WITH
CODEINE ORAL
CAPSULE
50-300-40-30 MG
3
FIORINAL-CODEINE
#3
3
TYLENOL-CODEINE
#3
3
TYLENOL-CODEINE
#4
3
ANALGESIC
NARCOTIC
DIHYDROCODEIN
E COMBINATIONS
dihydrocode-acetamino
phen-caff oral capsule
3
dihydrocodeine-aspirincaff
1
SYNALGOS-DC
1
TREZIX ORAL
CAPSULE 16-320.5-30
MG
3
ANALGESIC
NARCOTIC
HYDROCODONE
COMBINATIONS
HYCET
1
hydrocodone-acetamino
phen oral solution
10-325 mg/15 ml(15
ml), 2.5-167 mg/5 ml,
5-163 mg/7.5ml(7.5ml),
7.5-325 mg/15 ml
1
phen oral tablet 10-300
mg, 2.5-325 mg, 5-300
mg, 7.5-300 mg
3
Drug Name
/Limits
phen oral tablet 10-325
mg, 5-325 mg, 7.5-325
mg
1
hydrocodone-ibuprofen
oral tablet 10-200 mg,
5-200 mg, 7.5-200 mg
3
IBUDONE
3
LORCET
(HYDROCODONE)
3
LORCET HD
3
LORCET PLUS ORAL
TABLET 7.5-325 MG
3
LORTAB 10-325
3
LORTAB 5-325
3
LORTAB 7.5-325
3
LORTAB ELIXIR
ORAL SOLUTION
10-300 MG/15 ML
3
NORCO
3
REPREXAIN
3
VERDROCET
3
VICODIN
3
VICODIN ES
3
VICODIN HP
3
VICOPROFEN
3
XODOL 10/300
3
XODOL 5/300
3
XODOL 7.5/300
3
XYLON 10
3
ZAMICET
1
ANALGESIC
NARCOTIC
OXYCODONE
COMBINATIONS
ENDOCET ORAL
TABLET 10-325 MG,
5-325 MG, 7.5-325 MG
1
this table.
23
Drug Name
/Limits
ENDOCET ORAL
TABLET 2.5-325 MG
3
ENDODAN
1
ibuprofen-oxycodone
3
oxycodone-acetaminoph
en oral tablet 10-325
mg, 2.5-325 mg, 5-325
mg, 7.5-325 mg
1
oxycodone-aspirin
Drug Name
/Limits
ANALGESIC OR
ANTIPYRETIC
NON-NARCOTIC
COMBINATIONS
OTHER
CRAMP TABS
3
EXCEDRIN TENSION
HEADACHE
1
1
MIDOL
1
PERCOCET ORAL
TABLET 10-325 MG,
2.5-325 MG, 5-325 MG,
7.5-325 MG
3
3
PAMPRIN (WITH
MAG SALICYLATE)
TENSION
HEADACHE
1
PRIMLEV
3
XARTEMIS XR
3
TENSION
HEADACHE PAIN
RELIEVER
1
TENSION
HEADACHE RELIEF
1
WOMEN'S
MENSTRUAL RELIEF
3
ANALGESIC
NARCOTIC
PARTIAL-MIXED
AGONISTS
BUPRENEX
1
buprenorphine hcl
injection
3
butorphanol tartrate
1
(bulk)
3
BUTRANS
2
nalbuphine
1
nalbuphine (bulk)
3
pentazocine-naloxone
1
TALWIN
1
ANALGESIC
NARCOTIC
TRAMADOL
COMBINATIONS
tramadol-acetaminophe
n
1
ULTRACET
3
ANALGESIC OR
ANTIPYRETIC
NON-NARCOTIC/S
EDATIVE
COMBINATIONS
PA
BUPAP ORAL
TABLET 50-300 MG
3
butalbital-acetaminophe
n
1
n-caff oral capsule
50-300-40 mg
3
n-caff oral capsule
50-325-40 mg
1
n-caff oral tablet
50-325-40 mg
1
CAPACET
1
ESGIC
3
this table.
24
Drug Name
/Limits
FIORICET ORAL
CAPSULE
3
HISTAFLEX
3
MARGESIC
1
MARTEN-TAB
Drug Name
/Limits
acetaminophen oral
tablet
1
acetaminophen oral
1
1
1
PAMPRIN
MULTI-SYMPTOM
acetaminophen oral
tablet,disintegrating
1
acetaminophen rectal
1
PMS MAXIMUM
STRENGTH
antipyrine (bulk)
3
1
1
PRE-MENSTRUAL
RELIEF
ARTHRITIS PAIN
RELIEF (ACETAM)
1
ATHENOL
1
PREMSYN PMS
1
BETATEMP
1
TENCON ORAL
TABLET 50-325 MG
3
CHILD NON-ASPIRIN
QUICK MELTS
1
VANATOL LQ
3
CHILD PAIN
REL-FEVER
REDUCER
1
CHILDREN'S
ACETAMINOPHEN
ORAL SUSPENSION
160 MG/5 ML, 160
MG/5 ML (5 ML)
1
CHILDREN'S
ACETAMINOPHEN
ORAL
TABLET,CHEWABLE
1
CHILDREN'S
ACETAMINOPHEN
ORAL
TABLET,DISINTEGR
ATING
1
ZEBUTAL ORAL
CAPSULE 50-325-40
MG
3
ANALGESIC OR
ANTIPYRETIC
NON-NARCOTIC
8 HOUR PAIN
RELIEVER
1
ACEPHEN
1
acetaminophen (bulk)
1
ACETAMINOPHEN
EXTRA STRENGTH
1
acetaminophen oral
drops,suspension
1
acetaminophen oral
elixir
1
CHILDREN'S
EASY-MELTS
1
acetaminophen oral
liquid 160 mg/5 ml
3
CHILDREN'S FEVER
REDUCING
1
acetaminophen oral
liquid 500 mg/5 ml
1
CHILDREN'S MAPAP
1
acetaminophen oral
solution
1
CHILDREN'S
NON-ASPIRIN ORAL
ELIXIR
1
acetaminophen oral
suspension 160 mg/5 ml
1
CHILDREN'S
NON-ASPIRIN ORAL
SUSPENSION
1
this table.
25
Drug Name
/Limits
CHILDREN'S
NON-ASPIRIN ORAL
TABLET,CHEWABLE
1
CHILDREN'S
NON-ASPIRIN PAIN
1
CHILDREN'S PAIN
RELIEF
1
CHILDREN'S PAIN
RELIEVER ORAL
SUSPENSION
1
CHILDREN'S PAIN
RELIEVER ORAL
TABLET,DISINTEGR
ATING
1
CHILDREN'S
PAIN-FEVER RELIEF
1
CHILDREN'S Q-PAP
1
CHILDREN'S
SILAPAP
1
CHILDREN'S
TACTINAL
1
CHILDREN'S
TYLENOL
1
ED-APAP
FEVER REDUCER
Drug Name
/Limits
INFANT'S
NON-ASPIRIN ORAL
DROPS,SUSPENSION
80 MG/0.8 ML
1
INFANTS' PAIN AND
FEVER
1
INFANTS' PAIN
RELIEF
1
INFANT'S PAIN
RELIEF ORAL
DROPS,SUSPENSION
80 MG/0.8 ML
1
INFANT'S PAIN
RELIEF ORAL
SUSPENSION
1
INFANT'S PAIN
RELIEVER
1
INFANT'S TYLENOL
3
JR.
ACETAMINOPHEN
1
JR. STR
NON-ASPIRIN PAIN
1
1
1
JR. STRENGTH PAIN
RELIEVER
1
JUNIOR MAPAP
1
FEVER REDUCER AN
PAIN RELIEVER
ORAL SUSPENSION
1
1
LITTLE REMEDIES
FEVER AND PAIN
FEVERALL
1
1
INFANT FEVER
REDUCER-PAIN
RELF
MAPAP
(ACETAMINOPHEN)
ORAL CAPSULE
1
1
INFANT PAIN
RELIEVER
MAPAP
(ACETAMINOPHEN)
ORAL ELIXIR
1
INFANT'S
NON-ASPIRIN ORAL
DROPS
1
3
MAPAP
(ACETAMINOPHEN)
ORAL LIQUID
INFANT'S
NON-ASPIRIN ORAL
DROPS,SUSPENSION
100 MG/ML
MAPAP
(ACETAMINOPHEN)
ORAL SUSPENSION
1
3
MAPAP
(ACETAMINOPHEN)
ORAL TABLET
1
this table.
26
Drug Name
/Limits
MAPAP
(ACETAMINOPHEN)
ORAL
TABLET,CHEWABLE
1
MAPAP ARTHRITIS
PAIN
Drug Name
/Limits
PAIN RELIEF ADULT
1
PAIN RELIEF EXTRA
STRENGTH ORAL
TABLET 500 MG
1
1
PAIN RELIEF ORAL
1
MAPAP EXTRA
STRENGTH
1
PAIN RELIEF
REGULAR
STRENGTH
1
MASOPHEN
3
PAIN RELIEVER
1
NON-ASPIRIN 8
HOUR
1
PAIN RELIEVER
EXTRA STRENGTH
1
NON-ASPIRIN
CHILDRENS
3
PAIN RELIEVER JR
STRENGTH
1
NON-ASPIRIN
CHILDREN'S
1
PEDIACARE FEVER
REDUCER
3
NON-ASPIRIN
EXTRA STRENGTH
ORAL CAPSULE
1
PHARBETOL
1
1
NON-ASPIRIN
EXTRA STRENGTH
ORAL LIQUID
Q-PAP EXTRA
STRENGTH
3
Q-PAP ORAL DROPS
1
Q-PAP ORAL LIQUID
1
Q-PAP ORAL
TABLET 325 MG
1
TACTINAL
1
NON-ASPIRIN
EXTRA STRENGTH
ORAL TABLET
1
NON-ASPIRIN JR
STRENGTH
1
TACTINAL EXTRA
STRENGTH
1
NON-ASPIRIN ORAL
ELIXIR
1
TYLENOL
1
NON-ASPIRIN ORAL
SUSPENSION
1
TYLENOL EXTRA
STRENGTH ORAL
TABLET
1
NON-ASPIRIN ORAL
TABLET
1
TYLOPHEN
3
NON-ASPIRIN ORAL
TABLET,CHEWABLE
80 MG
1
NON-ASPIRIN PAIN
RELIEF ORAL
TABLET 500 MG
ANTI-INFLAMMA
TORY INTERLEUKIN-1
BETA BLOCKERS
1
ILARIS (PF)
NORTEMP
1
OFIRMEV
4
PAIN AND FEVER
1
3
this table.
27
Drug Name
/Limits
ANTI-INFLAMMA
TORY INTERLEUKIN-1
RECEPTOR
ANTAGONIST
ARCALYST
/Limits
DMARD ANTIMALARIALS
3
2
hydroxychloroquine
oral
1
PLAQUENIL
3
DMARD ANTIMETABOLIT
ES
ANTI-INFLAMMA
TORY TUMOR
NECROSIS
FACTOR
INHIBITING
AGNTS,NON-SEIE
CTIVE
ENBREL
SUBCUTANEOUS
SYRINGE
Drug Name
PA
ANTI-INFLAMMA
TORY TUMOR
NECROSIS
FACTOR
INHIBITING
AGNTS,TNF-ALPH
A SEL
CIMZIA
3
PA
CIMZIA POWDER
FOR RECONST
3
PA
CIMZIA STARTER
KIT
3
PA
HUMIRA
2
PA
HUMIRA PEDIATRIC
CROHN'S START
2
PA
HUMIRA PEN
2
PA
HUMIRA PEN
CROHN'S-UC-HS
START
2
PA
REMICADE
4
SIMPONI
3
PA
SIMPONI ARIA
4
PA
methotrexate sodium
oral
1
OTREXUP (PF)
SUBCUTANEOUS
AUTO-INJECTOR 10
MG/0.4 ML, 15 MG/0.4
ML, 20 MG/0.4 ML, 25
MG/0.4 ML
3
RASUVO (PF)
3
RHEUMATREX
1
TREXALL
1
DMARD ANTINFLAMMAT
ORY, SELECT.
COSTIMULATION
MODULATOR,T-C
ELL INHIB.
ORENCIA
2
ORENCIA (WITH
MALTOSE)
4
PA
DMARD - B CELL
TARGETED
AGENTS
RITUXAN
4
DMARD - GOLD
COMPOUNDS
gold sodium thiomalate
(bulk)
3
RIDAURA
1
this table.
28
Drug Name
/Limits
DMARD IMMUNOSUPPRES
SIVES
AZASAN
3
azathioprine
1
CELLCEPT
3
CELLCEPT
INTRAVENOUS
Drug Name
/Limits
DMARD INTERLEUKIN-6
(IL-6) RECEPTOR
INHIBITORS,
MONOCLONAL
ANTIBODY
4
ACTEMRA
INTRAVENOUS
4
cyclophosphamide
intravenous
4
ACTEMRA
SUBCUTANEOUS
1
cyclophosphamide oral
capsule
3
cyclosporine modified
1
cyclosporine oral
capsule
1
DMARD - OTHER
GENGRAF
1
AZULFIDINE
3
IMURAN
3
3
mycophenolate mofetil
oral capsule
AZULFIDINE
EN-TABS
1
CUPRIMINE
1
DEPEN TITRATABS
1
MINOCIN ORAL
3
minocycline oral
capsule
1
DMARD - JANUS
KINASE (JAK)
INHIBITORS
XELJANZ
2
oral suspension for
reconstitution
3
oral tablet
1
minocycline oral tablet
3
NEORAL
3
sulfasalazine
1
SANDIMMUNE ORAL
CAPSULE
3
SULFAZINE
1
SANDIMMUNE ORAL
SOLUTION
1
DMARD PHOSPHODIESTE
RASE-4 (PDE4)
INHIBITORS
DMARD INTERLEUKIN-1
RECEPTOR
ANTAGONIST
(IL-1RA)
KINERET
3
PA
OTEZLA
3
OTEZLA STARTER
3
PA
DMARD PYRIMIDINE
SYNTHESIS
INHIBITORS
ARAVA
3
leflunomide
1
this table.
29
Drug Name
/Limits
IMMUNOMODULA
TOR
B-LYMPHOCYTE
STIMULATOR
(BLYS)-SPECIFIC
INHIBITOR MCAB
BENLYSTA
/Limits
NSAID
ANALGESIC &
PROTON PUMP
INHIBITOR
COMBINATIONS
VIMOVO
3
4
NSAID
ANALGESIC &
TOPICAL
IRRITANT
COUNTER-IRRITA
NT
COMBINATIONS
3
COMFORT
PAC-IBUPROFEN
3
COMFORT
PAC-MELOXICAM
3
COMFORT
PAC-NAPROXEN
3
NSAID
ANALGESIC &
HISTAMINE H2
RECEPTOR
ANTAGONIST
COMBINATIONS
DUEXIS
Drug Name
NSAID
ANALGESIC &
HYPNOTIC (1ST
GENERATION
ANTIHISTAMINE)
COMBOS
ADVIL PM
1
ADVIL PM
LIQUI-GELS
3
ALEVE PM
3
IBUPROFEN PM
ORAL TABLET
1
ibuprofen-diphenhydra
mine cit
1
ibuprofen-diphenhydra
mine hcl
3
MOTRIN PM
1
NSAID
ANALGESIC &
PROSTAGLANDIN
ANALOG
COMBINATIONS
NSAID
ANALGESIC,
CYCLOOXYGENA
SE-2 (COX-2)
SELECTIVE
INHIBITORS
CELEBREX
3
celecoxib
3
celecoxib (bulk)
3
NSAID
ANALGESICS
(COX
NON-SPECIFIC) ANTHRANILIC
ACID
DERIVATIVES
meclofenamate oral
2
PA
PA
ARTHROTEC 50
3
mefenamic acid
2
ARTHROTEC 75
3
mefenamic acid (bulk)
1
diclofenac-misoprostol
3
PONSTEL
3
this table.
30
Drug Name
/Limits
NSAID
ANALGESICS
(COX
NON-SPECIFIC) OTHER
ketorolac (bulk)
3
ketorolac injection
cartridge
1
ketorolac injection
solution
1
ketorolac injection
syringe 30 mg/ml
3
ketorolac intramuscular
solution
1
ketorolac oral
2
nabumetone
1
nabumetone (bulk)
3
nabumetone, micronized
(bulk)
3
SPRIX
Drug Name
/Limits
NSAID
ANALGESICS
(COX
NON-SPECIFIC) PHENYLACETIC
ACID
DERIVATIVES
QL (1 EA per 5
days)
CAMBIA
3
diclofenac potassium
1
diclofenac sodium
(bulk)
3
diclofenac sodium oral
1
DYLOJECT
4
VOLTAREN-XR
3
ZIPSOR
3
ZORVOLEX
3
NSAID
ANALGESICS
(COX
NON-SPECIFIC) PROPIONIC ACID
DERIVATIVES
NF
sulindac oral
1
tolmetin oral capsule
2
PA
tolmetin oral tablet 200
mg
3
PA
tolmetin oral tablet 600
mg
2
PA
NSAID
ANALGESICS
(COX
NON-SPECIFIC) OXICAM
DERIVATIVES
ADVIL
1
ADVIL LIQUI-GEL
1
ADVIL MIGRAINE
1
ALEVE
1
ALL DAY PAIN
RELIEF
1
ALL DAY RELIEF
1
ANAPROX DS
3
CALDOLOR
4
CHILD IBUPROFEN
1
FELDENE
3
CHILDREN'S ADVIL
1
meloxicam
1
meloxicam (bulk)
1
CHILDREN'S
IBUPROFEN
1
MOBIC
3
1
piroxicam
2
CHILDREN'S
MOTRIN
piroxicam (bulk)
3
CHILDREN'S PROFEN
IB
1
PA
this table.
31
Drug Name
/Limits
Drug Name
DAYPRO
3
EC-NAPROSYN
3
fenoprofen oral capsule
3
fenoprofen oral tablet
2
FLANAX
(NAPROXEN)
1
flurbiprofen oral tablet
100 mg
2
PA
flurbiprofen oral tablet
50 mg
3
PA
IBU-DROPS
1
ibuprofen
1
ibuprofen (bulk)
1
IBUPROFEN IB
1
NSAID
ANALGESICS
(CYCLOOXYGENA
SE
INHIBITORS-NONSELECTIVE)
IBUPROFEN JR
STRENGTH
1
CAMBIA
INFANTS IBU-DROPS
1
INFANT'S
IBUPROFEN
1
INFANT'S MOTRIN
3
INFANTS PROFENIB
1
I-PRIN
1
ketoprofen oral capsule
2
PA
/Limits
naproxen sodium oral
tablet
1
tablet, er multiphase 24
hr 500 mg
3
oxaprozin
1
PROVIL
1
WAL-PROFEN
1
WAL-PROXEN
1
3
NSAID
ANALGESICS,
(COX
NON-SPECIFIC) INDOLE ACETIC
ACID
DERIVATIVES
PA
etodolac
1
INDOCIN ORAL
1
INDOCIN RECTAL
3
indomethacin oral
1
TIVORBEX
3
ketoprofen oral
capsule,ext rel. pellets
24 hr 200 mg
3
ketoprofen, micronized
(bulk)
3
MEDIPROXEN
1
MIDOL (NAPROXEN)
1
MOTRIN IB
1
SALICYLATE
ANALGESIC AND
SEDATIVE
COMBINATIONS
NALFON ORAL
CAPSULE 400 MG
3
butalbital-aspirin-caffei
ne oral capsule
1
NAPRELAN CR
3
FIORINAL
3
NAPROSYN ORAL
TABLET 500 MG
3
naproxen
1
capsule
1
SALICYLATE
ANALGESIC
COMBINATIONS,
BUFFERED
VANQUISH
3
this table.
32
Drug Name
/Limits
SALICYLATE
ANALGESIC
COMBINATIONS
Drug Name
/Limits
PAIN RELIEF EXTRA
STRENGTH ORAL
TABLET 250-250-65
MG
1
ADDED STRENGTH
HEADACHE RELIEF
1
3
ADDED STRENGTH
PAIN RELIEVER
PAIN RELIEF(WITH
SALICYLAMIDE)
1
1
ANACIN
3
PAIN RELIEVER
(ACETAM-ASPIRIN)
ANACIN MAXIMUM
STRENGTH
3
PAIN RELIEVER
PLUS
1
BACK AND BODY
PAIN RELIEVER
PAIN-OFF
1
1
PAMPRIN MAX
1
BACK PAIN-OFF
3
SUPER PAIN RELIEF
1
BAYER ASPIRIN
(WITH CAFFEINE)
3
BAYER BACK AND
BODY
SALICYLATE
ANALGESICS,
BUFFERED
3
BC
3
BC ARTHRITIS
3
cholin and mg
salicylate(bulk)
3
choline,magnesium
salicylate
1
EXCEDRIN EXTRA
STRENGTH
1
EXCEDRIN
MIGRAINE
1
GOODY'S EXTRA
STRENGTH ORAL
POWDER IN PACKET
3
aspirin, buffered
1
BAYER PLUS EXTRA
STRENGTH
1
BUFFERIN
3
TRI-BUFFERED
ASPIRIN
1
WOMEN'S ASPIRIN
WITH CALCIUM
1
SALICYLATE
ANALGESICS
ADULT LOW DOSE
ASPIRIN
1
ALKA-SELTZER
3
ALKA-SELTZER
EXTRA STRENGTH
3
ALKA-SELTZER
ORIGINAL
3
HEADACHE
FORMULA ADDED
STR
1
HEADACHE RELIEF
(ASA-ACET-CAF)
1
ANTACID AND PAIN
RELIEF
1
MIGRAINE
FORMULA
1
ASPIR-81
1
aspirin (bulk)
3
MIGRAINE PAIN
RELIEVER
3
ASPIRIN CHILDRENS
1
MIGRAINE RELIEF
1
ASPIRIN LOW DOSE
1
this table.
33
Drug Name
/Limits
Drug Name
/Limits
ASPIRIN
LOW-STRENGTH
1
EXTRA STRENGTH
BAYER
1
aspirin oral tablet
1
LITE COAT ASPIRIN
1
aspirin oral
tablet,chewable
1
LO-DOSE ASPIRIN
1
MEDI-SELTZER
1
aspirin oral
tablet,delayed release
(dr/ec) 325 mg, 81 mg
1
salsalate
1
salsalate (bulk)
3
sodium thiosalicylate
(bulk)
3
aspirin oral
(dr/ec) 500 mg, 650 mg
3
aspirin rectal
1
ASPIR-LOW
1
ASPIR-TRIN
3
BACKACHE RELIEF
3
ANESTHETICS
GENERAL
ANESTHETIC INHALANT
VOLATILE
COMPOUND 347
3
3
FORANE
3
BAYER ADVANCED
1
isoflurane
3
BAYER ASPIRIN
1
sevoflurane
3
BAYER CHEWABLE
ASPIRIN
1
SOJOURN
3
SUPRANE
3
CHILD ASPIRIN
1
TERRELL
3
CHILDREN'S
ASPIRIN
1
ULTANE
3
diflunisal
2
DISALCID
3
E.C. PRIN
1
ECOTRIN
1
ECOTRIN LOW
STRENGTH
3
EFFERVES PAIN
RELIEF ANTACID
1
EFFERVESCENT
ANTACID
1
EFFERVESCENT
PAIN RELIEF
1
EFFERVESCENT
PAIN RELIEVER
1
ENTERIC COATED
ASPIRIN
1
BACKACHE RELIEF
EXTRA STRENGTH
PA
GENERAL
ANESTHETIC PARENTERAL,
ARYLCYCLOHEX
YLAMINES
KETALAR
3
ketamine (bulk)
1
ketamine injection
solution 10 mg/ml
3
ketamine injection
mg/ml
1
this table.
34
Drug Name
/Limits
Drug Name
/Limits
GENERAL
BARBITURATES
GENERAL
ANESTHETIC
ADJUNCTS NARCOTIC
BREVITAL
INJECTION RECON
SOLN 2.5 GRAM, 500
MG
injection
1
intravenous syringe 100
mcg/2 ml (50 mcg/ml)
4
SUBLIMAZE (PF)
1
SUFENTA
4
sufentanil citrate
4
ULTIVA
4
3
GENERAL
BENZODIAZEPINE
S
midazolam (pf) injection
cartridge
1
solution
1
syringe 2 mg/2 ml (1
mg/ml)
1
syringe 5 mg/ml
3
midazolam injection
1
GENERAL
ANESTHETIC
ADJUNCTS NEUROLEPTIC,
BUTYROPHENON
E DERIVATIVE
droperidol
1
droperidol injection
solution
1
LOCAL
ANESTHETIC AMIDES
GENERAL
OTHERS
bupivacaine
1
AMIDATE
4
bupivacaine (bulk)
1
etomidate
4
1
etomidate (bulk)
3
bupivacaine (pf)
injection solution
bupivacaine-dextrose-w
ater(pf)
3
CARBOCAINE
3
CARBOCAINE (PF)
3
CITANEST PLAIN
DENTAL
3
EXPAREL (PF)
3
lidocaine (pf) in d7.5w
3
GENERAL
PHENOL
DERIVATIVES
DIPRIVAN
4
propofol intravenous
emulsion
4
PROPOVEN (PF)
4
this table.
35
Drug Name
lidocaine (pf) injection
solution 10 mg/ml (1
%), 20 mg/ml (2 %), 40
mg/ml (4 %), 5 mg/ml
(0.5 %)
/Limits
1
lidocaine (pf) injection
solution 15 mg/ml (1.5
%)
3
lidocaine hcl injection
solution 10 mg/ml (1
%), 20 mg/ml (2 %)
1
lidocaine hcl
laryngotracheal
3
lidocaine topical
ointment
3
LTA PRE-ATTACHED
3
MARCAINE
3
MARCAINE (PF)
Drug Name
/Limits
LOCAL
ANESTHETIC ESTERS
NESACAINE
3
NESACAINE-MPF
3
tetracaine hcl (pf)
injection
3
LOCAL
ANESTHETIC SYMPATHOMIME
TIC
COMBINATIONS
ARTICADENT
DENTAL
3
bupivacaine-epinephrin
e
1
3
1
MARCAINE SPINAL
(PF)
e (pf)
3
3
mepivacaine (pf)
3
CITANEST FORTE
DENTAL
NAROPIN (PF)
1
3
POLOCAINE
3
lidocaine-epinephrine
(pf) injection solution
1.5 %-1:200,000
POLOCAINE-MPF
3
ropivacaine (pf)
injection
1
3
(pf) injection solution 2
%-1:200,000
SENSORCAINE
3
3
SENSORCAINE-MPF
3
bit
SENSORCAINE-MPF
SPINAL
3
injection solution 0.5
%-1:200,000
3
XYLOCAINE
INJECTION
3
%-1:100,000, 2
%-1:100,000
1
MARCAINE-EPINEPH
RINE
3
MARCAINE-EPINEPH
RINE (PF)
3
SENSORCAINE/EPIN
EPHRINE
3
XYLOCAINE-MPF
INJECTION
SOLUTION 10 MG/ML
(1 %), 15 MG/ML (1.5
%), 20 MG/ML (2 %), 5
MG/ML (0.5 %)
3
this table.
36
Drug Name
/Limits
SENSORCAINE-MPF/
EPINEPHRINE
3
XYLOCAINE-EPINEP
HRINE
3
XYLOCAINE-MPF/EP
INEPHRINE
3
ANORECTAL
PREPARATIONS
ANAL FISSURE
PAIN/TREATMEN
T AGENTS NITRATES
RECTIV
3
ANORECTAL GLUCOCORTICOI
DS
ANUCORT-HC
NF
ANUSOL-HC
NF
hydrocortisone acetate
rectal suppository
NF
PROCTOCORT
RECTAL CREAM
3
PROCTOCORT
RECTAL
SUPPOSITORY
NF
PROCTO-PAK
1
PROCTOSOL HC
3
PROCTOZONE-HC
1
ANORECTAL HEMORRHOIDAL
& LOCAL
ANESTHETIC
COMBINATIONS
OTHER
HEMORRHOIDAL
CREAM
PREPARATION H
MAXIMUM
STRENGTH
3
Drug Name
/Limits
RECTICARE
(GLYCERIN)
3
TRONOLANE
3
COMBINATIONS
OTHER
CALMOL-4
1
GRX
HEMORRHOIDAL
3
HEMORRHOID
PREPARATION
1
HEMORRHOIDAL
(PHENYLEPH-COCO
A) RECTAL
SUPPOSITORY
0.25-85.39 %,
0.25-88.44 %
3
HEMORRHOIDAL
(PHENYLEPH-COCO
A) RECTAL
SUPPOSITORY
0.25-85.5 %
1
HEMORRHOIDAL
COOLING
3
HEMORRHOIDAL H
1
HEMORRHOIDAL
RECTAL CREAM
3
HEMORRHOIDAL
RECTAL OINTMENT
3
HEMORRHOIDAL
RECTAL
SUPPOSITORY 0.25-3
%
1
PREPARATION H
3
PREPARATION H(PE,
WITCH HAZEL)
3
PREPARATION
H(PE,CB)
3
1
this table.
37
Drug Name
/Limits
RECTAL
GLUCOCORTICOI
D-LOCAL
ANESTHETIC
COMB
Drug Name
/Limits
HEMORRHOIDAL
SUPPOSITORY
1
MEDICATED PADS
TOPICAL PADS,
MEDICATED 50 %
1
1
ANA-LEX KIT
3
MEDICATED WIPES
TOPICAL PADS,
MEDICATED
ANALPRAM
ADVANCED
3
MEDICATED WIPES
WITH ALOE
1
ANALPRAM E
3
1
ANALPRAM-HC
RECTAL CREAM
PREPARATION H
(WITCH HAZEL)
1
TUCKS TOPICAL
1
1
ANORECTAL LOCAL
ANESTHETIC
AMIDES
ANALPRAM-HC
SINGLES RECTAL
CREAM 2.5-1 % (4G)
hydrocortisone-pramoxe-pram#1
NF
hydrocortisone-pramoxi
ne rectal
NF
lidocaine
hcl-hydrocortison ac
rectal
3
lidocaine-hydrocortison
e-aloe
3
PRAMCORT
3
PROCORT
3
PROCTOFOAM HC
1
ZYPRAM
3
SINGLE AGENTS
OTHER
ANU-MED
1
HEMORRHOIDAL
(WITCH HAZEL)
3
HEMORRHOIDAL
HYGIENE
1
HEMORRHOIDAL
RECTAL
SUPPOSITORY 51 %
1
ANECREAM5
3
LC-5
3
LMX 5
3
NUPERCAINAL
1
RECTICARE
3
ANTIDOTES
AND OTHER
REVERSAL
AGENTS
ANTIDOTE ACETAMINOPHEN
POISONING
ACETADOTE
4
acetylcysteine
1
acetylcysteine (bulk)
1
acetylcysteine
intravenous
4
ANTIDOTE ACTIVATED
CHARCOAL
COMBINATIONS
ACTIDOSE/SORBITO
3
L
this table.
38
Drug Name
INSTA-CHAR-SORBI
TOL
/Limits
3
ANTIDOTE ACTIVATED
CHARCOAL
Drug Name
/Limits
ANTIDOTE ANTICHOLINESTE
RASE AND
MUSCARINIC
ANTAGONIST
COMBINATIONS
ACTIDOSE-AQUA
ORAL SUSPENSION
15 G/72 ML, 50
GRAM/240 ML
3
ACTIDOSE-AQUA
ORAL SUSPENSION
25 GRAM/120 ML
1
activated charcoal
(bulk)
3
activated charcoal oral
capsule 200 mg
3
activated charcoal oral
capsule 260 mg
1
CHARCOAL
3
pralidoxime
3
CHARCOCAPS
3
EZ CHAR
3
pralidoxime chloride
(bulk)
3
INSTA-CHAR ORAL
SUSPENSION 25
GRAM/120 ML
1
PROTOPAM
CHLORIDE
3
INSTA-CHAR ORAL
SUSPENSION 50
GRAM/240 ML
3
ANTIDOTE CYANIDE
POISONING
ENLON-PLUS
ANTIDOTE CHOLINESTERAS
E REACTIVATING
AGENT &
MUSCARINIC
ANTAGONIST
DUODOTE
ANTIDOTE ALCOHOL
DEHYDROGENAS
E ENZYME
INHIBITOR
CYANOKIT
4
NITHIODOTE
4
sodium nitrite
4
sodium thiosulfate
(bulk) powder
1
4
4
METHYLPYRAZOLE
3
sodium thiosulfate
intravenous solution
12.5 gram/50 ml (250
mg/ml)
3
ANTIDOTE DIGITALIS
GLYCOSIDE
TOXICITY
AGENTS
physostigmine salicylate
3
ANTIDOTE CHOLINESTERAS
E REACTIVATING
AGENT
fomepizole
ANTIDOTE ANTICHOLINESTE
RASE AGENTS
4
DIGIFAB
4
this table.
39
Drug Name
/Limits
ANTIDOTE METHEMOGLOBI
NEMIA
methylene blue
(antidote)
/Limits
CALCIUM DISODIUM
VERSENATE
1
CHEMET
1
CHELATING
AGENTS - OTHERS
4
ANTIDOTE RADIOACTIVE
AGENTS
RADIOGARDASE
Drug Name
3
ANTIDOTE
OTHERS
BAL IN OIL
1
betadex (bulk)
3
CA-DTPA
4
CYCLODEXTRIN
REAGENT
3
GALZIN
3
nh4 tetrathiomolybdate
(bulk)
3
RADIOGARDASE
3
ZN-DTPA
4
BENZODIAZEPINE
REVERSAL
AGENTS BENZODIAZEPINE
ANTAGONISTS
CHELATING
AGENTS
edetate tetrasod thydr
(bulk)
flumazenil
4
flumazenil (bulk)
3
EMETICS
ipecac
1
DEPEN TITRATABS
1
SYPRINE
2
PA
CHELATING
AGENTS - IRON
deferoxamine injection
recon soln 2 gram
3
deferoxamine injection
recon soln 500 mg
1
DESFERAL
3
EXJADE
2
PA
FERRIPROX
2
PA
JADENU
3
PA
CHELATING
AGENTS - LEAD
POISONING
BAL IN OIL
3
MU-OPIOID
RECEPTOR
ANTAGONISTS,
PERIPHERALLY-A
CTING
CHELATING
AGENTS - COPPER
CUPRIMINE
3
ENTEREG
3
MOVANTIK
3
RELISTOR
SUBCUTANEOUS
SOLUTION
2
PA
RELISTOR
SUBCUTANEOUS
SYRINGE
2
PA
OPIATE/NARCOTI
C REVERSAL
AGENTS - OPIATE
ANTAGONISTS
EVZIO
3
naloxone
1
naltrexone hcl (bulk)
1
1
this table.
40
Drug Name
/Limits
naltrexone hcl
dihydrate(bulk)
1
naltrexone oral
Drug Name
/Limits
neomycin
1
1
streptomycin
intramuscular
3
NARCAN
1
tobramycin (bulk)
1
REVIA
3
tobramycin in 0.9 %
nacl intravenous
piggyback 60 mg/50 ml
4
tobramycin sulfate
1
tobramycin sulfate
(bulk)
1
REVERSAL
AGENTS HEPARIN
ANTAGONISTS
protamine
4
protamine sulfate (bulk)
3
AMINOPENICILLI
N ANTIBIOTIC BETA-LACTAMAS
E INHIBITOR
COMBINATIONS
iodoquinol (bulk)
1
1
paromomycin
1
amoxicillin-pot
clavulanate
paromomycin sulfate
(bulk)
3
ampicillin-sulbactam
injection recon soln 1.5
gram, 3 gram
1
3
ANTI-INFECTIV
E AGENTS
AMEBICIDES
AMINOGLYCOSID
E ANTIBIOTIC
amikacin (bulk)
3
injection recon soln 15
gram
amikacin injection
solution 1,000 mg/4 ml,
500 mg/2 ml
1
intravenous
4
AUGMENTIN ES-600
3
gentamicin (bulk)
1
AUGMENTIN ORAL
SUSPENSION FOR
RECONSTITUTION
125-31.25 MG/5 ML,
250-62.5 MG/5 ML
3
AUGMENTIN ORAL
TABLET 500-125 MG,
875-125 MG
3
AUGMENTIN XR
3
UNASYN INJECTION
3
gentamicin in nacl
(iso-osm) intravenous
piggyback 100 mg/100
ml, 100 mg/50 ml, 120
mg/100 ml, 60 mg/50
ml, 70 mg/50 ml, 80
mg/100 ml, 80 mg/50
ml, 90 mg/100 ml
4
gentamicin injection
1
gentamicin sulfate (ped)
(pf)
1
gentamicin sulfate (pf)
100 mg/10 ml, 60 mg/6
ml
4
AMINOPENICILLI
N ANTIBIOTIC
amoxicillin oral capsule
1
this table.
41
Drug Name
/Limits
amoxicillin oral
suspension for
reconstitution
1
amoxicillin oral tablet
1
amoxicillin oral tablet,
er multiphase 24 hr
3
amoxicillin oral
tablet,chewable 125 mg,
250 mg
1
ampicillin
1
ampicillin sodium
injection
1
ampicillin sodium
intravenous
4
MOXATAG
3
Drug Name
/Limits
ANTIBACTERIAL
FOLATE
ANTAGONIST OTHER
COMBINATIONS
BACTRIM
3
BACTRIM DS
3
sulfamethoxazole-trimet
hoprim intravenous
4
sulfamethoxazole-trimet
hoprim oral
1
SULFATRIM
3
ANTIBACTERIAL
FOLATE
ANTAGONIST
OTHERS
ANTHELMINTIC
AGENTS BENZIMIDAZOLE
DERIVATIVES
PRIMSOL
3
trimethoprim
1
trimethoprim (bulk)
1
1
ALBENZA
1
niclosamide (bulk)
3
trimethoprim, micro
(bulk)
BILTRICIDE
3
ANTIBACTERIAL
NITROFURAN
DERIVATIVES
diethylcarbamazine cit
(bulk)
3
furazolidone (bulk)
ivermectin oral
3
PIN-X ORAL
SUSPENSION
1
PIN-X ORAL
TABLET,CHEWABLE
ANTHELMINTIC
AGENTS OTHER
PA
3
ANTIFUNGAL ALLYLAMINES
LAMISIL
3
terbinafine (bulk)
3
3
terbinafine hcl oral
1
praziquantel (bulk)
3
pyrantel pamoate (bulk)
3
REESE'S PINWORM
MEDICINE
1
ANTIFUNGAL AMPHOTERIC
POLYENE
MACROLIDES
STROMECTOL
3
PA
ABELCET
4
AMBISOME
4
amphotericin b
1
nystatin (bulk) powder
100 million unit
3
this table.
42
Drug Name
/Limits
15 billion unit
1
nystatin oral powder
3
nystatin oral tablet
1
ANTIFUNGAL GLUCAN
SYNTHESIS
INHIBITORS
(ECHINOCANDINS
)
CANCIDAS
4
ERAXIS(WATER
DILUENT)
4
MYCAMINE
4
1
ORAVIG
2
/Limits
SPORANOX ORAL
CAPSULE
3
PA
SPORANOX ORAL
SOLUTION
2
PA
VFEND
3
VFEND IV
4
voriconazole (bulk)
3
voriconazole
intravenous
4
voriconazole oral
suspension for
reconstitution
3
voriconazole oral tablet
2
PA
ANTIFUNGAL
OTHER
ANTIFUNGAL IMIDAZOLES
ketoconazole oral
Drug Name
PA
ANTIFUNGAL TRIAZOLES
ANCOBON
3
flucytosine
2
flucytosine (bulk)
3
griseofulvin microsize
1
griseofulvin
ultramicrosize
1
CRESEMBA
INTRAVENOUS
4
CRESEMBA ORAL
3
GRIS-PEG
(ULTRAMICROSIZE)
1
DIFLUCAN
3
octanoic acid (bulk)
3
fluconazole
1
fluconazole (bulk)
3
fluconazole in
dextrose(iso-o)
4
ANTI-INFECTIVE
IMMUNOLOGIC
ADJUVANTS INTERFERONS
fluconazole in nacl
(iso-osm)
4
itraconazole
2
PA
NOXAFIL
INTRAVENOUS
ANTILEPROTIC IMMUNOMODULA
TORS
4
PA
THALOMID
NOXAFIL ORAL
SUSPENSION
2
PA
NOXAFIL ORAL
TABLET,DELAYED
RELEASE (DR/EC)
3
PA
ONMEL
3
PA
ACTIMMUNE
2
PA
PA
1
ANTILEPROTIC PHENAZINE DYE
DERIVATIVES
clofazimine (bulk)
3
this table.
43
Drug Name
/Limits
ANTILEPROTIC SULFONE AGENTS
Drug Name
/Limits
FLAGYL ER
3
METRO I.V.
4
dapsone
1
metronidazole (bulk)
3
dapsone (bulk)
3
metronidazole in nacl
(iso-os)
4
metronidazole oral
capsule
3
metronidazole oral
tablet
1
ANTIMALARIAL
COMBINATIONS
atovaquone-proguanil
1
COARTEM
1
MALARONE
3
MALARONE
PEDIATRIC
3
PA
ANTIPROTOZOAL
-ANTIBACTERIAL
2ND GENERATION
2-METHYL-5-NITR
OIMIDAZOLE
ANTIMALARIALS
chloroquine phosphate
oral
1
TINDAMAX
3
DARAPRIM
3
tinidazole
3
hydroxychloroquine
oral
1
tinidazole (bulk)
1
mefloquine
1
PLAQUENIL
3
primaquine
1
ANTIRETROVIRA
L - CCR5
CO-RECEPTOR
ANTAGONIST
QUALAQUIN
3
SELZENTRY
quinine hcl dihydrate
(bulk)
3
quinine sulfate
2
PA
ALINIA ORAL
SUSPENSION FOR
RECONSTITUTION
3
ALINIA ORAL
TABLET
2
atovaquone
1
MEPRON
3
ANTIPROTOZOAL
-ANTIBACTERIAL
1ST GENERATION
2-METHYL-5-NITR
OIMIDAZOLE
FLAGYL
ANTIRETROVIRA
L - HIV-1 FUSION
INHIBITORS
FUZEON
SUBCUTANEOUS
RECON SOLN
ANTIPROTOZOAL
AGENTS - OTHER
PA
1
1
ANTIRETROVIRA
L - HIV-1
INTEGRASE
STRAND
TRANSFER
INHIBITORS
ISENTRESS ORAL
POWDER IN PACKET
3
ISENTRESS ORAL
TABLET
1
ISENTRESS ORAL
TABLET,CHEWABLE
1
3
this table.
44
Drug Name
/Limits
TIVICAY
1
VITEKTA
1
ANTIRETROVIRA
LNON-NUCLEOSID
E REVERSE
TRANSCRIPTASE
INHIB (NNRTI)
Drug Name
/Limits
EPIVIR ORAL
SOLUTION
3
EPIVIR ORAL
TABLET
1
lamivudine oral solution
3
lamivudine oral tablet
150 mg, 300 mg
1
RETROVIR
INTRAVENOUS
4
EDURANT
1
INTELENCE
1
3
nevirapine oral
suspension
RETROVIR ORAL
CAPSULE
1
3
nevirapine oral tablet
1
RETROVIR ORAL
SYRUP
stavudine
1
VIDEX 2 GRAM
PEDIATRIC
1
VIDEX 4 GRAM
PEDIATRIC
1
VIDEX EC ORAL
CAPSULE,DELAYED
RELEASE(DR/EC) 125
MG
1
VIDEX EC ORAL
CAPSULE,DELAYED
RELEASE(DR/EC) 200
MG, 250 MG, 400 MG
3
ZERIT
1
ZIAGEN
1
zidovudine
1
100 mg
1
400 mg
3
RESCRIPTOR
1
SUSTIVA
1
VIRAMUNE
1
VIRAMUNE XR
3
ANTIRETROVIRA
L - NUCLEOSIDE
& NUCLEOTIDE
ANALOGS,
INTEGRASE
INHIBITORS
GENVOYA
1
STRIBILD
1
ANTIRETROVIRA
L - NUCLEOSIDE
REVERSE
TRANSCRIPTASE
INHIBITORS
(NRTI)
abacavir
1
didanosine
1
EMTRIVA
1
ANTIRETROVIRA
L - NUCLEOTIDE
ANALOG
REVERSE
TRANSCRIPTASE
INHIBITORS
VIREAD ORAL
POWDER
3
VIREAD ORAL
TABLET
1
this table.
45
Drug Name
/Limits
ANTIRETROVIRA
L COMBINATIONS
- NRTI'S
abacavir-lamivudine-zid
ovudine
1
COMBIVIR
3
EPZICOM
1
lamivudine-zidovudine
1
TRIZIVIR
3
ANTIRETROVIRA
L COMBINATIONS
- NUCLEOSIDE &
NUCLEOTIDE
ANALOG RTIS
TRUVADA
/Limits
ANTITUBERCULA
RAMINOBENZOIC
ACID ANALOGS
PASER
1
ANTITUBERCULA
R - CYCLIC
PEPTIDE
ANTIBIOTICS
CAPASTAT
3
ANTITUBERCULA
R - D-ALANINE
ANALOGS
1
cycloserine
2
cycloserine (bulk)
3
PA
ANTITUBERCULA
RDIARYLQUINOLIN
E ANTIBIOTICS
ANTIRETROVIRA
L COMBINATIONS
- NUCLEOSIDE
ANALOGS &
INTEGRASE
INHIBITOR
TRIUMEQ
Drug Name
SIRTURO
1
ANTIRETROVIRA
L COMBINATIONS
- PROTEASE
INHIBITORS
ANTITUBERCULA
R - ISONICOTINIC
ACID
DERIVATIVES
isoniazid
EVOTAZ
1
KALETRA
1
ANTITUBERCULA
R - NIACINAMIDE
DERIVATIVES
PREZCOBIX
1
pyrazinamide
ANTIRETROVIRA
L-NUCLEOSIDE&
NUCLEOTIDE
ANALOGS&
NON-NUCLEOSID
E RTI COMB
3
1
1
ANTITUBERCULA
R - RIFAMYCIN
AND
DERIVATIVES
ATRIPLA
1
COMPLERA
1
MYCOBUTIN
3
PRIFTIN
1
rifabutin
2
RIFADIN
INTRAVENOUS
4
RIFADIN ORAL
3
PA
this table.
46
Drug Name
/Limits
rifampin intravenous
4
rifampin oral
1
1
MYAMBUTOL ORAL
TABLET 400 MG
3
TRECATOR
2
ANTITUBERCULA
R COMBINATIONS
RIFAMATE
3
RIFATER
1
ANTIVIRAL
MISCELLANEOUS
2-deoxy-d-glucose
(bulk)
3
CARBAPENEM
ANTIBIOTIC
COMBINATIONS
imipenem-cilastatin
4
PRIMAXIN IV
4
CARBAPENEM
ANTIBIOTICS
(THIENAMYCINS)
/Limits
CEPHALOSPORIN
ANTIBIOTICS 1ST GENERATION
ANTITUBERCULA
R AGENTS OTHER
ethambutol
Drug Name
PA
cefadroxil oral capsule
1
cefadroxil oral
suspension for
reconstitution 250 mg/5
ml, 500 mg/5 ml
1
cefadroxil oral tablet
1
cefazolin in dextrose
(iso-os) intravenous
piggyback 1 gram/50
ml, 2 gram/50 ml
4
cefazolin injection
3
cefazolin intravenous
4
cephalexin oral capsule
250 mg, 500 mg
1
cephalexin oral capsule
750 mg
3
cephalexin oral
suspension for
reconstitution
1
cephalexin oral tablet
1
KEFLEX ORAL
CAPSULE
3
DORIBAX
4
INVANZ INJECTION
3
CEPHALOSPORIN
ANTIBIOTICS 2ND GENERATION
INVANZ
INTRAVENOUS
4
cefaclor oral capsule
1
meropenem
4
MERREM
4
cefaclor oral suspension
for reconstitution 125
mg/5 ml, 250 mg/5 ml,
375 mg/5 ml
3
cefaclor oral tablet
3
cefotetan in dextrose,
iso-osm
4
CEPHALOSPORIN
ANTIBIOTIC &
BETA-LACTAMAS
E INHIBITOR
COMBINATIONS
AVYCAZ
4
cefotetan injection
3
ZERBAXA
4
cefotetan intravenous
4
cefoxitin
4
this table.
47
Drug Name
/Limits
cefoxitin in dextrose,
iso-osm
4
cefprozil
1
Drug Name
/Limits
ceftibuten
3
ceftriaxone in
dextrose,iso-os
4
ceftriaxone injection
recon soln 1 gram, 10
gram, 2 gram, 250 mg,
500 mg
3
ceftriaxone intravenous
recon soln
4
CEFTIN ORAL
SUSPENSION FOR
RECONSTITUTION
1
CEFTIN ORAL
TABLET 250 MG, 500
MG
3
cefuroxime axetil oral
tablet
1
CLAFORAN
INJECTION
3
cefuroxime sodium
injection recon soln 1.5
gram, 750 mg
3
CLAFORAN
INTRAVENOUS
RECON SOLN
4
cefuroxime sodium
intravenous
4
FORTAZ IN
DEXTROSE 5 %
4
MEFOXIN IN
DEXTROSE
(ISO-OSM)
FORTAZ INJECTION
3
4
FORTAZ
INTRAVENOUS
4
ZINACEF IN STERILE
WATER
4
SPECTRACEF ORAL
TABLET 400 MG
3
ZINACEF INJECTION
3
SUPRAX ORAL
CAPSULE
3
SUPRAX ORAL
SUSPENSION FOR
RECONSTITUTION
3
SUPRAX ORAL
TABLET,CHEWABLE
3
TAZICEF INJECTION
3
4
ZINACEF
INTRAVENOUS
4
CEPHALOSPORIN
ANTIBIOTICS 3RD GENERATION
CEDAX ORAL
CAPSULE
3
CEDAX ORAL
SUSPENSION FOR
RECONSTITUTION
180 MG/5 ML
3
TAZICEF
INTRAVENOUS
cefdinir
1
CEPHALOSPORIN
ANTIBIOTICS 4TH GENERATION
cefditoren pivoxil
3
cefepime
3
cefixime
1
cefotaxime
3
cefepime in dextrose 5
%
4
cefpodoxime
1
4
ceftazidime
3
cefepime in
dextrose,iso-osm
ceftazidime (bulk)
3
MAXIPIME
INJECTION
3
ceftazidime in d5w
4
this table.
48
Drug Name
MAXIPIME
INTRAVENOUS
/Limits
CUBICIN
CHLORAMPHENI
COL ANTIBIOTICS
AND
DERIVATIVES SINGLE AGENTS
1
chloramphenicol sod
succinate
4
CMV ANTIVIRAL
AGENT INORGANIC
PYROPHOSPHATE
ANALOGS
foscarnet
4
FOSCAVIR
4
CMV ANTIVIRAL
AGENT NUCLEOSIDE
ANALOGS
4
FLUOROQUINOLO
NE ANTIBIOTICS
4
chloramphenicol (bulk)
/Limits
CYCLIC
LIPOPEPTIDE
ANTIBIOTICS
4
CEPHALOSPORIN
ANTIBIOTICS 5TH GENERATION
TEFLARO
Drug Name
PA
AVELOX
3
AVELOX ABC PACK
3
AVELOX IN NACL
(ISO-OSMOTIC)
4
CIPRO IN D5W
INTRAVENOUS
PIGGYBACK 400
MG/200 ML
4
CIPRO ORAL
SUSPENSION,MICRO
CAPSULE RECON
3
CIPRO ORAL
TABLET 250 MG, 500
MG
3
ciprofloxacin
1
ciprofloxacin (bulk)
3
ciprofloxacin hcl oral
1
ciprofloxacin in 5 %
dextrose
4
CYTOVENE
4
ciprofloxacin lactate
4
ganciclovir sodium
4
FACTIVE
2
VALCYTE ORAL
RECON SOLN
1
LEVAQUIN ORAL
TABLET
3
VALCYTE ORAL
TABLET
3
levofloxacin (bulk)
3
levofloxacin in d5w
4
valganciclovir
3
levofloxacin intravenous
4
levofloxacin oral
solution
3
levofloxacin oral tablet
1
moxifloxacin
2
moxifloxacin hcl (bulk)
3
moxifloxacin-sod.ace,su
l-water
4
CMV ANTIVIRAL
AGENT NUCLEOTIDE
ANALOGS
cidofovir
4
cidofovir (bulk)
3
VISTIDE
4
PA
PA
this table.
49
Drug Name
ofloxacin oral tablet
400 mg
/Limits
GLYCOPEPTIDE
ANTIBIOTICS
1
vancomycin (bulk)
3
vancomycin in d5w
intravenous piggyback
4
vancomycin in dextrose
iso-osm
4
vancomycin intravenous
4
vancomycin oral
1
PEGASYS PROCLICK
SUBCUTANEOUS
PEN INJECTOR 180
MCG/0.5 ML
2
PA
PEGASYS
SUBCUTANEOUS
SYRINGE
2
PA
HEPATITIS C NS5A INHIBITOR
AND NS3/4A
PROTEASE
INHIBITOR
COMBINATION
GLYCYLCYCLINE
ANTIBIOTICS
TYGACIL
/Limits
HEPATITIS C INTERFERONS
1
VANCOCIN
Drug Name
TECHNIVIE
4
3
HEPATITIS C NS5A
REPLICATION
COMPLEX
INHIBITORS
HEPATITIS B
TREATMENTNUCLEOSIDE
ANALOGS
(ANTIVIRAL)
DAKLINZA
BARACLUDE ORAL
SOLUTION
1
BARACLUDE ORAL
TABLET
3
entecavir
1
EPIVIR HBV ORAL
SOLUTION
1
SOVALDI
EPIVIR HBV ORAL
TABLET
3
lamivudine oral tablet
100 mg
HEPATITIS C NUCLEOSIDE
ANALOGS
1
TYZEKA
2
HEPATITIS C NUCLEOS(T)IDE
ANALOG NS5B
POLYMERASE
INHIBITORS
PA
HEPATITIS B
TREATMENTNUCLEOTIDE
ANALOGS
(ANTIVIRAL)
adefovir
2
HEPSERA
3
3
PA
2
REBETOL ORAL
SOLUTION
1
RIBASPHERE ORAL
TABLET 200 MG
1
ribavirin oral capsule
1
PA
HERPES
ANTIVIRAL
AGENT - PURINE
ANALOGS
acyclovir (bulk)
1
this table.
50
Drug Name
/Limits
acyclovir oral capsule
1
acyclovir oral
1
acyclovir oral tablet
Drug Name
/Limits
LINCOSAMIDE
ANTIBIOTICS
1
CLEOCIN IN 5 %
DEXTROSE
4
acyclovir sodium
4
CLEOCIN INJECTION
3
SITAVIG
3
4
valacyclovir
1
CLEOCIN
INTRAVENOUS
valacyclovir (bulk)
3
3
VALTREX
3
CLEOCIN ORAL
CAPSULE 150 MG,
300 MG
vidarabine (bulk)
3
ZOVIRAX ORAL
3
CLEOCIN ORAL
CAPSULE 75 MG
1
CLEOCIN ORAL
RECON SOLN
1
clindamycin hcl
1
clindamycin in 5 %
dextrose
4
clindamycin palmitate
hcl
1
CLINDAMYCIN
PEDIATRIC
1
clindamycin phosphate
injection
1
intravenous
4
LINCOCIN
3
HERPES
ANTIVIRAL
AGENT THYMIDINE
ANALOGS
famciclovir
2
FAMVIR
3
PA
INFLUENZA
ANTIVIRAL
AGENTS NEURAMINIDASE
INHIBITORS
RAPIVAB
4
RELENZA
DISKHALER
1
TAMIFLU
1
LIPOGLYCOPEPTI
DE ANTIBIOTICS
INFLUENZA-A
ANTIVIRAL
AGENTS
FLUMADINE ORAL
TABLET
3
rimantadine
1
2
4
ORBACTIV
4
VIBATIV
4
MACROLIDES
KETOLIDE
ANTIBIOTICS
KETEK
DALVANCE
PA
azithromycin (bulk)
3
azithromycin
intravenous
4
azithromycin oral
1
BIAXIN ORAL
SUSPENSION FOR
RECONSTITUTION
250 MG/5 ML
1
this table.
51
Drug Name
/Limits
BIAXIN ORAL
TABLET
3
clarithromycin (bulk)
3
clarithromycin oral
suspension for
reconstitution
1
clarithromycin oral
tablet
1
clarithromycin oral
24 hr
3
DIFICID
1
E.E.S. 400 ORAL
TABLET
3
E.E.S. GRANULES
3
ERYPED 200
3
ERYPED 400
1
ERY-TAB ORAL
TABLET,DELAYED
RELEASE (DR/EC)
250 MG
3
ERY-TAB ORAL
TABLET,DELAYED
RELEASE (DR/EC)
333 MG, 500 MG
1
ERYTHROCIN
4
ERYTHROCIN (AS
STEARATE) ORAL
TABLET 250 MG
3
erythromycin estolate
(bulk)
3
erythromycin
ethylsuccinate oral
tablet
1
erythromycin oral
capsule,delayed
release(dr/ec)
1
erythromycin oral tablet
1
PCE
3
ZITHROMAX
INTRAVENOUS
4
Drug Name
/Limits
ZITHROMAX ORAL
PACKET
1
ZITHROMAX ORAL
SUSPENSION FOR
RECONSTITUTION
3
ZITHROMAX ORAL
TABLET
3
ZITHROMAX
TRI-PAK
3
ZITHROMAX Z-PAK
3
ZMAX
3
MISC
ANTI-INFECTIVE
NEBUPENT
2
PENTAM
3
PA
MONOBACTAM
ANTIBIOTICS
AZACTAM
1
AZACTAM IN
DEXTROSE
(ISO-OSM)
4
aztreonam
1
OXAZOLIDINONE
ANTIBIOTICS
linezolid intravenous
4
PA
linezolid oral
2
PA
linezolid-0.9% sodium
chloride
4
SIVEXTRO
INTRAVENOUS
4
SIVEXTRO ORAL
3
ZYVOX
INTRAVENOUS
4
PA
ZYVOX ORAL
SUSPENSION FOR
RECONSTITUTION
2
PA
ZYVOX ORAL
TABLET
3
PA
this table.
52
Drug Name
/Limits
PENICILLIN
ANTIBIOTIC NATURAL
BICILLIN L-A
1
penicillin g pot in
dextrose
4
penicillin g potassium
million unit
3
Drug Name
PENICILLIN
ANTIBIOTIC,
EXTENDED-SPECT
RUM &
BETA-LACTAMAS
E INHIB. COMB
piperacillin-tazobactam
4
ticarcillin-k
clavulanat(bulk)
3
ZOSYN
4
ZOSYN IN
DEXTROSE
(ISO-OSM)
4
penicillin g potassium
million unit
1
penicillin g procaine
intramuscular syringe
1.2 million unit/2 ml
1
penicillin g procaine
intramuscular syringe
600,000 unit/ml
3
penicillin g sodium
1
PENICILLIN
NATURAL
ANTIBIOTIC
COMBINATIONS EXTENDED
RELEASE
penicillin v potassium
1
BICILLIN C-R
PFIZERPEN-G
3
POLYMYXINS
AND
DERIVATIVES SINGLE AGENTS
PENICILLIN
ANTIBIOTIC PENICILLINASE-R
ESISTANT
/Limits
1
BACIIM
1
bacitracin (bulk)
powder 5 million unit
1
bacitracin (bulk)
powder 65 unit/mg
3
dicloxacillin
1
nafcillin in dextrose
iso-osm
4
nafcillin injection
3
nafcillin intravenous
4
1
oxacillin in
dextrose(iso-osm)
bacitracin
intramuscular
4
3
oxacillin injection
3
bacitracin zn
micronized(bulk)
oxacillin intravenous
4
bacitracin, micronized
(bulk) powder 100 %
3
(bulk) powder 75.7
unit/mg
1
colistimethate sodium
(bulk)
3
this table.
53
Drug Name
/Limits
colistin (colistimethate
na)
1
COLY-MYCIN M
PARENTERAL
3
polymyxin b sulfate
1
Drug Name
RESPIRATORY
SYNCYTIAL
VIRUS (RSV)
ANTIVIRAL
AGENTS
VIRAZOLE
polymyxin b sulfate,mic
(bulk) powder 100
million unit
3
(bulk) powder 50
million unit, 6,000
unit/mg
1
PROTEASE
INHIBITORS
(NON-PEPTIDIC)
ANTIRETROVIRA
L
/Limits
3
RIFAMYCINS AND
RELATED
DERIVATIVE
ANTIBIOTICS
MYCOBUTIN
3
PRIFTIN
1
rifabutin
2
RIFADIN
INTRAVENOUS
4
RIFADIN ORAL
3
APTIVUS
1
rifampin (bulk)
1
PREZCOBIX
1
rifampin intravenous
4
PREZISTA
1
rifampin oral
1
rifaximin (bulk)
3
XIFAXAN
3
PROTEASE
INHIBITORS
(PEPTIDIC)
ANTIRETROVIRA
L
PA
STREPTOGRAMIN
ANTIBIOTICS
SYNERCID
4
CRIXIVAN ORAL
CAPSULE 200 MG,
400 MG
1
SULFONAMIDE
ANTIBIOTIC
EVOTAZ
1
1
INVIRASE
1
sulfacetamide sod, mono
(bulk)
LEXIVA
1
sulfadiazine oral
2
NORVIR
1
sulfamethoxazole (bulk)
1
REYATAZ ORAL
CAPSULE 150 MG,
200 MG, 300 MG
1
REYATAZ ORAL
POWDER IN PACKET
TETRACYCLINE &
TETRACYCLINE
ANTIBIOTIC
COMBINATIONS
1
AVIDOXY DK
VIRACEPT ORAL
TABLET
1
TETRACYCLINE
ANTIBIOTICS
ACTICLATE
PA
3
3
this table.
54
Drug Name
/Limits
ADOXA ORAL
CAPSULE
3
AVIDOXY
3
demeclocycline
Drug Name
/Limits
VIBRAMYCIN ORAL
CAPSULE 100 MG
3
1
3
DORYX ORAL
TABLET,DELAYED
RELEASE (DR/EC)
200 MG, 50 MG
VIBRAMYCIN ORAL
SUSPENSION FOR
RECONSTITUTION
3
VIBRAMYCIN ORAL
SYRUP
3
DOXY-100
4
ANTINEOPLAST
ICS
doxycycline hyclate
intravenous
4
doxycycline hyclate oral
capsule
1
tablet 100 mg
1
(dr/ec)
3
doxycycline
monohydrate
3
MINOCIN
INTRAVENOUS
4
MINOCIN ORAL
3
TYKERB
minocycline oral
capsule
1
3
3
ANTINEOPLASTIC
- CYP17 (17
ALPHA-HYDROXY
LASE/C17,20-LYAS
E) INHIBITOR
MONODOX
3
ZYTIGA
MORGIDOX
3
MORGIDOX 1X100
3
MORGIDOX 2X100
3
ORACEA
3
SOLODYN ORAL
TABLET EXTENDED
RELEASE 24 HR 105
MG, 115 MG, 55 MG,
65 MG, 80 MG
ANTINEOPLASTIC
- 1ST
GENERATION
EGFR TYROSINE
KINASE
INHIBITOR
3
tetracycline
1
ANP - HUMAN
VASCULAR
ENDOTHELIAL
GROWTH
FACTOR INHIB
REC-MC
ANTIBODY
AVASTIN
4
ANTINEOPLASICEPIDERM.GROWT
H FACTOR-EGFR
(ERBB1)&HER-2
(ERBB2)R.INHIB
2
PA
2
PA
IRESSA
3
TARCEVA
2
PA
this table.
55
Drug Name
/Limits
ANTINEOPLASTIC
- 2ND
GENERATION
EGFR TYROSINE
KINASE
INHIBITOR
GILOTRIF
Drug Name
ANTINEOPLASTIC
- ALKYLATING
AGENT NITROGEN
MUSTARDS
3
ANTINEOPLASTIC
- ALKYLATING
AGENT - ALKYL
SULFONATES
BUSULFEX
4
MYLERAN
1
ANTINEOPLASTIC
- ALKYLATING
AGENT ETHYLENIMINES
AND
METHYLMELAMI
NES
ALKERAN
INTRAVENOUS
4
ALKERAN ORAL
1
cyclophosphamide
(bulk)
3
cyclophosphamide
intravenous
4
cyclophosphamide oral
capsule
3
IFEX
4
ifosfamide
4
LEUKERAN
1
mechlorethamine (bulk)
3
melphalan hcl
4
1
HEXALEN
1
MUSTARGEN
thiotepa
3
thiotepa (bulk)
3
ANTINEOPLASTIC
- ALKYLATING
AGENT NITROSOUREAS
ANTINEOPLASTIC
- ALKYLATING
AGENT METHYLHYDRAZ
INES
MATULANE
1
procarbazine hcl (bulk)
3
ANTINEOPLASTIC
- ALKYLATING
AGENT NITROGEN
MUSTARD WITH
RESCUE AGENT
ifosfamide-mesna
/Limits
BICNU
4
GLEOSTINE ORAL
CAPSULE 10 MG, 100
MG, 40 MG
3
GLIADEL WAFER
3
ANTINEOPLASTIC
- ALKYLATING
AGENT - OTHER
TREANDA
4
4
ANTINEOPLASTIC
- ALKYLATING
AGENT TRIAZENES
dacarbazine
4
TEMODAR
INTRAVENOUS
4
this table.
56
Drug Name
/Limits
TEMODAR ORAL
1
temozolomide
1
2
ZYKADIA
3
PA
ANTINEOPLASTIC
- ANTIADRENALS
ALIMTA
4
FOLOTYN
4
methotrexate (bulk)
3
methotrexate sodium
1
methotrexate sodium
(pf)
1
1
LYSODREN
1
TREXALL
mitotane (bulk)
3
ANTINEOPLASTIC
ANTIMETABOLIT
E - PURINE
ANALOGS
ANTINEOPLASTIC
ANTIANDROGENS
bicalutamide
1
CASODEX
1
flutamide
1
NILANDRON
2
PA
XTANDI
2
PA
ZYTIGA
2
PA
ANTINEOPLASTIC
ANTIBODY-DRUG
COMPLEXES
ARRANON
4
cladribine
4
CLOLAR
4
fludarabine
4
mercaptopurine
1
mercaptopurine (bulk)
3
NIPENT
4
PURIXAN
3
TABLOID
1
3
ADCETRIS
4
thioguanine (bulk)
KADCYLA
4
ANTINEOPLASTIC
ANTIMETABOLIT
E - PYRIMIDINE
ANALOGS
ANTINEOPLASTIC
- ANTI-GD2
GANGLIOSIDE
MONOCLONAL
ANTIBODY
UNITUXIN
4
/Limits
ANTINEOPLASTIC
ANTIMETABOLIT
E - FOLIC ACID
ANALOGS
ANTINEOPLASTIC
- ANAPLASTIC
LYMPHOMA
KINASE (ALK)
INHIBITORS
XALKORI
Drug Name
ADRUCIL
4
azacitidine
3
capecitabine
3
cytarabine
1
cytarabine (pf) injection
solution
1
DACOGEN
4
this table.
57
Drug Name
/Limits
Drug Name
/Limits
decitabine
4
AROMASIN
1
DEPOCYT (PF)
3
exemestane
1
floxuridine
3
FEMARA
3
floxuridine (bulk)
3
letrozole
1
fluorouracil (bulk)
1
letrozole (bulk)
3
fluorouracil intravenous
4
gemcitabine
4
GEMZAR
4
ANTINEOPLASTIC
- ARSENIC
COMPOUNDS
VIDAZA
4
TRISENOX
XELODA
3
ANTINEOPLASTIC
- ASPARAGINASE
ENZYME
THERAPY
AGENTS
ANTINEOPLASTIC
ANTIMETABOLIT
E - UREA
DERIVATIVES
ERWINAZE
3
1
HYDREA
3
ONCASPAR
hydroxyurea
1
hydroxyurea (bulk)
3
ANTINEOPLASTIC
- BRUTON'S
TYROSINE
KINASE (BTK)
INHIBITOR
ANTINEOPLASTIC
ANTI-PROGRAMM
ED DEATH
RECEPTOR-1
(PD-1) MC
ANTIBODY
IMBRUVICA
KEYTRUDA
4
OPDIVO
4
ANTINEOPLASTIC
- ANTI-SLAMF7
MONOCLONAL
ANTIBODY
AGENTS
EMPLICITI
2
ANTINEOPLASTIC
- AROMATASE
INHIBITORS
anastrozole
1
anastrozole (bulk)
3
ARIMIDEX
3
4
3
ANTINEOPLASTIC
- CD20 SPECIFIC
RECOMBINANT
MONOCLONAL
ANTIBODY
AGENTS
ARZERRA
4
GAZYVA
4
RITUXAN
4
ANTINEOPLASTIC
CYCLIN-DEPENDE
NT KINASE (CDK)
4/6 INHIBITORS
IBRANCE
2
PA
this table.
58
Drug Name
/Limits
ANTINEOPLASTIC
- CYTOTOXIC
T-LYMPHOCYTE
ANTIGEN
(CTLA-4),R-MC
ANTIBODY
YERVOY
Drug Name
/Limits
ANTINEOPLASTIC
- HEDGEHOG
PATHWAY
INHIBITOR
ERIVEDGE
4
ANTINEOPLASTIC
EPIPODOPHYLLO
TOXINS
2
ANTINEOPLASTIC
- HISTONE
DEACETYLASE
(HDAC)
INHIBITORS
BELEODAQ
4
ETOPOPHOS
4
FARYDAK
3
etoposide (bulk)
3
ISTODAX
4
etoposide intravenous
4
ZOLINZA
2
etoposide oral
1
teniposide
4
TOPOSAR
4
ANTINEOPLASTIC
IMMUNOTHERAP
Y, THERAPEUTIC
VACCINES
ANTINEOPLASTIC
- EPOTHILONES
AND ANALOGS
IXEMPRA
PROVENGE
4
ANTINEOPLASTIC
- ESTROGEN
RECEPTOR
ANTAGONIST
FASLODEX
3
ANTINEOPLASTIC
- ESTROGENS
EMCYT
1
ANTINEOPLASTIC
- HALICHONDRIN
B ANALOGS,
MICROTUBULE
INHIBITORS
HALAVEN
PA
4
ANTINEOPLASTIC
- INTERFERONS
INTRON A
INJECTION RECON
SOLN
2
INTRON A
INJECTION
SOLUTION 6
MILLION UNIT/ML
2
ANTINEOPLASTIC
- INTERLEUKIN-6
(IL-6) INHIBITORS,
MONOCLONAL
ANTIBODY
SYLVANT
4
PA
4
ANTINEOPLASTIC
- INTERLEUKINS
PROLEUKIN
4
this table.
59
Drug Name
/Limits
ANTINEOPLASTIC
- JANUS KINASE
(JAK) INHIBITORS
JAKAFI
Drug Name
ANTINEOPLASTIC
- MAST CELL
STABILIZERS
2
PA
ANTINEOPLASTIC
- LHRH (GNRH)
AGONIST
ANALOG
PITUITARY
SUPPRESSANTS
cromolyn oral
1
GASTROCROM
1
ANTINEOPLASTIC
- MEK1 AND MEK2
KINASE
INHIBITORS
MEKINIST
ELIGARD
1
leuprolide (bulk)
3
leuprolide subcutaneous
kit
1
LUPRON DEPOT (3
MONTH)
INTRAMUSCULAR
SYRINGE KIT 22.5
MG
ANTINEOPLASTIC
- MONOCLONAL
ANTIBODIES FOR
RADIOPHARMAC
EUTICAL
THERAPY
3
ZEVALIN (Y-90)
LUPRON DEPOT (4
MONTH)
3
ANTINEOPLASTIC
- MTOR KINASE
INHIBITORS
LUPRON DEPOT (6
MONTH)
3
LUPRON DEPOT
INTRAMUSCULAR
SYRINGE KIT 7.5 MG
3
TRELSTAR
INTRAMUSCULAR
SYRINGE
2
VANTAS
3
ZOLADEX
4
2
PA
4
AFINITOR
2
PA
AFINITOR DISPERZ
2
PA
TORISEL
4
ANTINEOPLASTIC
- MULTIKINASE
INHIBITORS
PA
ANTINEOPLASTIC
- LHRH (GNRH)
ANTAGONIST
PITUITARY
SUPPRESSANTS
FIRMAGON KIT W
DILUENT SYRINGE
/Limits
COMETRIQ
2
PA
ICLUSIG
2
PA
NEXAVAR
2
PA
STIVARGA
2
PA
TAFINLAR
2
PA
ZELBORAF
2
PA
ANTINEOPLASTIC
- OTHER
2
PA
THERACYS
1
TICE BCG
1
this table.
60
Drug Name
/Limits
ANTINEOPLASTIC
PHOTOSENSITIZE
RS
4
UVADEX
1
ANTINEOPLASTIC
- PI3K-DELTA
INHIBITORS
3
ANTINEOPLASTIC
- PLATINUM
COMPLEXES
/Limits
INLYTA
2
LENVIMA
3
OFEV
PHOTOFRIN
ZYDELIG
Drug Name
NF
SPRYCEL
2
PA
SUTENT ORAL
CAPSULE 12.5 MG, 25
MG, 50 MG
2
PA
SUTENT ORAL
CAPSULE 37.5 MG
3
PA
TASIGNA
3
VOTRIENT
2
carboplatin
4
ANTINEOPLASTIC
- RADIOPHARMAC
EUTICALS
cisplatin
4
METASTRON
4
oxaliplatin
4
XOFIGO
4
ANTINEOPLASTIC
- PROGESTINS
PA
PA
ANTINEOPLASTIC
- RETINOIDS
DEPO-PROVERA
INTRAMUSCULAR
SOLUTION
1
megestrol acetate,micro
(bulk)
3
megestrol oral tablet
1
tretinoin
(chemotherapy)
1
ANTINEOPLASTIC
- SELECTIVE
ESTROGEN
RECEPTOR
MODULATORS
(SERMS)
ANTINEOPLASTIC
- PROTEASOME
ENZYME
INHIBITORS
FARESTON
1
SOLTAMOX
3
1
KYPROLIS
4
tamoxifen
VELCADE
4
ANTINEOPLASTIC
- SELECTIVE
RETINOID X
RECEPTOR
AGONISTS
ANTINEOPLASTIC
PROTEIN-TYROSI
NE KINASE
INHIBITORS
BOSULIF
3
CAPRELSA
2
PA
GLEEVEC
3
PA
IMBRUVICA
3
bexarotene
1
TARGRETIN ORAL
3
ANTINEOPLASTIC
- TAXANES
ABRAXANE
4
this table.
61
Drug Name
/Limits
DOCEFREZ
4
docetaxel intravenous
mg/7 ml (20 mg/ml), 160
mg/16 ml (10 mg/ml),
160 mg/8 ml (20 mg/ml),
20 mg/2 ml (10 mg/ml),
20 mg/ml (1 ml), 80
mg/4 ml (20 mg/ml), 80
mg/8 ml (10 mg/ml)
4
JEVTANA
4
paclitaxel
4
TAXOTERE
INTRAVENOUS
SOLUTION 20 MG/ML
(1 ML), 80 MG/4 ML
(20 MG/ML)
Drug Name
ANTINEOPLASTIC
- VASC
ENDOTHELIAL
GROWTH
FACTOR
RECEPTOR
(VEGFR) ANTAG
CYRAMZA
ANTINEOPLASTIC
- THALIDOMIDE
ANALOGS
3
REVLIMID
3
THALOMID
1
4
ANTINEOPLASTIC
- VINCA
ALKALOIDS AND
ANALOGS
4
POMALYST
/Limits
MARQIBO
4
NAVELBINE
4
vinblastine intravenous
solution
4
VINCASAR PFS
4
vincristine
4
vinorelbine
4
ANTINEOPLASTIC
ANTIBIOTIC ACTINOMYCINS
ANTINEOPLASTIC
TOPOISOMERASE
I INHIBITORS
COSMEGEN
4
CAMPTOSAR
4
ANTINEOPLASTIC
ANTIBIOTIC ANTHRACYCLINE
S
HYCAMTIN
INTRAVENOUS
4
daunorubicin
4
HYCAMTIN ORAL
2
DAUNOXOME
4
irinotecan
4
DOXIL
4
topotecan
4
doxorubicin
4
doxorubicin,
peg-liposomal
4
ELLENCE
4
epirubicin
4
IDAMYCIN PFS
4
idarubicin
4
LIPODOX
4
LIPODOX 50
4
ANTINEOPLASTIC
- VASC
ENDOTHELIAL
GROWTH FAC
(VEGF-A,B&PLGF)
INHIBITOR
ZALTRAP
4
PA
this table.
62
Drug Name
/Limits
mitoxantrone
4
VALSTAR
4
ANTINEOPLASTIC
ANTIBIOTIC OTHERS
bleomycin
1
mitomycin
4
mitomycin (bulk)
3
ZANOSAR
4
ANTINEOPLASTIC
-CEPHALOTAXIN
ES
SYNRIBO
3
ANTINEOPLASTIC
- POLY
(ADP-RIBOSE)
POLYMERASE
(PARP)
INHIBITORS
LYNPARZA
3
ANTINEOPLASTIC
-CD30 DIRECTED
ANTIBODY-MICR
OTUBULE
DISRUPTING
CONJUGATE
ADCETRIS
4
4
/Limits
BISPECIFIC
CD19-DIRECTED
CD3 T-CELL
ENGAGER,
MONOCLONAL
ANTIBODY
BLINCYTO
4
CARDIAC
PROTECTIVE
AGENTS USED IN
CONJUNCTION
WITH
CHEMOTHERAPY
dexrazoxane hcl
4
ZINECARD (AS HCL)
4
EPIDERMAL
GROWTH
FACTOR RECEPT
(HER-2)
SUBDOMAIN II
BLOCKER,
REC-MC AB
PERJETA
ANTINEOPLASTIC
-HER2 TARGETED
ANTIBODY-MICR
OTUBULE
INHIBITOR
CONJUGATE
KADCYLA
Drug Name
4
EPIDERMAL
GROWTH
FACTOR RECEPT
BLOCKER (HER-1
TYPE), REC-MC
ANTIBODY
ERBITUX
4
VECTIBIX
4
EPIDERMAL
GROWTH
FACTOR RECEPT
BLOCKER (HER-2
TYPE), REC-MC
ANTIBODY
HERCEPTIN
4
this table.
63
Drug Name
/Limits
METHOTREXATE
RESCUE AGENTS CARBOXYPEPTID
ASE G2 TYPE
VORAXAZE
Drug Name
/Limits
ANTISEPTICS &
DISINFECTANT
S
4
METHOTREXATE
RESCUE AGENTS FOLIC ACID
ANTAGONIST
TYPE
ANTISEPTIC ALCOHOL AND
TOPICAL
ANESTHETIC
COMBINATIONS
ALCOHOL-BENZOCA
INE
3
3
CALCIUM FOLINATE
(LEUCOVORIN)
1
isopropyl
alcohol-benzocaine
FUSILEV
4
leucovorin calcium
injection recon soln
1
ANTISEPTIC ALCOHOLS
leucovorin calcium oral
1
levoleucovorin calcium
4
METHOTREXATE
RESCUE AGENTS
1,3-butanediol (bulk)
3
ALCOHOL PADS
3
ALCOHOL PREP
PADS
3
ALCOHOL PREP
SWABS
3
CALCIUM FOLINATE
(LEUCOVORIN)
1
alcohol swabs
3
FUSILEV
4
ALCOHOL WIPES
3
leucovorin calcium
injection recon soln
1
ANTISEPTIC
BIO-HAND
3
leucovorin calcium oral
1
ANTISEPTIC GEL
3
levoleucovorin calcium
4
VORAXAZE
4
BD ALCOHOL
SWABS
3
CURITY ALCOHOL
SWABS
3
DERMA STAT
3
DERMAGEL HAND
SANITIZER
3
EASY TOUCH
ALCOHOL PREP
PADS
3
ethyl alcohol
3
GELRITE HAND
SANITIZER
3
GERM DEFENSE
3
URINARY TRACT
PROTECTIVE
AGENTS USED IN
CONJUNCTION
WITH
CHEMOTHERAPY
amifostine crystalline
4
mesna
4
MESNEX
INTRAVENOUS
4
MESNEX ORAL
3
this table.
64
Drug Name
/Limits
Drug Name
/Limits
HAND SANITIZER
3
DI-DAK-SOL
1
ISAGEL NO RINSE
3
H-CHLOR 12
3
isopropyl alcohol
topical gel
3
HYSEPT
1
isopropyl alcohol
topical
spray,non-aerosol 70 %
3
ANTISEPTIC IODINE/IODOPHO
RES
IV PREP WIPES
1
ammonium and
potassium iodides
3
RENEWAL HAND
SANITIZER
3
IODIDES TINCTURE
3
RUBBING ALCOHOL
(ETHANOL)
iodine (bulk) granules
3
1
iodine strong
1
IODINE TOPICAL
1
iodine-sodium iodide
topical tincture
1
IODOFLEX
1
iodoform (bulk)
3
IODOSORB
1
SURE COMFORT
ALCOHOL PREP
PADS
3
SURE-PREP
ALCOHOL PREP
PADS
3
ULTILET ALCOHOL
SWAB
3
LUGOLS TOPICAL
3
WEBCOL
3
STRONG IODINE
TOPICAL
1
ANTISEPTIC BIGUANIDES
ANTISEPTIC OTHERS
ANTISEPTIC SKIN
CLNSR(CHLORHE)
3
BETASEPT
SURGICAL SCRUB
3
chlorhexidine acetate
(bulk)
3
chlorhexidine gluconate
topical
HIBICLENS
B.F.I
3
FORMADON
3
formaldehyde
3
formaldehyde (bulk)
3
FORMA-RAY
3
3
glutaraldehyde
3
3
glutaraldehyde (bulk)
solution 50 %
3
NEW SKIN
(OXYQUINOLINE)
3
S.T.37 ANTISEPTIC
1
ANTISEPTIC CHLORINE
RELEASING
ANASEPT
SKIN-WOUND
CLEANSER
3
CLORPACTIN
WCS-90
1
DAKIN'S SOLUTION
1
ANTISEPTIC OXIDIZING
AGENTS
hydrogen peroxide
(bulk)
3
this table.
65
Drug Name
/Limits
hydrogen peroxide
solution 3 %
1
hydrogen peroxide
topical
3
ANTISEPTIC PHENOL
DERIVATIVES
Drug Name
/Limits
ANTISEPTIC QUATERNARY
AMMONIUM
ANTI-BACTERIAL
CLEANSING
3
ANTIBACTERIAL
WIPES
3
AMERIWASH HAND
SOAP
3
ANTISEPTIC
PERINEAL WASH II
3
ANTIBACTERIAL
(TRICLOSAN) LIQ
3
ANTISEPTIC
WOUND-SKIN
3
ANTIBACTERIAL
LOTION SOAP
3
BEDSIDE-CARE
1
ASC LOTIONIZED
CLEANSER
3
3
BEDSIDE-CARE
PERINEAL
CA-REZZ
3
3
CASTELLANI PAINT
3
COLD SORE
TREATMENT
TOPICAL SOLUTION
CASTELLANI PAINT
MODIFIED
CURE CHROME
3
1
CETAPHIL
ANTIBACTERIAL
1
1
DERMAL WOUND
CLEANSER TOPICAL
CLEANSER 0.13 %
DERMA CIDOL 2000
1
3
GENTLE RAIN
3
KENDALL
ANTIMICROBIAL
HAND SOAP
3
MERTHIOLATE
(BENZALKONIUM)
3
parachlorophenol (bulk)
3
PERICLEAN
3
NEOSPORIN WOUND
CLEANSER KIDS
3
PERIGIENE
3
3
phenol
1
NEW SKIN
(BENZETHONIUM)
phenol (bulk) liquid
1
3
PHYSICIANS
ANTIBACTERIAL
PERINEAL SKIN
CLEANSER
3
3
RENEWAL
ANTIBACTERIAL LIQ
SOAP
REMEDY 4-IN-1
CLEANSER
3
3
SWEEN PREP
1
SALINE WOUND
WASH
(BENZETHONM)
SWEEN PREP WIPES
1
1
triclosan (bulk)
3
SECURA
MOISTURIZING
TOPICAL CLEANSER
SECURA PERSONAL
1
this table.
66
Drug Name
SECURA TOTAL
BODY CLEANSER
/Limits
3
ANTISEPTIC &
DISINFECTANT
COMBINATIONS
OXYZAL WET
DRESSING
3
Drug Name
ORALAIR
SUBLINGUAL
TABLET 300 INDX
REACTIVITY
/Limits
3
ALLERGENIC
EXTRACTS MOLD EXTRACTS
DISINFECTANTS ALDEHYDES
aller ext-alternaria
alternata
3
FORMADON
TOPICAL SOLUTION
allergen ext-aspergillus
fumig injection solution
20,000 unit/ml
3
3
DISINFECTANTS OTHER
ALCOH-GLOVE
3
ALCOH-WIPE
3
BIOLOGICALS
ALLERGENIC
EXTRACT
OTHERS
3
CANDIN
1
ALLERGENIC
EXTRACTS - CAT
HAIR/DANDER
EXTRACTS
3
ALLERGENIC
EXTRACTS - DOG
HAIR/DANDER
EXTRACTS
allergenic ext-dog
epithelium
3
RAGWITEK
3
aller ext tree pollen-am
elm
3
aller ext-tree
pollen-mt.cedar
3
aller xt-tree
pol-e.cottonwood
3
ANTIVENOMS SCORPION
ANTIVENOMS
ANASCORP
3
ALLERGENIC
EXTRACTS GRASS POLLEN
GRASTEK
allergenic ext-mixed
ragweed
ALLERGENIC
EXTRACTS- TREE
POLLEN
aller ext-american
cockroach
cat hair std allergenic
ext
ALLERGENIC
EXTRACTS WEED POLLEN
3
4
ANTIVENOMS SNAKE
ANTIVENOMS
antivenin latrodectus
mactans
3
antivenin micrurus
fulvius
3
CROFAB
1
this table.
67
Drug Name
/Limits
ANTIVIRAL
MONOCLONAL
ANTIBODIES
SYNAGIS
4
HEPATITIS A AND
HEPATITIS B
VACCINE
COMBINATIONS
TWINRIX (PF)
3
HEPATITIS A
VACCINE SINGLE AGENTS
HAVRIX (PF)
1
VAQTA (PF)
INTRAMUSCULAR
SUSPENSION
1
VAQTA (PF)
INTRAMUSCULAR
SYRINGE
3
HEPATITIS B
VACCINE
COMBINATIONS
PEDIARIX (PF)
3
HEPATITIS B
VACCINES SINGLE AGENTS
ENGERIX-B (PF)
1
ENGERIX-B
PEDIATRIC (PF)
1
RECOMBIVAX HB
(PF)
1
IMMUNE
GLOBULIN CYTOMEGALOVI
RUS (CMV)
CYTOGAM
INTRAVENOUS
SOLUTION 50 MG/ML
Drug Name
/Limits
IMMUNE
GLOBULIN GAMMA
GLOBULIN (IGG),
HUMAN
BIVIGAM
4
CARIMUNE NF
NANOFILTERED
INTRAVENOUS
RECON SOLN 12
GRAM, 6 GRAM
4
FLEBOGAMMA DIF
4
GAMASTAN S/D
3
GAMMAGARD
LIQUID
4
GAMMAGARD S-D
(IGA &LT< 1
4
GAMMAKED
3
GAMMAPLEX
4
GAMUNEX-C
4
HIZENTRA
3
HYQVIA
3
OCTAGAM
4
PRIVIGEN
4
IMMUNE
GLOBULIN HEPATITIS B
HEPAGAM B
3
HYPERHEP B S/D
3
HYPERHEP B S-D
NEONATAL
3
NABI-HB
3
IMMUNE
GLOBULIN RABIES
4
HYPERRAB S/D (PF)
1
IMOGAM RABIES-HT
(PF)
1
this table.
68
Drug Name
/Limits
Drug Name
ZOSTAVAX (PF)
IMMUNE
GLOBULIN RHO(D)
/Limits
1
TOXOID VACCINE
COMBINATIONS
HYPERRHO S/D
3
MICRHOGAM
ULTRA-FILTERED
PLUS
3
RHOGAM
ULTRA-FILTERED
PLUS
ADACEL(TDAP
ADOLESN/ADULT)(P
F)
3
BOOSTRIX TDAP
3
3
DAPTACEL (DTAP
PEDIATRIC) (PF)
3
RHOPHYLAC
3
INFANRIX (DTAP)
(PF)
3
WINRHO SDF
1
KINRIX (PF)
3
PEDIARIX (PF)
3
QUADRACEL (PF)
3
TENIVAC (PF)
3
tetanus,diphtheria tox
ped(pf)
3
tetanus-diphtheria
toxoids-td
3
IMMUNE
GLOBULIN TETANUS
HYPERTET S/D (PF)
1
IMMUNE
GLOBULIN VARICELLA-ZOST
ER
VARIZIG
3
IMMUNE SERUMS
ATGAM
4
THYMOGLOBULIN
4
LIVE VACCINES
bcg vaccine, live (pf)
1
VACCINE
BACTERIAL GRAM NEGATIVE
BACILLI
(NON-ENTERIC)
ACTHIB (PF)
1
PEDVAX HIB (PF)
1
TYPHIM VI
1
VIVOTIF BERNA
VACCINE
3
FLUMIST QUAD
2015-2016
1
M-M-R II (PF)
1
PROQUAD (PF)
3
ROTARIX
3
ROTATEQ VACCINE
3
THERACYS
1
VACCINE
COCCI AND
BACILLI
TICE BCG
1
MENHIBRIX (PF)
VARIVAX (PF)
1
VIVOTIF BERNA
VACCINE
3
YF-VAX (PF)
1
3
this table.
69
Drug Name
/Limits
VACCINE
COCCI
Drug Name
/Limits
VACCINE MIXED
COMBINATIONS
(BACTERIAL &
VIRAL)
MENACTRA (PF)
INTRAMUSCULAR
SOLUTION
3
PENTACEL (PF)
MENOMUNE A/C/Y/W-135
1
MENOMUNE A/C/Y/W-135 (PF)
1
CERVARIX VACCINE
(PF)
3
MENVEO
A-C-Y-W-135-DIP (PF)
3
GARDASIL (PF)
3
GARDASIL 9 (PF)
3
VACCINE
BACTERIAL GRAM POSITIVE
COCCI
3
VACCINE VIRAL HUMAN
PAPILLOMAVIRU
S (HPV) VACCINES
VACCINE VIRAL INFLUENZA A & B
PNEUMOVAX 23
INJECTION
SOLUTION
1
PNEUMOVAX 23
INJECTION SYRINGE
3
PREVNAR 13 (PF)
3
VACCINE
BACTERIAL MENINGOCOCCA
L GROUP B
VACCINES
AFLURIA 2015-2016
3
AFLURIA 2015-2016
(PF)
3
FLUARIX QUAD
2015-2016 (PF)
3
FLUBLOK 2015-2016
(PF)
3
FLUCELVAX
2015-2016 (PF)
3
FLULAVAL QUAD
2015-2016
3
1
BEXSERO (PF)
3
FLUMIST QUAD
2015-2016
TRUMENBA
3
FLUVIRIN 2015-2016
3
FLUVIRIN 2015-2016
(PF)
3
FLUZONE 2015-2016
3
FLUZONE
HIGH-DOSE 2015-16
(PF)
3
FLUZONE
INTRADERM QUAD
2015-16
3
FLUZONE QUAD
2015-2016
3
VACCINE
BACTERIAL OTHER
bcg vaccine, live (pf)
1
VACCINE
BACTERIAL TOXIN-PRODUCIN
G BACILLI
BIOTHRAX
3
this table.
70
Drug Name
/Limits
FLUZONE QUAD
2015-2016 (PF)
3
FLUZONE QUAD
PEDI 2015-16 (PF)
3
/Limits
1
VACCINE VIRAL YELLOW FEVER
1
VACCINE VIRAL
COMBINATIONS
3
VACCINE VIRAL MEASLES
M-M-R II (PF)
1
PROQUAD (PF)
3
VACCINE VIRAL MUMPS AND
RELATED
M-M-R II (PF)
1
PROQUAD (PF)
3
VACCINE VIRAL POLIOMYELITIS
IPOL INJECTION
SUSPENSION
ZOSTAVAX (PF)
YF-VAX (PF)
VACCINE VIRAL JAPANESE
ENCEPHALITIS
IXIARO (PF)
Drug Name
1
VACCINE VIRAL RABIES
M-M-R II (PF)
1
PROQUAD (PF)
3
CARDIOVASCU
LAR THERAPY
AGENTS
ACE INHIBITOR
AND CALCIUM
CHANNEL
BLOCKER
COMBINATIONS
amlodipine-benazepril
3
LOTREL
3
PRESTALIA
3
TARKA
3
trandolapril-verapamil
3
IMOVAX RABIES
VACCINE (PF)
1
ACE INHIBITOR
AND DIURETIC
COMBINATIONS
RABAVERT (PF)
1
ACCURETIC
3
benazepril-hydrochlorot
hiazide
1
captopril-hydrochloroth
iazide
3
enalapril-hydrochloroth
iazide
1
fosinopril-hydrochlorot
hiazide
3
lisinopril-hydrochloroth
iazide
1
LOTENSIN HCT
3
moexipril-hydrochloroth
iazide
3
VACCINE VIRAL ROTAVIRUS
ROTARIX
3
ROTATEQ VACCINE
3
VACCINE VIRAL RUBELLA
M-M-R II (PF)
1
PROQUAD (PF)
3
VACCINE VIRAL VARICELLA
PROQUAD (PF)
3
VARIVAX (PF)
1
this table.
71
Drug Name
/Limits
Drug Name
/Limits
quinapril-hydrochloroth
iazide
3
VASERETIC
3
ALDOSTERONE
RECEPTOR
ANTAGONISTS
ZESTORETIC
3
ALDACTONE
3
eplerenone
2
INSPRA
3
spironolactone
1
ACE INHIBITORS
PA
ACCUPRIL
3
ACEON ORAL
TABLET 4 MG, 8 MG
3
ALTACE
3
ALPHA-BETA
BLOCKERS
benazepril
1
carvedilol
1
benazepril hcl (bulk)
3
COREG
3
captopril
2
COREG CR
3
captopril (bulk)
3
labetalol (bulk)
3
enalapril maleate
1
4
enalapril maleate (bulk)
3
labetalol intravenous
solution
enalaprilat intravenous
solution
4
4
EPANED
3
labetalol intravenous
syringe 20 mg/4 ml (5
mg/ml)
fosinopril
2
labetalol oral
1
lisinopril
1
TRANDATE ORAL
3
lisinopril (bulk)
3
LOTENSIN ORAL
TABLET 20 MG, 40
MG
3
MAVIK
3
moexipril
2
PA
amlodipine-valsartan
3
perindopril erbumine
2
PA
AZOR
3
ST
PRINIVIL ORAL
TABLET 10 MG, 20
MG, 5 MG
EXFORGE
3
ST
3
telmisartan-amlodipine
3
quinapril
2
PA
TWYNSTA
3
ramipril
2
PA
trandolapril
2
PA
VASOTEC
3
ZESTRIL
3
PA
PA
ANGIOTENSIN II
RECEPTOR
BLOCKER
(ARB)-CALCIUM
CHANNEL
BLOCKER COMB.
ST
this table.
72
Drug Name
/Limits
ANGIOTENSIN II
RECEPTOR
BLOCKER
(ARB)-CALCIUM
CHANNEL
BLOCKER-DIURE
TIC
Drug Name
/Limits
ANGIOTENSIN II
RECEPTOR
BLOCKERS (ARBS)
ATACAND
3
ST
AVAPRO
3
ST
BENICAR
2
ST
candesartan
2
PA
COZAAR
3
ST
ST
amlodipine-valsartan-hc
thiazid
3
EXFORGE HCT
3
ST
DIOVAN
3
TRIBENZOR
3
ST
EDARBI
NF
ANGIOTENSIN II
RECEPTOR
BLOCKER
(ARB)-DIURETIC
COMBINATIONS
ATACAND HCT
3
ST
AVALIDE
3
ST
BENICAR HCT
3
ST
candesartan-hydrochlor
othiazid
3
DIOVAN HCT
3
EDARBYCLOR
3
HYZAAR
3
irbesartan-hydrochlorot
hiazide
ST
eprosartan
1
irbesartan
1
losartan
1
MICARDIS
3
ST
telmisartan
2
PA
valsartan
2
ST
ANTIANGINAL CORONARY
VASODILATORS
(NITRATES)
DILATRATE-SR
1
ISOCHRON
3
ISORDIL
1
1
ISORDIL TITRADOSE
ORAL TABLET 5 MG
3
losartan-hydrochlorothi
azide
1
isosorbide (bulk)
3
MICARDIS HCT
3
isosorbide dinitrate oral
1
telmisartan-hydrochloro
thiazid
isosorbide mononitrate
1
3
MINITRAN
3
valsartan-hydrochloroth
iazide
3
NITRO-BID
1
NITRO-DUR
TRANSDERMAL
PATCH 24 HOUR 0.1
MG/HR, 0.2 MG/HR,
0.4 MG/HR, 0.6
MG/HR
3
ANGIOTENSIN II
RECEPTOR
BLOCKER-NEPRIL
YSIN INHIBITOR
COMB. (ARNI)
ENTRESTO
ST
ST
PA
NF
this table.
73
Drug Name
/Limits
NITRO-DUR
TRANSDERMAL
PATCH 24 HOUR 0.3
MG/HR, 0.8 MG/HR
1
nitroglycerin in 5 %
dextrose
4
nitroglycerin
intravenous
4
nitroglycerin oral
1
Drug Name
/Limits
ANTIARRHYTHMI
C - CLASS IB
lidocaine (pf)
intravenous
4
lidocaine in 5 %
dextrose (pf)
intravenous parenteral
solution 4 mg/ml (0.4
%), 8 mg/ml (0.8 %)
4
mexiletine
1
mexiletine (bulk)
3
phenytoin sodium
4
XYLOCAINE
(CARDIAC) (PF)
4
nitroglycerin
transdermal patch 24
hour
1
nitroglycerin
translingual
3
NITROLINGUAL
1
NITROMIST
3
ANTIARRHYTHMI
C - CLASS IC
NITRONAL
4
flecainide
1
NITROSTAT
1
NITRO-TIME
NF
propafenone oral
capsule,extended
release 12 hr
3
propafenone oral tablet
1
RYTHMOL ORAL
TABLET 150 MG, 225
MG
3
RYTHMOL SR
3
ANTIANGINAL
AND
ANTI-ISCHEMIC
AGENTS,
NON-HEMODYNA
MIC
RANEXA
2
ANTIARRHYTHMI
C - CLASS IA
PA
ANTIARRHYTHMI
C - CLASS II
BETAPACE
3
disopyramide phosphate
oral capsule
1
BETAPACE AF
3
NORPACE
3
BREVIBLOC IN
NACL (ISO-OSM)
4
NORPACE CR
1
procainamide injection
1
4
quinidine gluconate
1
BREVIBLOC
INTRAVENOUS
SOLUTION 100 MG/10
ML (10 MG/ML)
quinidine sulfate
1
quinidine sulfate (bulk)
powder
4
3
esmolol intravenous
solution
SORINE
1
SOTALOL AF
1
sotalol intravenous
4
this table.
74
Drug Name
/Limits
sotalol oral
1
SOTYLIZE
3
ANTIARRHYTHMI
C - CLASS III
Drug Name
/Limits
ANTIHYPERLIPID
EMIC - BILE ACID
SEQUESTRANTS
cholestyramine (with
sugar)
1
CHOLESTYRAMINE
LIGHT
1
COLESTID
3
COLESTID
FLAVORED
3
colestipol oral granules
1
colestipol oral packet
3
colestipol oral tablet
1
PREVALITE
3
QUESTRAN
3
amiodarone intravenous
4
amiodarone oral tablet
100 mg
3
amiodarone oral tablet
200 mg, 400 mg
1
CORDARONE
3
CORVERT
4
ibutilide fumarate
4
MULTAQ
3
NEXTERONE
4
PACERONE ORAL
TABLET 100 MG
3
3
PACERONE ORAL
TABLET 200 MG, 400
MG
QUESTRAN LIGHT
ORAL POWDER
1
WELCHOL ORAL
POWDER IN PACKET
3
TIKOSYN
3
WELCHOL ORAL
TABLET
2
CALAN
3
diltiazem hcl
intravenous
4
ANTIHYPERLIPID
EMIC - FIBRIC
ACID
DERIVATIVES
verapamil intravenous
4
verapamil oral tablet
1
ANTIARRHYTHMI
C - CLASS IV
ANTIARRHYTHMI
C OTHERS
ADENOCARD
4
adenosine
4
ANTIHYPERLIPID
EMIC APOLIPOPROTEIN
B-100 SYNTHESIS
INHIBITOR
KYNAMRO
3
ANTARA ORAL
CAPSULE 30 MG, 90
MG
3
fenofibrate micronized
oral capsule 130 mg, 43
mg
3
fenofibrate micronized
oral capsule 134 mg,
200 mg, 67 mg
1
fenofibrate
nanocrystallized
1
fenofibrate oral capsule
3
fenofibrate oral tablet
120 mg
3
PA
fenofibrate oral tablet
1
160 mg, 54 mg
this table.
75
Drug Name
/Limits
Drug Name
fenofibric acid
3
ZOCOR
fenofibric acid (choline)
3
FENOGLIDE
3
FIBRICOR
3
gemfibrozil oral
1
ANTIHYPERLIPID
EMIC - NICOTINIC
ACID
DERIVATIVES
LIPOFEN
3
LOFIBRA
3
LOPID
3
TRICOR
3
TRIGLIDE ORAL
TABLET 160 MG
3
TRILIPIX
3
ST
/Limits
3
niacin oral tablet 500
mg
1
niacin oral tablet
1
NIACOR
3
NIASPAN
EXTENDED-RELEAS
E
3
ANTIHYPERLIPID
EMIC SELECTIVE
CHOLESTEROL
ABSORPTION
INHIBITOR
ANTIHYPERLIPID
EMIC - HMG COA
REDUCTASE
INHIBITOR &
NIACIN
COMBINATIONS
ADVICOR
3
ZETIA
SIMCOR
3
ANTIHYPERLIPID
EMIC AGENTS DIETARY SOURCE
COMBINATIONS
ANTIHYPERLIPID
EMIC - HMG COA
REDUCTASE
INHIBITORS
(STATINS)
2
CARDIOSTEROL
3
CARDIOVID PLUS
3
ALTOPREV
3
CHOLEST CARE
3
atorvastatin
1
3
CRESTOR
2
ST
CHOLESTEROL
RELIEF
fluvastatin oral capsule
2
PA
LESCOL
3
COD LIVER OIL
ORAL CAPSULE
240-1,000 MG
3
LESCOL XL
3
LIPITOR
3
LIVALO
1
3
lovastatin
1
PRAVACHOL
3
COROMEGA ORAL
EMULSION IN
PACKET 2,000-650-12
MG/2.5 GRAM,
284-850 MG/2.5
GRAM
pravastatin
1
1
simvastatin
1
FISH OIL EXTRA
STRENGTH
simvastatin (bulk)
3
PA
this table.
76
Drug Name
FISH OIL OMEGA
3-6-9
/Limits
3
FISH OIL ORAL
CAPSULE
100-160-1,000 MG,
120-180-500 MG,
138-183-1,000 MG,
183.3 MG-75 MG -91.6
MG-306 MG, 300-1,000
MG, 300-500 MG,
340-1,000 MG,
60-90-500 MG,
720-1,200 MG
3
FISH OIL ORAL
CAPSULE 360-1,200
MG, 500-100 MG
1
FISH OIL ORAL
CAPSULE,DELAYED
RELEASE(DR/EC) 120
MG-180 MG- 60
MG-1,200 MG,
360-1,200 MG
1
FISH OIL ORAL
CAPSULE,DELAYED
RELEASE(DR/EC)
150-217-840 MG,
300-1,000 MG,
300-108-162-600 MG,
500 MG, 900 (253-647)
MG, 900-1,400 MG
3
FISH OIL PEARLS
3
FISH OIL WITH
KRILL
3
FISH OIL-VIT D3
3
FISH, FLAX
ANDBORAGE
OIL(PRIM)
3
fish,bora,flax
oils-om3,6,9 #1
3
FISH-FLAX-BORAGE
OIL
3
KRILL OIL (OMEGA 3
AND 6)
3
Drug Name
/Limits
KRILL OIL ORAL
CAPSULE
1,000-170-80-50 MG,
300-90-24-50 MG
3
krill
oil-omega-3-dha-epa
3
krill-om-3-dha-epa-phos
pho-ast oral capsule
1,000-230-60 mg
3
krill-omega-3-dha-epa-l
ipids
3
LIPOCHOL
3
LIPOCHOL PLUS
3
LIPOGEN
1
MEGAKRILL ORAL
CAPSULE
300-90-24-50 MG
3
om-3-dha-epa-fish
oil-vit d3
3
OMEGA 3 FISH OIL
3
OMEGA 3-6-9
3
OMEGA 3-6-9
COMPLEX
3
OMEGA 3-6-9 FATTY
ACIDS
3
omega 3-dha-epa-fish
oil oral capsule 1,000
mg (120 mg-180 mg),
1,200 (144-216) mg,
100-150-750 mg,
250-500-1,000 mg,
300-1,000 mg, 356 mg
(100 mg- 256 mg)-554
mg, 500-1,000 mg
3
omega 3-dha-epa-fish
oil oral capsule,delayed
release(dr/ec)
300-1,000 mg,
980-1,400 mg
3
OMEGA ESSENTIALS
3
OMEGA-3
3
this table.
77
Drug Name
/Limits
OMEGA-3 (WITH
DPA)
1
OMEGA-3 2100
omega-3 fatty acids-fish
oil oral capsule
300-1,000 mg
oil oral capsule
340-1,000 mg,
360-1,200 mg, 440-880
mg
Drug Name
/Limits
SUPER DHA GEMS
3
1
SUPER OMEGA-3
ORAL CAPSULE
400-400-200 MG
3
1
THEROMEGA
3
THEROMEGA SPORT
3
TRIPLE OMEGA 3-6-9
3
VASCAZEN
3
VAYAROL
3
vitamin e oral capsule
100 unit
1
400 unit
3
3
release(dr/ec)
1
OMEGA-3 FISH OIL
ORAL CAPSULE
910-1,400 MG
1
omega-3-dha-epa-ala-vi
t d3
3
omega-3s-dha-epa-fish
release(dr/ec)
1,000-1,400 mg
3
ANTIHYPERLIPID
EMIC AGENTS DIETARY SOURCE
ALGAL OMEGA-3
DHA
1
ALGAL-900 DHA
ORAL CAPSULE 300
MG
1
ALGAL-900 DHA
ORAL CAPSULE 450
MG
3
ATABEX DHA
3
chia seed oil-omega
3-6-9 oral capsule 1,000
mg (580 mg), 1,000 mg
(630 mg-210 mg-72mg)
3
choline bitartrate (bulk)
3
choline chloride (bulk)
3
release(dr/ec)
300-1,000 mg
1
oil-d3
3
OMERA
3
ONE-PER-DAY
OMEGA-3
3
OVEGA-3
3
phytosterol-om-3-dha-e
pa-fish
DHA ALGAL-900
1
3
docosahexanoic acid
3
RESTORA
3
3
SALMON OIL-1000
3
FISH OIL
CONCENTRATE
salmon oil-omega-3
fatty acids
3
FISH OIL ORAL
CAPSULE 120-180 MG
1
SEA-OMEGA 30
3
SEA-OMEGA 50
3
FISH OIL ORAL
CAPSULE 300 MG,
500 MG
3
this table.
78
Drug Name
/Limits
Drug Name
fish oil-dha-epa
1
GRAM-O-LECI
3
inositol oral
1
krill oil oral capsule
500 mg
3
lecithin oral capsule
1,200 mg
1
lecithin oral capsule
518 mg
3
lecithin, soy (bulk)
3
lecithin, soy oral
capsule 1,200 mg
1
lecithin, soy oral
capsule 400 mg
3
LOVAZA
3
MAXEPA
3
omega-3 acid ethyl
esters
3
omega-3 fatty acids oral
capsule
3
phosphatidyl serine
(bulk) powder 20 %
3
phosphatidylcholine
(bulk)
3
POLICOSANOL-GAR
LIC-NIACIN
3
JUXTAPID
3
ANTI-PCSK9
MONOCLONAL
ANTIBODIES
PRENATAL DHA
ORAL CAPSULE 200
MG
SUPER OMEGA-3
ORAL CAPSULE
1,000 MG
3
SUPER TWIN
EPA-DHA
3
VASCEPA
3
ZYNCOL
3
/Limits
ANTIHYPERLIPID
EMIC HMG COA
REDUCT INHIB &
CALCIUM
CHANNEL
BLOCKER COMB
amlodipine-atorvastatin
3
CADUET
3
ANTIHYPERLIPID
EMIC-HMG COA
REDUCT INHIB &
CHOLESTEROL
ABSORPTION
INHIB
VYTORIN 10-10
3
ST
VYTORIN 10-20
3
ST
VYTORIN 10-40
3
ST
VYTORIN 10-80
3
ST
ANTIHYPERLIPID
EMIC-MICROSOM
AL
TRIGLYCERIDE
TRANSFER
PROTEIN
(MTP)INHIB
3
PRALUENT PEN
3
PRALUENT SYRINGE
3
BETA BLOCKERS
CARDIAC
SELECTIVE,
INTRINSIC
SYMPATHOMIME
TIC ACTIVITY
acebutolol
2
SECTRAL
3
PA
this table.
79
Drug Name
/Limits
BETA BLOCKERS
CARDIAC
SELECTIVE
Drug Name
/Limits
BETA BLOCKERS
NON-CARDIAC
SELECTIVE
atenolol
1
BETAPACE
3
atenolol (bulk)
3
BETAPACE AF
3
betaxolol oral
1
CORGARD
3
bisoprolol fumarate
2
HEMANGEOL
3
BREVIBLOC IN
NACL (ISO-OSM)
4
INDERAL LA
3
INDERAL XL
3
INNOPRAN XL
3
nadolol
1
nadolol (bulk)
3
propranolol (bulk)
3
propranolol intravenous
4
propranolol oral
1
SORINE
1
SOTALOL AF
1
sotalol intravenous
4
sotalol oral
1
SOTYLIZE
3
timolol maleate (bulk)
3
timolol maleate oral
1
BREVIBLOC
INTRAVENOUS
SOLUTION 100 MG/10
ML (10 MG/ML)
4
BYSTOLIC
2
esmolol intravenous
solution
4
LOPRESSOR
INTRAVENOUS
4
LOPRESSOR ORAL
3
metoprolol succinate
1
metoprolol tartrate
(bulk)
3
metoprolol tartrate
intravenous
4
PA
PA
metoprolol tartrate oral
tablet 100 mg, 25 mg,
50 mg
1
BRADYKININ B2
RECEPTOR
ANTAGONISTS
TENORMIN
3
FIRAZYR
TOPROL XL
3
ZEBETA
3
CALCIUM
CHANNEL
BLOCKERS BENZOTHIAZEPIN
ES
BETA BLOCKERS
NON-CARDIAC
SELECT.,
INTRINSIC
SYMPATHOMIME
TIC ACTIVITY
LEVATOL
2
pindolol
1
PA
2
CARDIZEM CD
3
CARDIZEM LA
3
CARDIZEM ORAL
TABLET 120 MG, 30
MG, 60 MG
3
CARTIA XT
1
PA
this table.
80
Drug Name
/Limits
diltiazem hcl
intravenous
4
diltiazem hcl oral
capsule, extended
release
1
diltiazem hcl oral
capsule,ext release
degradable
1
diltiazem hcl oral
capsule,extended
release 12 hr
1
Drug Name
/Limits
amlodipine besylate
(bulk)
3
CARDENE IV
4
CARDENE IV IN
DEXTROSE
4
CARDENE IV IN
SODIUM CHLORIDE
4
CLEVIPREX
4
felodipine
1
isradipine
2
nicardipine intravenous
4
nicardipine oral
2
NIFEDICAL XL
1
nifedipine
1
ST
PA
diltiazem hcl oral
capsule,extended
release 24hr
1
diltiazem hcl oral tablet
1
diltiazem hcl oral tablet
3
nisoldipine
2
PA
DILT-XR
1
NORVASC
3
ST
MATZIM LA
3
PROCARDIA
3
ST
TAZTIA XT
3
PROCARDIA XL
3
ST
TIAZAC
3
SULAR ORAL
TABLET EXTENDED
RELEASE 24 HR 17
MG, 34 MG, 8.5 MG
3
ST
CALCIUM
CHANNEL
BLOCKERS DIHYDROPYRIDIN
ES CEREBROVASCUL
AR SPECIFIC
PA
CALCIUM
CHANNEL
BLOCKERS PHENYLAKYLAMI
NES
nimodipine
1
nimodipine (bulk)
3
NYMALIZE
3
CALCIUM
CHANNEL
BLOCKERS DIHYDROPYRIDIN
ES
ST
CALAN
3
CALAN SR
3
verapamil (bulk)
1
verapamil intravenous
4
verapamil oral capsule,
24 hr er pellet ct
3
verapamil oral
capsule,ext rel. pellets
24 hr
1
ADALAT CC
3
AFEDITAB CR
1
1
amlodipine
1
extended release
1
this table.
81
Drug Name
/Limits
VERELAN
3
VERELAN PM
3
CARDIAC
INOTROPES PHOSPHODIESTE
RASE INHIBITORS
milrinone
4
milrinone in 5 %
dextrose
4
CARDIAC
SELECTIVE BETA
BLOCKER-THIAZI
DE DIURETIC &
RELATED COMB.
Drug Name
/Limits
epinephrine injection
solution
1
EPIPEN
3
EPIPEN 2-PAK
3
EPIPEN JR
3
EPIPEN JR 2-PAK
3
CARDIOVASCULA
R
SYMPATHOMIME
TIC BETA-ADRENERG
IC AGONISTS
ISUPREL
3
CARDIOVASCULA
R
SYMPATHOMIME
TICS
atenolol-chlorthalidone
1
bisoprolol-hydrochlorot
hiazide
1
DUTOPROL
3
dobutamine
4
LOPRESSOR HCT
3
metoprolol
ta-hydrochlorothiaz
3
TENORETIC 100
3
4
TENORETIC 50
3
ZIAC
3
dobutamine in d5w
solution 1,000 mg/250
ml (4,000 mcg/ml), 250
mg/250 ml (1 mg/ml),
500 mg/250 ml (2,000
mcg/ml), 500 mg/500 ml
(1,000 mcg/ml)
dopamine in 5 %
dextrose
4
dopamine intravenous
solution
4
ephedrine hcl (bulk)
1
ephedrine sulfate (bulk)
1
CARDIOVASCULA
R
SYMPATHOMIME
TIC ANAPHYLAXIS
THERAPY SINGLE
AGENTS
ADRENACLICK
3
ADRENALIN
INJECTION
SOLUTION 1 MG/ML
(1 ML)
ephedrine sulfate
injection solution
1
3
LEVOPHED
(BITARTRATE)
4
epinephrine hcl (pf)
intravenous
3
4
midodrine oral tablet 10
mg
auto-injector
1
1
midodrine oral tablet
2.5 mg, 5 mg
this table.
82
Drug Name
/Limits
Drug Name
/Limits
norepinephrine
bitartrate
4
DIRECT ACTING
VASODILATORS
NORTHERA
3
diazoxide (bulk)
3
phenylephrine hcl
injection
1
hydralazine
1
minoxidil oral
1
VAZCULEP
3
NITROPRESS
4
tolazoline (bulk)
3
CENTRAL
ALPHA-2
AGONISTS-THIAZI
DE DIURETIC &
RELATED COMB.
CLORPRES
1
methyldopa-hydrochlor
othiazide
1
DIURETIC ALDOSTERONE
RECEPTOR
ANTAGONIST,
NON-SELECTIVE
CENTRAL
ALPHA-2
RECEPTOR
AGONISTS
ALDACTONE
3
spironolactone
1
spironolactone (bulk)
3
spironolactone micro
(bulk)
3
CATAPRES
3
PA
CATAPRES-TTS-1
3
PA
CATAPRES-TTS-2
3
PA
CATAPRES-TTS-3
3
PA
DIURETIC ALDOSTERONE
RECEPTOR
ANTAGONIST,
SELECTIVE
clonidine
2
PA
eplerenone
2
clonidine hcl oral tablet
2
PA
INSPRA
3
guanabenz (bulk)
3
guanfacine oral tablet
2
methyldopa
1
methyldopate
4
DIGITALIS
GLYCOSIDES
DIGITEK
3
DIGOX
1
digoxin injection
1
digoxin oral solution 50
mcg/ml
1
digoxin oral tablet
LANOXIN
PA
DIURETIC ARGININE
VASOPRESSIN
V1A/V2
RECEPTOR
ANTAGONISTS
VAPRISOL
4
DIURETIC CARBONIC
ANHYDRASE
INHIBITORS
acetazolamide
1
1
acetazolamide sodium
3
3
DIAMOX SEQUELS
3
LANOXIN
methazolamide oral
1
3
PEDIATRIC
this table.
83
Drug Name
NEPTAZANE
/Limits
Drug Name
/Limits
3
DYRENIUM
ammonium chloride
4
ammonium chloride
(bulk)
1
DIURETIC POTASSIUM
SPARING-THIAZI
DE & RELATED
COMBINATIONS
3
bumetanide
1
ALDACTAZIDE
ORAL TABLET 25-25
MG
DEMADEX ORAL
TABLET 10 MG, 20
MG, 5 MG
3
ALDACTAZIDE
ORAL TABLET 50-50
MG
1
EDECRIN
3
ethacrynate sodium
4
amiloride-hydrochlorot
hiazide
1
furosemide injection
1
DYAZIDE
3
furosemide oral solution
10 mg/ml, 40 mg/5 ml
1
MAXZIDE
3
MAXZIDE-25MG
3
furosemide oral tablet
1
LASIX
3
spironolacton-hydrochl
orothiaz
1
SODIUM EDECRIN
4
1
torsemide oral
1
triamterene-hydrochlor
othiazid
DIURETIC INORGANIC SALT
DIURETIC - LOOP
1
3
DIURETIC SELECTIVE
ARGININE
VASOPRESSIN V2
RECEPTOR
ANTAGONISTS
mannitol 10 %
4
SAMSCA
mannitol 20 %
4
mannitol 25 %
4
DIURETIC THIAZIDES AND
RELATED
mannitol 5 %
4
chlorothiazide
1
OSMITROL 10 %
4
chlorothiazide sodium
4
OSMITROL 15 %
4
1
OSMITROL 20 %
4
chlorthalidone oral
tablet 25 mg, 50 mg
OSMITROL 5 %
4
DIURIL
1
DIURIL IV
4
hydrochlorothiazide
1
hydrochlorothiazide
(bulk)
1
DIURETIC MISCELLANEOUS
DIURETIC SOFTGELS
DIURETIC OSMOTIC
DIURETIC POTASSIUM
SPARING
amiloride oral
1
2
PA
this table.
84
Drug Name
/Limits
Drug Name
/Limits
indapamide
1
methyclothiazide
1
metolazone
1
MICROZIDE
3
NON-CARDIAC
SELECTIVE BETA
BLOCKER-THIAZI
DE DIURETIC &
RELATED COMB.
trichlormethiazide
(bulk)
3
CORZIDE
3
nadolol-bendroflumethi
azide
3
propranolol-hydrochlor
othiazid
1
DOPAMINE D1
RECEPTOR
AGONISTS,
ANTIHYPERTENSI
VE
CORLOPAM
PATENT DUCTUS
ARTERIOSUS
(PDA)
TREATMENT
AGENTS ,
NSAID-TYPE
4
GANGLIONIC
BLOCKING,
NON-DEPOLARIZI
NG
mecamylamine hcl
(bulk)
3
VECAMYL
2
HYPERPOLARIZA
TION-ACTIVATED
CYCLIC
NUCLEOTIDE-GA
TED CHANNEL
INHIBITORS
CORLANOR
3
PA
indomethacin sodium
4
NEOPROFEN
(IBUPROFEN
LYSN)(PF)
4
PATENT DUCTUS
ARTERIOSUS
(PDA)
TREATMENT
AGENTS,
PROSTAGLANDINTYPE
MUSCARINIC
RECEPTOR
ANTAGONISTS
alprostadil
3
PROSTIN VR
PEDIATRIC
3
ATROPEN
INTRAMUSCULAR
PEN INJECTOR 0.5
MG/0.7 ML, 1 MG/0.7
ML, 2 MG/0.7 ML
3
PERIPHERAL
ALPHA-1
RECEPTOR
BLOCKERS
atropine injection
syringe 0.1 mg/ml
1
CARDURA
3
CARDURA XL
3
DIBENZYLINE
3
doxazosin
1
MINIPRESS
3
phenoxybenzamine
1
this table.
85
Drug Name
/Limits
Drug Name
/Limits
phentolamine injection
recon soln
1
TYVASO STARTER
KIT
3
prazosin oral
1
VELETRI
4
terazosin
1
VENTAVIS
1
buflomedil (bulk)
3
cyclandelate
3
isoxsuprine
3
PULMONARY
ANTIHYPERTENSI
VE
AGENTS-SOLUBL
E GUANYLATE
CYCLASE
STIMULATOR
isoxsuprine hcl (bulk)
3
nylidrin (bulk)
1
papaverine (bulk)
1
papaverine injection
solution
1
PERIPHERAL
VASODILATORS,
SINGLE AGENTS
PHEOCHROMOCY
TOMA, AGENTS
TO TREAT
DEMSER
3
PLASMA
KALLIKREIN
INHIBITOR
AGENTS
KALBITOR
3
PULMONARY
ANTIHYPERTENSI
VE AGENTS PROSTACYCLIN-T
YPE
epoprostenol (glycine)
4
FLOLAN
4
ORENITRAM
3
REMODULIN
3
TYVASO
3
TYVASO
INSTITUTIONAL
START KIT
4
TYVASO REFILL KIT
3
ADEMPAS ORAL
TABLET 0.5 MG, 1
MG, 1.5 MG, 2 MG
3
PULMONARY
ARTERIAL
HYPERTENSION ENDOTHELIN
RECEPTOR
ANTAGONISTS
LETAIRIS
2
ST
OPSUMIT
3
ST
TRACLEER
2
ST
ADCIRCA
2
PA
REVATIO
INTRAVENOUS
4
PA
REVATIO ORAL
3
PA
sildenafil intravenous
4
PA
sildenafil oral
2
PA
PULMONARY
ARTERIAL
HYPERTENSION
AGENTS-SELECTI
VE CGMP-PDE5
INHIBITORS
this table.
86
Drug Name
/Limits
RENIN
INHIBITOR,
DIRECT AND
CALCIUM
CHANNEL
BLOCKER
COMBINATIONS
TEKAMLO
BIDIL
3
VASODILATOR
OTHERS
3
3
RENIN
INHIBITOR,
DIRECT
TEKTURNA
/Limits
VASODILATOR
COMBINATIONS
RENIN
INHIBITOR,
DIRECT AND
DIURETIC
COMBINATIONS
TEKTURNA HCT
Drug Name
3
RESERPINE AND
DERIVATIVES
adenosine phosphate
(bulk)
3
CENTRAL
NERVOUS
SYSTEM
AGENTS
ANTIANXIETY
AGENT ANTIHISTAMINE
TYPE
hydroxyzine hcl
intramuscular
1
hydroxyzine hcl oral
solution 10 mg/5 ml
1
rauwolfia serpentina
(bulk)
3
hydroxyzine hcl oral
tablet
1
reserpine
1
hydroxyzine pamoate
1
reserpine (bulk)
3
VISTARIL
3
ASCLERA
4
ANTIANXIETY
AGENT BENZODIAZEPINE
S
ETHAMOLIN
4
alprazolam (bulk)
1
ethanolamine (bulk)
3
laureth 9 (bulk)
3
ALPRAZOLAM
INTENSOL
3
sodium tetradecyl sulf
(bulk)
3
alprazolam oral tablet
1
SOTRADECOL
4
alprazolam oral tablet
3
VARITHENA
4
alprazolam oral
3
ATIVAN ORAL
3
chlordiazepoxide hcl
1
clonazepam (bulk)
3
clonazepam oral tablet
1
SCLEROSING
AGENTS
VASOACTIVE
NATRIURETIC
PEPTIDES
NATRECOR
4
this table.
87
Drug Name
/Limits
Drug Name
/Limits
clonazepam oral
3
clorazepate dipotassium
1
diazepam (bulk)
3
diazepam injection
1
DIAZEPAM
INTENSOL
MYSOLINE
3
1
phenobarbital
1
diazepam oral solution
1
1
diazepam oral tablet
1
phenobarbital sodium
injection solution
KLONOPIN
3
primidone
1
lorazepam (bulk)
1
primidone (bulk)
3
LORAZEPAM
INTENSOL
1
lorazepam oral
1
oxazepam
1
TRANXENE T-TAB
ORAL TABLET 3.75
MG, 7.5 MG
3
VALIUM
3
XANAX
3
XANAX XR
3
ANTICONVULSAN
TBARBITURATES
AND
DERIVATIVES
ANTICONVULSAN
TBENZODIAZEPINE
S
ANTIANXIETY
AGENT DICARBAMATE
TYPE
meprobamate
2
ANTIANXIETY
AGENT NON-BENZODIAZ
EPINE
3
clonazepam oral tablet
1
clonazepam oral
3
DIASTAT
1
DIASTAT ACUDIAL
1
diazepam rectal
1
KLONOPIN
3
ONFI ORAL
SUSPENSION
3
ONFI ORAL TABLET
10 MG, 20 MG
2
PA
ANTICONVULSAN
T - CARBAMATES
buspirone
1
buspirone (bulk)
3
ANTICONVULSAN
T - AMPA-TYPE
GLUTAMATE
RECEPTOR
ANTAGONISTS
FYCOMPA ORAL
TABLET
PA
clonazepam (bulk)
felbamate
1
FELBATOL ORAL
SUSPENSION
1
FELBATOL ORAL
TABLET
3
ANTICONVULSAN
T - CARBOXYLIC
ACID
DERIVATIVES
3
DEPACON
4
this table.
88
Drug Name
/Limits
DEPAKENE
3
DEPAKOTE
3
DEPAKOTE ER
3
DEPAKOTE
SPRINKLES
3
divalproex
1
valproate sodium
4
valproate sodium (bulk)
3
valproic acid
1
valproic acid (as sodium
salt) oral solution 250
mg/5 ml, 500 mg/10 ml
(10 ml)
1
valproic acid (bulk)
3
4
VIMPAT ORAL
SOLUTION
3
VIMPAT ORAL
TABLET
3
/Limits
ANTICONVULSAN
T - GABA
RE-UPTAKE
INHIBITOR,
NIPECOTIC ACID
DERIVATIVES
GABITRIL
3
tiagabine
2
PA
2
PA
ANTICONVULSAN
T - GABA
TRANSAMINASE
(GABA-T)
INHIBITOR
SABRIL
ANTICONVULSAN
T - HYDANTOINS
ANTICONVULSAN
TFUNCTIONALIZE
D AMINO ACID
VIMPAT
INTRAVENOUS
Drug Name
ANTICONVULSAN
T - GABA
ANALOGS
CEREBYX
3
DILANTIN
1
DILANTIN
EXTENDED
1
DILANTIN INFATABS
3
DILANTIN-125
3
fosphenytoin
1
PEGANONE
1
PHENYTEK
1
phenytoin oral
suspension
1
phenytoin oral
tablet,chewable
1
phenytoin sodium
4
phenytoin sodium
extended
1
gabapentin (bulk)
1
gabapentin oral capsule
1
gabapentin oral solution
250 mg/5 ml, 300 mg/6
ml (6 ml)
3
gabapentin oral tablet
600 mg, 800 mg
1
LYRICA
2
NEURONTIN
3
ANTICONVULSAN
TIMINOSTILBENE
DERIVATIVES
pregabalin (bulk)
3
APTIOM
3
carbamazepine oral
capsule, er multiphase
12 hr
3
PA
this table.
89
Drug Name
/Limits
Drug Name
/Limits
carbamazepine oral
1
LAMICTAL ODT
STARTER (GREEN)
3
carbamazepine oral
tablet
1
LAMICTAL ODT
STARTER (ORANGE)
1
carbamazepine oral
12 hr
1
LAMICTAL ORAL
TABLET
3
carbamazepine oral
tablet,chewable
1
3
CARBATROL
3
LAMICTAL ORAL
TABLET, CHEWABLE
DISPERSIBLE 25 MG,
5 MG
EPITOL
1
3
oxcarbazepine
1
LAMICTAL STARTER
(BLUE) KIT
OXTELLAR XR
3
LAMICTAL STARTER
(GREEN) KIT
3
TEGRETOL ORAL
SUSPENSION
3
LAMICTAL STARTER
(ORANGE) KIT
3
TEGRETOL ORAL
TABLET
3
LAMICTAL XR
3
TEGRETOL XR
3
LAMICTAL XR
STARTER (BLUE)
3
TRILEPTAL
3
LAMICTAL XR
STARTER (GREEN)
3
LAMICTAL XR
STARTER (ORANGE)
3
lamotrigine (bulk)
3
lamotrigine oral tablet
1
lamotrigine oral tablet
extended release 24hr
3
lamotrigine oral tablet,
chewable dispersible
1
lamotrigine oral
1
lamotrigine oral
tablets,dose pack 25 mg
(35)
3
ANTICONVULSAN
TMONOSACCHARI
DE DERIVATIVES
QUDEXY XR
3
TOPAMAX
3
topiramate (bulk)
1
topiramate oral capsule,
sprinkle
1
topiramate oral
capsule,sprinkle,er 24hr
2
topiramate oral tablet
1
TROKENDI XR
3
ANTICONVULSAN
TPHENYLTRIAZINE
DERIVATIVES
LAMICTAL ODT
3
LAMICTAL ODT
STARTER (BLUE)
3
PA
PA
ANTICONVULSAN
T - POTASSIUM
CHANNEL
OPENER
POTIGA
3
this table.
90
Drug Name
/Limits
ANTICONVULSAN
T - PYRROLIDINE
DERIVATIVES
Drug Name
/Limits
ANTICONVULSAN
T OTHERS
KEPPRA
INTRAVENOUS
4
KEPPRA ORAL
3
KEPPRA XR
3
levetiracetam (bulk)
3
levetiracetam in nacl
(iso-os)
4
levetiracetam
intravenous
4
levetiracetam oral
solution
1
levetiracetam oral tablet
1
levetiracetam oral tablet
3
potassium bromide
(bulk) pellet
3
ANTIDEPRESSANT
- ALPHA-2
RECEPTOR
ANTAGONISTS
(NASSA)
mirtazapine
1
mirtazapine (bulk)
3
REMERON
3
REMERON SOLTAB
3
ANTIDEPRESSANT
- MAO INHIBITOR
NONSELECTIVE &
IRREVERSIBLE
-TYPES A,B
ANTICONVULSAN
T - SUCCINIMIDES
EMSAM
1
MARPLAN
1
CELONTIN ORAL
CAPSULE 300 MG
1
NARDIL
1
ethosuximide
1
PARNATE
3
ethosuximide (bulk)
3
phenelzine
1
ZARONTIN
3
phenelzine (bulk)
3
tranylcypromine
1
ANTICONVULSAN
T - SULFONAMIDE
DERIVATIVES
ZONEGRAN ORAL
CAPSULE 100 MG, 25
MG
3
zonisamide
1
ANTIDEPRESSANT
- NOREPINEPHRIN
E & DOPAMINE
REUPTAKE
INHIBITORS
(NDRIS)
zonisamide (bulk)
3
APLENZIN
2
bupropion (bulk)
3
bupropion hcl
1
FORFIVO XL
2
WELLBUTRIN ORAL
TABLET 100 MG
3
WELLBUTRIN SR
3
WELLBUTRIN XL
3
ANTICONVULSAN
T - TRIAZOLE
DERIVATIVES
BANZEL
2
PA
ST
ST
this table.
91
Drug Name
/Limits
ANTIDEPRESSANT
- SELECTIVE
SEROTONIN
REUPTAKE
INHIBITORS
(SSRIS)
Drug Name
/Limits
sertraline (bulk)
3
ZOLOFT
3
ANTIDEPRESSANT
- SEROTONIN-2
ANTAGONIST-RE
UPTAKE
INHIBITORS
(SARIS)
CELEXA ORAL
TABLET
3
citalopram
1
nefazodone
1
escitalopram oxalate
1
OLEPTRO ER
3
fluoxetine (bulk)
3
trazodone
1
fluoxetine oral capsule
1
fluoxetine oral
capsule,delayed
release(dr/ec)
1
fluoxetine oral solution
1
fluoxetine oral tablet 10
mg, 20 mg
3
ANTIDEPRESSANT
- SEROTONIN-NOR
EPINEPHRINE
REUPTAKE
INHIBITORS
(SNRIS)
fluoxetine oral tablet 60
mg
3
fluvoxamine
1
LEXAPRO
3
paroxetine hcl oral
tablet
1
paroxetine hcl oral
24 hr
1
PAXIL CR
3
PAXIL ORAL
SUSPENSION
2
PAXIL ORAL
TABLET
3
PEXEVA
3
PROZAC ORAL
CAPSULE
3
PROZAC WEEKLY
3
SARAFEM ORAL
TABLET 10 MG, 20
MG
3
sertraline
1
ST
ST
ST
ST
CYMBALTA
3
PA
desvenlafaxine
3
ST
desvenlafaxine fumarate
3
ST
duloxetine hcl (bulk)
1
duloxetine oral
capsule,delayed
release(dr/ec) 20 mg, 30
mg, 60 mg
1
duloxetine oral
capsule,delayed
release(dr/ec) 40 mg
3
EFFEXOR XR
3
FETZIMA
3
ST
IRENKA
3
PA
KHEDEZLA
3
ST
PRISTIQ
3
ST
SAVELLA ORAL
TABLET
1
SAVELLA ORAL
TABLETS,DOSE
PACK
3
PA
this table.
92
Drug Name
/Limits
venlafaxine oral
capsule,extended
release 24hr
1
venlafaxine oral tablet
1
venlafaxine oral tablet
3
ANTIDEPRESSANT
- SSRI & 5HT1A
PARTIAL
AGONIST
VIIBRYD ORAL
TABLET
3
ST
ANTIDEPRESSANT
- SSRI &
SEROTONIN
(5-HT) RECEPTOR
MODULATOR
BRINTELLIX
/Limits
imipramine pamoate
1
maprotiline
1
NORPRAMIN ORAL
TABLET 10 MG, 100
MG, 150 MG, 25 MG,
50 MG
3
nortriptyline
1
PAMELOR
3
protriptyline
1
SURMONTIL
1
TOFRANIL
3
trimipramine
1
ANTIDEPRESSANT
S
benactyzine hcl (bulk)
3
ANTIDEPRESSANT
TRICYCLIC-BENZ
ODIAZEPINE
COMBINATIONS
amitriptyline-chlordiaze
poxide
Drug Name
1
ANTIDEPRESSANT
- TRICYCLICS &
RELATED
(NON-SELECT
REUPTAKE
INHIBITORS)
ST
3
ANTIDEPRESSANT
-SSRI & ATYPICAL
ANTIPSYCH,DOPA
MINE&SEROTONI
N ANTAG COMB
olanzapine-fluoxetine
2
PA
SYMBYAX
3
PA
ANTIPARKINSON DOPAMINERGIC-P
ERIPH
COMT-DOPA-DEC
ARBOXYLASE
INHIB COMB
carbidopa-levodopa-ent
acapone
3
amitriptyline
1
STALEVO 100
3
amoxapine
1
STALEVO 125
3
ANAFRANIL
3
STALEVO 150
3
clomipramine
1
STALEVO 200
3
clomipramine (bulk)
3
STALEVO 50
3
desipramine oral
1
STALEVO 75
3
doxepin oral
1
imipramine (bulk)
1
imipramine hcl
1
this table.
93
Drug Name
/Limits
ANTIPARKINSON DOPAMINERG-PE
RIPHERAL
DOPA-DECARBOX
YLASE INHIBIT
COMB
carbidopa-levodopa
oral tablet
/Limits
ANTIPARKINSON
THERAPY ANTICHOLINERGI
C AGENTS
1
carbidopa-levodopa
release
1
carbidopa-levodopa
oral
3
DUOPA
3
RYTARY
3
SINEMET
3
SINEMET CR
3
ANTIPARKINSON
ADJUVANT CENTRAL/PERIPH
ERAL COMT
INHIBITORS
TASMAR ORAL
TABLET 100 MG
3
tolcapone
1
ANTIPARKINSON
ADJUVANT PERIPHERAL
COMT
INHIBITORS
COMTAN
1
entacapone
1
ANTIPARKINSON
ADJUVANT PERIPHERAL
DOPA-DECARBOX
YLASE
INHIBITORS
carbidopa
Drug Name
3
benztropine
1
COGENTIN
1
trihexyphenidyl
1
ANTIPARKINSON
THERAPY ERGOT
ALKALOIDS AND
DERIVATIVES
bromocriptine
1
PARLODEL ORAL
CAPSULE
1
PARLODEL ORAL
TABLET
3
ANTIPARKINSON
THERAPY MONOAMINE
OXIDASE
INHIBITOR(MAOB)
AZILECT
2
ELDEPRYL
3
selegiline hcl
1
ZELAPAR
3
PA
ANTIPARKINSON
THERAPY NON-ERGOT
DOPAMINE
AGONIST AGENTS
amantadine hcl oral
capsule
1
amantadine hcl oral
solution
1
amantadine hcl oral
tablet
3
APOKYN
1
MIRAPEX
3
LODOSYN
1
this table.
94
Drug Name
/Limits
MIRAPEX ER
3
NEUPRO
3
pramipexole oral tablet
1
pramipexole oral tablet
0.375 mg, 0.75 mg, 1.5
mg, 3 mg, 4.5 mg
3
REQUIP
Drug Name
/Limits
ANTIPSYCHOTIC ATYPICAL
DOPAMINE-SERO
TONIN ANTAGBENZISOXAZOLE
DERIV
FANAPT
2
PA; ST
1
INVEGA
2
PA; ST
REQUIP XL
3
INVEGA SUSTENNA
2
ropinirole oral tablet
1
QL (234 MG
per 30 days)
ropinirole oral tablet
INVEGA TRINZA
3
3
paliperidone
1
PA
ANTIPSYCHOTIC ATYP
DOPAMINE-SERO
TONIN ANTAG
DIBENZO-OXEPIN
O PYRROLES
RISPERDAL CONSTA
2
QL (337.5 MG
per 30 days)
RISPERDAL M-TAB
ORAL
TABLET,DISINTEGR
ATING 3 MG, 4 MG
3
PA
SAPHRIS (BLACK
CHERRY)
SUBLINGUAL
TABLET 10 MG, 5 MG
RISPERDAL ORAL
TABLET 3 MG, 4 MG
3
PA
risperidone oral
solution
2
PA
risperidone oral tablet
0.25 mg, 0.5 mg, 1 mg, 3
mg, 4 mg
2
PA
risperidone oral
2
PA
clozapine oral tablet
2
PA
clozapine oral
tablet,disintegrating 100
mg, 12.5 mg, 25 mg
2
PA
FAZACLO ORAL
TABLET,DISINTEGR
ATING 150 MG, 200
MG
2
PA
SAPHRIS (BLACK
CHERRY)
SUBLINGUAL
TABLET 2.5 MG
2
3
PA; ST
PA; ST
DOPAMINE-SERO
TONIN ANTAGBENZISOTHIAZOL
ONES
GEODON
INTRAMUSCULAR
2
QL (40 MG per
1 day)
LATUDA
2
PA; ST
ziprasidone hcl
2
PA
DOPAMINE-SERO
TONIN
ANTAG-DIBENZO
DIAZEPINE DER
this table.
95
Drug Name
VERSACLOZ
/Limits
3
ANTIPSYCHOTIC BUTYROPHENON
E DERIVATIVES
Drug Name
/Limits
perphenazine
2
perphenazine (bulk)
3
trifluoperazine
1
ANTIPSYCHOTIC PHENOTHIAZINES
, PIPERIDINE
HALDOL
3
HALDOL
DECANOATE
3
thioridazine
1
haloperidol decanoate
1
thioridazine (bulk)
3
(bulk)
3
haloperidol lactate
injection
1
acepromazine maleate
(bulk)
haloperidol lactate oral
2
PA
haloperidol oral tablet
0.5 mg, 1 mg, 10 mg, 20
mg, 5 mg
2
PA
ANTIPSYCHOTIC DIBENZOXAZEPIN
E DERIVATIVES
ADASUVE
3
loxapine succinate
1
ANTIPSYCHOTIC DIPHENYLBUTYL
PIPERIDINE
DERIVATIVES
ORAP
1
pimozide
1
, ALIPHATIC
chlorpromazine
1
chlorpromazine (bulk)
1
, PIPERAZINE
fluphenazine decanoate
1
(bulk)
3
fluphenazine hcl
1
PA
3
ANTIPSYCHOTIC THIOXANTHENES
thiothixene
1
ANTIPSYCHOTIC
-ATYPICAL
DOPAMINE-SERO
TONIN
ANTAG-DIBENZO
THIAZEPINE DER
quetiapine oral tablet
100 mg, 25 mg, 300 mg,
400 mg, 50 mg
2
PA
SEROQUEL ORAL
TABLET 100 MG, 200
MG, 25 MG, 300 MG,
400 MG
3
PA
SEROQUEL ORAL
TABLET 50 MG
2
PA
SEROQUEL XR ORAL
TABLET EXTENDED
RELEASE 24 HR
2
PA
ANTIPSYCHOTIC
-ATYPICAL
DOPAMINE-SERO
TONIN
ANTAG-THIENOB
ENZODIAZEPINES
olanzapine
intramuscular
1
this table.
96
Drug Name
/Limits
olanzapine oral tablet
10 mg, 15 mg, 20 mg, 5
mg, 7.5 mg
2
PA
olanzapine oral
mg, 20 mg
2
PA
ZYPREXA
INTRAMUSCULAR
Drug Name
/Limits
ATTENTION
DEFICIT-HYPERA
CTIVITY (ADHD)
THERAPY,
STIMULANT-TYPE
ADDERALL
2
PA
3
ADDERALL XR
2
PA
ZYPREXA ORAL
TABLET 10 MG, 15
MG, 20 MG, 5 MG, 7.5
MG
3
PA
AMPHETAMINE
SALT COMBO ORAL
TABLET 10 MG, 12.5
MG, 20 MG, 30 MG, 5
MG, 7.5 MG
2
PA
ZYPREXA
RELPREVV
2
QL (600 MG
per 30 days)
CONCERTA
3
ZYPREXA ZYDIS
3
PA
DESOXYN
3
DEXEDRINE
SPANSULE
3
dexmethylphenidate
2
PA
dextroamphetamine oral
capsule, extended
release
2
PA
tablet
2
PA
2
PA
3
PA
ANTIPSYCHOTICATYPICAL,D2
RECEPTOR
PARTIAL
AGONIST-5HT
SEROTONIN
MIXED
ABILIFY MAINTENA
2
QL (400 MG
per 30 days)
ABILIFY ORAL
TABLET
3
PA
aripiprazole
2
PA
ARISTADA
1
dextroamphetamine-am
phetamine oral
capsule,extended
release 24hr 10 mg, 15
mg, 20 mg, 25 mg, 30
mg
REXULTI
3
EVEKEO
FOCALIN XR
ATTENTION
DEFICIT-HYPERA
CT. DISORDER
(ADHD)- ALPHA-2
RECEPTOR
AGONIST
clonidine hcl oral tablet
2
PA
guanfacine oral tablet
2
ST
INTUNIV ER
3
PA
KAPVAY
2
PA
NF
METADATE CD
3
METADATE ER
3
methamphetamine
1
methylphenidate
2
PA
methylphenidate oral
capsule, er biphasic
30-70 10 mg, 50 mg, 60
mg
2
PA
capsule,er biphasic
50-50
2
PA
this table.
97
Drug Name
/Limits
tablet 5 mg
2
2
PA
24hr
2
PA
QUILLIVANT XR
3
RITALIN LA ORAL
CAPSULE,ER
BIPHASIC 50-50 60
MG
VYVANSE
ZENZEDI
2
3
PA
PA
PA; QL (30 EA
per 30 days)
3
ATTENTION
DEFICIT-HYPERA
CTIVITY
DISORDER (ADHD)
THERAPY,
NRI-TYPE
STRATTERA
2
BIPOLAR
THERAPY
AGENTS ANTICONVULSAN
T TYPE
carbamazepine oral
capsule, er multiphase
12 hr
3
carbamazepine oral
1
carbamazepine oral
tablet
1
carbamazepine oral
12 hr
1
carbamazepine oral
tablet,chewable
1
CARBATROL
3
DEPAKENE
3
PA; ST
Drug Name
/Limits
DEPAKOTE
3
DEPAKOTE ER
3
DEPAKOTE
SPRINKLES
3
divalproex
1
EPITOL
1
EQUETRO
3
LAMICTAL ODT
3
LAMICTAL ODT
STARTER (BLUE)
3
LAMICTAL ODT
STARTER (GREEN)
3
LAMICTAL ODT
STARTER (ORANGE)
1
LAMICTAL STARTER
(BLUE) KIT
3
LAMICTAL STARTER
(GREEN) KIT
3
LAMICTAL STARTER
(ORANGE) KIT
3
lamotrigine oral
1
lamotrigine oral
tablets,dose pack 25 mg
(35)
3
TEGRETOL ORAL
SUSPENSION
3
TEGRETOL ORAL
TABLET
3
TEGRETOL XR ORAL
TABLET EXTENDED
RELEASE 12 HR 200
MG, 400 MG
3
valproic acid
1
valproic acid (as sodium
salt) oral solution 250
mg/5 ml, 500 mg/10 ml
(10 ml)
1
this table.
98
Drug Name
/Limits
BIPOLAR
THERAPY
AGENTS ATYPICAL
ANTIPSYCHOTICS
ABILIFY ORAL
TABLET
3
PA
aripiprazole
2
PA
GEODON
INTRAMUSCULAR
2
QL (40 MG per
1 day)
olanzapine
intramuscular
1
olanzapine oral tablet
2
PA
olanzapine oral
mg, 20 mg
2
PA
quetiapine oral tablet
100 mg, 25 mg, 300 mg,
400 mg, 50 mg
2
PA
Drug Name
/Limits
SEROQUEL XR ORAL
TABLET EXTENDED
RELEASE 24 HR
2
PA
ziprasidone hcl
2
PA
ZYPREXA
INTRAMUSCULAR
3
ZYPREXA ORAL
TABLET 10 MG, 15
MG, 20 MG, 5 MG, 7.5
MG
3
PA
ZYPREXA ZYDIS
3
PA
BIPOLAR
THERAPY
AGENTS LITHIUM
lithium carbonate
1
lithium carbonate (bulk)
1
lithium citrate oral
solution 8 meq/5 ml
1
lithium citrate
tetrahyd(bulk)
3
LITHOBID
3
RISPERDAL M-TAB
ORAL
TABLET,DISINTEGR
ATING 3 MG, 4 MG
3
RISPERDAL ORAL
TABLET 3 MG, 4 MG
3
PA
risperidone oral
solution
CNS STIMULANT AMPHETAMINE
COMBINATIONS
2
PA
ADDERALL
2
PA
ADDERALL XR
2
PA
PA
risperidone oral tablet
0.25 mg, 0.5 mg, 1 mg, 3
mg, 4 mg
2
PA
AMPHETAMINE
SALT COMBO
2
PA
risperidone oral
2
PA
dextroamphetamine-am
phetamine oral
capsule,extended
release 24hr 10 mg, 15
mg, 20 mg, 25 mg, 30
mg
2
PA
SAPHRIS (BLACK
CHERRY)
SUBLINGUAL
TABLET 10 MG, 5 MG
2
SAPHRIS (BLACK
CHERRY)
SUBLINGUAL
TABLET 2.5 MG
3
SEROQUEL
3
PA; ST
PA; ST
PA
CNS STIMULANT AMPHETAMINES
DESOXYN
3
DEXEDRINE
SPANSULE
3
this table.
99
Drug Name
/Limits
Drug Name
capsule, extended
release
2
PA
FIBROMYALGIA
AGENTS - GABA
ANALOGS
tablet
2
PA
LYRICA
EVEKEO
3
PA
methamphetamine
1
PROCENTRA
2
ZENZEDI
3
CNS STIMULANT ANALEPTICS
PA
2
PA
CYMBALTA
3
PA
duloxetine oral
capsule,delayed
release(dr/ec) 20 mg, 30
mg, 60 mg
1
SAVELLA ORAL
TABLET
1
SAVELLA ORAL
TABLETS,DOSE
PACK
3
FIBROMYALGIA
AGENTS SEROTONIN-NOR
EPINEPHRINE
REUPTAKE-INHIB
(SNRIS)
ALERTNESS AID
1
CAFCIT
INTRAVENOUS
4
caffeine
1
caffeine (bulk)
1
caffeine citrated
intravenous
4
caffeine citrated oral
3
caffeine-sodium
benzoate
1
DOPRAM
4
doxapram
1
HSDD
AGENTS-MIXED
SEROTONIN
AGONIST/ANTAG
ONISTS
NO DOZ
1
ADDYI
STAY AWAKE
1
STAY AWAKE
MAXIMUM
STRENGTH
1
HYPNOTICS MELATONIN SINGLE AGENTS
VIVARIN
1
CNS STIMULANT
OTHERS
ammonia aromatic
inhalation solution
1
ammonia aromatic
inhalation spirit
3
meclofenoxate hcl (bulk)
3
/Limits
NC
MELADOX
3
MELATIN
3
melatonin (bulk)
3
melatonin oral
3
tablet 1 mg, 5 mg
3
3
this table.
100
Drug Name
/Limits
HYPNOTICS MELATONIN
COMBINATIONS
3
ESTROVEN
NIGHTTIME
(VALE-MELA)
3
MEDI-DOZE
3
MELATONEX
3
MELATONIN (WITH
B6)
3
melatonin-chamomile
flower
3
(vit b6) oral tablet 3-2
mg
3
hcl (b6)
3
MIDNITE
3
MIDNITE FOR
MENOPAUSE
3
MIDNITE PM
3
RESTONE
3
SINTRALYNE-PM
3
SLEEP CAPS
3
SOMNICIN
3
TOPROPHAN
1
WRESTONE
3
isomethepten-caf-aceta
minophen oral tablet
65-20-325 mg
PRODRIN ORAL
TABLET 65-20-325
MG
3
isometh-dichloral-aceta
minophn
NF
NODOLOR
NF
MIGRAINE
THERAPY CARBOXYLIC
ACID
DERIVATIVES
DEPAKOTE ER
3
divalproex oral tablet
1
MIGRAINE
THERAPY ERGOT
ALKALOIDS AND
DERIVATIVES
3
3
NF
MIGRAINE
THERAPY ANALGESIC-VASO
CONSTRICTOR-SE
DATIVE
COMBINATIONS
HYPNOTICS MELATONIN
M1/M2 RECEPTOR
AGONISTS
ROZEREM
/Limits
MIGRAINE
THERAPY ANALGESIC-VASO
CONSTRICTORS
ESTROVEN
NIGHTTIME
(CAL-MELTN)
HETLIOZ
Drug Name
PA; QL (15 EA
per 30 days)
D.H.E.45
3
dihydroergotamine
injection
3
dihydroergotamine
nasal
2
ERGOMAR
1
methysergide (bulk)
3
MIGRANAL
3
PA
this table.
101
Drug Name
/Limits
MIGRAINE
THERAPY ERGOT
COMBINATIONS
Drug Name
/Limits
sumatriptan succinate
subcutaneous syringe 6
mg/0.5 ml
1
SUMAVEL DOSEPRO
3
CAFERGOT
1
zolmitriptan (bulk)
3
MIGERGOT
1
zolmitriptan oral tablet
1
zolmitriptan oral
3
ZOMIG NASAL
3
ZOMIG ORAL
3
ZOMIG ZMT
3
MIGRAINE
THERAPY - NSAID
ANALGESICS(CYC
LOOXYGENASE
INHIB-NON-SELEC
TIV)
CAMBIA
MIGRAINE
THERAPY SEROTONIN
AGONIST 5-HT(1)
AND NSAID COMB.
3
MIGRAINE
THERAPY SELECTIVE
SEROTONIN
AGONISTS 5-HT(1)
TREXIMET
almotriptan malate
1
ALSUMA
3
AMERGE
3
AXERT
1
FROVA
2
IMITREX STATDOSE
KIT REFILL
3
IMITREX STATDOSE
PEN
3
MAXALT
PA
3
MIGRAINE
THERAPY SYMPATHOMIME
TICS
PA
isometheptene mucate
(bulk)
3
ST
MOVEMENT
DISORDER
THERAPY HUNTINGTON'S
DISEASE
MAXALT-MLT
3
ST
2
PA
naratriptan
1
tetrabenazine oral tablet
12.5 mg
RELPAX
2
PA
tetrabenazine oral tablet
25 mg
3
PA
rizatriptan
2
ST
sumatriptan (bulk)
3
XENAZINE ORAL
TABLET 12.5 MG
3
PA
(bulk)
3
XENAZINE ORAL
TABLET 25 MG
2
PA
subcutaneous cartridge
1
3
subcutaneous pen
1
injector
this table.
