Union Star - Nevada Health CO-OP

Transcription

2015 Union Star
Essential Health Benefits
Formulary Reference Guide
List of covered drugs
INTRODUCTION
Catamaran utilizes a Pharmacy and Therapeutics Committee (P & T Committee), made up of
practicing physicians, pharmacists, and nurses to help ensure that our formulary is medically
sound and that it supports patient health. This committee reviews and evaluates medications
on the formulary based on safety and efficacy to help maintain clinical integrity in all
therapeutic categories.
FORMULARY DESIGN
Catamaran has chosen a closed formulary structure for our standard Essential Health Benefits
Formulary. The formulary structure features generics, preferred and non-preferred brand-name
drugs, specialty drugs, and ACA (Affordable Care Act) preventive drugs. A closed formulary
limits coverage to only those products listed in these levels. Products not listed on the
formulary are generally not covered.
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Generic drugs: Most generic drugs are listed under “GENERIC”. Drugs listed under
“GENERIC” have the same active ingredient as the brand-name versions but at a lower
cost.
Preferred drugs: Drugs listed under “PREFERRED” include preferred brand name drugs
that will generally have lower co-payments than non-preferred brand name drugs.
Non-preferred drugs: Drugs listed under “NON PREFERRED” generally have higher copayments than preferred brand name drugs.
Specialty drugs: Drugs listed under ‘SPECIALTY” generally have the highest co-payment
and cost. Specialty drugs are prescription medications that are sometimes used to
treat complex and chronic conditions. They may require special monitoring or
handling.
ACA preventive drugs: Drugs listed under “PREVENTIVE” may have coverage and no
co-payment when health care reform requirements are met for age, gender, and/or
risk factors.
REASONABLE MEDICAL MANAGEMENT
Catamaran’s formulary also uses medical and utilization management functions to determine
whether a prescription is medically necessary. These industry recognized and accepted
management functions include but are not limited to quantity limits, step therapy, and prior
authorization and help Catamaran and its clients determine whether the prescribed medication
was prescribed in accordance with generally accepted medical practice standards, is clinically
appropriate, and confirm that the prescribed medication is not more costly than an alternative
product that is as likely to produce therapeutically equivalent results. As recommended by the
United States Department of Labor, Catamaran’s reasonable medical and utilization
management functions apply to ACA preventive drugs.
USING THIS FORMULARY REFERENCE GUIDE TO HELP CONTAIN COSTS
Many health plans use the Catamaran formulary to help manage the overall cost of providing
prescription drug benefits. This formulary offers a wide range of medications from which to
choose. We realize that this formulary reference guide may not include every drug from every
manufacturer. However, choosing a generic or preferred drug when it is appropriate can
provide access to the necessary medications to stay healthy, at a cost that is more affordable.
SAVING ON OUT-OF-POCKET COSTS
Your health plan sets the co-payments for each formulary drug status which include generic,
preferred brand-name, non-preferred brand-name, and specialty medications. Co-payments
and deductibles for preventive products follow health care reform rules. Health plans often
design prescription drug plans to encourage the use of generic and preferred brand-name
drugs. Choosing non-preferred drugs (or specialty drugs) may mean paying higher out-of-pocket
expenses (such as coinsurance, co-payments, and deductible amounts) or not receiving
coverage at all. Patients may also pay less for generic drugs.
PLEASE NOTE: Brand-name drugs may become non-formulary if a generic version becomes
available.
CONSULTING THE PRESCRIBER’S OFFICE WHEN APPROPRIATE
When employers and other benefit sponsors design their prescription drug plans, they may
choose to provide coverage only for certain medications, time periods, doses, quantities, or for
specific conditions (e.g. they may exclude coverage for medications for unapproved, unproven,
or cosmetic indications). When coverage for medications is provided based on use or quantity,
Catamaran may contact your prescriber’s office for additional information to determine
whether coverage is available under your plan. Patients who are unsure whether these
coverage rules apply for a particular medication can consult their prescription drug benefit
manual or contact a Catamaran Member Services representative to determine specific
coverage requirements.
KNOWING HOW THE FORMULARY INFORMATION IS ORGANIZED
The following formulary reference guide is designed in the following order: generics, generic
preventive, preferred brand name, non-preferred brand name, brand name preventive,
specialty drugs. In addition, immediately preceding the index is a section listing ACA preventive
drugs by category.
*Formulary Disclaimer: Coverage for some drugs may be limited to specific dosage forms and/or strengths. The benefit design
determines what is covered and the applicable co-payment. The medications listed on this formulary are subject to change
pursuant to the formulary management activities of catamaran. The presence of a medication on this formulary list does not
guarantee coverage. To see the most up-to-date formulary, please visit your member website. You may also call Member
Services at the number listed on your ID card to request a copy be mailed to you.
35756461v.2
Table of Contents
ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
PENICILLINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
CEPHALOSPORIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
FIRST GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
SECOND GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
THIRD GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
FOURTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
FIFTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
MACROLIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
TETRACYCLINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
QUINOLONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
AMINOGLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
SULFONAMIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
ANTIMYCOBACTERIAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
ANTIFUNGALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
ANTIVIRALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
ANTIMALARIALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
AMEBICIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
ANTHELMINTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
MISC. ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
ANTINEOPLASTICS, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
ALKYLATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
ANTIBIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
ANTINEOPLASTIC ENZYMES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
ANTIMETABOLITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
ANGIOGENESIS INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
ANTIBODIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
HORMONAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
MITOTIC INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
ENZYME INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
TOPOISOMERASE I INHIBITOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
RADIOPHARMACEUTICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
CELLULAR IMMUNOTHERAPY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
ANTINEOPLASTICS MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
CHEMOTHERAPY RESCUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
CHEMOTHERAPY ADJUNCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
ANTINEOPLASTIC COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
CARDIOVASCULAR DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
PHOSPHODIESTERASE INHBTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
CARDIAC GLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
ANTIANGINAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
BETA BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
CALCIUM CHANNEL BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
ANTIARRHYTHMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
ACE INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
ANGIOTENSIN RCPTR BLOCKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
DIRECT RENIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
ANTIHYPERTENSIVES MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
ANTIHYPERTENSIVE COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
DIURETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
VASOPRESSORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
ANTIHYPERLIPIDEMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
CARDIOVASCULAR - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
DERMATOLOGICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
ACNE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
ROSACEA AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
ANTIBIOTICS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
ANTIFUNGALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
ANTIVIRALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
ANTI-INFLAMMATORY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
ANTIPRURITICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
ANTIPSORIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
ANTISEBORRHEIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
CORTICOSTEROIDS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
IMMUNOMODULATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
DERMATOLOGICALS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
ENDOCRINE AND METABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
CORTICOSTEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
ANDROGENS-ANABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
ESTROGENS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
CONTRACEPTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
PROGESTINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
ANTIDIABETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
INSULIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
AMYLIN ANALOGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
INCRETIN MIMETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
SULFONYLUREAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
BIGUANIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
MEGLITINIDE ANALOGUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
DIABETIC OTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
ALPHA-GLUCOSIDASE INHIBIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
DPP-4 INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
INSULIN SENSITIZING AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
ANTIDIABETIC COMBINATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
BISPHOSPHONATES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
CALCITONINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
PARATHYROID HORMONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
RANK LIGAND INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
CALCIUM REGULATORS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
HORMONE RECEPTOR MDLTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
FERTILITY REGULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
LHRH/GNRH AGONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
GNRH/LHRH ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
GROWTH HORMONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
GHRH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
SOMATOMEDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
SOMATOSTATIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
GH RECEPTOR ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
POSTERIOR PITUITARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
CORTICOTROPIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
PROLACTIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
VASOPRESSIN ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
METABOLIC MODIFIERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
THYROID AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
GASTROINTESTINAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
LAXATIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
ANTIDIARRHEALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
ANTACIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
ULCER DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
ANTIEMETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
DIGESTIVE AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
GASTROINTESTINAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
GENITOURINARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
URINARY ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
URINARY ANTISPASMODICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
VAGINAL PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
GENITOURINARY - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
HEMATOLOGICAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
HEMATOPOIETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
ANTICOAGULANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
HEMOSTATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
HEMATOLOGICAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
MOUTH/THROAT/DENTAL AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
NEUROLOGY, CNS, PSYCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
ANTIANXIETY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
ANTIDEPRESSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
ANTIPSYCHOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
HYPNOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
ADHD, NARCOLEPSY, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
ANTICONVULSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
ANTIPARKINSON AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
NEUROLOGY, PSYCH - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
NEUROMUSCULAR AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
MUSCULOSKELETAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
ANTIMYASTHENIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
OPHTHALMOLOGY AND OTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
ARTIFICIAL TEAR/LUBRICANT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
BETA-BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
OPHTHALMIC STEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
PROSTAGLANDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
CYCLOPLEGIC MYDRIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
DECONGESTANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
MIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
ADRENERGIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
LOCAL ANESTHETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
OPHTHALMICS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
OTIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24
OXYTOCICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24
PAIN MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24
ANALGESICS - NONNARCOTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24
ANALGESICS - OPIOID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25
ANTI-INFLAMMATORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
26
MIGRAINE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
26
GOUT AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
26
LOCAL ANESTHETICS-INJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
26
GENERAL ANESTHETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
RESPIRATORY, ALLERGY, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
ANTIHISTAMINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
NASAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
COUGH/COLD/ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
ANTIASTHMATIC/COPD AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
RESPIRATORY AGENTS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28
TOXOIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28
VACCINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28
VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
29
VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
29
MULTIVITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30
MEDICAL DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31
DIABETIC SUPPLIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31
MEDICAL DEVICES - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
35
MISCELLANEOUS AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
37
ACA PREVENTIVE DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
39
ASPIRIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
39
CONTRACEPTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
40
FLUORIDE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
41
FOLIC ACID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
41
IMMUNIZATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
42
IRON . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
42
SMOKING CESSATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
43
VITAMIN D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
43
BOWEL PREPARATION AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
44
January 2015
ANTI-INFECTIVES
PENICILLINS
TIER 01
TIER 02
TIER 03
GENERIC
amoxicillin
amoxicillin ER
amoxicillin/clavulanate potassium
amoxicillin/clavulanate potassium ER
ampicillin
ampicillin sodium
ampicillin-sulbactam
dicloxacillin sodium
nafcillin sodium
oxacillin sodium
penicillin v potassium
penicillin G potassium
penicillin G potassium IN iso-osmotic dextrose
penicillin G procaine
penicillin G sodium
pfizerpen-G
piperacillin sodium/ tazobactam sodium
piperacillin sodium/tazobactam sodium
piperacillin/tazobactam
PREFERRED BRAND
Augmentin
NON PREFERRED
Bactocill IN Dextrose
Bicillin C-R
Bicillin L-a
Moxatag
Timentin
Zosyn
CEPHALOSPORIN
FIRST GENERATION
GENERIC
TIER 01
TIER 03
FOURTH GENERATION
GENERIC
TIER 01
TIER 03
Teflaro
MACROLIDES
TIER 01
TIER 03
THIRD GENERATION
GENERIC
TIER 01
cefdinir
cefditoren pivoxil
cefotaxime sodium
GENERIC
azithromycin
clarithromycin
clarithromycin ER
e.e.s. 400
erythrocin lactobionate
erythromycin
erythromycin base
erythromycin ethylsuccinate
NON PREFERRED
Dificid QL
Erythrocin Lactobionate
PCE
Zithromax
TETRACYCLINES
TIER 01
SECOND GENERATION
GENERIC
TIER 01
TIER 03
cefepime
NON PREFERRED
Maxipime
FIFTH GENERATION
NON PREFERRED
TIER 03
cefadroxil
cefazolin sodium
cefazolin sodium/dextrose
cephalexin
cefaclor
cefaclor ER
cefotetan
cefotetan/dextrose
cefoxitin sodium
cefprozil
cefuroxime axetil
cefuroxime sodium
cefuroxime/dextrose
zinacef
NON PREFERRED
Ceftin
Mefoxin
Zinacef
Zinacef IN Iso-osmotic Dextrose
Zinacef IN Iso-osmotic Diluent
cefpodoxime proxetil
ceftazidime
ceftazidime/dextrose
ceftibuten
ceftriaxone sodium
ceftriaxone IN iso-osmotic dextrose
ceftriaxone/dextrose
tazicef
NON PREFERRED
Cedax
Claforan
Fortaz
Spectracef
Suprax
TIER 03
GENERIC
avidoxy
demeclocycline HCL
doxy 100
doxycycline
doxycycline hyclate
doxycycline hyclate DR
doxycycline monohydrate
minocin
minocycline HCL
minocycline HCL ER
morgidox 1X100MG
morgidox 2X100MG
tetracycline HCL
NON PREFERRED
Alodox Convenience Kit
Ocudox
Solodyn
QUINOLONES
TIER 01
GENERIC
ciprofloxacin
ciprofloxacin ER
ciprofloxacin HCL
ciprofloxacin I.V.-IN D5W
levofloxacin
levofloxacin IN D5W
moxifloxacin HCL
ofloxacin
Effective January 1, 2015
PA=Prior Auth Required; ST =Step T herapy; QL=Quantity Limits;
1
TIER 02
TIER 03
PREFERRED BRAND
Avelox
NON PREFERRED
Factive
Noroxin
Ambisome
Amphotec
Eraxis
Terbinex
ANTIVIRALS
AMINOGLYCOSIDES
TIER 01
TIER 04
TIER 01
GENERIC
amikacin sulfate
gentamicin sulfate
gentamicin sulfate pediatric
gentamicin sulfate/sodium chloride
gentamicin sulfate/0.9% sodium chloride
isotonic gentamicin
neomycin sulfate
paromomycin sulfate
streptomycin sulfate
tobramycin sulfate
tobramycin sulfate/sodium chloride
SPECIALTY
tobramycin PA
Tobi PodhalerQL,PA
SULFONAMIDES
TIER 01
GENERIC
sulfadiazine
TIER 02
ANTIMYCOBACTERIAL AGENTS
TIER 01
TIER 02
TIER 03
GENERIC
cycloserine
ethambutol HCL
isoniazid
pyrazinamide
rifabutin
rifampin
PREFERRED BRAND
Priftin
Seromycin
Sirturo
NON PREFERRED
Capastat Sulfate
Paser
Rifamate
Rifater
Trecator
ANTIFUNGALS
TIER 01
TIER 02
TIER 03
GENERIC
amphotericin b
bio-statin
fluconazole
fluconazole IN dextrose
fluconazole IN NACL
flucytosine
griseofulvin microsize
griseofulvin ultramicrosize
itraconazole
ketoconazole
nystatin
terbinafine HCL QL
voriconazole
PREFERRED BRAND
Cancidas
Lamisil
Mycamine
Noxafil
Sporanox
NON PREFERRED
Abelcet
TIER 04
GENERIC
abacavir
abacavir sulfate/lamivudine/zidovudineQL
acyclovir
acyclovir sodium
cidofovir
didanosine
famciclovirQL
foscarnet sodium
ganciclovir
lamivudine
lamivudine/zidovudine
nevirapine
nevirapine ER
rimantadine HCL
stavudine
valacyclovir HCL QL
zidovudine
PREFERRED BRAND
Aptivus
Atripla QL
Complera QL
Crixivan
Edurant
Emtriva
Epivir HBV
Epzicom
Fuzeon QL,PA
Intelence
Invirase
Isentress
Kaletra
Lexiva
Norvir
Prezista
Relenza DiskhalerQL
Rescriptor
Retrovir IV Infusion
Reyataz
SelzentryPA
QL
Stribild
Sustiva
Tamiflu QL
Truvada PA
Videx Pediatric
Viracept
Viramune
Viramune XR
Viread
Ziagen
SPECIALTY
adefovir dipivoxilQL,PA
entecavirQL,PA
moderiba
ribasphere
ribasphere ribapak
ribatab
ribavirin
valganciclovir
Baraclude QL,PA
PA
Harvoni
Infergen
Moderiba
2
Moderiba 1200 Dose Pack
Moderiba 800 Dose Pack
Olysio PA
Peg-intron PA
PA
Peg-intron Redipen
Peg-intron Redipen PAK 4 PA
PegasysPA
Pegasys ProclickPA
Pegintron PA
Rebetol
Ribasphere Ribapak
Sovaldi PA
Tivicay
Tyzeka QL,PA
Valcyte
VictrelisPA
Virazole
TIER 02
TIER 03
ANTIMALARIALS
TIER 01
TIER 02
GENERIC
atovaquone/proguanil HCL
chloroquine phosphate
hydroxychloroquine sulfate
mefloquine HCL
primaquine phosphate
qualaquin
quinine sulfate
PREFERRED BRAND
Coartem
Daraprim
AMEBICIDES
TIER 03
TIER 04
ANTINEOPLASTICS, ETC.
ALKYLATING AGENTS
TIER 01
TIER 02
TIER 04
NON PREFERRED
Yodoxin
ANTHELMINTICS
TIER 01
TIER 02
TIER 03
GENERIC
ivermectin
PREFERRED BRAND
Albenza
NON PREFERRED
Biltricide
MISC. ANTI-INFECTIVES
TIER 01
GENERIC
atovaquone
aztreonam
baciim
bacitracin
chloramphenicol sodium succinate
clindamycin palmitate HCL
clindamycin phosphate
clindamycin phosphate add-vantage
clindamycin phosphate pharmacy bulk package
clindamycin phosphate IN D5W
clindamycin HCL
colistimethate sodium
dapsone
e.s.p.
imipenem/cilastatin
linezolid
meropenem
metronidazole
metronidazole IN NACL 0.79%
polymyxin b sulfate
sulfamethoxazole/trimethoprim
sulfamethoxazole/trimethoprim DS
sulfatrim pediatric
tinidazole
trimethoprim
vancomycin
vancomycin HCL
vancomycin HCL IN dextrose
PREFERRED BRAND
Alinia
Nebupent
Tygacil
Xifaxan
QL
Zyvox
NON PREFERRED
Azactam IN Iso-osmotic Dextrose
Cubicin
Doribax
Flagyl ER
Invanz
Ketek
Lincocin
Primsol
Vibativ
SPECIALTY
Cayston PA
GENERIC
lomustine
PREFERRED BRAND
Alkeran
Gleostine
Leukeran
SPECIALTY
carboplatin
cisplatin
cyclophosphamide
ifosfamide
melphalan hydrochloride
oxaliplatin
temozolomidePA
Bicnu
Busulfex
Eloxatin
Gliadel Wafer
Hexalen
Ifex
Mustargen
PA
Myleran
Temodar
Treanda
ValchlorPA
Zanosar
ANTIBIOTICS
TIER 01
TIER 04
GENERIC
bleomycin sulfate
SPECIALTY
adriamycin
daunorubicin HCL
doxorubicin HCL
doxorubicin HCL liposome
epirubicin HCL
idarubicin HCL
lipodox
lipodox 50
mitomycin
mitoxantrone HCL PA
Daunoxome
Valstar
3
ANTINEOPLASTIC ENZYMES
TIER 04
SPECIALTY
Elspar
Erwinaze PA
Oncaspar
TIER 04
ANTIMETABOLITES
TIER 01
TIER 02
TIER 04
GENERIC
adrucil
fluorouracil
methotrexate
methotrexate sodium
PREFERRED BRAND
Trexall
SPECIALTY
azacitidinePA
capecitabinePA
cladribine
cytarabine
cytarabine aqueous
decitabine PA
floxuridine
fludarabine phosphate
gemcitabine
gemcitabine HCL
mercaptopurine
Alimta
Arranon
Clolar
Depocyt
Folotyn
Tabloid
IMMUNOMODULATORS
TIER 01
TIER 02
ANGIOGENESIS INHIBITORS
TIER 04
SPECIALTY
Avastin
PA
Zaltrap
TIER 03
ANTIBODIES
TIER 02
TIER 04
PREFERRED BRAND
Bexxar
SPECIALTY
AdcetrisPA
Arzerra PA
Erbitux
Gazyva PA
PA
Herceptin
Kadcyla PA
Perjeta PA
Rituxan PA
Vectibix
PA
Yervoy
Zevalin Y-90
HORMONAL AGENTS
TIER 01
TIER 02
GENERIC
anastrozole
bicalutamide
exemestane
flutamide
letrozole
megestrol acetate
PREVENTIVE
tamoxifen citrate
PREFERRED BRAND
Depo-provera
Emcyt
Fareston
Megestrol
Nilandron
Soltamox
SPECIALTY
firmagon QL,PA
PA
leuprolide acetate
Eligard QL,PA
Faslodex
Firmagon QL,PA
Lupron Depot QL,PA
Lysodren
Trelstar Depot QL,PA
Trelstar Depot Mixject QL,PA
Trelstar LA QL,PA
Trelstar LA Mixject QL,PA
QL,PA
Trelstar Mixject
VantasQL,PA
Xtandi PA
ZoladexQL,PA
Zytiga PA
TIER 04
GENERIC
azathioprine
cyclosporine
cyclosporine modified
gengraf
hecoria
mycophenolate mofetil
mycophenolic acid DR
sirolimus
tacrolimus
PREFERRED BRAND
Azasan
Rapamune
Sandimmune
NON PREFERRED
Atgam
Cellcept Intravenous
NulojixPA
Prograf
Simulect
Thymoglobulin
ZortressPA
SPECIALTY
Pomalyst PA
RevlimidPA
PA
Thalomid
MITOTIC INHIBITORS
TIER 01
TIER 02
TIER 04
GENERIC
docetaxel
teniposide
PREFERRED BRAND
Vumon
SPECIALTY
etoposide
paclitaxel
toposar
vinblastine sulfate
vincasar PFS
vincristine sulfate
vinorelbine tartrate
Abraxane
Docefrez
Etopophos
Halaven PA
Ixempra Kit
Jevtana PA
Marqibo
4
Synribo PA
Targretin PA
Theracys
Tice Bcg
Trisenox
ENZYME INHIBITORS
TIER 04
SPECIALTY
Afinitor
Afinitor Disperz
PA
Bosulif
Caprelsa QL,PA
Cometriq PA
Gilotrif PA
GleevecPA
PA
Iclusig
Imbruvica PA
Inlyta PA
IstodaxPA
Jakafi PA
PA
Kyprolis
Mekinist PA
NexavarPA
Sprycel PA
Stivarga PA
PA
Sutent
TafinlarPA
Tarceva PA
Tasigna PA
Torisel
Tykerb PA
Velcade PA
Votrient PA
Xalkori PA
Zelboraf PA
Zolinza PA
TOPOISOMERASE I INHIBITOR
TIER 04
SPECIALTY
irinotecan
topotecan HCL
Camptosar
Hycamtin
CHEMOTHERAPY RESCUE
TIER 01
TIER 02
TIER 04
CHEMOTHERAPY ADJUNCTS
TIER 04
TIER 04
PREFERRED BRAND
Bexxar 131 Iodine
Metastron
Quadramet
SPECIALTY
Xofigo
CELLULAR IMMUNOTHERAPY
TIER 02
TIER 04
CARDIOVASCULAR DRUGS
TIER 01
TIER 02
TIER 04
GENERIC
milrinone lactate
milrinone IN dextrose
CARDIAC GLYCOSIDES
TIER 01
TIER 03
GENERIC
digitek
digox
digoxin
NON PREFERRED
Lanoxin
Lanoxin Pediatric
ANTIANGINAL AGENTS
TIER 01
PREFERRED BRAND
Provenge
GENERIC
hydroxyurea
PREFERRED BRAND
Photofrin
Uvadex
SPECIALTY
dacarbazine
tretinoin
Actimmune
Alferon N
Erivedge PA
Intron A PA
Intron-a PA
Intron-a W/Diluent PA
Matulane
Nipent
Proleukin
PA
Sylatron
SPECIALTY
ifosfamide/mesna
PHOSPHODIESTERASE INHBTR
ANTINEOPLASTICS MISC.
TIER 01
SPECIALTY
Elitek
Kepivance
ANTINEOPLASTIC COMBO
RADIOPHARMACEUTICALS
TIER 02
GENERIC
calcium folinate
leucovorin calcium
PREFERRED BRAND
Fusilev
SPECIALTY
amifostine
dexrazoxane
mesna
Mesnex
Totect
Voraxaze
TIER 02
TIER 03
GENERIC
isoditrate ER
isosorbide dinitrate
isosorbide dinitrate ER
isosorbide mononitrate
isosorbide mononitrate ER
minitran
nitro-time
nitroglycerin
nitroglycerin lingual
nitroglycerin transdermal
nitroglycerin ER
nitroglycerin IN dextrose 5%
nitroglycerin IN 5% dextrose
PREFERRED BRAND
Dilatrate SR
Nitro-bid
Nitrostat
Ranexa
NON PREFERRED
Nitro-dur
Nitromist
5
BETA BLOCKERS
TIER 01
TIER 02
TIER 03
TIER 05
GENERIC
esmolol HCL
pindolol
propranolol HCL
sotalol hydrochloride
timolol maleate
PREFERRED BRAND
Bystolic
Coreg CR
NON PREFERRED
Inderal XL
Innopran XL
Levatol
ZERO COPAY
acebutolol HCL
atenolol
betaxolol HCL
bisoprolol fumarate
carvedilol
labetalol HCL
metoprolol succinate ER
metoprolol tartrate
nadolol
propranolol HCL ER
sorine
sotalol HCL
sotalol HCL (AF)
TIER 02
TIER 03
ACE INHIBITORS
TIER 01
TIER 05
CALCIUM CHANNEL BLOCKERS
TIER 01
TIER 03
GENERIC
afeditab CR
amlodipine besylate
cartia XT
dilt-CD
dilt-XR
diltiazem CD
diltiazem HCL
diltiazem HCL CD
diltiazem HCL ER
diltzac
felodipine ER
isradipine
matzim LA
nicardipine HCL
nifediac CC
nifedical XL
nifedipine
nifedipine ER
nimodipine
nisoldipine
nisoldipine ER
taztia XT
verapamil HCL
verapamil HCL ER
verapamil HCL SR
verelan
verelan PM
NON PREFERRED
Cardene IV
Cardizem LA
GENERIC
adenosine
amiodarone HCL
disopyramide phosphate
flecainide acetate
ibutilide fumarate
GENERIC
enalaprilat
perindopril erbumine
ZERO COPAY
benazepril HCL
captopril
enalapril maleate
fosinopril sodium
lisinopril
moexipril HCL
quinapril HCL
ramipril
trandolapril
ANGIOTENSIN RCPTR BLOCKER
TIER 01
TIER 02
TIER 03
GENERIC
candesartan cilexetil PA,ST
eprosartan mesylate
irbesartan
losartan potassium
telmisartan
valsartan
PREFERRED BRAND
Benicar
NON PREFERRED
PA,ST
Edarbi
Teveten PA,ST
DIRECT RENIN INHIBITORS
TIER 02
PREFERRED BRAND
ST
Tekturna
ANTIHYPERTENSIVES MISC.
TIER 01
ANTIARRHYTHMICS
TIER 01
lidocaine HCL
lidocaine HCL IN D5W
lidocaine HCL/dextrose
mexiletine HCL
pacerone
procainamide HCL
propafenone HCL
propafenone HCL ER
quinidine gluconate
quinidine gluconate CR
quinidine gluconate ER
quinidine sulfate
quinidine sulfate ER
PREFERRED BRAND
Tikosyn
NON PREFERRED
Multaq
Nexterone
Norpace CR
GENERIC
clonidine HCL
doxazosin mesylate
eplerenone
fenoldopam mesylate
guanfacine HCL
hydralazine HCL
methyldopa
methyldopate HCL
minoxidil
phentolamine mesylate
prazosin HCL
reserpine
terazosin HCL
TIER 02
6
PREFERRED BRAND
Demser
Dibenzyline
Sodium Edecrin
VASOPRESSORS
TIER 01
ANTIHYPERTENSIVE COMBO
TIER 01
TIER 02
TIER 03
TIER 05
GENERIC
amlodipine besylate/benazepril hydrochloride
amlodipine besylate/benazepril HCL
amlodipine besylate/valsartan
amlodipine/valsartan/hctz
atenolol/chlorthalidone
bisoprolol fumarate/hydrochlorothiazide
candesartan cilexetil/hydrochlorothiazide
irbesartan/hydrochlorothiazide
losartan potassium/hydrochlorothiazide
methyldopa/hydrochlorothiazide
metoprolol/hydrochlorothiazide
nadolol/bendroflumethiazide
propranolol/hydrochlorothiazide
quinapril/hydrochlorothiazide
telmisartan/amlodipine
telmisartan/hydrochloroth
telmisartan/hydrochlorothiazide
valsartan/hydrochlorothiazide
PREFERRED BRAND
Amturnide
Azor
Benicar HCT
Tarka
Tekamlo
Tekturna HCT ST
Tribenzor
NON PREFERRED
EdarbyclorPA,ST
Teveten HCT PA,ST
ZERO COPAY
benazepril HCL/hydrochlorothiazide
captopril/hydrochlorothiazide
enalapril maleate/hydrochlorothiazide
fosinopril sodium/hydrochlorothiazide
lisinopril/hydrochlorothiazide
moexipril/hydrochlorothiazide
TIER 02
ANTIHYPERLIPIDEMICS
TIER 01
TIER 02
DIURETICS
TIER 01
TIER 03
GENERIC
acetazolamide
acetazolamide sodium
acetazolamide ER
amiloride HCL
amiloride/hydrochlorothiazide
bumetanide
chlorothiazide
chlorothiazide sodium
chlorthalidone
furosemide
hydrochlorothiazide
indapamide
mannitol
methazolamide
methyclothiazide
metolazone
osmitrol viaflex
spironolactone
spironolactone/hydrochlorothiazide
torsemide
triamterene/hydrochlorothiazide
NON PREFERRED
Dyrenium
Edecrin
GENERIC
dobutamine HCL
dobutamine HCL/D5W
dobutamine/dextrose 5%
dopamine HCL
dopamine HCL-dextrose 5%
dopamine HCL/dextrose 5%
dopamine/D5W
ephedrine sulfate
epinephrine
epinephrine HCL
levophed
midodrine HCL
norepinephrine bitartrate
phenylephrine HCL
PREFERRED BRAND
Auvi-q
Epipen 2-PAK
Epipen-JR 2-PAK
TIER 03
TIER 04
TIER 05
GENERIC
cholestyramine
cholestyramine light
colestipol HCL
colestipol HCL for oral suspension
fenofibrate
fenofibrate micronized
fenofibric acid
fenofibric acid DR
fluvastatin
gemfibrozil
micronized colestipol HCL
niacin ER
niacor
omega-3-acid ethyl esters
prevalite
PREFERRED BRAND
ST
Crestor
Lipofen
Liptruzet ST
Simcor
Vascepa
ST
Vytorin
Welchol
Zetia
NON PREFERRED
AltoprevST
Fenoglide
Fibricor
Livalo ST
Triglide
SPECIALTY
QL,PA
Juxtapid
Kynamro QL,PA
ZERO COPAY
atorvastatin calcium
lovastatin
pravastatin sodium
simvastatin
CARDIOVASCULAR - MISC.