102
Drug Name
/Limits
MOVEMENT
DISORDER
THERAPY RESTLESS LEGS
SYNDROME
HORIZANT
2
PA
NARCOLEPSY &
CATAPLEXY
THERAPY
AGENTS SEDATIVE-TYPE
XYREM
3
NARCOLEPSY
THERAPY
AGENTS NON-SYMPATHO
MIMETIC
Drug Name
/Limits
AMPHETAMINE
SALT COMBO ORAL
TABLET 10 MG, 12.5
MG, 20 MG, 30 MG, 5
MG, 7.5 MG
2
DEXEDRINE
SPANSULE
3
capsule, extended
release
2
PA
tablet
2
PA
EVEKEO
3
PA
ZENZEDI
3
POSTHERPETIC
NEURALGIA
AGENTS
modafinil
1
GRALISE
3
NUVIGIL
3
3
PROVIGIL
3
GRALISE 30-DAY
STARTER PACK
PSEUDOBULBAR
AFFECT (PBA)
AGENTS, NMDA
ANTAGONISTS
TYPE
NARCOLEPSY
THERAPY
AGENTS STIMULANT-TYPE
, PIPERADINE
DERIVATIVE
NUEDEXTA
methylphenidate
2
PA
tablet 5 mg
2
PA
NARCOLEPSY
THERAPY
AGENTSSTIMULANT-TYPE
,SYMPATHOMIME
TIC,AMPHETAMI
NES
ADDERALL
PA
2
PA
2
PA
SEDATIVE-HYPNO
TIC ANTIHISTAMINES
ALKA-SELTZER
PLUS ALLERGY
1
COMPOZ
1
diphenhydramine hcl
oral capsule
1
diphenhydramine hcl
oral tablet 25 mg
1
NIGHTIME SLEEP
1
NIGHTTIME SLEEP
AID (DIPHEN)
1
ORMIR
1
this table.
103
Drug Name
/Limits
REST SIMPLY
NIGHTTIME SLEEP
1
RESTFULLY SLEEP
1
SLEEP
Drug Name
/Limits
WAL-SLEEP Z ORAL
TABLET,DISINTEGR
ATING
3
1
SLEEP AID
(DIPHENHYDRAMIN
E) ORAL CAPSULE 25
MG
WAL-SOM
(DIPHENHYDRAMIN
E) ORAL CAPSULE
1
3
SLEEP AID
(DIPHENHYDRAMIN
E) ORAL CAPSULE 50
MG
3
1
WAL-SOM
(DIPHENHYDRAMIN
E) ORAL
TABLET,DISINTEGR
ATING
3
SLEEP AID
(DIPHENHYDRAMIN
E) ORAL LIQUID
WAL-SOM
(DOXYLAMINE)
1
Z-SLEEP
3
3
SLEEP AID
(DIPHENHYDRAMIN
E) ORAL TABLET
ZZZQUIL ORAL
CAPSULE
1
ZZZQUIL ORAL
LIQUID
1
SLEEP AID
(DOXYLAMINE)
1
SLEEP AID MAX STR
(DIPHENHYDR)
1
SLEEP II
SEDATIVE-HYPNO
TIC BARBITURATES
AMYTAL
1
1
SLEEP TABLET
(DIPHENHYDRAMIN
E)
BUTISOL ORAL
TABLET 30 MG
3
1
NEMBUTAL SODIUM
1
SLEEP TIME
1
pentobarbital sodium
(bulk)
3
SLEEP-TABS
1
phenobarbital
1
ULTRA SLEEP
(DOXYLAMINE
SUCC)
1
phenobarbital sodium
injection solution
1
UNISOM
(DOXYLAMINE)
SECONAL SODIUM
3
1
UNISOM SLEEPGELS
1
UNISOM
SLEEPMELTS
3
WAL-SLEEP Z ORAL
CAPSULE
3
WAL-SLEEP Z ORAL
LIQUID
1
SEDATIVE-HYPNO
TIC BENZODIAZEPINE
S
ATIVAN INJECTION
3
estazolam
3
PA
flurazepam
2
PA
HALCION ORAL
TABLET 0.25 MG
3
PA
this table.
104
Drug Name
/Limits
lorazepam injection
solution
3
lorazepam injection
syringe
1
midazolam (bulk)
3
midazolam oral syrup 2
mg/ml
3
RESTORIL ORAL
CAPSULE 15 MG, 22.5
MG, 30 MG
3
RESTORIL ORAL
CAPSULE 7.5 MG
Drug Name
/Limits
SEDATIVE-HYPNO
TIC - SELECTIVE
ALPHA2-ADRENO
RECEPTOR
AGONISTS
dexmedetomidine
4
PRECEDEX
4
PA
PRECEDEX IN 0.9 %
SODIUM CHLOR
4
2
PA
temazepam
2
PA
SEDATIVE-HYPNO
TIC - TRICYCLIC
ANTIDEPRESSANT
TYPE
triazolam
2
PA
SILENOR
SEDATIVE-HYPNO
TIC GABA-RECEPTOR
MODULATORS
3
CHEMICAL
DEPENDENCY,
AGENTS TO
TREAT
AMBIEN
3
PA
AMBIEN CR
3
PA
EDLUAR
3
PA
AGENTS FOR
NARCOTIC
WITHDRAWAL
eszopiclone
2
PA
BUNAVAIL
1
INTERMEZZO
3
PA
LUNESTA
3
PA
buprenorphine hcl
sublingual
1
zaleplon
2
PA
2
PA
zolpidem oral tablet
2
PA
buprenorphine-naloxon
e
zolpidem oral tablet,ext
release multiphase
3
PA
SUBOXONE
SUBLINGUAL FILM
2
PA; QL (3 EA
per 30 days)
ZOLPIMIST
3
PA
ZUBSOLV
SUBLINGUAL
TABLET 1.4-0.36 MG,
5.7-1.4 MG, 8.6-2.1 MG
1
SEDATIVE-HYPNO
TIC - OREXIN
RECEPTOR
ANTAGONIST
BELSOMRA
3
SEDATIVE-HYPNO
TIC - OTHERS
dichloralphenazone
(bulk)
3
PA
ALCOHOL
ABSTINENCE
THERAPY GLUTAMATE AND
GABA SYSTEM
TYPE
acamprosate
1
this table.
105
Drug Name
/Limits
ALCOHOL
ABSTINENCE
THERAPY OPIOID
RECEPTOR
ANTAGONIST-TYP
E
VIVITROL
2
ALCOHOL
DETERRENTS
PA
Drug Name
/Limits
NICOTINE
TARTRATE
3
nicotine transdermal
patch 24 hour 14 mg/24
hr, 21 mg/24 hr, 7
mg/24 hr
1
nicotine transdermal
patch, td daily,
sequential
3
NICOTROL
1
ANTABUSE
1
NICOTROL NS
1
disulfiram
1
NTS STEP 1
1
disulfiram (bulk)
3
QUIT 2
1
QUIT 4
1
STOP SMOKING AID
1
SMOKING
DETERRENTS - NE
& DOPAMINE
REUPTAKE
INHIBITOR
(NDRI)-TYPE
BUPROBAN
1
bupropion hcl oral
150 mg
1
ZYBAN
3
SMOKING
DETERRENTS NICOTINE-TYPE
SMOKING
DETERRENTS NICOTINIC
RECEPTOR
PARTIAL
AGONIST,
ALPHA4BETA2
CHANTIX
1
CHANTIX
CONTINUING
MONTH BOX
1
CHANTIX STARTING
MONTH BOX
1
NICODERM CQ
1
NICORELIEF
BUCCAL GUM
1
NICORETTE
1
nicotine (polacrilex)
buccal gum
1
BULK
CHEMICALS
buccal lozenge 2 mg
3
(d)-limonene flavor
(bulk)
1
buccal lozenge 4 mg
1
1,2-pentanediol (bulk)
3
1,3-butanediol (bulk)
3
nicotine polacrilex
(bulk)
3
1,4-benzoquinone (bulk)
3
1ST BASE
3
CHEMICALS-PH
ARMACEUTICA
L ADJUVANTS
this table.
106
Drug Name
/Limits
Drug Name
/Limits
2-deoxy-d-glucose
(bulk)
3
adenosine phosphate
(bulk)
3
2-methoxyestradiol
(bulk)
3
ADENOSYLCOBALA
MIN
3
2-methoxyethanol (bulk)
3
alanine (bulk)
3
3,4-diaminopyridine
(bulk)
3
ALBA-DERM
3
albendazole (bulk)
3
3,5-diiodothyronine
(bulk)
3
albumin, bovine (bulk)
3
5-AMINOSALICYLIC
ACID
albuterol sulfate (bulk)
1
1
3
5-HYDROXY-L-TRYP
TOPHAN
aldosterone (bulk)
powder 95 %
1
ALFALFA FLAVOR
3
7-KETO DHEA
3
alginic acid (bulk)
1
7-KETO DHEA,
MICRONIZED
1
alkyl (c12-15) benzoate
(bulk)
1
acacia (bulk)
1
3
acebutolol (bulk)
1
alkyl acrylate crosspol
(bulk)
acepromazine maleate
(bulk)
allantoin (bulk)
1
3
allopurinol (bulk)
3
acesulfame potassium
(bulk)
almond oil, sweet (bulk)
3
3
aloe vera (bulk) oil
3
acetaminophen (bulk)
1
aloe vera (bulk) powder
1
acetarsol (bulk)
3
3
acetazolamide (bulk)
1
aloe vera leaf gel xtr
(bulk)
acetic acid (bulk) liquid
100 %, 3 %, 5 %
ALPAWASH
3
3
alpha lipoic acid (bulk)
1
acetyl hexapeptide-8
(bulk)
3
alpha pinene (bulk)
3
acetylcarnitine (bulk)
3
alpha-ketoglutaric acid
(bulk)
3
acetylcholine chloride
(bulk)
1
alprazolam (bulk)
1
alprostadil (bulk)
3
1
alum, ammonium (bulk)
1
ACETYL-L-CARNITI
NE
3
aluminum acetate (bulk)
3
acyclovir (bulk)
1
aluminum chloride
(bulk)
1
adenos triph disod tri
(bulk)
3
aluminum chlorohydrate
(bulk)
3
adenosine (bulk)
1
this table.
107
Drug Name
/Limits
aluminum hydroxide gel
(bulk)
3
aluminum silicate mag
(bulk)
3
aluminum sulfate (bulk)
3
aluminum,
(acetato-o)dih(bulk)
Drug Name
/Limits
amoxicillin (bulk)
3
amphotericin b (bulk)
3
anastrozole (bulk)
3
androstenedione (bulk)
3
ANHYDROUS BASE
3
1
ANHYDROUS GEL
3
amantadine hcl (bulk)
1
3
american ginseng root
(bulk)
ANHYDROUS
OINTMENT
3
1
amikacin (bulk)
3
anise flavor extract
(bulk)
amikacin sulfate (bulk)
3
anisindione (bulk)
3
aminobenzoic acid
(bulk)
anthralin (bulk)
1
1
3
aminocaproic acid
(bulk)
antimony trichloride
(bulk)
3
3
aminolevulinic acid hcl
(bulk)
antimony trisulfide
(bulk)
3
antipyrine (bulk)
3
aminophylline (bulk)
1
apomorphine (bulk)
3
aminosalicylate sodium
(bulk)
3
APOTHEDERM
TRANSDERMAL
3
aminosalicylic acid
(bulk)
APOTHESIL BASE
3
1
1
AMINOSALICYLIC
ACID-5
apple flavor (bulk)
liquid
1
3
amitriptyline (bulk)
1
apple flavor (bulk)
powder
amlodipine besylate
(bulk)
APPLE FLAVORING
3
3
APPLE-ADE FLAVOR
1
ammonia sol, strong
(bulk)
3
apricot flavor (bulk)
liquid
1
ammonium bromide
(bulk)
3
powder
3
ammonium chloride
(bulk)
1
ARBEM
H-COSMETIC
3
ammonium lactate
(bulk)
3
ARBEM LIPOPEN
3
ammonium lauryl
sulfate (bulk)
3
3
arginine (l-arginine)
(bulk) crystals
ammonium sulfate
(bulk)
1
1
(bulk) powder
this table.
108
Drug Name
/Limits
arginine
hcl(l-arginine)(bulk)
1
ARLACEL 165
3
arnica flower (bulk)
3
aromatic cascara fld xt
(bulk)
3
arsenic trioxide (bulk)
Drug Name
/Limits
azathioprine (bulk)
3
azelaic acid (bulk)
flakes 100 %, 88 %
3
azelaic acid (bulk)
powder 100 %
3
azelastine (bulk)
3
3
azithromycin (bulk)
3
asafetida
3
3
ascorbate calcium
(bulk)
bacitracin (bulk)
powder 65 unit/mg
3
3
ascorbate sodium (bulk)
powder
bacitracin zn
micronized(bulk)
3
3
ascorbic acid (bulk)
granules
(bulk) powder 100 %
3
powder
1
1
(bulk) powder 75.7
unit/mg
ascorbyl palmitate
(bulk)
baclofen (bulk)
1
3
balsam peru (bulk)
1
ashwagandha root
extract(bulk)
3
BANANA
CONCENTRATE
1
asparagine
monohydrate (bulk)
3
BANANA CREAM
FLAVOR
1
aspartame
3
1
aspartic acid (bulk)
3
banana creme flavor
(bulk)
aspirin (bulk)
3
banana flavor (bulk)
1
astragalus root (bulk)
3
barium sulfate (bulk)
1
astragalus root extract
(bulk)
BASE 7542
3
3
3
atenolol (bulk)
3
BASE LECITHIN
ISOPROPYL PALMIT
atropine (bulk) powder
1
BASE W301
1
attapulgite
3
BASE X
1
AUXIPRO
EMOLLIENT
3
BASE, CUSTOM
POLYGLYCOL
3
AUXIPRO
PLASTICIZED
BASE, PCCA ACACIA
3
3
3
AUXIPRO
VANISHING CREAM
BASE, PCCA BITTER
DRUG
3
3
avocado oil (bulk)
3
BASE, PCCA COBASE
#1
AZ
1
BASE, PCCA DMAE
COMPLEX
3
this table.
109
Drug Name
/Limits
BASE, PCCA
EMULSIFIX-205
3
BASE, PCCA FIXED
OIL SUSP
3
BASE, PCCA
LOXASPERSE
Drug Name
/Limits
belladonna tincture
(bulk)
1
benactyzine hcl (bulk)
3
benazepril hcl (bulk)
3
3
benzalkonium chloride
solution 50 %
1
BASE, PCCA
LOXORAL
3
benzethonium chloride
1
BASE, PCCA
MUCOLOX
benzocaine (bulk)
3
3
3
BASE, PCCA
OCCLUSADERM
benzocaine micronized
(bulk)
3
benzoic acid
1
BASE, PCCA
PLASTICIZED
benzoin (bulk)
1
3
1
BASE, PCCA
POLOXAMER 407
benzoin compound
(bulk)
3
benzoin gum (bulk)
3
BASE, PCCA
POLYPEG
1
benzoyl peroxide (bulk)
1
benzyl alcohol
3
BASE, PCCA
PRACAMAC OIL
3
benzyl benzoate (bulk)
3
BASE, PCCA RAPID
DISSOLVE
bergamot (bulk)
3
3
beta 1,3 glucan (bulk)
3
BASE, PCCA
SPIRA-WASH
beta carotene (bulk)
3
3
betadex (bulk)
3
BASE, PCCA
SUSPENDALL
3
beta-glucan,1-3, 1-4
(bulk)
3
betahistine (bulk)
3
betaine (bulk)
3
betaine hcl (bulk)
3
BASE, PCCA
VANISHING
CRM-LOT
3
BASE, PCCA
VANPEN
1
3
BASE, PCCA
VERSABASE
betamethasone
acet,micro(bulk)
3
3
BASE, PCCA
XYLIFOS
betamethasone
dipropion (bulk)
3
1
BASE-I SORBITAN
MONOPALMITATE
betamethasone sod phos
(bulk)
3
1
beclomethasone diprop
(bulk)
betamethasone valerate
(bulk)
3
betanaphthol (bulk)
3
3
bethanechol chloride
(bulk)
1
belladonna alk leaf ext
(bulk)
this table.
110
Drug Name
/Limits
BHRT BASE
3
bioflavonoid, lemon
(bulk)
3
bioflavonoids, citrus
(bulk) powder 100 %
1
(bulk) powder 13 %
3
BIOPEPTIDE
BIOCOSMETIC BASE
3
biotin (bulk) powder
100 %
Drug Name
/Limits
boric acid (bulk)
powder
1
boron (bulk)
3
boron citrate (bulk)
3
boswellia serrata xt
(bulk)
3
BRIJ 35 WAX
3
BRIJ 700
3
BRIJ 93
3
1
brilliant green (bulk)
3
bisabolol (bulk)
3
3
bisacodyl
3
brimonidine tartrate
(bulk)
bismuth citrate
1
BROMELAIN
3
bismuth subcarbonate
(bulk)
1
bromelains (bulk)
powder 1,200 unit/gram
3
bismuth subgallate
(bulk)
bromhexine
3
3
bromocriptine (bulk)
1
bismuth subnitrate
(bulk)
1
brompheniramine
maleate (bulk)
1
bismuth subsalicylate
(bulk)
3
BUBBLE GUM
CONCENTRATE
1
bitter almond oil (bulk)
1
bubblegum flavor (bulk)
1
bitter mask flavoring
(bulk)
1
budesonide, micronized
(bulk)
1
bitter melon extract
(bulk)
BUFFER CREAM
3
3
buflomedil (bulk)
3
BITTERNESS MASK
FLAVOR
1
bupivacaine (bulk)
1
black food color (bulk)
3
buprenorphine hcl
(bulk)
1
blackberry flavor (bulk)
1
bupropion (bulk)
3
blue agave extract
(bulk)
3
buspirone (bulk)
3
butalbital (bulk)
1
blue food color (bulk)
3
(bulk)
3
butter flavor (bulk)
1
blue royal (food color)
(bulk)
3
BLUEBERRY
FLAVOR
1
butter rum flavor (bulk)
1
boric acid
1
BUTTER RUM
FLAVORING
3
this table.
111
Drug Name
/Limits
Drug Name
/Limits
butterscotch flavor
(bulk)
1
calcium phos, tribasic
(bulk)
1
BUTTERSCOTCH
FLAVORING
1
calcium phosphate
(bulk)
1
butyl alcohol (bulk)
3
calcium pyruvate (bulk)
3
butylated
hydroxyanisole(bulk)
3
CALCIUM
SACCHARATE
3
butylparaben (bulk)
3
calcium sulfate
3
caffeine (bulk)
1
CAMPHOR BLOCKS
3
caffeine citrated
1
camphor crystals
3
calamine (bulk)
3
CANADA BALSAM
3
calc thioglycol trihydr
(bulk)
3
cantharidin (bulk)
3
calcipotriene (bulk)
3
caprylic-capric trigly
(bulk)
3
CALCIPOTRIOL
(BULK)
3
capsaicin
3
calcitriol (bulk)
3
capsaicin palmitate
(bulk)
3
calcitriol-almond oil
(bulk)
3
capsicum oleoresin
(bulk)
3
calcium acetate
3
captopril (bulk)
3
calcium alginate (bulk)
3
caramel flavor (bulk)
1
calcium carbonate
(bulk)
3
carbachol (bulk)
3
carbamazepine (bulk)
1
calcium chloride
3
calcium chloride (bulk)
3
carbamide peroxide
(bulk)
3
calcium citrate (bulk)
3
carbazochrome (bulk)
3
calcium glubionate
(bulk)
3
carbidopa (bulk)
1
carbimazole (bulk)
3
calcium glucon
monohyd (bulk)
1
CARBOGEL
3
calcium gluconate
(bulk)
CARBOHOL
3
3
carbomer 934 (bulk)
3
calcium hydroxide
(bulk)
carbomer 940 (bulk)
3
3
3
calcium lactate (bulk)
3
CARBOMER
GEL-AQUEOUS
calcium levulinate dihy
(bulk)
3
3
calcium pantothenate
3
CARBOMER
GEL-HYDROALCOH
OLIC
carbomer homopolymer
c (bulk)
3
this table.
112
Drug Name
carboxymethyl sod, low
(bulk)
/Limits
3
Drug Name
/Limits
chlorhexidine (bulk)
1
chlorhexidine acetate
(bulk)
3
1
3
carboxymethylcellulose
sodium
1
cardamom oil (bulk)
3
carisoprodol (bulk)
3
chloroallyl methenam cl
(bulk)
carnauba wax
3
chlorobutanol
1
carnosine (bulk)
3
3
carrageenan (bulk)
3
chlorophyllin copper
com(bulk)
ceftazidime (bulk)
3
chloroquine phosphate
1
ceftriaxone
3
chloroxine (bulk)
3
CELA CREAM BASE
3
chloroxylenol (bulk)
3
celecoxib (bulk)
3
3
celery seed oil (bulk)
3
chlorpheniramine
maleate
cellulase (bulk) powder
5,000 unit/gram
chlorpromazine (bulk)
1
3
1
cellulose (bulk) powder
100 %
chocolate flavor (bulk)
liquid
3
3
ceresin (bulk)
3
powder
cesium chloride (bulk)
3
chocolate hazelnut flav
(bulk)
1
ceto.alcohol-ceteareth2
0(bulk)
3
cholecalciferol (vit
d3)(bulk)
3
cetyl alcohol (bulk)
3
cetyl esters (bulk)
3
cholecalciferol (vitamin
d3)
3
cetyl myristoleate (bulk)
3
cholesterol (bulk)
3
cetylpyridinium chloride
3
cholestyramine (bulk)
1
chamomile flower (bulk)
3
3
cheesecake flavor (bulk)
1
cholin and mg
salicylate(bulk)
cherry flavor oral
1
choline bitartrate (bulk)
3
cherry-ade flavor (bulk)
3
choline chloride (bulk)
3
CHEW-HESIVE
3
3
chinese red pine bk ext
(bulk)
chondroitin sulf a sod
(bulk)
3
3
chloral hydrate (bulk)
1
CHONDROITIN
SULFATE
chlorambucil
3
chor gonadotropin, hum
(bulk)
3
chloramphenicol (bulk)
1
chromium picolinate
(bulk)
3
chloramphenicol
palmitate
3
this table.
113
Drug Name
/Limits
chromium
polynicotinate (bulk)
3
chromium pot sul
dodeca (bulk)
3
CHRYSADERM DAY
CREAM
3
CHRYSADERM
NIGHT CREAM
3
chrysin
Drug Name
/Limits
clomipramine (bulk)
3
clonazepam (bulk)
3
clonidine hcl (bulk)
1
clotrimazole (bulk)
1
CLOVE FLAVORING
3
coal tar (crude) tar
1
cobalt gluconate
3
3
cobamamide (bulk)
3
chymotrypsin
3
cocaine (bulk)
3
ciclopirox olamine
1
1
cidofovir (bulk)
3
cocoa butter (bulk)
topical ointment
cimetidine (bulk)
3
3
cinnamon bark (bulk)
3
coconut diethanolamide
(bulk)
CINNAMON
FLAVORING
coconut flavor (bulk)
1
3
coconut oil (bulk)
3
ciprofloxacin (bulk)
3
cod liver oil (bulk)
1
citric acid (bulk)
3
1
citric acid anhydrous
(bulk)
codeine phosphate
(bulk)
1
coenzyme q10 (bulk)
1
citric acid monohydrate
(bulk)
coffee flavor (bulk)
1
3
cola flavor (bulk)
1
citrulline
1
colchicine
1
clarithromycin (bulk)
3
3
clemastine
3
colistimethate sodium
(bulk)
clemizole hcl (bulk)
3
colistin sulfate (bulk)
1
clidinium bromide
(bulk)
3
collagen, hydr (bovine)
(bulk)
3
clindamycin hcl (bulk)
powder
1
collagenase clos hist.
(bulk)
3
1
collodion (bulk)
1
(bulk)
COPASIL
3
1
copper gluconate (bulk)
3
clioquinol
1
copper glycinate (bulk)
3
clobetasol propionate
(bulk)
3
COPPER SULFATE
3
CORAL CALCIUM
3
clofazimine (bulk)
3
corn oil
3
clomiphene citrate
(bulk)
1
corn starch (bulk)
1
corticotropin
1
this table.
114
Drug Name
/Limits
cortisone (bulk)
1
cotton candy flavor
(bulk)
1
cottonseed oil (bulk)
3
coumarin
3
cranberry extract (bulk)
3
cran-raspberry flavor
(bulk)
1
cream base no.43 (bulk)
Drug Name
/Limits
cyproheptadine (bulk)
3
cysteamine hcl (bulk)
3
cysteine (l-cysteine)
3
(bulk)
3
cysteine
hcl(l-cysteine)(bulk)
3
3
3
d and c green no.6
(bulk)
3
dalfampridine (bulk)
1
1
danazol
3
cream de menthe (bulk)
1
dantrolene (bulk)
3
creatine (bulk)
3
dapiprazole (bulk)
3
(bulk)
dapsone (bulk)
3
3
deanol (bulk)
3
creatinine (bulk)
3
deanol bitartrate (bulk)
3
cromolyn
1
1
crotamiton (bulk)
3
DEHYDROEPIANDR
OSTERONE (MICRO)
croton oil (bulk)
3
3
cupric sulfate pentahyd
(bulk) powder
demecarium bromide
(bulk)
3
DENTAL BASE
3
CURCUMIN
3
deoxycholic acid (bulk)
3
CUSTOM BASE PCCA
LIPODERM
DERMACINRX TSS
3
3
DERMA-N
3
CUTIS PLUS
3
desipramine
3
cyanocobalamin
(vitamin b-12) powder
1
desmopressin
1
desonide (bulk)
3
cyclandelate
3
cyclobenzaprine (bulk)
powder
1
1
desoximetasone, micro
(bulk)
CYCLODEXTRIN
REAGENT
3
3
desoxycorticosterone ac
(bulk)
CYCLOMETHICONE
3
devil's claw extract
(bulk)
3
cyclopentolate (bulk)
3
1
cyclophosphamide
(bulk)
dexamethasone ac,
micro (bulk)
3
1
cycloserine (bulk)
3
dexamethasone acetate
(bulk)
cyclosporine
1
dexamethasone isonic
(bulk)
3
this table.
115
Drug Name
/Limits
Drug Name
/Limits
dexamethasone sod
phos (bulk)
1
DIMERCAPTOPROPA
NESULFONATE SOD
3
dexamethasone,microniz
ed(bulk)
1
dimethyl fumarate
(bulk)
3
dexpanthenol (bulk)
3
1
dextromethorphan hbr
(bulk) crystals
dimethyl sulfoxide
(bulk) liquid 99 %
3
3
dextromethorphan hbr
(bulk) powder
dimethyl sulfoxide
(bulk) liquid 99.99 %
1
3
dextrose (bulk)
3
dimethylacetamide
(bulk)
diazepam (bulk)
3
3
diazoxide (bulk)
3
dimethylglycine hcl
(bulk)
dibucaine hcl (bulk)
1
dinitrochlorobenzene
(bulk)
1
dichloracetic acid (bulk)
3
diosgenin (bulk)
3
dichloralphenazone
(bulk)
3
diosmin (bulk)
3
diclofenac sodium
(bulk)
dioxybenzone (bulk)
3
3
1
dicumarol (bulk)
3
diphencyprone (bulk)
powder 98 %
dicyclomine (bulk)
3
diphenhydramine (bulk)
1
diethanolamine (bulk)
3
diphenidol (bulk)
3
diethylcarbamazine cit
(bulk)
dipyridamole (bulk)
3
3
disulfiram (bulk)
3
DIETHYLENE
GLYCOL
MONOETHYL ET
3
3
dl-alpha tocopherol
(bulk)
dl-leucine (bulk)
3
diethylpropion hcl
(bulk)
3
d-mannose (bulk)
3
DMPS
3
diethylstilbestrol (bulk)
1
DMSA (BULK)
1
diethyltoluamide (bulk)
3
docosanol (bulk)
3
dihydrocodeine
bitartrat(bulk)
3
docusate sodium
3
dihydroergotamine
mesylt(bulk) powder
docusate sodium (bulk)
3
3
dopamine (bulk)
3
dihydroxyacet 1,3 dimer
(bulk)
doxepin
1
3
1
diindolylmethane (bulk)
3
doxycycline hyclate
(bulk)
diltiazem hcl
1
3
dimenhydrinate (bulk)
3
doxylamine succinate
(bulk)
droperidol
1
this table.
116
Drug Name
/Limits
duloxetine hcl (bulk)
1
d-xylose (bulk)
3
dyclonine (bulk)
3
dyphylline (bulk)
3
econazole
1
edetate calcium
disodium(bulk)
3
edetate disodium (bulk)
1
edetate tetrasod thydr
(bulk)
Drug Name
/Limits
erythromycin estolate
(bulk)
3
erythromycin
ethylsuccinate
3
ESPUMIL
3
estradiol (bulk)
3
estradiol benzoate
(bulk)
3
3
estradiol cypionate
(bulk)
1
edetic acid (bulk)
3
estradiol hemihyd,micro
(bulk)
3
edrophonium chloride
(bulk)
3
estradiol micronized
(bulk)
3
EFFERVESCENT
3
estradiol valerate (bulk)
1
emollient combo no.64
(bulk)
1
estriol (bulk)
1
emu oil (bulk)
3
estriol micronized (bulk)
1
emulsifying wax (bulk)
3
estrone
1
EMULSION
CONCENTRATE
estrone (bulk)
1
3
ethanolamine (bulk)
3
enalapril maleate (bulk)
3
ether (bulk)
3
ENGLISH TOFFEE
FLAVOR
ethinyl estradiol (bulk)
1
1
ethosuximide (bulk)
3
1
3
1
ETHOXY ETHOXY
ETHANOL REAGENT
epigallocatechin
gallate(bulk)
ethoxydiglycol (bulk)
3
3
3
epinephrine (bulk)
1
ethyl alcohol (bulk)
liquid 95 %
epinephrine bitartrate
3
ethyl oleate (bulk)
3
epinephrine hcl (bulk)
3
ethylenediamine (bulk)
3
EPSOM SALT
1
etomidate (bulk)
3
ergocalciferol (vitamin
d2)
etoposide (bulk)
3
1
eugenol (bulk)
3
ergoloid (bulk)
3
evans blue (bulk)
3
ergotamine tartrate
(bulk)
1
FAGRON CAPFILL
PRO
3
erythromycin (bulk)
3
FAGRON
DISPERSAPRO
3
this table.
117
Drug Name
/Limits
Drug Name
/Limits
FAGRON LS PLUS
3
FLAVORX
1
FAGRON LS ULTRA
3
flexible collodion (bulk)
3
FAGRON NATURAL
CREAM
3
floxuridine (bulk)
3
fluconazole (bulk)
3
FAGRON SUPREME
CREAM
3
flucytosine (bulk)
3
FAGRON VERSIFIX
3
fludrocortisone (bulk)
3
famotidine (bulk)
3
flumazenil (bulk)
3
FATTYBLEND
1
flunisolide (bulk)
1
fd and c blue no.1 (bulk)
3
fluocinolone acetonide
(bulk)
1
fd and c no.3 (green)
(bulk)
3
fluocinonide (bulk)
1
fd and c no.40 red
(bulk)
fluorescein (bulk)
3
3
3
FD AND C RED NO.3
3
FLUORESCEIN C.I.
45350
fdc 6 (sunset yel fcf)
(bulk)
fluorouracil (bulk)
1
3
fluoxetine (bulk)
3
fdc no.5 (tartrazine)
(bulk)
fluoxymesterone (bulk)
3
3
3
fentanyl (bulk)
3
(bulk)
fentanyl citrate (bulk)
1
flurbiprofen (bulk)
3
ferric ammonium citrate
(bulk)
3
fluticasone propionate
(bulk)
3
ferric chloride (bulk)
powder
folic acid (bulk)
1
1
3
ferric subsulfate (bulk)
3
FOOD COLOR
BROWN
ferric sulfate (bulk)
3
3
ferrous fumarate (bulk)
1
FOOD COLOR
GREEN
ferrous gluconate (bulk)
1
FOOD COLOR RED
3
ferrous sulfate (bulk)
3
formaldehyde (bulk)
3
ferrous sulfate, dried
(bulk)
3
formoterol fumarate
(bulk)
3
ferulic acid (bulk)
3
FP CEPA GEL
3
feverfew extract (bulk)
3
FP DERM CREAM
3
fexofenadine (bulk)
3
FP DERM GEL
3
finasteride (bulk)
3
FP ENHANCING
CREAM
3
FITALITE CREAM
BASE
3
FP NATURAL
CREAM
3
this table.
118
Drug Name
/Limits
FP NATURAL
LOTION
3
FP PLUS CREAM
Drug Name
/Limits
fructose
3
fuchsin, basic
3
3
fullers earth
3
FP SILO GEL
3
furazolidone (bulk)
3
FP SUPREME CREAM
3
furosemide (bulk)
3
FP ULTRA CREAM
3
gabapentin (bulk)
1
FREE AND CLEAR
3
galactose (bulk)
3
FREEDOM
ADAPTADERM
3
gamma-aminobutyric
acid (bulk)
3
FREEDOM
ADAPTADERM
CREAM
3
gardenia fragrance
(bulk)
3
FREEDOM ALCOHOL
3
gelatin troche base #53
(bulk)
3
FREEDOM CEPAPRO
3
gemfibrozil
3
FREEDOM DERMA
SERUM
3
genistein (bulk)
3
FREEDOM DERMA-D
3
gentamicin (bulk)
1
FREEDOM
ESTERDERM
gentian violet crystals
3
3
geranium oil (bulk)
3
FREEDOM HRT
ULTRA CREAM
GERMALL PLUS
3
3
3
FREEDOM LOLLIPOP
BASE
germanium sesquioxide
(bulk)
3
ginger root (bulk)
3
FREEDOM ODT BASE
3
ginkgo biloba (bulk)
3
FREEDOM PEG
TROCHE BASE
3
glipizide (bulk)
1
gluconolactone
3
FREEDOM
POLYMATRIX
3
glucosamine (bulk)
3
FREEDOM SET-GEL
3
glucosamine su 2kcl
(bulk)
3
FREEDOM SILOMAC
3
glucosamine sulfate
nacl(bulk)
3
glutamine
1
glutaraldehyde (bulk)
solution 50 %
3
glutathione (bulk)
3
glycerin (bulk) liquid
100 %
1
FREEDOM SILOMAC
ULTRA
3
FREEDOM
SIMPLECAP
3
FREEDOM
TRIBLEND SUPPOS
BASE
3
FREEDOM
ULTRAPEN
3
glycerol formal (bulk)
1
FREEDOM XYLOX
3
glyceryl oleate (bulk)
3
this table.
119
Drug Name
/Limits
glycine
1
glycofurol (bulk)
3
glycopyrrolate (bulk)
1
glycosaminoglycans,mix
ed(bulk)
Drug Name
/Limits
heparin (porcine) (bulk)
powder 180 unit/mg
(usp)
3
hepes (bulk)
3
3
heptaminol (bulk)
3
glycyrrhizic acid (bulk)
3
1
gold sodium thiomalate
(bulk)
histamine phosphate
(bulk) crystals
3
3
gramicidin d
3
histidine (l-histidine)
(bulk)
grape flavor (bulk)
1
homatropine
methylbrom (bulk)
1
grape seed oil (bulk)
3
GRAPEFRUIT
1
honey almond fragrance
(bulk)
3
green food color (bulk)
liquid
3
honey flavor (bulk)
1
HRT BASE
3
green soap (bulk)
3
HRT BASE (JOJOBA)
3
GREEN TEA
EXTRACT
3
HRT BASE
BOTANICAL
3
green tea extract (bulk)
3
HRT BASE HEAVY
3
green tea oil (bulk)
3
HRT CREAM
3
griseofulvin (bulk)
1
guaiacol
3
HRT CREAM BASE
WOMEN
3
guaifenesin (bulk)
1
HRT GEL BASE MEN
3
guanabenz (bulk)
3
3
guanethidine
1
HRT NATURAL
CREAM BASE
GUANIDINEACETIC
ACID
3
HRT NATURAL
LOTION BASE
3
guarana seed extract
(bulk)
3
HRT SUPREME
CREAM BASE
3
guava flavor (bulk)
1
3
GUM BASE
3
HUMCO BASE, PAIN
MGMT
gymnema leaf (bulk)
3
huperzine serrate a
(bulk)
3
H2O GEL BASE
3
haloperidol (bulk)
3
hyaluronidase, bovine
(bulk)
3
(bulk)
3
hydralazine hcl (bulk)
3
hydrazine sulfate (bulk)
3
hawthorn berry (bulk)
3
hematoxylin, c.i. 75290
(bulk)
3
3
hydrochloric acid (bulk)
liquid 37 %
this table.
120
Drug Name
hydrochlorothiazide
(bulk)
/Limits
1
Drug Name
/Limits
ibuprofen (bulk)
1
ichthammol (bulk)
liquid
3
IDEALBASE
3
hydrocodone bitartrate
(bulk)
3
hydrocortisone (bulk)
1
idebenone (bulk)
3
(bulk)
1
idoxuridine
3
HYDROFLUORIC
ACID
imidurea (bulk)
3
3
imipramine (bulk)
1
HYDROGEL
3
imiquimod (bulk)
3
HYDROLYZED
HYALURONIC ACID
3
indocyanine green
(bulk)
3
hydromorphone (bulk)
1
indole-3-carbinol (bulk)
3
indomethacin (bulk)
1
HYDROPHILIC
OINTMENT
BASE(FAG)
1
inositol
3
hydroquinone (bulk)
3
INOSITOL
HEXANICOTINATE
3
HYDROUS
EMULSIFIED BASE
1
iodine (bulk) crystals
1
iodine (bulk) granules
3
hydroxocobalamin
(bulk)
3
iodoform (bulk)
3
hydroxyamphetamine
(bulk)
iodoquinol (bulk)
1
3
iopanoic acid (bulk)
1
hydroxyapatite (bulk)
3
1
hydroxychloroquine
1
ipratropium bromide
(bulk)
hydroxyethyl
methacrylate,bulk
3
iron bisglycin chelate
(bulk)
3
hydroxyethylcellulose
(bulk)
isoleucine
3
3
isoleucine (bulk)
3
hydroxyprogesterone
capr(bulk)
3
isometheptene mucate
(bulk)
3
hydroxypropyl betadex
(bulk)
isoniazid (bulk)
3
3
isopropamide iodide
3
hydroxytryptophan
1
isopropyl myristate
3
hydroxyurea (bulk)
3
3
hydroxyzine hcl (bulk)
1
isopropyl palmitate
(bulk)
hydroxyzine pamoate
(bulk)
isoproterenol hcl (bulk)
3
3
isosorbide (bulk)
3
hyoscyamine sulfate
(bulk)
1
isosulfan blue (bulk)
3
isotretinoin (bulk)
3
this table.
121
Drug Name
/Limits
isoxsuprine hcl (bulk)
3
itraconazole (bulk)
3
ivermectin
1
jasmine fragrance
(bulk)
Drug Name
/Limits
lactobacill.acidophilus
(bulk) powder 1 billion
unit/gram
3
L-ALANINE
1
3
lamotrigine (bulk)
3
JELENE
3
lanolin (bulk)
3
JESSNER'S
3
lanolin alcohols (bulk)
3
jojoba oil (bulk)
3
lansoprazole (bulk)
3
juniper tar
3
L-ASPARTIC ACID
3
kahlua flavor (bulk)
1
latanoprost (bulk)
3
kanamycin (bulk)
3
laureth 9 (bulk)
3
kaolin (bulk)
3
lauric acid (bulk)
3
karaya gum (bulk)
1
3
ketamine (bulk)
1
LAVARE WOUND
WASH
ketoconazole (bulk)
powder
L-CARNITINE
1
1
L-CITRULLINE
3
ketoprofen (bulk)
3
l-cystine (bulk)
3
ketoprofen, micronized
(bulk)
lead tetroxide (bulk)
3
3
3
ketorolac (bulk)
3
lead acetate trihydrate
(bulk)
ketotifen fumarate
(bulk)
lecithin
1
3
3
KIDNEY BEAN
EXTRACT (BULK)
LECITHIN
ORGANOGEL
3
lecithin, soy (bulk)
3
kinetin (bulk)
3
LEMON FLAVORING
3
kiwi fragrance (bulk)
3
1
kojic acid
3
lemonade flavor oil
(bulk)
korean ginseng root
(bulk)
letrozole (bulk)
3
3
LETS KIT
3
KRISGEL 100
3
leucine
3
kudzu root (bulk)
3
leucine (bulk)
3
labetalol (bulk)
3
1
lactase (bulk)
3
leucovorin calcium
(bulk)
lactic acid (bulk) liquid
88 % to 92 % (usp)
leuprolide (bulk)
3
1
levamisole (bulk)
1
(bulk) powder
1
levetiracetam (bulk)
3
levocarnitine
1
levocetirizine (bulk)
3
PA
this table.
122
Drug Name
/Limits
Drug Name
/Limits
levodopa (bulk)
1
LIPOPEN ULTRA
3
levofloxacin (bulk)
3
1
levomefolate calcium
(bulk)
LIPOVAN CREAM
BASE
3
LIPOZYME BASE
3
levorphanol tartrate
(bulk)
1
LIQUIGEL COMPLEX
3
lisinopril (bulk)
3
levothyroxine (bulk)
1
L-ISOLEUCINE
1
L-GLUTAMIC ACID
3
LISSAMINE GREEN B
3
L-GLUTAMINE
POWDER
1
lithium carbonate (bulk)
1
licorice flavor (bulk)
1
lithium citrate
tetrahyd(bulk)
3
licorice root extract
(bulk)
3
LOCUST BEAN GUM
3
licorice,deglycyrrhizin
(bulk)
LOLLIBASE
3
3
LOLLIPOP BASE
3
lidocaine (bulk)
3
loperamide (bulk)
1
lidocaine hcl (bulk)
3
loratadine (bulk)
3
LIME FLAVOR
1
3
lime green food color
(bulk)
loratadine, micronized
(bulk)
3
lorazepam (bulk)
1
lime oil (bulk)
3
LOZIBASE
3
lincomycin
3
L-PROLINE
3
linoleic acid (bulk)
3
L-THREONINE
3
liothyronine (bulk)
3
lutein (bulk)
3
LIP BALM BASE
(BULK)
lycopene (bulk)
3
1
lysine hcl (bulk)
3
LIP BALM NATURAL
3
maca (bulk)
3
LIPMAX
3
mafenide acetate (bulk)
3
LIPO CREAM BASE
3
3
LIPOBASE BASE
(GEL MATRIX)
mag amino acid chelate
(bulk)
3
MAGNASWEET 110
1
LIPOBASE HEAVY
3
MAGNASWEET 135
3
LIPOBASE REGULAR
1
3
LIPOIC ACID
1
magnesium ascorbate
(bulk)
LIPOIL
3
3
LIPOPEN
ABSORPTION
magnesium aspart dihyd
(bulk)
3
magnesium carbonate
1
LIPOPEN PLUS
3
magnesium chloride
(bulk) crystals
3
this table.
123
Drug Name
/Limits
Drug Name
/Limits
magnesium citrate
1
MEDIDERM
3
magnesium gluconate
1
3
magnesium glycinate
(bulk) powder 11.7 %,
15 %
MEDIHOL GEL BASE
ALCOHOL
3
MEDI-RDT BASE
3
magnesium hydroxide
(bulk)
3
1
medium chain triglycer
(bulk)
MEDIUM CREAM
1
magnesium malate
3
magnesium oxide (bulk)
3
medroxyprogest, ac
micro(bulk)
3
magnesium phosphate
3
mefenamic acid (bulk)
1
magnesium sulfate
(bulk) crystals
1
megestrol acetate,micro
(bulk)
3
magnesium sulfate
(bulk) powder
3
melatonin (bulk)
3
meloxicam (bulk)
1
maleic acid (bulk)
3
memantine hcl (bulk)
3
malic acid (bulk)
3
menadione
3
maltodextrin (bulk)
3
mandelic acid (bulk)
3
menadione sod bisulfite
(bulk)
3
manganese chloride
(bulk)
3
menthol
1
meperidine (bulk)
3
manganese gluconate
(bulk)
3
mequinol (bulk)
3
manganese sulfate
3
mercaptopurine (bulk)
3
mango flavor (bulk)
3
mesalamine
1
mannitol (bulk)
1
meta-cresol (bulk)
3
maple flavor (bulk)
1
metformin (bulk)
3
marshmallow flavor
(bulk)
1
methacholine chloride
(bulk)
1
m-cresol acetate (bulk)
3
methacryl acid coplym a
(bulk)
3
mebendazole
3
methadone (bulk)
2
mecamylamine hcl
(bulk)
3
methanesulfonic acid
(bulk)
3
mechlorethamine (bulk)
3
methazolamide
3
meclizine
3
methenamine (bulk)
3
meclofenamate
3
meclofenoxate hcl (bulk)
3
methenamine mandelate
(bulk)
1
mecobalamin (bulk)
1
methimazole (bulk)
3
MEDIBASE C
3
methionine
3
PA
this table.
124
Drug Name
/Limits
methocarbamol (bulk)
3
METHOCEL K 100 M
3
methotrexate (bulk)
3
methoxsalen
1
methscopolamine
Drug Name
/Limits
MICRO-CELLULOSECMC NA
3
MICRODERM BASE
CREAM
3
3
MICROSOME BASE
CREAM
3
methscopolamine nitrate
(bulk)
3
midazolam (bulk)
3
methylcellulose (bulk)
3
milk thistle (bulk)
3
methylcellulose 1500cps
(bulk)
mineral oil
1
1
1
methylcellulose 4000cps
(bulk)
MINERAL OIL
HEAVY
1
MINERAL OIL LIGHT
1
methylparaben (bulk)
3
minocycline
3
methylphenidate
2
minoxidil (bulk)
1
methylprednisolon
ac,mic(bulk)
1
mint chocolate chip flv
(bulk)
1
methylprednisolone, mic
(bulk)
mirtazapine (bulk)
3
1
misoprostol (bulk)
3
METHYLPYRAZOLE
3
mitomycin (bulk)
3
(bulk)
3
mitotane (bulk)
3
methyltestosterone
(bulk)
3
1
MOISTURE
RECOVERY
molybdenum (bulk)
3
methyltestosterone,micr
o(bulk)
1
mometasone furoate
(bulk)
3
methyltetrahydrofol ca
(bulk)
3
monobenzone (bulk)
3
METHYLTETRAHYD
ROFOLIC ACID
3
monochloroacetic acid
(bulk)
3
methysergide (bulk)
3
monosodium glutamate
(bulk)
3
metoclopramide (bulk)
1
montelukast (bulk)
3
metoprolol tartrate
(bulk)
3
morphine (bulk)
1
metronidazole (bulk)
3
moxifloxacin hcl (bulk)
3
metronidazole benzoate
(bulk)
moxisylyte (bulk)
3
3
MULTIBASE
1
mexiletine (bulk)
3
MULTIUSE BASE
1
miconazole
3
mupirocin (bulk)
3
miconazole nitrate
3
nabumetone (bulk)
3
PA
this table.
125
Drug Name
/Limits
nabumetone, micronized
(bulk)
3
N-ACETYL-ALPHA-D
-GLUCOSAMINE
1
nad, reduced, disodium
(bulk)
3
nadolol (bulk)
3
nalbuphine (bulk)
3
nalidixic acid
3
naloxone (bulk)
1
naltrexone hcl (bulk)
Drug Name
/Limits
NICOTINIC ACID
3
nifedipine (bulk)
1
nimodipine (bulk)
3
nitric acid (bulk)
3
nitrofuran macrocrystal
(bulk)
3
nitrofurantoin
1
nitrofurazone (bulk)
3
norethindrone (bulk)
3
1
norethindrone acetate
(bulk)
3
naltrexone hcl
dihydrate(bulk)
1
nortriptyline (bulk)
3
nandrolone decanoate
(bulk)
NOURISIL
3
3
NOURIVAN ANTIOX
3
naproxen (bulk)
1
nylidrin (bulk)
1
naproxen sodium
1
NATURAL
BITTERNESS
MASKING
3
1
neomycin sulfate (bulk)
3
nystatin (bulk) powder 1
billion unit, 10 billion
unit, 15 billion unit, 2
billion unit, 5 billion
unit, 50 million unit,
500 million unit
neostigmine methylsulf
(bulk)
3
3
nettle leaf (bulk)
3
100 million unit, 150
million unit
nh4 tetrathiomolybdate
(bulk)
octanoic acid (bulk)
3
3
octinoxate (bulk)
3
niacin (bulk)
3
3
niacinamide (bulk)
1
OINTMENT BASE
(EMULSIFYING)
niaouli oil (bulk)
3
3
niclosamide (bulk)
3
OLEABASE
PLASTICIZED
NICOTINAMIDE
ADEN.DINUC.REDNA
2
3
3
omeg3-dha-epa-fish-snfl
(bulk)
omeprazole (bulk)
1
NICOTINAMIDE
ADENINE DINUC.
ondansetron hcl (bulk)
3
3
1
nicotine polacrilex
(bulk)
ORANGE
CONCENTRATE
3
1
NICOTINE
TARTRATE
orange cream flavor
(bulk)
3
orange flavor (bulk)
1
this table.
126
Drug Name
/Limits
orange food color (bulk)
3
origanum oil (bulk)
3
ornithine
3
orphenadrine citrate
3
oxandrolone (bulk)
Drug Name
/Limits
PCCA
EFFERVESCENT
3
PCCA LIPODERM
BASE
3
3
PCCA LIPODERM
HMW
3
oxybenzone
3
PCCA MBK BASE
3
oxybutynin chloride
1
PCCA MVC CREAM
3
oxycodone (bulk)
1
PCCA NATACREAM
1
oxymetazoline (bulk)
3
PCCA POLOXAMER
407 NF
3
PCCA STEVIOSIDE
3
PCCA T3 SODIUM
DILUTION
3
PCCA T4 SODIUM
DILUTION
1
PCCA VANISHING
BASE
3
peach flavor (bulk)
1
PEANUT BUTTER
FLAVOR
1
peanut butter flavor
(bulk)
1
pectin
1
oxyquinoline sulfate
(bulk)
3
oxytetracycline (bulk)
1
oxytocin (bulk)
1
palmarosa oil (bulk)
3
palmitoyl
pentapeptide-4(bulk)
3
pancreatin
1
pancuronium bromide
(bulk)
3
panthenol (bulk)
3
papain (bulk)
3
papaverine (bulk)
1
parachlorophenol (bulk)
3
paraffin (bulk)
3
peg 400 monostearate
(bulk)
3
paromomycin sulfate
(bulk)
3
PEG OINTMENT
BASE (BULK)
1
passion fruit flavor
(bulk)
3
peg-40 castor oil (bulk)
3
PCCA ALADERM
BASE
PEGBLEND
1
3
PCCA ANHYDROUS
LIPODERMA
3
3
PENCREAM
COMPOUNDING
AGENT
PCCA BASE
ANHYDROUS
PENDERM
3
3
penicillamine
1
PCCA COSMETIC
HRT BASE
PENICILLAMINE(D-)
1
3
pennyroyal oil (bulk)
3
PCCA CUSTOM
LIPO-MAX
3
pentobarbital sodium
(bulk)
3
this table.
127
Drug Name
/Limits
pentosan polysulfate na
(bulk)
3
pentoxifylline (bulk)
Drug Name
/Limits
phenoxyethanol (bulk)
3
phentermine hcl (bulk)
3
3
phentolamine
3
PENTRAVAN
3
PENTRAVAN PLUS
3
phenyl salicylate (bulk)
powder
3
pentylenetetrazol
3
phenylalanine, l- (bulk)
3
PEPPERMINT
FLAVORING
1
phenylalanine,dl- (bulk)
3
phenylbutazone
1
PEPSIN 3,000
DIGESTION
3
phenylephrine hcl (bulk)
1
perfluorodecalin (bulk)
3
phenylmercuric acetate
(bulk)
3
permethrin (bulk) liquid
92 %
3
phenylmercuric nitrate
(bulk)
3
perphenazine (bulk)
3
PEUCEDANUM
OSTRUTHIUM
3
3
phenylpropanolamine
(bulk)
phenytoin (bulk)
1
PFCB
3
phenytoin sodium (bulk)
1
PHARMABASE
1
PHARMABASE
COSMETIC
3
1
phosphatidyl serine
(bulk)
PHARMABASE
HEAVY
3
1
phosphatidylcholine
(bulk)
PHARMABASE
LIGHT
3
1
phosphoric acid (bulk)
liquid 85 %
phytic acid (bulk)
3
PHARMABASE
NATURAL
1
PHYTOBASE
3
PHARMABASE
VAGINAL
phytonadione (bulk)
3
1
1
phenazopyridine (bulk)
3
pilocarpine hcl (bulk)
powder
phenelzine (bulk)
3
pilocarpine nitrate
(bulk) powder
3
phenethylamine hcl
(bulk)
3
pina colada flavor
(bulk)
3
phenindione (bulk)
3
pine oil (bulk)
3
phenobarbital (bulk)
1
pine tar (bulk)
3
phenol (bulk)
1
pineapple flavor (bulk)
1
phenolsulfonic acid
(bulk)
3
pineapple fruit extract
(bulk)
3
phenoxybenzamine
(bulk)
3
pink food color (bulk)
3
piperine (bulk)
3
this table.
128
Drug Name
/Limits
piroxicam (bulk)
3
PLACEBO #00
3
PLO GEL MEDIFLO
Drug Name
/Limits
POLYGLYCOL
TROCHE BASE
3
3
3
PLO GEL MEDIFLO
COMPOUND B
polyhexamethylene
bigua (bulk)
3
PLO GEL MEDIFLO
PRE-MIXED
3
3
(bulk) powder 100
million unit
PLO GEL PREMIUM
LECITHIN BASE
3
1
PLO TRANSDERMAL
3
(bulk) powder 50
million unit, 6,000
unit/mg
PLO ULTRAMAX
GEL PREM LECITHIN
3
POLYOX WSR-301
3
PLO20
3
polyoxyl 40 stearate
(bulk) wax
3
PLO20 FLOWABLE
3
3
PLURONIC
3
POLYPEG
SUPPOSITORY BASE
PLURONIC L64
3
polysorbate 20 (bulk)
3
PNA-HRT BASE
CREAM
3
3
polyvinyl alcohol (bulk)
3
podofilox (bulk)
3
potash, sulfurated
3
podophyllum resin
3
potassium acetate (bulk)
3
POLOX
3
potassium alum (bulk)
3
poloxalene (bulk)
3
3
POLOXAMER 188
3
potassium
aminobenzoate (bulk)
POLOXAMER 407
3
3
polyethylene glycol
1000
potassium aspartate
(bulk)
1
3
polyethylene glycol
1450
potassium azeloyl digly
(bulk)
1
1
polyethylene glycol 300
3
potassium bicarbonate
(bulk) granules
polyethylene glycol
3350
1
potassium bicarbonate
(bulk) powder
3
polyethylene glycol
3350(bulk)
1
potassium bitartrate
(bulk)
3
(bulk) liquid
3
potassium bromide
(bulk)
3
(bulk) liquid
3
potassium chloride
(bulk) granules
1
polyethylene glycol
8000(bulk)
3
potassium chloride
(bulk) powder
1
this table.
129
Drug Name
/Limits
potassium citrate (bulk)
3
potassium citrate
m-hyd(bulk)
3
potassium gluconate
(bulk)
3
potassium hydroxide
(bulk) pellet
3
potassium hydroxide
(bulk) solution 10 %, 20
%, 45 % (w/w)
3
potassium iodide (bulk)
crystals
Drug Name
/Limits
povidone-iodine (bulk)
powder
3
powder scent fragrance
(bulk)
3
PRACASIL TM-PLUS
3
pralidoxime chloride
(bulk)
3
pralines and cream
flavr(bulk)
1
pramoxine
1
1
prasterone (dhea),
micro(bulk)
1
granules
1
praziquantel (bulk)
3
powder
prazosin
3
3
prednisolone (bulk)
1
potassium metabisulfite
(bulk)
3
prednisolone ac, micro
(bulk)
1
potassium nitrate (bulk)
granules
3
prednisolone sod phos
(bulk)
1
potassium nitrate (bulk)
powder
3
prednisolone, micro
(bulk)
1
potassium perchlorate
(bulk)
prednisone
1
3
1
potassium
permanganate
prednisone micronized
(bulk)
3
pregabalin (bulk)
3
potassium phosph,
mono (bulk)
1
pregnenolone
3
pregnenolone,
micronized(bulk)
3
prezatide copper (bulk)
3
prilocaine (bulk)
1
primidone (bulk)
3
procainamide
3
procaine (bulk)
1
procarbazine hcl (bulk)
3
potassium
phosphate,dib (bulk)
crystals
3
potassium
powder
1
potassium sorbate
crystals
3
potassium sorbate
powder
1
prochlorperazine
edisylt(bulk)
3
potassium sulfate (bulk)
3
povidone (bulk)
3
prochlorperazine
maleate
1
progesterone (bulk)
3
this table.
130
Drug Name
/Limits
progesterone
micronized (bulk)
3
promazine (bulk)
3
promethazine (bulk)
1
PROPANEDIOL
3
propantheline (bulk)
3
proparacaine (bulk)
3
propranolol (bulk)
3
propyl gallate (bulk)
3
propylene glycol (bulk)
1
propylene glycol
m-stear(bulk)
Drug Name
/Limits
crystals
1
powder
3
quinine hcl dihydrate
(bulk)
3
quinine sulfate (bulk)
3
racemethionine (bulk)
3
racepinephrine (bulk)
3
ranitidine hcl (bulk)
1
rapeseed oil (bulk)
3
3
3
propylparaben (bulk)
powder
RAPID DISSOLVE
TABLET
3
1
propylthiouracil (bulk)
3
raspberry flavor (bulk)
liquid
protamine sulfate (bulk)
3
powder
3
protirelin (bulk)
3
pseudoephedrine hcl
(bulk) powder
3
1
RASPBERRY
FLAVORING
psyllium husk (bulk)
3
rauwolfia serpentina
(bulk)
3
pumice (bulk)
3
red algae (bulk)
3
PUMPKIN FLAVOR
1
3
pyrantel pamoate (bulk)
3
red food color (bulk)
liquid
pyridostigmine bromide
(bulk)
3
red yeast rice extract
(bulk)
3
pyridoxal-5 phosphate
(bulk)
reserpine (bulk)
3
3
resorcinol (bulk)
1
pyridoxine (bulk)
1
RETINOIC ACID
1
pyrilamine maleate
powder
1
riboflavin (vitamin b2)
1
pyrimethamine
1
riboflavin 5-phosphate
sodium
1
pyrithione zinc (bulk)
3
ribose (bulk)
3
pyrogallol
3
rifampin (bulk)
1
pyruvic acid (bulk)
3
rifaximin (bulk)
3
Q-DERM
3
root beer flavor (bulk)
1
quercetin dihydrate
(bulk)
3
rose bengal (bulk)
3
rosin (bulk) lump
3
quinacrine (bulk)
1
rubidium chloride (bulk)
3
this table.
131
Drug Name
/Limits
rutin (bulk)
3
s-adenosylmeth sulf tos
(bulk)
3
sage leaf (bulk)
Drug Name
/Limits
silver nitrate
3
silver protein mild
1
3
silver sulfadiazine
(bulk)
3
salicylic acid (bulk)
1
SIMPLGEL 30
3
salsalate (bulk)
3
simvastatin (bulk)
3
SALT DURABLE
3
sirolimus (bulk)
3
SALTSTABLE LO
1
3
SALTSTABLE LS
1
SKYYDERM CREAM
BASE
SANARE ADV SCAR
THERAPY BASE
3
sod ascorbyl phos dihyd
(bulk)
3
saw palmetto fruit
(bulk)
3
sod phos dibasic, hept
(bulk)
3
SCAR CARE BASE
ENHANCED
sodium acetate
3
3
3
scarlet red (bulk)
3
sodium acetate
trihydrate
scopolamine hbr (bulk)
3
sodium alginate
3
secretin (human) (bulk)
3
sodium benzoate (bulk)
1
SEDANARE
3
1
selegiline hcl (bulk)
3
sodium bicarbonate
(bulk)
selenium sulfide (bulk)
3
sodium borate
3
selenium yeast (bulk)
3
sodium bromide
3
selenomethionine (bulk)
3
sodium butyrate (bulk)
3
SEPINEO P 600
3
sodium cacodylate
3
serine (bulk) crystals
3
sodium caprylate
3
sermorelin acetate
(bulk)
3
sodium carb anhydrous
(bulk)
3
serotonin hcl (bulk)
3
sodium chloride (bulk)
3
sertraline (bulk)
3
sodium chloride powder
3
shark cartilage (bulk)
3
sodium chlorite (bulk)
3
shea butter (bulk)
3
sodium citrate (bulk)
1
shower fresh fragrance
(bulk)
sodium citrate dihydrate
1
3
sodium decanoate (bulk)
3
siberian ginseng (bulk)
3
3
sildenafil (bulk)
3
sodium desoxycholate
(bulk)
silica
1
sodium dichloroacetate
(bulk)
3
silicon dioxide (bulk)
3
sodium fluoride (bulk)
1
SILOSOME
3
this table.
132
Drug Name
/Limits
Drug Name
/Limits
sodium gluconate (bulk)
3
3
sodium hyaluronate
(bulk) powder 100 %,
94 %
sodium salicylate
powder
3
sodium selenite (bulk)
3
sodium stearate (bulk)
3
sodium hyaluronate
(bulk) topical
3
sodium stearyl fumarate
(bulk)
3
sodium hydroxide (bulk)
pellet
3
sodium sulfate (bulk)
3
powder
sodium sulfite (bulk)
3
3
3
sodium iodide (bulk)
3
sodium tartrate dihydr
(bulk)
sodium lactate
3
sodium tetradecyl sulf
(bulk)
3
sodium laureth sulfate
(bulk)
3
sodium thiosalicylate
(bulk)
3
sodium lauryl sulfate
(bulk)
3
sodium thiosulfate
(bulk)
1
sodium metabisulfite
(bulk)
3
sorbic acid
3
sodium
monofluorophosphate
3
sorbitan monolaurate
(bulk)
3
sodium nitrate (bulk)
powder
3
sorbitan monooleate
(bulk)
3
sodium nitrite (bulk)
3
sorbitol (bulk)
3
sodium oleate (bulk)
3
sorbitol powder
3
sodium perborate (bulk)
crystals
3
SOYBEAN CASEIN
DIGEST MEDIUM
3
powder
soybean oil (bulk)
3
3
3
sodium phenylbutyrate
(bulk)
SPEARMINT
FLAVORING
3
SPERMACETI
3
sodium phosphate
monobasic powder
SPG SUPPOSI-BASE
3
3
spironolactone (bulk)
3
sodium
phosphate,dibasic(bulk)
3
spironolactone micro
(bulk)
3
sodium propionate
3
SPIRULINA
3
sodium pyroglutamate
(bulk)
3
squalane (bulk)
3
squaric acid (bulk)
1
sodium pyruvate (bulk)
3
sodium saccharin (bulk)
1
squaric acid
dibutylest.(bulk)
3
this table.
133
Drug Name
/Limits
squaric acid
dibutylester
1
SQUARIC ACID IN
BUTANOL
1
st. john's wort (bulk)
3
stannous chloride dihyd
(bulk)
3
stanozolol (bulk)
3
stanozolol micronized
(bulk)
Drug Name
/Limits
sulfanilamide
1
sulfapyridine
3
sulfasalazine (bulk)
3
sulfathiazole (bulk)
3
sulfisoxazole
1
sulfosalicylic acid
dihy(bulk)
3
sulfur (bulk)
3
3
sulfur sublimed (bulk)
1
stearic acid (bulk)
3
sulfuric acid (bulk)
3
STERA BASE
3
sulindac
3
STEVIA
1
sumatriptan (bulk)
3
STEVIA EXTRACT
3
3
steviol glycosides (bulk)
3
(bulk)
stevioside (bulk)
3
super synersweet flavor
(bulk)
3
strawberry flavor (bulk)
1
superoxide dismutase
(bulk)
3
STRAWBERRY
FLAVORING
3
SUPPOSIBASE F
3
streptomycin
3
SUPPOSIBLEND
3
strontium chl hexahyd
(bulk)
3
SWEET OIL
1
strontium nitrate (bulk)
3
SWEETNESS
ENHANCER FLAVOR
1
succinic acid
3
tacrolimus (bulk)
3
succinylcholine cl (bulk)
3
sucralfate (bulk)
1
tacrolimus anhydrous
(bulk)
3
sucrose octaacetate
(bulk) powder
3
tacrolimus micronized
(bulk)
3
sucrose powder
1
talc (bulk)
1
sufentanil citrate (bulk)
3
tamoxifen (bulk)
1
sulfacetamide
1
tangerine flavor (bulk)
3
sulfacetamide sod, mono
(bulk)
1
tangerine oil (bulk)
1
sulfacetamide sodium
1
TANGERINE OIL,
NATURAL
1
sulfadiazine
1
tannic acid (bulk)
1
sulfadiazine sodium
(bulk)
1
tartaric acid (bulk)
crystals
3
sulfamerazine (bulk)
3
taurine (bulk)
3
this table.
134
Drug Name
/Limits
Drug Name
/Limits
tazarotene (bulk)
3
tinidazole (bulk)
1
TDC MAX
3
titanium dioxide (bulk)
3
tea tree oil (bulk)
3
tizanidine (bulk)
3
teaberry oil flavor
(bulk)
1
tobramycin (bulk)
1
terbinafine (bulk)
3
tobramycin sulfate
(bulk)
1
terbutaline
1
tolazoline (bulk)
3
TERODERM
3
tolnaftate
3
terpin hydrate
3
TOLUIDINE BLUE O
3
testosterone (bulk)
1
TOMMY GEL
3
testosterone cyp, micro
(bulk)
1
topiramate (bulk)
1
testosterone cypionate
(bulk)
3
1
tramadol hydrochloride
(bulk)
testosterone enanthate
(bulk)
1
3
tranexamic acid (bulk)
powder
testosterone propionate
(bulk)
3
1
tranexamic acid (bulk)
powder 98 %
tranilast (bulk)
3
tetracaine (bulk)
3
tetracaine hcl (bulk)
3
TRANS D HORMONE
BASE
3
tetracycline hcl (bulk)
1
3
TETRAHYDROBIOPT
ERIN DI-HCL
TRANSDERMAL
PAIN BASE
3
1
tetrahydrozoline
3
TRANS-PEN
TRANSDERMAL
theanine (bulk)
3
trazodone (bulk)
3
theobromine (bulk)
3
tretinoin
1
theophylline (bulk)
1
1
thiabendazole
1
triamcin diacet, micro
(bulk)
thiamine hcl (bulk)
1
triamcin hexacet, micro
(bulk)
3
thioguanine (bulk)
3
triamcinolone (bulk)
1
thiotepa (bulk)
3
threonine
3
triamcinolone acetonide
(bulk)
1
thymol
1
1
thymol iodide
3
triamcinolone diacetate
(bulk)
thyroid, pork (bulk)
3
triamterene
1
ticarcillin-k
clavulanat(bulk)
3
trichlormethiazide
(bulk)
3
timolol maleate (bulk)
3
trichloroacetic acid
3
PA
this table.
135
Drug Name
/Limits
triclosan (bulk)
3
triethanolamine
l.sulfat(bulk)
3
trifluridine (bulk)
Drug Name
/Limits
UNIVERSAL WATER
GEL
3
urea (bulk)
1
3
uridine (bulk)
3
trilostane (bulk)
3
ursodiol (bulk)
1
trimeprazine tartrate
(bulk)
3
valacyclovir (bulk)
3
valerian root (bulk)
3
trimethobenzamide
(bulk)
3
valine
3
trimethoprim (bulk)
1
valproate sodium (bulk)
3
trimethoprim, micro
(bulk)
valproic acid (bulk)
3
1
vanadium (bulk)
3
trioxsalen (bulk)
3
vanadyl sulfate (bulk)
3
tripelennamine (bulk)
3
vancomycin (bulk)
3
triprolidine hcl (bulk)
powder
VANIBASE
1
3
TROCHE BASE
3
1
TROCHIBASE
1
VANIBASE
TRADITIONAL
FORMULA
TROCHIBASE S
3
1
TROCHIBASE S
CLASSIC
1
VANILLA
BUTTERNUT
FLAVOR
trolamine (bulk)
3
vanilla butternut
flavor(bulk)
1
tromethamine (bulk)
3
1
tropical punch flavor
(bulk)
vanilla extract flavor
(bulk)
1
vanillin (bulk) powder
3
tropicamide
3
1
trypan blue (bulk)
3
VANISHING
BOTANICAL
trypsin
3
VANISHING CREAM
3
tryptophan (bulk)
3
1
turmeric (bulk)
3
VANISHING CREAM
TOPICAL
tutti-frutti flavor (bulk)
1
VANISH-PEN CREAM
BASE
1
tyrosine (bulk)
3
VEEGUM
3
U-BASE
1
verapamil (bulk)
1
ubiquinol (bulk)
3
VERSABASE
3
ULTRADERM BASE
3
VERSABASEA
3
undecylenic acid (bulk)
3
UNIBASE
3
VERSAPRO CREAM
BASE
3
this table.
136
Drug Name
/Limits
VERSAPRO GEL
BASE
3
VERSAPRO LOTION
BASE
3
VERSASKIN
3
VERSATILE
1
VERSATILE RICH
3
VERSIGEL
3
vidarabine (bulk)
Drug Name
/Limits
white willow bark-salic
(bulk)
3
wild cherry flavor (bulk)
1
WILEY BASIC
ELEMENTS BHRT
BASE
3
WINTERGREEN
FLAVORING
3
3
witch hazel extract
(bulk)
3
vidarabine monohydrate
(bulk)
3
WITEPSOL H-15
3
vinpocetine (bulk)
3
WOUND CARE
CREAM
3
violet food color (bulk)
3
xanthan gum
3
vit e acid succinate
(bulk)
3
XCEL 100
3
vitamin a acetate (bulk)
beads
xylitol (bulk)
3
3
xylometazoline (bulk)
3
vitamin a palmitate
3
yeast extract (bulk)
3
vitamin a palmitate
(bulk)
yellow food color (bulk)
3
3
3
vitamin e (dl, acetate)
(bulk)
YLANG-YLANG
FRAGRANCE
3
yohimbine
3
vitamin e acetate (bulk)
3
zeaxanthin (bulk)
3
VITAMIN K1
3
1
VITAMIN K-1
3
zinc acetate dihydrate
(bulk) crystals
vitamin k2 (bulk)
3
3
V-MAX
3
zinc acetate dihydrate
(bulk) powder
voriconazole (bulk)
3
zinc chloride (bulk)
3
warfarin (bulk)
3
zinc citrate (bulk)
3
water
3
zinc gluconate (bulk)
3
watermelon flavor
(bulk)
1
zinc methionine sulfate
(bulk)
3
WATERMELON
FLAVORING
zinc oxide (bulk)
1
3
zinc picolinate (bulk)
3
whey protein isolate
(bulk)
3
zinc sulfate (bulk)
powder
3
white food color (bulk)
3
zinc undecylenate
3
white petrolatum (bulk)
1
zolmitriptan (bulk)
3
zonisamide (bulk)
3
this table.
137
Drug Name
/Limits
CHEMICALS ACIDS
acetic acid (bulk) liquid
100 %, 3 %, 5 %
3
glycolic acid
3
glycolic acid (bulk)
1
hydrochloric acid (bulk)
3
lactic acid (bulk) liquid
88 % to 92 % (usp)
1
maleic acid (bulk)
3
nitric acid (bulk)
3
oxalic acid
1
sulfuric acid (bulk)
3
CHEMICALS BASES
Drug Name
/Limits
cedar leaf oil
3
CINNAMON OIL
3
citronella oil
3
clove oil (bulk)
3
eucalyptus oil oil
3
lime oil (bulk)
3
pine needle oil
3
pine oil (bulk)
3
rose oil
3
rosemary oil
3
1
TANGERINE OIL,
NATURAL
1
CHEMICALS FIXED OILS
ORA-HESIVE BASE
3
potassium hydroxide
(bulk) pellet
3
castor oil
1
cottonseed oil (bulk)
3
LINSEED OIL
3
olive oil
1
peanut oil
3
potassium hydroxide
(bulk) solution 10 %, 20
%, 45 % (w/w)
3
sodium hydroxide
3
safflower oil
3
pellet
3
SWEET OIL
1
SWEET OIL ORAL
3
powder
3
CHEMICALS BUFFERS
BORAX
3
sodium carb anhydrous
(bulk)
3
tartaric acid (bulk)
3
CHEMICALS CRYOPRESERVAT
IVE AGENTS
CRYOSERV
3
CHEMICALS ESSENTIAL OILS
anise
3
CHEMICALS SOLVENTS
2-methoxyethanol (bulk)
3
acetone
1
ALCOHOL,
DENATURED
1
ALCOHOL, RUBBING
1
alpha pinene (bulk)
3
chloroform
3
dimethyl sulfoxide
(bulk) liquid 99 %
1
dimethylacetamide
(bulk)
3
DY-O-DERM
1
this table.
138
Drug Name
/Limits
Drug Name
/Limits
ether (bulk)
3
ethyl alcohol (bulk)
3
glycerin (bulk) liquid
100 %
1
PHARMACEUTICA
L ADJUVANT CAPSULE
EXCIPIENTS
glycerol formal (bulk)
1
CAPSUBLEND-H
3
glycofurol (bulk)
3
CAPSUBLEND-P
3
INSTACLEAN
1
CAPSUBLEND-S
3
isopropyl alcohol
solution 70 %, 91 %, 99
%
3
1
FAGRON CAPFILL
PRO
3
isopropyl palmitate
3
FREEDOM
SIMPLECAP
isopropyl palmitate
(bulk)
3
m-cresol acetate (bulk)
3
meta-cresol (bulk)
3
methyl alcohol
3
mineral oil
1
CAPSULE #0
(CELLULOSE)
1
MINERAL OIL
HEAVY
1
CAPSULE #00
(CELLULOSE)
1
MINERAL OIL LIGHT
1
MURI-LUBE
3
CAPSULE #1
(CELLULOSE)
1
PROPANEDIOL
3
1
propylene glycol (bulk)
1
CAPSULE #3
(CELLULOSE)
sesame oil
3
sodium succinate
1
turpentine (bulk)
3
PHARMACEUTICA
L ADJUVANT ANTICORROSIVE
AGENTS
PHARMACEUTICA
L ADJUVANT CELLULOSE
CAPSULES
(EMPTY)
PHARMACEUTICA
L ADJUVANT COLORING
AGENTS
black food color (bulk)
3
blue food color (bulk)
3
blue royal (food color)
(bulk)
3
butylated
hydroxytoluene powder
3
d and c green no.6
(bulk)
3
potassium metabisulfite
(bulk)
3
evans blue (bulk)
3
sodium bisulfite
3
3
3
fd and c no.3 (green)
(bulk)
3
this table.
139
Drug Name
/Limits
fd and c no.40 red
(bulk)
3
FD AND C RED NO.3
Drug Name
/Limits
APOTHESIL BASE
3
AQUABASE
1
3
AQUAPHILIC
3
fdc 6 (sunset yel fcf)
(bulk)
3
ARBEM
H-COSMETIC
3
fdc no.5 (tartrazine)
(bulk)
3
ARBEM LIPOPEN
3
FOOD COLOR
BROWN
3
AUXIPRO
VANISHING CREAM
3
FOOD COLOR
GREEN
AZ
1
3
BASE W301
1
FOOD COLOR RED
3
3
green food color (bulk)
liquid
BASE, PCCA COBASE
#1
3
BHRT BASE
3
lime green food color
(bulk)
3
BIOPEPTIDE
BIOCOSMETIC BASE
3
LISSAMINE GREEN B
3
CELA CREAM BASE
3
methylene blue
(bulk-solid)
cetyl esters (bulk)
3
3
cocoa butter
1
orange food color (bulk)
3
1
pink food color (bulk)
3
cocoa butter (bulk)
topical ointment
red food color (bulk)
liquid
1
3
CUTIS PLUS
3
scarlet red (bulk)
3
1
violet food color (bulk)
3
DELBASE
COMPOUNDING
white food color (bulk)
3
1
yellow food color (bulk)
3
DERMAFIX TOPICAL
OINTMENT
DERMA-N
3
FAGRON LS PLUS
3
FAGRON LS ULTRA
3
3
PHARMACEUTICA
L ADJUVANT CREAM/OINTMEN
T VEHICLES
1ST BASE
3
FAGRON NATURAL
CREAM
ALBA-DERM
3
FATTIBASE
1
ALPAWASH
3
3
ANHYDROUS BASE
3
FITALITE CREAM
BASE
ANHYDROUS
OINTMENT
FP DERM CREAM
3
3
3
APOTHEDERM
TRANSDERMAL
FP NATURAL
CREAM
3
FP PLUS CREAM
3
this table.
140
Drug Name
/Limits
Drug Name
/Limits
FP ULTRA CREAM
3
3
FREEDOM
ADAPTADERM
CREAM
MEDIHOL GEL BASE
ALCOHOL
3
MEDIUM CREAM
1
MULTIBASE
1
FREEDOM DERMA-D
3
MULTIUSE BASE
1
FREEDOM
ULTRAPEN
3
NOURIVAN ANTIOX
3
HRT BASE
3
OLEABASE
PLASTICIZED
3
HRT BASE (JOJOBA)
3
paraffin
3
HRT BASE
BOTANICAL
3
PCCA ANHYDROUS
LIPODERMA
3
HRT BASE HEAVY
3
PCCA MBK BASE
3
HRT CREAM BASE
WOMEN
3
PCCA MVC CREAM
3
HRT NATURAL
CREAM BASE
PCCA NATACREAM
1
3
3
hydrophilic
1
PCCA VANISHING
BASE
HYDROPHILIC
OINTMENT
BASE(FAG)
PEGBLEND
1
1
PENTRAVAN
3
PETROLATUM
1
HYDROPHILIC
PETROLATUM
1
petrolatum, yellow
(bulk)
1
HYDROUS
EMULSIFIED BASE
1
PETROLEUM JELLY
1
IDEALBASE
3
PETROLEUM JELLY,
WHITE
1
lanolin alcohols (bulk)
3
PFCB
3
lanolin anhydrous
3
PHARMABASE
1
LIP BALM NATURAL
3
1
LIP TREATMENT
3
PHARMABASE
HEAVY
LIPO CREAM BASE
3
1
LIPOBASE HEAVY
3
PHARMABASE
LIGHT
LIPOBASE REGULAR
1
PHARMABASE
NATURAL
1
LIPOPEN PLUS
3
LIPOPEN ULTRA
3
PHARMABASE
VAGINAL
1
LIPOVAN CREAM
BASE
1
PHYTOBASE
3
LIPOZYME BASE
3
PLO GEL MEDIFLO
PRE-MIXED
3
MEDIBASE C
3
PLO TRANSDERMAL
3
MEDIDERM
3
PLO20
3
this table.
141
Drug Name
/Limits
Drug Name
/Limits
PNA-HRT BASE
CREAM
3
VANISH-PEN CREAM
BASE
1
POLYBASE
1
VASELINE
1
polyethylene glycol
1000
1
VERSABASEA
3
3
VERSAPRO CREAM
BASE
3
polyethylene glycol
3350
1
VERSAPRO GEL
BASE
3
polyethylene glycol
3350(bulk)
1
VERSASKIN
3
VERSATILE
1
(bulk) liquid
3
VERSATILE RICH
3
(bulk) liquid
VERSIGEL
3
3
V-MAX
3
polyethylene glycol
8000(bulk)
white petrolatum (bulk)
1
3
1
propylene glycol
m-stear(bulk)
white petrolatum topical
gel
3
1
Q-DERM
3
WHITE PETROLEUM
JELLY
rosin (bulk)
3
3
SALT DURABLE
3
WHITE WAX
(BEESWAX)
SALTSTABLE LO
1
3
SALTSTABLE LS
1
WILEY BASIC
ELEMENTS BHRT
BASE
SEDANARE
3
3
SILOSOME
3
WOUND CARE
CREAM
SPERMACETI
3
XCEL 100
3
STERA BASE
3
3
TDC MAX
3
YELLOW WAX
(BEESWAX)
TRANS D HORMONE
BASE
3
TRANS-PEN
TRANSDERMAL
1
TROCHE BASE
PELLET
PHARMACEUTICA
L ADJUVANT EXTERNAL
VEHICLES
ANHYDROUS GEL
3
3
BASE 7542
3
U-BASE
1
1
ULTRADERM BASE
3
BASE, PCCA
POLYPEG
UNIBASE
3
BASE, PCCA
SPIRA-WASH
3
VANISHING CREAM
3
BASE, PCCA
SUSPENDALL
3
this table.
142
Drug Name
/Limits
Drug Name
/Limits
BASE, PCCA
VANPEN
1
PCCA CUSTOM
LIPO-MAX
3
BASE, PCCA
VERSABASE
3
PCCA LIPODERM
HMW
3
CARBOHOL
3
CARBOMER
GEL-AQUEOUS
3
3
PENCREAM
COMPOUNDING
AGENT
CHRYSADERM DAY
CREAM
3
PLO GEL PREMIUM
LECITHIN BASE
3
CHRYSADERM
NIGHT CREAM
3
PLO ULTRAMAX
GEL PREM LECITHIN
3
3
PLO20 FLOWABLE
3
3
PRACASIL TM-PLUS
3
DENTAL BASE
3
propylene glycol
1
ESPUMIL
3
3
FAGRON SUPREME
CREAM
SANARE ADV SCAR
THERAPY BASE
3
3
FP ENHANCING
CREAM
SCAR CARE BASE
ENHANCED
3
SIMPLGEL 30
3
FP SUPREME CREAM
3
TOMMY GEL
3
FREEDOM HRT
ULTRA CREAM
3
TRANSDERMAL
PAIN BASE
3
HRT CREAM
3
3
HRT GEL BASE MEN
3
UNIVERSAL WATER
GEL
HRT SUPREME
CREAM BASE
3
VANIBASE
TRADITIONAL
FORMULA
1
HUMCO BASE, PAIN
MGMT
3
VANISHING
BOTANICAL
1
HYDROGEL
3
LIPOBASE BASE
(GEL MATRIX)
3
3
VERSABASE
TOPICAL GEL
LIPOPEN
ABSORPTION
3
3
VERSABASE
TOPICAL LOTION
LIQUIGEL COMPLEX
3
MICRODERM BASE
CREAM
3
MICROSOME BASE
CREAM
3
(d)-limonene flavor
(bulk)
1
NOURISIL
3
ALFALFA FLAVOR
3
PHARMACEUTICA
L ADJUVANT FLAVORING
AGENTS
this table.
143
Drug Name
/Limits
almond oil, sweet (bulk)
3
anise flavor extract
(bulk)
1
apple flavor (bulk)
liquid
Drug Name
/Limits
cheesecake flavor (bulk)
1
cherry-ade flavor (bulk)
3
chlorhexidine (bulk)
1
1
liquid
1
apple flavor (bulk)
powder
3
powder
3
APPLE FLAVORING
3
APPLE-ADE FLAVOR
1
chocolate hazelnut flav
(bulk)
1
liquid
1
CINNAMON
FLAVORING
3
BANANA
CONCENTRATE
1
CLOVE FLAVORING
3
coconut flavor (bulk)
1
BANANA CREAM
FLAVOR
1
coconut oil (bulk)
3
banana creme flavor
(bulk)
coffee flavor (bulk)
1
1
cola flavor (bulk)
1
banana flavor (bulk)
1
1
BASE, PCCA BITTER
DRUG
cotton candy flavor
(bulk)
3
1
bitter almond oil (bulk)
1
cran-raspberry flavor
(bulk)
bitter mask flavoring
(bulk)
cream de menthe (bulk)
1
1
3
BITTERNESS MASK
FLAVOR
dihydroxyacet 1,3 dimer
(bulk)
1
1
blackberry flavor (bulk)
1
ENGLISH TOFFEE
FLAVOR
BLUEBERRY
FLAVOR
ethyl acetate
3
1
eucalyptol
3
BUBBLE GUM
CONCENTRATE
1
EUCALYPTUS
FLAVOR
3
bubblegum flavor (bulk)
1
eucalyptus oil oil 100 %
3
butter flavor (bulk)
1
FLAVOR PACKETS
3
butter rum flavor (bulk)
1
FLAVORX
1
BUTTER RUM
FLAVORING
FLAVOUR PAC
3
3
grape flavor (bulk)
1
butterscotch flavor
(bulk)
1
GRAPEFRUIT
1
guava flavor (bulk)
1
BUTTERSCOTCH
FLAVORING
1
honey flavor (bulk)
1
caramel flavor (bulk)
1
kahlua flavor (bulk)
1
this table.
144
Drug Name
/Limits
lemon flavor extract
(bulk)
1
LEMON FLAVORING
3
lemon oil
3
lemonade flavor oil
(bulk)
1
licorice flavor (bulk)
1
LIME FLAVOR
1
lime oil (bulk)
3
MAGNASWEET 110
1
MAGNASWEET 135
3
mango flavor (bulk)
Drug Name
/Limits
PUMPKIN FLAVOR
1
liquid
1
powder
3
raspberry flavor,
artificial
3
RASPBERRY
FLAVORING
3
root beer flavor (bulk)
1
sassafras oil
3
3
SPEARMINT
FLAVORING
3
maple flavor (bulk)
1
spearmint oil
1
marshmallow flavor
(bulk)
1
strawberry flavor (bulk)
1
mint chocolate chip flv
(bulk)
1
STRAWBERRY
FLAVORING
3
super synersweet flavor
(bulk)
3
SWEET OIL
1
SWEETNESS
ENHANCER FLAVOR
1
tangerine flavor (bulk)
3
1
TANGERINE OIL,
NATURAL
1
1
NATURAL
BITTERNESS
MASKING
3
ORANGE
CONCENTRATE
1
orange cream flavor
(bulk)
1
orange oil
3
passion fruit flavor
(bulk)
3
peach flavor (bulk)
1
teaberry oil flavor
(bulk)
PEANUT BUTTER
FLAVOR
1
tropical punch flavor
(bulk)
1
peanut butter flavor
(bulk)
tutti-frutti flavor (bulk)
1
1
PEPPERMINT
FLAVORING
1
1
VANILLA
BUTTERNUT
FLAVOR
pina colada flavor
(bulk)
3
vanilla butternut
flavor(bulk)
1
pineapple flavor (bulk)
1
1
pralines and cream
flavr(bulk)
vanilla extract flavor
(bulk)
1
vanillin (bulk) powder
3
this table.
145
Drug Name
/Limits
watermelon flavor
(bulk)
1
WATERMELON
FLAVORING
3
wild cherry flavor (bulk)
1
WINTERGREEN
FLAVORING
3
PHARMACEUTICA
L ADJUVANT GELATIN
CAPSULES
(EMPTY)
Drug Name
/Limits
CAPSULE
CONI-SNAP #3
(GELATIN)
1
CAPSULE
CONI-SNAP #4
(GELATIN)
1
PHARMACEUTICA
L ADJUVANT HYPROMELLOSE
CAPSULES
(EMPTY)
AR CAPS
3
CAPSULE #0
1
CAPSULE #0
1
CAPSULE #00
1
1
CAPSULE #000
1
CAPSULE #0
(HYPROMELLOSE)
CAPSULE #1
1
CAPSULE #0 DRCAPS
1
CAPSULE #10
1
CAPSULE #00
(HYPROMELLOSE)
1
CAPSULE #11
1
CAPSULE #13
1
CAPSULE #1
(HYPROMELLOSE)
1
CAPSULE #2
1
CAPSULE #1 DRCAPS
1
CAPSULE #3
1
1
CAPSULE #4
1
CAPSULE #3
(HYPROMELLOSE)
CAPSULE #5
1
CAPSULE #4
1
CAPSULE #7
1
CAPSULE
CONI-SNAP #0
(GELATIN)
1
1
CAPSULE
CONI-SNAP
#0(HYPROMEL)
CAPSULE
CONI-SNAP #00
(GELATIN
1
1
CAPSULE
CONI-SNAP
#1(HYPROMEL)
CAPSULE
CONI-SNAP #000
1
1
CAPSULE
CONI-SNAP
#3(HYPROMEL)
CAPSULE
CONI-SNAP #1
(GELATIN)
1
CAPSULE
CONI-SNAP #2
(GELATIN)
PHARMACEUTICA
L ADJUVANT INHALATION
VEHICLES
1
HYPER-SAL
3
NEBUSAL
3
PULMOSAL
3
this table.
146
Drug Name
/Limits
sodium chloride
inhalation solution for
nebulization 0.9 %, 7 %
1
sodium chloride
nebulization 10 %, 3 %
3
PHARMACEUTICA
L ADJUVANT LIQUID VEHICLES
OTHER
PCCA NATAPRES
3
water
3
PHARMACEUTICA
L ADJUVANT LIQUID VEHICLES
Drug Name
/Limits
PHARMACEUTICA
L ADJUVANT LOTION
VEHICLES
FP NATURAL
LOTION
3
HRT NATURAL
LOTION BASE
3
VERSAPRO LOTION
BASE
3
PHARMACEUTICA
L ADJUVANT ORAL
THICKENING
AGENTS
DIAFOODS THICK-IT
1
DIAFOODS THICK-IT
#2
1
RESOURCE
THICKENUP ORAL
PACKET
3
1
3
RESOURCE
THICKENUP ORAL
POWDER
FP DERM GEL
3
SIMPLYTHICK
2
FP SILO GEL
3
THICK NOW
1
FREEDOM
ADAPTADERM
3
THICKEN UP CLEAR
ORAL POWDER
1
FREEDOM ALCOHOL
3
FREEDOM CEPAPRO
3
3
FREEDOM DERMA
SERUM
THICKEN UP CLEAR
ORAL POWDER IN
PACKET
3
THICK-IT #2
1
FREEDOM SILOMAC
3
FREEDOM SILOMAC
ULTRA
3
PHARMACEUTICA
L ADJUVANT ORAL VEHICLES
gelatin troche base #53
(bulk)
3
H2O GEL BASE
KRISGEL 100
BASE, PCCA
EMULSIFIX-205
3
BASE, PCCA
MUCOLOX
3
CARBOHOL
3
COPASIL
3
FAGRON VERSIFIX
3
FP CEPA GEL
BASE, PCCA ACACIA
3
3
BASE, PCCA SYRUP
VEHICLE
3
3
cherry flavor oral
1
PA
cpd vehicle
LAVARE WOUND
3
3
sus.sugar-free #12
WASH
this table.
147
Drug Name
/Limits
ENFAMIL WATER
3
FLAVOR BLEND 2 IN
1
1
FLAVOR PLUS
1
FLAVOR SWEET
1
FLAVOR SWEET-SF
1
GERBER GOOD
START WATER
3
ORA-BLEND
1
ORA-BLEND SF
1
ORAL MIX
1
ORAL MIX SF
1
ORAL SUSPEND
1
ORAL SYRUP
1
ORAL SYRUP SF
1
orange flavor (bulk)
Drug Name
/Limits
PHARMACEUTICA
L ADJUVANT PARENTERAL
VEHICLES
BACTERIOSTATIC
WATER(PARABENS)
1
DILUENT FOR
EPOPROSTENOL/FLO
LA
4
PHARMACEUTICA
L ADJUVANT PERFUMES
gardenia fragrance
(bulk)
3
honey almond fragrance
(bulk)
3
1
jasmine fragrance
(bulk)
3
ORA-PLUS
1
kiwi fragrance (bulk)
3
ORA-SWEET
1
lavender oil
3
ORA-SWEET SF
1
PCCA-PLUS BASE
3
powder scent fragrance
(bulk)
3
raspberry
3
ROSE WATER
3
SIMILAC
STERILIZED WATER
3
shower fresh fragrance
(bulk)
3
simple syrup
1
sorbitol solution
1
SWEET-SF
3
SYRPALTA VEHICLE
1
butylparaben (bulk)
3
SYRSPEND SF
3
3
SYRSPEND SF ALKA
1
chloroallyl methenam cl
(bulk)
SYRSPEND SF
LIQUID
imidurea (bulk)
3
1
propyl gallate (bulk)
3
SYRUP VEHICLE SF
3
propylparaben (bulk)
3
VERSA FREE
1
sodium benzoate (bulk)
1
VERSA PLUS
1
PHARMACEUTICA
L ADJUVANT SUPPOSITORY
VEHICLES
PHARMACEUTICA
L ADJUVANT PRESERVATIVES
FATTYBLEND
1
this table.
148
Drug Name
/Limits
POLYPEG
SUPPOSITORY BASE
3
SPG SUPPOSI-BASE
3
SUPPOSIBASE F
3
SUPPOSIBLEND
3
WITEPSOL H-15
3
PHARMACEUTICA
L ADJUVANT SURFACTANTS
Drug Name
/Limits
PHARMACEUTICA
L ADJUVANT SUSPENDING
AGENTS
alkyl (c12-15) benzoate
(bulk)
1
bentonite powder
3
BRIJ 35 WAX
3
calcium alginate (bulk)
3
CARBOGEL
3
carbomer 934 (bulk)
3
ammonium lauryl
sulfate (bulk)
3
BASE-I SORBITAN
MONOPALMITATE
3
carbomer homopolymer
c (bulk)
3
BRIJ 93
3
cholesterol (bulk)
3
carboxymethyl sod, low
(bulk)
3
glyceryl monostearate
3
carrageenan (bulk)
3
glyceryl oleate (bulk)
3
diethanolamine (bulk)
3
lauric acid (bulk)
3
FREEDOM SET-GEL
3
poloxalene (bulk)
3
gelatin (bulk)
1
3
guar gum
3
(bulk) wax
3
hydroxypropyl cellulose
3
hypromellose
3
3
3
METHOCEL E 4 M
GRANULES
1
polysorbate 60
3
3
polysorbate 80
1
METHOCEL E 4 M
POWDER
sodium laureth sulfate
(bulk)
oleic acid
3
3
polyvinyl alcohol (bulk)
3
sodium lauryl sulfate
(bulk)
3
SEPINEO P 600
3
sodium silicate
3
stearic acid (bulk)
3
SUSPENDOL-S
1
triethanolamine
l.sulfat(bulk)
3
tragacanth powder
1
VEEGUM
3
TRITON X-100
3
PHARMACEUTICA
L ADJUVANT TABLETING
BASE, PCCA RAPID
DISSOLVE
3
this table.
149
Drug Name
/Limits
cellulose (bulk)
3
FREEDOM ODT BASE
Drug Name
/Limits
3
3
ceto.alcohol-ceteareth2
0(bulk)
lactose (bulk)
1
cetyl alcohol
3
magnesium stearate
3
cetyl alcohol (bulk)
3
MEDI-RDT BASE
3
3
RAPID DISSOLVE
TABLET
coconut diethanolamide
(bulk)
3
CYCLOMETHICONE
3
stearic acid
3
3
THIK AND CLEAR
3
EMULSION
CONCENTRATE
ethyl oleate (bulk)
3
ethylenediamine (bulk)
3
FREEDOM
POLYMATRIX
3
hydroxypropyl betadex
(bulk)
3
maltodextrin (bulk)
3
monosodium glutamate
(bulk)
3
palmarosa oil (bulk)
3
peg-40 castor oil (bulk)
3
PLO GEL MEDIFLO
3
PLO GEL MEDIFLO
COMPOUND B
3
sodium decanoate (bulk)
3
PHARMACEUTICA
L ADJUVANT TROCHE/SOFT
LOZENGE BASE
BASE, CUSTOM
POLYGLYCOL
3
FREEDOM PEG
TROCHE BASE
3
LOZIBASE
3
polyethylene glycol
1450
1
POLYGLYCOL
TROCHE BASE
3
TROCHE BASE
POWDER
3
TROCHIBASE
1
sodium stearate (bulk)
3
TROCHIBASE S
3
stearyl alcohol
1
TROCHIBASE S
CLASSIC
1
PHARMACEUTICA
L ADJUVANTS
PHARMACEUTICA
L ADJUVANT VEHICLE
EXCIPIENTS
BASE, PCCA
LOXORAL
3
BASE, PCCA
XYLIFOS
3
BUFFER CREAM
3
CARBOMER
GEL-HYDROALCOH
OLIC
3
BRIJ 700
3
peg 400 monostearate
(bulk)
3
sodium stearyl fumarate
(bulk)
3
this table.
150
Drug Name
/Limits
Drug Name
/Limits
ALZHEIMER'S
THX - NMDA
RECEPTOR
ANTAG. &
CHOLINESTERAS
E INHIB. COMB
COGNITIVE
DISORDER
THERAPY
ALZHEIMER'S
DISEASE
THERAPY CHOLINESTERAS
E INHIBITORS
NAMZARIC
3
PA
ergoloid
2
PA
ergoloid (bulk)
3
COGNITIVE
DISORDER
THERAPY CEREBRAL
VASODILATORS
ARICEPT
3
PA
donepezil oral tablet 10
mg, 5 mg
2
PA
donepezil oral tablet 23
mg
3
PA
donepezil oral
2
PA
EXELON ORAL
CAPSULE
3
PA
EXELON
TRANSDERMAL
2
PA
galantamine
2
PA
NEXPLANON
RAZADYNE ER
3
PA
RAZADYNE ORAL
TABLET
3
PA
CONTRACEPTIVE
INJECTABLE PROGESTIN
rivastigmine tartrate
3
PA
ALZHEIMER'S
DISEASE
THERAPY - NMDA
RECEPTOR
ANTAGONISTS
memantine hcl (bulk)
3
memantine oral tablet
2
PA
memantine oral
tablets,dose pack
3
PA
NAMENDA
3
PA
NAMENDA
TITRATION PAK
2
PA
NAMENDA XR
2
PA
CONTRACEPTI
VES
CONTRACEPTIVE
IMPLANT PROGESTIN
4
DEPO-PROVERA
INTRAMUSCULAR
SUSPENSION
3
DEPO-PROVERA
INTRAMUSCULAR
SYRINGE
3
DEPO-SUBQ
PROVERA 104
3
medroxyprogesterone
intramuscular
1
CONTRACEPTIVE
INTRAUTERINE COPPER IUD
PARAGARD T 380A
3
this table.
151
Drug Name
/Limits
CONTRACEPTIVE
INTRAUTERINE PROGESTERONE
IUD
Drug Name
/Limits
AVIANE
1
BALZIVA (28)
3
BEYAZ
3
LILETTA
1
BLISOVI FE 1.5/30
(28)
1
MIRENA
2
BREVICON (28)
3
SKYLA
2
BRIELLYN
3
CHATEAL
1
CRYSELLE (28)
1
CYCLAFEM 1/35 (28)
1
DASETTA 1/35 (28)
1
DELYLA (28)
3
DESOGEN
3
desogestrel-ethinyl
estradiol
1
1
CONTRACEPTIVE
ORAL - BIPHASIC
AMETHIA
3
AMETHIA LO
3
ASHLYNA
3
AZURETTE (28)
1
CAMRESE
3
CAMRESE LO
1
DAYSEE
3
desog-e.estradiol/e.estra
diol
3
drospirenone-ethinyl
estradiol oral tablet
3-0.03 mg
KARIVA (28)
1
ELINEST
1
KIMIDESS (28)
3
EMOQUETTE
1
ENSKYCE
1
ESTARYLLA
1
FALMINA (28)
1
FEMCON FE
3
GENERESS FE
3
GIANVI (28)
1
GILDAGIA
3
GILDESS 1.5/30 (21)
1
GILDESS 1/20 (21)
1
GILDESS 24 FE
1
GILDESS FE 1.5/30
(28)
1
GILDESS FE 1/20 (28)
1
INTROVALE
1
JOLESSA
1
JUNEL 1.5/30 (21)
1
JUNEL 1/20 (21)
1
l
norgest/e.estradiol-e.est
rad
3
LO LOESTRIN FE
1
LOSEASONIQUE
3
MIRCETTE (28)
3
NECON 10/11 (28)
1
PIMTREA (28)
1
SEASONIQUE
3
VIORELE (28)
1
CONTRACEPTIVE
ORAL MONOPHASIC
ALTAVERA (28)
1
ALYACEN 1/35 (28)
1
AMETHYST
3
APRI
1
AUBRA
1
this table.
152
Drug Name
/Limits
JUNEL FE 1.5/30 (28)
1
JUNEL FE 1/20 (28)
1
JUNEL FE 24
1
KELNOR 1/35 (28)
1
KURVELO
1
LARIN 1.5/30 (21)
3
LARIN 1/20 (21)
3
LARIN 24 FE
1
LARIN FE 1.5/30 (28)
1
LARIN FE 1/20 (28)
1
LAYOLIS FE
3
LESSINA
1
levonorgestrel-ethinyl
estrad oral tablet 0.1-20
mg-mcg, 0.15-0.03 mg
1
estrad oral tablet 90-20
mcg
3
Drug Name
/Limits
MICROGESTIN FE
1.5/30 (28)
1
MICROGESTIN FE
1/20 (28)
1
MINASTRIN 24 FE
1
MODICON (28)
3
MONO-LINYAH
1
MONONESSA (28)
1
NECON 0.5/35 (28)
1
NECON 1/35 (28)
1
NECON 1/50 (28)
1
NIKKI (28)
3
noreth-ethinyl
estradiol-iron
1
norethindrone ac-eth
1-20 mg-mcg
1
norethindrone-e.estradi
ol-iron oral tablet 1
mg-20 mcg (21)/75 mg
(7)
3
norethindrone-e.estradi
ol-iron oral tablet 1
mg-20 mcg (24)/75 mg
(4)
1
estrad oral tablets,dose
pack,3 month
1
LEVORA-28
1
LOESTRIN 1.5/30 (21)
3
LOESTRIN 1/20 (21)
3
LOESTRIN FE 1.5/30
(28-DAY)
3
1
LOESTRIN FE 1/20
(28-DAY)
norgestimate-ethinyl
0.25-35 mg-mcg
3
NORINYL 1+35 (28)
3
LOMEDIA 24 FE
1
NORINYL 1+50 (28)
1
LORYNA (28)
1
NORTREL 0.5/35 (28)
1
LOW-OGESTREL (28)
1
NORTREL 1/35 (21)
1
LUTERA (28)
1
OCELLA
1
MARLISSA
1
OGESTREL (28)
1
MICROGESTIN 1.5/30
(21)
ORSYTHIA
1
1
ORTHO-CYCLEN (28)
3
MICROGESTIN 1/20
(21)
1
ORTHO-NOVUM 1/35
(28)
3
MICROGESTIN 24 FE
1
OVCON-35 (28)
3
this table.
153
Drug Name
PHILITH
/Limits
3
Drug Name
/Limits
NORLYROC
3
NOR-QD
3
ORTHO MICRONOR
3
SHAROBEL
3
PIRMELLA ORAL
TABLET 1-35
MG-MCG
1
PORTIA
1
PREVIFEM
1
QUASENSE
1
CONTRACEPTIVE
ORAL QUADRAPHASIC
RECLIPSEN (28)
1
NATAZIA
3
SAFYRAL
3
QUARTETTE
3
SPRINTEC (28)
1
SRONYX
1
SYEDA
1
CONTRACEPTIVE
ORAL TRIPHASIC
TARINA FE 1/20 (28)
3
ALYACEN 7/7/7 (28)
1
VESTURA (28)
1
ARANELLE (28)
1
VYFEMLA (28)
3
CAZIANT (28)
1
WERA (28)
1
CYCLAFEM 7/7/7 (28)
1
WYMZYA FE
3
CYCLESSA (28)
3
YASMIN (28)
3
DASETTA 7/7/7 (28)
1
YAZ (28)
3
ENPRESSE
1
ZARAH
1
ESTROSTEP FE-28
3
ZENCHENT (28)
3
LEENA 28
1
ZENCHENT FE
3
LEVONEST (28)
1
ZOVIA 1/35E (28)
1
MYZILRA
1
ZOVIA 1/50E (28)
1
NECON 7/7/7 (28)
1
norgestimate-ethinyl
0.18/0.215/0.25 mg-35
mcg (28)
1
NORTREL 7/7/7 (28)
1
ORTHO TRI-CYCLEN
(28)
3
ORTHO TRI-CYCLEN
LO (28)
1
ORTHO-NOVUM 7/7/7
(28)
3
PIRMELLA ORAL
TABLET 0.5/0.75/1
MG- 35 MCG
1
CONTRACEPTIVE
ORAL PROGESTIN
CAMILA
1
DEBLITANE
3
ERRIN
1
HEATHER
1
JENCYCLA
1
JOLIVETTE
1
LYZA
1
NORA-BE
1
norethindrone
(contraceptive)
1
TILIA FE
3
this table.
154
Drug Name
/Limits
Drug Name
/Limits
TRI-ESTARYLLA
1
TRI-LEGEST FE
3
TRI-LINYAH
1
EMERGENCY
CONTRACEPTIVE
S
TRINESSA (28)
1
AFTERA
3
TRI-NORINYL (28)
3
ECONTRA EZ
3
TRI-PREVIFEM (28)
1
ELLA
1
TRI-SPRINTEC (28)
1
FALLBACK SOLO
1
TRIVORA (28)
1
MY WAY
1
VELIVET TRIPHASIC
REGIMEN (28)
1
NEXT CHOICE ONE
DOSE
1
OPCICON ONE-STEP
1
PLAN B ONE-STEP
1
TAKE ACTION
1
CONTRACEPTIVE
TRANSDERMAL
COMBINATIONS
XULANE
1
CONTRACEPTIVE
SINTRAVAGINAL,
SYSTEMIC
NUVARING
1
EMERGENCY
CONTRACEPTIVE
SPROGESTERONE
AGONIST/ANTAG
ONIST TYPE
ELLA
1
EMERGENCY
CONTRACEPTIVE
S - PROGESTIN
TYPE
SPERMICIDES
CONCEPTROL
3
GYNOL II
3
TODAY
CONTRACEPTIVE
SPONGE
3
VAGINAL
CONTRACEPTIVE
FILM
1
VAGINAL
CONTRACEPTIVE
FOAM
1
DERMATOLOGI
CAL
AFTERA
3
ACNE THERAPY
SYSTEMIC RETINOIDS &
DERIVATIVES
ECONTRA EZ
3
ABSORICA
3
FALLBACK SOLO
1
CLARAVIS
1
MY WAY
1
isotretinoin (bulk)
3
NEXT CHOICE ONE
DOSE
1
3
OPCICON ONE-STEP
1
MYORISAN ORAL
CAPSULE 10 MG, 20
MG, 40 MG
PLAN B ONE-STEP
1
ZENATANE
3
TAKE ACTION
1
this table.
155
Drug Name
/Limits
ACNE THERAPY
SYSTEMIC TETRACYCLINES
SOLODYN ORAL
TABLET EXTENDED
RELEASE 24 HR 105
MG, 115 MG, 55 MG,
65 MG, 80 MG
3
3
ACNE THERAPY
TOPICAL ANTI-INFECTIVE
COMBINATIONS
OTHER
CLINDACIN ETZ
TOPICAL KIT
3
CLINDACIN PAC
3
ACNE THERAPY
TOPICAL ANTI-INFECTIVE
ACZONE
3
azelaic acid (bulk)
flakes 100 %, 88 %
3
azelaic acid (bulk)
powder 100 %
3
AZELEX
3
CLEOCIN T
3
CLINDACIN ETZ
TOPICAL SWAB
3
CLINDACIN P
Drug Name
/Limits
topical swab
3
ERY PADS
1
ERYGEL
3
erythromycin with
ethanol
1
EVOCLIN
3
FINACEA
3
KLARON
1
METROCREAM
3
METROLOTION
3
metronidazole topical
cream
1
metronidazole topical
lotion
1
NORITATE
3
ROSADAN TOPICAL
CREAM
1
powder
3
(acne)
1
ACNE THERAPY
TOPICAL ANTI-INFECTIVEKERATOLYTIC
COMBINATIONS
ACANYA
3
AVAR
3
3
AVAR LS
3
CLINDAGEL
3
AVAR-E LS
3
topical foam
3
BENZACLIN
3
BENZACLIN PUMP
3
topical gel
1
BENZAMYCIN
3
topical lotion
BENZAMYCINPAK
3
1
BP 10-1
3
topical solution
1
CLEANSING WASH
TOPICAL CLEANSER
3
this table.
156
Drug Name
/Limits
clindamycin-benzoyl
peroxide
3
DUAC
Drug Name
/Limits
3
3
sulfacetamide
sod-sulfur-urea topical
cleanser
erythromycin-benzoyl
peroxide
1
sulfacetamide-sulfur-cle
ansr23
3
NEUAC
3
SULFACLEANSE 8-4
3
NEUAC KIT
3
3
ONEXTON
3
sulfact
na-sul-avobnz-otn-ocsa
PLEXION
3
SUMADAN
3
PLEXION
CLEANSING CLOTHS
SUMADAN XLT
3
3
SUMAXIN
3
ROSANIL
3
SUMAXIN CP
3
ROSULA
3
SUMAXIN TS
3
ROSULA CLEANSING
CLOTHS
ZENCIA
3
3
SS 10-2
3
SSS 10-5 TOPICAL
FOAM
3
sulfacetamide
sodium-sulfur topical
cleanser
3
sulfacetamide
cream 10-2 %, 9.8-4.8
%
3
sulfacetamide
foam
3
sulfacetamide
lotion 10-5 % (w/v),
10-5 % (w/w)
1
sulfacetamide
lotion 9.8-4.8 %
3
sulfacetamide
pads, medicated 10-4 %
3
sulfacetamide
suspension
3
ACNE THERAPY
TOPICAL ANTI-INFECTIVERETINOID
COMBINATIONS
VELTIN
3
ZIANA
3
ACNE THERAPY
TOPICAL KERATOLYTIC
COMBINATIONS
OTHER
INOVA 4-1
3
INOVA 8-2
3
ACNE THERAPY
TOPICAL KERATOLYTIC
MIXTURES
ACNOMEL
3
NUOX
3
REZAMID
1
ACNE THERAPY
TOPICAL KERATOLYTIC
ACNE CLEANSER
3
this table.
157
Drug Name
/Limits
ACNE CLEANSING
BAR
3
ACNE CLEANSING
PADS
1
Drug Name
/Limits
BPO CREAMY WASH
PACK
3
BPO TOPICAL GEL
1
BPO TOPICAL
TOWELETTE 6 %
3
BPO-10
3
ACNE CONTROL
CLEANSER
1
ACNE FOAMING
WASH
3
BPO-5
3
ACNE MEDICATION
3
CREAMY ACNE
FACE
3
ACNE PADS
1
DAILY FACE WASH
3
ACNE SPOT
TREATMENT
3
FOAMING ACNE
FACE WASH
3
ACNE TREATMENT
(BENZOYL PEROX)
TOPICAL CREAM
1
INOVA
3
INVISIBLE ACNE
1
LIQUIMAT
3
ACNE TREATMENT
(BENZOYL PEROX)
TOPICAL GEL
3
NEUTROGENA ON
THE SPOT
3
ACNE VANISHING
1
OC8
3
ACNE-CLEAR
3
PACNEX
3
BENZEFOAM
3
PACNEX HP
3
BENZEFOAM ULTRA
3
PACNEX LP
3
BENZEPRO
3
PACNEX MX
3
BENZEPRO
(MICROSPHERES)
3
PANOXYL
3
PANOXYL-4
3
benzoyl peroxide topical
cleanser 10 %, 5 %
1
PERSA-GEL
3
cleanser 6 %, 7 %
potassium hydroxide
3
3
3
foam
PR BENZOYL
PEROXIDE
3
1
gel 10 %, 2.5 %, 5 %
RAPID CLEAR
TREATMENT PADS
1
RIAX
3
lotion 10 %
SULFO-LO
3
1
1
BP FOAM
3
3
BP TOPICAL GEL
3
TARGETED ACNE
SPOT TREATMENT
BP WASH
3
BP WASH ACNE
TREATMENT
3
this table.
158
Drug Name
/Limits
TRETIN-X CREAM
KIT
ACNE THERAPY
TOPICAL KERATOLYTIC-G
LUCOCORTICOID
COMBINATIONS
VANOXIDE-HC
Drug Name
ACNE THERAPY
TOPICAL RETINOID
COMBINATIONS
OTHER
3
EPIDUO FORTE
3
3
ANTIPSORIATIC VITAMIN D
ANALOG GLUCOCORTICOI
D COMBINATIONS
1
EPIDUO
/Limits
calcipotriene-betametha
sone
3
TACLONEX
3
ANTIPSORIATIC
AGENTS - MC
ANTIBODY,
HUMAN
INTERLEUKIN
12/23 INHIBITORS
ACNE THERAPY
TOPICAL RETINOIDS &
DERIVATIVES
STELARA
SUBCUTANEOUS
SYRINGE
3
PA
COSENTYX
3
PA
COSENTYX (2
SYRINGES)
3
PA
COSENTYX PEN
2
PA
COSENTYX PEN (2
PENS)
2
PA
adapalene topical
cream
1
adapalene topical gel
0.1 %
1
0.3 %
3
with pump
3
adapalene topical lotion
3
ATRALIN
3
PA
AVITA
3
PA
DIFFERIN
3
FABIOR
3
RETIN-A
3
PA
RETIN-A MICRO
3
PA
RETIN-A MICRO
PUMP
3
PA
DERMATOLOGIC
AL ANTIBACTERIAL
& ANTIFUNGAL
AGENTS
tretinoin microspheres
3
PA
ALOQUIN
tretinoin topical cream
2
PA
tretinoin topical gel
0.01 %, 0.025 %
2
PA
TRETIN-X
3
PA
ANTIPSORIATIC
AGENTS - MC
ANTIBODY,
INTERLEUKIN-17
A ANTAGONIST
3
this table.
159
Drug Name
/Limits
DERMATOLOGIC
AL ANTIBACTERIAL
AMINOGLYCOSID
ES
gentamicin topical
1
DERMATOLOGIC
AL ANTIBACTERIAL
COMBINATIONS
OTHER
CAMPHO-PHENIQUE
TOPICAL SOLUTION
1
COLD SORE
TREATMNT
(CAMP-PHEN)
3
oxyquinoline sulfate
(bulk)
3
PAIN RELIEF
INSTANT
ANTISEPTIC
3
DERMATOLOGIC
AL ANTIBACTERIAL
MIXTURES
ANTIBIOTIC
(NEOMY-BACIT-POL
YM)
3
bacitracin-polymyxin b
topical
1
DOUBLE
ANTIBIOTIC
1
DOUBLE
ANTIBIOTIC
(B.TRACN ZN)
1
FIRST AID
ANTIBIOTIC
3
NEOSPORIN
(NEO-BAC-POLYM)
TOPICAL OINTMENT
3
POLY BACITRACIN
1
Drug Name
/Limits
POLY BACITRACIN
(ZINC)
1
POLYSPORIN
3
TRIPLE ANTIBIOTIC
3
WAL-SPORIN
3
DERMATOLOGIC
AL ANTIBACTERIAL
OTHER
BACTROBAN
TOPICAL CREAM
1
BACTROBAN
TOPICAL OINTMENT
3
CENTANY
3
CENTANY AT
3
EXCEL AP
3
mupirocin
1
mupirocin (bulk)
3
mupirocin calcium
1
SILVER GEL
3
silver nitrate topical
3
SILVERMED
TOPICAL CLEANSER
3
SILVRSTAT
3
DERMATOLOGIC
AL ANTIBACTERIAL
PLEUROMUTILIN
DERIVATIVES
ALTABAX
3
DERMATOLOGIC
AL ANTIBACTERIAL
POLYMYXINS
AND
DERIVATIVES
ANTIBIOTIC
(BACITRACIN ZINC)
1
bacitracin topical
1
this table.
160
Drug Name
/Limits
Drug Name
/Limits
bacitracin zinc topical
ointment
1
povidone-iodine topical
spray,non-aerosol
3
bacitracin zinc topical
packet
3
swab 10 %
1
BACITRAYCIN PLUS
TOPICAL OINTMENT
500 UNIT/GRAM
1
swab 7.5 %
3
DERMATOLOGIC
AL ANTIBACTERIAL
SULFONAMIDES
DERMATOLOGIC
AL ANTIBACTERIAL
POVIDONE-IODIN
E PREPARATIONS
AVAR-E
3
AVAR-E GREEN
3
ANTISEPTIC
SOLUTION
3
3
ANTISEPTIC
TOPICAL SOLUTION
SSS 10-5 TOPICAL
CREAM
3
BETADINE SKIN
CLEANSER
3
1
sulfacetamide
cream 10-5 % (w/w)
BETADINE
SURGICAL SCRUB
1
BETADINE
SWABSTICKS
1
BETADINE TOPICAL
SOLUTION
3
FIRST AID
ANTISEPTIC
TOPICAL SOLUTION
3
gel
liquid in packet
DERMATOLOGIC
AL ANTIBACTERIAL,
ANTIFUNGAL
AGENT WITH
GLUCOCORTICOI
D
ALA-QUIN
NF
ALCORTIN A
3
3
DERMASORB AF
COMPLETE KIT
3
3
hydrocortisone-iodoqui
nol-aloe
VYTONE
NF
3
ointment
3
pads, medicated
3
solution 10 %
3
DERMATOLOGIC
AL ANTIBACTERIALGLUCOCORTICOI
D COMBINATIONS
solution 7.5 %
1
CORTISPORIN
TOPICAL CREAM
1
sponge
3
CORTISPORIN
TOPICAL OINTMENT
3
NEO-SYNALAR
3
this table.
161
Drug Name
NEO-SYNALAR KIT
/Limits
3
DERMATOLOGIC
AL ANTIBACTERIALLOCAL
ANESTHETIC
COMBINATIONS
ANTIBIOTIC + PAIN
RELIEF TOPICAL
CREAM
1
ANTIBIOTIC + PAIN
RELIEF TOPICAL
OINTMENT
3
ANTIBIOTIC PLUS
(PRAMOXINE)
3
BACITRAYCIN PLUS
TOPICAL OINTMENT
500-10
UNIT-MG/GRAM
3
BACTINE (WITH
ALCOHOL)
3
BLOOD CLOTTING
SPRAY
3
FIRST AID ABX PAIN
RELIEF
1
MULTI ANTIBIOTIC
PLUS
1
Drug Name
/Limits
DERMATOLOGIC
AL - ANTIFUNGAL
ALLYLAMINES
ANTIFUNGAL
(TERBINAFINE)
1
ATHLETE'S FOOT
(TERBINAFINE)
1
ATHLETE'S FOOT AF
3
JOCK ITCH
(TERBINAFINE)
1
LAMISIL (AEROSOL)
3
LAMISIL AT
3
naftifine
1
NAFTIN TOPICAL
CREAM 2 %
1
NAFTIN TOPICAL
GEL
1
terbinafine hcl topical
1
DERMATOLOGIC
AL - ANTIFUNGAL
AMPHOTERIC
POLYENE
MACROLIDES
NYAMYC
1
nystatin topical
1
NYSTOP
1
3
NEOSPORIN + PAIN
RELIEF
1
PEDIADERM AF
NEOSPORIN + PAIN
RELIEF (BAC)
3
PROCOMYCIN
3
DERMATOLOGIC
AL - ANTIFUNGAL
BENZYLAMINES
TRI-BIOZENE
3
LOTRIMIN ULTRA
3
TRIPLE ANTIBIOTIC
(PRAM) EXTRA
3
MENTAX
2
TRIPLE ANTIBIOTIC
PLUS
3
TRIPLE
ANTIBIOTIC-PAIN
RELIEF
3
PA
DERMATOLOGIC
AL - ANTIFUNGAL
COMBINATIONS
OTHER
BAZA CREAM
HOSPITAL CARE
PACK
3
BREEZEE MIST
3
this table.
162
Drug Name
/Limits
EXODERM
3
FUNGI-NAIL
TOPICAL TINCTURE
1
GORDOCHOM
1
DERMATOLOGIC
AL - ANTIFUNGAL
HYDROXYPYRIDI
NONE
Drug Name
/Limits
ANTI-FUNGAL
TOPICAL POWDER
3
ATHLETE'S FOOT
3
ATHLETE'S FOOT
(CLOTRIMAZOLE)
1
ATHLETIC FOOT
CREAM
1
AZOLEN TINCTURE
3
BAZA ANTIFUNGAL
1
CLOTRIMAZOLE AF
1
clotrimazole topical
1
CICLODAN KIT
3
CICLODAN TOPICAL
CREAM
1
CICLODAN TOPICAL
SOLUTION
3
CRITIC-AID CLEAR
AF
3
ciclopirox topical cream
1
DERMAFUNGAL
3
ciclopirox topical gel
1
DESENEX SPRAY
3
ciclopirox topical
shampoo
1
DESENEX TOPICAL
AEROSOL,SPRAY
3
ciclopirox topical
solution
3
DESENEX TOPICAL
POWDER
3
ciclopirox topical
suspension
1
econazole topical
2
ciclopirox-ure-camph-m
enth-euc
ECOZA
3
3
ERTACZO
3
CNL 8 NAIL
3
EXELDERM
3
LOPROX TOPICAL
SHAMPOO
EXTINA
3
3
FUNGI CURE
3
PENLAC
3
FUNGOID TINCTURE
TOPICAL KIT
1
FUNGOID TINCTURE
TOPICAL TINCTURE
3
INZO ANTIFUNGAL
1
3
ITCH RELIEF
(CLOTRIMAZOLE)
3
ALOE VESTA
ANTIFUNGAL
(MICON)
3
JOCK ITCH
(CLOTRIMAZOLE)
1
ANTIFUNGAL
(CLOTRIMAZOLE)
1
1
ketoconazole topical
cream
ANTIFUNGAL
CREAM
3
1
foam
DERMATOLOGIC
AL - ANTIFUNGAL
IMIDAZOLE &
RELATED
AGENTS
ALEVAZOL
PA
this table.
163
Drug Name
/Limits
shampoo
1
LOTRIMIN AF
POWDER
3
LOTRIMIN AF
TOPICAL
AEROSOL,SPRAY
Drug Name
/Limits
DERMATOLOGIC
AL - ANTIFUNGAL
MIXTURES
FUNGI-NAIL
TOPICAL OINTMENT
3
3
TRIPLE DYE
3
LOTRIMIN AF
TOPICAL CREAM
1
DERMATOLOGIC
AL - ANTIFUNGAL
OXABOROLE
LOTRIMIN AF
TOPICAL POWDER
3
KERYDIN
LUZU
3
MICATIN
1
miconazole nitrate
topical aerosol powder
3
miconazole nitrate
topical cream
1
MICONAZORB AF
3
MICRO-GUARD
3
NIZORAL A-D
1
NIZORAL TOPICAL
SHAMPOO
3
OXISTAT
3
REMEDY
ANTIFUNGAL
TOPICAL CREAM
1
REMEDY
ANTIFUNGAL
TOPICAL POWDER
3
REMEDY
PHYTOPLEX
ANTIFUNGAL
3
RINGWORM
1
SECURA
ANTIFUNGAL
1
TRIPLE PASTE AF
3
VUSION
3
XOLEGEL
3
ZEASORB
(MICONAZOLE)
3
3
DERMATOLOGIC
AL - ANTIFUNGAL
THIOCARBAMAT
E
AF
3
ANTIFUNGAL
(TOLNAFTATE)
TOPICAL
AEROSOL,SPRAY
3
ANTIFUNGAL
(TOLNAFTATE)
TOPICAL CREAM
1
ANTIFUNGAL
(TOLNAFTATE)
TOPICAL POWDER
3
ANTIFUNGAL SPRAY
3
ATHLETE'S FOOT
(TOLNAFTATE)
TOPICAL AEROSOL
POWDER
3
ATHLETE'S FOOT
(TOLNAFTATE)
TOPICAL
AEROSOL,SPRAY
3
ATHLETE'S FOOT
(TOLNAFTATE)
TOPICAL CREAM
1
BLIS-TO-SOL
(TOLNAFTATE)
3
FOOT AND SNEAKER
3
FUNGOID-D
1
this table.
164
Drug Name
/Limits
Drug Name
/Limits
JOCK ITCH
3
LAMISIL AF
3
MEDI-FIRST
ANTI-FUNGAL
1
DERMATOLOGIC
AL ANTIFUNGALS
OTHER
ODOR CONTROL
FOOT-SNEAKER
3
ANTIFUNGAL
TOPICAL LIQUID
3
TINACTIN TOPICAL
AEROSOL POWDER
3
ANTIFUNGAL
TOPICAL SOLUTION
3
TINACTIN TOPICAL
AEROSOL,SPRAY
3
ELON DUAL
DEFENSE
3
TINACTIN TOPICAL
CREAM
1
FUNGI-NAIL
TOPICAL SOLUTION
3
TINACTIN TOPICAL
POWDER
gentian violet topical
1
3
3
tolnaftate
3
HONGO CURA
SPRAY
tolnaftate topical
aerosol powder
MYCO NAIL
1
3
MYCO NAIL A
3
tolnaftate topical cream
1
triacetin
3
tolnaftate topical
powder
3
undecylenic acid (bulk)
3
tolnaftate topical
solution
3
3
UNDELENIC
TOPICAL TINCTURE
DERMATOLOGIC
AL - ANTIFUNGAL
TRIAZOLE
JUBLIA
3
DERMATOLOGIC
AL ANTINEOPLASTIC
ALKYLATING
AGENTS
VALCHLOR
DERMATOLOGIC
AL ANTIFUNGAL-GL
UCOCORTICOID
COMBINATIONS
clotrimazole-betamethas
one
1
DERMAZENE
1
iodoquinol-hc
1
LOTRISONE
TOPICAL CREAM
3
nystatin-triamcinolone
1
3
DERMATOLOGIC
AL ANTINEOPLASTIC
ANTIMETABOLIT
ES
CARAC
1
EFUDEX TOPICAL
CREAM
1
FLUOROPLEX
1
fluorouracil topical
cream 0.5 %
3
cream 5 %
1
this table.
165
Drug Name
solution
/Limits
3
DERMATOLOGIC
AL ANTINEOPLASTIC
OR
PREMALIGNANT
LESIONS - NSAID'S
3
SOLARAZE
3
DERMATOLOGIC
AL ANTINEOPLASTIC
RETINOIDS
2
DERMATOLOGIC
AL ANTINEOPLASTIC
SELECTIVE
RETINOID X
RECEPTOR
AGONIST
TARGRETIN
TOPICAL
3
DERMATOLOGIC
AL ANTIPARASITICS
OTHER
diethyltoluamide (bulk)
BROMI-LOTION
1
CERTAIN DRI
3
DR SCHOLL'S FOOT
POWDER
3
DRYSOL
DAB-O-MATIC
3
FOOT POWDER
3
XERAC AC
3
DERMATOLOGIC
AL ANTIPRURITICS
COMBINATIONS
diclofenac sodium
topical gel
PANRETIN
/Limits
DERMATOLOGIC
AL ANTIPERSPIRANT
S
1
DERMATOLOGIC
AL ANTINEOPLASTIC
OR PREMALIG.
LESIONS
-DITERPENE
ESTERS
PICATO
Drug Name
3
PA
ALLEGRA
INTENSIVE RELIEF
3
ALLERGY CREAM
(DIPHENHYD, ZN)
1
ALLERGY RELIEF
SPRAY
1
ANTI-ITCH
(MENTHOL/CAMPHO
R)
3
ANTI-ITCH(DIPHENH
YD) WITH ZINC
1
BANOPHEN
ANTI-ITCH
1
BENADRYL EXTRA
STRENGTH
1
BENADRYL ITCH
RELIEF STICK
1
BENADRYL ITCH
STOPPING TOPICAL
CREAM
1
CALAGEL
3
DERMASARRA
3
ITCH RELIEF
TOPICAL
AEROSOL,SPRAY
3
this table.
166
Drug Name
/Limits
ITCH RELIEF
TOPICAL CREAM
1
MEN-PHOR
3
POISON IVY
ANTI-ITCH
3
POISON IVY DUAL
ACTION
3
POISON IVY
TREATMENT
3
SARNA ANTI-ITCH
3
WAL-DRYL
(DIPHENHYDRAMIN
E-ZN) TOPICAL
AEROSOL,SPRAY
3
WAL-DRYL
(DIPHENHYDRAMIN
E-ZN) TOPICAL
CREAM
1
ZANFEL
1
DERMATOLOGIC
AL ANTIPSORIATIC
AGENTS
SYSTEMIC,
PHOTOSENSITIZI
NG
8-MOP
1
methoxsalen rapid
1
OXSORALEN ULTRA
3
DERMATOLOGIC
AL ANTIPSORIATIC
AGENTS
SYSTEMIC,
VITAMIN A
DERIVATIVES
acitretin
SORIATANE ORAL
CAPSULE 10 MG, 17.5
MG, 25 MG
Drug Name
/Limits
DERMATOLOGIC
AL ANTIPSORIATIC
AGENTS TOPICAL
calcipotriene (bulk)
3
calcipotriene scalp
1
calcipotriene topical
cream
1
calcipotriene topical
ointment
3
CALCIPOTRIOL
(BULK)
3
CALCITRENE
3
calcitriol topical
3
DOVONEX TOPICAL
3
DRITHOCREME HP
1
SORILUX
3
tazarotene (bulk)
3
TAZORAC
3
VECTICAL
3
ZITHRANOL
3
ZITHRANOL-RR
3
DERMATOLOGIC
AL ANTIPSORIATICS
SYSTEMIC,
PHOSPHODIESTE
RASE 4 INHIB.
OTEZLA
3
OTEZLA STARTER
3
DERMATOLOGIC
AL ANTISEBORRHEI
C COMBINATIONS
3
ALA-SEB-T
1
3
ANTI-DANDRUFF
WITH MENTHOL
3
this table.
167
Drug Name
/Limits
DANDRUFF
SHAMPOO (SELEN
SULF)
3
PAZOL XS
1
SELSUN BLUE WITH
MENTHOL
3
DERMATOLOGIC
AL ANTISEBORRHEI
C
ANTI-DANDRUFF
1
BETA MED
1
chloroxine (bulk)
3
DANDRUFF
SHAMPOO
1
Drug Name
/Limits
selenium sulfide topical
shampoo 2.25 %
3
SELRX
3
SELSUN BLUE
3
topical
3
TERSI FOAM
3
DERMATOLOGIC
AL - ANTIVIRAL,
HERPES
ABREVA
1
acyclovir topical
1
DENAVIR
3
docosanol (bulk)
3
ZOVIRAX TOPICAL
3
DANDRUFF
SHAMPOO/CONDITI
ONER
1
DERMAZINC CREAM
1
DERMAZINC
SHAMPOO
1
DERMATOLOGIC
AL ANTIVIRAL-GLUC
OCORTICOID
COMBINATIONS
DERMAZINC SPRAY
1
XERESE
DHS ZINC
1
LOUTREX
3
NOBLE FORMULA
SCALP
DERMATOLOGIC
AL - ASTRINGENT
COMBINATIONS
1
NOBLE FORMULA
TOPICAL
3
OVACE
3
A.E.R TRAVELER
3
A.E.R. WITCH HAZEL
1
ASTRINGENT
3
3
BAY RUM
3
OVACE PLUS
3
BORO-PACKS
1
OVACE PLUS
SHAMPOO
3
calamine phenolated
3
DOMEBORO
1
OVACE PLUS WASH
3
PROMISEB
3
HEMORRHOIDAL
MEDICATED
1
PROMISEB
COMPLETE
3
HYGIENIC
CLEANSING
1
pyrithione zinc (bulk)
3
MEDI PADS
3
SEB-PREV
3
selenium sulfide (bulk)
3
MEDICATED PADS
TOPICAL PADS,
MEDICATED
3
this table.
168
Drug Name
/Limits
Drug Name
tacrolimus topical
/Limits
MEDICATED WIPES
TOPICAL PADS,
MEDICATED
1
MEDICATED WIPES
WITH ALOE
1
DERMATOLOGIC
AL DEODORANTS
PEDI-BORO SOAK
1
DESENEX TOPICAL
AEROSOL POWDER
3
PRE-MOISTENED
HEMORRHOIDAL
1
GORDON'S NO. FIVE
3
M9 ODOR
ELIMINATOR
1
NULLO
3
DERMATOLOGIC
AL ASTRINGENTS
aluminum acetate
1
calamine
1
PRE-MOISTENED
MEDICATED WIPES
1
witch hazel extract
(bulk)
3
DERMATOLOGIC
AL DEPIGMENTING
AGENTS
BLANCHE
3
3
ESOTERICA FADE
TOPICAL CREAM 2 %
1
witch hazel leaf
(hamamelis)
1
hydroquinone
3
WITCH HAZEL
TOPICAL LIQUID
1
hydroquinone (bulk)
crystals
3
witch hazel topical
solution
3
hydroquinone
microspheres
3
MELQUIN 3
3
mequinol (bulk)
3
monobenzone (bulk)
3
DERMATOLOGIC
AL - BURN
PRODUCTS
ANTI-INFECTIVE
DERMATOLOGIC
AL DEPIGMENTING
COMBINATIONS
SILVADENE
3
silver sulfadiazine
1
silver sulfadiazine
(bulk)
3
ACLARO
3
SSD
1
ALPHAQUIN HP
1
SULFAMYLON
1
THERMAZENE
1
ESOTERICA FADE
TOPICAL CREAM
2-10 %-SPF
3
MELPAQUE HP
3
TRI-LUMA
3
DERMATOLOGIC
AL CALCINEURIN
INHIBITORS
ELIDEL
2
ST
PROTOPIC
3
ST
this table.
169
Drug Name
/Limits
DERMATOLOGIC
AL - EMOLLIENT
COMBINATIONS
OTHER
Drug Name
/Limits
DERMATOLOGIC
AL - EMOLLIENT
MIXTURES
A + D (LAN, PET)
1
DERMANAIL
3
ABSORBASE
3
DML FACIAL
MOISTURIZER
1
ADVANCED
RECOVERY
3
DML FORTE
3
ELON
1
ALEVICYN
ANTIPRURITIC SG
3
HPR PLUS
HYDROGEL
3
ALOE GRANDE
1
ALPHABATH
1
HPR PLUS-MB
HYDROGEL
3
ALPHASOFT
3
LIQUA-GEL TOPICAL
1
AMERIPHOR
1
lubricants
1
AMLACTIN TOPICAL
CREAM
1
MB HYDROGEL
3
MB HYDROGEL
(CYCLOMETHICONE
)
AQUA GLYCOLIC
TOPICAL LOTION
3
3
AQUA LACTEN
3
RADIADERM R1-R2
3
AQUAMED
3
RADIADERM R2
3
AQUAPHILIC
3
vit e-wheat germ-aloe
vera
ATOPICLAIR
3
3
ATRAC-TAIN (WITH
AHA)
1
ATRAPRO CP
3
ATRAPRO
HYDROGEL
3
3
DERMATOLOGIC
AL - EMOLLIENT
COMBINATIONS
CERAVE PM
3
CERAVE TOPICAL
CLEANSER
3
AUXIPRO
EMOLLIENT
CERAVE TOPICAL
CREAM
1
AVEENO BABY
MOISTURE
3
CERAVE TOPICAL
LOTION
3
1
OINTMENT BASE
(EMULSIFYING)
3
AVEENO DAILY
MOISTURIZING
TOPICAL LOTION
1.25 %
AVEENO INTENSE
RELIEF
3
AVO CREAM
3
AVOSIL
1
RENEWAL
MOISTURIZING
CREAM
3
BALNEOL TOPICAL
1
LOTION
this table.
170
Drug Name
/Limits
BALNEOL TOPICAL
LOTION IN PACKET
3
BASE, PCCA
PLASTICIZED
3
BATH OIL
1
BETA CARE
3
BETAMIDE
1
BIAFINE EMULSION
3
BODI PROTECT
Drug Name
/Limits
DERMAPLEX
3
DERMAVANTAGE
3
DESITIN CLEAR
1
DML
3
DRY SKIN BATH OIL
3
DRY SKIN CARE
3
DRY SKIN THERAPY
3
3
DRY SKIN THERAPY
MOISTURIZING
3
CAM
3
ELETONE
3
CARB-O-LAN10
3
EMOLLIA
3
CARB-O-LAN20
3
emollient combo no.64
(bulk)
1
EMU-LAC
3
EMULSION SB
3
EPICERAM
3
CAVILON
MOISTURIZING
BODY
3
CELACYN
3
CETAPHIL
DAILYADVANCE
3
EUCERIN
1
CETAPHIL HAND
3
3
CETAPHIL
MOISTURIZING
EUCERIN INTENSIVE
REPAIR
3
3
CETAPHIL
RESTORADERM
TOPICAL LOTION
EUCERIN INTENSIVE
REPAIR CREAM
3
EUCERIN ORIGINAL
3
3
CETAPHIL TOPICAL
CREAM
EUCERIN SKIN
CALMING
3
EXCEL-GEL
1
COCOA BUTTER
CREAM
1
FLEXITOL
3
FOOT EMOLLIENT
3
COCONUT OIL
CREAM
3
3
COMPLEX 15
3
GENTLE
MOISTURIZING
LOTION
CUSTOM BASE PCCA
LIPODERM
3
3
DAILY
MOISTURIZING
LOTION
GOLD BOND
ULTIMATE HEALING
TOPICAL LIQUID
1
3
DERMACERIN
1
GOLD BOND
ULTIMATE TOPICAL
LIQUID
DERMADAILY
3
3
DERMAPHOR
TOPICAL OINTMENT
GRX VITAMIN E
TOPICAL LOTION
3
HPR
3
this table.
171
Drug Name
/Limits
HPR PLUS
3
HYDRASYN25
3
HYDRATING
HEALING
3
HYDROCERIN
1
HYDROCERIN PLUS
1
HYDRO-LAN
3
HYLATOPIC
3
HYLATOPIC PLUS
3
HYPER-HEAL
1
JELENE
3
KERADAN
3
KERODEX 51 DRY
OR OILY
3
L-LYSINE TOPICAL
LOUTREX
Drug Name
/Limits
MOITURIZING
LOTION
3
NEOSALUS
3
NEUTROGENA
SENSITIVE SKN
MOIST
3
NIVATOPIC PLUS
3
NIVEA
3
NIVEA ORIGINAL
3
NIVEA SOFT
3
OCEAN WITH
HYALURONAN
3
PCCA ALADERM
BASE
3
PEN-KERA
3
3
PETROLATUM
1
3
PHARMABASE
COSMETIC
1
PRESERA
3
PROMISEB
3
LUBRIDERM
ADVANCED
THERAPY
3
LUBRIDERM DAILY
MOISTURE
3
3
LUBRIDERM DAILY
MOISTURE (PET)
PROMISEB
COMPLETE
3
PRUCLAIR
3
LUBRIDERM
SENSITIVE SKIN
PRUMYX
3
3
PRUTECT
3
LUBRIDERM SKIN
NOURISHING
3
3
LUBRISILK
3
RADIGEL
ACEMANNAN
HYDROGEL
LUBRISKIN
3
1
LUBRISOFT
3
RENEWAL DAILY
MOISTURE LOTION
MEDERMA
1
RESTORE SKIN
CONDITIONING
3
MEDERMA FOR KIDS
1
SCAR
1
MIADERM
1
SCAR GEL
1
MINERIN TOPICAL
CREAM
1
SILICONE SCAR
1
MINERIN TOPICAL
LOTION
SILK SKIN BATH
1
3
SKARJEL
3
MOISTURIZING
CREAM
3
SKIN PROTECTANT
A AND D
3
this table.
172
Drug Name
/Limits
SKIN REPAIR
3
SONAFINE
Drug Name
/Limits
3
3
VITAMINS E AND D
BEAUTY OIL
SOOTHE AND COOL
BODY LOTION
3
VITAMN E BEAUTY
WITH SAFFLOWER
1
SOOTHE AND COOL
SKIN CREAM,ALO
VITA-RAY
1
3
1
SORBOLENE
3
vits a and d-white
pet-lanolin
SPECIAL CARE
LOTION
WOUND GEL
3
3
XCLAIR
3
STUDIO 35 BEAUTY
COCOA BUTTER
3
XTRACARE
3
STUDIO 35
MOISTURIZING SKIN
3
SWEEN CREAM
1
TEARS AGAIN
ADVANCED
DERMATOLOGIC
AL - EMOLLIENTS
aloe vera topical gel
3
ALUVEA
3
3
AMERISTORE
1
THERA BATH
1
AMLACTIN TOPICAL
LOTION
1
THERA-DERM
3
THERA-DERM BATH
1
ammonium lactate
topical
1
THERAPEUTIC
MOISTURIZING
3
AQUA CARE
1
TROPAZONE LOTION
3
AQUA GLYCOLIC
FACE
3
ULTRASONE
3
VANIBASE
1
AQUANIL SKIN
CLEANSER
1
VELVACHOL
3
AVEENO
3
vitamin a and d
1
3
VITAMIN A AND D
GRX
AVEENO BABY
ECZEMA THERAPY
1
1
VITAMIN E AND C
BEAUTY LOTION
AVEENO BABY
TOPICAL CREAM
3
VITAMIN E AND K
BEAUTIFUL SKIN
3
AVEENO DAILY
MOISTURIZING
TOPICAL LOTION 1.2
%
1
VITAMIN E PLUS
3
vitamin e-safflower oil
1
AVEENO
MOISTURIZING
1
vitamin e-vitamins a and
d
3
AVEENO SOOTHING
BATH
1
VITAMINS E AND A
BEAUTY OIL
3
BABY DARLINGS
1
this table.
173
Drug Name
/Limits
BASE, PCCA
VANISHING
CRM-LOT
3
BODI LOTION
3
caprylic-capric trigly
(bulk)
3
Drug Name
/Limits
HPA LANOLIN
3
LAC-HYDRIN FIVE
1
lactic acid
3
LACTIC ACID E
3
LACTINOL HX
3
lanolin
3
lanolin (bulk)
3
lanolin anhydrous
3
LANOLIN GRX
3
LAN-O-SOOTHE
3
LANTISEPTIC DRY
SKIN THERAPY
3
CARB-O-PHILIC
TOPICAL CREAM 10
%, 20 %
1
collagen, hydr (bovine)
(bulk)
3
colloidal oatmeal
1
CUTEMOL
3
DERMABASE
3
DERMACLOUD
1
LANTISEPTIC SKIN
PROTECTANT
3
ECZEMA
3
MAPO BATH
1
ECZEMA RELIEF
3
1
emollient
1
MINERAL OIL LIGHT
TOPICAL
EUCERIN ECZEMA
RELIEF
3
MOISTURE
RECOVERY
3
FINGER CREAM
3
1
GERI-HYDROLAC
1
NATURAL OATMEAL
BATH TREATMENT
GLYCERIN AND
ROSE WATER
3
NEOSPORIN
MOISTURIZING
1
glycerin topical liquid
1
3
glycerin topical liquid
10 %
3
NEUTROGENA
NORWEGIAN
FORMULA
glycerin topical solution
1
OATMEAL BATH
REGULAR
1
GLYCINE SOYA
PROTEIN
3
PCCA BASE
ANHYDROUS
3
GORDONS UREA
3
3
GORDON'S VITE A
3
PCCA EMOLLIENT
BASE
GORDONS-VITE E
1
PENTRAVAN PLUS
3
GORDO-VITE A
3
3
GORDO-VITE E
1
PRETTY FEET
HANDS
GORMEL
1
RADIAGEL
1
GORMEL 10
1
REA LO 39
3
GRX VITAMIN E
TOPICAL CREAM
3
RENEWAL BATH
TREATMENT
1
this table.
174
Drug Name
/Limits
SKIN RELIEF
MOISTURE
3
SKIN TREATMENT
1
sodium pyroglutamate
(bulk)
3
SOOTHE AND COOL
FREE MEDSEPTIC
3
SOOTHE AND COOL
MEDSEPTIC
3
SOOTHING BATH
TREATMENT
1
SORBIDON
HYDRATE
3
sorbitan monolaurate
(bulk)
3
sorbitan monooleate
(bulk)
Drug Name
/Limits
vitamin e topical oil
3
WIBI
3
DERMATOLOGIC
AL - ENZYMES
SANTYL
3
DERMATOLOGIC
AL - EYELID
CLEANSERS
ACUICYN
3
AVENOVA
3
CLEANSING EYELID
1
CLEANSING EYELID
MOIST PADS
3
EYELID WIPES
1
3
EYESCRUB
1
squalane (bulk)
3
1
SUPERSOFT
1
OCUSOFT LID
SCRUB
COMPLIANCE
TENDER CARE
LANOLIN
3
OCUSOFT LID
SCRUB ORIGINAL
3
ULTRA MIDE 25
1
STERILID
1
UNSCENTED COLD
CREAM
1
urea topical cream 10
%, 20 %
1
DERMATOLOGIC
AL GLUCOCORTICOI
D
%
3
ALA-CORT TOPICAL
CREAM
3
urea topical lotion 10 %
1
ALA-SCALP
1
UREACIN-10
1
alclometasone
1
UREACIN-20
1
amcinonide
3
VANICREAM
3
VANICREAM LITE
3
ANTI-ITCH (HC)
TOPICAL
AEROSOL,SPRAY
3
VANISHING CREAM
TOPICAL
1
ANTI-ITCH (HC)
TOPICAL CREAM
1
topical
3
ANTI-ITCH (HC)
TOPICAL OINTMENT
1
VITAMIN E BEAUTY
3
APEXICON E
3
vitamin e topical cream
3
AQUANIL HC
1
this table.
175
Drug Name
/Limits
BETA-HC
1
betamethasone
dipropionate
1
topical cream
1
topical foam
3
topical lotion
1
topical ointment
1
betamethasone,
augmented
1
CAPEX
1
clobetasol scalp
Drug Name
/Limits
CORDRAN TOPICAL
LOTION
3
CORDRAN TOPICAL
OINTMENT
3
CORMAX SCALP
3
CORTAID
1
CORTICOOL
1
CORTISONE
(HYDROCORTISONE)
TOPICAL CREAM
1
CORTISONE
(HYDROCORTISONE)
TOPICAL LOTION
3
1
1
CORTISONE +
COOLING RELIEF
clobetasol topical cream
1
CORTIZONE-10 PLUS
3
clobetasol topical foam
3
3
clobetasol topical gel
1
CORTIZONE-10
TOPICAL CREAM
clobetasol topical lotion
3
CORTIZONE-10
TOPICAL GEL
1
clobetasol topical
ointment
1
CORTIZONE-10
TOPICAL LOTION
3
clobetasol topical
shampoo
3
CORTIZONE-10
TOPICAL OINTMENT
1
clobetasol topical
spray,non-aerosol
3
CUTIVATE TOPICAL
CREAM
3
clobetasol-emollient
topical cream
1
CUTIVATE TOPICAL
LOTION
3
clobetasol-emollient
topical foam
3
3
CLOBEX
3
DERMAREST
ECZEMA
(HYDROCORT)
clocortolone pivalate
3
1
CLODAN
3
DERMA-SMOOTHE/F
S BODY OIL
CLODERM
3
1
CORDRAN TAPE
LARGE ROLL
DERMA-SMOOTHE/F
S SCALP OIL
3
DERMATOP
3
CORDRAN TAPE
SMALL ROLL
DESONATE
3
3
desonide topical cream
1
CORDRAN TOPICAL
CREAM
3
desonide topical lotion
3
this table.
176
Drug Name
/Limits
desonide topical
ointment
1
DESOWEN
3
desoximetasone topical
cream
1
gel
1
ointment 0.05 %
3
ointment 0.25 %
1
diflorasone
3
DIPROLENE AF
3
DIPROLENE
TOPICAL LOTION
1
DIPROLENE
TOPICAL OINTMENT
3
ECZEMA ANTI-ITCH
Drug Name
/Limits
hydrocortisone
butyr-emollient
3
HYDROCORTISONE
PLUS
1
hydrocortisone topical
cream
1
lotion
1
ointment
1
hydrocortisone valerate
1
ne topical
1
HYDROCREAM
1
HYDROSKIN
TOPICAL LOTION
1
KENALOG TOPICAL
3
1
LOCOID
3
ELOCON
3
LOCOID LIPOCREAM
3
fluocinolone
1
LUXIQ
3
fluocinolone and shower
cap
1
mometasone topical
cream
2
PA
fluocinonide topical
cream 0.05 %
1
mometasone topical
ointment
2
PA
cream 0.1 %
3
mometasone topical
solution
3
fluocinonide topical gel
1
1
ointment
NEOSPORIN
ANTI-ITCH
1
solution
3
1
NOBLE FORMULA
HC TOPICAL
AEROSOL,SPRAY
FLUOCINONIDE-E
1
1
fluticasone topical
3
NOBLE FORMULA
HC TOPICAL CREAM
halobetasol propionate
1
OLUX
3
HALOG
1
OLUX-E
3
topical
PANDEL
3
1
prednicarbate
3
hydrocortisone butyrate
3
PREPARATION H
HYDROCORTISONE
1
PSORCON
3
this table.
177
Drug Name
/Limits
RECORT PLUS
1
SCALACORT
1
SCALACORT DK
Drug Name
/Limits
AVEENO ANTI-ITCH
(HYDROCORTSN)
3
3
3
SCALP RELIEF
TOPICAL SOLUTION
DERMACINRX
SILAPAK
1
3
SCALPICIN
ANTI-ITCH
DERMASORB TA
COMPLETE KIT
1
1
SOOTHING CARE
(HYDROCORTISONE)
HYDROCORTISONE
PLUS
1
3
SYNALAR
3
hydrocortisone-aloe
vera
TEMOVATE E
3
hydrocortisone-min
oil-wht pet
1
TEMOVATE
TOPICAL CREAM
3
HYDROSKIN WITH
ALOE
3
TEMOVATE
TOPICAL OINTMENT
3
PEDIADERM HC
3
TEXACORT
1
PEDIADERM TA
3
TOPICORT
3
SYNALAR CREAM
KIT
3
topical aerosol
3
SYNALAR
OINTMENT KIT
3
topical cream
1
U-CORT
1
topical lotion
ULTRAVATE X
3
1
topical ointment 0.025
%, 0.1 %, 0.5 %
1
TRIANEX
1
TRIDERM TOPICAL
CREAM
1
EPIFOAM
ULTRAVATE
3
ne topical
VANOS
3
VERDESO
3
DERMATOLOGIC
AL GLUCOCORTICOI
D-EMOLLIENT
COMBINATIONS
ANTI-ITCH (HC)
WITH ALOE-VIT E
1
ANTI-ITCH PLUS
1
DERMATOLOGIC
AL GLUCOCORTICOI
D-LOCAL
ANESTHETIC
COMBINATIONS
lidocaine
hcl-hydrocortison ac
topical
1
NF
3
NOVACORT
NF
PRAMOSONE E
NF
PRAMOSONE
TOPICAL CREAM
NF
PRAMOSONE
TOPICAL LOTION
NF
this table.
178
Drug Name
PRAMOSONE
TOPICAL OINTMENT
1-1 %
/Limits
Drug Name
/Limits
DERMATOLOGIC
AL KERATOLYTIC
COMBINATIONS
OTHER
NF
DERMATOLOGIC
AL GLUCOCORTICOI
D-SKIN
CLEANSER
COMBINATIONS
CARB-O-LAC HP
3
CARB-O-LAC5
3
DERMASORB XM
COMPLETE KIT
3
GORDOFILM
3
JESSNER'S
3
AQUA GLYCOLIC HC
3
CLODAN KIT
3
DERMASORB HC
COMPLETE KIT
3
P AND S LIQUID
1
SYNALAR TS
3
URAMAXIN GT
TOPICAL
KIT,CREAM AND
GEL
3
urea-hyaluronate
sodium
3
DERMATOLOGIC
AL IMMUNOMODULA
TOR - CATECHINS
- GENITAL
WART/HPV TX
VEREGEN
DERMATOLOGIC
AL KERATOLYTIC-A
NTIMITOTIC
COMBINATIONS
3
DERMATOLOGIC
AL IMMUNOMODULA
TOR IMIDAZOQUINOLI
NAMINES
ALA-SEB
1
CARB-O-SAL5
3
FOOT MOISTURIZER
3
NOBLE FORMULA S
3
SALACTIC FILM
3
ALDARA
3
imiquimod
2
imiquimod (bulk)
3
SALKERA
3
ZYCLARA
3
SALVAX DUO PLUS
3
SEBEX
1
silver nitrate
applicators
3
WART REMOVER
TOPICAL LIQUID
3
DERMATOLOGIC
AL IMMUNOMODULA
TOR INTERFERONS
ALFERON N
PA
3
this table.
179
Drug Name
/Limits
DERMATOLOGIC
AL KERATOLYTIC-A
NTIMITOTIC
SINGLE AGENTS
Drug Name
/Limits
dichloracetic acid (bulk)
3
DR SCHOLL'S CLEAR
AWAY
1
DUOFILM
3
3
ACNE SPOT
TREATMENT
3
FAST CLEARING
SPOT
AVEENO CLEAR
COMPLEXION
3
FREEZONE CORN
REMOVER
1
BENSAL HP TOPICAL
OINTMENT 3 %
HYDRO 35
3
3
HYDRO 40
3
BETASAL
1
KERAFOAM
3
BP-50% UREA
3
KERALAC
3
CALICYLIC
3
KERALYT
1
CALLUS REMOVER
1
KERALYT RX
3
CALLUS REMOVERS
1
3
cantharidin (bulk)
crystals
KERALYT SCALP
COMPLETE
3
LATRIX
3
CEM-UREA
3
3
CLEAN AND CLEAR
ADVANTAGE
LIQUID CORN AND
CALLUS REMOVER
3
CLEAR AWAY
1
MEDIPLAST
CORN-CALLUS-WAR
T
1
COMPOUND W
TOPICAL ADHESIVE
PATCH,MEDICATED
1
MOSCO
CALLUS-CORN
REMOVER
3
COMPOUND W
TOPICAL GEL
1
MOSCO CORN
REMOVER
1
COMPOUND W
TOPICAL LIQUID
3
1
CONDYLOX
TOPICAL GEL
1
NEUTROGENA
OIL-FREE ACNE
WASH
CONDYLOX
TOPICAL SOLUTION
3
NEUTROGENA
T-GEL
CONDITNER(SA)
1
CORN AND CALLUS
REMOVER
3
ONE-STEP PLANTAR
WART REMOVER
1
CORN REMOVER
1
1
CORN-CALLUS
REMOVER TOPICAL
LIQUID
ONE-STEP WART
REMOVER
3
P AND S (SALICYLIC
ACID)
1
DHS SAL
1
this table.