TIER 01
GENERIC
amlodipine besylate/atorvastatin calcium
cardioplegic
isoxsuprine HCL
7
TIER 02
TIER 03
TIER 04
papaverine HCL
PREFERRED BRAND
CaverjectQL
Caverject Impulse QL
QL
Cialis
Muse QL
Viagra QL
NON PREFERRED
Bidil
SPECIALTY
epoprostenol sodium
sildenafilQL,PA
sildenafil citrate QL,PA
veletri PA
QL,PA
Adcirca
AdempasQL,PA
LetairisQL,PA
Opsumit QL,PA
Remodulin PA
QL,PA
Revatio
TracleerQL,PA
Tyvaso QL,PA
Tyvaso Refill QL,PA
Tyvaso StarterQL,PA
PA
Veletri
VentavisQL,PA
DERMATOLOGICALS
ACNE PRODUCTS
TIER 01
GENERIC
adapalene
amnesteem
avar cleanser
avar-e emollient
avar-e green
avita
benzepro
benzepro SHORT contact
benziq wash
benzoyl peroxide
benzoyl peroxide wash acne treatment pack
benzoyl peroxide SHORT contact
bp cleansing wash
bp foam
bp foaming wash
bp wash
bp 10-1
bpo
bpo 3% foaming cloths
cerisa wash
claravis
claris clarifying wash
clearplex x
clindacin etz pledgets
clindacin-p
clindamax
clindamycin/benzoyl peroxide
ery
erythromycin
erythromycin/benzoyl peroxide
lavoclen-4 acne wash kit
lavoclen-4 creamy wash
lavoclen-8 acne wash kit
lavoclen-8 creamy wash
myorisan
neuac
TIER 02
TIER 03
oscion cleanser
pr benzoyl peroxide wash
prascion
prascion fc
prascion ra with sunscreens
rosanil cleanser
se bpo wash
se bpo 3% foaming cloths
se bpo 7-5.5 wash kit
se 10-5 ss
sodium sulfacetamide
sodium sulfacetamide/sulfur
sodium sulfacetamide/sulfur cleanser
sodium sulfacetamide/sulfur cleanser IN urea
sodium sulfacetamide/sulfur cleansing cloths
sodium sulfacetamide/sulfur green
sodium sulfacetamide/sulfur w/sunscreen
sodium sulfacetamide/sulfur wash
sodium sulfacetamide/sulfur IN urea
ss 10-2
sss 10-5
sss 10%-5%
sulfacetamide sodium
sulfacetamide sodium/sulfur cleanser
sulfacleanse 8/4
tretinoin
tretinoin microsphere
tretinoin microsphere P.M.
virti-sulf
zaclir cleansing
zenatane
zencia
PREFERRED BRAND
Acanya
Atralin
Differin
Epiduo
Ziana
NON PREFERRED
Absorica
Azelex
Tretin-x
Veltin
ROSACEA AGENTS
TIER 01
TIER 02
TIER 03
GENERIC
doxycycline
metronidazole
rosadan
PREFERRED BRAND
Finacea
Oracea
NON PREFERRED
Metronidazole
ANTIBIOTICS - TOPICAL
TIER 01
TIER 03
GENERIC
centany
gentamicin sulfate
mupirocin
mupirocin calcium
NON PREFERRED
Altabax
Cortisporin
ANTIFUNGALS - TOPICAL
TIER 01
8
TIER 03
GENERIC
ciclodan
ciclopirox
ciclopirox nail lacquer
ciclopirox olamine
ciclopirox topical solution kit
ciclopirox treatment
clotrimazole
clotrimazole/betamethasone dipropionate
dermazene
econazole nitrate
exoderm
hydrocortisone/iodoquinol
ketoconazole
ketodan
nyamyc
nystatin
nystatin/triamcinolone
nystop
pedi-dri
versiclear
NON PREFERRED
Cnl8 Nail Kit
Ertaczo
Exelderm
Mentax
Naftin
Oxistat
Pedipirox-4 Nail
Xolegel
ANTISEBORRHEIC AGENTS
TIER 01
TIER 03
CORTICOSTEROIDS - TOPICAL
TIER 01
ANTIVIRALS - TOPICAL
TIER 01
TIER 02
GENERIC
acyclovir
PREFERRED BRAND
Denavir
Zovirax
ANTI-INFLAMMATORY AGENTS
TIER 01
TIER 02
TIER 03
GENERIC
diclofenac sodiumQL,PA
ketorolac 2% gel
PREFERRED BRAND
Voltaren QL
NON PREFERRED
FlectorQL
QL,PA
Pennsaid
ANTIPRURITICS
TIER 01
TIER 03
GENERIC
prudoxin
NON PREFERRED
Zonalon
ANTIPSORIATICS
TIER 01
TIER 02
TIER 03
TIER 04
GENERIC
acitretin
calcipotriene
calcitrene
calcitriol
dritho-creme HP
methoxsalen
PREFERRED BRAND
TazoracQL
8-mop
NON PREFERRED
Vectical
SPECIALTY
Stelara PA
GENERIC
glycolic acid
glycolic acid 70% high purity
seb-prev
seb-prev wash
selenium sulfide
sodium sulfacetamide wash
NON PREFERRED
Ovace Plus
TIER 02
TIER 03
GENERIC
ala cort
alclometasone dipropionate
alphatrex
amcinonide
apexicon
apexicon e
augmented betamethasone dipropionate
betamethasone dipropionate
betamethasone valerate
calcipotriene/betamethasone dipropionate QL
clobetasol propionate
clobetasol propionate e
clobetasol propionate emollient
clocortolone pivalate
clocortolone pivalate P.M.
clodan
cormax scalp application
cortalo
desonide
desoximetasone
diflorasone diacetate
fluocinolone acetonide
fluocinolone acetonide body
fluocinolone acetonide scalp
fluocinonide
fluocinonide emollient base
fluocinonide-e
fluticasone propionate
halac
halobetasol propionate
halonate PAC
hydrocortisone
hydrocortisone acetate/aloe
hydrocortisone acetate/pramoxine
hydrocortisone butyrate
hydrocortisone butyrate (lipid)
hydrocortisone butyrate (lipophilic)
hydrocortisone valerate
hydrocortisone IN absorbase
lokara
mometasone furoate
prednicarbate
scalacort
synalar
triamcinolone acetonide
trianex
triderm
u-cort
PREFERRED BRAND
Pramosone
Pramosone E
TaclonexQL
Tucks Anti-itch
NON PREFERRED
Capex
9
Cloderm
Cloderm P.M.
Cordran
Cordran Tape
Dermasorb Ta
Desonate
Desowen Cream/Cetaphil Lotion
Desowen Lotion/Cetaphil Cream
Desowen Ointment/Cetaphil Lotion
Halog
Kenalog
Locoid
Pediaderm HC
Pediaderm Ta
Texacort
Ultravate PAC
Verdeso
IMMUNOMODULATING AGENTS
TIER 01
TIER 02
TIER 03
GENERIC
imiquimod
tacrolimus
PREFERRED BRAND
Elidel
NON PREFERRED
Zyclara
Zyclara P.M.
DERMATOLOGICALS - MISC.
TIER 01
GENERIC
acticin
alphaquin HP
ammonium lactate
arnica flower
arzol silver nitrate app licators
benzoin compound tincture
benzoin tincture
boric acid
capsaicin
cem-urea
cerovel
coal TAR
cocaine HCL
diab
diab f.d.g. freeze-dried
diclofenac sodium
ethyl chloride
ethyl chloride/fine pinpoint
ethyl chloride/fine stream
ethyl chloride/medium jet stream
ethyl chloride/medium stream
ethyl chloride/mist
exuderm RCD
finasteride
fluorouracil
glydo
grafco silver nitrate applicator
hydroquinone
hydroquinone time release
hygel
hypercare
laclotion
lactic acid
lactic acid e
lactic acid w/vitamin e
latrix
latrix XM
lidocaine
lidocaine HCL
TIER 02
TIER 03
lidocaine HCL jelly
lidocaine/prilocaine
lidopin
lindane
mafenide acetate
malathion
melpaque HP
melquin HP
melquin 3
nuquin HP
permethrin
podocon 25 IN benzoin tincture
podofilox
pramox gel
prutect
pyrogallic acid
radiagel
rea LO 39
rea LO 40
remergent HQ
remeven
salacyn
salicylic acid
salicylic acid cream
salicylic acid lotion
salicylic acid wart remover
salicylic acid IN ammonium lactate vehicle
salvax
scar patch
silver nitrate
silver sulfadiazine
skin bleaching
skin bleaching/sunscreen
sodium hyaluronate
sonafine
spinosad
ssd
sulfurated lime
thermazene
tretinoin emollient
tropazone
u-kera e
umecta mousse
uramaxin
urea
urea hydrating
urea nail
urea nail kit
urea topical
urea IN zinc undecylenate/lactic acid vehicle
urea 40% nail film
urea-c40
witch hazel
x-viate
xclair
CARB-o-philic 40
CARB-o-philic/40
TL hydroquinone
PREFERRED BRAND
Carac
Condylox
Oxsoralen
Regranex
Sulfamylon
NON PREFERRED
Avage
Eurax
Fluoroplex
Natroba
Panretin
10
TIER 04
Picato
Refissa
Renova
Renova P.M.
Sklice
Synera
Targretin PA
Ulesfia
Veregen
SPECIALTY
ValchlorPA
Testim
Vogelxo PA,ST
Vogelxo P.M.PA,ST
ESTROGENS
TIER 01
ENDOCRINE AND METABOLIC
CORTICOSTEROIDS
TIER 01
TIER 02
TIER 03
GENERIC
a-hydrocort
a-methapred
baycadron
betamethasone sodium phosphate/betamethasone
acetate
budesonide
cortisone acetate
dexamethasone
dexamethasone sodium phosphate
fludrocortisone acetate
hydrocortisone
methylprednisolone
methylprednisolone acetate
methylprednisolone dose pack
methylprednisolone sodiumsuccinate
prednisolone
prednisolone sodium phosphate
prednisolone sodium phosphate odt
prednisone
PREFERRED BRAND
Uceris
NON PREFERRED
Depo-medrol
Dexamethasone Intensol
Dexpak 10 Day
Dexpak 13 Day
Dexpak 6 Day
Millipred
Millipred DP
Orapred Odt
Prednisone Intensol
Rayos
Solu-cortef
Veripred 20
ANDROGENS-ANABOLIC
TIER 01
TIER 02
TIER 03
GENERIC
danazol
oxandrolone QL
testosterone PA,ST
testosterone cypionate
testosterone enanthate
testosterone P.M. PA,ST
PREFERRED BRAND
Androgel
Androgel P.M.
Androxy
Axiron
Methitest
NON PREFERRED
Anadrol-50
PA,ST
Androderm
Fortesta
Striant PA,ST
TIER 02
TIER 03
GENERIC
covaryx
covaryx HS
eemt
eemt HS
esterified estrogens/methltestosterone
esterified estrogens/methyltestosterone
esterified estrogens/methyltestosterone DS
esterified estrogens/methyltestosterone HS
estradiol
estradiol valerate
estradiol/norethindrone acetate
estropipate
jinteli
lopreeza
mimvey
mimvey LO
ortho-est
PREFERRED BRAND
Cenestin
Combipatch
Enjuvia
Evamist
Minivelle
Premarin
Premphase
Prempro
NON PREFERRED
Alora
Estrogel
Menest
CONTRACEPTIVES
TIER 01
PREVENTIVE
altavera
alyacen 1/35
alyacen 7/7/7
amethia QL
amethia LO QL
amethyst
apri
aranelle
aubra
aviane
azurette
balziva
briellyn
camila
camrese QL
camrese LO QL
caziant
cesia
chateal
cryselle-28
cyclafem 1/35
cyclafem 7/7/7
dasetta 1/35
dasetta 7/7/7
daysee QL
deblitane
delyla
desogestrel/ethinyl estradiol
drospirenone/ethinyl estradiol
econtra EZ
11
elinest
emoquette
enpresse-28
enskyce
errin
estarylla
falmina
gianvi
gildagia
gildess FE 1.5/30
gildess FE 1/20
gildess 1.5/30
gildess 1/20
gildess 24 FE
heather
introvale QL
jencycla
jolessa QL
jolivette
junel FE 1.5/30
junel FE 1/20
junel 1.5/30
junel 1/20
kariva
kelnor 1/35
kurvelo
larin FE 1.5/30
larin FE 1/20
larin 1.5/30
larin 1/20
leena
lessina
levonest
levonorgestrel
QL
levonorgestrel and ethinyl estradiol
levonorgestrel/ethinyl estradiol
levora 0.15/30-28
lomedia 24 FE
loryna
low-ogestrel
lutera
lyza
marlissa
medroxyprogesterone acetate QL
microgestin FE
microgestin FE 1.5/30
microgestin 1.5/30
microgestin 1/20
mono-linyah
mononessa
my way
myzilra
necon 0.5/35-28
necon 1/35
necon 1/50-28
necon 10/11-28
necon 7/7/7
next choice one dose
nikki
nora-be
norethindrone
norethindrone acetate/ethinyl estradiol
norethindrone acetate/ethinyl estradiol/ferrous fumarate
norgestimate/ethinyl estradiol
norlyroc
nortrel 0.5/35 (28)
nortrel 1/35
nortrel 7/7/7
ocella
ogestrel
TIER 02
TIER 03
TIER 04
orsythia
philith
pimtrea
pirmella 1/35
pirmella 7/7/7
portia-28
previfem
quasense QL
reclipsen
sharobel
solia
sprintec 28
sronyx
syeda
tarina FE 1/20
tilia FE
tri-estarylla
tri-legest FE
tri-linyah
tri-previfem
tri-sprintec
trinessa
trivora-28
velivet
vestura
viorele
vyfemla
wera
wymzya FE
xulane
zarah
zenchent
zenchent FE
zovia 1/35e
zovia 1/50e
PREFERRED BRAND
Beyaz
LO Loestrin FE
Minastrin 24 FE
Safyral
PREVENTIVE
Natazia
Nuvaring QL
NON PREFERRED
Depo-subq Provera 104 QL
Ella
PREVENTIVE
Implanon
Mirena
Nexplanon
Paragard Intrauterine Copper Contraceptive T380a
Skyla
PROGESTINS
TIER 01
TIER 04
GENERIC
medroxyprogesterone acetate
norethindrone acetate
progesterone
progesterone 10% kit
SPECIALTY
Makena PA
ANTIDIABETIC AGENTS
INSULIN
TIER 02
TIER 03
PREFERRED BRAND
Lantus
Lantus Solostar
Novolog Penfill
NON PREFERRED
Apidra PA,ST
12
TIER 05
Apidra SolostarPA,ST
Humalog PA,ST
Humalog Kwikpen PA,ST
Humalog Mix 50/50PA,ST
PA,ST
Humalog Mix 50/50 Kwikpen
Humalog Mix 75/25PA,ST
Humalog Mix 75/25 Kwikpen PA,ST
Humulin NPA,ST
Humulin N Kwikpen PA,ST
PA,ST
Humulin N U-100 Pen
PA,ST
Humulin R
Humulin R U-500 (concentrated)PA,ST
Humulin 70/30PA,ST
Humulin 70/30 Kwikpen PA,ST
PA,ST
Humulin 70/30 Pen
LevemirPA,ST
Levemir Flexpen PA,ST
Levemir Flextouch PA,ST
ZERO COPAY
Novolin N
Novolin N Relion
Novolin R
Novolin R Relion
Novolin 70/30
Novolin 70/30 Relion
Novolog
Novolog Flexpen
Novolog Mix 70/30
Novolog Mix 70/30 Prefilled Flexpen
TIER 03
ALPHA-GLUCOSIDASE INHIBIT
GENERIC
TIER 01
TIER 03
TIER 03
TIER 03
TIER 03
TIER 05
BIGUANIDES
TIER 02
TIER 03
TIER 05
PREFERRED BRAND
Riomet
NON PREFERRED
Glumetza
ZERO COPAY
metformin HCL
metformin HCL ER
M EGLITINIDE ANALOGUES
GENERIC
TIER 01
nateglinide
repaglinide
DIABETIC OTHER
PREFERRED BRAND
TIER 02
Glucagen
Glucagen Hypokit
Glucagon Emergency Kit
Invokana PA
pioglitazone HCL
NON PREFERRED
Avandia
ANTIDIABETIC COM BINATIONS
GENERIC
TIER 01
TIER 02
TIER 03
glipizide/metformin HCL
glyburide/metformin HCL
pioglitazone HCL-glimepiride
pioglitazone HCL/metformin HCL
PREFERRED BRAND
Actoplus Met XR
JanumetPA
Janumet XRPA
Juvisync
Kombiglyze XRPA
Prandimet
NON PREFERRED
Jentadueto
BISPHOSPHONATES
TIER 01
SULFONYLUREAS
GENERIC
TIER 01
chlorpropamide
tolazamide
tolbutamide
NON PREFERRED
Diabeta
ZERO COPAY
glimepiride
glipizide
glipizide ER
glipizide XL
glyburide
glyburide micronized
Januvia PA
Onglyza PA
NON PREFERRED
Tradjenta
INSULIN SENSITIZING AGENT
GENERIC
TIER 01
INCRETIN M IM ETIC AGENTS
PREFERRED BRAND
TIER 02
Bydureon ST
Byetta ST
Victoza
acarbose
NON PREFERRED
Glyset
DPP-4 INHIBITORS
PREFERRED BRAND
TIER 02
AM YLIN ANALOGS
PREFERRED BRAND
TIER 02
Symlinpen 120
Symlinpen 60
Proglycem
NON PREFERRED
Cycloset
TIER 02
TIER 03
TIER 04
GENERIC
alendronate sodium
etidronate disodium
ibandronate sodiumQL
risedronate sodium QL,PA,ST
PREFERRED BRAND
Fosamax Plus DQL,ST
NON PREFERRED
Actonel ST
Atelvia QL,ST
QL,ST
Binosto
SPECIALTY
pamidronate disodium
zoledronic acid PA
Zometa PA
CALCITONINS
TIER 01
TIER 03
GENERIC
calcitonin salmon QL
calcitonin-salmonQL
QL
fortical
NON PREFERRED
Miacalcin
PARATHYROID HORMONE
TIER 04
SPECIALTY
Forteo QL,PA
RANK LIGAND INHIBITORS
TIER 04
SPECIALTY
Prolia QL,PA
Xgeva PA
13
SPECIALTY
octreotide acetatePA
Sandostatin Lar Depot PA
SigniforQL,PA
PA
Somatuline Depot
CALCIUM REGULATORS - MISC
TIER 03
NON PREFERRED
Ganite
HORMONE RECEPTOR MDLTR
TIER 01
GENERIC
raloxifene hydrochloride
GH RECEPTOR ANTAGONISTS
TIER 04
FERTILITY REGULATORS
TIER 01
TIER 04
GENERIC
clomiphene citrate
serophene
SPECIALTY
chorionic gonadotropinQL
novarel QL
pregnyl w/diluent benzyl alcohol/NACL QL
QL
Bravelle
Follistim AQ QL
Gonal-fQL,PA
Gonal-f RFFQL,PA
Gonal-f RFF Pen QL,PA
QL,PA
Gonal-f RFF Rediject
Menopur
Ovidrel QL
RepronexQL
LHRH/GNRH AGONIST
TIER 04
SPECIALTY
Lupron Depot-PEDQL,PA
Supprelin LA QL,PA
Synarel
POSTERIOR PITUITARY
TIER 01
TIER 04
SPECIALTY
ganirelix acetate QL
Cetrotide QL
GROWTH HORMONES
TIER 04
SPECIALTY
GenotropinPA
Genotropin MiniquickPA
Humatrope PA
Humatrope Combo PackPA
PA
Norditropin Cartridge
Norditropin Flexpro PA
Norditropin Nordiflex Pen PA
Nutropin PA
Nutropin AQ Nuspin 10 PA
PA
Nutropin AQ Nuspin 20
PA
Nutropin AQ Nuspin 5
Nutropin AQ Pen PA
Omnitrope PA
Saizen PA
PA
Saizen Click.easy
Serostim PA
Tev-tropin PA
Zorbtive PA
TIER 04
PROLACTIN INHIBITORS
TIER 01
GENERIC
cabergoline
VASOPRESSIN ANTAGONISTS
TIER 04
SPECIALTY
Samsca QL
METABOLIC MODIFIERS
TIER 01
TIER 02
TIER 03
TIER 04
TIER 01
SPECIALTY
Egrifta QL,PA
SOMATOMEDINS
TIER 04
SPECIALTY
H.p. ActharPA
GENERIC
calcitriol
doxercalciferol
levocarnitine
paricalcitol
PREFERRED BRAND
Sensipar
NON PREFERRED
Hectorol
Zemplar
SPECIALTY
sodium phenylbutyrate
Aldurazyme PA
Buphenyl
Carbaglu PA
Cystadane
Elaprase PA
Fabrazyme PA
PA
Kuvan
Lumizyme PA
Myalept PA
Myozyme PA
Naglazyme PA
Orfadin
Ravicti PA
VimizimPA
THYROID AGENTS
GHRH
TIER 04
GENERIC
desmopressin acetate
vasopressin
SPECIALTY
Stimate
CORTICOTROPIN
GNRH/LHRH ANTAGONISTS
TIER 04
SPECIALTY
Somavert PA
SPECIALTY
IncrelexPA
SOMATOSTATIC AGENTS
TIER 04
GENERIC
levothroid
levothyroxine sodium
levothyroxine sodium TAB 0.075MG
levoxyl
liothyronine sodium
methimazole
nature-throid
propylthiouracil
unithroid
unithroid direct
14
TIER 02
TIER 03
westhroid
NP thyroid
NP thyroid 30
NP thyroid 60
NP thyroid 90
PREFERRED BRAND
Armour Thyroid
NON PREFERRED
Cytomel
Synthroid
Thyrolar-1
Thyrolar-1/2
Thyrolar-1/4
Thyrolar-2
Thyrolar-3
GASTROINTESTINAL
LAXATIVES
TIER 01
TIER 02
TIER 03
GENERIC
cascara sagrada
constulose
lactulose
mineral oil heavy
pegylax
polyethylene glycol 3350
senna plus
PREVENTIVE
gavilyte-c
gavilyte-n/flavor pack
gavilyte-G
peg 3350/electrolytes
peg-3350/electrolytes
peg-3350/NACL/NA bicarbonate/KCL
trilyte
PREFERRED BRAND
Halflytely Bowel Prep/Flavor Packs
Moviprep
Suclear
Suprep Bowel Prep
NON PREFERRED
Colyte-flavor Packs
Golytely
Kristalose
Osmoprep
Prepopik
TIER 02
TIER 03
ANTIDIARRHEALS
TIER 01
TIER 03
GENERIC
diphenoxylate/atropine
lofene
lonox
loperamide HCL
opium
opium tincture
opium tincture (paregoric)
NON PREFERRED
Motofen
ANTIEMETICS
TIER 01
ANTACIDS
TIER 01
GENERIC
sodium bicarbonate
ULCER DRUGS
TIER 01
GENERIC
atropine sulfate
belladonna & opium
belladonna alkaloids & opium
chlordiazepoxide HCL/clidinium bromide
cimetidine
cimetidine HCL
dicyclomine HCL
ed-spaz
esomeprazole magnesiumQL
esomeprazole sodium
famotidine
famotidine premixed
gastrinex NF
glycopyrrolate
hyomax-SL
hyoscyamine sulfate
hyoscyamine sulfate odt
hyoscyamine sulfate ER
hyoscyamine sulfate SR
hyosyne
lansoprazole QL
lansoprazole/amoxicillin/clarithromycin
methscopolamine bromide
misoprostol
nizatidine
nulev
omeprazoleQL
omeprazole/sodium bicarbonateQL
oscimin
oscimin SR
pantoprazole sodiumQL
propantheline bromide
rabeprazole sodium QL,PA,ST
ranitidine HCL
scopolamine hydrobromide
sucralfate
symax fastabs
symax-SL
symax-SR
PREFERRED BRAND
Carafate
Nexium QL
Pylera
NON PREFERRED
QL,PA,ST
esomeprazole strontium
QL,PA,ST
Aciphex Sprinkle
Atropen
Cantil
Cuvposa
DexilantQL,PA,ST
Donnatal
Donnatal Extentabs
First-lansoprazole
Helidac
Omeclamox-PAK
Prevacid Solutab QL,PA,ST
PrilosecQL,PA,ST
Zegerid QL,PA,ST
TIER 02
GENERIC
dimenhydrinate
dronabinol QL
granisetron HCL QL
meclizine HCL
ondansetron odt QL
QL
ondansetron HCL
trimethobenzamide HCL
univert
PREFERRED BRAND
Aloxi
QL
Emend
Sancuso QL
Transderm-scop
15
TIER 03
NON PREFERRED
Anzemet QL
CesametQL
Granisol QL
QL
Zuplenz
TIER 03
DIGESTIVE AIDS
TIER 01
TIER 02
TIER 03
TIER 04
GENERIC
pancrelipase
PREFERRED BRAND
Creon
Viokace
NON PREFERRED
Pertzye PA,ST
PA,ST
Ultresa
Zenpep PA,ST
SPECIALTY
Sucraid
GASTROINTESTINAL - MISC.
TIER 01
TIER 02
GENERIC
ana-lex
anucort-HC
auryxia
balsalazide disodium
calcium acetate
colocort
cromolyn sodium
dexpanthenol
enulose
generlac
grx hicort 25
hemril-30
hydrocortisone
hydrocortisone acetate
hydrocortisone acetate/lidocaine HCL
hydrocortisone acetate/pramoxine
hydrocortisone acetate/pramoxine HCL
lactulose
lidazone HC
lidocaine HCL-hydrocortisone acetate with aloe
lidocaine HCL/hydrocortisone acetate
mesalamine
metoclopramide HCL
pramcort
procto-PAK
proctocream HC
proctosol HC
proctozone-HC
rectacort-HC
sevelamer carbonate
sulfasalazine
sulfazine
sulfazine EC
ursodiol
PREFERRED BRAND
QL
Amitiza
Analpram Advanced
Analpram-HC
Asacol
Asacol HD
Canasa
Chenodal
Cortifoam
Delzicol
Fosrenol
Lialda
LinzessQL
Lotronex
TIER 04
Pentasa
Proctofoam HC
Rectiv
Relistor
Renvela
NON PREFERRED
Apriso
Dipentum
Giazo
Phoslyra
Renagel
SPECIALTY
Cimzia PA
Cimzia Starter KitPA
PA
Gattex
Remicade PA
GENITOURINARY
URINARY ANTI-INFECTIVES
TIER 01
TIER 03
GENERIC
hyophen
methenamine hippurate
methenamine mandelate
nitrofurantoin
nitrofurantoin macrocrystals
nitrofurantoin monohydrate
nitrofurantoin monohydrate/macrocrystals
phosphasal
ur n-c
urelle
uretron d/s
uribel
urimar-t
urin d/s
uro-blue
uro-l
uro-mp
uryl
ustell
uta
uticap
utira-c
utrona-c
NON PREFERRED
Monurol
URINARY ANTISPASMODICS
TIER 01
TIER 02
TIER 03
GENERIC
bethanechol chloride
flavoxate HCL
oxybutynin chloride
oxybutynin chloride ER
tolterodine tartrate
tolterodine tartrate ER
trospium chloride
trospium chloride ER
PREFERRED BRAND
Gelnique
Myrbetriq
Oxytrol QL
Oxytrol For Women QL
Toviaz
Vesicare
NON PREFERRED
EnablexPA,ST
VAGINAL PRODUCTS
TIER 01
GENERIC
16
TIER 02
TIER 03
TIER 04
metronidazole vaginal
miconazole 3
terconazole
vandazole
zazole
PREVENTIVE
encare
vcf vaginal contraceptive foam
PREFERRED BRAND
Clindesse
Endometrin
Estrace
Estring QL
Vagifem
NON PREFERRED
Avc
Cleocin
Gynazole-1
PREVENTIVE
Options Conceptrol Vaginal Contraceptive
Options Gynol II Vaginal Contraceptive
Shur-seal
Today Sponge
Vcf Vaginal Contraceptive Film
SPECIALTY
Crinone
GENITOURINARY - MISC.
TIER 01
TIER 02
TIER 03
TIER 04
GENERIC
acetic acid 0.25%
alfuzosin HCL ER
aminoacetic acid
argyle sterile saline 100ML
citric acid/sodium citrate
curity sterile saline
cytra k crystals
cytra-k
cytra-2
cytra-3
finasteride
glycine
hydrochloric acid
neomycin/polymyxin b sulfates
phenazo
phenazopyridine HCL
potassium citrate ER
potassium citrate-citric acid crystals
potassium citrate/citric acid
potassium citrate/sodium citrate/citric acid
sodium chloride
sodium chloride 0.9%
sodium citrate/citric acid
sorbitol
sorbitol-mannitol
tamsulosin HCL
taron-crystals
tricitrates
virtrate-3
PREFERRED BRAND
Elmiron
Rapaflo
Renacidin
NON PREFERRED
Avodart
Cardura XL
Oracit
SPECIALTY
Cystagon
Procysbi PA
HEMATOLOGICAL AGENTS
HEMATOPOIETIC AGENTS
TIER 01
GENERIC
airavite
b-6 folic acid
bp vit 3
corvita 150
cyanocobalamin
dexferrum
ed cyte f
fabb
ferocon
ferotrinsic
ferraplus 90
ferrex 150 forte plus
ferrex 28
ferrocite plus
ferrogels forte
folbee
folcaps
folic acid
folic acid/vitamin b-6/vitamin b-12
folplex 2.2
foltrin
hematinic plus vitamins/minerals
hematinic/folic acid
hematogen
hematogen fa
hematogen forte
hemocyte-f
hemocyte-plus
hydroxocobalamin
iferex 150 forte
infed
iron asp gly/ polysacch compl/ascorb CAL/b12/fa/c
threon/suc
mi-omega NF
multigen
multigen folic
multigen plus
myferon 150 forte
nufol
poly-iron 150 forte
polysaccharide iron forte
purevit dualfe plus
se-tan plus
tandem f
tricon
trigels-f forte
virt-vite
FE c plus
MV FE asparto gly/vit c/vit b12/CA threonate/succ
acd/stomac
MV FE asparto gly/FE fum/succ acid/vit c/threonic
acd/b12/fa
TL gard RX
TL icon
TL-fol 500
TL-hem 150
PREVENTIVE
bprotected pedia iron
eq slow-release iron
eql folic acid
eql iron supplement therapy
eql slow release iron
ezfe 200
fa-8
feosol
fer-iron
ferate
17
TIER 02
TIER 03
ferosul
ferretts
ferrex 150
ferric x-150
ferro-bob
ferrocite
ferrotabs
ferrous drops
ferrous fumarate
ferrous fumarate 324
ferrous gluconate
ferrous sulfate
ferrousul
ferus
gnp folic acid
gnp iron
gnp slow release iron
high potency iron
iferex 150
iron
iron chews pediatric
iron slow release
iron supplement
iron supplement childrens
kp ferrous gluconate
kp ferrous sulfate
kp folic acid
meijer ferrous sulfate
myferon 150
nu-iron 150
poly-iron 150
px folic acid
px iron
qc ferrous sulfate
ra folic acid
ra high potency iron
ra iron
ra slow release iron
slow iron
slow release iron
sm folic acid
sm iron
sm iron slow release
th folic acid
th iron
th slow release iron
wee care
yl folic acid
CVS folic acid
CVS iron
CVS slow release iron
FE aspartate
FE gluconate
FE TABS
HM folic acid
HM iron
HM iron slow release
PREFERRED BRAND
Droxia
Feraheme
Nascobal
Venofer
NON PREFERRED
Foltrate
PREVENTIVE
CVS Slow Release Iron
Elite Iron
Fa-8
Femiron
Feosol
TIER 04
Ferretts Chewable Iron
Ferretts IPS
Ferrimin 150
Ferro-sequels
Iron Up
Mykidz Iron 10
Novaferrum Pediatric Drops
Perfect Iron
Profe
Proferrin ES
Slow Release Iron
Sm Slow Release Iron
SPECIALTY
sodium ferric gluconate complex/sucrose
PA
Aranesp Albumin Free
Cerezyme PA
Elelyso PA
Epogen PA
Leukine PA
QL,PA
Mozobil
Neulasta PA
Neulasta Delivery Kit PA
Neumega PA
Neupogen PA
PA
Nplate
ProcritPA
Promacta PA
VprivPA
Zavesca PA
ANTICOAGULANTS
TIER 01
TIER 02
TIER 03
GENERIC
acd formula a
acd formula b
acd-a noclot-50
anticoagulant citrate dextrose solution a
anticoagulant sodium citrate
argatroban
enoxaparin sodiumQL
fondaparinux sodiumQL
hep flush-10
heparin lock
heparin lock flush
heparin lock flush for flushing vascular access devices
heparin lock flush/NACL for flushing vascular access
devices
heparin sodium
heparin sodium dcu
heparin sodium lock flush
heparin sodium/sodium chloride 0.9%
heparin sodium/sodium chloride 0.9% premix
heparin sodium/D5W
heparin sodium/NACL 0.45%
heparin sodium/NACL 0.9%
jantoven
monoject pharma grade flush syringe/heparin lock
monoject prefill advanced heparin lock flush
sash kit for flushing vascular access devices
warfarin sodium
PREFERRED BRAND
EliquisQL
Pradaxa QL
Xarelto QL
Xarelto Starter PackQL
NON PREFERRED
Fragmin QL
HEMOSTATICS
TIER 01
18
GENERIC
aminocaproic acid
tranexamic acid
Thrombate Iii W/10 ML Sterile Water
Thrombate Iii W/20 ML Sterile Water
Tretten
Wilate
Xyntha
Xyntha Solofuse
HEMATOLOGICAL - MISC.