180
Drug Name
/Limits
Drug Name
/Limits
PLANTAR WART
REMOVER
1
sodium dichloroacetate
(bulk)
3
PODOCON
3
1
podofilox
1
podofilox (bulk)
3
1
PSORIASIS
MEDICATED
THERAPEUTIC
SHAMPOO TOPICAL
SHAMPOO 3 %
1
1
REA LO 40
3
THERAPEUTIC T
PLUS
REMEVEN
3
TRI-CHLOR
3
SALACYN
3
SALEX
3
3
salicylic acid
er-ceramides
3
trichloroacetic acid
topical recon soln 100
%, 20 %, 25 %, 30 %,
35 %, 40 %, 50 %, 75
%, 80 %, 85 %, 90 %
salicylic acid topical
cream
ULTRASAL-ER
3
3
3
cream,extended release
UMECTA NAIL FILM
PEN
3
UMECTA PD
3
UMECTA TOPICAL
EMULSION
3
UMECTA TOPICAL
FOAM
3
UMECTA TOPICAL
NAIL FILM
SUSPENSION
3
URAMAXIN
3
URAMAXIN GT
TOPICAL GEL
3
UREA NAIL STICK
3
%, 45 %, 47 %, 50 %
3
film forming liquid
w/appl
3
foam
3
salicylic acid topical gel
3
liquid 26 %
3
lotion
3
lotion,extended release
3
shampoo
3
urea topical foam
3
SAL-PLANT
1
urea topical gel
3
SALVAX
3
urea topical lotion 40
%, 45 %
3
urea topical nail film
suspension
3
UTOPIC
3
VIRASAL
3
SCALP
ITCH-DANDRUFF
RELIEF
1
SCALP RELIEF
TOPICAL LIQUID
1
SELSUN BLUE
NATURALS
1
this table.
181
Drug Name
/Limits
WART REMOVER
TOPICAL ADHESIVE
PATCH,MEDICATED
1
WART REMOVER
TOPICAL GEL
1
WART REMOVER
TOPICAL LIQUID
3
WART REMOVER
TOPICAL PLASTER
1
Drug Name
X-SEB T PLUS
/Limits
1
DERMATOLOGIC
AL KERATOPLASTICKERATOLYTIC
COMBINATIONS
TARSUM
1
X-SEB T PEARL
3
DERMATOLOGIC
AL - LIVER
DERIVATIVE
COMPLEX
DERMATOLOGIC
AL KERATOPLASTIC
TAR PRODUCTS
NEXAVIR
3
ANTI-DANDRUFF
(COAL TAR)
1
BETATAR GEL
3
coal tar
1
DERMATOLOGIC
AL - LOCAL
ANESTHETIC
COMBINATIONS
coal tar (bulk)
1
1ST RELIEF
3
CUTAR
3
ADAZIN
3
DHS TAR
1
AFLEXERYL-LC
3
DHS TAR GEL
1
IONIL T
1
ALCOHOL-BENZOCA
INE
3
MG217 PSORIASIS
1
ALOE BURN RELIEF
3
NEUTROGENA T/GEL
EX-STR
1
ALOE VERA PAIN
RELIEVING
3
NEUTROGENA
T-GEL
1
ANECREAM (WITH
DRESSINGS)
3
OXIPOR VHC
1
PC-TAR
1
ANTI-ITCH
MEDICATED
3
PSORIASIN
3
3
SCYTERA
3
ANTISEPTIC AND
ANESTHETIC
T+PLUS
1
BACTINE PAIN
RELIEVING CLEANS
3
TERA-GEL TAR
SHAMPOO
1
BURN RELIEF
3
THERA-GEL
1
BURN RELIEF WITH
ALOE
3
CALACLEAR
1
CALAGESIC
1
CALAHIST
1
THERAPEUTIC
SHAMPOO TOPICAL
SHAMPOO 0.5 %, 1 %,
2%
1
this table.
182
Drug Name
/Limits
CALAHIST CLEAR
1
CALAHIST WITH
PRAMOXINE
3
CALAMINE
MEDICATED
Drug Name
/Limits
LENZAGEL
3
LENZAPATCH
3
lidocaine-aloe vera
3
3
lidocaine-prilocaine
1
CALDYPHEN CLEAR
1
lidocaine-transparent
dressing
3
CALDYPHEN
TOPICAL LOTION 1-8
%
1
LIDOCREAM
TOPICAL KIT
3
CALLERGY CLEAR
1
LIDOPATCH
3
LIDOPRO
3
LIDOPRO PATCH
3
LIMENCIN
3
LIQUID BANDAGE
3
LIVIXIL PAK
3
LMX 4 PLUS
3
LMX 4 TOPICAL KIT
3
CETACAINE
NF
CETACAINE
ANESTHETIC
NF
COOLING BURN
3
DERMOPLAST (WITH
MENTHOL)
1
DERMOPLAST
ANTIBACTERIAL
3
MEDI-DERM-L
3
EMLA
3
MEDI-DERM-L-RX
3
ENDOXCIN
3
FIRST AID
3
MEDI-FIRST BURN
CREAM
3
FIRST AID
(TRICLOSAN)
3
MEDI-PATCH
3
NEOSPORIN NEO TO
GO
3
PUROXCIN
3
RELADOR PAK
3
SOLARCAINE
3
SOLARCAINE ALOE
EXTRA
1
SYNVEXIA TC
3
FIRST AID
ANTISEPTIC
TOPICAL LIQUID
3
FIRST AID
ANTISEPTIC
TOPICAL
SPRAY,NON-AEROS
OL
3
GOLD BOND
MEDICATED
ANTI-ITCH
3
TEROCIN
(LIDOCAINE-MENTH
OL)
3
isopropyl
alcohol-benzocaine
3
TEROCIN (WITH
LIDOCAINE)
3
ITCH RELIEF
(PRAMOXINE-ZINC)
1
ITCH-X
1
LANACANE FIRST
AID
3
this table.
183
Drug Name
/Limits
DERMATOLOGIC
AL - LOCAL
ANESTHETIC GAS
COMBINATIONS
PAIN EASE
3
SPRAY AND
STRETCH
3
DERMATOLOGIC
AL - LOCAL
ANESTHETIC GAS
SINGLE AGENTS
ethyl chloride
3
DERMATOLOGIC
AL - LUBRICANTS
Drug Name
/Limits
NAIL SCRUB
3
RESINOL
1
TOETAL FRESH
3
YODORA
3
DERMATOLOGIC
AL MISCELLANEOUS
SINGLE AGENTS
AQUA GLYCOLIC
TOPICAL LIQUID
3
ichthammol
1
PHENOL EZ
3
phenolsulfonic acid
(bulk)
3
PYROGALLIC ACID
3
AQUA LUBE
1
FEM MOIST
ANDLUB(GLYCERINHEC)
1
SALJET SALINE
RINSE
3
GERI-LUB
3
ointment
3
K-Y LUBRICATING
1
lubricants
1
LUBRICATING
1
LUBRICATING
JELLY
1
MAXILUBE
1
PERSONAL
LUBRICANT
3
PERSONAL
LUBRICATING
JELLY
1
diclofenac sodium
topical drops
3
SURGILUBE
1
FLECTOR
3
PENNSAID TOPICAL
SOLUTION IN
METERED-DOSE
PUMP
3
VOLTAREN TOPICAL
1
DERMATOLOGIC
AL MISCELLANEOUS
COMBINATIONS
DERMAFIX TOPICAL
AEROSOL,SPRAY
3
DRAW OUT SALVE
3
GORDOMATIC
TOPICAL CRYSTALS
3
DERMATOLOGIC
AL NON-SURGICAL
DEPILATORIES
(bulk)
3
DERMATOLOGIC
AL - NSAID
SINGLE AGENTS
this table.
184
Drug Name
/Limits
DERMATOLOGIC
AL - ORNITHINE
DECARBOXYLASE
(ODC)
INHIBITORS
VANIQA
3
DERMATOLOGIC
AL PHOTODYNAMIC
THERAPY
AGENTS TOPICAL
Drug Name
/Limits
BABY ANTI
MONKEY BUTT
(ZINC)
3
BALMEX DIAPER
RASH
1
BALMEX TOPICAL
CREAM
1
BAZA PROTECT
1
BETA XMA
3
calamine-zinc oxide
topical lotion
3
aminolevulinic acid hcl
(bulk)
3
calamine-zinc oxide
topical lotion 8-8 %
1
LEVULAN
3
calamine-zinc
oxide-phenol
3
CALMOSEPTINE
3
CARRINGTON MOIST
BARRIER-ZINC
3
CHAMOSYN
3
COMFORT SHIELD
3
CRITIC-AID
3
DESITIN TOPICAL
PASTE
1
DIAPER RASH
1
DR. SMITH'S
RASH-SKIN TOPICAL
OINTMENT
3
DURABLE BARRIER
TOPICAL CREAM
3
3
DERMATOLOGIC
AL - PIGMENTING
AGENTS
trioxsalen (bulk)
3
DERMATOLOGIC
AL - PIGMENTING,
COLORIZING
AGENTS
CHROMELIN
1
DERMATOLOGIC
AL - PIGMENTING,
PHOTOSENSITIZI
NG AGENTS
OXSORALEN
1
DERMATOLOGIC
AL - POWDERS
FORDUSTIN
1
GOLD BOND
MEDICATED BABY
VAGISIL TOPICAL
POWDER
1
GOLD BOND TRIPLE
ACTION
3
GOLD BOND
ULTIMATE TOPICAL
OINTMENT
3
ILEX SKIN
PROTECTANT
1
KELO-COTE
TOPICAL GEL
1
DERMATOLOGIC
AL PROTECTANT
COMBINATIONS
A AND D ZINC
OXIDE CREAM
1
this table.
185
Drug Name
/Limits
LANTISEPTIC
MULTI-PURPOSE
3
NO STING BARRIER
FILM TOPICAL
AEROSOL,SPRAY
1
NO STING BARRIER
FILM TOPICAL
PADS, MEDICATED
3
NO STING BARRIER
FILM TOPICAL
SWAB
1
OATMEAL
MOISTURIZING
3
ONE-STEP SKIN
CARE LOTION
3
PEDIATRIC OINT
(COD LIVER OIL)
1
PERISHIELD
TOPICAL OINTMENT
3
PR CREAM
3
PROTECTIVE
POWDER
3
RADIAPLEXRX
3
RASH RELIEF-ZINC
OXIDE
3
RECEDO
3
REMEDY CALAZIME
PROTECT PASTE
3
REMEDY CALAZIME
SKIN PASTE
3
REMEDY
PHYTOPLEX
Z-GUARD (ZN)
3
RISAMINE
Drug Name
/Limits
SENSI-CARE
TOPICAL OINTMENT
1
SOOTHE AND COOL
SKIN PASTE
3
SOOTHE-COOL
MOISTURE BARRIER
3
UNGUENTINE
3
VITAMIN A AND D
DIAPER RASH
1
Z-BUM
3
ZINC OXIDE DIAPER
CREAM
3
ZINC-OXYDE PLUS
3
DERMATOLOGIC
AL PROTECTANTS
4-N-1 NO RINSE
WASH TOPICAL
CLEANSER
3
4-N-1 NO RINSE
WASH TOPICAL
CREAM
1
ADVANCED
HEALING
3
ADVANCED
HEALING
(PETROLATUM)
3
ALOE VESTA
3
ALOE VESTA SKIN
CONDITIONER 2
1
AMERICERIN
3
AMERIGEL
3
3
ANTI MONKEY BUTT
1
SECURA PERSONAL
SKIN CARE
3
AQUAPHOR
HEALING
3
SECURA TWO-STEP
KIT
3
AQUAPHOR
ORIGINAL
3
SENSI-CARE
MOISTURIZING 2
1
AVEENO BABY
DIAPER RASH
1
BABY ANTI
3
MONKEY BUTT
this table.
186
Drug Name
/Limits
BASLE
3
BAZA CLEANSE AND
PROTECT
3
BAZA CLEAR
3
benzoin
1
benzoin (bulk)
1
benzoin compound
(bulk)
1
benzoin compound
topical tincture
3
BENZOIN
COMPOUND
TOPICAL TINCTURE
10-2-8-4 %
1
BENZ-PROTECT
3
BIONECT TOPICAL
CREAM
3
Drug Name
/Limits
DERMAGRAN
(ALUMINUM
HYDROXIDE)
3
DERMAMED
(ALUMINUM
HYDROXIDE)
1
DERMAMED (ZINC
ACETATE)
3
DERMAPHOR
TOPICAL OINTMENT
44 %
3
DESITIN TOPICAL
CREAM
1
DIAPER RASH
RELIEF
1
DIAPER RASH
TOPICAL OINTMENT
1
DR. SMITH'S ADULT
BARRIER
3
DR. SMITH'S DIAPER
1
BIONECT TOPICAL
FOAM
3
BIONECT TOPICAL
GEL
3
DR. SMITH'S DIAPER
RASH
3
BOUDREAUXS BUTT
PASTE
1
3
BOUDREAUXS RASH
PROTECTOR
3
DR. SMITH'S
RASH-SKIN TOPICAL
AEROSOL,SPRAY
CALDESENE
3
3
CARRINGTON
MOISTURE BARRIER
CR
DURABLE BARRIER
TOPICAL CREAM 1.3
%
3
ELTA SEAL
MOISTURE BARRIER
3
CERAVE BABY
MOISTURIZING
3
HYDROLATUM
3
HYDROPHOR
3
CLOVERINE
1
KENDALL 2-IN-1
3
COCOA BUTTER
PETROLEUM
3
KENDALL
MOISTURE BARRIER
3
COOL BOTTOMS
1
corn starch
1
KENDALL
MOISTURIZING
3
CRITIC-AID CLEAR
3
3
DERMADROX
3
KENDALL
SOOTHING
KERODEX-71 WET
3
this table.
187
Drug Name
/Limits
LADY ANTI
MONKEY BUTT
3
LIP TREATMENT
3
MEXSANA
1
MOISTUREL
THERAPEUTIC
Drug Name
/Limits
RESTORE
DIMETHICREME
3
SECURA
DIMETHICONE
TOPICAL CREAM
3
3
1
MOISTURIZING SKIN
PROTECTANT
SECURA EXTRA
PROTECTIVE
3
MONISTAT
SOOTHING CARE
3
3
SECURA
PROTECTIVE
TOPICAL CREAM
NEUTRAPHOR
1
1
NORMLSHIELD
3
SECURA
PROTECTIVE
TOPICAL OINTMENT
NUVAIL
3
3
ONE STEP PERINEAL
3
SECURA STARTER
KIT
PERIGUARD
3
SKIN PROTECTANT
3
PETROLEUM JELLY
1
1
PETROLEUM JELLY,
WHITE
SOOTHE AND COOL
BODY POWDER
1
3
PHARMABASE
BARRIER
SOOTHE AND COOL
INZO BARRIER
3
SPRAYZOIN
1
PROSHIELD PLUS
3
SWEEN 24
1
PROTECTIVE
OINTMENT
talc (bulk)
1
1
THERASEAL
1
REMEDY
CLEANSING BODY
1
1
REMEDY CLEAR-AID
PROTECT
TRIPLE PASTE
TOPICAL OINTMENT
12.8 %
3
VANIPLY
1
VASELINE
1
VASELINE WHITE
PETROLEUM
3
REMEDY
DIMETHICONE
CREAM
3
REMEDY
NUTRASHIELD SKIN
PROTEC
1
WALGREENS DRY
SKIN TREATMENT
3
REMEDY SKIN
REPAIR
3
gel
1
RENEWAL HEALING
3
ointment
3
RESTORE
CLEANSER-MOISTU
RIZER
3
ointment in packet
3
WHITE PETROLEUM
JELLY
1
this table.
188
Drug Name
/Limits
ZEASORB
1
zinc oxide topical
ointment , 20 %
3
zinc oxide topical
ointment 40 %
1
zinc oxide topical paste
1
DERMATOLOGIC
AL - RETINOIDS
(VITAMIN A
DERIVATIVES) TOPICAL
COSMETIC
AVAGE
3
REFISSA
3
RENOVA TOPICAL
CREAM 0.02 %
3
tretinoin (emollient)
3
DERMATOLOGIC
AL - ROSACEA
THERAPY,
SYSTEMIC
Drug Name
ROSADAN TOPICAL
KIT, CLEANSER AND
GEL
3
ROSADAN TOPICAL
KIT,CLEANSER AND
CREAM
3
SOOLANTRA
3
sulfacetamide
sod-sulfur-urea topical
cleanser
3
sulfact
na-sul-avobnz-otn-ocsa
3
SUMADAN XLT
3
DERMATOLOGIC
AL - SHAMPOOS
AQUA GLYCOLIC
TOPICAL SHAMPOO
3
BODI BATH
1
FREE AND CLEAR
3
GERI-SHAMPOO
1
GRX RINSE-FREE
1
NEUTROGENA
TOPICAL SHAMPOO
1
VERSABASE
TOPICAL SHAMPOO
3
doxycycline
monohydrate oral
capsule,ir - delay
rel,biphase
3
ORACEA
3
DERMATOLOGIC
AL - SKIN
CONTACT
SENSITIZING
AGENTS
azelaic acid (bulk)
flakes 100 %, 88 %
3
dinitrochlorobenzene
(bulk)
azelaic acid (bulk)
powder 100 %
3
AZELEX
3
CLEANSING WASH
TOPICAL CLEANSER
3
DERMATOLOGIC
AL - SOAP AND
CLEANSER
SINGLE AGENTS
FINACEA
3
MIRVASO
3
DERMATOLOGIC
AL - ROSACEA
THERAPY,
TOPICAL
/Limits
1
green soap
1
green soap (bulk)
3
this table.
189
Drug Name
/Limits
DERMATOLOGIC
AL - SOAP AND/OR
CLEANSER
COMBINATIONS
4-N-1 NO RINSE
WASH TOPICAL
CLEANSER
3
ACUWASH
3
ALOE VESTA BODY
WASH/SHAMPOO
ALOE VESTA
CLEANSING
ALOE VESTA
PERINEAL
3
3
3
Drug Name
/Limits
KENDALL 2-IN-1
3
MEDICATED WIPES
TOPICAL PAD
1
NATURE'S WASH
PLUS WHIRLPOOL
1
NEOSPORIN DAILY
BODY
3
NEUTROGENA ACNE
CLEANSING SOAP
1
NEUTROGENA
FACIAL SOAP
1
OCUSOFT HAND
SOAP
3
PERIANAL
CLEANSING
1
PERIFRESH
1
ANTIBACTERIAL
LIQUID SOAP
3
AQUA GLYCOLIC
CLEANSER
1
PERISCENT
3
AVEENO BABY
TOPICAL CLEANSER
3
PROSHIELD
FOAM/SPRAY
CLEANSER
1
BABY WASH
1
REHYLA
3
CAVILON SKIN
CLEANSER
3
REMEDY
CLEANSING BODY
1
CETA-KLENZ
GENTLE
1
RESTORE SKIN
CLEANSER
3
CETA-KLENZ MILD
3
CETAPHIL GENTLE
CLEANSER
3
3
RESTORE WOUND
CLEANSER
SAF-CLENS AF
DERMAL WOUND
1
SENSI-CARE
TOPICAL SOLUTION
3
CETAPHIL
RESTORADERM
TOPICAL CLEANSER
1
CETAPHIL TOPICAL
BAR
1
SKIN CLEANSER
1
CETAPHIL TOPICAL
CLEANSER
1
SKINTEGRITY
WOUND CLEANSER
3
CONTI CASTILE
SOAP
1
SOOTHE AND COOL
PERINEAL WASH
3
GENTLE SKIN
CLEANSER
1
SUMMERS EVE
CLEANSING CLOTHS
3
ISAGEL
3
TENA
3
JOHNSON'S FOOT
3
this table.
190
Drug Name
/Limits
WOUND AND SKIN
CLEANSER
3
Z-CLINZ
1
DERMATOLOGIC
AL - SUNSCREENS
Drug Name
DERMATOLOGIC
AL TISSUE/WOUND
ADHESIVES
NO-STING
SKIN-PREP TOPICAL
CERAVE
SUNSCREEN
3
CETAPHIL DAILY
FACIAL
3
CETAPHIL
DERMACONTROL
3
EUCERIN DAILY
PROTECTION
3
NEUTROGENA LIP
MOISTURIZER
1
NEUTROGENA
MOISTURE SPF15
/Limits
3
DERMATOLOGIC
AL - TOPICAL
LOCAL
ANESTHETIC
AMIDES
ANECREAM
3
dibucaine
1
GLYDO
3
LC-4
3
1
lidocaine hcl mucous
membrane gel
3
octinoxate (bulk)
3
RADIADERM R1-R2
3
3
RADIADERM R2
3
membrane jelly in
applicator
titanium dioxide (bulk)
liquid
lidocaine hcl topical
3
3
TOTAL BLOCK
CLEAR
2
3
lidocaine topical
adhesive
patch,medicated
TOTAL BLOCK
COVER UP
3
lidocaine topical cream
4%
3
TROPICAL STYLE
3
lidocaine topical
ointment
3
lidocaine-tetracaine
3
LIDOCREAM
TOPICAL CREAM
3
LIDODERM
2
LIDOPIN
3
LIDORX
3
LIDOVEX
3
LMX 4 TOPICAL
CREAM
3
PLIAGLIS
3
RADIAGUARD
3
REGENECARE
3
DERMATOLOGIC
AL - SURGICAL
DEPILATORIES
(bulk)
3
DERMATOLOGIC
AL TISSUE/WOUND
ADHESIVES FIBRIN SEALANTS
ARTISS
3
PA
PA
this table.
191
Drug Name
/Limits
REGENECARE HA
1
REGENECARE WITH
ALOE
3
SYNERA
3
TOPICAINE
3
XOLIDO
3
XOLIDO XP
3
DERMATOLOGIC
AL - TOPICAL
LOCAL
ANESTHETIC
ESTERS
Drug Name
/Limits
DERMATOLOGIC
AL
ANTIPRURITICS ANTIHISTAMINES
ALLERGY CREAM
(DIPHENHYDRAMIN)
1
ANTI-ITCH
(DIPHENHYDRAMIN
E)
1
ANTI-ITCH
MAXIMUM
STRENGTH
1
1
ANACAINE
3
BOIL RELIEF
3
BENADRYL ITCH
STOPPING TOPICAL
GEL
BOIL-EASE
(BENZOCAINE)
3
diphenhydramine hcl
topical
1
cocaine
3
cocaine (bulk)
3
ITCH RELIEF
(DIPHENHYDRAMIN
E)
1
OUTGRO
3
PRUDOXIN
3
PAIN RELIEVING
(BENZOCAINE)
3
1
PONTOCAINE
3
WAL-DRYL
(DIPHENHYDRAMIN
E)
ZONALON
3
DERMATOLOGIC
AL - TOPICAL
LOCAL
ANESTHETIC
OTHERS
DERMATOLOGIC
AL
ANTIPRURITICS
OTHER
ANTI-ITCH
(PRAMOXINE)
1
ALEVICYN
ANTIPRURITIC
3
pramoxine topical
1
PRAX
1
AMLACTIN DIST
PACK (PRAMOXINE)
3
PROCTOFOAM
1
SARNA SENSITIVE
1
SENSITIVE
ANTI-ITCH
1
VAGISIL ANTI-ITCH
3
DERMATOLOGIC
AL
IRRITANTS-COUN
TER-IRRITANT
COMBINATIONS
ABSORBINE JR.
ORIGINAL
1
AFLEXERYL-MC
3
this table.
192
Drug Name
ALIVIO
/Limits
Drug Name
/Limits
3
EXOTEN-C
3
ANALGESIC GRX
BALM TOPICAL
OINTMENT
1
FLANAX
(M.SALICYLATE-ME
NTHOL)
3
ARCTIC RELIEF
3
3
BABY CHEST RUB
3
FLANDERS
BUTTOCKS
BENGAY
GREASELESS
FLEXALL PLUS
3
1
1
BENGAY ULTRA
STRENGTH TOPICAL
CREAM
FLEXALL TOPICAL
GEL 7 %
1
GOLD BOND
MEDICATED
1
BIO-THERM
3
GORDOBALM
3
CALYPXO
3
1
CAPZASIN TOPICAL
GEL
ICY HOT TOPICAL
CREAM
1
1
CASTIVA COOLING
3
ICY HOT TOPICAL
OINTMENT
CHEST RUB
TOPICAL OINTMENT
3
ICY HOT TOPICAL
STICK
3
CLEANSING SKIN
CREAM
3
3
COLD AND HOT
EXTRA STRENGTH
TOPICAL CREAM
ISOPROPYL
ALCOHOL-WINTERG
REEN
1
KERA TEK
3
MAC
3
COLD AND HOT
EXTRA STRENGTH
TOPICAL OINTMENT
MECHOLYL
3
1
MEDICATED BODY
1
COLD AND HOT
PAIN RELIEF
TOPICAL CREAM
1
MEDICATED BODY
POWDER TOPICAL
POWDER 0.15-1 %
1
COLD AND HOT
THERAPY BALM
3
MEDICATED CHEST
RUB
1
COOL HEAT
(M-SALICYLATE-ME
NTH)
MEDI-DERM
3
1
MEDROX
3
1
COOL 'N HEAT
EXTRA STRENGTH
MEDROX (WITHOUT
METHYL SALICY)
3
MEDROX-RX
3
croton oil (bulk)
3
MENTHODERM
1
DEEP BLUE RELIEF
3
METHAGUAL
3
DENDRACIN
3
1
DURAFLEX TOPICAL
3
MUSCLE RUB (WITH
CAMPHOR)
this table.
193
Drug Name
/Limits
Drug Name
/Limits
MUSCLE RUB
TOPICAL CREAM
15-10 %
ULTRACIN
3
1
VICKS BABYRUB
3
MUSCLE RUB
ULTRA-STRENGTH
1
VICKS VAPORUB
TOPICAL OINTMENT
4.8-1.2-2.6 %
1
NEW TEROCIN
3
XOTEN
3
ORTHO-NESIC
3
XOTEN-C
3
PAIN RELIEF CREAM
1
ZIKS ARTHRITIS
PAIN RELIEF
1
PAIN RELIEVING
(M-SAL-MEN-CAM)
3
PAIN RELIEVING
CREAM
1
PENETRAN + PLUS
3
POLAR FREEZE
3
RELIADERM
3
SALONPAS
3
SOMBRA NATURAL
PAIN RELIEVING
3
SPORTS RUB PAIN
RELIEVING
3
THERA-GESIC PLUS
3
THERA-GESIC
TOPICAL CREAM
15-1 %
1
TIGER BALM (WITH
CAPSICUM)
3
TIGER BALM
TOPICAL ADHESIVE
PATCH,MEDICATED
3
TIGER BALM
TOPICAL CREAM
11-10 %, 11-11 %
3
TIGER BALM
TOPICAL CREAM
3-15-5 %
1
TIGER BALM
TOPICAL LINIMENT
3
TIGER BALM
TOPICAL OINTMENT
3
TRANSANOSIL
3
DERMATOLOGIC
AL
IRRITANTS-COUN
TER-IRRITANT
SINGLE AGENTS
ABSORBINE PAIN
RELIEVING
1
ammonia sol, strong
(bulk)
3
ANALGESIC
(TROLAMINE
SALICYL)
1
ANALGESIC CREME
1
ARTHRICREAM
1
ARTHRICREAM RUB
1
ARTHRITIS
1
ARTHRITIS PAIN
RELIEF(CAPSAIC)
3
ARTHRITIS RELIEF
WITH ALOE
3
ASPERCREME
1
ASPERCREME HEAT
1
ASPERCREME MAX
3
ASPERCREME WITH
ALOE
1
ASPER-FLEX
1
BENGAY COLD
THERAPY
3
this table.
194
Drug Name
/Limits
BENGAY ULTRA
STRENGTH TOPICAL
ADHESIVE
PATCH,MEDICATED
1
BENGAY
VANISHING SCENT
1
BENGAY ZERO
DEGREES
BERRI-FREEZ
TOPICAL GEL 4.5 %
Drug Name
/Limits
COLD AND HOT
PAIN RELIEF
TOPICAL ADHESIVE
PATCH,MEDICATED
1
COOL AND HEAT
1
COOL 'N HEAT
3
3
eucalyptus oil topical
3
3
EUCERIN CALMING
ITCH-RELIEF
3
FLEXALL TOPICAL
GEL 16 %
1
GOLD BOND FOOT
3
GOLD BOND
MEDICATED FOOT
3
3
BERRI-FREEZ
TOPICAL
SPRAY,NON-AEROS
OL
3
BIOFREEZE
(MENTHOL)
3
BLUE GEL
1
GOLD BOND PAIN
RELIEVING
camphor topical
3
GORDOGESIC
3
capsaicin topical
adhesive
patch,medicated
3
1
GORDOMATIC
TOPICAL LOTION
3
capsaicin topical cream
0.025 %, 0.1 %
HIGH POTENCY
CAPSAICIN
3
ICE BLUE GEL
1
capsaicin topical liquid
3
ICE GEL
1
CAPSICUM
1
ICY HOT (MENTHOL)
3
capsicum oleoresin
(bulk)
3
ICY HOT
MEDICATED SLEEVE
1
CAPZASIN TOPICAL
LIQUID
3
ICY HOT NATURALS
3
ICY HOT NO MESS
3
CAPZASIN-HP
3
CAPZASIN-P
1
ICY HOT PAIN
RELIEVING
1
CASTIVA WARMING
3
ICY HOT ROLL
3
CHILD BENADRYL
ITCH (CAMPHOR)
3
1
COLD AND HOT
EXTRA STRENGTH
TOPICAL ADHESIVE
PATCH,MEDICATED
ICY HOT TOPICAL
ADHESIVE
PATCH,MEDICATED
1
MEDICATED BODY
POWDER TOPICAL
POWDER 0.15 %
3
MEDICATED HEAT
PATCH
1
menthol topical
1
this table.
195
Drug Name
/Limits
Drug Name
/Limits
methyl salicylate
1
TRIXAICIN HP
3
MINERAL FREEZ
1
trolamine salicylate
1
MOBISYL
1
3
MUSCLE RELIEF
3
TRU-MICIN TOPICAL
LOTION
MYOFLEX
1
turpentine oil
3
ORIGINAL
OINTMENT
WINTERGREEN OIL
1
3
ZIM'S MAX-FREEZE
3
PAIN PADS
3
ZOSTRIX
3
PAIN RELIEF
TOPICAL CREAM
1
ZOSTRIX-HP
3
PAIN RELIEF
TOPICAL GEL
1
PAIN RELIEVING
(MENTHOL)
TOPICAL ADHESIVE
PATCH,MEDICATED
1
PAIN RELIEVING
(MENTHOL)
TOPICAL GEL
HAIR GROWTH
AGENTS TOPICAL
HAIR REGROWTH
FOR MEN
3
HAIR REGROWTH
FOR WOMEN
3
1
3
PAIN RELIEVING
(MENTHOL)
TOPICAL GEL 3.5 %
HAIR REGROWTH
TREATMENT
TOPICAL SOLUTION
3
MEN'S X-STR HAIR
REGROWTH TMNT
3
PERFORM PAIN
RELIEVING
minoxidil topical
3
3
RENEWAL
3
POLAR FROST
1
ROGAINE
3
QUTENZA
3
3
SALONPAS-HOT
1
ROGAINE EXTRA
STRENGTH FOR MEN
SOMBRA COOL
THERAPY
3
SORE MUSCLE RUB
3
SPORTS PAIN RELIEF
RUB
1
SPORTSCREME
1
STOPAIN
HAIR GROWTH
AGENTS - TYPE II
5-ALPHA
REDUCTASE
INHIBITORS
finasteride (bulk)
3
3
finasteride oral tablet 1
mg
3
THERAPEUTIC BLUE
1
PROPECIA
3
THERAPEUTIC
MINERAL ICE
1
THRITEX
3
TRIXAICIN
3
this table.
196
Drug Name
/Limits
HAIR GROWTH,
TOPICAL
HYPERTRICHOTI
C AGENTS,
EYELASHES
LATISSE
3
HUMAN
CELLULAR
REGENERATIVE
TISSUE MATRIX
EPIFIX AMNIOTIC
MEMBRANE
3
GRAFIX CORE
TOPICAL SHEET 5 X
5 CM
3
GRAFIX PRIME
TOPICAL SHEET 5 X
5 CM
3
LIP PROTECTIVES
HERPECIN L
3
NAIL
PROTECTIVES
GENADUR
3
GENADUR (WITH
LEXINAL)
3
OVINE (SHEEP)
SKIN DRESSINGS,
NON-LIVING
ENDOFORM
FENESTRATED
3
ENDOFORM
TOPICAL SHEET 2 X
2 ", 4 X 5 "
3
SCABICIDE &
PEDICULICIDE
COMBINATIONS
COMPLETE LICE
TREATMENT
1
LICE COMPLETE KIT
1-2-3
1
Drug Name
/Limits
LICE KILLING
1
LICE PYRINYL
SHAMPOO
1
LICE SOLUTION
1
LICE TREATMENT
(RESMETHRIN)
3
LICE TREATMENT
TOPICAL KIT 0.33-4
%
3
LICE TREATMENT
TOPICAL SHAMPOO
1
LYCELLE
3
PEDICULICIDE 11
1
PYRETHRIN LICE
TREATMENT M
1
RID COMPLETE LICE
ELIM KIT TOPICAL
1
RID LICE KILLING
1
SCABICIDE &
PEDICULICIDE
SINGLE AGENTS
BEDDING SPRAY
1
crotamiton (bulk)
3
ELIMITE
3
EURAX
1
LICE BEDDING
SPRAY
1
LICE CREAM RINSE
3
LICE KILLING
(PERMETHRIN)
1
LICE TREATMENT
(PERMETHRIN)
1
LICE TREATMENT
TOPICAL LIQUID 1 %
1
lindane
1
malathion
2
NATROBA
3
NIX CREME RINSE
1
PA
OVIDE
3
LICE EGG REMOVER
3
this table.
197
Drug Name
/Limits
permethrin
1
permethrin (bulk) liquid
92 %
3
RID COMPLETE LICE
ELIM KIT
AEROSOL,SPRAY
3
SKLICE
2
spinosad
3
STOP LICE
3
ULESFIA
3
SKIN
REPLACEMENT,
LIVE TISSUE
DRESSINGS
PA
Drug Name
/Limits
VASHE WOUND
THERAPY
3
WOUND CLEANSER
3
WOUND WASH
SALINE
3
WOUND CARE DRESSINGS
ACTICOAT 7
DRESSING TOPICAL
BANDAGE 2 X 2 ", 6
X6"
3
ACTICOAT 7
DRESSING TOPICAL
BANDAGE 4 X 5 "
1
ACTICOAT
ABSORBENT
3
3
APLIGRAF
3
DERMAGRAFT
3
OASIS ULTRA
FENESTRATED
3
OASIS WOUND
MATRIX
FENESTRATED
ACTICOAT
DRESSING TOPICAL
BANDAGE 2 X 2 ", 4
X 4 ", 5 X 5 "
3
ACTICOAT FLEX 3
DRESSING
3
OASIS WOUND
MATRIX MESHED
3
ACTICOAT FLEX 7
DRESSING
3
ACTICOAT
MOISTURE
CONTROL TOPICAL
BANDAGE 2 X 2 "
3
ACTICOAT SITE
3
WOUND CARE CLEANSER
COMBINATIONS
ALEVICYN DERMAL
3
AMERIGEL WOUND
WASH
3
ALGICELL AG
3
ATRAPRO DERMAL
SPRAY
3
ALGISITE M
TOPICAL BANDAGE
2 X 2 ", 6 X 8 "
3
ALGISITE M
TOPICAL BANDAGE
4X4"
1
ALLEVYN
ADHESIVE
DRESSING TOPICAL
BANDAGE 7 X 7 "
3
ALLEVYN AG
ADHESIVE
3
WOUND CARE CLEANSERS
ADVANCED WOUND
3
SAFE WASH
1
SALINE WOUND
WASH
1
SALINE WOUND
WASH TOPICAL
3
this table.
198
Drug Name
/Limits
ALLEVYN GENTLE
BORDER
3
ALLEVYN GENTLE
BORDER LITE
TOPICAL BANDAGE
2 X 2 ", 3 X 3 "
3
ALLEVYN LIFE
DRESSING TOPICAL
BANDAGE 4 X 4 "
3
ALLEVYN SACRUM
TOPICAL BANDAGE
6 3/4 X 6 3/4 "
3
ALLEVYN TOPICAL
BANDAGE 8 X 8 "
1
AMERIGEL
DRESSING
1
AQUACEL AG FOAM
HEEL
3
AQUACEL AG FOAM
SACRAL
3
AQUACEL AG FOAM
TOPICAL BANDAGE
1.2 %- 10" X 12", 1.2
%- 3.2" X 3.2", 1.2 %4" X 4", 1.2 %- 6" X 6",
1.2 %- 6" X 8", 1.2 %8" X 8"
3
AQUACEL EXTRA
TOPICAL BANDAGE
2 X 2 ", 6 X 6 "
1
AQUACEL EXTRA
TOPICAL BANDAGE
4X5"
3
AQUACEL FOAM
TOPICAL BANDAGE
4 X 4 ", 6 X 6 ", 7 X 7 "
1
AQUACEL FOAM
TOPICAL BANDAGE
5 X 5 ", 6 X 8 ", 8 X 5.5
", 8 X 7 "
3
Drug Name
/Limits
AQUACEL
HYDROFIBER
DRESSING TOPICAL
BANDAGE 0.39 X 18 "
3
AQUACEL-AG
EXTRA TOPICAL
BANDAGE 1.2-6 X 6
%-"
1
AQUACEL-AG
TOPICAL BANDAGE
1.2-0.39 X 18 %-",
1.2-3.5 X 10 %-",
1.2-3.5 X 14 %-",
1.2-3.5 X 6 %-",
1.2-3.5" X 12 %-"
3
AQUACEL-AG
TOPICAL BANDAGE
1.2-3.5 X 4 %-"
1
AQUAFLO
3
ARGLAES TOPICAL
POWDER
3
AVOGEL
1
AVOGEL DRESSING
1
BIATAIN
1
BIATAIN ADHESIVE
FOAM DRESSING
TOPICAL BANDAGE
5X5"
3
BIATAIN ADHESIVE
FOAM DRESSING
TOPICAL BANDAGE
7X7"
1
BIATAIN HEEL ADH
FOAM DRESSING
3
BIATAIN
NON-ADHESIVE
FOAM
1
BIATAIN
NON-ADHESIVEFOA
M ROUND
3
BIOBRANE
3
BIOBRANE
DRESSING
3
this table.
199
Drug Name
/Limits
BIOBRANE GLOVES
PEDIATRIC
3
BIOBRANE GLOVES
SMALL
3
BIOBRANE-L
3
BIOBRANE-L
DRESSING
3
Drug Name
/Limits
COMFEEL SEASORB
TOPICAL BANDAGE
16 "
3
COMFEEL SEASORB
TOPICAL BANDAGE
4X4"
1
COMFEEL ULCER
CARE DRESSING
TOPICAL BANDAGE
1 1/2 X 2 1/2 "
3
COMFEEL ULCER
CARE DRESSING
TOPICAL BANDAGE
4 X 4 ", 6 X 6 ", 8 X 8 "
1
COOLMAGIC
FENESTRATED
3
COOLMAGIC
TOPICAL BANDAGE
3 3/4 X 3 3/4 ", 8 X 12 "
3
1
BIOGUARD GAUZE
TOPICAL BANDAGE
0.3 %- 2" X 2", 0.3 %4" X 4"
3
BIOGUARD ISLAND
3
BIOGUARD
NON-ADHERENT
3
BIOSTEP
3
BIOSTEP AG
3
BLISTER CARE
1
BURNS-SCALDS-ABR
ASIONS
1
CALALGIN-GRX
DRESSING
1
COOLMAGIC
TOPICAL BANDAGE
6X8"
CARBOFLEX ODOR
CONTROL DRESSIN
3
COPA HYDROPHILIC
FOAM
1
CURAFIL GEL
WOUND
3
CURITY AMD (WITH
POLYHEXAMETH)
TOPICAL SPONGE 0.2
%- 2" X 2"
3
CURITY AMD (WITH
POLYHEXAMETH)
TOPICAL STRIP
3
CURITY DRESSING
TOPICAL BANDAGE
6 X 6 3/4 "
3
CURITY GAUZE
BURN DRESSING
3
CURITY WET
DRESSING
1
CARRASYN
HYDROGEL WOUND
DRESS
3
COMFEEL PLUS
CLEAR DRESSING
1
COMFEEL PLUS
CONTOUR
DRESSING
3
COMFEEL PLUS
PRESSURE RELIEF
3
COMFEEL PLUS
PRESSURE ROUND
3
COMFEEL PLUS
TRIANGLE
DRESSING
1
COMFEEL PLUS
ULCER DRESSING
1
CUTINOVA HYDRO
DRESSING
3
COMFEEL PURILON
3
DERMADRESS
1
this table.
200
Drug Name
DERMAGAUZE
/Limits
1
DERMAGAUZE
HYDROGEL
DRESSING
1
DERMAGINATE
1
DERMAGRAN
HYDROGEL
DRESSING
3
DERMAGRAN
HYDROPHILIC
DRESSING TOPICAL
BANDAGE 2 X 2 ", 4
X4"
3
DERMALEVIN
1
DERMASYN
3
DRYMAX EXTRA
3
DUODERM CGF
BORDER DRESSING
TOPICAL BANDAGE
2 1/2 X 2 1/2 ", 6 X 6 ",
6X7"
1
Drug Name
/Limits
ELASTO-GEL
TOPICAL BANDAGE
12 X 12 "
3
ELASTO-GEL
TOPICAL BANDAGE
6X8"
1
EXCILON AMD
(WITH
POLYHEXAMET)
3
EXUDERM RCD
TOPICAL BANDAGE
6X6"
3
EXUDERM SACRUM
3
EXUDERM SATIN
DRESSING TOPICAL
BANDAGE 4 X 4 ", 6
X 6 ", 8 X 8 "
3
EXUDERM ULTRA
1
FLEXIBLE FOAM
3
FLEXZAN WOUND
DRESSING
1
foam bandage
3
DUODERM CGF
BORDER DRESSING
TOPICAL BANDAGE
4X5"
3
FOAM TOE
BANDAGE
3
DUODERM CGF
DRESSING
1
GELPAD TOPICAL
BANDAGE 2 X 2 ", 4
X4"
1
DUODERM CGF
EXTRA THIN
1
3
DUODERM CGF
EXTRA THIN SPOTS
1
GELPAD TOPICAL
BANDAGE 4 X 8 ", 6
X 10 "
GRX WOUND GEL
3
DUODERM
HYDROACTIVE
1
HYDROCOL II
1
DUODERM SIGNAL
DRESSING
1
HYDROCOL II
SACRAL
1
DURAFIBER
DRESSING TOPICAL
BANDAGE 2 X 2 ", 3/4
X 18 ", 4 X 4 "
HYDROCOL THIN II
1
3
3
ELASTO-GEL CIRCLE
DRESSING
hydrocolloid dressing
topical bandage 17
square inch, 26.5 sq
inch
1
topical bandage 4 x 4 ",
6 x 6 ", 6 x 8 ", 8 x 8 "
1
this table.
201
Drug Name
/Limits
HYDROFERA BLUE
3
INTRASITE GEL
DRESSING
3
KALTOSTAT
FORTEX
KALTOSTAT ROPE
Drug Name
/Limits
PRODERM
1
3
1
REPLICARE
DRESSING TOPICAL
BANDAGE 1 1/2 X 2
1/2 "
1
REPLICARE THIN
3
REPLICARE ULTRA
DRESSING
3
RESTORE CALCIUM
ALGINATE TOPICAL
BANDAGE 12 ", 2 X 2
"
1
RESTORE CALCIUM
ALGINATE TOPICAL
BANDAGE 4 X 4 3/4 ",
4X8"
3
RESTORE CONTACT
LAYER SILVER
3
RESTORE EXTRA
THIN DRESSING
1
RESTORE FOAM
DRESSING SILVER
TOPICAL BANDAGE
4X4"
1
RESTORE FOAM
DRESSING SILVER
TOPICAL BANDAGE
6X8"
3
RESTORE FOAM
HEEL DRESSING
3
3
3
RESTORE
HYDROGEL
DRESSING
MPM FOAM
DRESSING TOPICAL
BANDAGE 4 X 4 "
1
1
RESTORE
HYDROGEL GAUZE
SPONGE
OPTIFOAM
1
3
PRIMER MODIFIED
UNNA BOOT
TOPICAL BANDAGE
25 %- 4" X 10 YARD
RESTORE TOPICAL
BANDAGE 1 X 12 ", 2
1/2 X 2 1/2 ", 4 X 5 ", 6
X8"
3
RESTORE TOPICAL
BANDAGE 2 X 2 ", 4
X 4 ", 6 X 6 ", 8 X 8 "
1
KALTOSTAT
WOUND DRESSING
TOPICAL BANDAGE
12 X 24 ", 2 X 2 ", 3 X
4 3/4 ", 6 X 9 1/2 "
1
KALTOSTAT
WOUND DRESSING
TOPICAL BANDAGE
4X8"
3
KENDALL TOPICAL
BANDAGE 12 ", 2 X 2
", 4 X 4 "
3
KENDALL TOPICAL
GEL
3
KERLIX AMD
3
KERLIX BURN PACK
3
MAXORB
3
MAXORB EXTRA
DRESSING
3
MAXORB ROPE
3
MEDIHONEY (CAL
ALGINATE-HONEY)
3
MEDIHONEY
(HONEY)
3
MPM FOAM
DRESSING TOPICAL
BANDAGE 2 X 2 "
this table.
202
Drug Name
/Limits
SAF-GEL
3
SILVASORB
3
SILVASORB CAVITY
3
SILVASORB
DRESSING
3
SILVERMED
TOPICAL
GEL,EXTENDED
RELEASE
3
SILVERSEAL
HYDROGEL
3
SKINTEGRITY
HYDROGEL
3
SKINTEGRITY
HYDROGEL
DRESSING TOPICAL
BANDAGE 2 X 2 "
3
SKINTEGRITY
HYDROGEL
DRESSING TOPICAL
BANDAGE 4 X 4 "
1
SOLOSITE WOUND
GEL
1
SORBSAN TOPICAL
WOUND DRESSING
TOPICAL BANDAGE
12 ", 4 X 4 "
1
Drug Name
/Limits
TEGADERM
HYDROCOLLOID
TOPICAL BANDAGE
4 X 4 ", 4 X 4 3/4 ", 5
1/8 X 6 ", 6 X 6 "
1
TEGADERM
HYDROCOLLOID
TOPICAL BANDAGE
6 3/4 X 6 3/8 ", 6 3/4 X
8"
3
TEGADERM
HYDROGEL
3
TEGAGEN HG
1
TEGAGEN HI
1
TEGASORB THIN
DRESSING
3
TENDERWET
ACTIVE CAVITY
DRESS
3
TENDERWET
ACTIVE DRESSING
3
TENDERWET
SYSTEM
3
TRIAD WOUND
DRESSING
1
TRIPLE HELIX
COLLAGEN
3
ULTRA-FLEX
1
SORBSAN TOPICAL
WOUND DRESSING
TOPICAL BANDAGE
3 X 3 ", 4 X 8 "
3
VASCUDERM
HYDROGEL WOUND
3
SORBSAN WOUND
DRESSING
1
3
SPECTRAGEL
1
VERSIVA XC
TOPICAL BANDAGE
10 X 8 ", 5 1/2 X 5 1/2
", 8 X 7 "
TEGADERM AG
MESH
3
1
TEGADERM
HYDROCOLLOID
THIN
1
VERSIVA XC
TOPICAL BANDAGE
3 X 3 ", 4 1/4 X 4 1/4 ",
4 X 4 ", 6 X 6 ", 8 X 8 "
VIGILON PRIMARY
WOUND DRESSING
1
this table.
203
Drug Name
WOUN'DRES
HYDROGEL WOUND
DRESS
/Limits
3
WOUND CARE GROWTH
FACTOR AGENTS
REGRANEX
Drug Name
/Limits
VARIBAR THIN
LIQUID
3
VOLUMEN
3
CONTRAST
MEDIA IODINATED IONIC
3
WOUND CARE
COMBINATIONS
OTHER
CONRAY
3
CONRAY 43
4
CONRAY-30
4
CYSTO-CONRAY II
3
3
CYSTOGRAFIN
3
RADIGEL
ACEMANNAN
HYDROGEL
3
CYSTOGRAFIN-DILU
TE
3
GASTROGRAFIN
3
VENELEX
3
iopanoic acid (bulk)
1
DIAGNOSTIC
AGENTS
MD-76 R
3
MD-GASTROVIEW
3
CONTRAST
MEDIA - BARIUM
SINOGRAFIN
3
ALEVICYN
ANTIPRURITIC
ENTERO VU ORAL
LIQUID 24 %
3
E-Z DISK
3
E-Z-CAT DRY
3
E-Z-HD BARIUM
3
E-Z-PAQUE
CONTRAST
MEDIA IODINATED
NONIONIC
ISOVUE-200
INJECTION
3
3
ISOVUE-200
INTRAVENOUS
4
E-Z-PASTE
3
ISOVUE-250
4
LIQUID E-Z PAQUE
3
ISOVUE-300
4
LIQUID POLIBAR
PLUS
3
ISOVUE-370
4
POLIBAR ACB
3
ISOVUE-M 200
3
READI-CAT 2
3
ISOVUE-M 300
1
TAGITOL V
3
OMNIPAQUE 140
4
VARIBAR HONEY
3
OMNIPAQUE 180
3
VARIBAR NECTAR
3
OMNIPAQUE 240
4
VARIBAR PUDDING
3
OMNIPAQUE 300
4
VARIBAR THIN
HONEY
OMNIPAQUE 350
4
3
OPTIRAY 300
4
OPTIRAY 320
4
this table.
204
Drug Name
/Limits
OPTIRAY 350
4
ULTRAVIST
3
VISIPAQUE
4
CONTRAST
MEDIA MAGNETIC
RESONANCE
GADOLINIUM
COMPLEXES
Drug Name
/Limits
DIAGNOSTIC BLOOD TEST
OTHERS
ACCUTREND
CHOLESTEROL
CONTROL
3
ACCUTREND
CHOLESTEROL TEST
3
ACCUTREND PLUS
3
ABLAVAR
4
AZOSTIX
3
DOTAREM
4
COAGUCHEK PT
3
EOVIST
4
3
GADAVIST
4
COAGUCHEK XS
STRIP
MAGNEVIST
4
NOVAMAX PLUS
KETONE
1
MULTIHANCE
4
MULTIHANCE
MULTIPACK
1
4
PRECISION XTRA
B-KETONE
OMNISCAN
4
DIAGNOSTIC INFECTION TESTS
OMNISCAN PREFILL
PLUS
4
REVEAL UTI TEST
STRIP
OPTIMARK
4
PROHANCE
4
DIAGNOSTIC MULTIPLE URINE
TESTS
CONTRAST
MEDIA MAGNETIC
RESONANCE IRON
COMPOUNDS
3
CHEK-STIX
CONTROL
1
CHEMSTRIP 10 MD
1
CHEMSTRIP 10/SG
1
FERIDEX IV
4
CHEMSTRIP 2 GP
1
GASTROMARK
3
CHEMSTRIP 50B
1
CHEMSTRIP 7
1
CHEMSTRIP 9
1
COMBISTIX
REAGENT
1
HEMA-COMBISTIX
1
LABSTIX REAGENT
1
MULTISTIX
1
MULTISTIX 10 SG
1
MULTISTIX 5
1
CONTRAST
MEDIA ULTRASOUND
AGENTS
DEFINITY
4
OPTISON
4
this table.
205
Drug Name
/Limits
MULTISTIX 7
1
MULTISTIX 8 SG
1
MULTISTIX 9
1
MULTISTIX 9 SG
1
URISTIX 4
1
URISTIX REAGENT
1
DIAGNOSTIC OCCULT BLOOD
TESTS
HEMATEST
3
REVEAL COLON
DISEASE TEST
3
DIAGNOSTIC OTHER
SITZMARKS
3
DIAGNOSTIC REPRODUCTIVE
SYSTEM TESTS
/Limits
REVEAL GET
PREGNANT QUICK
3
REVEAL
OVULATION
PREDICTOR
3
REVEAL
OVULATION TEST
3
REVEAL
PREGNANCY TEST
1
DIAGNOSTIC THERAPEUTIC
MONITORING-TO
XICOLOGY-ABUS
E TESTS
TOXICOLOGY
SALIVA
COLLECTION
3
DIAGNOSTIC URINE TEST
OTHERS
CLEARBLUE
DIGITAL
OVULATION
3
CLEARBLUE EASY
OVULATION TEST
3
CLEARBLUE
FERTILITY
MONITOR
Drug Name
3
CLEARBLUE
FERTILITY STICKS
3
EARLY OVULATION
TEST
3
EARLY PREGNANCY
TEST
1
ONE STEP
OVULATION TEST
3
ONE STEP
PREGNANCY TEST
1
ovulation prediction test
ALBUSTIX REAGENT
1
AZO TEST STRIPS
1
CHEMSTRIP 2
1
CHEMSTRIP MICRAL
1
NITRATEST PAPER
WITH DISPENSER
1
URINARY TRACT
INF.TEST (WBCS)
1
DIAGNOSTIC
BIOLOGICALS
APLISOL
3
SPHERUSOL
3
TUBERSOL
3
DIAGNOSTIC
DRUGS - BILIARY
IC GREEN
3
3
indocyanine green
3
PRECISE
PREGNANCY
1
indocyanine green
(bulk)
3
pregnancy test
1
this table.
206
Drug Name
/Limits
DIAGNOSTIC
DRUGS CARDIOVASCULA
R
Drug Name
/Limits
DIAGNOSTIC
DRUGS PITUITARY
FUNCTION
ADENOSCAN
4
ACTHREL
4
adenosine (diagnostic)
4
CORTROSYN
3
dipyridamole
intravenous
4
cosyntropin injection
3
cosyntropin intravenous
4
LEXISCAN
4
DIAGNOSTIC
DRUGS GASTROINTESTIN
AL
RADIOLOGICAL
ADJUNCT
GLUCAGEN
DIAGNOSTIC KIT
1
glucagon hcl
3
DIAGNOSTIC
DRUGS GLUCOSE
TOLERANCE
TEST, ORAL
GLUTOL GEL
DIAGNOSTIC
DRUGS PULMONARY
methacholine chloride
(bulk)
1
PROVOCHOLINE
1
DIAGNOSTIC
DRUGS - RENAL
FUNCTION
creatinine (bulk)
3
INDIGO CARMINE
3
DIAGNOSTIC
DRUGS - THYROID
FUNCTION
1
DIAGNOSTIC
DRUGS - IN VIVO
OTHER
isosulfan blue
3
isosulfan blue (bulk)
3
KINEVAC
1
LYMPHAZURIN
3
protirelin (bulk)
3
THYROGEN
4
DIAGNOSTIC
RADIOPHARMAC
EUTICALS BRAIN, AMYLOID
PLAQUE IMAGING
AMYVID
4
CHIRHOSTIM
4
DIAGNOSTIC
RADIOPHARMAC
EUTICALS CEREBRAL
PERFUSION
IMAGING
METOPIRONE
1
CERETEC
4
R-GENE 10
4
INDIUM IN-111 DTPA
3
secretin (human) (bulk)
3
DIAGNOSTIC
DRUGS METABOLIC
FUNCTION
this table.
207
Drug Name
/Limits
DIAGNOSTIC
RADIOPHARMAC
EUTICALS DOPAMINE
TRANSPORTER
(DAT) IMAGING
DATSCAN
Drug Name
/Limits
DIAGNOSTIC
RADIOPHARMAC
EUTICALS RENAL IMAGING
4
DIAGNOSTIC
RADIOPHARMAC
EUTICALS ENDOCRINE
DMSA
4
DRAXIMAGE DTPA
4
DIAGNOSTIC SKIN
TESTS
PRE-PEN
ADREVIEW
4
OCTREOSCAN
4
DIAGNOSTIC
RADIOPHARMAC
EUTICALS MYOCARDIAL
PERFUSION
IMAGING
3
DRUGS TO
TREAT
ERECTILE
DYSFUNCTION
ERECTILE
DYSFUNCTION
(ED) DRUGS PROSTAGLANDIN
S
MYOVIEW KIT
4
CAVERJECT
3
thallous chloride tl-201
4
CAVERJECT
IMPULSE
3
EDEX
3
MUSE
3
DIAGNOSTIC
RADIOPHARMAC
EUTICALS PROSTATIC
PROSTASCINT
4
DIAGNOSTIC
RADIOPHARMAC
EUTICALS RADIOLABELING
AUTOLOGOUS
LEUKOCYTES
indium in-111
oxyquinoline
4
DIAGNOSTIC
RADIOPHARMAC
EUTICALS RADIOLABELING
REAGENTS
INDICLOR
3
ERECTILE
DYSFUNCTION
(ED)
DRUGS-SEL.CGMP
PHOSPHODIESTE
RASE TYPE5
INHIB
CIALIS ORAL
TABLET 10 MG, 20
MG
3
CIALIS ORAL
TABLET 2.5 MG, 5
MG
2
LEVITRA
3
sildenafil (bulk)
3
STAXYN
3
PA
STENDRA
3
this table.
208
Drug Name
VIAGRA
/Limits
3
EATING
DISORDER
THERAPY
ANOREXIANT
COMBINATIONS
QSYMIA
3
3
ADIPEX-P
3
benzphetamine oral
tablet 50 mg
3
diethylpropion
3
diethylpropion hcl
(bulk)
3
phendimetrazine
tartrate
3
phentermine hcl (bulk)
3
phentermine oral
3
phentermine oral
capsule 37.5 mg
NF
phentermine oral tablet
NF
REGIMEX
3
SUPRENZA
3
ANTI-OBESITY FAT ABSORPTION
DECREASING
AGENTS
ALLI
3
XENICAL
3
3
ANTI-OBESITY OPIOID
ANTAG/NOREPIN
EPHRINE &
DOPAMINE
REUPTAKE
INHIBIT
CONTRAVE
ANOREXIANTS
/Limits
ANTI-OBESITY GLUCAGON-LIKE
PEPTIDE-1 (GLP-1)
RECEPTOR
AGONISTS
SAXENDA
ANOREXIANT
NUTRITIONAL
SUPPLEMENTS
(DIET AIDS)
RESVERATROL DIET
Drug Name
3
ANTI-OBESITY SEROTONIN 2C
RECEPTOR
AGONISTS
BELVIQ
3
APPETITE
STIMULANTS PROGESTIN
HORMONE TYPE
MEGACE
3
MEGACE ES
3
megestrol oral
suspension 400 mg/10
ml (10 ml), 400 mg/10
ml (40 mg/ml)
1
megestrol oral
3
ELECTROLYTE
BALANCE-NUT
RITIONAL
PRODUCTS
AMINO ACID CARNITINE
DERIVATIVES
acetylcarnitine
3
this table.
209
Drug Name
/Limits
L-CARNITINE
(TARTRATE)
3
L-CARNITINE ORAL
TABLET
3
AMINO ACID TYROSINE
tyrosine oral capsule
3
tyrosine oral packet
1
AMINO
ACID-AMINO
ACID
COMBINATIONS,
ORAL
Drug Name
/Limits
oral powder in packet
500 mg
1
oral tablet
1
arginine hcl (l-arginine)
1
asparagine
monohydrate (bulk)
3
CITRULLINE 1000
3
CITRULLINE 200
3
3
cysteine (l-cysteine) oral
3
GLUTAMENT
3
AMINO ACID
3
glutathione (bulk)
3
amino acids
3
glycine oral powder
1
AMINO ACTION
1
COMPLETE AMINO
ACID MIX
3
1
glycine oral powder in
packet
ISOLEUCINE 1000
3
DAILY AMINO
1
HIGH PROTEIN
3
ISOLEUCINE AMINO
ACID SUPPLMNT
1
NUTRASENTIALS
3
l-cystine
1
PRE PROTEIN
1
leucine oral
1
PROTEIN 2000
3
PROTEINEX ORAL
TABLET
3
1
L-GLUTAMINE ORAL
TABLET
L-LYSINE ORAL
TABLET
1
L-PHENYLALANINE
3
lysine acetate
3
lysine hcl
1
lysine oral tablet 1,000
mg, 500 mg
1
AMINO ACIDS,
SINGLE
INGREDIENT,
ORAL
(NON-INJECTABL
E)
acetylcysteine oral
capsule 600 mg
3
3
oral capsule
lysine oral tablet 600
mg
3
METHIONINE ORAL
3
NAC
3
NUTRESTORE
3
phenylalanine
3
phenylalanine, l- (bulk)
3
oral powder in packet
2,000 mg
3
this table.
210
Drug Name
/Limits
PURE L-CITRULLINE
ORAL CAPSULE
1
PURE L-CITRULLINE
ORAL POWDER
3
taurine
3
taurine (bulk)
3
threonine oral
3
tyrosine (bulk)
3
VALINE 1000
3
VALINE AMINO
ACID SUPPLEMENT
1
B-COMPLEX
VITAMIN
COMBINATIONS
Drug Name
/Limits
B-COMPLEX WITH
VITAMIN C ORAL
TABLET 400-500
MCG-MG
3
b-complex with vitamin
c oral tablet extended
release
1
B-COMPLEX WITH
VITAMIN C ORAL
TABLET EXTENDED
RELEASE
1
B-STRESS
3
CARDIOTEK-RX
(BIOPERINE)
3
3
ALBA-LYBE
1
APETEX
1
COMPLEX B-100
ORAL TABLET
EXTENDED
RELEASE 400 MCG
APETIGEN
1
COMPLEX B-50
3
B COMPLEX 100
ORAL
1
DIALYVITE 3000
3
DIALYVITE 800
1
B COMPLEX PLUS
VITAMIN C
3
DIALYVITE 800
WITH ZINC 15
3
b complex-vitamin
c-folic acid
1
DIALYVITE 800
WITH ZINC 50
3
B-100 COMPLEX
ORAL TABLET
EXTENDED
RELEASE
1
DIALYVITE
800-ULTRA D
3
3
BALANCED B
COMPLEX-VIT C
DIALYVITE ORAL
TABLET 100-1 MG
1
3
BALANCED B-100
COMPLEX ORAL
TABLET EXTENDED
RELEASE 100 MG
DIALYVITE
SUPREME D
1
FATIGUE RELIEF
COMPLEX
3
FOLBEE AR
3
BALANCED B-100
ORAL TABLET 0.4
MG, 100 MG
FOLBEE PLUS
3
1
FULL SPECTRUM
B-VITAMIN C
1
B-COMPLEX ORAL
TABLET 300 MG-150
MG CALCIUM
3
KOBEE
1
LIPOGEN
1
b-complex with vitamin
c oral tablet
1
LYSIPLEX PLUS
ORAL TABLET
3
this table.
211
Drug Name
/Limits
MEDTYCHOLL-B
COMPLEX-LIVER
3
MYNEPHROCAPS
3
NATURAL B-100
COMPLEX
1
NEPHROCAPS
Drug Name
/Limits
SUPER B
COMPLEX-VITAMIN
C
1
SUPER B/C
1
SUPER QUINTS
1
3
SUPERPLEX-T
1
NEPHROCAPS QT
3
SUPERVITE
3
NEPHRONEX
3
SUPPORT-500
3
NEPHRONEX-SL
3
TOTAL B/C
1
NEPHRO-VITE
1
TRIPHROCAPS
1
NUTRIVIT
3
VIRT-CAPS
3
PRORENAL
3
VIRT-VITE PLUS
3
QUIN B STRONG
3
1
RENAL CAPS
3
vit b complex-folic acid
oral tablet
RENA-VITE
1
RENO CAPS
3
vit b complex-folic acid
release
3
STRESS 500
1
VITA-BEE WITH C
3
STRESS 500 PLUS
ZINC
3
VITAMIN B
COMPLEX WITH C
1
STRESS B PLUS ZINC
3
STRESS B WITH
ZINC
3
3
STRESS FORMULA
1
VITAMINS B
COMPLEX ORAL
TABLET 500 MG-400
MCG- 18 MG IRON
STRESS FORMULA
600 C
1
VITAMINS FOR HAIR
ORAL TABLET
1
STRESS FORMULA
ENERGY
3
STRESS FORMULA
PLUS IRON
B-COMPLEX
VITAMINS AND
COMBINATIONS
3
STRESS FORMULA
WITH IRON
3
STRESS FORMULA
WITH IRON(SULF)
3
STRESS FORMULA
WITH ZINC
1
SUPER B COMPLEX +
C
3
APETIGEN PLUS
ORAL LIQUID
1
DIALYVITE ORAL
TABLET 1-100-300-50
MG-MG-MCG-MG
3
NEPHPLEX RX
3
NEPHRO-VITE RX
3
RABANO YODADO
3
RENA-VITE RX
3
VOL-CARE RX
3
this table.
212
Drug Name
/Limits
B-COMPLEX
VITAMINS
Drug Name
/Limits
ULTRA B-100
COMPLEX ORAL
TABLET
1
vitamin b complex
1
VITAMIN B-100
COMPLEX
1
1
1
B COMPLETE
1
B COMPLEX 1
1
B COMPLEX 100
INJECTION
1
B COMPLEX ORAL
1
B COMPLEX
SUBLINGUAL
3
VITAMINS B
COMPLEX ORAL
CAPSULE
B
COMPLEX-VITAMIN
B12
1
VITAMINS B
COMPLEX ORAL
TABLET
B-100 COMPLEX
ORAL TABLET
1
BIOFLAVONOID
COMBINATIONS
B-50 COMPLEX
1
BAL B-100
1
BAL B-50
1
BALANCE B-100
BALANCE B-50
BIOFLEX
3
BIOFLONEX
3
3
1
C
1000-BIOFLAVONOID
S-ROSE HIPS
3
DAFLONEX-XL
3
EAR CARE
1
EAR HEALTH
FORMULA
1
EAR HEALTH PLUS
3
3
BALANCED B-100
COMPLEX ORAL
TABLET EXTENDED
RELEASE
1
BALANCED B-150
1
BALANCED B-50
ORAL TABLET
1
COMPLEX B-100
ORAL TABLET
EXTENDED
RELEASE
ESTER-C WITH
BIOFLAVONOIDS
ORAL TABLET
500-200 MG
1
FLEXGEN
3
FLOGEN
3
FOLGARD
1
3
PODIAPN
3
LIPO-FLAVONOID
PLUS
STRESS FORMULA
1
LIPOFLAVOVIT
1
SUPER B-50
COMPLEX
PAN-C 500
3
3
PERIDIN-C
1
SUPER B-50
COMPLEX PLUS
SPAN C
3
3
TROMBONEX
1
SUPER QUINTS B-50
1
VASCULERA
3
VASOFLEX
3
VASOFLEX D1
3
this table.
213
Drug Name
/Limits
VASOFLEX FORTE
1
VASOFLEX HD
3
VENALIV
VITAMIN
C-BIOFLAVONOIDS
Drug Name
/Limits
dextrose 30 % in water
(d30w)
4
3
(d40w)
4
3
(d50w)
4
(d70w)
4
BREWERS YEAST
BREWER'S YEAST
3
yeast
3
DEXTROSE AND
LACTATED
RINGER'S
SOLUTIONS
DEXTROSE
SOLUTIONS
(d10w)
4
(d20w)
4
(d25w)
4
(d30w)
4
4
4
(d40w)
4
4
(d5w)
d5 % and 0.9 % sodium
chloride
4
4
(d50w)
d5 %-0.45 % sodium
chloride
4
4
(d70w)
dextrose 10 % and 0.2
% nacl
4
dextrose 5%-0.2 % sod
chloride
4
DIETARY
PRODUCT DIETARY
SUPPLEMENTS
dextrose 5%-0.3 %
sod.chloride
3
4
acetylcysteine oral
capsule 600 mg
ADVANCED EYE
HEALTH
3
AIRSHIELD ORAL
TABLET,
EFFERVESCENT
2,000-1,000-30
UNIT-MG-UNIT
3
ANTI-ALLERGY
FORMULA
3
dextrose 5 %-lactated
ringers
4
DEXTROSE AND
SODIUM
CHLORIDE
SOLUTIONS
d10 %-0.45 % sodium
chloride
d2.5 %-0.45 % sodium
chloride
DEXTROSE
SOLUTIONS,
CONCENTRATED
(d20w)
4
(d25w)
4
this table.
214
Drug Name
/Limits
ARGINAID
3
ARGINAID EXTRA
3
BABY'S ONLY ORG
LACTORELIEF
3
BABY'S ONLY
ORGANIC DAIRY
3
BABY'S ONLY
ORGANIC SOY
3
BALANCED
NUTRITIONAL
3
BALANCED
NUTRITIONAL PLUS
3
BENECALORIE
3
BIOTALAN CLEAR
3
BIOTIN 100+10
3
BOOST BREEZE
NUTRITIONAL
3
BOOST CALORIE
SMART
3
BOOST COMPACT
3
BOOST KID
ESSENTIALS
3
BOOST KID
ESSENTIALS
W-FIBER
3
BOOST ORAL
LIQUID 0.04 GRAM- 1
KCAL/ML
Drug Name
/Limits
choline dihydrogen
citrate
3
CLA
3
coconut oil
3
COLLAGEN PLUS
VITAMIN C
3
COMPLEAT
3
COMPLEAT
PEDIATRIC
REDUCED CAL
3
COMPLETE
NUTRITION
3
COMPLETE
NUTRITION PLUS
3
COROMEGA ORAL
EMULSION IN
PACKET 650
MG-1,000 UNIT/2.5
GRAM
3
CRANBERRY-PROBI
OTIC
1
CYSTEX
CRANBERRY
3
CYTOTINE
1
DEXATRIM
NATURAL
3
3
DIABETIC SUPPORT
FORMULA
3
BOOST PUDDING
3
3
BOOST VHC
3
DRY EYE OMEGA
BENEFITS ORAL
LIQUID
BRAIN
MIGHT-DHA-CO Q10
3
DUOCAL
3
EGG-PRO
3
BREAKFAST
ESSENTIALS
3
ENFAGROW NEXT
STEP
3
BRIGHT
BEGINNINGS SOY
1
3
CHILDREN'S
OMEGA-3 DHA-EPA
3
ENFAGROW
TODDLER NEXT
STEP
ENSURE
3
CHOLESTEROL
RELIEF
3
ENSURE ACTIVE
CLEAR
3
this table.
215
Drug Name
/Limits
ENSURE ACTIVE
HEART HEALTH
3
ENSURE ACTIVE
HIGH PROTEIN
Drug Name
/Limits
hydrazine sulfate (bulk)
3
HYPROST
1
3
indole-3-carbinol (bulk)
3
ENSURE ACTIVE
LIGHT
3
ISOSOURCE 1.5 CAL
FEEDING TUBE
3
ENSURE ACTIVE
MUSCLE HEALTH
ISOSOURCE HN
3
3
JEVITY 1 CAL
3
ENSURE ACTIVE
PROTEIN-MUSCLE
JEVITY 1.5 CAL
3
3
3
ENSURE COMPLETE
3
KIDS OMEGA-3
WITH DHA
ENSURE HIGH
PROTEIN ORAL
LIQUID
3
3
K-PAX IMMUNE
BOOSTER
LIQUID HOPE
3
ENSURE HIGH
PROTEIN-MUSCLE
3
LIQUID NUTRITION
3
LIQUID NUTRITION
PLUS
3
LISTER-V
3
LITHATE
3
ENSURE MUSCLE
HEALTH ORAL
LIQUID
3
ENSURE ORIGINAL
3
ENSURE PLUS
3
LUKAID GLA FOR
ASTHMA
3
ENSURE PUDDING
3
MEGAVITE
3
EO28 SPLASH ORAL
LIQUID
3
MEGAVITE GOLDEN
YEARS 55+
3
ESTRONATURAL
3
ESTROPLUS
3
MINUS WEIGHT
PLUS ENERGY
3
FIBERSOURCE HN
3
MONOGEN
3
FLAX, FISH AND
BORAGE OIL
3
NAC
3
NEUREPA
3
GLYCOTROL
3
NIACIN-AZE
AC-TURMER-FA-B6ZN
3
NICADAN
3
NICAZEL
3
NICAZEL FORTE
3
NUTRA PRO HIGH
PROTEIN
1
NUTRAFIT
3
NUTRAFIT PLUS
3
HAIR,SKIN AND
NAILS ORAL
TABLET 3.3 MG
IRON-25 MCG
3
HI-CAL
3
HIGH-PROTEIN
NUTRITIONAL
SHAKE
3
huperzine serrate a
(bulk)
3
this table.
216
Drug Name
/Limits
Drug Name
/Limits
NUTRAMENT
3
OSMOLITE 1.5 CAL
3
NUTREN 1.0
3
PEDIASURE
3
NUTREN 1.5
3
NUTREN 2.0
3
3
NUTRITION PLUS
3
PEDIASURE
ENTERAL W/FIBER
1.0
NUTRITIONAL
DRINK
3
PEDIASURE SHAKE
MIX
3
NUTRITIONAL
DRINK PLUS
3
PEDIASURE
SIDEKICKS
3
PEDIASURE
SIDEKICKS CLEAR
3
PEDIASURE WITH
FIBER
3
PEDIATRIC DRINK
3
PEDIATRIC DRINK
WITH FIBER
3
PEPTAMEN
3
PEPTAMEN 1.5
3
PEPTAMEN 1.5 CAL
WITH PREBIO1
3
PEPTAMEN JUNIOR
1.5-PREBIO1
3
PEPTAMEN
W-PREBIO1
3
PHLEXY-VITS
1
PIVOT 1.5 CAL
3
PROMOTE
3
PROMOTE WITH
FIBER
3
PROSTAMEN
3
PROVIMIN
3
QUINOA-KALE-HEM
P
3
RA PEDIATRIC
NUTRITION DRINK
3
racemethionine (bulk)
3
RED WINE EXTRACT
3
RED WINE EXTRACT
PLUS
3
NUTRITIONAL
SHAKE ORAL
LIQUID , 0.04-1.05
GRAM-KCAL/ML
3
NUTRITIONAL
SHAKE PLUS
3
NUTRITIONAL
SUPP(LACTOSE-FRE
E)
3
NUTRITIONAL
SUPPLEMENT ORAL
LIQUID
3
NUTRITIONAL
SUPPLEMENT PLUS
ORAL LIQUID
3
OMEGA-3 FISH OIL
ORAL CAPSULE
300-1,000 MG
3
ONE DAILY ORAL
TABLET
300-18-400-50
MG-MG-MCG-MG
3
ONE DAILY
WOMEN'S
METABOLISM
3
ORANGE
CHICKEN-CARROTSBARLEY
3
ORGANIC
PEDIASMART
3
OSMOLITE 1 CAL
3
OSMOLITE 1.2 CAL
3
this table.
217
Drug Name
/Limits
Drug Name
/Limits
REPHRESH PRO-B
3
VIGRAPLEX
3
REPLETE
3
vinpocetine (bulk)
3
RESOURCE 2.0
3
3
RESOURCE
THICKENUP DAIRY
VITAL HIGH
NITROGEN
3
3
resveratrol-quercetin
3
VITAMIN D3
COMPLETE
resver-red-bfl-grpsd-pol
-c-pom
VP-ZEL
3
3
XYDRA EF
3
SALMON-OATS-SQU
ASH
3
ZYTAZE
3
SCANDICAL
3
SCANDISHAKE
3
SCANDISHAKE
(LACTOSE FREE)
3
SIMILAC GO AND
GROW NON-GMO
3
SIMILAC GO AND
GROW SENSITIVE
3
sodium pyruvate (bulk)
3
SOUTH AFRICAN
HOODIA
3
SOUTH AFRICAN
HOODIA PLUS CAP
3
DIETARY
PRODUCT INFANT
FORMULAS
ADVANTAGE WITH
IRON
1
BCAD 1
3
CALCILO XD
3
CYCLINEX-1
3
ELECARE (INFANT
FORM.)
3
ENFAGROW
GENTLEASE
FORMULA
3
ENFAGROW
TODDLER
TRANSITIONS
3
1
SUPER OMEGA-3
ORAL CAPSULE
400-5 MG-UNIT
3
TART CHERRY
1
theanine (bulk)
3
THERA TEARS
NUTRITION
ENFAGROW
TODDLR
TRANSITION SOY
3
ENFAMIL 24
3
THICKENUP
CRANBERRY HONEY
3
ENFAMIL A.R. ORAL
LIQUID
3
TL-ICARE
3
1
TONALIN CLA
3
ENFAMIL
ENFACARE LIPIL
TOZAL
3
3
TWOCAL HN
3
ENFAMIL
ENFACARE ORAL
LIQUID
ULTRA MEN'S PACK
3
3
ULTRAMINO
3
ENFAMIL FOR
SUPPLEMENTING
UTI-STAT
3
this table.
218
Drug Name
ENFAMIL
GENTLEASE LIPIL
LIQUID
/Limits
1
ENFAMIL
GENTLEASE ORAL
LIQUID
1
ENFAMIL
GENTLEASE ORAL
POWDER
1
Drug Name
/Limits
ENFAMIL
PREMATURE 30
3
ENFAMIL PROSOBEE
LIPIL
1
ENFAMIL PROSOBEE
ORAL LIQUID
3
ENFAMIL REGULINE
3
ENFAPORT
3
1
ENFAMIL
GENTLEASE ORAL
POWDER IN PACKET
3
GERBER GOOD
START GENTLE
ENFAMIL HUMAN
MILK FORTIFIER
1
3
GERBER GOOD
START PREMATURE
20
GERBER GOOD
START PREMATURE
24 ORAL LIQUID
3.6-5.2 GRAM/100
KCAL
3
GERBER GOOD
START PREMATURE
24 ORAL LIQUID
3-5.2 GRAM/100
KCAL
1
GERBER GOOD
START PREMATURE
30
1
GERBER GOOD
START SOOTHE
3
GERBER GOOD
START SOY
1
GERBER
GRADUATES
GENTLE
1
GERBER
GRADUATES
SOOTHE
3
GERBER
GRADUATES SOY
1
GERBER GS GENTLE
- SUPPLEMENT
1
GLUTAREX-1
3
HCY 1 POWDER
3
ENFAMIL INFANT
ORAL
CONCENTRATE
3
ENFAMIL INFANT
ORAL LIQUID
3
ENFAMIL INFANT
ORAL POWDER
1
ENFAMIL INFANT
ORAL POWDER IN
PACKET
3
ENFAMIL NEWBORN
ORAL LIQUID
3
ENFAMIL NEWBORN
ORAL POWDER
1
ENFAMIL
PREMATURE 20
ORAL LIQUID 3.3-5
GRAM/100 KCAL
ENFAMIL
PREMATURE 24
ORAL LIQUID 3.3-5
GRAM/100 KCAL,
3.5-5.1 GRAM/100
KCAL, 3.6-5
GRAM/100 KCAL
ENFAMIL
PREMATURE 24
ORAL LIQUID 3-5.1
GRAM/100 KCAL
3
3
1
this table.
219
Drug Name
/Limits
HOMINEX-1
3
infant formula with iron
1
ISOMIL ADVANCE
1
ISOMIL DF
1
ISOMIL/IRON
1
IVA ANAMIX NEXT
3
I-VALEX-1
3
KETONEX-1
3
MMA-PA ANAMIX
NEXT
3
MSUD ANALOG
1
NEOCATE INFANT
DHA-ARA
NUTRAMIGEN
DHA-ARA
Drug Name
/Limits
SIMILAC ADVANCE
ORAL
CONCENTRATE
1
SIMILAC ADVANCE
ORAL LIQUID
1
SIMILAC ADVANCE
ORAL POWDER
3
SIMILAC ADVANCE
ORAL POWDER IN
PACKET
1
SIMILAC ADVANCE
ORAL SUSPENSION
1
3
SIMILAC ADVANCE
ORGANIC
3
1
SIMILAC ADVANCE
WITH IRON
1
SIMILAC EXPERT
CARE ALIMENTUM
3
SIMILAC EXPERT
CARE NEOSURE
1
SIMILAC EXPERT
CARE ORAL LIQUID
1
SIMILAC EXPERT
CARE ORAL
SUSPENSION
3
SIMILAC FOR
SPIT-UP ORAL
LIQUID 2.14-5.4-11
GRAM/100 KCAL
3
SIMILAC FOR
SPIT-UP ORAL
POWDER
1
3
NUTRAMIGEN
TODDLER
ENFLORA-LGG
1
NUTRAMIGEN WITH
ENFLORA LGG
3
OA 1 POWDER
3
PFD TODDLER
3
PHENEX-1
3
PREGESTIMIL
1
PREMIUM INFANT
FORMULA
1
PRODUCT 3232A
3
PRO-PHREE
3
PROPIMEX-1
3
PURAMINO
DHA-ARA ORAL
POWDER 2.8-5.3-10.6
GRAM/100 KCAL
3
SIMILAC GO AND
GROW ORAL
POWDER 3 GRAM-5.4
GRAM/100 KCAL
RCF SOY PROTEIN
FORMULA BASE
1
SIMILAC GO AND
GROW SOY
3
SENSITIVITY WITH
IRON
3
SIMILAC ADVANCE
NON-GMO
3
3
SIMILAC HUMAN
MILK FORTIFIER
ORAL LIQUID IN
PACKET
this table.
220
Drug Name
/Limits
SIMILAC HUMAN
MILK FORTIFIER
ORAL POWDER IN
PACKET
1
SIMILAC LOW-IRON
1
SIMILAC NEOSURE
Drug Name
/Limits
TODDLER-INFANT
FORMULA
3
3
1
TUGABOOS
SENSITIVITY ORAL
POWDER 2.14-5.4-10.7
GRAM/100 KCAL
SIMILAC PM
1
TYREX-1
3
SIMILAC SENSITIVE
3
TYROS 1
3
WND 1
3
XLEU ANALOG
1
XLYS- XTRP
ANALOG
1
XMET ANALOG
1
XMTVI ANALOG
1
XPHE, XTYR
ANALOG
1
XPTM ANALOG
1
SIMILAC SENSITIVE
FUSS AND GAS
ORAL
CONCENTRATE
2.1-5.4-11.1
GRAM/100 KCAL
3
SIMILAC SENSITIVE
FUSS AND GAS
ORAL LIQUID
2.14-5.4-11.1
GRAM/100 KCAL
3
SIMILAC SENSITIVE
FUSS AND GAS
ORAL POWDER
3
SIMILAC SENSITIVE
ISOMIL SOY
1
SIMILAC SOY
ISOMIL
1
SIMILAC SPECIAL
CARE 24
1
SIMILAC SPECIAL
CARE 30
3
SIMILAC
SUPPLEMENTATION
3
SIMILAC TOTAL
COMFORT ORAL
LIQUID
3
SIMILAC TOTAL
COMFORT ORAL
POWDER
1
SIMILAC WITH IRON
3
TENDER INFANT
FORMULA
3
DIETARY
PRODUCT SWEETENERS
acesulfame potassium
(bulk)
3
DIABETISWEET
3
LOLLIBASE
3
PCCA STEVIOSIDE
3
saccharin
1
saccharin sodium
3
sodium saccharin (bulk)
1
STEVIA
1
STEVIA EXTRACT
3
steviol glycosides (bulk)
3
stevioside (bulk)
3
sucrose crystals
1
DILUENTS SODIUM
CHLORIDE
sodium chlor 0.9%
bacteriostat
1
this table.
221
Drug Name
sodium chloride 0.9 %
injection solution
/Limits
1
DILUENTS STERILE WATER
FOR INJECTION
water for inject,
bacteriostat
1
water for injection,
sterile injection
1
ELECTROLYTE
DEPLETERS - ION
EXCHANGE RESIN
KAYEXALATE
3
KIONEX ORAL
POWDER
3
KIONEX ORAL
SUSPENSION
2
MARLEXATE
3
SODIUM
POLYSTYRENE
(SORB FREE)
1
sodium polystyrene
sulfonate oral powder
3
sodium polystyrene
sulfonate oral
suspension
1
sodium polystyrene
sulfonate rectal
3
SPS ORAL
2
SPS RECTAL
3
GERIATRIC
VITAMINS
PA
PA
PA
PA
Drug Name
/Limits
CENTRAVITES 50
PLUS
3
CEROVITE SENIOR
3
COMPLETE SENIOR
ORAL TABLET
3
DAILY
MULTIVITAMIN-MIN
ERALS
3
ELDERTONIC
1
ELLIS TONIC
3
GERAVIM
1
GERIATON
1
GERITOL TONIC
WITH FERREX 18
1
MILLTRIUM SENIOR
3
MULTIVITAL
PLATINUM ORAL
TABLET
3
MULTIVITAMIN 50
PLUS
3
multivitamin with
minerals oral tablet
3
MULTI-VITE 50 AND
OVER
3
ONE DAILY 50 PLUS
3
REQ49+
3
SPECTRAVITE
SENIOR ORAL
TABLET
3
SPECTRAVITE
SENIOR
W-LYCOPENE
3
THERATRUM
COMPLETE 50 PLUS
3
3
A THRU Z HIGH
POTENCY
3
A THRU Z SELECT
ORAL TABLET
3
CENTRAL VITE
1
THERATRUM
COMPLETE 50
PLUS/LUT
CENTRAL-VITE
SELECT
3
VISION PLUS
LUTEIN
3
VITRUM SENIOR
ORAL TABLET
3
this table.
222
Drug Name
/Limits
IRRIGATION
SOLUTIONS
CURITY STERILE
WATER
3
lactated ringers
irrigation
1
PHYSIOLYTE
3
PHYSIOSOL
IRRIGATION
3
ringers irrigation
3
sodium chloride
irrigation
1
sodium chloride
tablet,soluble
3
STERILE SALINE
IRRIGATION
1
water for irrigation,
sterile
1
MINERALS &
ELECTROLYTES BICARBONATE
PRODUCING OR
CONTAINING
AGENTS
NEUT
4
sodium acetate
intravenous
4
sodium bicarbonate
intravenous
4
sodium lactate
intravenous
4
THAM
4
MINERALS &
ELECTROLYTES CALCIUM
REPLACEMENT
COMBINATIONS
Drug Name
/Limits
BONE DENSITY
CALCIUM + D
3
bone meal-vitamin d2
3
ca-d3-mag
ox-zinc-cop-mang-bor
3
ca-d3-mag-zinc-cop-ma
ng-bor
3
CAL MAG ZINC + D3
3
CALCI-MAX
3
CALCIUM 600 +
MINERALS
1
calcium carb-d3-mag
cmb11-zinc
3
calcium carb-mag
oxide-zinc ox
3
calcium carb-mag
ox-zinc gluc
3
calcium carb-mag
ox-zinc sulf
3
calcium carbonate-vit
d3-min
1
CALCIUM FOR
WOMEN
1
CALCIUM
MAGNESIUM + D
3
CALCIUM PLUS
3
CALCIUM SOFT
CHEW ORAL
TABLET,CHEWABLE
500 MG-1,000 UNIT-40
MCG
3
CALCIUM SOFT
CHEW ORAL
TABLET,CHEWABLE
500-100-40
MG-UNIT-MCG,
500-200-40
MG-UNIT-MCG
1
ADVANCED
CALCIUM
3
CALCIUM WITH
BORON
3
BIOCAL
3
CALCIUM-FOLIC
ACID-VITAMIN D
3
this table.
223
Drug Name
calcium-magnesium
/Limits
3
calcium-magnesium-zin
c oral tablet ,
333-133-5 mg
1
calcium-magnesium-zin
c oral tablet
333-133-8.3 mg
3
Drug Name
/Limits
FEM-CAL CITRATE
3
FOLGARD OS
3
LOCALNESIUM
3
LOCALNESIUM-C
3
OYSTER SHELL
CALCIUM AND MAG
3
PRO-CAL ORAL
TABLET
3
SOFT CHEWS
CALCIUM
1
SOY FORMULA
3
SUPER CAL-MAG
3
TL G-FOL OS
3
3
calcium-vitamin
d3-vitamin k oral
tablet,chewable 500
mg-1,000 unit-40 mcg,
500-200-40
mg-unit-mcg,
500-500-40
mg-unit-mcg
1
CAL-MAG
3
VIACTIV
CALMAG THINS
3
CALTRATE 600+D
PLUS MINERALS
ORAL TABLET
3
CALTRATE 600+D
PLUS MINERALS
ORAL
TABLET,CHEWABLE
1
MINERALS &
REPLACEMENT/V
ITAMIN D
COMBINATIONS
CITRACAL + BONE
DENSITY
1
CITRACAL D +
HEART HEALTH
CITRACAL PLUS
MAGNESIUM
CALCET CREAMY
BITES
3
CALCET PETITES
1
CAL-CITRATE
3
3
CALCITRATE-VITAM
IN D
3
1
CALCIUM 500 + D
(D3)
3
CALCIUM 500 + D
ORAL TABLET
1
CALCIUM 500 WITH
D
1
CALCIUM 600 + D(3)
ORAL CAPSULE
1
CALCIUM 600 + D(3)
ORAL TABLET 600
MG(1,500MG) -200
UNIT, 600-125
MG-UNIT
3
CORAL CALCIUM
ORAL CAPSULE 133
MG CALCIUM -133
UNIT-67 MG,
185-50-100
MG-MG-UNIT,
200-100-100
MG-MG-UNIT,
250-200-125
MG-UNIT-MG
3
CORAL CALCIUM
ORAL CAPSULE
250-125-100
MG-MG-UNIT
1
this table.
224
Drug Name
CALCIUM 600 + D(3)
ORAL TABLET 600
MG(1,500MG) -400
UNIT
CALCIUM 600 WITH
VITAMIN D3 ORAL
CAPSULE 600
MG(1,500MG) -500
UNIT
CALCIUM 600 WITH
VITAMIN D3 ORAL
TABLET
/Limits
1
3
3
CALCIUM 600 WITH
VITAMIN D3 ORAL
TABLET,CHEWABLE
1
calcium carb and
citrate-vitd3
3
calcium
carbonate-vitamin d3
oral capsule 600
mg(1,500mg) -100 unit,
600 mg(1,500mg) -500
unit, 600mg (1,000mg)
-1,000 unit
calcium
oral capsule 600
mg(1,500mg) -400 unit
calcium
oral tablet 1,000
mg(2,500 mg)-800 unit,
500 mg(1,250mg) -125
unit, 500mg (1,250mg)
-600 unit, 600
mg(1,500mg) -200 unit,
600 mg(1,500mg) -800
unit
calcium
oral tablet 500
mg(1,250mg) -200 unit,
500 mg(1,250mg) -400
unit, 600 mg(1,500mg)
-400 unit
3
1
3
1
Drug Name
/Limits
calcium
oral tablet,chewable
500 mg(1,250mg) -400
unit
1
calcium
oral tablet,chewable
500-100 mg-unit
3
CALCIUM CITRATE +
D
3
calcium citrate
malate-vit d3
3
calcium citrate-vitamin
d2
3
d3 oral tablet 200 mg
calcium -250 unit, 250
mg calcium- 200 unit,
315-200 mg-unit,
315-250 mg-unit
3
d3 oral tablet 200-125
mg-unit
1
calcium
phosphate-vitamin d3
3
CALCIUM WITH
VITAMIN D
1
CALCIUM+D ORAL
TABLET 500
MG(1,250MG) -200
UNIT
1
CAL-QUICK
3
CALTRATE 600 + D
1
CALTRATE WITH
VITAMIN D3
1
CHILDREN'S
CALCIUM GUMMIES
3
CITRACAL + D
MAXIMUM
1
CITRACAL + D
PETITES
1
this table.
225
Drug Name
CITRACAL + D SLOW
RELEASE
/Limits
3
CITRACAL + D3
(CALCIUM PHOS)
ORAL
TABLET,CHEWABLE
250 MG CALCIUM500 UNIT
3
CITRACAL
REGULAR
1
CITRUS CALCIUM
Drug Name
YOGURT+CALCIUM
GUMMIES
/Limits
3
MINERALS &
REPLACEMENT
CALCI-CHEW
1
CALCI-MIX
3
CALCIONATE
1
3
CALCITRATE
3
HI-CAL PLUS VIT D
1
1
LIQUID CALCIUM
WITH VITAMIN D
CALCIUM 500 ORAL
TABLET
1
CALCIUM 600
3
calcium acetate oral
tablet 667 mg
3
calcium amino acid
chelate
3
calcium carbonate
(bulk)
3
calcium carbonate oral
powder
3
suspension
1
tablet 500 mg calcium
(1,250 mg)
1
tablet 600 mg (1,500
mg)
3
tablet,chewable 260 mg
(650 mg), 300 mg (750
mg)
3
calcium (1,250 mg)
1
calcium chloride
intravenous
4
calcium citrate (bulk)
3
calcium citrate oral
granules
3
OS-CAL 500 + D3
ORAL TABLET 500
MG(1,250MG) -200
UNIT
1
OS-CAL 500 + D3
ORAL TABLET
500MG (1,250MG)
-600 UNIT
3
OSTEO-PORETICAL
3
OYSCO 500/D ORAL
TABLET
1
OYSCO D
3
OYSTER SHELL + D3
3
OYSTER SHELL
CALCIUM WITH D
3
OYSTER SHELL
CALCIUM-VIT D3
3
OYSTERCAL-D
3
PARVA-CAL 250
3
PARVA-CAL 500
3
PROSTEON
3
RISACAL-D
1
THERACAL
3
THERACAL D2000
3
THERACAL D4000
3
UPCAL D
3
this table.
226
Drug Name
tablet 200 mg (950 mg)
calcium glubionate
(bulk)
calcium gluconate
intravenous
/Limits
3
1
3
4
calcium gluconate oral
tablet 45 mg (500 mg),
50 mg calcium, 60 mg
(650 mg), 61 mg (648
mg)
3
calcium lactate
3
calcium lactate (bulk)
3
calcium levulinate dihy
(bulk)
3
calcium phos, tribasic
(bulk)
1
CALCIUM
SACCHARATE
3
CAL-MINT
3
CORAL CALCIUM
Drug Name
/Limits
IONOSOL-B IN D5W
4
IONOSOL-MB IN
D5W
4
ISOLYTE-P IN 5 %
DEXTROSE
4
NORMOSOL-M IN 5
% DEXTROSE
4
NORMOSOL-R IN 5 %
DEXTROSE
4
PLASMA-LYTE-56 IN
5 % DEXTROSE
4
MINERALS &
ELECTROLYTES IODINE
IODOPEN
4
IOSAT
3
KELP (IODINE)
3
LUGOLS ORAL
1
potassium iodide
3
crystals
1
3
3
CORAL CALCIUM
ORAL TABLET
powder
3
sodium iodide (bulk)
3
hydroxyapatite (bulk)
3
SSKI
1
OYSCO-500
1
1
OYST-CAL-500
1
STRONG IODINE
ORAL
OYSTER SHELL
CALCIUM
THYROSAFE
3
1
OYSTER SHELL
CALCIUM 500
1
SUPER CALCIUM
3
MINERALS &
ELECTROLYTES ELECTROLYTES
& DEXTROSE
MINERALS &
ELECTROLYTES IRON
COMBINATIONS
ABATRON AF
3
ACTIVE FE
3
APETIGEN PLUS
ORAL TABLET
1
dextrose 5 % in ringers
4
BIFERA RX
3
electrolyte-48 in d5w
4
CENTRATEX
3
ELLIOTTS B (PF)
3
CHEWABLE IRON
3
this table.
227
Drug Name
CORVITA 150
/Limits
3
Drug Name
/Limits
HEMATOGEN FA
3
HEMATOGEN FORTE
3
HEMATRON
3
HEMATRON-AF
3
HEMAX
3
HEMETAB
3
CORVITE 150 ORAL
TABLET 150 MG
IRON- 1 MG
3
CORVITE FE ORAL
TABLET 150 MG
IRON- 1 MG
3
DUOFER
1
HEMOCYTE-F
3
FE C
1
HEMOCYTE-PLUS
3
FEOSOL BIFERA
1
I.L.X. B-12
1
FERIVA
3
ICAR-C
1
FERIVA 21-7 TABLET
3
IFEREX 150 FORTE
3
FERIVA FA
(SUMALATE)
3
INTEGRA
1
INTEGRA F
3
FEROCON
3
INTEGRA PLUS
3
FERRACTIV
3
IRON 21/7
3
FERRALET 90
DUAL-IRON
DELIVERY
3
iron-vitamin c
1
3
FERRAPLUS 90
3
IRO-PLEX (IRON
CARBONYL)
FERREX 150 FORTE
3
IRO-PLEX (IRON
POLYSACCHARIDE)
3
FERREX 150 FORTE
PLUS
3
IROSPAN 24/6
3
FERREX 150 PLUS
3
3
FERREX 28
3
LYDIA PINKHAM
HERBAL ORAL
TABLET
FERROCITE PLUS
3
MAXARON FORTE
3
FERROGELS FORTE
3
FOCALGIN DSS
3
3
FOLITAB
3
MAXFE
(FOLATE-DOCUSATE
)
FOLIVANE-F
3
MULTIGEN
3
FOLIVANE-PLUS
3
MULTIGEN FOLIC
3
FUSION
3
MULTIGEN PLUS
3
FUSION PLUS
3
MYFERON 150
FORTE
3
HEMATINIC PLUS
VIT/MINERALS
3
NEPHRON FA
3
HEMATINIC/FOLIC
ACID
3
OB COMPLETE ORAL
TABLET
3
HEMATOGEN
3
OB COMPLETE
PREMIER
3
this table.
228
Drug Name
/Limits
PARVLEX
3
POLY-IRON 150
FORTE
3
PROFERRIN-FORTE
3
SIDEROL ORAL
TABLET
3
STRESS FORMULA
1
TARON FORTE
3
TL ICON
3
TL-HEM 150
3
TRICON
3
TRIGELS-F FORTE
3
VITAFOL
1
VITRON-C
1
MINERALS &
ELECTROLYTES IRON
Drug Name
/Limits
FERRLECIT
4
FERROCITE
3
FERRO-TIME
1
ferrous fumarate
3
ferrous fumarate (bulk)
1
ferrous gluconate (bulk)
1
ferrous gluconate oral
tablet 236 mg (27 mg
iron), 240 mg (27 mg
iron)
3
ferrous gluconate oral
iron), 324 mg (37.5 mg
iron)
1
ferrous sulfate oral
drops
1
liquid
3
CHILDREN'S IRON
1
EZFE 200
1
FE C PLUS
3
FEOSOL ORAL
TABLET 325 MG (65
MG IRON)
solution
1
1
1
FEOSOL ORAL
TABLET 45 MG
3
iron)
FERAHEME
4
3
1
FERATE ORAL
TABLET 240 MG (27
MG IRON)
3
(dr/ec)
FERGON
3
3
FER-IN-SOL
3
ferrous sulfate, dried
(bulk)
FER-IRON
1
FERROUSUL
1
FEROSUL
1
HEMOCYTE
3
FERRETTS
3
HIGH POTENCY
IRON
3
FERRETTS IPS
3
FERREX 150
3
ICAR ORAL
SUSPENSION
1
FERRIC X-150
3
ICAR-C PLUS
3
FERRIMIN 150
3
IFEREX 150
3
this table.
229
Drug Name
/Limits
INFED
1
INJECTAFER
4
IRON (DRIED)
3
IRON (FERROUS
SULFATE)
1
IRON 100 PLUS
3
iron bisglycin chelate
(bulk)
3
IRON CHEWS
1
IRON HIGH
POTENCY
3
iron oral tablet 18 mg
3
IRON ORAL TABLET
325 MG (65 MG IRON)
1
Drug Name
/Limits
SLOW RELEASE
IRON ORAL TABLET
EXTENDED
RELEASE 142 MG (45
MG IRON), 143 MG
(45 MG IRON), 159
MG (45 MG IRON),
160 MG (50 MG
IRON), 168 MG (50
MG IRON), 47.5 MG
IRON
3
sodium ferric
gluconat-sucrose
4
TANDEM DUAL
ACTION
1
VENOFER
4
WEE CARE
1
IRON ORAL TABLET
EXTENDED
RELEASE 159 MG (45
MG IRON)
3
IRONUP
3
MINERALS &
ELECTROLYTES MAGNESIUM
COMBINATIONS
MYFERON 150
3
BEELITH
MYKIDZ IRON ORAL
SUSPENSION 15 MG
IRON/1.5 ML
3
NOVAFERRUM 125
3
NOVAFERRUM 50
3
NOVAFERRUM
ORAL DROPS
3
NU-IRON
3
PERFECT IRON
3
POLY-IRON
3
PRO FE
3
PROFERRIN ES
1
1
MINERALS &
ELECTROLYTES MAGNESIUM
EPSOM SALT
1
LAXATIVE DIETARY
SUPPLEMENT
3
MAG 64
3
MAG-DELAY
3
MAG-G
3
MAGINEX
3
MAGNESIUM
(OXIDE/AA
CHELATE)
3
magnesium amino acid
chelate oral tablet 100
mg
1
magnesium amino acid
chelate oral tablet 27
mg
3
this table.
230
Drug Name
/Limits
Drug Name
/Limits
magnesium ascorbate
(bulk)
3
MAGONATE
(MAGNESIUM CARB)
3
magnesium aspart dihyd
(bulk)
3
MAGOX
3
MAGTAB
3
magnesium chloride
injection
1
MGO
3
magnesium chloride
oral
PHILLIPS
1
3
SLOW-MAG
3
magnesium citrate oral
tablet
3
URO-MAG
3
magnesium gluconate
oral
3
magnesium glycinate
(bulk) powder 11.7 %,
15 %
manganese chloride
4
3
manganese chloride
(bulk)
3
magnesium malate
3
magnesium oral tablet
200 mg, 30 mg
3
3
manganese gluconate
(bulk)
magnesium oral tablet
250 mg
4
1
manganese sulfate
intravenous
magnesium oxide (bulk)
3
magnesium oxide oral
capsule
3
tablet 250 mg
1
tablet 400 mg, 420 mg,
500 mg
3
magnesium sulfate
(bulk) crystals
1
magnesium sulfate
(bulk) powder
3
MINERALS &
ELECTROLYTES MANGANESE
MINERALS &
ELECTROLYTES MULTIPLE
MINERAL
COMBINATIONS
FLORICAL
1
MEDI-LYTE
3
MONOCAL
1
MINERALS &
ELECTROLYTES MULTIPLE
MINERALS
calcium-magnesium-cop
per-zinc
magnesium sulfate in
d5w intravenous
piggyback 1 gram/100
ml
4
magnesium sulfate in
water
4
magnesium sulfate
injection
1
magnesium sulfate oral
3
1
MINERALS &
ELECTROLYTES ORAL
ELECTROLYTES
CERALYTE 50
3
CERALYTE 70
1
CERALYTE 90
1
this table.
231
Drug Name
/Limits
CERALYTE-70 ORAL
POWDER IN PACKET
2.3-1.5-2.9-160
G-G-G-KCAL/50 G
1
CERALYTE-70 ORAL
POWDER IN PACKET
440-300-32
MG-MG-KCAL/10 G
3
CERALYTE-70 ORAL
SOLUTION
3
CERAORS 75
Drug Name
/Limits
MINERALS &
ELECTROLYTES PARENTERAL
ELECTROLYTE
COMBINATIONS
HYPERLYTE CR
4
ISOLYTE S PH 7.4
4
ISOLYTE-S
4
NORMOSOL-R
4
3
NORMOSOL-R PH 7.4
4
CERASPORT
3
NUTRILYTE
4
CERASPORT EX1
3
PLASMA-LYTE 148
4
DRIPDROP
3
PLASMA-LYTE A
4
ENFAMIL ENFALYTE
1
TPN ELECTROLYTES
4
oral electrolytes
1
ORALYTE
1
TPN ELECTROLYTES
II
4
PEDIALYTE
ADVANCED CARE
1
PEDIALYTE
FREEZER POPS
1
PEDIALYTE ORAL
POWDER IN PACKET
3
PEDIALYTE ORAL
SOLUTION
PEDIALYTE SINGLES
MINERALS &
ELECTROLYTES PHOSPHATE
GLYCOPHOS
4
K-PHOS-NEUTRAL
3
PHOS-NAK
1
1
PHOSPHA 250
NEUTRAL
1
1
potassium phosphate
m-/d-basic
4
sodium phosphate
4
VIRT-PHOS 250
NEUTRAL
3
PEDIATRIC
ELECTROLYTE
ORAL POWDER IN
PACKET
3
PEDIATRIC
ELECTROLYTE
ORAL SOLUTION
1
PEDIATRIC FREEZER
POPS
1
PEDIAVANCE
3
RE:IIMMUNE
3
THERMOTABS
3
MINERALS &
ELECTROLYTES POTASSIUM
COMBINATIONS
potassium bicarb and
chloride
1
this table.
232
Drug Name
/Limits
Drug Name
/Limits
MINERALS &
ELECTROLYTES POTASSIUM FOR
INJECTION
EFFER-K ORAL
TABLET,
EFFERVESCENT 25
MEQ
1
potassium acetate
intravenous solution 2
meq/ml
K-EFFERVESCENT
1
4
KLOR-CON
1
KLOR-CON 10
1
potassium
chlorid-d5-0.45%nacl
4
KLOR-CON 8
1
potassium chloride in
0.9%nacl intravenous
parenteral solution 20
meq/l, 40 meq/l
KLOR-CON M10
1
KLOR-CON M15
1
4
KLOR-CON M20
1
KLOR-CON/25
1
KLOR-CON/EF
1
K-SOL
3
K-TAB
3
potassium
1
potassium chloride in 5
% dex intravenous
meq/l, 30 meq/l, 40
meq/l
4
potassium chloride in
lr-d5
4
potassium bicarb-citric
acid
1
potassium chloride
intravenous
4
1
potassium chloride-0.45
% nacl
4
potassium chloride oral
capsule, extended
release
potassium
chloride-d5-0.2%nacl
1
4
liquid
potassium
solution 20 meq/l
packet
3
4
10 meq, 8 meq
1
potassium
4
20 meq
3
tablet,er
particles/crystals
1
potassium gluconate
oral tablet 2.5 meq, 500
mg (83 mg), 550 mg (90
mg), 595 mg (99 mg)
1
potassium gluconate
release
3
MINERALS &
ELECTROLYTES POTASSIUM,
ORAL
EFFER-K ORAL
TABLET,
EFFERVESCENT 10
MEQ, 20 MEQ
3
this table.
233
Drug Name
/Limits
MINERALS &
ELECTROLYTES POTASSIUM
potassium aspartate
(bulk)
3
potassium
powder
1
MINERALS &
ELECTROLYTES SODIUM
CHLORIDE, ORAL
sodium chloride oral
3
sodium chloride
tablet,soluble
3
MINERALS &
ELECTROLYTES TRACE MINERAL
COMBINATIONS
Drug Name
/Limits
chrom pico-chrom
hist-min aa
3
chromium amino acid
chelate
3
chromium chloride
4
chromium picolinate
oral capsule
1
chromium picolinate
oral tablet 1,000 mcg,
400 mcg
3
chromium picolinate
oral tablet 200 mcg
1
chromium
polynicotinate (bulk)
3
chromium pot sul
dodeca (bulk)
3
COPPER CHLORIDE
4
copper gluconate
3
copper gluconate (bulk)
3
ADDAMEL N
4
copper glycinate (bulk)
3
CRO-MAN-ZIN
3
MULTITRACE-4
4
germanium sesquioxide
(bulk)
3
MULTITRACE-4
CONCENTRATE
4
molybdenum (bulk)
3
rubidium chloride (bulk)
3
MULTITRACE-4
NEONATAL
4
selenium intravenous
4
MULTITRACE-4
PEDIATRIC
selenium oral capsule
3
4
selenium oral tablet
1
MULTITRACE-5
4
MULTITRACE-5
CONCENTRATE
1
4
selenium oral
(dr/ec)
PEDITRACE
4
SELENOMAX
3
TRACE ELEMENTS
4/PEDIATRIC
selenomethionine
3
4
selenomethionine (bulk)
3
sodium selenite (bulk)
3
vanadium (bulk)
3
vanadyl sulfate (bulk)
3
MINERALS &
ELECTROLYTES TRACE MINERALS
boron (bulk)
3
boron citrate (bulk)
3
cesium chloride (bulk)
3
this table.
234
Drug Name
/Limits
MINERALS &
ELECTROLYTES ZINC
COMBINATIONS
ZINC PLUS
Drug Name
/Limits
MULTIPLE
VITAMINS AND
MINERAL
COMBINATIONS
3
MINERALS &
ELECTROLYTES ZINC
50+ ADULT EYE
HEALTH
3
A THRU Z
3
3
CHELATED ZINC
3
A THRU Z MEN'S
ULTIMATE
ORAZINC ORAL
CAPSULE
3
A THRU Z SELECT
50+ FORMULA
3
ORAZINC ORAL
TABLET
1
3
zinc
3
A THRU Z SELECT
ORAL TABLET
300-600-300 MCG,
500-300-250 MCG
ZINC (WITH A AND
C) LOZENGES
3
A THRU Z SELECT
WOMEN'S
3
zinc amino acid chelate
3
ABC PLUS
3
zinc chloride
4
ACTICAL
3
zinc chloride (bulk)
3
zinc gluconate (bulk)
3
3
zinc gluconate oral
lozenge
3
ADULT
MULTIVITAMIN
GUMMIES
zinc gluconate oral
tablet 100 mg, 30 mg
3
1
ADULT ONE DAILY
GUMMIES
ADVANCED AM-PM
3
zinc gluconate oral
tablet 50 mg
3
zinc gluconate-zinc
picolinate
3
3
zinc methionine sulfate
(bulk)
AIRSHIELD ORAL
TABLET,
EFFERVESCENT
5,000-1000-30
UNIT-MG-UNIT
3
3
zinc picolinate (bulk)
3
ALIVE WOMEN'S
ENERGY
zinc sulfate (bulk)
powder 100 %
3
ALIVE WOMEN'S
GUMMY VITAMINS
3
zinc sulfate intravenous
4
ANTIOXIDANT
A/C/E/SELENIUM
3
zinc sulfate oral
3
ZINC-15
1
3
ZINC-220
3
ANTIOXIDANT
FORMULA
(SELENIUM)
this table.
235
Drug Name
/Limits
ANTIOXIDANT
VITAMINS ORAL
TABLET 1,000
UNIT-200 MG-60
UNIT-2 MG
3
APATATE FORTE
3
AQUADEKS ORAL
CAPSULE
1
Drug Name
/Limits
CENTRAL-VITE
MEN'S UNDER 50
3
CENTRAL-VITE
PERFORMANCE
ORAL TABLET
1
CENTRAL-VITE
SELECT
3
CENTRAL-VITE
SENIOR
3
CENTRAL-VITE
WITH LYCOPENE
3
AQUADEKS ORAL
TABLET,CHEWABLE
3
BACMIN
3
BEE-ZEE
1
3
BEROCCA
(FA-GUARANA-CAFF
)
CENTRAL-VITE
WOMEN'S MATURE
3
CENTRAVITES
3
CENTRUM
3
BIO-35, GLUTEN
FREE
3
CENTRUM MEN
3
BIOCEL (WITH
LUTEIN)
CENTRUM SILVER
3
3
3
BIOSUPP
3
CENTRUM SILVER
ULTRA MEN'S
BIOTECT PLUS
3
CENTRUM SILVER
WOMEN
3
BIOTIN
PLUS-CALCIUM AND
VIT D3
3
CENTRUM
SPECIALIST ENERGY
3
BIOVOL
1
CENTRUM
SPECIALIST HEART
3
BLADDER 2.2
3
BODY, HAIR, SKIN
AND NAILS
3
3
CENTRUM ULTRA
MEN'S
CALCIUM CITRATE +
D WITH MAG
3
1
CENTURY ADULTS
50+
CENTURY CARDIO
3
CALCIUM CITRATE
PLUS (VIT B6)
1
CENTURY CARDIO
HEALTH FORMULA
3
CENTAMIN
3
CENTRAL VITE
1
CENTURY ENERGY
METABOLISM
3
CENTRAL VITE
WITH LUTEIN
3
CENTRAL-VITE
CARDIO
3
3
CENTRAL-VITE
ENERGY
CENTURY MATURE
ORAL TABLET
0.4-300-250
MG-MCG-MCG,
500-300-250 MCG
3
CENTURY ORAL
TABLET 18-0.4 MG
3
this table.
236
Drug Name
CENTURY
ULTIMATE MEN'S
/Limits
3
Drug Name
/Limits
DAILY GUMMIES
3
DAILY MULTIPLE
FOR MEN
3
DAILY MULTIPLE
ORAL TABLET ,
400-120 MCG-MG
3
DAILY MULTIPLE
VITAMINS/IRON
3
CENTURY
ULTIMATE
WOMEN'S ORAL
TABLET 8 MG
IRON-400 MCG-300
MCG
3
CEROVITE
3
CERTA PLUS
3
DAILY MULTIPLE
WEIGHT LOSS
3
CERTAVITE
SENIOR-ANTIOXIDA
NT
3
DAILY
MULTIVITAMIN
3
CERTAVITE-ANTIOX
ID (IRON GLUC)
ORAL LIQUID 9 MG
IRON/15 ML
3
3
DAILY
MULTIVITAMIN-MIN
ERALS
COMPETE
3
DAILY
MULTI-VITAMINS/IR
ON
3
COMPLETE 50+
3
COMPLETE MULTI
3
3
COMPLETE MULTI
50+
DAILY VITAMIN
FORMULA-MINERAL
S
3
3
COMPLETE
MULTIVITAMIN
ORAL TABLET
DAILY VITAMIN
WITH IRON
3
DAILY VITAMIN
WITH IRON AND CA
3
COMPLETE
MULTIVITAMIN-MIN
ERAL ORAL LIQUID
DAILY VITES/IRON
3
3
DAILY-VITE
3
COMPLETE ORAL
TABLET
18-500-300-250
MG-MCG-MCG-MCG
DIABETES HEALTH
3
3
DIABETES HEALTH
FORMULA
3
DIALYVITE 5000
3
COMPLETE
PREMIUM VITAMIN
3
ECEE PLUS
1
ELDERCAPS
3
ESSENTIAL
BALANCE WITH
LUTEIN
3
ESSENTIAL DAILY
3
ESSENTIAL MAN
3
ESSENTIAL MAN 50+
3
COMPLETE SENIOR
ORAL TABLET
0.4-300-250
MG-MCG-MCG
3
CORVITA
3
CORVITE
3
CORVITE FREE
3
DAILY ENERGY
1
this table.
237
Drug Name
/Limits
ESSENTIAL WOMAN
50+
3
ESTRO SUPPORT ES
3
EYE-VITE EXTRA +
LUTEIN
3
FOSFREE
3
FREEDAVITE
Drug Name
/Limits
LIFE-PACK
WOMEN'S
3
LIPOTRIAD (WITH
LUTEIN)
1
MACUVEX
3
3
3
MACUVITE EYE
CARE
GERITOL COMPLETE
1
MACUZIN
3
HAIR FORMULA
3
MAXIMIN PACK
3
HAIR VITAMINS
3
3
HAIR, SKIN AND
NAILS-ARGAN OIL
MAXIMUM DAILY
GREEN
3
MAXIMUM DAILY
MULTIVITAMIN
3
MEGA MULTI FOR
WOMEN
3
MEGA
MULTIPLE/CHELATE
D MINERAL
1
MEGA
MULTIVITAMIN FOR
MEN
3
3
HAIR,SKIN AND
NAILS ORAL
TABLET , 1 MG
IRON-66.7 MCG-1,000
MCG
3
HAIR,SKIN AND
NAILS(FA-BIOTIN)
3
HEALTHY EYES
3
HEALTHY EYES
SUPERVISION
3
HEARTBURN AND
ACID REFLUX-ALOE
3
ICAPS
1
I-CAPS
3
MEGA
MULTIVITAMIN
WITH MINERAL
ORAL TABLET
13.5-200-250
MG-MCG-MCG
ICAPS AREDS
3
MEN'S DAILY
3
ICAPS MV
3
3
ICAPS PLUS
3
MEN'S DAILY
GUMMIES
I-VITE
3
MEN'S DAILY
MULTIVIT-MINERAL
3
I-VITE PROTECT
3
K-PAX IMMUNE
SUPPORT
3
MEN'S
MULTIVITAMIN
GUMMIES
3
K-PAX ORAL
CAPSULE
3
MEN'S ONE DAILY
3
MEN'S PACK
3
K-PAX ORAL
POWDER
1
MONOCAPS
3
LIFE-PACK MEN'S
3
MULTI FOR HER
3
MULTI FOR HER 50
PLUS
3
this table.
238
Drug Name
/Limits
MULTI VITAMIN
3
MULTI-BETIC
Drug Name
/Limits
3
3
ONE DAILY
CALCIUM/IRON
MULTI-DELYN WITH
IRON
3
ONE DAILY
COMPLETE
3
MULTILEX
3
3
MULTILEX-T AND M
3
ONE DAILY DIET
SUPPORT
MULTIPLE VITAMIN,
WOMENS
3
ONE DAILY
DIETER'S SUPPORT
3
MULTIPLE
VITAMIN-MINERALS
3
ONE DAILY ENERGY
ORAL TABLET
3
MULTIVITAL
3
ONE DAILY ENERGY
ORAL TABLET
250-9-400
MG-MG-MCG
1
ONE DAILY
ESSENTIAL ORAL
TABLET 0.4 MG
3
ONE DAILY FOR
MEN
3
ONE DAILY FOR
WOMEN
3
ONE DAILY GUMMY
VITES
3
ONE DAILY
HEALTHY WEIGHT
3
MULTIVITAL
PERFORMANCE
MULTIVITAL
PLATINUM ORAL
TABLET 500-300-250
MCG
3
3
MULTI-VITAMIN
HP/MINERALS
3
multivitamin with iron
3
MULTIVITAMIN
WITH MINERALS
3
mv-min-folic acid-lutein
3
MY-VITALIFE
3
NICOMIDE
3
3
NICOMIDE
(SELENIUM-CHROMI
UM)
ONE DAILY
MAXIMUM
3
3
NUTRICAP
3
ONE DAILY
MAXIMUM (WITH
CA)
OCUTABS
3
3
OCUVEL
3
ONE DAILY MEN'S
50+ ORAL TABLET
400-120 MCG-MG
OCUVITE
3
OCUVITE EYE +
MULTI
3
3
ONE DAILY
MULTI-VIT
W-MINERAL
OCUVITE WITH
LUTEIN
3
3
OMNICAP
3
ONE DAILY
MULTIVITAMIN-IRO
N
ONE DAILY 50 PLUS
3
ONE DAILY ORAL
TABLET 0.4-600
MG-MCG
3
this table.
239
Drug Name
/Limits
Drug Name
/Limits
ONE DAILY PLUS
IRON ORAL TABLET
3
ONE-A-DAY
WEIGHTSMART
3
ONE DAILY PLUS
MINERALS
3
ONE-A-DAY WOMEN
VITACRAVES
3
ONE DAILY WITH
IRON
3
ONE-A-DAY
WOMEN'S 50+
3
ONE DAILY WOMEN
50 PLUS
3
ONE-A-DAY
WOMEN'S ACTIVE
3
ONE DAILY
WOMENS 50 PLUS
3
ONE-A-DAY
WOMENS FORMULA
ORAL TABLET 18 MG
IRON-400 MCG-500
MG
3
ONE DAILY
WOMEN'S ORAL
TABLET 27-0.4 MG
3
ONE-A-DAY
CHOLESTEROL PLUS
3
3
ONE-A-DAY
MAXIMUM
FORMULA
ONE-A-DAY
WOMEN'S HEALTHY
SKIN
3
OPTISOURCE
3
OPTI-VITAMINS
3
ONE-A-DAY MEN
VITACRAVES
3
OPURITY
MULTIVITAMIN
3
ONE-A-DAY
MENOPAUSE
FORMULA
3
PRESERVISION
AREDS
3
PRESERVISION
LUTEIN
3
PREVENT
3
PROCERV HP
3
PRORENAL QD
3
PROSIGHT WITH
LUTEIN
3
PROTECT CARDIO
AF
3
PROTECT IRON
3
PROTECT PLUS NF
3
PROTECT PLUS SO
3
QUINTABS-M
3
QUINTABS-M IRON
FREE
3
REQ49+
3
SAVISION
3
SENIOR TABS
3
ONE-A-DAY MEN'S
50+ ADVANTAGE
ORAL TABLET
400-20-370 MCG
3
ONE-A-DAY MEN'S
MULTIVITAMIN
3
ONE-A-DAY TEEN
ADVANTAGE ORAL
TABLET 9 MG
IRON-400 MCG
3
ONE-A-DAY
VITACRAVES
3
ONE-A-DAY
VITACRAVES
IMMUNITY
3
ONE-A-DAY
VITACRAVES
OMEGA-3
3
this table.
240
Drug Name
SENTRY ORAL
TABLET
18-500-300-250
MG-MCG-MCG-MCG
/Limits
Drug Name
/Limits
SUPER MULTIPLE
3
3
SUPER MULTIPLE LOW IRON
3
SENTRY SENIOR
3
SUPER THERA VITE
M
3
SOFTGELS
MULTIVIT-A,B,D,E,K,
ZN
3
SUPERVITE (EC)
3
SUPPORT
3
SOLO
3
TAB-A-VITE/IRON
3
SPECTRAVITE
ADULT
3
TAB-A-VITE-MINER
ALS
3
SPECTRAVITE
ADULT 50+
3
THERA M PLUS
(FERROUS
FUMARAT)
3
THERAGRAN-M
PREMIER 50 PLUS
3
THERALOGIX
COMPANION
3
SPECTRAVITE
ADVANCED
FORMULA ORAL
TABLET 0.4-300-250
MG-MCG-MCG
3
SPECTRAVITE MEN'S
3
THERA-M
3
SPECTRAVITE
PERFORMANCE
3
THERANATAL ORAL
COMBO PACK
3
THERAPEUTIC M +
BETA-CAROTENE
3
THERAPEUTIC-M
ORAL TABLET 9 MG
IRON-400 MCG
3
THERAPEUTIC-M
VITAMIN/MINERALS
3
THERA-TABS M
3
THERATRUM
COMPLETE WITH
LUTEIN
3
THEREMS
3
SPECTRAVITE
SENIOR ORAL
TABLET 500-300-250
MCG
3
SPECTRAVITE
ULTRA MEN 50+
3
SPECTRAVITE
ULTRA MEN'S SR
3
SPECTRAVITE
ULTRA WOMEN'S SR
3
STRESS B-COMPLEX
3
STRESS FORMULA
ADVANCED
3
THEREMS-H
1
STROVITE FORTE
3
THEREMS-M
3
STROVITE ONE
3
SUNVITE
3
TOTALDAY
MULTIPLE
3
SUPER
ANTIOXIDANT
3
3
SUPER GINSENG
MULTIVITAMIN
TRUEPLUS
DIABETIC
MULTIVITAMIN
3
this table.
241
Drug Name
/Limits
TYR COOLER ORAL
LIQUID
3
UDAMIN SP
3
ULTIMATE MEN'S
COMPLETE 50+
3
ULTIMATE
WOMEN'S
COMPLETE 50+
3
ULTRA
ANTIOXIDANT
FORMULA
3
ULTRA FREEDA
3
UNICOMPLEX-M
3
UROSEX
3
V-C FORTE
3
VIC-FORTE
3
VISION FORMULA
3
VISION FORMULA
(WITH LUTEIN)
3
VISION-VITE + ZINC
3
VITACEL (WITH
LUTEIN)
3
VITAL-D RX
3
VITALEE
3
VITAMIN D-3 WITH
ALOE
3
VITAMINS A-D-E
SELENIUM
3
VITAMINS AND
MINERALS
3
VITAMINS FOR HAIR
ORAL TABLET
400-125-250-35
MCG-MG-MG-MG
3
VITATRUM
3
VITRUM SENIOR
ORAL TABLET
500-300-250 MCG
3
WHOLE SOURCE
MULTI-VITAMINS
3
Drug Name
/Limits
WOMEN'S ACTIVE
3
WOMEN'S
BIOMULTIPLE
3
WOMEN'S COMPLEX
3
WOMEN'S DAILY
CAPLET
3
WOMEN'S DAILY
FORMULA ORAL
TABLET 27-0.4 MG
3
WOMENS DAILY
GUMMIES
3
WOMEN'S DAILY
MULTIVITAMIN
3
WOMEN'S
MULTIVITAMIN
GUMMIES
3
MULTIVITAMINS
A THRU Z
ADVANCED
FORMULA
3
ANIMI-3 WITH
VITAMIN D
3
CENTRAL VITE
1
CENTRAL-VITE
ORAL TABLET 18-400
MG-MCG
3
CENTRAL-VITE
WOMEN'S UNDER 50
1
CENTRUM
COMPLETE
3
CENTURY ORAL
TABLET 18-400
MG-MCG
3
CENTURY
ULTIMATE
WOMEN'S ORAL
TABLET 18-400
MG-MCG
3
CEREFOLIN
3
CEROVITE
ADVANCED
FORMULA
3
this table.
242
Drug Name
/Limits
CERTAVITE-ANTIOX
IDANT
3
CHEWABLE MULTI
VITAMIN
1
CHEWABLE-VITE
1
COD LIVER OIL
CONC WITH VIT C
3
cod liver oil oral
capsule
1
cod liver oil oral oil
Drug Name
/Limits
E-400 C-500 AND
BETA CAROTENE
3
ESSENTIA
3
ESSENTIAL
BALANCE WITH
LUTEIN
3
FORTAVIT
3
INFUVITE ADULT
4
L-METHYL-MC
3
1
M.V.I. ADULT
4
cod liver oil-ascorbic
acid
3
MEN'S
MULTI-VITAMIN
3
COMPLETE
MULTIVITAMIN-MIN
ERAL ORAL TABLET
3
METAFOLBIC
1
3
CRANBERRY
URINARY COMFORT
MULTI COMPLETE
WITH IRON
1
3
DAILY MULTIPLE
FOR MEN 50+
MULTI-DAY WITH
IRON
3
MULTI-DELYN
1
DAILY MULTIPLE
FOR WOMEN
3
MULTIPLE
VITAMINS
3
DAILY MULTIPLE
ORAL TABLET ,
18-400 MG-MCG
1
3
multivitamin oral
capsule
multivitamin oral tablet
3
DAILY
MULTI-VITAMIN
3
MULTI-VITE
3
NORWEGIAN COD
LIVER OIL
1
ONCE DAILY
3
ONCOVITE
3
3
DAILY
MULTIVITAMIN
WITH IRON
3
DAILY VALUE
1
DAILY VITAMIN
FORMULA
3
ONE DAILY
ESSENTIAL ORAL
TABLET , 400 MCG
DAILY VITAMIN
FORMULA + IRON
3
ONE DAILY FOR
MEN 50+ ADVANCED
3
DAILY-VITE
3
DECUBI VITE
3
3
DIABETES HEALTH
SUPPORT
3
ONE DAILY MEN'S
50+ ORAL TABLET
400-600-120
MCG-MCG-MG
DIALYVITE 800
WITH IRON
3
ONE DAILY
MULTIVITAMIN
3
this table.
243
Drug Name
/Limits
ONE DAILY
MULTIVIT-IRON(FOL
IC)
3
ONE DAILY ORAL
TABLET
3
ONE DAILY PLUS
IRON ORAL TABLET
18-400 MG-MCG
3
ONE DAILY
WOMEN'S HEALTH
1
ONE DAILY
WOMEN'S ORAL
TABLET 18 MG
IRON-400 MCG-450
MG CA
1
ONE-A-DAY ENERGY
3
ONE-A-DAY
ESSENTIAL
3
ONE-A-DAY
MAXIMUM
FORMULA
3
ONE-A-DAY MEN'S
50+ ADVANTAGE
ORAL TABLET
400-300-120
MCG-MCG-MG
ONE-A-DAY TEEN
ADVANTAGE ORAL
TABLET 18-400
MG-MCG
3
3
ONE-A-DAY
WOMENS FORMULA
ORAL TABLET 18 MG
IRON-400 MCG-500
MG CA
1
ONE-A-DAY
WOMEN'S PETITES
3
PUREVIT DUALFE
PLUS
3
QUINTABS
3
SENTRY ORAL
TABLET 18-400
MG-MCG
3
Drug Name
/Limits
SE-TAN PLUS
3
SPECTRAVITE
ADVANCED
FORMULA ORAL
TABLET 18-400
MG-MCG
3
SPECTRAVITE
ULTRA WOMEN
3
SUPER
MULTIVITAMIN
3
TAB-A-VITE
3
TANDEM PLUS
3
THERA
3
THERA VITAMIN
3
THERAPEUTIC
LIQUID
3
THERA-TABS
3
THEREMS
3
VIT 3
3
vitamin e
acetate-selenium
3
vitamins a and d
3
VITAMINS FOR HAIR
ORAL TABLET
1
WOMEN'S DAILY
FORMULA ORAL
TABLET 18 MG
IRON-400 MCG-500
MG CA
3
WOMEN'S ONE
DAILY
1
YELETS
3
NUTRITIONAL
PRODUCT CARBOHYDRATE
S, ORAL
ENFAMIL GLUCOSE
1
GERBER GOOD
START GLUCOSE
1
SOL CARB
3
this table.
244
Drug Name
/Limits
NUTRITIONAL
PRODUCT CHYLOTHORAX
OR LCHAD
SPECIFIC
FORMULATION
ENFAPORT
/Limits
NUTRITIONAL
PRODUCT ISOVALERIC
ACIDEMIA
SPECIFIC
FORMULATION
3
NUTRITIONAL
PRODUCT GLUTARIC
ACIDURIA TYPE 1
SPECIFIC
FORMULATION
GA EXPRESS 15
3
GA GEL
3
GA POWDER
3
GLUTARADE AMINO
ACID BLEND
3
GLUTARADE GA-1
3
GLUTARADE JUNIOR
1
GLUTAREX-1
3
GLUTAREX-2
3
XLYS- XTRP
ANALOG
1
XLYS, XTRP
MAXAMAID
3
XLYS, XTRP
MAXAMUM
3
NUTRITIONAL
PRODUCT GLYCOGEN
STORAGE
DISEASE
SPECIFIC
FORMULATION
GLYCOSADE
Drug Name
IVA ANAMIX NEXT
3
I-VALEX-1
3
I-VALEX-2
3
LMD POWDER
3
XLEU ANALOG
1
XLEU MAXAMAID
3
NUTRITIONAL
PRODUCT KETOGENIC
FORMULATION
BETAQUIK
3
CARBZERO
3
KETOCAL 3:1
3
KETOCAL 4:1
(MILK-SOY)
3
KETOVIE
3
KETOVOLVE
3
LIQUIGEN
3
MICROLIPID
1
NUTRITIONAL
PRODUCT LEUCINE-FREE
SPECIFIC
FORMULATION
LEU-FREE COOLER
3
NUTRITIONAL
PRODUCT - LIPID
OTHERS
3
BETAQUIK
3
CARBZERO
3
LIQUIGEN
3
MCT OIL
1
MICROLIPID
1
this table.
245
Drug Name
/Limits
NUTRITIONAL
PRODUCT MEDICAL
CONDITION
SPECIFIC
FORMULATION
Drug Name
/Limits
COMPLEX
ESSENTIAL
1
COMPLEX JUNIOR
MSD
3
COMPLEX MSUD
1
CHOLEXTRA
3
COMPLEX MSUD
AMINO ACID BLEND
1
CYTOSE
3
ISOLEUCINE 1000
3
NUTRESTORE
3
ISOLEUCINE AMINO
ACID SUPPLMNT
1
KETONEX-1
3
KETONEX-2
3
METHIONINE ORAL
3
MSUD 2
3
MSUD AID
3
MSUD ANALOG
1
NUTRITIONAL
PRODUCT METHIONINE-FRE
E SPECIFIC
FORMULATION
HCU ANAMIX NEXT
3
HCU COOLER
3
HCU EXPRESS
POWDER
3
MSUD COOLER
3
HCU EXPRESS20
3
MSUD COOLER20
3
HCU GEL POWDER
3
3
HCU LOPHLEX
3
MSUD EXPRESS
COOLER
HCY 1 POWDER
3
MSUD EXPRESS15
3
HCY 2
3
MSUD EXPRESS20
3
HOM 2
3
MSUD GEL POWDER
3
HOMINEX-1
3
MSUD LOPHLEX
3
HOMINEX-2
3
MSUD MAXAMAID
3
METHIONAID
3
MSUD MAXAMUM
3
XMET ANALOG
1
XMET MAXAMAID
3
XMET MAXAMUM
3
NUTRITIONAL
PRODUCT - MSUD
SPECIFIC
FORMULATION
NUTRITIONAL
PRODUCT NUTRITIONAL
THERAPY
BCAD 1
3
BOOST GLUCOSE
CONTROL
3
DIABETISOURCE AC
3
ACERFLEX
3
ELECARE JR
3
BCAD 1
3
ENSURE CLEAR
3
BCAD 2
3
CAMINO PRO 15 PE
3
MSUD
this table.
246
Drug Name
/Limits
EO28 SPLASH ORAL
LIQUID 0.025-1
GRAM-KCAL/ML
3
FRUITIVITS
3
GLUCERNA
3
GLUCERNA 1 CAL
3
GLUCERNA 1.2 CAL
3
GLUCERNA 1.5 CAL
Drug Name
/Limits
NEOCATE JUNIOR
WITH PREBIOTICS
3
NEOCATE NUTRA
3
NEOCATE SPLASH
3
NEPRO CARB
STEADY
3
3
3
NOVASOURCE
RENAL 2 CAL
GLUCERNA
ADVANCE
3
NUTREN 1.0 WITH
FIBER
3
GLUCERNA BAR
3
3
GLUCERNA CRISPY
DELIGHTS
NUTREN JUNIOR
FIBER
3
GLUCERNA HUNGER
SMART
3
3
NUTREN JUNIOR
ORAL LIQUID 0.03-1
GRAM-KCAL/ML
GLUCERNA SHAKE
3
NUTREN
PULMONARY
3
GLUCERNA SNACK
SHAKE
3
3
GLUCO BURST
DIABETIC DRINK
3
NUTRIHEP ORAL
LIQUID 0.04-1.5
GRAM-KCAL/ML
OXEPA
3
GLUTAREX-1
3
GLUTAREX-2
3
PEDIASURE PEPTIDE
1.0 CAL
3
GLYTROL
3
3
GLYTROL WITH
PREBIO1
PEDIASURE PEPTIDE
1.5 CAL
3
PEPDITE JUNIOR
3
HCU COOLER WITH
OMEGA-3
3
PEPTAMEN AF
3
HCU COOLER20
3
PEPTAMEN
BARIATRIC
3
IMPACT 1 CAL
3
3
IMPACT ADVANCED
RECOVERY
PEPTAMEN JUNIOR
FIBER
3
IMPACT
GLUTAMINE
3
3
PEPTAMEN JUNIOR
ORAL LIQUID 0.03-1
GRAM-KCAL/ML
IMPACT PEPTIDE 1.5
CAL
3
PEPTAMEN JUNIOR
WITH PREBIO1
3
IMPACT/FIBER
3
PERATIVE
3
LIPISTART
3
PFD 2
3
MCT PRO-CAL
3
POLYCAL
3
NEOCATE JUNIOR
3
PULMOCARE
3
this table.
247
Drug Name
/Limits
Drug Name
/Limits
RENA START
3
PERIFLEX INFANT
1
RENAMENT
3
PERIFLEX JUNIOR
3
S.O.S. 15
3
PERIFLEX LQ PKU
1
S.O.S. 20
3
PHENEX-1
3
S.O.S. 25
3
PHENEX-2
3
SUPLENA CARB
STEADY
3
PHENYLADE 40
1
PHENYLADE 60
3
TYR COOLER ORAL
SUSPENSION
3
PHENYLADE AMINO
ACID
1
TYR COOLER20
3
VITAL 1.0 CAL
3
PHENYLADE AMINO
ACIDS
3
VITAL 1.5 CAL
3
3
VITAL AF 1.2 CAL
3
PHENYLADE DRINK
MIX
VITAL HIGH
PROTEIN
3
PHENYLADE
ESSENTIAL
3
VIVONEX RTF
3
PHENYLADE GMP
3
XTRACAL PLUS
3
PHENYLADE MTE
AMINO ACIDS ORAL
POWDER
1
PHENYLADE MTE
AMINO ACIDS ORAL
POWDER IN PACKET
3
PHENYLADE
PHEBLOC
3
PHENYLADE RTD
PKU 10
3
PHENYL-FREE 1
1
NUTRITIONAL
PRODUCT PHENYLKETONU
RIA (PKU)
SPECIFIC
FORMULATION
CAMINO PRO 15 PE
PKU
3
EAA SUPPLEMENT
3
GLYTACTIN 15 PE
BETTERMILK
3
PHENYL-FREE 2 PKU
3
GLYTACTIN
RESTORE 10 PE
3
PHENYL-FREE 2HP
PKU
3
GLYTACTIN
RESTORE 10 PE LITE
3
PHLEXY-10 DRINK
MIX POWDER
3
GLYTACTIN RTD 10
PE
PKU 2
3
3
PKU 3
3
GLYTACTIN RTD 15
PE
3
PKU COOLER 10
3
PKU COOLER 15
3
LANAFLEX
3
PKU COOLER 20
3
LOPHLEX
3
PERIFLEX ADVANCE
3
this table.
248
Drug Name
/Limits
PKU EASY ORAL
GRANULES
DELAYED RELEASE
3
PKU EXPRESS15
3
PKU EXPRESS20
3
PKU GEL POWDER
3
PKU LOPHLEX
Drug Name
/Limits
BENEPROTEIN ORAL
POWDER 6 GRAM-25
KCAL/7 GRAM
3
BENEPROTEIN ORAL
POWDER IN PACKET
3
3
ENSURE HIGH
PROTEIN ORAL
POWDER
3
PKU PERIFLEX
JUNIOR PLUS
3
G-PREPROTEIN
1
XPHE MAXAMAID
3
HEPAMENT
3
XPHE MAXAMUM
ORAL POWDER
IMMULIFE
3
3
JUVEN
3
1
LIQUACEL ORAL
LIQUID 16-90
GRAM-KCAL/30 ML
3
LIQUACEL ORAL
LIQUID IN PACKET
3
LIQUID PROTEIN
FORTIFIER
3
PRE PROTEIN 20
3
PRE-PROTEIN
(WHEY)
1
PRE-PROTEIN ORAL
LIQUID
1
PRE-PROTEIN ORAL
POWDER IN PACKET
3
PROCEL
1
PROCEL 100
1
PROCEL SINGLES
1
PROMOD PROTEIN
1
PROSOURCE NO
CARB
1
PROSOURCE ORAL
LIQUID
3
PROSOURCE ORAL
PACKET
3
PROSOURCE ORAL
POWDER
1
PROSOURCE PLUS
3
PROSOURCE TF
3
XPHE MAXAMUM
ORAL POWDER IN
PACKET
NUTRITIONAL
PRODUCT PROPIONIC
ACIDEMIA
SPECIFIC
FORMULATION
MMA-PA ANAMIX
NEXT
3
MMA-PA COOLER15
3
MMA-PA EXPRESS
3
MMA-PA GEL
3
OA 1 POWDER
3
OA2 POWDER
3
OS 2
3
PROPIMEX-1
3
PROPIMEX-2
3
XMTVI ANALOG
1
XMTVI MAXAMAID
3
XMTVI MAXAMUM
3
NUTRITIONAL
PRODUCT PROTEIN
REPLACEMENTS
ARGIMENT
3
this table.
249
Drug Name
/Limits
Drug Name
/Limits
PROSOURCE ZAC
3
TYR GEL POWDER
3
PRO-STAT AWC
3
TYR LOPHLEX
3
PRO-STAT MAX
ORAL LIQUID
3
TYREX-1
3
TYREX-2
3
PRO-STAT PROFILE
1
TYROS 1
3
PRO-STAT RENAL
CARE
1
TYROS 2
3
PRO-STAT SUGAR
FREE
1
XPHE, XTRP
MAXAMAID
3
PRO-STAT SUGAR
FREE WITH FIBER
3
XPHE, XTYR
ANALOG
1
PROSYNMINIC
1
XPTM ANALOG
1
protein oral powder
1
protein oral tablet
3
PROTEINEX ORAL
LIQUID
1
PROTEINEX-18
1
CYCLINEX-1
3
serine (bulk) crystals
3
CYCLINEX-2
3
TRIAMINO
3
UNJURY ORAL
POWDER
1
3
ESSENTIAL AMINO
ACID MIX
UCD 2
3
whey protein isolate
(bulk)
3
UCD ANAMIX
JUNIOR
3
UCD TRIO
3
WND 1
3
WND 2
3
WHEY PROTEIN
ORAL POWDER 20
GRAM-140 KCAL/39
GRAM, 26 GRAM-150
KCAL/39 GRAM
3
NUTRITIONAL
PRODUCT - UREA
CYCLE DISORDER
SPECIFIC
FORMULATION
PARENTERAL
NUTRITION AMINO ACID &
DEXTROSE
COMBINATIONS
NUTRITIONAL
PRODUCT TYROSINEMIA
SPECIFIC
FORMULATION
TYLACTIN RESTORE
10 PE
3
TYLACTIN RTD 15 PE
3
TYR ANAMIX NEXT
3
TYR EXPRESS
POWDER
3
CLINIMIX 5%/D15W
SULFITE FREE
4
CLINIMIX 5%/D25W
SULFITE-FREE
4
CLINIMIX 2.75%/D5W
SULFIT FREE
4
CLINIMIX
4.25%/D10W SULF
4
TYR EXPRESS20
3
FREE
this table.
250
Drug Name
/Limits
CLINIMIX 4.25%/D5W
SULFIT FREE
4
CLINIMIX
4.25%-D20W
SULF-FREE
4
CLINIMIX
4.25%-D25W
SULF-FREE
4
CLINIMIX
5%-D20W(SULFITE-F
REE)
4
PARENTERAL
NUTRITION AMINO ACID &
ELECTROLYTES
COMBINATION
Drug Name
/Limits
AMINOSYN-PF 7 %
(SULFITE-FREE)
4
AMINOSYN-RF 5.2 %
4
CLINIMIX E
2.75%/D10W SUL
FREE
4
CLINIMIX E
2.75%/D5W SULF
FREE
4
CLINIMIX E
4.25%/D10W SUL
FREE
4
CLINIMIX E
4.25%/D25W SUL
FREE
4
4
AMINOSYN 7 %
WITH
ELECTROLYTES
4
CLINIMIX E
4.25%/D5W SULF
FREE
AMINOSYN 8.5
%-ELECTROLYTES
4
CLINIMIX E
5%/D15W SULFIT
FREE
4
AMINOSYN II 8.5
%-ELECTROLYTES
4
CLINIMIX E
5%/D20W SULFIT
FREE
4
CLINIMIX E
5%/D25W SULFIT
FREE
4
PARENTERAL
NUTRITION AMINO ACID
SOLUTIONS
AMINO ACIDS 15 %
4
CLINISOL SF 15 %
4
AMINOSYN 10 %
4
4
AMINOSYN 3.5 %
4
AMINOSYN 7 %
4
FREAMINE HBC 6.9
%
4
AMINOSYN 8.5 %
4
FREAMINE III 10 %
4
AMINOSYN II 10 %
4
HEPATAMINE 8%
4
AMINOSYN II 15 %
4
NEPHRAMINE 5.4 %
4
AMINOSYN II 7 %
4
PREMASOL 10 %
4
AMINOSYN II 8.5 %
4
PREMASOL 6 %
4
AMINOSYN M 3.5 %
4
PROCALAMINE 3%
4
AMINOSYN-HBC 7%
4
PROSOL 20 %
4
AMINOSYN-PF 10 %
4
TRAVASOL 10 %
4
TROPHAMINE 10 %
4
this table.
251
Drug Name
TROPHAMINE 6%
/Limits
4
PARENTERAL
NUTRITION AMINO ACID,
DEXTROSE,
E-LYTES & FAT
EMUL COMB
KABIVEN
4
PERIKABIVEN
4
PARENTERAL
NUTRITION INTRAVENOUS
FAT EMULSIONS
INTRALIPID
INTRAVENOUS
EMULSION 20 %, 30
%
4
LIPOSYN II
4
LIPOSYN III
4
NUTRILIPID
4
PEDIATRIC
VITAMINS AND
MINERAL
COMBINATIONS
ANIMAL SHAPES
COMPLETE ORAL
TABLET,CHEWABLE
1
Drug Name
/Limits
CHILDREN'S
CHEWABLE
COMPLETE ORAL
TABLET,CHEWABLE
1
CHILDREN'S
CHEWABLE
COMPLETE ORAL
TABLET,CHEWABLE
9-200 MG IRON-MCG
3
CHILDREN'S
CHEWABLE
W/MINERALS
1
CHILDREN'S
COMPLETE VITAMIN
3
CHILDREN'S
MULTIVITAMIN
3
CHILD'S CHEWABLE
VITAMINS/IRON
ORAL
TABLET,CHEWABLE
1
CHILD'S CHEWABLE
VITAMINS/IRON
ORAL
TABLET,CHEWABLE
15 MG
3
CHILD'S VITAMIN
WITH IRON
1
CHILDS/IRON
1
DINO-LIFE WITH
IRON-ZINC
1
FLINTSTONES
COMPLETE (IRON)
1
1
ANIMAL SHAPES
COMPLETE ORAL
TABLET,CHEWABLE
18 MG IRON
3
AQUADEKS
PEDIATRIC
1
CENTRUM KIDS
3
CEROVITE JR
1
FLINTSTONES
MULTI-VIT
GUMMIES ORAL
TABLET,CHEWABLE
100 MCG
CHEWABLE-VITE
WITH IRON
1
FLINTSTONES PLUS
CALCIUM
1
CHILD COMPLETE
MULTIVITAMIN
3
FLINTSTONES TAB
CHEW
1
CHILD VITAMIN
WITH MINERALS
1
FLINTSTONES WITH
IRON
3
this table.
252
Drug Name
/Limits
HONEY BEARS WITH
IRON-ZINC
1
KIDS VITAMINS +
IRON
1
KID'S VITAMINS +
IRON
1
KIDS VITAMINS
COMPLETE
1
LITTLE
ANIMALS-IRON
ORAL
TABLET,CHEWABLE
3
LYSIPLEX PLUS
ORAL LIQUID
1
MYKIDZ IRON ORAL
SUSPENSION
10-1,500-400 MG
-UNIT-UNIT/2 ML
1
NANOVM 9-18
3
NANOVM T/F
3
NOVAFERRUM
PEDIATRIC
3
POLY-VI-SOL
3
POLY-VI-SOL WITH
IRON
3
POLY-VITA (IRON)
Drug Name
/Limits
MYKIDZ IRON
FLUORIDE
3
TRI-VIT WITH
FLUORIDE AND
IRON
1
PEDIATRIC
VITAMINS WITH
FLUORIDE
COMBINATIONS
ESCAVITE
3
ESCAVITE D
3
ESCAVITE LQ
3
FLORIVA
(FLUORIDE-VITAMI
N D3)
3
FLORIVA ORAL
TABLET,CHEWABLE
0.5 MG FLUORIDE
(1.1 MG), 1 MG
FLUORIDE (2.2 MG)
3
MULTI-VIT WITH
FLUORIDE-IRON
3
MULTIVITAMIN
WITH FLUORIDE
1
1
1
MULTI-VITAMIN
WITH FLUORIDE
POLY-VITAMIN
WITH IRON
1
MULTIVITAMINS
WITH FLUORIDE
1
POLYVITAMIN/IRON
1
MVC-FLUORIDE
1
SCOOBY-DOO ONE A
DAY
POLY-VI-FLOR
3
1
POLY-VI-FLOR FS
3
VITALETS
3
3
ZOO FRIENDS
COMPLETE
POLY-VI-FLOR WITH
IRON
3
QUFLORA
PEDIATRIC
3
QUFLORA
PEDIATRIC DROPS
3
TEXAVITE LQ
3
TRIPLE VITAMIN
WITH FLUORIDE
3
TRI-VI-FLOR
3
PEDIATRIC
VITAMINS WITH
FLUORIDE AND
MINERALS
COMBINATIONS
MULTI-VIT WITH
FLUORIDE-IRON
3
this table.
253
Drug Name
/Limits
TRI-VITAMIN WITH
FLUORIDE
1
VITAMINS A,C,D
AND FLUORIDE
1
PEDIATRIC
VITAMINS
ANIMAL CHEWS
1
Drug Name
/Limits
CHILDREN'S
MULTIVIT W/EXTRA
C
1
CHILDREN'S
MULTIVITAMIN
3
CHILDREN'S SOUR
GUMMIES
3
CHILDS CHEW VITE
1
CHILD'S GUMMY
VITAMIN-MINERAL
3
ANIMAL SHAPE
VITAMINS
1
ANIMAL SHAPES
COMPLETE ORAL
TABLET,CHEWABLE
1
CHILD'S VITAMIN
WITH VITAMIN C
1
CHEWABLE
MULTIVIT-A,B,D,E,K,
ZN
3
COMPLETE
FORMULATION
D3000
3
CHEWABLE-VITE
1
CHILD
MULTIVITAMINS
3
3
COMPLETE
FORMULATION
MULTIVIT
CHILDREN'S
CHEWABLE
1
COMPLETE
FORMULATION
PEDIATRIC
3
DINO-LIFE
1
DINO-LIFE WITH
EXTRA C
1
FLINTSTONES
COMPLETE
3
FLINTSTONES
GUMMIES
1
CHILDREN'S
CHEWABLE
COMPLETE ORAL
TABLET,CHEWABLE
1
CHILDREN'S
CHEWABLE
MULTIVITMN
3
CHILDREN'S
CHEWABLE
VITAMIN
1
FLINTSTONES
GUMMIES OMEGA-3
3
CHILDREN'S
CHEWABLES
3
FLINTSTONES
MULTI-VIT
GUMMIES ORAL
TABLET,CHEWABLE
200 MCG
1
FLINTSTONES
MULTIVITAMIN
ORAL
TABLET,CHEWABLE
1
CHILDREN'S
CHEWABLES EXTRA
C
3
CHILDREN'S
CHEWABLES WITH
IRON
3
CHILDREN'S
MULTI-VIT
GUMMIES
3
this table.
254
Drug Name
/Limits
FLINTSTONES
MULTIVITAMIN
ORAL
TABLET,CHEWABLE
300 MCG
3
FLINTSTONES SOUR
GUMMIES
3
FLINTSTONES/EXTR
A C ORAL
TABLET,CHEWABLE
1
Drug Name
/Limits
LITTLE
ANIMALS-IRON
ORAL
TABLET,CHEWABLE
15 MG IRON
3
M.V.I. PEDIATRIC
4
NANO VM 1-3 ORAL
POWDER
1
NANO VM 4-8 ORAL
POWDER
1
ONE-A-DAY KID'S
3
ONE-A-DAY TEEN
HIM VITACRAVES
3
FLINTSTONES/EXTR
A C ORAL
TABLET,CHEWABLE
100 MCG
3
GUMMI BEAR
MULTIVITAMIN
1
3
GUMMIES
CHILDREN
MULTIVITAMIN
PED
MULTIVITAMINS-A,
B,D,E,K,ZN
3
POLY-VITA
3
POLY-VITAMIN
3
POLY-VITAMINS
1
SCOOBY-DOO ONE A
DAY KIDS
3
TRI-VI-SOL
3
TRI-VITA
1
TRI-VITAMIN
1
GUMMY DINOS
ORAL
TABLET,CHEWABLE
3
GUMMY DINOS
ORAL
TABLET,CHEWABLE
200 MCG
1
GUMMY SWIRLS
1
ZOO CHEWS
1
HONEY BEARS
1
ZOO FRIENDS
3
INFUVITE
PEDIATRIC
4
ZOO FRIENDS
ORIGINAL
3
KIDS COD LIVER OIL
AND VIT D
3
KIDS' GUMMY
3
KIDS
MULTIVITAMIN-MIN
ERALS
1
KID'S VITAMINS
1
KID'S VITAMINS +
EXTRA C
1
LITTLE ANIMALS
3
PRENATAL
VITAMINS AND
MINERALS
ACTIVE OB
3
ATABEX EC
3
BAL-CARE DHA
3
BAL-CARE DHA
ESSENTIAL
3
CALCIUM PNV
3
CENTRUM
SPECIALIST
PRENATAL
1
this table.
255
Drug Name
/Limits
CITRANATAL
(DUAL-IRON)
3
CITRANATAL 90
DHA (ALGAL OIL)
3
CITRANATAL
ASSURE ORAL
COMBO PACK 35 MG
IRON-1 MG -50
MG-300 MG
3
CITRANATAL
B-CALM (FE GLUC)
3
CITRANATAL DHA
(ALGAL OIL)
3
Drug Name
/Limits
FOCALGIN 90 DHA
3
FOCALGIN CA
3
FOLBECAL
1
FOLET DHA
3
FOLET ONE
3
FOLIVANE-OB
3
HEMENATAL OB
3
HEMENATAL OB +
DHA
3
INATAL ADVANCE
1
INATAL ULTRA
1
KPN
1
CITRANATAL
HARMONY (IRON
FUM)
3
LEVOMEFOLATE
DHA
3
CLASSIC PRENATAL
1
MACNATAL CN DHA
3
C-NATE DHA
3
MARNATAL-F
3
COMPLETE NATAL
DHA
3
MAXINATE
3
MINI PRENATAL
3
COMPLETENATE
3
M-VIT
3
CONCEPT DHA
3
MYNATAL
1
CONCEPT OB
3
DAILY PRENATAL
1
MYNATAL
ADVANCE
1
DOTHELLE DHA
3
MYNATAL PLUS
1
MYNATAL-Z
1
MYNATE 90 PLUS
1
NATACHEW (FE
BIS-GLYCINATE)
3
NATALVIT
3
NATELLE ONE
3
NEEVODHA (WITH
ALGAL OIL)
3
DUET DHA
BALANCED ORAL
COMBO PACK 25 MG
IRON-1 MG -267
MG-233 MG
3
DUET DHA WITH
OMEGA-3 ORAL
COMBO PACK 25 MG
IRON-1 MG -400 MG
3
ELITE-OB
3
NESTABS
3
ELITE-OB 400
3
NESTABS ABC
3
ENBRACE HR
3
NESTABS DHA
3
EXPECTA
PRENATAL
1
NEWGEN
3
EXTRA-VIRT PLUS
DHA
NEXA PLUS
3
3
NIVA-PLUS
3
this table.