TIER 01
TIER 02
TIER 03
TIER 04
GENERIC
albuked 25
albuked 5
albumin human
albumin-zlb
albuminar-25
albuminar-5
alburx
albutein
anagrelide hydrochloride
buminate
cilostazol
clopidogrel
dipyridamole
flexbumin
hetastarch 6%/NACL
human albumin grifols
kedbumin
pentoxifylline ER
plasbumin-25
plasbumin-5
protamine sulfate
ticlopidine HCL
LMD 10% dextrose 5%
LMD 10% sodium chloride 0.9%
PREFERRED BRAND
Aggrenox
Brilinta
Effient
NON PREFERRED
Aggrastat
Integrilin
SPECIALTY
hemofil m
koate-dvi
Advate
Alphanate/Von Willebrand Factor Complex/Human
Alphanine SD
Bebulin
Bebulin VH
Benefix
Berinert
Ceprotin
Cinryze
Corifact
Feiba
Feiba NF
Firazyr
Helixate FS
Hemofil M
Humate-p
Kalbitor
Koate-dvi
Kogenate FS
Kogenate FS Bio-set
Monoclate-p
Mononine
Novoseven
Novoseven Rt
Profilnine SD
Recombinate
Riastap
Rixubis
SolirisPA
MOUTH/THROAT/DENTAL AGENT
TIER 01
TIER 03
GENERIC
cavarest
cavirinse
cevimeline HCL
chlorhexidine gluconate
chlorhexidine gluconate oral rinse
clinpro 5000
clotrimazole
controlrx
denta 5000 plus
dentagel
easygel
fluoridex daily defense
fluoridex daily defense enhanced whitening
fluoridex daily defense sensitivity relief
karigel
karigel-n
lidocaine viscous
lidocaine HCL
lidocaine HCL viscous
neutragard advanced
neutral sodium fluoride
numoisyn
nystatin
oralone
paroex
periogard
phos-flur
pilocarpine hydrochloride
pilocarpine HCL
stannous fluoride oral rinse
topex topical anesthetic
triamcinolone acetonide
triamcinolone IN orabase
SF
SF 5000 plus
NON PREFERRED
Oravig
NEUROLOGY, CNS, PSYCH
ANTIANXIETY AGENTS
TIER 01
GENERIC
alprazolam
alprazolam odt
alprazolam ER
alprazolam XR
buspirone HCL
chlordiazepoxide HCL
clorazepate dipotassium
diazepam
diazepam intensol
droperidol
hydroxyzine pamoate
hydroxyzine HCL
lorazepam
meprobamate
oxazepam
ANTIDEPRESSANTS
TIER 01
19
TIER 02
TIER 03
GENERIC
amitriptyline HCL
amoxapine
budeprion SRQL
bupropion HCL
bupropion HCL ERQL
bupropion HCL SRQL
bupropion HCL XL QL
citalopram hydrobromide
clomipramine HCL
desipramine HCL
desvenlafaxine ERQL
doxepin HCL
duloxetine HCL QL
escitalopram oxalate
fluoxetine DRQL
fluoxetine HCL
fluvoxamine maleate
fluvoxamine maleate ERQL
imipramine pamoate
imipramine HCL
maprotiline HCL
mirtazapine
mirtazapine odt
nefazodone HCL
nortriptyline HCL
paroxetine HCL
paroxetine HCL ER
phenelzine sulfate
protriptyline HCL
sertraline HCL
tranylcypromine sulfate
trazodone HCL
trimipramine maleate
QL
venlafaxine HCL
venlafaxine HCL ERQL
PREFERRED BRAND
Pristiq QL
NON PREFERRED
QL
Aplenzin
QL
Emsam
Forfivo XL QL
Marplan
Paxil
Viibryd QL
TIER 02
TIER 03
quetiapine fumarateQL
risperidone QL
risperidone odt QL
risperidone M-TABQL
thioridazine HCL
thiothixene
trifluoperazine HCL
ziprasidone HCL QL
PREFERRED BRAND
QL
Abilify
Abilify Discmelt QL
Abilify Maintena
Latuda QL
Risperdal Consta
QL
Seroquel XR
NON PREFERRED
FanaptQL,PA,ST
Fanapt Titration PackQL,PA,ST
Fazaclo QL
Geodon
Invega QL,PA,ST
Invega Sustenna
SaphrisQL,PA,ST
HYPNOTICS
TIER 01
TIER 02
TIER 03
TIER 04
GENERIC
dexmedetomidine HCL
estazolam
eszopiclone QL
flurazepam HCL
midazolam HCL
phenobarbital
phenobarbital sodium
quazepam
temazepam
triazolam
zaleplonQL
zolpidem tartrateQL
zolpidem tartrate ERQL
PREFERRED BRAND
Rozerem QL
NON PREFERRED
Intermezzo QL
SilenorQL
SPECIALTY
HetliozQL,PA
ANTIPSYCHOTICS
TIER 01
GENERIC
chlorpromazine HCL
clozapineQL
clozapine odt QL
compazine
compro
fluphenazine decanoate
fluphenazine HCL
haloperidol
haloperidol decanoate
haloperidol lactate
lithium
lithium carbonate
lithium carbonate ER
loxapine
loxapine succinate
olanzapineQL
olanzapine odt QL
perphenazine
prochlorperazine
prochlorperazine edisylate
prochlorperazine maleate
ADHD, NARCOLEPSY, ETC.
TIER 01
GENERIC
amphetamine/dextroamphetamine QL
benzphetamine HCL
caffeine citrate
caffeine/sodium benzoate
clonidine HCL ER
dexedrine QL
dexmethylphenidate HCL QL
QL
dexmethylphenidate HCL ER
QL
dextroamphetamine sulfate
dextroamphetamine sulfate ERQL
diethylpropion HCL
diethylpropion HCL ER
doxapram HCL
guanfacine ER
metadate ERQL
QL
methamphetamine HCL
methylphenidate hydrochloride
QL
methylphenidate HCL
methylphenidate HCL CDQL
methylphenidate HCL ERQL
20
TIER 02
TIER 03
methylphenidate HCL SRQL
modafinilQL
phendimetrazine tartrate
phendimetrazine tartrate ER
phentermine HCL
procentra QL
zenzedi QL
PREFERRED BRAND
Daytrana QL
QL
Nuvigil
Quillivant XRQL
Strattera QL
Vyvanse QL
NON PREFERRED
QL
Concerta
Focalin XRQL
Kapvay Dose Pack
Xenical
TIER 04
ANTIPARKINSON AGENTS
TIER 01
ANTICONVULSANTS
TIER 01
TIER 02
TIER 03
GENERIC
carbamazepine
carbamazepine ER
clonazepam
clonazepam odt
diazepam
divalproex sodium
divalproex sodium DR
divalproex sodium ER
epitol
ethosuximide
felbamate
fosphenytoin sodium
gabapentin
lamotrigine
lamotrigine odt
lamotrigine ER
levetiracetam
levetiracetam ER
oxcarbazepine
phenytoin
phenytoin infatabs
phenytoin sodium
phenytoin sodium extended
primidone
tiagabine hydrochloride
topiragen
topiramate
topiramate ER
valproate sodium
valproic acid
zonisamide
PREFERRED BRAND
Banzel
Celontin
Dilantin
Fycompa
Gabitril
Lyrica QL
Onfi
Peganone
Potiga
Tegretol-XR
Vimpat
NON PREFERRED
Diastat Pediatric
Lamictal
Lamictal Odt
Stavzor
SPECIALTY
Sabril PA
TIER 02
TIER 03
TIER 04
GENERIC
amantadine HCL
benztropine mesylate
bromocriptine mesylate
carbidopa
carbidopa/levodopa
carbidopa/levodopa odt
carbidopa/levodopa ER
carbidopa/levodopa/entacapone
entacapone
pramipexole dihydrochloride
pramipexole dihydrochloride ER
ropinirole ER
ropinirole HCL
selegiline HCL
trihexyphenidyl HCL
PREFERRED BRAND
AzilectST
Mirapex ER
NON PREFERRED
Neupro
Tasmar
SPECIALTY
Apokyn PA
NEUROLOGY, PSYCH - MISC.
TIER 01
GENERIC
acamprosate calcium DR
chlordiazepoxide/amitriptyline
disulfiram
donepezil HCL
ergoloid mesylates
fluoxetine
galantamine
galantamine hydrobromide
olanzapine/fluoxetine QL
perphenazine/amitriptyline
rivastigmine tartrate
PREVENTIVE
buproban QL
bupropion HCL SRQL
eq nicotineQL
QL
eq nicotine gum refill
eq nicotine gum starterQL
eq nicotine polacrilexQL
eq nicotine step 3 QL
eql nicotine QL
QL
eql nicotine polacrilex
eql nicotine polacrilex refillQL
eql nicotine polacrilex starterQL
gnp nicotine polacrilexQL
gnp nicotine polacrilex miniQL
QL
kls quit2
kls quit4 QL
nicorelief QL
nicotineQL
nicotine polacrilexQL
QL
nicotine polacrilex refill
nicotine polacrilex starter kit QL
nicotine step 1 QL
QL
nicotine step 2
nicotine step 3 QL
QL
nicotine transdermal system
QL
px stop smoking aid
qc nicotine polacrilexQL
21
TIER 02
TIER 03
TIER 04
ra mini nicotineQL
ra nicotineQL
ra nicotine polacrilexQL
ra nicotine transdermal system step 3 QL
QL
sm nicotine
sm nicotine polacrilexQL
sw nicotine polacrilexQL
tgt nicotine gum QL
tgt nicotine polacrilexQL
QL
tgt nicotine step one
tgt nicotine step three QL
tgt nicotine step two QL
thrive QL
CVS nicotine QL
QL
CVS nicotine polacrilex
CVS nicotine polacrilex starterQL
CVS nicotine transdermal system QL
CVS nts step 1 QL
HM nicotine polacrilexQL
QL
HM nicotine transdermal system
HM nicotine transdermal system step 3 QL
SR nicotine gumQL
PREFERRED BRAND
Exelon
QL
Gralise
Gralise StarterQL
Namenda
Namenda Titration PAK
Namenda XRQL
QL
Namenda XR Titration Pack
Nuedexta
Savella QL
PREVENTIVE
ChantixQL,PA,ST
QL,PA,ST
Chantix Continuing Month PAK
Chantix Starting Month PAK QL,PA,ST
NON PREFERRED
HorizantQL
Orap
PREVENTIVE
Nicotrol InhalerQL
Nicotrol NsQL
SPECIALTY
Ampyra QL,PA
Aubagio QL,PA
AvonexQL,PA
Avonex Pen QL,PA
Betaseron QL,PA
Copaxone QL,PA
QL,PA
Extavia
Gilenya QL,PA
RebifQL,PA
Rebif Rebidose QL,PA
Rebif Rebidose Titration PackQL,PA
Rebif Titration PackQL,PA
Tecfidera QL,PA
QL,PA
Tecfidera Starter Pack
Tysabri QL,PA
Xenazine PA
Xyrem QL,PA
NEUROMUSCULAR AGENTS
TIER 01
GENERIC
atracurium besylate
cisatracurium besylate
pancuronium bromide
QL
riluzole
rocuronium bromide
vecuronium bromide
TIER 04
SPECIALTY
BotoxPA
DysportPA
MyoblocPA
PA
Xeomin
MUSCULOSKELETAL AGENTS
TIER 01
TIER 02
TIER 03
TIER 04
GENERIC
baclofen
carisoprodol
carisoprodol/aspirin
carisoprodol/aspirin/codeine
chlorzoxazone
cyclobenzaprine HCL
dantrolene sodium
enovarx-cyclobenzaprine HCL
metaxalone
methocarbamol
orphenadrine citrate
orphenadrine citrate ER
orphenadrine/asa/caffeine
revonto
tizanidine HCL
PREFERRED BRAND
Gablofen
Lioresal Intrathecal
NON PREFERRED
Lorzone
SPECIALTY
Euflexxa PA
Hyalgan PA
MonoviscPA
OrthoviscPA
SupartzPA
SynviscPA
Synvisc One PA
ANTIMYASTHENIC AGENTS
TIER 01
TIER 02
GENERIC
guanidine HCL
neostigmine methylsulfate
pyridostigmine bromide
regonol
PREFERRED BRAND
Mestinon
Mestinon Timespan
Prostigmin
OPHTHALMOLOGY AND OTIC
ANTI-INFECTIVES
TIER 01
GENERIC
ak-poly-bac
bacitracin
bacitracin/polymyxin b
ciprofloxacin HCL
erythromycin
garamycin
gatifloxacin
gentak
gentamicin sulfate
ilotycin
levofloxacin
neo-polycin
neomycin/bacitracin/polymyxin
neomycin/polymyxin/bacitracin zinc
neomycin/polymyxin/gramicidin
ofloxacin
polycin
polycin b
22
TIER 02
TIER 03
polymyxin b sulfate/trimethoprim sulfate
romycin
sulfacetamide sodium
tobramycin sulfate
trifluridine
trimethoprim sulfate/polymyxin b sulfate
PREFERRED BRAND
Besivance
Moxeza
Natacyn
Vigamox
NON PREFERRED
Azasite
Ciloxan
Tobrex
Zirgan
TIER 02
TIER 03
GENERIC
latanoprost QL
travoprost QL
PREFERRED BRAND
QL
Lumigan
Travatan ZQL
NON PREFERRED
Zioptan QL
CYCLOPLEGIC MYDRIATICS
TIER 01
GENERIC
atropine sulfate
atropine-care
cyclopentolate HCL
homatropaire
homatropine HBR
mydral
tropicamide
ARTIFICIAL TEAR/LUBRICANT
TIER 03
NON PREFERRED
Lacrisert
DECONGESTANTS
TIER 01
BETA-BLOCKERS
TIER 01
TIER 02
TIER 03
GENERIC
betaxolol HCL
carteolol HCL
dorzolamide HCL/timolol maleate
istalol
levobunolol HCL
metipranolol
timolol maleate
timolol maleate ophthalmic gel forming
PREFERRED BRAND
Combigan
NON PREFERRED
Betimol
Betoptic-s
MIOTICS
TIER 01
TIER 02
TIER 03
TIER 02
TIER 03
GENERIC
dexamethasone sodium phosphate
fluorometholone
neo-polycin HC
neomycin/polymyxin/bacitracin/hydrocortisone
neomycin/polymyxin/dexamethasone
neomycin/polymyxin/hydrocortisone
poly-dex
prednisolone acetate
prednisolone sodium phosphate
sulfacetamide sodium/prednisolone sodium phosphate
tobramycin/dexamethasone
PREFERRED BRAND
Alrex
FML
Lotemax
Pred Mild
Retisert
Tobradex
Tobradex ST
Zylet
NON PREFERRED
Blephamide S.o.p.
Durezol
Flarex
Ozurdex
Vexol
PROSTAGLANDINS
TIER 01
GENERIC
pilocarpine HCL
PREFERRED BRAND
Phospholine Iodide
Pilopine HS
NON PREFERRED
Isopto Carbachol
ADRENERGIC AGENTS
TIER 01
OPHTHALMIC STEROIDS
TIER 01
GENERIC
altafrin
naphazoline HCL
neofrin
phenylephrine HCL
TIER 02
TIER 03
GENERIC
apraclonidine
brimonidine tartrate
PREFERRED BRAND
Alphagan P
NON PREFERRED
Iopidine
IMMUNOMODULATORS
TIER 02
PREFERRED BRAND
RestasisQL
LOCAL ANESTHETICS
TIER 01
GENERIC
altacaine
parcaine
proparacaine HCL
tetcaine
tetracaine HCL
tetravisc
tetravisc forte
OPHTHALMICS - MISC.
TIER 01
GENERIC
ak-fluor
akorn balanced salt solution
altafluor
azelastine HCL
balanced salt
balanced salt solution
bio GLO
bromfenac
bss
23
TIER 02
TIER 03
TIER 04
cromolyn sodium
diclofenac sodium
dorzolamide HCL
epinastine HCL
flucaine
fluor-i-strips a.t.
fluorescein-benoxinate
fluorescein/proparacaine
fluorets
flurbiprofen sodium
flurox
ful-GLO
green GLO lissamine greenophthalmic strips
ketorolac tromethamine
lissamine green
ocucoat viscoadherent
PREFERRED BRAND
Bepreve
BromdayQL
QL
Ilevro
NevanacQL
Pataday
Patanol
Prolensa QL
NON PREFERRED
Acuvail
Alocril
Alomide
Azopt
Emadine
Lastacaft
SPECIALTY
Cystaran QL,PA
Eylea
Jetrea
Lucentis
Macugen
Visudyne
OTIC AGENTS
TIER 01
TIER 02
TIER 03
GENERIC
acetasol HC
acetic acid
acetic acid/aluminum acetate
aero otic HC
antipyrine/benzocaine
aurax
aurodex
ciprofloxacin
cortic-nd
cyotic
exotic-HC
fluocinolone acetonide
fluocinolone acetonide ear drops
hydrocortisone/acetic acid
myoxin
neomycin/polymyxin/hydrocortisone
neomycin/polymyxin/HC
ofloxacin
otic care
oticin
oto-end 10
otomax-HC
otozin
pramoxine-HC
PREFERRED BRAND
Ciprodex
NON PREFERRED
Cipro HC
Coly-mycin S
Cortisporin-tc
OXYTOCICS
TIER 01
GENERIC
methylergonovine maleate
oxytocin
PAIN MANAGEMENT
ANALGESICS - NONNARCOTIC
TIER 01
GENERIC
ali-flex
alpain
biogesic
bupap
butalbital/acetaminophen
butalbital/acetaminophen/caffeine
butalbital/apap/caffeine
butalbital/aspirin/caffeine
capacet
choline magnesium trisalicylate
clonidine HCL
diflunisal
dologesic
dolorex
duraxin
ed-flex
esgic
margesic
marten-TAB
promacet
rhinoflex-650
salsalate
tencon
zebutal
zflex
zgesic
PREVENTIVE
adult aspirin EC low strength
aspir-low
aspir-81
aspirin
aspirin adult low strength
aspirin childrens
aspirin enteric coated adult low strength
aspirin low dose
aspirin low strength
aspirin EC
aspirin EC low dose
aspirin EC LO-dose
aspirin 81
aspirin 81 low dose
aspirtab
bayer advanced aspirin regular strength
bayer aspirin
bayer aspirin regimen
bayer aspirin EC low dose
bayer chewable low dose
bayer low dose
childrens aspirin
childrens aspirin low strength
ecotrin low strength
ecpirin
enteric coated aspirin
eq adult aspirin low strength
eq aspirin
eq aspirin adult low dose
eq aspirin low dose
24
TIER 02
TIER 03
eq aspirin EC
eq childrens aspirin
eql adult aspirin low strength
eql aspirin
eql aspirin low dose
eql aspirin EC
eql childrens aspirin
gnp adult aspirin low strength
gnp aspirin
gnp aspirin low dose
gnp childrens aspirin
goodsense aspirin low dose
halfprin
kls aspirin low dose
kls aspirin EC
kp aspirin
meijer aspirin EC
miniprin low dose
norwich aspirin
px aspirin
px enteric aspirin
qc aspirin
qc aspirin low dose
qc childrens aspirin
ra aspirin
ra aspirin adult low dose
ra aspirin adult low strength
ra aspirin childrens
ra aspirin EC
ra aspirin EC adult low strength
ra childrens aspirin
sm aspirin
sm aspirin adult low strength
sm aspirin enteric coated
sm aspirin low dose
sm aspirin EC low strength
sm childrens aspirin
st joseph aspirin
tgt aspirin
tgt aspirin low dose
tgt childrens aspirin
tgt enteric-coated aspirin
th aspirin
th aspirin low dose
th enteric aspirin
CVS aspirin
CVS aspirin adult low dose
CVS aspirin adult low strength
CVS aspirin child
CVS aspirin low dose
CVS aspirin low strength
CVS aspirin EC
CVS childrens aspirin
CVS enteric aspirin
EC-81 aspirin
HM aspirin
HM aspirin EC
HM aspirin EC low dose
MM aspirin
SB aspirin
SB aspirin EC
SB childrens aspirin
SB low dose asa EC
1/2halfprin
PREVENTIVE
Halfprin
PREVENTIVE
Adult Aspirin Low Strength
Medi-seltzer
SPECIALTY
Prialt
ANALGESICS - OPIOID
TIER 01
GENERIC
acetaminophen/caffeine/dihydrocodeine bitartrate
acetaminophen/codeine
acetaminophen/codeine #2
acetaminophen/codeine phosphate
alfentanil
ascomp/codeine
aspirin-caffeine-dihydrocodeine
astramorph
buprenorphine HCL QL
buprenorphine HCL/naloxone HCL QL
butalbital/acetaminophen/caffeine/codeine
butalbital/aspirin/caffeine/codeine
QL
butorphanol tartrate
codeine sulfate
duramorph
endocet
endodan
fentanyl QL
fentanyl citrate
fentanyl citrate oral transmucosal QL
hydrocodone bitartrate/acetaminophen
hydrocodone/acetaminophen
hydrocodone/ibuprofen
hydrogesic
hydromorphone HCL
hydromorphone HCL dosette
hydromorphone HCL ERQL
ibudone
levorphanol tartrate
lorcet
lorcet plus
lorcet HD
lortab
meperidine HCL
meperidine HCL/promethazine HCL
meperitab
methadone HCL
methadone HCL intensol
methadose
methadose sugar-free
morphine sulfate
morphine sulfate add-vantage
morphine sulfate ERQL
nalbuphine HCL
oxycodone HCL
oxycodone HCL ERQL
oxycodone/acetaminophen
oxycodone/aspirin
oxycodone/ibuprofen
oxymorphone hydrochloride
oxymorphone hydrochloride ERQL
pentazocine/acetaminophen
pentazocine/naloxone HCL
reprexain
roxicet
stagesic
sufentanil citrate
tramadol hydrochloride/acetaminophen QL
tramadol HCL QL
QL
tramadol HCL ER
trezix
verdrocet
TIER 04
25
TIER 02
TIER 03
vicodin
vicodin ES
vicodin HP
xylon
zamicet
CO-gesic
PREFERRED BRAND
ButransQL
Lazanda QL
QL
Nucynta
Nucynta ERQL
Opana ER (crush Resistant)QL
Oxycontin QL
Suboxone QL
NON PREFERRED
Abstral QL
Conzip QL
Depodur
Embeda QL
QL
Exalgo
Fentora QL
Infumorph 200
Infumorph 500
Kadian QL
Oxecta
Rybix Odt
SubsysQL
Talwin
ArcalystPA
Enbrel PA
Enbrel SureclickPA
Humira PA
PA
Humira Pediatric Crohns Disease Starter Pack
Humira Pen PA
Humira Pen-crohns DiseasestarterPA
Humira Pen-psoriasis StarterPA
IlarisPA
PA
Kineret
Orencia PA
SimponiPA
Simponi Aria PA
XeljanzPA
MIGRAINE PRODUCTS
TIER 01
ANTI-INFLAMMATORY
TIER 01
TIER 02
TIER 03
TIER 04
GENERIC
celecoxib QL
diclofenac potassium
diclofenac sodium DR
diclofenac sodium ER
diclofenac sodium/misoprostol
etodolac
etodolac ER
fenoprofen calcium
flurbiprofen
ibuprofen
indomethacin
indomethacin sodium
indomethacin ER
ketoprofen
ketoprofen ER
QL
ketorolac tromethamine
leflunomide
meclofenamate sodium
mefenamic acid
meloxicam
nabumetone
naproxen
naproxen sodium
naproxen DR
oxaprozin
piroxicam
sulindac
tolmetin sodium
PREFERRED BRAND
Ridaura
NON PREFERRED
Nalfon
Naprelan
Rheumatrex
SprixQL
QL
Vimovo
SPECIALTY
Actemra PA
TIER 02
TIER 03
GENERIC
dihydroergotamine mesylate
isometheptene mucate/caffeine/acetaminophen
isometheptene/caffeine/acetaminophen
isometheptene/dichloralphenazone/acetaminophen
migragesic ida
migralam
naratriptan HCL QL
nodolor
rizatriptan benzoate QL
rizatriptan benzoate odt QL
sumatriptan QL
sumatriptan succinateQL
sumatriptan succinate refillQL
zolmitriptanQL
zolmitriptan odt QL
PREFERRED BRAND
RelpaxQL
NON PREFERRED
Alsuma QL,PA,ST
AxertQL,PA,ST
Cafergot
Ergomar
Frova QL,PA,ST
Sumavel Dosepro QL,PA,ST
Treximet QL,PA,ST
Zomig QL,PA,ST
Zomig Nasal SprayQL,PA,ST
GOUT AGENTS
TIER 01
TIER 02
TIER 04
GENERIC
allopurinol
colchicine
probenecid
probenecid/colchicine
PREFERRED BRAND
Colcrys
Uloric
SPECIALTY
Krystexxa PA
LOCAL ANESTHETICS-INJ
TIER 01
GENERIC
bupivacaine spinal
bupivacaine HCL
bupivacaine/epinephrine
chloroprocaine HCL
lidocaine HCL
lidocaine HCL/dextrose
lidocaine/epinephrine
mepivacaine HCL
polocaine
polocaine-mpf
26
ropivacaine
ropivacaine HCL
sensorcaine
sensorcaine-mpf
sensorcaine-mpf spinal
sensorcaine-mpf/epinephrine
sensorcaine/epinephrine
tetracaine HCL
xylocaine dental
BD pudendal/local block tray 1% lidocaine
Zetonna QL,PA,ST
COUGH/COLD/ALLERGY
TIER 01
GENERAL ANESTHETICS
TIER 01
GENERIC
compound 347
etomidate
fresenius propoven
isoflurane
ketamine HCL
propofol
sevoflurane
sojourn
terrell
RESPIRATORY, ALLERGY, ETC
ANTIHISTAMINES
TIER 01
TIER 03
GENERIC
arbinoxa
bpm
brompheniramine tannate
carbinoxamine maleate
cetirizine HCL
clemastine fumarate
cyproheptadine HCL
desloratadine
desloratadine odt
dexchlorpheniramine maleate
diphenhydramine HCL
levocetirizine dihydrochloride
pharbedryl
phenadoz
phenergan
promethazine HCL
promethazine HCL plain
promethegan
respa-BR
NON PREFERRED
Clarinex
NASAL AGENTS
TIER 01
TIER 02
TIER 03
GENERIC
azelastine HCL QL
budesonide QL,PA,ST
flunisolideQL
fluticasone propionate QL
ipratropium bromide QL
olopatadine HCL QL
triamcinolone acetonide QL
PREFERRED BRAND
Dymista QL
NasonexQL
NON PREFERRED
Bactroban Nasal
Beconase AQ QL,PA,ST
OmnarisQL,PA,ST
Qnasl QL,PA,ST
Qnasl ChildrensPA,ST
Tyzine
Tyzine Pediatric Nasal Drops
QL,PA,ST
Veramyst
TIER 02
TIER 03
GENERIC
acetylcysteine
albatussin NN
benzonatate
biotuss
biotuss pediatric
bpm pseudo
bromfed DM
bromphen/pseudoephedrine HCL/dextromethorphan HBR
dextromethorphan HBR/chlorpheniramine/phenylephrine
HCL
giltuss pediatric
giltuss TR
hydrocodone bitartrate/chlorpheniramine maleate/PSE
hydrocodone bitartrate/homatropine methylbromide
hydrocodone polistirex/chlorpheniramine polistirex
hydrocodone/homatropine
hydromet
nebusal
nortuss-DE
nortuss-EX
phenylephrine/guaifenesin
promethazine VC
promethazine VC plain
promethazine VC/codeine
promethazine-DM
promethazine/codeine
promethazine/dextromethorphan
pulmosal
rescon-JR
sodium chloride
tgq 15DM/5PEH/2CPM
tgq 30PSE/150GFN/15DM
tgq 30PSE/3BRM/15DM
tgq 50PSE/3BRM/30DM
tgq 7.5PEH/4BRM/15DM
tussafed EX
tussigon
PREFERRED BRAND
Tussicaps
NON PREFERRED
Clarinex-d 12 HOUR
Clarinex-d 24 HOUR
Rezira
ANTIASTHMATIC/COPD AGENTS
TIER 01
GENERIC
albuterol sulfate
albuterol sulfate ER
aminophylline
budesonide
cromolyn sodium
difil-G forte
epinephrine HCL
ipratropium bromide QL
ipratropium bromide/albuterol sulfateQL
levalbuterolQL
levalbuterol HCL QL
metaproterenol sulfate
montelukast sodium
terbutaline sulfate
theochron
theophylline
theophylline CR
theophylline ER
theophylline/D5W
27
TIER 02
TIER 03
TIER 04
zafirlukast
PREFERRED BRAND
Arcapta NeohalerQL
Asmanex HFA QL
QL
Asmanex Twisthaler 120 Metered Doses
Asmanex Twisthaler 14 Metered DosesQL
Asmanex Twisthaler 30 Me Tered DosesQL
QL
Asmanex Twisthaler 7 Metered Doses
QL
Atrovent HFA
Combivent
Combivent Respimat QL
Daliresp
QL
Dulera
Foradil AerolizerQL
Perforomist QL
Proair HFA QL
Pulmicort QL
QL
Pulmicort Flexhaler
QL
Qvar
Serevent DiskusQL
Spiriva HandihalerQL
Spiriva Respimat QL
QL
Symbicort
Tudorza PressairQL
NON PREFERRED
Advair DiskusQL,PA,ST
Advair HFA QL,PA,ST
QL,PA,ST
Alvesco
Breo ElliptaQL,PA,ST
Brovana QL
Elixophyllin
Flovent DiskusQL,PA,ST
QL,PA,ST
Flovent HFA
Lufyllin
Maxair AutohalerQL
Proventil HFA QL
Theo-24
QL
Ventolin HFA
Xopenex HFA QL
Zyflo
Zyflo CR
SPECIALTY
XolairPA
RESPIRATORY AGENTS - MISC
TIER 04
SPECIALTY
Aralast NP PA
Glassia PA
Kalydeco PA
PA
Prolastin-c
PulmozymePA
Zemaira PA
TOXOIDS
TIER 01
TIER 02
GENERIC
tetanus toxoid adsorbed
PREVENTIVE
diphtheria/tetanus toxoids adsorbed pediatric
tetanus/diphtheria toxoids-adsorbed adult
Adacel
Boostrix
Daptacel
Infanrix
Kinrix
Pediarix
Pentacel
Tenivac
VACCINES
TIER 01
TIER 02
GENERIC
bcg vaccine
yf-vax
PREFERRED BRAND
Biothrax
Imovax Rabies (h.d.c.v.)