256
Drug Name
/Limits
OB COMPLETE ONE
3
OB COMPLETE
PETITE
3
OB COMPLETE WITH
DHA
3
OBSTETRIX DHA
3
OBSTETRIX EC
Drug Name
/Limits
PR NATAL 400 EC
3
PR NATAL 430
3
PR NATAL 430 EC
3
PREFERA-OB
3
PREFERA-OB ONE
3
3
PREFERA-OB PLUS
DHA
3
OBTREX DHA
3
PRENA1 CHEW
3
O-CAL FA
1
PRENA1 PEARL
3
O-CAL PRENATAL
3
PRENAISSANCE
3
PRENAISSANCE
PLUS
3
PRENATA
3
PRENATABS FA
1
PRENATABS RX
1
PRENATAL
1
PRENATAL + DHA
1
PRENATAL 19
3
PRENATAL 19 (WITH
DOCUSATE)
3
ONE A DAY
WOMEN'S
PRENATAL DHA
ORAL COMBO PACK
28 MG IRON- 800
MCG
3
ONE DAILY
PRENATAL ORAL
COMBO PACK
28-800-440
MG-MCG-MG
1
ONE-A-DAY
WOMEN'S
PRENATAL 1
3
PRENATAL
COMPLETE
1
PAIRE OB PLUS DHA
3
PERRY PRENATAL
3
1
PNV 29-1
3
PRENATAL
DHA+COMPLETE
PRENATAL
PNV OB+DHA ORAL
COMBO PACK
27-1-50-250 MG
1
3
PRENATAL
FORMULA
PRENATAL GUMMY
3
PNV-DHA
1
1
PNV-DHA +
DOCUSATE
PRENATAL LOW
IRON
3
PRENATAL MULTI
3
PNV-FERROUS
FUMARATE-DOCU-F
A
3
1
PNV-OMEGA
3
PRENATAL MULTI +
DHA ORAL CAPSULE
27 MG IRON-800
MCG-228 MG
PNV-SELECT
3
3
PNV-VP-U
3
PRENATAL MULTI
+DHA(ALGAL OIL)
PR NATAL 400
3
PRENATAL PLUS
(CALCIUM CARB)
1
this table.
257
Drug Name
/Limits
PRENATAL TABLET
1
prenatal vit no.90-iron
fum-fa
3
prenatal vit#96-ferrous
fum-fa
1
PRENATAL VITAMIN
ORAL TABLET
1
Drug Name
/Limits
PREQUE 10
3
PRETAB
3
PROFE FORTE
1
PROVIDA DHA
3
PROVIDA OB
3
PUREFE OB PLUS
3
PUREFE PLUS
3
RELNATE DHA
3
RIGHT STEP
PRENATAL
VITAMINS
1
R-NATAL OB
3
RULAVITE DHA
3
PRENATAL VITAMIN
ORAL TABLET 27 MG
IRON- 800 MCG
3
PRENATAL VITAMIN
PLUS LOW IRON
3
PRENATAL VITAMIN
WITH MINERALS
1
prenatal vit-iron
fumarate-fa
1
SELECT-OB
3
PRENATAL-1
1
SELECT-OB (FOLIC
ACID)
3
PRENATAL-U
3
SELECT-OB + DHA
3
PRENATE AM
3
SE-NATAL 19
1
PRENATE
CHEWABLE
3
SE-NATAL 19 (WITH
DOCUSATE)
1
PRENATE DHA
3
SE-TAN DHA
3
PRENATE DHA
(FERR ASP GLYCIN)
3
SIMILAC PRENATAL
3
PRENATE ELITE
3
STUART ONE
3
PRENATE ELITE
(IRON ASP GLYC)
TARON-C DHA
3
3
3
PRENATE ENHANCE
3
TARON-PREX
PRENATAL-DHA
PRENATE
ESSENTIAL
3
THERANATAL
COMPLETE
3
THERANATAL ORAL
TABLET
3
THERANATAL
OVAVITE
3
THERANATAL PLUS
3
PRENATE
ESSENTIAL(IRON-AS
P-GL)
3
PRENATE MINI
3
PRENATE MINI
(FERR ASP GLYCIN)
3
THRIVITE-19
1
PRENATE PIXIE
3
TL-SELECT
3
PRENATE RESTORE
3
TRIADVANCE
1
PRENATE STAR
3
TRICARE
3
PREPLUS
1
this table.
258
Drug Name
/Limits
TRICARE PRENATAL
DHA ONE
3
TRINATAL GT
Drug Name
/Limits
VIRT-VITE GT
3
VITAFOL NANO
3
3
VITAFOL ULTRA
3
TRINATAL RX 1
3
VITAFOL-OB
1
TRINATE
3
VITAFOL-OB+DHA
3
TRISTART DHA
3
VITAFOL-ONE
3
TRI-TABS DHA
3
TRIVEEN-DUO DHA
3
VITAMED MD ONE
RX
3
TRIVEEN-ONE
3
3
TRIVEEN-PRX RNF
3
VITAMED MD PLUS
RX
TRUST NATAL DHA
3
3
ULTIMATECARE
ONE
VITAMEDMD
REDICHEW RX
3
VITAPEARL
3
ULTIMATECARE
ONE NF
VIVA DHA
3
3
VOL-NATE
3
VEMAVITE-PRX-2
3
VOL-PLUS
1
VENA-BAL DHA
3
VOL-TAB RX
1
VINACAL
3
VP-CH PLUS
3
VINACAL B
3
VP-CH-PNV
3
VINATE CARE
3
VP-HEME OB
3
VINATE DHA
1
VP-HEME OB + DHA
3
VINATE DHA RF
3
VP-HEME ONE
3
VINATE GT
3
VP-PNV-DHA
3
VINATE II
3
3
VINATE M
1
WOMEN'S
PRENATAL + DHA
VINATE ONE
1
ZATEAN-CH
3
VINATE PN CARE
3
ZATEAN-PN DHA
3
VINATE ULTRA
1
ZATEAN-PN PLUS
3
VIRT NATE
3
VIRT-ADVANCE
3
VIRT-C DHA
3
PRENATAL
VITAMINS
WITHOUT IRON
VIRT-CARE ONE
3
PRENAISSANCE
NEXT
3
VIRT-PN
3
VP-GGR-B6
3
VIRT-PN DHA
3
ZINGIBER
3
VIRT-PN PLUS
3
VIRTPREX
3
VIRT-SELECT
3
this table.
259
Drug Name
/Limits
RINGER'S AND
LACTATED
RINGER'S
SOLUTIONS
Drug Name
SWABFLUSH
3
SYREX SODIUM
CHLORIDE 0.9%
1
lactated ringers
intravenous
4
STERILE WATER
FOR INJECTION
ringers intravenous
4
water for injection,
sterile intravenous
SODIUM
CHLORIDE
SOLUTIONS,
CONCENTRATED
4
VITAMIN C
COMBINATIONS
sodium chloride 3 %
4
sodium chloride 5 %
4
sodium chloride
intravenous
/Limits
4
SODIUM
CHLORIDE,
PARENTERAL
BD PRE-FILLED
NORMAL SALINE
1
MONOJECT 0.9%
SODIUM CHLORIDE
1
MONOJECT PREFILL
ADVANCED NS
1
MONOJECT PREFILL
SALINE FLUSH
ESSENCE C
3
SUPER ENERGY
BOOSTER
3
VITAMIN C ENERGY
BOOSTER
3
VITAMIN C ORAL
POWDER
EFFERVESCENT IN
PACKET
3
VITAMINS - A AND
D
COMBINATIONS,
SYSTEMIC
COD LIVER OIL
ORAL CAPSULE
1,250-135 UNIT
1
1
3
NORMAL SALINE
FLUSH
COD LIVER OIL
ORAL LIQUID
1
1
intravenous
NORWEGIAN COD
LIVER OIL
4
1
injection syringe
vit a and d3 in cod liver
oil
1
3
injection syringe, with
swab cap
vitamin a
palmitate-vitamin d2
3
vitamin a-vitamin d3
3
intravenous
4
sodium chloride 3 %
4
sodium chloride 5 %
4
VITAMINS - A
AQUASOL A
1
beta carotene
1
beta carotene (bulk)
3
LUMITENE
1
sodium chloride
4
intravenous
this table.
260
Drug Name
/Limits
Drug Name
/Limits
vitamin a acetate (bulk)
beads
3
HOMOCYSTEINE
FORMULA
3
vitamin a oral capsule
10,000 unit, 8,000 unit
1
INTRINSI
B12-FOLATE
3
vitamin a oral capsule
25,000 unit
3
levomefol-b6-meb12-alg
al oil
3
vitamin a palmitate
3
3
vitamin a palmitate
(bulk) liquid 1,700,000
unit/gram
lmefol
ca-acetyl-meb12-algal
3
L-METHYL-B6-B12
3
L-METHYLFOLATE
CA P-5-P ME-CBL
3
LMTHF-PYRIDOXINE
-CYANOCOBALAMN
3
METAFOLBIC PLUS
RF
3
3
vitamin a
palmitate-b-carotene
3
VITAMINS - B
PREPARATION
COMBINATIONS
ABANEU-SL
3
APATATE
1
METANX (ALGAL
OIL)
B COMPLEX W-VIT C
3
NEURIN-SL
3
B-COMPLEX WITH
B-12
3
NEURO VITE
3
NIVA-FOL
3
CEREFOLIN NAC
(ALGAL OIL)
3
TL GARD RX
3
VIRT-GARD
3
FABB
3
VIRT-VITE
1
FOLBEE
1
VIRT-VITE FORTE
1
FOLBIC
1
VITA-RESPA
3
FOLBIC RF
3
FOLGARD RX
1
folic acid-vit b6-vit b12
oral tablet 0.5-5-0.2 mg
3
VITAMINS - B-1,
THIAMINE AND
DERIVATIVES
oral tablet 2.2-25-0.5
mg
ARKALIOX
3
1
thiamine hcl (vitamin
b1) injection
1
FOLINIC-PLUS
3
b1) oral tablet 100 mg
1
FOLPLEX 2.2
1
FOLTABS 800
1
3
FOLTANX
1
b1) oral tablet 250 mg,
50 mg, 500 mg
FOLTANX RF
3
1
FOLTX
3
VITAMIN B-1
(MONONITRATE)
VITAMIN B-1 ORAL
TABLET 100 MG
3
this table.
261
Drug Name
VITAMIN B-1 ORAL
TABLET 250 MG, 50
MG
/Limits
1
VITAMINS - B-12
AND FOLIC ACID
COMBINATIONS
FOLTRATE
3
MTX SUPPORT
3
OPURITY
3
vitamin b12-folic acid
oral
3
vitamin b12-folic acid
sublingual
1
VITAMINS - B-12,
CYANOCOBALAM
IN AND
DERIVATIVES
ABANEU-SL
3
ADENOSYLCOBALA
MIN
3
B12
1
B-12 DOTS
1
B-12 PLUS
3
cobamamide (bulk)
3
cyanocobalamin
(vitamin b-12) injection
1
cyanocobalamin
(vitamin b-12) oral
liquid
3
cyanocobalamin
(vitamin b-12) oral
lozenge
3
cyanocobalamin
(vitamin b-12) oral
tablet 1,000 mcg, 2,000
mcg, 2,500 mcg, 500
mcg
3
cyanocobalamin
(vitamin b-12) oral
tablet 250 mcg
1
Drug Name
/Limits
cyanocobalamin
(vitamin b-12) oral
1
cyanocobalamin
(vitamin b-12) oral
3
cyanocobalamin
(vitamin b-12)
sublingual lozenge
3
cyanocobalamin
(vitamin b-12)
sublingual tablet 1,000
mcg, 2,500 mcg
1
cyanocobalamin
(vitamin b-12)
sublingual tablet 3,000
mcg, 500 mcg
3
cyanocobalamin
(vitamin b-12)
sublingual
3
ELIGEN B12
3
hydroxocobalamin
1
LIQUID B 12
3
mecobalamin
3
NASCOBAL
3
NEURIN-SL
3
PHYSICIANS EZ USE
B-12
3
RAPID B-12 ENERGY
3
VITAMELTS
ENERGY
3
VITAMIN B-12 ORAL
DROPS
3
VITAMIN B-12 ORAL
LOZENGE
3
VITAMIN B-12 ORAL
TABLET 1,000 MCG,
50 MCG, 500 MCG
3
VITAMIN B-12 ORAL
TABLET 100 MCG,
250 MCG
1
this table.
262
Drug Name
/Limits
VITAMIN B-12 ORAL
TABLET EXTENDED
RELEASE 1,000 MCG,
2,000 MCG
1
VITAMIN B-12
SUBLINGUAL DROPS
3
VITAMIN B-12
SUBLINGUAL
TABLET
1
VITAMINS - B-2,
RIBOFLAVIN AND
DERIVATIVES
CYTO B-2
3
riboflavin (vitamin b2)
oral
3
VITAMIN B-2 ORAL
TABLET 100 MG, 50
MG
1
VITAMIN B-2 ORAL
TABLET 25 MG
3
VITAMINS - B-3,
NIACIN AND
DERIVATIVES
Drug Name
/Limits
niacin oral tablet
extended release 1,000
mg
3
niacin oral tablet
extended release 250
mg, 500 mg, 750 mg
1
niacinamide (bulk)
powder
1
niacinamide oral tablet
100 mg
1
500 mg
3
extended release
3
SLO-NIACIN
3
VITAMINS - B-5,
PANTOTHENIC
ACID AND
DERIVATIVES
calcium pantothenate
oral
3
pantothenic acid
1
INOSITOL
HEXANICOTINATE
1
VITAMINS - B-6,
PYRIDOXINE AND
DERIVATIVES
niacin (inositol
niacinate)
1
B-NATAL
3
NIACIN
(NIACINAMIDE)
3
B-NATAL
THERAPOPS
3
CHROMIUM
PICOLINATE KLB6
3
pyridoxal-5 phosphate
(bulk)
3
NIACIN FLUSH FREE
ORAL CAPSULE 400
MG NIACIN (500 MG)
1
NIACIN FLUSH FREE
ORAL CAPSULE 750
MG
3
pyridoxine (bulk)
powder
1
NIACIN NO FLUSH
1
1
niacin oral capsule,
extended release
pyridoxine (vitamin b6)
injection
1
mg, 50 mg
3
3
oral tablet 100 mg, 25
mg, 250 mg, 500 mg
1
oral tablet 50 mg
1
mg, 500 mg
this table.
263
Drug Name
/Limits
VITAMIN B-6 ORAL
TABLET 100 MG, 200
MG, 25 MG, 250 MG
3
VITAMIN B-6 ORAL
TABLET 50 MG
1
VITAMIN B-6 ORAL
TABLET EXTENDED
RELEASE
3
VITAMINS BIOFLAVONOIDS
Drug Name
/Limits
ascorbate sodium (bulk)
powder
3
granules
3
powder
1
ascorbic acid injection
1
ascorbic acid oral
granules
3
3
bioflavonoid, lemon
(bulk)
3
ascorbic acid oral tablet
250 mg, 500 mg
3
ascorbic acid oral tablet
extended release
3
(bulk) powder 100 %
1
ascorbic acid oral
tablet,chewable
3
(bulk) powder 13 %
3
ASCORBIC ACID
WITH ROSE HIPS
3
rutin
3
ascorbyl palmitate
(bulk)
3
C 500 TIMED
RELEASED
3
C COMPLEX
3
C-1000
3
C-1000 WITH ROSE
HIPS
3
C-250
3
C-500
3
FRUIT C
3
FRUIT C-100
3
FRUIT C-200
3
FRUIT C-500
3
HALLS DEFENSE
3
sod ascorbyl phos dihyd
(bulk)
3
SOOTHING
PUREWAY-C
3
VITA-C
3
VITAMIN C COUGH
DROPS
3
VITAMINS BIOTIN
biotin (bulk) powder
100 %
1
biotin oral capsule 1
mg, 2,500 mcg
3
biotin oral capsule 5 mg
1
biotin oral tablet 1 mg,
10 mg, 5 mg, 800 mcg
3
biotin oral tablet 300
mcg
1
CYTO B7
3
HARD NAIL
3
MEGA BIOTIN
3
MERIBIN
1
VITAMINS - C,
ASCORBIC ACID
AND
DERIVATIVES
ACEROLA C-500
3
ascorbate calcium
3
this table.
264
Drug Name
/Limits
VITAMIN C DROPS
3
VITAMIN C ORAL
CAPSULE,
EXTENDED
RELEASE
3
VITAMIN C ORAL
LIQUID
3
VITAMIN C ORAL
LOZENGE
3
VITAMIN C ORAL
POWDER
3
VITAMIN C ORAL
SYRUP
VITAMIN C ORAL
TABLET
Drug Name
/Limits
cholecalciferol (vit
d3)(bulk)
3
d3) oral capsule
1
d3) oral drops
1
d3) oral liquid
3
1
3
d3) oral tablet 1,000
unit, 2,000 unit, 3,000
unit, 400 unit, 5,000
unit
3
d3) oral tablet,chewable
1
VITAMIN C ORAL
TABLET EXTENDED
RELEASE
3
3
d3) sublingual
CIFEREX
3
VITAMIN C ORAL
TABLET,CHEWABLE
250 MG, 500 MG
D3-2000
1
3
DECARA
3
VITAMIN C WITH
ROSE HIPS
DELTA D3
3
3
3
zinc sulfate-vitamin c
3
DIALYVITE
VITAMIN D
DIALYVITE
VITAMIN D3 MAX
3
DRISDOL
3
DURACHOL
3
D-VI-SOL
3
D-VITA
3
d2) oral capsule
1
d2) oral drops
3
1
VITAMINS - D AND
K COMBINATIONS
D3 + K2 DOTS
3
VITAMINS - D
DERIVATIVES
CALCIDOL
3
CALCIFEROL
3
calcitriol (bulk)
3
calcitriol intravenous
solution 1 mcg/ml
4
calcitriol oral capsule
1
d2) oral tablet
calcitriol oral solution
3
JUST D
3
calcitriol-almond oil
(bulk)
3
KIDS VITAMIN D3
1
MAXIMUM D3
3
CHILDREN'S
REPLESTA
3
OPTIMAL D3
3
ORTHO D
3
this table.
265
Drug Name
/Limits
Drug Name
/Limits
REPLESTA
3
REPLESTA NX
3
REVESTA
3
VITAMINS - FOLIC
ACID AND
DERIVATIVES
ROCALTROL
3
DEPLIN (ALGAL OIL)
3
SUPER DAILY D3
3
FA-8
3
THERA-D
1
folic acid injection
1
THERA-D 4000
3
3
VITAL-D RX
3
folic acid oral capsule
20 mg
VITAMIN D3
1
folic acid oral tablet 1
mg
1
AQUA-E
3
folic acid oral tablet
400 mcg, 800 mcg
3
AQUASOL E
1
3
dl-alpha tocopherol
(bulk)
3
(bulk)
3
E-200
3
levomefolate-algal oil
3
LIQUI-E
1
L-METHYLFOLATE
3
vit e acid succinate
(bulk)
3
L-METHYLFOLATE
FORTE
3
(bulk)
3
METHYLTETRAHYD
ROFOLIC ACID
3
oral capsule 1,000 unit,
200 unit, 400 unit
3
VITAMINS - FOLIC
ACID
COMBINATIONS
oral drops
3
ENLYTE (FERROUS
GLYCINE)
3
vitamin e acetate
3
FABB
3
vitamin e acetate (bulk)
powder
3
FOLBEE
1
FOLBIC
1
vitamin e mixed
3
FOLGARD RX
1
1,000 unit, 200 unit, 400
unit
3
oral tablet 2.2-25-0.5
mg
1
100 unit, 600 unit
1
FOLPLEX 2.2
1
vitamin e oral drops
3
NIVA-FOL
3
VITAMIN E ORAL
DROPS
PURALOR CI
3
3
RESTORA RX
3
vitamin e succinate
3
TL GARD RX
3
wheat germ oil
3
VIRT-GARD
3
VITAMINS - E
this table.
266
Drug Name
/Limits
VIRT-VITE
1
VIRT-VITE FORTE
1
VITA-RESPA
3
Drug Name
ADRENAL
STEROID
INHIBITORS
trilostane (bulk)
VITAMINS - K,
PHYTONADIONE
AND
DERIVATIVES
/Limits
3
ADRENOCORTICO
TROPHIC
HORMONES
MEPHYTON
1
ACTHAR H.P.
3
phytonadione (bulk)
3
corticotropin
1
phytonadione (vitamin
k1) injection
1
phytonadione (vitamin
k1) oral
1
VITAMIN K
3
AGENTS TO
TREAT
HYPOGLYCEMIA
(HYPERGLYCEMI
CS)
VITAMIN K1
3
DEX4 GLUCOSE BITS
1
VITAMIN K-1
3
3
vitamin k2 (bulk)
3
DEX4 GLUCOSE
ORAL GEL
DEX4 GLUCOSE
ORAL GEL IN
PACKET
3
DEX4 GLUCOSE
ORAL LIQUID
3
DEX4 GLUCOSE
ORAL
TABLET,CHEWABLE
1
DEX4 GLUCOSE
POUCH PACK
1
DEX4 GLUCOSE
QUICK DISSOLVE
1
dextrose oral liquid 15
gram/59 ml
3
GLUCAGEN
HYPOKIT
1
GLUCAGON
EMERGENCY KIT
(HUMAN)
1
glucagon hcl
3
GLUCO BURST
1
GLUCO SHOT
3
glucose
1
VITAMINS - PABA
POTABA ORAL
CAPSULE
potassium
aminobenzoate (bulk)
NF
3
ENDOCRINE
ABORTIFACIENTS
OR CERVICAL
RIPENING
AGENTS PROSTAGLANDIN
ANALOGS
CERVIDIL
3
HEMABATE
3
PREPIDIL
3
PROSTIN E2
3
ABORTIFACIENTS
- PROGESTERONE
RECEPTOR
ANTAGONIST
MIFEPREX
3
this table.
267
Drug Name
/Limits
Drug Name
/Limits
GLUCOSE BITS
1
NATESTO
3
GLUCOSE GEL
1
STRIANT
3
GLUTOSE 15
1
TESTIM
1
GLUTOSE 45
1
TESTONE CIK
3
INSTA-GLUCOSE
3
TESTOPEL
3
PROGLYCEM
3
testosterone
3
RELION GLUCOSE
3
testosterone (bulk)
1
TRUEPLUS
GLUCOSE
3
testosterone cyp, micro
(bulk)
1
1
(bulk)
1
ANABOLIC
STEROID - SINGLE
AGENTS
ANADROL-50
1
1
nandrolone decanoate
(bulk)
3
(bulk)
3
OXANDRIN
3
oxandrolone
1
testosterone propionate
(bulk)
1
oxandrolone (bulk)
3
TESTRED
1
stanozolol (bulk)
3
VOGELXO
3
stanozolol micronized
(bulk)
3
ANDROGEN SINGLE AGENTS
ANTIDIURETIC
AND
VASOPRESSOR
HORMONES
ANDRODERM
3
DDAVP INJECTION
3
ANDROGEL
3
DDAVP NASAL
3
DDAVP ORAL
1
ANDROID
NC
ANDROXY
1
desmopressin injection
1
AVEED
3
desmopressin nasal
1
AXIRON
3
desmopressin oral
1
DEPO-TESTOSTERO
NE
STIMATE
1
1
vasopressin
3
fluoxymesterone (bulk)
3
VASOSTRICT
4
FORTESTA
3
METHITEST
1
methyltestosterone oral
capsule
1
ANTIHYPERGLYC
EMIC ALPHA-GLUCOSI
DASE INHIBITORS
methyltestosterone,micr
o(bulk)
1
acarbose
1
GLYSET
1
this table.
268
Drug Name
PRECOSE
/Limits
1
GLYXAMBI
JANUVIA
2
NESINA
3
ONGLYZA
3
TRADJENTA
3
PA
ANTIHYPERGLYC
EMIC - DOPAMINE
RECEPTOR
AGONISTS
3
ANTIHYPERGLYC
EMIC - SODIUM
GLUCOSE
COTRANSPORTER
-2 (SGLT2)
INHIBITORS
FARXIGA
3
PA
INVOKANA
3
PA
JARDIANCE
3
PA
ANTIHYPERGLYC
EMIC SULFONYLUREA
AND BIGUANIDE
COMBINATIONS
3
ANTIHYPERGLYC
EMIC GLUCOCORTICOI
D (CORTISOL)
RECEPTOR
BLOCKER (GR-II)
KORLYM
/Limits
ANTIHYPERGLYC
EMIC - SGLT-2
INHIBITOR &
DPP-4 INHIBITOR
COMBINATIONS
ANTIHYPERGLYC
EMIC DIPEPTIDYL
PEPTIDASE-4
(DPP-4)
INHIBITORS
CYCLOSET
Drug Name
1
ANTIHYPERGLYC
EMIC MEGLITINIDE
ANALOGS
glipizide-metformin
1
GLUCOVANCE
3
glyburide-metformin
1
ANTIHYPERGLYC
EMIC SULFONYLUREA
DERIVATIVES
nateglinide
2
PRANDIN
3
repaglinide
3
STARLIX
3
PA
ANTIHYPERGLYC
EMIC - SGLT-2
INHIBITOR &
BIGUANIDE
COMBINATIONS
INVOKAMET
3
XIGDUO XR
3
PA
AMARYL
3
chlorpropamide oral
tablet 100 mg
1
chlorpropamide oral
tablet 250 mg
3
glimepiride
1
glipizide
1
GLUCOTROL
3
GLUCOTROL XL
3
glyburide micronized
2
PA
glyburide oral
2
PA
GLYNASE
3
this table.
269
Drug Name
/Limits
tolazamide
1
tolbutamide
1
ANTIHYPERGLYC
EMIC THIAZOLIDINEDI
ONE AND
BIGUANIDE
COMBINATIONS
ACTOPLUS MET
3
ST
ACTOPLUS MET XR
3
ST
AVANDAMET ORAL
TABLET 2-1,000 MG,
2-500 MG
3
ST
pioglitazone-metformin
1
ANTIHYPERGLYC
EMIC THIAZOLIDINEDI
ONE AND
SULFONYLUREA
COMBINATIONS
DUETACT
3
pioglitazone-glimepiride
3
ST
3
SYMLINPEN 60
3
ANTIHYPERGLYC
EMIC, INCRETIN
MIMETIC,GLP-1
RECEPTOR
AGONIST
ANALOG-TYPE
BYDUREON
BYETTA
SUBCUTANEOUS
PEN INJECTOR 10
MCG/DOSE(250
MCG/ML) 2.4 ML
/Limits
BYETTA
SUBCUTANEOUS
PEN INJECTOR 5
MCG/DOSE (250
MCG/ML) 1.2 ML
2
TANZEUM
3
TRULICITY
3
VICTOZA 2-PAK
2
PA; QL (6 ML
per 30 days)
VICTOZA 3-PAK
2
PA; QL (9 ML
per 30 days)
PA; QL (1.2
ML per 30
days)
ANTIHYPERGLYC
EMIC-DIPEPTIDY
L PEPTIDASE-4
(DPP-4)
INHIBITOR &
BIGUANIDE
JANUMET
3
JANUMET XR
3
JENTADUETO
3
KAZANO
3
KOMBIGLYZE XR
3
ANTIHYPERGLYC
EMIC-DIPEPTIDY
L PEPTIDASE-4
INHIBITOR &
THIAZOLIDINEDI
ONE
ANTIHYPERGLYC
EMIC, AMYLIN
ANALOG-TYPE
SYMLINPEN 120
Drug Name
OSENI
2
PA
2
PA; QL (2.4
ML per 30
days)
3
ANTITHYROID
AGENTS,
THIONAMIDES IMIDAZOLE
DERIVATIVES
carbimazole (bulk)
3
methimazole (bulk)
3
methimazole oral tablet
10 mg, 5 mg
1
TAPAZOLE
3
this table.
270
Drug Name
/Limits
ANTITHYROID
AGENTS,
THIONAMIDES THIOURACIL
DERIVATIVES
propylthiouracil
1
propylthiouracil (bulk)
3
BONE
FORMATION
STIMULATING
AGENTS PARATHYROID
HORMONE-TYPE
FORTEO
/Limits
risedronate oral tablet
150 mg, 35 mg, 5 mg
1
risedronate oral tablet
30 mg
3
risedronate oral
(dr/ec)
3
zoledronic acid
4
zoledronic
acid-mannitol-water
4
ZOMETA
4
CALCIMIMETIC,
PARATHYROID
CALCIUM
RECEPTOR
SENSITIVITY
ENHANCER
1
BONE
RESORPTION
INHIBITORS BISPHOSPHONAT
E AND VITAMIN D
COMBINATIONS
FOSAMAX PLUS D
Drug Name
SENSIPAR
1
CALCITONINS
3
BONE
RESORPTION
INHIBITORS BISPHOSPHONAT
ES
ACTONEL
3
alendronate
1
ATELVIA
3
BINOSTO
3
BONIVA
INTRAVENOUS
4
BONIVA ORAL
3
etidronate disodium
1
FOSAMAX ORAL
TABLET 70 MG
3
ibandronate intravenous
4
ibandronate oral
2
pamidronate
4
ST
calcitonin (salmon)
1
FORTICAL
1
MIACALCIN
INJECTION
3
MIACALCIN NASAL
1
ESTROGEN &
PROGESTIN WITH
ANTIMINERALOC
ORTICOID
ACTIVITY,
COMBINATIONS
ANGELIQ
3
ESTROGEN &
SELECTIVE
ESTROGEN
RECEPTOR
MODULATOR
(SERM)
COMBINATIONS
ST
DUAVEE
3
RECLAST
4
this table.
271
Drug Name
/Limits
ESTROGEN-ANDR
OGEN
COVARYX
NF
COVARYX H.S.
NF
EEMT
NF
EEMT HS
NF
estrogens-methyltestoste
rone
NF
ESTROGEN-PROG
ESTIN
ACTIVELLA
3
CLIMARA PRO
3
COMBIPATCH
1
Drug Name
/Limits
ESTRACE ORAL
3
estradiol (bulk)
3
estradiol hemihyd,micro
(bulk)
3
estradiol micronized
(bulk)
3
estradiol oral
1
estradiol transdermal
patch semiweekly
1
patch weekly 0.025
mg/24 hr, 0.0375 mg/24
hr, 0.06 mg/24 hr, 0.075
mg/24 hr
3
1
estradiol-norethindrone
acet oral tablet 0.5-0.1
mg
3
patch weekly 0.05
mg/24 hr, 0.1 mg/24 hr
estradiol-norethindrone
acet oral tablet 1-0.5 mg
1
1
FEMHRT LOW DOSE
3
estradiol valerate
intramuscular oil 20
mg/ml, 40 mg/ml
JINTELI
1
estriol (bulk)
1
LOPREEZA
3
estriol micronized (bulk)
1
MIMVEY
1
ESTROGEL
3
MIMVEY LO
3
estrone (bulk)
1
norethindrone ac-eth
0.5-2.5 mg-mcg, 1-5
mg-mcg
estropipate
1
EVAMIST
3
3
MENEST
3
MENOSTAR
3
PREFEST
3
MINIVELLE
3
PREMPHASE
1
PREMPRO
1
PREMARIN
INJECTION
1
PREMARIN ORAL
1
VIVELLE-DOT
3
ESTROGENS
ALORA
3
CLIMARA
3
DELESTROGEN
1
DEPO-ESTRADIOL
1
DIVIGEL
3
ELESTRIN
3
ENJUVIA
3
this table.
272
Drug Name
/Limits
FERTILITY
ENHANCER LUTEAL PHASE
SUPPORTING,
PROGESTERONETYPE
CRINONE VAGINAL
GEL 8 %
3
ENDOMETRIN
3
3
clomiphene citrate
(bulk)
1
SEROPHENE
3
2
3
FOLLICLE-STIMU
LATING
HORMONE (FSH)
BRAVELLE
FOLLISTIM AQ
INJECTION
SOLUTION 75
UNIT/0.5 ML
3
GONAL-F
3
GONAL-F RFF
3
GONAL-F RFF
REDI-JECT
3
betamethasone acet,sod
phos
1
CELESTONE
SOLUSPAN
1
EZ USE
JOINT-TUNNEL-TRIG
GER
3
PHYSICIANS EZ USE
M-PRED
3
GLUCOCORTICOI
DS
FOLLICLE-STIMU
LATING &
LUTEINIZING
HORMONES
MENOPUR
FOLLISTIM AQ
SUBCUTANEOUS
GLUCOCORTICOI
D-ANESTHETIC
COMBINATIONS
FERTILITY
ENHANCER PRETERM BIRTH
PREVENTION,
PROGESTERONETYPE
MAKENA
INTRAMUSCULAR
OIL 250 MG/ML
/Limits
GLUCOCORTICOI
D SALT
COMBINATIONS
FERTILITY
ENHANCER OVULATION
STIMULANT SYNTHETIC
(NON-FSH)
clomiphene citrate
Drug Name
3
3
PA
A-HYDROCORT
1
ARISTOSPAN
INTRA-ARTICULAR
1
ARISTOSPAN
INTRALESIONAL
1
budesonide, micronized
(bulk)
1
CORTEF ORAL
TABLET 10 MG, 20
MG
3
CORTEF ORAL
TABLET 5 MG
1
cortisone
1
DELTASONE ORAL
TABLET 20 MG
3
DEPO-MEDROL
1
dexamethasone
1
this table.
273
Drug Name
/Limits
dexamethasone ac,
micro (bulk)
1
DEXAMETHASONE
INTENSOL
1
dexamethasone sod
phos (bulk)
Drug Name
/Limits
mometasone furoate
(bulk)
3
ORAPRED ODT
3
PEDIAPRED
3
1
prednisolone ac, micro
(bulk)
1
dexamethasone sodium
phos (pf)
1
prednisolone oral
solution 15 mg/5 ml
1
phosphate injection
solution
1
dexamethasone,microniz
ed(bulk)
1
1
DEXPAK 10 DAY
1
prednisolone sodium
phosphate oral solution
15 mg/5 ml (3 mg/ml),
25 mg/5 ml (5 mg/ml), 5
mg base/5 ml (6.7 mg/5
ml)
DEXPAK 13 DAY
1
DEXPAK 6 DAY
1
prednisolone sodium
phosphate oral
3
FLO-PRED
3
hydrocortisone oral
1
prednisolone, micro
(bulk)
1
KENALOG
INJECTION
1
PREDNISONE
INTENSOL
1
MEDROL (PAK)
3
1
MEDROL ORAL
TABLET 16 MG, 2
MG, 32 MG, 8 MG
prednisone micronized
(bulk)
1
prednisone oral
1
RAYOS
3
MEDROL ORAL
TABLET 4 MG
3
SOLU-CORTEF
1
methylprednisolone
1
SOLU-CORTEF (PF)
1
methylprednisolone
acetate
SOLU-MEDROL
4
1
3
methylprednisolone
sodium succ injection
recon soln 125 mg, 40
mg
SOLU-MEDROL (PF)
INJECTION
3
SOLU-MEDROL (PF)
INTRAVENOUS
4
3
methylprednisolone
sodium succ intravenous
triamcin hexacet, micro
(bulk)
4
1
methylprednisolone, mic
(bulk)
(bulk)
1
3
MILLIPRED
3
injection
MILLIPRED DP
3
VERIPRED 20
3
this table.
274
Drug Name
/Limits
GONADOTROPIN
INHIBITOR
PITUITARY
SUPPRESSANTS
danazol oral
1
HUMULIN N
1
HUMULIN N
KWIKPEN
2
NOVOLIN N
3
ST; QL (60 ML
per 30 days)
HUMAN INSULINS
- SHORT ACTING
3
GROWTH
HORMONE
RELEASING
HORMONES
(GHRH)
EGRIFTA
3
sermorelin acetate
(bulk)
3
AFREZZA
3
HUMULIN R
1
HUMULIN R U-500
(CONCENTRATED)
1
NOVOLIN R
1
INSULIN
ANALOGS - FIXED
COMBINATIONS
GROWTH
HORMONES
ZORBTIVE
/Limits
HUMAN INSULINS
- INTERMEDIATE
ACTING
GROWTH
HORMONE
RECEPTOR
ANTAGONISTS
SOMAVERT
Drug Name
4
HUMAN
CHORIONIC
GONADOTROPIN
(HCG)
HUMALOG MIX 50-50
1
HUMALOG MIX 50-50
KWIKPEN
2
HUMALOG MIX 75-25
1
HUMALOG MIX 75-25
KWIKPEN
2
NOVOLOG MIX 70-30
3
2
ST
ST
chor gonadotropin, hum
(bulk)
3
NOVOLOG MIX 70-30
FLEXPEN
chorionic gonadotropin,
human
2
NOVAREL
3
INSULIN
ANALOGS - LONG
ACTING
OVIDREL
3
LANTUS
1
PREGNYL
3
LANTUS SOLOSTAR
2
LEVEMIR
1
LEVEMIR
FLEXTOUCH
3
ST
TOUJEO SOLOSTAR
3
ST
TRESIBA
FLEXTOUCH U-100
3
HUMAN INSULINS
- FIXED
COMBINATIONS
HUMULIN 70/30
1
HUMULIN 70/30
KWIKPEN
2
NOVOLIN 70/30
3
ST; QL (60 ML
per 30 days)
ST; QL (60 ML
per 30 days)
PA; ST; QL
(60 ML per 30
days)
this table.
275
Drug Name
TRESIBA
FLEXTOUCH U-200
/Limits
3
INSULIN
ANALOGS - RAPID
ACTING
APIDRA
1
APIDRA SOLOSTAR
2
HUMALOG
KWIKPEN
2
HUMALOG
SUBCUTANEOUS
CARTRIDGE
2
HUMALOG
SUBCUTANEOUS
SOLUTION
1
NOVOLOG
1
PA; ST; QL
(60 ML per 30
days)
ST; QL (60 ML
per 30 days)
ST
/Limits
INSULIN
RESPONSE
ENHANCERS THIAZOLIDINEDI
ONES
(PPAR-GAMMA
AGONISTS)
ACTOS
3
AVANDIA ORAL
TABLET 2 MG
3
AVANDIA ORAL
TABLET 4 MG
1
pioglitazone
2
ST
LEPTIN
HORMONE
ANALOGS
MYALEPT
NOVOLOG FLEXPEN
2
ST; QL (60 ML
per 30 days)
NOVOLOG PENFILL
3
ST
INSULIN
RESPONSE
ENHANCERS BIGUANIDES
Drug Name
3
LHRH (GNRH)
AGONIST
ANALOG PIT
SUPPRES CENTRAL
PRECOCIOUS
PUBERTY
LUPRON DEPOT-PED
3
3
3
FORTAMET
3
GLUCOPHAGE
3
LUPRON DEPOT-PED
(3 MONTH)
GLUCOPHAGE XR
3
SUPPRELIN LA
GLUMETZA
3
metformin (bulk)
3
metformin oral tablet
1
1
LHRH (GNRH)
AGONIST
ANALOG
PITUITARY SUPP.
AND PROGESTIN
COMB.
3
LUPANETA PACK (1
MONTH)
3
RIOMET
3
LUPANETA PACK (3
MONTH)
3
this table.
276
Drug Name
/Limits
fludrocortisone
LHRH (GNRH)
AGONIST
ANALOG
PITUITARY
SUPPRESSANTS
methylergonovine
3
LUPRON DEPOT
INTRAMUSCULAR
SYRINGE KIT 3.75
MG
3
SYNAREL
1
1
PITOCIN
3
3
PROGESTINS
AYGESTIN
3
3
hydroxyprogesterone
capr(bulk)
3
3
MAKENA
INTRAMUSCULAR
OIL 250 MG/ML
2
medroxyprogest, ac
micro(bulk)
3
medroxyprogesterone
oral
1
norethindrone (bulk)
3
norethindrone acetate
1
progesterone
3
progesterone (bulk)
3
progesterone
micronized
1
progesterone
micronized (bulk)
3
PROMETRIUM
3
PROVERA
3
3
3
MINERALOCORTI
COIDS
aldosterone (bulk)
powder 95 %
oxytocin injection
solution
NATPARA
MENOPAUSAL
SYMPTOMS
SUPPRESSANT-SS
RI
ANTIDEPRESSANT
TYPE
BRISDELLE
1
PARATHYROID
HORMONES
MENOPAUSAL
SYMPTOMS
SUPPRESSANT-SE
LECTIVE
ESTROGEN
RECEPTOR
MODULATORS
OSPHENA
1
OXYTOCIC OXYTOCIN &
ANALOGS
LHRH (GNRH)
ANTAGONISTS
ganirelix
/Limits
OXYTOCIC ERGOT
ALKALOIDS
LUPRON DEPOT (3
MONTH)
INTRAMUSCULAR
SYRINGE KIT 11.25
MG
CETROTIDE
SUBCUTANEOUS KIT
0.25 MG
Drug Name
ST
PA
3
desoxycorticosterone ac
3
(bulk)
this table.
277
Drug Name
/Limits
PROLACTIN
INHIBITOR ERGOT
DERIVATIVE
DOPAMINE
RECEPTOR
AGONISTS
cabergoline
Drug Name
/Limits
THYROID
HORMONE
COMBINATIONS SYNTHETIC T3
AND T4
1
RANK LIGAND
(RANKL)
INHIBITOR, MC
ANTIBODY
PROLIA
3
XGEVA
3
3
raloxifene
2
SOMATOSTATIC
AGENTS
octreotide acetate
injection solution
4
octreotide acetate
injection syringe
3
SANDOSTATIN
1
SANDOSTATIN LAR
DEPOT
INTRAMUSCULAR
KIT
1
1
THYROLAR-1/2
1
THYROLAR-1/4
1
THYROLAR-2
1
THYROLAR-3
1
THYROID
HORMONES ANIMAL SOURCE
(PORCINE)
SELECTIVE
ESTROGEN
RECEPTOR
MODULATORS
(SERMS)
EVISTA
THYROLAR-1
PA
ARMOUR THYROID
3
NATURE-THROID
3
NP THYROID
3
powder 100 % 3 x usp
3
powder 100 % usp
1
WESTHROID ORAL
TABLET 130 MG, 195
MG, 32.5 MG, 65 MG,
97.5 MG
3
WP THYROID
3
THYROID
HORMONES SYNTHETIC T3
(TRIIODOTHYRO
NINE)
CYTOMEL
3
liothyronine (bulk)
3
liothyronine intravenous
4
liothyronine oral
1
3
PCCA T3 SODIUM
DILUTION
3
SIGNIFOR LAR
3
TRIOSTAT
4
SOMATULINE
DEPOT
3
SANDOSTATIN LAR
DEPOT
INTRAMUSCULAR
SUSPENSION,EXTEN
DED REL RECON
3
SIGNIFOR
this table.
278
Drug Name
/Limits
THYROID
HORMONES SYNTHETIC T4
(THYROXINE)
Drug Name
/Limits
GASTROINTEST
INAL THERAPY
AGENTS
levothyroxine (bulk)
1
levothyroxine
intravenous
4
levothyroxine oral
1
LEVOXYL ORAL
TABLET 100 MCG,
112 MCG, 125 MCG,
137 MCG, 150 MCG,
175 MCG, 200 MCG,
25 MCG, 50 MCG, 75
MCG, 88 MCG
1
PCCA T4 SODIUM
DILUTION
ANTACID ALGINATE
COMBINATIONS
FOAMING ANTACID
ORAL
TABLET,CHEWABLE
3
GAVISCON ORAL
TABLET,CHEWABLE
3
ANTACID ALUMINUM
3
1
(bulk) granules
3
SYNTHROID
3
TIROSINT
3
aluminum silicate mag
(bulk)
3
UNITHROID
1
ENZYMES
ENZYMES
ANTACID ANTACID
COMBINATIONS
ACID GONE
ANTACID
3
ACID GONE
ANTACID
E.STRENGTH
3
ALKA-SELTZER
GOLD
3
3
ALKA-SELTZER
HEARTBURN
3
3
ANTACID (CALCIUM
CARB-MAG HYD)
3
PAPAYA ENZYME
ORAL
TABLET,CHEWABLE
1
ANTACID EXST (CA
CARB-MAG HYD)
3
PINEAPPLE
EXTRACT
3
ANTACID EXST
(MAG CARB-AL
HYD)
3
VITRASE
3
ANTACID SUPREME
3
FOAMING ANTACID
EXTRA STRENGTH
3
bromelains
3
bromelains (bulk)
powder 1,200 unit/gram
3
carica papaya oral
tablet
3
carica papaya oral
tablet,chewable
1
HYLENEX
PAPAYA ENZYME
ORAL TABLET
this table.
279
Drug Name
/Limits
FOAMING ANTACID
ORAL SUSPENSION
3
GAVISCON EXTRA
STRENGTH
3
GAVISCON ORAL
SUSPENSION
3
HEARTBURN
ANTACID
Drug Name
/Limits
ANTACID
EXTRA-STRENGTH
ORAL
TABLET,CHEWABLE
200 MG CALCIUM
(500 MG), 300 MG
(750 MG)
1
3
ANTACID ORAL
TABLET,CHEWABLE
1
HEARTBURN RELIEF
3
MAG-AL
3
3
MI-ACID ORAL
TABLET,CHEWABLE
3
ANTACID ULTRA
STRENGTH ORAL
TABLET,CHEWABLE
1,177 MG
RIGINIC
3
ROLAIDS
3
1
SUPREME ANTACID
3
ANTACID ULTRA
STRENGTH ORAL
TABLET,CHEWABLE
400 MG (1,000 MG)
CALCIUM ANTACID
1
CALCIUM ANTACID
TROPICAL
1
CALCIUM ANTACID
ULTRA MAX ST
1
suspension
1
ANTACID BICARBONATE
sodium bicarbonate
(bulk) oral
3
sodium bicarbonate oral
3
ANTACID CALCIUM
ALCALAK
3
ANTACID CALCIUM
ORAL
TABLET,CHEWABLE
215 MG CALCIUM
(500 MG)
(648 mg)
3
3
1
ANTACID EXT STR
(CALCIUM CARB)
calcium (500 mg), 400
mg (1,000 mg)
1
ANTACID
EXTRA-STRENGTH
ORAL
TABLET,CHEWABLE
168 MG (420 MG)
(750 mg)
3
3
CAL-GEST ANTACID
1
CHILDREN'S PEPTO
3
CHILDREN'S
SOOTHE
3
FLAVOR CHEWS
ANTACID
3
PRELIEF
1
SMOOTH ANTACID
1
this table.
280
Drug Name
/Limits
TUMS
3
TUMS E-X
Drug Name
/Limits
3
3
ANTACID PLUS
ANTI-GAS
TUMS EXTRA
STRENGTH
SMOOTHIES
3
3
ANTACID REGULAR
STRENGTH
3
TUMS FRESHERS
3
ANTACID WITH
SIMETHICONE
TUMS ULTRA
3
ANTACID-ANTIGAS
3
ULTRA STRENGTH
ANTACID
1
ANTACID-SIMETHIC
ONE
3
ULTRA STRENGTH
CALCIUM ANTACID
COMFORT GEL
3
1
COMFORT GEL
EXTRA STRENGTH
3
E-Z-GAS II
3
FLANAX ANTACID
3
GELUSIL ANTACID
AND ANTI-GAS
ORAL
TABLET,CHEWABLE
3
GERI-LANTA
3
GERI-MOX
ANTACID-ANTIGAS
1
ANTACID MAGNESIUM
PHILLIPS MILK OF
MAGNESIA ORAL
TABLET,CHEWABLE
1
RI-MAG
3
ANTACID SIMETHICONE
COMBINATIONS
ADVANCED
ANTACID-ANTIGAS
3
LIQUID ANTACID
3
ALMACONE
3
3
ALMACONE-2
3
MAALOX
ADVANCED
ANTACID ANTI-GAS
3
3
ANTACID ANTI-GAS
(CA CARB-SIM)
MAALOX MAXIMUM
STRENGTH
3
MAG-AL PLUS
1
ANTACID ANTI-GAS
DOUBLE STR
3
MAG-AL PLUS
EXTRA STRENGTH
3
ANTACID
EXTRA-STRENGTH
ORAL SUSPENSION
3
3
MASANTI DOUBLE
STRENGTH
3
ANTACID LIQUID
3
MI-ACID ORAL
SUSPENSION
ANTACID M
3
MINTOX
3
ANTACID MAXIMUM
STRENGTH
3
MINTOX MAXIMUM
STRENGTH
3
ANTACID
MULTI-SYMPTOM
MINTOX PLUS
3
3
RI-GEL
3
ANTACID ORAL
SUSPENSION
3
RI-GEL II
3
RI-MAG PLUS
3
this table.
281
Drug Name
/Limits
RI-MOX
3
RI-MOX PLUS
RULOX
1
3
3
DIOTAME
1
GERI-PECTATE
3
KAOPECTATE
(BISMUTH
SUBSALICY)
1
KAOPECTATE
CHILD(BIS
SSALICYL)
3
KAOPECTATE EX
STR (BISMUTH SS)
1
KAO-TIN (BISMUTH
SUBSALICYLAT)
1
K-PEC
ANTIDIARRHEAL
(BISM SUB)
1
PEPTIC RELIEF
1
PEPTO-BISMOL
1
3
ANTIDIARRHEAL
- ANTIPERISTALTI
C AGENTS
ANTI-DIARRHEA
/Limits
DIARRHEA RELIEF
(BISMUTH SUBS)
ANTACID
COMBINATIONS
OTHER
DEWEE'S
CARMINATIVE
Drug Name
1
ANTI-DIARRHEAL
(LOPERAMIDE)
ORAL CAPSULE
3
ANTI-DIARRHEAL
(LOPERAMIDE)
ORAL LIQUID
1
ANTI-DIARRHEAL
(LOPERAMIDE)
ORAL TABLET
1
PEPTO-BISMOL MAX
ST
1
DIAMODE
1
1
IMODIUM A-D ORAL
LIQUID
PEPTO-BISMOL
TO-GO
1
PINK BISMUTH
1
IMODIUM A-D ORAL
TABLET
1
1
loperamide oral capsule
3
PINK BISMUTH
MAXIMUM
STRENGTH
loperamide oral liquid
1
1
loperamide oral tablet
3
SOOTHE (BISMUTH
SUBSALICYLATE)
ORAL TABLET
opium tincture
3
paregoric
3
SOOTHE (BISMUTH
SUBSALICYLATE)
ORAL
TABLET,CHEWABLE
3
SOOTHE REGULAR
STRENGTH
1
STOMACH RELIEF
1
ANTIDIARRHEAL
- BISMUTH
AGENTS
ANTI-DIARRHEAL
3
BISMATROL
1
BISMUTH
1
STOMACH RELIEF
MAX STRENGTH
1
BISMUTH MAXIMUM
STRENGTH
1
STOMACH RELIEF
ORIGINAL
1
this table.
282
Drug Name
/Limits
ANTIDIARRHEAL
ANTIPERISTALTI
C-ANTICHOLINER
GIC
COMBINATIONS
Drug Name
/Limits
ANTIDIARRHEAL
MISCELLANEOUS
COMBINATIONS
BANATROL PLUS
3
diphenoxylate-atropine
1
LOMOTIL
3
ANTIEMETIC ANTICHOLINERGI
CS
MOTOFEN
3
scopolamine hbr
1
TRANSDERM-SCOP
3
ANTIDIARRHEAL
ANTIPERISTALTI
C-ANTIFLATULEN
T COMBINATIONS
ANTIEMETIC ANTIHISTAMINES
ANTIVERT ORAL
TABLET 12.5 MG, 25
MG
3
BONINE
3
dimenhydrinate (bulk)
3
dimenhydrinate
injection solution
3
dimenhydrinate oral
3
DRAMAMINE LESS
DROWSY
1
ANTIDIARRHEAL
GI
ADSORBENT-INTE
STINAL FLORA
MODIFIERS
COMBINATIONS
DRAMAMINE ORAL
TABLET,CHEWABLE
25 MG
3
DRIMINATE
3
meclizine oral tablet
12.5 mg, 25 mg
1
ACIDOPHILUS-PECTI
N ORAL CAPSULE 75
MILLION CELL -100
MG
meclizine oral
tablet,chewable
1
MEDI-MECLIZINE
1
MOTION RELIEF
(MECLIZINE)
1
MOTION SICKNESS
3
MOTION SICKNESS
(MECLIZINE)
1
MOTION SICKNESS II
1
MOTION SICKNESS
RELIEF
3
MOTION SICKNESS
RELIEF II
1
ANTI-DIARRHEAL
(LOPE)-ANTI-GAS
IMODIUM
MULTI-SYMPTOM
RELIEF ORAL
TABLET
1
1
ANTIDIARRHEAL
GI ADSORBENT
MIXTURES
kaolin-pectin
3
1
ACIDOPHILUS-PECTI
N ORAL
TABLET,CHEWABLE
3
KALA
3
RISAQUAD
1
RISAQUAD-2
1
this table.
283
Drug Name
/Limits
MOTION SICKNESS
RELIEF(MECLIZ)
1
MOTION-TIME
3
TRAVEL SICKNESS
Drug Name
/Limits
prochlorperazine
edisylate
1
3
3
prochlorperazine
edisylt(bulk)
TRAVEL SICKNESS
(MECLIZINE)
1
prochlorperazine
maleate oral
1
WAL-DRAM
3
promethazine (bulk)
1
promethazine injection
solution
1
promethazine oral
1
promethazine rectal
suppository 12.5 mg, 25
mg
1
promethazine rectal
suppository 50 mg
3
PROMETHEGAN
1
ANTIEMETIC ANTIHISTAMINEVITAMIN
COMBINATIONS
DICLEGIS
3
ANTIEMETIC CANNABINOIDS
CESAMET
2
dronabinol
3
MARINOL
3
ANTIEMETIC DOPAMINE
(D2)/5-HT3
ANTAGONISTS
TIGAN
INTRAMUSCULAR
1
TIGAN ORAL
CAPSULE 300 MG
3
trimethobenzamide
(bulk)
3
trimethobenzamide oral
1
ANTIEMETIC OTHER
cola (syrup)
1
ANTIEMETIC PHENOTHIAZINES
COMPAZINE
3
COMPRO
1
PHENADOZ
1
PHENERGAN
3
prochlorperazine
1
PA
ANTIEMETIC PHOSPHORATED
CARBOHYDRATE
S
ANTI-NAUSEA
3
EMETROL
3
FORMULA EM
3
NAUSEA CONTROL
3
NAUSEA RELIEF
3
ANTIEMETIC SELECTIVE
SEROTONIN 5-HT3
ANTAGONISTS
ALOXI
4
ANZEMET
INTRAVENOUS
4
ANZEMET ORAL
2
granisetron (pf)
4
granisetron hcl
intravenous
4
granisetron hcl oral
2
ondansetron
1
ondansetron hcl (bulk)
3
PA
PA
PA
this table.
284
Drug Name
/Limits
Drug Name
/Limits
ondansetron hcl (pf)
3
ondansetron hcl
intravenous
4
DIGESTIVE
ENZYME
MIXTURES
ondansetron hcl oral
1
CREON
1
SANCUSO
3
ZOFRAN (AS
HYDROCHLORIDE)
INTRAVENOUS
3
4
ENZYMATIC
DIGESTANT ORAL
TABLET EXTENDED
RELEASE
PANCREAZE
3
PERTZYE
3
VIOKACE
3
3
ZOFRAN (AS
HYDROCHLORIDE)
ORAL
3
ZOFRAN ODT
3
ZENPEP
ZUPLENZ
3
DIGESTIVE
ENZYMES
ANTIEMETIC SUBSTANCE
P-NEUROKININ 1
(NK1) RECEPTOR
ANTAGONISTS
EMEND
INTRAVENOUS
4
EMEND ORAL
2
ANTIEMETIC SUBSTANCE
P-NEUROKININ 1
AND 5-HT3
RECEPT
ANTAGONIST
COMB
AKYNZEO
3
BILE ACIDS
CHOLBAM
3
COLONIC
ACIDIFIER
(AMMONIA
INHIBITOR)
PA
cellulase (bulk) powder
5,000 unit/gram
3
DAIRY AID
1
DAIRY DIGESTIVE
1
DAIRY DIGESTIVE
SUPPLEMENT
1
DAIRY RELIEF
1
digestive enzymes
1
DIGESTIVE
ENZYMES(MAL,LAC,
INV)
3
ENZYME DIGEST
3
LAC-DOSE
1
LACTAID FAST ACT
3
lactase
1
lactase (bulk)
3
LACTASE ENZYME
3
LACTASE FAST
ACTING
1
1
ENULOSE
1
LACTOSE FAST
ACTING RELIEF
GENERLAC
1
SUCRAID
1
lactulose oral solution
10 gram/15 ml
1
ULTRA DAIRY
DIGESTIVE
1
this table.
285
Drug Name
/Limits
GALLSTONE
SOLUBILIZING
(LITHOLYSIS)
AGENTS
Drug Name
/Limits
HEARTBURN RELIEF
(CIMETIDINE)
3
HEARTBURN RELIEF
(FAMOTIDINE)
1
1
ACTIGALL
3
CHENODAL
3
HEARTBURN RELIEF
(RANITIDINE)
URSO 250
3
nizatidine oral capsule
2
URSO FORTE
3
nizatidine oral solution
3
ursodiol (bulk)
1
PEPCID
3
ursodiol oral capsule
1
1
ursodiol oral tablet
3
PEPCID AC ORAL
TABLET 10 MG
PEPCID AC ORAL
TABLET 20 MG
3
ranitidine hcl
1
TAGAMET HB
1
WAL-ZAN 150
1
WAL-ZAN 75
1
ZANTAC 75
1
ZANTAC INJECTION
1
ZANTAC MAXIMUM
STRENGTH
1
3
GASTRIC ACID
SECRETION
REDUCERS HISTAMINE
H2-RECEPTOR
ANTAGONISTS
PA
ACID CONTROL
(RANITIDINE) ORAL
TABLET 150 MG
1
ACID CONTROLLER
1
ACID REDUCER
(CIMETIDINE)
1
ZANTAC ORAL
TABLET
ACID REDUCER
(FAMOTIDINE)
1
ACID REDUCER
(RANITIDINE)
1
ACID RELIEF
(CIMETIDINE)
1
GASTRIC ACID
SECRETION
REDUCING
AGENTS PROTON PUMP
INHIBITORS (PPIS)
cimetidine
1
ACIPHEX
3
cimetidine hcl oral
1
ACIPHEX SPRINKLE
2
PA
famotidine (bulk)
3
DEXILANT
2
PA
famotidine (pf)
4
esomeprazole
magnesium
1
esomeprazole sodium
4
HEARTBURN
TREATMENT 24
HOUR
3
lansoprazole (bulk)
3
famotidine (pf)-nacl
(iso-os)
4
famotidine intravenous
4
famotidine oral
1
HEARTBURN
PREVENTION
1
PA
this table.
286
Drug Name
lansoprazole oral
capsule,delayed
/Limits
3
lansoprazole oral
capsule,delayed
2
NEXIUM
3
NEXIUM 24HR
3
NEXIUM IV
INTRAVENOUS
RECON SOLN 40 MG
4
NEXIUM PACKET
3
omeprazole
1
omeprazole (bulk)
1
omeprazole magnesium
3
pantoprazole oral
1
PREVACID
3
PREVACID 24HR
1
PREVACID SOLUTAB
3
PRILOSEC ORAL
CAPSULE,DELAYED
RELEASE(DR/EC)
3
PRILOSEC ORAL
SUSP,DELAYED
RELEASE FOR
RECON
2
PRILOSEC OTC
PA
PA
PA
Drug Name
/Limits
ACID REDUCER
COMPLETE (FAMOT)
3
COMPLETE ORAL
TABLET,CHEWABLE
3
DUAL ACTION
COMPLETE
3
PEPCID COMPLETE
3
TUMS DUAL ACTION
(FAMOTIDINE)
3
GASTRIC ACID
SECRETION
REDUCINGPROTON PUMP
INHIBITOR &
ANTACID COMB.
PA
omeprazole-sodium
bicarbonate
3
ZEGERID
3
ZEGERID OTC
3
GASTRIC
MUCOSA CYTOPROTECTIV
E
PROSTAGLANDIN
ANALOGS
CYTOTEC
3
3
misoprostol
1
PROTONIX
INTRAVENOUS
4
PROTONIX ORAL
3
GASTROINTESTIN
AL - PROKINETIC
AGENTS - OTHER
rabeprazole
3
GASTRIC ACID
SECRETION
REDUCING- H2
ANTAGONIST &
ANTACID
COMBINATIONS
ACID CONTROLLER
COMPLETE
dexpanthenol (bulk)
liquid
3
GASTROINTESTIN
AL
ANTIFLATULENT
S
3
ANTI-GAS
3
ANTI-GAS
MAXIMUM
STRENGTH
3
this table.
287
Drug Name
/Limits
Drug Name
TOXIN CONTROL
/Limits
ANTI-GAS ULTRA
STRENGTH
1
3
BEANO ORAL
TABLET
1
BEANO ORAL
TABLET,DISINTEGR
ATING
3
GASTROINTESTIN
AL PROKINETIC
AGENTS - D2
ANTAGONIST/5-H
T4 AGONISTS
BICARSIM
1
metoclopramide hcl
injection
1
BICARSIM FORTE
1
GAS RELIEF
1
metoclopramide hcl oral
solution
1
GAS RELIEF 80
1
1
GAS RELIEF EXTRA
STRENGTH
tablet
1
GAS RELIEF ULTRA
STRENGTH
3
1
mg
GAS-X EXTRA
STRENGTH
1
3
GAS-X ORAL STRIP
3
METOZOLV ODT
ORAL
TABLET,DISINTEGR
ATING 5 MG
GAS-X ORAL
TABLET,CHEWABLE
1
REGLAN ORAL
3
GAS-X
ULTRA-STRENGTH
1
INFANTS GAS
RELIEF
1
GI
ANTISPASMODIC BELLADONNA
ALKALOIDS
MI-ACID GAS RELIEF
1
MYTAB GAS
ANASPAZ
3
1
atropine injection
solution
1
MYTAB GAS
MAXIMUM
STRENGTH
1
atropine injection
syringe 0.05 mg/ml
3
PHAZYME ORAL
CAPSULE 180 MG
3
1
belladonna alk leaf ext
(bulk)
PHAZYME ORAL
CAPSULE 250 MG
1
3
belladonna tincture
(bulk)
ED-SPAZ
1
simethicone
3
simethicone oral
capsule
1
3
homatropine
methylbrom (bulk)
hyoscyamine sulfate
1
simethicone oral
drops,suspension
1
HYOSYNE
1
simethicone oral
tablet,chewable
LEVBID
3
1
LEVSIN INJECTION
1
this table.
288
Drug Name
/Limits
LEVSIN ORAL
3
LEVSIN/SL
Drug Name
/Limits
1
3
dicyclomine oral
capsule
methscopolamine nitrate
(bulk)
3
dicyclomine oral
solution
1
methscopolamine oral
1
dicyclomine oral tablet
1
NULEV
3
OSCIMIN
1
OSCIMIN SL
1
GI
ANTISPASMODIC
COMBINATIONS
OTHER
OSCIMIN SR
1
scopolamine hbr
1
SYMAX DUOTAB
3
SYMAX FASTABS
1
SYMAX-SL
1
SYMAX-SR
1
GI
ANTISPASMODIC QUATERNARY
AMMONIUM
COMPOUNDS
belladonna
alkaloids-opium
3
BELLADONNA-OPIU
M
3
BELLADONNA-PHEN
OBARBITAL
NF
chlordiazepoxide-clidini
um
NF
DONNATAL ORAL
ELIXIR 16.2-0.1037
-0.0194 MG/5 ML
3
3
CANTIL
1
DONNATAL ORAL
TABLET
clidinium bromide
(bulk)
3
LIBRAX (WITH
CLIDINIUM)
glycopyrrolate injection
1
glycopyrrolate oral
1
phenobarb-hyoscy-atrop
ine-scop oral tablet
propantheline
1
ROBINUL FORTE
1
ROBINUL INJECTION
3
ROBINUL ORAL
1
GI
ANTISPASMODIC SYNTHETIC
TERTIARY
AMINES
3
BENTYL ORAL
CAPSULE
3
1
IBS AGENT GASTROINTESTIN
AL CHLORIDE
CHANNEL
ACTIVATOR
AGENTS
AMITIZA
BENTYL
INTRAMUSCULAR
NF
3
PA
2
PA
IBS AGENT GUANYLATE
CYCLASE-C
(GC-C) AGONISTS
LINZESS
BENTYL ORAL
3
TABLET
this table.
289
Drug Name
/Limits
IBS AGENT SELECTIVE 5-HT3
RECEPTOR
ANTAGONISTS
alosetron
1
LOTRONEX
3
PA
INFLAMMATORY
BOWEL AGENT AMINOSALICYLA
TES AND
RELATED
AGENTS
Drug Name
/Limits
CORTENEMA
3
CORTIFOAM
1
ENTOCORT EC
1
hydrocortisone rectal
enema
1
UCERIS ORAL
3
INFLAMMATORY
BOWEL AGENT INTEGRIN
RECEPTOR
ANTAGONIST, MC
ANTIBODY
APRISO
3
ENTYVIO
ASACOL HD
1
AZULFIDINE
3
AZULFIDINE
EN-TABS
3
balsalazide
2
CANASA
1
INFLAMMATORY
BOWEL AGENT TUMOR
NECROSIS
FACTOR ALPHA
BLOCKERS
COLAZAL
3
DELZICOL
1
DIPENTUM
1
GIAZO
2
LIALDA
PA
4
CIMZIA
3
PA
CIMZIA POWDER
FOR RECONST
3
PA
CIMZIA STARTER
KIT
3
PA
3
HUMIRA
2
PA
mesalamine rectal
1
mesalamine with
cleansing wipe
2
PA
3
HUMIRA PEDIATRIC
CROHN'S START
REMICADE
4
PENTASA
3
ROWASA
3
SFROWASA
3
INTESTINAL
FLORA
MODIFIERS
sulfasalazine
1
ACIDOPHILUS
3
SULFAZINE
1
ACIDOPHILUS EX
STR (L. SPOROG)
1
ACIDOPHILUS
PROBIOTIC
3
ACIDOPHILUS
PROBIOTIC BLEND
1
acidophilus-pectin,
citrus
1
INFLAMMATORY
BOWEL AGENT GLUCOCORTICOI
DS
budesonide oral
1
COLOCORT
3
PA
this table.
290
Drug Name
/Limits
ADULT 50+
PROBIOTIC
3
ADULT PROBIOTIC
Drug Name
/Limits
FLORASTOR
1
FLORASTOR KIDS
1
3
GERBER SOOTHE
3
ADVANCED
PROBIOTIC
3
INTESTINEX
3
ALIGN
3
l.acidoph,saliva-b.bif-s.t
herm
1
BACID
1
BIOGAIA ORAL OIL
IN STRAW
3
3
l.acidophilus-bifido.long
um
LACTINEX
1
BIOGAIA ORAL
TABLET,CHEWABLE
3
3
BIOGAIA PROTECTIS
3
(bulk) powder 1 billion
unit/gram
lactobacillus
acidophilus oral capsule
, 100 million cell
3
lactobacillus
acidophilus oral tablet 1
billion cell, 500 million
cell
1
lactobacillus
acidophilus oral tablet 1
mg (100 million cell), 2
billion cell
3
CHILDREN'S
CHEWABLE
PROBIOTIC
3
CULTURELLE
3
CULTURELLE
IMMUNE DEFENSE
3
CULTURELLE KIDS
PROBIOTICS
3
CULTURELLE
PROBIOTICS
3
DIFF-STAT ORAL
POWDER IN PACKET
3
lactobacillus
acidophilus oral wafer
3
DIGEST PROBIOTIC
(S.BOULARDII)
3
lactobacillus acidoph-l.
bifid
3
METABIOTIC
3
MORE-DOPHILUS
3
ONE-A-DAY
TRUBIOTICS ORAL
CAPSULE
1
DIGESTIVE
PROBIOTIC ORAL
CAPSULE 1.5
BILLION CELL, 10
BILLION CELL
3
DIGESTIVE
PROBIOTIC ORAL
CAPSULE, SPRINKLE
3
PHILLIPS' COLON
HEALTH
1
FLORAJEN
3
PRE B2
3
FLORAJEN
BIFIDOBLEND
3
PREORBOTIC
3
PROBIOTIC
3
FLORAJEN3
1
PROBIOTIC 4X
3
FLORAJEN4KIDS
1
FLORANEX
1
PROBIOTIC
ACIDOPHILUS
BEADS
3
this table.
291
Drug Name
/Limits
PROBIOTIC
ACIDOPHILUS-PECTI
N
3
PROBIOTIC AND
ACIDOPHILUS
3
PROBIOTIC COLON
CARE
3
PROBIOTIC COLON
SUPPORT ORAL
CAPSULE 240 MG (3
BILLION CELL)
3
PROBIOTIC
COMPLEX
3
PROBIOTIC
COMPLEX (INULIN)
3
PROBIOTIC
DIGESTIVE CARE
3
PROBIOTIC
DIGESTIVE SYSTEM
SUP
Drug Name
/Limits
IRRITABLE
BOWEL
SYNDROME (IBS)
AGENTS
alosetron
1
PA
LINZESS
2
PA
LOTRONEX
3
KERATINOCYTE
GROWTH
FACTOR (KGF)
KEPIVANCE
4
LAXATIVE - BULK
FORMING
BENEFIBER CLEAR
SF (DEXTRIN)
3
3
BENEFIBER SUGAR
FREE (DEXTRIN)
ORAL POWDER 3
GRAM/3.8 GRAM
3
PROBIOTIC
FORMULA (INULIN)
3
BEST FIBER
3
PROBIOTIC PEARLS
3
CHILD'S FIBER
SELECT GUMMIES
3
PROBIOTIC PEARLS
COMPLETE
3
CITRUCEL
3
PROBIOTIC WITH
PREBIOTIC
3
3
CITRUCEL SUGAR
FREE
COLOX
1
PROVELLA
1
RESTORA RX
3
RISA-BID
1
3
SENIOR PROBIOTIC
1
DAILY FIBER
(PSYLLIUM-SUCROS
E) ORAL POWDER 3.4
GRAM/7 GRAM
SUPER PROBIOTIC
3
EASY FIBER (WHEAT
DEXTRIN)
3
ULTRA FLORA PLUS
3
VSL#3
1
EASY FIBER ORAL
POWDER
1
VSL#3 DS
3
EQUALACTIN
1
VSL#3 JUNIOR
3
EVAC
3
FIBER
1
FIBER (CALCIUM
POLYCARBOPHIL)
3
FIBER (DEXTRIN)
1
this table.
292
Drug Name
/Limits
FIBER (PSYLLIUM
HUSK)
3
FIBER (PSYLLIUM
HUSK/SUGAR)
1
FIBER (WITH
ASPARTAME)
1
FIBER CHOICE
(INULIN)
3
FIBER LAXATIVE
(CA POLYCARBO)
3
FIBER LAXATIVE
(HUSK/SUGAR)
1
FIBER LAXATIVE
(METHYLCELLULO)
3
FIBER LAXATIVE
(PS.SEED/SUGAR)
3
FIBER LAXATIVE
(PSYLLIUM HUSK)
3
FIBER LAXATIVE
(PSYLLIUM) S/F
1
FIBER SELECT
GUMMIES
3
FIBER SMOOTH
1
FIBER SMOOTH
(SUCROSE)
1
FIBER SUPPLEMENT
(INULIN)
1
FIBER THERAPY
3
FIBER THERAPY (CA
POLYCARBOPH)
3
FIBER THERAPY
(PSYLLIUM SEED)
1
FIBER THERAPY
(PSYLLIUM)
1
FIBER THERAPY
LAXATIVE (HUSK)
3
FIBER THERAPY
SUGAR FREE
3
FIBER-CAPS
3
FIBERCON
3
Drug Name
/Limits
FIBER-LAX
3
FIBER-STAT
3
FIBER-TABS
3
GERI-MUCIL
1
HYDROCIL
1
HYDROCIL INSTANT
1
HYFIBER WITH FOS
3
KONSYL (SUGAR)
ORAL POWDER
3
KONSYL (SUGAR)
ORAL POWDER IN
PACKET
1
KONSYL EASY MIX
1
KONSYL FIBER
3
KONSYL
FORMULA-D
1
KONSYL
SUGAR-FREE
3
KONSYL
SUGAR-FREE
(ASPARTAME)
3
LIQUAFIBER ORAL
LIQUID
3
METAMUCIL (WITH
SUGAR) ORAL
POWDER 3.4
GRAM/12 GRAM
3
METAMUCIL (WITH
SUGAR) ORAL
POWDER 3.4 GRAM/7
GRAM
1
METAMUCIL (WITH
SUGAR) ORAL
POWDER IN PACKET
3
METAMUCIL FIBER
SINGLES
1
METAMUCIL
MULTIHEALTH
FIBER
1
METAMUCIL ORAL
CAPSULE
3
this table.
293
Drug Name
/Limits
METAMUCIL ORAL
POWDER
1
METAMUCIL ORAL
WAFER
3
METAMUCIL PLUS
CALCIUM
1
METAMUCIL
SUGAR-FREE
(ASPART) ORAL
POWDER 3.3
GRAM/5.95 GRAM
3
METAMUCIL
SUGAR-FREE
(ASPART) ORAL
POWDER 3.4
GRAM/5.8 GRAM
1
NATURAL DAILY
FIBER
3
NATURAL FIBER
LAXATIVE
3
NATURAL FIBER
LAXATIVE (SUGAR)
ORAL POWDER , 3.4
GRAM/11 GRAM, 3.4
GRAM/7 GRAM
1
NATURAL FIBER
LAXATIVE (SUGAR)
ORAL POWDER 3.4
GRAM/12 GRAM
3
NATURAL FIBER
LAXATIVE SMOOTH
1
NATURAL FIBER
LAXATIVE THERAPY
1
NATURAL FIBER
LAXATIVE(ASPART)
ORAL POWDER
1
NATURAL FIBER
SUPPLEMENT ORAL
POWDER IN PACKET
3
NATURAL
PSYLLIUM FIBER
1
NATURAL
VEGETABLE
1
Drug Name
/Limits
NATURAL
VEGETABLE
(PSYLLIUM)
1
NATURAL
VEGETABLE
POWDER
3
NUTRISOURCE
FIBER
1
psyllium husk
3
psyllium husk (bulk)
3
REGULOID ORAL
CAPSULE
3
REGULOID ORAL
POWDER
1
REGULOID, SUGAR
FREE
1
SOLUBLE FIBER
3
UNIFIBER
1
WAL-MUCIL FIBER
3
WAL-MUCIL FIBER
(ASPARTAME)
3
WAL-MUCIL FIBER
(SUGAR)
3
WAL-MUCIL
NATURAL FIBER
LAX
1
WAL-MUCIL WITH
CALCIUM
3
LAXATIVE LUBRICANT
ENEMA RECTAL
ENEMA
1
FLEET MINERAL OIL
1
KONDREMUL
3
MINERAL OIL
EXTRA HEAVY
ORAL
1
MINERAL OIL
HEAVY ORAL
1
MINERAL OIL
1
LAXATIVE
this table.
294
Drug Name
/Limits
mineral oil oral
1
mineral oil rectal
3
READY-TO-USE
ENEMA (MIN OIL)
3
LAXATIVE SALINE AND
OSMOTIC
Drug Name
/Limits
magnesium citrate oral
solution
1
MILK OF MAGNESIA
1
MILK OF MAGNESIA
CONCENTRATED
3
MIRALAX
3
PEDIA-LAX ORAL
1
PEDIA-LAX RECTAL
3
PEG3350
3
PHILLIPS MILK OF
MAGNESIA ORAL
SUSPENSION 400
MG/5 ML
1
1
CHILD
SUPPOSITORY
1
CITRATE OF
MAGNESIA
1
CITROMA
1
CLEARLAX ORAL
POWDER
3
CONSTULOSE
1
polyethylene glycol
3350 oral
EPSOM SALT ORAL
3
POWDERLAX
3
FLEET GLYCERIN
(ADULT)
1
PURELAX
3
SANI-SUPP (ADULT)
1
FLEET GLYCERIN
(CHILD)
1
SANI-SUPP (INFANT)
1
SMOOTHLAX
3
FLEET GLYCERIN
LAXATIVE
3
sorbitol solution 70 %
1
GAVILAX ORAL
POWDER
3
SUPPOSITORY
ADULT
1
GENTLELAX
3
glycerin (adult)
1
glycerin (child)
1
GLYCOLAX ORAL
POWDER
3
HEALTHYLAX
3
KRISTALOSE
1
lactulose oral solution
10 gram/15 ml, 20
gram/30 ml
LAXATIVE SALINE/OSMOTIC
MIXTURES
COLYTE WITH
FLAVOR PACKS
ORAL RECON SOLN
240-22.72-6.72 -5.84
GRAM
3
DISPOSABLE ENEMA
1
1
ENEMA DISPOSABLE
1
LAXA CLEAR
3
1
LAXATIVE
(GLYCERIN-PEDIAT
RIC)
ENEMA RECTAL
ENEMA 19-7
GRAM/118 ML
1
FLEET ENEMA
1
FLEET PEDIATRIC
1
LAXATIVE PEG 3350
ORAL POWDER
3
GAVILYTE-C
3
GAVILYTE-G
1
this table.
295
Drug Name
/Limits
GAVILYTE-N
1
GOLYTELY
3
MOVIPREP
1
NULYTELY WITH
FLAVOR PACKS
1
Drug Name
/Limits
LAXATIVE STIMULANT &
SURFACTANT
COMBINATIONS
DOC-Q-LAX
3
DOK PLUS
3
ORAL SALINE
LAXATIVE ORAL
LIQUID
1
LAXACIN
3
OSMOPREP
3
LAXATIVE PLUS
STOOL SOFTENER
3
peg 3350-electrolytes
1
MEDI-LAXX
3
PEG-3350 WITH
FLAVOR PACKS
1
P-COL RITE
3
PERI-COLACE
3
peg-electrolyte soln
1
SENEXON-S
3
PHOSPHATE
LAXATIVE ORAL
LIQUID
1
SENNA LAXATIVE
ORAL TABLET 8.6-50
MG
3
PHOSPHATE
LAXATIVE ORAL
SOLUTION
3
SENNA PLUS
3
3
PREPARATION
CLEANSING
SENNA WITH
DOCUSATE SODIUM
3
SENNALAX-S
3
READY-TO-USE
ENEMA
SENNA-S
3
1
SENNA-TIME S
3
SUPREP BOWEL
PREP KIT
1
sennosides-docusate
sodium
3
TRILYTE WITH
FLAVOR PACKETS
3
SENOKOT-S
3
STIMULANT
LAXATIVE PLUS
3
STOOL
SOFTENER-LAXATIV
E
3
STOOL
SOFTENER-STIMULA
NT LAXAT
3
PA
BULK FORMING
COMBINATIONS
SENNA PROMPT
3
SALINE/OSMOTIC
COMBINATIONS
LAXATIVE STIMULANT
GAVILYTE-H AND
BISACODYL
1
PEG-PREP
3
PREPOPIK
2
PA
ALOPHEN
1
aromatic cascara fld xt
(bulk)
3
BISAC-EVAC
1
this table.
296
Drug Name
/Limits
bisacodyl oral
1
bisacodyl rectal
1
BISA-LAX
1
BISCOLAX
Drug Name
/Limits
NATURAL
VEGETABLE
LAXATIVE
3
1
PERDIEM
OVERNIGHT RELIEF
1
castor oil oral oil , 100
%
1
SENEXON
1
CHOCOLATE
LAXATIVE
SENNA LAX
1
1
CORRECTOL
1
SENNA LAXATIVE
ORAL TABLET 25
MG, 8.6 MG
1
DUCODYL
1
senna leaf
3
DULCOLAX
(BISACODYL)
1
SENNA ORAL
CAPSULE
3
EVAC-U-GEN
(SENNOSIDES)
3
SENNA ORAL SYRUP
1
EX-LAX
(SENNOSIDES)
1
SENNA ORAL
TABLET
1
EX-LAX MAXIMUM
STRENGTH
SENNA-EXTRA
1
1
SENNA-GEN
1
FLEET BISACODYL
3
SENNO
1
FLEET LAXATIVE
1
SENOKOT
1
GENTLE LAXATIVE
1
SENOKOTXTRA
1
GERI-KOT
1
SEN-O-TAB
3
LAXATIVE
(BISACODYL)
THE MAGIC BULLET
1
1
1
LAXATIVE
(SENNOSIDES)
VEGETABLE
LAXATIVE
1
1
LAXATIVE
FEMININE
WOMAN'S
LAXATIVE
1
1
LAXATIVE
MAXIMUM
STRENGTH
WOMEN'S GENTLE
LAXATIVE(BISAC)
1
1
LAXATIVE PILLS
1
WOMEN'S
LAXATIVE
(BISACODYL)
LAXATIVE PILLS
REGULAR
1
LAXATIVE SURFACTANT
NATURAL
LAXATIVE
1
NATURAL VEG
LAXATIVE(SENNOSI
D)
3
COLACE CLEAR
3
COLACE ORAL
CAPSULE 100 MG
1
COL-RITE
1
DIOCTO
1
this table.
297
Drug Name
/Limits
Drug Name
/Limits
DIOCTYL
3
DOC-Q-LACE
1
DOCU
1
LAXATIVE
COMBINATIONS OTHER
DOCUPRENE
1
CEO-TWO
docusate calcium
1
docusate sodium (bulk)
3
docusate sodium oral
capsule
1
PEPTIC ULCER GASTRIC LUMEN
ADHERENT
CYTOPROTECTIV
ES
liquid
1
CARAFATE ORAL
SUSPENSION
1
tablet
1
CARAFATE ORAL
TABLET
3
DOCUSIL
1
sucralfate oral tablet
1
DOCUSOL
1
DOCUSOL KIDS
3
DOCUSOL PLUS
3
DOK
1
DSS
1
PEPTIC ULCER TREATMENT OF
H. PYLORI:
ANTIBIOTIC-BISM
UTH
COMBINATIONS
DULCOLAX STOOL
SOFTENER (DSS)
1
ENEMEEZ
1
ENEMEEZ PLUS
1
KAOPECTATE
(DOCUSATE
CALCIUM)
3
KAO-TIN
(DOCUSATE
CALCIUM)
1
PEDIA-LAX STOOL
SOFTENER
1
PHILLIPS
LIQUI-GELS
1
PROMOLAXIN
1
SILACE
1
SOF-LAX
1
STOOL SOFTENER
1
SURFAK
1
WOMEN'S STOOL
SOFTENER
1
PYLERA
3
3
PEPTIC
ULCER-TREATME
NT H. PYLORI PROTON PUMP
INHIBITOR &
ANTIBIOTICS
amoxicil-clarithromy-la
nsopraz
3
OMECLAMOX-PAK
3
PREVPAC
3
SHORT BOWEL
SYNDROME (SBS) GLUCAGON-LIKE
PEPTIDE-2 (GLP-2)
ANALOG
GATTEX 30-VIAL
3
GATTEX ONE-VIAL
3
this table.
298
Drug Name
/Limits
SHORT BOWEL
SYNDROME (SBS)
AGENTS
Drug Name
G.U. IRRIGANTS ANTI-INFECTIVE
neomycin-polymyxin b
gu
3
3
GLUTAMENT
3
NUTRESTORE
3
octreotide acetate
injection solution
NEOSPORIN GU
IRRIGANT
4
G.U. IRRIGANTS
octreotide acetate
injection syringe
3
SANDOSTATIN
1
SANDOSTATIN LAR
DEPOT
INTRAMUSCULAR
KIT
1
SANDOSTATIN LAR
DEPOT
INTRAMUSCULAR
SUSPENSION,EXTEN
DED REL RECON 10
MG, 20 MG
3
ZORBTIVE
4
acetic acid irrigation
3
glycine irrigation
3
GLYCINE UROLOGIC
3
RENACIDIN
1
RESECTISOL
1
SEA-CLENS WOUND
CLEANSER
1
sorbitol irrigation
3
sorbitol-mannitol
3
INTERSTITIAL
CYSTITIS AGENTS
GENITOURINA
RY THERAPY
BPH AGENT 5-ALPHA
REDUCTASE
INHIB. & ALPHA-1
ADRENOCEPTOR
ANTAG COMB
JALYN
/Limits
ELMIRON
3
pentosan polysulfate na
(bulk)
3
RIMSO-50
3
KIDNEY STONE
AGENTS
3
CYSTINOSIS
THERAPY
(CYSTINE
DEPLETING
AGENTS)
phytic acid (bulk)
3
THIOLA
3
OVERACTIVE
BLADDER
AGENTS - BETA -3
ADRENERGIC
RECEPTOR
AGONIST
MYRBETRIQ
CYSTAGON
1
cysteamine hcl (bulk)
3
PROCYSBI
3
3
PA
PHOSPHATE
BINDERS CALCIUM-BASED
capsule
1
this table.
299
Drug Name
/Limits
tablet
3
CALPHRON
Drug Name
/Limits
RAPAFLO
2
tamsulosin
1
3
UROXATRAL
3
ELIPHOS
3
PHOSLO
3
PHOSLYRA
3
PROSTATIC
HYPERTROPHY
AGENT - TYPE I &
II 5-ALPHA
REDUCTASE
INHIBITORS
AURYXIA
3
AVODART
NC
VELPHORO
3
dutasteride
1
AURYXIA
3
capsule
1
PROSTATIC
HYPERTROPHY
AGENT - TYPE II
5-ALPHA
REDUCTASE
INHIBITORS
tablet
3
finasteride (bulk)
3
CALPHRON
3
finasteride oral tablet 5
mg
1
ELIPHOS
3
PROSCAR
3
FOSRENOL ORAL
POWDER IN PACKET
3
FOSRENOL ORAL
TABLET,CHEWABLE
1
MAGNEBIND 300
1
MAGNEBIND 400
3
PROSTATIC
HYPERTROPHY
AGENT-SEL.CGMP
PHOSPHODIESTE
RASE TYPE5
INHIBITOR
PHOSLO
3
PHOSLYRA
3
RENAGEL
1
RENVELA
1
VELPHORO
3
PHOSPHATE
BINDERS IRON-BASED
PHOSPHATE
BINDERS
CIALIS ORAL
TABLET 2.5 MG, 5
MG
PA
URINARY
ACIDIFIER BACTERIAL
UREASE
INHIBITOR
PROSTATIC
HYPERTROPHY
AGENT ALPHA-1-ADRENO
CEPTOR
ANTAGONISTS
alfuzosin
2
PA
LITHOSTAT
3
URINARY
ACIDIFIER OTHERS
2
PA
ammonium chloride
4
FLOMAX
3
this table.
300
Drug Name
/Limits
ammonium chloride
(bulk)
1
methionine
3
URINARY
ACIDIFIER PHOSPHATES
K-PHOS NO 2
1
K-PHOS ORIGINAL
1
K-PHOS-NEUTRAL
3
PHOSPHA 250
NEUTRAL
1
VIRT-PHOS 250
NEUTRAL
3
URINARY
ALKALINIZER CITRATES
Drug Name
/Limits
UROCIT-K 10
3
UROCIT-K 15
3
UROCIT-K 5
3
VIRTRATE-2
3
VIRTRATE-3
3
VIRTRATE-K
3
URINARY
ANALGESICS
AZO
1
AZO STANDARD
MAXIMUM
STRENGTH
3
AZO URINARY PAIN
RELIEF ORAL
TABLET 95 MG
1
AZO URINARY PAIN
RELIEF ORAL
TABLET 97.5 MG
3
AZO URINARY
TRACT HEALTH
3
CYTRA K CRYSTALS
1
CYTRA-2
1
CYTRA-3
1
CYTRA-K
1
ORACIT
1
AZO-DINE ORAL
TABLET 95 MG
1
pot,sodium citrate-citric
acid
3
AZO-DINE ORAL
TABLET 97.5 MG
3
potassium citrate
m-hyd(bulk) powder
3
phenazopyridine (bulk)
3
phenazopyridine oral
tablet 100 mg, 200 mg
1
1
PYRIDIUM
3
potassium citrate oral
15 meq
1
3
URINARY PAIN
RELIEF ORAL
TABLET 95 MG
potassium citrate-citric
acid oral packet
3
3
URINARY PAIN
RELIEF ORAL
TABLET 97.5 MG
potassium citrate-citric
acid oral solution
URINARY TRACT
1
1
SHOHL'S MODIFIED
1
sodium citrate-citric
acid
1
URINARY
ANTIBACTERIAL METHENAMINE &
SALTS
TRICITRATES
1
HIPREX
potassium citrate oral
10 meq (1,080 mg), 5
meq (540 mg)
3
this table.
301
Drug Name
/Limits
methenamine (bulk)
3
methenamine hippurate
3
methenamine mandelate
3
UROQID-ACID NO.2
3
URINARY
ANTIBACTERIAL NITROFURAN
DERIVATIVES
Drug Name
URINARY
ANTI-INFECTIVE
METHENAMINE-A
NALGESIC
COMBINATIONS
OTHER
CYSTEX PLUS
(METHENAMINE-SA
L)
FURADANTIN
1
MACROBID
3
MACRODANTIN
ORAL CAPSULE 100
MG, 50 MG
3
MACRODANTIN
ORAL CAPSULE 25
MG
1
nitrofuran macrocrystal
(bulk)
3
/Limits
3
URINARY
ANTI-INFECTIVE
METHENAMINE-A
NTISPAS-ANALG
COMBINATIONS
HYOLEV MB
3
HYOPHEN
3
PHOSPHASAL
1
UR N-C
1
URAMIT MB
3
nitrofurantoin
macrocrystal oral
1
URELLE
3
nitrofurantoin
monohyd/m-cryst
1
URETRON D-S ORAL
TABLET
81.6-10.8-40.8 MG
1
nitrofurantoin oral
1
URIBEL
3
URIMAR-T
3
URIN DS
1
URO-L
3
URINARY
ANTIBACTERIAL QUINOLONES
CIPRO XR
3
URO-MP
3
ciprofloxacin (mixture)
1
USTELL
3
UTIRA-C
3
URINARY
ANTIBACTERIALS
OTHER
mandelic acid (bulk)
3
MONUROL
3
URINARY
ANTI-INFECTIVE
METHENAMINE-A
NTISPASMODIC
COMBINATIONS
URO-BLUE
3
UROGESIC-BLUE
3
UROLET MB
3
URYL
3
this table.
302
Drug Name
UTA
/Limits
3
URINARY
ANTISPASMODIC ANTICHOL., M(3)
MUSCARINIC
SELECTIVE
(BLADDER)
ENABLEX
2
VESICARE
1
PA
Drug Name
COLCRYS
1
MITIGARE
3
GOUT AND
HYPERURICEMIA
ANTIMITOTIC-UR
ICOSURIC
COMBINATIONS
colchicine-probenecid
URINARY
ANTISPASMODIC SMOOTH MUSCLE
RELAXANTS
/Limits
1
HYPERURICEMIA
THERAPY URATE-OXIDASE
ENZYME-TYPE
DETROL
3
ELITEK
4
DETROL LA
3
KRYSTEXXA
4
DITROPAN XL
3
flavoxate
1
GELNIQUE
3
HYPERURICEMIA
THERAPY URICOSURICS
oxybutynin chloride oral
1
probenecid
OXYTROL
3
OXYTROL FOR
WOMEN
3
tolterodine
1
HYPERURICEMIA
THERAPY XANTHINE
OXIDASE
INHIBITORS
TOVIAZ
1
trospium
2
URINARY
RETENTION
THERAPY PARASYMPATHO
MIMETIC AGENTS
1
URECHOLINE
3
GOUT ACUTE
THERAPY ANTIMITOTICS
allopurinol
1
ALOPRIM
4
ULORIC
3
ZYLOPRIM
3
HEMATOLOGIC
AL AGENTS
bethanechol chloride
GOUT AND
HYPERURICEM
IA THERAPY
PA
1
ANTICOAGULANT
SCITRATE-BASED
ACD
3
ACD-A
3
anticoag citrate phos
dextrose
1
sodium citrate
3
sodium citrate (bulk)
1
colchicine oral
3
this table.
303
Drug Name
TRICITRASOL
/Limits
3
ANTICOAGULANT
S - COUMARIN
COUMADIN ORAL
3
dicumarol (bulk)
3
JANTOVEN
3
warfarin
1
warfarin (bulk)
3
ANTICOAGULANT
S - INDANEDIONE
anisindione (bulk)
3
phenindione (bulk)
3
ANTI-INHIBITOR
COAGULATION
COMPLEX
FEIBA NF
4
ANTIPORPHYRIA
FACTORS
PANHEMATIN
4
C1 ESTERASE
INHIBITOR
AGENTS
BERINERT
INTRAVENOUS KIT
4
CINRYZE
4
RUCONEST
4
CXCR4
CHEMOKINE
RECEPTOR
ANTAGONISTS
MOZOBIL
3
DIRECT FACTOR
XA INHIBITORS
ELIQUIS
1
SAVAYSA
3
XARELTO
1
Drug Name
/Limits
ERYTHROPOIETI
NS
ARANESP (IN
POLYSORBATE)
INJECTION
SOLUTION
2
PA
ARANESP (IN
POLYSORBATE)
INJECTION SYRINGE
10 MCG/0.4 ML
3
PA
ARANESP (IN
POLYSORBATE)
INJECTION SYRINGE
100 MCG/0.5 ML, 150
MCG/0.3 ML, 200
MCG/0.4 ML, 25
MCG/0.42 ML, 300
MCG/0.6 ML, 40
MCG/0.4 ML, 500
MCG/ML, 60 MCG/0.3
ML
2
PA
EPOGEN INJECTION
SOLUTION 10,000
UNIT/ML, 2,000
UNIT/ML, 20,000
UNIT/2 ML, 20,000
UNIT/ML, 3,000
UNIT/ML, 4,000
UNIT/ML
2
PA
MIRCERA
3
PROCRIT
2
PA
FACTOR IX
COMPLEX
(PROTHROMBIN
COMPLEX
CONCENTRATE)
PREPARATIONS
BEBULIN
4
KCENTRA
INTRAVENOUS KIT
4
FACTOR IX
PREPARATIONS
ALPHANINE SD
4
this table.
304
Drug Name
/Limits
ALPROLIX
4
BENEFIX
4
IXINITY
4
MONONINE
4
PROFILNINE
4
RIXUBIS
4
FACTOR VII
PREPARATIONS
NOVOSEVEN RT
4
FACTOR VIII
PREPARATIONS
(AHF)
Drug Name
/Limits
GRANULOCYTE
COLONY-STIMUL
ATING FACTOR
(G-CSF)
GRANIX
3
NEULASTA
3
NEUPOGEN
2
PA
ZARXIO
2
PA
2
PA
GRANULOCYTEMACROPHAGE
COLONY-STIMUL
ATING FACTOR
(GM-CSF)
ADVATE
4
ALPHANATE
4
ELOCTATE
4
HELIXATE FS
4
HEMATORHEOLO
GIC AGENTS
HEMOFIL M HIGH
4
pentoxifylline
1
HEMOFIL M LOW
4
pentoxifylline (bulk)
3
HEMOFIL M MID
4
HEMOFIL M SUPER
HIGH
4
HUMATE-P
4
HEMOSTATIC
SYSTEMIC ANTIFIBRINOLYT
IC AGENTS
LEUKINE INJECTION
RECON SOLN
AMICAR
3
4
aminocaproic acid
(bulk)
3
KOGENATE FS
4
4
MONOCLATE-P
4
aminocaproic acid
intravenous
NOVOEIGHT
4
CYKLOKAPRON
4
OBIZUR
4
LYSTEDA
3
RECOMBINATE
4
RIASTAP
4
WILATE
4
4
XYNTHA
4
tranexamic acid
intravenous
XYNTHA SOLOFUSE
4
tranexamic acid oral
3
KOATE-DVI
INTRAVENOUS
RECON SOLN
FACTOR XIII
PREPARATIONS
CORIFACT
4
TRETTEN
4
HEMOSTATIC
SYSTEMIC OTHERS
carbazochrome (bulk)
3
this table.
305
Drug Name
/Limits
Drug Name
/Limits
ASTRINGYN
3
AVITENE
3
heparin (porcine) in
nacl (pf) intravenous
parenteral solution
1,000 unit/500 ml, 2,000
unit/1,000 ml
AVITENE FLOUR
3
HEPARIN FLUSH
4
ENDO AVITENE
3
GELFILM IMPLANT
3
heparin
flush(porcine)-0.9nacl
4
GELFOAM
3
HEPARIN LOCK
4
GELFOAM
COMPRESSED SIZE
100
3
HEPARIN LOCK
FLUSH
4
GELFOAM SPONGE
SIZE 100
3
heparin lock flush
(porcine) intravenous
solution
4
GELFOAM SPONGE
SIZE 12-7MM
3
4
GELFOAM SPONGE
SIZE 200
heparin lock flush
syringe 100 unit/ml
3
GELFOAM SPONGE
SIZE 50
4
3
HEPARIN
LOCKFLUSH(PORCIN
E)(PF)
MONSEL'S
1
4
OXYCEL
COTTON-TYPE
PLEDGET
heparin, porcine (pf)
100 unit/ml (1 ml)
3
intravenous syringe
4
RECOTHROM
3
RECOTHROM SPRAY
KIT
4
3
MONOJECT PREFILL
(PF)
SYRINGE AVITENE
3
MONOJECT PREFILL
ADVANCED (PF)
4
THROMBI-GEL
3
HEPARINS
THROMBIN-JMI
3
HEP FLUSH-10 (PF)
4
THROMBI-PAD
3
ULTRAFOAM
3
heparin (porcine) (bulk)
powder 180 unit/mg
(usp)
3
heparin (porcine) in 5
% dex
4
heparin (porcine) in
nacl (pf) intravenous
parenteral solution
1,000 unit/500 ml, 2,000
unit/1,000 ml
4
HEMOSTATIC
TOPICAL AGENTS
HEMOSTATIC
TOPICAL
COMBINATIONS
TACHOSIL
3
TISSEEL VHSD
3
HEPARIN FLUSH
FORMULATIONS
HEP FLUSH-10 (PF)
4
4
this table.
306
Drug Name
/Limits
heparin (porcine)
injection cartridge
1
heparin (porcine)
injection solution
Drug Name
/Limits
ALBUMINAR 25 %
4
ALBUMINAR 5 %
4
1
ALBURX (HUMAN)
25 %
4
HEPARIN FLUSH
4
heparin
flush(porcine)-0.9nacl
4
4
ALBURX (HUMAN) 5
%
ALBUTEIN 25 %
4
HEPARIN LOCK
4
ALBUTEIN 5 %
4
HEPARIN LOCK
FLUSH
4
BUMINATE 25 %
4
heparin lock flush
solution
BUMINATE 5 %
4
4
FLEXBUMIN 25 %
4
FLEXBUMIN 5 %
4
heparin lock flush
syringe 100 unit/ml
KEDBUMIN
4
4
PLASBUMIN 25 %
4
HEPARIN
LOCKFLUSH(PORCIN
E)(PF)
PLASBUMIN 5 %
4
4
heparin(porcine) in
0.45% nacl intravenous
parenteral solution
12,500 unit/250 ml,
25,000 unit/250 ml,
25,000 unit/500 ml
4
injection
1
100 unit/ml (1 ml)
HUMAN
MONOCLONAL
ANTIBODY
COMPLEMENT
(C5) INHIBITORS
SOLIRIS
4
INDIRECT
FACTOR XA
INHIBITORS
ARIXTRA
3
PA
4
fondaparinux
2
PA
intravenous syringe
4
MONOJECT PREFILL
(PF)
LOW
MOLECULAR
WEIGHT
HEPARINS
4
MONOJECT PREFILL
ADVANCED (PF)
4
HUMAN ALBUMIN
ALBUKED-25
4
ALBUKED-5
4
albumin, human 25 %
4
albumin, human 5 %
4
enoxaparin
1
FRAGMIN
SUBCUTANEOUS
SOLUTION
3
FRAGMIN
SUBCUTANEOUS
SYRINGE
3
this table.
307
Drug Name
/Limits
LOVENOX
SUBCUTANEOUS
SOLUTION
1
LOVENOX
SUBCUTANEOUS
SYRINGE
3
PLASMA
EXPANDERS
Drug Name
/Limits
PLATELET
AGGREGATION
INHIB CYCLOPENTYL-T
RIAZOLO-PYRIMI
DINES (CPTPS)
BRILINTA ORAL
TABLET 90 MG
2
KENGREAL
4
HESPAN 6 % IN NS
4
hetastarch 6 % in 0.9 %
nacl
4
HEXTEND
4
LMD 10 % IN 0.9 %
SODIUM CHLOR
4
LMD 10 % IN 5 %
DEXTROSE
4
PLATELET
AGGREGATION
INHIB PDESTERASE
&ADENOSINE
DEAMINASE
INHIBITOR
VOLUVEN 6 %
4
dipyridamole (bulk)
3
dipyridamole
intravenous
4
dipyridamole oral
1
PERSANTINE
3
PLASMA
FRACTIONS
OCTAPLAS (BLOOD
GROUP A)
4
OCTAPLAS (BLOOD
GROUP AB)
4
OCTAPLAS (BLOOD
GROUP B)
4
OCTAPLAS (BLOOD
GROUP O)
4
PLASMANATE
4
PLATELET
AGGREGATION
INHIBITORS GLYCOPROTEIN
IIB/IIIA
RECEPTOR INHIB
4
AGGRASTAT IN
SODIUM CHLORIDE
4
INTEGRILIN
4
PLASMA
PROTEINS WHICH
FACILITATE
ANTICOAGULATI
ON
THROMBATE III
PA
PLATELET
AGGREGATION
INHIBITOR
COMBINATIONS
AGGRENOX
aspirin-dipyridamole
3
NF
this table.
308
Drug Name
/Limits
PLATELET
AGGREGATION
INHIBITORS MONOCLONAL
AGENTS
REOPRO
4
PLATELET
AGGREGATION
INHIBITORS PHOSPHODIESTE
RASE III
INHIBITORS
cilostazol
1
PLATELET
AGGREGATION
INHIBITORS QUINAZOLINE
AGENTS
AGRYLIN
3
anagrelide
1
PLATELET
AGGREGATION
INHIBITORS SALICYLATES
ADULT LOW DOSE
ASPIRIN
1
ASPIR-81
1
aspirin (bulk)
3
ASPIRIN CHILDRENS
1
ASPIRIN LOW DOSE
1
ASPIRIN
LOW-STRENGTH
1
aspirin oral tablet
1
aspirin oral
tablet,chewable
1
aspirin oral
(dr/ec) 325 mg, 81 mg
1
ASPIR-LOW
1
ASPIR-TRIN
3
Drug Name
/Limits
BAYER ASPIRIN
1
BAYER CHEWABLE
ASPIRIN
1
CHILD ASPIRIN
1
CHILDREN'S
ASPIRIN
1
E.C. PRIN
1
ECOTRIN
1
ECOTRIN LOW
STRENGTH
3
ENTERIC COATED
ASPIRIN
1
LITE COAT ASPIRIN
1
LO-DOSE ASPIRIN
1
PLATELET
AGGREGATION
INHIBITORS THIENOPYRIDINE
AGENTS
clopidogrel
1
EFFIENT
2
PLAVIX
3
ticlopidine
3
PA
PLATELET
AGGREGATION
INHIB-PROTEASEACTIV.RECEPTOR
-1(PAR-1)
ANTAGONIST
ZONTIVITY
3
PROTEIN C
PREPARATIONS
CEPROTIN (BLUE
BAR)
4
CEPROTIN (GREEN
BAR)
4
SICKLE CELL
ANEMIA AGENTS
DROXIA
1
this table.
309
Drug Name
/Limits
THROMBIN
INHIBITOR SELECTIVE
DIRECT &
REVERSIBLE HIRUDIN TYPE
Drug Name
/Limits
HISTAMINE
PREPARATIONS
FOR
DESENSITIZATI
ON
ANGIOMAX
4
bivalirudin
4
IPRIVASK
3
HISTAMINE
PREPARATIONS
FOR
DESENSITIZATIO
N
THROMBIN
INHIBITOR SELECTIVE
DIRECT &
REVERSIBLE
histamine phosphate
(bulk) crystals
argatroban
4
argatroban in 0.9 % sod
chlor
4
argatroban in nacl
(iso-os)
4
PRADAXA
2
1
IMMUNOSUPPR
ESSIVE AGENTS
IMMUNOSUPPRES
SIVE CALCINEURIN
INHIBITORS
PA
THROMBOLYTIC TISSUE
PLASMINOGEN
ACTIVATORS
ASTAGRAF XL
3
cyclosporine
1
cyclosporine
intravenous
4
cyclosporine modified
1
1
ACTIVASE
4
CATHFLO ACTIVASE
1
cyclosporine oral
capsule
TNKASE
4
GENGRAF
1
NEORAL
3
PROGRAF
INTRAVENOUS
4
PROGRAF ORAL
1
SANDIMMUNE
INTRAVENOUS
4
SANDIMMUNE ORAL
CAPSULE
3
SANDIMMUNE ORAL
SOLUTION
1
tacrolimus (bulk)
3
tacrolimus anhydrous
(bulk)
3
THROMBOPOIETI
N RECEPTOR
AGONISTS
NPLATE
3
PROMACTA
2
PA
this table.
310
Drug Name
/Limits
tacrolimus micronized
(bulk)
3
tacrolimus oral
1
Drug Name
IMMUNOSUPPRES
SIVE - PURINE
ANALOGS
IMMUNOSUPPRES
SIVE - INOSINE
MONOPHOSPHAT
E
DEHYDROGENAS
E INHIBITORS
AZASAN
3
azathioprine
1
IMURAN
3
IMMUNOSUPPRES
SIVE - SELECTIVE
T-CELL
COSTIMULATION
BLOCKER
CELLCEPT
3
CELLCEPT
INTRAVENOUS
4
oral capsule
1
oral suspension for
reconstitution
LOCOMOTOR
SYSTEM
3
oral tablet
1
ALS AGENT BENZATHIAZOLE
S
mycophenolate sodium
2
MYFORTIC
3
NULOJIX
PA
3
sirolimus
2
sirolimus (bulk)
3
ZORTRESS
2
IMMUNOSUPPRES
SIVE MONOCLONAL
ANTIBODIES
SIMULECT
4
4
RILUTEK
3
riluzole
2
PA
ANTIMYASTHENI
C AGENT REVERSIBLE
CHOLINESTERAS
E INHIBITORS
IMMUNOSUPPRES
SIVE MAMMALIAN
TARGET OF
RAPAMYCIN
(MTOR)
INHIBITORS
RAPAMUNE
/Limits
PA
PA
BLOXIVERZ
4
edrophonium chloride
(bulk)
3
ENLON
3
MESTINON ORAL
SYRUP
1
MESTINON ORAL
TABLET
3
MESTINON
TIMESPAN
3
neostigmine methylsulf
(bulk)
3
neostigmine
methylsulfate injection
1
this table.
311
Drug Name
/Limits
neostigmine
methylsulfate
4
1
(bulk)
3
REGONOL
1
2
MUSCULOSKELET
AL THERAPY
AGENT - JOINT
TISSUE
REPLACEMENT
CARTICEL
3
MUSCULOSKELET
AL THERAPY
AGENT VISCOSUPPLEME
NTS
/Limits
NEUROMUSCULA
R BLOCKER DEPOLARIZING
AGENTS
ANTIMYASTHENI
C AGENTS OTHER
guanidine
Drug Name
PA
ANECTINE
3
QUELICIN
INJECTION
SOLUTION
3
succinylcholine cl (bulk)
3
NEUROMUSCULA
R BLOCKER NEUROTOXINS
BOTOX
1
BOTOX COSMETIC
3
DYSPORT
3
MYOBLOC
1
XEOMIN
INTRAMUSCULAR
RECON SOLN 100
UNIT, 50 UNIT
3
EUFLEXXA
3
GEL-ONE
3
HYALGAN
3
NEUROMUSCULA
R BLOCKER NONDEPOLARIZI
NG AGENTS
MONOVISC
3
atracurium
4
ORTHOVISC
3
cisatracurium
4
SYNVISC
3
NIMBEX
4
SYNVISC-ONE
3
pancuronium bromide
(bulk)
3
pancuronium
intravenous solution 1
mg/ml
4
rocuronium intravenous
solution
4
vecuronium bromide
4
ZEMURON
4
MUSCULOSKELET
AL TX
AGENT-JOINT
CONTRACTURE
THERAPY,
COLLAGENASE
ENZYME
XIAFLEX
3
this table.
312
Drug Name
/Limits
SKELETAL
MUSCLE
RELAXANT ANALGESIC
SALICYLATE
COMBINATIONS
carisoprodol-aspirin
3
SKELETAL
MUSCLE
RELAXANT CENTRAL
MUSCLE
RELAXANTS
AMRIX
3
baclofen
1
baclofen (bulk)
1
carisoprodol
2
chlorzoxazone
1
cyclobenzaprine (bulk)
powder
Drug Name
/Limits
PARAFON FORTE
DSC
3
ROBAXIN INJECTION
1
ROBAXIN ORAL
3
ROBAXIN-750
3
SKELAXIN
3
SOMA
3
tizanidine
2
tizanidine (bulk)
3
ZANAFLEX
3
PA
SKELETAL
MUSCLE
RELAXANT DIRECT MUSCLE
RELAXANTS
DANTRIUM
INTRAVENOUS
4
1
DANTRIUM ORAL
CAPSULE 25 MG, 50
MG
1
cyclobenzaprine oral
tablet 10 mg, 5 mg
1
dantrolene
1
cyclobenzaprine oral
tablet 7.5 mg
dantrolene (bulk)
3
3
REVONTO
4
FEXMID
3
RYANODEX
4
GABLOFEN
3
LIORESAL
1
LORZONE
3
metaxalone oral tablet
400 mg
3
PA
SKELETAL
MUSCLE
RELAXANT NARCOTIC
ANALGESIC
COMBINATIONS
metaxalone oral tablet
800 mg
2
PA
methocarbamol (bulk)
3
methocarbamol
injection
3
methocarbamol oral
1
injection
1
oral
1
PA
carisoprodol-asa-codein
e
3
this table.
313
Drug Name
/Limits
Drug Name
/Limits
SKELETAL
MUSCLE
RELAXANT &
TOPICAL
IRRITANT
COUNTER-IRRITA
NT COMB.
ANTIBACTERIAL
BANDAGES TOPICAL
ADHESIVE
PATCH,MEDICATED
3
ANTIBACTERIAL
BANDAGES TOPICAL
BANDAGE
1
COMFORT
PAC-CYCLOBENZAP
RINE
3
ANTIBACTERIAL
PAD
3
COMFORT
PAC-TIZANIDINE
3
AQUACEL FOAM
TOPICAL BANDAGE
3.2 X 3.2 "
3
MEDICAL
SUPPLIES AND
DURABLE
MEDICAL
EQUIPMENT
(DME)
BANDAGE TOPICAL
BANDAGE
1
BANDAGES
FLEXIBLE FABRIC
1
BANDAGES SHEER
1
BANDAGES TOPICAL
BANDAGE , 3/4 "
1
MEDICAL
SUPPLIES & DME ADHESIVE
BANDAGES
BANDAGES/FLEXIBL
E/ASSORTED
1
BANDAGES/PLASTIC
1
BAND-AID CLEAR
SPOTS
3
adhesive bandage
topical bandage , 1 ", 1
x 3 ", 2 x 4 ", 3 x 4 ", 3/4
", 3/4 x 3 "
1
BAND-AID FLEXIBLE
3
adhesive bandage
topical bandage 7/8 "
3
3
BAND-AID FLEXIBLE
FABRIC TOPICAL
BANDAGE
adhesive bandage-adhes
remov#1
3
BAND-AID FLEXIBLE
FABRIC TOPICAL
BANDAGE 3/4 X 3 "
1
ADHESIVE GAUZE
PAD TOPICAL
BANDAGE 2.375 X 4 "
1
BAND-AID PLASTIC
TOPICAL BANDAGE
3
ADHESIVE PADS
TOPICAL BANDAGE
1
BAND-AID PLASTIC
TOPICAL BANDAGE
3/4 X 3 "
1
ADVANCED
ANTIBACTERIAL
BANDAGE
3
BAND-AID PLUS
ANTIBIOTIC
3
BAND-AID SHEER
ALLEVYN GENTLE
1
STRIPS
BORDER SACRUM
3
BAND-AID TOUGH
TOPICAL BANDAGE
3
PADS
6 5/8 X 6 3/4 "
this table.
314
Drug Name
/Limits
Drug Name
/Limits
BAND-AID TOUGH
STRIPS
3
hydrocol dress-adhesive
rem#1
3
BAND-AID
WATERPROOF PAD
3
HYPO-ALLERGENIC
BANDAGES
1
BLISTER RELIEF
BANDAGES
1
MEDIPORE DRESS-IT
COVER
3
CAMO BANDAGES
1
CLEAR BANDAGES
1
1
CLEAR SPOT
BANDAGES
MPM FOAM
DRESSING TOPICAL
BANDAGE 4 X 4 "
3
CLEAR STRIPS
TOPICAL BANDAGE
3
3
MPM FOAM
DRESSING TOPICAL
BANDAGE 6 X 6 "
NATURAL CARE
BANDAGES
3
NEW GENERATION
1
PLASTIC STRIPS
1
RESTORE TRIO
TOPICAL BANDAGE
3 X 3 ", 6 X 8 "
3
RESTORE TRIO
TOPICAL BANDAGE
4X5"
1
SHEER ADHESIVE
1
CLEAR STRIPS
TOPICAL BANDAGE
3/4 X 3 "
CLEAR
WATERPROOF
STRIPS TOPICAL
BANDAGE
1
3
CLEAR
WATERPROOF
STRIPS TOPICAL
BANDAGE 1 "
1
FABRIC BANDAGES
1
SHEER BANDAGE
1
FABRIC
KNUCKLE-FINGER
BANDAGE
1
SHEER SPOT
BANDAGES
3
FABRIC STRIP
EXTRA LARGE
SHEER STRIP
3
1
1
FLEXIBLE FABRIC
BANDAGES TOPICAL
BANDAGE
SHEER STRIP EXTRA
LARGE
3
SHEER STRIPS
1
1
FLEXIBLE FABRIC
BANDAGES TOPICAL
BANDAGE 2 X 3 ", 2
X 4 ", 3/4 X 3 "
SHEER STRIPS
ASSORTED
1
SKIN CLOSURE
STRIPS TOPICAL
COMBO PACK
3
FLEXIBLE FOAM
3
1
GRX FOAM
DRESSING
SOF-SET ADHESIVE
PATCH
3
HEAVY DUTY
FABRIC STRIPS
1
this table.
315
Drug Name
/Limits
SOFT CLOTH
TOPICAL BANDAGE
2 X 2 3/4 ", 3 1/2 X 10
", 3 1/2 X 13 3/4 ", 3 1/2
X 4 ", 3 1/2 X 8 "
3
SOFT CLOTH
TOPICAL BANDAGE
2.375 X 4 ", 3 1/2 X 6 "
1
SORESPOT
3
STERI-STRIP
DRESSING
STRATASORB
COMPOSITE WOUND
Drug Name
WATERPROOF
STRONG STRIPS
/Limits
1
MEDICAL
SUPPLIES & DME ADHESIVE
REMOVERS
adhesive remover
aerosol,spray
1
1
adhesive remover
packet
1
3
ALLKARE ADHESIVE
REMOVER WIPES
1
BARD ADHESIVE
REMOVER WIPES
1
DETACHOL
ADHESIVE
REMOVER
1
STRATASORB
ISLAND DRESSING
TOPICAL BANDAGE
4X4"
1
STRONG STRIPS
TOPICAL BANDAGE
1X3"
1
1
STRONG STRIPS
TOPICAL BANDAGE
1 X 3 1/4 "
UNISOLVE
ADHESIVE
REMOVER WIPE
3
UNIVERSAL
REMOVER WIPES
1
STRONG STRIPS
X-LARGE
1
SUPER STRIP
BANDAGES
MEDICAL
SUPPLIES & DME ADHESIVE TAPE
1
TELFA AMD
1
3M NEXCARE
DURAPORE
1
1
TELFA ISLAND
DRESSING TOPICAL
BANDAGE 4 X 10 ", 4
X 6 ", 4 X 8 ", 6 X 7 "
3
TELFA ISLAND
DRESSING TOPICAL
BANDAGE 4 X 5 "
adhesive tape topical
tape 1 x 10 "-yard, 1 x 5
"-yard, 1 x 6 "-yard, 1/2
x 10 "-yard, 1/2 x 12
"-yard, 1/2 x 5 "-yard
1
tape 1 x 12 "-yard
3
ALL PURPOSE
CLOTH TAPE
1
ATHLETIC TAPE
3
BAND-AID
BUTTERFLY
CLOSURE
1
BAND-AID CLOTH
TAPE
3
TELFA TOPICAL
BANDAGE 2 X 3 ", 3
X4"
1
TELFA TOPICAL
BANDAGE 2 X 3 3/4 "
3
WATER SHIELD
BANDAGES
1
this table.
316
Drug Name
/Limits
BAND-AID PAPER
TAPE
3
BAND-AID
WATERPROOF
3
BLENDERM
SURGICAL
1
BUTTERFLY
CLOSURES
1
CLEAR TAPE
3
CLOTH FIRST AID
TAPE
1
CLOTH TAPE
1
CURI-STRIP WOUND
CLOSURES TOPICAL
STRIP 1/2 X 4 ", 1/4 X
4 ", 1/8 X 3 "
1
CURI-STRIP WOUND
CLOSURES TOPICAL
STRIP 1/4 X 1 1/2 ",
1/4 X 3 "
3
DURAPORE
SURGICAL
1
FIRST AID CLOTH
TAPE
1
FIRST AID PAPER
TAPE TOPICAL TAPE
1 X 10 "-YARD
1
J AND J FIRST AID
TAPE PAPER
1
KENDALL PAPER
TAPE
1
MEDFIX
3
MEDFIX EZ
DRESSING
3
MEDIPORE
1
MEDIPORE H
1
MEDIPORE SOFT
CLOTH TAPE
1
Drug Name
/Limits
MICROFOAM
SURGICAL TOPICAL
TAPE 1 X 5 1/2
"-YARD, 2 X 5 1/2
"-YARD, 3 X 5 1/2
"-YARD, 4 X 5 1/2
"-YARD
1
MICROFOAM
SURGICAL TOPICAL
TAPE 4 X 7 "
3
MICROPORE
SURGICAL
1
NEXCARE GENTLE
PAPER TAPE
1
PAIN FREE TAPE
1
PAPER TAPE
1
PAPER TAPE,
HYPOALLERGENIC
1
PRO SPORTS TAPE
1
SCANPOR TAPE
3
SELF-GRIP TOPICAL
TAPE
1
SKIN CLOSURE
STRIPS TOPICAL
COMBO PACK
3
SKIN CLOSURE
STRIPS TOPICAL
STRIP
1
SPORTS TAPE
1
STERI-STRIP
3
STERI-STRIP SKIN
CLOSURES TOPICAL
STRIP 1 X 5 ", 1/4 X 1
1/2 ", 1/4 X 3 "
3
STERI-STRIP SKIN
CLOSURES TOPICAL
STRIP 1/2 X 4 ", 1/4 X
4 ", 1/8 X 3 "
1
TRANSPORE
SURGICAL
1
this table.
317
Drug Name
/Limits
MEDICAL
SUPPLIES & DME APPLICATORS &
COTTON
SUPPLIES
Drug Name
/Limits
HEATWRAPS
1
HEATWRAPS BACK
AND HIP PADS
1
THERMACARE
KNEE/ELBOW
1
ABSORBENT
COTTON BALLS
1
COSMETIC BALLS
1
COSMETIC PUFFS
1
COTTON BALLS
1
MEDICAL
SUPPLIES & DME BLOOD
ADMINISTRATION
SETS
COTTON BALLS
STERILE
1
BD LUER-LOK
COLLECTION SET
3
COTTON SQUARES
1
COTTON SWABS
1
3
COTTON, STERILE
1
CURITY
ABSORBENT
WADDING
BD SAFETY-LOK
COLLECTION SET
BLOOD
ADMINISTRATION
SET 25 GAUGE X 3/4"
1
BD SAF-T E-Z
COLLECTION SET
3
CURITY COTTON
PREP BALLS
1
BD VACUTAINER
COLLECTION SET
3
CURITY COTTON TIP
APPLICATOR
1
VACUTAINER
COLLECTION SET
3
NO-STING
SKIN-PREP
1
PLASTIC SWABS
1
PURE COTTON
1
Q-TIPS/SINGLE-TIP
1
Q-TIPS/SINGLE-TIP
APPLICATOR
1
ROLLED
ABSORBENT
COTTON
1
TOOTHETTE
1
MEDICAL
SUPPLIES & DME BANDAGES-DRESS
INGS-TAPE
ARTHRITIS
HEATWRAPS
1
HEAT THERAPY
1
MEDICAL
COAGULATION
TESTING
SUPPLIES
COAGUCHEK XS
3
COAGUCHEK XS
PRO
3
MEDICAL
COLLECTION
NEEDLES
MONOJECT BLOOD
COLLECTION
3
MULTI-DRAW
NEEDLE
1
this table.
318
Drug Name
/Limits
MEDICAL
COLLECTION
SETS
Drug Name
/Limits
ON CALL EXPRESS
TEST STRIP
3
QUINTET AC STRIP
3
RELION ULTIMA
3
SIDEKICK BLOOD
GLUCOSE SYSTEM
3
1
BD LUER-LOK
COLLECTION SET
3
BD SAF-T E-Z
COLLECTION SET
3
TRUE METRIX
GLUCOSE TEST
STRIP
BD VACUTAINER
COLLECTION SET
3
TRUETEST TEST
STRIPS
1
TRUETRACK SMART
SYSTEM STRIP
1
TRUETRACK TEST
1
ULTIMA TEST
STRIPS
3
ULTRATRAK
3
MEDICAL
SUPPLIES & DME BLOOD GLUCOSE
TESTS
ASSURE PRISM
MULTI STRIP
3
BLOOD GLUCOSE
TEST
3
3
EASYGLUCO PLUS
STRIP
UNISTRIP1 TEST
STRIP
3
3
EMBRACE EVO TEST
STRIPS
WAVESENSE JAZZ
STRIP
3
EMBRACE PRO TEST
STRIPS
3
FORA D10 STRIP
3
MEDICAL
SUPPLIES & DME BLOOD PRESSURE
DEVICE
COMBINATIONS
FORA GD50 TEST
STRIPS
3
FORA V10 STRIP
3
3
2TEK
GLUCOSE/BLOOD
PRESSURE
FORA V12 GLUCOSE
3
ADVOCATE DUO
3
FORTISCARE
GLUCOSE TEST
STRIPS
3
ADVOCATE DUO
METER
3
GLUCOCARD 01
SENSOR PLUS
3
ADVOCATE
REDI-CODE DUO
METER
3
GLUCOCARD SHINE
TEST STRIPS
3
FORA D10 KIT
3
FORA D15
3
HEALTHPRO TEST
STRIPS
3
MICRO BLOOD
GLUCOSE
3
this table.
319
Drug Name
/Limits
MEDICAL
SUPPLIES & DME CASTS &
ACCESSORIES
ELASTO-GEL
CAST-SPLINT
PADDING TOPICAL
BANDAGE 12 X 12 ",
8 X 16 "
1
Drug Name
/Limits
T.E.D.
ANTI-EMBOLISM
STOCKING
1
T.E.D. KNEE
LENGTH-S-REGULA
R
1
TRUFORM
COMPRESSION
STOCKING
1
ELASTO-GEL
CAST-SPLINT
PADDING TOPICAL
BANDAGE 4 X 4 ", 6
X8"
3
MEDICAL
SUPPLIES & DME CONCEPTION
ASSISTANCE
SUPPLIES
WEBRIL
3
CONCEPTION
WEBRIL II
3
3
COLD PACK
1
ice bag
1
MEDICAL
SUPPLIES & DME CRUTCHES,
WALKERS, AND
RELATED
DEVICES
ICE CAP
1
cane
1
ICE IT!
COLDCOMFORT
cane tips
3
1
crutch
1
ICE IT! PACK
1
CRUTCH
HANDGRIPS
3
CRUTCH TIPS
1
QUAD CANE TIPS
3
MEDICAL
SUPPLIES & DME COLD PACKS
MEDICAL
SUPPLIES & DME COMPRESSION
STOCKINGS
EMS
ANTI-EMBOLISM
STOCKING
3
MEDICAL
SUPPLIES & DME DENTAL
SUPPLIES OTHER
FUTURO
ANTI-EMBOLISM
STOCKINGS
1
EZO CUSHIONS
LOWER HEAVY
3
FUTURO RESTORING
MEDIUM
1
EZO CUSHIONS
UPPER HEAVY
3
RELIEF KNEE OPEN
TOE STOCKING
ferric sulfate (bulk)
3
3
HURRIVIEW
3
HURRIVIEW II
3
Q-CARE RX Q2
3
this table.
320
Drug Name
Q-CARE RX Q4
/Limits
3
MEDICAL
SUPPLIES & DME DENTIFRICES
SENSODYNE
1
MEDICAL
SUPPLIES & DME DIAPHRAGMS
Drug Name
/Limits
MD PUMP BOTTLE
AIRLESS
3
MD SYRINGE
AIRLESS
3
MEGAPUMP
AIRLESS
3
MEGAPUMP MEZZO
3
MEGAPUMP-BLUE
3
CAYA CONTOURED
3
PCCA ACCUPEN-15
3
WIDE-SEAL
DIAPHRAGM 60
3
STERILE
DROPTAINERS
3
WIDE-SEAL
DIAPHRAGM 65
1
TOPI-CLICK
3
WIDE-SEAL
DIAPHRAGM 70
3
1
ZYMOGENETICS
SPRAY APPLICATOR
WIDE-SEAL
DIAPHRAGM 75
1
WIDE-SEAL
DIAPHRAGM 80
1
WIDE-SEAL
DIAPHRAGM 85
1
WIDE-SEAL
DIAPHRAGM 90
3
WIDE-SEAL
DIAPHRAGM 95
3
MEDICAL
SUPPLIES & DME DRUG
APPLICATION
SUPPLIES
MEDICAL
SUPPLIES & DME ELASTIC
BANDAGES &
SUPPORTS
ACE ANKLE BRACE
1
ACE ELBOW BRACE
1
ACE KNEE BRACE
1
ANKLE BRACE
1
ARCH BANDAGE
3
back brace
1
BACK SUPPORT S/M
1
BANDAGE TOPICAL
BANDAGE 4.5 X 108 "
1
BAND-AID ACTIVE
FLEX
3
BAND-AID
HURT-FREE
3
FREEDOM
PRECISION AIRLESS
3
MD JAR AIRLESS
3
MD PEN AIRLESS
3
3
MD PUMP
ACTUATOR A
BAND-AID
SECURE-FLEX
3
1
MD PUMP
ACTUATOR B
COBAN ACTION
WRAP
3
MD PUMP
ACTUATOR C
1
3
COBAN
SELF-ADHERENT
WRAP
CURITY BANDAGE
3
this table.
321
Drug Name
/Limits
DELUXE WRIST
STABILIZER
1
elastic bandage
1
ELBOW STRAP
1
FINGER SLEEVES
3
finger splint
3
FIRST AID
HURT-FREE WRAP
1
GENTLE TAPE
TOPICAL BANDAGE
1 X 2.2 "-YARD
1
GENTLE TAPE
TOPICAL BANDAGE
2 X 2.2 "-YARD
3
HAND SUPPORT
1
KLING ROLLS
1
KNEE BRACE
1
KNEE BRACE
LARGE-XLARGE
1
KNEE STABILIZER
1
KNEE SUPPORT
1
MEDIGRIP
3
MEDIGRIP
ELASTICATED
SUPPORT
3
MEDIGRIP TUBULAR
3
NEOPRENE KNEE
SUPPORT
1
NEOPRENE WRIST
SPLINT SUPPORT
1
PAIN FREE WRAP
1
SELF ADHERENT
WRAP TOPICAL
BANDAGE 1 X 2.2
"-YARD
1
SELF ADHERENT
WRAP TOPICAL
BANDAGE 2 X 2.2
"-YARD
3
Drug Name
/Limits
SELF-ADHERING
BANDAGE
1
SELF-GRIP TOPICAL
BANDAGE 2 ", 3 ", 4 ",
4 X 66 "
1
SELFGRIP TOPICAL
BANDAGE 2 X 1.9
"-YARD, 3 X 1.9
"-YARD
3
SELF-GRIP TOPICAL
BANDAGE 2 X 66 ", 3
X 66 "
3
SELFGRIP TOPICAL
BANDAGE 4 "
1
SLIP ON KNEE
3
STRETCH GAUZE
BANDAGE TOPICAL
BANDAGE 2 X 4.1
"-YARD
3
SUREPRESS HIGH
COMPRESSION
1
TENDER TAPE
3
TENSOR TOPICAL
BANDAGE 2 X 5
"-YARD, 3 X 5
"-YARD, 6 X 5
"-YARD
1
TENSOR TOPICAL
BANDAGE 4 X 4.5
"-YARD
3
THUMB SUPPORT
3
WRIST BRACE
1
WRIST BRACE
MEDIUM
1
WRIST SUPPORT
LARGE-XLARGE
1
WRIST SUPPORT
ONE SIZE
1
WRIST SUPPORT
SMALL-MEDIUM
1
this table.
322
Drug Name
/Limits
MEDICAL
SUPPLIES & DME EQUIPMENT
CLEANING
AGENTS
/Limits
MEDICAL
SUPPLIES & DME FEEDING TUBES
& SUPPLIES
ALCOH-GLOVE
3
ALCOH-WIPE
3
MEDICAL
SUPPLIES & DME EUSTACHIAN
TUBE/MIDDLE
EAR VENTILATOR
DEVICES
EAR POPPER
INFLATION DEVICE
Drug Name
3
MEDICAL
SUPPLIES & DME EYE PATCHES
CURITY EYE
1
EYE PAD
1
eye patch
1
OPTICLUDE EYE
PATCH JUNIOR
1
MEDICAL
SUPPLIES & DME FACIAL MASKS
ARGYLE
1
KANGAROO 924
SAFETY SCREW
3
KANGAROO
BURETTE/PUMP SET
1
KANGAROO
DELUXE EZ PUMP
SET
1
KANGAROO
DELUXE PUMP SET
1
KANGAROO
ENTERAL-FEED-IRRI
G KT
1
KANGAROO EPUMP
SET
3
KANGAROO EZ CAP
BAG
1
KANGAROO EZ CAP
PUMP SET
1
KANGAROO EZ CAP
PUMP SET/500ML
1
KANGAROO
FEEDING TUBE 10-36
FR-", 8-36 FR-"
1
3
AIRS PEDIATRIC
DISPOSABLE MASK
1
BACT-POLLEN-DUST
FILTER MASK
1
FACE
MASK,EARLOOP-ST
YLE
KANGAROO
FEEDING TUBE 10-43
FR-", 12-36 FR-", 14-36
FR-"
3
KANGAROO
GRAVITY SET
3
NEXCARE ALL
PURPOSE MASK
1
KANGAROO PUMP
EXTENSION SET
3
PILLOW MASK
ADULT
1
KANGAROO PUMP
SET
1
PROCEDURAL FACE
MASKS
1
KANGAROO RIGID
CONTAINER
1
KANGAROO RIGID
CONTAINER PUMP
1
this table.
323
Drug Name
/Limits
Drug Name
/Limits
KANGAROO SCREW
CAP PUMP SET
1
BANDAGE TOPICAL
BANDAGE
1
KANGAROO SPIKE
PUMP SET
1
BAND-AID GAUZE
PADS
3
KANGAROO Y-SITE
EXTENSION SET
3
BAND-AID
MIRASORB GAUZE
3
BAND-AID ROLLED
GAUZE
3
BORDERED GAUZE
TOPICAL BANDAGE
2 X 2 ", 4 X 10 ", 4 X
14 "
3
BORDERED GAUZE
TOPICAL BANDAGE
4 X 4 ", 6 X 6 "
1
BULKEE II
3
CONFORM TOPICAL
BANDAGE 1 X 5
"-YARD, 3 X 5
"-YARD, 4 X 75 ", 6 X
5 "-YARD
1
3
MEDICAL
SUPPLIES & DME FEMALE
CONDOMS
FC2 FEMALE
CONDOM
3
MEDICAL
SUPPLIES & DME FIRST AID KITS
first aid kits
1
MEDICAL
SUPPLIES & DME FOOT CARE
SUPPLIES
ALL GEL BUNION
TOE SPREADER
1
BROMI-TALC
3
CONFORM TOPICAL
BANDAGE 2 X 5
"-YARD
BROMI-TALC PLUS
3
CURITY AMD
3
CUSHION INSOLE
1
3
FOAM INSOLE
1
CURITY
DETECTABLE LAP
GEL BUNION
CUSHION
1
CURITY DISP LAP
SPONGE POUCH
3
GEL BUNION GUARD
1
CURITY DISP LAP
SPONGE TRAY
3
GORDOMATIC
TOPICAL POWDER
3
MOLESKIN PLUS
1
3
PLANTAR FASCIITIS
ARCH SLEEVE
1
CURITY DRESSING
TOPICAL BANDAGE
4 1/2 X 3600 ", 9 X 100
"-YARD
SUPER MOLESKIN
1
CURITY GAUZE
TOPICAL BANDAGE
1 X 10 "-YARD, 2 X
360 ", 3 X 360 ", 36 X
3600 ", 4 X 360 "
3
CURITY GAUZE
TOPICAL BANDAGE
2 X 2 ", 3 X 3 ", 4 X 4 "
1
MEDICAL
SUPPLIES & DME GAUZE
BANDAGES
AGIE-GRX
3
this table.
324
Drug Name
/Limits
CURITY GAUZE
TOPICAL SPONGE 2
X 2 ", 3 X 4 ", 4 X 4 "
1
CURITY GAUZE
TOPICAL SPONGE 3
X 3 ", 4 X 3 1/2 ", 8 X 4
"
CURITY
MULTI-TRAUMA
DRESSING
CURITY
NON-ADHERENT
STRIP TOPICAL
BANDAGE 9 X 16 "
CURITY PLAIN
PACKING STRIP
TOPICAL BANDAGE
1 X 5 "-YARD, 1/2 X 5
"-YARD, 1/4 X 5
"-YARD
Drug Name
/Limits
1
3
DERMACEA
TOPICAL BANDAGE
2 1/4 X 3 "-YARD, 2 X
2 ", 3 X 3 ", 3.4 X 3.6
"-YARD, 4 X 4 ", 4 X
4.1 "-YARD
3
3
DERMACEA
TOPICAL BANDAGE
4.5 X 4.1 "-YARD
DERMACEA
TOPICAL SPONGE , 2
X 2 ", 4 X 4 "
1
DERMACEA
TOPICAL SPONGE 3
X3"
3
gauze bandage
1
GAUZE PAD
1
GAUZE ROLL
1
INTERSORB
3
ISLAND GARD-GRX
TOPICAL BANDAGE
4X4"
3
KENDALL CLOTH
3
3
1
CURITY PLAIN
PACKING STRIP
TOPICAL BANDAGE
2 X 5 "-YARD
3
CURITY READY-CUT
GAUZE
3
KERLIX PACKING
SPONGE
3
1
KERLIX TOPICAL
BANDAGE 2 1/4 X 3
"-YARD, 3.4 X 3.6
"-YARD, 4 1/2 X 147 "
1
3
KERLIX TOPICAL
BANDAGE 9 X 100
"-YARD
3
KERLIX TOPICAL
SPONGE , 4 X 4 "
1
KERLIX TOPICAL
SPONGE 14 X 14 ", 14
X 3 ", 26 X 17 ", 30 X 7
", 9 X 9 "
3
LISCO
1
MICROSPONGE
3
MIRASORB
1
DERMACEA
NON-WOVEN
TOPICAL SPONGE 2
X 2 ", 3 X 4 ", 4 X 4 "
DERMACEA
NON-WOVEN
TOPICAL SPONGE 3
X3"
DERMACEA
STRETCH TOPICAL
BANDAGE 2 X 4
"-YARD, 3 X 4.1
"-YARD
1
DERMACEA
STRETCH TOPICAL
BANDAGE 4 X 144 ",
6 X 144 "
3
this table.
325
Drug Name
/Limits
ROLLED GAUZE
TOPICAL BANDAGE
, 3 X 2.5 "-YARD, 4 X
2.5 "-YARD
1
ROLLED GAUZE
TOPICAL BANDAGE
4.5" X 3 YARD
RONDIC
Drug Name
/Limits
BAND-AID
SURGIPAD
3
COMBINE ABD
1
CONFORMANT 2
3
3
CURAD NON-STICK
PAD
3
1
CURITY
ABDOMINAL PAD
TOPICAL BANDAGE
5X9"
1
CURITY
ABDOMINAL PAD
TOPICAL BANDAGE
7 1/2 X 8 "
3
3
STERILE PADS
TOPICAL BANDAGE
2 X 2 ", 3 X 3 ", 4 X 4 "
1
STRETCH GAUZE
BANDAGE TOPICAL
BANDAGE 2 X 4.1
"-YARD
3
TUBULAR GAUZE
TOPICAL
3
CURITY COVER
TOPICAL SPONGE 3
X 3 ", 4 X 3 "
UNNA-FLEX
CONVENIENCE
PACK
3
CURITY COVER
TOPICAL SPONGE 4
X4"
1
VERSALON TOPICAL
SPONGE 2 X 2 ", 3 X 4
", 4 X 4 "
1
CURITY IODOFORM
PACKING STRIP
3
VERSALON TOPICAL
SPONGE 3 X 3 "
3
3
VISTEC X-RAY
DETECT TOPICAL
SPONGE 4 X 3 1/2 ", 8
X4"
CURITY
NON-ADHERENT
STRIP TOPICAL
BANDAGE 1/2 X 144 "
3
1
VISTEC X-RAY
DETECT TOPICAL
SPONGE 4 X 4 "
CURITY
NON-ADHERENT
STRIP TOPICAL
BANDAGE 3 X 8 "
1
1
WOUNDGARD
GAUZE
3
CURITY
NON-ADHERING
DRESSING
CUTICERIN
DRESSING
3
DERMACEA I.V.
3
DERMACEA
TOPICAL BANDAGE
8 X 10 "
1
DERMAVIEW
1
DERMAVIEW II
1
MEDICAL
SUPPLIES & DME GAUZE PADS &
DRESSINGS
ARGLAES 3.25"X 14"
FILM
3
BAND-AID
NON-STICK PADS
3
this table.
326
Drug Name
/Limits
ELASTO-GEL FACE
DRESSING
1
EXCILON DRAIN
1
EXCILON I.V.
3
EXCILON TOPICAL
SPONGE 4 X 3 "
3
EXCILON TOPICAL
SPONGE 4 X 4 "
1
EXU-DRY ADULT
DRESSING
1
EXU-DRY ARM
DRESSING
1
Drug Name
/Limits
EXU-DRY WOUND
DRESSING TOPICAL
BANDAGE 15 X 18 ",
15 X 24 ", 20 X 28 ", 24
X 36 ", 36 X 72 ", 4 X 6
", 6 X 9 ", 9 X 15 "
3
EXU-DRY WOUND
DRESSING TOPICAL
BANDAGE 2 X 3 "
1
IV 3000 TOPICAL
BANDAGE 2 3/8 X 2
3/4 "
3
IV3000 FRAME
DELIVERY
DRESSING
3
J AND J NON-STICK
PADS LARGE
1
J AND J NON-STICK
PADS MEDIUM
1
KENDALL TOPICAL
BANDAGE 2 X 2 3/4 "
1
NEXCARE
TEGADERM
1
non-adherent bandage
1
NON-STICK PAD
TOPICAL BANDAGE
3 X 4 ", 4 X 3 "
1
3
EXU-DRY
BOOT-FOOT
DRESSING
1
EXU-DRY BURN
JACKET-LARGE
1
EXU-DRY BURN
JACKET-MEDIUM
1
EXU-DRY BURN
JACKET-SMALL
1
EXU-DRY BURN
VEST-LARGE
1
EXU-DRY BURN
VEST-SMALL
1
EXU-DRY
ELBOW-KNEE-HEEL
1
EXU-DRY FACE
DRESSING
1
NON-STICK PAD
TOPICAL BANDAGE
3X8"
EXU-DRY HAND
DRESSING, MEDIUM
1
OPSITE TOPICAL
BANDAGE 4 X 5 1/2 "
3
EXU-DRY HAND
DRESSING, SMALL
1
1
EXU-DRY INCISION
DRESSING
3
PETROLATUM
GAUZE TOPICAL
BANDAGE , 1/2 X 72
", 3 X 18 ", 6 X 36 "
EXU-DRY LEG
DRESSING
1
3
EXU-DRY NECK
DRESSING
1
PETROLATUM
GAUZE TOPICAL
BANDAGE 1 X 36 ", 1
X 8 ", 3 X 36 "
POLYSKIN II
1
EXU-DRY SCALP
DRESSING
1
RESTON HIGH
SUPPORT PAD
1
this table.
327
Drug Name
/Limits
RESTON LIGHT
SUPPORT ROLL
3
RESTON MEDIUM
SUPPORT PAD
1
RESTORE TOPICAL
BANDAGE 2 X 2 "
1
SUREPRESS
ABSORBENT
PADDING
1
SURESITE MATRIX
3
Drug Name
/Limits
TEGADERM HP
FRAME STYLE
TOPICAL BANDAGE
5 1/2 X 7 "
3
TEGADERM I.V.
3
TEGADERM
TOPICAL BANDAGE
2 X 2 3/4 ", 2.375 X 4 ",
3 1/2 X 4 ", 4 X 4 3/4 "
1
3
SURESITE WINDOW
TOPICAL BANDAGE
2 3/8 X 2 3/4 "
1
TEGADERM
TOPICAL BANDAGE
3 1/2 X 6 ", 3.5 X 10 ",
3.5 X 13.75 ", 3.5 X 8 "
SURESITE WINDOW
TOPICAL BANDAGE
4 X 4 1/2 "
3
TEGADERM
TRANSPARENT
DRESSING
3
SURGICAL
DRESSING
1
3
SURGICAL
DRESSING EXTR
PROTCT
1
TELFA CLEAR
WOUND DRESSING
TOPICAL BANDAGE
12 X 12 ", 12 X 24 ", 39
X 25 "-YARD, 4 X 5 "
SURGICAL PADS
3
1
TEGADERM
ABSORBENT
3
TELFA CLEAR
WOUND DRESSING
TOPICAL BANDAGE
3X3"
TEGADERM FIRST
AID STYLE
1
1
TEGADERM FRAME
STYLE TOPICAL
BANDAGE 1 3/4 X 1
3/4 "
TELFA OUCHLESS
NON-ADHERENT
TOPICAL BANDAGE
4X3"
3
3
TEGADERM FRAME
STYLE TOPICAL
BANDAGE 2 3/8 X 2
3/4 ", 4 X 10 ", 4 X 4
3/4 ", 6 X 8 ", 8 X 12 "
TELFA OUCHLESS
NON-ADHERENT
TOPICAL BANDAGE
6X3"
1
TELFA TOPICAL
BANDAGE 2 X 3 ", 3
X 4 ", 3 X 8 ", 8 X 10 "
1
TENDERSORB
1
TENDERWRAP
UNNA BOOT
1
transparent dressings
topical bandage 2 3/8 x
2 3/4 "
3
TEGADERM HP
FRAME STYLE
TOPICAL BANDAGE
2 1/8 X 2 1/2 ", 2 3/8 X
2 3/4 ", 4 1/2 X 4 3/4 ",
4 X 4 1/2 ", 4 X 4 3/4 "
1
this table.
328
Drug Name
/Limits
topical bandage 2 x 2
3/4 ", 4 x 4 3/4 "
1
TRANSPARENT THIN
FILM DRESSING
1
UNNA-FLEX
ELASTIC UNNA
BOOT
1
VASELINE
PETROLATUM
GAUZE TOPICAL
BANDAGE , 1/2 X 72
", 3 X 18 ", 6 X 36 "
1
VASELINE
PETROLATUM
GAUZE TOPICAL
BANDAGE 1 X 36 ", 1
X 8 ", 3 X 36 "
3
XEROFLO GAUZE
DRESSING TOPICAL
BANDAGE 1 X 8 ", 2
X2"
1
XEROFORM
1
XEROFORM
PETROLATUM
DRESSING TOPICAL
BANDAGE 2 X 2 ", 4
X 3 "-YARD, 4 X 4 "
1
XEROFORM
PETROLATUM
OVERWRAP
1
MEDICAL
SUPPLIES & DME GLOVES
Drug Name
/Limits
DISPOSABLE
LATEX-FREE
GLOVES
1
latex gloves
1
latex gloves package
3
LATEX GLOVES,
LARGE
1
LATEX GLOVES,
MEDIUM
1
LATEX GLOVES,
SMALL
1
NITRILE EXAM
GLOVES
1
PREMIUM NITRILE
GLOVES
1
PURPLE NITRILE
GLOVES
3
STERILE NITRILE
GLOVE
1
ULTRA-SOFT
GLOVES
1
VINYL GLOVES
1
MEDICAL
SUPPLIES & DME GLUCOSE
MONITORING &
INSULIN ADMIN.
SUPPLIES
ACCU-CHEK COMBO
SYSTEM
3
CLEO 90 INFUSION
SET 24"
1
ALOE VERA LATEX
GLOVES
3
CLEO 90 INFUSION
SET 31"
1
BIOBRANE GLOVES
LARGE
1
COMFORT INFUSION
SET 23"
3
BIOBRANE GLOVES
MEDIUM
1
COMFORT INFUSION
SET 32"
3
disposable gloves
1
COMFORT INFUSION
SET 43"
3
this table.
329
Drug Name
/Limits
COMFORT SHORT
INSULIN PUMP 23"
3
COMFORT SHORT
INSULIN PUMP 32"
3
COMFORT SHORT
INSULIN PUMP 43"
Drug Name
/Limits
ACCU-CHEK
COMPACT PLUS
CARE
3
3
3
ACCU-CHEK
COMPACT PLUS
CONTROL
CONTACT DETACH
INFUS SET 23"
1
ACCU-CHEK
FASTCLIX
1
CONTACT DETACH
INFUS SET 32"
1
ACCU-CHEK
MULTICLIX LANCET
1
CONTACT DETACH
INFUS SET 43"
ACCU-CHEK NANO
3
1
3
MINIMED INFUSION
SET-MMT 390
ACCU-CHEK
SAFE-T-PRO
3
MIO INFUSION SET
3
3
QUICK-SET
PARADIGM
ACCU-CHEK
SMARTVIEW
CONTRL SOL
1
SNAP INSULIN
PUMP-INFUSION SET
1
3
ACCU-CHEK
SOFTCLIX LANCET
DEV
SURE-T PARADIGM
3
ACCU-CHEK
SOFTCLIX LANCETS
1
ACCU-CHEK
VOICEMATE
3
ACCUTREND
GLUCOSE CONTROL
3
ADJUSTABLE
LANCING DEVICE
1
ADVANCED
GLUCOSE METER
3
MEDICAL
SUPPLIES & DME GLUCOSE
MONITORING
TEST SUPPLIES
1ST TIER UNILET
COMFORTOUCH 30
GAUGE
1
2TEK CONTROL
(HIGH-NORMAL)
3
1
2TEK
GLUCOSE/BLOOD
PRESSURE
ADVANCED
LANCING DEVICE
3
ADVANCED TRAVEL
LANCETS 28 GAUGE
1
ACCU-CHEK AVIVA
CONNECT METER
3
ADVOCATE BLOOD
GLUCOSE MONITOR
3
ACCU-CHEK AVIVA
CONTROL SOLN
3
3
ACCU-CHEK AVIVA
PLUS METER
ADVOCATE
CONTROL
SOLUTION HIGH
3
ADVOCATE DUO
3
ACCU-CHEK COMP
BLUE CONT, M-H
3
ADVOCATE DUO
METER
3
this table.
330
Drug Name
/Limits
ADVOCATE LANCET
1
ADVOCATE
LANCING DEVICE
1
ADVOCATE LOW
CONTROL
3
ADVOCATE
RAPID-SAFE
LANCING
3
ADVOCATE
REDI-CODE DUO
METER
3
ADVOCATE
REDI-CODE GLU
MONITOR
3
ADVOCATE
REDI-CODE+
3
ADVOCATE
REDI-CODE+ CTRL
HIGH
3
Drug Name
/Limits
ASSURE
HAEMOLANCE PLUS
18 GAUGE, 21
GAUGE, 25 GAUGE,
28 GAUGE
1
ASSURE LANCE
1
ASSURE PLATINUM
3
ASSURE PRISM
CONTROL 1-2 SOLN
3
ASSURE PRISM
MULTI METER
3
AUTO-LANCET MINI
1
AUTOLET
IMPRESSION LANC
DEV
1
AUTOLET LANCING
DEVICE
1
BD LANCET DEVICE
1
BD MAGNI-GUIDE
SYRINGE MAGNIFI
1
1
ADVOCATE
REDI-CODE+ CTRL
LOW
3
AGAMATRIX AMP
GLUC MONITOR SYS
3
BD MICROTAINER
LANCET 21 GAUGE,
30 GAUGE
AGAMATRIX
CONTROL HIGH
3
BD ULTRA FINE
LANCETS
1
AGAMATRIX
CONTROL NORM-HI
3
BD ULTRA-FINE II
LANCETS
1
ALKALINE
BATTERIES
3
BIONIME RIGHTEST
GM300 SYSTEM
3
ALTERNATE SITE
LANCING DEVICE
1
blood glucose contrl
hi,normal
3
AQUA LANCE
LANCING DEVICE
1
blood glucose control,
normal
3
ASSURE 4 CONTROL
SOLUTION
3
BLOOD GLUCOSE
MONITORING
3
ASSURE DOSE
NORMAL CONTROL
blood-glucose meter
3
3
BREEZE 2
3
ASSURE DOSE
NORM-HI CONTROL
3
BREEZE 2 CONTROL
SOLUTION, LOW
3
BREEZE 2 CONTROL
SOLUTION, NML
3
this table.
331
Drug Name
/Limits
BREEZE 2 CONTROL
SOLUTION,HIGH
3
BULLSEYE MINI
SAFETY LANCETS 25
GAUGE, 28 GAUGE
1
CAREONE LANCING
DEVICE
1
CAREONE THIN
LANCET
CAREONE ULTRA
THIN LANCET
Drug Name
/Limits
CONTOUR CONTROL
SOLUTION, HIGH
3
CONTOUR CONTROL
SOLUTION, LOW
3
CONTOUR CONTROL
SOLUTION, NML
3
CONTOUR LINK
3
1
CONTOUR METER
3
1
CONTOUR NEXT EZ
METER
3
CONTOUR NEXT
LEV 1 CONTROL SOL
3
CONTOUR NEXT
LEV 2 CONTROL SOL
3
CARESENS
CONTROL A
NORMAL
3
CARESENS N
3
CARESENS N VOICE
3
CONTOUR NEXT
LINK
3
CHEMSTRIP BG LOG
BOOK
1
CONTOUR NEXT
METER
3
CLEVER CHEK
BLOOD GLUCOSE
3
CONTOUR NEXT
USB METER
3
CLEVER CHEK
BLOOD GLUCOSE
SYST
3
CONTROL
MONITORING
SYSTEM
3
CLEVER CHOICE
BLOOD GLUC SYS
3
DEXCOM G4
RECEIVER
3
CLEVER CHOICE
GLUCOSE MONITOR
3
3
CLEVER CHOICE
LEVEL 1 CONTROL
3
DEXCOM G4
RECEIVER
PEDIATRIC
CLEVER CHOICE
LEVEL 2 CONTROL
3
DEXCOM G4
RECEIVER-SHARE
(PED)
3
CLEVER CHOICE
LEVEL 3 CONTROL
3
3
CLEVER CHOICE
MICRO
DEXCOM G4
RECEIVER-SHARE
KIT
3
3
CLEVER CHOICE
PRO
DEXCOM G4
TRANSMITTER
3
3
COAGUCHEK
LANCETS
DEXCOM G5-G4
SENSOR
1
3
COMFORT LANCETS
1
DIATRUE CONTROL
SOLN NORMAL
this table.
332
Drug Name
/Limits
DIATRUE CONTROL
SOLUTION HIGH
3
DIATRUE CONTROL
SOLUTION LOW
3
DIATRUE PLUS
BLOOD GLUCOSE
MET
3
DROPLET LANCETS
1
DROPLET LANCING
DEVICE
Drug Name
/Limits
EASY TOUCH
SAFETY LANCETS 21
GAUGE, 23 GAUGE,
26 GAUGE, 28
GAUGE, 32 GAUGE
1
EASY TOUCH TWIST
LANCETS 28 GAUGE,
32 GAUGE, 33
GAUGE
1
1
EASY TRAK BLOOD
GLUCOSE METER
3
EASY CLICK
LANCING DEVICE
1
EASY TRAK
GLUCOSE SYSTEM
3
EASY COMFORT
LANCETS
1
EASY TRAK HIGH
CONTROL
3
EASY PLUS II BLOOD
GLUCOSE MET
3
EASY TRAK LOW
CONTROL
3
EASY PLUS II HIGH
CONTROL
3
EASY TWIST AND
CAP LANCETS
1
EASY PLUS II LOW
CONTROL
3
EASYGLUCO METER
3
EASY STEP BLOOD
GLUCOSE METER
3
EASYGLUCO
MONITORING
SYSTEM
3
EASY STEP BLOOD
GLUCOSE SYSTEM
3
EASYMAX 15 LEVEL
1
3
EASY TALK BLOOD
GLUCOSE METER
3
EASYMAX 15 LEVEL
2
3
EASY TALK
GLUCOSE SYSTEM
3
EASYMAX L BLOOD
GLUCOSE METER
3
EASY TALK HIGH
CONTROL
3
EASYMAX LOW
CONTROL
3
EASY TALK LOW
CONTROL
3
EASYMAX NG
3
EASY TOUCH
GLUCOSE MONITOR
3
EASYMAX NORMAL
CONTROL
3
EASY TOUCH
HIGH-LOW
CONTROL
1
EASYMAX V
SPEAKING GLUCOSE
SYS
3
EASY TOUCH
LANCING DEVICE
1
EASYMAX V2
BLOOD GLUCOSE
METER
3
this table.