Ixiaro
Rabavert
Typhim VI
Vivotif Berna
PREVENTIVE
influenza a (h1n1) monovalent 2009
pneumovax 23/1 dose
pneumovax 23/5 dose
Acthib
Afluria PF 2012-2013
Afluria 2012-2013
Afluria 2013-2014
Afluria 2014-2015
Bexsero
Cervarix
Comvax
Engerix-b
Fluarix Quadrivalent 2013-2014
Fluarix 2012-2013
Fluarix 2013-2014
Fluarix 2014-2015
Flublok 2013-2014
Flublok 2014-2015
Flucelvax 2012-2013
Flucelvax 2013-2014
Flucelvax 2014-2015
Flulaval Quadrivalent 2013-2014
Flulaval 2012-2013
Flulaval 2013-2014
Flulaval 2014-2015
Flumist Nasal Vaccine 2012-2013
Flumist Quadrivalent
Fluvirin PF 2012-2013
Fluvirin 2012-2013
Fluvirin 2013-2014
Fluvirin 2014-2015
Fluzone High-dose PF 2012-2013
Fluzone Intradermal
Fluzone Intradermal Quadrivalent
Fluzone Pediatric PF 2012-2013
Fluzone PF 2012-2013
Fluzone Quadrivalent 2013-2014
Fluzone Split 2012-2013
Gardasil
Gardasil 9
28
Havrix
Hiberix
Influenza Vaccine For Safeway Dependants
Ipol Inactivated IPV
M-m-r II W/Diluent 10 Dose
Medical Provider EZ Flu Shot PF 2012-2013
Medical Provider EZ Flu Shot 2013-2014
Menactra
Menhibrix
Menomune-a/C/Y/W-135
Menveo
Pedvax HIB
Physicians EZ Use Flu Kit 2012-2013
Pneumovax 23
Pneumovax 23/1 Dose
Pneumovax 23/5 Dose
Prevnar 13
Proquad
Recombivax HB
Rotarix
Rotateq
Trumenba
Twinrix
Vaqta
Varivax
Zostavax
VITAMINS
VITAMINS
TIER 01
GENERIC
aminobenzoate potassium
ascorbic acid
decara
ergocalciferol
mega-c/a plus
ortho-CS 250
phytonadione
pyridoxine HCL
thiamine HCL
vitamin c 222MG
vitamin d
vitamin k1
wheat germ
PREVENTIVE
aqueous vitamin d infants
bio-d-mulsion
bio-d-mulsion forte
bprotected pedia d-vite
d 1000
d 10000
d 2000
d 400
d 5000
d-vita
d-1000
d-1000 extra strength
d-2000 maximum strength
d-3-5
d-400
d-5000
delta d3
dialyvite vitamin d 5000
d2000 ultra strength
d3
d3 adult
TIER 02
TIER 03
d3 high potency
d3 kids
d3 maximum strength
d3 super strength
d3 ultra strength
d3-1000
d3-50
eql childrens vitamin d gummies
eql vitamin d-3
eql vitamin d3
gnp vitamin d
gnp vitamin d maximum strength
gnp vitamin d super strength
gnp vitamin d3 extra strength
healthy kids vitamin d3
just d
kp vitamin d
maximum d3
nat-rul vitamin d
optimal-d
optimal-d pack
opurity vitamin d
pronutrients vitamin d3
ra vitamin d-3
sm vitamin d
sm vitamin d3
th vitamin d3
thera-d rapid repletion
thera-d sport
thera-d 2000
vitamin d high potency
vitamin d 400
vitamin d-1000
vitamin d-1000 maximum strength
vitamin d-3
vitamin d-400
vitamin d3
vitamin d3 adult gummies
vitamin d3 high potency
vitamin d3 maximum strength
vitamin d3 super strength
vitamin d3 400
CVS childrens vitamin d for bone health
CVS vitamin d
CVS vitamin d infants
CVS vitamin d 5000 high-potency
CVS vitamin d3
HM vitamin d
HM vitamin d3
PA vitamin d-3
PA vitamin d-3 gummy
PREFERRED BRAND
Mephyton
NON PREFERRED
Potaba
PREVENTIVE
CVS Vitamin D3
Ddrops
Dialyvite Vitamin D3 Max
D3 Dots
HM Vitamin D3
Replesta
Replesta Childrens
Replesta Nx
Sm Vitamin D3 Maximum Strength
Super Daily D3
Thera-d 4000
Vitamelts Vitamin D
Wellesse Vitamin D3
29
MULTIVITAMINS
TIER 01
GENERIC
b-complex
b-complex 100
b-plex
b-plex plus
biocel
bp folinatal plus b
bp multinatal plus
cavan-EC sod DHA
choice-TABS
cod liver oil
complete natal DHA
completenate
corvita
corvite free
dialyvite
elite-OB
folbecal
folbee plus
folbee plus cz
inatal advance
inatal ultra
inatal GT
infuvite
infuvite adult
infuvite pediatric
lysiplex plus
m-vit
macnatal CN DHA
mult-vitamin/fluoride
multi vitamin/fluoride
multi-vit/fluoride
multi-vit/iron/fluoride
multi-vitamin/fluoride
multi-vitamin/fluoride/iron
multivitamin with fluoride
multivitamin/fluoride
multivitamins/fluoride
mynatal advance
mynatal plus
mynatal ultracaplet
mynatal-z
mynate 90 plus
mynephrocaps
nephronex
neurodep
niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper
nutricap
nutrifac ZX
obstetrix EC
pr natal 400
pr natal 400 EC
pr natal 430
pr natal 430 EC
prenaissance plus
prenaplus
prenatabs fa
prenatabs RX
prenatal ad
prenatal low iron
prenatal 19
prenatal-u
quflora pediatric
rena-vite RX
renal
renalpren
reno CAPS
se-natal 19
TIER 03
se-tan DHA
seton et-EC
setonet
siderol
strovite forte
strovite plus
taron-prex
tri-vit/fluoride
tri-vit/fluoride/iron
tri-vitamin/fluoride
triadvance
tricare
trinatal RX 1
trinate
triphrocaps
triple-vitamin/fluoride
ultimatecare one
ultimatecare one NF
ultra TABS
urosex
v-c forte
vic-forte
vinate c
vinate care
vinate m
vinate one
vinate pn care
vinate ultra
vinate GT
vinate IC
vinate II
virt-vite plus
virt-CAPS
vita s forte
vita-min
vitacel
vitafol-OB
vitamax pediatric
vitamin b-complex 100
vitamins a/c/d/fluoride
vol-care RX
vp-zel
CO-natal fa
MVC-fluoride
OB-natal one
PNV-select
PNV-DHA
PREVENTIVE
classic prenatal
eql prenatal formula
gnp prenatal vitamins
mission prenatal HP
multi prenatal
nat-rul prenatal vitamins
perry prenatal
pre-natal formula
prenatal
prenatal and iron
prenatal formula
prenatal forte
prenatal vitamins
px prenatal multivitamins
ra prenatal
sm prenatal vitamins
CVS prenatal
NON PREFERRED
AP-zel
Bacmin
M.v.i. Adult
M.v.i. Pediatric
30
M.v.i.-12 Without Vitamin K
Neevo DHA
Nicadan
Nicazel
Nicazel Forte
Prefera OB
Prefera OB + DHA
Preferaob One
Req 49+
Strovite One
Tri-zel
Vinate DHA RF
PREVENTIVE
Atabex Prenatal
Brainstrong Prenatal
Centrum Specialist Prenatal
CVS Prenatal
CVS Prenatal Gummy/DHA/Folic Acid
CVS Prenatal Multi+dha
Enfamil Expecta
Gnp Daily Prenatal
Gnp Prenatal
Goodsense Prenatal Vitamins
Healthy Mama Be Well Rounded
HM One Daily Prenatal Combo
HM Prenatal
Kp Prenatal Multivitamins
Mission Prenatal
One A Day Womens Prenatal/DHA
One-a-day Womens Prenatal
Prenatal
Prenatal Complete
Prenatal Formula
Prenatal Multi +dha
Prenatal Multivitamin + DHA
Prenatal One Daily
Prenatal Plus DHA
Prenatal/Omega-3/Folic Acid/Iron
PA Prenatal Formula
Qc Prenatal
Ra One Daily
Ra Prenatal Formula/Folicacid
Right Step Prenatal
Similac Prenatal Early Shield
Sm One Daily Prenatal
Sm Prenatal Vitamins
Stuart One
Stuart Prenatal
Stuart Prenatal + DHA
Th Prenatal Vitamins
Your Life Multi Prenatal
MEDICAL DEVICES
DIABETIC SUPPLIES
TIER 01
GENERIC
cartridge IR 1000 3ML
cartridge IR 1200
cartridge P.M.
infusion catheter soft/23"/60CM
insulin cartridge 3ML
insulin P.M. IR2020 black
insulin P.M. IR2020 blue
insulin P.M. IR2020 green
insulin P.M. IR2020 red
insulin P.M. IR2020 silver
reservior 3ML
TIER 02
PREFERRED BRAND
Accu-chek Fastclix LancetsQL
Accu-chek Multiclix LancetsQL
Accu-chek Safe-t-pro LancetsQL
QL
Accu-chek Safe-t-pro Pluslancets
Accu-chek Soft Touch LancetsQL
Accu-chek Softclix LancetsQL
Acti-lance Lancets 28G QL
Acti-lance Lite Safety Lancets 28G QL
QL
Acti-lance Special Safety Lancets 17G
QL
Acti-lance Special Safetylancets 17G
Acti-lance Universal Safety Lancets 23G QL
Advocate LancetsQL
Advocate Safety LancetsQL
QL
Agamatrix Ultra-thin Lancets 33G
Amigo Insulin P.M.
Animas Vibe Insulin P.M.
Animas Vibe Insulin P.M./Black
Animas Vibe Insulin P.M./Blue
Animas Vibe Insulin P.M./Limelight Green
Animas Vibe Insulin P.M./Pink Glow
Assure Comfort Lancets Ultra Thin 28G QL
Assure Comfort Lancets Ultra Thin 30GQL
Assure Haemolance Plus High Flow 18G QL
QL
Assure Haemolance Plus Low Flow 25G
Assure Haemolance Plus Micro Flow 28G QL
Assure Haemolance Plus Normal Flow 21G QL
Assure Haemolance Plus Pediatric BladeQL
Assure Lance LancetsQL
QL
Assure Lancets
Aurora Lancet Super Thin 30G QL
Aurora Lancet Thin 23G QL
AF Lancets Super ThinQL
AT Last LancetsQL
QL
Bayer Microlet Lancets
Bullseye Mini Safety LancetsQL
Bullseye Safety LancetsQL
BD Insulin Syringe LUER-LOK/U-100/1MLQL
BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2" QL
QL
BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2"
QL
BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8"
BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2"QL
BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2" QL
BD Insulin Syringe Microfine/U-100/0.5ML/28G X 1/2" QL
BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8"QL
BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2"QL
BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X
5/16" QL
BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2"QL
QL
BD Insulin Syringe Safetyglide/1ML/29G X 1/2"
BD Insulin Syringe Slip Tip/U-100/1ML QL
BD Insulin Syringe U-40/1ML/25G X 5/8"QL
BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16" QL
BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X
QL
5/16"
BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16" QL
BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2"QL
BD Insulin Syringe Ultrafine/U-100/0.5ML/29G X 1/2"QL
BD Insulin Syringe Ultrafine/U-100/1ML/29G X 1/2" QL
QL
BD Insulin Syringe Ultrafine/U-100/1ML/30G X 1/2"
QL
BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2"
BD Insulin Syringe Ultrafine/0.3ML/31G X 5/16" QL
BD Insulin Syringe Ultrafine/0.5ML/30G X 1/2"QL
BD Insulin Syringe Ultrafine/0.5ML/31G X 5/16" QL
QL
BD Insulin Syringe Ultrafine/1ML/30G X 1/2"
BD Insulin Syringe Ultrafine/1ML/31G X 5/16"QL
BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X
1" QL
5/8" QL
31
1/2" QL
BD Insulin Syringe/U-100/0.5ML/30G X 1/2"QL
BD Insulin Syringe/U-100/1ML/27G X 1/2" QL
QL
BD Insulin Syringe/U-100/1ML/28G X 1/2"
BD Insulin Syringe/U-100/2ML/27.5G X 5/8"QL
BD Insulin Syringe/U-100/2ML/29G X 1/2" QL
BD Lancet Ultrafine 30GQL
BD Lancet Ultrafine 33GQL
BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X
1/2" QL
BD Microtainer LancetsQL
QL
BD Pen Needle/Mini/Ultrafine/31G X 3/16"
BD Pen Needle/Nano/Ultra Fine/32G X 4MM QL
BD Pen Needle/SHORT/Ultrafine/31G X 5/16" QL
BD Pen Needle/Ultrafine/29G X 12.7MMQL
BD Pen Needle/Ultrafine/29GX1/2" 12.7MM QL
QL
BD Pen Needles SHORT/Ultrafine/31G X 5/16"
QL
Careone Lancet Thin
Careone Lancet Ultra ThinQL
Cleanlet Lancets 28G QL
Clever Chek Lancets Ultrathin QL
Clever Chek Lancets Ultrathin 30G QL
Coaguchek LancetsQL
Comfort Assured Lancets Micro Thin 33G QL
Comfort Assured Lancets Super Thin 28G QL
Comfort Infusion Set 23"/17MM
Comfort LancetsQL
Comfort SHORT Infusion Set 23"/13MM
Contact Detach Infusion Set 23" 6MM/29G
CVS Lancets Micro Thin 33GQL
CVS Lancets Original QL
CVS Lancets Thin 26G QL
CVS Lancets Ultra Thin 30G QL
CVS Lancets 21G QL
CVS Ultra Thin LancetsQL
Diastar Easy Test II Lancets 30G QL
QL
Diastar Easy Test Lancets30G
Droplet Lancets Ultra Thin 30G QL
Drug Mart Lancets Thin QL
Drug Mart Lancets Ultra Thin QL
Drug Mart On-the-go Lancets Gentle 30G QL
QL
Drug Mart Unilet Lancets Super Thin 30G
QL
Drug Mart Unilet Lancets Ultra Thin 28G
Duane Reade Lancet Alternate Site 26G QL
Duane Reade Lancet Super Thin 30G QL
Duane Reade Lancet Ultra Thin 28GQL
QL
E-z Ject Lancets
E-z Ject Lancets ColorQL
E-z Ject Lancets Super Thin QL
E-z Ject Lancets Super Thin 30GQL
E-z Ject Lancets Thin 26G QL
QL
E-z Ject Lancets 21G
E-ZJECT Lancets Micro-thin 33G QL
Easy Comfort LancetsQL
Easy Comfort Lancets 30G/Pull Top QL
Easy Comfort Lancets 30G/Thin TopQL
QL
Easy Touch Lancets 21G/Pressure Activated
Easy Touch Lancets 23G/Pressure Activated QL
Easy Touch Lancets 26G/Pull-top QL
Easy Touch Lancets 26G/Twist QL
QL
Easy Touch Lancets 28G/Pressure Activated
QL
Easy Touch Lancets 28G/Pull-top
Easy Touch Lancets 30G/Button-activatedQL
QL
Easy Touch Lancets 30G/Twist
QL
Easy Touch Safety Lancets21G/Pressure Activated
Easy Touch Safety Lancets23G/Pressure ActivatedQL
Easy Touch Safety Lancets26G/Button ActivatedQL
Easy Touch Safety Lancets26G/Pressure ActivatedQL
Easy Touch Safety Lancets28G/Button ActivatedQL
QL
Easy Touch Safety Lancets28G/Pressure Activated
Easytest II LancetsQL