333
Drug Name
/Limits
EASYMAX V2
GLUCOSE SYSTEM
KIT
3
ELEMENT COMPACT
GLUCOSE METER
Drug Name
/Limits
ENLITE SYSTEM
3
EVENCARE
3
EVENCARE G2
3
3
3
ELEMENT COMPACT
HIGH CONTROL
EVENCARE G2
SOLUTION
3
3
ELEMENT COMPACT
NORMAL CONTROL
EVENCARE G3
CONTROL
3
3
ELEMENT COMPACT
V GLUCOSE MTR
EVENCARE G3
GLUCOSE METER
3
3
ELEMENT HIGH
CONTROL
EVOLUTION BLOOD
GLUCOSE METER
3
3
ELEMENT LOW
CONTROL
EVOLUTION
NORMAL CONTROL
3
3
ELEMENT NORMAL
CONTROL
EZ SMART PLUS
SYSTEM
3
EZ SMART SYSTEM
3
EZ-VAC
3
FIFTY50 SAFETY
SEAL LANCETS
1
FIRST CHOICE
LANCETS THIN
1
FORA D10 KIT
3
FORA D15
3
FORA D20 KIT
3
FORA G20 KIT
3
FORA G30A
3
FORA GD50 BLOOD
GLUCOSE SYSTEM
3
FORA HIGH
CONTROL
3
FORA LANCING
DEVICE
1
3
ELEMENT PLUS
BLOOD GLUCOSE
KIT
3
EMBRACE BLOOD
GLUCOSE
3
EMBRACE BLOOD
GLUCOSE SYSTEM
3
EMBRACE EVO
BLOOD GLUCOSE
KIT
3
EMBRACE EVO
LEVEL 1
3
EMBRACE EVO
LEVEL 2
3
EMBRACE GLUCOSE
CONTROL HIGH
3
EMBRACE GLUCOSE
CONTROL LOW
3
EMBRACE PRO
3
FORA LOW
CONTROL
EMBRACE PRO
GLUCOSE METER
3
FORA NORMAL
CONTROL
3
ENLITE GLUCOSE
SENSOR
3
FORA TEST N'GO
VOICE METER
3
ENLITE SERTER
3
FORA V10 KIT
3
this table.
334
Drug Name
/Limits
FORA V12 BLOOD
GLUCOSE SYSTEM
3
FORA V20 KIT
3
FORA V30A
3
FORA V30A KIT
Drug Name
/Limits
FREESTYLE SYSTEM
KIT
3
GE100 BLOOD
GLUCOSE SYSTEM
3
3
3
FORACARE GD20
GLUCOSE METER
GE100 CONTROL
SOLUTION NORMAL
3
3
FORACARE GD40A
GLUCOSE METER
GLUCO NAVII
GLUCOSE MONITOR
3
FORACARE GD40B
GLUCOSE METER
3
3
GLUCOCARD 01
HI-NORMAL
CONTROL
FORACARE GDH
HIGH CONTROL
3
GLUCOCARD 01
METER
3
FORACARE GDH
LOW CONTROL
3
GLUCOCARD 01
NORMAL CONTROL
3
FORACARE GDH
NORMAL CONTROL
3
GLUCOCARD
EXPRESSION
3
FORTISCARE BLOOD
GLUCOSE SYST
3
GLUCOCARD
EXPRESSION KIT
3
FORTISCARE HIGH
3
3
FORTISCARE LOW
3
GLUCOCARD
EXPRESSION
SOLUTION
FORTISCARE
NORMAL
3
GLUCOCARD SHINE
3
GLUCOCARD SHINE
METER
3
GLUCOCARD SHINE
METER KIT
3
GLUCOCARD VITAL
3
FREESTYLE
CONTROL
3
FREESTYLE FLASH
SYSTEM
3
FREESTYLE
FREEDOM
3
GLUCOCOM
AUTOLINK
3
FREESTYLE
FREEDOM LITE
3
GLUCOCOM BLOOD
GLUCOSE
3
FREESTYLE
INSULINX
3
GLUCOCOM
CONTROL HIGH
3
FREESTYLE LITE
METER
3
GLUCOCOM
CONTROL NORMAL
3
FREESTYLE
NAVIGATOR GLUC
SENS
3
GLUCOLET 2
AUTOMATIC
LANCING
1
FREESTYLE
SIDEKICK II
3
GLUCOSE CONTROL
3
this table.
335
Drug Name
/Limits
GLUCOSE KETONE
CONTROL SOLN
1
GM100 KIT
3
GMATE CONTROL
SOLUTION, NORMAL
3
GMATE LANCING
DEVICE
3
GMATE SMART
METER
Drug Name
/Limits
INFINITY CONTROL
SOLUTION HIGH
3
INFINITY CONTROL
SOLUTION LOW
3
INFINITY CONTROL
SOLUTION NORM
3
INFINITY METER KIT
3
3
INFINITY STARTER
KIT
3
GMATE SMART
STARTER
3
INJECT EASE
LANCETS
1
GMATE VOICE
METER
3
1
GUARDIAN
REAL-TIME GLU
MONITOR
INJECT-EASE
AUTOMATIC
INJECTOR
3
INSUL-CAP
3
INSUL-EZE
3
GUARDIAN RT
CHARGER
3
INVACARE LANCETS
1
GUARDIAN RT
MONITOR SYSTEM
3
KINNEY BRAND
LANCETS
1
GUARDIAN RT
STARTER KIT
3
LANCETS,ULTRA
THIN
1
GUARDIAN RT TEST
PLUG DEVICE
lancing device
1
3
1
GUARDIAN RT
TRANSMITTER TAPE
lancing device with
lancets
3
LANCING SYSTEM
3
HEALTHPRO
GLUCOSE MONITOR
3
LANZO LANCING
DEVICE
3
HEALTHPRO
HIGH-LOW
CONTROL
3
3
LIBERTY BLOOD
GLUCOSE MONITOR
3
HEALTHY ACCENTS
AUTOLET
LIBERTY LEV 1
GLUCOSE CONTROL
1
3
HEALTHY ACCENTS
UNILET LANCET
LIBERTY LEV 2
GLUCOSE CONTROL
1
1
HYPOLANCE AST
LANCING
LITE TOUCH
LANCING DEVICE
1
MEDISENSE
3
INCONTROL
LANCING DEVICE
1
MEDISENSE
GLUCOSE KETONE
1
INCONTROL SUPER
THIN LANCETS
1
MEDISENSE MID
CONTROL
3
this table.
336
Drug Name
/Limits
Drug Name
/Limits
MEDPOINT NORMAL
CONTROL
3
NOVA SUREFLEX
LANCETS
1
MEDTRONIC
REMOTE CONTROL
3
NOVAMAX PLUS
GLU-KET
3
MICRO THIN
LANCETS
1
ON CALL EXPRESS
CONTROL
3
MICRODOT BLOOD
GLUCOSE SYSTEM
3
ON CALL EXPRESS
METER
3
MICRODOT
HIGH-LOW
CONTROL
3
ON CALL LANCING
DEVICE
1
MICRODOT NORMAL
CONTROL
3
3
ON CALL PLUS
CONTROL
MICROLET 2
LANCING DEVICE
1
1
ON CALL PLUS
LANCING DEVICE
MICROLET LANCET
1
ON CALL PLUS
METER
3
MINI LANCING
DEVICE
1
ON CALL VIVID
CONTROL
3
ON CALL VIVID
METER
3
ON CALL VIVID PAL
METER
3
ONETOUCH DELICA
LANC DEVICE
1
ONETOUCH DELICA
LANCETS 30 GAUGE
1
ONETOUCH
SURESOFT LANCING
DEV
1
ONETOUCH ULTRA
CONTROL
3
ONETOUCH ULTRA2
3
MINILINK
REAL-TIME
TRANSMITTER
3
MINIMED
QUICK-SERTER-MM
T 395
3
MONOLET LANCETS
1
MONOLET THIN
LANCETS
1
MYGLUCOHEALTH
CONTROL
SOLUTION
3
MYGLUCOHEALTH
KIT
3
MYGLUCOHEALTH
LANCETS
1
ONETOUCH
ULTRAMINI
3
NOVA MAX BLOOD
GLUCOSE METER
3
1
NOVA MAX
GLUCOSE CONTROL
3
ONETOUCH
ULTRASOFT
LANCETS
NOVA SAFETY
LANCETS
3
1
ONETOUCH VERIO
HIGH CONTROL
ONETOUCH VERIO
IQ METER
3
this table.
337
Drug Name
/Limits
Drug Name
/Limits
ONETOUCH VERIO
MID CONTROL
3
PRODIGY TWIST TOP
LANCET
1
ONETOUCH VERIO
SYNC
3
PRODIGY VOICE
GLUCOSE METER
3
ONETOUCH VERIO
SYSTEM
3
QUINTET AC
3
OPTUMRX
3
QUINTET BLOOD
GLUCOSE METER
3
OPTUMRX KIT
3
3
OPTUMRX
SOLUTION
REFUAH PLUS
GLUCOSE CONTROL
3
3
PARADIGM
REAL-TIME
TRANSMIT-SN
REFUAH PLUS
GLUCOSE MONITOR
3
1
PARADIGM REMOTE
CONTROL
RELIAMED LANCET
28 GAUGE, 30
GAUGE
3
1
PHARMACIST
CHOICE GLUCOSE
SYS
RELIAMED MINI
LANCING DEVICE
3
1
PRECISION XTRA
MONITOR
RELIAMED SAFETY
SEAL LANCETS 28
GAUGE
3
RELION CONFIRM
3
PREMIUM BLOOD
GLUCOSE MONITOR
3
3
PREMIUM V10
3
RELION MICRO
GLUCOSE MONITOR
KIT
PRESSURE
ACTIVATED
LANCETS
3
1
RELION PRIME
METER
PRESTO PRO BLOOD
GLUCOSE METER
3
3
REPLACEMENT
PEDIATRIC
MONITOR
PRODIGY
AUTOCODE METER
3
REVEAL BLOOD
GLUCOSE METER
3
PRODIGY
AUTOCODE
MONITOR SYST
3
3
RIGHTEST CONTROL
SOLUTION HIGH
3
PRODIGY CONTROL
SOLUTION, LOW
RIGHTEST CONTROL
SOLUTION NORM
3
1
PRODIGY CONTROL
SOLUTION,HIGH
RIGHTEST GD500
LANCING DEVICE
3
3
PRODIGY LANCING
DEVICE
RIGHTEST GM550
SYSTEM
1
3
PRODIGY POCKET
METER
SAFE-CLIP NEEDLE
STORAGE DEV
3
SAFETY LANCETS
1
this table.
338
Drug Name
/Limits
Drug Name
/Limits
SAFETY SEAL
LANCETS 30 GAUGE
1
SUREFLEX DEVICE
WITH LANCETS
1
SAFETY-LET
LANCETS
1
SUREFLEX LANCING
DEVICE
1
SEN-SERTER
3
1
SIL-SERTER
3
SURE-PEN LANCING
DEVICE
SINGLE-LET
3
SMART SENSE
LANCETS 26 GAUGE
3
1
SURE-TEST
EASYPLUS MINI
METER
SMART SENSE
MONITORING
SYSTEM
3
SURE-TEST
EASYPLUS MINI
SOLUTION
3
SMARTDIABETES
VANTAGE
TELCARE BGM
3
1
3
SMARTEST
CONTROL
TELCARE BLOOD
GLUCOSE KIT
3
TELCARE CONTROL
3
SMARTEST EJECT
3
3
SMARTEST LANCET
1
TEST N'GO BLOOD
GLUCOSE SYSTEM
SMARTEST
PERSONA STARTER
3
TRUE METRIX AIR
GLUCOSE METER
3
SMARTEST PRONTO
STARTER
3
TRUE METRIX
GLUCOSE METER
3
SMARTEST
PROTEGE
3
TRUE METRIX
LEVEL 1
3
SOF-SENSOR
3
TRUE METRIX
LEVEL 2
3
SOFT TOUCH
LANCETS
1
TRUE METRIX
LEVEL 3
3
SOFT-SERTER
INFUSION PUMP ATT
3
TRUE2GO BLOOD
GLUCOSE SYSTEM
1
SOLUS V2 AUDIBLE
METER
3
TRUECONTROL
LEVEL 0
3
SOLUS V2 CONTROL
SOLUTION, LOW
3
TRUECONTROL
LEVEL 1
3
SOLUS V2 CONTROL
SOLUTION,HIGH
3
TRUEDRAW
LANCING DEVICE
1
SOLUS V2 LANCING
DEVICE
1
1
SURE COMFORT
LANCING PEN
1
TRUEPLUS LANCETS
26 GAUGE, 30
GAUGE, 33 GAUGE
this table.
339
Drug Name
TRUERESULT
BLOOD GLUCOSE
SYSTM
/Limits
3
Drug Name
/Limits
UNISTRIP LOW
CONTROL
3
UNIVERSAL 1
LANCETS 33 GAUGE
1
VOCALPOINT
GLUCOSE CONTROL
3
TRUERESULT
BLOOD GLUCOSE
SYSTM KIT
1
TRUETEST HIGH
GLUCOSE CONTROL
1
WAVESENSE AMP
3
TRUETEST LOW
GLUCOSE CONTROL
1
WAVESENSE
CONTROL
SOLUTION
3
TRUETEST NORMAL
GLUCOSE CNTRL
1
WAVESENSE JAZZ
KIT
3
TRUETRACK BLOOD
GLUCOSE SYSTEM
1
WAVESENSE
PRESTO
3
TRUETRACK SMART
SYSTEM KIT
1
WAVESENSE
PRESTO KIT
3
ULTI-LANCE
1
ULTIMA MONITOR
3
ULTRA TLC
LANCETS
3
ULTRATRAK
GLUCOSE METER
3
MEDICAL
SUPPLIES & DME HEARING AID
SUPPLIES &
BATTERIES
ULTRATRAK
HIGH-LOW
CONTROL
3
ULTRATRAK
NORMAL CONTROL
3
ULTRATRAK
ULTIMATE
HEARING AID
BATTERIES
1
MEDICAL
SUPPLIES & DME HEATING PADS
heating pads
1
3
HEATWRAPS BACK
AND HIP PADS
1
ULTRATRAK
ULTIMATE
SOLUTION
3
HEATWRAPS
MENSTRUAL RELIEF
PAD
1
UNILET LANCET
1
UNISTIK 3 COMFORT
LANCET
1
HEATWRAPS
NECK-SHOULDER-W
RIST
1
UNISTIK 3 LANCETS
1
1
UNISTIK CZT
LANCET 23 GAUGE
THERMOPHORE
MAXHEAT
1
1
UNISTRIP HIGH
CONTROL
THERMOPHORE
PACK
3
THERMOPHORE
PACK STANDARD
1
this table.
340
Drug Name
/Limits
MEDICAL
SUPPLIES & DME HOT/COLD
COMBINATION
THERAPY AIDS
Drug Name
/Limits
MEDICAL
SUPPLIES & DME INCONTINENCE
SUPPLIES
ADULT BRIEF EXTRA LARGE
1
ADULT BRIEFS LARGE
1
ADULT BRIEFS MEDIUM
1
AIR PERMEABLE
UNDERPAD
1
ATN BRIEF
1
BARD DELUXE
FABRIC LEG STRAPS
1
BARD EXTENSION
TUBING/CONNECT
1
BARD INFECTION
CONTROL BAG
1
BARD LATEX LEG
STRAPS
1
BACK AND NECK
COLD REUSABL.PAD
1
BACK-SHOULDER
ICE,HEAT WRAP
1
COLD PACK BACK
PAD
1
COLD WRAP
1
HOT AND COLD
PACK
1
INSTANT COLD
PACK
1
MULTIPURPOSE ICE
AND HEAT WRAP
1
MULTI-USE COLD
REUSABLE PAD
1
REUSABLE
HOT-COLD
COMPRESS
1
BARD LEG BAG
HOLDER
1
THERMACARE
MUSCLE THERAPY
1
BARD LEG BAG
STRAPS/FABRIC
1
BELTED
UNDERGARMENTS
1
BELTLESS
UNDERGARMENTS
1
BLADDER CONTROL
PAD
1
BLADDER CONTROL
PAD EXTRA PLUS
1
BLADDER CONTROL
PAD LONG
1
BLADDER CONTROL
PAD ULTRA
1
BLADDER CONTROL
PAD ULTRA PLUS
1
BLADDER CONTROL
PADS
1
MEDICAL
SUPPLIES & DME HUMIDIFIERS
COOL MIST
HUMIDIFIER 1
GALLON
1
HEALTHMIST
1
humidifiers
1
VICKS HUMIDIFIER
1
VICKS WARM MIST
HUMIDIFIER
1
this table.
341
Drug Name
/Limits
Drug Name
/Limits
BLADDER CONTROL
PADS EX ABSORB
1
CURITY URETERAL
DRAIN SET
1
BLADDER CONTROL
PADS FOR WOMEN
1
CURITY URINE
METER
1
BOXERS FOR MEN
1
1
BREEZERS ADULT
BRIEF
DAY AND NIGHT
BRIEF, LARGE
1
1
BRIEFS
1
DAY AND NIGHT
BRIEF,MEDIUM
BRIEFS MEDIUM
1
DAY, PLUS PAD
1
BRIEFS OVERNIGHT
1
1
BRIEFS SMALL
1
DEPEND EASY FIT
UNDERGARMENTS
DEPEND GUARDS
FOR MEN
1
DEPEND
PROTECTION SZ S-M
1
1
BRIEFS,
ADULT-EXTRA
LARGE
1
CERTAINTY BELTED
SHIELDS
1
CERTAINTY
GUARDS
1
DEPEND
PROTECTION WITH
TABS LG
CERTAINTY LARGE
1
DEPEND REAL FIT
BRIEF MEN L/XL
1
CERTAINTY
LARGE-EXTRA
LARGE
1
DEPEND REAL FIT
BRIEF MEN S-M
1
CERTAINTY PADS
1
DEPEND SHIELDS
FOR MEN
1
CERTAINTY
REGULAR
1
1
CERTAINTY
SMALL-MEDIUM
1
DEPEND
SILHOUETTE
WOMEN L/XL
CERTAINTY
UNDERPADS
3
DEPEND
SILHOUETTE
WOMEN S/M
1
CERTAINTY
X-LARGE
1
1
CONVEEN DRIP
COLLECTOR
DEPEND
UNDERWEAR FOR
MEN L-XL
1
COTTON SNAP
PANTS
1
1
DEPEND
UNDERWEAR FOR
MEN SM-MD
CURITY BEDSIDE
DRAINAGE BAG
1
1
CURITY DRAINAGE
BAG
DEPEND
UNDERWEAR FOR
WOMEN LRG
3
DEPEND
UNDERWEAR FOR
WOMEN S-M
1
this table.
342
Drug Name
/Limits
DEPEND
UNDERWEAR FOR
WOMEN XL
1
DEPEND
UNDERWEAR S-M
1
DISPOSABLE BRIEF
Drug Name
/Limits
FLEXI-SEAL FMS
RECTAL
3
FLEXI-SEAL SIGNAL
FMS
3
1
GOODNITES BED
MATS
3
DOVER
ADVANTAGE
DRAINAGE BAG
3
GOODNITES TRU-FIT
LINERS
3
DOVER
ADVANTAGE URINE
3
GOODNITES
UNDERPANT YOUTH
L-XL
3
DOVER PEDIATRIC
URINE METER
1
3
DOVER PREMIUM
URINE
GOODNITES
UNDERPANTS
SMALL-MED
3
GUARD MALE
1
DRAINABLE POUCH
CLOSURE
1
GUARDS FOR MEN
1
DRY COMFORT
1
HANDICARE
GARMENT LINER
1
DRY COMFORT
EXTRA BRIEFS
1
HARMONIE
UNDERPAD
1
DURASORB
UNDERPAD
1
1
ENTRUST PLUS
BRIEFS
KENGUARD
URINARY DRAIN
BAG
1
KNIT PANTS, PLUS
1
ENTRUST PLUS
SUPER UNDERPADS
1
KNIT PANTS,
REGULAR
1
ENTRUST PLUS
UNDERGARMENTS
1
LINEN FRESH
1
ENTRUST PLUS
UNDERWEAR
1
1
MAXICARE BELTED
UNDERGARMENT
EXTENSION TUBING
W-CONNECTOR
1
1
MAXICARE
UNDERPADS
MESH PANTS
1
FITTED BRIEFS
1
MONO-FLO
DRAINAGE BAG
3
NIGHT SUPER PAD
1
FITTED BRIEFS
LARGE
1
FITTED BRIEFS
MEDIUM
1
NIGHTTIME
UNDERPANTS L-XL
3
FITTED BRIEFS
X-LARGE
1
NIGHTTIME
UNDERPANTS S-M
3
FLEXI-SEAL FECAL
3
NUFIT BRIEF EXTRA LARGE
1
this table.
343
Drug Name
/Limits
NU-FIT BRIEF
LARGE
1
NU-FIT BRIEF
MEDIUM
1
NUFIT UNDERWEAR
1
OPTIONS LINERS
1
OPTIONS PADS
1
OPTIONS ULTRA
THINS
1
OVER NITES
1
OVERNIGHT
UNDERWEAR
EX-LARGE
1
Drug Name
/Limits
PERSONAL
CONFIDENCE
UNDERPAD
1
PERSONAL
CONFIDENCE
UNDERWEAR
1
POISE PADS
1
PREVAIL ADJUST
UNDERWEAR
LARGE
1
PREVAIL ADJUST
UNDERWEAR
SM-MD
1
PREVAIL BLADDER
CONTROL PAD
1
PREVAIL BOXERS
1
PREVAIL BREEZERS
1
OVERNIGHT
UNDERWEAR
LARGE
1
OVERNIGHT
UNDERWEAR
SMALL-MED
1
PREVAIL BREEZERS
360
3
OVERNITE BRIEFS
1
1
PANT LINERS,
LARGE
PREVAIL BRIEF
BARIATRIC
1
1
PANT LINERS,
LARGE PLUS
PREVAIL BRIEF
EXTRA LARGE
1
1
PANTY LINERS
1
PREVAIL BRIEF
LARGE
PANTY SHIELDS
1
PREVAIL BRIEF
MEDIUM
1
PERFIT BRIEF EXTRA LARGE
1
PREVAIL BRIEF
SMALL
1
PER-FIT BRIEFS
1
PREVAIL BRIEF
YOUTH
1
PREVAIL CURVE
1
PER-FIT
UNDERWEAR
1
PERSONAL
CONFIDENCE
BRIEFS
1
PREVAIL EXTRA
UNDERWEAR
1
PERSONAL
CONFIDENCE
LINERS
1
PREVAIL FULL
COVERAGE
UNDRWEAR
1
PERSONAL
CONFIDENCE PADS
1
PREVAIL GUARDS
FOR MEN
1
PREVAIL MALE
GUARD
1
this table.
344
Drug Name
/Limits
PREVAIL PADS
1
PREVAIL PANT
LINER
3
PREVAIL PANTY
LINER
1
PREVAIL PER-FIT
1
PREVAIL PER-FIT 360
3
PREVAIL PM BRIEF
LARGE
1
PREVAIL PM BRIEF
MEDIUM
Drug Name
/Limits
PROTECTIVE
UNDERWEAR
MEDIUM
1
PROTECTIVE
UNDERWEAR
SMALL-MED
1
PROTECTIVE
UNDERWEAR-SMAL
L
1
SELECT BRIEFS
1
1
SELECT
DISPOSABLE BRIEFS
1
PREVAIL
PROTECTIVE
UNDERWEAR
1
SELECT
UNDERPADS
1
PREVAIL SIMPLY
STRETCH FIT
1
SELECT
UNDERWEAR
1
PREVAIL SMOOTH
FIT
1
SERENITY ULTRA
PLUS
1
PREVAIL STRETCH
FIT
SHIELDS
1
1
1
PREVAIL SUPER
PLUS
SIMPLICITY ADULT
FLAT FOLD XL
1
1
PREVAIL
UNDERWEAR
SIMPLICITY ADULT
POLY MEDIUM
1
1
PROCARE ADULT
BRIEF
SIMPLICITY
CONTOURED LINER
1
SIMPLICITY PAD
1
PROCARE
BARIATRIC BRIEF
SLEEP COMFORTS
1
1
SLEEP OVERS PANTS
1
SLEEP PANTS
1
SLIP-ON
UNDERGARMENT
1
PROCARE
PROTECTIVE
UNDERWEAR
1
PROTECTIVE PADS
1
STA-PUT UNDERPAD
1
PROTECTIVE
UNDERWEAR
1
1
PROTECTIVE
UNDERWEAR
EX-LARGE
SURE CARE
PROTECTIVE
UNDERGMNT
1
1
PROTECTIVE
UNDERWEAR
LARGE
SURE CARE
PROTECTIVE
UNDERWEAR
1
SURECARE
1
SURECHOICE
BLADDER CONTROL
1
this table.
345
Drug Name
/Limits
SURECHOICE PAD
1
SURECHOICE
PANTILINER
3
TENA
BRIEFS-SMALL
Drug Name
/Limits
UNDERPADS
REGULAR
1
UNDERWEAR
1
1
UNDERWEAR FOR
MEN
1
TENA PANTS SUPER
LARGE
1
UNIGARD
INCONTINENT PAD
1
TENA PROTECTIVE
UNDERWEAR
1
URINARY LEG BAG
1
TENA SERENITY
1
UROCARE FABRIC
LEG STRAPS
3
TENA STRETCH
ULTRA
1
WELL BEGINNINGS
SLEEP PANTS
1
TENA ULTRA
BRIEFS-LARGE
1
WINGS CHOICE
ADULT BRIEF
1
TENA ULTRA
BRIEFS-MEDIUM
1
WINGS CHOICE
PLUS ADULT BRIEFS
1
TENDERSORB
UNDERPAD
1
WINGS CHOICE
PLUS YOUTH BRIEFS
1
WINGS CLASSIC
ADULT BRIEFS
1
WINGS CLASSIC
ADULT BRIEFS X-L
1
WINGS FLUFF AND
POLYMER
1
WINGS MAXIMA
UNDERPADS
1
WINGS UNDERPAD
1
WINGS XXL ADULT
BRIEF
1
WOMEN'S
UNDERWEAR
1
WOUND DRAINAGE
COLLECTOR
1
TRANQUILITY
PREMIUM
UNDERWEAR
1
TRANQUILITY
TOPLINER PADS
1
TUGABOOS
OVERNIGHTS
1
UNDERGARMENT
1
UNDERGARMENT
EXTRA ABSORBENT
1
UNDERGARMENT
REGULAR
ABSORBENT
1
UNDERJAMS
LARGE-EXTRA
LARGE
1
UNDERJAMS
SMALL-MEDIUM
1
UNDERPAD-EXTRA
LARGE
1
underpads
1
UNDERPADS EXTRA
LARGE
1
MEDICAL
SUPPLIES & DME INFANT
CARE-NURSING
SUPPLIES
O-CAL-ETTE
NURSING CUP
3
this table.
346
Drug Name
/Limits
MEDICAL
SUPPLIES & DME INFANT DIAPERS
Drug Name
/Limits
GOODNITES
UNDERPANTS
SMALL-MED
3
BABY BASICS XX
LARGE DIAPER
1
HUGGIES LITTLE
MOVERS
1
BASICS FOR KIDS
1
HUGGIES PULL-UPS
1
COMFORT-STRETCH
DIAPERS
1
HUGGIES PULL-UPS
2T-3T
1
COMFORT-STRETCH
TRAINING PANTS
1
HUGGIES PULL-UPS
3T-4T
1
CUTIEPANTS
TRAINING PANTS
1
HUGGIES PULL-UPS
4T-5T
1
CUTIES BABY
DIAPERS
1
HUGGIES PURE AND
NATURAL SIZE5
3
diaper,brief,infant-todd,
disp
1
HUGGIES SLIP-ON
1
DIAPERS
1
HUGGIES SNUG AND
DRY STEP 5
1
DIAPERS ULTRAFITS
3
1
HUGGIES SNUG AND
DRY STEP 6
1
DIAPERS ULTRAFITS
4
1
KID PANTS BOYS
X-LARGE
1
DIAPERS ULTRAFITS
5
1
KID PANTS FOR
BOYS
1
DIAPERS ULTRAFITS
6
1
KID PANTS FOR
GIRLS
1
DIAPERS, UNISEX
SIZE 2
1
KID PANTS GIRLS
MEDIUM
1
DIAPERS, UNISEX
SIZE 3
1
KID PANTS GIRLS
X-LARGE
1
DIAPERS, UNISEX
SIZE 4
1
KIDPANT
1
DIAPERS, UNISEX
SIZE 5
1
1
LITTLE DARLINGS
2T-3T
DIAPERS, UNISEX
SIZE 6
1
1
LITTLE DARLINGS
3T-4T
DIAPERS-DISP-POLY
ETHYLENE BACK
1
1
LITTLE DARLINGS
4T-5T
LUVS NEWBORN
1
GOODNITES
UNDERPANTS L-XL
1
LUVS SIZE 1
1
LUVS SIZE 2
1
LUVS SIZE 3
1
this table.
347
Drug Name
/Limits
LUVS SIZE 4
1
LUVS SIZE 5
1
LUVS SIZE 6
1
OVER NITES
1
OVERNITE BRIEFS
1
PAMPERS
BABY-DRY SIZE 1
1
PAMPERS
BABY-DRY SIZE 2
PAMPERS
BABY-DRY SIZE 3
PAMPERS
BABY-DRY SIZE 4
PAMPERS
BABY-DRY SIZE 5
PAMPERS
BABY-DRY SIZE 6
1
1
1
1
1
Drug Name
/Limits
PAMPERS
SWADDLERS SENS.
SIZE 1
1
PAMPERS
SWADDLERS SIZE 1
1
PAMPERS
SWADDLERS SIZE 2
1
PAMPERS
SWADDLERS SIZE 3
1
PAMPERS
SWADDLERS SIZE N
1
PAMPERS UNISEX
BABY-DRY
1
PREMIUM BABY
DIAPERS
1
PREMIUM
COMFORT-STRETCH
1
PREMIUM TRAINING
PANTS
1
PAMPERS
BABY-DRY SIZE N
1
SELECT KIDS BRIEFS
1
PAMPERS CRUISERS
1
SLEEP PANTS
1
PAMPERS CRUISERS
SIZE 3
1
SUPREME DIAPERS
SIZE 1
1
PAMPERS CRUISERS
SIZE 5
1
SUPREME DIAPERS
SIZE 2
1
PAMPERS CRUISERS
SIZE 6
1
SUPREME DIAPERS
SIZE 3
1
PAMPERS CRUISERS
SIZE 7
1
SUPREME DIAPERS
SIZE 4
1
PAMPERS EASY UPS
1
PAMPERS EXTRA
PROTECTION SZ 3
1
1
SUPREME DIAPERS
SIZE 5
PAMPERS EXTRA
PROTECTION SZ 4
1
1
SUPREME DIAPERS
SIZE 6
PAMPERS EXTRA
PROTECTION SZ 5
1
1
TRAINING PANTS
2T-3T
PAMPERS EXTRA
PROTECTION SZ 6
1
1
TRAINING PANTS
3T-4T
PAMPERS PREEMIE
SWAD SIZE P-S
1
1
TRAINING PANTS
4T-5T
TUGABOOS DIAPERS
1
PAMPERS PREMIE
1
this table.
348
Drug Name
/Limits
Drug Name
/Limits
TUGABOOS
TRAINING PANTS
1
AUTOPEN 1 TO 16
UNITS
1
UP AND UP BABY
DIAPER
1
AUTOPEN 1 TO 21
UNITS
1
WELL BEGINNINGS
DIAPERS
3
AUTOPEN 2 TO 32
UNITS
1
WELL BEGINNINGS
SLEEP PANTS
1
AUTOPEN 2 TO 42
UNITS
1
WELL BEGINNINGS
TRAINING PANTS
3
BD AUTOSHIELD
DUO PEN NEEDLE
3
WONDERPANTS
1
BD AUTOSHIELD
PEN NEEDLE
1
BD ECLIPSE
LUER-LOK SYRINGE
1 ML 30 GAUGE X
1/2"
1
BD INSULIN PEN
NEEDLE UF MINI
1
BD INSULIN PEN
NEEDLE UF ORIG
1
BD INSULIN PEN
NEEDLE UF SHORT
1
BD INSULIN
SYRINGE HALF UNIT
1
BD INSULIN
SYRINGE
MICRO-FINE
1
BD INSULIN
SYRINGE SLIP TIP
1
BD INSULIN
SYRINGE SYRINGE 1
ML 25 X 1", 1 ML 26 X
1/2", 1 ML 28 GAUGE
X 1/2"
1
BD INSULIN
SYRINGE ULT-FINE
II
1
BD INSULIN
SYRINGE
ULTRA-FINE
1
BD INTEGRA
INSULIN SYRINGE
1
MEDICAL
SUPPLIES & DME INSULIN
NEEDLES-SYRING
ES & ADMIN.
SUPPLIES
1ST TIER UNIFINE
PENTIPS NEEDLE 29
GAUGE X 1/2", 31
GAUGE X 1/4", 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
1ST TIER UNIFINE
PENTIPS NEEDLE 32
GAUGE X 5/32"
3
1ST TIER UNIFINE
PENTIPS PLUS
1
ADVOCATE PEN
NEEDLES NEEDLE 29
GAUGE X 1/2"
3
ADVOCATE PEN
NEEDLES NEEDLE 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
ADVOCATE
SYRINGES
1
ASSURE ID INSULIN
SAFETY
1
AUTOJECT 2
INJECTION DEVICE
1
this table.
349
Drug Name
/Limits
BD LO-DOSE
MICRO-FINE IV
1
BD LO-DOSE
ULTRA-FINE
1
BD SAFETYGLIDE
INSULIN SYRINGE
SYRINGE 0.3 ML 29
GAUGE X 1/2", 0.3 ML
31 X 5/16", 1 ML 29 X
1/2", 1/2 ML 30
GAUGE X 5/16
1
BD SAFETYGLIDE
SYRINGE SYRINGE 1
ML 27 GAUGE X 5/8"
1
BD ULTRA-FINE
NANO PEN NEEDLES
1
CAREFINE PEN
NEEDLE
3
CLICKFINE NEEDLE
31 GAUGE X 1/4", 31
GAUGE X 5/16"
1
CLICKFINE NEEDLE
32 GAUGE X 5/32"
3
COMFORT EZ PEN
NEEDLES NEEDLE 31
GAUGE X 1/4", 31
GAUGE X 3/16", 31
GAUGE X 5/16", 32
GAUGE X 1/4", 32
GAUGE X 3/16", 32
GAUGE X 5/16", 32
GAUGE X 5/32", 33
GAUGE X 1/4", 33
GAUGE X 3/16", 33
GAUGE X 5/16", 33
GAUGE X 5/32"
3
COMFORT EZ
SYRINGE
1
Drug Name
/Limits
EASY COMFORT
INSULIN SYRINGE
SYRINGE 0.3 ML 30
GAUGE X 5/16, 1 ML
30 GAUGE X 1/2", 1
ML 30 GAUGE X 5/16,
1/2 ML 30 GAUGE X
1/2", 1/2 ML 30
GAUGE X 5/16
1
EASY COMFORT PEN
NEEDLES NEEDLE 31
GAUGE X 1/4", 32
GAUGE X 5/32"
3
EASY COMFORT PEN
NEEDLES NEEDLE 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
EASY TOUCH
INSULIN SAFETY
SYR SYRINGE 0.5 ML
29 GAUGE X 1/2", 1
ML 29 GAUGE X 1/2"
1
EASY TOUCH
INSULIN SAFETY
SYR SYRINGE 0.5 ML
30 GAUGE X 5/16", 1
ML 30 GAUGE X 1/2"
3
EASY TOUCH
INSULIN SYRINGE
1
EASY TOUCH
NEEDLE 29 GAUGE X
1/2", 31 GAUGE X
1/4", 31 GAUGE X
3/16", 31 GAUGE X
5/16", 32 GAUGE X
1/4", 32 GAUGE X
3/16"
1
EASY TOUCH
NEEDLE 32 GAUGE X
5/32"
3
this table.
350
Drug Name
/Limits
EXEL INSULIN
SYRINGE 0.3 ML 29
GAUGE X 1/2", 1 ML
30 GAUGE X 5/16, 1/2
ML 28 GAUGE X 1/2",
1/2 ML 30 GAUGE X
5/16
1
FIFTY50 RESERVOIR
FREESTYLE
PRECISION
Drug Name
/Limits
1
1
INSULIN SYRINGE
SYRINGE 1 ML 28
GAUGE X 1/2", 1 ML
29 X 1/2", 1 ML 30
GAUGE X 5/16, 1/2
ML 28 GAUGE X 1/2",
1/2 ML 29 X 1/2", 1/2
ML 30 GAUGE X 5/16
1
insulin syringe-needle
u-100
1
insulin syringes
(disposable)
1
INSUPEN NEEDLE 29
GAUGE X 1/2", 30
GAUGE X 5/16", 31
GAUGE X 1/4", 31
GAUGE X 5/16", 32
GAUGE X 1/4", 32
GAUGE X 5/16"
1
INSUPEN NEEDLE 32
GAUGE X 5/32", 33
GAUGE X 5/32"
3
LITE TOUCH
INSULIN PEN
NEEDLES
1
LITE TOUCH
INSULIN SYRINGE
1
MAGELLAN INSULIN
SAFETY SYRNG
SYRINGE 0.3 ML 29 X
1/2", 0.5 ML 29
GAUGE X 1/2", 1 ML
30 GAUGE X 5/16"
3
MAGELLAN INSULIN
SAFETY SYRNG
SYRINGE 1 ML 29
GAUGE X 1/2"
1
MAGELLAN
SYRINGE SYRINGE
0.3 ML 30 X 5/16"
3
MAGELLAN
SYRINGE SYRINGE
0.5 ML 30 GAUGE X
5/16"
1
HEALTHY ACCENTS
UNIFINE PENTIP
NEEDLE 29 GAUGE X
1/2", 31 GAUGE X
1/4", 31 GAUGE X
3/16", 31 GAUGE X
5/16"
1
HEALTHY ACCENTS
UNIFINE PENTIP
NEEDLE 32 GAUGE X
5/32"
3
HUMAPEN LUXURA
HD
3
INCONTROL PEN
NEEDLE NEEDLE 29
GAUGE X 1/2", 31
GAUGE X 1/4", 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
INCONTROL PEN
NEEDLE NEEDLE 32
GAUGE X 5/32"
3
INSULIN SYRINGE
MICROFINE
SYRINGE 0.3 ML 28 X
1/2", 1 ML 27 GAUGE
X 5/8"
1
insulin syringe
needleless
1
this table.
351
Drug Name
/Limits
MAXI-COMFORT
INSULIN SYRINGE
1
MINI ULTRA-THIN II
1
MINIMED SYRINGE
RESERVOIR
3
MONOJECT INSULIN
SAFETY SYRING
1
MONOJECT INSULIN
SYRINGE SYRINGE
0.3 ML 29 GAUGE X
1/2", 0.3 ML 31 X
5/16", 1 ML , 1 ML 25
GAUGE X 5/8", 1 ML
27 GAUGE X 1/2", 1
ML 28 GAUGE X 1/2",
1 ML 29 X 1/2", 1 ML
30 GAUGE X 5/16, 1
ML 31 X 5/16", 1/2 ML
28 GAUGE X 1/2", 1/2
ML 29 X 1/2", 1/2 ML
31 X 5/16"
1
Drug Name
/Limits
PEN NEEDLE
NEEDLE 30 GAUGE X
5/16", 32 GAUGE X
5/32"
3
pen needle, diabetic
needle 29 gauge x 1/2",
31 gauge x 1/3", 31
gauge x 1/4", 31 gauge
x 5/16"
1
needle 31 gauge x 1/6"
3
PENTIPS
3
PRODIGY INSULIN
SYRINGE
1
RELION NEEDLES
1
RELION PEN
NEEDLES
3
SAFESNAP INSULIN
SYRINGE
1
SNAP INSULIN PUMP
CONTROLLER
3
SURE COMFORT INS.
SYR. U-100
1
MONOJECT SYRINGE
SYRINGE 1/2 ML 28
GAUGE
3
MONOJECT ULTRA
COMFORT INSULIN
1
SURE COMFORT
INSULIN SYRINGE
1
NOVOFINE 30
1
NOVOFINE 32
1
NOVOFINE
AUTOCOVER
1
1
NOVOFINE PLUS
3
SURE COMFORT PEN
NEEDLE NEEDLE 29
GAUGE X 1/2", 31
GAUGE X 3/16", 31
GAUGE X 5/16"
NOVOPEN ECHO
3
NOVOTWIST
3
3
PARADIGM
RESERVOIR
3
SURE COMFORT PEN
NEEDLE NEEDLE 30
GAUGE X 5/16", 32
GAUGE X 1/4", 32
GAUGE X 5/32"
SURE-FINE PEN
NEEDLES
1
SURE-JECT INSULIN
SYRINGE
1
TERUMO INSULIN
SYRINGE
1
PEN NEEDLE
NEEDLE 29 GAUGE X
1/2", 31 GAUGE X
1/4", 31 GAUGE X
3/16", 31 GAUGE X
5/16"
1
this table.
352
Drug Name
/Limits
THINPRO INSULIN
SYRINGE
1
THINSET
RESERVOIR
3
TOPCARE
CLICKFINE
1
TOPCARE ULTRA
COMFORT
1
TRUEPLUS INSULIN
1
ULTICARE NEEDLE
29 GAUGE X 1/2", 31
GAUGE X 1/4", 31
GAUGE X 5/16"
1
ULTICARE NEEDLE
32 GAUGE X 5/32"
3
ULTICARE SYRINGE
0.3 ML 29 X 1/2", 0.3
ML 30 X5/16 ", 1 ML
29 X 1/2", 1 ML 30
GAUGE X 5/16", 1/2
ML 29 X 1/2 ", 1/2 ML
30 GAUGE X 5/16"
3
ULTICARE SYRINGE
0.3 ML 30 GAUGE X
1/2", 0.3 ML 31 X
5/16", 1 ML 30
GAUGE X 1/2", 1 ML
31 X 5/16", 1/2 ML 30
GAUGE X 1/2", 1/2
ML 31 X 5/16"
1
ULTILET INSULIN
SYRINGE
1
ULTILET PEN
NEEDLE
3
ULTRA CMFT INS
SYR HALF UNIT
1
Drug Name
/Limits
ULTRA COMFORT
INSULIN SYRINGE
SYRINGE 0.3 ML 29
30, 0.3 ML 30 GAUGE
X 5/16, 0.3 ML 31 X
5/16", 1 ML 28, 1 ML
28 GAUGE X 1/2", 1
ML 29, 1 ML 29 X 1/2",
1 ML 30 GAUGE X
5/16, 1 ML 30 GAUGE
X 7/16", 1 ML 31 X
5/16", 1/2 ML 28
GAUGE, 1/2 ML 28
GAUGE X 1/2", 1/2
ML 29 , 1/2 ML 29 X
1/2", 1/2 ML 30 , 1/2
ML 30 GAUGE X 5/16,
1/2 ML 31 X 5/16"
1
ULTRA-THIN II
(SHORT) INS SYR
1
ULTRA-THIN II
(SHORT) PEN NDL
1
ULTRA-THIN II INS
PEN NEEDLES
1
ULTRA-THIN II
INSULIN SYRINGE
1
UNIFINE PENTIPS
NEEDLE 29 GAUGE X
5/16", 30 GAUGE X
5/16", 32 GAUGE X
5/32"
3
UNIFINE PENTIPS
NEEDLE 29 GAUGE,
29 GAUGE X 1/2", 31
GAUGE X 1/4", 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
UNIFINE PENTIPS
PLUS NEEDLE 29
GAUGE X 1/2", 31
GAUGE X 1/4", 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
this table.
353
Drug Name
UNIFINE PENTIPS
PLUS NEEDLE 32
GAUGE X 5/32"
VANISHPOINT
SYRINGE SYRINGE 1
ML 29 X 1/2"
VANISHPOINT
SYRINGE SYRINGE
1/2 ML 30 GAUGE X
1/2"
/Limits
3
3
1
MEDICAL
SUPPLIES & DME IRRIGATION
SUPPLIES
BSS/BSS PLUS
ADMIN SET
1
Drug Name
/Limits
BD INTEGRA
SYRINGE SYRINGE 3
ML 25 GAUGE X 1"
3
BD Q-SYTE
EXTENSION SET, 6"
1
BD SAF-T-INTIMA
3
COMFORT INFUSION
SET 31"
1
COMFORT SHORT
INFUSION SET 23"
3
COMFORT SHORT
INFUSION SET 31"
3
COMFORT SHORT
INFUSION SET 43"
3
ECLIPSE SYRINGE
SYRINGE 3 ML 21
GAUGE X 1", 3 ML 25
GAUGE X 1"
3
3
COLOPLAST
IRRIGATION SET
IRRIGATION SET
1
COMBINATION
CONE/TUBE DRAIN
1
HI-VOLUME
PUMPING CHAMBER
SET
CONE-TUBE
IRRIGATION SET
1
INFUSION SET
1
INFUSION SET 23"
1
INFUSION SET 23"
6MM
1
INFUSION SET 43"
6MM
1
INFUSION SET 43"
9MM
1
INSYTE IV
CATHETER
3
3
MEDICAL
SUPPLIES & DME IRRIGATION-TYP
E SYRINGES
ASEPTO BULB
SYRINGE,REUSABLE
3
MEDICAL
SUPPLIES & DME IV SETS-TUBING
ANGIOCATH
AUTOGUARD IV
CATH
3
INTEGRA SYRINGE
SYRINGE 3 ML 21
GAUGE X 1"
ASEPTO BULB
1
INTROSYTE
AUTOGUARD
3
BD ANGIOCATH IV
CATHETER
3
iv administration set
1
BD INSYTE
AUTOGUARD
3
MICROBORE
EXTENSION SET
3
this table.
354
Drug Name
/Limits
MONOJECT SAFETY
SYRINGES SYRINGE
3 ML 21 GAUGE X 1"
1
NEXIVA
3
PHASEAL
SECONDARY SET
3
PHASEAL Y-SITE
3
PIPETTE 120ML
CATHETER TIP
1
PIPETTE 30ML
CATHETER TIP
1
PIPETTE 45ML
CATHETER TIP
1
PIPETTE 90ML
CATHETER TIP
1
POSIDYNE ELD
FILTER
Drug Name
/Limits
CONDOMS-PREM
LUBRICATED
1
FANTASY
1
KIMONO
CONDOMS(NON-LUB
RICATED)
1
KIMONO MAXX
CONDOMS
1
KIMONO
MICROTHIN AQUA
LUBE CON
1
KIMONO
MICROTHIN
CONDOMS
1
1
3
KIMONO
MICROTHIN LARGE
CONDOMS
SAFELET IV
CATHETER
3
KIMONO TEXTURED
CONDOMS
1
SCALP VEIN SET
3
TRUSTEX LATEX
CONDOM
1
SILHOUETTE
23"-FULL SET
3
1
SILHOUETTE
43"-FULL SET
3
TRUSTEX
LUBRICATED
CONDOMS
SILHOUETTE
INFUSION SET
1
3
TRUSTEX NON-LUB
CONDOMS
SOF-SET
3
TRUSTEX-RIA
LUB/SPERMICIDE
1
SOF-SET MICRO 42"
POLYFIN TUB
3
TRUSTEX-RIA
NON-LUB CONDOMS
1
SOF-SET QR 42"
TUBING
3
SOLUTION
TRANSFER DEVICE
3
SURGUARD2
SAFETY SYRINGE 3
ML 21 GAUGE X 1", 3
ML 25 GAUGE X 1"
3
MEDICAL
SUPPLIES & DME MALE ERECTILE
DYSFUNCTION
AIDS
RAPPORT VACUUM
THERAPY
3
MEDICAL
SUPPLIES & DME MALE CONDOMS
AIMSCO
1
this table.
355
Drug Name
/Limits
MEDICAL
SUPPLIES & DME MISCELLANEOUS
OTHER
Drug Name
/Limits
blood pressure kit-extra
large
1
blood pressure monitor
1
blood pressure test
kit-large
1
blood pressure test
kit-medium
1
470V TWO WAY
VALVE
3
adapter cap for bottle
1
AIRS PEDIATRIC
DISPOSABLE MASK
1
blood pressure test
kit-small
1
AMBER GLASS
BOTTLE
3
blood pressure test
kit-wrist
1
AMIELLE VAGINAL
TRAINER
3
BLOOD PRESSURE
UNIT-WRIST
1
ANTI-EMBOLISM
STOCKINGS
1
BOSTON ROUND
NATURAL
1
ARGYLE
TRACHEOSTOM
TUBE HOLDER
BOTTLE
1
3
1
ARGYLE
TRACHEOSTOMY
CARE TRAY
BOTTLETOP
DISPENSER
ADAPTER
3
BOULES QUIES EAR
PLUGS
3
AUTODROP
3
cane tips
3
AUTOSQUEEZE
3
CARTRIDGE
STAMPED IR 1200
3
CLEAR GLASS
SERUM BOTTLE
3
COMBINATION
WATER BOTTLE
3
BARD CATHETER
STRAP
3
BARD
CUNNINGHAM
INCONTIN CLAMP
1
BD SHARPS
COLLECTOR
3
CRUTCH
ACCESSORY KIT
3
BD THERMOMETER
ORAL SHEATHS
3
CRUTCH
HANDGRIPS
3
BEUTLICH PH TEST
ROLL
3
CRUTCH TIPS
1
BLOOD PRESSURE
CUFF
C-TUB
3
1
BLOOD PRESSURE
KIT
1
1
CURITY SPNG
COUNTER BAG
STRIPS
blood pressure kit med
and lrg
1
CURITY
TRIANGULAR
BANDAGE
3
CUT N CRUSH
2
ST
this table.
356
Drug Name
/Limits
DELUXE ARM
BLOOD PRESSURE
MON
1
DISPOSABLE PAPER
MOUTHPIECE
3
DOVER TWO-SIDED
ADHESIVE STRAP
Drug Name
/Limits
ICY HOT SMART
RELIEF THERAPY
3
INCONTROL BP
MONITOR
1
INSUL-TRAY
3
3
JETCO-SPRAY
CANNULA
3
DRAINABLE POUCH
CLAMP
1
KANGAROO PET
CHARGING CORD
3
DRAIN-TUBE
ATTACHMENT
DEVICE
1
KANGAROO PET
FRAME FOR PUMP
3
ELASTIC FOAM
STRAPS
3
KANGAROO PET
PUMP CARRY CASE
3
empty container
3
KENDALL
CONTAINER
3
ENEMA
1
ERASE
3
LICE AND NIT
REMOVAL COMB
3
ERASE RAS-POURI
3
LIQUA SPEN
3
FACE SPLASH
SHIELD, FULL
3
MASTISOL STERTIP
AEROSOL,SPRAY
3
FACE SPLASH
SHIELD, SHORT
3
MASTISOL STERTIP
LIQUID
1
medical information id
tag
3
MONOJECT
BRACKET-SHARPS
CONT
3
FEEDING TUBE
ATTACHMENT
DEVICE
3
FORA TEST N'GO BP
SYSTEM
3
GUARDIAN SHARPS
COLLECTOR
3
MONOJECT FILTER
CONNECTOR
1
HEAVY DRAINAGE
DRESSING STERIL
3
MONOJECT FINGER
GRIP EXTENDERS
3
HORIZONTAL
DRAIN-TUBE ATT
DEV
1
MONOJECT SHARPS
WALL CABINET
3
HURRICAINE LIQUID
DISPENSER
3
NEEDLE
COLLECTION AND
DISPOSAL
3
HURRICAINE SPRAY
EXTENSION
3
OCUSOFT EYELID
CLEANSING PADS
3
ICY HOT SMART
RELIEF PADS
3
OMNIPOD INSULIN
REFILL
3
this table.
357
Drug Name
/Limits
PEDIATRIC
MOUTHPIECES
3
PEDIATRIC-SMALL
MOUTH ADAPTOR
3
PEDI-PRE TAPE
SPRAY
3
PLASTIC ADAPTER
3
PLASTIC ADAPTER
KIT-AUTOINJECT
3
PRECISEDOSE
DISPENSER TIP CAP
1
PROBE COVERS
1
PRO-CEPTION
Drug Name
/Limits
SUCTION TUBE
ATTACHMENT
DEVICE
1
SUMMERS EVE
CLEANSING CLOTHS
3
SUPPOSISTRIP
1
suppository container,
empty
3
suppository molds
1
SUPPOSITORY
SHELL, MEDIUM
1
1
3
SUPPOSITORY
SHELL, SMALL
PROFIT PRECISION
SCALE
3
SYRINGE TIP
RECTAL-VAGINAL
3
PROVIEW
3
QUAD CANE TIPS
3
T.E.D.
ANTI-EMBOLISM
STOCKING
1
QUICK RESPONSE BP
MONITOR-LARG
1
T.E.D. SEQUNT
COMPRESS DEVICE
3
RCRA HAZARDOUS
WASTE
3
T:SLIM
3
RECONSTITUBE
3
TABLET CUTTER
3
rectal, vaginal
applicator tip
3
TAMPER-TUF
CONTAINER CLOSER
3
REPLACEMENT
NECKBAND STRAPS
3
TAMPER-TUF ORAL
MED CONT 15CC
3
RID COMPLETE LICE
ELIM KIT
3
TAMPER-TUF ORAL
MED CONT 30CC
3
SAFE-CLIP BY MAIL
3
TENDEROL
3
SEAL TIGHT
3
TENS 502
3
SELF-CATH
3
TENS 504
3
SHARPS CONTAINER
3
tens unit electrodes pad
2x2 "
3
SHARPSAFETY
CONTAINER
3
thermometer probe
covers
1
SHARPS-A-GATOR
DISPOSAL SYSTEM
3
TRANSPORT CHAIR
1
SPECIPAN
COLLECTION UNIT
troche mold
3
3
TUBULAR GAUZE
3
SPLASH SHIELD
FLEX
3
ULTRA-LIGHT
ROLLATOR
1
this table.
358
Drug Name
/Limits
Drug Name
/Limits
UNGUATOR LID
1
3
UNIVERSAL
CATHETER ACCESS
PORT
ALTERA NEBULIZER
SYSTEM
3
1
URI-DRAIN
1
COMPACT
COMPRESSOR
NEBULIZER
vaginal cream
applicator
1
1
vaginal suppository
applicator
COMPACT
ULTRASONIC
NEBULIZER
1
VERTICAL
DRAIN-TUBE ATT
DEVICE
1
3
DEVILBISS
DISPOSABLE
NEBULIZER
3
wheelchair
1
ERAPID NEBULIZER
SYSTEM
YALE CLEANER
3
INSPIRATION
NEBULIZER SYSTEM
1
LC D NEBULIZER
SET
1
LC PLUS
1
LC STAR
3
MICRO AIR
1
MICRO PLUS
NEBULIZER
3
3
MEDICAL
SUPPLIES & DME NASAL DILATOR
STRIPS
BREATHE RIGHT
3
BREATHE RIGHT
VAPOR
3
NASAL STRIPS
3
NASAL STRIPS
LARGE
3
MINI PLUS
NEBULIZER
NASAL STRIPS
MEDIUM
3
NASONEB NASAL
NEBULIZER
3
NASAL STRIPS
MEDIUM-LARGE
3
PARI BABY
NEBULIZER
1
NASAL STRIPS
SMALL-MEDIUM
3
PARI LC SPRINT
NEBULIZER SET
1
PARI LC SPRINT
SINUS
3
PRODIGY MINI-MIST
NEBULIZER
1
MEDICAL
SUPPLIES & DME NEBULIZERS
AEROECLIPSE II
NEBULIZER
3
SIDESTREAM
1
AERONEB GO
NEBULIZER
3
SIDESTREAM
NEBULIZER
1
AIRS DISPOSABLE
NEBULIZER
SIDESTREAM PLUS
3
1
3
ALTERA NEBULIZER
3
SINUSTAR
NEBULIZER
this table.
359
Drug Name
SOOTHE NEB MESH
NEBULIZER
/Limits
3
MEDICAL
SUPPLIES & DME NEEDLES &
SYRINGES
ALLERGIST
PACKAGE
1CC/26GX1/2"
1
ALLERGIST
PACKAGE
1CC/26GX3/8"
1
ALLERGIST
SYRINGE SYRINGE 1
ML 26 X 1/2", 1 ML 26
X 3/8"
3
ALLERGIST
SYRINGE SYRINGE 1
ML 27 X 1/2"
1
ALLERGIST TRAY
1/2 ML 27GX3/8"
1
ALLERGIST TRAY
INTRADERMAL BEV
SYRINGE 1 ML 26 X
3/8", 1 ML 27 X 3/8"
1
Drug Name
/Limits
BD BULK SYRINGE
SLIP TIP SYRINGE 1
ML
1
BD CORNWALL
GLASS CONTROL
LUER
1
BD CURVED TONSIL
REUSABLE
1
BD ECLIPSE
1
BD ECLIPSE
LUER-LOK NEEDLE
1
BD ECLIPSE
LUER-LOK SYRINGE
1 ML 27 X 1/2", 3 ML
23 X 1", 3 ML 25 X
5/8"
1
BD FILTER NEEDLE
5-MICRON NOKO
1
BD FILTER
NEEDLE-5 MICRON
1
BD GLASPAK
SYRINGE
1
BD GLASPAK TB
SYRINGE
1
BD INTEGRA
NEEDLE
1
BD INTEGRA
SYRINGE SYRINGE 1
ML 25 X 5/8", 3 ML 21
X 1 1/2", 3 ML 22
GAUGE X 1 1/2", 3 ML
23 GAUGE X 1", 3 ML
25 GAUGE X 5/8"
1
BD INTERLINK
BLUNT PLASTIC
CAN
1
ALLERGIST TRAY
INTRADERMAL BEV
TRAY 1 ML 26
GAUGE X 3/8"
1
ALLERGIST TRAY
REGULAR BEVEL
TRAY
1
BD ALLERGIST
TRAY
1
BD ALLERGIST
TRAY REG BEVEL
1
BD ALLERGY
SYRINGE
1
BD INTERLINK
SYRINGE
1
BD BLUNT PLASTIC
CANNULA SYRINGE
1
BD INTRADERMAL
BEVEL NEEDLES
1
BD BULK LUER-LOK
NON-STERILE
1
BD LUER-LOK BULK
SYRINGE
1
this table.
360
Drug Name
/Limits
BD LUER-LOK
SYRINGE SYRINGE 1
ML, 1 ML 20 GAUGE
X 1", 10 ML 20 X 1
1/2", 10 ML 20 X 1", 10
ML 21 GAUGE X 1",
10 ML 21 X 1 1/2", 10
ML 22 X 1 1/2", 10 ML
22 X 1", 10 ML 23X 1
1/4 ", 20 ML, 3 ML, 3
ML 18 X 1 1/2", 3 ML
20 GAUGE X 1", 3 ML
20 X 1 1/2", 3 ML 21
GAUGE X 1", 3 ML 21
X 1 1/2", 3 ML 21 X 1
1/4", 3 ML 22 GAUGE
X 1", 3 ML 22 X 1 1/2",
3 ML 22 X 1 1/4", 3 ML
23 GAUGE X 1 1/2", 3
ML 23 X 1 1/4 ", 3 ML
23 X 1", 3 ML 24 X 1",
3 ML 25 GAUGE X 1",
3 ML 25 X 1 1/2 ", 3
ML 25 X 5/8", 3 ML 26
X 5/8", 5 ML, 5 ML 20
X 1 1/2", 5 ML 20 X 1",
5 ML 21 GAUGE X 1
1/2", 5 ML 21 GAUGE
X 1", 5 ML 22 GAUGE
X 1 1/2", 5 ML 22 X 1",
5 ML 23 X 1 1/4 ", 5
ML 23 X 1", 60 ML
1
BD LUER-LOK TIP
CONTROL SYRING
1
BD MULTIFIT
REUSABLE BULK
SYRINGE,REUSABLE
2 ML
1
BD MULTIFIT
REUSABLE SYRINGE
Drug Name
/Limits
BD QUINCKE SPINAL
NEEDLE NEEDLE 19
GAUGE X 3", 20
GAUGE X 1 1/4", 20
GAUGE X 2 1/2", 20
GAUGE X 3"
1
BD REGULAR BEVEL
NEEDLES
1
BD SAFETYGLIDE
ALLERGIST TRAY
1
BD SAFETYGLIDE
NEEDLE
1
BD SAFETYGLIDE
SHIELDING REG
1
BD SAFETYGLIDE
SYRINGE SYRINGE
10 ML 22 X 1 1/2", 3
ML 22 X 1 1/2", 3 ML
23 X 1", 3 ML 25 X
5/8", 5 ML 22 GAUGE
X 1 1/2"
1
BD SAFETYGLIDE
TB REG BEVEL
1
BD SAFETYGLIDE
TUBERCULIN
1
BD SAFETY-LOK
DETACHABLE
NEEDL
1
BD SAFETY-LOK
TUBERCULIN
SYRINGE 1 ML 25
GAUGE X 5/8"
3
BD SAFETY-LOK
TUBERCULIN
SYRINGE 1 ML 27
GAUGE X 1/2"
1
1
1
BD NOKOR ADMIX
NEEDLE
BD SAFETY-LOK
WITH LUER-LOK
1
1
BD PRECISIONGLIDE
1
BD SLIP TIP
SYRINGE
BD PRECISIONGLIDE
NON-STERILE
1
B-D SLIP TIP
SYRINGE
1
this table.
361
Drug Name
/Limits
Drug Name
/Limits
BD SPECIALTY USE
NEEDLES
1
DISPOSABLE
NEEDLES
1
BD STRAIGHT
TONSIL REUSABLE
1
DOVER BULB
SYRINGE
3
BD SYRINGE BULK
STERILE PAK
SYRINGE 10 ML
1
EASY TOUCH
FLURINGE
1
3
1
EASY TOUCH
FLURINGE FLU
TRAY
EASY TOUCH SYR
ALLERGY TRAY
3
EASY TOUCH
SYRINGE
1
ECLIPSE NEEDLE
NEEDLE 23 GAUGE X
1"
3
ECLIPSE SYRINGE
SYRINGE 1 ML 25 X
5/8"
1
EXCEL SYRINGE
1
EXEL HYPODERMIC
NEEDLES NEEDLE 16
GAUGE X 1 1/2", 18
GAUGE X 1 1/2", 19
GAUGE X 1", 20
GAUGE X 1 1/2", 20
GAUGE X 1", 20 X 3/4
", 21 GAUGE X 1", 21
X 1 1/2 ", 22 GAUGE X
1 1/2", 22 GAUGE X
1", 22 X 3/4 ", 23
GAUGE X 3/4", 25
GAUGE X 1 1/2", 25
GAUGE X 1", 25 X 3/4
", 25 X 5/8 ", 26
GAUGE X 1 1/2", 26
GAUGE X 1/2", 26
GAUGE X 3/8", 26
GAUGE X 5/8", 27
GAUGE X 1/2", 30
GAUGE X 1/2"
1
BD SYRINGE
SYRINGE 1 ML, 60
ML
BD SYRINGE-DUAL
CANNULA
1
BD TUBERCULIN
SLIP-TIP
1
BD TUBERCULIN
SYRINGE
1
BD WHITACRE
SPINAL NEEDLE
3
BD YALE REGULAR
BEVEL
1
BD YALE REUSABLE
GLASS LUER
1
BD YALE REUSABLE
REG METAL
1
BD YALE REUSABLE
SHORT METAL
1
BD YALE SHORT
BEVEL
1
BD YALE TB
REUSABLE GLASS
LUE
1
blunt needle, disposable
needle 18 x 1 1/2 "
3
needle 22 x 1 1/2 ", 23 x
1"
1
BLUNT SPINAL
NEEDLE
1
DAVOL IRRIGATION
SYRINGE
1
DAVOL PISTON
IRRIGATION
1
this table.
362
Drug Name
/Limits
EXEL SYRINGE
SYRINGE 10 ML, 3
ML 27 X 1 1/4", 30 ML,
50 ML
1
filter needles needle 18
gauge x 1 1/2"
Drug Name
/Limits
MEDSAVER
SYRINGE
1
MONOJECT 140CC
PISTON SYRINGE
1
1
MONOJECT 3CC SYR
25GX1"
1
FLOW-EZE VENTED
NEEDLE
1
MONOJECT
ALLERGY TRAY
1
huber safety needles
(disp.)
1
MONOJECT
ALLERGY TRAY
DETACH
1
MONOJECT BLUNT
CANNULAS
1
MONOJECT
CONTROL SYRINGE
LUER
1
MONOJECT
DISPOSABLE
SYRINGE
1
MONOJECT
ECCENTRIC
NON-STERILE
SYRINGE 35 ML
1
MONOJECT FILTER
ASPIRATOR
1
MONOJECT FILTER
NEEDLE
1
HYPODERMIC
NEEDLES NEEDLE 21
GAUGE X 1", 22
GAUGE X 1", 23
GAUGE X 1 1/2", 26
GAUGE X 5/8"
1
INJECT-EASE
1
INTEGRA SYRINGE
SYRINGE 1 ML 25
GAUGE X 1"
1
INTERLINK SYRINGE
AND CANNULA
3
LIFESHIELD BLUNT
CANNULA NEEDLE
1
LIFESHIELD BLUNT
CANNULA SYRINGE
1 ML 18 GAUGE X 1",
3 ML 18 X 1"
1
LOCAL ANESTHESIA
NEEDLE 20GX6"
3
LOCAL ANESTHESIA
NEEDLE 22GX2"
3
LUER LOCK
SYRINGE SYRINGE
30 ML
1
LUER SLIP TIP
SYRINGE TRAY
3
LUER-LOK TIP
1
MAGELLAN
SYRINGE SYRINGE 1
ML 27 GAUGE X 1/2"
3
this table.
363
Drug Name
MONOJECT
HYPODERMIC
NEEDLES NEEDLE 14
GAUGE X 1 1/2", 14
GAUGE X 1", 14
GAUGE X 2", 15
GAUGE X 1 1/2", 16
GAUGE X 1 1/2", 16
GAUGE X 1", 16
GAUGE X 3/4", 16
GAUGE X 5/8", 18
GAUGE X 1 1/2", 18
GAUGE X 1", 19
GAUGE X 1 1/2", 19
GAUGE X 1", 20
GAUGE X 1 1/2", 20
GAUGE X 1", 21
GAUGE X 1", 21
GAUGE X 2", 21 X 1
1/2 ", 22 GAUGE X 1
1/2", 22 GAUGE X 1",
23 GAUGE X 1", 25
GAUGE X 1 1/2", 25
GAUGE X 1", 25 X 1
1/4 ", 25 X 2 ", 25 X 5/8
", 27 GAUGE X 1 1/2",
27 GAUGE X 1 1/4", 27
GAUGE X 1/2", 30
GAUGE X 3/4"
/Limits
1
Drug Name
/Limits
MONOJECT
PHARMACY TRAY
LUER
1
MONOJECT
PHARMACY TRAY
REG TIP
1
MONOJECT REG TIP
NON-STERILE
1
MONOJECT
REGULAR LUER
SYRINGE 3 ML, 35
ML, 6 ML
1
MONOJECT SAFETY
LUER LOCK TIP
1
MONOJECT SAFETY
SYRINGES SYRINGE
, 12 ML, 12 ML 20 X 1
1/2", 3 ML 20 GAUGE
X 1 1/2", 3 ML 21
22 GAUGE X 1 1/2", 3
ML 22 GAUGE X 1", 3
ML 23 GAUGE X 1", 3
ML 25 GAUGE X 5/8"
1
MONOJECT SAFETY
SYRINGES SYRINGE
12 ML 21X 1 1/2", 6
ML
3
MONOJECT
SMARTIP CANNULA
3
MONOJECT SYRINGE
CATHETER
1
MONOJECT
HYPODERMIC
NEEDLES NEEDLE 23
GAUGE X 1/2", 26
GAUGE X 1 1/2"
3
MONOJECT
HYPODERMIC
POLYPROPYL
1
MONOJECT SYRINGE
LUER LOK SYRINGE
35 ML, 60 ML
1
MONOJECT
LUER-LOCK TIP
SYRINGE 12 ML
1
MONOJECT SYRINGE
REGULAR LUER
1
MONOJECT
MAGELLAN
SYRINGE
3
MONOJECT
MEDICATION
TRANSF NDL
1
this table.
364
Drug Name
/Limits
MONOJECT SYRINGE
SYRINGE 12 ML, 12
ML 18 GAUGE X 1",
12 ML 20 X 1 1/2", 12
ML 21 GAUGE X 1
1/2", 12 ML 21
GAUGE X 1", 3 ML, 3
ML 20 GAUGE X 1", 3
ML 20 X 1 1/2", 3 ML
20 X 3/4", 3 ML 21
GAUGE X 1", 3 ML 21
X 1 1/2", 3 ML 22
GAUGE X 1", 3 ML 22
X 1 1/2", 3 ML 23 X 1",
3 ML 25 GAUGE X 1",
3 ML 25 X 1 1/4", 3 ML
25 X 5/8", 3 ML 27 X 1
1/4"
1
MONOJECT SYRINGE
SYRINGE 140 ML, 6
ML, 6 ML 20 X 1 1/2",
6 ML 21 X 1 1/2", 6 ML
21 X 1", 6 ML 22 X 1
1/2"
3
MONOJECT TB
1
MONOJECT TB LUER
LOK
1
MONOJECT TB
SAFETY SYRINGE
1
MONOJECT
TUBERCULIN
SYRINGE SYRINGE 1
ML
3
MONOJECT
TUBERCULIN
SYRINGE SYRINGE 1
ML 25 X 5/8", 1 ML 26
X 3/8", 1 ML 27 X 1/2",
1 ML 28 GAUGE X
1/2", 1/2 ML 28 X 1/2"
1
needle (disp) 16 g
1
needle (disp) 18 g
1
needle (disp) 19 g
1
needle (disp) 23 gauge
1
Drug Name
/Limits
needles, huber
disposable
1
NOKOR NEEDLE
1
PARASYMPATH
NERVE NDL 20 G X6"
3
POLY HUB NEEDLE
1
SAFESNAP SYRINGE
SYRINGE 1 ML 25
GAUGE X 5/8", 1 ML
27 GAUGE X 1/2", 10
ML 22 GAUGE X 1
1/2", 3 ML 25 X 1", 5
ML 20 X 1"
3
SAFESNAP SYRINGE
SYRINGE 10 ML, 10
ML 20 GAUGE X 1
1/2", 10 ML 20
GAUGE X 1", 10 ML
21 GAUGE X 1 1/2", 10
ML 21 GAUGE X 1",
10 ML 22 GAUGE X
1", 3 ML, 3 ML 20
20 GAUGE X 1", 3 ML
21 GAUGE X 1 1/2", 3
ML 21 GAUGE X 1", 3
ML 22 GAUGE X 1", 3
ML 22 X 1 1/2", 3 ML
23 GAUGE X 1 1/2", 3
ML 23 GAUGE X 1", 3
ML 25 GAUGE X 5/8",
5 ML, 5 ML 20
21 GAUGE X 1 1/2", 5
ML 21 GAUGE X 1", 5
ML 22 GAUGE X 1
1/2", 5 ML 22 GAUGE
X 1"
1
safety needles
3
SURGUARD2
SAFETY NEEDLE
3
this table.
365
Drug Name
/Limits
SURGUARD2
SAFETY SYRINGE 1
ML 25 GAUGE X 5/8",
1 ML 26 GAUGE X
3/8", 1 ML 27 GAUGE
X 1/2", 10 ML 20
GAUGE X 1 1/2", 10
ML 20 GAUGE X 1",
10 ML 21 GAUGE X 1
1/2", 3 ML 20 GAUGE
X 1 1/2", 3 ML 20
GAUGE X 1", 3 ML 21
22 GAUGE X 1 1/2", 3
ML 22 GAUGE X 1", 3
ML 23 GAUGE X 1", 3
ML 25 GAUGE X 5/8",
5 ML 20 GAUGE X 1
1/2", 5 ML 20 GAUGE
X 1", 5 ML 21 GAUGE
X 1 1/2"
3
syringe (disposable)
1
syringe (reusable)
1
SYRINGE
3CC/20GX1"
1
SYRINGE
3CC/21GX1"
1
SYRINGE
3CC/21GX1-1/2"
1
SYRINGE
3CC/22GX1"
1
SYRINGE
3CC/22GX3/4"
1
SYRINGE
3CC/25GX1"
1
syringe with needle
(disp) syringe 1 ml 25
gauge x 1", 3 ml 20 x 1
1/2", 3 ml 22 x 1 1/2"
1
syringe with needle,
safety
3
TERUMO ALLERGY
SYRINGE
1
Drug Name
/Limits
TERUMO
HYPODERMIC
NEEDLE/SYRIN
1
TERUMO SYRINGE
1
TITUS NEEDLE
1
TOOMEY SYRINGE
3
TUBERCULIN
SYRINGE SYRINGE 1
ML, 1 ML 25 GAUGE
X 1", 1 ML 25 X 5/8", 1
ML 27 X 1/2"
1
tuberculin-allergy
syringes
1
ULTICARE SYRINGE
1 ML 25 X 5/8"
1
ULTICARE SYRINGE
1.5 ML 22 GAUGE X 1
1/2"
3
VANISHPOINT
SYRINGE SYRINGE 1
ML 25 GAUGE X 1", 3
ML 20 GAUGE X 1", 3
ML 21 GAUGE X 1", 3
ML 21 X 1 1/2", 3 ML
22 GAUGE X 1", 3 ML
22 X 1 1/2", 3 ML 23
23 X 1", 3 ML 25
GAUGE X 1", 3 ML 25
X 5/8", 5 ML 21
GAUGE X 1", 5 ML 22
GAUGE X 1 1/2"
1
VANISHPOINT
TUBERCULIN
SYRINGE
1
YALE DISPOSABLE
NEEDLES
1
YALE NEEDLE
HUBER BEVEL
1
YALE NEEDLE
INTRADERMAL
BEVEL
1
this table.
366
Drug Name
/Limits
Drug Name
/Limits
YALE NEEDLE
REGULAR BEVEL
1
PRECISEDOSE
DISPENSER
1
YALE REUSABLE
NEEDLE
1
ULTRA FINE CUT N
CRUSH
1
YALE REUSABLE
SYRINGE 100CC
1
YALE SPINAL
NEEDLE
1
MEDICAL
SUPPLIES & DME NERVE
STIMULATORS &
ACCESSORIES
NEUROPEN
3
NEUROTIPS
3
MEDICAL
SUPPLIES & DME NEUROLOGICAL
DIAGNOSTIC
SUPPLIES
NEUROPEN
MONOFILAMENTS
3
MEDICAL
SUPPLIES & DME OPTICAL
SUPPLIES OTHER
SCHIRMER TEAR
TEST
3
MEDICAL
SUPPLIES & DME ORAL DOSING
DEVICES
MEDICINE DROPPER
1
MEDICINE DROPPER
AND SPOON
1
MEDICINE SPOON
3
MONOJECT ORAL
MEDICAL SYRINGE
1
oral dosing syringes
1
ORAL DROPPER
1
MEDICAL
SUPPLIES & DME OSTOMY
SUPPLIES
ACTIVE LIFE 1-PC
CL-END POUCH
1
ACTIVE LIFE 1-PC
STOMA CAP
1
ACTIVE LIFE
CLOSED-END POUCH
3
ACTIVE LIFE
CONVEX DRAIN
POUCH 1 1/8 ", 1 3/8 ",
7/8 "
1
ACTIVE LIFE
CONVEX
UROSTOMY
1
ACTIVE LIFE
CUT-TO-FIT CLOSED
1
ACTIVE LIFE
DRAINABLE POUCH
,1"
1
ACTIVE LIFE
PRE-CUT CLOSED
END
1
ACTIVE LIFE
PRE-CUT
DRAINABLE
1
ACTIVE LIFE
UROSTOMY POUCH
1 3/4 " (9")
1
ADAPT BARRIER
RING
1
ADAPT BARRIER
STRIPS
1
ADAPT CONVEX
BARRIER RINGS
1
this table.
367
Drug Name
/Limits
ADAPT
LUBRICATING
DEODORANT
1
ADAPT OSTOMY
PASTE
1
ADAPT PASTE
3
ADAPT STOMA
POWDER
Drug Name
/Limits
ASSURA CONVEX
FLANGE
1
ASSURA CONVEX
LIGHT STANDARD
1
ASSURA CONVEX
SKIN BARRIER
1
1
ASSURA CONVEX
SKIN BARRIER FLA
1
ADHESIVE BARRIER
2-PC
1
ASSURA CONVEX
UROPOUCH
1
ADHESIVE
BARRIERS
1
1
ALLKARE PROTECT
BARRIER WIPES
ASSURA EASICLOSE
DRAINABLE 11
1/4-600 "-ML
1
1
ASSURA 2PC
DRAINABLE
ASSURA EASICLOSE
MINI POUCH
1
ASSURA 2PC
IRRIGATION SLEEVE
3
1
ASSURA EASICLOSE
MINI POUCH 10
1/4-470 "-ML
ASSURA AC
BASEPLATE
1
ASSURA EASICLOSE
WIDE MAXI
1
ASSURA AC CLOSED
POUCH
1
ASSURA EXTRA
CONVEX FLANGE
1
ASSURA EXTRA
CONVEX POUCH
1
ASSURA EXTRA
NON-CONVEX
FLANGE
1
ASSURA EXTRA
NON-CONVEX
POUCH
1
ASSURA FLANGE 1
5/8 "
1
ASSURA FLANGE 1
7/8 "
3
ASSURA FLANGE
CONVEX 1 1/2 ", 1 5/8
"
1
ASSURA FLANGE
CONVEX 1 7/8 "
3
ASSURA ILEO NIGHT
POUCH
1
ASSURA AC
CONVEX
BASEPLATE , 1 1/4 ",
1 1/8 ", 1 3/8 "
1
ASSURA AC
CONVEX
BASEPLATE 1 ", 7/8 "
3
ASSURA AC DRAIN
POUCH MAXI
1
ASSURA AC
EASICLOSE DRAIN
MIDI
1
ASSURA AC
EASICLOSE POUCH
1
ASSURA CONVEX
1-PIECE DRAINABL
1
ASSURA CONVEX
CLOSED POUCH
1
ASSURA CONVEX
EASICLOSE MAXI
1
this table.
368
Drug Name
/Limits
ASSURA IRRIG FCE
PLT 1/2-2 1/4
1
ASSURA LIGHT
EASICLOSE
DRAINAB
1
ASSURA
NON-CONVEX
DRAINABLE
1
ASSURA OSTOMY
BELT
Drug Name
/Limits
CENTERPOINTLOCK
FLEXWEAR SKIN 1 ",
1 1/2 ", 1 1/4 ", 1 3/4 ",
3/4 ", 4 "
1
CENTERPOINTLOCK
SOFTFLEX SKIN
1
CENTERPOINTLOCK
STOMA CAP
1
1
CENTERPOINTLOCK
STOMA IRRIGAT
1
ASSURA PEDIATRIC
POUCH
1
CENTERPOINTLOCK
UROSTOMY POUCH
1
ASSURA PEDIATRIC
SKIN BARRIER
1
CHLOROPHYLL
1
CLOSED-END POUCH
1
ASSURA POUCH
1
ASSURA SKIN
BARRIER FLANGE
1
1
COLOPLAST
BARRIER RING
ASSURA STANDARD
WEAR
1
3
COLOPLAST
IRRIGATION SET KIT
COLOPLAST PASTE
1
ASSURA STANDARD
WEAR UROSTOMY
1
COLOPLAST SKIN
BARRIER
1
ASSURA WOUND
MANAGER 1/2-2 3/4
1
CONTOUR I STOMA
CAP
1
BARD PLASTIC
TUBING/ADAPTER
1
CONVATEC NIGHT
DRAIN CONTAINER
3
CENTERPOINTLOCK
CLOSED POUCH
1
CONVATEC NIGHT
DRAINAGE TUBING
1
CENTERPOINTLOCK
DRAIN FILTER
1
CONVEX SYN BARR
- FLOAT FLANGE
1
CENTERPOINTLOCK
DRAINABLE MINI
1
CPL DRAINABLE
POUCH
1
CENTERPOINTLOCK
DRAINABLE POUC
1
DRAINABLE FECAL
COLLECTOR
1
DRAINABLE POUCH
1
DRAINABLE POUCH
CLAMP
1
1
1
CENTERPOINTLOCK
FLEXTEND CONVE 1
", 1 1/2 ", 1 1/8 ", 1 3/8
", 3/4 ", 5/8 ", 7/8 "
1
CENTERPOINTLOCK
FLEXTEND SKIN 1
1/4 ", 1 3/4 ", 2 1/4 "
1
DUOLOCK CURVED
TAIL CLOSURE
CENTERPOINTLOCK
FLEXWEAR CONVE
1
DURAHESIVE
MOLDABLE
CONVEX
this table.
369
Drug Name
/Limits
EAKIN COHESIVE
SEALS
1
EAKIN COHESIVE
SLIMS
Drug Name
/Limits
3
1
ESTEEM SYNERGY
DRAINABLE POUCH
1 7/8 " (12"), 2 3/8 "
(12")
EAKIN COHESIVE
WAFER 4 X 4 "
1
ESTEEM SYNERGY
UROSTOMY POUCH
1
EAKIN COHESIVE
WAFER 4 X 8 "
ESTEEM SYNERGY+
3
3
EASICLOSE WIDE
OUTLET 2-PC , 11
1/2-655 "-ML
1
3
EASICLOSE WIDE
OUTLET 2-PC 10
1/2-485 "-ML
3
ESTEEM+ CLOSED
POUCH 1 " (8"), 1 3/16
" (8"), 1 3/8 " (8"), 1
9/16 " (8"), 13/16" -2
3/4" (6"), 13/16"-2 3/4"
(8")
FECAL COLLECTOR
1
ELIMINATOR ODOR
SPRAY
1
FILTER CLOSED
MINI-POUCH
1
ESTEEM CLOSED
POUCH
3
FILTRODOR POUCH
FILTER
1
FLEXI-SEAL FMS
1
FLEXI-TRAK
ANCHORING DEVICE
1
FLEXTEND SKIN
BARRIER
1
FRESHNET
1
HEX-ON LIGHT
ODOR
1
HOLLIHESIVE SKIN
BARRIER
1
HOLLISTER
REPLACEMENT
FILTERS
1
ILE-SORB ORIGINAL
1
IRRIGATION SLEEVE
1
KARAYA 5 CLOSED
POUCH
1
KARAYA 5 CLOSED
POUCH - TAPE
1
KARAYA 5
DRAINABLE
MINI-POUCH
1
ESTEEM DRAINABLE
POUCH 1 " (12"), 1 1/2
" (12"), 1 1/4 " (12"), 1
1/8 " (12"), 3/4 " (12"),
7/8 " (12")
3
ESTEEM DRAINABLE
POUCH 1 3/16 " (12"),
1 3/8 " (12"), 1 9/16 "
(12"), 13/16-2 3/4 "
(12")
1
ESTEEM SYNERGY
1
ESTEEM SYNERGY
CLOSED POUCH 1 3/8
"
ESTEEM SYNERGY
CLOSED POUCH 1 7/8
", 2 3/8 "
ESTEEM SYNERGY
DRAINABLE INVIS
ESTEEM SYNERGY
DRAINABLE POUCH
, 1 3/8 " (12")
1
3
3
1
this table.
370
Drug Name
/Limits
KARAYA 5
DRAINABLE POUCH
1
KARAYA 5
DRAINABLE POUCH
CLOTH
1
KARAYA PASTE
1
KARAYA POWDER
1
LITTLE ONES
CLOSED-END POUCH
1
LITTLE ONES
DRAINABLE POUCH
1
LITTLE ONES
FLEXIBLE SKIN
1
LITTLE ONES SKIN
BARRIER
1
LITTLE ONES
UROSTOMY POUCH
1
LOOP OSTOMY
BRIDGE STERILE
1
LO-PROFILE
UROSTOMY POUCH
Drug Name
/Limits
NATURA CLOSED
POUCH
1
NATURA
DRAINABLE POUCH
1 1/2 " (12"), 1 3/4"
(14"), 2 1/4" (14"), 2
3/4" (14"), 4 " (12")
3
NATURA
DRAINABLE POUCH
1 3/4 " (12"), 2 1/4 "
(12"), 2 3/4 " (12")
1
NATURA
DURAHESIVE SKIN
BARRIER
1
NATURA
STOMAHESIVE SKN
BARRIER
1
NEW IMAGE
CLOSED
MINI-POUCH 1 3/4 ",
2 1/4 ", 2 3/4 "
1
1
1
M9
CLEANER-DECRYST
ALLIZER
NEW IMAGE
CLOSED POUCH
1
3
MEDICAL ADHESIVE
1
NEW IMAGE
COLOST-ILEO
KIT,STE
MICRODERM 1 ", 1
1/8 "
1
3
MICRODERM 1 1/2 ",
1 3/8 ", 7/8 "
3
NEW IMAGE
COLOSTOMY-ILEO
KIT 2 3/4 " (12"), 4 "
(12")
NEW IMAGE DRAIN
MINI-POUCH
1
NEW IMAGE
DRAINABLE KIT
3
NEW IMAGE
DRAINABLE
MINI-POUCH 2 1/4 "
1
NEW IMAGE
DRAINABLE POUCH
1 3/4 ", 1 3/4 " (12"), 2
1/4 ", 2 1/4 " (12"), 2
3/4 ", 4 "
1
MICRODERM
PACKAGE
3
MICRODERM PLUS 1
", 1 1/8 "
1
MICRODERM PLUS 1
1/2 ", 1 3/8 ", 7/8 "
3
MICRODERM PLUS
PACKAGE
3
MICROHESIVE
STOMA PASTE
1
MINI UROSTOMY
POUCH
3
this table.
371
Drug Name
NEW IMAGE
DRAINABLE POUCH
2 1/4 " (7"), 4 " (12")
/Limits
3
NEW IMAGE
FLEXTEND BARRIER
FLA
1
NEW IMAGE
FLEXTEND SKN
BARRIER
1
Drug Name
/Limits
OSTOMY
APPLIANCE BELT
1
OSTOMY BELT
LARGE
1
OSTOMY BELT
MEDIUM
1
OSTOMY PASTE
1
ostomy supplies
1
POUCH CLAMP
1
POUCHKINS
DRAINABLE POUCH
1
NEW IMAGE
FLEXWEAR
BARRIER 1 ", 1 1/2 "
1
NEW IMAGE
FLEXWEAR FLAT
1
POUCHKINS
OSTOMY SYSTEM
1
NEW IMAGE
IRRIGATOR SLEEVE
1
POUCHKINS PED
OSTOMY BELT
1
NEW IMAGE LOCK'N
ROLL POUCH 2 3/4 "
1
POUCHKINS SKIN
BARRIER
1
NEW IMAGE
OSTOMY KIT 2 1/4 "
(12 ")
1
POUCHKINS
UROSTOMY POUCH
1
NEW IMAGE
OSTOMY KIT 4 " (12")
3
PREMIER CLOSED
MINI-POUCH 1 " (7"),
1 3/8 " (7")
3
NEW IMAGE SKIN
BARRIER 2 3/4 ", 4 "
1
1
NEW IMAGE SKIN
BARRIER-FLANGE
PREMIER CLOSED
MINI-POUCH 5/8-2 1/8
" (7")
1
NEW IMAGE
UROSTOMY POUCH
1
1
PREMIER CLOSED
POUCH 1 ", 1 3/16 "
(9"), 5/8-2 1/8 " (9")
NEW IMAGE
UROSTOMY SET
3
PREMIER CLOSED
POUCH 1 3/8 " (9")
3
NEW IMAGE
UROSTOMYSET,STE
RILE
3
PREMIER
COLOSTOMY-ILEOS
TOMY
3
NIGHT DRAIN
ADAPTER
1
PREMIER CONVEX
SKIN BARRIER
1
NUTRIPORT
BALLOON
3
PREMIER DRAIN
FLEXTEND CONVEX
1
O.A.D.
1
ODOR ELIMINATOR
DROPS
1
PREMIER
DRAINABLE LOCK N
ROLL 1 1/4 ", 1 1/8 ", 1
3/4 ", 1 3/8 ", 2 1/2 ",
3/4 ", 7/8 "
1
this table.
372
Drug Name
PREMIER
DRAINABLE
1 3/16 " (7"), 1 3/8 "
(7"), 1 9/16 " (7")
/Limits
Drug Name
/Limits
PREMIER
UROSTOMY POUCH
1 ", 1 1/2 ", 1 1/2 " (9"),
1 1/4 ", 1 3/4 ", 1/2 ", 2
", 2 1/2 ", 3/4 ", 5/8 ",
7/8 "
1
PREMIER
UROSTOMY POUCH
1 1/8 ", 1 3/8 ", 2 1/2 "
(9")
3
PREMIUM
DRAINABLE
POUCH/KARAYA
1
PREMIUM SKIN
BARRIER
1
PROTECTIVE
BARRIER FILM
WIPES
1
SENSURA CLICK
OSTOMY POUCH
3
1
SENSURA
EASICLOSE WIDE
(NS)
3
PREMIER HIGH
OUTPUT
DRAINABLE
1
SENSURA
EASICLOSE WIDE
OUTLET
1
PREMIER LOCK N
ROLL 1 ", 1 1/2 ", 2 "
1
SENSURA OSTOMY
BASE PLATE
3
PREMIER PRE-SIZED
MINI-POUCH
3
SKIN GEL PROTECT
DRESSING WIPE
1
PREMIER
UROSTOMY
SKIN PREP WIPES
1
3
SKIN-PREP
SPRAY-ON
DRESSING
3
SOFTFLEX SKIN
BARRIER RING
1
STOMA
CAP-ADHESIVE-FILT
ER
1
STOMA
CONE-CONNECTOR
REPL UNIT
1
STOMA LUBRICANT
1
3
PREMIER
DRAINABLE
MINI-POUCH 1 ", 1
1/2 ", 1 1/4 ", 1 3/16 "
(12"), 1 3/4 ", 2 ", 2 1/2
" (9"), 2 1/8 " (12"), 3/4
", 5/8-2 1/8 " (7")
1
PREMIER
DRAINABLE POUCH
1 ", 1 3/16 " (12"), 1 3/8
" (12"), 1 9/16 " (12"), 2
1/2 ", 2 3/4 ", 3/4 "
1
PREMIER
DRAINABLE POUCH
1 3/8 ", 1 9/16 " (11"), 3
" (12"), 4 1/3 " (12")
3
PREMIER
DRAINABLE POUCH
CONVEX 2 "
PREMIER
UROSTOMY
CONVEX POUCH 1 ",
1 1/2 ", 1 1/8 ", 1 3/8 ",
1/2 ", 5/8 ", 7/8 "
PREMIER
UROSTOMY
FLEXTEND POUC , 1
1/2 ", 1 1/4 ", 1 3/4 "
1
1
this table.
373
Drug Name
/Limits
STOMAHESIVE
MOLDABLE
ADHESIVE
1
STOMAHESIVE
PASTE
1
STOMAHESIVE
PROTECTIVE
1
Drug Name
/Limits
SUR-FIT NATURA
MINI-POUCH
1
SUR-FIT NATURA
STOMAHESIVE
1
SUR-FIT NATURA
UROSTOMY ACCUSE
1 1/2 "
1
SUR-FIT NATURA
UROSTOMY POUCH
1
SUR-FIT-ACTIVE
LIFE TAIL CLOS
1
URO MINICAP
1
STOMAHESIVE SKIN
BARRIER , 1 ", 1 1/2
", 1 1/4 ", 1 1/8 ", 1 3/4
", 1 3/8 ", 1 5/8 ", 1/2 ",
3/4 ", 5/8 ", 7/8 "
1
STOMAHESIVE SKIN
BARRIER 1 7/8 "
3
1
STOMAHESIVE SKIN
BARRIER WAFER
UROSTOMY DRAIN
TUBE ADAPTER
1
1
SUR-FIT NATURA
ADAPTOR
UROSTOMY
MICRO-POUCH
1
3
SUR-FIT NATURA
CLOSED POUCH
UROSTOMY
MULTI-CHAMBER
1
SUR-FIT NATURA
CONVEX INSERTS
1
1
UROSTOMY
MULTI-CHAMBER
POUCH
urostomy pouch
1
UROSTOMY
POUCH-MIC
WASHER
1
VISI-FLOW
IRRIGATION SLEEVE
1
VISI-FLOW
IRRIGATION
STARTER 45 MM
1
VISI-FLOW
IRRIGATION
STARTER 70 MM
3
1
SUR-FIT NATURA
DRAINABLE POUCH
, 1 1/2 ", 1 1/4 ", 1 3/4 ",
1 3/4 " (12"), 2 1/4 ", 2
1/4 " (12"), 2 3/4 ", 2
3/4 " (12")
1
SUR-FIT NATURA
DRAINABLE POUCH
1 1/2 " (12")
3
SUR-FIT NATURA
DURAHESIVE
1
SUR-FIT NATURA
FLANGE CAP
1
SUR-FIT NATURA
HIGH OUTPUT
1
VISI-FLOW
IRRIGATOR-STOMA
CONE
SUR-FIT NATURA
IRRIG FACEPLATE
1
VISI-FLOW SLEEVE
TAIL CLOSURES
1
SUR-FIT NATURA
LOW-PRESSURE
1
VISI-FLOW STOMA
CONE
1
this table.
374
Drug Name
/Limits
MEDICAL
SUPPLIES & DME PARENTERAL
THERAPY
SUPPLIES
Drug Name
/Limits
FILTER, MILLEX-OR
SYRINGE
3
HURRICAINE
LUER-LOCK DIS CAP
1
INSET 30 TUBING 23"
GREY
3
INSET 30 TUBING 43"
GREY
3
INTERLINK LEVER
LOCK CANNULA
1
INTERLINK SYRINGE
CANNULA
1
I-PORT
3
ACCU-CHEK
LINKASSIST INS DEV
3
ACCU-CHEK SPIRIT
ADAPTER
1
ACCU-CHEK SPIRIT
CARTRIDGE SYS
3
BD BLUNT PLASTIC
CANNULA
1
BD Q-SYTE MDV
ADAPTER
1
I-PORT ADVANCE 6
MM INJEC PORT
3
BD Q-SYTE
SPLIT-SEPT DEVICE
1
I-PORT ADVANCE 9
MM INJEC PORT
3
BD SYRINGE
STORAGE BINS
3
KENDALL
DISINFECTANT CAP
3
CHEMO TRANSFER
PIN
1
LUER LOCK
ADAPTER
3
CORNWALL METAL
PIPETTING
1
MINI TRANSFER PIN
1
CURITY LUMBAR
PUNCTURE TRAY
3
MONOJECT FINGER
GRIP EXTENDERS
3
CURITY SKIN SCRUB
3
MONOJECT LUER
ADAPTER
3
CURITY
THORACENTESIS
TRAYS
3
MONOJECT SAFETY
SYR TIP CAP
3
MONOJECT TIP
CAPS/FLEX/LUER
3
PARADIGM
INFUSION SET
1
1
CURITY
THORACENTESIS-CA
TH TRAY
3
DISPOSABLE POWER
1
EMPTY
CONTAINERS
STERILE
3
PARADIGM
SILHOUETTE INFUS
SET
EMPTY STERILIZED
VIAL
1
PHASEAL
ASSEMBLY FIXTURE
3
empty vial
1
3
FILTER, MILLEX-FG
0.2 UM
3
PHASEAL
CONNECTOR LUER
LOCK
this table.
375
Drug Name
/Limits
PHASEAL INFUSION
ADAPTER
3
PHASEAL INFUSION
CLAMP
3
PHASEAL INJECTOR
LUER LOCK
3
PHASEAL
PROTECTOR
3
POLYFIN QR/WINGS
INFUSION SET
3
PRODIGY
COUNT-A-DOSE
3
SILHOUETTE
Drug Name
/Limits
ASSESS FULL
RANGE PEAK
METER
1
ASTHMA CHECK
METER
1
ASTHMAMENTOR
PEAK FLOW METER
3
ASTHMAPACK
CHILDREN'S
1
IN-CHECK NASAL
WITH MASK
1
1
3
IN-CHECK ORAL
FLOW METER
SUPOR SYRINGE
FILTER 25-0.2
MM-MICRON
1
3
MICROLIFE PEAK
FLOW METER
3
SURE-T INFUSION
SET
MINI WRIGHT PEAK
FLOW METER
1
1
syringe filter
3
PEAK AIR PEAK
FLOW METER
SYRINGE LUER TIP
CAP
1
PERSONAL BEST
FULL RANGE
1
SYRINGE TIP
CONNECTOR
PIKO 1
1
1
1
TOPI-CLICK FILLING
NOZZLE
POCKET PEAK FLOW
METER
1
1
TRANSFER PIN
1
TRUZONE PEAK
FLOW METER
UNIVERSAL SLEEVE
1
UNIVERSAL
SYRINGE TIP
ADAPTOR
3
VARITHENA
ADMINISTRATION
PACK
3
MEDICAL
SUPPLIES & DME PEAK FLOW
METERS
AEROGEAR ACTION
ASTHMA KIT
3
AIRZONE PEAK
FLOW METER
1
MEDICAL
SUPPLIES & DME RESPIRATORY
THERAPY
SUPPLIES
A.I.R.S NEBULIZER
REPLACEMENT
3
ACE AEROSOL
CLOUD ENHANCER
1
ADULT AEROSOL
MASK
1
ADULT DISPOSABLE
MOUTHPIECE
1
this table.
376
Drug Name
/Limits
AEROBIKA
OSCILLATING PEP
SYSTM
3
AEROCHAMBER
MINI
Drug Name
/Limits
ALL FLOW 3000 PFT
FILTER
3
ALL FLOW 4000 KIT
3
1
ALL FLOW 4000 PFT
FILTER
3
AEROCHAMBER MV
1
ALL FLOW 5000 KIT
3
AEROCHAMBER
PLUS FLOW-VU
1
ALL FLOW 5000 PFT
FILTER
3
AEROCHAMBER
PLUS FLOW-VU,L
MSK
1
ALL FLOW 6000 PFT
FILTER
3
BREATHERITE MDI
SPACER
3
BREATHERITE
VALVED MDI
CHAMBER
3
BREATHERITE
VALVED MDI
SPACER
3
BUBBLES THE FISH
PEDI MASK
1
AEROCHAMBER
PLUS FLOW-VU,M
MSK
1
AEROCHAMBER
PLUS FLOW-VU,S
MSK
1
AEROCHAMBER
PLUS Z STAT LG
MSK
1
AEROCHAMBER
PLUS Z STAT MD
MSK
1
COMP-AIR ELITE
COMP NEB SYSTEM
1
AEROCHAMBER
PLUS Z STAT SM
MSK
1
COMP-AIR
NEBULIZER
COMPRESSOR
1
AEROCHAMBER
WITH FLOWSIGNAL
1
COMP-AIR XLT
COMPRESSOR NEB
1
AEROCHAMBER
Z-STAT PLUS-FLW
SG
1
DEVILBISS
COMPACT
COMPRESSOR
1
AERONEB GO
3
AEROTRACH PLUS
1
DEVILBISS
PULMO-AIDE
COMPRESSR
1
AIR TUBE WITH AIR
PLUGS
1
1
AIRS ADULT
AEROSOL MASK
1
DEVILBISS
PULMOMATE
COMPRESSOR
ALL FLOW 1000 KIT
3
1
ALL FLOW 1000 PFT
FILTER
DEVILBISS
TRAVELER
COMPRESSOR
3
1
ALL FLOW 3000 KIT
3
EASIVENT HOLDING
CHAMBER
this table.
377
Drug Name
/Limits
Drug Name
/Limits
EASIVENT MASK
LARGE
1
LITETOUCH-SMALL
MASK
1
EASIVENT MASK
MEDIUM
1
MASK VORTEX
BABY WHIRL DUCK
1
EASIVENT MASK
SMALL
1
MASK VORTEX
SPINNER THE DUCK
1
ERAPID NEBULIZER
HANDSET
3
MICRO ELITE
COMP-NEBUL
3
EXPIRATORY
MOUTHPIECE
1
MICRO ELITE
LITHIUM BATTERY
3
E-Z SPACER
1
FILTERS
REPLACEMENT
1
1
MICRO ELITE
REPLACEMENT
FILTER
FLEXICHAMBER
3
MICROCHAMBER
1
FLUTTER
1
MICROSPACER
1
IN-CHECK DIAL
TRAINING DEVICE
3
3
INNOSPIRE DELUXE
3
MINI ELITE
COMPRESSOR-NEBU
LIZE
INNOSPIRE
ELEGANCE
1
MINI ELITE FILTER
REPLACEMENT
1
INNOSPIRE ESSENCE
1
MINI ELITE LITHIUM
BATTERY
3
INNOSPIRE MINI
3
MOUTHPIECE
1
INNOSPIRE
REPLACEMENT
FILTER
3
MOUTHPIECE
REUSABLE MW
1
INSPIRACHAMBER
3
NASONEB NASAL
NEBULIZER DEVICE
3
INSPIRACHAMBER
WITH MASK-MED
3
NOSE CLIP
3
INSPIRACHAMBER
WITH MASK-SMALL
3
ONE WAY VALVED
MOUTHPIECE
1
INSPIRATION ELITE
3
1
INSPIRATION ELITE
FILTER
3
OPTICHAMBER
ADULT
MASK-LARGE
OPTICHAMBER
DIAMOND LG MASK
1
OPTICHAMBER
DIAMOND VHC
1
OPTICHAMBER
DIAMOND-MED MSK
1
LITE
TOUCH-MEDIUM
MASK
1
LITEAIRE MDI
CHAMBER
1
LITETOUCH-LARGE
MASK
1
this table.
378
Drug Name
/Limits
OPTICHAMBER
DIAMOND-SML
MASK
1
PANDA MASK
1
PARI BABY CONV
KIT - SIZE 1
Drug Name
/Limits
PRONEB ULTRA II
FILTER ASSEM
1
PROVENT
3
PROVENT STARTER
3
1
PULMO-AIDE
COMPRESSOR
1
PARI BABY
CONVERSION PACK
1
3
PULMONEB LT
COMPRESSOR
NEBUL
1
PARI BABY
CONVERSION PACK
2
3
QUAKE VIBRATORY
PEP
3
PARI LC FILTER
WITH VALVE SET
3
REUSABLE
NEBULIZER KIT
1
PARI LC MASK SET
3
RITEFLO
AEROCHAMBER
3
PARI SINUS
AEROSOL SYSTEM
3
RUBBER
MOUTHPIECE
3
PARI TREK S COMBO
PACK
3
SAMI THE SEAL
1
SAMI THE SEAL
FILTER
1
SAMI THE SEAL
MASK
1
PARI TREK S
COMPACT
COMPRESSOR
3
PARI TREK S
PORTABLE PWR KIT
3
1
PEDIATRIC MEDIUM
MASK
SIDESTREAM ADULT
FACE MASK
1
SIDESTREAM MASK
1
PEDIATRIC PANDA
MASK
1
1
PEDIATRIC SMALL
MASK
SIDESTREAM
PEDIATRIC FACE
MASK
1
SILICONE MASK
3
PFLEX
INSPIRATORY
TRAINER
1
1
SILICONE MASK INFANT
1
PILLOW MASK
CHILD
SILICONE MASK PEDIATRIC
1
SINUSTAR AEROSOL
3
PILLOW MASK
PEDIATRIC
1
3
POCKET CHAMBER
1
SUNRISE
COMPRESSOR-NEBU
LIZER
PRIMEAIRE
1
3
PROCHAMBER
1
THRESHOLD IMT
TRAINER
PRONEB ULTRA II
1
THRESHOLD PEP
DEVICE
3
this table.
379
Drug Name
/Limits
VAPORIZER
CLEANING
3
VAPORIZER
INHALANT
1
VIOS AEROSOL
DELIVERY SYSTEM
1
VORTEX HOLDING
CHAMBER
Drug Name
/Limits
MEDICAL
SUPPLIES & DME SANITARY
NAPKINS &
TAMPONS
PANTY LINERS
1
1
TENA SERENITY
1
VORTEX VHC FROG
MASK-CHILD
1
VORTEX VHC
LADYBUG
MASK-TODDLR
MEDICAL
SUPPLIES & DME SCAR
TREATMENTS
1
CELACYN
3
WINDMILL TRAINER
3
CICA-CARE
ADHESIVE SILICONE
3
WING TIP TUBING
1
REJUVENESS
1
SCAR TREATMENT
3
MEDICAL
SUPPLIES & DME RUBBER
SYRINGES &
SUPPLIES
MEDICAL
SUPPLIES & DME SUBCUTANEOUS
ADMINISTRATION
SUPPLY
CHILD EAR SYRINGE
1
ear syringe
1
ENEMA SYRINGE
3
ACCU-CHEK RAPID
D INFUSION
3
FEMININE BULB
SYRINGE
1
ACCU-CHEK
TENDER
3
FEMININE COMPACT
TRAVEL SYRNGE
1
ACCU-CHEK
ULTRAFLEX
3
FEMININE FOLDING
SYRINGE
1
INSUFLON
1
FOUNTAIN SYRINGE
1
NERIA MULTI
(BI-FURCATED)
3
INFANT EAR
SYRINGE
1
NERIA MULTI
(TRI-FURCATED)
3
NASAL ASPIRATOR
1
rectal syringe (reusable)
3
WATER BOTTLE
1
3
WATER
BOTTLE-FOUNTAIN
SYRINGE
NERIA
SUBCUTANEOUS
INFUSION SET 10 X
110 MM-CM, 6 MM X
110 CM
1
NERIA
SUBCUTANEOUS
INFUSION SET 8 X
110 MM-CM
1
this table.
380
Drug Name
/Limits
Drug Name
STIK IT
MEDICAL
INSULIN
DELIVERY
DEVICES
/Limits
3
MEDICAL
SUPPLIES & DME SURGICAL
SUPPLIES OTHER
VGO 20
3
VGO 30
3
VGO 40
3
MEDICAL
INSULIN PUMP
ARGYLE
CONNECTING TUBES
3
MEDICAL
SUPPLIES & DME THERMOMETERS
BABY
THERMOMETER
1
basal thermometer
1
basal thermometer,
electronic
1
DELUXE INSTANT
EAR THERMOMETER
1
DIGITAL
THERMOMETER
1
ear thermometer
1
ANIMAS VIBE
3
MINIMED 530G
INSULIN PUMP
3
OMNIPOD INSULIN
MANAGEMENT
3
ONETOUCH PING
INSULIN PUMP
3
REVEL PEDIATRIC
PROGRAM PUMP
3
FAST READ
THERMOMETER
1
REVEL
PROGRAMMABLE
PUMP
3
FEVER FLASH
THERMOMETER
1
T:FLEX INSULIN
DELIVERY PUMP
1
3
FOREHEAD
THERMOMETER
T:SLIM INSULIN
DELIVERY SYSTEM
1
3
INSTANT EAR
THERMOMETER
oral thermometer
1
oral thermometer,
electronic
1
PROBE COVERS
1
1
MEDICAL
SUPPLIES & DME SURGICAL
ADHESIVES
MASTISOL
ADHESIVE
1
QUICK READ
DIGITAL
THERMOMETER
MASTISOL LIQUID
ADHESIVE
1
rectal thermometer
1
MASTISOL STERTIP
AEROSOL,SPRAY
3
SOFT-TIP
THERMOMETER
1
MASTISOL STERTIP
LIQUID
1
THERMOMETER
COVERS
1
this table.
381
Drug Name
/Limits
thermometer probe
covers
1
thermometer, temple
electronic
3
THERMOSCAN
THERMOMETER
1
UNIVERSAL GLASS
THERMOMETER
3
VICKS DIGITAL
THERMOMETER
1
VICKS FOREHEAD
THERMOMETER
3
MEDICAL
SUPPLIES & DME TISSUE BULKING
IMPLANTS
COSMETIC
SCULPTRA
3
MEDICAL
IMPLANTS
NON-COSMETIC
SOLESTA
3
MEDICAL
IMPLANTS
SCULPTRA
3
SOLESTA
3
MEDICAL
SUPPLIES & DME URINARY
CATHETERS AND
RELATED
DEVICES
ACTIVE CATH
3
ADD-A-FOLEY
CATH-MONO-FLO
DRNG
1
Drug Name
/Limits
ADD-A-FOLEY
CATH-PRE-FILL
SYRN
1
ADD-A-FOLEY TRAY
1
ADVANCE PLUS
INTERMITTENT
3
ARGYLE TROCAR
1
ASSURA UROSTOMY
POUCH
3
BARD CENTER
ENTRY CLOSE
SYSTEM
1
BARD CLEAN-CATH
1
BARD COUDE TIP
CATHETER
1
BARD FEMALE
INTERMITTENT
CATH
1
BARD INFECT CONT
TRAY-NO CATH
1
BARD LUBRICATH
FOLEY TRAY
1
BARD LUBRICATH
FOLEY TRAY 18FR
1
BARD RUBBER
UTILITY CATHETER
1
BARD UNIVERSAL
FOLEY CATH TRAY
1
BARD URETHRAL
CATHETER TRAY
TRAY 14 FR, 15 FR
3
BARD URETHRAL
CATHETER TRAY
TRAY 16 FR
1
BARD URINARY
DRAINAGE SYSTEM
1
BARDEX
ALL-SILICONE
FOLEY CATH
1
BARDEX CLOSED
SYSTEM CATH TRAY
1
this table.
382
Drug Name
/Limits
BARDEX
LUBRICATH FOLEY
CATH
3
BARDEX URETHRAL
CATHETERTRAY
1
BARDIA URINARY
DRAINAGE BAG
1
BEDSIDE DRAINAGE
COLLECT SYSTM
1
CURITY 8000 URINE
MTR FLY TRAY
1
CURITY BEDSIDE
DRAINAGE SET
1
Drug Name
/Limits
CURITY URETHRAL
CATHETER
1
DAVOL C.S. FOLEY
CATHETER TRAY
1
DAVOL COMPLETE
FOLEY
3
DAVOL FOLEY
CATH INSERT TRAY
1
DAVOL SILICONE
FOLEY CATH
1
DAVOL UNIVERSAL
CATH TRAY
1
DAVOL URETHRAL
CATHETER TRAY
3
DAVOL URETHRAL
CATHTRAY (W/O)
1
CURITY
BEDSIDE-MONO-FLO
DRANGE
1
CURITY FOLEY
CATHETER KIT
3
DAVOL URINARY
DRAINAGE BAG
1
CURITY PREMIUM
CATHETER TRAY
1
DISPOZ-A-BAG LEG
BAG LARGE
1
CURITY STRMLIN
CATH - MONO-FLO
3
DISPOZ-A-BAG LEG
BAG MEDIUM
1
DISPOZ-A-BAG LEG
BAG SMALL
1
DOVER CATHETER
1
DOVER COATED
LATEX FOLEY
3
DOVER LATEX
FOLEY CATHETER
3
DOVER RED
RUBBER ROBINSON
CATH
3
DOVER TEXAS
MALE EXTERNAL
CATH
1
DOVER UNIVERSAL
3
DOVER URI-DRAIN
DELUXE LEG BAG
1
DOVER URI-DRAIN
MALE EXT CATH
1
CURITY ULTRAMER
2-WAY CATHETER
12 FR, 14 FR, 16 FR,
18 FR, 20 FR, 22 FR,
24 FR, 26 FR
1
CURITY ULTRAMER
2-WAY CATHETER
28 FR, 30 FR
3
CURITY ULTRAMER
IRRG 3WAY CATH
1
CURITY ULTRAMER
URETHRAL CATH
1
CURITY UNIVERSAL
- NO DRAINAGE
1
CURITY URETH
CATH CLOSED
SYSTM
1
CURITY URETH
CATH OPEN SYSTEM
1
this table.
383
Drug Name
/Limits
DOVER URINARY
LEG BAG
1
external catheter, male
26 mm to 30 mm, 36 mm
to 39 mm
Drug Name
/Limits
1
3
ROB-NEL URETHRAL
CATHETER 10-16
FR-", 12-16 FR-", 14-16
FR-", 16-16 FR-"
31 mm to 35 mm
3
1
ROB-NEL URETHRAL
CATHETER 18-16
FR-", 8-16 FR-"
FEMALE URINARY
POUCH
1
SELF-CATH , 14-16
FR-"
3
SELF-CATH 10"
3
SELF-CATHETER,
FEMALE 14 FR
3
SELF-CATHETER,
FEMALE 8 FR
1
TOUCH-TROL
1
URETHRAL
CATHETER
1
URI-DRAIN
1
URINARY LEG BAG
1
URINARY LEG
MEDIUM BAG
1
UROSTOMY NIGHT
BAG
1
VENTED URINARY
LEG BAG
1
VINYL CATHETER
1
FOLEY CATHETER
14 FR, 16 FR, 18 FR,
20 FR, 22 FR, 24 FR,
26 FR
1
FOLEY CATHETER
28 FR, 30 FR
3
FOLEY CATHETER
TRAY
1
GENTLECATH 10 FR,
12 FR, 12-16 FR-", 14
FR, 14-16 FR-", 16 FR,
16-16 FR-", 8 FR
1
GENTLECATH 8-16
FR-"
3
INCARE INVIEW
CATHETER 25 MM,
29 MM, 32 MM, 41
MM
3
INCARE INVIEW
CATHETER 36 MM
1
KENGUARD FOLEY
CATHETER
3
KENLINE
ADD-A-FOLEY TRAY
30CC
1
PRECISION 200
CATHETER TRAY
1
RETRACTED PENIS
POUCH
1
ROBINSON CLEAR
VINYL CATHETER
3
MEDICAL
SUPPLIES & DME URINE GLUCOSE
TESTS
CLINITEST
REAGENT
1
DIASTIX
1
MEDICAL
SUPPLIES & DME URINE
GLUCOSE-ACETO
NE COMBINATION
TESTS
CHEMSTRIP UGK
1
KETO-DIASTIX
1
this table.
384
Drug Name
/Limits
MEDICAL
SUPPLIES & DME URINE KETONE
TESTS
Drug Name
/Limits
2TEK
GLUCOSE/BLOOD
PRESSURE
3
1
ACETEST
1
3M NEXCARE
DURAPORE
CHEK-STIX
CONTROL
1
470V TWO WAY
VALVE
3
CHEMSTRIP K
1
3
KETONE CARE
1
A.I.R.S NEBULIZER
REPLACEMENT
KETONE URINE
TEST
1
ABSORBENT
COTTON BALLS
1
KETOSTIX
1
ACCU-CHEK AVIVA
CONNECT METER
3
ACCU-CHEK AVIVA
CONTROL SOLN
3
MEDICAL
SUPPLIES & DME VAPORIZERS
vaporizers
1
ACCU-CHEK AVIVA
PLUS METER
3
WARM STEAM
VAPORIZER
1
ACCU-CHEK COMBO
SYSTEM
3
ACCU-CHEK COMP
BLUE CONT, M-H
3
ACCU-CHEK
COMPACT PLUS
CARE
3
ACCU-CHEK
COMPACT PLUS
CONTROL
3
ACCU-CHEK
FASTCLIX
1
ACCU-CHEK
LINKASSIST INS DEV
3
ACCU-CHEK
MULTICLIX LANCET
1
ACCU-CHEK NANO
3
MEDICAL
SUPPLY, FDB
SUPERSET
MEDICAL
SUPPLY, FDB
SUPERSET
1ST TIER UNIFINE
PENTIPS NEEDLE 29
GAUGE X 1/2", 31
GAUGE X 1/4", 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
1ST TIER UNIFINE
PENTIPS NEEDLE 32
GAUGE X 5/32"
3
1ST TIER UNIFINE
PENTIPS PLUS
1
ACCU-CHEK RAPID
D INFUSION
3
1ST TIER UNILET
COMFORTOUCH 30
GAUGE
1
ACCU-CHEK
SAFE-T-PRO
3
2TEK CONTROL
(HIGH-NORMAL)
3
ACCU-CHEK
SMARTVIEW
CONTRL SOL
3
this table.
385
Drug Name
/Limits
Drug Name
/Limits
ACCU-CHEK
SOFTCLIX LANCET
DEV
1
ACTIVE LIFE
CONVEX
UROSTOMY
1
ACCU-CHEK
SOFTCLIX LANCETS
1
ACTIVE LIFE
CUT-TO-FIT CLOSED
1
ACCU-CHEK SPIRIT
ADAPTER
1
1
ACCU-CHEK SPIRIT
CARTRIDGE SYS
ACTIVE LIFE
DRAINABLE POUCH
,1"
3
ACCU-CHEK
TENDER
1
3
ACTIVE LIFE
PRE-CUT CLOSED
END
ACCU-CHEK
ULTRAFLEX
3
1
ACCU-CHEK
VOICEMATE
ACTIVE LIFE
PRE-CUT
DRAINABLE
3
ACCUTREND
CHOLESTEROL
CONTROL
1
3
ACTIVE LIFE
UROSTOMY POUCH
1 3/4 " (9")
1
ACCUTREND
CHOLESTEROL TEST
ADAPT BARRIER
RING
3
1
ACCUTREND
GLUCOSE CONTROL
ADAPT BARRIER
STRIPS
3
1
ACCUTREND PLUS
3
ADAPT CONVEX
BARRIER RINGS
ACE AEROSOL
CLOUD ENHANCER
1
ADAPT
LUBRICATING
DEODORANT
1
ACE ANKLE BRACE
1
ACE ELBOW BRACE
1
ADAPT OSTOMY
PASTE
1
ACE KNEE BRACE
1
ADAPT PASTE
3
ACETEST
1
1
ACTIVE CATH
3
ADAPT STOMA
POWDER
ACTIVE LIFE 1-PC
CL-END POUCH
adapter cap for bottle
1
1
ACTIVE LIFE 1-PC
STOMA CAP
1
1
ADD-A-FOLEY
CATH-MONO-FLO
DRNG
ACTIVE LIFE
CLOSED-END POUCH
3
1
ACTIVE LIFE
CONVEX DRAIN
POUCH 1 1/8 ", 1 3/8 ",
7/8 "
ADD-A-FOLEY
CATH-PRE-FILL
SYRN
ADD-A-FOLEY TRAY
1
1
this table.
386
Drug Name
adhesive bandage
topical bandage , 1 ", 1
x 3 ", 2 x 4 ", 3 x 4 ", 3/4
", 3/4 x 3 "
adhesive bandage
topical bandage 7/8 "
adhesive bandage-adhes
remov#1
ADHESIVE BARRIER
2-PC
/Limits
1
3
3
1
Drug Name
/Limits
ADVANCED
ANTIBACTERIAL
BANDAGE
3
ADVANCED
GLUCOSE METER
3
ADVANCED
LANCING DEVICE
1
ADVANCED TRAVEL
LANCETS 28 GAUGE
1
ADVOCATE BLOOD
GLUCOSE MONITOR
3
ADVOCATE
CONTROL
SOLUTION HIGH
3
ADVOCATE DUO
3
ADHESIVE
BARRIERS
1
ADHESIVE GAUZE
PAD TOPICAL
BANDAGE 2.375 X 4 "
1
ADHESIVE PADS
TOPICAL BANDAGE
1
ADVOCATE DUO
METER
3
adhesive remover
aerosol,spray
1
ADVOCATE LANCET
1
adhesive remover
packet
1
ADVOCATE
LANCING DEVICE
1
ADVOCATE LOW
CONTROL
3
ADVOCATE PEN
NEEDLES NEEDLE 29
GAUGE X 1/2"
3
ADVOCATE PEN
NEEDLES NEEDLE 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
ADVOCATE
RAPID-SAFE
LANCING
3
ADVOCATE
REDI-CODE DUO
METER
3
ADVOCATE
REDI-CODE GLU
MONITOR
3
ADVOCATE
REDI-CODE+
3
tape 1 x 10 "-yard, 1 x 5
"-yard, 1 x 6 "-yard, 1/2
x 10 "-yard, 1/2 x 12
"-yard, 1/2 x 5 "-yard
1
tape 1 x 12 "-yard
3
ADJUSTABLE
LANCING DEVICE
1
ADULT AEROSOL
MASK
1
ADULT BRIEF EXTRA LARGE
1
ADULT BRIEFS LARGE
1
ADULT BRIEFS MEDIUM
1
ADULT DISPOSABLE
MOUTHPIECE
1
ADVANCE PLUS
INTERMITTENT
3
this table.
387
Drug Name
/Limits
ADVOCATE
REDI-CODE+ CTRL
HIGH
3
ADVOCATE
REDI-CODE+ CTRL
LOW
3
ADVOCATE
SYRINGES
Drug Name
/Limits
AEROGEAR ACTION
ASTHMA KIT
3
AERONEB GO
3
AERONEB GO
NEBULIZER
3
AEROTRACH PLUS
1
1
3
AEROBIKA
OSCILLATING PEP
SYSTM
AGAMATRIX AMP
GLUC MONITOR SYS
3
AGAMATRIX
CONTROL HIGH
3
AEROCHAMBER
MINI
1
AGAMATRIX
CONTROL NORM-HI
3
AEROCHAMBER MV
1
AGIE-GRX
3
AEROCHAMBER
PLUS FLOW-VU
AIMSCO
1
1
1
AEROCHAMBER
PLUS FLOW-VU,L
MSK
AIR PERMEABLE
UNDERPAD
1
AIR TUBE WITH AIR
PLUGS
1
AIRS ADULT
AEROSOL MASK
1
AIRS DISPOSABLE
NEBULIZER
1
AIRS PEDIATRIC
DISPOSABLE MASK
1
AIRZONE PEAK
FLOW METER
1
ALBUSTIX REAGENT
1
ALKALINE
BATTERIES
3
ALL FLOW 1000 KIT
3
ALL FLOW 1000 PFT
FILTER
3
ALL FLOW 3000 KIT
3
ALL FLOW 3000 PFT
FILTER
3
AEROCHAMBER
PLUS FLOW-VU,M
MSK
1
AEROCHAMBER
PLUS FLOW-VU,S
MSK
1
AEROCHAMBER
PLUS Z STAT LG
MSK
1
AEROCHAMBER
PLUS Z STAT MD
MSK
1
AEROCHAMBER
PLUS Z STAT SM
MSK
1
AEROCHAMBER
WITH FLOWSIGNAL
1
AEROCHAMBER
Z-STAT PLUS-FLW
SG
1
ALL FLOW 4000 KIT
3
AEROECLIPSE II
NEBULIZER
3
ALL FLOW 4000 PFT
FILTER
3
ALL FLOW 5000 KIT
3
this table.
388
Drug Name
/Limits
ALL FLOW 5000 PFT
FILTER
3
ALL FLOW 6000 PFT
FILTER
3
ALL GEL BUNION
TOE SPREADER
1
ALL PURPOSE
CLOTH TAPE
Drug Name
/Limits
ALLEVYN GENTLE
BORDER LITE
TOPICAL BANDAGE
2 X 2 ", 3 X 3 "
3
3
1
ALLEVYN GENTLE
BORDER SACRUM
TOPICAL BANDAGE
6 5/8 X 6 3/4 "
ALLERGIST
PACKAGE
1CC/26GX1/2"
1
ALLEVYN LIFE
DRESSING TOPICAL
BANDAGE 4 X 4 "
3
ALLERGIST
PACKAGE
1CC/26GX3/8"
1
ALLEVYN SACRUM
TOPICAL BANDAGE
6 3/4 X 6 3/4 "
3
ALLEVYN TOPICAL
BANDAGE 8 X 8 "
1
ALLKARE ADHESIVE
REMOVER WIPES
1
ALLKARE PROTECT
BARRIER WIPES
1
ALTERA NEBULIZER
3
ALTERA NEBULIZER
SYSTEM
3
ALTERNATE SITE
LANCING DEVICE
1
AMBER GLASS
BOTTLE
3
AMERIGEL
DRESSING
1
AMIELLE VAGINAL
TRAINER
3
ANGIOCATH
AUTOGUARD IV
CATH
3
ANIMAS VIBE
3
ANKLE BRACE
1
ANTIBACTERIAL
BANDAGES TOPICAL
ADHESIVE
PATCH,MEDICATED
3
ALLERGIST
SYRINGE SYRINGE 1
ML 26 X 1/2", 1 ML 26
X 3/8"
3
ALLERGIST
SYRINGE SYRINGE 1
ML 27 X 1/2"
1
ALLERGIST TRAY
1/2 ML 27GX3/8"
1
ALLERGIST TRAY
INTRADERMAL BEV
SYRINGE 1 ML 26 X
3/8", 1 ML 27 X 3/8"
1
ALLERGIST TRAY
INTRADERMAL BEV
TRAY 1 ML 26
GAUGE X 3/8"
1
ALLERGIST TRAY
REGULAR BEVEL
TRAY
1
ALLEVYN
ADHESIVE
DRESSING TOPICAL
BANDAGE 7 X 7 "
3
ALLEVYN GENTLE
BORDER
3
this table.
389
Drug Name
/Limits
ANTIBACTERIAL
BANDAGES TOPICAL
BANDAGE
1
ANTIBACTERIAL
PAD
3
ANTI-EMBOLISM
STOCKINGS
1
AQUA LANCE
LANCING DEVICE
1
AQUACEL EXTRA
TOPICAL BANDAGE
2 X 2 ", 6 X 6 "
1
AQUACEL EXTRA
TOPICAL BANDAGE
4X5"
3
AQUACEL FOAM
TOPICAL BANDAGE
3.2 X 3.2 ", 5 X 5 ", 6 X
8 ", 8 X 5.5 ", 8 X 7 "
3
AQUACEL FOAM
TOPICAL BANDAGE
4 X 4 ", 6 X 6 ", 7 X 7 "
1
Drug Name
/Limits
ASEPTO BULB
1
ASEPTO BULB
SYRINGE,REUSABLE
3
ASSESS FULL
RANGE PEAK
METER
1
ASSURA 2PC
DRAINABLE
1
ASSURA 2PC
IRRIGATION SLEEVE
1
ASSURA AC
BASEPLATE
1
ASSURA AC CLOSED
POUCH
1
ASSURA AC
CONVEX
BASEPLATE , 1 1/4 ",
1 1/8 ", 1 3/8 "
1
ASSURA AC
CONVEX
BASEPLATE 1 ", 7/8 "
3
ASSURA AC DRAIN
POUCH MAXI
1
ASSURA AC
EASICLOSE DRAIN
MIDI
1
AQUACEL
HYDROFIBER
DRESSING TOPICAL
BANDAGE 0.39 X 18 "
3
AQUAFLO
3
ARCH BANDAGE
3
ASSURA AC
EASICLOSE POUCH
1
ARGLAES 3.25"X 14"
FILM
3
ASSURA CONVEX
1-PIECE DRAINABL
1
ARGYLE
1
ARGYLE
CONNECTING TUBES
1
3
ASSURA CONVEX
CLOSED POUCH
ASSURA CONVEX
EASICLOSE MAXI
1
ASSURA CONVEX
FLANGE
1
ARGYLE
TRACHEOSTOM
TUBE HOLDER
3
ARGYLE
TRACHEOSTOMY
CARE TRAY
3
ASSURA CONVEX
LIGHT STANDARD
1
ARGYLE TROCAR
1
ASSURA CONVEX
SKIN BARRIER
1
ARTHRITIS
HEATWRAPS
1
ASSURA CONVEX
SKIN BARRIER FLA
1
this table.
390
Drug Name
/Limits
ASSURA CONVEX
UROPOUCH
1
ASSURA EASICLOSE
DRAINABLE 11
1/4-600 "-ML
1
ASSURA EASICLOSE
MINI POUCH
1
ASSURA EASICLOSE
MINI POUCH 10
1/4-470 "-ML
Drug Name
/Limits
ASSURA OSTOMY
BELT
1
ASSURA PEDIATRIC
POUCH
1
ASSURA PEDIATRIC
SKIN BARRIER
1
ASSURA POUCH
1
3
ASSURA SKIN
BARRIER FLANGE
1
ASSURA EASICLOSE
WIDE MAXI
1
ASSURA STANDARD
WEAR
3
ASSURA EXTRA
CONVEX FLANGE
1
ASSURA STANDARD
WEAR UROSTOMY
1
ASSURA EXTRA
CONVEX POUCH
1
ASSURA UROSTOMY
POUCH
3
ASSURA WOUND
MANAGER 1/2-2 3/4
1
ASSURE 4 CONTROL
SOLUTION
3
ASSURA EXTRA
NON-CONVEX
FLANGE
1
ASSURA EXTRA
NON-CONVEX
POUCH
1
ASSURE DOSE
NORMAL CONTROL
3
ASSURA FLANGE 1
5/8 "
1
ASSURE DOSE
NORM-HI CONTROL
3
ASSURA FLANGE 1
7/8 "
3
ASSURA FLANGE
CONVEX 1 1/2 ", 1 5/8
"
1
1
ASSURE
HAEMOLANCE PLUS
18 GAUGE, 21
GAUGE, 25 GAUGE,
28 GAUGE
ASSURA FLANGE
CONVEX 1 7/8 "
3
ASSURE ID INSULIN
SAFETY
1
ASSURA ILEO NIGHT
POUCH
ASSURE LANCE
1
1
ASSURE PLATINUM
3
ASSURA IRRIG FCE
PLT 1/2-2 1/4
1
ASSURE PRISM
CONTROL 1-2 SOLN
3
ASSURA LIGHT
EASICLOSE
DRAINAB
3
1
ASSURE PRISM
MULTI METER
3
ASSURA
NON-CONVEX
DRAINABLE
ASSURE PRISM
MULTI STRIP
1
ASTHMA CHECK
METER
1
this table.
391
Drug Name
/Limits
ASTHMAMENTOR
PEAK FLOW METER
3
ASTHMAPACK
CHILDREN'S
1
ATHLETIC TAPE
Drug Name
/Limits
BANDAGE TOPICAL
BANDAGE , 4.5 X 108
"
1
1
3
BANDAGES
FLEXIBLE FABRIC
ATN BRIEF
1
BANDAGES SHEER
1
AUTODROP
3
1
AUTOJECT 2
INJECTION DEVICE
BANDAGES TOPICAL
BANDAGE , 3/4 "
1
1
AUTO-LANCET MINI
1
BANDAGES/FLEXIBL
E/ASSORTED
AUTOLET
IMPRESSION LANC
DEV
BANDAGES/PLASTIC
1
1
BAND-AID ACTIVE
FLEX
3
AUTOLET LANCING
DEVICE
1
1
AUTOPEN 1 TO 16
UNITS
BAND-AID
BUTTERFLY
CLOSURE
1
3
AUTOPEN 1 TO 21
UNITS
BAND-AID CLEAR
SPOTS
1
3
AUTOPEN 2 TO 32
UNITS
BAND-AID CLOTH
TAPE
1
BAND-AID FLEXIBLE
3
AUTOPEN 2 TO 42
UNITS
1
3
AUTOSQUEEZE
3
BAND-AID FLEXIBLE
FABRIC TOPICAL
BANDAGE
AVOGEL
1
1
AVOGEL DRESSING
1
BAND-AID FLEXIBLE
FABRIC TOPICAL
BANDAGE 3/4 X 3 "
AZO TEST STRIPS
1
3
AZOSTIX
3
BAND-AID GAUZE
PADS
BABY BASICS XX
LARGE DIAPER
1
BAND-AID
HURT-FREE
3
BABY
THERMOMETER
1
BAND-AID
MIRASORB GAUZE
3
BACK AND NECK
COLD REUSABL.PAD
1
BAND-AID
NON-STICK PADS
3
back brace
1
3
BACK SUPPORT S/M
1
BAND-AID PAPER
TAPE
BACK-SHOULDER
ICE,HEAT WRAP
1
BAND-AID PLASTIC
TOPICAL BANDAGE
3
BACT-POLLEN-DUST
FILTER MASK
1
this table.
392
Drug Name
/Limits
BAND-AID PLASTIC
TOPICAL BANDAGE
3/4 X 3 "
1
BAND-AID ROLLED
GAUZE
3
BAND-AID
SECURE-FLEX
3
BAND-AID SHEER
STRIPS
1
BAND-AID
SURGIPAD
3
BAND-AID TOUGH
PADS
3
BAND-AID TOUGH
STRIPS
3
BAND-AID
WATERPROOF
3
BAND-AID
WATERPROOF PAD
3
BARD ADHESIVE
REMOVER WIPES
1
BARD CATHETER
STRAP
3
BARD CENTER
ENTRY CLOSE
SYSTEM
Drug Name
/Limits
BARD INFECTION
CONTROL BAG
1
BARD LATEX LEG
STRAPS
1
BARD LEG BAG
HOLDER
1
BARD LEG BAG
STRAPS/FABRIC
1
BARD LUBRICATH
FOLEY TRAY
1
BARD LUBRICATH
FOLEY TRAY 18FR
1
BARD PLASTIC
TUBING/ADAPTER
1
BARD RUBBER
UTILITY CATHETER
1
BARD UNIVERSAL
FOLEY CATH TRAY
1
BARD URETHRAL
CATHETER TRAY
TRAY 14 FR, 15 FR
3
BARD URETHRAL
CATHETER TRAY
TRAY 16 FR
1
1
BARD URINARY
DRAINAGE SYSTEM
1
BARD CLEAN-CATH
1
BARD COUDE TIP
CATHETER
1
1
BARDEX
ALL-SILICONE
FOLEY CATH
BARD
CUNNINGHAM
INCONTIN CLAMP
1
1
BARDEX CLOSED
SYSTEM CATH TRAY
BARD DELUXE
FABRIC LEG STRAPS
3
1
BARDEX
LUBRICATH FOLEY
CATH
BARD EXTENSION
TUBING/CONNECT
1
BARDEX URETHRAL
CATHETERTRAY
1
BARD FEMALE
INTERMITTENT
CATH
1
1
BARDIA URINARY
DRAINAGE BAG
basal thermometer
1
BARD INFECT CONT
TRAY-NO CATH
1
basal thermometer,
electronic
1
this table.
393
Drug Name
/Limits
BASICS FOR KIDS
1
BD ALLERGIST
TRAY
1
BD ALLERGIST
TRAY REG BEVEL
1
BD ALLERGY
SYRINGE
Drug Name
/Limits
BD INSULIN PEN
NEEDLE UF SHORT
1
BD INSULIN
SYRINGE HALF UNIT
1
1
1
BD INSULIN
SYRINGE
MICRO-FINE
BD ANGIOCATH IV
CATHETER
3
BD INSULIN
SYRINGE SLIP TIP
1
BD AUTOSHIELD
DUO PEN NEEDLE
3
BD AUTOSHIELD
PEN NEEDLE
1
1
BD INSULIN
SYRINGE SYRINGE 1
ML 25 X 1", 1 ML 26 X
1/2", 1 ML 28 GAUGE
X 1/2"
BD BLUNT PLASTIC
CANNULA
1
1
BD BULK LUER-LOK
NON-STERILE
1
BD INSULIN
SYRINGE ULT-FINE
II
BD BULK SYRINGE
SLIP TIP SYRINGE 1
ML
1
1
BD INSULIN
SYRINGE
ULTRA-FINE
BD INSYTE
AUTOGUARD
3
BD INTEGRA
INSULIN SYRINGE
1
BD CORNWALL
GLASS CONTROL
LUER
1
BD CURVED TONSIL
REUSABLE
1
BD INTEGRA
NEEDLE
1
BD ECLIPSE
1
BD ECLIPSE
LUER-LOK
1
BD FILTER NEEDLE
5-MICRON NOKO
1
1
BD FILTER
NEEDLE-5 MICRON
1
BD INTEGRA
SYRINGE SYRINGE 1
ML 25 X 5/8", 3 ML 21
X 1 1/2", 3 ML 22
23 GAUGE X 1", 3 ML
25 GAUGE X 5/8"
BD GLASPAK
SYRINGE
1
BD INTEGRA
SYRINGE SYRINGE 3
ML 25 GAUGE X 1"
3
BD GLASPAK TB
SYRINGE
1
1
BD INSULIN PEN
NEEDLE UF MINI
1
BD INTERLINK
BLUNT PLASTIC
CAN
BD INSULIN PEN
NEEDLE UF ORIG
1
1
BD INTERLINK
SYRINGE
BD INTRADERMAL
BEVEL NEEDLES
1
this table.
394
Drug Name
/Limits
BD LANCET DEVICE
1
BD LO-DOSE
MICRO-FINE IV
1
BD LO-DOSE
ULTRA-FINE
1
BD LUER-LOK BULK
SYRINGE
BD LUER-LOK
COLLECTION SET
Drug Name
/Limits
BD MICROTAINER
LANCET 21 GAUGE,
30 GAUGE
1
1
1
BD MULTIFIT
REUSABLE BULK
SYRINGE,REUSABLE
2 ML
3
BD MULTIFIT
REUSABLE SYRINGE
1
BD NOKOR ADMIX
NEEDLE
1
BD PRECISIONGLIDE
1
BD PRECISIONGLIDE
NON-STERILE
1
BD Q-SYTE
EXTENSION SET, 6"
1
BD Q-SYTE MDV
ADAPTER
1
BD Q-SYTE
SPLIT-SEPT DEVICE
1
BD QUINCKE SPINAL
NEEDLE NEEDLE 19
GAUGE X 3", 20
GAUGE X 1 1/4", 20
GAUGE X 2 1/2", 20
GAUGE X 3"
1
BD REGULAR BEVEL
NEEDLES
1
BD SAFETYGLIDE
ALLERGIST TRAY
1
BD SAFETYGLIDE
INSULIN SYRINGE
SYRINGE 0.3 ML 29
31 X 5/16", 1 ML 29 X
1/2", 1/2 ML 30
GAUGE X 5/16
1
BD SAFETYGLIDE
NEEDLE
1
BD LUER-LOK
SYRINGE SYRINGE 1
ML, 1 ML 20 GAUGE
X 1", 10 ML 20 X 1
1/2", 10 ML 20 X 1", 10
ML 21 GAUGE X 1",
10 ML 21 X 1 1/2", 10
ML 22 X 1 1/2", 10 ML
22 X 1", 10 ML 23X 1
1/4 ", 20 ML, 3 ML, 3
ML 18 X 1 1/2", 3 ML
20 GAUGE X 1", 3 ML
20 X 1 1/2", 3 ML 21
GAUGE X 1", 3 ML 21
X 1 1/2", 3 ML 21 X 1
1/4", 3 ML 22 GAUGE
X 1", 3 ML 22 X 1 1/2",
3 ML 22 X 1 1/4", 3 ML
23 GAUGE X 1 1/2", 3
ML 23 X 1 1/4 ", 3 ML
23 X 1", 3 ML 24 X 1",
3 ML 25 GAUGE X 1",
3 ML 25 X 1 1/2 ", 3
ML 25 X 5/8", 3 ML 26
X 5/8", 5 ML, 5 ML 20
X 1 1/2", 5 ML 20 X 1",
5 ML 21 GAUGE X 1
1/2", 5 ML 21 GAUGE
X 1", 5 ML 22 GAUGE
X 1 1/2", 5 ML 22 X 1",
5 ML 23 X 1 1/4 ", 5
ML 23 X 1", 60 ML
1
BD LUER-LOK TIP
CONTROL SYRING
1
1
BD MAGNI-GUIDE
SYRINGE MAGNIFI
BD SAFETYGLIDE
SHIELDING REG
1
BD SAFETYGLIDE
SYRINGE
1
this table.
395
Drug Name
/Limits
Drug Name
/Limits
BD SAFETYGLIDE
TB REG BEVEL
1
BD THERMOMETER
ORAL SHEATHS
3
BD SAFETYGLIDE
TUBERCULIN
1
BD TUBERCULIN
SLIP-TIP
1
BD SAFETY-LOK
COLLECTION SET
3
BD TUBERCULIN
SYRINGE
1
BD SAFETY-LOK
DETACHABLE
NEEDL
1
BD ULTRA FINE
LANCETS
1
BD ULTRA-FINE II
LANCETS
1
BD ULTRA-FINE
NANO PEN NEEDLES
1
BD VACUTAINER
COLLECTION SET
3
BD WHITACRE
SPINAL NEEDLE
3
BD SAFETY-LOK
TUBERCULIN
SYRINGE 1 ML 25
GAUGE X 5/8"
3
BD SAFETY-LOK
TUBERCULIN
SYRINGE 1 ML 27
GAUGE X 1/2"
1
BD SAFETY-LOK
WITH LUER-LOK
1
BD YALE REGULAR
BEVEL
1
BD SAF-T E-Z
COLLECTION SET
3
BD YALE REUSABLE
GLASS LUER
1
BD SAF-T-INTIMA
3
1
BD SHARPS
COLLECTOR
BD YALE REUSABLE
REG METAL
3
1
BD SLIP TIP
SYRINGE
BD YALE REUSABLE
SHORT METAL
1
1
B-D SLIP TIP
SYRINGE
BD YALE SHORT
BEVEL
1
BD SPECIALTY USE
NEEDLES
1
1
BD YALE TB
REUSABLE GLASS
LUE
BD STRAIGHT
TONSIL REUSABLE
1
BEDSIDE DRAINAGE
COLLECT SYSTM
1
BELTED
UNDERGARMENTS
1
BELTLESS
UNDERGARMENTS
1
BD SYRINGE BULK
STERILE PAK
SYRINGE 10 ML
1
BD SYRINGE
STORAGE BINS
3
3
BD SYRINGE
SYRINGE 1 ML, 60
ML
BEUTLICH PH TEST
ROLL
1
BIATAIN
1
BD SYRINGE-DUAL
CANNULA
1
this table.
396
Drug Name
BIATAIN ADHESIVE
FOAM DRESSING
TOPICAL BANDAGE
5X5"
/Limits
3
Drug Name
/Limits
BLADDER CONTROL
PAD
1
BLADDER CONTROL
PAD EXTRA PLUS
1
BLADDER CONTROL
PAD LONG
1
BLADDER CONTROL
PAD ULTRA
1
BIATAIN ADHESIVE
FOAM DRESSING
TOPICAL BANDAGE
7X7"
1
BIATAIN HEEL ADH
FOAM DRESSING
3
1
BIATAIN
NON-ADHESIVE
FOAM
BLADDER CONTROL
PAD ULTRA PLUS
1
BLADDER CONTROL
PADS
1
1
BIATAIN
NON-ADHESIVEFOA
M ROUND
3
BLADDER CONTROL
PADS EX ABSORB
1
BIO TRUE
1
BLADDER CONTROL
PADS FOR WOMEN
BIOBRANE
3
1
BIOBRANE
DRESSING
BLENDERM
SURGICAL
3
BLISTER CARE
1
BIOBRANE GLOVES
LARGE
1
BLISTER RELIEF
BANDAGES
1
BIOBRANE GLOVES
MEDIUM
1
blood glucose contrl
hi,normal
3
BIOBRANE GLOVES
PEDIATRIC
3
blood glucose control,
normal
3
BIOBRANE GLOVES
SMALL
3
BLOOD GLUCOSE
MONITORING
3
BIOBRANE-L
3
3
BIOBRANE-L
DRESSING
BLOOD GLUCOSE
TEST
3
1
BIOGUARD GAUZE
TOPICAL BANDAGE
0.3 %- 2" X 2", 0.3 %4" X 4"
BLOOD PRESSURE
CUFF
3
BLOOD PRESSURE
KIT
1
1
BIOGUARD ISLAND
3
blood pressure kit med
and lrg
BIOGUARD
NON-ADHERENT
3
blood pressure kit-extra
large
1
BIONIME RIGHTEST
GM300 SYSTEM
blood pressure monitor
1
3
1
BIOSTEP
3
blood pressure test
kit-large
this table.
397
Drug Name
/Limits
Drug Name
/Limits
blood pressure test
kit-medium
1
BREATHE RIGHT
VAPOR
3
blood pressure test
kit-small
1
BREATHERITE MDI
SPACER
3
blood pressure test
kit-wrist
1
3
BLOOD PRESSURE
UNIT-WRIST
BREATHERITE
VALVED MDI
CHAMBER
1
blood-glucose meter
3
3
needle 18 x 1 1/2 "
BREATHERITE
VALVED MDI
SPACER
3
BREEZE 2
3
needle 22 x 1 1/2 ", 23 x
1"
3
1
BREEZE 2 CONTROL
SOLUTION, LOW
3
BLUNT SPINAL
NEEDLE
BREEZE 2 CONTROL
SOLUTION, NML
1
3
BORDERED GAUZE
TOPICAL BANDAGE
2 X 2 ", 4 X 10 ", 4 X
14 "
BREEZE 2 CONTROL
SOLUTION,HIGH
3
BREEZERS ADULT
BRIEF
1
BRIEFS
1
BORDERED GAUZE
TOPICAL BANDAGE
4 X 4 ", 6 X 6 "
1
BRIEFS MEDIUM
1
BRIEFS OVERNIGHT
1
BOSTON CLEANER
1
BRIEFS SMALL
1
BOSTON
CONDITIONING
1
1
BOSTON ONE STEP
(PF)
BRIEFS,
ADULT-EXTRA
LARGE
1
1
BOSTON
REWETTING
BSS/BSS PLUS
ADMIN SET
3
1
BOSTON ROUND
NATURAL
BUBBLES THE FISH
PEDI MASK
1
BULKEE II
3
BOSTON SIMPLUS
1
BOTTLE
1
BULLSEYE MINI
SAFETY LANCETS 25
GAUGE, 28 GAUGE
1
BOTTLETOP
DISPENSER
ADAPTER
1
BURNS-SCALDS-ABR
ASIONS
1
BOULES QUIES EAR
PLUGS
3
BUTTERFLY
CLOSURES
1
BOXERS FOR MEN
1
CALLUS CUSHION
1
BREATHE RIGHT
3
CALLUS PADS
3
this table.
398
Drug Name
/Limits
CAMO BANDAGES
1
cane
1
cane tips
3
CARBOFLEX ODOR
CONTROL DRESSIN
Drug Name
/Limits
CENTERPOINTLOCK
FLEXWEAR SKIN 1 ",
1 1/2 ", 1 1/4 ", 1 3/4 ",
3/4 ", 4 "
1
3
CENTERPOINTLOCK
SOFTFLEX SKIN
1
CAREFINE PEN
NEEDLE
3
CENTERPOINTLOCK
STOMA CAP
1
CAREONE LANCING
DEVICE
1
CENTERPOINTLOCK
STOMA IRRIGAT
1
CAREONE THIN
LANCET
1
CENTERPOINTLOCK
UROSTOMY POUCH
1
CAREONE ULTRA
THIN LANCET
1
CERTAINTY BELTED
SHIELDS
1
CARESENS
CONTROL A
NORMAL
3
CERTAINTY
GUARDS
1
CARESENS N
3
CERTAINTY LARGE
1
CARESENS N VOICE
3
1
CARRASYN
HYDROGEL WOUND
DRESS
CERTAINTY
LARGE-EXTRA
LARGE
3
CERTAINTY PADS
1
CARTRIDGE
STAMPED IR 1200
3
CERTAINTY
REGULAR
1
CAYA CONTOURED
3
CERTAINTY
SMALL-MEDIUM
1
CENTERPOINTLOCK
CLOSED POUCH
1
CERTAINTY
UNDERPADS
3
CENTERPOINTLOCK
DRAIN FILTER
1
CERTAINTY
X-LARGE
1
CENTERPOINTLOCK
DRAINABLE MINI
1
CHEK-STIX
CONTROL
1
CENTERPOINTLOCK
DRAINABLE POUC
1
CHEMO TRANSFER
PIN
1
CHEMSTRIP 10 MD
1
CHEMSTRIP 10/SG
1
CHEMSTRIP 2
1
CHEMSTRIP 2 GP
1
CHEMSTRIP 50B
1
CHEMSTRIP 7
1
CHEMSTRIP 9
1
CENTERPOINTLOCK
FLEXTEND CONVE 1
", 1 1/2 ", 1 1/8 ", 1 3/8
", 3/4 ", 5/8 ", 7/8 "
1
CENTERPOINTLOCK
FLEXTEND SKIN 1
1/4 ", 1 3/4 ", 2 1/4 "
1
CENTERPOINTLOCK
FLEXWEAR CONVE
1
this table.
399
Drug Name
/Limits
CHEMSTRIP BG LOG
BOOK
1
CHEMSTRIP K
1
CHEMSTRIP MICRAL
1
CHEMSTRIP UGK
1
CHILD EAR SYRINGE
1
CICA-CARE
ADHESIVE SILICONE
Drug Name
/Limits
CLERZ PLUS
3
CLEVER CHEK
BLOOD GLUCOSE
3
CLEVER CHEK
BLOOD GLUCOSE
SYST
3
3
CLEVER CHOICE
BLOOD GLUC SYS
3
CLEAR BANDAGES
1
CLEVER CHOICE
GLUCOSE MONITOR
3
CLEAR GLASS
SERUM BOTTLE
3
CLEVER CHOICE
LEVEL 1 CONTROL
3
CLEAR SPOT
BANDAGES
3
CLEVER CHOICE
LEVEL 2 CONTROL
3
CLEAR STRIPS
TOPICAL BANDAGE
3
CLEVER CHOICE
LEVEL 3 CONTROL
3
CLEAR STRIPS
TOPICAL BANDAGE
3/4 X 3 "
1
CLEVER CHOICE
MICRO
3
CLEAR TAPE
3
CLEVER CHOICE
PRO
3
3
CLICKFINE NEEDLE
31 GAUGE X 1/4", 31
GAUGE X 5/16"
1
CLICKFINE NEEDLE
32 GAUGE X 5/32"
3
CLINITEST
REAGENT
1
CLOSED-END POUCH
1
CLOTH FIRST AID
TAPE
1
CLOTH TAPE
1
COAGUCHEK
LANCETS
1
COAGUCHEK PT
3
COAGUCHEK XS
3
CLEAR
WATERPROOF
STRIPS TOPICAL
BANDAGE
CLEAR
WATERPROOF
STRIPS TOPICAL
BANDAGE 1 "
1
CLEARBLUE
DIGITAL
OVULATION
3
CLEARBLUE EASY
OVULATION TEST
3
CLEARBLUE
FERTILITY
MONITOR
3
CLEARBLUE
FERTILITY STICKS
3
3
CLEO 90 INFUSION
SET 24"
COAGUCHEK XS
PRO
1
1
CLEO 90 INFUSION
SET 31"
COBAN ACTION
WRAP
1
this table.
400
Drug Name
/Limits
COBAN
SELF-ADHERENT
WRAP
1
COLD PACK
1
COLD PACK BACK
PAD
1
COLD WRAP
1
COLOPLAST
BARRIER RING
1
COLOPLAST
IRRIGATION SET
1
COLOPLAST PASTE
1
COLOPLAST SKIN
BARRIER
1
COMBINATION
CONE/TUBE DRAIN
1
COMBINATION
WATER BOTTLE
3
COMBINE ABD
Drug Name
/Limits
COMFEEL ULCER
CARE DRESSING
TOPICAL BANDAGE
4 X 4 ", 6 X 6 ", 8 X 8 "
1
COMFORT EZ PEN
NEEDLES NEEDLE 31
GAUGE X 1/4", 31
GAUGE X 3/16", 31
GAUGE X 5/16", 32
GAUGE X 1/4", 32
GAUGE X 3/16", 32
GAUGE X 5/16", 32
GAUGE X 5/32", 33
GAUGE X 1/4", 33
GAUGE X 3/16", 33
GAUGE X 5/16", 33
GAUGE X 5/32"
3
COMFORT EZ
SYRINGE
1
3
1
COMFORT INFUSION
SET 23"
COMBISTIX
REAGENT
1
COMFORT INFUSION
SET 31"
1
COMFEEL PLUS
CLEAR DRESSING
1
COMFORT INFUSION
SET 32"
3
COMFEEL PLUS
CONTOUR
DRESSING
3
3
COMFORT INFUSION
SET 43"
COMFORT LANCETS
1
COMFEEL PLUS
PRESSURE RELIEF
3
COMFORT SHORT
INFUSION SET 23"
3
COMFEEL PLUS
PRESSURE ROUND
3
COMFORT SHORT
INFUSION SET 31"
3
COMFEEL PLUS
TRIANGLE
DRESSING
1
COMFORT SHORT
INFUSION SET 43"
3
COMFORT SHORT
INSULIN PUMP 23"
3
COMFORT SHORT
INSULIN PUMP 32"
3
COMFORT SHORT
INSULIN PUMP 43"
3
COMFORT-STRETCH
DIAPERS
1
COMFEEL PLUS
ULCER DRESSING
1
COMFEEL PURILON
3
COMFEEL ULCER
CARE DRESSING
TOPICAL BANDAGE
1 1/2 X 2 1/2 "
3
this table.
401
Drug Name
/Limits
COMFORT-STRETCH
TRAINING PANTS
1
COMPACT
COMPRESSOR
NEBULIZER
1
COMPACT
ULTRASONIC
NEBULIZER
1
COMP-AIR ELITE
COMP NEB SYSTEM
Drug Name
/Limits
CONTOUR CONTROL
SOLUTION, NML
3
CONTOUR I STOMA
CAP
1
CONTOUR LINK
3
CONTOUR METER
3
CONTOUR NEXT EZ
METER
3
1
3
COMP-AIR
NEBULIZER
COMPRESSOR
CONTOUR NEXT
LEV 1 CONTROL SOL
1
CONTOUR NEXT
LEV 2 CONTROL SOL
3
COMP-AIR XLT
COMPRESSOR NEB
1
CONTOUR NEXT
LINK
3
CONCEPTION
3
3
CONDOMS-PREM
LUBRICATED
CONTOUR NEXT
METER
1
3
CONE-TUBE
IRRIGATION SET
CONTOUR NEXT
USB METER
1
CONFORM TOPICAL
BANDAGE 1 X 5
"-YARD, 3 X 5
"-YARD, 4 X 75 ", 6 X
5 "-YARD
CONTROL
MONITORING
SYSTEM
3
1
CONVATEC NIGHT
DRAIN CONTAINER
3
1
CONFORM TOPICAL
BANDAGE 2 X 5
"-YARD
CONVATEC NIGHT
DRAINAGE TUBING
3
CONVEEN DRIP
COLLECTOR
1
CONFORMANT 2
3
1
CONTACT DETACH
INFUS SET 23"
CONVEX SYN BARR
- FLOAT FLANGE
1
CONTACT DETACH
INFUS SET 32"
1
1
COOL MIST
HUMIDIFIER 1
GALLON
CONTACT DETACH
INFUS SET 43"
1
COOLMAGIC
FENESTRATED
3
CONTACT LENS
RELIEF
1
3
CONTOUR CONTROL
SOLUTION, HIGH
COOLMAGIC
TOPICAL BANDAGE
3 3/4 X 3 3/4 ", 8 X 12 "
3
CONTOUR CONTROL
SOLUTION, LOW
1
3
COOLMAGIC
TOPICAL BANDAGE
6X8"
this table.
402
Drug Name
/Limits
COPA HYDROPHILIC
FOAM
1
CORN CUSHION
1
CORNWALL METAL
PIPETTING
1
COSMETIC BALLS
1
COSMETIC PUFFS
1
COTTON BALLS
1
COTTON BALLS
STERILE
1
COTTON SNAP
PANTS
1
COTTON SQUARES
1
COTTON SWABS
1
COTTON, STERILE
1
CPL DRAINABLE
POUCH
1
crutch
Drug Name
/Limits
CURITY
ABDOMINAL PAD
TOPICAL BANDAGE
5X9"
1
CURITY
ABDOMINAL PAD
TOPICAL BANDAGE
7 1/2 X 8 "
3
CURITY
ABSORBENT
WADDING
1
CURITY AMD
3
CURITY AMD (WITH
POLYHEXAMETH)
TOPICAL SPONGE 0.2
%- 2" X 2"
3
CURITY AMD (WITH
POLYHEXAMETH)
TOPICAL STRIP
3
1
CURITY BANDAGE
3
CRUTCH
ACCESSORY KIT
3
CURITY BEDSIDE
DRAINAGE BAG
1
CRUTCH
HANDGRIPS
3
CURITY BEDSIDE
DRAINAGE SET
1
CRUTCH TIPS
1
C-TUB
3
1
CURAD NON-STICK
PAD
CURITY
BEDSIDE-MONO-FLO
DRANGE
3
1
CURAFIL GEL
WOUND
CURITY COTTON
PREP BALLS
3
1
CURI-STRIP WOUND
CLOSURES TOPICAL
STRIP 1/2 X 4 ", 1/4 X
4 ", 1/8 X 3 "
CURITY COTTON TIP
APPLICATOR
1
CURITY COVER
TOPICAL SPONGE 3
X 3 ", 4 X 3 "
3
CURITY COVER
TOPICAL SPONGE 4
X4"
1
CURITY
DETECTABLE LAP
3
CURITY DISP LAP
SPONGE POUCH
3
CURI-STRIP WOUND
CLOSURES TOPICAL
STRIP 1/4 X 1 1/2 ",
1/4 X 3 "
3
CURITY 8000 URINE
MTR FLY TRAY
1
this table.
403
Drug Name
/Limits
CURITY DISP LAP
SPONGE TRAY
3
CURITY DRAINAGE
BAG
3
CURITY DRESSING
3
CURITY EYE
1
CURITY FOLEY
CATHETER KIT
3
CURITY GAUZE
BURN DRESSING
3
CURITY GAUZE
TOPICAL BANDAGE
1 X 10 "-YARD, 2 X
360 ", 3 X 360 ", 36 X
3600 ", 4 X 360 "
3
Drug Name
/Limits
CURITY
NON-ADHERING
DRESSING
1
CURITY PLAIN
PACKING STRIP
TOPICAL BANDAGE
1 X 5 "-YARD, 1/2 X 5
"-YARD, 1/4 X 5
"-YARD
1
CURITY PLAIN
PACKING STRIP
TOPICAL BANDAGE
2 X 5 "-YARD
3
CURITY PREMIUM
CATHETER TRAY
1
CURITY READY-CUT
GAUZE
3
CURITY GAUZE
TOPICAL BANDAGE
2 X 2 ", 3 X 3 ", 4 X 4 "
1
CURITY SKIN SCRUB
3
CURITY GAUZE
TOPICAL SPONGE 2
X 2 ", 3 X 4 ", 4 X 4 "
1
CURITY SPNG
COUNTER BAG
STRIPS
1
CURITY STRMLIN
CATH - MONO-FLO
3
CURITY
THORACENTESIS
TRAYS
3
3
CURITY GAUZE
TOPICAL SPONGE 3
X 3 ", 4 X 3 1/2 ", 8 X 4
"
3
CURITY IODOFORM
PACKING STRIP
3
CURITY LUMBAR
PUNCTURE TRAY
3
CURITY
THORACENTESIS-CA
TH TRAY
CURITY
MULTI-TRAUMA
DRESSING
3
CURITY
TRIANGULAR
BANDAGE
3
CURITY
NON-ADHERENT
STRIP TOPICAL
BANDAGE 1/2 X 144
", 9 X 16 "
3
CURITY ULTRAMER
2-WAY CATHETER
12 FR, 14 FR, 16 FR,
18 FR, 20 FR, 22 FR,
24 FR, 26 FR
1
CURITY
NON-ADHERENT
STRIP TOPICAL
BANDAGE 3 X 8 "
3
1
CURITY ULTRAMER
2-WAY CATHETER
28 FR, 30 FR
CURITY ULTRAMER
IRRG 3WAY CATH
1
this table.
404
Drug Name
/Limits
Drug Name
/Limits
CURITY ULTRAMER
URETHRAL CATH
1
DAVOL URETHRAL
CATHETER TRAY
3
CURITY UNIVERSAL
- NO DRAINAGE
1
DAVOL URETHRAL
CATHTRAY (W/O)
1
CURITY URETERAL
DRAIN SET
1
DAVOL URINARY
DRAINAGE BAG
1
CURITY URETH
CATH CLOSED
SYSTM
1
DAY AND NIGHT
BRIEF, LARGE
1
CURITY URETH
CATH OPEN SYSTEM
1
1
DAY AND NIGHT
BRIEF,MEDIUM
DAY, PLUS PAD
1
CURITY URETHRAL
CATHETER
1
1
CURITY URINE
METER
1
DELUXE ARM
BLOOD PRESSURE
MON
CURITY WET
DRESSING
1
1
DELUXE INSTANT
EAR THERMOMETER
CUSHION INSOLE
1
DELUXE WRIST
STABILIZER
1
CUT N CRUSH
2
1
CUTICERIN
DRESSING
DEPEND EASY FIT
UNDERGARMENTS
3
1
CUTIEPANTS
TRAINING PANTS
DEPEND GUARDS
FOR MEN
1
1
CUTIES BABY
DIAPERS
DEPEND
PROTECTION SZ S-M
1
CUTINOVA HYDRO
DRESSING
1
3
DEPEND
PROTECTION WITH
TABS LG
DAVOL C.S. FOLEY
CATHETER TRAY
1
DEPEND REAL FIT
BRIEF MEN L/XL
1
DAVOL COMPLETE
FOLEY
3
DEPEND REAL FIT
BRIEF MEN S-M
1
DAVOL FOLEY
CATH INSERT TRAY
1
DEPEND SHIELDS
FOR MEN
1
DAVOL IRRIGATION
SYRINGE
1
1
DAVOL PISTON
IRRIGATION
DEPEND
SILHOUETTE
WOMEN L/XL
1
DAVOL SILICONE
FOLEY CATH
1
1
DEPEND
SILHOUETTE
WOMEN S/M
DAVOL UNIVERSAL
CATH TRAY
1
DEPEND
UNDERWEAR FOR
MEN L-XL
1
ST
this table.
405
Drug Name
DEPEND
UNDERWEAR FOR
MEN SM-MD
/Limits
1
Drug Name
/Limits
DERMACEA
TOPICAL SPONGE 3
X3"
3
DERMADRESS
1
DEPEND
UNDERWEAR FOR
WOMEN LRG
1
DERMAGAUZE
1
DEPEND
UNDERWEAR FOR
WOMEN S-M
1
DERMAGAUZE
HYDROGEL
DRESSING
1
DEPEND
UNDERWEAR FOR
WOMEN XL
1
DERMAGRAN
HYDROGEL
DRESSING
3
DEPEND
UNDERWEAR S-M
1
3
DERMACEA I.V.
3
DERMACEA
NON-WOVEN
TOPICAL SPONGE 2
X 2 ", 3 X 4 ", 4 X 4 "
DERMAGRAN
HYDROPHILIC
DRESSING TOPICAL
BANDAGE 2 X 2 ", 4
X4"
1
DERMALEVIN
1
DERMASYN
3
DERMACEA
NON-WOVEN
TOPICAL SPONGE 3
X3"
DERMAVIEW
1
DERMAVIEW II
1
3
1
DERMACEA
STRETCH TOPICAL
BANDAGE 2 X 4
"-YARD, 3 X 4.1
"-YARD
DETACHOL
ADHESIVE
REMOVER
1
DEVILBISS
COMPACT
COMPRESSOR
1
DEVILBISS
DISPOSABLE
NEBULIZER
1
DEVILBISS
PULMO-AIDE
COMPRESSR
1
DEVILBISS
PULMOMATE
COMPRESSOR
1
DEVILBISS
TRAVELER
COMPRESSOR
1
DEXCOM G4
RECEIVER
3
DERMACEA
STRETCH TOPICAL
BANDAGE 4 X 144 ",
6 X 144 "
3
DERMACEA
TOPICAL BANDAGE
2 1/4 X 3 "-YARD, 2 X
2 ", 3 X 3 ", 3.4 X 3.6
"-YARD, 4 X 4 ", 4 X
4.1 "-YARD, 8 X 10 "
1
DERMACEA
TOPICAL BANDAGE
4.5 X 4.1 "-YARD
3
DERMACEA
TOPICAL SPONGE , 2
X 2 ", 4 X 4 "
1
this table.
406
Drug Name
DEXCOM G4
RECEIVER
PEDIATRIC
DEXCOM G4
RECEIVER-SHARE
(PED)
/Limits
Drug Name
/Limits
3
DIATRUE CONTROL
SOLUTION LOW
3
3
3
DIATRUE PLUS
BLOOD GLUCOSE
MET
DIGITAL
THERMOMETER
1
DISINFECTING
SOLUTION
1
DISPOSABLE BRIEF
1
disposable gloves
1
1
DEXCOM G4
RECEIVER-SHARE
KIT
3
DEXCOM G4
TRANSMITTER
3
DEXCOM G5-G4
SENSOR
3
diaper,brief,infant-todd,
disp
1
DISPOSABLE
LATEX-FREE
GLOVES
DIAPERS
1
DISPOSABLE
NEEDLES
1
DIAPERS ULTRAFITS
3
1
DISPOSABLE PAPER
MOUTHPIECE
3
DIAPERS ULTRAFITS
4
1
DISPOSABLE POWER
1
DIAPERS ULTRAFITS
5
1
DISPOZ-A-BAG LEG
BAG LARGE
1
DIAPERS ULTRAFITS
6
1
DISPOZ-A-BAG LEG
BAG MEDIUM
1
DIAPERS, UNISEX
SIZE 2
1
DISPOZ-A-BAG LEG
BAG SMALL
1
DIAPERS, UNISEX
SIZE 3
1
DOVER
ADVANTAGE
DRAINAGE BAG
3
DIAPERS, UNISEX
SIZE 4
1
DOVER
ADVANTAGE URINE
3
DIAPERS, UNISEX
SIZE 5
1
DOVER BULB
SYRINGE
3
DIAPERS, UNISEX
SIZE 6
1
DOVER CATHETER
1
DIAPERS-DISP-POLY
ETHYLENE BACK
1
DOVER COATED
LATEX FOLEY
3
DIASTIX
1
DOVER LATEX
FOLEY CATHETER
3
DIATRUE CONTROL
SOLN NORMAL
3
DOVER PEDIATRIC
URINE METER
1
DIATRUE CONTROL
SOLUTION HIGH
3
DOVER PREMIUM
URINE
3
this table.
407
Drug Name
DOVER RED
RUBBER ROBINSON
CATH
/Limits
3
Drug Name
/Limits
DUODERM CGF
DRESSING
1
DUODERM CGF
EXTRA THIN
1
DUODERM CGF
EXTRA THIN SPOTS
1
DUODERM
HYDROACTIVE
TOPICAL BANDAGE
1
DUODERM
HYDROACTIVE
TOPICAL GEL
1
DUODERM SIGNAL
DRESSING
1
DUOLOCK CURVED
TAIL CLOSURE
1
DURAFIBER
DRESSING TOPICAL
BANDAGE 2 X 2 ", 3/4
X 18 ", 4 X 4 "
3
1
DOVER TEXAS
MALE EXTERNAL
CATH
1
DOVER TWO-SIDED
ADHESIVE STRAP
3
DOVER UNIVERSAL
3
DOVER URI-DRAIN
DELUXE LEG BAG
1
DOVER URI-DRAIN
MALE EXT CATH
1
DOVER URINARY
LEG BAG
1
DRAINABLE FECAL
COLLECTOR
1
DRAINABLE POUCH
1
DRAINABLE POUCH
CLAMP
1
DRAINABLE POUCH
CLOSURE
1
DURAHESIVE
MOLDABLE
CONVEX
DRAIN-TUBE
ATTACHMENT
DEVICE
1
DURAPORE
SURGICAL
1
DROPLET LANCETS
1
DURASORB
UNDERPAD
1
DROPLET LANCING
DEVICE
1
EAKIN COHESIVE
SEALS
1
DRY COMFORT
1
EAKIN COHESIVE
SLIMS
1
EAKIN COHESIVE
WAFER 4 X 4 "
1
EAKIN COHESIVE
WAFER 4 X 8 "
3
EAR POPPER
INFLATION DEVICE
3
ear syringe
1
ear thermometer
1
EARLY OVULATION
TEST
3
DRY COMFORT
EXTRA BRIEFS
1
DRYMAX EXTRA
3
DUODERM CGF
BORDER DRESSING
TOPICAL BANDAGE
2 1/2 X 2 1/2 ", 6 X 6 ",
6X7"
1
DUODERM CGF
BORDER DRESSING
TOPICAL BANDAGE
4X5"
3
this table.
408
Drug Name
/Limits
EARLY PREGNANCY
TEST
1
EASICLOSE WIDE
OUTLET 2-PC , 11
1/2-655 "-ML
1
Drug Name
/Limits
EASY STEP BLOOD
GLUCOSE METER
3
EASY STEP BLOOD
GLUCOSE SYSTEM
3
EASY TALK BLOOD
GLUCOSE METER
3
EASY TALK
GLUCOSE SYSTEM
3
EASICLOSE WIDE
OUTLET 2-PC 10
1/2-485 "-ML
3
EASIVENT HOLDING
CHAMBER
1
EASY TALK HIGH
CONTROL
3
EASIVENT MASK
LARGE
1
EASY TALK LOW
CONTROL
3
EASIVENT MASK
MEDIUM
1
EASY TOUCH
FLURINGE
1
EASIVENT MASK
SMALL
1
3
EASY CLICK
LANCING DEVICE
1
EASY TOUCH
FLURINGE FLU
TRAY
EASY TOUCH
GLUCOSE MONITOR
3
EASY TOUCH
HIGH-LOW
CONTROL
1
EASY TOUCH
INSULIN SAFETY
SYR SYRINGE 0.5 ML
29 GAUGE X 1/2", 1
ML 29 GAUGE X 1/2"
1
EASY TOUCH
INSULIN SAFETY
SYR SYRINGE 0.5 ML
30 GAUGE X 5/16", 1
ML 30 GAUGE X 1/2"
3
EASY TOUCH
INSULIN SYRINGE
1
EASY TOUCH
LANCING DEVICE
1
EASY COMFORT
INSULIN SYRINGE
SYRINGE 0.3 ML 30
GAUGE X 5/16, 1 ML
30 GAUGE X 1/2", 1
ML 30 GAUGE X 5/16,
1/2 ML 30 GAUGE X
1/2", 1/2 ML 30
GAUGE X 5/16
1
EASY COMFORT
LANCETS
1
EASY COMFORT PEN
NEEDLES NEEDLE 31
GAUGE X 1/4", 32
GAUGE X 5/32"
3
EASY COMFORT PEN
NEEDLES NEEDLE 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
EASY PLUS II BLOOD
GLUCOSE MET
3
EASY PLUS II HIGH
CONTROL
3
EASY PLUS II LOW
CONTROL
3
this table.
409
Drug Name
/Limits
EASY TOUCH
NEEDLE 29 GAUGE X
1/2", 31 GAUGE X
1/4", 31 GAUGE X
3/16", 31 GAUGE X
5/16", 32 GAUGE X
1/4", 32 GAUGE X
3/16"
1
EASY TOUCH
NEEDLE 32 GAUGE X
5/32"
3
EASY TOUCH
SAFETY LANCETS 21
GAUGE, 23 GAUGE,
26 GAUGE, 28
GAUGE, 32 GAUGE
1
EASY TOUCH SYR
ALLERGY TRAY
3
EASY TOUCH
SYRINGE
1
EASY TOUCH TWIST
LANCETS 28 GAUGE,
32 GAUGE, 33
GAUGE
1
EASY TRAK BLOOD
GLUCOSE METER
3
EASY TRAK
GLUCOSE SYSTEM
3
EASY TRAK HIGH
CONTROL
3
EASY TRAK LOW
CONTROL
3
EASY TWIST AND
CAP LANCETS
1
EASYGLUCO METER
3
EASYGLUCO
MONITORING
SYSTEM
3
EASYGLUCO PLUS
STRIP
3
EASYMAX 15 LEVEL
1
3
Drug Name
/Limits
EASYMAX 15 LEVEL
2
3
EASYMAX L BLOOD
GLUCOSE METER
3
EASYMAX LOW
CONTROL
3
EASYMAX NG
3
EASYMAX NORMAL
CONTROL
3
EASYMAX V
SPEAKING GLUCOSE
SYS
3
EASYMAX V2
BLOOD GLUCOSE
METER
3
EASYMAX V2
GLUCOSE SYSTEM
KIT
3
ECLIPSE NEEDLE
NEEDLE 23 GAUGE X
1"
3
ECLIPSE SYRINGE
SYRINGE 1 ML 25 X
5/8"
1
ECLIPSE SYRINGE
SYRINGE 3 ML 21
GAUGE X 1", 3 ML 25
GAUGE X 1"
3
elastic bandage
1
ELASTIC FOAM
STRAPS
3
ELASTO-GEL
CAST-SPLINT
PADDING TOPICAL
BANDAGE 12 X 12 ",
8 X 16 "
1
ELASTO-GEL
CAST-SPLINT
PADDING TOPICAL
BANDAGE 4 X 4 ", 6
X8"
3
ELASTO-GEL CIRCLE
DRESSING
1
this table.
410
Drug Name
/Limits
ELASTO-GEL FACE
DRESSING
1
ELASTO-GEL
TOPICAL BANDAGE
12 X 12 "
3
ELASTO-GEL
TOPICAL BANDAGE
6X8"
Drug Name
/Limits
EMBRACE GLUCOSE
CONTROL HIGH
3
EMBRACE GLUCOSE
CONTROL LOW
3
EMBRACE PRO
3
1
EMBRACE PRO
GLUCOSE METER
3
ELBOW STRAP
1
EMBRACE PRO TEST
STRIPS
3
ELEMENT COMPACT
GLUCOSE METER
3
empty container
3
ELEMENT COMPACT
HIGH CONTROL
3
EMPTY
CONTAINERS
STERILE
3
ELEMENT COMPACT
NORMAL CONTROL
3
EMPTY STERILIZED
VIAL
1
ELEMENT COMPACT
V GLUCOSE MTR
3
empty vial
1
ELEMENT HIGH
CONTROL
3
EMS
ANTI-EMBOLISM
STOCKING
3
ELEMENT LOW
CONTROL
3
ENEMA
1
ELEMENT NORMAL
CONTROL
enema bag, disposable
3
3
ENEMA SYRINGE
3
ELEMENT PLUS
BLOOD GLUCOSE
KIT
3
3
ENLITE GLUCOSE
SENSOR
ENLITE SERTER
3
ELIMINATOR ODOR
SPRAY
1
ENLITE SYSTEM
3
ENTRUST PLUS
BRIEFS
1
ENTRUST PLUS
SUPER UNDERPADS
1
ENTRUST PLUS
UNDERGARMENTS
1
ENTRUST PLUS
UNDERWEAR
1
EMBRACE BLOOD
GLUCOSE
EMBRACE BLOOD
GLUCOSE SYSTEM
3
3
EMBRACE EVO
BLOOD GLUCOSE
KIT
3
EMBRACE EVO
LEVEL 1
3
ERAPID NEBULIZER
HANDSET
3
EMBRACE EVO
LEVEL 2
3
ERAPID NEBULIZER
SYSTEM
3
EMBRACE EVO TEST
STRIPS
3
ERASE
3
ERASE RAS-POURI
3
this table.
411
Drug Name
ESTEEM CLOSED
POUCH
ESTEEM DRAINABLE
POUCH 1 " (12"), 1 1/2
" (12"), 1 1/4 " (12"), 1
1/8 " (12"), 3/4 " (12"),
7/8 " (12")
/Limits
3
3
Drug Name
/Limits
EVENCARE G3
GLUCOSE METER
3
EVOLUTION BLOOD
GLUCOSE METER
3
EVOLUTION
NORMAL CONTROL
3
EXCEL SYRINGE
1
EXCILON AMD
(WITH
POLYHEXAMET)
3
EXCILON DRAIN
1
ESTEEM DRAINABLE
POUCH 1 3/16 " (12"),
1 3/8 " (12"), 1 9/16 "
(12"), 13/16-2 3/4 "
(12")
1
ESTEEM SYNERGY
1
EXCILON I.V.
3
1
EXCILON TOPICAL
SPONGE 4 X 3 "
3
EXCILON TOPICAL
SPONGE 4 X 4 "
1
EXEL HYPODERMIC
NEEDLES NEEDLE 16
GAUGE X 1 1/2", 18
GAUGE X 1 1/2", 19
GAUGE X 1", 20
GAUGE X 1 1/2", 20
GAUGE X 1", 20 X 3/4
", 21 GAUGE X 1", 21
X 1 1/2 ", 22 GAUGE X
1 1/2", 22 GAUGE X
1", 22 X 3/4 ", 23
GAUGE X 3/4", 25
GAUGE X 1 1/2", 25
GAUGE X 1", 25 X 3/4
", 25 X 5/8 ", 26
GAUGE X 1 1/2", 26
GAUGE X 1/2", 26
GAUGE X 3/8", 26
GAUGE X 5/8", 27
GAUGE X 1/2", 30
GAUGE X 1/2"
1
EXEL INSULIN
SYRINGE 0.3 ML 29
GAUGE X 1/2", 1 ML
30 GAUGE X 5/16, 1/2
ML 28 GAUGE X 1/2",
1/2 ML 30 GAUGE X
5/16
1
ESTEEM SYNERGY
CLOSED POUCH 1 3/8
"
ESTEEM SYNERGY
CLOSED POUCH 1 7/8
", 2 3/8 "
3
ESTEEM SYNERGY
DRAINABLE INVIS
3
ESTEEM SYNERGY
DRAINABLE POUCH
, 1 3/8 " (12")
1
ESTEEM SYNERGY
DRAINABLE POUCH
1 7/8 " (12"), 2 3/8 "
(12")
3
ESTEEM SYNERGY
UROSTOMY POUCH
1
ESTEEM SYNERGY+
3
ESTEEM+ CLOSED
POUCH 1 " (8"), 1 3/16
" (8"), 1 3/8 " (8"), 1
9/16 " (8"), 13/16" -2
3/4" (6"), 13/16"-2 3/4"
(8")
3
EVENCARE
3
EVENCARE G2
3
EVENCARE G2
SOLUTION
3
EVENCARE G3
CONTROL
3
this table.
412
Drug Name
/Limits
EXEL SYRINGE
SYRINGE 10 ML, 3
ML 27 X 1 1/4", 30 ML,
50 ML
1
EXPIRATORY
MOUTHPIECE
Drug Name
/Limits
EXU-DRY FACE
DRESSING
1
EXU-DRY HAND
DRESSING, MEDIUM
1
1
EXU-DRY HAND
DRESSING, SMALL
1
EXTENSION TUBING
W-CONNECTOR
1
EXU-DRY INCISION
DRESSING
3
26 mm to 30 mm, 36 mm
to 39 mm
3
EXU-DRY LEG
DRESSING
1
31 mm to 35 mm
1
EXU-DRY NECK
DRESSING
1
EXU-DRY SCALP
DRESSING
1
EXU-DRY WOUND
DRESSING TOPICAL
BANDAGE 15 X 18 ",
15 X 24 ", 20 X 28 ", 24
X 36 ", 36 X 72 ", 4 X 6
", 6 X 9 ", 9 X 15 "
3
EXU-DRY WOUND
DRESSING TOPICAL
BANDAGE 2 X 3 "
1
EYE PAD
1
eye patch
1
EZ SMART PLUS
SYSTEM
3
EZ SMART SYSTEM
3
E-Z SPACER
1
EXUDERM RCD
TOPICAL BANDAGE
6X6"
3
EXUDERM SACRUM
3
EXUDERM SATIN
DRESSING TOPICAL
BANDAGE 4 X 4 ", 6
X 6 ", 8 X 8 "
3
EXUDERM ULTRA
1
EXU-DRY ADULT
DRESSING
1
EXU-DRY ARM
DRESSING
1
EXU-DRY
BOOT-FOOT
DRESSING
1
EXU-DRY BURN
JACKET-LARGE
1
3
EXU-DRY BURN
JACKET-MEDIUM
EZO CUSHIONS
LOWER HEAVY
1
3
EXU-DRY BURN
JACKET-SMALL
EZO CUSHIONS
UPPER HEAVY
1
EZ-VAC
3
EXU-DRY BURN
VEST-LARGE
FABRIC BANDAGES
1
1
EXU-DRY BURN
VEST-SMALL
1
1
FABRIC
KNUCKLE-FINGER
BANDAGE
EXU-DRY
ELBOW-KNEE-HEEL
1
FABRIC STRIP
EXTRA LARGE
1
this table.
413
Drug Name
/Limits
Drug Name
/Limits
FACE
MASK,EARLOOP-ST
YLE
FINGER SLEEVES
3
3
finger splint
3
FACE SPLASH
SHIELD, FULL
3
FIRST AID CLOTH
TAPE
1
FACE SPLASH
SHIELD, SHORT
3
FIRST AID
HURT-FREE WRAP
1
FANTASY
1
first aid kits
1
FAST READ
THERMOMETER
1
FIRST AID PAPER
TAPE TOPICAL TAPE
1 X 10 "-YARD
1
FC2 FEMALE
CONDOM
3
FIRST CHOICE
LANCETS THIN
1
FECAL COLLECTOR
1
FITTED BRIEFS
1
FEEDING TUBE
ATTACHMENT
DEVICE
3
FITTED BRIEFS
LARGE
1
FEMALE URINARY
POUCH
1
FITTED BRIEFS
MEDIUM
1
FEMININE BULB
SYRINGE
1
FITTED BRIEFS
X-LARGE
1
FEMININE COMPACT
TRAVEL SYRNGE
1
FLEXIBLE FABRIC
BANDAGES TOPICAL
BANDAGE
3
FEMININE FOLDING
SYRINGE
1
FLEXIBLE FABRIC
BANDAGES TOPICAL
BANDAGE 2 X 3 ", 2
X 4 ", 3/4 X 3 "
1
FLEXIBLE FOAM
3
FLEXICHAMBER
3
FLEXI-SEAL FECAL
3
FEVER FLASH
THERMOMETER
1
FIFTY50 RESERVOIR
1
FIFTY50 SAFETY
SEAL LANCETS
1
FILTER CLOSED
MINI-POUCH
1
FLEXI-SEAL FMS
1
filter needles needle 18
gauge x 1 1/2"
1
FLEXI-SEAL FMS
RECTAL
3
FILTER, MILLEX-FG
0.2 UM
3
FLEXI-SEAL SIGNAL
FMS
3
FILTER, MILLEX-OR
SYRINGE
3
FLEXI-TRAK
ANCHORING DEVICE
1
FILTERS
REPLACEMENT
1
FLEXTEND SKIN
BARRIER
1
FILTRODOR POUCH
FILTER
1
FLEXZAN WOUND
DRESSING
1
this table.
414
Drug Name
/Limits
FLOW-EZE VENTED
NEEDLE
1
FLUTTER
Drug Name
/Limits
FORA V20 KIT
3
FORA V30A
3
1
FORA V30A KIT
3
foam bandage
3
FOAM INSOLE
1
FORACARE GD20
GLUCOSE METER
3
FOAM TOE
BANDAGE
3
FORACARE GD40A
GLUCOSE METER
3
FORACARE GD40B
GLUCOSE METER
3
FORACARE GDH
HIGH CONTROL
3
FOLEY CATHETER
14 FR, 16 FR, 18 FR,
20 FR, 22 FR, 24 FR,
26 FR
1
FOLEY CATHETER
28 FR, 30 FR
3
FORACARE GDH
LOW CONTROL
3
FOLEY CATHETER
TRAY
1
FORACARE GDH
NORMAL CONTROL
3
FORA D10
3
FORA D15
3
FOREHEAD
THERMOMETER
1
FORA D20 KIT
3
3
FORA G20 KIT
3
FORTISCARE BLOOD
GLUCOSE SYST
FORA G30A
3
FORA GD50 BLOOD
GLUCOSE SYSTEM
3
3
FORTISCARE
GLUCOSE TEST
STRIPS
FORA GD50 TEST
STRIPS
FORTISCARE HIGH
3
3
FORTISCARE LOW
3
FORA HIGH
CONTROL
3
FORTISCARE
NORMAL
3
FORA LANCING
DEVICE
FOUNTAIN SYRINGE
1
1
3
FORA LOW
CONTROL
FREEDOM
PRECISION AIRLESS
3
3
FORA NORMAL
CONTROL
FREESTYLE
CONTROL
3
3
FORA TEST N'GO BP
SYSTEM
FREESTYLE FLASH
SYSTEM
3
3
FORA TEST N'GO
VOICE METER
FREESTYLE
FREEDOM
3
3
FORA V10
3
FREESTYLE
FREEDOM LITE
FORA V12 BLOOD
GLUCOSE SYSTEM
3
FREESTYLE
INSULINX
3
FORA V12 GLUCOSE
3
this table.
415
Drug Name
/Limits
FREESTYLE LITE
METER
3
FREESTYLE
NAVIGATOR GLUC
SENS
3
FREESTYLE
PRECISION
Drug Name
/Limits
GENTLE TAPE
TOPICAL BANDAGE
2 X 2.2 "-YARD
3
1
1
GENTLECATH 10 FR,
12 FR, 12-16 FR-", 14
FR, 14-16 FR-", 16 FR,
16-16 FR-", 8 FR
FREESTYLE
SIDEKICK II
3
GENTLECATH 8-16
FR-"
3
FREESTYLE SYSTEM
KIT
3
GLUCO NAVII
GLUCOSE MONITOR
3
FUTURO
ANTI-EMBOLISM
STOCKINGS
1
GLUCOCARD 01
HI-NORMAL
CONTROL
3
FUTURO RESTORING
MEDIUM
1
GLUCOCARD 01
METER
3
gauze bandage
1
3
GAUZE PAD
1
GLUCOCARD 01
NORMAL CONTROL
GAUZE ROLL
1
GLUCOCARD 01
SENSOR PLUS
3
GE100 BLOOD
GLUCOSE SYSTEM
3
GLUCOCARD
EXPRESSION
3
GE100 CONTROL
SOLUTION NORMAL
3
GLUCOCARD
EXPRESSION KIT
3
GEL BUNION
CUSHION
1
3
GEL BUNION GUARD
1
GLUCOCARD
EXPRESSION
SOLUTION
GEL CORN
PROTECTORS
1
GLUCOCARD SHINE
3
GEL TOE
PROTECTOR
3
1
GLUCOCARD SHINE
METER
GEL TOE SPACERS
1
GLUCOCARD SHINE
METER KIT
3
GELPAD TOPICAL
BANDAGE 2 X 2 ", 4
X4"
1
GLUCOCARD SHINE
TEST STRIPS
3
GLUCOCARD VITAL
3
GELPAD TOPICAL
BANDAGE 4 X 8 ", 6
X 10 "
3
GLUCOCOM
AUTOLINK
3
GLUCOCOM BLOOD
GLUCOSE
3
GLUCOCOM
CONTROL HIGH
3
GENTLE TAPE
TOPICAL BANDAGE
1 X 2.2 "-YARD
1
this table.
416
Drug Name
/Limits
GLUCOCOM
CONTROL NORMAL
3
GLUCOLET 2
AUTOMATIC
LANCING
Drug Name
/Limits
GUARDIAN RT
MONITOR SYSTEM
3
1
GUARDIAN RT
STARTER KIT
3
GLUCOSE CONTROL
3
GUARDIAN RT TEST
PLUG DEVICE
3
GLUCOSE KETONE
CONTROL SOLN
1
GUARDIAN RT
TRANSMITTER TAPE
3
GM100 KIT
3
3
GMATE CONTROL
SOLUTION, NORMAL
GUARDIAN SHARPS
COLLECTOR
3
GUARDS FOR MEN
1
GMATE LANCING
DEVICE
3
HAND SUPPORT
1
GMATE SMART
METER
1
3
HANDICARE
GARMENT LINER
GMATE SMART
STARTER
1
3
HARMONIE
UNDERPAD
HEALTHMIST
1
GMATE VOICE
METER
3
HEALTHPRO
GLUCOSE MONITOR
3
GOODNITES BED
MATS
3
3
GOODNITES TRU-FIT
LINERS
3
HEALTHPRO
HIGH-LOW
CONTROL
HEALTHPRO TEST
STRIPS
3
HEALTHY ACCENTS
AUTOLET
1
HEALTHY ACCENTS
UNIFINE PENTIP
NEEDLE 29 GAUGE X
1/2", 31 GAUGE X
1/4", 31 GAUGE X
3/16", 31 GAUGE X
5/16"
1
HEALTHY ACCENTS
UNIFINE PENTIP
NEEDLE 32 GAUGE X
5/32"
3
HEALTHY ACCENTS
UNILET LANCET
1
HEARING AID
BATTERIES
1
HEAT THERAPY
1
GOODNITES
UNDERPANT YOUTH
L-XL
3
GOODNITES
UNDERPANTS L-XL
1
GOODNITES
UNDERPANTS
SMALL-MED
3
GRX FOAM
DRESSING
3
GRX WOUND GEL
3
GUARD MALE
1
GUARDIAN
REAL-TIME GLU
MONITOR
3
GUARDIAN RT
CHARGER
3
this table.
417
Drug Name
/Limits
heating pads
1
HEATWRAPS
1
HEATWRAPS BACK
AND HIP PADS
1
HEATWRAPS
MENSTRUAL RELIEF
PAD
1
HEATWRAPS
NECK-SHOULDER-W
RIST
1
HEAVY DRAINAGE
DRESSING STERIL
Drug Name
/Limits
HUGGIES PURE AND
NATURAL SIZE5
3
HUGGIES SLIP-ON
1
HUGGIES SNUG AND
DRY STEP 5
1
HUGGIES SNUG AND
DRY STEP 6
1
HUMAPEN LUXURA
HD
3
humidifiers
1
3
HURRICAINE LIQUID
DISPENSER
3
HEAVY DUTY
FABRIC STRIPS
1
HURRICAINE
LUER-LOCK DIS CAP
1
HEMA-COMBISTIX
1
HEMATEST
3
HURRICAINE SPRAY
EXTENSION
3
HURRIVIEW
3
HI-VOLUME
PUMPING CHAMBER
SET
3
HURRIVIEW II
3
HOLLIHESIVE SKIN
BARRIER
1
hydrocol dress-adhesive
rem#1
3
HOLLISTER
REPLACEMENT
FILTERS
HYDROCOL II
1
1
HYDROCOL II
SACRAL
1
HYDROCOL THIN II
1
topical bandage 17
square inch, 26.5 sq
inch
3
topical bandage 4 x 4 ",
6 x 6 ", 6 x 8 ", 8 x 8 "
1
HYDROFERA BLUE
TOPICAL BANDAGE
2 X 2 ", 2.25 X 8 ", 2.5
", 9 MM
3
HYPO-ALLERGENIC
BANDAGES
1
HORIZONTAL
DRAIN-TUBE ATT
DEV
1
HOT AND COLD
PACK
1
huber safety needles
(disp.)
1
HUGGIES LITTLE
MOVERS
1
HUGGIES PULL-UPS
1
HUGGIES PULL-UPS
2T-3T
1
HUGGIES PULL-UPS
3T-4T
1
HUGGIES PULL-UPS
4T-5T
1
this table.
418
Drug Name
/Limits
HYPODERMIC
NEEDLES NEEDLE 21
GAUGE X 1", 22
GAUGE X 1", 23
GAUGE X 1 1/2", 26
GAUGE X 5/8"
1
HYPOLANCE AST
LANCING
Drug Name
/Limits
INCONTROL PEN
NEEDLE NEEDLE 32
GAUGE X 5/32"
3
INCONTROL SUPER
THIN LANCETS
1
1
INFANT EAR
SYRINGE
1
ice bag
1
INFINITY CONTROL
SOLUTION HIGH
3
ICE CAP
1
INFINITY CONTROL
SOLUTION LOW
3
INFINITY CONTROL
SOLUTION NORM
3
INFINITY METER KIT
3
INFINITY STARTER
KIT
3
INFUSION SET
1
ICE IT!
COLDCOMFORT
1
ICE IT! PACK
1
ICY HOT SMART
RELIEF PADS
3
ICY HOT SMART
RELIEF THERAPY
3
ILE-SORB ORIGINAL
1
INFUSION SET 23"
1
INCARE INVIEW
CATHETER 25 MM,
29 MM, 32 MM, 41
MM
3
INFUSION SET 23"
6MM
1
1
INCARE INVIEW
CATHETER 36 MM
INFUSION SET 43"
6MM
1
1
IN-CHECK DIAL
TRAINING DEVICE
INFUSION SET 43"
9MM
3
1
IN-CHECK NASAL
WITH MASK
INJECT EASE
LANCETS
1
INJECT-EASE
1
IN-CHECK ORAL
FLOW METER
1
1
INCONTROL BP
MONITOR
INJECT-EASE
AUTOMATIC
INJECTOR
1
INNOSPIRE DELUXE
3
INCONTROL
LANCING DEVICE
1
INNOSPIRE
ELEGANCE
1
INNOSPIRE ESSENCE
1
INNOSPIRE MINI
3
INNOSPIRE
REPLACEMENT
FILTER
3
INSET 30 TUBING 23"
GREY
3
INCONTROL PEN
NEEDLE NEEDLE 29
GAUGE X 1/2", 31
GAUGE X 1/4", 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
this table.
419
Drug Name
/Limits
INSET 30 TUBING 43"
GREY
3
INSPIRACHAMBER
3
INSPIRACHAMBER
WITH MASK-MED
3
INSPIRACHAMBER
WITH MASK-SMALL
3
INSPIRATION ELITE
3
INSPIRATION ELITE
FILTER
3
INSPIRATION
NEBULIZER SYSTEM
1
INSTANT COLD
PACK
1
INSTANT EAR
THERMOMETER
1
INSUFLON
1
INSUL-CAP
3
INSUL-EZE
3
INSULIN SYRINGE
MICROFINE
SYRINGE 0.3 ML 28 X
1/2", 1 ML 27 GAUGE
X 5/8"
1
insulin syringe
needleless
1
INSULIN SYRINGE
SYRINGE 1 ML 28
GAUGE X 1/2", 1 ML
29 X 1/2", 1 ML 30
GAUGE X 5/16, 1/2
ML 28 GAUGE X 1/2",
1/2 ML 29 X 1/2", 1/2
ML 30 GAUGE X 5/16
1
insulin syringe-needle
u-100
1
insulin syringes
(disposable)
1
INSUL-TRAY
3
Drug Name
/Limits
INSUPEN NEEDLE 29
GAUGE X 1/2", 30
GAUGE X 5/16", 31
GAUGE X 1/4", 31
GAUGE X 5/16", 32
GAUGE X 1/4", 32
GAUGE X 5/16"
1
INSUPEN NEEDLE 32
GAUGE X 5/32", 33
GAUGE X 5/32"
3
INSYTE IV
CATHETER
3
INTEGRA SYRINGE
SYRINGE 1 ML 25
GAUGE X 1"
1
INTEGRA SYRINGE
SYRINGE 3 ML 21
GAUGE X 1"
3
INTERLINK LEVER
LOCK CANNULA
1
INTERLINK SYRINGE
AND CANNULA
3
INTERLINK SYRINGE
CANNULA
1
INTERSORB
3
INTRASITE GEL
DRESSING
3
INTROSYTE
AUTOGUARD
3
INVACARE LANCETS
1
I-PORT
3
I-PORT ADVANCE 6
MM INJEC PORT
3
I-PORT ADVANCE 9
MM INJEC PORT
3
IRRIGATION SLEEVE
1
ISLAND GARD-GRX
TOPICAL BANDAGE
4X4"
3
IV 3000 TOPICAL
BANDAGE 2 3/8 X 2
3/4 "
3
this table.
420
Drug Name
/Limits
Drug Name
/Limits
iv administration set
1
3
IV3000 FRAME
DELIVERY
DRESSING
KANGAROO PET
CHARGING CORD
3
KANGAROO PET
FRAME FOR PUMP
3
J AND J FIRST AID
TAPE PAPER
1
KANGAROO PET
PUMP CARRY CASE
3
J AND J NON-STICK
PADS LARGE
1
KANGAROO PUMP
EXTENSION SET
3
J AND J NON-STICK
PADS MEDIUM
1
KANGAROO PUMP
SET
1
JETCO-SPRAY
CANNULA
3
KANGAROO RIGID
CONTAINER
1
KANGAROO 924
SAFETY SCREW
3
KANGAROO RIGID
CONTAINER PUMP
1
KANGAROO
BURETTE/PUMP SET
1
KANGAROO SCREW
CAP PUMP SET
1
KANGAROO SPIKE
PUMP SET
1
KANGAROO Y-SITE
EXTENSION SET
3
KARAYA 5 CLOSED
POUCH
1
KARAYA 5 CLOSED
POUCH - TAPE
1
KARAYA 5
DRAINABLE
MINI-POUCH
1
KARAYA 5
DRAINABLE POUCH
1
KARAYA 5
DRAINABLE POUCH
CLOTH
1
KARAYA PASTE
1
KARAYA POWDER
1
KENDALL CLOTH
3
KENDALL
CONTAINER
3
KENDALL
DISINFECTANT CAP
3
KENDALL PAPER
TAPE
1
KANGAROO
DELUXE EZ PUMP
SET
1
KANGAROO
DELUXE PUMP SET
1
KANGAROO
ENTERAL-FEED-IRRI
G KT
1
KANGAROO EPUMP
SET
3
KANGAROO EZ CAP
BAG
1
KANGAROO EZ CAP
PUMP SET
1
KANGAROO EZ CAP
PUMP SET/500ML
1
KANGAROO
FEEDING TUBE 10-36
FR-", 8-36 FR-"
1
KANGAROO
FEEDING TUBE 10-43
FR-", 12-36 FR-", 14-36
FR-"
3
KANGAROO
GRAVITY SET
3
this table.
421
Drug Name
/Limits
KENDALL TOPICAL
BANDAGE 12 ", 2 X 2
", 4 X 4 "
3
KENDALL TOPICAL
BANDAGE 2 X 2 3/4 "
1
KENDALL TOPICAL
GEL
3
KENGUARD FOLEY
CATHETER
3
KENGUARD
URINARY DRAIN
BAG
1
KENLINE
ADD-A-FOLEY TRAY
30CC
1
KERLIX AMD
3
KERLIX BURN PACK
3
KERLIX PACKING
SPONGE
3
KERLIX TOPICAL
BANDAGE 2 1/4 X 3
"-YARD, 3.4 X 3.6
"-YARD, 4 1/2 X 147 "
1
KERLIX TOPICAL
BANDAGE 9 X 100
"-YARD
3
KERLIX TOPICAL
SPONGE , 4 X 4 "
1
Drug Name
/Limits
KID PANTS FOR
GIRLS
1
KID PANTS GIRLS
MEDIUM
1
KID PANTS GIRLS
X-LARGE
1
KIDPANT
1
KIMONO
CONDOMS(NON-LUB
RICATED)
1
KIMONO MAXX
CONDOMS
1
KIMONO
MICROTHIN AQUA
LUBE CON
1
KIMONO
MICROTHIN
CONDOMS
1
KIMONO
MICROTHIN LARGE
CONDOMS
1
KIMONO TEXTURED
CONDOMS
1
KINNEY BRAND
LANCETS
1
KLING ROLLS
1
KNEE BRACE
1
KNEE BRACE
LARGE-XLARGE
1
KNEE STABILIZER
1
KNEE SUPPORT
1
KERLIX TOPICAL
SPONGE 14 X 14 ", 14
X 3 ", 26 X 17 ", 30 X 7
", 9 X 9 "
3
KETO-DIASTIX
1
KNIT PANTS, PLUS
1
KETONE CARE
1
1
KETONE URINE
TEST
KNIT PANTS,
REGULAR
1
LABSTIX REAGENT
1
KETOSTIX
1
LAMB'S WOOL
1
KID PANTS BOYS
X-LARGE
1
LANCETS,ULTRA
THIN
1
KID PANTS FOR
BOYS
1
lancing device
1
this table.
422
Drug Name
/Limits
LANCING DEVICE
WITH LANCETS
1
LANCING SYSTEM
3
LANZO LANCING
DEVICE
3
latex gloves
1
latex gloves package
3
LATEX GLOVES,
LARGE
Drug Name
/Limits
LITE TOUCH
LANCING DEVICE
1
LITE
TOUCH-MEDIUM
MASK
1
LITEAIRE MDI
CHAMBER
1
1
LITETOUCH-LARGE
MASK
1
LATEX GLOVES,
MEDIUM
1
LITETOUCH-SMALL
MASK
1
LATEX GLOVES,
SMALL
1
LITTLE DARLINGS
2T-3T
1
LC D NEBULIZER
SET
1
LITTLE DARLINGS
3T-4T
1
LC PLUS
1
LITTLE DARLINGS
4T-5T
1
LC STAR
3
LITTLE ONES
CLOSED-END POUCH
1
LITTLE ONES
DRAINABLE POUCH
1
LITTLE ONES
FLEXIBLE SKIN
1
LITTLE ONES SKIN
BARRIER
1
LITTLE ONES
UROSTOMY POUCH
1
LOCAL ANESTHESIA
NEEDLE 20GX6"
3
LIBERTY BLOOD
GLUCOSE MONITOR
LIBERTY LEV 1
GLUCOSE CONTROL
LIBERTY LEV 2
GLUCOSE CONTROL
LICE AND NIT
REMOVAL COMB
LIFESHIELD BLUNT
CANNULA NEEDLE
3
3
3
3
1
LIFESHIELD BLUNT
CANNULA SYRINGE
1 ML 18 GAUGE X 1",
3 ML 18 X 1"
1
LOCAL ANESTHESIA
NEEDLE 22GX2"
3
LINEN FRESH
1
LOOP OSTOMY
BRIDGE STERILE
1
LIQUA SPEN
3
LISCO
1
LO-PROFILE
UROSTOMY POUCH
1
LITE TOUCH
INSULIN PEN
NEEDLES
1
LUBRICATING AND
REWETTING
1
LITE TOUCH
INSULIN SYRINGE
3
1
LUER LOCK
ADAPTER
this table.
423
Drug Name
/Limits
LUER LOCK
SYRINGE SYRINGE
30 ML
1
LUER SLIP TIP
SYRINGE TRAY
3
LUER-LOK TIP
Drug Name
/Limits
MAXICARE BELTED
UNDERGARMENT
1
MAXICARE
UNDERPADS
1
1
MAXI-COMFORT
INSULIN SYRINGE
1
LUVS NEWBORN
1
MAXORB
3
LUVS SIZE 1
1
3
LUVS SIZE 2
1
MAXORB EXTRA
DRESSING
LUVS SIZE 3
1
MAXORB ROPE
3
LUVS SIZE 4
1
MD JAR AIRLESS
3
LUVS SIZE 5
1
MD PEN AIRLESS
3
LUVS SIZE 6
1
3
M9
CLEANER-DECRYST
ALLIZER
MD PUMP
ACTUATOR A
1
MD PUMP
ACTUATOR B
3
MD PUMP
ACTUATOR C
3
MD PUMP BOTTLE
AIRLESS
3
MD SYRINGE
AIRLESS
3
MEDFIX
3
MEDFIX EZ
DRESSING
3
MEDICAL ADHESIVE
1
medical information id
tag
3
MEDICINE DROPPER
1
MEDICINE DROPPER
AND SPOON
1
MEDICINE SPOON
3
MEDIGRIP
3
MEDIGRIP
ELASTICATED
SUPPORT
3
MEDIGRIP TUBULAR
3
MEDIHONEY (CAL
ALGINATE-HONEY)
3
MEDIPORE
1
MAGELLAN INSULIN
SAFETY SYRNG
SYRINGE 0.3 ML 29 X
1/2", 0.5 ML 29
GAUGE X 1/2", 1 ML
30 GAUGE X 5/16"
MAGELLAN INSULIN
SAFETY SYRNG
SYRINGE 1 ML 29
GAUGE X 1/2"
MAGELLAN
SYRINGE SYRINGE
0.3 ML 30 X 5/16", 1
ML 27 GAUGE X 1/2"
3
1
3
MAGELLAN
SYRINGE SYRINGE
0.5 ML 30 GAUGE X
5/16"
1
MASK VORTEX
BABY WHIRL DUCK
1
MASK VORTEX
SPINNER THE DUCK
1
MASTISOL STERTIP
AEROSOL,SPRAY
3
MASTISOL STERTIP
LIQUID
1
this table.
424
Drug Name
/Limits
MEDIPORE DRESS-IT
COVER
3
MEDIPORE H
1
MEDIPORE SOFT
CLOTH TAPE
1
MEDISENSE
Drug Name
/Limits
MICRODERM 1 1/2 ",
1 3/8 ", 7/8 "
3
MICRODERM
PACKAGE
3
1
3
MICRODERM PLUS 1
", 1 1/8 "
MEDISENSE
GLUCOSE KETONE
1
MICRODERM PLUS 1
1/2 ", 1 3/8 ", 7/8 "
3
MEDISENSE MID
CONTROL
3
MICRODERM PLUS
PACKAGE
3
MEDPOINT NORMAL
CONTROL
3
MICRODOT BLOOD
GLUCOSE SYSTEM
3
MEDSAVER
SYRINGE
1
3
MEDTRONIC
REMOTE CONTROL
MICRODOT
HIGH-LOW
CONTROL
3
3
MEGAPUMP
AIRLESS
MICRODOT NORMAL
CONTROL
3
MEGAPUMP MEZZO
3
MEGAPUMP-BLUE
3
1
MESH PANTS
1
MICRO AIR
1
MICROFOAM
SURGICAL TOPICAL
TAPE 1 X 5 1/2
"-YARD, 2 X 5 1/2
"-YARD, 3 X 5 1/2
"-YARD, 4 X 5 1/2
"-YARD
MICRO BLOOD
GLUCOSE
3
3
MICRO ELITE
COMP-NEBUL
3
MICROFOAM
SURGICAL TOPICAL
TAPE 4 X 7 "
MICRO ELITE
LITHIUM BATTERY
1
3
MICROHESIVE
STOMA PASTE
MICROLET 2
LANCING DEVICE
1
MICRO ELITE
REPLACEMENT
FILTER
1
MICROLET LANCET
1
MICRO PLUS
NEBULIZER
3
MICROLIFE PEAK
FLOW METER
1
MICRO THIN
LANCETS
1
MICROPORE
SURGICAL
1
MICROBORE
EXTENSION SET
MICROSPACER
1
3
MICROSPONGE
3
MICROCHAMBER
1
MICRODERM 1 ", 1
1/8 "
3
1
MINI ELITE
COMPRESSOR-NEBU
LIZE
this table.
425
Drug Name
/Limits
Drug Name
/Limits
MINI ELITE FILTER
REPLACEMENT
1
MONOJECT BLOOD
COLLECTION
3
MINI ELITE LITHIUM
BATTERY
3
MONOJECT BLUNT
CANNULAS
1
MINI LANCING
DEVICE
1
3
MINI PLUS
NEBULIZER
MONOJECT
BRACKET-SHARPS
CONT
3
MINI TRANSFER PIN
1
1
MINI ULTRA-THIN II
1
MONOJECT
CONTROL SYRINGE
LUER
MINI UROSTOMY
POUCH
3
MONOJECT
DISPOSABLE
SYRINGE
1
MINI WRIGHT PEAK
FLOW METER
3
MONOJECT
ECCENTRIC
NON-STERILE
SYRINGE 35 ML
1
MONOJECT FILTER
ASPIRATOR
1
MONOJECT FILTER
CONNECTOR
1
MONOJECT FILTER
NEEDLE
1
MONOJECT FINGER
GRIP EXTENDERS
3
MINILINK
REAL-TIME
TRANSMITTER
3
MINIMED 530G
INSULIN PUMP
3
MINIMED INFUSION
SET-MMT 390
3
MINIMED
QUICK-SERTER-MM
T 395
3
MINIMED SYRINGE
RESERVOIR
3
MIO INFUSION SET
3
MIRASORB
1
MOLESKIN PLUS
1
MONO-FLO
DRAINAGE BAG
3
MONOJECT 140CC
PISTON SYRINGE
1
MONOJECT 3CC SYR
25GX1"
1
MONOJECT
ALLERGY TRAY
1
MONOJECT
ALLERGY TRAY
DETACH
1
this table.
426
Drug Name
MONOJECT
HYPODERMIC
NEEDLES NEEDLE 14
GAUGE X 1 1/2", 14
GAUGE X 1", 14
GAUGE X 2", 15
GAUGE X 1 1/2", 16
GAUGE X 1 1/2", 16
GAUGE X 1", 16
GAUGE X 3/4", 16
GAUGE X 5/8", 18
GAUGE X 1 1/2", 18
GAUGE X 1", 19
GAUGE X 1 1/2", 19
GAUGE X 1", 20
GAUGE X 1 1/2", 20
GAUGE X 1", 21
GAUGE X 1", 21
GAUGE X 2", 21 X 1
1/2 ", 22 GAUGE X 1
1/2", 22 GAUGE X 1",
23 GAUGE X 1", 25
GAUGE X 1 1/2", 25
GAUGE X 1", 25 X 1
1/4 ", 25 X 2 ", 25 X 5/8
", 27 GAUGE X 1 1/2",
27 GAUGE X 1 1/4", 27
GAUGE X 1/2", 30
GAUGE X 3/4"
/Limits
1
MONOJECT
HYPODERMIC
NEEDLES NEEDLE 23
GAUGE X 1/2", 26
GAUGE X 1 1/2"
3
MONOJECT
HYPODERMIC
POLYPROPYL
1
MONOJECT INSULIN
SAFETY SYRING
1
Drug Name
/Limits
MONOJECT INSULIN
SYRINGE SYRINGE
0.3 ML 29 GAUGE X
1/2", 0.3 ML 31 X
5/16", 1 ML , 1 ML 25
GAUGE X 5/8", 1 ML
27 GAUGE X 1/2", 1
ML 28 GAUGE X 1/2",
1 ML 29 X 1/2", 1 ML
30 GAUGE X 5/16, 1
ML 31 X 5/16", 1/2 ML
28 GAUGE X 1/2", 1/2
ML 29 X 1/2", 1/2 ML
31 X 5/16"
1
MONOJECT LUER
ADAPTER
3
MONOJECT
LUER-LOCK TIP
SYRINGE 12 ML
1
MONOJECT
MAGELLAN
SYRINGE
3
MONOJECT
MEDICATION
TRANSF NDL
1
MONOJECT ORAL
MEDICAL SYRINGE
1
MONOJECT
PHARMACY TRAY
LUER
1
MONOJECT
PHARMACY TRAY
REG TIP
1
MONOJECT REG TIP
NON-STERILE
1
MONOJECT
REGULAR LUER
SYRINGE 3 ML, 35
ML, 6 ML
1
MONOJECT SAFETY
LUER LOCK TIP
1
MONOJECT SAFETY
SYR TIP CAP
3
this table.
427
Drug Name
/Limits
MONOJECT SAFETY
SYRINGES SYRINGE
, 12 ML, 12 ML 20 X 1
1/2", 3 ML 20 GAUGE
X 1 1/2", 3 ML 21
21 GAUGE X 1", 3 ML
22 GAUGE X 1 1/2", 3
ML 22 GAUGE X 1", 3
ML 23 GAUGE X 1", 3
ML 25 GAUGE X 5/8"
1
MONOJECT SAFETY
SYRINGES SYRINGE
12 ML 21X 1 1/2", 6
ML
3
MONOJECT SHARPS
WALL CABINET
3
MONOJECT
SMARTIP CANNULA
MONOJECT SYRINGE
CATHETER
/Limits
MONOJECT SYRINGE
SYRINGE 12 ML, 12
ML 18 GAUGE X 1",
12 ML 20 X 1 1/2", 12
ML 21 GAUGE X 1
1/2", 12 ML 21
GAUGE X 1", 3 ML, 3
ML 20 GAUGE X 1", 3
ML 20 X 1 1/2", 3 ML
20 X 3/4", 3 ML 21
GAUGE X 1", 3 ML 21
X 1 1/2", 3 ML 22
GAUGE X 1", 3 ML 22
X 1 1/2", 3 ML 23 X 1",
3 ML 25 GAUGE X 1",
3 ML 25 X 1 1/4", 3 ML
25 X 5/8", 3 ML 27 X 1
1/4"
1
3
MONOJECT TB
1
1
MONOJECT TB LUER
LOK
1
MONOJECT TB
SAFETY SYRINGE
1
MONOJECT TIP
CAPS/FLEX/LUER
3
MONOJECT
TUBERCULIN
SYRINGE SYRINGE 1
ML
3
MONOJECT
TUBERCULIN
SYRINGE SYRINGE 1
ML 25 X 5/8", 1 ML 26
X 3/8", 1 ML 27 X 1/2",
1 ML 28 GAUGE X
1/2", 1/2 ML 28 X 1/2"
1
MONOJECT ULTRA
COMFORT INSULIN
1
MONOLET LANCETS
1
MONOLET THIN
LANCETS
1
MOUTHPIECE
1
MOUTHPIECE
REUSABLE MW
1
MONOJECT SYRINGE
LUER LOK SYRINGE
35 ML, 60 ML
1
MONOJECT SYRINGE
REGULAR LUER
1
MONOJECT SYRINGE
SYRINGE 1/2 ML 28
GAUGE, 140 ML, 6
ML, 6 ML 20 X 1 1/2",
6 ML 21 X 1 1/2", 6 ML
21 X 1", 6 ML 22 X 1
1/2"
Drug Name
3
this table.
428
Drug Name
/Limits
MPM FOAM
DRESSING TOPICAL
BANDAGE 2 X 2 ", 6
X6"
3
MPM FOAM
DRESSING TOPICAL
BANDAGE 4 X 4 "
1
MULTI-DRAW
NEEDLE
1
MULTIPURPOSE
CONTACT LENS
1
MULTIPURPOSE ICE
AND HEAT WRAP
1
MULTI-PURPOSE
SOFT CONTACT LEN
3
MULTISTIX
1
MULTISTIX 10 SG
1
MULTISTIX 5
1
MULTISTIX 7
1
MULTISTIX 8 SG
1
MULTISTIX 9
1
MULTISTIX 9 SG
1
MULTI-USE COLD
REUSABLE PAD
1
Drug Name
/Limits
NASAL STRIPS
SMALL-MEDIUM
3
NASONEB NASAL
NEBULIZER
3
NATURA CLOSED
POUCH
1
NATURA
DRAINABLE POUCH
1 1/2 " (12"), 1 3/4"
(14"), 2 1/4" (14"), 2
3/4" (14"), 4 " (12")
3
NATURA
DRAINABLE POUCH
1 3/4 " (12"), 2 1/4 "
(12"), 2 3/4 " (12")
1
NATURA
DURAHESIVE SKIN
BARRIER
1
NATURA
STOMAHESIVE SKN
BARRIER
1
NATURAL CARE
BANDAGES
3
needle (disp) 16 g
1
needle (disp) 18 g
1
needle (disp) 19 g
1
needle (disp) 23 gauge
1
NEEDLE
COLLECTION AND
DISPOSAL
3
needles, huber
disposable
1
1
MYGLUCOHEALTH
CONTROL
SOLUTION
3
MYGLUCOHEALTH
KIT
3
MYGLUCOHEALTH
LANCETS
1
NASAL ASPIRATOR
1
NASAL STRIPS
3
NEOPRENE KNEE
SUPPORT
NASAL STRIPS
LARGE
3
NEOPRENE WRIST
SPLINT SUPPORT
1
NASAL STRIPS
MEDIUM
3
NERIA MULTI
(BI-FURCATED)
3
NASAL STRIPS
MEDIUM-LARGE
3
NERIA MULTI
(TRI-FURCATED)
3
this table.
429
Drug Name
NERIA
SUBCUTANEOUS
INFUSION SET 10 X
110 MM-CM, 6 MM X
110 CM
/Limits
3
NERIA
SUBCUTANEOUS
INFUSION SET 8 X
110 MM-CM
1
NEUROPEN
3
NEUROPEN
MONOFILAMENTS
3
NEUROTIPS
3
NEW GENERATION
1
NEW IMAGE
CLOSED
MINI-POUCH 1 3/4 ",
2 1/4 ", 2 3/4 "
1
NEW IMAGE
CLOSED
MINI-POUCH 2 3/4 "
(7")
3
NEW IMAGE
CLOSED POUCH
1
NEW IMAGE
COLOST-ILEO
KIT,STE
3
NEW IMAGE
COLOSTOMY-ILEO
KIT 2 3/4 " (12"), 4 "
(12")
3
NEW IMAGE DRAIN
MINI-POUCH
1
NEW IMAGE
DRAINABLE KIT
3
NEW IMAGE
DRAINABLE
MINI-POUCH 2 1/4 "
1
NEW IMAGE
DRAINABLE
MINI-POUCH 2 3/4 "
(7")
3
Drug Name
/Limits
NEW IMAGE
DRAINABLE POUCH
1 3/4 ", 1 3/4 " (12"), 2
1/4 ", 2 1/4 " (12"), 2
3/4 ", 4 "
1
NEW IMAGE
DRAINABLE POUCH
2 1/4 " (7"), 4 " (12")
3
NEW IMAGE
FLEXTEND BARRIER
FLA
1
NEW IMAGE
FLEXTEND SKN
BARRIER
1
NEW IMAGE
FLEXWEAR
BARRIER 1 ", 1 1/2 "
1
NEW IMAGE
FLEXWEAR FLAT
1
NEW IMAGE
IRRIGATOR SLEEVE
1
NEW IMAGE LOCK'N
ROLL POUCH 2 3/4 "
1
NEW IMAGE
OSTOMY KIT 2 1/4 "
(12 ")
1
NEW IMAGE
OSTOMY KIT 4 " (12")
3
NEW IMAGE SKIN
BARRIER 2 3/4 ", 4 "
1
NEW IMAGE SKIN
BARRIER-FLANGE
1
NEW IMAGE
UROSTOMY POUCH
1
NEW IMAGE
UROSTOMY SET
3
NEW IMAGE
UROSTOMYSET,STE
RILE
3
NEXCARE ALL
PURPOSE MASK
1
this table.
430
Drug Name
NEXCARE GENTLE
PAPER TAPE
/Limits
1
Drug Name
/Limits
NOVOFINE 32
1
NOVOFINE
AUTOCOVER
1
NOVOFINE PLUS
3
NEXCARE
TEGADERM
1
NEXIVA
3
NOVOPEN ECHO
3
NIGHT DRAIN
ADAPTER
1
NOVOTWIST
3
NIGHT SUPER PAD
1
NUFIT BRIEF EXTRA LARGE
1
NIGHTTIME
UNDERPANTS L-XL
3
NU-FIT BRIEF
LARGE
1
NIGHTTIME
UNDERPANTS S-M
3
NU-FIT BRIEF
MEDIUM
1
NITRATEST PAPER
WITH DISPENSER
1
NUFIT UNDERWEAR
1
NITRILE EXAM
GLOVES
1
NUTRIPORT
BALLOON
3
NOKOR NEEDLE
1
O.A.D.
1
non-adherent bandage
1
OASIS ULTRA
FENESTRATED
3
NON-STICK PAD
TOPICAL BANDAGE
3 X 4 ", 4 X 3 "
1
OASIS WOUND
MATRIX
FENESTRATED
3
NON-STICK PAD
TOPICAL BANDAGE
3X8"
3
OASIS WOUND
MATRIX MESHED
3
NOSE CLIP
3
O-CAL-ETTE
NURSING CUP
3
NO-STING
SKIN-PREP
1
OCUSOFT EYELID
CLEANSING PADS
3
NOVA MAX BLOOD
GLUCOSE METER
3
OMNIPOD INSULIN
MANAGEMENT
3
NOVA MAX
GLUCOSE CONTROL
3
OMNIPOD INSULIN
REFILL
3
NOVA SAFETY
LANCETS
1
ON CALL EXPRESS
CONTROL
3
NOVA SUREFLEX
LANCETS
1
ON CALL EXPRESS
METER
3
NOVAMAX PLUS
GLU-KET
3
ON CALL EXPRESS
TEST STRIP
3
NOVAMAX PLUS
KETONE
1
ON CALL LANCING
DEVICE
1
NOVOFINE 30
1
this table.
431
Drug Name
/Limits
Drug Name
/Limits
ON CALL PLUS
CONTROL
3
ONETOUCH VERIO
SYNC
3
ON CALL PLUS
LANCING DEVICE
1
ONETOUCH VERIO
SYSTEM
3
ON CALL PLUS
METER
3
OPSITE TOPICAL
BANDAGE 4 X 5 1/2 "
3
ON CALL VIVID
CONTROL
3
1
ON CALL VIVID
METER
OPTICHAMBER
ADULT
MASK-LARGE
3
1
ON CALL VIVID PAL
METER
OPTICHAMBER
DIAMOND LG MASK
3
1
ONE STEP
OVULATION TEST
OPTICHAMBER
DIAMOND VHC
3
1
ONE STEP
PREGNANCY TEST
OPTICHAMBER
DIAMOND-MED MSK
1
ONE WAY VALVED
MOUTHPIECE
1
1
OPTICHAMBER
DIAMOND-SML
MASK
ONETOUCH DELICA
LANC DEVICE
1
OPTICLUDE EYE
PATCH JUNIOR
1
ONETOUCH DELICA
LANCETS 30 GAUGE
OPTIFOAM
1
1
OPTI-FREE
3
ONETOUCH PING
INSULIN PUMP
3
OPTI-FREE EXPRESS
1
OPTI-FREE
REPLENISH
1
OPTI-FREE
REWETTING DROPS
1
OPTIONS LINERS
1
OPTIONS PADS
1
OPTIONS ULTRA
THINS
1
OPTUMRX
3
OPTUMRX KIT
3
OPTUMRX
SOLUTION
3
oral dosing syringes
1
ORAL DROPPER
1
oral thermometer
1
oral thermometer,
electronic
1
ONETOUCH
SURESOFT LANCING
DEV
1
ONETOUCH ULTRA
CONTROL
3
ONETOUCH ULTRA2
3
ONETOUCH
ULTRAMINI
3
ONETOUCH
ULTRASOFT
LANCETS
1
ONETOUCH VERIO
HIGH CONTROL
3
ONETOUCH VERIO
IQ METER
3
ONETOUCH VERIO
MID CONTROL
3
this table.
432
Drug Name
/Limits
Drug Name
/Limits
OSTOMY
APPLIANCE BELT
1
PAMPERS CRUISERS
SIZE 5
1
OSTOMY BELT
LARGE
1
PAMPERS CRUISERS
SIZE 6
1
OSTOMY BELT
MEDIUM
1
PAMPERS CRUISERS
SIZE 7
1
OSTOMY PASTE
1
PAMPERS EASY UPS
1
ostomy supplies
1
1
OVER NITES
1
PAMPERS EXTRA
PROTECTION SZ 3
OVERNIGHT
UNDERWEAR
EX-LARGE
1
1
PAMPERS EXTRA
PROTECTION SZ 4
1
OVERNIGHT
UNDERWEAR
LARGE
PAMPERS EXTRA
PROTECTION SZ 5
1
PAMPERS EXTRA
PROTECTION SZ 6
1
OVERNIGHT
UNDERWEAR
SMALL-MED
1
PAMPERS PREEMIE
SWAD SIZE P-S
1
PAMPERS PREMIE
1
OVERNITE BRIEFS
1
ovulation prediction test
3
1
PAIN FREE TAPE
1
PAMPERS
SWADDLERS SENS.
SIZE 1
PAIN FREE WRAP
1
1
PAMPERS
BABY-DRY SIZE 1
PAMPERS
SWADDLERS SIZE 1
1
1
PAMPERS
BABY-DRY SIZE 2
PAMPERS
SWADDLERS SIZE 2
1
1
PAMPERS
BABY-DRY SIZE 3
PAMPERS
SWADDLERS SIZE 3
1
1
PAMPERS
BABY-DRY SIZE 4
PAMPERS
SWADDLERS SIZE N
1
1
PAMPERS
BABY-DRY SIZE 5
PAMPERS UNISEX
BABY-DRY
1
PANDA MASK
1
PAMPERS
BABY-DRY SIZE 6
1
PANT LINERS,
LARGE
1
PAMPERS
BABY-DRY SIZE N
1
PANT LINERS,
LARGE PLUS
1
PAMPERS CRUISERS
1
PANTY LINERS
1
PAMPERS CRUISERS
SIZE 3
PANTY SHIELDS
1
1
PAPER TAPE
1
this table.
433
Drug Name
PAPER TAPE,
HYPOALLERGENIC
PARADIGM
INFUSION SET
/Limits
1
1
Drug Name
/Limits
PCCA ACCUPEN-15
3
PEAK AIR PEAK
FLOW METER
1
PEDIATRIC MEDIUM
MASK
1
PEDIATRIC
MOUTHPIECES
3
PARADIGM
REAL-TIME
TRANSMIT-SN
3
PARADIGM REMOTE
CONTROL
3
PEDIATRIC PANDA
MASK
1
PARADIGM
RESERVOIR
3
PEDIATRIC SMALL
MASK
1
PARADIGM
SILHOUETTE INFUS
SET
1
PEDIATRIC-SMALL
MOUTH ADAPTOR
3
PARASYMPATH
NERVE NDL 20 G X6"
3
PEDI-PRE TAPE
SPRAY
3
PARI BABY CONV
KIT - SIZE 1
1
PEN NEEDLE
NEEDLE 29 GAUGE X
1/2", 31 GAUGE X
1/4", 31 GAUGE X
3/16", 31 GAUGE X
5/16"
1
PEN NEEDLE
NEEDLE 30 GAUGE X
5/16", 32 GAUGE X
5/32"
3
needle 29 gauge x 1/2",
31 gauge x 1/3", 31
gauge x 1/4", 31 gauge
x 5/16"
1
PARI BABY
CONVERSION PACK
1
3
PARI BABY
CONVERSION PACK
2
3
PARI BABY
NEBULIZER
1
PARI LC FILTER
WITH VALVE SET
3
PARI LC MASK SET
3
PARI LC SPRINT
NEBULIZER SET
1
needle 31 gauge x 1/6"
3
PARI LC SPRINT
SINUS
3
PENTIPS
3
PARI SINUS
AEROSOL SYSTEM
3
PERFIT BRIEF EXTRA LARGE
1
PARI TREK S COMBO
PACK
PER-FIT BRIEFS
1
3
1
PARI TREK S
COMPACT
COMPRESSOR
PER-FIT
UNDERWEAR
3
PERSONAL BEST
FULL RANGE
1
PARI TREK S
PORTABLE PWR KIT
3
this table.
434
Drug Name
PERSONAL
CONFIDENCE
BRIEFS
/Limits
1
Drug Name
/Limits
PHASEAL Y-SITE
3
PIKO 1
1
PILLOW MASK
ADULT
1
PILLOW MASK
CHILD
1
PERSONAL
CONFIDENCE
LINERS
1
PERSONAL
CONFIDENCE PADS
1
1
PERSONAL
CONFIDENCE
UNDERPAD
PILLOW MASK
PEDIATRIC
1
PIPETTE 120ML
CATHETER TIP
1
PIPETTE 30ML
CATHETER TIP
1
PIPETTE 45ML
CATHETER TIP
1
PIPETTE 90ML
CATHETER TIP
1
PLANTAR FASCIITIS
ARCH SLEEVE
1
PLASTIC ADAPTER
3
PLASTIC ADAPTER
KIT-AUTOINJECT
3
PLASTIC STRIPS
1
PLASTIC SWABS
1
POCKET CHAMBER
1
POCKET PEAK FLOW
METER
1
POISE PADS
1
POLY HUB NEEDLE
1
POLYFIN QR/WINGS
INFUSION SET
3
POLYSKIN II
1
POSIDYNE ELD
FILTER
3
POUCH CLAMP
1
PERSONAL
CONFIDENCE
UNDERWEAR
1
PETROLATUM
GAUZE TOPICAL
BANDAGE , 1/2 X 72
", 3 X 18 ", 6 X 36 "
1
PETROLATUM
GAUZE TOPICAL
BANDAGE 1 X 36 ", 1
X 8 ", 3 X 36 "
3
PFLEX
INSPIRATORY
TRAINER
1
PHARMACIST
CHOICE GLUCOSE
SYS
3
PHASEAL
ASSEMBLY FIXTURE
3
PHASEAL
CONNECTOR LUER
LOCK
3
PHASEAL INFUSION
ADAPTER
3
PHASEAL INFUSION
CLAMP
3
PHASEAL INJECTOR
LUER LOCK
3
POUCHKINS
DRAINABLE POUCH
1
PHASEAL
PROTECTOR
3
POUCHKINS
OSTOMY SYSTEM
1
PHASEAL
SECONDARY SET
3
POUCHKINS PED
OSTOMY BELT
1
this table.
435
Drug Name
/Limits
POUCHKINS SKIN
BARRIER
1
POUCHKINS
UROSTOMY POUCH
1
PRECISE
PREGNANCY
1
PRECISEDOSE
DISPENSER
1
PRECISEDOSE
DISPENSER TIP CAP
1
PRECISION 200
CATHETER TRAY
1
PRECISION XTRA
B-KETONE
1
PRECISION XTRA
MONITOR
3
pregnancy test
1
Drug Name
/Limits
PREMIER
DRAINABLE
1 3/16 " (7"), 1 3/8 "
(7"), 1 9/16 " (7")
3
PREMIER
DRAINABLE
MINI-POUCH 1 ", 1
1/2 ", 1 1/4 ", 1 3/16 "
(12"), 1 3/4 ", 2 ", 2 1/2
" (9"), 2 1/8 " (12"), 3/4
", 5/8-2 1/8 " (7")
1
PREMIER
DRAINABLE POUCH
1 ", 1 3/16 " (12"), 1 3/8
" (12"), 1 9/16 " (12"), 2
1/2 ", 2 3/4 ", 3/4 "
1
3
3
PREMIER
DRAINABLE POUCH
1 3/8 ", 1 9/16 " (11"), 3
" (12"), 4 1/3 " (12")
PREMIER CLOSED
MINI-POUCH 5/8-2 1/8
" (7")
1
1
PREMIER
DRAINABLE POUCH
CONVEX 2 "
PREMIER CLOSED
POUCH 1 ", 1 3/16 "
(9"), 5/8-2 1/8 " (9")
1
1
PREMIER HIGH
OUTPUT
DRAINABLE
PREMIER CLOSED
POUCH 1 3/8 " (9")
1
3
PREMIER LOCK N
ROLL 1 ", 1 1/2 ", 2 "
PREMIER PRE-SIZED
MINI-POUCH
3
PREMIER
UROSTOMY
3
PREMIER
UROSTOMY
CONVEX POUCH 1 ",
1 1/2 ", 1 1/8 ", 1 3/8 ",
1/2 ", 5/8 ", 7/8 "
1
PREMIER
UROSTOMY
FLEXTEND POUC , 1
1/2 ", 1 1/4 ", 1 3/4 "
1
PREMIER CLOSED
1 3/8 " (7")
PREMIER
COLOSTOMY-ILEOS
TOMY
3
PREMIER CONVEX
SKIN BARRIER
1
PREMIER DRAIN
FLEXTEND CONVEX
1
PREMIER
DRAINABLE LOCK N
ROLL 1 1/4 ", 1 1/8 ", 1
3/4 ", 1 3/8 ", 2 1/2 ",
3/4 ", 7/8 "
1
this table.
436
Drug Name
/Limits
PREMIER
UROSTOMY POUCH
1 ", 1 1/2 ", 1 1/2 " (9"),
1 1/4 ", 1 3/4 ", 1/2 ", 2
", 2 1/2 ", 3/4 ", 5/8 ",
7/8 "
1
PREMIER
UROSTOMY POUCH
1 1/8 ", 1 3/8 ", 2 1/2 "
(9")
3
PREMIUM BABY
DIAPERS
1
PREMIUM BLOOD
GLUCOSE MONITOR
3
PREMIUM
COMFORT-STRETCH
1
PREMIUM
DRAINABLE
POUCH/KARAYA
1
PREMIUM NITRILE
GLOVES
1
PREMIUM SKIN
BARRIER
Drug Name
/Limits
PREVAIL BREEZERS
360
3
PREVAIL BRIEF
BARIATRIC
1
PREVAIL BRIEF
EXTRA LARGE
1
PREVAIL BRIEF
LARGE
1
PREVAIL BRIEF
MEDIUM
1
PREVAIL BRIEF
SMALL
1
PREVAIL BRIEF
YOUTH
1
PREVAIL CURVE
1
PREVAIL EXTRA
UNDERWEAR
1
PREVAIL FULL
COVERAGE
UNDRWEAR
1
1
PREVAIL GUARDS
FOR MEN
1
PREMIUM TRAINING
PANTS
1
PREVAIL MALE
GUARD
1
PREMIUM V10
3
PREVAIL PADS
1
PRESSURE
ACTIVATED
LANCETS
1
PREVAIL PANT
LINER
3
PRESTO PRO BLOOD
GLUCOSE METER
1
3
PREVAIL PANTY
LINER
PREVAIL PER-FIT
1
PREVAIL ADJUST
UNDERWEAR
LARGE
1
PREVAIL PER-FIT 360
3
1
PREVAIL ADJUST
UNDERWEAR
SM-MD
PREVAIL PM BRIEF
LARGE
1
PREVAIL PM BRIEF
MEDIUM
1
PREVAIL BLADDER
CONTROL PAD
1
1
PREVAIL BOXERS
1
PREVAIL
PROTECTIVE
UNDERWEAR
PREVAIL BREEZERS
1
PREVAIL SIMPLY
STRETCH FIT
1
this table.
437
Drug Name
/Limits
Drug Name
/Limits
PREVAIL SMOOTH
FIT
1
PRODIGY MINI-MIST
NEBULIZER
1
PREVAIL STRETCH
FIT
1
PRODIGY POCKET
METER
3
PREVAIL SUPER
PLUS
1
PRODIGY TWIST TOP
LANCET
1
PREVAIL
UNDERWEAR
1
PRODIGY VOICE
GLUCOSE METER
3
PRIMEAIRE
1
3
PRIMER MODIFIED
UNNA BOOT
TOPICAL BANDAGE
25 %- 4" X 10 YARD
PROFIT PRECISION
SCALE
3
PRONEB ULTRA II
1
PRONEB ULTRA II
FILTER ASSEM
1
PRO SPORTS TAPE
1
PROBE COVERS
1
1
PROCARE ADULT
BRIEF
PROTECTIVE
BARRIER FILM
WIPES
1
PROTECTIVE PADS
1
PROCARE
BARIATRIC BRIEF
1
PROTECTIVE
UNDERWEAR
1
PROCARE
PROTECTIVE
UNDERWEAR
1
PROTECTIVE
UNDERWEAR
EX-LARGE
1
PROCEDURAL FACE
MASKS
1
1
PRO-CEPTION
3
PROTECTIVE
UNDERWEAR
LARGE
PROCHAMBER
1
PRODIGY
AUTOCODE METER
1
3
PROTECTIVE
UNDERWEAR
MEDIUM
PRODIGY
AUTOCODE
MONITOR SYST
3
PROTECTIVE
UNDERWEAR
SMALL-MED
1
PRODIGY CONTROL
SOLUTION, LOW
3
PROTECTIVE
UNDERWEAR-SMAL
L
1
PRODIGY CONTROL
SOLUTION,HIGH
3
PROVENT
3
PRODIGY
COUNT-A-DOSE
PROVENT STARTER
3
3
PROVIEW
3
PRODIGY INSULIN
SYRINGE
1
PULMO-AIDE
COMPRESSOR
1
PRODIGY LANCING
DEVICE
1
this table.
438
Drug Name
/Limits
PULMONEB LT
COMPRESSOR
NEBUL
1
PURE COTTON
1
PURPLE NITRILE
GLOVES
3
Q-TIPS/SINGLE-TIP
1
Q-TIPS/SINGLE-TIP
APPLICATOR
Drug Name
/Limits
RELIAMED SAFETY
SEAL LANCETS 28
GAUGE
1
RELIEF KNEE OPEN
TOE STOCKING
3
RELION CONFIRM
3
3
1
RELION MICRO
GLUCOSE MONITOR
KIT
QUAD CANE TIPS
3
RELION NEEDLES
1
QUAKE VIBRATORY
PEP
3
RELION PEN
NEEDLES
3
QUICK READ
DIGITAL
THERMOMETER
3
1
RELION PRIME
METER
RELION ULTIMA
3
QUICK RESPONSE BP
MONITOR-LARG
1
RENU DISINFECTING
1
RENU MULTIPLUS
3
QUICK-SET
PARADIGM
1
RENU REWETTING
DROPS
1
QUINTET AC
3
QUINTET BLOOD
GLUCOSE METER
3
3
REPLACEMENT
NECKBAND STRAPS
RAPPORT VACUUM
THERAPY
3
REPLACEMENT
PEDIATRIC
MONITOR
3
RCRA HAZARDOUS
WASTE
3
3
RECONSTITUBE
3
rectal syringe (reusable)
3
REPLICARE
DRESSING TOPICAL
BANDAGE 1 1/2 X 2
1/2 "
rectal thermometer
1
REPLICARE THIN
3
rectal, vaginal
applicator tip
3
REPLICARE ULTRA
DRESSING
3
REFUAH PLUS
GLUCOSE CONTROL
3
RESTON HIGH
SUPPORT PAD
1
REFUAH PLUS
GLUCOSE MONITOR
3
RESTON LIGHT
SUPPORT ROLL
3
RESTON MEDIUM
SUPPORT PAD
1
RESTORE EXTRA
THIN DRESSING
1
RESTORE FOAM
HEEL DRESSING
3
RELIAMED LANCET
28 GAUGE, 30
GAUGE
1
RELIAMED MINI
LANCING DEVICE
1
this table.
439
Drug Name
RESTORE
HYDROGEL
DRESSING
RESTORE
HYDROGEL GAUZE
SPONGE
/Limits
3
1
RESTORE TOPICAL
BANDAGE 2 1/2 X 2
1/2 ", 4 X 5 ", 6 X 8 "
3
RESTORE TOPICAL
BANDAGE 2 X 2 ", 4
X 4 ", 6 X 6 ", 8 X 8 "
1
RESTORE TRIO
TOPICAL BANDAGE
3 X 3 ", 6 X 8 "
3
RESTORE TRIO
TOPICAL BANDAGE
4X5"
1
RETRACTED PENIS
POUCH
1
REUSABLE
HOT-COLD
COMPRESS
1
REUSABLE
NEBULIZER KIT
1
REVEAL BLOOD
GLUCOSE METER
3
REVEAL COLON
DISEASE TEST
3
REVEAL GET
PREGNANT QUICK
3
Drug Name
/Limits
REVEL
PROGRAMMABLE
PUMP
3
REWETTING
1
REWETTING DROPS
1
RID COMPLETE LICE
ELIM KIT
3
RIGHTEST CONTROL
SOLUTION HIGH
3
RIGHTEST CONTROL
SOLUTION NORM
3
RIGHTEST GD500
LANCING DEVICE
1
RIGHTEST GM550
SYSTEM
3
RITEFLO
AEROCHAMBER
3
ROBINSON CLEAR
VINYL CATHETER
3
ROB-NEL URETHRAL
CATHETER 10-16
FR-", 12-16 FR-", 14-16
FR-", 16-16 FR-"
1
ROB-NEL URETHRAL
CATHETER 18-16
FR-", 8-16 FR-"
3
ROLLED
ABSORBENT
COTTON
1
ROLLED GAUZE
TOPICAL BANDAGE
, 3 X 2.5 "-YARD, 4 X
2.5 "-YARD
1
3
REVEAL
OVULATION
PREDICTOR
3
REVEAL
OVULATION TEST
3
ROLLED GAUZE
TOPICAL BANDAGE
4.5" X 3 YARD
REVEAL
PREGNANCY TEST
1
RONDIC
1
REVEAL UTI TEST
STRIP
3
RUBBER
MOUTHPIECE
3
REVEL PEDIATRIC
PROGRAM PUMP
SAFE-CLIP BY MAIL
3
3
SAFE-CLIP NEEDLE
STORAGE DEV
3
this table.
440
Drug Name
/Limits
SAFELET IV
CATHETER
3
SAFESNAP INSULIN
SYRINGE
1
SAFESNAP SYRINGE
SYRINGE 1 ML 25
GAUGE X 5/8", 1 ML
27 GAUGE X 1/2", 10
ML 22 GAUGE X 1
1/2", 3 ML 25 X 1", 5
ML 20 X 1"
3
Drug Name
/Limits
SALINE SOLUTION
1
SALINE
SOLUTION,STERILE
PRESRV
1
SAMI THE SEAL
1
SAMI THE SEAL
FILTER
1
SAMI THE SEAL
MASK
1
SCALP VEIN SET
3
SCANPOR TAPE
3
SCAR TREATMENT
3
SCHIRMER TEAR
TEST
3
SEAL TIGHT
3
SELECT BRIEFS
1
SELECT
DISPOSABLE BRIEFS
1
SELECT KIDS BRIEFS
1
SELECT
UNDERPADS
1
SELECT
UNDERWEAR
1
SELF ADHERENT
WRAP TOPICAL
BANDAGE 1 X 2.2
"-YARD
1
SELF ADHERENT
WRAP TOPICAL
BANDAGE 2 X 2.2
"-YARD
3
SELF-ADHERING
BANDAGE
1
SELF-CATH , 14-16
FR-"
3
SELF-CATH 10"
3
SAFESNAP SYRINGE
SYRINGE 10 ML, 10
ML 20 GAUGE X 1
1/2", 10 ML 20
GAUGE X 1", 10 ML
21 GAUGE X 1 1/2", 10
ML 21 GAUGE X 1",
10 ML 22 GAUGE X
1", 3 ML, 3 ML 20
20 GAUGE X 1", 3 ML
21 GAUGE X 1 1/2", 3
ML 21 GAUGE X 1", 3
ML 22 GAUGE X 1", 3
ML 22 X 1 1/2", 3 ML
23 GAUGE X 1 1/2", 3
ML 23 GAUGE X 1", 3
ML 25 GAUGE X 5/8",
5 ML, 5 ML 20
21 GAUGE X 1 1/2", 5
ML 21 GAUGE X 1", 5
ML 22 GAUGE X 1
1/2", 5 ML 22 GAUGE
X 1"
1
SAFETY LANCETS
1
safety needles
3
SAFETY SEAL
LANCETS 30 GAUGE
1
SAFETY-LET
LANCETS
1
SELF-CATHETER,
FEMALE 14 FR
3
SAF-GEL
3
SALINE SENSITIVE
EYES
1
3
SELF-CATHETER,
FEMALE 8 FR
this table.
441
Drug Name
SELF-GRIP TOPICAL
BANDAGE 2 ", 3 ", 4 ",
4 X 66 "
SELFGRIP TOPICAL
BANDAGE 2 X 1.9
"-YARD, 3 X 1.9
"-YARD
/Limits
1
3
Drug Name
/Limits
SHEER SPOT
BANDAGES
3
SHEER STRIP
3
SHEER STRIP EXTRA
LARGE
1
SHEER STRIPS
1
SHEER STRIPS
ASSORTED
1
SHIELDS
1
SIDEKICK BLOOD
GLUCOSE SYSTEM
3
SIDESTREAM
1
1
SELF-GRIP TOPICAL
BANDAGE 2 X 66 ", 3
X 66 "
3
SELFGRIP TOPICAL
BANDAGE 4 "
1
SELF-GRIP TOPICAL
TAPE
1
SEN-SERTER
3
SIDESTREAM ADULT
FACE MASK
SENSITIVE EYES
3
SIDESTREAM MASK
1
SENSITIVE EYES
DAILY CLEANER
3
SIDESTREAM
NEBULIZER
1
SENSITIVE EYES
PLUS SALINE
1
1
SENSODYNE
1
SIDESTREAM
PEDIATRIC FACE
MASK
SENSURA CLICK
OSTOMY POUCH
SIDESTREAM PLUS
3
3
SILHOUETTE
3
SENSURA
EASICLOSE WIDE
(NS)
3
SILHOUETTE
23"-FULL SET
3
SILHOUETTE
43"-FULL SET
3
SENSURA
EASICLOSE WIDE
OUTLET
1
SILICONE MASK
3
SENSURA OSTOMY
BASE PLATE
3
SILICONE MASK INFANT
1
SERENITY ULTRA
PLUS
1
SILICONE MASK PEDIATRIC
1
SHARPS CONTAINER
3
SIL-SERTER
3
SHARPSAFETY
CONTAINER
3
SIMPLICITY ADULT
FLAT FOLD XL
1
SHARPS-A-GATOR
DISPOSAL SYSTEM
3
SIMPLICITY ADULT
POLY MEDIUM
1
SHEER ADHESIVE
1
SIMPLICITY
CONTOURED LINER
1
SHEER BANDAGE
1
SIMPLICITY PAD
1
SINGLE-LET
3
this table.
442
Drug Name
/Limits
Drug Name
/Limits
SINUSTAR AEROSOL
3
SMARTEST LANCET
1
SINUSTAR
NEBULIZER
3
SMARTEST
PERSONA STARTER
3
SMARTEST PRONTO
STARTER
3
SMARTEST
PROTEGE
3
SNAP INSULIN PUMP
CONTROLLER
3
SKIN CLOSURE
STRIPS TOPICAL
COMBO PACK
3
SKIN CLOSURE
STRIPS TOPICAL
STRIP
1
SKIN GEL PROTECT
DRESSING WIPE
1
SNAP INSULIN
PUMP-INFUSION SET
3
SKIN PREP WIPES
1
SOF-SENSOR
3
SKIN-PREP
SPRAY-ON
DRESSING
3
SOF-SET
3
1
SKINTEGRITY
HYDROGEL
SOF-SET ADHESIVE
PATCH
3
3
SKINTEGRITY
HYDROGEL
DRESSING TOPICAL
BANDAGE 2 X 2 "
SOF-SET MICRO 42"
POLYFIN TUB
3
SOF-SET QR 42"
TUBING
3
SKINTEGRITY
HYDROGEL
DRESSING TOPICAL
BANDAGE 4 X 4 "
3
1
SOFT CLOTH
TOPICAL BANDAGE
2 X 2 3/4 ", 3 1/2 X 10
", 3 1/2 X 13 3/4 ", 3 1/2
X 4 ", 3 1/2 X 8 "
SLEEP COMFORTS
1
SLEEP OVERS PANTS
1
SOFT CLOTH
TOPICAL BANDAGE
2.375 X 4 ", 3 1/2 X 6 "
1
SLEEP PANTS
1
SLIP ON KNEE
3
SOFT TOUCH
LANCETS
1
SLIP-ON
UNDERGARMENT
1
SOFTFLEX SKIN
BARRIER RING
1
SMART SENSE
LANCETS 26 GAUGE
1
SOFT-SERTER
INFUSION PUMP ATT
3
SMART SENSE
MONITORING
SYSTEM
3
SOFT-TIP
THERMOMETER
1
SMARTDIABETES
VANTAGE
1
1
SOLOSITE WOUND
GEL
SMARTEST
CONTROL
3
3
SOLUS V2 AUDIBLE
METER
SMARTEST EJECT
3
SOLUS V2 CONTROL
SOLUTION, LOW
3
this table.
443
Drug Name
/Limits
SOLUS V2 CONTROL
SOLUTION,HIGH
3
SOLUS V2 LANCING
DEVICE
1
SOLUTION
TRANSFER DEVICE
Drug Name
/Limits
STOMA LUBRICANT
1
STOMAHESIVE
MOLDABLE
ADHESIVE
1
3
STOMAHESIVE
PASTE
1
SOOTHE NEB MESH
NEBULIZER
3
STOMAHESIVE
PROTECTIVE
1
SORESPOT
3
SPECIPAN
COLLECTION UNIT
3
1
SPECTRAGEL
1
STOMAHESIVE SKIN
BARRIER , 1 ", 1 1/2
", 1 1/4 ", 1 1/8 ", 1 3/4
", 1 3/8 ", 1 5/8 ", 1/2 ",
3/4 ", 5/8 ", 7/8 "
SPLASH SHIELD
FLEX
3
STOMAHESIVE SKIN
BARRIER 1 7/8 "
3
SPORTS TAPE
1
STA-PUT UNDERPAD
1
STOMAHESIVE SKIN
BARRIER WAFER
1
STERILE
DROPTAINERS
3
STRATASORB
COMPOSITE WOUND
3
STERILE NITRILE
GLOVE
1
1
STERILE PADS
TOPICAL BANDAGE
2 X 2 ", 3 X 3 ", 4 X 4 "
1
STRATASORB
ISLAND DRESSING
TOPICAL BANDAGE
4X4"
STERI-STRIP
3
3
STERI-STRIP
DRESSING
1
STRETCH GAUZE
BANDAGE TOPICAL
BANDAGE 2 X 4.1
"-YARD
STERI-STRIP SKIN
CLOSURES TOPICAL
STRIP 1 X 5 ", 1/4 X 1
1/2 ", 1/4 X 3 "
1
3
STRONG STRIPS
TOPICAL BANDAGE
1X3"
STERI-STRIP SKIN
CLOSURES TOPICAL
STRIP 1/2 X 4 ", 1/4 X
4 ", 1/8 X 3 "
STRONG STRIPS
TOPICAL BANDAGE
1 X 3 1/4 "
3
1
STRONG STRIPS
X-LARGE
1
STIK IT
3
STOMA
CAP-ADHESIVE-FILT
ER
1
1
SUCTION TUBE
ATTACHMENT
DEVICE
3
STOMA
CONE-CONNECTOR
REPL UNIT
SUMMERS EVE
CLEANSING CLOTHS
1
SUNRISE
COMPRESSOR-NEBU
LIZER
3
this table.
444
Drug Name
/Limits
SUPER MOLESKIN
1
SUPER STRIP
BANDAGES
1
SUPOR SYRINGE
FILTER 25-0.2
MM-MICRON
3
SUPPOSISTRIP
1
suppository container,
empty
3
suppository molds
Drug Name
/Limits
SURE COMFORT PEN
NEEDLE NEEDLE 29
GAUGE X 1/2", 31
GAUGE X 3/16", 31
GAUGE X 5/16"
1
SURE COMFORT PEN
NEEDLE NEEDLE 30
GAUGE X 5/16", 32
GAUGE X 1/4", 32
GAUGE X 5/32"
3
1
SURECARE
1
SUPPOSITORY
SHELL, MEDIUM
1
SURECHOICE
BLADDER CONTROL
1
SUPPOSITORY
SHELL, SMALL
1
SURECHOICE PAD
1
SUPREME DIAPERS
SIZE 1
3
1
SURECHOICE
PANTILINER
SUPREME DIAPERS
SIZE 2
1
1
SURE-FINE PEN
NEEDLES
SUPREME DIAPERS
SIZE 3
1
1
SUREFLEX DEVICE
WITH LANCETS
SUPREME DIAPERS
SIZE 4
1
1
SUREFLEX LANCING
DEVICE
SUPREME DIAPERS
SIZE 5
1
1
SURE-JECT INSULIN
SYRINGE
SUPREME DIAPERS
SIZE 6
1
1
SURE-PEN LANCING
DEVICE
SUREPRESS
ABSORBENT
PADDING
1
SUREPRESS HIGH
COMPRESSION
1
SURE CARE
PROTECTIVE
UNDERGMNT
1
SURE CARE
PROTECTIVE
UNDERWEAR
1
SURESITE MATRIX
3
SURE COMFORT INS.
SYR. U-100
1
SURESITE WINDOW
TOPICAL BANDAGE
2 3/8 X 2 3/4 "
1
SURE COMFORT
INSULIN SYRINGE
1
3
SURE COMFORT
LANCING PEN
1
SURESITE WINDOW
TOPICAL BANDAGE
4 X 4 1/2 "
SURE-T INFUSION
SET
1
SURE-T PARADIGM
3
this table.
445
Drug Name
SURE-TEST
EASYPLUS MINI
METER
/Limits
Drug Name
/Limits
3
SURGICAL
DRESSING
1
SURE-TEST
EASYPLUS MINI
SOLUTION
1
3
SURGICAL
DRESSING EXTR
PROTCT
SURGICAL PADS
3
SUR-FIT NATURA
ADAPTOR
1
SURGUARD2
SAFETY
3
SUR-FIT NATURA
CLOSED POUCH
1
syringe (disposable)
1
SUR-FIT NATURA
CONVEX INSERTS
syringe (reusable)
1
1
SYRINGE
3CC/20GX1"
1
SYRINGE
3CC/21GX1"
1
SYRINGE
3CC/21GX1-1/2"
1
SYRINGE
3CC/22GX1"
1
SYRINGE
3CC/22GX3/4"
1
SUR-FIT NATURA
DRAINABLE POUCH
, 1 1/2 ", 1 1/4 ", 1 3/4 ",
1 3/4 " (12"), 2 1/4 ", 2
1/4 " (12"), 2 3/4 ", 2
3/4 " (12")
1
SUR-FIT NATURA
DRAINABLE POUCH
1 1/2 " (12")
3
SUR-FIT NATURA
DURAHESIVE
1
SYRINGE
3CC/25GX1"
1
SUR-FIT NATURA
FLANGE CAP
1
syringe filter
3
SUR-FIT NATURA
HIGH OUTPUT
1
SYRINGE LUER TIP
CAP
1
SUR-FIT NATURA
IRRIG FACEPLATE
1
SYRINGE TIP
CONNECTOR
1
SUR-FIT NATURA
LOW-PRESSURE
1
SYRINGE TIP
RECTAL-VAGINAL
3
SUR-FIT NATURA
MINI-POUCH
1
1
SUR-FIT NATURA
STOMAHESIVE
1
syringe with needle
(disp) syringe 1 ml 25
gauge x 1", 3 ml 20 x 1
1/2", 3 ml 22 x 1 1/2"
syringe with needle,
safety
3
SYSTANE
CONTACTS
3
T.E.D.
ANTI-EMBOLISM
STOCKING
1
SUR-FIT NATURA
UROSTOMY ACCUSE
1 1/2 "
1
SUR-FIT NATURA
UROSTOMY POUCH
1
SUR-FIT-ACTIVE
LIFE TAIL CLOS
1
this table.
446
Drug Name
/Limits
T.E.D. KNEE
LENGTH-S-REGULA
R
1
T.E.D. SEQUNT
COMPRESS DEVICE
3
T:FLEX INSULIN
DELIVERY PUMP
3
T:SLIM
3
T:SLIM INSULIN
DELIVERY SYSTEM
3
TABLET CUTTER
3
TAMPER-TUF
CONTAINER CLOSER
3
TAMPER-TUF ORAL
MED CONT 15CC
3
TAMPER-TUF ORAL
MED CONT 30CC
3
TEGADERM
ABSORBENT
3
TEGADERM FIRST
AID STYLE
1
TEGADERM FRAME
STYLE TOPICAL
BANDAGE 1 3/4 X 1
3/4 "
3
Drug Name
/Limits
TEGADERM
HYDROCOLLOID
TOPICAL BANDAGE
4 X 4 ", 4 X 4 3/4 ", 5
1/8 X 6 ", 6 X 6 "
1
TEGADERM
HYDROCOLLOID
TOPICAL BANDAGE
6 3/4 X 6 3/8 ", 6 3/4 X
8"
3
TEGADERM
HYDROGEL
3
TEGADERM I.V.
3
TEGADERM
TOPICAL BANDAGE
2 X 2 3/4 ", 2.375 X 4 ",
3 1/2 X 4 ", 4 X 4 3/4 "
1
TEGADERM
TOPICAL BANDAGE
3 1/2 X 6 ", 3.5 X 10 ",
3.5 X 13.75 ", 3.5 X 8 "
3
TEGADERM
TRANSPARENT
DRESSING
3
TEGASORB THIN
DRESSING
3
TELCARE BGM
3
TELCARE BLOOD
GLUCOSE KIT
3
TELCARE CONTROL
3
TELFA AMD
1
1
TELFA CLEAR
WOUND DRESSING
TOPICAL BANDAGE
12 X 12 ", 12 X 24 ", 39
X 25 "-YARD, 4 X 5 "
3
TEGADERM HP
FRAME STYLE
TOPICAL BANDAGE
5 1/2 X 7 "
3
TELFA CLEAR
WOUND DRESSING
TOPICAL BANDAGE
3X3"
1
TEGADERM
HYDROCOLLOID
THIN
1
TEGADERM FRAME
STYLE TOPICAL
BANDAGE 2 3/8 X 2
3/4 ", 4 X 10 ", 4 X 4
3/4 ", 6 X 8 ", 8 X 12 "
TEGADERM HP
FRAME STYLE
TOPICAL BANDAGE
2 1/8 X 2 1/2 ", 2 3/8 X
2 3/4 ", 4 1/2 X 4 3/4 ",
4 X 4 1/2 ", 4 X 4 3/4 "
1
this table.
447
Drug Name
/Limits
TELFA ISLAND
DRESSING TOPICAL
BANDAGE 4 X 10 ", 4
X 6 ", 4 X 8 ", 6 X 7 "
3
TELFA ISLAND
DRESSING TOPICAL
BANDAGE 4 X 5 "
1
Drug Name
/Limits
TENDERWET
ACTIVE DRESSING
3
TENDERWET
SYSTEM
3
TENS 502
3
TENS 504
3
tens unit electrodes pad
2x2 "
3
1
3
TENSOR TOPICAL
BANDAGE 2 X 5
"-YARD, 3 X 5
"-YARD, 6 X 5
"-YARD
TELFA TOPICAL
BANDAGE 2 X 3 ", 3
X 4 ", 3 X 8 ", 8 X 10 "
3
1
TENSOR TOPICAL
BANDAGE 4 X 4.5
"-YARD
1
TELFA TOPICAL
BANDAGE 2 X 3 3/4 "
TERUMO ALLERGY
SYRINGE
3
TENA
BRIEFS-SMALL
1
1
TERUMO
HYPODERMIC
NEEDLE/SYRIN
TENA PANTS SUPER
LARGE
1
TERUMO INSULIN
SYRINGE
1
TENA PROTECTIVE
UNDERWEAR
TERUMO SYRINGE
1
1
3
TENA SERENITY
1
TEST N'GO BLOOD
GLUCOSE SYSTEM
TENA STRETCH
ULTRA
1
THERMACARE
KNEE/ELBOW
1
TENA ULTRA
BRIEFS-LARGE
1
THERMACARE
MUSCLE THERAPY
1
TENA ULTRA
BRIEFS-MEDIUM
1
THERMOMETER
COVERS
1
TENDER TAPE
3
1
TENDEROL
3
thermometer probe
covers
TENDERSORB
1
thermometer, temple
electronic
3
TENDERSORB
UNDERPAD
1
THERMOPHORE
MAXHEAT
1
TENDERWET
ACTIVE CAVITY
DRESS
3
THERMOPHORE
PACK
1
TELFA OUCHLESS
NON-ADHERENT
TOPICAL BANDAGE
4X3"
TELFA OUCHLESS
NON-ADHERENT
TOPICAL BANDAGE
6X3"
1
this table.
448
Drug Name
/Limits
THERMOPHORE
PACK STANDARD
1
THERMOSCAN
THERMOMETER
1
THINPRO INSULIN
SYRINGE
1
THINSET
RESERVOIR
3
THRESHOLD IMT
TRAINER
3
Drug Name
/Limits
topical bandage 2 x 2
3/4 ", 4 x 4 3/4 "
1
TRANSPARENT THIN
FILM DRESSING
1
TRANSPORE
SURGICAL
1
TRANSPORT CHAIR
1
troche mold
3
TRUE METRIX AIR
GLUCOSE METER
3
TRUE METRIX
GLUCOSE METER
3
TRUE METRIX
GLUCOSE TEST
STRIP
1
3
THRESHOLD PEP
DEVICE
3
THUMB SUPPORT
3
TITUS NEEDLE
1
TOOMEY SYRINGE
3
TOOTHETTE
1
TOPCARE
CLICKFINE
1
TRUE METRIX
LEVEL 1
TOPCARE ULTRA
COMFORT
1
TRUE METRIX
LEVEL 2
3
TOPI-CLICK
3
TRUE METRIX
LEVEL 3
3
TOPI-CLICK FILLING
NOZZLE
1
TRUE2GO BLOOD
GLUCOSE SYSTEM
1
TOUCH-TROL
1
TRAINING PANTS
2T-3T
3
1
TRUECONTROL
LEVEL 0
TRAINING PANTS
3T-4T
3
1
TRUECONTROL
LEVEL 1
TRAINING PANTS
4T-5T
1
1
TRUEDRAW
LANCING DEVICE
TRUEPLUS INSULIN
1
TRANQUILITY
PREMIUM
UNDERWEAR
1
TRUEPLUS LANCETS
26 GAUGE, 30
GAUGE, 33 GAUGE
1
TRANQUILITY
TOPLINER PADS
1
3
TRANSFER PIN
1
TRUERESULT
BLOOD GLUCOSE
SYSTM
topical bandage 2 3/8 x
2 3/4 "
3
TRUERESULT
BLOOD GLUCOSE
SYSTM KIT
1
this table.
449
Drug Name
/Limits
TRUETEST HIGH
GLUCOSE CONTROL
1
TRUETEST LOW
GLUCOSE CONTROL
Drug Name
/Limits
1
1
ULTICARE NEEDLE
29 GAUGE X 1/2", 31
GAUGE X 1/4", 31
GAUGE X 5/16"
TRUETEST NORMAL
GLUCOSE CNTRL
1
ULTICARE NEEDLE
32 GAUGE X 5/32"
3
TRUETRACK BLOOD
GLUCOSE SYSTEM
1
TRUETRACK SMART
SYSTEM
1
3
TRUETRACK TEST
1
TRUFORM
COMPRESSION
STOCKING
1
ULTICARE SYRINGE
0.3 ML 29 X 1/2", 0.3
ML 30 X5/16 ", 1 ML
29 X 1/2", 1 ML 30
GAUGE X 5/16", 1.5
ML 22 GAUGE X 1
1/2", 1/2 ML 29 X 1/2 ",
1/2 ML 30 GAUGE X
5/16"
TRUSTEX LATEX
CONDOM
1
TRUSTEX
LUBRICATED
CONDOMS
1
1
TRUSTEX NON-LUB
CONDOMS
1
ULTICARE SYRINGE
0.3 ML 30 GAUGE X
1/2", 0.3 ML 31 X
5/16", 1 ML 25 X 5/8",
1 ML 30 GAUGE X
1/2", 1 ML 31 X 5/16",
1/2 ML 30 GAUGE X
1/2", 1/2 ML 31 X 5/16"
TRUSTEX-RIA
LUB/SPERMICIDE
1
ULTI-LANCE
1
TRUSTEX-RIA
NON-LUB CONDOMS
1
1
ULTILET INSULIN
SYRINGE
TRUZONE PEAK
FLOW METER
3
1
ULTILET PEN
NEEDLE
ULTIMA MONITOR
3
ULTIMA TEST
STRIPS
3
ULTRA CMFT INS
SYR HALF UNIT
1
TUBERCULIN
SYRINGE SYRINGE 1
ML, 1 ML 25 GAUGE
X 1", 1 ML 25 X 5/8", 1
ML 27 X 1/2"
1
tuberculin-allergy
syringes
1
TUBULAR GAUZE
3
TUGABOOS DIAPERS
1
TUGABOOS
OVERNIGHTS
1
TUGABOOS
TRAINING PANTS
1
this table.
450
Drug Name
/Limits
ULTRA COMFORT
INSULIN SYRINGE
SYRINGE 0.3 ML 29
30, 0.3 ML 30 GAUGE
X 5/16, 0.3 ML 31 X
5/16", 1 ML 28, 1 ML
28 GAUGE X 1/2", 1
ML 29, 1 ML 29 X 1/2",
1 ML 30 GAUGE X
5/16, 1 ML 30 GAUGE
X 7/16", 1 ML 31 X
5/16", 1/2 ML 28
GAUGE, 1/2 ML 28
GAUGE X 1/2", 1/2
ML 29 , 1/2 ML 29 X
1/2", 1/2 ML 30 , 1/2
ML 30 GAUGE X 5/16,
1/2 ML 31 X 5/16"
1
ULTRA FINE CUT N
CRUSH
1
ULTRA TLC
LANCETS
3
ULTRA-FLEX
1
ULTRA-LIGHT
ROLLATOR
1
Drug Name
/Limits
ULTRATRAK
NORMAL CONTROL
3
ULTRATRAK
ULTIMATE
3
ULTRATRAK
ULTIMATE
SOLUTION
3
UNDERGARMENT
1
UNDERGARMENT
EXTRA ABSORBENT
1
UNDERGARMENT
REGULAR
ABSORBENT
1
UNDERJAMS
LARGE-EXTRA
LARGE
1
UNDERJAMS
SMALL-MEDIUM
1
UNDERPAD-EXTRA
LARGE
1
underpads
1
UNDERPADS EXTRA
LARGE
1
UNDERPADS
REGULAR
1
UNDERWEAR
1
ULTRA-SOFT
GLOVES
1
ULTRA-THIN II
(SHORT) INS SYR
1
UNDERWEAR FOR
MEN
1
ULTRA-THIN II
(SHORT) PEN NDL
1
UNGUATOR LID
1
ULTRA-THIN II INS
PEN NEEDLES
1
3
ULTRA-THIN II
INSULIN SYRINGE
1
UNIFINE PENTIPS
NEEDLE 29 GAUGE X
5/16", 30 GAUGE X
5/16", 32 GAUGE X
5/32"
ULTRATRAK
3
ULTRATRAK
GLUCOSE METER
3
1
ULTRATRAK
HIGH-LOW
CONTROL
3
UNIFINE PENTIPS
NEEDLE 29 GAUGE,
29 GAUGE X 1/2", 31
GAUGE X 1/4", 31
GAUGE X 3/16", 31
GAUGE X 5/16"
this table.
451
Drug Name
UNIFINE PENTIPS
PLUS NEEDLE 29
GAUGE X 1/2", 31
GAUGE X 1/4", 31
GAUGE X 3/16", 31
GAUGE X 5/16"
UNIFINE PENTIPS
PLUS NEEDLE 32
GAUGE X 5/32"
/Limits
1
3
Drug Name
/Limits
URINARY LEG
MEDIUM BAG
1
URINARY TRACT
INF.TEST (WBCS)
1
URISTIX 4
1
URISTIX REAGENT
1
URO MINICAP
1
UROCARE FABRIC
LEG STRAPS
3
UROSTOMY DRAIN
TUBE ADAPTER
1
UNIGARD
INCONTINENT PAD
1
UNILET LANCET
1
UNISOL 4
1
1
UNISOLVE
ADHESIVE
REMOVER WIPE
UROSTOMY
MICRO-POUCH
1
UROSTOMY
MULTI-CHAMBER
3
UNISTRIP HIGH
CONTROL
3
1
UNISTRIP LOW
CONTROL
UROSTOMY
MULTI-CHAMBER
POUCH
3
1
UNISTRIP1 TEST
STRIP
UROSTOMY NIGHT
BAG
3
urostomy pouch
1
UNIVERSAL
CATHETER ACCESS
PORT
3
UROSTOMY
POUCH-MIC
WASHER
1
UNIVERSAL GLASS
THERMOMETER
3
VACUTAINER
COLLECTION SET
3
UNIVERSAL
REMOVER WIPES
1
vaginal cream
applicator
1
UNIVERSAL SLEEVE
1
1
UNIVERSAL
SYRINGE TIP
ADAPTOR
vaginal suppository
applicator
3
UNNA-FLEX
CONVENIENCE
PACK
3
UP AND UP BABY
DIAPER
1
URETHRAL
CATHETER
1
URI-DRAIN
1
URINARY LEG BAG
1
this table.
452
Drug Name
/Limits
VANISHPOINT
SYRINGE SYRINGE 1
ML 25 GAUGE X 1",
1/2 ML 30 GAUGE X
1/2", 3 ML 20 GAUGE
X 1", 3 ML 21 GAUGE
X 1", 3 ML 21 X 1 1/2",
3 ML 22 GAUGE X 1",
3 ML 22 X 1 1/2", 3 ML
23 GAUGE X 1 1/2", 3
ML 23 X 1", 3 ML 25
GAUGE X 1", 3 ML 25
X 5/8", 5 ML 21
GAUGE X 1", 5 ML 22
GAUGE X 1 1/2"
1
VANISHPOINT
SYRINGE SYRINGE 1
ML 29 X 1/2"
3
VANISHPOINT
TUBERCULIN
SYRINGE
1
VAPORIZER
CLEANING
Drug Name
/Limits
VERSALON TOPICAL
SPONGE 2 X 2 ", 3 X 4
", 4 X 4 "
1
VERSALON TOPICAL
SPONGE 3 X 3 "
3
VERSIVA XC
TOPICAL BANDAGE
10 X 8 ", 5 1/2 X 5 1/2
", 8 X 7 "
3
VERSIVA XC
TOPICAL BANDAGE
3 X 3 ", 4 1/4 X 4 1/4 ",
4 X 4 ", 6 X 6 ", 8 X 8 "
1
VERTICAL
DRAIN-TUBE ATT
DEVICE
3
VGO 20
3
VGO 30
3
VGO 40
3
3
VICKS DIGITAL
THERMOMETER
1
VAPORIZER
INHALANT
1
VICKS FOREHEAD
THERMOMETER
3
vaporizers
1
VICKS HUMIDIFIER
1
VARITHENA
ADMINISTRATION
PACK
1
3
VICKS WARM MIST
HUMIDIFIER
1
VASCUDERM
HYDROGEL WOUND
VIGILON PRIMARY
WOUND DRESSING
3
VINYL CATHETER
1
VINYL GLOVES
1
VIOS AEROSOL
DELIVERY SYSTEM
1
VISI-FLOW
IRRIGATION SLEEVE
1
VISI-FLOW
IRRIGATION
STARTER 45 MM
1
VISI-FLOW
IRRIGATION
STARTER 70 MM
3
VASELINE
PETROLATUM
GAUZE TOPICAL
BANDAGE , 1/2 X 72
", 3 X 18 ", 6 X 36 "
1
VASELINE
PETROLATUM
GAUZE TOPICAL
BANDAGE 1 X 36 ", 1
X 8 ", 3 X 36 "
3
VENTED URINARY
LEG BAG
1
this table.
453
Drug Name
/Limits
VISI-FLOW
IRRIGATOR-STOMA
CONE
1
VISI-FLOW SLEEVE
TAIL CLOSURES
Drug Name
/Limits
WAVESENSE
PRESTO KIT
3
WEBRIL
3
1
WEBRIL II
3
VISI-FLOW STOMA
CONE
1
WELL BEGINNINGS
DIAPERS
3
VISINE FOR
CONTACTS
1
WELL BEGINNINGS
SLEEP PANTS
1
WELL BEGINNINGS
TRAINING PANTS
3
wheelchair
1
WIDE-SEAL
DIAPHRAGM 60
3
WIDE-SEAL
DIAPHRAGM 65
1
VISTEC X-RAY
DETECT TOPICAL
SPONGE 4 X 3 1/2 ", 8
X4"
3
VISTEC X-RAY
DETECT TOPICAL
SPONGE 4 X 4 "
1
VOCALPOINT
GLUCOSE CONTROL
3
WIDE-SEAL
DIAPHRAGM 70
1
VORTEX HOLDING
CHAMBER
1
WIDE-SEAL
DIAPHRAGM 75
1
VORTEX VHC FROG
MASK-CHILD
1
WIDE-SEAL
DIAPHRAGM 80
1
VORTEX VHC
LADYBUG
MASK-TODDLR
1
WIDE-SEAL
DIAPHRAGM 85
1
WARM STEAM
VAPORIZER
3
1
WIDE-SEAL
DIAPHRAGM 90
WATER BOTTLE
1
WIDE-SEAL
DIAPHRAGM 95
3
WATER
BOTTLE-FOUNTAIN
SYRINGE
WINDMILL TRAINER
3
1
WING TIP TUBING
1
WATER SHIELD
BANDAGES
1
WINGS CHOICE
ADULT BRIEF
1
WATERPROOF
STRONG STRIPS
1
WINGS CHOICE
PLUS ADULT BRIEFS
1
WAVESENSE AMP
3
WINGS CHOICE
PLUS YOUTH BRIEFS
1
WAVESENSE
CONTROL
SOLUTION
3
WINGS CLASSIC
ADULT BRIEFS
1
WAVESENSE JAZZ
3
WINGS CLASSIC
ADULT BRIEFS X-L
1
WAVESENSE
PRESTO
3
this table.
454
Drug Name
/Limits
Drug Name
/Limits
WINGS FLUFF AND
POLYMER
1
YALE DISPOSABLE
NEEDLES
1
WINGS MAXIMA
UNDERPADS
1
YALE NEEDLE
HUBER BEVEL
1
WINGS UNDERPAD
1
WINGS XXL ADULT
BRIEF
1
1
YALE NEEDLE
INTRADERMAL
BEVEL
WOMEN'S
UNDERWEAR
1
YALE NEEDLE
REGULAR BEVEL
1
WONDERPANTS
1
1
WOUND DRAINAGE
COLLECTOR
YALE REUSABLE
NEEDLE
1
1
WOUNDGARD
GAUZE
YALE REUSABLE
SYRINGE 100CC
3
1
WOUN'DRES
HYDROGEL WOUND
DRESS
YALE SPINAL
NEEDLE
3
ZYMOGENETICS
SPRAY APPLICATOR
3
WRIST BRACE
1
WRIST BRACE
MEDIUM
1
WRIST SUPPORT
LARGE-XLARGE
1
METABOLIC
DISEASE
ENZYME
REPLACEMENT
AGENTS
WRIST SUPPORT
ONE SIZE
1
WRIST SUPPORT
SMALL-MEDIUM
1
XEROFLO GAUZE
DRESSING TOPICAL
BANDAGE 1 X 8 ", 2
X2"
1
XEROFORM
1
XEROFORM
PETROLATUM
DRESSING TOPICAL
BANDAGE 2 X 2 ", 4
X 3 "-YARD, 4 X 4 "
1
XEROFORM
PETROLATUM
OVERWRAP
1
YALE CLEANER
3
METABOLIC
DISEASE ENZYME
REPLACEMENT,
FABRY'S DISEASE
FABRAZYME
4
PA
METABOLIC
DISEASE ENZYME
REPLACEMENT,
GAUCHER'S
DISEASE
CEREZYME
INTRAVENOUS
RECON SOLN 400
UNIT
4
ELELYSO
4
VPRIV
4
this table.
455
Drug Name
/Limits
METABOLIC
DISEASE ENZYME
REPLACEMENT,
MUCOPOLYSACC
HARIDOSIS
Drug Name
/Limits
HECTOROL ORAL
3
paricalcitol
3
ROCALTROL
3
ZEMPLAR
INTRAVENOUS
4
ZEMPLAR ORAL
CAPSULE 1 MCG, 2
MCG
3
ALDURAZYME
4
ELAPRASE
4
NAGLAZYME
4
VIMIZIM
4
METABOLIC
MODIFIER CARNITINE
REPLENISHER
AGENTS
LUMIZYME
4
3
MYOZYME
4
CARNITOR
(SUGAR-FREE)
CARNITOR
INTRAVENOUS
4
CARNITOR ORAL
3
levocarnitine (with
sugar)
1
levocarnitine
intravenous
4
levocarnitine oral tablet
1
METABOLIC
DISEASE ENZYME
REPLACEMENT,
POMPE DISEASE
METABOLIC DX
ENZYME
REPLACEMENT,
SEVERE
COMBINED
IMMUNE
DEFICIENCY
ADAGEN
1
METABOLIC
MODIFIER GAUCHER'S
DISEASE, TYPE-1,
SUBSTRATE
REDUCTION TX
METABOLIC
MODIFIERS
HYPERPARATHY
ROID
TREATMENT
AGENTS VITAMIN D
ANALOG-TYPE
CERDELGA
ZAVESCA
calcitriol intravenous
solution 1 mcg/ml
4
calcitriol oral capsule
1
calcitriol oral solution
3
doxercalciferol
intravenous
4
doxercalciferol oral
3
HECTOROL
INTRAVENOUS
4
NF
3
METABOLIC
MODIFIER HEREDITARY
TYROSINEMIA
TREATMENT
AGENTS
ORFADIN
3
this table.
456
Drug Name
/Limits
METABOLIC
MODIFIER HOMOCYSTINURI
A TREATMENT
AGENTS
CYSTADANE
2
PA
METABOLIC
MODIFIER HYDROGEN
SULFIDE
METABOLISM
SULFZIX
3
AMMONUL
4
BUPHENYL ORAL
POWDER
1
BUPHENYL ORAL
TABLET
3
RAVICTI
3
1
(bulk)
3
PHENYLKETONU
RIA(PKU) TX
AGENTS COFACTOR OF
PHENYLALANINE
HYDROXYLASE
KUVAN ORAL
POWDER IN PACKET
3
PA
KUVAN ORAL
TABLET,SOLUBLE
2
PA
TETRAHYDROBIOPT
ERIN DI-HCL
3
PA
DENTAL
PRODUCT FLUORIDE
PREPARATIONS
METABOLIC
MODIFIER-CARBA
MOYL
PHOSPHATE
SYNTHETASE 1
(CPS 1)
ACTIVATOR
2
PHARMACOENHA
NCER CYTOCHROME
P450 INHIBITORS
TYBOST
/Limits
MOUTH-THROA
T-DENTAL PREPARATIONS
METABOLIC
MODIFIER - UREA
CYCLE DISORDER
AGENTS-CONJUG
ATING AGENTS
CARBAGLU
Drug Name
1
PA
CLINPRO 5000
3
DENTA 5000 PLUS
3
DENTAGEL
3
FLORIVA
(FLUORIDE-VITAMI
N D3)
3
FLUORABON
1
FLUOR-A-DAY
3
FLUOR-A-DAY
(WITH XYLITOL)
1
FLUORIDEX DAILY
DEFENSE
3
FLUORIDEX
SENSITIVITY RELIEF
3
FLUORITAB ORAL
DROPS
3
FLUORITAB ORAL
TABLET,CHEWABLE
1
FLURA-DROPS
1
GEL-KAM
3
LUDENT FLUORIDE
1
this table.
457
Drug Name
/Limits
Drug Name
/Limits
PERIO MED
3
PHOS-FLUR DENTAL
SOLUTION
3
PREVIDENT
3
1
PREVIDENT 5000
BOOSTER PLUS
clotrimazole mucous
membrane
3
nystatin oral suspension
1
PREVIDENT 5000
DRY MOUTH
3
PREVIDENT 5000
ENAMEL PROTECT
3
PREVIDENT 5000
PLUS
3
PREVIDENT 5000
SENSITIVE
3
SF
3
SF 5000 PLUS
3
sodium fluoride dental
3
sodium fluoride oral
drops
1
sodium fluoride oral
tablet,chewable
1
DENTAL
PRODUCT LOCAL
ANESTHETICS
MOUTH AND
THROAT ANTIFUNGALS
MOUTH AND
THROAT ANTI-INFECTIVE
MIXTURES
DEBACTEROL
3
MOUTH AND
THROAT ANTI-INFECTIVELOCAL
ANESTHETIC
COMBINATIONS
BUCALSEP
3
ORASEP MUCOUS
MEMBRANE
AEROSOL,SPRAY
3
TOOTHACHE
3
MOUTH AND
THROAT ANTISEPTICS
ARTICADENT
DENTAL
3
e bitart
3
CITANEST FORTE
DENTAL
3
CITANEST PLAIN
DENTAL
3
bit
3
mepivacaine (pf)
3
ANTISEPTIC ORAL
CLEANSER
1
CANK-OXIDE
3
CHLORASEPTIC
1
mucous membrane
1
DENTIVA
3
GLY-OXIDE
1
MOUTH CLEANSER
1
ORAL CLEANSING
1
PAROEX ORAL
RINSE
1
PERIDEX
3
PERIOGARD
1
this table.
458
Drug Name
/Limits
PEROXIDE SORE
MOUTH CLEANSER
1
PEROXYL
1
SALESE
3
SORE THROAT
(HEXYLRESORCINO
L) MUCOUS
MEMBRANE
LOZENGE 2.4 MG
3
ULCEREASE
1
MOUTH AND
THROAT ARTIFICIAL
SALIVA
Drug Name
/Limits
MOUTH AND
THROAT GLUCOCORTICOI
DS
ORALONE
3
dental
1
MOUTH AND
THROAT - LOCAL
ANESTHETIC
AMIDES
ADVANCED DNA
MEDICATED
COLLECT
3
AQUORAL
3
DYNAMIC
3
BIOTENE DRY
MOUTH ORAL RINSE
3
membrane gel
3
BIOTENE PBF
3
CAPHOSOL
3
3
DRY MOUTH
MUCOUS
MEMBRANE
MOUTHWASH
membrane solution 4 %
(40 mg/ml)
3
LIDOCAINE
VISCOUS
1
3
MOI-STIR
1
PRO DNA
COLLECTION
MOUTH KOTE
1
NEUTRASAL
3
NUMOISYN
3
MOUTH AND
THROAT - COLD
SORE PRODUCTS
BLISTEX
MEDICATED
3
COLD SORE
TREATMENT
TOPICAL GEL
3
COLD SORE
TREATMNT
(BENZ-CMPH)
3
LIP-GUARD
3
MOUTH AND
THROAT - LOCAL
ANESTHETIC
ESTERS
ANBESOL
(BENZOCAINE) MAX
STR
3
ANBESOL
(BENZOCAINE)
MUCOUS
MEMBRANE GEL
1
ANBESOL
(BENZOCAINE)
MUCOUS
MEMBRANE LIQUID
10 %
3
this table.
459
Drug Name
/Limits
ANBESOL
(BENZOCAINE)
MUCOUS
MEMBRANE LIQUID
20 %
1
ANESTHETIC ORAL
GEL
3
BABY TEETHING
GEL
1
BABY TEETHING
PAIN MEDICINE
1
BENZODENT
3
Drug Name
/Limits
INTENSE
TOOTHACHE PAIN
RELIEF
3
ORABASE
(BENZOCAINE)
1
ORAL ANALGESIC
MUCOUS
MEMBRANE GEL
3
ORAL ANALGESIC
MUCOUS
MEMBRANE
SOLUTION
1
ORAL ANESTHETIC
MUCOUS
MEMBRANE GEL
3
1
1
ORAL ANESTHETIC
MUCOUS
MEMBRANE PASTE
BENZ-O-STHETIC
MUCOUS
MEMBRANE
SPRAY,NON-AEROS
OL
1
3
ORAL PAIN RELIEF
MUCOUS
MEMBRANE
SOLUTION
3
BENZ-O-STHETIC
MUCOUS
MEMBRANE SWAB
ORAL PAIN
RELIEVER MUCOUS
MEMBRANE CREAM
1
1
DENT-O-KAIN
1
ORAL PAIN
RELIEVER MUCOUS
MEMBRANE PASTE
GUMSOL
3
ORAMAGIC PLUS
1
1
SORE THROAT
(BENZOCAINE-MENT
H) MUCOUS
MEMBRANE STRIP
3
HURRICAINE
MUCOUS
MEMBRANE GEL
3
HURRICAINE
MUCOUS
MEMBRANE
SOLUTION
MOUTH AND
THROAT - LOCAL
ANESTHETIC
OTHERS
1
CHLORASEPTIC
MAX SORE THROAT
3
HURRICAINE ONE
3
CHLORASEPTIC
THROAT SPRAY
1
HURRICAINE SWAB
APPLICATOR
1
ORA RELIEF
1
BENZ-O-STHETIC
MUCOUS
MEMBRANE GEL
BENZ-O-STHETIC
MUCOUS
MEMBRANE
SOLUTION
HURRICAINE
MUCOUS
MEMBRANE
AEROSOL,SPRAY
3
this table.
460
Drug Name
/Limits
ORAL RELIEF
1
PHENASEPTIC
1
SORE THROAT
1
SORE THROAT
(DYCLONINE)
3
SORE THROAT
(PHENOL)
1
THROAT LOZENGES
3
MOUTH AND
THROAT LOZENGES
CEPACOL SORE
THROAT
(BENZ-MEN)
1
CEPASTAT
1
CHERRY MENTHOL
1
CHLORASEPTIC
MAX
3
CHLORASEPTIC
SORE THROAT
1
COUGH DROPS
(WITH
EUCALYPTUS)
MUCOUS
MEMBRANE
LOZENGE , 6.5 MG, 7
MG, 7.6 MG, 8 MG
1
COUGH DROPS
(WITH
EUCALYPTUS)
MUCOUS
MEMBRANE
LOZENGE 3.1 MG
3
COUGH DROPS
MUCOUS
MEMBRANE
LOZENGE 2.7 MG, 5.4
MG, 7.5 MG, 7.6 MG,
9.1 MG
3
Drug Name
/Limits
HALLS COUGH
DROPS MUCOUS
MEMBRANE
LOZENGE 7.6 MG, 9.1
MG
3
HONEY LEMON
1
MEDIKOFF
3
MEDIKOFF DROPS
1
MENTHOL COUGH
MUCOUS
MEMBRANE
LOZENGE 6.5 MG
1
MENTHOL DROPS
1
NATURAL HERB
COUGH DROPS
MUCOUS
MEMBRANE
LOZENGE 4.8 MG
3
SORE THROAT
(BENZOCAINE-MENT
H) MUCOUS
MEMBRANE
LOZENGE 15-2.6 MG
3
SORE THROAT
(BENZOCAINE-MENT
H) MUCOUS
MEMBRANE
LOZENGE 15-3.6 MG,
6-10 MG
1
SORE THROAT
RELIEF (PECTIN)
3
THROAT DROPS
MUCOUS
MEMBRANE
LOZENGE 2 MG, 2.8
MG
3
THROAT LOZENGES
3
VICKS VAPODROPS
3
ZINC WITH
VITAMINS A AND C
3
this table.
461
Drug Name
/Limits
MOUTH AND
THROAT MOUTHWASHES
DOBELL'S
Drug Name
/Limits
MOUTH AND
THROAT - SALIVA
STIMULANTS
3
MOUTH AND
THROAT MUCOSITIS-STOM
ATITIS AGENTS
BIOTENE
MOISTURIZING
MOUTH
1
BIOTENE
ORALBALANCE
1
EPISIL
3
cevimeline
2
GELCLAIR
3
GELX
3
3
MUCOTROL
3
MUGARD
3
DRY MOUTH
MUCOUS
MEMBRANE
SPRAY,NON-AEROS
OL
ORAMAGIC PLUS
1
EVOXAC
3
ORAMAGICRX
3
pilocarpine hcl oral
1
SALAGEN
3
MOUTH AND
THROAT NON-NARCOTIC
ANTITUSSIVE LOCAL
ANESTHETIC
COMBOS
PA
PERIODONTAL
PRODUCT TETRACYCLINE
ANTIINFECTIVE,
LOCAL
ARESTIN
CEPACOL
SORETHROAT-COUG
H
1
CHLORASEPTIC
TOTAL
3
SORE THROAT AND
COUGH
3
PERIODONTAL
PRODUCT TETRACYCLINE-T
YPE,
COLLAGENASE
INHIBITORS
tablet 20 mg
MOUTH AND
THROAT PROTECTANTS
3
ENTERTAINER'S
SECRET
3
GELX
3
MUGARD
3
THERAPY FOR
DROOLINGPRIMARY OR
SECONDARY
SIALORRHEA-AN
TICHOLINERGIC
ORAFATE
3
CUVPOSA
PROTHELIAL
3
3
3
this table.
462
Drug Name
/Limits
Drug Name
/Limits
MULTIPLE
SCLEROSIS
AGENTS
REBIF (WITH
ALBUMIN)
2
PA
REBIF REBIDOSE
2
PA
LEUKOCYTE
ADHESION
INHIBITORS,
ALPHA4-MEDIATE
D, IGG4K MC
ANTIBODY
REBIF TITRATION
PACK
2
PA
COPAXONE
SUBCUTANEOUS
SYRINGE 20 MG/ML
2
PA
COPAXONE
SUBCUTANEOUS
SYRINGE 40 MG/ML
3
PA
dimethyl fumarate
(bulk)
3
GLATOPA
1
TECFIDERA
2
PA
3
PA
3
PA
2
PA
TYSABRI
MULTIPLE
SCLEROSIS
AGENT - OTHERS
4
MULTIPLE
SCLEROSIS
AGENT - CD52
SPECIFIC
MONOCLONAL
ANTIBODY
LEMTRADA
4
MULTIPLE
SCLEROSIS
AGENT INTERFERONS
MULTIPLE
SCLEROSIS
AGENT POTASSIUM
CHANNEL
BLOCKER
AVONEX (WITH
ALBUMIN)
2
PA
AVONEX
INTRAMUSCULAR
PEN INJECTOR KIT
2
PA
AMPYRA
AVONEX
INTRAMUSCULAR
SYRINGE
2
PA
AVONEX
INTRAMUSCULAR
SYRINGE KIT
2
PA
MULTIPLE
SCLEROSIS
AGENT PYRIMIDINE
SYNTHESIS
INHIBITORS
BETASERON
SUBCUTANEOUS KIT
3
PA
EXTAVIA
SUBCUTANEOUS KIT
2
PA
EXTAVIA
SUBCUTANEOUS
RECON SOLN
3
PLEGRIDY
3
AUBAGIO
PA
MULTIPLE
SCLEROSIS
AGENT SPHINGOSINE
1-PHOSPHATE
RECEPTOR
MODULATOR
GILENYA
this table.
463
Drug Name
/Limits
MULTIPLE
SCLEROSIS
AGENTS
3,4-diaminopyridine
(bulk)
3
OPHTHALMIC
AGENTS
ARTIFICIAL
TEARS AND
LUBRICANT
COMBINATIONS
Drug Name
/Limits
LUBRICANT EYE
OPHTHALMIC
OINTMENT 56.8-41.5
%, 57.3-42.5 %
3
LUBRICANT EYE
OPHTHALMIC
OINTMENT 83-15 %
1
LUBRICANT
EYE(DEXTRAN70-HY
PML)
3
LUBRICANT GEL
3
LUBRICATING
DROPS
3
LUBRIFRESH PM
1
ADVANCED EYE
RELIEF
3
ADVANCED EYE
RELIEF (MO-WPET)
3
MOISTURE DROPS
3
ARTIFICIAL TEARS
3
NATURAL TEARS
(PF)
3
ARTIFICIAL TEARS
(PETRO/MIN)
1
PURALUBE
3
ARTIFICIAL TEARS
(PF)
3
REFRESH CLASSIC
(PF)
3
REFRESH
LACRI-LUBE
3
REFRESH OPTIVE
ADVANCED
3
REFRESH OPTIVE
ADVANCED (PF)
3
REFRESH OPTIVE
OPHTHALMIC
DROPS
3
REFRESH OPTIVE
SENSITIVE (PF)
3
REFRESH P.M.
3
RETAINE PM
3
SOOTHE LUBRICANT
3
SYSTANE
3
ARTIFICIAL
TEARS(GLYCERIN-P
EG)
3
BION TEARS (PF)
3
DRY EYE RELIEF
3
EYE DROP TEARS
3
FOR STY RELIEF
3
FRESHKOTE
3
GENTEAL GEL
3
GENTEAL PM
3
HYPOTEARS
3
LUBRICANT EYE
(CMC-GLYCERIN)
3
LUBRICANT EYE
(PG-PEG 400)
3
SYSTANE (PF)
3
LUBRICANT EYE
(PG-PEG 400)(PF)
3
3
LUBRICANT EYE
DROPS (GLYC-PG)
SYSTANE GEL
OPHTHALMIC
DROPS,GEL
3
SYSTANE LIQUID
GEL
3
this table.
464
Drug Name
/Limits
SYSTANE
NIGHTTIME
3
SYSTANE ULTRA
3
SYSTANE ULTRA
(PF)
3
TEARS NATURALE
FORTE
3
TEARS NATURALE
FREE (PF)
3
TEARS NATURALE II
3
TEARS NATURALE
PM
3
TEARS PURE
Drug Name
/Limits
LACRISERT
3
LIQUITEARS
1
LUBRICANT DRY
EYE RELIEF
3
LUBRICANT EYE
(POLYV ALCOHOL)
1
LUBRICANT EYE
(PROPYL GLYCOL)
3
LUBRICANT EYE
DROPS
3
LUBRICATING PLUS
3
3
MOISTURIZING
LUBRICANT
3
ULTRA FRESH PM
3
NATURAL BALANCE
1
ULTRA LUBRICANT
EYE
3
NATURE'S TEARS
(HYPROMELLOSE)
3
VISINE TEARS
3
polyvinyl alcohol
1
VISINE TIRED EYE
RELIEF
3
PURE AND GENTLE
EYE
3
REFRESH
CELLUVISC
3
REFRESH
CONTACTS
1
REFRESH LIQUIGEL
3
REFRESH PLUS
1
REFRESH TEARS
3
RESTORE TEARS
3
RETAINE CMC
3
REVIVE PLUS
3
SOOTHE
HYDRATION
3
3
ARTIFICIAL
TEARS AND
LUBRICANT
SINGLE AGENTS
AKWA TEARS
(POLYVINYL
ALCOHOL)
1
ARTIFICIAL TEARS
(POLYVIN ALC)
1
artificial
tears(hypromellose)
3
GENTEAL MILD TO
MODERATE
3
GENTEAL MILD
3
GENTEAL SEVERE
3
STERILE
LUBRICANT
GONAK
3
SYSTANE BALANCE
3
GONIOSOFT
3
3
GONIOTAIRE
3
SYSTANE GEL
OPHTHALMIC GEL
GONIOVISC
3
1
ISOPTO TEARS
1
TEARS AGAIN
OPHTHALMIC
DROPS
this table.
465
Drug Name
/Limits
THERATEARS
3
ULTRA FRESH
1
CONTACT LENS
PREPARATION HARD LENS
PRODUCTS
Drug Name
/Limits
MULTIPURPOSE
CONTACT LENS
1
MULTI-PURPOSE
SOFT CONTACT LEN
3
OPTI-FREE EXPRESS
1
1
BOSTON CLEANER
1
OPTI-FREE
REPLENISH
BOSTON
CONDITIONING
1
OPTI-FREE
REWETTING DROPS
1
BOSTON ONE STEP
(PF)
RENU DISINFECTING
1
1
RENU MULTIPLUS
3
BOSTON
REWETTING
3
RENU REWETTING
DROPS
1
BOSTON SIMPLUS
1
REWETTING
1
REWETTING DROPS
1
SALINE SENSITIVE
EYES
3
SALINE SOLUTION
1
SALINE
SOLUTION,STERILE
PRESRV
1
SENSITIVE EYES
3
SENSITIVE EYES
DAILY CLEANER
3
SENSITIVE EYES
PLUS SALINE
1
UNISOL 4
1
VISINE FOR
CONTACTS
1
CONTACT LENS
PREPARATION HARD/SOFT/GAS
PERMEABLE
PRODUCTS
SYSTANE
CONTACTS
3
CONTACT LENS
PREPARATION OXYGEN
PERMEABLE
LENS PRODUCTS
OPTI-FREE
3
CONTACT LENS
PREPARATION SOFT LENS
PRODUCTS
BIO TRUE
1
CLERZ PLUS
3
CONTACT LENS
RELIEF
1
DISINFECTING
SOLUTION
1
LUBRICATING AND
REWETTING
1
MIOTICS CHOLINESTERAS
E INHIBITORS
demecarium bromide
(bulk)
3
PHOSPHOLINE
IODIDE
1
MIOTICS DIRECT ACTING
carbachol (bulk)
3
dapiprazole (bulk)
3
this table.
466
Drug Name
/Limits
ISOPTO CARPINE
3
MIOCHOL-E
3
MIOSTAT
3
pilocarpine hcl
ophthalmic drops 1 %, 2
%, 4 %
1
MYDRIATIC AND
CYCLOPLEGIC
COMBINATIONS
Drug Name
/Limits
TOBRADEX
OPHTHALMIC
OINTMENT
1
TOBRADEX ST
3
tobramycin-dexamethas
one
1
ZYLET
3
CYCLOMYDRIL
3
OPHTHALMIC ANTICHOLINERGI
CS
PAREMYD
3
atropine ophthalmic
1
CYCLOGYL
OPHTHALMIC
DROPS 0.5 %, 2 %
1
CYCLOGYL
OPHTHALMIC
DROPS 1 %
3
cyclopentolate (bulk)
3
cyclopentolate
ophthalmic drops 1 %, 2
%
1
HOMATROPAIRE
1
homatropine hbr
1
ISOPTO ATROPINE
3
MYDRIACYL
3
tropicamide ophthalmic
1
OPHTHALMIC ADRENERGIC-CA
RBONIC
ANHYDRASE
INHIBITOR
COMBINATIONS
SIMBRINZA
3
OPHTHALMIC ANTIBACTERIALGLUCOCORTICOI
D COMBINATIONS
BLEPHAMIDE
1
BLEPHAMIDE S.O.P.
1
MAXITROL
3
neomycin-bacitracin-pol
y-hc
1
neomycin-polymyxin
b-dexameth
1
neomycin-polymyxin-hc
ophthalmic
1
NEO-POLYCIN HC
1
PRED-G
3
PRED-G S.O.P.
3
sulfacetamide-prednisol
one
1
TOBRADEX
OPHTHALMIC
DROPS,SUSPENSION
3
OPHTHALMIC ANTIFIBROTIC
AGENTS
MITOSOL
3
OPHTHALMIC ANTIHISTAMINEDECONGESTANT
COMBINATIONS
ALL CLEAR AR
3
ALLERGY EYE
(NAPHAZOLINE-PHE
N)
3
EYE ALLERGY
RELIEF
1
this table.
467
Drug Name
/Limits
LUBRICANT
REDNESS RELIEVER
OPHTHALMIC
DROPS 0.03-0.5 %
1
MAXIMUM REDNESS
RELIEF
1
NAPHCON-A
1
OPCON-A
REDNESS RELIEVER
LUBRICANT
Drug Name
/Limits
OPHTHALMIC ANTI-INFLAMMA
TORY,
GLUCOCORTICOI
DS
ALREX
2
1
phosphate ophthalmic
1
1
DUREZOL
2
FLAREX
3
fluorometholone
1
FML FORTE
1
FML LIQUIFILM
3
FML S.O.P.
1
ILUVIEN
3
LOTEMAX
OPHTHALMIC
DROPS,GEL
3
LOTEMAX
OPHTHALMIC
DROPS,SUSPENSION
2
LOTEMAX
OPHTHALMIC
OINTMENT
3
STERILE EYE DROPS
OPHTHALMIC
DROPS 0.012-0.2 %,
0.03-0.5 %
1
VISINE-A
3
OPHTHALMIC ANTIHISTAMINES
ALAWAY
1
ALLERGY EYE
(KETOTIFEN)
1
azelastine ophthalmic
2
PA
BEPREVE
2
PA
CHILDREN'S
ALAWAY
1
ELESTAT
3
MAXIDEX
1
EMADINE
2
PA
OMNIPRED
3
epinastine
2
PA
OZURDEX
4
EYE ITCH RELIEF
1
PRED FORTE
3
ITCHY EYE DROPS
1
PRED MILD
1
ketotifen fumarate
1
prednisolone acetate
1
LASTACAFT
3
PATADAY
3
prednisolone sodium
phosphate ophthalmic
1
PATANOL
3
RETISERT
4
PAZEO
3
TRIESENCE (PF)
3
WAL-ZYR
(KETOTIFEN)
1
VEXOL
2
ZADITOR
3
PA
PA
PA
PA
this table.
468
Drug Name
/Limits
TORY,
IMMUNOMODULA
TORS
RESTASIS
Drug Name
/Limits
OPHTHALMIC CARBONIC
ANHYDRASE
INHIBITORS
3
TORY, NSAIDS
AZOPT
3
dorzolamide
2
TRUSOPT
3
ACULAR
3
ACULAR LS
3
OPHTHALMIC CYSTINE
DEPLETING
AGENTS
ACUVAIL (PF)
3
CYSTARAN
bromfenac
2
diclofenac sodium
ophthalmic
1
flurbiprofen sodium
2
PA
ILEVRO
2
PA
ketorolac ophthalmic
1
ADVANCED
FORMULA EYE
DROPS
1
NEVANAC
2
PA
OCUFEN
3
EYE DROPS (WITH
POVIDONE)
1
PROLENSA
3
EYE DROPS
ADVANCED RELIEF
1
LUBRICANT
REDNESS RELIEVER
OPHTHALMIC
DROPS 0.05-1 %
1
VISINE ADVANCED
REDNESS RELIEF
3
PA
OPHTHALMIC BETA
BLOCKERS-ADRE
NERGIC
COMBINATIONS
COMBIGAN
2
PA
OPHTHALMIC BETA
BLOCKERS-CARB
ONIC
ANHYDRASE
INHIBITOR
COMBINATIONS
PA
3
OPHTHALMIC DECONGESTANTARTIFICIAL TEAR
COMBINATIONS
OPHTHALMIC DECONGESTANTASTRINGENT
COMBINATIONS
COSOPT
3
COSOPT (PF)
3
dorzolamide-timolol
2
PA
CLEAR EYES
COMPLETE
3
CLEAR EYES ITCHY
EYE RELIEF
3
EYE DROPS
1
EYE DROPS
ALLERGY RELIEF
1
VISINE TOTALITY
3
this table.
469
Drug Name
VISINE-AC
/Limits
1
OPHTHALMIC DECONGESTANTS
Drug Name
fluorescein-proparacain
e
1
FLUORESCITE
4
FUL-GLO
3
rose bengal (bulk)
3
ALTAZINE
1
CLEAR EYES
REDNESS RELIEF
1
EYE DROPS
(TETRAHYDROZOLI
NE)
1
naphazoline
3
OPHTHALMIC DIAGNOSTIC
DYES, PIGMENTS,
AND REVEALING
AGENTS
OPTI-CLEAR
1
trypan blue (bulk)
phenylephrine hcl
ophthalmic
1
REDNESS RELIEF
OPHTHALMIC
DROPS 0.012-0.2 %,
0.012-0.25 %
1
REDNESS RELIEF
OPHTHALMIC
DROPS 0.03-0.5 %
3
REDNESS RELIEVER
EYE DROPS
1
STERILE EYE DROPS
OPHTHALMIC
DROPS 0.05 %
1
tetrahydrozoline
ophthalmic
1
VISINE
1
VISINE MAX
REDNESS RELIEF
/Limits
3
OPHTHALMIC GONIOSCOPIC
SOLUTIONS
GONAK
3
GONIOSOFT
3
GONIOTAIRE
3
GONIOVISC
3
OPHTHALMIC HYPEROSMOLAR
AGENTS
ALTACHLORE
3
ARTIFICIAL TEARS
OPHTHALMIC
DROPS
3
MURO 128
3
SOCHLOR
3
3
sodium chloride
ophthalmic
3
AK-FLUOR
4
BIOGLO
3
FLUCAINE
3
OPHTHALMIC INTRAOCULAR
PRESSURE
REDUCING
AGENTS,
BETA-BLOCKERS
fluorescein (bulk)
3
FLUORESCEIN C.I.
45350
3
OPHTHALMIC DIAGNOSTIC
AGENTS
BETAGAN
OPHTHALMIC
DROPS 0.5 %
3
betaxolol ophthalmic
1
BETIMOL
3
this table.
470
Drug Name
/Limits
Drug Name
/Limits
BETOPTIC S
1
carteolol
2
ISTALOL
3
levobunolol ophthalmic
drops 0.5 %
1
ALCAINE
3
metipranolol
3
ALTACAINE
3
timolol maleate
ophthalmic
proparacaine
2
1
proparacaine (bulk)
3
TIMOPTIC
3
TETCAINE
3
TIMOPTIC OCUDOSE
(PF)
1
tetracaine hcl
3
TIMOPTIC-XE
3
tetracaine hcl (pf)
ophthalmic
3
TETRAVISC
3
TETRAVISC FORTE
3
OPHTHALMIC IRRIGATION
SOLUTIONS
PA
OPHTHALMIC LOCAL
ANESTHETIC
ESTERS
BALANCED SALT
3
BSS
3
BSS PLUS
3
OPHTHALMIC LOCAL
ANESTHETIC,
AMIDES
COLLYRIUM
3
AKTEN (PF)
EYE IRRIGATING
SOLUTION
3
EYE STREAM
3
EYE WASH
3
EYE WASH STERILE
3
OPHTHALMIC MACULAR
DEGENERATION,
AGE-RELATED,
THERAPY
AGENTS
MEDIWASH
3
EYLEA
3
MEDIWASH EYE
IRRIGANT
3
LUCENTIS
3
OCUSOFT
IRRIGATING OPHTH
SOLN
MACUGEN
3
3
STERILE EYE WASH
3
OPHTHALMIC LOCAL
ANESTHETIC
COMBINATIONS
PA
3
OPHTHALMIC MAST CELL
STABILIZERS
ALOCRIL
2
PA
ALOMIDE
2
PA
cromolyn ophthalmic
1
ALTAFLUOR
3
fluorescein-benoxinate
3
OPHTHALMIC MYDRIATIC-NSAI
D COMBINATIONS
FLUROX
3
OMIDRIA
3
this table.
471
Drug Name
/Limits
OPHTHALMIC PHOTODYNAMIC
THERAPY
AGENTS
VISUDYNE
4
OPHTHALMIC PROTEOLYTIC
ENZYME AGENTS
JETREA (PF)
3
OPHTHALMIC SURGICAL AID
COMBINATIONS
DISCOVISC
3
DUOVISC VISCO
ELASTIC
3
VISCOAT
1
OPHTHALMIC SURGICAL AIDS
OTHER
Drug Name
/Limits
neomycin-polymyxin-gr
amicidin
1
NEO-POLYCIN
1
NEOSPORIN
(NEO-POLYM-GRAMI
CID)
3
POLYCIN
3
polymyxin b
sulf-trimethoprim
1
POLYTRIM
3
OPHTHALMIC
ANTIBIOTIC AMINOGLYCOSID
ES
GARAMYCIN
OPHTHALMIC
DROPS
1
GENTAK
OPHTHALMIC
OINTMENT
1
CELLUGEL
3
gentamicin ophthalmic
1
GELFILM
OPHTHALMIC
3
tobramycin
1
MEMBRANEBLUE
3
3
OCUCOAT
3
TOBREX
OPHTHALMIC
DROPS
VISIONBLUE
3
TOBREX
OPHTHALMIC
OINTMENT
1
OPHTHALMIC VISCOELASTIC
AGENTS
AMVISC
1
AMVISC PLUS
1
OPHTHALMIC
ANTIBIOTIC DEHYDROPEPTID
ASE INHIBITORS
PROVISC
3
bacitracin ophthalmic
AK-POLY-BAC
3
OPHTHALMIC
ANTIBIOTIC FLUOROQUINOLO
NES
bacitracin-polymyxin b
ophthalmic
3
BESIVANCE
2
CILOXAN
3
neomycin-bacitracin-pol
ymyxin
1
ciprofloxacin hcl
ophthalmic
1
OPHTHALMIC
ANTIBACTERIAL
MIXTURES
1
PA
this table.
472
Drug Name
/Limits
/Limits
gatifloxacin
2
levofloxacin ophthalmic
3
MOXEZA
2
OCUFLOX
3
ofloxacin ophthalmic
1
VIGAMOX
3
OPHTHALMIC-IN
TRAOCULAR
PRESS.
REDUCING, SEL.
ALPHA
ADRENERGIC
AGONISTS
ZYMAXID
3
ALPHAGAN P
3
apraclonidine
3
brimonidine ophthalmic
drops 0.15 %
3
brimonidine ophthalmic
drops 0.2 %
1
IOPIDINE
3
OPHTHALMIC
ANTIBIOTIC MACROLIDES
AZASITE
3
erythromycin
ophthalmic
1
ILOTYCIN
3
OPHTHALMIC
ANTIBIOTIC SULFONAMIDES
BLEPH-10
3
ophthalmic
1
OPHTHALMIC
ANTIFUNGALS
NATACYN
3
OPHTHALMIC
ANTISEPTICS
BETADINE
OPHTHALMIC PREP
3
OPHTHALMIC
ANTIVIRALS
trifluridine
1
trifluridine (bulk)
3
VIROPTIC
3
ZIRGAN
1
OPHTHALMIC
OTHERS
ENUCLENE
1
PA
Drug Name
PA
OPHTHALMIC-IN
TRAOCULAR
PRESSURE
REDUCING
AGENTS,
PROSTAGLANDIN
ANALOGS
bimatoprost
3
latanoprost
1
latanoprost (bulk)
3
LUMIGAN
OPHTHALMIC
DROPS 0.01 %
2
RESCULA
3
TRAVATAN Z
2
travoprost
(benzalkonium)
3
XALATAN
1
ZIOPTAN (PF)
3
PA
PA
SELECTIVE
VASCULAR
ENDOTHELIAL
GROWTH
FACTOR (VEGF)
ANTAGONISTS
MACUGEN
3
this table.
473
Drug Name
/Limits
SWIMMER'S
INSTANT EAR DRY
VASCULAR
ENDOTHELIAL
GROWTH
FACTOR
(VEGF-A& PLGF)
RECEPTOR
INHIBITORS
EYLEA
3
3
3
CIPRO HC
2
CIPRODEX
1
CORTISPORIN-TC
3
neomycin-polymyxin-hc
otic
1
PA
OTIC ANTI-INFECTIVES
OTHER
acetic acid otic
ORGAN
PRESERVATIO
N SOLUTIONS
1
OTIC FLUOROQUINOLO
NES
CARDIOPLEGIC
AND OTHER
RELATED ORGAN
PRESERVATION
SOLUTIONS
VIASPAN (BELZER
UW) COLD SS
/Limits
OTIC ANTI-INFECTIVEGLUCOCORTICOI
D COMBINATIONS
VASCULAR
ENDOTHELIAL
GROWTH
FACTOR (VEGF-A)
RECEPTOR
ANTAGONISTS
LUCENTIS
Drug Name
3
CETRAXAL
3
ciprofloxacin hcl otic
3
ofloxacin otic
1
OTIC GLUCOCORTICOI
DS
ACETASOL HC
1
DERMOTIC OIL
3
fluocinolone acetonide
oil
3
OTIC
hydrocortisone-acetic
acid
1
OTIC ANTI-INFECTIVE
MIXTURES
OTIC - PINNA
COMBINATIONS
CARDIOPLEGIC
SOLUTIONS
cardioplegic soln
3
PLEGISOL
3
acetic acid-aluminum
acetate
1
EAR DROPS FOR
SWIMMERS
1
EAR DRY
1
SWIM EAR
1
CORTANE-B
TOPICAL
NF
OTIC - WAX
REMOVERS-SOFT
ENERS
CARBAMOXIDE EAR
DROPS
3
this table.
474
Drug Name
/Limits
Drug Name
/Limits
CLEARCANAL EAR
WAX
3
DEBROX
3
PERITONEAL
DIALYSIS
SOLUTIONS
EAR DROPS
(CARBAMIDE
PEROXIDE)
1
DELFLEX-LC/1.5%
DEXTROSE
3
EAR DROPS OTC
1
DELFLEX-LC/2.5%
DEXTROSE
3
EAR WAX REMOVAL
DROPS
1
DELFLEX-LC/4.25%
DEXTROSE
3
EAR WAX REMOVAL
KIT
1
DELFLEX-SM WITH
1.5% DEXTROSE
3
EAR WAX REMOVAL
SYSTEM OTIC
COMBO PACK
3
DIANEAL LOW
CALCIUM/1.5% DEX
3
EAR WAX REMOVAL
SYSTEM OTIC
DROPS
DIANEAL PD-2 WITH
2.5 % DEX
3
1
DIANEAL PD-2 WITH
4.25 % DEX
3
EAR WAX
TREATMENT
1
DIANEAL PD-2/1.5%
DEXTROSE
3
MIN-O-EAR OTIC
DROPS
3
DIANEAL WITH 2.5 %
DEXTROSE
3
MURINE EAR WAX
REMOVAL SYSTEM
3
DIANEAL WITH 4.25
% DEXTROSE
3
EXTRANEAL 7.5 %
3
PROSTAGLAND
INS
RESPIRATORY
THERAPY
AGENTS
PROSTAGLANDIN
S
alprostadil (bulk)
3
RENAL
REPLACEMENT
THERAPY
HEMODIALYSIS &
HEMOFILTRATE
SOLUTIONS
PRISMASOL B22GK
3
PRISMASOL BGK
3
PRISMASOL BK
3
1ST GEN
ANTIHISTAMINEDECONGESTANTNSAID
ANALGESIC, COX
NON-SPECIFIC
ADVIL ALLERGY
SINUS
3
ADVIL
ALLERGY-CONGEST
ION RLF
3
this table.
475
Drug Name
/Limits
1ST GENERATION
ANTIHISTAMINE
AND SALICYLATE
COMBINATIONS
BAYER PM
3
1ST GENERATION
ANTIHISTAMINEANALGESIC,
NON-SALICYLATE
COMBINATIONS
Drug Name
/Limits
PAIN RELIEF PM
3
PAIN RELIEF PM
RAPID RELEASE
1
PAIN RELIEVER PM
EX-STRENGTH
3
PAIN RELIEVER PM
ORAL TABLET 25-500
MG
3
PERCOGESIC
1
ACETADRYL
3
PERCOGESIC EXTRA
STRENGTH
1
ACETA-GESIC
1
PM PAIN RELIEVER
1
ACETAMINOPHEN
PM
3
RELAGESIC ORAL
TABLET 29-500 MG
3
ACETAMINOPHEN
PM EXTRA STR
3
SEVERE ALLERGY
1
CORICIDIN HBP
COLD AND FLU
1
STAFLEX
(BROMPHENIRA-AC
ETAMIN)
3
diphenhydramine-aceta
minophen
3
TYLENOL PM EXTRA
STRENGTH
3
DOLOGEN
3
DOLOGEN 325
3
DOLOGESIC
3
G-DOLOGEN
3
GOODY'S PM
3
HEADACHE PM
3
HEADACHE RELIEF
PM
1
MAPAP PM
1ST GENERATION
NON-SALICYLATE
-XANTHINE
COMB.
MENSTRUAL
COMPLETE
1
MENSTRUAL RELIEF
1
3
MIDOL COMPLETE
3
MIDOL PM
1
NIGHT TIME PAIN
MEDICINE
3
3
MIDOL MAX ST
MENSTRUAL
NIGHTTIME PAIN
PLUS SLEEP
3
NON-ASPIRIN
NIGHTIME
3
NON-ASPIRIN PAIN
RELIEF PM
NON-ASPIRIN PM
1ST GENERATION
ANTIHISTAMINEDECONGESTANT
COMBINATIONS
ACTA-TABS PE
1
3
ALA-HIST PE
1
3
ALLERGY AND
SINUS RELIEF
1
this table.
476
Drug Name
/Limits
ALLERGY-D
1
AMBI 10PEH-4CPM
1
AMBI 60PSE-4CPM
1
APRODINE
1
BROHIST D
3
BROTAPP
1
BROVEX PEB
3
CENTERGY
3
CHILD
DOMETUSS-DA
3
CHILD TRIAMINIC
COLD-ALLERGY
3
CHILD WAL-TAP
COLD-ALLERGY
1
CHILDREN NIGHT
TIME COLD-COUGH
1
CHILDREN'S
COLD-ALLERGY (PE)
Drug Name
/Limits
DIMETAPP
COLD-ALLERGY (PE)
3
DIMETAPP
COLD-CONGESTION
1
ED A-HIST
1
ED A-HIST PSE
1
ED CHLORPED D
3
ENTRE-HIST PSE
3
EXAPHEN
3
HISTEX PE
3
HIST-PSE
3
J-TAN D PD
3
LODRANE D
3
LOHIST - D
3
LORTUSS LQ
3
NASOPEN PE
3
1
1
CHILDREN'S
DIBROMM
COLD-ALLERG
NIGHTTIME
COUGH-COLD
1
NOHIST-LQ
1
PHENAGIL
1
CHILDS TRIACTING
COLD-COUGH
1
POLY HIST FORTE
(DOXYLAMINE)
3
COLD AND
ALLERGY
1
PROMETHAZINE VC
1
pyrilamine-phenylephri
ne
3
Q-TAPP
1
RESCON
3
RITIFED
3
RU-HIST D
1
RYMED
(DEXCHLORPHENIR
AMINE-PE)
3
RYNEX PE
1
COLD AND
ALLERGY PE
1
COLD AND COUGH
(DIPHENHYDR-PE)
1
CONEX
1
DALLERGY
(CHLORPHENIRAMI
NE-PE) ORAL DROPS
1-2.5 MG/ML
3
DALLERGY
(DEXBROMPHENIRA
MN-PE)
3
RYNEX PSE
1
DELTUSS DP
3
SINUS AND
ALLERGY PE
1
DIMAPHEN (PE)
1
SINUS-ALLERGY
(PHENYLEPHRINE)
1
this table.
477
Drug Name
/Limits
STAHIST AD
3
SUDOGEST COLD
AND ALLERGY
1
SUDOGEST SINUS
AND ALLERGY
1
SUPHEDRINE PE
COLD AND
ALLERGY
1
SUPHEDRINE PE
SINUS
ANDALLERGY
Drug Name
/Limits
ALLERGY
MULTI-SYMPTOM
1
ALLERGY PLUS
SEVERE SINUS HA
1
ALLERGY RELIEF
MULTI-SYMPTOM
1
ALLERGY
RELIEF-SINUS
HEADACHE
1
1
ALLERGY SINUS
HEADACHE (PE)
3
TRIACTING ORANGE
3
ALLERGY SINUS PE
1
TRIAMINIC COLDALLERGY PE
1
ALLERGY SINUS-D
3
ALLERGY-SINUS
3
TRIAMINIC COLD
AND COUGHNT(PE)
3
CHILD DELSYM
COUGH+COLD
3
VALU-TAPP
3
VAZOBID-PD
1
3
VAZOTAB
(PYRILAMINE)
CHILDREN'S
MUCINEX NIGHT
TIME
3
1
WAL-ACT D COLD
AND ALLERGY
CHILDRENS PLUS
COLD
1
3
WAL-DRYL-D
ALLERGY AND
SINUS
CHILDS PLUS COLD
AND ALLERGY
1
COLD AND FLU
RELIEF(DIPHEN-PE)
3
WAL-FINATE-D
1
3
WAL-PHED ORAL
TABLET 4-60 MG
COMPLETE SINUS
RELIEF
1
3
WAL-PHED PE SINUS
AND ALLERGY
CONTAC COLD-FLU
DAY AND NIGHT
1
CONTAC COLD-FLU
MAX STRENGTH
3
COUGH AND
SEVERE COLD
3
DAYTIME AND
NITETIME SINUS
3
1ST GENERATION
ANTIHISTAMINEDECONGESTANTANALGESIC,
NON-SALICYLATE
ADULT ROBITUSSIN
NIGHT M-S CLD
1
3
ALLERGY AND
COLD PE
DELSYM
COUGH+COLD
NIGHTTIME
3
DRISTAN COLD
1
ALLERGY M-S
NIGHTTIME
1
FLU AND SEVERE
COLD-NIGHTTIME
1
this table.
478
Drug Name
/Limits
FLU AND SORE
THROAT RELIEF
1
FLU RELIEF
THERAPY
NIGHTTIME
1
Drug Name
/Limits
THERAFLU
FLU-SORE THROAT
1
THERAFLU NIGHT
SEVERE COLD-CGH
1
THERAFLU SINUS
AND COLD
3
VICKS
DAYQUIL-NYQUIL
SINEX
3
3
FLU-SEVERE
COLD-COUGH
NIGHT
3
INTENSE COLD AND
FLU
3
MEDICIDIN-D
1
VICKS NYQUIL
SINEX
3
VICKS QLEARQUIL
NIGHTIME SINUS
3
WAL-DRYL SEVERE
ALLERGY-SINUS
1
WAL-FLU COLD AND
SORE THROAT
3
WAL-FLU NIGHT
SEVERE COLD
1
WAL-FLU NIGHT
TIME
1
WAL-FLU SEVERE
COLD AND COUGH
3
WAL-PHED PE
NIGHTTIME COLD
1
WAL-PHED PE
SEVERE COLD
3
MUCINEX
FAST-MAX NITE
COLD-FLU
MUCINEX
SINUS-MAX NITE
CONGEST
3
NIGHTTIME SINUS
3
NIGHTTIME
SINUS-CONGESTION
3
NOREL AD
1
PAIN RELIEF
ALLERGY SINUS
1
SEVERE
ALLERGY-SINUS
HEADACHE
1
SEVERE COLD
(DIPHEN-PE-ACETA
M)
3
SEVERE COLD PE
3
SINUS
CONGESTION-PAIN(
CHLORPH)
1
SINUS
CONGEST-PAIN
DAY-NIGHT
1
ALKA-SELTZER
PLUS COLD (PE)
3
SINUS
DAYTIME-NIGHTIME
3
COLD RELIEF ORAL
TABLET,
EFFERVESCENT
1
THERAFLU
COLD-SORE THROAT
(PE)
COLD RELIEF PLUS
1
3
1ST GENERATION
ANTIHISTAMINEDECONGESTANTANALGESIC,
SALICYLATE
COMB
this table.
479
Drug Name
/Limits
Drug Name
/Limits
1ST GENERATION
ANTIHISTAMINEDECONGESTANTANALGESIC-EXPE
CTORANT COMB.
ALLERGY
RELIEF,NASAL
DECONGEST
3
ALLERGY RELIEF-D
(CETIRIZINE)
3
MUCINEX
SINUS-MAX D-N
(DIPHEN) ORAL
TABLETS,
SEQUENTIAL
ALLERGY RELIEF-D
(LORATADINE)
3
ALLERGY
RELIEF-D(FEXOFEN
ADINE)
3
ALLERGY+CONGEST
ION RELIEF-D
3
ALLERGY-CONGEST
ION RELIEF-D
3
ALLER-TEC D
3
CETIRI-D
3
cetirizine-pseudoephedr
ine
3
CLARINEX-D 12
HOUR
3
3
1ST GENERATION
ANTIHISTAMINEDECONGESTANTANTICHOLINERGI
C COMBINATIONS
RESPA-AR
3
2ND GENERATION
COMBINATIONS
ALAVERT D-12
ALLERGY-SINUS
3
CLARITIN-D 12
HOUR
3
ALL DAY
ALLERGY-D
3
CLARITIN-D 24
HOUR
3
ALLEGRA-D 12
HOUR
3
LORATA-D
3
ALLEGRA-D 24
HOUR
LORATA-DINE D
3
3
LORATADINE-D
3
ALLERCLEAR
D-12HR
3
SEMPREX-D
3
WAL-FEX D 12 HOUR
3
ALLERCLEAR
D-24HR
3
WAL-FEX D 24 HOUR
3
WAL-ITIN D
3
ALLERGY AND
CONGESTION
RELIEF
3
WAL-ITIN D 12 HOUR
3
WAL-ZYR D
3
ALLERGY
COMPLETE-D
3
ZYRTEC-D
3
ALLERGY D-12
3
ALLERGY RELIEF
D12
3
ANALGESIC,
NON-SALICYLATE
-EXPECTORANT
COMBINATIONS
CHEST CONGESTION
3
ALLERGY RELIEF
3
D-24
this table.
480
Drug Name
/Limits
ANTIHISTAMINE 1ST GENERATION
- ALKYLAMINES
ALA-HIST IR
1
ALLER-CHLOR ORAL
SYRUP
3
ALLER-CHLOR ORAL
TABLET
Drug Name
/Limits
ETHANOLAMINES
ALLER-G-TIME
3
1
ALLERGY
(DIPHENHYDRAMIN
E)
1
ALLERGY
(CHLORPHENIRAMI
NE)
1
ALLERGY
MEDICATION
1
ALLERGY MEDICINE
1
ALLERGY 4-HOUR
1
ALLERGY
RELIEF(CHLORPHEN
IRAMN) ORAL
TABLET
ALLERGY RELIEF
(CLEMASTINE)
3
1
ALLERGY
RELIEF(DIPHENHYD
RAMIN)
1
ALLERHIST-1
3
PA
ARBINOXA
3
PA
BANOPHEN
1
1
ALLERGY
RELIEF(CHLORPHEN
IRAMN) ORAL
TABLET EXTENDED
RELEASE
3
ALLERGY-TIME
1
BANOPHEN
ALLERGY
brompheniramine
maleate (bulk)
1
BENADRYL
ALLERGY
1
CHLORPHEN SR
3
BENADRYL ORAL
1
chlorpheniramine
maleate oral tablet
1
carbinoxamine maleate
2
chlorpheniramine
maleate oral tablet
extended release
CHILD ALLERGY
RELIEF (DIPHEN)
3
1
CHLORTABS
1
1
CHLOR-TRIMETON
1
CHILDREN'S
ALLERGY
(DIPHENHYD) ORAL
ELIXIR
ED CHLORPED JR
3
ED-CHLORPED
3
1
ED-CHLORTAN
1
CHILDREN'S
ALLERGY
(DIPHENHYD) ORAL
LIQUID
J-TAN PD
3
PEDIAVENT
3
3
PHARBECHLOR
1
WAL-FINATE
1
CHILDREN'S
ALLERGY
(DIPHENHYD) ORAL
TABLET,DISINTEGR
ATING
PA
PA
this table.
481
Drug Name
CHILDREN'S
COMPLETE
ALLERGY
CHILDREN'S
WAL-DRYL
ALLERGY ORAL
LIQUID
CHILDREN'S
WAL-DRYL
ALLERGY ORAL
PREFILLED SPOON
/Limits
3
1
1
Drug Name
/Limits
diphenhydramine hcl
oral elixir
1
diphenhydramine hcl
oral liquid
3
diphenhydramine hcl
oral syrup
3
diphenhydramine hcl
oral tablet 25 mg
1
GERI-DRYL
3
KARBINAL ER
3
NARAMIN
3
NIGHTTIME
ALLERGY RELIEF
3
PHARBEDRYL
1
Q-DRYL
1
QUENALIN
1
SILADRYL SA
1
SILPHEN COUGH
1
CHILDREN'S
WAL-DRYL
ALLERGY ORAL
TABLET,DISINTEGR
ATING
3
clemastine oral tablet
1.34 mg
3
PA
2.68 mg
2
PA
COMPLETE
ALLERGY
1
TOTAL ALLERGY
MEDICINE
3
COMPLETE
ALLERGY MEDICINE
1
1
DAYHIST ALLERGY
3
VALU-DRYL
ALLERGY ORAL
CAPSULE
DIPHEDRYL
1
3
DIPHEDRYL
ALLERGY
VICKS QLEARQUIL
NIGHTTIME RLF
1
1
DIPHENHIST ORAL
CAPSULE
WAL-DRYL
ALLERGY
1
DIPHENHIST ORAL
LIQUID
1
DIPHENHIST ORAL
TABLET 25 MG
1
PA
ETHYLENEDIAMI
NES
tripelennamine (bulk)
diphenhydramine hcl
mg/ml
1
diphenhydramine hcl
injection syringe
1
diphenhydramine hcl
oral capsule
1
3
PHENOTHIAZINES
PHENADOZ
1
PHENERGAN
3
this table.
482
Drug Name
/Limits
Drug Name
/Limits
solution
1
ALLER-CHLOR ORAL
TABLET
1
promethazine oral
1
ALLER-G-TIME
3
promethazine rectal
mg
1
ALLERGY
(CHLORPHENIRAMI
NE)
1
promethazine rectal
suppository 50 mg
3
1
PROMETHEGAN
1
ALLERGY
(DIPHENHYDRAMIN
E)
(bulk)
ALLERGY 4-HOUR
1
3
ALLERGY
MEDICATION
1
ALLERGY MEDICINE
1
ALLERGY RELIEF
(CLEMASTINE)
3
ALLERGY
RELIEF(CHLORPHEN
IRAMN) ORAL
TABLET
1
ALLERGY
RELIEF(CHLORPHEN
IRAMN) ORAL
TABLET EXTENDED
RELEASE
3
1
- PIPERAZINES
AHIST
(CHLORCYCLIZINE)
3
- PIPERIDINES
cyproheptadine
1
cyproheptadine (bulk)
3
- PROPYLAMINES
PA
HISTEX
(TRIPROLIDINE)
3
ALLERGY
RELIEF(DIPHENHYD
RAMIN)
HISTEX PD
3
ALLERGY-TIME
1
triprolidine hcl (bulk)
powder
ALLERHIST-1
3
PA
3
ARBINOXA
3
PA
VANAHIST PD
3
BANOPHEN
1
BANOPHEN
ALLERGY
1
BENADRYL
ALLERGY
1
BENADRYL ORAL
1
ANTIHISTAMINES
- 1ST
GENERATION
AHIST
(CHLORCYCLIZINE)
3
ALA-HIST IR
1
carbinoxamine maleate
2
ALKA-SELTZER
PLUS ALLERGY
1
CHILD ALLERGY
RELIEF (DIPHEN)
3
ALLER-CHLOR ORAL
SYRUP
3
PA
this table.
483
Drug Name
/Limits
CHILDREN'S
ALLERGY
(DIPHENHYD) ORAL
ELIXIR
1
CHILDREN'S
ALLERGY
(DIPHENHYD) ORAL
LIQUID
1
CHILDREN'S
ALLERGY
(DIPHENHYD) ORAL
TABLET,DISINTEGR
ATING
3
CHILDREN'S
COMPLETE
ALLERGY
3
CHILDREN'S
WAL-DRYL
ALLERGY ORAL
LIQUID
1
CHILDREN'S
WAL-DRYL
ALLERGY ORAL
PREFILLED SPOON
1
Drug Name
/Limits
COMPLETE
ALLERGY MEDICINE
1
COMPOZ
1
cyproheptadine
1
DAYHIST ALLERGY
3
DIPHEDRYL
1
DIPHEDRYL
ALLERGY
1
DIPHENHIST ORAL
CAPSULE
1
DIPHENHIST ORAL
LIQUID
1
DIPHENHIST ORAL
TABLET 25 MG
1
diphenhydramine hcl
mg/ml
1
diphenhydramine hcl
injection syringe
1
diphenhydramine hcl
oral capsule
1
diphenhydramine hcl
oral elixir
1
diphenhydramine hcl
oral liquid
3
diphenhydramine hcl
oral syrup
3
diphenhydramine hcl
oral tablet 25 mg
1
ED CHLORPED JR
3
ED-CHLORPED
3
ED-CHLORTAN
1
CHILDREN'S
WAL-DRYL
ALLERGY ORAL
TABLET,DISINTEGR
ATING
3
CHLORPHEN SR
3
chlorpheniramine
maleate oral tablet
1
chlorpheniramine
maleate oral tablet
extended release
1
CHLORTABS
1
GERI-DRYL
3
CHLOR-TRIMETON
1
3
1.34 mg
HISTEX
(TRIPROLIDINE)
3
PA
HISTEX PD
3
2.68 mg
2
PA
J-TAN PD
3
KARBINAL ER
3
COMPLETE
ALLERGY
1
NARAMIN
3
PA
this table.
484
Drug Name
/Limits
NIGHTIME SLEEP
1
NIGHTTIME
ALLERGY RELIEF
Drug Name
/Limits
1
3
SLEEP AID
(DIPHENHYDRAMIN
E) ORAL TABLET
NIGHTTIME SLEEP
AID (DIPHEN)
1
SLEEP AID MAX STR
(DIPHENHYDR)
1
ORMIR
1
SLEEP II
1
PEDIAVENT
3
PHARBECHLOR
1
SLEEP TABLET
(DIPHENHYDRAMIN
E)
1
PHARBEDRYL
1
SLEEP TIME
1
PHENADOZ
1
SLEEP-TABS
1
PHENERGAN
3
promethazine (bulk)
1
TOTAL ALLERGY
MEDICINE
3
solution
1
(bulk)
3
promethazine oral
1
UNISOM SLEEPGELS
1
promethazine rectal
mg
1
UNISOM
SLEEPMELTS
3
promethazine rectal
suppository 50 mg
3
VALU-DRYL
ALLERGY ORAL
CAPSULE
1
PROMETHEGAN
1
VANAHIST PD
3
Q-DRYL
1
3
QUENALIN
1
VICKS QLEARQUIL
NIGHTTIME RLF
REST SIMPLY
NIGHTTIME SLEEP
1
WAL-DRYL
ALLERGY
1
RESTFULLY SLEEP
1
WAL-FINATE
1
SILADRYL SA
1
3
SILPHEN COUGH
1
WAL-SLEEP Z ORAL
CAPSULE
SLEEP
1
WAL-SLEEP Z ORAL
LIQUID
1
3
WAL-SLEEP Z ORAL
TABLET,DISINTEGR
ATING
3
WAL-SOM
(DIPHENHYDRAMIN
E) ORAL CAPSULE
1
SLEEP AID
(DIPHENHYDRAMIN
E) ORAL CAPSULE 25
MG
SLEEP AID
(DIPHENHYDRAMIN
E) ORAL CAPSULE 50
MG
1
SLEEP AID
(DIPHENHYDRAMIN
E) ORAL LIQUID
1
this table.
485
Drug Name
WAL-SOM
(DIPHENHYDRAMIN
E) ORAL
TABLET,DISINTEGR
ATING
/Limits
Drug Name
/Limits
1
3
CHILDREN'S
ALLERGY
COMPLETE
1
Z-SLEEP
3
CHILDREN'S
ALLERGY(CETIRIZIN
E)
ZZZQUIL ORAL
CAPSULE
3
CHILDREN'S
ALLER-TEC
1
ZZZQUIL ORAL
LIQUID
1
CHILDREN'S
CETIRIZINE
1
CHILDREN'S
WAL-ZYR
1
CHILDREN'S
ZYRTEC ALLERGY
ORAL SOLUTION
1
CHILDREN'S
ZYRTEC ALLERGY
ORAL
TABLET,DISINTEGR
ATING
3
CHILD'S ALL DAY
ALLERGY(CETIR)
1
3
levocetirizine oral
solution
3
levocetirizine oral tablet
1
WAL-ZYR
(CETIRIZINE) ORAL
SOLUTION
1
WAL-ZYR
(CETIRIZINE) ORAL
TABLET
1
XYZAL
3
ZYRTEC ORAL
CAPSULE
3
ZYRTEC ORAL
TABLET
3
ZYRTEC ORAL
TABLET,CHEWABLE
3
ANTIHISTAMINES
- 2ND
GENERATION PIPERAZINES
ALL DAY ALLERGY
(CETIRIZINE) ORAL
CAPSULE
ALL DAY ALLERGY
(CETIRIZINE) ORAL
SOLUTION
ALL DAY ALLERGY
(CETIRIZINE) ORAL
TABLET
3
1
1
ALL DAY ALLERGY
(CETIRIZINE) ORAL
TABLET,CHEWABLE
1
ALL DAY ALLERGY
RELIEF(CETIR)
1
ALLERGY RELIEF
(CETIRIZINE)
3
ALLER-TEC
1
cetirizine oral solution
1
cetirizine oral tablet 10
mg
1
mg
3
cetirizine oral
tablet,chewable
1
CHILD ALLERGY
RELF(CETIRIZINE)
1
this table.
486
Drug Name
/Limits
ANTIHISTAMINES
- 2ND
GENERATION PIPERIDINES
Drug Name
/Limits
fexofenadine oral tablet
180 mg, 60 mg
2
LORADAMED
1
loratadine
1
loratadine (bulk)
3
(bulk)
3
1
ALAVERT
3
ALLEGRA ALLERGY
3
ALLERCLEAR
1
ALLER-EASE
2
ST
ALLER-FEX
2
ST
NON-DROWSY
ALLERGY
ALLERGY RELIEF
(FEXOFENADINE)
2
ST
VICKS QLEARQUIL
ALLERGY
3
ALLERGY RELIEF
(LORATADINE)
WAL-FEX ALLERGY
2
1
1
CHILDREN'S
ALLEGRA ALLERGY
ORAL SUSPENSION
WAL-ITIN ORAL
SOLUTION
3
WAL-ITIN ORAL
TABLET
1
CHILDREN'S
ALLEGRA ALLERGY
ORAL
TABLET,DISINTEGR
ATING
CHILDREN'S
ALLERGY
RELIEF(FEX)
2
3
ST
ST
ST
ST
ST
ST
ANTIHISTAMINES
- 2ND
GENERATION
ALAVERT
3
ALL DAY ALLERGY
(CETIRIZINE) ORAL
CAPSULE
3
1
CHILDREN'S
ALLERGY
RELIEF(LOR)
1
ALL DAY ALLERGY
(CETIRIZINE) ORAL
SOLUTION
CHILDREN'S
CLARITIN
3
1
CLARINEX ORAL
SYRUP
ALL DAY ALLERGY
(CETIRIZINE) ORAL
TABLET
3
CLARINEX ORAL
TABLET
1
3
ALL DAY ALLERGY
(CETIRIZINE) ORAL
TABLET,CHEWABLE
CLARITIN
3
ALL DAY ALLERGY
RELIEF(CETIR)
1
CLARITIN LIQUI-GEL
3
ALLEGRA ALLERGY
3
CLARITIN REDITABS
3
ALLERCLEAR
1
desloratadine
3
ALLER-EASE
2
ST
fexofenadine (bulk)
3
ALLER-FEX
2
ST
fexofenadine oral
suspension
3
ALLERGY RELIEF
(CETIRIZINE)
3
ST
ST
this table.
487
Drug Name
/Limits
ALLERGY RELIEF
(FEXOFENADINE)
2
ALLERGY RELIEF
(LORATADINE)
1
ALLER-TEC
1
cetirizine oral solution
1
mg
1
mg
3
cetirizine oral
tablet,chewable
1
CHILD ALLERGY
RELF(CETIRIZINE)
1
CHILDREN'S
ALLEGRA ALLERGY
ORAL SUSPENSION
3
CHILDREN'S
ALLEGRA ALLERGY
ORAL
TABLET,DISINTEGR
ATING
CHILDREN'S
ALLERGY
COMPLETE
ST
2
ST
ST
1
Drug Name
/Limits
CHILDREN'S
ZYRTEC ALLERGY
ORAL SOLUTION
1
CHILDREN'S
ZYRTEC ALLERGY
ORAL
TABLET,DISINTEGR
ATING
3
CHILD'S ALL DAY
ALLERGY(CETIR)
1
CLARINEX ORAL
SYRUP
3
CLARINEX ORAL
TABLET
3
CLARITIN
3
CLARITIN LIQUI-GEL
3
CLARITIN REDITABS
3
desloratadine
3
fexofenadine (bulk)
3
fexofenadine oral
suspension
3
ST
fexofenadine oral tablet
180 mg, 60 mg
2
ST
3
levocetirizine oral
solution
3
levocetirizine oral tablet
1
LORADAMED
1
loratadine
1
loratadine (bulk)
3
CHILDREN'S
ALLERGY
RELIEF(FEX)
3
CHILDREN'S
ALLERGY
RELIEF(LOR)
1
CHILDREN'S
ALLERGY(CETIRIZIN
E)
1
(bulk)
3
CHILDREN'S
ALLER-TEC
1
NON-DROWSY
ALLERGY
1
CHILDREN'S
CETIRIZINE
1
VICKS QLEARQUIL
ALLERGY
3
CHILDREN'S
CLARITIN
WAL-FEX ALLERGY
2
3
1
CHILDREN'S
WAL-ZYR
WAL-ITIN ORAL
SOLUTION
1
ST
ST
this table.
488
Drug Name
/Limits
WAL-ITIN ORAL
TABLET
1
WAL-ZYR
(CETIRIZINE) ORAL
SOLUTION
1
WAL-ZYR
(CETIRIZINE) ORAL
TABLET
Drug Name
/Limits
DAY-TIME COUGH
3
DELSYM 12 HOUR
1
dextromethorphan
polistirex
3
ROBAFEN COUGH
1
1
ROBITUSSIN
PEDIATRIC
1
XYZAL
3
1
ZYRTEC ORAL
CAPSULE
SCOT-TUSSIN
DIABETES CF
3
TESSALON PERLES
3
ZYRTEC ORAL
TABLET
3
TUSSIN COUGH (DM
ONLY)
1
ZYRTEC ORAL
TABLET,CHEWABLE
3
TUSSIN MAXIMUM
STRENGTH
1
TUSSIN MAXIMUM
STRENGTH COUGH
1
VICKS DAYQUIL
COUGH
3
VICKS NATURE
FUSION COUGH
3
WAL-TUSSIN COUGH
1
WAL-TUSSIN MAX
STRENGTH COUGH
1
ZONATUSS
3
ANTIHISTAMINES
clemizole hcl (bulk)
3
ANTITUSSIVE-AN
TIHISTAMINE-AN
ALGESIC-EXPECT
ORANT
COMBINATIONS
CORICIDIN HBP
DAY-NIGHT
3
ANTITUSSIVES NARCOTIC
dihydrocodeine
bitartrat(bulk)
3
ANTITUSSIVES NONNARCOTIC
AROMATIC
ANTITUSSIVE
DEMULCENTS
COUGH DROPS
MUCOUS
MEMBRANE
LOZENGE 10 MG, 5
MG, 6.1 MG, 8 MG, 9.1
MG
3
1
3
benzonatate oral
1
benzonatate oral
capsule 150 mg
3
CHILD WAL-TUSSIN
COUGH RELIEF
3
COUGH CONTROL
(DEXTROMETHORPH
)
COUGH DROPS
MUCOUS
MEMBRANE
LOZENGE 5.8 MG
3
FLANAX COUGH
RELIEF (MENTHOL)
COUGH DM ER
3
COUGH RELIEF
1
this table.
489
Drug Name
/Limits
HALLS COUGH
DROPS MUCOUS
MEMBRANE
LOZENGE 5.8 MG
1
HALLS COUGH
DROPS MUCOUS
MEMBRANE
LOZENGE 9.1 MG
3
Drug Name
/Limits
ASTHMA
THERAPY ALPHA/BETA
ADRENERGIC
AGENTS
ADRENALIN
INJECTION
SOLUTION 1 MG/ML
3
ASTHMANEFRIN
REFILL
3
ASTHMANEFRIN
STARTER KIT
3
MENTHOL COUGH
MUCOUS
MEMBRANE
LOZENGE 6.1 MG
3
SORE THROAT
(MENTHOL)
3
BRONCHIAL MIST
3
VICKS VAPODROPS
3
3
VICKS VAPORUB
TOPICAL OINTMENT
4.7-1.2-2.6 %
BRONCHIAL MIST
REFILL
3
solution 1 mg/ml
1
syringe 0.1 mg/ml
1
racepinephrine
3
racepinephrine (bulk)
3
S2 RACEPINEPHRINE
3
AROMATIC
ANTITUSSIVES
FOR
VAPORIZATION
WITH NASAL
DECONGESTANT
DECONGESTANT
INHALER
ASTHMA
THERAPY ALPHA/BETA
ADRENERGIC-EX
PECTORANT
COMBINATIONS
1
AROMATIC
ANTITUSSIVES
FOR
VAPORIZATION
HOT STEAM LIQUID
3
MEDICATED CHEST
RUB
1
VAPORIZING STEAM
3
VICKS VAPOSTEAM
1
BRONKAID DUAL
ACTION
ASTHMA
THERAPY GLUCOCORTICOI
DS
ASTHMA
THERAPY 5-LIPOXYGENASE
INHIBITORS
ZYFLO
3
ZYFLO CR
2
3
PA
AEROSPAN
3
ALVESCO
3
ARNUITY ELLIPTA
3
ASMANEX HFA
3
ASMANEX
TWISTHALER
3
this table.
490
Drug Name
/Limits
Drug Name
/Limits
budesonide inhalation
suspension for
nebulization 0.25 mg/2
ml, 0.5 mg/2 ml
1
budesonide inhalation
suspension for
nebulization 1 mg/2 ml
3
FLOVENT DISKUS
1
FLOVENT HFA
1
fluticasone propionate
(bulk)
3
ASTHMA
THERAPY XANTHINES
PULMICORT
3
aminophylline
intravenous
4
PULMICORT
FLEXHALER
1
dyphylline (bulk)
3
QVAR
1
ELIXOPHYLLIN
ORAL ELIXIR 80
MG/15 ML
1
THEO-24
1
THEOCHRON
3
theophylline in dextrose
5 % intravenous
mg/100 ml, 200 mg/50
ml, 400 mg/250 ml, 400
mg/500 ml, 800 mg/250
ml
4
ASTHMA
THERAPY MONOCLONAL
ANTIBODIES TO
IMMUNOGLOBUL
IN E (IGE)
XOLAIR
ASTHMA
THERAPY LEUKOTRIENE
RECEPTOR
ANTAGONISTS
4
ACCOLATE
3
montelukast
1
montelukast (bulk)
3
SINGULAIR ORAL
GRANULES IN
PACKET
1
theophylline oral elixir
3
SINGULAIR ORAL
TABLET
3
theophylline oral
solution
3
SINGULAIR ORAL
TABLET,CHEWABLE
3
theophylline oral tablet
extended release
1
zafirlukast
2
theophylline oral tablet
1
ASTHMA
THERAPY - MAST
CELL
STABILIZERS
PA
ASTHMA/COPD PHOSPHODIESTE
RASE-4 (PDE4)
INHIBITORS
cromolyn inhalation
1
tranilast (bulk)
3
DALIRESP
3
this table.
491
Drug Name
/Limits
Drug Name
SEREVENT DISKUS
ASTHMA/COPD ANTICHOLINERGI
C AGENTS,
INHALED LONG
ACTING
INCRUSE ELLIPTA
3
SPIRIVA RESPIMAT
INHALATION MIST
2.5 MCG/ACTUATION
3
SPIRIVA WITH
HANDIHALER
1
TUDORZA PRESSAIR
1
ASTHMA/COPD ANTICHOLINERGI
C AGENTS,
INHALED SHORT
ACTING
ATROVENT HFA
1
ipratropium bromide
inhalation
1
ASTHMA/COPD BETA
2-ADRENERGIC
AGENTS,
INHALED,
ULTRA-LONG
ACTING
ARCAPTA
NEOHALER
3
STRIVERDI
RESPIMAT
3
ASTHMA/COPD
THERAPY - BETA
2-ADRENERGIC
AGENTS,
INHALED, LONG
ACTING
/Limits
1
ASTHMA/COPD
THERAPY - BETA
2-ADRENERGIC
AGENTS,
INHALED, SHORT
ACTING
albuterol sulfate
nebulization
1
levalbuterol hcl
nebulization 0.31 mg/3
ml, 0.63 mg/3 ml, 1.25
mg/3 ml
2
levalbuterol hcl
nebulization 1.25
mg/0.5 ml
3
PROAIR HFA
1
PROAIR RESPICLICK
3
PROVENTIL HFA
3
VENTOLIN HFA
1
XOPENEX
3
XOPENEX
CONCENTRATE
3
XOPENEX HFA
3
PA
ASTHMA/COPD
THERAPY - BETA
ADRENERGIC
AGENTS
albuterol sulfate oral
syrup
1
tablet
1
3
BROVANA
1
12 hr
FORADIL
AEROLIZER
1
formoterol fumarate
(bulk)
3
PERFOROMIST
3
metaproterenol oral
1
this table.
492
Drug Name
/Limits
Drug Name
/Limits
terbutaline oral
1
TOBI PODHALER
3
terbutaline
subcutaneous
3
tobramycin in 0.225 %
nacl
1
VOSPIRE ER
3
CYSTIC FIBROSIS
- INHALED
MONOBACTAMS
ASTHMA/COPD
THERAPY - BETA
ADRENERGIC-AN
TICHOLINERGIC
COMBINATIONS
CAYSTON
ANORO ELLIPTA
3
COMBIVENT
RESPIMAT
1
ipratropium-albuterol
1
STIOLTO RESPIMAT
3
2
ST
KALYDECO ORAL
GRANULES IN
PACKET
3
PA
KALYDECO ORAL
TABLET
2
PA
CYSTIC
FIBROSIS-TRANS
MEMBRANE
CONDUCTANCE
REGULATOR
(CFTR)
POTENTIATOR
ASTHMA/COPD
THERAPY - BETA
ADRENERGIC-GL
UCOCORTICOID
COMBINATIONS
ADVAIR DISKUS
2
ST
ADVAIR HFA
2
ST
BREO ELLIPTA
INHALATION
BLISTER WITH
DEVICE 100-25
MCG/DOSE
2
PA
CYSTIC
FIB-TRANSMEMB
CONDUCT.
REG.(CFTR)
POTENTIATOR &
CORRECTOR
COMB.
ORKAMBI
BREO ELLIPTA
INHALATION
BLISTER WITH
DEVICE 200-25
MCG/DOSE
3
DULERA
3
SYMBICORT
2
CYSTIC FIBROSIS
- INHALED
AMINOGLYCOSID
ES
BETHKIS
3
KITABIS PAK
3
TOBI
2
PA
ST
2
DECONGESTANTANALGESIC,
NON-SALICYLATE
COMBINATIONS
DAYTIME SINUS
3
DAYTIME
SINUS-CONGESTION
3
MAPAP SINUS MAX
STRENGTH (PE)
1
NEXAFED SINUS
PRESSURE-PAIN
3
PAIN RELIEF SINUS
PE
1
this table.
493
Drug Name
/Limits
PAIN RELIEVER PM
ORAL TABLET 30-500
MG
3
PRESSURE AND
PAIN
1
SINUS CONGESTION
AND PAIN
1
SINUS HEADACHE
PE
1
SINUS PAIN RELIEF
1
SINUS RELIEF
(NON-DROWSY)
1
SUPHEDRINE PE
SINUS HEADACHE
1
VICKS DAYQUIL
SINEX
3
VICKS QLEARQUIL
DAYTIME SINUS
Drug Name
/Limits
MUCUS RELIEF
COLD AND SINUS
3
MUCUS RELIEF
SINUSPRESSUR-PAIN
3
MUCUS RLF SEVERE
SINUS CONGEST
3
SEVERE SINUS
3
SINUS
CONGESTION-PAIN(
GUAIF)
3
WAL-PHED PE
TRIPLE RELIEF
3
DECONGESTANTEXPECTORANT
COMBINATIONS
AMBI 60PSE-400GFN
1
3
BRONCHIAL
ASTHMA RELIEF
1
WAL-FLU SEVERE
COLD
3
CHEST CONGESTION
RELIEF D
1
WAL-PHED PE SINUS
HEADACHE
3
CHEST CONGESTION
RELIEF PE
3
CHEST-SINUS
CONGESTION
RELIEF
3
CHILD MUCINEX
STUFFY NOSE-COLD
1
CONGESTAC
1
DECONEX IR
3
DURAVENT PE
3
ED BRON GP
1
ENTEX LQ
3
ENTEX T
1
EXAPHEX TR
3
FENESIN PE IR
3
GILPHEX TR
3
J-MAX
3
DECONGESTANTANALGESIC,
NON-SALICYLATE
-EXPECTORANT
COMBINATIONS
CCP CAFFEINE FREE
3
COLD HEAD
CONGEST(GG-PE-AC
ETM)
3
MUCINEX COLD
AND SINUS
3
MUCINEX
FAST-MAX
COLD-SINUS
3
MUCINEX
SINUS-MAX
PRESSUR-PAIN
3
LIQUIBID D-R
3
MUCINEX
SINUS-MAX SEV
3
LIQUIBID PD-R
3
CONGESTN
this table.
494
Drug Name
/Limits
MAXIPHEN
3
MUCAPHED
3
MUCINEX D
Drug Name
/Limits
ALEVE SINUS AND
HEADACHE
1
1
1
MUCINEX D
MAXIMUM
STRENGTH
ALEVE-D SINUS AND
COLD
1
ALEVE-D SINUS AND
HEADACHE
1
MUCUS RELIEF D
(PHENYLEPHRINE)
3
ALL DAY PAIN
RELIEF SINUS,COLD
3
MUCUS RELIEF D
(PSEUDOEPHED)
1
COLD AND SINUS
PAIN RELIEF
1
MUCUS RELIEF PE
3
COLD-SINUS RELIEF
1
MUCUS RELIEF
SINUS
3
3
NON-DRYING SINUS
3
CONGESTION
RELIEF
(IBUPROF-PE)
POLY-VENT IR ORAL
TABLET 60-380 MG
IBUPROFEN COLD
1
3
PRIMATENE
ASTHMA
1
1
IBUPROFEN
COLD-SINUS(WITH
PSE)
REFENESEN PE
3
SINUS AND COLD-D
3
RESCON-GG
1
WAL-PROFEN
COLD-SINUS
1
RESPAIRE-30
3
SUPRESS-PE
3
WAL-PROFEN D
COLD AND SINUS
3
TG 10PEH-380GFN
3
TRIAMINIC
CHEST-NASAL
CONGEST
ELASTASE
INHIBITORS
3
ARALAST NP
4
GLASSIA
4
TUSNEL PEDIATRIC
ORAL DROPS
3
PROLASTIN-C
4
TUSSIN PE ORAL
LIQUID
ZEMAIRA
4
1
DECONGESTANTNSAID
ANALGESIC, COX
NON-SPECIFIC
EXPECTORANTS SINGLE AGENTS,
GENERAL
ADULT TUSSIN
CHEST CONGESTION
1
ADULT WAL-TUSSIN
1
ALLFEN
3
ADVIL COLD AND
SINUS
1
ADVIL CONGESTION
RELIEF
3
CHEST CONGESTION
RELIEF
3
ALEVE COLD AND
SINUS
1
CHILD MUCINEX
CHEST CONGESTION
3
this table.
495
Drug Name
/Limits
Drug Name
/Limits
CHILD MUCUS
RELIEF
EXPECTORANT
MUCOSA
3
1
MUCUS RELIEF
3
CHILDREN'S CHEST
CONGESTION
1
MUCUS RELIEF
CHEST
3
COUGH CONTROL
(GUAIFENESIN)
1
1
COUGH SYRUP
1
MUCUS RELIEF ER
ORAL TABLET
EXTENDED
RELEASE 12HR
COUGHTAB
3
ORGAN-I NR
3
DIABETIC SILTUSSIN
DAS-NA
1
Q-TUSSIN
1
DIABETIC TUSSIN
EX
3
1
REFENESEN ORAL
TABLET 400 MG
RI-TUSSIN
3
EXPECTORANT
ORAL LIQUID
1
ROBAFEN
1
FENESIN IR
3
SCOT-TUSSIN
EXPECTORANT
1
GERI-TUSSIN
1
SILTUSSIN SA
1
guaifenesin (bulk)
1
TAB TUSSIN
3
guaifenesin oral liquid
1
TRIACTIN
3
guaifenesin oral tablet
200 mg
3
TUSSIN CHEST
CONGESTION
1
guaifenesin oral tablet
600 mg
1
TUSSIN
EXPECTORANT
1
IOPHEN-NR
3
TUSSIN HONEY
3
LIQUITUSS GG
3
TUSSIN ORAL
LIQUID
1
MEDIFIN
EXPECTORANT
MUCUS RLF
1
TUSSIN ORAL
TABLET
3
MUCINEX
MINI-MELTS ORAL
GRANULES IN
PACKET 100 MG
1
MUCINEX ORAL
TABLET EXTENDED
RELEASE 12HR 1,200
MG
MUCINEX ORAL
TABLET EXTENDED
RELEASE 12HR 600
MG
LUNG
SURFACTANTS
3
CUROSURF
3
INFASURF
3
SURFAXIN
3
SURVANTA
3
MUCOLYTICS
1
acetylcysteine
1
1
PULMOZYME
1
this table.
496
Drug Name
/Limits
NARCOTIC
ANTITUSSIVE-1ST
GEN.
COMBINATIONS
CAPCOF
3
Drug Name
/Limits
TUSSIONEX
PENNKINETIC ER
3
TUZISTRA XR
3
VITUZ
2
ZODRYL AC 25
3
ZODRYL AC 30
3
ZODRYL AC 35
3
hydrocodone-cpm-pseud
oephed
3
ZODRYL AC 40
3
MAR-COF BP
3
ZODRYL AC 50
3
M-END MAX D
3
ZODRYL AC 60
3
M-END PE
3
ZODRYL AC 80
3
PHENYLHISTINE DH
1
Z-TUSS AC
POLY-TUSSIN AC
ORAL LIQUID 4-10-10
MG/5 ML
3
promethazine-phenyleph
-codeine
1
PRO-RED AC (W/
DEXCHLORPHENIR)
3
RYDEX
NF
NARCOTIC
ANTITUSSIVE-AN
TICHOLINERGIC
COMBINATIONS
hydrocodone-homatropi
ne oral syrup
1
3
hydrocodone-homatropi
ne oral tablet
3
ZODRYL DAC 25
3
HYDROMET
1
ZODRYL DAC 30
3
TUSSIGON
1
ZODRYL DAC 35
3
ZODRYL DAC 40
3
ZODRYL DAC 50
3
NARCOTIC
ANTITUSSIVE-DE
CONGESTANT
COMBINATIONS
ZODRYL DAC 60
3
ZODRYL DAC 80
3
ZUTRIPRO
3
NARCOTIC
ANTITUSSIVE-1ST
GENERATION
ANTIHISTAMINE
COMBINATIONS
PA
REZIRA
3
NARCOTIC
ANTITUSSIVE-DE
CONGESTANT-EX
PECTORANT
COMBINATIONS
CHERATUSSIN DAC
1
GUAIFENESIN DAC
NF
hydrocodone-chlorpheni
ramine
1
HYCOFENIX
3
PRO-CLEAR AC
3
LORTUSS EX ORAL
SYRUP
3
promethazine-codeine
1
TUSNEL C
1
TUSSICAPS
3
VIRTUSSIN DAC
3
this table.
497
Drug Name
/Limits
Drug Name
ZODRYL DEC 25
3
ZODRYL DEC 30
1
ZODRYL DEC 35
3
ZODRYL DEC 40
3
ZODRYL DEC 50
3
NASAL
ANTIHISTAMINE
AND
ANTI-INFLAMMA
TORY STEROID
COMBINATIONS
ZODRYL DEC 60
3
DYMISTA
ZODRYL DEC 80
3
NASAL
ANTIHISTAMINES
NARCOTIC
ANTITUSSIVE-EXP
ECTORANT
COMBINATIONS
/Limits
3
ASTEPRO NASAL
SPRAY,NON-AEROS
OL
3
CHERATUSSIN AC
1
azelastine nasal
2
codeine-guaifenesin
1
olopatadine nasal
3
FLOWTUSS
3
PATANASE
3
GUAIATUSSIN AC
1
GUAIFENESIN AC
1
IOPHEN C-NR
1
NASAL
CORTICOSTEROI
DS
MAR-COF CG
3
BECONASE AQ
2
M-CLEAR WC
3
budesonide nasal
3
NINJACOF-XG
3
3
OBREDON
3
FLONASE ALLERGY
RELIEF
PRO-CLEAR CAPS
3
1
RELCOF C
3
flunisolide nasal
spray,non-aerosol 25
mcg (0.025 %)
VIRTUSSIN AC
3
fluticasone nasal
1
NASACORT
3
NASONEX
3
OMNARIS
3
QNASL
3
RHINOCORT AQUA
3
NASAL
ANTIBIOTICS
BACTROBAN NASAL
1
NASAL
ANTICHOLINERGI
CS
ATROVENT
3
nasal
2
ipratropium bromide
nasal
1
VERAMYST
3
ZETONNA
3
PA
PA
ST
NASAL MAST
CELL
STABILIZERS
cromolyn nasal
3
this table.
498
Drug Name
/Limits
Drug Name
/Limits
NASAL ALLERGY
SYMPTOM
CONTROL
NASADROPS
3
3
NASAL MIST
1
NASALCROM
3
NASAL
MOISTURIZING
1
NASAL SPRAY
(SODIUM CHLORIDE)
1
OCEAN FOR KIDS
1
NASAL
MOISTURIZER
COMBINATIONS
AYR SINUS RINSE
REFILL
3
OCEAN NASAL
1
ENTSOL NASAL GEL
3
RHINARIS NASAL
GEL
3
GELONASAL
3
NASA MIST
3
1
NASALCARE REFILL
3
RHINARIS NASAL
SPRAY,NON-AEROS
OL
NASALCARE WITH
IRRIGATOR
3
SALINE MIST
1
SALINE NASAL
1
NASAMIST
3
NASOGEL
1
SALINE NASAL
(ALOE VERA)
3
NEILMED PEDIAT
SINUS RINSE REF
3
1
NEILMED SINUS
RINSE REFILL
SALINE NASAL MIST
NASAL
AEROSOL,SPRAY
3
SALINE NOSE
1
OCEAN COMPLETE
3
1
PRETZ
3
SEA SOFT NASAL
MIST
SALTAIRE
3
STERILE SALINE
NASAL
1
SINUFLO
READYRINSE
3
SINUS RINSE
3
SINUS WASH NASAL
PACKET
3
NASAL
MOISTURIZERS
ALTAMIST
1
AYR ALLERGY AND
SINUS
3
AYR SALINE
1
AYR SALINE GEL
1
BABY AYR SALINE
1
DEEP SEA NASAL
1
LITTLE REMEDIES
1
NASAL
SYMPATHOMIME
TIC
DECONGESTANTS
(INTRANASAL)
12 HOUR NASAL
RELIEF SPRAY
3
12 HOUR NASAL
SPRAY
3
ADRENALIN NASAL
1
AFRIN
(OXYMETAZOLINE)
3
AFRIN NO
DRIP(OXYMETAZOLI
N)
3
this table.
499
Drug Name
/Limits
ANEFRIN
3
BENZEDREX
1
DRISTAN LONG
LASTING
3
EPHRINE
1
FAST ACTING
NASAL
1
LITTLE NOSES
MUCINEX
SINUS-MAX
NASAL
DECONGESTANT
(OXYMETAZL)
Drug Name
/Limits
NOSE DROPS EXTRA
STRENGTH
1
NRS NASAL RELIEF
3
NU WAY
1
ORIGINAL NASAL
SPRAY
3
oxymetazoline
3
1
oxymetazoline (bulk)
3
3
SEVERE
CONGESTION
3
SINEX ULTRA FINE
MIST 12-HOUR
3
SINUS NASAL
SPRAY
3
SINUS RELIEF
(OXYMETAZOLINE)
3
3
NASAL
DECONGESTANT
INHALER
3
NASAL FOUR
1
TYZINE
3
NASAL RELIEF
3
VAPOR INHALER
3
NASAL SPRAY
(OXYMETAZOLINE)
3
3
NASAL SPRAY 12
HOUR
3
VICKS
QLEARQUIL(OXYME
TAZOLINE)
NASAL SPRAY 12
HOUR SINUS
3
3
VICKS SINEX
12-HOUR
WAL-FOUR
1
NASAL SPRAY
EXTRA
MOISTURIZING
3
xylometazoline (bulk)
3
NASAL SPRAY LONG
ACTING
3
NASAL SPRAY
SINUS
NASAL WASH
COMBINATIONS
AYR SALINE NASAL
NETI RINSE
3
3
AYR SINUS RINSE
3
NASAL SPRAY
X-MOIST
3
3
NEO-SYNEPHRINE
(PHENYLEPHRINE)
NASAL
ENTSOL NASAL
SPRAY,NON-AEROS
OL
1
ENTSOL NASAL
WASH
3
NEO-SYNEPHRINE 12
H SPR (OXYM)
3
NASADOCK PLUS
KIT
3
NO DRIP
3
3
NOSE DROPS
1
NASAFLO
PORCELAIN KIT
this table.
500
Drug Name
/Limits
NASAL RELIEF
SINUS WASH W/NETI
3
NEILMED NASAFLO
3
NEILMED SINUS
RINSE COMPLETE
3
SINUGATOR NASAL
WASH KIT
3
SINUS RINSE
PEDIATRIC
3
SINUS RINSE
PEDIATRIC
STARTER
3
SINUS RINSE
STARTER
3
SINUS WASH NASAL
PACKET 700-2,300
MG
3
SINUS WASH
NETIPOT
3
NON NARC
ANTITUSS-1ST
GEN.ANTIHISTAM
INE-DECONGESTANALGESIC-EXPE
CT CMB
CHILD MUCINEX
M-S COLD DAY-NTE
3
MUCINEX
FAST-MAX
DAY-NITE COLD
3
MUCINEX
FAST-MAX
DAY-NITE CONG
3
MUCINEX
FAST-MAX
DAY-NT(DOXYL)
3
MUCINEX FST-MX
DY-NT COLD(DPH)
3
MUCINEX
SINUS-MAX DY-NT
(DXYL)
3
Drug Name
/Limits
SEVERE COLD AND
FLU(DAY/NIGHT)
3
SUPHEDRINE PE
DAY-NIGHT
3
VICKS
DAYQUIL-NYQUIL
SEVERE
3
NON-NARC
ANTITUS-1ST GEN
ANTIHISTAMINEDECONGEST-ANA
LGESIC,NON-SALI
CYL
ALKA-SELTZER
PLUS
COLD/COUGHFM
1
ALKA-SELTZER
PLUS COLD+FLU
3
ALKA-SELTZER
PLUS FLU
3
ALKA-SELTZER
PLUS NIGHT
3
ALKA-SELTZER
PLUS SIN-ALLG-CGH
3
ALKA-SELTZER
PLUS-D SINUS-COLD
3
CHILD TRIAMINIC
MS FEVER-COLD
3
CHILDREN'S FLU
RELIEF
1
CHILDREN'S PLUS
FLU
1
CHILDRENS PLUS
MULTI-SYMP COLD
1
COLD HEAD
CONGESTION
DAY/NITE
1
COLD HEAD
CONGESTION
NIGHTTIME
1
this table.
501
Drug Name
COLD
MULTI-SYMPTOM
(CHLORPHEN)
/Limits
1
Drug Name
/Limits
TYLENOL COLD
MULTI-SYMPT
NIGHT ORAL LIQUID
3
3
COLD
MULTI-SYMPTOM
DAY/NIGHT
1
VICKS
DAYQUIL-NYQUIL
COLD
MULTI-SYMPTOM
NIGHTTIME
3
1
VICKS
DAYQUIL-NYQUIL
COLD-FLU
COLD RELIEF M/S
DAY/NIGHT
1
VICKS NYQUIL
SEVERE COLD-FLU
ORAL LIQUID
1
COLD-FLU RELIEF,
DAY/NIGHT
3
3
DAYTIME AND
NIGHTTIME COLD
VICKS NYQUIL
SEVERE COLD-FLU
ORAL TABLET
1
DAYTIME-NIGHTTIM
E
3
DAYTIME-NIGHTTIM
E COLD-FLU
3
HEAD CONGESTION
COLD RELIEF ORAL
TABLETS,
SEQUENTIAL
1
HEAD CONGESTION
DAY-NIGHT
3
MUCINEX
FAST-MAX NITE
(DOXYL)
3
MULTI-SYMPTOM
COLD (PE-CPM)
1
MULTI-SYMPTOM
COLD NIGHT TIME
1
NIGHT TIME COLD
ORAL TABLET
1
NIGHT TIME
COLD-FLU ORAL
CAPSULE
1
NITE TIME-D
COLD-FLU RELIEF
1
NYQUIL D
1
SEVERE COLD AND
FLU NIGHTTIME
3
NON-NARC
ANTITUS-1ST GEN
ANTIHISTAMINEDECONGEST-ANA
LGESIC,SALICYL
ATES
ALKA-SELTZER
PLUS C/C(PE,DM)
3
ALKA-SELTZER
PLUS DAY-NIGHT
3
ALKA-SELTZER
PLUS NIGHT (ASA)
3
NON-NARC
ANTITUSSIVE-1ST
GEN
NON-SALICYLATE
ALL-NITE COLD-FLU
1
CHILD PLUS COUGH
AND RUNNYNOSE
3
CHILDREN'S COUGH
AND RUNNYNOSE
3
COLD-FLU RELIEF
ORAL LIQUID
12.5-30-1,000 MG/30
ML
1
this table.
502
Drug Name
/Limits
CONTAC COLD-FLU
NIGHT
1
CORICIDIN HBP
COLD-MULTI SYMPT
1
CORICIDIN HBP
ORAL TABLET
1
COUGH-SORE
THROAT NIGHT
1
DIABETIC TUSSIN
NIGHT TIME
3
FLU BP
3
FLU HBP
Drug Name
/Limits
NITE TIME
COLD-FLU RELIEF
ORAL CAPSULE
3
NITE TIME
COLD-FLU RELIEF
ORAL LIQUID
1
NITE-TIME
1
NITE-TIME
COLD-FLU
1
NITETIME
MULTI-SYMPTOM
1
3
3
MAXIMUM
STRENGTH FLU
VICKS NATURE
FUSION COLD-FLU
3
3
NIGHT TIME COLD
AND FLU RELIEF
VICKS NYQUIL
COLD/FLU (CPM)
1
1
NIGHT TIME
COLD-FLU ORAL
LIQUID
VICKS NYQUIL
COLD/FLU LIQUICAP
1
VICKS NYQUIL
NIGHTTIME RELIEF
3
NIGHT TIME
COLD-FLU RELIEF
ORAL LIQUID
12.5-30-1,000 MG/30
ML
1
NIGHT TIME
COUGH-SORE
THROAT
NON-NARC
ANTITUSSIVE-1ST
GEN.
COMBINATIONS
1
ABATUSS DMX
3
ALA-HIST DM
3
NIGHT TIME ORAL
CAPSULE 6.25-15-325
MG
1
AMBI
10PEH-4CPM-20DM
3
AMBI
60PSE-4CPM-20DM
3
AP-HIST DM
3
BALAMINE DM
(CHLOR-PE)
3
BIONATUSS DXP
3
BROMFED DM
3
BROMPHENEX DM
3
brompheniramine-pseud
oeph-dm oral syrup
3
NIGHTTIME
COLD-FLU
1
NIGHTTIME
COLD-FLU RELIEF
1
NINJACOF-A
3
NITE TIME
COLD-FLU
1
NITE TIME
COLD-FLU
FORMULA
1
this table.
503
Drug Name
/Limits
brompheniramin-phenyl
ephrin-dm oral liquid
2-5-10 mg/5 ml
3
BRONKIDS
3
BROTAPP DM
Drug Name
/Limits
KIDKARE
COUGH/COLD
1
LOHIST-DM
3
LORTUSS DM
3
1
M-END DMX
3
BROVEX PEB DM
3
NEOTUSS PLUS
3
CARBAPHEN CH
3
NIVA-HIST DM
3
CENTERGY DM
3
NOHIST-DM
1
CHILDREN'S COLD
AND COUGH (PE)
1
PANATUSS PED
3
CHILDREN'S COLD
AND COUGH DM
1
PANATUSS PED
DROPS
3
PEDIA RELIEF
COUGH-COLD
1
PEDIATRIC COUGH
AND COLD ORAL
LIQUID 1-15-5 MG/5
ML
1
PHENAGIL CH
3
POLY-HIST DM
(THONZYLAMINE)
3
PRESGEN B
3
PRO-CHLO
3
Q-TAPP DM
1
CHILDREN'S
DIBROMM DM
COLD-COU
1
CHLO TUSS
3
chlorpheniramine-pheny
leph-dm
1
CODITUSS DM
1
COLD AND COUGH
DM
1
COLD AND COUGH
ELIXIR
1
dexchlorphen-pse-chlop
hedianol
3
RESCON-DM
1
DIMAPHEN DM
1
RYCONTUSS
3
DIMETAPP DM
COLD-COUGH (PE)
RYNEX DM
1
1
SUPRESS A
3
DONATUSSIN
3
TL-HIST DM
3
ED A-HIST DM ORAL
LIQUID
1
TREXBROM
3
TUSSI PRES-B
3
ED A-HIST DM ORAL
TABLET
3
VANACOF
3
ENDACOF - DM
1
WAL-TAP DM
1
EXAPHEN CH
3
GENCONTUSS
3
G-P-TUSS DXP
3
HISTEX DM
3
this table.
504
Drug Name
/Limits
NON-NARCOTIC
ANTITUS-DECON
GESTANT-ANALG
ESIC,NON-SALICY
LATE-EXPECTOR
ANT
Drug Name
/Limits
MUCINEX
SINUS-MAX SEV
CONG(DM)
3
MUCUS RELIEF
COLD-FLU-SORE
THR ORAL LIQUID
3
CHILDREN'S
COLD-COUGH-SORE
1
1
CHILDREN'S
MUCINEX
COLD-FEVER
MUCUS RELIEF
COLD-FLU-SORE
THR ORAL TABLET
1
MUCUS RELIEF PLUS
1
COLD AND COUGH
(PE-DM-GG-ACET)
1
3
MUCUS RELIEF SEV
CONGEST-COLD
COLD AND FLU
SEVERE
3
3
MULTI-SYMPTOM
COLD (PE)
NON-ASPIRIN
SEVERE CONGEST
M-S
1
NON-PSEUDO COLD
RELIEF
3
PAIN RELIEF COLD
1
COLD HEAD
CONGESTION SEVER
DAY
1
COLD SEVERE
CONGESTION
1
COLD-COUGH SINUS
RELIEF PE
3
PRESSURE-PAIN-CO
LD
3
DECOREL FORTE
PLUS
3
SEVERE COLD
1
DELSYM
COUGH+COLD
DAYTIME
3
3
SEVERE COLD AND
FLU (PE) ORAL
TABLET
SEVERE COLD
MULTI-SYMPTOM
1
THERAFLU MAX-D
SEVERE COLD-FLU
3
VICKS DAYQUIL
SEVERE COLD-FLU
ORAL LIQUID
3
VICKS DAYQUIL
SEVERE COLD-FLU
ORAL TABLET
1
WAL-PHED PE
COLD-COUGH
3
WAL-PHED PE
PRESSURE+PAIN+CO
LD
3
DURAFLU ORAL
TABLET
60-20-200-500 MG
1
HEAD CONGESTION
COLD RELIEF ORAL
TABLET
1
MUCINEX
COLD,FLU,SORE
THROAT
3
MUCINEX
FAST-MAX
COLD-FLU-THRT
3
MUCINEX
FAST-MAX SEVERE
COLD
3
this table.
505
Drug Name
/Limits
NON-NARCOTIC
ANTITUSSIVE-AN
ALGESIC,
NON-SALICYLATE
COMBINATIONS
Drug Name
/Limits
promethazine-dm
1
ROBITUSSIN
LONG-ACTING
1
ROBITUSSIN
NIGHTTIME COUGH
DM
3
SCOT-TUSSIN DM
1
CHILD COUGH AND
SORE THROAT
3
CHILD TRIAMINIC
COUGH-SORE THR
3
VANACOF-8
3
DAYTIME COLD
AND COUGH
3
VICKS CHILDREN'S
NYQUIL COLD-C
3
PAIN RELIEF COLD
AND COUGH
3
VICKS NYQUIL
COUGH
3
TRIAMINIC
COUGH-SORE
THROAT
3
NON-NARCOTIC
ANTITUSSIVE-AN
TIHISTAMINE
COMBINATIONS
NON-NARCOTIC
ANTITUSSIVE-DE
CONGESTANT
COMBINATIONS
CHILDREN'S
SUDAFED PE COUGH
1
PEDIACARE
MULTI-SYMPTOM
COLD
1
TRIAMINIC COLD
AND COUGH (PE)
1
AMBI 20DM-4CPM
1
CAPRON DM
3
CHLO HIST
3
CORICIDIN HBP
COUGH AND COLD
1
COUGH AND COLD
BP
3
COUGH AND COLD
ORAL TABLET
1
NON-NARCOTIC
ANTITUSSIVE-DE
CONGESTANT-AN
ALGESIC,
NON-SALICYLATE
COMB
COUGH AND RUNNY
NOSE
3
ALKA-SELTZER
PLUS DAY
1
DAYTIME-NIGHTTIM
E COUGH
3
ALKA-SELTZER
PLUS SINUS-COUGH
1
DIMETAPP
LONG-ACTING
(CPM-DM)
1
COLD HEAD
CONGESTION
DAYTIME
1
NIGHTTIME COUGH
1
3
NINJACOF
3
COLD
MULTI-SYMPTOM
NITE TIME COUGH
1
1
POLY HIST PD
3
COLD-FLU RELIEF
ORAL LIQUID
5-10-325 MG/15 ML
this table.
506
Drug Name
/Limits
DAY TIME PE
1
DAYTIME
1
DAYTIME COLD-FLU
1
DAYTIME COLD-FLU
RELIEF (PE)
1
DAY-TIME ORAL
CAPSULE 30-15-325
MG
1
FLU AND SEVERE
COLD-DAYTIME
FLU RELIEF
THERAPY DAYTIME
Drug Name
WAL-FLU SEVERE
COLD-COUGH
/Limits
3
NON-NARCOTIC
ANTITUSSIVE-DE
CONGESTANT-EX
PECTORANT
COMBINATIONS
30PSE-150GFN-15DM
1
3
ADULT ROBITUSSIN
PEAK COLD M-S
1
1
ADULT TUSSIN
MULTI-SYMP COLD
1
FLU-SEVERE
COLD-COUGH
DAYTIME
3
AMBI
40PSE-400GFN-20DM
3
AQUANAZ
3
MAPAP COLD
FORMULA
1
BIO T PRES
3
BIO T PRES
PEDIATRIC
3
BIOBRON SF
3
BIODESP DM
3
BIOGIL
3
BIONEL
1
BIONEL PEDIATRIC
3
BRONCOTRON PED
3
MUCINEX
FAST-MAXSEV
COLD-SINUS
3
MULTI-SYMPTOM
COLD DAYTIME
1
NON-ASPIRIN FLU
ORAL TABLET
30-15-500 MG
3
PAIN RELIEVER FLU
3
BRONTUSS SF
3
SUDAFED PE
PRESSURE+PAIN+CO
UGH
3
CAPMIST DM ORAL
TABLET 60-15-400
MG
3
THERAFLU
DAYTIME
COLD-COUGH
1
CERTUSS-D
3
THERAFLU
MULTI-SYMPTOM
COLD
1
1
CHILD MUCINEX
CONGESTION-COUG
H
TYLENOL COLD
MULTI-SYMPTOM
DAY
1
1
CHILD
MULTI-SYMPTOM
COLD/COUGH
VICKS DAYQUIL
COLD-FLU RELIEF
1
1
CHILDREN'S
MUCINEX
MULTI-SYMP
VICKS NATURE
FUSION
1
CHILD'S MUCUS
RELIEF M-S COLD
3
this table.
507
Drug Name
/Limits
COUGH AND COLD
MUCUS RELIEF CF
3
COUGH AND COLD
ORAL LIQUID
1
COUGH CONTROL
CF (PE)
Drug Name
/Limits
MUCUS RELIEF
CONGESTION-COUG
H
1
3
3
NEOTUSS-D
(IMPROVED
FORMULA)
DECONEX DMX
3
NIVANEX DMX
3
DESGEN
3
PECGEN PSE
3
DESGEN DM
3
DESPEC EDA
COUGH-COLD
DROPS
3
1
POLY-VENT DM
ORAL TABLET
60-20-380 MG
PRES GEN
3
PRES GEN
PEDIATRIC
3
pseudoephed-chlophedi
anol-gg
3
ROBAFEN CF
(PHENYLEPHRINE)
1
ROBITUSSIN COUGH
AND COLD CF
1
1
DESPEC-DM
(PHENYLEPH-DM-GU
AIF) ORAL LIQUID
5-10-100 MG/5 ML
3
DESPEC-DM
(PSEUDOEPH-DM-GU
AIF) ORAL TABLET
30-10-200 MG
3
DURAVENT DM
3
ENDACON
3
ENTEX PAC
3
SEVERE
CONGESTION AND
COUGHMAX
ENTRE-COUGH
1
SUPRESS DX
1
EXACTUSS TR
3
3
GILTUSS TR
3
TG
10PEH-380GFN-15DM
G-SUPRESS DX
3
3
G-TRON PED
3
TRISPEC PSE ORAL
LIQUID 30-10-187
MG/5 ML
G-TUSICOF
1
1
MAXIFED DM
1
TUSICOF ORAL
LIQUID
MAXIPHEN DM
3
3
MUCINEX
FAST-MAX
CONGEST-COUGH
ORAL LIQUID
TUSICOF ORAL
TABLET
1
TUSNEL NEW
FORMULA ORAL
SOLUTION
1
TUSNEL NEW
FORMULA ORAL
TABLET
3
TUSNEL PEDIATRIC
ORAL LIQUID
3
MUCINEX
FAST-MAX
CONGEST-COUGH
ORAL TABLET
3
this table.
508
Drug Name
/Limits
TUSNEL-DM
PEDIATRIC
1
TUSSIN CF
1
TUSSIN CF
COUGH-COLD
1
TUSSIN CF MAX
3
TUSSIN
COLD-CONGESTION
Drug Name
/Limits
CHEST
CONGESTION-COUG
H RELIEF
1
CHILD CHEST
CONGESTION +
COUGH
1
3
CHILD DELSYM
COUGH+CHEST DM
3
TUSSI-PRES
3
CHILD MUCUS
RELIEF COUGH
1
TUSSI-PRES
PEDIATRIC
3
CHILD TRIAMINIC
COUGH-CONGEST
3
TUSSLIN
3
CHILDREN'S COUGH
1
VANACOF DM
3
CHILDREN'S
MUCINEX COUGH
1
CORICIDIN HBP
ORAL CAPSULE
1
COUGH CONTROL
DM MAX
1
COUGH CONTROL
DM ORAL LIQUID
1
COUGH CONTROL
DM ORAL SYRUP
3
COUGH FORMULA
DM
1
COUGH
SUPPRESSANT-EXPE
CTORANT
1
COUGH SYRUP DM
1
DELSYM
COUGH+CHEST
CONGEST DM
3
1
WAL-TUSSIN COUGH
AND COLD CF
1
NON-NARCOTIC
ANTITUSSIVE-EXP
ECTORANT
COMBINATIONS
ADT ROBITUSSIN
PEAK CLD DM MAX
ADULT COUGH
FORMULA DM MAX
ADULT ROBITUSSIN
PEAK COLD DM
1
1
1
ADULT TUSSIN
COUGH CONGEST
DM
1
ADULT TUSSIN DM
1
ADULT WAL-TUSSIN
DM MAX
1
ALKA-SELTZER
PLUS
MUCUS-CONGES
3
dextromethorphan-guaif
enesin
ALLFEN DM
3
DIABETIC
SILTUSSIN-DM
1
ANTITUSSIVE DM
1
BIOCOTRON
1
1
BIOSPEC DMX
3
DIABETIC
SILTUSSIN-DM MAX
STR
CHEST CONGESTION
RELIEF + DM
1
DIABETIC TUSSIN
DM
1
this table.
509
Drug Name
/Limits
DIABETIC TUSSIN
MAX ST
1
DM MAX
Drug Name
/Limits
REFENESEN DM
1
RI-TUSSIN DM
3
1
ROBAFEN DM
1
FENESIN DM IR
ORAL TABLET 15-400
MG
3
ROBAFEN DM
COUGH
1
GERI-TUSSIN DM
3
G-TRON
1
3
GUAIASORB DM
3
ROBITUSSIN
COUGH-CHEST
CONG DM ORAL
CAPSULE
GUAICON DMS
3
SAFE TUSSIN DM
1
GUAIFENESIN-DM
1
3
G-ZYNCOF
1
SCOT-TUSSIN
SENIOR
INTENSE COUGH
RELIEVER ORAL
LIQUID 20-300 MG/5
ML
SILTUSSIN DM DAS
1
SILTUSSIN-DM
1
3
SORBUGEN NR
3
SORBUTUSS
1
IOPHEN DM-NR
1
SUPRESS DM
3
MUCINEX COUGH
MINI-MELTS
1
TAB TUSSIN DM
3
MUCINEX DM
1
3
MUCINEX
FAST-MAX DM MAX
1
TRISPEC DMX ORAL
LIQUID 10-187 MG/5
ML
TUSNEL DIABETIC
1
MUCOSA DM
1
TUSSIN COUGH DM
1
MUCUS AND COUGH
RELIEF
1
1
MUCUS DM
1
TUSSIN
COUGH-CHEST
CONGESTION
MUCUS DM MAX
1
TUSSIN DM CLEAR
1
MUCUS RELIEF
COUGH
1
TUSSIN DM COUGH
1
MUCUS RELIEF DM
1
TUSSIN DM COUGH
AND CHEST
1
MUCUS RELIEF DM
MAX
1
3
NEO-TUSS
1
TUSSIN DM MAX
ORAL LIQUID 10-100
MG/5 ML
TUSSIN DM MAX
ORAL LIQUID 10-200
MG/5 ML
1
TUSSIN DM ORAL
LIQUID
1
PECGEN DMX ORAL
LIQUID 10-187 MG/5
ML
3
PECGEN DMX ORAL
LIQUID 15-125 MG/5
ML
1
Q-TUSSIN DM
1
this table.
510
Drug Name
/Limits
TUSSIN DM ORAL
SYRUP 10-100 MG/5
ML
1
TUSSIN DM ORAL
TABLET
1
VICKS DAYQUIL
MUCUS CONTROL
DM
3
VICKS NATURE
FUSION
COUGH-CONG
3
WAL-TUSSIN DM
1
ZYNCOF ORAL
LIQUID
1
PLEURAL
SCLEROSING
AGENTS
SCLEROSOL
INTRAPLEURAL
3
sterile talc
3
PULMONARY
FIBROSIS
TREATMENT
AGENTS ANTIFIBROTIC
THERAPY
ESBRIET
NF
PULMONARY
FIBROSIS
TREATMENT
AGENTS MULTIKINASE
INHIBITORS
OFEV
NF
SYSTEMIC
SYMPATHOMIME
TIC
DECONGESTANTS
12 HOUR COLD
RELIEF
3
Drug Name
/Limits
12 HOUR
DECONGESTANT
3
CHILDREN'S
SILFEDRINE
3
CHILDREN'S
SUDAFED
3
CHILDREN'S
SUDAFED PE NASAL
3
1
1
MEDI-PHENYL
3
NASAL
DECONGESTANT
(PE) ORAL TABLET
10 MG
1
NASAL
DECONGESTANT
(PSEUDOEPH) ORAL
LIQUID
3
NASAL
DECONGESTANT
(PSEUDOEPH) ORAL
TABLET
1
NASAL
DECONGESTANT
(PSEUDOEPH) ORAL
TABLET EXTENDED
RELEASE
3
NEXAFED
3
PEDIA RELIEF
INFANT NASAL
3
pseudoephedrine hcl
(bulk) powder
1
pseudoephedrine hcl
oral liquid
3
pseudoephedrine hcl
oral tablet
1
pseudoephedrine hcl
release
3
SINUS 12 HOUR
3
this table.
511
Drug Name
SINUS AND
ALLERGY
NON-DROWSY
/Limits
3
SINUS
DECONGESTANT
(PE)
1
SUDAFED
3
SUDAFED 12 HOUR
3
SUDAFED 24 HOUR
3
SUDOGEST
1
SUDOGEST 12-HOUR
3
SUDOGEST PE
Drug Name
/Limits
VAGICREAM
TOPICAL CREAM 5-2
%
1
VAGINAL ITCH
3
VAGISIL TOPICAL
CREAM
1
VAGINAL
ANTIBACTERIAL LINCOSAMIDES
CLEOCIN VAGINAL
CREAM
3
1
1
SUPHEDRIN 12
HOUR
CLEOCIN VAGINAL
SUPPOSITORY
3
1
SUPHEDRIN ORAL
LIQUID
vaginal
3
CLINDESSE
3
SUPHEDRIN ORAL
TABLET
1
SUPHEDRINE
1
VAGINAL
ANTIBACTERIAL SULFONAMIDES
AVC VAGINAL
SUPHEDRINE 12
HOUR
3
SUPHEDRINE PE
1
WAL-PHED 12 HOUR
3
WAL-PHED ORAL
TABLET 30 MG
1
VAGINAL
ANTIFUNGAL IMIDAZOLES
1-DAY
3
1
3 DAY VAGINAL
1
WAL-PHED PE
1
3-DAY VAGINAL
1
ZEPHREX-D
3
CLOTRIMAZOLE 3
DAY
1
clotrimazole vaginal
cream
1
clotrimazole vaginal
tablet
3
CLOTRIMAZOLE-3
1
CLOTRIMAZOLE-7
1
GYNAZOLE-1
3
GYNE-LOTRIMIN
1
GYNE-LOTRIMIN 7
1
MICONAZOLE 7
1
VAGINAL
PRODUCTS
VAGINAL
ANESTHETIC
COMBINATIONS
ANTI-ITCH
(BENZ-RESOR)
1
VAGICAINE
1
VAGICREAM
TOPICAL CREAM
5-0.13 %
3
this table.
512
Drug Name
/Limits
Drug Name
/Limits
miconazole nitrate
vaginal comb
pack,prefill appl, cream
3
miconazole nitrate
vaginal cream
1
miconazole nitrate
vaginal kit 1,200-2
mg-%
3
miconazole nitrate
vaginal suppository
1
MICONAZOLE-3
PREFIL,CREAM,WIPE
3
MICONAZOLE-3
VAGINAL KIT
3
VAGINAL
ANTISEPTIC
MIXTURES
MICONAZOLE-3
VAGINAL
SUPPOSITORY
3
1
DOUCHE VINEGAR
AND WATER EXTRA
FEM PH
3
MONISTAT 1 COMBO
PACK
3
RELAGARD
3
TRIMO-SAN JELLY
1
MONISTAT 3
VAGINAL CREAM
3
VAGINAL
ANTISEPTICS
MONISTAT 3
VAGINAL KIT
3
DOUCHE VINEGAR
AND WATER EXTRA
3
MONISTAT 7
3
EXTRA CLEANSING
DOUCHE
3
FEMININE CARE
DOUCHE
3
MEDICATED
DOUCHE
1
povidone-iodine vaginal
solution 0.3 %
3
SUMMER'S EVE
DISPOSABLE
DOUCHE VAGINAL
SOLUTION
3
SUMMER'S EVE
DOUCHE
1
SUMMERS EVE
EXTRA CLEANSING
3
MONISTAT 7
CREAM, APPL,
WIPES
3
tioconazole
3
TIOCONAZOLE-1
3
VAGISTAT-1
3
VAGISTAT-3
3
VAGINAL
ANTIFUNGAL TRIAZOLES
TERAZOL 3
VAGINAL CREAM
3
TERAZOL 7
3
terconazole
1
VAGINAL
ANTIPROTOZOAL
-ANTIBACTERIAL
- NITROIMIDAZOL
E DERIVATIVES
METROGEL
VAGINAL
1
metronidazole vaginal
1
NUVESSA
3
VANDAZOLE
1
this table.
513
Drug Name
/Limits
VAGINAL
DOUCHE
PRODUCTS
Drug Name
/Limits
SAUGELLA
3
SUMMER'S EVE
FEMININE WASH
1
FRESH SCENT
DOUCHE
3
VAGINAL
PROGESTINS
ROMANTIC MIST
DOUCHE
3
CRINONE VAGINAL
GEL 4 %
SUMMER'S EVE
3
SUMMER'S EVE
DISPOSABLE
DOUCHE VAGINAL
SOLUTION
3
TROPICAL BREEZE
DOUCHE
3
3
VAGINAL
ESTROGENS
ESTRACE VAGINAL
1
ESTRING
1
FEMRING
3
PREMARIN
VAGINAL
1
VAGIFEM
1
VAGINAL
LUBRICANTS &
MOISTURIZERS
LONG LASTING
VAGINAL MOIST
3
REPHRESH
3
REPLENS
3
SILKY
LUBRICATING
MOISTURIZER
3
VAGINAL
PRODUCTS
MISCELLANEOUS
CLEANSING WASH
TOPICAL SOLUTION
1
FEMININE WASH
1
LUBRIN
1
NORFORMS FEM
3
this table.
514
this table.
515
Index
Index
Index
Index
(d)-limonene flavor (bulk)
A AND D ZINC OXIDE CREAM
................................................................................................... 185
A THRU Z .............................................................. 235
A THRU Z ADVANCED
FORMULA ........................................................... 242
A THRU Z HIGH POTENCY
................................................................................................... 222
A THRU Z MEN'S ULTIMATE
................................................................................................... 235
A THRU Z SELECT ............... 222, 235
A THRU Z SELECT 50+
FORMULA ........................................................... 235
A THRU Z SELECT WOMEN'S
................................................................................................... 235
A.E.R TRAVELER ................................... 168
A.E.R. WITCH HAZEL .................... 168
A.I.R.S NEBULIZER
REPLACEMENT ........................ 376, 385
abacavir .......................................................................... 45
abacavir-lamivudine-zidovudine
....................................................................................................... 46
ABANEU-SL ..................................... 261, 262
ABATRACE ........................................................... 13
ABATRON AF ............................................... 227
ABATUSS DMX ......................................... 503
ABC PLUS ............................................................ 235
ABELCET .................................................................. 42
ABILIFY ........................................................... 97, 99
ABILIFY MAINTENA .......................... 97
ABLAVAR ............................................................ 205
ABRAXANE .......................................................... 61
ABREVA ................................................................. 168
ABSORBASE ................................................... 170
ABSORBENT COTTON BALLS
................................................................................... 318, 385
ABSORBINE JR. ORIGINAL
................................................................................................... 192
ABSORBINE PAIN RELIEVING
................................................................................................... 194
ABSORICA .......................................................... 155
ABSTRAL .................................................................. 20
acacia (bulk) ........................................................ 107
acai berry extract ............................................. 13
ACAI WEIGHT CONTROL ......... 13
acamprosate ......................................................... 105
ACANYA ................................................................ 156
acarbose ..................................................................... 268
ACCOLATE ........................................................ 491
ACCU-CHEK AVIVA
CONNECT METER ............... 330, 385
ACCU-CHEK AVIVA
CONTROL SOLN ...................... 330, 385
ACCU-CHEK AVIVA PLUS
METER ....................................................... 330, 385
ACCU-CHEK COMBO SYSTEM
................................................................................... 329, 385
ACCU-CHEK COMP BLUE
CONT, M-H ......................................... 330, 385
ACCU-CHEK COMPACT PLUS
CARE ............................................................. 330, 385
ACCU-CHEK COMPACT PLUS
CONTROL ............................................. 330, 385
ACCU-CHEK FASTCLIX
................................................................................... 330, 385
ACCU-CHEK LINKASSIST INS
DEV .................................................................. 375, 385
ACCU-CHEK MULTICLIX
LANCET ................................................... 330, 385
ACCU-CHEK NANO ........... 330, 385
ACCU-CHEK RAPID D
INFUSION ............................................. 380, 385
ACCU-CHEK SAFE-T-PRO
................................................................................... 330, 385
ACCU-CHEK SMARTVIEW
CONTRL SOL ................................. 330, 385
ACCU-CHEK SOFTCLIX
LANCET DEV ................................ 330, 386
ACCU-CHEK SOFTCLIX
LANCETS .............................................. 330, 386
ACCU-CHEK SPIRIT ADAPTER
................................................................................... 375, 386
ACCU-CHEK SPIRIT
CARTRIDGE SYS .................... 375, 386
ACCU-CHEK TENDER
................................................................................... 380, 386
ACCU-CHEK ULTRAFLEX
................................................................................... 380, 386
ACCU-CHEK VOICEMATE
................................................................................... 330, 386
ACCUPRIL ............................................................... 72
ACCURETIC ......................................................... 71
ACCUTREND CHOLESTEROL
CONTROL ............................................. 205, 386
ACCUTREND CHOLESTEROL
TEST ............................................................... 205, 386
ACCUTREND GLUCOSE
CONTROL ............................................. 330, 386
ACCUTREND PLUS ............ 205, 386
ACD ................................................................................. 303
ACD-A ......................................................................... 303
ACE AEROSOL CLOUD
ENHANCER ....................................... 376, 386
ACE ANKLE BRACE ......... 321, 386
ACE ELBOW BRACE ....... 321, 386
ACE KNEE BRACE .............. 321, 386
acebutolol ..................................................................... 79
acebutolol (bulk) ........................................... 107
ACEON ........................................................................... 72
106, 143
1,2-pentanediol (bulk) ........................... 106
1,3-butanediol (bulk) .................. 64, 106
1,4-benzoquinone (bulk) .................... 106
12 HOUR COLD RELIEF ............. 511
12 HOUR DECONGESTANT
................................................................................................... 511
12 HOUR NASAL RELIEF
SPRAY ........................................................................ 499
12 HOUR NASAL SPRAY ......... 499
1-DAY .......................................................................... 512
1ST BASE .............................................. 106, 140
1ST RELIEF ........................................................ 182
1ST TIER UNIFINE PENTIPS
................................................................................... 349, 385
1ST TIER UNIFINE PENTIPS
PLUS ............................................................... 349, 385
1ST TIER UNILET
COMFORTOUCH ..................... 330, 385
2-deoxy-d-glucose (bulk) ...... 47, 107
2-methoxyestradiol (bulk) ............... 107
2-methoxyethanol (bulk) .... 107, 138
2TEK CONTROL
(HIGH-NORMAL) .................... 330, 385
2TEK GLUCOSE/BLOOD
PRESSURE ........................... 319, 330, 385
3 DAY VAGINAL ..................................... 512
3,4-diaminopyridine (bulk)
................................................................................... 107, 464
3,5-diiodothyronine (bulk) ............. 107
30PSE-150GFN-15DM ...................... 507
3-DAY VAGINAL .................................... 512
3M NEXCARE DURAPORE
................................................................................... 316, 385
470V TWO WAY VALVE
................................................................................... 356, 385
4-N-1 NO RINSE WASH
................................................................................... 186, 190
50+ ADULT EYE HEALTH
....................................................................................... 11, 235
5-AMINOSALICYLIC ACID
................................................................................................... 107
5-HTP ................................................................................. 12
5-HYDROXY-L-TRYPTOPHAN
................................................................................................... 107
5-hydroxytryptophan (5-htp) ........... 13
7-KETO DHEA .................................. 12, 107
7-KETO DHEA, MICRONIZED
....................................................................................... 12, 107
8 HOUR PAIN RELIEVER ............ 25
8-MOP .......................................................................... 167
A + D (LAN, PET) .................................... 170
...................................................................................
516
Index
Index
Index
ACEPHEN ................................................................. 25
acepromazine maleate (bulk)
....................................................................................... 96, 107
ACERFLEX ......................................................... 246
ACEROLA C-500 ....................................... 264
acesulfame potassium (bulk)
................................................................................... 107, 221
ACETADOTE ...................................................... 38
ACETADRYL .................................................. 476
ACETA-GESIC .............................................. 476
acetaminophen ..................................................... 25
acetaminophen (bulk) ................ 25, 107
ACETAMINOPHEN EXTRA
STRENGTH ............................................................. 25
ACETAMINOPHEN PM ................ 476
ACETAMINOPHEN PM EXTRA
STR .................................................................................... 476
acetaminophen-codeine .......................... 22
acetarsol (bulk) ............................................... 107
ACETASOL HC ........................................... 474
acetazolamide ........................................................ 83
acetazolamide (bulk) ............................... 107
acetazolamide sodium ............................... 83
ACETEST ............................................... 385, 386
acetic acid ............................................... 299, 474
acetic acid (bulk) .......................... 107, 138
acetic acid-aluminum acetate .... 474
acetone ......................................................................... 138
acetyl hexapeptide-8 (bulk) ........... 107
acetylcarnitin hcl-a lipoic ac .......... 13
acetylcarnitine .................................................. 209
acetylcarnitine (bulk) ................. 13, 107
acetylcholine chloride (bulk) ...... 107
acetylcysteine ......... 38, 210, 214, 496
acetylcysteine (bulk) .... 38, 107, 496
ACETYL-L-CARNITINE ............. 107
ACID CONTROL (RANITIDINE)
................................................................................................... 286
ACID CONTROLLER ........................ 286
ACID CONTROLLER
COMPLETE ........................................................ 287
ACID GONE ANTACID ................. 279
ACID GONE ANTACID
E.STRENGTH .................................................. 279
ACID REDUCER (CIMETIDINE)
................................................................................................... 286
ACID REDUCER
(FAMOTIDINE) ........................................... 286
ACID REDUCER (RANITIDINE)
................................................................................................... 286
ACID REDUCER COMPLETE
(FAMOT) ................................................................. 287
ACID RELIEF (CIMETIDINE)
................................................................................................... 286
ACIDOPHILUS ............................................. 290
ACIDOPHILUS EX STR (L.
SPOROG) ................................................................ 290
ACIDOPHILUS PROBIOTIC
................................................................................................... 290
ACIDOPHILUS PROBIOTIC
BLEND ........................................................................ 290
ACIDOPHILUS-PECTIN .............. 283
acidophilus-pectin, citrus ................. 290
ACIPHEX ................................................................ 286
ACIPHEX SPRINKLE ....................... 286
acitretin ....................................................................... 167
ACLARO ................................................................. 169
ACNE CLEANSER ................................. 157
ACNE CLEANSING BAR ........... 158
ACNE CLEANSING PADS ....... 158
ACNE CONTROL CLEANSER
................................................................................................... 158
ACNE FOAMING WASH ............ 158
ACNE MEDICATION ........................ 158
ACNE PADS ...................................................... 158
ACNE SPOT TREATMENT
................................................................................... 158, 180
ACNE TREATMENT
(BENZOYL PEROX) ........................... 158
ACNE VANISHING .............................. 158
ACNE-CLEAR ................................................ 158
ACNOMEL ........................................................... 157
ACTA-TABS PE .......................................... 476
ACTEMRA ............................................................... 29
ACTHAR H.P. ................................................. 267
ACTHIB (PF) ........................................................ 69
ACTHREL ............................................................. 207
ACTICAL ................................................................ 235
ACTICLATE .......................................................... 54
ACTICOAT 7 DRESSING ........... 198
ACTICOAT ABSORBENT ........ 198
ACTICOAT DRESSING ................. 198
ACTICOAT FLEX 3 DRESSING
................................................................................................... 198
ACTICOAT FLEX 7 DRESSING
................................................................................................... 198
ACTICOAT MOISTURE
CONTROL ............................................................. 198
ACTICOAT SITE ....................................... 198
ACTIDOSE/SORBITOL ..................... 38
ACTIDOSE-AQUA ..................................... 39
ACTIGALL .......................................................... 286
ACTIMMUNE ..................................................... 43
ACTIQ .............................................................................. 20
ACTIVASE ........................................................... 310
activated charcoal ........................................... 39
activated charcoal (bulk) ..................... 39
ACTIVE CATH ............................. 382, 386
ACTIVE FE .......................................................... 227
ACTIVE LIFE 1-PC CL-END
POUCH ....................................................... 367, 386
ACTIVE LIFE 1-PC STOMA
CAP ................................................................... 367, 386
ACTIVE LIFE CLOSED-END
POUCH ....................................................... 367, 386
ACTIVE LIFE CONVEX DRAIN
POUCH ....................................................... 367, 386
ACTIVE LIFE CONVEX
UROSTOMY ..................................... 367, 386
ACTIVE LIFE CUT-TO-FIT
CLOSED ................................................... 367, 386
ACTIVE LIFE DRAINABLE
POUCH ....................................................... 367, 386
ACTIVE LIFE PRE-CUT
CLOSED END ................................. 367, 386
ACTIVE LIFE PRE-CUT
DRAINABLE .................................... 367, 386
ACTIVE LIFE UROSTOMY
POUCH ....................................................... 367, 386
ACTIVE OB ........................................................ 255
ACTIVE Q ................................................................. 13
ACTIVELLA ..................................................... 272
ACTONEL ............................................................. 271
ACTOPLUS MET ...................................... 270
ACTOPLUS MET XR ......................... 270
ACTOS ........................................................................ 276
ACUICYN .............................................................. 175
ACULAR ................................................................. 469
ACULAR LS ...................................................... 469
ACUVAIL (PF) .............................................. 469
ACUWASH .......................................................... 190
acyclovir ......................................................... 51, 168
acyclovir (bulk) ................................... 50, 107
acyclovir sodium ............................................... 51
ACZONE .................................................................. 156
ADACEL(TDAP
ADOLESN/ADULT)(PF) ................... 69
ADAGEN ................................................................. 456
ADALAT CC ......................................................... 81
adapalene ................................................................. 159
ADAPT BARRIER RING
................................................................................... 367, 386
ADAPT BARRIER STRIPS
................................................................................... 367, 386
ADAPT CONVEX BARRIER
RINGS .......................................................... 367, 386
ADAPT LUBRICATING
DEODORANT ................................. 368, 386
ADAPT OSTOMY PASTE
................................................................................... 368, 386
ADAPT PASTE ............................. 368, 386
ADAPT STOMA POWDER
................................................................................... 368, 386
adapter cap for bottle ............ 356, 386
517
Index
Index
Index
ADASUVE ................................................................ 96
ADAZIN .................................................................... 182
ADCETRIS ................................................... 57, 63
ADCIRCA .................................................................. 86
ADD-A-FOLEY
CATH-MONO-FLO DRNG
................................................................................... 382, 386
ADD-A-FOLEY
CATH-PRE-FILL SYRN
................................................................................... 382, 386
ADD-A-FOLEY TRAY .... 382, 386
ADDAMEL N ................................................... 234
ADDED STRENGTH
HEADACHE RELIEF ............................. 33
ADDED STRENGTH PAIN
RELIEVER ................................................................ 33
ADDERALL ............................... 97, 99, 103
ADDERALL XR .................................. 97, 99
ADDYI ......................................................................... 100
adefovir ............................................................................ 50
ADEMPAS ................................................................ 86
ADENOCARD .................................................... 75
adenos triph disod tri (bulk) ........ 107
ADENOSCAN ................................................. 207
adenosine ...................................................................... 75
adenosine (bulk) ............................................. 107
adenosine (diagnostic) ......................... 207
adenosine phosphate (bulk)
....................................................................................... 87, 107
ADENOSYLCOBALAMIN
................................................................................... 107, 262
adhesive bandage ......................... 314, 387
adhesive bandage-adhes remov#1
................................................................................... 314, 387
ADHESIVE BARRIER 2-PC
................................................................................... 368, 387
ADHESIVE BARRIERS
................................................................................... 368, 387
ADHESIVE GAUZE PAD
................................................................................... 314, 387
ADHESIVE PADS .................... 314, 387
adhesive remover .......................... 316, 387
adhesive tape ....................................... 316, 387
ADIPEX-P .............................................................. 209
ADJUSTABLE LANCING
DEVICE ..................................................... 330, 387
ADOXA ......................................................................... 55
ADRENACLICK ............................................. 82
ADRENALIN ........................ 82, 490, 499
ADRENOID ............................................................. 13
ADREVIEW ........................................................ 208
ADRUCIL ................................................................... 57
ADT ROBITUSSIN PEAK CLD
DM MAX ................................................................. 509
ADULT 50+ PROBIOTIC ............ 291
ADULT AEROSOL MASK
................................................................................... 376, 387
ADULT BRIEF - EXTRA LARGE
................................................................................... 341, 387
ADULT BRIEFS - LARGE
................................................................................... 341, 387
ADULT BRIEFS - MEDIUM
................................................................................... 341, 387
ADULT COUGH FORMULA DM
MAX ................................................................................ 509
ADULT DISPOSABLE
MOUTHPIECE ............................... 376, 387
ADULT LOW DOSE ASPIRIN
....................................................................................... 33, 309
ADULT MULTIVITAMIN
GUMMIES ............................................................. 235
ADULT ONE DAILY GUMMIES
................................................................................................... 235
ADULT PROBIOTIC ........................... 291
ADULT ROBITUSSIN NIGHT
M-S CLD .................................................................. 478
ADULT ROBITUSSIN PEAK
COLD DM .............................................................. 509
ADULT ROBITUSSIN PEAK
COLD M-S ............................................................ 507
ADULT TUSSIN CHEST
CONGESTION ............................................... 495
ADULT TUSSIN COUGH
CONGEST DM ............................................... 509
ADULT TUSSIN DM .......................... 509
ADULT TUSSIN MULTI-SYMP
COLD ............................................................................. 507
ADULT WAL-TUSSIN .................... 495
ADULT WAL-TUSSIN DM MAX
................................................................................................... 509
ADVAIR DISKUS .................................... 493
ADVAIR HFA ................................................. 493
ADVANCE PLUS
INTERMITTENT ........................ 382, 387
ADVANCED AM-PM ........................ 235
ADVANCED
ANTACID-ANTIGAS ......................... 281
ADVANCED ANTIBACTERIAL
BANDAGE ........................................... 314, 387
ADVANCED CALCIUM ............... 223
ADVANCED DNA MEDICATED
COLLECT .............................................................. 459
ADVANCED EYE HEALTH
................................................................................................... 214
ADVANCED EYE RELIEF ....... 464
ADVANCED EYE RELIEF
(MO-WPET) ........................................................ 464
ADVANCED FORMULA EYE
DROPS ........................................................................ 469
ADVANCED GLUCOSE METER
................................................................................... 330, 387
ADVANCED HEALING ................ 186
ADVANCED HEALING
(PETROLATUM) ....................................... 186
ADVANCED LANCING
DEVICE ..................................................... 330, 387
ADVANCED PROBIOTIC ......... 291
ADVANCED RECOVERY ........ 170
ADVANCED TRAVEL
LANCETS .............................................. 330, 387
ADVANCED WOUND ..................... 198
ADVANTAGE WITH IRON .... 218
ADVATE ................................................................. 305
ADVICOR .................................................................. 76
ADVIL ............................................................................. 31
ADVIL ALLERGY SINUS ......... 475
ADVIL
ALLERGY-CONGESTION RLF
................................................................................................... 475
ADVIL COLD AND SINUS ..... 495
ADVIL CONGESTION RELIEF
................................................................................................... 495
ADVIL LIQUI-GEL ................................... 31
ADVIL MIGRAINE ................................... 31
ADVIL PM ................................................................ 30
ADVIL PM LIQUI-GELS ................. 30
ADVOCATE BLOOD GLUCOSE
MONITOR ............................................. 330, 387
ADVOCATE CONTROL
SOLUTION HIGH .................... 330, 387
ADVOCATE DUO ... 319, 330, 387
ADVOCATE DUO METER
................................................................... 319, 330, 387
ADVOCATE LANCET ..... 331, 387
ADVOCATE LANCING DEVICE
................................................................................... 331, 387
ADVOCATE LOW CONTROL
................................................................................... 331, 387
ADVOCATE PEN NEEDLES
................................................................................... 349, 387
ADVOCATE RAPID-SAFE
LANCING .............................................. 331, 387
ADVOCATE REDI-CODE DUO
METER ....................................... 319, 331, 387
ADVOCATE REDI-CODE GLU
MONITOR ............................................. 331, 387
ADVOCATE REDI-CODE+
................................................................................... 331, 387
ADVOCATE REDI-CODE+
CTRL HIGH ........................................ 331, 388
ADVOCATE REDI-CODE+
CTRL LOW .......................................... 331, 388
ADVOCATE SYRINGES
................................................................................... 349, 388
518
Index
Index
Index
AEROBIKA OSCILLATING PEP
SYSTM ........................................................ 377, 388
AEROCHAMBER MINI
................................................................................... 377, 388
AEROCHAMBER MV ...... 377, 388
AEROCHAMBER PLUS
FLOW-VU ............................................. 377, 388
AEROCHAMBER PLUS
FLOW-VU,L MSK ................... 377, 388
AEROCHAMBER PLUS
FLOW-VU,M MSK ................. 377, 388
AEROCHAMBER PLUS
FLOW-VU,S MSK .................... 377, 388
AEROCHAMBER PLUS Z STAT
LG MSK .................................................... 377, 388
MD MSK .................................................. 377, 388
SM MSK ................................................... 377, 388
AEROCHAMBER WITH
FLOWSIGNAL .............................. 377, 388
AEROCHAMBER Z-STAT
PLUS-FLW SG ............................... 377, 388
AEROECLIPSE II NEBULIZER
................................................................................... 359, 388
AEROGEAR ACTION ASTHMA
KIT ..................................................................... 376, 388
AERONEB GO ............................... 377, 388
AERONEB GO NEBULIZER
................................................................................... 359, 388
AEROSPAN ........................................................ 490
AEROTRACH PLUS ............ 377, 388
AF ........................................................................................ 164
AFEDITAB CR .................................................. 81
AFINITOR ................................................................. 60
AFINITOR DISPERZ ............................... 60
AFLEXERYL-LC ....................................... 182
AFLEXERYL-MC ..................................... 192
AFLURIA 2015-2016 ............................... 70
AFLURIA 2015-2016 (PF) ............... 70
AFREZZA .............................................................. 275
AFRIN (OXYMETAZOLINE)
................................................................................................... 499
AFRIN NO
DRIP(OXYMETAZOLIN) ........... 499
AFTERA ................................................................... 155
AGAMATRIX AMP GLUC
MONITOR SYS ............................ 331, 388
AGAMATRIX CONTROL HIGH
................................................................................... 331, 388
AGAMATRIX CONTROL
NORM-HI ............................................... 331, 388
AGGRASTAT IN SODIUM
CHLORIDE .......................................................... 308
AGGRENOX ..................................................... 308
AGIE-GRX ............................................ 324, 388
AGRYLIN .............................................................. 309
AHIST (CHLORCYCLIZINE)
................................................................................................... 483
A-HYDROCORT ........................................ 273
AIMSCO ................................................... 355, 388
AIR PERMEABLE UNDERPAD
................................................................................... 341, 388
AIR TUBE WITH AIR PLUGS
................................................................................... 377, 388
AIRBORNE (WITH LYSINE
ACETATE) ............................................................... 13
AIRS ADULT AEROSOL MASK
................................................................................... 377, 388
AIRS DISPOSABLE
NEBULIZER ...................................... 359, 388
AIRS PEDIATRIC DISPOSABLE
MASK ........................................... 323, 356, 388
AIRSHIELD ........................................ 214, 235
AIRZONE PEAK FLOW METER
................................................................................... 376, 388
AK-FLUOR .......................................................... 470
AK-POLY-BAC ............................................ 472
AKTEN (PF) ....................................................... 471
AKWA TEARS (POLYVINYL
ALCOHOL) ......................................................... 465
AKYNZEO ............................................................ 285
ALA-CORT .......................................................... 175
ALA-HIST DM ............................................... 503
ALA-HIST IR ................................... 481, 483
ALA-HIST PE .................................................. 476
alanine (bulk) ..................................................... 107
ALA-QUIN ........................................................... 161
ALA-SCALP ...................................................... 175
ALA-SEB ................................................................. 179
ALA-SEB-T ......................................................... 167
ALAVERT ............................................................. 487
ALAVERT D-12
ALLERGY-SINUS ................................... 480
ALAWAY ............................................................... 468
ALBA-DERM ................................... 107, 140
ALBA-LYBE ..................................................... 211
albendazole (bulk) ....................................... 107
ALBENZA ................................................................. 42
ALBUKED-25 ................................................. 307
ALBUKED-5 ..................................................... 307
albumin, bovine (bulk) .......................... 107
albumin, human 25 % ............................ 307
albumin, human 5 % ................................ 307
ALBUMINAR 25 % ............................... 307
ALBUMINAR 5 % ................................... 307
ALBURX (HUMAN) 25 % ......... 307
ALBURX (HUMAN) 5 % ............. 307
ALBUSTIX REAGENT ... 206, 388
ALBUTEIN 25 % ........................................ 307
ALBUTEIN 5 % ............................................ 307
albuterol sulfate .............................................. 492
albuterol sulfate (bulk) ......................... 107
ALCAINE ............................................................... 471
ALCALAK ............................................................ 280
alclometasone .................................................... 175
ALCOH-GLOVE ............................. 67, 323
ALCOHOL PADS .......................................... 64
ALCOHOL PREP PADS .................... 64
ALCOHOL PREP SWABS ............. 64
alcohol swabs ......................................................... 64
ALCOHOL WIPES ...................................... 64
ALCOHOL, DENATURED ....... 138
ALCOHOL, RUBBING .................... 138
ALCOHOL-BENZOCAINE
....................................................................................... 64, 182
ALCOH-WIPE ..................................... 67, 323
ALCORTIN A .................................................. 161
ALDACTAZIDE .............................................. 84
ALDACTONE ......................................... 72, 83
ALDARA ................................................................. 179
aldosterone (bulk) ....................... 107, 277
ALDURAZYME .......................................... 456
alendronate ............................................................ 271
ALERTNESS AID ..................................... 100
ALEVAZOL ........................................................ 163
ALEVE ............................................................................ 31
ALEVE COLD AND SINUS .... 495
ALEVE PM ............................................................... 30
ALEVE SINUS AND
HEADACHE ...................................................... 495
ALEVE-D SINUS AND COLD
................................................................................................... 495
ALEVE-D SINUS AND
HEADACHE ...................................................... 495
ALEVICYN ANTIPRURITIC
................................................................................... 192, 204
ALEVICYN ANTIPRURITIC SG
................................................................................................... 170
ALEVICYN DERMAL ...................... 198
alfalfa ................................................................................. 13
ALFALFA FLAVOR ............ 107, 143
ALFENTA .................................................................. 20
alfentanil ........................................................................ 20
ALFERON N ...................................................... 179
alfuzosin ..................................................................... 300
ALGAL OMEGA-3 DHA .................. 78
ALGAL-900 DHA ......................................... 78
ALGICELL AG .............................................. 198
alginic acid (bulk) ....................................... 107
ALGISITE M ..................................................... 198
ALIGN ......................................................................... 291
ALIMTA ....................................................................... 57
ALINIA ........................................................................... 44
519
Index
Index
Index
ALIVE WOMEN'S ENERGY
ALL DAY RELIEF ...................................... 31
ALL FLOW 1000 KIT ......... 377, 388
ALL FLOW 1000 PFT FILTER
................................................................................... 377, 388
ALL FLOW 3000 KIT ......... 377, 388
................................................................................... 377, 388
ALL FLOW 4000 KIT ......... 377, 388
................................................................................... 377, 388
ALL FLOW 5000 KIT ......... 377, 388
................................................................................... 377, 389
................................................................................... 377, 389
ALL GEL BUNION TOE
SPREADER ......................................... 324, 389
ALL PURPOSE CLOTH TAPE
................................................................................... 316, 389
allantoin (bulk) ................................................ 107
ALLEGRA ALLERGY ...................... 487
ALLEGRA INTENSIVE RELIEF
................................................................................................... 166
ALLEGRA-D 12 HOUR .................. 480
ALLEGRA-D 24 HOUR .................. 480
aller ext tree pollen-am elm ............. 67
aller ext-alternaria alternata ......... 67
aller ext-american cockroach ........ 67
aller ext-tree pollen-mt.cedar ........ 67
aller xt-tree pol-e.cottonwood ....... 67
ALLER-CHLOR ........................... 481, 483
ALLERCLEAR .............................................. 487
ALLERCLEAR D-12HR ................. 480
ALLERCLEAR D-24HR ................. 480
ALLER-EASE .................................................. 487
ALLER-FEX ....................................................... 487
allergen ext-aspergillus fumig ...... 67
allergenic ext-dog epithelium ........ 67
allergenic ext-mixed ragweed ....... 67
ALLERGIST PACKAGE
1CC/26GX1/2" ................................ 360, 389
ALLERGIST PACKAGE
1CC/26GX3/8" ................................ 360, 389
ALLERGIST SYRINGE
................................................................................... 360, 389
ALLERGIST TRAY 1/2 ML
27GX3/8" ................................................. 360, 389
ALLERGIST TRAY
INTRADERMAL BEV ...... 360, 389
ALLERGIST TRAY REGULAR
BEVEL ......................................................... 360, 389
ALLER-G-TIME .......................... 481, 483
ALLERGY
(CHLORPHENIRAMINE)
................................................................................... 481, 483
ALLERGY
(DIPHENHYDRAMINE)
235
ALIVE WOMEN'S GUMMY
VITAMINS ........................................................... 235
ALIVIO ....................................................................... 193
ALKALINE BATTERIES
................................................................................... 331, 388
ALKA-SELTZER ........................................... 33
ALKA-SELTZER EXTRA
STRENGTH ............................................................. 33
ALKA-SELTZER GOLD ............... 279
ALKA-SELTZER HEARTBURN
................................................................................................... 279
ALKA-SELTZER ORIGINAL ... 33
ALKA-SELTZER PLUS
ALLERGY ............................................. 103, 483
ALKA-SELTZER PLUS
C/C(PE,DM) ........................................................ 502
ALKA-SELTZER PLUS COLD
(PE) .................................................................................... 479
ALKA-SELTZER PLUS
COLD/COUGHFM .................................. 501
ALKA-SELTZER PLUS
COLD+FLU ......................................................... 501
ALKA-SELTZER PLUS DAY
................................................................................................... 506
ALKA-SELTZER PLUS
DAY-NIGHT ..................................................... 502
ALKA-SELTZER PLUS FLU
................................................................................................... 501
ALKA-SELTZER PLUS
MUCUS-CONGES ................................... 509
ALKA-SELTZER PLUS NIGHT
................................................................................................... 501
ALKA-SELTZER PLUS NIGHT
(ASA) ............................................................................. 502
ALKA-SELTZER PLUS
SIN-ALLG-CGH .......................................... 501
ALKA-SELTZER PLUS
SINUS-COUGH ............................................ 506
ALKA-SELTZER PLUS-D
SINUS-COLD ................................................... 501
ALKERAN ................................................................ 56
alkyl (c12-15) benzoate (bulk)
................................................................................... 107, 149
alkyl acrylate crosspol (bulk) .... 107
ALL CLEAR AR ......................................... 467
ALL DAY ALLERGY
(CETIRIZINE) ................................. 486, 487
ALL DAY ALLERGY
RELIEF(CETIR) ........................... 486, 487
ALL DAY ALLERGY-D ................ 480
ALL DAY PAIN RELIEF .................. 31
ALL DAY PAIN RELIEF
SINUS,COLD ................................................... 495
...................................................................................................
520
481, 483
ALLERGY 4-HOUR .............. 481, 483
ALLERGY AND COLD PE ....... 478
ALLERGY AND CONGESTION
RELIEF ....................................................................... 480
ALLERGY AND SINUS RELIEF
................................................................................................... 476
ALLERGY COMPLETE-D ........ 480
ALLERGY CREAM
(DIPHENHYD, ZN) ................................ 166
ALLERGY CREAM
(DIPHENHYDRAMIN) .................... 192
ALLERGY D-12 ........................................... 480
ALLERGY EYE (KETOTIFEN)
................................................................................................... 468
ALLERGY EYE
(NAPHAZOLINE-PHEN) ............. 467
ALLERGY MEDICATION
................................................................................... 481, 483
ALLERGY MEDICINE .... 481, 483
ALLERGY M-S NIGHTTIME
................................................................................................... 478
ALLERGY MULTI-SYMPTOM
................................................................................................... 478
ALLERGY PLUS SEVERE
SINUS HA .............................................................. 478
ALLERGY RELIEF
(CETIRIZINE) ................................. 486, 487
ALLERGY RELIEF
(CLEMASTINE) .......................... 481, 483
ALLERGY RELIEF
(FEXOFENADINE) ................ 487, 488
ALLERGY RELIEF
(LORATADINE) ......................... 487, 488
ALLERGY RELIEF D12 ................ 480
ALLERGY RELIEF D-24 ............. 480
ALLERGY RELIEF
MULTI-SYMPTOM ............................... 478
ALLERGY RELIEF SPRAY .... 166
ALLERGY
RELIEF(CHLORPHENIRAMN)
................................................................................... 481, 483
ALLERGY
RELIEF(DIPHENHYDRAMIN)
................................................................................... 481, 483
ALLERGY RELIEF,NASAL
DECONGEST ................................................... 480
ALLERGY RELIEF-D
(CETIRIZINE) ................................................. 480
ALLERGY RELIEF-D
(LORATADINE) ......................................... 480
...................................................................................
Index
Index
Index
ALLERGY
RELIEF-D(FEXOFENADINE)
................................................................................................... 480
ALLERGY RELIEF-SINUS
HEADACHE ...................................................... 478
ALLERGY SINUS HEADACHE
(PE) .................................................................................... 478
ALLERGY SINUS PE ......................... 478
ALLERGY SINUS-D ........................... 478
ALLERGY+CONGESTION
RELIEF-D ............................................................... 480
ALLERGY-CONGESTION
RELIEF-D ............................................................... 480
ALLERGY-D ..................................................... 477
ALLERGY-SINUS ................................... 478
ALLERGY-TIME ....................... 481, 483
ALLERHIST-1 ................................ 481, 483
ALLER-TEC ....................................... 486, 488
ALLER-TEC D ............................................... 480
ALLEVYN ............................................. 199, 389
ALLEVYN ADHESIVE
DRESSING ........................................... 198, 389
ALLEVYN AG ADHESIVE ..... 198
ALLEVYN GENTLE BORDER
................................................................................... 199, 389
LITE ................................................................. 199, 389
SACRUM ................................................ 314, 389
ALLEVYN LIFE DRESSING
................................................................................... 199, 389
ALLEVYN SACRUM ......... 199, 389
ALLFEN .................................................................... 495
ALLFEN DM ..................................................... 509
ALLI ................................................................................ 209
ALLKARE ADHESIVE
REMOVER WIPES ................. 316, 389
ALLKARE PROTECT BARRIER
WIPES .......................................................... 368, 389
ALL-NITE COLD-FLU .................... 502
allopurinol .............................................................. 303
allopurinol (bulk) ......................................... 107
ALMACONE ..................................................... 281
ALMACONE-2 .............................................. 281
almond oil, sweet (bulk) ..... 107, 144
almotriptan malate ..................................... 102
ALOCRIL ................................................................ 471
ALOE BURN RELIEF ........................ 182
ALOE GRANDE .......................................... 170
aloe vera ........................................................ 13, 173
aloe vera (bulk) ............................................... 107
ALOE VERA LATEX GLOVES
................................................................................................... 329
aloe vera leaf gel xtr (bulk) ........... 107
ALOE VERA PAIN RELIEVING
................................................................................................... 182
ALOE VESTA ................................................. 186
ALOE VESTA ANTIFUNGAL
(MICON) .................................................................. 163
ALOE VESTA BODY
WASH/SHAMPOO ................................. 190
ALOE VESTA CLEANSING
................................................................................................... 190
ALOE VESTA PERINEAL ......... 190
ALOE VESTA SKIN
CONDITIONER 2 ...................................... 186
ALOMIDE ............................................................. 471
ALOPHEN ............................................................. 296
ALOPRIM .............................................................. 303
ALOQUIN .............................................................. 159
ALORA ....................................................................... 272
alosetron .................................................... 290, 292
ALOXI ......................................................................... 284
ALPAWASH ...................................... 107, 140
alpha lipoic acid ................................................ 11
alpha lipoic acid (bulk) ........... 11, 107
alpha pinene (bulk) .................... 107, 138
ALPHABATH .................................................. 170
ALPHAGAN P ................................................ 473
alpha-ketoglutaric acid (bulk)
....................................................................................... 11, 107
ALPHANATE .................................................. 305
ALPHANINE SD ........................................ 304
ALPHAQUIN HP ....................................... 169
ALPHASOFT .................................................... 170
alprazolam .................................................................. 87
alprazolam (bulk) ............................. 87, 107
ALPRAZOLAM INTENSOL ....... 87
ALPROLIX ........................................................... 305
alprostadil ................................................................... 85
alprostadil (bulk) .......................... 107, 475
ALREX ........................................................................ 468
ALSUMA ................................................................. 102
ALTABAX ............................................................ 160
ALTACAINE ..................................................... 471
ALTACE ....................................................................... 72
ALTACHLORE ............................................. 470
ALTAFLUOR ................................................... 471
ALTAMIST .......................................................... 499
ALTAVERA (28) ........................................ 152
ALTAZINE ........................................................... 470
ALTERA NEBULIZER .... 359, 389
ALTERA NEBULIZER SYSTEM
................................................................................... 359, 389
ALTERNATE SITE LANCING
DEVICE ..................................................... 331, 389
ALTOPREV ............................................................. 76
alum, ammonium (bulk) ...................... 107
aluminum acetate ......................................... 169
aluminum acetate (bulk) .................... 107
aluminum chloride (bulk) ................. 107
aluminum chlorohydrate (bulk)
................................................................................................... 107
aluminum hydroxide gel ..................... 279
aluminum hydroxide gel (bulk)
................................................................................... 108, 279
aluminum silicate mag (bulk)
................................................................................... 108, 279
aluminum sulfate (bulk) ...................... 108
aluminum, (acetato-o)dih(bulk)
................................................................................................... 108
ALUVEA ................................................................. 173
ALVESCO ............................................................. 490
ALYACEN 1/35 (28) ............................. 152
ALYACEN 7/7/7 (28) .......................... 154
amantadine hcl ..................................................... 94
amantadine hcl (bulk) ............................ 108
AMARYL ................................................................ 269
AMBER GLASS BOTTLE
................................................................................... 356, 389
AMBI 10PEH-4CPM ............................. 477
AMBI 10PEH-4CPM-20DM ..... 503
AMBI 20DM-4CPM ............................... 506
AMBI 40PSE-400GFN-20DM
................................................................................................... 507
AMBI 60PSE-400GFN ....................... 494
AMBI 60PSE-4CPM .............................. 477
AMBI 60PSE-4CPM-20DM ...... 503
AMBIEN ................................................................... 105
AMBIEN CR ...................................................... 105
AMBISOME ........................................................... 42
amcinonide ............................................................. 175
AMERGE ................................................................. 102
american ginseng root (bulk)
....................................................................................... 13, 108
AMERICERIN ................................................. 186
AMERIGEL ......................................................... 186
AMERIGEL DRESSING
................................................................................... 199, 389
AMERIGEL WOUND WASH
................................................................................................... 198
AMERIPHOR ................................................... 170
AMERISTORE ............................................... 173
AMERIWASH HAND SOAP ..... 66
AMETHIA ............................................................. 152
AMETHIA LO ................................................. 152
AMETHYST ....................................................... 152
AMICAR .................................................................. 305
AMIDATE ................................................................. 35
AMIELLE VAGINAL TRAINER
................................................................................... 356, 389
amifostine crystalline ................................. 64
amikacin ......................................................................... 41
amikacin (bulk) .................................... 41, 108
521
Index
Index
Index
amikacin sulfate (bulk) ......................... 108
amiloride ....................................................................... 84
amiloride-hydrochlorothiazide .... 84
AMINO ACID .................................................. 210
amino acids ........................................................... 210
AMINO ACIDS 15 % ........................... 251
AMINO ACTION ....................................... 210
aminobenzoic acid (bulk) ................. 108
aminocaproic acid ...................................... 305
aminocaproic acid (bulk)
................................................................................... 108, 305
aminolevulinic acid hcl (bulk)
................................................................................... 108, 185
aminophylline ..................................................... 491
aminophylline (bulk) ............................... 108
aminosalicylate sodium (bulk)
................................................................................................... 108
aminosalicylic acid (bulk) ............... 108
AMINOSALICYLIC ACID-5
................................................................................................... 108
AMINOSYN 10 % ..................................... 251
AMINOSYN 3.5 % ................................... 251
AMINOSYN 7 % ......................................... 251
AMINOSYN 7 % WITH
ELECTROLYTES ..................................... 251
AMINOSYN 8.5 % ................................... 251
AMINOSYN 8.5
%-ELECTROLYTES ............................ 251
AMINOSYN II 10 % ............................. 251
AMINOSYN II 15 % ............................. 251
AMINOSYN II 7 % ................................. 251
AMINOSYN II 8.5 % ........................... 251
AMINOSYN II 8.5
%-ELECTROLYTES ............................ 251
AMINOSYN M 3.5 % ......................... 251
AMINOSYN-HBC 7% ....................... 251
AMINOSYN-PF 10 % ......................... 251
AMINOSYN-PF 7 %
(SULFITE-FREE) ....................................... 251
AMINOSYN-RF 5.2 % ...................... 251
amiodarone ................................................................ 75
AMITIZA ................................................................. 289
amitriptyline ............................................................. 93
amitriptyline (bulk) .................................... 108
amitriptyline-chlordiazepoxide ... 93
AMLACTIN ........................................ 170, 173
AMLACTIN DIST PACK
(PRAMOXINE) ............................................. 192
amlodipine .................................................................. 81
amlodipine besylate (bulk)
....................................................................................... 81, 108
amlodipine-atorvastatin ......................... 79
amlodipine-benazepril .............................. 71
amlodipine-valsartan ................................. 72
amlodipine-valsartan-hcthiazid
ANASEPT SKIN-WOUND
CLEANSER ............................................................. 65
ANASPAZ ............................................................. 288
anastrozole ................................................................. 58
anastrozole (bulk) ............................ 58, 108
ANBESOL (BENZOCAINE)
................................................................................... 459, 460
ANBESOL (BENZOCAINE)
MAX STR ............................................................... 459
ANCOBON ............................................................... 43
ANDRODERM ............................................... 268
ANDROGEL ...................................................... 268
ANDROID ............................................................. 268
androstenedione (bulk) ........................ 108
ANDROXY .......................................................... 268
ANECREAM ..................................................... 191
ANECREAM (WITH
DRESSINGS) .................................................... 182
ANECREAM5 ..................................................... 38
ANECTINE .......................................................... 312
ANEFRIN ................................................................ 500
ANESTHETIC ORAL GEL ........ 460
ANGELIQ ............................................................... 271
ANGIOCATH AUTOGUARD IV
CATH ............................................................. 354, 389
ANGIOMAX ...................................................... 310
ANHYDROUS BASE .......... 108, 140
ANHYDROUS GEL ............... 108, 142
ANHYDROUS OINTMENT
................................................................................... 108, 140
ANIMAL CHEWS .................................... 254
ANIMAL SHAPE VITAMINS
................................................................................................... 254
ANIMAL SHAPES COMPLETE
................................................................................... 252, 254
ANIMAS VIBE .............................. 381, 389
ANIMI-3 WITH VITAMIN D
................................................................................................... 242
anise ................................................................................. 138
anise flavor extract (bulk)
................................................................................... 108, 144
anisindione (bulk) ........................ 108, 304
ANKLE BRACE ........................... 321, 389
ANORO ELLIPTA ................................... 493
ANTABUSE ........................................................ 106
ANTACID .............................................. 280, 281
ANTACID (CALCIUM
CARB-MAG HYD) ................................. 279
ANTACID AND PAIN RELIEF
....................................................................................................... 33
ANTACID ANTI-GAS ....................... 281
ANTACID ANTI-GAS (CA
CARB-SIM) ......................................................... 281
ANTACID ANTI-GAS DOUBLE
STR .................................................................................... 281
522
73
ammonia aromatic ...................................... 100
ammonia sol, strong (bulk)
................................................................................... 108, 194
ammonium and potassium iodides
....................................................................................................... 65
ammonium bromide (bulk) ............. 108
ammonium chloride ...................... 84, 300
ammonium chloride (bulk)
....................................................................... 84, 108, 301
ammonium lactate ....................................... 173
ammonium lactate (bulk) .................. 108
ammonium lauryl sulfate (bulk)
................................................................................... 108, 149
ammonium sulfate (bulk) .................. 108
AMMONUL ........................................................ 457
amoxapine ................................................................... 93
amoxicil-clarithromy-lansopraz
................................................................................................... 298
amoxicillin ...................................................... 41, 42
amoxicillin (bulk) ......................................... 108
amoxicillin-pot clavulanate .............. 41
AMPHETAMINE SALT COMBO
........................................................................... 97, 99, 103
amphotericin b ...................................................... 42
amphotericin b (bulk) ............................. 108
ampicillin ...................................................................... 42
ampicillin sodium ............................................. 42
ampicillin-sulbactam .................................. 41
AMPYRA ................................................................ 463
AMRIX ........................................................................ 313
AMVISC ................................................................... 472
AMVISC PLUS .............................................. 472
AMYTAL ................................................................ 104
AMYVID ................................................................. 207
ANACAINE ......................................................... 192
ANACIN ....................................................................... 33
ANACIN MAXIMUM
STRENGTH ............................................................. 33
ANADROL-50 ................................................. 268
ANAFRANIL ........................................................ 93
anagrelide ................................................................ 309
ANA-LEX KIT ................................................... 38
ANALGESIC (TROLAMINE
SALICYL) .............................................................. 194
ANALGESIC CREME ....................... 194
ANALGESIC GRX BALM ......... 193
ANALPRAM ADVANCED ........... 38
ANALPRAM E ................................................... 38
ANALPRAM-HC ............................................ 38
ANALPRAM-HC SINGLES ......... 38
ANAMU ........................................................................ 13
ANAPROX DS ................................................... 31
ANASCORP ............................................................ 67
.......................................................................................................
Index
Index
Index
ANTACID CALCIUM ....................... 280
ANTACID EXST (CA
CARB-MAG HYD) ................................. 279
ANTACID EXST (MAG
CARB-AL HYD) ......................................... 279
ANTACID EXT STR (CALCIUM
CARB) .......................................................................... 280
ANTACID EXTRA-STRENGTH
................................................................................... 280, 281
ANTACID LIQUID ................................. 281
ANTACID M ..................................................... 281
ANTACID MAXIMUM
STRENGTH ......................................................... 281
ANTACID MULTI-SYMPTOM
................................................................................................... 281
ANTACID PLUS ANTI-GAS
................................................................................................... 281
ANTACID REGULAR
STRENGTH ......................................................... 281
ANTACID SUPREME ....................... 279
ANTACID ULTRA STRENGTH
................................................................................................... 280
ANTACID WITH
SIMETHICONE ............................................ 281
ANTACID-ANTIGAS ......................... 281
ANTACID-SIMETHICONE ..... 281
ANTARA ..................................................................... 75
anthralin (bulk) ............................................... 108
ANTI MONKEY BUTT ................... 186
ANTI-ALLERGY FORMULA
................................................................................................... 214
ANTIBACTERIAL
(TRICLOSAN) LIQ ..................................... 66
ANTIBACTERIAL BANDAGES
................................................................... 314, 389, 390
ANTI-BACTERIAL
CLEANSING ......................................................... 66
ANTIBACTERIAL LIQUID
SOAP .............................................................................. 190
ANTIBACTERIAL LOTION
SOAP .................................................................................. 66
ANTIBACTERIAL PAD
................................................................................... 314, 390
ANTIBACTERIAL WIPES ............ 66
ANTIBIOTIC (BACITRACIN
ZINC) ............................................................................. 160
ANTIBIOTIC
(NEOMY-BACIT-POLYM) ...... 160
ANTIBIOTIC + PAIN RELIEF
................................................................................................... 162
ANTIBIOTIC PLUS
(PRAMOXINE) ............................................. 162
anticoag citrate phos dextrose
................................................................................................... 303
ANTI-DANDRUFF ................................. 168
ANTI-DANDRUFF (COAL TAR)
................................................................................................... 182
ANTI-DANDRUFF WITH
MENTHOL ........................................................... 167
ANTI-DIARRHEA ................................... 282
ANTI-DIARRHEAL .............................. 282
ANTI-DIARRHEAL
(LOPE)-ANTI-GAS ................................. 283
ANTI-DIARRHEAL
(LOPERAMIDE) ......................................... 282
ANTI-EMBOLISM STOCKINGS
................................................................................... 356, 390
ANTIFUNGAL ............................................... 165
ANTI-FUNGAL ............................................ 163
ANTIFUNGAL
(CLOTRIMAZOLE) ............................... 163
ANTIFUNGAL (TERBINAFINE)
................................................................................................... 162
ANTIFUNGAL (TOLNAFTATE)
................................................................................................... 164
ANTIFUNGAL CREAM ................ 163
ANTIFUNGAL SPRAY ................... 164
ANTI-GAS ............................................................. 287
ANTI-GAS MAXIMUM
STRENGTH ......................................................... 287
ANTI-GAS ULTRA STRENGTH
................................................................................................... 288
ANTI-ITCH (BENZ-RESOR)
................................................................................................... 512
ANTI-ITCH
(DIPHENHYDRAMINE) ............... 192
ANTI-ITCH (HC) ....................................... 175
ANTI-ITCH (HC) WITH
ALOE-VIT E ...................................................... 178
ANTI-ITCH
(MENTHOL/CAMPHOR) ............ 166
ANTI-ITCH (PRAMOXINE) ... 192
ANTI-ITCH MAXIMUM
STRENGTH ......................................................... 192
ANTI-ITCH MEDICATED ......... 182
ANTI-ITCH PLUS .................................... 178
ANTI-ITCH(DIPHENHYD)
WITH ZINC ......................................................... 166
antimony trichloride (bulk) ........... 108
antimony trisulfide (bulk) ................. 108
ANTI-NAUSEA ............................................ 284
ANTI-NAUSEA GINGER ................ 13
ANTIOXIDANT
A/C/E/SELENIUM ....................... 11, 235
ANTIOXIDANT FORMULA
(SELENIUM) ......................................... 11, 235
ANTIOXIDANT VITAMINS
....................................................................................... 11, 236
antipyrine (bulk) ................................ 25, 108
ANTISEPTIC ..................................................... 161
ANTISEPTIC AND
ANESTHETIC ................................................. 182
ANTISEPTIC BIO-HAND ............... 64
ANTISEPTIC GEL ....................................... 64
ANTISEPTIC ORAL CLEANSER
................................................................................................... 458
ANTISEPTIC PERINEAL WASH
II ................................................................................................. 66
ANTISEPTIC SKIN
CLNSR(CHLORHE) ................................. 65
ANTISEPTIC SOLUTION ........... 161
ANTISEPTIC WOUND-SKIN ... 66
ANTITUSSIVE DM ............................... 509
antivenin latrodectus mactans ...... 67
antivenin micrurus fulvius .................. 67
ANTIVERT .......................................................... 283
ANUCORT-HC .................................................. 37
ANU-MED ................................................................. 38
ANUSOL-HC ........................................................ 37
ANZEMET ............................................................ 284
APATATE .............................................................. 261
APATATE FORTE ................................... 236
APETEX .................................................................... 211
APETIGEN ........................................................... 211
APETIGEN PLUS ...................... 212, 227
APEXICON E ................................................... 175
AP-HIST DM ..................................................... 503
APIDRA ..................................................................... 276
APIDRA SOLOSTAR ......................... 276
APLENZIN ............................................................... 91
APLIGRAF ........................................................... 198
APLISOL ................................................................. 206
APOKYN ..................................................................... 94
apomorphine (bulk) ................................... 108
APOTHEDERM
TRANSDERMAL ...................... 108, 140
APOTHESIL BASE ................ 108, 140
APPETITE CONTROL .......................... 13
apple cider vinegar ........................................ 13
APPLE CIDER VINEGAR PLUS
....................................................................................................... 13
apple flavor (bulk) ...................... 108, 144
APPLE FLAVORING .......... 108, 144
APPLE-ADE FLAVOR ..... 108, 144
APPTRIM .................................................................... 13
APPTRIM-D ........................................................... 13
apraclonidine ..................................................... 473
APRI ................................................................................ 152
apricot flavor (bulk) ................. 108, 144
APRISO ...................................................................... 290
APRODINE .......................................................... 477
APTIOM ........................................................................ 89
APTIVUS ..................................................................... 54
AQUA CARE .................................................... 173
523
Index
Index
Index
AQUA GLYCOLIC
ARGIMENT ........................................................ 249
ARGIMENT AT ............................................... 13
ARGINAID ........................................................... 215
ARGINAID EXTRA .............................. 215
arginine (l-arginine) ................................ 210
arginine (l-arginine) (bulk) ........... 108
arginine hcl (l-arginine) .................... 210
arginine hcl(l-arginine)(bulk) ... 109
ARGITEIN ................................................................. 13
ARGLAES ............................................................. 199
ARGLAES 3.25"X 14" FILM
................................................................................... 326, 390
ARGYLE .................................................. 323, 390
ARGYLE CONNECTING TUBES
................................................................................... 381, 390
ARGYLE TRACHEOSTOM
TUBE HOLDER ........................... 356, 390
ARGYLE TRACHEOSTOMY
CARE TRAY ..................................... 356, 390
ARGYLE TROCAR ............... 382, 390
ARICEPT ................................................................. 151
ARIMIDEX .............................................................. 58
aripiprazole ................................................... 97, 99
ARISTADA .............................................................. 97
ARISTOSPAN
INTRA-ARTICULAR ......................... 273
ARISTOSPAN
INTRALESIONAL ................................... 273
ARIXTRA ............................................................... 307
ARKALIOX ......................................................... 261
ARLACEL 165 ............................................... 109
ARMOUR THYROID ......................... 278
arnica ................................................................................. 13
arnica flower (bulk) ...................... 13, 109
ARNUITY ELLIPTA ............................ 490
AROMASIN ............................................................ 58
aromatic cascara fld xt (bulk)
................................................................................... 109, 296
ARRANON ............................................................... 57
arsenic trioxide (bulk) ........................... 109
ARTHRICREAM ........................................ 194
ARTHRICREAM RUB ...................... 194
ARTHRI-FLEX ...................................................... 8
ARTHRITIS ......................................................... 194
ARTHRITIS HEATWRAPS
................................................................................... 318, 390
ARTHRITIS PAIN RELIEF
(ACETAM) ............................................................... 25
ARTHRITIS PAIN
RELIEF(CAPSAIC) ................................ 194
ARTHRITIS RELIEF WITH
ALOE ............................................................................. 194
ARTHROTEC 50 ............................................ 30
ARTHROTEC 75 ............................................ 30
ARTICADENT DENTAL
170, 184, 189
AQUA GLYCOLIC CLEANSER
................................................................................................... 190
AQUA GLYCOLIC FACE .......... 173
AQUA GLYCOLIC HC .................... 179
AQUA LACTEN .......................................... 170
AQUA LANCE LANCING
DEVICE ..................................................... 331, 390
AQUA LUBE .................................................... 184
AQUABASE ....................................................... 140
AQUACEL AG FOAM ..................... 199
AQUACEL AG FOAM HEEL
................................................................................................... 199
AQUACEL AG FOAM SACRAL
................................................................................................... 199
AQUACEL EXTRA ............... 199, 390
AQUACEL FOAM ... 199, 314, 390
AQUACEL HYDROFIBER
DRESSING ........................................... 199, 390
AQUACEL-AG .............................................. 199
AQUACEL-AG EXTRA ................. 199
AQUADEKS ...................................................... 236
AQUADEKS PEDIATRIC ........... 252
AQUA-E .................................................................... 266
AQUAFLO ............................................ 199, 390
AQUAMED ......................................................... 170
AQUANAZ ........................................................... 507
AQUANIL HC ................................................. 175
AQUANIL SKIN CLEANSER
................................................................................................... 173
AQUAPHILIC ................................. 140, 170
AQUAPHOR HEALING ................ 186
AQUAPHOR ORIGINAL ............. 186
AQUASOL A .................................................... 260
AQUASOL E ..................................................... 266
AQUORAL ........................................................... 459
AR CAPS ................................................................. 146
ARALAST NP ................................................. 495
ARANELLE (28) ......................................... 154
ARANESP (IN POLYSORBATE)
................................................................................................... 304
ARAVA .......................................................................... 29
ARBEM H-COSMETIC ... 108, 140
ARBEM LIPOPEN ................... 108, 140
ARBINOXA ........................................ 481, 483
ARCALYST ............................................................ 28
ARCAPTA NEOHALER ................ 492
ARCH BANDAGE ................... 321, 390
ARCTIC RELIEF ........................................ 193
ARESTIN ................................................................. 462
argatroban .............................................................. 310
argatroban in 0.9 % sod chlor
................................................................................................... 310
argatroban in nacl (iso-os) ........... 310
...................................................................
524
36, 458
ARTIFICIAL TEARS ........... 464, 470
ARTIFICIAL TEARS
(PETRO/MIN) .................................................. 464
ARTIFICIAL TEARS (PF) .......... 464
ARTIFICIAL TEARS (POLYVIN
ALC) ................................................................................ 465
ARTIFICIAL
TEARS(GLYCERIN-PEG) ......... 464
artificial tears(hypromellose) .... 465
ARTISS ....................................................................... 191
ARZERRA ................................................................. 58
ASACOL HD ..................................................... 290
asafetida ..................................................................... 109
ASC LOTIONIZED CLEANSER
....................................................................................................... 66
ASCLERA .................................................................. 87
ASCOMP WITH CODEINE ......... 22
ascorbate calcium ....................................... 264
ascorbate calcium (bulk) .................. 109
ascorbate sodium (bulk) ..... 109, 264
ascorbic acid ....................................................... 264
ascorbic acid (bulk) .................. 109, 264
ASCORBIC ACID WITH ROSE
HIPS ................................................................................. 264
ascorbyl palmitate (bulk)
................................................................................... 109, 264
ASEPTO BULB ............................. 354, 390
ASHLYNA ............................................................ 152
ashwagandha root extract(bulk)
....................................................................................... 13, 109
ASMANEX HFA ......................................... 490
ASMANEX TWISTHALER ...... 490
asparagine monohydrate (bulk)
................................................................................... 109, 210
aspartame ................................................................. 109
aspartic acid (bulk) ................................... 109
ASPERCREME .............................................. 194
ASPERCREME HEAT ...................... 194
ASPERCREME MAX ......................... 194
ASPERCREME WITH ALOE
................................................................................................... 194
ASPER-FLEX ................................................... 194
ASPIR-81 ..................................................... 33, 309
aspirin ................................................................ 34, 309
aspirin (bulk) ........................... 33, 109, 309
ASPIRIN CHILDRENS ........ 33, 309
ASPIRIN LOW DOSE ............ 33, 309
ASPIRIN LOW-STRENGTH
....................................................................................... 34, 309
aspirin, buffered ................................................. 33
aspirin-dipyridamole .............................. 308
ASPIR-LOW ........................................... 34, 309
ASPIR-TRIN .......................................... 34, 309
.......................................................................................
Index
Index
Index
ASSESS FULL RANGE PEAK
METER ....................................................... 376, 390
ASSURA 2PC DRAINABLE
................................................................................... 368, 390
ASSURA 2PC IRRIGATION
SLEEVE ..................................................... 368, 390
ASSURA AC BASEPLATE
................................................................................... 368, 390
ASSURA AC CLOSED POUCH
................................................................................... 368, 390
ASSURA AC CONVEX
BASEPLATE ..................................... 368, 390
ASSURA AC DRAIN POUCH
MAXI ............................................................. 368, 390
ASSURA AC EASICLOSE
DRAIN MIDI ..................................... 368, 390
ASSURA AC EASICLOSE
POUCH ....................................................... 368, 390
ASSURA CONVEX 1-PIECE
DRAINABL ......................................... 368, 390
ASSURA CONVEX CLOSED
POUCH ....................................................... 368, 390
ASSURA CONVEX EASICLOSE
MAXI ............................................................. 368, 390
ASSURA CONVEX FLANGE
................................................................................... 368, 390
ASSURA CONVEX LIGHT
STANDARD ....................................... 368, 390
ASSURA CONVEX SKIN
BARRIER ................................................ 368, 390
ASSURA CONVEX SKIN
BARRIER FLA .............................. 368, 390
ASSURA CONVEX UROPOUCH
................................................................................... 368, 391
ASSURA EASICLOSE
DRAINABLE .................................... 368, 391
ASSURA EASICLOSE MINI
POUCH ....................................................... 368, 391
ASSURA EASICLOSE WIDE
MAXI ............................................................. 368, 391
ASSURA EXTRA CONVEX
FLANGE ................................................... 368, 391
ASSURA EXTRA CONVEX
POUCH ....................................................... 368, 391
ASSURA EXTRA
NON-CONVEX FLANGE
................................................................................... 368, 391
ASSURA EXTRA
NON-CONVEX POUCH
................................................................................... 368, 391
ASSURA FLANGE ................. 368, 391
ASSURA FLANGE CONVEX
................................................................................... 368, 391
ASSURA ILEO NIGHT POUCH
................................................................................... 368, 391
ASSURA IRRIG FCE PLT 1/2-2
1/4 ........................................................................ 369, 391
ASSURA LIGHT EASICLOSE
DRAINAB .............................................. 369, 391
ASSURA NON-CONVEX
DRAINABLE .................................... 369, 391
ASSURA OSTOMY BELT
................................................................................... 369, 391
ASSURA PEDIATRIC POUCH
................................................................................... 369, 391
ASSURA PEDIATRIC SKIN
BARRIER ................................................ 369, 391
ASSURA POUCH ...................... 369, 391
ASSURA SKIN BARRIER
FLANGE ................................................... 369, 391
ASSURA STANDARD WEAR
................................................................................... 369, 391
ASSURA STANDARD WEAR
UROSTOMY ..................................... 369, 391
ASSURA UROSTOMY POUCH
................................................................................... 382, 391
ASSURA WOUND MANAGER
1/2-2 3/4 ..................................................... 369, 391
ASSURE 4 CONTROL
SOLUTION .......................................... 331, 391
ASSURE DOSE NORMAL
CONTROL ............................................. 331, 391
ASSURE DOSE NORM-HI
CONTROL ............................................. 331, 391
ASSURE HAEMOLANCE PLUS
................................................................................... 331, 391
ASSURE ID INSULIN SAFETY
................................................................................... 349, 391
ASSURE LANCE ....................... 331, 391
ASSURE PLATINUM ........ 331, 391
ASSURE PRISM CONTROL 1-2
SOLN ............................................................. 331, 391
ASSURE PRISM MULTI METER
................................................................................... 331, 391
ASSURE PRISM MULTI STRIP
................................................................................... 319, 391
ASTAGRAF XL ........................................... 310
astaxanthin ................................................................. 11
ASTEPRO ............................................................... 498
ASTHMA CHECK METER
................................................................................... 376, 391
ASTHMAMENTOR PEAK
FLOW METER ............................... 376, 392
ASTHMANEFRIN REFILL ....... 490
ASTHMANEFRIN STARTER
KIT ..................................................................................... 490
ASTHMAPACK CHILDREN'S
................................................................................... 376, 392
astragalus root (bulk) ................ 13, 109
astragalus root extract (bulk)
....................................................................................... 13, 109
ASTRAMORPH-PF .................................... 20
ASTRINGENT ................................................ 168
ASTRINGYN .................................................... 306
ATABEX DHA ................................................... 78
ATABEX EC ...................................................... 255
ATACAND ............................................................... 73
ATACAND HCT ............................................. 73
ATELVIA ................................................................ 271
atenolol ............................................................................ 80
atenolol (bulk) ....................................... 80, 109
atenolol-chlorthalidone .......................... 82
ATGAM ......................................................................... 69
ATHENOL ................................................................. 25
ATHLETE'S FOOT .................................. 163
ATHLETE'S FOOT
(CLOTRIMAZOLE) ............................... 163
ATHLETE'S FOOT
(TERBINAFINE) ......................................... 162
ATHLETE'S FOOT
(TOLNAFTATE) ......................................... 164
ATHLETE'S FOOT AF ..................... 162
ATHLETIC FOOT CREAM ...... 163
ATHLETIC TAPE ..................... 316, 392
ATIVAN ........................................................ 87, 104
ATN BRIEF ......................................... 341, 392
ATOPICLAIR ................................................... 170
atorvastatin ................................................................ 76
atovaquone ................................................................. 44
atovaquone-proguanil ............................... 44
ATRAC-TAIN (WITH AHA)
................................................................................................... 170
atracurium .............................................................. 312
ATRALIN ............................................................... 159
ATRAPRO CP ................................................. 170
ATRAPRO DERMAL SPRAY
................................................................................................... 198
ATRAPRO HYDROGEL ............... 170
ATRIPLA ..................................................................... 46
ATROPEN ................................................................. 85
atropine ........................................... 85, 288, 467
atropine (bulk) .................................................. 109
ATROVENT ....................................................... 498
ATROVENT HFA ..................................... 492
attapulgite ................................................................ 109
AUBAGIO ............................................................. 463
AUBRA ...................................................................... 152
AUGMENTIN ...................................................... 41
AUGMENTIN ES-600 ............................ 41
AUGMENTIN XR ......................................... 41
AURYXIA ............................................................. 300
AUTODROP ....................................... 356, 392
AUTOJECT 2 INJECTION
DEVICE ..................................................... 349, 392
525
Index
Index
Index
AUTO-LANCET MINI ...... 331, 392
AUTOLET IMPRESSION LANC
DEV .................................................................. 331, 392
AUTOLET LANCING DEVICE
................................................................................... 331, 392
AUTOPEN 1 TO 16 UNITS
................................................................................... 349, 392
................................................................................... 349, 392
................................................................................... 349, 392
................................................................................... 349, 392
AUTOSQUEEZE ......................... 356, 392
AUXIPRO EMOLLIENT
................................................................................... 109, 170
AUXIPRO PLASTICIZED .......... 109
AUXIPRO VANISHING CREAM
................................................................................... 109, 140
AVAGE ...................................................................... 189
AVALIDE ................................................................... 73
AVANDAMET ............................................... 270
AVANDIA ............................................................. 276
AVAPRO ..................................................................... 73
AVAR ............................................................................ 156
AVAR LS ................................................................ 156
AVAR-E .................................................................... 161
AVAR-E GREEN ....................................... 161
AVAR-E LS ......................................................... 156
AVASTIN ................................................................... 55
AVC VAGINAL ........................................... 512
AVEED ....................................................................... 268
AVEENO ................................................................. 173
AVEENO ANTI-ITCH
(HYDROCORTSN) ................................. 178
AVEENO BABY ......................... 173, 190
AVEENO BABY DIAPER RASH
................................................................................................... 186
AVEENO BABY ECZEMA
THERAPY ............................................................. 173
AVEENO BABY MOISTURE
................................................................................................... 170
AVEENO CLEAR
COMPLEXION .............................................. 180
AVEENO DAILY
MOISTURIZING ......................... 170, 173
AVEENO INTENSE RELIEF
................................................................................................... 170
AVEENO MOISTURIZING ...... 173
AVEENO SOOTHING BATH
................................................................................................... 173
AVELOX ..................................................................... 49
AVELOX ABC PACK ............................ 49
AVELOX IN NACL
(ISO-OSMOTIC) ............................................. 49
AVENOVA ........................................................... 175
AVIANE .................................................................... 152
AVIDOXY ................................................................. 55
AVIDOXY DK ................................................... 54
AVITA ......................................................................... 159
AVITENE ................................................................ 306
AVITENE FLOUR ................................... 306
AVO CREAM ................................................... 170
avocado oil (bulk) ............................ 13, 109
AVODART ........................................................... 300
AVOGEL ................................................. 199, 392
AVOGEL DRESSING ........ 199, 392
AVONEX ................................................................. 463
AVONEX (WITH ALBUMIN)
................................................................................................... 463
AVOSIL ..................................................................... 170
AVYCAZ ..................................................................... 47
AXERT ........................................................................ 102
AXIRON ................................................................... 268
AYGESTIN .......................................................... 277
AYR ALLERGY AND SINUS
................................................................................................... 499
AYR SALINE ................................................... 499
AYR SALINE GEL ................................. 499
AYR SALINE NASAL NETI
RINSE ........................................................................... 500
AYR SINUS RINSE ............................... 500
AYR SINUS RINSE REFILL
................................................................................................... 499
AZ ........................................................................ 109, 140
azacitidine ................................................................... 57
AZACTAM ............................................................... 52
AZACTAM IN DEXTROSE
(ISO-OSM) ................................................................ 52
AZASAN ...................................................... 29, 311
AZASITE ................................................................. 473
azathioprine .............................................. 29, 311
azathioprine (bulk) ..................................... 109
azelaic acid (bulk) ....... 109, 156, 189
azelastine .................................................. 468, 498
azelastine (bulk) ............................................. 109
AZELEX ................................................... 156, 189
AZILECT ..................................................................... 94
azithromycin ............................................................. 51
azithromycin (bulk) ....................... 51, 109
AZO .................................................................................. 301
AZO BLADDER CONTROL ...... 13
AZO CRANBERRY ................................... 13
AZO CRANBERRY +
PROBIOTIC ............................................................ 13
AZO CRANBERRY PLUS VIT C
....................................................................................................... 13
AZO STANDARD MAXIMUM
STRENGTH ......................................................... 301
AZO TEST STRIPS ................ 206, 392
AZO URINARY PAIN RELIEF
................................................................................................... 301
AZO URINARY TRACT
HEALTH .................................................................. 301
AZO-DINE ............................................................ 301
AZOLEN TINCTURE ......................... 163
AZOPT ......................................................................... 469
AZOR ................................................................................. 72
AZOSTIX ................................................ 205, 392
aztreonam ..................................................................... 52
AZULFIDINE ....................................... 29, 290
AZULFIDINE EN-TABS ... 29, 290
AZURETTE (28) .......................................... 152
B COMPLETE ................................................. 213
B COMPLEX ..................................................... 213
B COMPLEX 1 ............................................... 213
B COMPLEX 100 ....................... 211, 213
B COMPLEX PLUS VITAMIN C
................................................................................................... 211
B COMPLEX W-VIT C .................... 261
B COMPLEX-VITAMIN B12
................................................................................................... 213
b complex-vitamin c-folic acid
................................................................................................... 211
B.F.I ...................................................................................... 65
B-100 COMPLEX ...................... 211, 213
B12 ..................................................................................... 262
B-12 DOTS ........................................................... 262
B-12 PLUS ............................................................. 262
B-50 COMPLEX .......................................... 213
BABY ANTI MONKEY BUTT
................................................................................................... 186
BABY ANTI MONKEY BUTT
(ZINC) .......................................................................... 185
BABY AYR SALINE ........................... 499
BABY BASICS XX LARGE
DIAPER ..................................................... 347, 392
BABY CHEST RUB .............................. 193
BABY DARLINGS .................................. 173
BABY TEETHING GEL ................. 460
BABY TEETHING PAIN
MEDICINE ........................................................... 460
BABY THERMOMETER
................................................................................... 381, 392
BABY WASH ................................................... 190
BABY'S ONLY ORG
LACTORELIEF ............................................. 215
BABY'S ONLY ORGANIC
DAIRY ......................................................................... 215
BABY'S ONLY ORGANIC SOY
................................................................................................... 215
BACID ......................................................................... 291
BACIIM ......................................................................... 53
bacitracin ..................................... 53, 160, 472
bacitracin (bulk) ................................ 53, 109
526
Index
Index
Index
bacitracin zinc ................................................... 161
bacitracin zn micronized(bulk)
....................................................................................... 53, 109
bacitracin, micronized (bulk)
....................................................................................... 53, 109
bacitracin-polymyxin b ........ 160, 472
BACITRAYCIN PLUS ...... 161, 162
BACK AND BODY PAIN
RELIEVER ................................................................ 33
BACK AND NECK COLD
REUSABL.PAD ............................ 341, 392
back brace ............................................... 321, 392
BACK PAIN-OFF .......................................... 33
BACK SUPPORT S/M ....... 321, 392
BACKACHE RELIEF ............................. 34
BACKACHE RELIEF EXTRA
STRENGTH ............................................................. 34
BACK-SHOULDER ICE,HEAT
WRAP ........................................................... 341, 392
baclofen ....................................................................... 313
baclofen (bulk) .................................. 109, 313
BACMIN .................................................................. 236
BACTERIOSTATIC
WATER(PARABENS) ....................... 148
BACTINE (WITH ALCOHOL)
................................................................................................... 162
BACTINE PAIN RELIEVING
CLEANS ................................................................... 182
BACT-POLLEN-DUST FILTER
MASK ........................................................... 323, 392
BACTRIM .................................................................. 42
BACTRIM DS ...................................................... 42
BACTROBAN ................................................. 160
BACTROBAN NASAL .................... 498
BAL B-100 ............................................................ 213
BAL B-50 ................................................................ 213
BAL IN OIL ............................................................. 40
BALAMINE DM (CHLOR-PE)
................................................................................................... 503
BALANCE B-100 ....................................... 213
BALANCE B-50 ........................................... 213
BALANCED B COMPLEX-VIT
C ............................................................................................. 211
BALANCED B-100 ................................. 211
BALANCED B-100 COMPLEX
................................................................................... 211, 213
BALANCED B-150 ................................. 213
BALANCED B-50 ..................................... 213
BALANCED NUTRITIONAL
................................................................................................... 215
BALANCED NUTRITIONAL
PLUS ............................................................................... 215
BALANCED SALT ................................. 471
BAL-CARE DHA ....................................... 255
BAL-CARE DHA ESSENTIAL
................................................................................................... 255
BALMEX ................................................................. 185
BALMEX DIAPER RASH .......... 185
BALNEOL ............................................. 170, 171
balsalazide .............................................................. 290
balsam peru (bulk) ......................... 13, 109
BALZIVA (28) ................................................ 152
BANANA CONCENTRATE
................................................................................... 109, 144
BANANA CREAM FLAVOR
................................................................................... 109, 144
banana creme flavor (bulk)
................................................................................... 109, 144
banana flavor (bulk) ................ 109, 144
BANATROL PLUS ................................. 283
BANDAGE ........... 314, 321, 324, 392
BANDAGES ....................................... 314, 392
BANDAGES FLEXIBLE
FABRIC ..................................................... 314, 392
BANDAGES SHEER ........... 314, 392
BANDAGES/FLEXIBLE/ASSOR
TED ................................................................... 314, 392
BANDAGES/PLASTIC .... 314, 392
BAND-AID ACTIVE FLEX
................................................................................... 321, 392
BAND-AID BUTTERFLY
CLOSURE .............................................. 316, 392
BAND-AID CLEAR SPOTS
................................................................................... 314, 392
BAND-AID CLOTH TAPE
................................................................................... 316, 392
BAND-AID FLEXIBLE ... 314, 392
BAND-AID FLEXIBLE FABRIC
................................................................................... 314, 392
BAND-AID GAUZE PADS
................................................................................... 324, 392
BAND-AID HURT-FREE
................................................................................... 321, 392
BAND-AID MIRASORB GAUZE
................................................................................... 324, 392
BAND-AID NON-STICK PADS
................................................................................... 326, 392
BAND-AID PAPER TAPE
................................................................................... 317, 392
BAND-AID PLASTIC
................................................................... 314, 392, 393
BAND-AID PLUS ANTIBIOTIC
................................................................................................... 314
BAND-AID ROLLED GAUZE
................................................................................... 324, 393
BAND-AID SECURE-FLEX
................................................................................... 321, 393
BAND-AID SHEER STRIPS
................................................................................... 314, 393
BAND-AID SURGIPAD
326, 393
BAND-AID TOUGH PADS
................................................................................... 314, 393
BAND-AID TOUGH STRIPS
................................................................................... 315, 393
BAND-AID WATERPROOF
................................................................................... 317, 393
BAND-AID WATERPROOF PAD
................................................................................... 315, 393
BANOPHEN ....................................... 481, 483
BANOPHEN ALLERGY
................................................................................... 481, 483
BANOPHEN ANTI-ITCH ............ 166
BANZEL ....................................................................... 91
BARACLUDE ..................................................... 50
BARD ADHESIVE REMOVER
WIPES .......................................................... 316, 393
BARD CATHETER STRAP
................................................................................... 356, 393
BARD CENTER ENTRY CLOSE
SYSTEM ................................................... 382, 393
BARD CLEAN-CATH ....... 382, 393
BARD COUDE TIP CATHETER
................................................................................... 382, 393
BARD CUNNINGHAM
INCONTIN CLAMP .............. 356, 393
BARD DELUXE FABRIC LEG
STRAPS ..................................................... 341, 393
BARD EXTENSION
TUBING/CONNECT ............ 341, 393
BARD FEMALE
INTERMITTENT CATH
................................................................................... 382, 393
BARD INFECT CONT
TRAY-NO CATH ....................... 382, 393
BARD INFECTION CONTROL
BAG ................................................................. 341, 393
BARD LATEX LEG STRAPS
................................................................................... 341, 393
BARD LEG BAG HOLDER
................................................................................... 341, 393
BARD LEG BAG
STRAPS/FABRIC ...................... 341, 393
BARD LUBRICATH FOLEY
TRAY ............................................................. 382, 393
BARD LUBRICATH FOLEY
TRAY 18FR ......................................... 382, 393
BARD PLASTIC
TUBING/ADAPTER ............. 369, 393
BARD RUBBER UTILITY
CATHETER ......................................... 382, 393
BARD UNIVERSAL FOLEY
CATH TRAY ..................................... 382, 393
...................................................................................
527
Index
Index
Index
BARD URETHRAL CATHETER
TRAY ............................................................. 382, 393
BARD URINARY DRAINAGE
SYSTEM ................................................... 382, 393
BARDEX ALL-SILICONE
FOLEY CATH ................................. 382, 393
BARDEX CLOSED SYSTEM
CATH TRAY ..................................... 382, 393
BARDEX LUBRICATH FOLEY
CATH ............................................................. 383, 393
BARDEX URETHRAL
CATHETERTRAY ................... 383, 393
BARDIA URINARY DRAINAGE
BAG ................................................................. 383, 393
barium sulfate (bulk) ............................... 109
basal thermometer ...................... 381, 393
basal thermometer, electronic
................................................................................... 381, 393
BASE 7542 ............................................ 109, 142
BASE LECITHIN ISOPROPYL
PALMIT ..................................................................... 109
BASE W301 ........................................ 109, 140
BASE X ...................................................................... 109
BASE, CUSTOM POLYGLYCOL
................................................................................... 109, 150
BASE, PCCA ACACIA .... 109, 147
BASE, PCCA BITTER DRUG
................................................................................... 109, 144
BASE, PCCA COBASE #1
................................................................................... 109, 140
BASE, PCCA DMAE COMPLEX
................................................................................................... 109
BASE, PCCA EMULSIFIX-205
................................................................................... 110, 147
BASE, PCCA FIXED OIL SUSP
................................................................................................... 110
BASE, PCCA LOXASPERSE
................................................................................................... 110
BASE, PCCA LOXORAL
................................................................................... 110, 150
BASE, PCCA MUCOLOX
................................................................................... 110, 147
BASE, PCCA OCCLUSADERM
................................................................................................... 110
BASE, PCCA PLASTICIZED
................................................................................... 110, 171
BASE, PCCA POLOXAMER 407
................................................................................................... 110
BASE, PCCA POLYPEG
................................................................................... 110, 142
BASE, PCCA PRACAMAC OIL
....................................................................................... 13, 110
BASE, PCCA RAPID DISSOLVE
................................................................................... 110, 149
BASE, PCCA SPIRA-WASH
................................................................................... 110, 142
BASE, PCCA SUSPENDALL
................................................................................... 110, 142
BASE, PCCA SYRUP VEHICLE
................................................................................................... 147
BASE, PCCA VANISHING
CRM-LOT .............................................. 110, 174
BASE, PCCA VANPEN
................................................................................... 110, 143
BASE, PCCA VERSABASE
................................................................................... 110, 143
BASE, PCCA XYLIFOS
................................................................................... 110, 150
BASE-I SORBITAN
MONOPALMITATE ............. 110, 149
BASICS FOR KIDS ................ 347, 394
BASLE ......................................................................... 187
BATH OIL ............................................................. 171
BAY RUM ............................................................. 168
BAYER ADVANCED ............................ 34
BAYER ASPIRIN .......................... 34, 309
BAYER ASPIRIN (WITH
CAFFEINE) ............................................................. 33
BAYER BACK AND BODY ....... 33
BAYER CHEWABLE ASPIRIN
....................................................................................... 34, 309
BAYER PLUS EXTRA
STRENGTH ............................................................. 33
BAYER PM .......................................................... 476
BAZA ANTIFUNGAL ....................... 163
BAZA CLEANSE AND
PROTECT ............................................................... 187
BAZA CLEAR ................................................ 187
BAZA CREAM HOSPITAL
CARE PACK ...................................................... 162
BAZA PROTECT ....................................... 185
BC ............................................................................................ 33
BC ARTHRITIS ................................................ 33
BCAD 1 ...................................................... 218, 246
BCAD 2 ...................................................................... 246
bcg vaccine, live (pf) ....................... 69, 70
B-COMPLEX .................................................... 211
B-COMPLEX WITH B-12 ........... 261
b-complex with vitamin c .................. 211
B-COMPLEX WITH VITAMIN C
................................................................................................... 211
BD ALCOHOL SWABS ..................... 64
BD ALLERGIST TRAY
................................................................................... 360, 394
BD ALLERGIST TRAY REG
BEVEL ......................................................... 360, 394
BD ALLERGY SYRINGE
................................................................................... 360, 394
BD ANGIOCATH IV
CATHETER ......................................... 354, 394
BD AUTOSHIELD DUO PEN
NEEDLE ................................................... 349, 394
BD AUTOSHIELD PEN
NEEDLE ................................................... 349, 394
BD BLUNT PLASTIC
CANNULA ........................... 360, 375, 394
BD BULK LUER-LOK
NON-STERILE .............................. 360, 394
BD BULK SYRINGE SLIP TIP
................................................................................... 360, 394
BD CORNWALL GLASS
CONTROL LUER ...................... 360, 394
BD CURVED TONSIL
REUSABLE ......................................... 360, 394
BD ECLIPSE ...................................... 360, 394
BD ECLIPSE LUER-LOK
................................................................... 349, 360, 394
BD FILTER NEEDLE
5-MICRON NOKO ................... 360, 394
BD FILTER NEEDLE-5
MICRON .................................................. 360, 394
BD GLASPAK SYRINGE
................................................................................... 360, 394
BD GLASPAK TB SYRINGE
................................................................................... 360, 394
BD INSULIN PEN NEEDLE UF
MINI ................................................................ 349, 394
ORIG ............................................................... 349, 394
SHORT ........................................................ 349, 394
BD INSULIN SYRINGE
................................................................................... 349, 394
BD INSULIN SYRINGE HALF
UNIT ............................................................... 349, 394
BD INSULIN SYRINGE
MICRO-FINE .................................... 349, 394
BD INSULIN SYRINGE SLIP
TIP ...................................................................... 349, 394
BD INSULIN SYRINGE
ULT-FINE II ....................................... 349, 394
BD INSULIN SYRINGE
ULTRA-FINE ................................... 349, 394
BD INSYTE AUTOGUARD
................................................................................... 354, 394
BD INTEGRA INSULIN
SYRINGE ................................................ 349, 394
BD INTEGRA NEEDLE
................................................................................... 360, 394
BD INTEGRA SYRINGE
................................................................... 354, 360, 394
BD INTERLINK BLUNT
PLASTIC CAN ............................... 360, 394
528
Index
Index
Index
BD INTERLINK SYRINGE
................................................................................... 360, 394
BD INTRADERMAL BEVEL
NEEDLES ............................................... 360, 394
BD LANCET DEVICE ...... 331, 395
BD LO-DOSE MICRO-FINE IV
................................................................................... 350, 395
BD LO-DOSE ULTRA-FINE
................................................................................... 350, 395
BD LUER-LOK BULK SYRINGE
................................................................................... 360, 395
BD LUER-LOK COLLECTION
SET .................................................... 318, 319, 395
BD LUER-LOK SYRINGE
................................................................................... 361, 395
BD LUER-LOK TIP CONTROL
SYRING ..................................................... 361, 395
BD MAGNI-GUIDE SYRINGE
MAGNIFI ................................................ 331, 395
BD MICROTAINER LANCET
................................................................................... 331, 395
BD MULTIFIT REUSABLE
BULK ............................................................. 361, 395
BD MULTIFIT REUSABLE
SYRINGE ................................................ 361, 395
BD NOKOR ADMIX NEEDLE
................................................................................... 361, 395
BD PRECISIONGLIDE .... 361, 395
BD PRECISIONGLIDE
NON-STERILE .............................. 361, 395
BD PRE-FILLED NORMAL
SALINE ...................................................................... 260
BD Q-SYTE EXTENSION SET,
6" ........................................................................... 354, 395
BD Q-SYTE MDV ADAPTER
................................................................................... 375, 395
BD Q-SYTE SPLIT-SEPT
DEVICE ..................................................... 375, 395
BD QUINCKE SPINAL NEEDLE
................................................................................... 361, 395
BD REGULAR BEVEL
NEEDLES ............................................... 361, 395
BD SAFETYGLIDE ALLERGIST
TRAY ............................................................. 361, 395
BD SAFETYGLIDE INSULIN
SYRINGE ................................................ 350, 395
BD SAFETYGLIDE NEEDLE
................................................................................... 361, 395
BD SAFETYGLIDE SHIELDING
REG .................................................................. 361, 395
BD SAFETYGLIDE SYRINGE
................................................................... 350, 361, 395
BD SAFETYGLIDE TB REG
BEVEL ......................................................... 361, 396
BD SAFETYGLIDE
TUBERCULIN ................................ 361, 396
BD SAFETY-LOK
COLLECTION SET ................ 318, 396
BD SAFETY-LOK
DETACHABLE NEEDL
................................................................................... 361, 396
BD SAFETY-LOK
TUBERCULIN ................................ 361, 396
BD SAFETY-LOK WITH
LUER-LOK .......................................... 361, 396
BD SAF-T E-Z COLLECTION
SET .................................................... 318, 319, 396
BD SAF-T-INTIMA ............... 354, 396
BD SHARPS COLLECTOR
................................................................................... 356, 396
BD SLIP TIP SYRINGE
................................................................................... 361, 396
B-D SLIP TIP SYRINGE
................................................................................... 361, 396
BD SPECIALTY USE NEEDLES
................................................................................... 362, 396
BD STRAIGHT TONSIL
REUSABLE ......................................... 362, 396
BD SYRINGE ................................... 362, 396
BD SYRINGE BULK STERILE
PAK .................................................................. 362, 396
BD SYRINGE STORAGE BINS
................................................................................... 375, 396
BD SYRINGE-DUAL CANNULA
................................................................................... 362, 396
BD THERMOMETER ORAL
SHEATHS .............................................. 356, 396
BD TUBERCULIN SLIP-TIP
................................................................................... 362, 396
BD TUBERCULIN SYRINGE
................................................................................... 362, 396
BD ULTRA FINE LANCETS
................................................................................... 331, 396
BD ULTRA-FINE II LANCETS
................................................................................... 331, 396
BD ULTRA-FINE NANO PEN
NEEDLES ............................................... 350, 396
BD VACUTAINER
COLLECTION SET
................................................................... 318, 319, 396
BD WHITACRE SPINAL
NEEDLE ................................................... 362, 396
BD YALE REGULAR BEVEL
................................................................................... 362, 396
BD YALE REUSABLE GLASS
LUER ............................................................. 362, 396
BD YALE REUSABLE REG
METAL ....................................................... 362, 396
BD YALE REUSABLE SHORT
METAL ....................................................... 362, 396
BD YALE SHORT BEVEL
................................................................................... 362, 396
BD YALE TB REUSABLE
GLASS LUE ....................................... 362, 396
BEANO ....................................................................... 288
BEAUTY AND SKIN THERAPY
....................................................................................................... 13
BEBULIN ................................................................ 304
beclomethasone diprop (bulk)
................................................................................................... 110
BECONASE AQ ........................................... 498
BEDDING SPRAY ................................... 197
BEDSIDE DRAINAGE
COLLECT SYSTM .................. 383, 396
BEDSIDE-CARE ............................................. 66
BEDSIDE-CARE PERINEAL .... 66
bee pollen ..................................................................... 13
BEELITH ................................................................. 230
BEE-ZEE .................................................................. 236
BELEODAQ ........................................................... 59
belladonna alk leaf ext (bulk)
................................................................................... 110, 288
belladonna alkaloids-opium ........ 289
belladonna tincture (bulk)
................................................................................... 110, 288
BELLADONNA-OPIUM ............... 289
BELLADONNA-PHENOBARBIT
AL ........................................................................................ 289
BELSOMRA ....................................................... 105
BELTED UNDERGARMENTS
................................................................................... 341, 396
BELTLESS UNDERGARMENTS
................................................................................... 341, 396
BELVIQ ..................................................................... 209
benactyzine hcl (bulk) ................ 93, 110
BENADRYL ....................................... 481, 483
BENADRYL ALLERGY
................................................................................... 481, 483
BENADRYL EXTRA
STRENGTH ......................................................... 166
BENADRYL ITCH RELIEF
STICK ........................................................................... 166
BENADRYL ITCH STOPPING
................................................................................... 166, 192
benazepril ..................................................................... 72
benazepril hcl (bulk) .................... 72, 110
benazepril-hydrochlorothiazide
....................................................................................................... 71
BENECALORIE ........................................... 215
BENEFIBER CLEAR SF
(DEXTRIN) .......................................................... 292
BENEFIBER SUGAR FREE
(DEXTRIN) .......................................................... 292
529
Index
Index
Index
BENEFIX ................................................................. 305
BENEPROTEIN ............................................ 249
BENGAY COLD THERAPY
................................................................................................... 194
BENGAY GREASELESS ............. 193
BENGAY ULTRA STRENGTH
................................................................................... 193, 195
BENGAY VANISHING SCENT
................................................................................................... 195
BENGAY ZERO DEGREES .... 195
BENICAR ................................................................... 73
BENICAR HCT ................................................. 73
BENLYSTA ............................................................. 30
BENSAL HP ....................................................... 180
bentonite ..................................................................... 149
BENTYL ................................................................... 289
BENZACLIN ..................................................... 156
BENZACLIN PUMP ............................. 156
benzalkonium chloride ......................... 110
BENZAMYCIN ............................................. 156
BENZAMYCINPAK ............................. 156
BENZEDREX ................................................... 500
BENZEFOAM ................................................. 158
BENZEFOAM ULTRA ..................... 158
BENZEPRO ......................................................... 158
BENZEPRO (MICROSPHERES)
................................................................................................... 158
benzethonium chloride ......................... 110
benzocaine (bulk) ......................................... 110
benzocaine micronized (bulk) .... 110
BENZODENT .................................................. 460
benzoic acid .......................................................... 110
benzoin ......................................................................... 187
benzoin (bulk) .................................... 110, 187
benzoin compound ...................................... 187
BENZOIN COMPOUND ............... 187
benzoin compound (bulk)
................................................................................... 110, 187
benzoin gum (bulk) ..................................... 110
benzonatate ............................................................ 489
BENZ-O-STHETIC ................................. 460
benzoyl peroxide ............................................ 158
benzoyl peroxide (bulk) ....................... 110
benzphetamine .................................................. 209
BENZ-PROTECT ....................................... 187
benztropine ................................................................. 94
benzyl alcohol .................................................... 110
benzyl benzoate (bulk) .......................... 110
BEPREVE ............................................................... 468
bergamot (bulk) ............................................... 110
BERINERT ........................................................... 304
BEROCCA
(FA-GUARANA-CAFF) ................. 236
BERRI-FREEZ ................................................ 195
BESIVANCE ..................................................... 472
BEST FIBER ...................................................... 292
beta 1,3 glucan (bulk) ............................ 110
BETA CARE ...................................................... 171
beta carotene ....................................................... 260
beta carotene (bulk) ................. 110, 260
BETA MED .......................................................... 168
BETA XMA ......................................................... 185
betadex (bulk) ........................................ 40, 110
BETADINE .......................................................... 161
BETADINE OPHTHALMIC
PREP ............................................................................... 473
BETADINE SKIN CLEANSER
................................................................................................... 161
BETADINE SURGICAL SCRUB
................................................................................................... 161
BETADINE SWABSTICKS ...... 161
BETAGAN ............................................................ 470
beta-glucan,1-3, 1-4 (bulk) ............ 110
BETA-HC ................................................................ 176
betahistine (bulk) .......................................... 110
betaine (bulk) ...................................................... 110
betaine hcl ................................................................... 13
betaine hcl (bulk) .......................................... 110
betamethasone acet,micro(bulk)
................................................................................................... 110
betamethasone acet,sod phos ..... 273
betamethasone dipropion (bulk)
................................................................................................... 110
betamethasone dipropionate ....... 176
betamethasone sod phos (bulk)
................................................................................................... 110
betamethasone valerate ...................... 176
betamethasone valerate (bulk)
................................................................................................... 110
betamethasone, augmented ........... 176
BETAMIDE ......................................................... 171
betanaphthol (bulk) ................................... 110
BETAPACE ................................................. 74, 80
BETAPACE AF ..................................... 74, 80
BETAQUIK ......................................................... 245
BETASAL .............................................................. 180
BETASEPT SURGICAL SCRUB
....................................................................................................... 65
BETASERON ................................................... 463
BETATAR GEL ............................................ 182
BETATEMP ............................................................ 25
betaxolol ......................................................... 80, 470
bethanechol chloride ............................... 303
bethanechol chloride (bulk) ......... 110
BETHKIS ................................................................. 493
BETIMOL ............................................................... 470
BETOPTIC S ...................................................... 471
BEUTLICH PH TEST ROLL
................................................................................... 356, 396
bexarotene ................................................................... 61
BEXSERO (PF) .................................................. 70
BEYAZ ........................................................................ 152
BHRT BASE ...................................... 111, 140
BIAFINE EMULSION ....................... 171
BIATAIN ................................................. 199, 396
BIATAIN ADHESIVE FOAM
DRESSING ........................................... 199, 397
BIATAIN HEEL ADH FOAM
DRESSING ........................................... 199, 397
BIATAIN NON-ADHESIVE
FOAM ........................................................... 199, 397
BIATAIN
NON-ADHESIVEFOAM ROUND
................................................................................... 199, 397
BIAXIN .............................................................. 51, 52
bicalutamide ............................................................. 57
BICARSIM ............................................................ 288
BICARSIM FORTE ................................ 288
BICILLIN C-R ..................................................... 53
BICILLIN L-A ..................................................... 53
BICNU ............................................................................. 56
BIDIL ................................................................................. 87
BIFERA RX ......................................................... 227
bilberry ............................................................................. 13
BILBERRY EXTRACT ........................ 13
bilberry fruit extract ..................................... 13
BILTRICIDE .......................................................... 42
bimatoprost ............................................................ 473
BINOSTO ................................................................ 271
BIO T PRES ........................................................ 507
BIO T PRES PEDIATRIC ............. 507
BIO TRUE .............................................. 397, 466
BIO-35, GLUTEN FREE ................ 236
BIOBRANE ......................................... 199, 397
BIOBRANE DRESSING
................................................................................... 199, 397
BIOBRANE GLOVES LARGE
................................................................................... 329, 397
BIOBRANE GLOVES MEDIUM
................................................................................... 329, 397
BIOBRANE GLOVES
PEDIATRIC ......................................... 200, 397
BIOBRANE GLOVES SMALL
................................................................................... 200, 397
BIOBRANE-L .................................. 200, 397
BIOBRANE-L DRESSING
................................................................................... 200, 397
BIOBRON SF ................................................... 507
BIOCAL ..................................................................... 223
BIOCEL (WITH LUTEIN) .......... 236
BIOCOTRON .................................................... 509
BIODESP DM .................................................. 507
bioflavonoid, lemon (bulk)
................................................................................... 111, 264
bioflavonoids, citrus ................................ 264
530
Index
Index
Index
bioflavonoids, citrus (bulk)
................................................................................... 111, 264
BIOFLEX ................................................................. 213
BIOFLONEX ..................................................... 213
BIOFREEZE (MENTHOL) ......... 195
BIOGAIA ................................................................. 291
BIOGAIA PROTECTIS .................... 291
BIOGIL ....................................................................... 507
BIOGLO .................................................................... 470
BIOGUARD GAUZE ........... 200, 397
BIOGUARD ISLAND ......... 200, 397
BIOGUARD NON-ADHERENT
................................................................................... 200, 397
BIO-IMMUNEX ............................................... 13
BION TEARS (PF) ................................... 464
BIONATUSS DXP ................................... 503
BIONECT ................................................................ 187
BIONEL ..................................................................... 507
BIONEL PEDIATRIC ......................... 507
BIONIME RIGHTEST GM300
SYSTEM ................................................... 331, 397
BIOPEPTIDE BIOCOSMETIC
BASE .............................................................. 111, 140
BIOSPEC DMX ............................................. 509
BIOSTEP .................................................. 200, 397
BIOSTEP AG .................................................... 200
BIOSUPP ................................................................. 236
BIOTALAN CLEAR ............................. 215
BIOTECT PLUS ........................................... 236
BIOTENE DRY MOUTH ORAL
RINSE ........................................................................... 459
BIOTENE MOISTURIZING
MOUTH ..................................................................... 462
BIOTENE ORALBALANCE ... 462
BIOTENE PBF ................................................ 459
BIO-THERM ...................................................... 193
BIOTHRAX ............................................................. 70
biotin ................................................................................ 264
biotin (bulk) ........................................... 111, 264
BIOTIN 100+10 ............................................. 215
BIOTIN PLUS-CALCIUM AND
VIT D3 ......................................................................... 236
BIOVOL .................................................................... 236
bisabolol (bulk) ............................................... 111
BISAC-EVAC .................................................. 296
bisacodyl .................................................... 111, 297
BISA-LAX ............................................................. 297
BISCOLAX .......................................................... 297
BISMATROL .................................................... 282
BISMUTH .............................................................. 282
bismuth citrate .................................................. 111
BISMUTH MAXIMUM
STRENGTH ......................................................... 282
bismuth subcarbonate (bulk) ...... 111
bismuth subgallate (bulk) ................. 111
bismuth subnitrate (bulk) ................. 111
bismuth subsalicylate (bulk) ........ 111
bisoprolol fumarate ...................................... 80
bisoprolol-hydrochlorothiazide
....................................................................................................... 82
bitter almond oil (bulk) ....... 111, 144
bitter mask flavoring (bulk)
................................................................................... 111, 144
bitter melon extract (bulk)
....................................................................................... 13, 111
BITTERNESS MASK FLAVOR
................................................................................... 111, 144
bivalirudin ............................................................... 310
BIVIGAM ................................................................... 68
black cohosh ............................................................ 13
BLACK COHOSH MENOPAUSE
COMPLEX ................................................................ 13
black cohosh root extract ..................... 13
BLACK
COHOSH-FLAXSEED-SOY ....... 13
black food color (bulk) ......... 111, 139
blackberry flavor (bulk) ..... 111, 144
BLADDER 2.2 ................................................. 236
BLADDER CONTROL PAD
................................................................................... 341, 397
BLADDER CONTROL PAD
EXTRA PLUS .................................. 341, 397
BLADDER CONTROL PAD
LONG ............................................................ 341, 397
BLADDER CONTROL PAD
ULTRA ........................................................ 341, 397
BLADDER CONTROL PAD
ULTRA PLUS .................................. 341, 397
BLADDER CONTROL PADS
................................................................................... 341, 397
BLADDER CONTROL PADS EX
ABSORB .................................................. 342, 397
BLADDER CONTROL PADS
FOR WOMEN .................................. 342, 397
BLANCHE ............................................................. 169
BLENDERM SURGICAL
................................................................................... 317, 397
bleomycin ..................................................................... 63
BLEPH-10 .............................................................. 473
BLEPHAMIDE ............................................... 467
BLEPHAMIDE S.O.P. ........................ 467
BLINCYTO .............................................................. 63
BLISOVI FE 1.5/30 (28) .................. 152
BLISTER CARE .......................... 200, 397
BLISTER RELIEF BANDAGES
................................................................................... 315, 397
BLISTEX MEDICATED ................ 459
BLIS-TO-SOL (TOLNAFTATE)
................................................................................................... 164
BLOOD CLOTTING SPRAY
162
blood glucose contrl hi,normal
................................................................................... 331, 397
blood glucose control, normal
................................................................................... 331, 397
BLOOD GLUCOSE
MONITORING ............................... 331, 397
BLOOD GLUCOSE TEST
................................................................................... 319, 397
BLOOD PRESSURE CUFF
................................................................................... 356, 397
BLOOD PRESSURE KIT
................................................................................... 356, 397
blood pressure kit med and lrg
................................................................................... 356, 397
blood pressure kit-extra large
................................................................................... 356, 397
blood pressure monitor ....... 356, 397
blood pressure test kit-large
................................................................................... 356, 397
blood pressure test kit-medium
................................................................................... 356, 398
blood pressure test kit-small
................................................................................... 356, 398
blood pressure test kit-wrist
................................................................................... 356, 398
BLOOD PRESSURE
UNIT-WRIST .................................... 356, 398
blood-glucose meter ................. 331, 398
BLOXIVERZ ..................................................... 311
blue agave extract (bulk) .................. 111
blue food color (bulk) ............ 111, 139
BLUE GEL ............................................................ 195
blue royal (food color) (bulk)
................................................................................... 111, 139
BLUEBERRY FLAVOR
................................................................................... 111, 144
blue-green algae (spirulina) ............ 13
blunt needle, disposable ..... 362, 398
BLUNT SPINAL NEEDLE
................................................................................... 362, 398
B-NATAL ............................................................... 263
B-NATAL THERAPOPS ............... 263
BODI BATH ....................................................... 189
BODI LOTION ............................................... 174
BODI PROTECT ......................................... 171
BODY, HAIR, SKIN AND NAILS
................................................................................................... 236
BOIL RELIEF ................................................... 192
BOIL-EASE (BENZOCAINE)
................................................................................................... 192
BONE DENSITY CALCIUM + D
................................................................................................... 223
bone meal-vitamin d2 ............................. 223
...................................................................................................
531
Index
Index
Index
BONINE .................................................................... 283
BONIVA ................................................................... 271
BOOST ........................................................................ 215
BOOST BREEZE
NUTRITIONAL ............................................ 215
BOOST CALORIE SMART ...... 215
BOOST COMPACT ............................... 215
BOOST GLUCOSE CONTROL
................................................................................................... 246
BOOST KID ESSENTIALS ....... 215
BOOST KID ESSENTIALS
W-FIBER ................................................................. 215
BOOST PUDDING .................................. 215
BOOST VHC ..................................................... 215
BOOSTRIX TDAP ....................................... 69
BORAX ...................................................................... 138
BORDERED GAUZE .......... 324, 398
boric acid .................................................................. 111
boric acid (bulk) ............................................. 111
boron (bulk) .......................................... 111, 234
boron citrate (bulk) ................... 111, 234
BORO-PACKS ................................................ 168
BOSTON CLEANER ........... 398, 466
BOSTON CONDITIONING
................................................................................... 398, 466
BOSTON ONE STEP (PF)
................................................................................... 398, 466
BOSTON REWETTING
................................................................................... 398, 466
BOSTON ROUND NATURAL
................................................................................... 356, 398
BOSTON SIMPLUS .............. 398, 466
BOSULIF ..................................................................... 61
boswellia serrata xt (bulk)
....................................................................................... 13, 111
BOTOX ....................................................................... 312
BOTOX COSMETIC ............................ 312
BOTTLE .................................................... 356, 398
BOTTLETOP DISPENSER
ADAPTER ............................................. 356, 398
BOUDREAUXS BUTT PASTE
................................................................................................... 187
BOUDREAUXS RASH
PROTECTOR .................................................... 187
BOULES QUIES EAR PLUGS
................................................................................... 356, 398
BOXERS FOR MEN ............. 342, 398
BP ........................................................................................ 158
BP 10-1 ........................................................................ 156
BP FOAM ............................................................... 158
BP WASH ............................................................... 158
BP WASH ACNE TREATMENT
................................................................................................... 158
BP-50% UREA ............................................... 180
BPO ................................................................................... 158
BPO CREAMY WASH PACK
BROMELAIN ................................................... 111
bromelains .............................................................. 279
bromelains (bulk) ......................... 111, 279
BROMFED DM ............................................. 503
bromfenac ................................................................ 469
bromhexine ............................................................. 111
BROMI-LOTION ........................................ 166
BROMI-TALC ................................................. 324
BROMI-TALC PLUS ........................... 324
bromocriptine ......................................................... 94
bromocriptine (bulk) ............................... 111
BROMPHENEX DM ............................ 503
brompheniramine maleate (bulk)
................................................................................... 111, 481
brompheniramine-pseudoeph-dm
................................................................................................... 503
brompheniramin-phenylephrin-dm
................................................................................................... 504
BRONCHIAL ASTHMA RELIEF
................................................................................................... 494
BRONCHIAL MIST ............................... 490
BRONCHIAL MIST REFILL
................................................................................................... 490
BRONCOTRON PED .......................... 507
BRONKAID DUAL ACTION
................................................................................................... 490
BRONKIDS ......................................................... 504
BRONTUSS SF .............................................. 507
BROTAPP .............................................................. 477
BROTAPP DM ............................................... 504
BROVANA ........................................................... 492
BROVEX PEB ................................................. 477
BROVEX PEB DM .................................. 504
BSS .................................................................................... 471
BSS PLUS .............................................................. 471
BSS/BSS PLUS ADMIN SET
................................................................................... 354, 398
B-STRESS .............................................................. 211
BUBBLE GUM CONCENTRATE
................................................................................... 111, 144
bubblegum flavor (bulk) ..... 111, 144
BUBBLES THE FISH PEDI
MASK ........................................................... 377, 398
BUCALSEP ......................................................... 458
budesonide .............................. 290, 491, 498
budesonide, micronized (bulk)
................................................................................... 111, 273
BUFFER CREAM ...................... 111, 150
BUFFERIN ................................................................ 33
buflomedil (bulk) ............................... 86, 111
BULKEE II ........................................... 324, 398
BULLSEYE MINI SAFETY
LANCETS .............................................. 332, 398
bumetanide ................................................................. 84
BUMINATE 25 % ..................................... 307
532
158
BPO-10 ........................................................................ 158
BPO-5 ............................................................................ 158
BRAIN MIGHT-DHA-CO Q10
................................................................................................... 215
BRAVELLE ......................................................... 273
BREAKFAST ESSENTIALS
................................................................................................... 215
BREATHE RIGHT ................... 359, 398
BREATHE RIGHT VAPOR
................................................................................... 359, 398
BREATHERITE MDI SPACER
................................................................................... 377, 398
BREATHERITE VALVED MDI
CHAMBER ........................................... 377, 398
BREATHERITE VALVED MDI
SPACER .................................................... 377, 398
BREEZE 2 .............................................. 331, 398
BREEZE 2 CONTROL
SOLUTION, LOW .................... 331, 398
BREEZE 2 CONTROL
SOLUTION, NML ..................... 331, 398
BREEZE 2 CONTROL
SOLUTION,HIGH .................... 332, 398
BREEZEE MIST .......................................... 162
BREEZERS ADULT BRIEF
................................................................................... 342, 398
BREO ELLIPTA ........................................... 493
BREVIBLOC ............................................. 74, 80
BREVIBLOC IN NACL
(ISO-OSM) .................................................... 74, 80
BREVICON (28) .......................................... 152
BREVITAL ............................................................... 35
BREWER'S YEAST ............................... 214
BRIEFS ....................................................... 342, 398
BRIEFS MEDIUM .................... 342, 398
BRIEFS OVERNIGHT ....... 342, 398
BRIEFS SMALL .......................... 342, 398
BRIEFS, ADULT-EXTRA
LARGE ........................................................ 342, 398
BRIELLYN ........................................................... 152
BRIGHT BEGINNINGS SOY
................................................................................................... 215
BRIJ 35 ........................................................ 111, 149
BRIJ 700 .................................................... 111, 150
BRIJ 93 ........................................................ 111, 149
BRILINTA ............................................................. 308
brilliant green (bulk) ............................... 111
brimonidine ........................................................... 473
brimonidine tartrate (bulk) ............ 111
BRINTELLIX ....................................................... 93
BRISDELLE ....................................................... 277
broccoli flower ..................................................... 13
BROHIST D ........................................................ 477
...................................................................................................
Index
Index
Index
BUMINATE 5 % ......................................... 307
BUNAVAIL ......................................................... 105
BUPAP ............................................................................ 24
BUPHENYL ........................................................ 457
bupivacaine ............................................................... 35
bupivacaine (bulk) .......................... 35, 111
bupivacaine (pf) .................................................. 35
bupivacaine-dextrose-water(pf)
....................................................................................................... 35
bupivacaine-epinephrine ...................... 36
bupivacaine-epinephrine (pf) ......... 36
bupivacaine-epinephrine bitart
................................................................................................... 458
BUPRENEX ............................................................ 24
buprenorphine hcl ........................... 24, 105
buprenorphine hcl (bulk) .................. 111
buprenorphine-naloxone ................... 105
BUPROBAN ....................................................... 106
bupropion (bulk) ................................ 91, 111
bupropion hcl ......................................... 91, 106
BURN CALORIES ....................................... 13
BURN RELIEF ............................................... 182
BURN RELIEF WITH ALOE
................................................................................................... 182
BURNS-SCALDS-ABRASIONS
................................................................................... 200, 398
buspirone ...................................................................... 88
buspirone (bulk) ................................. 88, 111
BUSULFEX ............................................................. 56
butalbital (bulk) .............................................. 111
BUTALBITAL COMPOUND
W/CODEINE ......................................................... 22
butalbital-acetaminop-caf-cod ..... 22
butalbital-acetaminophen .................... 24
butalbital-acetaminophen-caff ..... 24
butalbital-aspirin-caffeine .................. 32
BUTISOL ................................................................. 104
butorphanol tartrate .................................... 24
butorphanol tartrate (bulk)
....................................................................................... 24, 111
BUTRANS ................................................................. 24
butter flavor (bulk) ..................... 111, 144
butter rum flavor (bulk) ...... 111, 144
BUTTER RUM FLAVORING
................................................................................... 111, 144
BUTTERFLY CLOSURES
................................................................................... 317, 398
butterscotch flavor (bulk)
................................................................................... 112, 144
BUTTERSCOTCH FLAVORING
................................................................................... 112, 144
butyl alcohol (bulk) ................................... 112
butylated hydroxyanisole(bulk)
................................................................................................... 112
butylated hydroxytoluene ................. 139
butylparaben (bulk) ................... 112, 148
BYDUREON ...................................................... 270
BYETTA ................................................................... 270
BYSTOLIC ............................................................... 80
C
1000-BIOFLAVONOIDS-ROSE
HIPS ................................................................................. 213
C 500 TIMED RELEASED ......... 264
C COMPLEX ..................................................... 264
C-1000 .......................................................................... 264
C-1000 WITH ROSE HIPS .......... 264
C-250 .............................................................................. 264
C-500 .............................................................................. 264
cabergoline ............................................................ 278
ca-d3-mag ox-zinc-cop-mang-bor
................................................................................................... 223
ca-d3-mag-zinc-cop-mang-bor
................................................................................................... 223
CA-DTPA .................................................................... 40
CADUET ...................................................................... 79
CAFCIT ...................................................................... 100
CAFERGOT ........................................................ 102
caffeine ......................................................................... 100
caffeine (bulk) .................................... 100, 112
caffeine citrated .............................. 100, 112
caffeine-sodium benzoate ................. 100
CAL MAG ZINC + D3 ....................... 223
CALACLEAR .................................................. 182
CALAGEL ............................................................. 166
CALAGESIC ..................................................... 182
CALAHIST ........................................................... 182
CALAHIST CLEAR ............................... 183
CALAHIST WITH PRAMOXINE
................................................................................................... 183
CALALGIN-GRX DRESSING
................................................................................................... 200
calamine ..................................................................... 169
calamine (bulk) ................................................ 112
CALAMINE MEDICATED ....... 183
calamine phenolated ............................... 168
calamine-zinc oxide .................................. 185
calamine-zinc oxide-phenol .......... 185
CALAN ............................................................... 75, 81
CALAN SR ............................................................... 81
calc thioglycol trihydr (bulk)
................................................................... 112, 184, 191
CALCET CREAMY BITES ....... 224
CALCET PETITES .................................. 224
CALCI-CHEW ................................................ 226
CALCIDOL .......................................................... 265
CALCIFEROL ................................................. 265
CALCILO XD .................................................. 218
CALCI-MAX ..................................................... 223
CALCI-MIX ........................................................ 226
CALCIONATE ............................................... 226
calcipotriene ........................................................ 167
calcipotriene (bulk) ................... 112, 167
calcipotriene-betamethasone ..... 159
CALCIPOTRIOL (BULK)
................................................................................... 112, 167
calcitonin (salmon) .................................... 271
CALCITRATE ................................................. 226
CAL-CITRATE .............................................. 224
CALCITRATE-VITAMIN D ... 224
CALCITRENE ................................................. 167
calcitriol ..................................... 167, 265, 456
calcitriol (bulk) ................................ 112, 265
calcitriol-almond oil (bulk)
................................................................................... 112, 265
CALCIUM 500 ............................................... 226
CALCIUM 500 + D ................................. 224
CALCIUM 500 + D (D3) ................ 224
CALCIUM 500 WITH D ................. 224
CALCIUM 600 ............................................... 226
CALCIUM 600 + D(3) ........ 224, 225
CALCIUM 600 + MINERALS
................................................................................................... 223
CALCIUM 600 WITH VITAMIN
D3 ......................................................................................... 225
calcium acetate ..............................................................
112, 226, 299, 300
calcium alginate (bulk) ........ 112, 149
calcium amino acid chelate .......... 226
CALCIUM ANTACID ....................... 280
CALCIUM ANTACID
TROPICAL ........................................................... 280
CALCIUM ANTACID ULTRA
MAX ST .................................................................... 280
calcium carb and citrate-vitd3
................................................................................................... 225
calcium carb-d3-mag cmb11-zinc
................................................................................................... 223
calcium carb-mag oxide-zinc ox
................................................................................................... 223
calcium carb-mag ox-zinc gluc
................................................................................................... 223
calcium carb-mag ox-zinc sulf
................................................................................................... 223
calcium carbonate ....................... 226, 280
calcium carbonate (bulk)
................................................................................... 112, 226
calcium carbonate-vit d3-min ... 223
calcium carbonate-vitamin d3
................................................................................................... 225
calcium chloride ............................ 112, 226
calcium chloride (bulk) ....................... 112
calcium citrate .................................. 226, 227
calcium citrate (bulk) ............. 112, 226
CALCIUM CITRATE + D ........... 225
533
Index
Index
Index
CALCIUM CITRATE + D WITH
MAG ................................................................................ 236
calcium citrate malate-vit d3 ...... 225
CALCIUM CITRATE PLUS (VIT
B6) ...................................................................................... 236
calcium citrate-vitamin d2 ............. 225
calcium citrate-vitamin d3 ............. 225
CALCIUM DISODIUM
VERSENATE ........................................................ 40
CALCIUM FOLINATE
(LEUCOVORIN) ............................................. 64
CALCIUM FOR WOMEN ........... 223
calcium glubionate (bulk)
................................................................................... 112, 227
calcium glucon monohyd (bulk)
................................................................................................... 112
calcium gluconate ....................................... 227
calcium gluconate (bulk) .................. 112
calcium hydroxide (bulk) .................. 112
calcium lactate ................................................. 227
calcium lactate (bulk) ............ 112, 227
calcium levulinate dihy (bulk)
................................................................................... 112, 227
CALCIUM MAGNESIUM + D
................................................................................................... 223
calcium pantothenate ............. 112, 263
calcium phos, tribasic (bulk)
................................................................................... 112, 227
calcium phosphate (bulk) ................. 112
calcium phosphate-vitamin d3
................................................................................................... 225
CALCIUM PLUS ........................................ 223
CALCIUM PNV ........................................... 255
calcium pyruvate (bulk) ...................... 112
CALCIUM SACCHARATE
................................................................................... 112, 227
CALCIUM SOFT CHEW .............. 223
calcium sulfate .................................................. 112
CALCIUM WITH BORON ......... 223
CALCIUM WITH VITAMIN D
................................................................................................... 225
CALCIUM+D ................................................... 225
CALCIUM-FOLIC
ACID-VITAMIN D .................................. 223
calcium-magnesium .................................. 224
calcium-magnesium-copper-zinc
................................................................................................... 231
calcium-magnesium-zinc .................. 224
calcium-vitamin d3-vitamin k .... 224
CALDESENE .................................................... 187
CALDOLOR ........................................................... 31
CALDYPHEN .................................................. 183
CALDYPHEN CLEAR ...................... 183
CAL-GEST ANTACID ...................... 280
CALICYLIC ........................................................ 180
CALLERGY CLEAR ........................... 183
CALLUS CUSHION .............................. 398
CALLUS PADS ............................................. 398
CALLUS REMOVER .......................... 180
CALLUS REMOVERS ...................... 180
CAL-MAG ............................................................. 224
CALMAG THINS ...................................... 224
CAL-MINT ........................................................... 227
CALMME ................................................................... 13
CALMOL-4 .............................................................. 37
CALMOSEPTINE ..................................... 185
CALPHRON ....................................................... 300
CAL-QUICK ...................................................... 225
CALTRATE 600 + D ............................ 225
CALTRATE 600+D PLUS
MINERALS ......................................................... 224
CALTRATE WITH VITAMIN D3
................................................................................................... 225
CALYPXO ............................................................. 193
CAM ................................................................................ 171
CAMBIA .......................................... 31, 32, 102
CAMILA ................................................................... 154
CAMINO PRO 15 PE MSUD
................................................................................................... 246
CAMINO PRO 15 PE PKU ......... 248
CAMO BANDAGES ............. 315, 399
CAMPHO-PHENIQUE ..................... 160
camphor ...................................................... 112, 195
CAMPHOR BLOCKS ......................... 112
CAMPTOSAR ..................................................... 62
CAMRESE ............................................................ 152
CAMRESE LO ................................................ 152
CANADA BALSAM ............................. 112
CANASA ................................................................. 290
CANCIDAS ............................................................. 43
candesartan ............................................................... 73
candesartan-hydrochlorothiazid
....................................................................................................... 73
CANDIN ....................................................................... 67
cane ................................................................... 320, 399
cane tips ...................................... 320, 356, 399
CANK-OXIDE ................................................ 458
cantharidin (bulk) ........................ 112, 180
CANTIL ..................................................................... 289
CAPACET .................................................................. 24
CAPASTAT ............................................................. 46
CAPCOF ................................................................... 497
capecitabine ............................................................. 57
CAPEX ........................................................................ 176
CAPHOSOL ........................................................ 459
CAPITAL WITH CODEINE ......... 23
CAPMIST DM ................................................. 507
CAPRELSA ............................................................. 61
CAPRON DM ................................................... 506
caprylic-capric trigly (bulk)
................................................................................... 112, 174
capsaicin .................................................... 112, 195
capsaicin palmitate (bulk) .............. 112
CAPSICUM ......................................................... 195
capsicum oleoresin (bulk)
................................................................................... 112, 195
CAPSUBLEND-H ..................................... 139
CAPSUBLEND-P ....................................... 139
CAPSUBLEND-S ....................................... 139
CAPSULE #0 ..................................................... 146
CAPSULE #0 (CELLULOSE)
................................................................................................... 139
CAPSULE #0
(HYPROMELLOSE) ............................. 146
CAPSULE #0 DRCAPS .................... 146
CAPSULE #00 ................................................. 146
................................................................................................... 139
CAPSULE #00
(HYPROMELLOSE) ............................. 146
CAPSULE #000 ............................................. 146
CAPSULE #1 ..................................................... 146
................................................................................................... 139
CAPSULE #1
(HYPROMELLOSE) ............................. 146
CAPSULE #1 DRCAPS .................... 146
CAPSULE #10 ................................................. 146
CAPSULE #11 ................................................. 146
CAPSULE #13 ................................................. 146
CAPSULE #2 ..................................................... 146
CAPSULE #3 ..................................................... 146
................................................................................................... 139
CAPSULE #3
(HYPROMELLOSE) ............................. 146
CAPSULE #4 ..................................................... 146
CAPSULE #5 ..................................................... 146
CAPSULE #7 ..................................................... 146
CAPSULE CONI-SNAP #0
(GELATIN) .......................................................... 146
CAPSULE CONI-SNAP
#0(HYPROMEL) ......................................... 146
(GELATIN ............................................................. 146
................................................................................................... 146
(GELATIN) .......................................................... 146
CAPSULE CONI-SNAP
#1(HYPROMEL) ......................................... 146
(GELATIN) .......................................................... 146
534
Index
Index
Index
(GELATIN) .......................................................... 146
CAPSULE CONI-SNAP
#3(HYPROMEL) ......................................... 146
(GELATIN) .......................................................... 146
captopril ......................................................................... 72
captopril (bulk) .................................... 72, 112
captopril-hydrochlorothiazide ..... 71
CAPZASIN ........................................... 193, 195
CAPZASIN-HP .............................................. 195
CAPZASIN-P .................................................... 195
CARAC ....................................................................... 165
CARAFATE ........................................................ 298
caramel flavor (bulk) .............. 112, 144
CARB INTERCEPT ................................... 13
carbachol (bulk) ............................. 112, 466
CARBAGLU ...................................................... 457
carbamazepine ............................. 89, 90, 98
carbamazepine (bulk) ............................ 112
carbamide peroxide (bulk) ............. 112
CARBAMOXIDE EAR DROPS
................................................................................................... 474
CARBAPHEN CH ..................................... 504
CARBATROL .......................................... 90, 98
carbazochrome (bulk) ........... 112, 305
carbidopa ..................................................................... 94
carbidopa (bulk) ............................................ 112
carbidopa-levodopa ..................................... 94
carbidopa-levodopa-entacapone
....................................................................................................... 93
carbimazole (bulk) ...................... 112, 270
carbinoxamine maleate ....... 481, 483
CARBOCAINE .................................................. 35
CARBOCAINE (PF) .................................. 35
CARBOFLEX ODOR CONTROL
DRESSIN ................................................. 200, 399
CARBOGEL ....................................... 112, 149
CARBOHOL ...................... 112, 143, 147
CARB-O-LAC HP ..................................... 179
CARB-O-LAC5 ............................................. 179
CARB-O-LAN10 ......................................... 171
CARB-O-LAN20 ......................................... 171
carbomer 934 (bulk) ................ 112, 149
carbomer 940 (bulk) ................................ 112
CARBOMER GEL-AQUEOUS
................................................................................... 112, 143
CARBOMER
GEL-HYDROALCOHOLIC
................................................................................... 112, 150
carbomer homopolymer c (bulk)
................................................................................... 112, 149
CARB-O-PHILIC ........................................ 174
carboplatin ................................................................. 61
CARB-O-SAL5 .............................................. 179
carboxymethyl sod, low (bulk)
................................................................................... 113, 149
carboxymethylcellulose sodium
................................................................................................... 113
CARBZERO ........................................................ 245
cardamom oil (bulk) ..................... 13, 113
CARDENE IV ...................................................... 81
CARDENE IV IN DEXTROSE
....................................................................................................... 81
CARDENE IV IN SODIUM
CHLORIDE .............................................................. 81
cardioplegic soln ........................................... 474
CARDIOPRESS ................................................ 13
CARDIOSTEROL ......................................... 76
CARDIOTEK-RX (BIOPERINE)
................................................................................................... 211
CARDIOVID PLUS .................................... 76
CARDIZEM ............................................................. 80
CARDIZEM CD ............................................... 80
CARDIZEM LA ................................................ 80
CARDURA ............................................................... 85
CARDURA XL ................................................... 85
CAREFINE PEN NEEDLE
................................................................................... 350, 399
CAREONE LANCING DEVICE
................................................................................... 332, 399
CAREONE THIN LANCET
................................................................................... 332, 399
CAREONE ULTRA THIN
LANCET ................................................... 332, 399
CARESENS CONTROL A
NORMAL ................................................ 332, 399
CARESENS N .................................. 332, 399
CARESENS N VOICE ....... 332, 399
CA-REZZ ..................................................................... 66
carica papaya .................................................... 279
CARIMUNE NF
NANOFILTERED ......................................... 68
carisoprodol ......................................................... 313
carisoprodol (bulk) .................................... 113
carisoprodol-asa-codeine ................ 313
carisoprodol-aspirin ................................ 313
carnauba wax ..................................................... 113
CARNI Q-GEL FORTE ........................ 13
CARNITOR ......................................................... 456
CARNITOR (SUGAR-FREE)
................................................................................................... 456
carnosine (bulk) .............................................. 113
carrageenan (bulk) .................... 113, 149
CARRASYN HYDROGEL
WOUND DRESS ......................... 200, 399
CARRINGTON MOIST
BARRIER-ZINC .......................................... 185
CARRINGTON MOISTURE
BARRIER CR ................................................... 187
carteolol ..................................................................... 471
CARTIA XT ............................................................ 80
CARTICEL ........................................................... 312
CARTIVISC ................................................................ 8
CARTRIDGE STAMPED IR 1200
................................................................................... 356, 399
carvedilol ...................................................................... 72
CASODEX ................................................................. 57
CASTELLANI PAINT ........................... 66
CASTELLANI PAINT
MODIFIED ............................................................... 66
CASTIVA COOLING .......................... 193
CASTIVA WARMING ...................... 195
castor oil .................................................... 138, 297
cat hair std allergenic ext .................... 67
CATAPRES ............................................................. 83
CATAPRES-TTS-1 ...................................... 83
CATAPRES-TTS-2 ...................................... 83
CATAPRES-TTS-3 ...................................... 83
CATHFLO ACTIVASE .................... 310
cat's claw (uncaria tomentosa) ... 14
CAVERJECT ..................................................... 208
CAVERJECT IMPULSE ................. 208
CAVILON MOISTURIZING
BODY ............................................................................ 171
CAVILON SKIN CLEANSER
................................................................................................... 190
CAYA CONTOURED ........ 321, 399
CAYSTON ............................................................. 493
CAZIANT (28) ................................................ 154
CCP CAFFEINE FREE ..................... 494
cedar leaf oil ........................................................ 138
CEDAX ........................................................................... 48
cefaclor ............................................................................ 47
cefadroxil ...................................................................... 47
cefazolin ......................................................................... 47
cefazolin in dextrose (iso-os) .......... 47
cefdinir ............................................................................. 48
cefditoren pivoxil .............................................. 48
cefepime .......................................................................... 48
cefepime in dextrose 5 % ...................... 48
cefepime in dextrose,iso-osm .......... 48
cefixime ............................................................................ 48
cefotaxime .................................................................... 48
cefotetan ......................................................................... 47
cefotetan in dextrose, iso-osm ....... 47
cefoxitin ........................................................................... 47
cefoxitin in dextrose, iso-osm ......... 48
cefpodoxime .............................................................. 48
cefprozil .......................................................................... 48
ceftazidime .................................................................. 48
ceftazidime (bulk) ............................. 48, 113
ceftazidime in d5w .......................................... 48
ceftibuten ....................................................................... 48
CEFTIN .......................................................................... 48
535
Index
Index
Index
ceftriaxone .................................................. 48, 113
ceftriaxone in dextrose,iso-os ........ 48
cefuroxime axetil ............................................... 48
cefuroxime sodium .......................................... 48
CELA CREAM BASE ........ 113, 140
CELACYN ............................................. 171, 380
CELEBREX ............................................................. 30
celecoxib ........................................................................ 30
celecoxib (bulk) ................................... 30, 113
celery seed oil (bulk) ................... 14, 113
CELESTONE SOLUSPAN ......... 273
CELEXA ....................................................................... 92
CELLCEPT ............................................... 29, 311
CELLCEPT INTRAVENOUS
....................................................................................... 29, 311
CELLUGEL ......................................................... 472
cellulase (bulk) ................................. 113, 285
cellulose (bulk) ................................. 113, 150
CELONTIN .............................................................. 91
CEM-UREA ......................................................... 180
CENTAMIN ........................................................ 236
CENTANY ............................................................ 160
CENTANY AT ............................................... 160
CENTERGY ........................................................ 477
CENTERGY DM ......................................... 504
CENTERPOINTLOCK CLOSED
POUCH ....................................................... 369, 399
CENTERPOINTLOCK DRAIN
FILTER ....................................................... 369, 399
CENTERPOINTLOCK
DRAINABLE MINI ................ 369, 399
CENTERPOINTLOCK
DRAINABLE POUC ............. 369, 399
CENTERPOINTLOCK
FLEXTEND CONVE ........... 369, 399
CENTERPOINTLOCK
FLEXTEND SKIN .................... 369, 399
CENTERPOINTLOCK
FLEXWEAR CONVE ......... 369, 399
CENTERPOINTLOCK
FLEXWEAR SKIN .................. 369, 399
CENTERPOINTLOCK
SOFTFLEX SKIN ...................... 369, 399
CENTERPOINTLOCK STOMA
CAP ................................................................... 369, 399
CENTERPOINTLOCK STOMA
IRRIGAT .................................................. 369, 399
CENTERPOINTLOCK
UROSTOMY POUCH ........ 369, 399
CENTRAL VITE ......... 222, 236, 242
CENTRAL VITE WITH LUTEIN
................................................................................................... 236
CENTRAL-VITE ......................................... 242
CENTRAL-VITE CARDIO ........ 236
CENTRAL-VITE ENERGY ...... 236
CENTRAL-VITE MEN'S UNDER
50 .......................................................................................... 236
CENTRAL-VITE
PERFORMANCE ....................................... 236
CENTRAL-VITE SELECT
................................................................................... 222, 236
CENTRAL-VITE SENIOR .......... 236
CENTRAL-VITE WITH
LYCOPENE ......................................................... 236
CENTRAL-VITE WOMEN'S
MATURE ................................................................. 236
CENTRAL-VITE WOMEN'S
UNDER 50 ............................................................. 242
CENTRATEX ................................................... 227
CENTRAVITES ............................................ 236
CENTRAVITES 50 PLUS ............ 222
CENTRUM ........................................................... 236
CENTRUM COMPLETE ............... 242
CENTRUM KIDS ....................................... 252
CENTRUM MEN ....................................... 236
CENTRUM SILVER ............................. 236
CENTRUM SILVER ULTRA
MEN'S ........................................................................... 236
CENTRUM SILVER WOMEN
................................................................................................... 236
CENTRUM SPECIALIST
ENERGY .................................................................. 236
CENTRUM SPECIALIST
HEART ........................................................................ 236
CENTRUM SPECIALIST
PRENATAL ......................................................... 255
CENTRUM ULTRA MEN'S ..... 236
CENTURY ............................................. 236, 242
CENTURY ADULTS 50+ ............ 236
CENTURY CARDIO ............................ 236
CENTURY CARDIO HEALTH
FORMULA ........................................................... 236
CENTURY ENERGY
METABOLISM ............................................. 236
CENTURY MATURE ......................... 236
CENTURY ULTIMATE MEN'S
................................................................................................... 237
CENTURY ULTIMATE
WOMEN'S ............................................. 237, 242
CEO-TWO ............................................................. 298
CEPACOL SORE THROAT
(BENZ-MEN) .................................................... 461
CEPACOL
SORETHROAT-COUGH .............. 462
CEPASTAT .......................................................... 461
cephalexin .................................................................... 47
CEPROTIN (BLUE BAR) ............. 309
CEPROTIN (GREEN BAR) ....... 309
CERALYTE 50 ............................................... 231
CERALYTE 70 ............................................... 231
CERALYTE 90 ............................................... 231
CERALYTE-70 .............................................. 232
CERAORS 75 ................................................... 232
CERASPORT .................................................... 232
CERASPORT EX1 ................................... 232
CERAVE .................................................................. 170
CERAVE BABY
MOISTURIZING ......................................... 187
CERAVE PM ..................................................... 170
CERAVE SUNSCREEN .................. 191
CERDELGA ........................................................ 456
CEREBYX ................................................................. 89
CEREFOLIN ...................................................... 242
CEREFOLIN NAC (ALGAL OIL)
................................................................................................... 261
ceresin (bulk) ...................................................... 113
CERETEC ............................................................... 207
CEREZYME ....................................................... 455
CEROVITE ........................................................... 237
CEROVITE ADVANCED
FORMULA ........................................................... 242
CEROVITE JR ................................................ 252
CEROVITE SENIOR ............................ 222
CERTA PLUS .................................................. 237
CERTAIN DRI ................................................ 166
CERTAINTY BELTED SHIELDS
................................................................................... 342, 399
CERTAINTY GUARDS
................................................................................... 342, 399
CERTAINTY LARGE ........ 342, 399
CERTAINTY LARGE-EXTRA
LARGE ........................................................ 342, 399
CERTAINTY PADS ............... 342, 399
CERTAINTY REGULAR
................................................................................... 342, 399
CERTAINTY SMALL-MEDIUM
................................................................................... 342, 399
CERTAINTY UNDERPADS
................................................................................... 342, 399
CERTAINTY X-LARGE
................................................................................... 342, 399
CERTAVITE
SENIOR-ANTIOXIDANT ........... 237
CERTAVITE-ANTIOXID (IRON
GLUC) .......................................................................... 237
CERTAVITE-ANTIOXIDANT
................................................................................................... 243
CERTUSS-D ....................................................... 507
CERVARIX VACCINE (PF) ........ 70
CERVIDIL ............................................................. 267
CESAMET ............................................................. 284
cesium chloride (bulk) .......... 113, 234
CETACAINE ..................................................... 183
CETACAINE ANESTHETIC
................................................................................................... 183
536
Index
Index
Index
CETA-KLENZ GENTLE ............... 190
CETA-KLENZ MILD .......................... 190
CETAPHIL ............................................ 171, 190
CETAPHIL ANTIBACTERIAL
....................................................................................................... 66
CETAPHIL DAILY FACIAL
................................................................................................... 191
CETAPHIL DAILYADVANCE
................................................................................................... 171
CETAPHIL DERMACONTROL
................................................................................................... 191
CETAPHIL GENTLE
CLEANSER ......................................................... 190
CETAPHIL HAND ................................... 171
CETAPHIL MOISTURIZING
................................................................................................... 171
CETAPHIL RESTORADERM
................................................................................... 171, 190
CETIRI-D ................................................................ 480
cetirizine ..................................................... 486, 488
cetirizine-pseudoephedrine ........... 480
ceto.alcohol-ceteareth20(bulk)
................................................................................... 113, 150
CETRAXAL ........................................................ 474
CETROTIDE ...................................................... 277
cetyl alcohol ......................................................... 150
cetyl alcohol (bulk) .................... 113, 150
cetyl esters (bulk) ......................... 113, 140
cetyl myristoleate (bulk) ..................... 113
cetylpyridinium chloride ................... 113
cevimeline ................................................................ 462
chamomile flower (bulk) .................... 113
CHAMOSYN ..................................................... 185
CHANTIX .............................................................. 106
CHANTIX CONTINUING
MONTH BOX .................................................. 106
CHANTIX STARTING MONTH
BOX ................................................................................. 106
CHARCOAL .......................................................... 39
CHARCOCAPS ................................................. 39
CHATEAL ............................................................. 152
cheesecake flavor (bulk) .... 113, 144
CHEK-STIX CONTROL
................................................................... 205, 385, 399
CHELATED ZINC ................................... 235
CHEMET ..................................................................... 40
CHEMO TRANSFER PIN
................................................................................... 375, 399
CHEMSTRIP 10 MD ............ 205, 399
CHEMSTRIP 10/SG ............... 205, 399
CHEMSTRIP 2 ............................... 206, 399
CHEMSTRIP 2 GP ................... 205, 399
CHEMSTRIP 50B ...................... 205, 399
CHEMSTRIP 7 ............................... 205, 399
CHEMSTRIP 9 ............................... 205, 399
CHEMSTRIP BG LOG BOOK
................................................................................... 332, 400
CHEMSTRIP K .............................. 385, 400
CHEMSTRIP MICRAL .... 206, 400
CHEMSTRIP UGK .................. 384, 400
CHENODAL ...................................................... 286
CHERATUSSIN AC .............................. 498
CHERATUSSIN DAC ........................ 497
cherry flavor ........................................ 113, 147
CHERRY MENTHOL ......................... 461
cherry-ade flavor (bulk) ..... 113, 144
CHEST CONGESTION .................... 480
CHEST CONGESTION RELIEF
................................................................................................... 495
+ DM ............................................................................... 509
D ............................................................................................. 494
PE ......................................................................................... 494
CHEST CONGESTION-COUGH
RELIEF ....................................................................... 509
CHEST RUB ...................................................... 193
CHEST-SINUS CONGESTION
RELIEF ....................................................................... 494
CHEW Q ....................................................................... 14
CHEWABLE IRON ................................ 227
CHEWABLE MULTI VITAMIN
................................................................................................... 243
CHEWABLE
MULTIVIT-A,B,D,E,K,ZN ......... 254
CHEWABLE-VITE ................. 243, 254
CHEWABLE-VITE WITH IRON
................................................................................................... 252
CHEW-HESIVE ............................................ 113
chia seed oil-omega 3-6-9 ....... 14, 78
CHILD ALLERGY
RELF(CETIRIZINE) ............. 486, 488
CHILD ALLERGY RELIEF
(DIPHEN) ................................................ 481, 483
CHILD ASPIRIN ............................. 34, 309
CHILD BENADRYL ITCH
(CAMPHOR) ..................................................... 195
CHILD CHEST CONGESTION +
COUGH ...................................................................... 509
CHILD COMPLETE
MULTIVITAMIN ...................................... 252
CHILD COUGH AND SORE
THROAT .................................................................. 506
CHILD DELSYM
COUGH+CHEST DM ......................... 509
CHILD DELSYM
COUGH+COLD ............................................ 478
CHILD DOMETUSS-DA ............... 477
CHILD EAR SYRINGE ... 380, 400
CHILD IBUPROFEN ............................... 31
CHILD MUCINEX CHEST
CONGESTION ............................................... 495
CHILD MUCINEX
CONGESTION-COUGH ................ 507
CHILD MUCINEX M-S COLD
DAY-NTE ............................................................... 501
CHILD MUCINEX STUFFY
NOSE-COLD ..................................................... 494
CHILD MUCUS RELIEF
COUGH ...................................................................... 509
CHILD MUCUS RELIEF
EXPECTORANT ......................................... 496
CHILD MULTI-SYMPTOM
COLD/COUGH .............................................. 507
CHILD MULTIVITAMINS ....... 254
CHILD NON-ASPIRIN QUICK
MELTS ............................................................................ 25
CHILD PAIN REL-FEVER
REDUCER ................................................................. 25
CHILD PLUS COUGH AND
RUNNYNOSE ................................................. 502
CHILD SUPPOSITORY .................. 295
CHILD TRIAMINIC
COLD-ALLERGY ..................................... 477
CHILD TRIAMINIC
COUGH-CONGEST .............................. 509
CHILD TRIAMINIC
COUGH-SORE THR ............................. 506
CHILD TRIAMINIC MS
FEVER-COLD ................................................. 501
CHILD VITAMIN WITH
MINERALS ......................................................... 252
CHILD WAL-TAP
COLD-ALLERGY ..................................... 477
CHILD WAL-TUSSIN COUGH
RELIEF ....................................................................... 489
CHILDREN NIGHT TIME
COLD-COUGH ............................................. 477
CHILDREN'S
ACETAMINOPHEN ................................. 25
CHILDREN'S ADVIL ............................. 31
CHILDREN'S ALAWAY .............. 468
CHILDREN'S ALLEGRA
ALLERGY ............................................. 487, 488
CHILDREN'S ALLERGY
(DIPHENHYD) .............................. 481, 484
CHILDREN'S ALLERGY
COMPLETE ........................................ 486, 488
CHILDREN'S ALLERGY
RELIEF(FEX) ................................... 487, 488
CHILDREN'S ALLERGY
RELIEF(LOR) .................................. 487, 488
537
Index
Index
Index
CHILDREN'S
ALLERGY(CETIRIZINE)
................................................................................... 486, 488
CHILDREN'S ALLER-TEC
................................................................................... 486, 488
CHILDREN'S ASPIRIN ....... 34, 309
CHILDREN'S CALCIUM
GUMMIES ............................................................. 225
CHILDREN'S CETIRIZINE
................................................................................... 486, 488
CHILDREN'S CHEST
CONGESTION ............................................... 496
CHILDREN'S CHEWABLE ...... 254
CHILDREN'S CHEWABLE
COMPLETE ........................................ 252, 254
CHILDREN'S CHEWABLE
MULTIVITMN ............................................... 254
CHILDREN'S CHEWABLE
PROBIOTIC ........................................................ 291
CHILDREN'S CHEWABLE
VITAMIN ................................................................ 254
CHILDREN'S CHEWABLE
W/MINERALS ................................................ 252
CHILDREN'S CHEWABLES
................................................................................................... 254
EXTRA C ................................................................ 254
WITH IRON ........................................................ 254
CHILDREN'S CLARITIN
................................................................................... 487, 488
CHILDREN'S COLD AND
COUGH (PE) ..................................................... 504
CHILDREN'S COLD AND
COUGH DM ....................................................... 504
CHILDREN'S COLD-ALLERGY
(PE) .................................................................................... 477
CHILDREN'S
COLD-COUGH-SORE ...................... 505
CHILDREN'S COMPLETE
ALLERGY ............................................. 482, 484
CHILDREN'S COMPLETE
VITAMIN ................................................................ 252
CHILDREN'S COUGH ...................... 509
CHILDREN'S COUGH AND
RUNNYNOSE ................................................. 502
CHILDREN'S DIBROMM
COLD-ALLERG .......................................... 477
CHILDREN'S DIBROMM DM
COLD-COU ......................................................... 504
CHILDREN'S EASY-MELTS .... 25
CHILDREN'S FEVER
REDUCING ............................................................. 25
CHILDREN'S FLU RELIEF ...... 501
CHILDREN'S IBUPROFEN .......... 31
CHILDREN'S IRON .............................. 229
CHILDREN'S MAPAP .......................... 25
CHILDREN'S MOTRIN ...................... 31
CHILDREN'S MUCINEX
COLD-FEVER ................................................. 505
CHILDREN'S MUCINEX
COUGH ...................................................................... 509
CHILDREN'S MUCINEX
MULTI-SYMP ................................................. 507
CHILDREN'S MUCINEX NIGHT
TIME ............................................................................... 478
CHILDREN'S MULTI-VIT
GUMMIES ............................................................. 254
CHILDREN'S MULTIVIT
W/EXTRA C ....................................................... 254
CHILDREN'S MULTIVITAMIN
................................................................................... 252, 254
CHILDREN'S NON-ASPIRIN
........................................................................................... 25, 26
CHILDREN'S NON-ASPIRIN
PAIN .................................................................................... 26
CHILDREN'S OMEGA-3
DHA-EPA ............................................................... 215
CHILDREN'S PAIN RELIEF ...... 26
CHILDREN'S PAIN RELIEVER
....................................................................................................... 26
CHILDREN'S PAIN-FEVER
RELIEF ........................................................................... 26
CHILDREN'S PEPTO .......................... 280
CHILDRENS PLUS COLD ........ 478
CHILDREN'S PLUS FLU ............. 501
CHILDRENS PLUS
MULTI-SYMP COLD ......................... 501
CHILDREN'S PROFEN IB ............. 31
CHILDREN'S Q-PAP ............................... 26
CHILDREN'S REPLESTA .......... 265
CHILDREN'S SILAPAP ...................... 26
CHILDREN'S SILFEDRINE .... 511
CHILDREN'S SOOTHE .................. 280
CHILDREN'S SOUR GUMMIES
................................................................................................... 254
CHILDREN'S SUDAFED ............. 511
CHILDREN'S SUDAFED PE
COUGH ...................................................................... 506
CHILDREN'S SUDAFED PE
NASAL ........................................................................ 511
CHILDREN'S TACTINAL .............. 26
CHILDREN'S TYLENOL ................. 26
CHILDREN'S WAL-DRYL
ALLERGY ............................................. 482, 484
CHILDREN'S WAL-ZYR
................................................................................... 486, 488
CHILDREN'S ZYRTEC
ALLERGY ............................................. 486, 488
CHILD'S ALL DAY
ALLERGY(CETIR) ................. 486, 488
CHILDS CHEW VITE ........................ 254
CHILD'S CHEWABLE
VITAMINS/IRON ..................................... 252
CHILD'S FIBER SELECT
GUMMIES ............................................................. 292
CHILD'S GUMMY
VITAMIN-MINERAL ......................... 254
CHILD'S MUCUS RELIEF M-S
COLD ............................................................................. 507
CHILDS PLUS COLD AND
ALLERGY ............................................................. 478
CHILDS TRIACTING
COLD-COUGH ............................................. 477
CHILD'S VITAMIN WITH IRON
................................................................................................... 252
CHILD'S VITAMIN WITH
VITAMIN C ........................................................ 254
CHILDS/IRON ................................................ 252
chinese red pine bk ext (bulk) .... 113
CHIRHOSTIM ................................................. 207
CHLO HIST ......................................................... 506
CHLO TUSS ....................................................... 504
chloral hydrate (bulk) ............................ 113
chlorambucil ........................................................ 113
chloramphenicol (bulk) ........... 49, 113
chloramphenicol palmitate ............ 113
chloramphenicol sod succinate ... 49
CHLORASEPTIC ....................................... 458
CHLORASEPTIC MAX .................. 461
CHLORASEPTIC MAX SORE
THROAT .................................................................. 460
CHLORASEPTIC SORE
THROAT .................................................................. 461
CHLORASEPTIC THROAT
SPRAY ........................................................................ 460
CHLORASEPTIC TOTAL ........... 462
chlordiazepoxide hcl ................................... 87
chlordiazepoxide-clidinium .......... 289
chlorhexidine (bulk) ................. 113, 144
chlorhexidine acetate (bulk)
....................................................................................... 65, 113
....................................................................... 65, 113, 458
chloroallyl methenam cl (bulk)
................................................................................... 113, 148
chlorobutanol ..................................................... 113
chloroform .............................................................. 138
CHLOROPHYLL ........................................ 369
CHLOROPHYLL (WITH
ALFALFA) ................................................................ 14
chlorophyllin copper com(bulk)
................................................................................................... 113
chloroquine phosphate ............. 44, 113
538
Index
Index
Index
chlorothiazide ........................................................ 84
chlorothiazide sodium ............................... 84
chloroxine (bulk) ........................... 113, 168
chloroxylenol (bulk) ................................. 113
CHLORPHEN SR ...................... 481, 484
chlorpheniramine maleate
................................................................... 113, 481, 484
chlorpheniramine-phenyleph-dm
................................................................................................... 504
chlorpromazine .................................................... 96
chlorpromazine (bulk) ............... 96, 113
chlorpropamide ............................................... 269
CHLORTABS ................................... 481, 484
chlorthalidone ....................................................... 84
CHLOR-TRIMETON ........... 481, 484
chlorzoxazone .................................................... 313
chocolate flavor (bulk) ......... 113, 144
chocolate hazelnut flav (bulk)
................................................................................... 113, 144
CHOCOLATE LAXATIVE ....... 297
CHOLASE CONTROL .......................... 14
CHOLBAM .......................................................... 285
cholecalciferol (vit d3)(bulk)
................................................................................... 113, 265
cholecalciferol (vitamin d3)
................................................................................... 113, 265
CHOLEST CARE ........................................... 76
CHOLEST OFF .................................................. 14
CHOLEST OFF PLUS ............................ 14
cholesterol (bulk) .......................... 113, 149
CHOLESTEROL RELIEF
....................................................................................... 76, 215
cholestyramine (bulk) ............................ 113
cholestyramine (with sugar) ............ 75
CHOLESTYRAMINE LIGHT ... 75
CHOLEXTRA .................................................. 246
cholin and mg salicylate(bulk)
....................................................................................... 33, 113
choline bitartrate (bulk) ......... 78, 113
choline chloride (bulk) ............. 78, 113
choline dihydrogen citrate ............. 215
choline,magnesium salicylate ........ 33
chondroitin sulf a sod (bulk) ....... 113
CHONDROITIN SULFATE
....................................................................................... 14, 113
chor gonadotropin, hum (bulk)
................................................................................... 113, 275
chorionic gonadotropin, human
................................................................................................... 275
chrom pico-chrom hist-min aa
................................................................................................... 234
CHROMELIN ................................................... 185
chromium amino acid chelate ... 234
chromium chloride ..................................... 234
chromium picolinate ................................ 234
chromium picolinate (bulk) ........... 113
CHROMIUM PICOLINATE
KLB6 .............................................................................. 263
chromium polynicotinate (bulk)
................................................................................... 114, 234
chromium pot sul dodeca (bulk)
................................................................................... 114, 234
CHRYSADERM DAY CREAM
................................................................................... 114, 143
CHRYSADERM NIGHT CREAM
................................................................................... 114, 143
chrysin ........................................................................... 114
chymotrypsin ....................................................... 114
CIALIS ......................................................... 208, 300
CICA-CARE ADHESIVE
SILICONE .............................................. 380, 400
CICLODAN ......................................................... 163
CICLODAN KIT .......................................... 163
ciclopirox .................................................................. 163
ciclopirox olamine ...................................... 114
ciclopirox-ure-camph-menth-euc
................................................................................................... 163
CIDAFLEX ................................................................... 8
CIDATRINE ............................................................... 8
cidofovir ......................................................................... 49
cidofovir (bulk) .................................... 49, 114
CIFEREX ................................................................. 265
cilostazol .................................................................... 309
CILOXAN .............................................................. 472
cimetidine ................................................................. 286
cimetidine (bulk) ............................................ 114
cimetidine hcl ..................................................... 286
CIMZIA .......................................................... 28, 290
CIMZIA POWDER FOR
RECONST .................................................. 28, 290
CIMZIA STARTER KIT ..... 28, 290
CINNAMON .......................................................... 14
cinnamon bark ...................................................... 14
cinnamon bark (bulk) ................. 14, 114
cinnamon bark-chromium picolin
....................................................................................................... 14
cinnamon bark-chromium-ala ...... 14
CINNAMON FLAVORING
................................................................................... 114, 144
CINNAMON OIL ....................................... 138
CINRYZE ................................................................ 304
CIPRO ............................................................................... 49
CIPRO HC .............................................................. 474
CIPRO IN D5W ................................................. 49
CIPRO XR .............................................................. 302
CIPRODEX .......................................................... 474
ciprofloxacin ............................................................ 49
ciprofloxacin (bulk) ....................... 49, 114
ciprofloxacin (mixture) ........................ 302
ciprofloxacin hcl ................ 49, 472, 474
ciprofloxacin in 5 % dextrose ........ 49
ciprofloxacin lactate .................................... 49
cisatracurium ..................................................... 312
cisplatin ........................................................................... 61
citalopram ................................................................... 92
CITANEST FORTE DENTAL
....................................................................................... 36, 458
CITANEST PLAIN DENTAL
....................................................................................... 35, 458
CITRACAL + BONE DENSITY
................................................................................................... 224
CITRACAL + D MAXIMUM
................................................................................................... 225
CITRACAL + D PETITES ........... 225
CITRACAL + D SLOW
RELEASE ............................................................... 226
CITRACAL + D3 (CALCIUM
PHOS) ........................................................................... 226
CITRACAL D + HEART
HEALTH .................................................................. 224
CITRACAL PLUS MAGNESIUM
................................................................................................... 224
CITRACAL REGULAR ................... 226
CITRANATAL (DUAL-IRON)
................................................................................................... 256
CITRANATAL 90 DHA (ALGAL
OIL) .................................................................................. 256
CITRANATAL ASSURE ............... 256
CITRANATAL B-CALM (FE
GLUC) .......................................................................... 256
CITRANATAL DHA (ALGAL
OIL) .................................................................................. 256
CITRANATAL HARMONY
(IRON FUM) ...................................................... 256
CITRATE OF MAGNESIA ........ 295
citric acid (bulk) ............................................. 114
citric acid anhydrous (bulk) ......... 114
citric acid monohydrate (bulk)
................................................................................................... 114
CITROMA ............................................................. 295
citronella oil ......................................................... 138
CITRUCEL ........................................................... 292
CITRUCEL SUGAR FREE ........ 292
citrulline ..................................................................... 114
CITRULLINE 1000 ................................. 210
CITRULLINE 200 ..................................... 210
CITRUS CALCIUM ............................... 226
CLA ...................................................................... 14, 215
cladribine ..................................................................... 57
CLAFORAN ........................................................... 48
CLARAVIS .......................................................... 155
CLARINEX .......................................... 487, 488
CLARINEX-D 12 HOUR ............... 480
clarithromycin ....................................................... 52
clarithromycin (bulk) .................. 52, 114
539
Index
Index
Index
CLARITIN ............................................. 487, 488
CLARITIN LIQUI-GEL ... 487, 488
CLARITIN REDITABS .... 487, 488
CLARITIN-D 12 HOUR .................. 480
CLARITIN-D 24 HOUR .................. 480
CLASSIC PRENATAL ...................... 256
CLEAN AND CLEAR
ADVANTAGE ................................................ 180
CLEANSING EYELID ...................... 175
CLEANSING EYELID MOIST
PADS .............................................................................. 175
CLEANSING SKIN CREAM
................................................................................................... 193
CLEANSING WASH
................................................................... 156, 189, 514
CLEAR AWAY ............................................. 180
CLEAR BANDAGES ........... 315, 400
CLEAR EYES COMPLETE ...... 469
CLEAR EYES ITCHY EYE
RELIEF ....................................................................... 469
CLEAR EYES REDNESS
RELIEF ....................................................................... 470
CLEAR GLASS SERUM
BOTTLE .................................................... 356, 400
CLEAR SPOT BANDAGES
................................................................................... 315, 400
CLEAR STRIPS ............................ 315, 400
CLEAR TAPE .................................. 317, 400
CLEAR WATERPROOF STRIPS
................................................................................... 315, 400
CLEARBLUE DIGITAL
OVULATION ................................... 206, 400
CLEARBLUE EASY
OVULATION TEST .............. 206, 400
CLEARBLUE FERTILITY
MONITOR ............................................. 206, 400
CLEARBLUE FERTILITY
STICKS ....................................................... 206, 400
CLEARCANAL EAR WAX ..... 475
CLEARLAX ........................................................ 295
clemastine ................................ 114, 482, 484
clemizole hcl (bulk) ................... 114, 489
CLEO 90 INFUSION SET 24"
................................................................................... 329, 400
CLEO 90 INFUSION SET 31"
................................................................................... 329, 400
CLEOCIN .................................................... 51, 512
CLEOCIN IN 5 % DEXTROSE
....................................................................................................... 51
CLEOCIN T ......................................................... 156
CLERZ PLUS ................................... 400, 466
CLEVER CHEK BLOOD
GLUCOSE ............................................. 332, 400
CLEVER CHEK BLOOD
GLUCOSE SYST ........................ 332, 400
CLEVER CHOICE BLOOD
GLUC SYS ............................................ 332, 400
CLEVER CHOICE GLUCOSE
MONITOR ............................................. 332, 400
CLEVER CHOICE LEVEL 1
CONTROL ............................................. 332, 400
CONTROL ............................................. 332, 400
CONTROL ............................................. 332, 400
CLEVER CHOICE MICRO
................................................................................... 332, 400
CLEVER CHOICE PRO
................................................................................... 332, 400
CLEVIPREX .......................................................... 81
CLICKFINE ......................................... 350, 400
clidinium bromide (bulk)
................................................................................... 114, 289
CLIMARA ............................................................. 272
CLIMARA PRO ............................................ 272
CLINDACIN ETZ ...................................... 156
CLINDACIN P ................................................ 156
CLINDACIN PAC ..................................... 156
CLINDAGEL ..................................................... 156
clindamycin hcl ................................................... 51
clindamycin hcl (bulk) .......................... 114
clindamycin in 5 % dextrose ........... 51
clindamycin palmitate hcl ................... 51
CLINDAMYCIN PEDIATRIC
....................................................................................................... 51
....................................................... 51, 114, 156, 512
clindamycin phosphate (bulk) ... 114
clindamycin-benzoyl peroxide
................................................................................................... 157
CLINDESSE ....................................................... 512
CLINIMIX 5%/D15W SULFITE
FREE ............................................................................... 250
CLINIMIX 5%/D25W
SULFITE-FREE ............................................ 250
CLINIMIX 2.75%/D5W SULFIT
FREE ............................................................................... 250
CLINIMIX 4.25%/D10W SULF
FREE ............................................................................... 250
CLINIMIX 4.25%/D5W SULFIT
FREE ............................................................................... 251
CLINIMIX 4.25%-D20W
SULF-FREE ........................................................ 251
CLINIMIX 4.25%-D25W
SULF-FREE ........................................................ 251
CLINIMIX
5%-D20W(SULFITE-FREE) .... 251
CLINIMIX E 2.75%/D10W SUL
FREE ............................................................................... 251
CLINIMIX E 2.75%/D5W SULF
FREE ............................................................................... 251
FREE ............................................................................... 251
FREE ............................................................................... 251
CLINIMIX E 4.25%/D5W SULF
FREE ............................................................................... 251
CLINIMIX E 5%/D15W SULFIT
FREE ............................................................................... 251
FREE ............................................................................... 251
FREE ............................................................................... 251
CLINISOL SF 15 % ................................ 251
CLINITEST REAGENT ... 384, 400
CLINPRO 5000 .............................................. 457
clioquinol .................................................................. 114
clobetasol ................................................................. 176
clobetasol propionate (bulk) ....... 114
clobetasol-emollient ................................. 176
CLOBEX .................................................................. 176
clocortolone pivalate .............................. 176
CLODAN ................................................................. 176
CLODAN KIT .................................................. 179
CLODERM ........................................................... 176
clofazimine (bulk) ............................ 43, 114
CLOLAR ...................................................................... 57
clomiphene citrate ....................................... 273
clomiphene citrate (bulk)
................................................................................... 114, 273
clomipramine .......................................................... 93
clomipramine (bulk) ..................... 93, 114
clonazepam .................................................... 87, 88
clonazepam (bulk) ............... 87, 88, 114
clonidine ......................................................................... 83
clonidine (pf) ........................................................... 20
clonidine hcl ................................................. 83, 97
clonidine hcl (bulk) .................................... 114
clopidogrel ............................................................. 309
clorazepate dipotassium ........................ 88
CLORPACTIN WCS-90 ...................... 65
CLORPRES .............................................................. 83
CLOSED-END POUCH ... 369, 400
CLOTH FIRST AID TAPE
................................................................................... 317, 400
CLOTH TAPE .................................. 317, 400
clotrimazole .......................... 163, 458, 512
clotrimazole (bulk) ..................................... 114
CLOTRIMAZOLE 3 DAY ........... 512
CLOTRIMAZOLE AF ........................ 163
CLOTRIMAZOLE-3 ............................. 512
CLOTRIMAZOLE-7 ............................. 512
clotrimazole-betamethasone ........ 165
CLOVE FLAVORING ....... 114, 144
540
Index
Index
Index
clove oil (bulk) .................................................. 138
CLOVERINE ..................................................... 187
clozapine ........................................................................ 95
C-NATE DHA .................................................. 256
CNL 8 NAIL ....................................................... 163
CO Q-10 ......................................................................... 14
CO Q-10 (WITH VIT E) ...................... 14
co q10-red yeast rice ................................... 14
CO Q-10-VITAMIN E-FISH OIL
....................................................................................................... 14
COAGUCHEK LANCETS
................................................................................... 332, 400
COAGUCHEK PT ..................... 205, 400
COAGUCHEK XS .... 205, 318, 400
COAGUCHEK XS PRO
................................................................................... 318, 400
coal tar ......................................................................... 182
coal tar (bulk) .................................................... 182
coal tar (crude) ................................................ 114
COARTEM ............................................................... 44
cobalt gluconate ............................................. 114
cobamamide (bulk) .................... 114, 262
COBAN ACTION WRAP
................................................................................... 321, 400
COBAN SELF-ADHERENT
WRAP ........................................................... 321, 401
cocaine ......................................................................... 192
cocaine (bulk) .................................... 114, 192
cocoa butter .......................................................... 140
cocoa butter (bulk) ..................... 114, 140
COCOA BUTTER CREAM ....... 171
COCOA BUTTER PETROLEUM
................................................................................................... 187
coconut diethanolamide (bulk)
................................................................................... 114, 150
coconut flavor (bulk) ............... 114, 144
coconut oil ............................................................... 215
coconut oil (bulk) ......................... 114, 144
COCONUT OIL CREAM .............. 171
COD LIVER OIL ............................. 76, 260
cod liver oil ............................................................ 243
cod liver oil (bulk) ....................................... 114
COD LIVER OIL CONC WITH
VIT C .............................................................................. 243
cod liver oil-ascorbic acid .............. 243
codeine phosphate (bulk) ..... 20, 114
codeine sulfate ...................................................... 20
codeine-guaifenesin .................................. 498
CODITUSS DM ............................................ 504
coenzyme q10 ......................................................... 14
coenzyme q10 (bulk) .................... 14, 114
coenzyme q10-l-carnitine-vit e ..... 14
coenzyme q10-vitamin e ......................... 14
coffee flavor (bulk) ..................... 114, 144
COGENTIN ............................................................. 94
cola (syrup) ........................................................... 284
cola flavor (bulk) .......................... 114, 144
COLACE .................................................................. 297
COLACE CLEAR ...................................... 297
COLAZAL ............................................................. 290
colchicine ................................................. 114, 303
colchicine-probenecid ........................... 303
COLCRYS ............................................................. 303
COLD AND ALLERGY .................. 477
COLD AND ALLERGY PE ....... 477
COLD AND COUGH
(DIPHENHYDR-PE) ............................. 477
COLD AND COUGH
(PE-DM-GG-ACET) .............................. 505
COLD AND COUGH DM ............ 504
COLD AND COUGH ELIXIR
................................................................................................... 504
COLD AND FLU FIGHTER ........ 14
COLD AND FLU
RELIEF(DIPHEN-PE) ......................... 478
COLD AND FLU SEVERE ........ 505
COLD AND HOT EXTRA
STRENGTH ......................................... 193, 195
COLD AND HOT PAIN RELIEF
................................................................................... 193, 195
COLD AND HOT THERAPY
BALM ........................................................................... 193
COLD AND SINUS PAIN
RELIEF ....................................................................... 495
COLD HEAD
CONGEST(GG-PE-ACETM)
................................................................................................... 494
COLD HEAD CONGESTION
DAY/NITE ............................................................. 501
DAYTIME ............................................................. 506
NIGHTTIME ...................................................... 501
SEVER DAY ...................................................... 505
COLD MULTI-SYMPTOM ....... 506
COLD MULTI-SYMPTOM
(CHLORPHEN) ............................................. 502
COLD MULTI-SYMPTOM
DAY/NIGHT ...................................................... 502
COLD MULTI-SYMPTOM
NIGHTTIME ...................................................... 502
COLD PACK ..................................... 320, 401
COLD PACK BACK PAD
................................................................................... 341, 401
COLD RELIEF ............................................... 479
COLD RELIEF M/S DAY/NIGHT
................................................................................................... 502
COLD RELIEF PLUS .......................... 479
COLD SEVERE CONGESTION
................................................................................................... 505
COLD SORE TREATMENT
....................................................................................... 66, 459
COLD SORE TREATMNT
(BENZ-CMPH) ............................................... 459
COLD SORE TREATMNT
(CAMP-PHEN) ............................................... 160
COLD WRAP ................................... 341, 401
COLD-COUGH SINUS RELIEF
PE ......................................................................................... 505
COLD-FLU RELIEF .............. 502, 506
COLD-FLU RELIEF,
DAY/NIGHT ...................................................... 502
COLD-SINUS RELIEF ...................... 495
COLESTID ................................................................ 75
COLESTID FLAVORED ................... 75
colestipol ....................................................................... 75
colistimethate sodium (bulk)
....................................................................................... 53, 114
colistin (colistimethate na) ................. 54
colistin sulfate (bulk) .............................. 114
COLLAGEN PLUS VITAMIN C
................................................................................................... 215
collagen, hydr (bovine) (bulk)
................................................................................... 114, 174
collagenase clos hist. (bulk) ......... 114
collodion (bulk) ............................................... 114
colloidal oatmeal .......................................... 174
COLLYRIUM ................................................... 471
COLOCORT ....................................................... 290
COLON HERBAL CLEANSER
....................................................................................................... 14
COLOPLAST BARRIER RING
................................................................................... 369, 401
COLOPLAST IRRIGATION SET
................................................................... 354, 369, 401
COLOPLAST PASTE .......... 369, 401
COLOPLAST SKIN BARRIER
................................................................................... 369, 401
colostrum, bovine ............................................. 14
COLOX ....................................................................... 292
COL-RITE .............................................................. 297
COLY-MYCIN M
PARENTERAL .................................................. 54
COLYTE WITH FLAVOR
PACKS ........................................................................ 295
COMBIGAN ....................................................... 469
COMBINATION CONE/TUBE
DRAIN ......................................................... 354, 401
COMBINATION WATER
BOTTLE .................................................... 356, 401
COMBINE ABD ........................... 326, 401
COMBIPATCH .............................................. 272
541
Index
Index
Index
COMBISTIX REAGENT
COMFORT SHORT INSULIN
PUMP 23" ............................................... 330, 401
PUMP 32" ............................................... 330, 401
PUMP 43" ............................................... 330, 401
COMFORT-STRETCH DIAPERS
................................................................................... 347, 401
COMFORT-STRETCH
TRAINING PANTS ................ 347, 402
COMPACT COMPRESSOR
NEBULIZER ...................................... 359, 402
COMPACT ULTRASONIC
NEBULIZER ...................................... 359, 402
COMP-AIR ELITE COMP NEB
SYSTEM ................................................... 377, 402
COMP-AIR NEBULIZER
COMPRESSOR ............................. 377, 402
COMP-AIR XLT COMPRESSOR
NEB .................................................................. 377, 402
COMPAZINE .................................................... 284
COMPETE ............................................................. 237
COMPLEAT ....................................................... 215
COMPLEAT PEDIATRIC
REDUCED CAL ........................................... 215
COMPLERA ........................................................... 46
COMPLETE ........................................ 237, 287
COMPLETE 50+ .......................................... 237
COMPLETE ALLERGY
................................................................................... 482, 484
COMPLETE ALLERGY
MEDICINE ........................................... 482, 484
COMPLETE AMINO ACID MIX
................................................................................................... 210
COMPLETE FORMULATION
D3000 ............................................................................. 254
MULTIVIT ............................................................ 254
PEDIATRIC ......................................................... 254
COMPLETE LICE TREATMENT
................................................................................................... 197
COMPLETE MULTI ............................. 237
COMPLETE MULTI 50+ .............. 237
COMPLETE MULTIVITAMIN
................................................................................................... 237
COMPLETE
MULTIVITAMIN-MINERAL
................................................................................... 237, 243
COMPLETE NATAL DHA ........ 256
COMPLETE NUTRITION ........... 215
COMPLETE NUTRITION PLUS
................................................................................................... 215
COMPLETE PREMIUM
VITAMIN ................................................................ 237
COMPLETE SENIOR ......... 222, 237
COMPLETE SINUS RELIEF
................................................................................................... 478
COMPLETENATE ................................... 256
COMPLEX 15 .................................................. 171
COMPLEX B-100 ...................... 211, 213
COMPLEX B-50 .......................................... 211
COMPLEX ESSENTIAL ............... 246
COMPLEX JUNIOR MSD .......... 246
COMPLEX MSUD ................................... 246
COMPLEX MSUD AMINO
ACID BLEND .................................................. 246
COMPOUND 347 ........................................... 34
COMPOUND W ........................................... 180
COMPOZ ................................................. 103, 484
COMPRO ................................................................ 284
COMTAN .................................................................... 94
CONCEPT DHA ........................................... 256
CONCEPT OB ................................................. 256
CONCEPTION ................................ 320, 402
CONCEPTIONXR MOTILITY
....................................................................................................... 14
CONCEPTIONXR
REPRODUCTIVE ......................................... 14
CONCEPTROL .............................................. 155
CONCERTA ........................................................... 97
CONDOMS-PREM
LUBRICATED ................................ 355, 402
CONDROLITE ....................................................... 8
CONDYLOX ..................................................... 180
CONE-TUBE IRRIGATION SET
................................................................................... 354, 402
CONEX ....................................................................... 477
CONFORM ........................................... 324, 402
CONFORMANT 2 .................... 326, 402
CONGESTAC .................................................. 494
CONGESTION RELIEF
(IBUPROF-PE) ............................................... 495
CONRAY ................................................................. 204
CONRAY 43 ....................................................... 204
CONRAY-30 ...................................................... 204
CONSTULOSE .............................................. 295
CONTAC COLD-FLU DAY AND
NIGHT ......................................................................... 478
CONTAC COLD-FLU MAX
STRENGTH ......................................................... 478
CONTAC COLD-FLU NIGHT
................................................................................................... 503
CONTACT DETACH INFUS SET
23" ....................................................................... 330, 402
32" ....................................................................... 330, 402
43" ....................................................................... 330, 402
205, 401
COMBIVENT RESPIMAT ......... 493
COMBIVIR .............................................................. 46
COMETRIQ ............................................................. 60
COMFEEL PLUS CLEAR
DRESSING ........................................... 200, 401
COMFEEL PLUS CONTOUR
DRESSING ........................................... 200, 401
COMFEEL PLUS PRESSURE
RELIEF ....................................................... 200, 401
COMFEEL PLUS PRESSURE
ROUND ...................................................... 200, 401
COMFEEL PLUS TRIANGLE
DRESSING ........................................... 200, 401
COMFEEL PLUS ULCER
DRESSING ........................................... 200, 401
COMFEEL PURILON ........ 200, 401
COMFEEL SEASORB ....................... 200
COMFEEL ULCER CARE
DRESSING ........................................... 200, 401
COMFORT EZ PEN NEEDLES
................................................................................... 350, 401
COMFORT EZ SYRINGE
................................................................................... 350, 401
COMFORT GEL .......................................... 281
COMFORT GEL EXTRA
STRENGTH ......................................................... 281
COMFORT INFUSION SET 23"
................................................................................... 329, 401
................................................................................... 354, 401
................................................................................... 329, 401
................................................................................... 329, 401
COMFORT LANCETS ...... 332, 401
COMFORT
PAC-CYCLOBENZAPRINE ... 314
COMFORT PAC-IBUPROFEN
....................................................................................................... 30
COMFORT PAC-MELOXICAM
....................................................................................................... 30
COMFORT PAC-NAPROXEN
....................................................................................................... 30
COMFORT PAC-TIZANIDINE
................................................................................................... 314
COMFORT SHIELD ............................. 185
COMFORT SHORT INFUSION
SET 23" ....................................................... 354, 401
SET 31" ....................................................... 354, 401
SET 43" ....................................................... 354, 401
...................................................................................
542
Index
Index
Index
CONTACT LENS RELIEF
................................................................................... 402, 466
CONTI CASTILE SOAP ................. 190
CONTOUR CONTROL
SOLUTION, HIGH .................. 332, 402
CONTOUR CONTROL
SOLUTION, LOW .................... 332, 402
CONTOUR CONTROL
SOLUTION, NML ..................... 332, 402
CONTOUR I STOMA CAP
................................................................................... 369, 402
CONTOUR LINK ....................... 332, 402
CONTOUR METER ............... 332, 402
CONTOUR NEXT EZ METER
................................................................................... 332, 402
CONTOUR NEXT LEV 1
CONTROL SOL ........................... 332, 402
CONTOUR NEXT LEV 2
CONTROL SOL ........................... 332, 402
CONTOUR NEXT LINK
................................................................................... 332, 402
CONTOUR NEXT METER
................................................................................... 332, 402
CONTOUR NEXT USB METER
................................................................................... 332, 402
CONTRAVE ....................................................... 209
CONTROL MONITORING
SYSTEM ................................................... 332, 402
CONVATEC NIGHT DRAIN
CONTAINER .................................... 369, 402
CONVATEC NIGHT
DRAINAGE TUBING ........ 369, 402
CONVEEN DRIP COLLECTOR
................................................................................... 342, 402
CONVEX SYN BARR - FLOAT
FLANGE ................................................... 369, 402
CONZIP ......................................................................... 20
COOL AND HEAT .................................. 195
COOL BOTTOMS .................................... 187
COOL HEAT
(M-SALICYLATE-MENTH) ... 193
COOL MIST HUMIDIFIER 1
GALLON ................................................. 341, 402
COOL 'N HEAT ............................................ 195
COOL 'N HEAT EXTRA
STRENGTH ......................................................... 193
COOLING BURN ...................................... 183
COOLMAGIC .................................. 200, 402
COOLMAGIC FENESTRATED
................................................................................... 200, 402
COPA HYDROPHILIC FOAM
................................................................................... 200, 403
COPASIL ................................................. 114, 147
COPAXONE ....................................................... 463
COPPER CHLORIDE .......................... 234
copper gluconate ........................................... 234
copper gluconate (bulk) ..... 114, 234
copper glycinate (bulk) ........ 114, 234
COPPER SULFATE ............................... 114
COQ-10 ........................................................................... 14
coq10 (ubiquinol) ............................................. 14
CORAL CALCIUM
................................................................... 114, 224, 227
CORDARONE ..................................................... 75
CORDRAN ........................................................... 176
CORDRAN TAPE LARGE ROLL
................................................................................................... 176
CORDRAN TAPE SMALL ROLL
................................................................................................... 176
COREG ........................................................................... 72
COREG CR .............................................................. 72
CORGARD ............................................................... 80
CORICIDIN HBP ....................... 503, 509
CORICIDIN HBP COLD AND
FLU ................................................................................... 476
CORICIDIN HBP COLD-MULTI
SYMPT ........................................................................ 503
CORICIDIN HBP COUGH AND
COLD ............................................................................. 506
CORICIDIN HBP DAY-NIGHT
................................................................................................... 489
CORIFACT ........................................................... 305
CORLANOR .......................................................... 85
CORLOPAM .......................................................... 85
CORMAX ............................................................... 176
CORN AND CALLUS
REMOVER ........................................................... 180
CORN CUSHION ....................................... 403
corn oil ......................................................................... 114
CORN REMOVER ................................... 180
corn starch .............................................................. 187
corn starch (bulk) ......................................... 114
CORN-CALLUS REMOVER
................................................................................................... 180
CORNWALL METAL
PIPETTING .......................................... 375, 403
COROMEGA ......................................... 76, 215
CORRECTOL ................................................... 297
CORTAID ............................................................... 176
CORTANE-B ..................................................... 474
CORTEF .................................................................... 273
CORTENEMA ................................................. 290
CORTICOOL ..................................................... 176
corticotropin ........................................ 114, 267
CORTIFOAM ................................................... 290
cortisone ..................................................................... 273
cortisone (bulk) ............................................... 115
CORTISONE
(HYDROCORTISONE) .................... 176
CORTISONE + COOLING
RELIEF ....................................................................... 176
CORTISPORIN .............................................. 161
CORTISPORIN-TC ................................. 474
CORTIZONE-10 .......................................... 176
CORTIZONE-10 PLUS ..................... 176
CORTROSYN .................................................. 207
CORVERT ................................................................. 75
CORVITA ............................................................... 237
CORVITA 150 ................................................. 228
CORVITE ................................................................ 237
CORVITE 150 .................................................. 228
CORVITE FE .................................................... 228
CORVITE FREE .......................................... 237
CORZIDE .................................................................... 85
COSAMIN DS ......................................................... 8
COSAMIN DS (WITH
MANGANESE) ..................................................... 8
COSENTYX ........................................................ 159
COSENTYX (2 SYRINGES) ... 159
COSENTYX PEN ....................................... 159
COSENTYX PEN (2 PENS) ...... 159
COSMEGEN .......................................................... 62
COSMETIC BALLS .............. 318, 403
COSMETIC PUFFS ................ 318, 403
COSOPT .................................................................... 469
COSOPT (PF) ................................................... 469
cosyntropin ............................................................. 207
COTTON BALLS ....................... 318, 403
COTTON BALLS STERILE
................................................................................... 318, 403
cotton candy flavor (bulk)
................................................................................... 115, 144
COTTON SNAP PANTS
................................................................................... 342, 403
COTTON SQUARES ........... 318, 403
COTTON SWABS .................... 318, 403
COTTON, STERILE .............. 318, 403
cottonseed oil (bulk) ................. 115, 138
COUGH AND COLD ........... 506, 508
COUGH AND COLD BP ............... 506
COUGH AND COLD MUCUS
RELIEF CF ........................................................... 508
COUGH AND RUNNY NOSE
................................................................................................... 506
COUGH AND SEVERE COLD
................................................................................................... 478
COUGH CONTROL
(DEXTROMETHORPH) ................. 489
COUGH CONTROL
(GUAIFENESIN) ........................................ 496
COUGH CONTROL CF (PE)
................................................................................................... 508
COUGH CONTROL DM ............... 509
543
Index
Index
Index
COUGH CONTROL DM MAX
................................................................................................... 509
COUGH DM ER ........................................... 489
COUGH DROPS .......................... 461, 489
COUGH DROPS (WITH
EUCALYPTUS) ............................................ 461
COUGH FORMULA DM .............. 509
COUGH RELIEF ......................................... 489
COUGH
SUPPRESSANT-EXPECTORAN
T ............................................................................................. 509
COUGH SYRUP .......................................... 496
COUGH SYRUP DM ........................... 509
COUGH-SORE THROAT NIGHT
................................................................................................... 503
COUGHTAB ...................................................... 496
COUMADIN ...................................................... 304
coumarin .................................................................... 115
COVARYX ........................................................... 272
COVARYX H.S. ........................................... 272
COZAAR ..................................................................... 73
cpd vehicle sus.sugar-free #12
................................................................................................... 147
CPL DRAINABLE POUCH
................................................................................... 369, 403
CRAMP TABS .................................................... 24
cranberry ...................................................................... 14
cranberry conc-ascorbic acid ....... 14
cranberry conc-c-bacillus coag
....................................................................................................... 14
CRANBERRY CONCENTRATE
....................................................................................................... 14
cranberry extract .............................................. 14
cranberry extract (bulk) ......... 14, 115
cranberry fruit ....................................................... 15
cranberry fruit concentrate ............... 15
CRANBERRY JUICE POWDER
....................................................................................................... 15
CRANBERRY PLUS VITAMIN
C ................................................................................................. 15
CRANBERRY URINARY
COMFORT ............................................................ 243
CRANBERRY-PROBIOTIC .... 215
CRANBERRY-PROBIOTICS-VI
TAMIN C ..................................................................... 15
CRAN-MAX ........................................................... 15
CRAN-MAX 500 MG .............................. 15
cran-raspberry flavor (bulk)
................................................................................... 115, 144
cream base no.43 (bulk) ..... 115, 143
cream de menthe (bulk) ....... 115, 144
CREAMY ACNE FACE .................. 158
creatine (bulk) ....................................... 15, 115
creatine monohydrate ............................ 210
creatine monohydrate (bulk)
....................................................................................... 15, 115
creatinine (bulk) ............................. 115, 207
CREON ....................................................................... 285
CRESEMBA ........................................................... 43
CRESTOR .................................................................. 76
CRINONE ............................................... 273, 514
CRITIC-AID ....................................................... 185
CRITIC-AID CLEAR ........................... 187
CRITIC-AID CLEAR AF ............... 163
CRIXIVAN ............................................................... 54
CROFAB ...................................................................... 67
CRO-MAN-ZIN ............................................. 234
cromolyn ........ 60, 115, 471, 491, 498
crotamiton (bulk) .......................... 115, 197
croton oil (bulk) .............................. 115, 193
crutch .............................................................. 320, 403
CRUTCH ACCESSORY KIT
................................................................................... 356, 403
CRUTCH HANDGRIPS
................................................................... 320, 356, 403
CRUTCH TIPS ............... 320, 356, 403
CRYOSERV ........................................................ 138
CRYSELLE (28) ........................................... 152
C-TUB .......................................................... 356, 403
CUBICIN ..................................................................... 49
CULTURELLE ............................................... 291
CULTURELLE IMMUNE
DEFENSE ............................................................... 291
CULTURELLE KIDS
PROBIOTICS .................................................... 291
CULTURELLE PROBIOTICS
................................................................................................... 291
cupric sulfate pentahyd (bulk)
................................................................................................... 115
CUPRIMINE .............................................. 29, 40
CURAD NON-STICK PAD
................................................................................... 326, 403
CURAFIL GEL WOUND
................................................................................... 200, 403
CURCUMIN ....................................................... 115
CURE CHROME ............................................. 66
CURI-STRIP WOUND
CLOSURES ......................................... 317, 403
CURITY 8000 URINE MTR FLY
TRAY ............................................................. 383, 403
CURITY ABDOMINAL PAD
................................................................................... 326, 403
CURITY ABSORBENT
WADDING ........................................... 318, 403
CURITY ALCOHOL SWABS ... 64
CURITY AMD ................................ 324, 403
CURITY AMD (WITH
POLYHEXAMETH) .............. 200, 403
CURITY BANDAGE ........... 321, 403
CURITY BEDSIDE DRAINAGE
BAG ................................................................. 342, 403
CURITY BEDSIDE DRAINAGE
SET .................................................................... 383, 403
CURITY BEDSIDE-MONO-FLO
DRANGE ................................................. 383, 403
CURITY COTTON PREP BALLS
................................................................................... 318, 403
CURITY COTTON TIP
APPLICATOR ................................. 318, 403
CURITY COVER ....................... 326, 403
CURITY DETECTABLE LAP
................................................................................... 324, 403
CURITY DISP LAP SPONGE
POUCH ....................................................... 324, 403
CURITY DISP LAP SPONGE
TRAY ............................................................. 324, 404
CURITY DRAINAGE BAG
................................................................................... 342, 404
CURITY DRESSING
................................................................... 200, 324, 404
CURITY EYE ................................... 323, 404
CURITY FOLEY CATHETER
KIT ..................................................................... 383, 404
CURITY GAUZE ....... 324, 325, 404
CURITY GAUZE BURN
DRESSING ........................................... 200, 404
CURITY IODOFORM PACKING
STRIP ............................................................ 326, 404
CURITY LUMBAR PUNCTURE
TRAY ............................................................. 375, 404
CURITY MULTI-TRAUMA
DRESSING ........................................... 325, 404
CURITY NON-ADHERENT
STRIP ............................................ 325, 326, 404
CURITY NON-ADHERING
DRESSING ........................................... 326, 404
CURITY PLAIN PACKING
STRIP ............................................................ 325, 404
CURITY PREMIUM CATHETER
TRAY ............................................................. 383, 404
CURITY READY-CUT GAUZE
................................................................................... 325, 404
CURITY SKIN SCRUB .... 375, 404
CURITY SPNG COUNTER BAG
STRIPS ........................................................ 356, 404
CURITY STERILE WATER .... 223
CURITY STRMLIN CATH MONO-FLO ........................................ 383, 404
CURITY THORACENTESIS
TRAYS ........................................................ 375, 404
CURITY
THORACENTESIS-CATH TRAY
................................................................................... 375, 404
544
Index
Index
Index
CURITY TRIANGULAR
BANDAGE ........................................... 356, 404
CURITY ULTRAMER 2-WAY
CATHETER ......................................... 383, 404
CURITY ULTRAMER IRRG
3WAY CATH ................................... 383, 404
CURITY ULTRAMER
URETHRAL CATH ................ 383, 405
CURITY UNIVERSAL - NO
DRAINAGE ......................................... 383, 405
CURITY URETERAL DRAIN
SET .................................................................... 342, 405
CURITY URETH CATH
CLOSED SYSTM ...................... 383, 405
CURITY URETH CATH OPEN
SYSTEM ................................................... 383, 405
CURITY URETHRAL
CATHETER ......................................... 383, 405
CURITY URINE METER
................................................................................... 342, 405
CURITY WET DRESSING
................................................................................... 200, 405
CUROSURF ........................................................ 496
CUSHION INSOLE ................ 324, 405
CUSTOM BASE PCCA
LIPODERM ......................................... 115, 171
CUT N CRUSH .............................. 356, 405
CUTAR ....................................................................... 182
CUTEMOL ............................................................ 174
CUTICERIN DRESSING
................................................................................... 326, 405
CUTIEPANTS TRAINING
PANTS ......................................................... 347, 405
CUTIES BABY DIAPERS
................................................................................... 347, 405
CUTINOVA HYDRO DRESSING
................................................................................... 200, 405
CUTIS PLUS ...................................... 115, 140
CUTIVATE .......................................................... 176
CUVPOSA ............................................................. 462
cyanocobalamin (vitamin b-12)
................................................................................... 115, 262
CYANOKIT ............................................................. 39
CYCLAFEM 1/35 (28) ....................... 152
CYCLAFEM 7/7/7 (28) ..................... 154
cyclandelate .............................................. 86, 115
CYCLESSA (28) .......................................... 154
CYCLINEX-1 ................................... 218, 250
CYCLINEX-2 ................................................... 250
cyclobenzaprine .............................................. 313
cyclobenzaprine (bulk) ......... 115, 313
CYCLODEXTRIN REAGENT
....................................................................................... 40, 115
CYCLOGYL ....................................................... 467
CYCLOMETHICONE ........ 115, 150
CYCLOMYDRIL ........................................ 467
cyclopentolate .................................................... 467
cyclopentolate (bulk) ............... 115, 467
cyclophosphamide ............................... 29, 56
cyclophosphamide (bulk) ...... 56, 115
cycloserine .................................................................. 46
cycloserine (bulk) ............................. 46, 115
CYCLOSET ......................................................... 269
cyclosporine ............................. 29, 115, 310
cyclosporine modified ............... 29, 310
CYKLOKAPRON ...................................... 305
CYMBALTA ......................................... 92, 100
cyproheptadine ................................. 483, 484
cyproheptadine (bulk) ........... 115, 483
CYRAMZA .............................................................. 62
CYSTADANE .................................................. 457
CYSTAGON ....................................................... 299
CYSTARAN ....................................................... 469
cysteamine hcl (bulk) .............. 115, 299
cysteine (l-cysteine) ... 115, 210, 251
cysteine (l-cysteine) (bulk) ............. 115
cysteine hcl(l-cysteine)(bulk) ...... 115
CYSTEX CRANBERRY ................ 215
CYSTEX PLUS
(METHENAMINE-SAL) ................ 302
CYSTO-CONRAY II ............................ 204
CYSTOGRAFIN .......................................... 204
CYSTOGRAFIN-DILUTE ........... 204
cytarabine .................................................................... 57
cytarabine (pf) ....................................................... 57
CYTO B-2 ............................................................... 263
CYTO B7 ................................................................. 264
CYTOGAM .............................................................. 68
CYTOMEL ............................................................ 278
CYTO-Q ........................................................................ 15
CYTO-Q MAX ................................................... 15
CYTO-Q T-F .......................................................... 15
CYTOSE ................................................................... 246
CYTOTEC ............................................................. 287
CYTOTINE .......................................................... 215
CYTOVENE ........................................................... 49
CYTRA K CRYSTALS .................... 301
CYTRA-2 ................................................................. 301
CYTRA-3 ................................................................. 301
CYTRA-K ............................................................... 301
d and c green no.6 (bulk)
................................................................................... 115, 139
D.H.E.45 .................................................................... 101
d10 %-0.45 % sodium chloride
................................................................................................... 214
d2.5 %-0.45 % sodium chloride
................................................................................................... 214
D3 + K2 DOTS ............................................... 265
D3-2000 ...................................................................... 265
d5 % and 0.9 % sodium chloride
................................................................................................... 214
d5 %-0.45 % sodium chloride ... 214
dacarbazine ............................................................... 56
DACOGEN ............................................................... 57
DAFLONEX-XL .......................................... 213
DAILY AMINO ............................................ 210
DAILY ENERGY ....................................... 237
DAILY FACE WASH ......................... 158
DAILY FIBER
(PSYLLIUM-SUCROSE) .............. 292
DAILY GARLIC ONCE-A-DAY
....................................................................................................... 15
DAILY GUMMIES .................................. 237
DAILY MOISTURIZING
LOTION ..................................................................... 171
DAILY MULTIPLE ................ 237, 243
DAILY MULTIPLE FOR MEN
................................................................................................... 237
DAILY MULTIPLE FOR MEN
50+ ...................................................................................... 243
DAILY MULTIPLE FOR
WOMEN ................................................................... 243
DAILY MULTIPLE
VITAMINS/IRON ..................................... 237
DAILY MULTIPLE WEIGHT
LOSS ............................................................................... 237
DAILY MULTIVITAMIN ........... 237
DAILY MULTI-VITAMIN ......... 243
DAILY MULTIVITAMIN WITH
IRON ............................................................................... 243
DAILY
MULTIVITAMIN-MINERALS
................................................................................... 222, 237
DAILY
MULTI-VITAMINS/IRON ......... 237
DAILY PRENATAL .............................. 256
DAILY VALUE ............................................ 243
DAILY VITAMIN FORMULA
................................................................................................... 243
DAILY VITAMIN FORMULA +
IRON ............................................................................... 243
DAILY VITAMIN
FORMULA-MINERALS ................ 237
DAILY VITAMIN WITH IRON
................................................................................................... 237
DAILY VITAMIN WITH IRON
AND CA .................................................................... 237
DAILY VITES/IRON ........................... 237
DAILY-VITE ..................................... 237, 243
DAIRY AID ......................................................... 285
DAIRY DIGESTIVE ............................. 285
DAIRY DIGESTIVE
SUPPLEMENT ............................................... 285
DAIRY RELIEF ............................................ 285
545
Index
Index
Index
DAKIN'S SOLUTION ............................. 65
DAKLINZA ............................................................. 50
dalfampridine (bulk) ................................ 115
DALIRESP ............................................................ 491
DALLERGY
(CHLORPHENIRAMINE-PE)
................................................................................................... 477
DALLERGY
(DEXBROMPHENIRAMN-PE)
................................................................................................... 477
DALVANCE .......................................................... 51
danazol ......................................................... 115, 275
DANDRUFF SHAMPOO .............. 168
DANDRUFF SHAMPOO (SELEN
SULF) ............................................................................ 168
DANDRUFF
SHAMPOO/CONDITIONER
................................................................................................... 168
DANTRIUM ....................................................... 313
dantrolene ................................................................ 313
dantrolene (bulk) ........................... 115, 313
dapiprazole (bulk) ....................... 115, 466
dapsone ............................................................................ 44
dapsone (bulk) ....................................... 44, 115
DAPTACEL (DTAP PEDIATRIC)
(PF) ........................................................................................ 69
DARAPRIM ............................................................ 44
DASETTA 1/35 (28) .............................. 152
DASETTA 7/7/7 (28) ............................ 154
DATSCAN ............................................................. 208
daunorubicin ........................................................... 62
DAUNOXOME .................................................. 62
DAVOL C.S. FOLEY
CATHETER TRAY ................. 383, 405
DAVOL COMPLETE FOLEY
................................................................................... 383, 405
DAVOL FOLEY CATH INSERT
TRAY ............................................................. 383, 405
DAVOL IRRIGATION SYRINGE
................................................................................... 362, 405
DAVOL PISTON IRRIGATION
................................................................................... 362, 405
DAVOL SILICONE FOLEY
CATH ............................................................. 383, 405
DAVOL UNIVERSAL CATH
TRAY ............................................................. 383, 405
DAVOL URETHRAL
CATHETER TRAY ................. 383, 405
DAVOL URETHRAL
CATHTRAY (W/O) ................ 383, 405
DAVOL URINARY DRAINAGE
BAG ................................................................. 383, 405
DAY AND NIGHT BRIEF,
LARGE ........................................................ 342, 405
DAY AND NIGHT
BRIEF,MEDIUM ........................ 342, 405
DAY TIME PE ................................................ 507
DAY, PLUS PAD ....................... 342, 405
DAYHIST ALLERGY ........ 482, 484
DAYPRO ..................................................................... 32
DAYSEE ................................................................... 152
DAYTIME ............................................................. 507
DAY-TIME ........................................................... 507
DAYTIME AND NIGHTTIME
COLD ............................................................................. 502
DAYTIME AND NITETIME
SINUS ........................................................................... 478
DAYTIME COLD AND COUGH
................................................................................................... 506
DAYTIME COLD-FLU .................... 507
DAYTIME COLD-FLU RELIEF
(PE) .................................................................................... 507
DAY-TIME COUGH ............................ 489
DAYTIME SINUS .................................... 493
DAYTIME
SINUS-CONGESTION ..................... 493
DAYTIME-NIGHTTIME .............. 502
DAYTIME-NIGHTTIME
COLD-FLU ........................................................... 502
DAYTIME-NIGHTTIME
COUGH ...................................................................... 506
DDAVP ....................................................................... 268
deanol (bulk) ....................................................... 115
deanol bitartrate (bulk) ....................... 115
DEBACTEROL ............................................. 458
DEBLITANE ..................................................... 154
DEBROX ................................................................. 475
DECARA ................................................................. 265
decitabine ..................................................................... 58
DECONEX DMX ....................................... 508
DECONEX IR .................................................. 494
DECONGESTANT INHALER
................................................................................................... 490
DECOREL FORTE PLUS ............ 505
DECUBI VITE ................................................ 243
DEEP BLUE RELIEF .......................... 193
DEEP SEA NASAL ................................. 499
deferoxamine ........................................................... 40
DEFINITY ............................................................. 205
DEHYDRATED ALCOHOL ....... 20
DEHYDROEPIANDROSTERON
E (MICRO) .................................................... 8, 115
DELBASE COMPOUNDING
................................................................................................... 140
DELESTROGEN ......................................... 272
DELFLEX-LC/1.5% DEXTROSE
................................................................................................... 475
DELFLEX-LC/2.5% DEXTROSE
................................................................................................... 475
DELFLEX-LC/4.25%
DEXTROSE ......................................................... 475
DELFLEX-SM WITH 1.5%
DEXTROSE ......................................................... 475
DELSYM 12 HOUR ............................... 489
DELSYM COUGH+CHEST
CONGEST DM ............................................... 509
DELSYM COUGH+COLD
DAYTIME ............................................................. 505
DELSYM COUGH+COLD
NIGHTTIME ...................................................... 478
DELTA D3 ............................................................ 265
DELTASONE ................................................... 273
DELTUSS DP ................................................... 477
DELUXE ARM BLOOD
PRESSURE MON ...................... 357, 405
DELUXE INSTANT EAR
THERMOMETER ..................... 381, 405
DELUXE WRIST STABILIZER
................................................................................... 322, 405
DELYLA (28) ................................................... 152
DELZICOL ........................................................... 290
DEMADEX .............................................................. 84
demecarium bromide (bulk)
................................................................................... 115, 466
demeclocycline ..................................................... 55
DEMEROL ................................................................ 20
DEMEROL (PF) ............................................... 20
DEMSER ...................................................................... 86
DENAVIR .............................................................. 168
DENDRACIN ................................................... 193
DENTA 5000 PLUS ................................ 457
DENTAGEL ........................................................ 457
DENTAL BASE ............................ 115, 143
DENTIVA ............................................................... 458
DENT-O-KAIN .............................................. 460
deoxycholic acid (bulk) ....................... 115
DEPACON ................................................................. 88
DEPAKENE ................................................ 89, 98
DEPAKOTE ................................................ 89, 98
DEPAKOTE ER .................... 89, 98, 101
DEPAKOTE SPRINKLES ... 89, 98
DEPEN TITRATABS ................... 29, 40
DEPEND EASY FIT
UNDERGARMENTS ........... 342, 405
DEPEND GUARDS FOR MEN
................................................................................... 342, 405
DEPEND PROTECTION SZ S-M
................................................................................... 342, 405
DEPEND PROTECTION WITH
TABS LG ................................................. 342, 405
DEPEND REAL FIT BRIEF MEN
L/XL ................................................................. 342, 405
DEPEND REAL FIT BRIEF MEN
S-M .................................................................... 342, 405
546
Index
Index
Index
DEPEND SHIELDS FOR MEN
................................................................................... 342, 405
DEPEND SILHOUETTE
WOMEN L/XL ............................... 342, 405
DEPEND SILHOUETTE
WOMEN S/M ................................... 342, 405
DEPEND UNDERWEAR FOR
MEN L-XL ............................................ 342, 405
MEN SM-MD ................................... 342, 406
WOMEN LRG ................................. 342, 406
WOMEN S-M ................................... 342, 406
WOMEN XL ....................................... 343, 406
DEPEND UNDERWEAR S-M
................................................................................... 343, 406
DEPLIN (ALGAL OIL) .................... 266
DEPOCYT (PF) ................................................. 58
DEPO-ESTRADIOL .............................. 272
DEPO-MEDROL ......................................... 273
DEPO-PROVERA ......................... 61, 151
DEPO-SUBQ PROVERA 104
................................................................................................... 151
DEPO-TESTOSTERONE .............. 268
DERMA CIDOL 2000 ............................. 66
DERMA STAT ................................................... 64
DERMABASE ................................................. 174
DERMACEA ..................... 325, 326, 406
DERMACEA I.V. ....................... 326, 406
DERMACEA NON-WOVEN
................................................................................... 325, 406
DERMACEA STRETCH
................................................................................... 325, 406
DERMACERIN ............................................. 171
DERMACINRX SILAPAK ......... 178
DERMACINRX TSS ............................. 115
DERMACLOUD .......................................... 174
DERMADAILY ............................................. 171
DERMADRESS ............................ 200, 406
DERMADROX ............................................... 187
DERMAFIX ......................................... 140, 184
DERMAFUNGAL ..................................... 163
DERMAGAUZE .......................... 201, 406
DERMAGAUZE HYDROGEL
DRESSING ........................................... 201, 406
DERMAGEL HAND SANITIZER
....................................................................................................... 64
DERMAGINATE ........................................ 201
DERMAGRAFT ........................................... 198
DERMAGRAN (ALUMINUM
HYDROXIDE) ................................................ 187
DERMAGRAN HYDROGEL
DRESSING ........................................... 201, 406
DERMAGRAN HYDROPHILIC
DRESSING ........................................... 201, 406
DERMAL WOUND CLEANSER
....................................................................................................... 66
DERMALEVIN ............................. 201, 406
DERMAMED (ALUMINUM
HYDROXIDE) ................................................ 187
DERMAMED (ZINC ACETATE)
................................................................................................... 187
DERMA-N ............................................. 115, 140
DERMANAIL .................................................. 170
DERMANIC ............................................................ 15
DERMAPHOR ................................ 171, 187
DERMAPLEX ................................................. 171
DERMAREST ECZEMA
(HYDROCORT) ........................................... 176
DERMASARRA ........................................... 166
DERMA-SMOOTHE/FS BODY
OIL ..................................................................................... 176
DERMA-SMOOTHE/FS SCALP
OIL ..................................................................................... 176
DERMASORB AF COMPLETE
KIT ..................................................................................... 161
DERMASORB HC COMPLETE
KIT ..................................................................................... 179
DERMASORB TA COMPLETE
KIT ..................................................................................... 178
DERMASORB XM COMPLETE
KIT ..................................................................................... 179
DERMASYN ..................................... 201, 406
DERMATOP ...................................................... 176
DERMAVANTAGE ............................... 171
DERMAVIEW ................................. 326, 406
DERMAVIEW II ......................... 326, 406
DERMAZENE ................................................. 165
DERMAZINC CREAM .................... 168
DERMAZINC SHAMPOO .......... 168
DERMAZINC SPRAY ....................... 168
DERMOPLAST (WITH
MENTHOL) ......................................................... 183
DERMOPLAST
ANTIBACTERIAL .................................. 183
DERMOTIC OIL ......................................... 474
DESENEX .............................................. 163, 169
DESENEX SPRAY .................................. 163
DESFERAL .............................................................. 40
DESGEN ................................................................... 508
DESGEN DM .................................................... 508
desipramine ............................................... 93, 115
DESITIN ................................................... 185, 187
DESITIN CLEAR ....................................... 171
desloratadine ...................................... 487, 488
desmopressin ....................................... 115, 268
desog-e.estradiol/e.estradiol ....... 152
DESOGEN ............................................................. 152
desogestrel-ethinyl estradiol ....... 152
DESONATE ........................................................ 176
desonide ...................................................... 176, 177
desonide (bulk) ................................................. 115
DESOWEN ........................................................... 177
desoximetasone ................................................ 177
desoximetasone, micro (bulk) .... 115
desoxycorticosterone ac (bulk)
................................................................................... 115, 277
DESOXYN .................................................... 97, 99
DESPEC EDA COUGH-COLD
DROPS ........................................................................ 508
DESPEC-DM
(PHENYLEPH-DM-GUAIF) .... 508
DESPEC-DM
(PSEUDOEPH-DM-GUAIF) .... 508
desvenlafaxine ....................................................... 92
desvenlafaxine fumarate ........................ 92
DETACHOL ADHESIVE
REMOVER ........................................... 316, 406
DETOX DIETARY ...................................... 15
DETOXAREX ..................................................... 15
DETROL ................................................................... 303
DETROL LA ...................................................... 303
DEVILBISS COMPACT
COMPRESSOR ............................. 377, 406
DEVILBISS DISPOSABLE
NEBULIZER ...................................... 359, 406
DEVILBISS PULMO-AIDE
COMPRESSR ................................... 377, 406
DEVILBISS PULMOMATE
COMPRESSOR ............................. 377, 406
DEVILBISS TRAVELER
COMPRESSOR ............................. 377, 406
devil's claw extract (bulk) ... 15, 115
DEWEE'S CARMINATIVE ...... 282
DEX4 GLUCOSE ....................................... 267
DEX4 GLUCOSE BITS .................... 267
DEX4 GLUCOSE POUCH PACK
................................................................................................... 267
DEX4 GLUCOSE QUICK
DISSOLVE ............................................................ 267
dexamethasone ................................................. 273
dexamethasone ac, micro (bulk)
................................................................................... 115, 274
dexamethasone acetate (bulk) ... 115
DEXAMETHASONE INTENSOL
................................................................................................... 274
dexamethasone isonic (bulk) ....... 115
dexamethasone sod phos (bulk)
................................................................................... 116, 274
dexamethasone sodium phos (pf)
................................................................................................... 274
dexamethasone sodium phosphate
................................................................................... 274, 468
547
Index
Index
Index
dexamethasone,micronized(bulk)
................................................................................... 116, 274
DEXATRIM NATURAL ................ 215
dexchlorphen-pse-chlophedianol
................................................................................................... 504
DEXCOM G4 RECEIVER
................................................................................... 332, 406
DEXCOM G4 RECEIVER
PEDIATRIC ......................................... 332, 407
DEXCOM G4
RECEIVER-SHARE (PED)
................................................................................... 332, 407
DEXCOM G4
RECEIVER-SHARE KIT
................................................................................... 332, 407
DEXCOM G4 TRANSMITTER
................................................................................... 332, 407
DEXCOM G5-G4 SENSOR
................................................................................... 332, 407
DEXEDRINE SPANSULE
........................................................................... 97, 99, 103
DEXILANT .......................................................... 286
dexmedetomidine .......................................... 105
dexmethylphenidate ...................................... 97
DEXPAK 10 DAY ..................................... 274
DEXPAK 13 DAY ..................................... 274
DEXPAK 6 DAY ......................................... 274
dexpanthenol (bulk) .................. 116, 287
dexrazoxane hcl .................................................. 63
dextroamphetamine ....... 97, 100, 103
dextroamphetamine-amphetamine
........................................................................................... 97, 99
dextromethorphan hbr (bulk) ..... 116
dextromethorphan polistirex ....... 489
dextromethorphan-guaifenesin
................................................................................................... 509
dextrose ....................................................................... 267
dextrose (bulk) .................................................. 116
dextrose 10 % and 0.2 % nacl
................................................................................................... 214
dextrose 10 % in water (d10w)
................................................................................................... 214
................................................................................................... 214
................................................................................................... 214
................................................................................................... 214
................................................................................................... 214
dextrose 5 % in ringers ....................... 227
dextrose 5 % in water (d5w) ....... 214
dextrose 5 %-lactated ringers ... 214
dextrose 5%-0.2 % sod chloride
................................................................................................... 214
dextrose 5%-0.3 % sod.chloride
................................................................................................... 214
................................................................................................... 214
................................................................................................... 214
DHA ALGAL-900 ......................................... 78
DHEA .................................................................................... 8
DHS SAL ................................................................. 180
DHS TAR ................................................................ 182
DHS TAR GEL ............................................... 182
DHS ZINC .............................................................. 168
DIABETES HEALTH .......................... 237
DIABETES HEALTH FORMULA
................................................................................................... 237
DIABETES HEALTH SUPPORT
................................................................................................... 243
DIABETIC SILTUSSIN DAS-NA
................................................................................................... 496
DIABETIC SILTUSSIN-DM ... 509
DIABETIC SILTUSSIN-DM
MAX STR ............................................................... 509
DIABETIC SUPPORT
FORMULA ........................................................... 215
DIABETIC TUSSIN DM ................ 509
DIABETIC TUSSIN EX .................. 496
DIABETIC TUSSIN MAX ST
................................................................................................... 510
DIABETIC TUSSIN NIGHT
TIME ............................................................................... 503
DIABETISOURCE AC ...................... 246
DIABETISWEET ........................................ 221
DIAFOODS THICK-IT ..................... 147
DIAFOODS THICK-IT #2 ........... 147
DIALYVITE ....................................... 211, 212
DIALYVITE 3000 ..................................... 211
DIALYVITE 5000 ..................................... 237
DIALYVITE 800 ......................................... 211
DIALYVITE 800 WITH IRON
................................................................................................... 243
DIALYVITE 800 WITH ZINC 15
................................................................................................... 211
DIALYVITE 800 WITH ZINC 50
................................................................................................... 211
DIALYVITE 800-ULTRA D .... 211
DIALYVITE SUPREME D ......... 211
DIALYVITE VITAMIN D ........... 265
DIALYVITE VITAMIN D3 MAX
................................................................................................... 265
DIAMODE ............................................................. 282
DIAMOX SEQUELS ................................ 83
DIANEAL LOW CALCIUM/1.5%
DEX .................................................................................. 475
DIANEAL PD-2 WITH 2.5 %
DEX .................................................................................. 475
DIANEAL PD-2 WITH 4.25 %
DEX .................................................................................. 475
DIANEAL PD-2/1.5%
DEXTROSE ......................................................... 475
DIANEAL WITH 2.5 %
DEXTROSE ......................................................... 475
DIANEAL WITH 4.25 %
DEXTROSE ......................................................... 475
DIAPER RASH .............................. 185, 187
DIAPER RASH RELIEF ................. 187
diaper,brief,infant-todd,disp
................................................................................... 347, 407
DIAPERS ................................................. 347, 407
DIAPERS ULTRAFITS 3
................................................................................... 347, 407
DIAPERS ULTRAFITS 4
................................................................................... 347, 407
DIAPERS ULTRAFITS 5
................................................................................... 347, 407
DIAPERS ULTRAFITS 6
................................................................................... 347, 407
DIAPERS, UNISEX SIZE 2
................................................................................... 347, 407
................................................................................... 347, 407
................................................................................... 347, 407
................................................................................... 347, 407
................................................................................... 347, 407
DIAPERS-DISP-POLYETHYLEN
E BACK ..................................................... 347, 407
DIARRHEA RELIEF (BISMUTH
SUBS) ............................................................................ 282
DIASTAT .................................................................... 88
DIASTAT ACUDIAL .............................. 88
DIASTIX .................................................. 384, 407
DIATRUE CONTROL SOLN
NORMAL ................................................ 332, 407
DIATRUE CONTROL
SOLUTION HIGH .................... 333, 407
DIATRUE CONTROL
SOLUTION LOW ...................... 333, 407
DIATRUE PLUS BLOOD
GLUCOSE MET ........................... 333, 407
diazepam ........................................................................ 88
diazepam (bulk) ................................... 88, 116
DIAZEPAM INTENSOL .................... 88
diazoxide (bulk) ................................... 83, 116
DIBENZYLINE ................................................. 85
dibucaine ................................................................... 191
dibucaine hcl (bulk) .................................. 116
dichloracetic acid (bulk) ... 116, 180
548
Index
Index
Index
dichloralphenazone (bulk)
diindolylmethane (bulk) .......... 15, 116
DILANTIN ................................................................ 89
DILANTIN EXTENDED ................... 89
DILANTIN INFATABS ....................... 89
DILANTIN-125 ................................................. 89
DILATRATE-SR ............................................. 73
DILAUDID ............................................................... 20
DILAUDID (PF) ............................................... 20
DILAUDID-HP (PF) .................................. 20
diltiazem hcl ................................. 75, 81, 116
DILT-XR ...................................................................... 81
DILUENT FOR
EPOPROSTENOL/FLOLA ......... 148
DIMAPHEN (PE) ....................................... 477
DIMAPHEN DM ......................................... 504
dimenhydrinate ................................................ 283
dimenhydrinate (bulk) ........... 116, 283
DIMERCAPTOPROPANESULF
ONATE SOD ..................................................... 116
DIMETAPP COLD-ALLERGY
(PE) .................................................................................... 477
DIMETAPP
COLD-CONGESTION ....................... 477
DIMETAPP DM COLD-COUGH
(PE) .................................................................................... 504
DIMETAPP LONG-ACTING
(CPM-DM) ............................................................. 506
dimethyl fumarate (bulk) ... 116, 463
dimethyl sulfoxide (bulk) ... 116, 138
dimethylacetamide (bulk)
................................................................................... 116, 138
dimethylglycine hcl (bulk) ............... 116
dinitrochlorobenzene (bulk)
................................................................................... 116, 189
DINO-LIFE ........................................................... 254
DINO-LIFE WITH EXTRA C
................................................................................................... 254
DINO-LIFE WITH IRON-ZINC
................................................................................................... 252
DIOCTO .................................................................... 297
DIOCTYL ............................................................... 298
diosgenin (bulk) .............................................. 116
diosmin (bulk) .................................................... 116
DIOTAME ............................................................. 282
DIOVAN ....................................................................... 73
DIOVAN HCT ..................................................... 73
dioxybenzone (bulk) .................................. 116
DIPENTUM ......................................................... 290
DIPHEDRYL ..................................... 482, 484
DIPHEDRYL ALLERGY
................................................................................... 482, 484
diphencyprone (bulk) .............................. 116
DIPHENHIST ................................... 482, 484
diphenhydramine (bulk) ..................... 116
diphenhydramine hcl
................................................... 103, 192, 482, 484
diphenhydramine-acetaminophen
................................................................................................... 476
diphenidol (bulk) ........................................... 116
diphenoxylate-atropine ........................ 283
DIPRIVAN ................................................................ 35
DIPROLENE ...................................................... 177
DIPROLENE AF .......................................... 177
dipyridamole ........................................ 207, 308
dipyridamole (bulk) ................... 116, 308
DISALCID ................................................................. 34
DISCOVISC ........................................................ 472
DISINFECTING SOLUTION
................................................................................... 407, 466
DISKETS ..................................................................... 20
disopyramide phosphate ........................ 74
DISPOSABLE BRIEF ......... 343, 407
DISPOSABLE ENEMA ................... 295
disposable gloves .......................... 329, 407
DISPOSABLE LATEX-FREE
GLOVES ................................................... 329, 407
DISPOSABLE NEEDLES
................................................................................... 362, 407
DISPOSABLE PAPER
MOUTHPIECE ............................... 357, 407
DISPOSABLE POWER .... 375, 407
DISPOZ-A-BAG LEG BAG
LARGE ........................................................ 383, 407
MEDIUM ................................................. 383, 407
SMALL ....................................................... 383, 407
disulfiram ................................................................. 106
disulfiram (bulk) ............................ 106, 116
DITROPAN XL ............................................. 303
DIURETIC ................................................................. 12
DIURETIC SOFTGELS ....................... 84
DIURIL ........................................................................... 84
DIURIL IV ................................................................. 84
divalproex ........................................ 89, 98, 101
DIVIGEL .................................................................. 272
dl-alpha tocopherol (bulk)
................................................................................... 116, 266
dl-leucine (bulk) ............................................. 116
DM MAX ................................................................. 510
d-mannose (bulk) .......................................... 116
DML ................................................................................. 171
DML FACIAL MOISTURIZER
................................................................................................... 170
DML FORTE ..................................................... 170
DMPS ............................................................................ 116
DMSA ........................................................................... 208
DMSA (BULK) .............................................. 116
DOBELL'S ............................................................. 462
105, 116
DICLEGIS .............................................................. 284
diclofenac potassium ................................... 31
diclofenac sodium
....................................................... 31, 166, 184, 469
diclofenac sodium (bulk) ....... 31, 116
diclofenac-misoprostol ............................. 30
dicloxacillin .............................................................. 53
dicumarol (bulk) ............................ 116, 304
dicyclomine ............................................................ 289
dicyclomine (bulk) ....................................... 116
DI-DAK-SOL ........................................................ 65
didanosine ................................................................... 45
DIETER'S DETOX ....................................... 15
DIETEX FORTE .............................................. 15
diethanolamine (bulk) ........... 116, 149
diethylcarbamazine cit (bulk)
....................................................................................... 42, 116
DIETHYLENE GLYCOL
MONOETHYL ET .................................... 116
diethylpropion ................................................... 209
diethylpropion hcl (bulk)
................................................................................... 116, 209
diethylstilbestrol (bulk) ....................... 116
diethyltoluamide (bulk) ....... 116, 166
DIFFERIN .............................................................. 159
DIFF-STAT .......................................................... 291
DIFICID ......................................................................... 52
diflorasone .............................................................. 177
DIFLUCAN .............................................................. 43
diflunisal ........................................................................ 34
DIGAZ ............................................................................. 15
DIGEST PROBIOTIC
(S.BOULARDII) ........................................... 291
digestive enzymes ......................................... 285
DIGESTIVE
ENZYMES(MAL,LAC,INV) ... 285
DIGESTIVE PROBIOTIC ............ 291
DIGIFAB ...................................................................... 39
DIGITAL THERMOMETER
................................................................................... 381, 407
DIGITEK ...................................................................... 83
DIGOX ............................................................................. 83
digoxin .............................................................................. 83
dihydrocode-acetaminophen-caff
....................................................................................................... 23
dihydrocodeine bitartrat(bulk)
................................................................................... 116, 489
dihydrocodeine-aspirin-caff ............. 23
dihydroergotamine ..................................... 101
dihydroergotamine mesylt(bulk)
................................................................................................... 116
dihydroxyacet 1,3 dimer (bulk)
................................................................................... 116, 144
...................................................................................
549
Index
Index
Index
dobutamine ................................................................. 82
dobutamine in d5w ......................................... 82
DOCEFREZ ............................................................. 62
docetaxel ........................................................................ 62
docosahexanoic acid ................................... 78
docosanol (bulk) ............................ 116, 168
DOC-Q-LACE ................................................. 298
DOC-Q-LAX ...................................................... 296
DOCU ............................................................................ 298
DOCUPRENE .................................................. 298
docusate calcium ........................................... 298
docusate sodium ............................. 116, 298
docusate sodium (bulk) ........ 116, 298
DOCUSIL ................................................................ 298
DOCUSOL ............................................................. 298
DOCUSOL KIDS ........................................ 298
DOCUSOL PLUS ....................................... 298
DOK ................................................................................. 298
DOK PLUS ........................................................... 296
DOLOGEN ............................................................ 476
DOLOGEN 325 .............................................. 476
DOLOGESIC ..................................................... 476
DOLOPHINE ......................................................... 20
DOMEBORO ..................................................... 168
DONA ................................................................................... 8
DONATUSSIN ............................................... 504
donepezil .................................................................... 151
dong quai (angelica sinensis) ........ 15
DONNATAL ...................................................... 289
dopamine ....................................................................... 82
dopamine (bulk) .............................................. 116
dopamine in 5 % dextrose ................... 82
DOPRAM ................................................................ 100
DORIBAX .................................................................. 47
DORYX .......................................................................... 55
dorzolamide .......................................................... 469
dorzolamide-timolol ................................. 469
DOTAREM ........................................................... 205
DOTHELLE DHA ..................................... 256
DOUBLE ANTIBIOTIC .................. 160
DOUBLE ANTIBIOTIC
(B.TRACN ZN) .............................................. 160
DOUCHE VINEGAR AND
WATER EXTRA ......................................... 513
DOVER ADVANTAGE
DRAINAGE BAG ...................... 343, 407
DOVER ADVANTAGE URINE
................................................................................... 343, 407
DOVER BULB SYRINGE
................................................................................... 362, 407
DOVER CATHETER ........... 383, 407
DOVER COATED LATEX
FOLEY ......................................................... 383, 407
DOVER LATEX FOLEY
CATHETER ......................................... 383, 407
DOVER PEDIATRIC URINE
METER ....................................................... 343, 407
DOVER PREMIUM URINE
................................................................................... 343, 407
DOVER RED RUBBER
ROBINSON CATH .................. 383, 408
DOVER TEXAS MALE
EXTERNAL CATH ................ 383, 408
DOVER TWO-SIDED
ADHESIVE STRAP ............... 357, 408
DOVER UNIVERSAL ....... 383, 408
DOVER URI-DRAIN DELUXE
LEG BAG ................................................ 383, 408
DOVER URI-DRAIN MALE EXT
CATH ............................................................. 383, 408
DOVER URINARY LEG BAG
................................................................................... 384, 408
DOVONEX ........................................................... 167
doxapram .................................................................. 100
doxazosin ...................................................................... 85
doxepin ............................................................. 93, 116
doxercalciferol ................................................. 456
DOXIL ............................................................................. 62
doxorubicin ................................................................ 62
doxorubicin, peg-liposomal .............. 62
DOXY-100 ................................................................. 55
doxycycline hyclate ....................... 55, 462
doxycycline hyclate (bulk) .............. 116
doxycycline monohydrate .... 55, 189
doxylamine succinate (bulk) ........ 116
DR SCHOLL'S CLEAR AWAY
................................................................................................... 180
DR SCHOLL'S FOOT POWDER
................................................................................................... 166
DR. SMITH'S ADULT BARRIER
................................................................................................... 187
DR. SMITH'S DIAPER ...................... 187
DR. SMITH'S DIAPER RASH
................................................................................................... 187
DR. SMITH'S RASH-SKIN
................................................................................... 185, 187
DRAINABLE FECAL
COLLECTOR ................................... 369, 408
DRAINABLE POUCH ....... 369, 408
DRAINABLE POUCH CLAMP
................................................................... 357, 369, 408
DRAINABLE POUCH CLOSURE
................................................................................... 343, 408
DRAIN-TUBE ATTACHMENT
DEVICE ..................................................... 357, 408
DRAMAMINE ................................................ 283
DRAMAMINE LESS DROWSY
................................................................................................... 283
DRAW OUT SALVE ............................ 184
DRAXIMAGE DTPA ........................... 208
DRIMINATE ..................................................... 283
DRIPDROP ........................................................... 232
DRISDOL ................................................................ 265
DRISTAN COLD ........................................ 478
DRISTAN LONG LASTING ... 500
DRITHOCREME HP ............................ 167
dronabinol ............................................................... 284
droperidol .................................................... 35, 116
DROPLET LANCETS ........ 333, 408
DROPLET LANCING DEVICE
................................................................................... 333, 408
drospirenone-ethinyl estradiol
................................................................................................... 152
DROXIA ................................................................... 309
DRY COMFORT ......................... 343, 408
DRY COMFORT EXTRA
BRIEFS ....................................................... 343, 408
DRY EYE OMEGA BENEFITS
................................................................................................... 215
DRY EYE RELIEF ................................... 464
DRY MOUTH .................................. 459, 462
DRY SKIN BATH OIL ...................... 171
DRY SKIN CARE ..................................... 171
DRY SKIN THERAPY ...................... 171
DRY SKIN THERAPY
MOISTURIZING ......................................... 171
DRYMAX EXTRA .................. 201, 408
DRYSOL DAB-O-MATIC ........... 166
DSS .................................................................................... 298
DUAC ............................................................................ 157
DUAL ACTION COMPLETE
................................................................................................... 287
DUAVEE ................................................................. 271
DUCODYL ........................................................... 297
DUET DHA BALANCED ............ 256
DUET DHA WITH OMEGA-3
................................................................................................... 256
DUETACT ............................................................. 270
DUEXIS ......................................................................... 30
DULCOLAX (BISACODYL)
................................................................................................... 297
DULCOLAX STOOL
SOFTENER (DSS) .................................... 298
DULERA .................................................................. 493
duloxetine ..................................................... 92, 100
duloxetine hcl (bulk) .................... 92, 117
DUOCAL ................................................................. 215
DUODERM CGF BORDER
DRESSING ........................................... 201, 408
DUODERM CGF DRESSING
................................................................................... 201, 408
DUODERM CGF EXTRA THIN
................................................................................... 201, 408
DUODERM CGF EXTRA THIN
SPOTS .......................................................... 201, 408
550
Index
Index
Index
DUODERM HYDROACTIVE
................................................................................... 201, 408
DUODERM SIGNAL DRESSING
................................................................................... 201, 408
DUODOTE ................................................................ 39
DUOFER .................................................................. 228
DUOFILM .............................................................. 180
DUOLOCK CURVED TAIL
CLOSURE .............................................. 369, 408
DUOPA ........................................................................... 94
DUOVISC VISCO ELASTIC
................................................................................................... 472
DURABLE BARRIER ........ 185, 187
DURACHOL ...................................................... 265
DURACLON (PF) .......................................... 20
DURAFIBER DRESSING
................................................................................... 201, 408
DURAFLEX ................................................ 8, 193
DURAFLU ............................................................. 505
DURAGESIC ......................................................... 20
DURAHESIVE MOLDABLE
CONVEX ................................................. 369, 408
DURAMORPH (PF) ................................... 20
DURAPORE SURGICAL
................................................................................... 317, 408
DURASORB UNDERPAD
................................................................................... 343, 408
DURAVENT DM ....................................... 508
DURAVENT PE ........................................... 494
DUREZOL ............................................................. 468
dutasteride .............................................................. 300
DUTOPROL ............................................................ 82
D-VI-SOL ................................................................ 265
D-VITA ....................................................................... 265
d-xylose (bulk) ................................................... 117
DYAZIDE ................................................................... 84
dyclonine (bulk) .............................................. 117
DYLOJECT .............................................................. 31
DYMISTA .............................................................. 498
DYNAMIC ............................................................ 459
DY-O-DERM ..................................................... 138
dyphylline (bulk) ............................ 117, 491
DYRENIUM ........................................................... 84
DYSPORT .............................................................. 312
E.C. PRIN .................................................... 34, 309
E.E.S. 400 .................................................................... 52
E.E.S. GRANULES ..................................... 52
E-200 ............................................................................... 266
E-400 C-500 AND BETA
CAROTENE ............................................ 11, 243
EAA SUPPLEMENT ............................ 248
EAKIN COHESIVE ................ 370, 408
EAKIN COHESIVE SEALS
................................................................................... 370, 408
EAKIN COHESIVE SLIMS
................................................................................... 370, 408
EAR CARE ........................................................... 213
EAR DROPS (CARBAMIDE
PEROXIDE) ........................................................ 475
EAR DROPS FOR SWIMMERS
................................................................................................... 474
EAR DROPS HOMEOPATHIC
....................................................................................................... 15
EAR DROPS OTC .................................... 475
EAR DRY ............................................................... 474
EAR HEALTH FORMULA ....... 213
EAR HEALTH PLUS ........................... 213
EAR POPPER INFLATION
DEVICE ..................................................... 323, 408
ear syringe .............................................. 380, 408
ear thermometer ............................. 381, 408
EAR WAX REMOVAL DROPS
................................................................................................... 475
EAR WAX REMOVAL KIT .... 475
EAR WAX REMOVAL SYSTEM
................................................................................................... 475
EAR WAX TREATMENT ........... 475
EARACHE RELIEF ................................... 15
EARLY OVULATION TEST
................................................................................... 206, 408
EARLY PREGNANCY TEST
................................................................................... 206, 409
EASICLOSE WIDE OUTLET
2-PC .................................................................. 370, 409
EASIVENT HOLDING
CHAMBER ........................................... 377, 409
EASIVENT MASK LARGE
................................................................................... 378, 409
EASIVENT MASK MEDIUM
................................................................................... 378, 409
EASIVENT MASK SMALL
................................................................................... 378, 409
EASY CLICK LANCING
DEVICE ..................................................... 333, 409
EASY COMFORT INSULIN
SYRINGE ................................................ 350, 409
EASY COMFORT LANCETS
................................................................................... 333, 409
EASY COMFORT PEN
NEEDLES ............................................... 350, 409
EASY FIBER ..................................................... 292
EASY FIBER (WHEAT
DEXTRIN) ............................................................. 292
EASY PLUS II BLOOD
GLUCOSE MET ........................... 333, 409
EASY PLUS II HIGH CONTROL
................................................................................... 333, 409
EASY PLUS II LOW CONTROL
................................................................................... 333, 409
EASY STEP BLOOD GLUCOSE
METER ....................................................... 333, 409
EASY STEP BLOOD GLUCOSE
SYSTEM ................................................... 333, 409
EASY TALK BLOOD GLUCOSE
METER ....................................................... 333, 409
EASY TALK GLUCOSE
SYSTEM ................................................... 333, 409
EASY TALK HIGH CONTROL
................................................................................... 333, 409
EASY TALK LOW CONTROL
................................................................................... 333, 409
EASY TOUCH ................ 350, 362, 410
EASY TOUCH ALCOHOL PREP
PADS .................................................................................. 64
EASY TOUCH FLURINGE
................................................................................... 362, 409
EASY TOUCH FLURINGE FLU
TRAY ............................................................. 362, 409
EASY TOUCH GLUCOSE
MONITOR ............................................. 333, 409
EASY TOUCH HIGH-LOW
CONTROL ............................................. 333, 409
EASY TOUCH INSULIN
SAFETY SYR .................................. 350, 409
EASY TOUCH INSULIN
SYRINGE ................................................ 350, 409
EASY TOUCH LANCING
DEVICE ..................................................... 333, 409
EASY TOUCH SAFETY
LANCETS .............................................. 333, 410
EASY TOUCH SYR ALLERGY
TRAY ............................................................. 362, 410
EASY TOUCH TWIST
LANCETS .............................................. 333, 410
EASY TRAK BLOOD GLUCOSE
METER ....................................................... 333, 410
EASY TRAK GLUCOSE
SYSTEM ................................................... 333, 410
EASY TRAK HIGH CONTROL
..................................................................

CHPW Medicaid Formulary - Community Health Plan of Washington

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