Easytest LancetsQL
Embrace Lancets Ultra Thin 30G QL
Eql Color Lancets Micro Thin 33G QL
QL
Eql Color Lancets 21G
Eql Super Thin Lancets 30G QL
Eql Thin Lancets 26G QL
EZ Smart Blood Glucose LancetsQL
EZ-lets Lancets 21G QL
QL
EZ-lets Lancets 23G
EZ-lets Lancets 26G Super-softQL
EZ-lets Lancets 28G Ultra-softQL
EZ-lets Lancets 30G QL
Fasttake Compact Monitoring System QL
QL
Fasttake Test Strips
Fifty50 Safety Seal Lancets 30G QL
Fifty50 Safety Seal Lancets 32G QL
Fine 30 QL
Fingerstix LancetsQL
QL
Fora Lancets
Freds Pharmacy Unilet Lancets Super Thin 30G QL
Freds Pharmacy Unilet Lancets Ultra Thin 28GQL
Freestyle LancetsQL
Freestyle Unistick II LancetsQL
QL
Gentle-let GP Lancets
Gentle-let Lancets General Purpose Style/Fine PointQL
Gentle-let Lancets General Purpose Style/Medium PointQL
Gentle-let Lancets Safety Style/Fine Point QL
Gentle-let Lancets Safety Style/Medium Point QL
Global Inject Ease Lancets 28G QL
Global Inject Ease Lancets 30G QL
Glucocom Lancets 28G QL
Glucopro Syringe Reservoir/3ML/Needle/22G X 3/8"
Glucosource LancetsQL
Gmate Lancets 30G QL
Gnp LancetsQL
Gnp Lancets Micro Thin 33G QL
Gnp Lancets Super Thin 30G QL
Gnp Lancets Thin QL
QL
Gnp Lancets Thin 26G
Gnp Lancets 21G QL
Gnp Micro Thin Lancets 33G QL
Gnp Super Thin Lancets/30G QL
H&h Thinlet Lancets 26G QL
H&h Thinlet Super Thin Lancets 30G QL
H-e-b Incontrol Lancets Super Thin 30GQL
H-e-b Incontrol Lancets Ultra Thin 28GQL
HaemolanceQL
Haemolance Low Flow LancetsQL
QL
Haemolance Plus
Haemolance Plus High FlowQL
Haemolance Plus Low FlowQL
Haemolance Plus Max FlowQL
32
Haemolance Plus Pediatric FlowQL
Healthwise Lancets 30G QL
Healthy Accents Unilet Lancets Super Thin 30G QL
Hy-vee LancetsQL
QL
Hy-vee Thin Lancets
HM Lancets Micro Thin 33GQL
HM Lancets Ultra Thin 30G QL
Inset Infusion Set 23" 6MM
Inset 30 Infusion Set 23"
Inset 30 Infusion Set 43"
Kinney LancetsQL
QL
Kinney Thin Lancets
Kroger LancetsQL
Kroger Lancets Micro Thin33G QL
Kroger Lancets Super Thin QL
Kroger Lancets Thin QL
QL
Kroger Lancets Thin 26G
Kroger Lancets Ultrathin 30G QL
Kroger Lancets 21G QL
Lady Lite LancetsQL
Lancets Micro Thin 33G QL
QL
Lancets Super Thin 28G
Lancets Thin QL
Lancets Ultra Fine QL
Lancets Ultra Thin QL
Lancets Ultra Thin 30G QL
QL
Leader Lancets Colored
Leader Super Thin Lancet QL
Leader Thin LancetsQL
Liberty Blood Glucose MeterQL
Liberty Glucose Control Mid
Liberty Glucose Control Normal
Liberty Test StripsQL
Lifescan Unistik II LancetsQL
Lifescan Unistik 2 Deep Penetration QL
Lite Touch LancetsQL
QL
Litetouch Lancets Micro Thin 33G
Live Better Lancet Super Thin 30G QL
Live Better Lancet Ultra Thin 28GQL
Longs Lancets Standard QL
Longs Lancets Thin QL
Longs Lancets Ultra Thin QL
Medi-lance LancetsQL
Medichoice Pre-set Safety Lancet Dual Use QL
Medichoice Pre-set Safety Lancet Low FlowQL
Medichoice Pre-set Safety Lancet Medium FlowQL
QL
Medichoice Pre-set Safety Lancet Moderate Flow
QL
Medichoice Safety Lancet Extra
Medichoice Safety Lancet Normal QL
Medicine Shoppe LancetsQL
Medicine Shoppe Lancets ThinQL
Medisense Thin LancetsQL
Medlance Plus Extra Lancets 21G QL
QL
Medlance Plus Lancets
Medlance Plus Lancets Lite 25G QL
Medlance Plus Lite Lancets 25G QL
Medlance Plus Special Lancets 0.8MMQL
Medlance Plus Superlite 30G QL
Medlance Plus Superlite 30G/Comfort Max QL
Medlance Plus Universal Lancets 21G QL
Medlance Plus/Lite 25G QL
Medlance/ExtraQL
Medlance/LiteQL
QL
Medlance/Universal
Meijer Color Lancets Universal 33G QL
Meijer LancetsQL
Meijer Lancets ThinQL
Meijer Lancets Universal 33G QL
Meijer Super Thin LancetsQL
Microlet LancetsQL
Microtainer Safety Flow Lancet/Sterile/Single-use QL
QL
Monolet Lancets
Monolet Opd LancetsQL
Monolettor Safety LancetsQL
Myglucohealth Mgh Softlance Lancets 30G QL
Netgroup LancetsQL
QL
Nova Safety Lancets 23G
Nova Safety Lancets 28G QL
Nova Sureflex LancetsQL
Novofine Autocover 30GX8MMQL
Novofine 30GX8MMQL
QL
Novofine 32GX6MM
Novotwist 30GX8MM QL
Novotwist 32GX5MM QL
On Call LancetsQL
On Call Plus LancetsQL
QL
Onetouch Basic System
Onetouch Basic/Profile Test StripsQL
Onetouch Club Lancets Fine PointQL
Onetouch Combo PackQL
Onetouch Delica Lancets Extra Fine 33G QL
QL
Onetouch Delica Lancets Fine 30G
Onetouch Finepoint LancetsQL
Onetouch LancetsQL
Onetouch Ping Insulin P.M.
Onetouch Ping Meter Remote
QL
Onetouch Profile System
QL
Onetouch Ultra Blue
Onetouch Ultra Control
Onetouch Ultra MiniQL
Onetouch Ultra System Kit QL
QL
Onetouch Ultra Test Strips
Onetouch Ultra 2 QL
Onetouch Ultralink System (hex)QL
Onetouch Ultralink System (DEC)QL
Onetouch Ultrasmart QL
QL
Onetouch Ultrasoft Lancets
QL
Onetouch Verio
Onetouch Verio Control Solution High
Onetouch Verio IQ Blood Glucose Monitoring System QL
Onetouch Verio Mid Control Solution
Onetouch Verio Sync Bloodglucose Monitoring System QL
Onetouch Verio Test StripsQL
Perfect Lancets 30G QL
Perfect Pressure Activated Safety Lancets 28G QL
Pharmacist Choice Ultra Thin LancetsQL
QL
Pharmacist Choice Ultra Thin Lancets 28G
Pharmacist Choice Ultra Thin Lancets 30G QL
Pharmacy Counter LancetsQL
Precision Thin LancetsQL
Precision Thins GP Lancet QL
QL
Precision Ultra Lancet
Preferred Plus Lancets Colored 21G QL
Preferred Plus Lancets Super Thin 30G QL
Preferred Plus Lancets Thin 26G QL
Prodigy Autocode Blood Glucose Monitoring System QL
Prodigy Autocode Blood Glucose Monitoring/TalkingQL
Prodigy Autocode Pro Blood Glucose Monitoring System QL
Prodigy NO Coding Blood Glucose Test StripsQL
Prodigy Pocket Blood Glucose Meter Kit QL
Prodigy Pocket Pro Blood Glucose Monitoring System QL
QL
Prodigy Pressure Activated Safety Lancets
Prodigy Twist Top LancetsQL
Prodigy Voice Blood Glucose Meter KitQL
Prodigy Voicepro Blood Glucose Monitoring System QL
33
Pss Select GP LancetsQL
Pss Select Safety LancetsQL
Px LancetsQL
Px Lancets Ultra Thin QL
QL
Qc Lancets Super Thin
Qc Lancets Ultra Thin QL
Ra E-ZJECT Color Lancets Micro-thin 33G QL
Ra E-ZJECT Lancets Thin 26GQL
Ra E-ZJECT Lancets Thin 28GQL
QL
Ra E-ZJECT Lancets Ultra Thin 30G
QL
Ra E-ZJECT Lancets 28G
Reality LancetsQL
Reality Trigger LancetsQL
Relion LancetsQL
QL
Relion Lancets Micro-thin33G
Relion Lancets Standard 21G QL
Relion Lancets Thin 26G QL
Relion Lancets Ultra-thin30GQL
Relion Thin LancetsQL
QL
Relion Ultra Thin Lancets
Relion Ultra Thin Lancets30G QL
Relion Ultra Thin Plus Lancets 32G QL
Relion Ultra Thin Plus Lancets 33G QL
Renew Advanced Lancing Cartridge RefillsQL
QL
Rexall Lancets Ultra Thin
Rightest Gl300 LancetsQL
Safe-t-lance Low Flow 25G QL
Safe-t-lance Normal Flow 21GQL
Safe-t-lance Plus Safety Lancet High FlowQL
QL
Safe-t-lance Plus Safety Lancet Low Flow
Safe-t-lance Plus Safety Lancet Normal FlowQL
Safety Lancet 2MMQL
Safety LancetsQL
Safety Lancets 21G QL
QL
Safety Let Lancets
Safety Seal Lancets 28G QL
Safety Seal Lancets 30G QL
Sapscare Twist Top Lancets 30G QL
Shopko On-the-go Comfort Lancets 30GQL
QL
Shopko Unilet Lancets Super Thin 30G
QL
Shopko Unilet Lancets Ultra Thin 28G
Single-letQL
Sm Lancets 21G QL
Sm Micro Thin Lancets 33G QL
Sm Super Thin Lancets 30G QL
Sm Thin Lancets 26G QL
Smart Diabetes Vantage Universal Lancets 30G QL
Smart Sense Color Lancets Universal 33G QL
Smart Sense Standard Lancets Universal 21G QL
QL
Smart Sense Super Thin Lancets Universal 30G
QL
Smart Sense Thin Lancets Universal 26G
Smartest Lancets 28G QL
Solus V2 Pressure Activated Safety Lancets 28G QL
Solus V2 Twist Lancets 30G QL
Sterilance TL QL
Sure Comfort Lancets 28G QL
QL
Sure Comfort Lancets 30G
Sure-lance Flat LancetsQL
Sure-lance Lancets 26G QL
Sure-lance Thin Lancets 28G QL
Sure-lance Ultra Thin LancetsQL
Sure-touch Lancets Universal QL
Surelite LancetsQL
Surestep Glucose Control
Surestep Glucose Control Solution
Surestep Pro High Glucosecontrol
Surestep Pro Low Glucose Control
Surestep Pro Normal Glucose Control
Surestep Pro Test StripsQL
Surestep Test StripsQL
SB Lancets Thin QL
SB Lancets Ultra Thin QL
Techlite AST LancetsQL
Techlite LancetsQL
QL
Techlite Lancets 30G
Tgt Lancet Alternate SiteQL
Tgt Lancet Micro Thin 33GQL
Tgt Lancet Super Thin 30G QL
Tgt Lancet Thin 23G QL
QL
Tgt Lancet Thin 26G
Tgt Lancet Ultra Thin 28G QL
Tgt Lancet Ultra Thin 30G QL
Thinlets GP LancetsQL
Thinlets Lancet QL
QL
Todays Health Super Thin Lancets 30G
Todays Health Ultra Thin Lancets 28G QL
Travel Lancets 30G QL
Trueplus Lancets 26G QL
QL
Trueplus Lancets 28G Super Thin
QL
Trueplus Lancets 30G
Trueplus Lancets 30G Ultra Thin QL
Trueplus Lancets 33G Micro Thin QL
QL
Trueplus Safety Lancets 28G
Ulticare Thin Lancets 30G QL
Ultilet Basic Lancets 30G QL
Ultilet Classic LancetsQL
Ultilet LancetsQL
QL
Ultilet Lancets 33G
Ultilet Safety Lancets 23G QL
Ultra Thin Lancets 28G QL
Ultra Thin Lancets 30G QL
Ultra-thin II Auto Lancet QL
QL
Ultra-thin II Lancets 28G
Ultra-thin II Lancets 30G QL
Ultra-thin II Safety Autolancets 26G QL
Unilet Comfortouch LancetQL
Unilet ExceliteQL
QL
Unilet Excelite II
Unilet G.p. Lancet QL
Unilet G.p. Superlite LancetQL
Unilet GP 28 Ultra Thin QL
Unilet LancetQL
Unilet Superlite Lancet QL
Unistik 3 Gentle QL
Universal 1 Lancets Thin 26G QL
Universal 1 Lancets Ultra Thin 30G QL
V-go 20
V-go 30
V-go 40
Value Plus Lancets Standard 21G QL
Value Plus Lancets Super Thin 30G QL
Value Plus Lancets Thin 26G QL
Valumark Lancet Super Thin 30GQL
Valumark Lancet Ultra Thin 28G QL
QL
Vida Mia Unilet Lancets Super Thin 30G
Vida Mia Unilet Lancets Ultra Thin 28G QL
Vitalet Pro LancetsQL
Vitalet Pro Plus LancetsQL
W&f Lancets Colored 21G QL
W&f Lancets 26G QL
Walgreens Advanced Travellancets 28G QL
Walgreens Comfort Assuredlancets Micro Thin/33GQL
Walgreens Comfort Assuredlancets Super Thin/28G QL
Walgreens LancetsQL
QL
Walgreens Thin Lancets
Walgreens Ultra Thin LancetsQL
1ST Choice Lancets Super Thin QL
1ST Choice Lancets ThinQL
34
TIER 03
1ST Choice Lancets Ultra ThinQL
1ST Tier Unilet Comfortouch Lancets 28G QL
1ST Tier Unilet Comfortouch Lancets 30G QL
NON PREFERRED
Accu-chek Active Glucose Control Solution
Accu-chek Active StripsQL
Accu-chek Aviva QL
Accu-chek Aviva PlusQL
Accu-chek Combo
Accu-chek Comfort Curve Control Solution (2 Levels)
Accu-chek Comfort Curve Linearity Solution
Accu-chek Comfort Curve Test StripsQL
Accu-chek Compact Blue Control Solution (2 Levels)
Accu-chek Compact PlusQL
QL
Accu-chek Compact Plus Care Kit
Accu-chek Compact Plus Clear Control Solution (2 Levels)
Accu-chek Compact StripsQL
Accu-chek Compact Test Drum QL
Accu-chek Fastclix Lancetdevice Kit
Accu-chek Instant Glucosecontrol Solution (2 Levels)
Accu-chek Multiclix Lanc Et Device Kit
Accu-chek Nano SmartviewQL
Accu-chek Rapid-d Infusion Set/24"/10MM
Accu-chek Smartview Control
Accu-chek Smartview StripsQL
Accu-chek Softclix Lancetdevice Kit
Accu-chek Spirit Adapter Kit
Accu-chek Spirit Battery Kit
Accu-chek Spirit Insulin P.M. Kit
Accu-chek Tender II Infusion Set/24"/13MM
Accu-chek Voicemate QL
Liberty Mini Lancing Device
Onetouch Delica Lancing Device
Onetouch Suresoft Lancing Device/18G
MEDICAL DEVICES - MISC
TIER 01
GENERIC
adapter CAP blue a 18MM
adapter CAP blue b 20MM
adapter CAP blue c 22MM
adapter CAP blue d 24MM
adapter CAP blue e 28MM/SHORT neck
adapter CAP blue f 28MM/long neck
adapter CAP blue k 28MM/medium neck
adapter CAP blue m 24MM
adapter CAP green a 18MM
adapter CAP green b 20MM
adapter CAP green c 22MM
adapter CAP green d 24MM
adapter CAP green e 28MM/SHORT neck
adapter CAP green f 28MM/long neck
adapter CAP green k 28MM/medium neck
adapter CAP green m 24MM
adapter CAP red a 18MM
adapter CAP red b 20MM
adapter CAP red c 22MM
adapter CAP red d 24MM
adapter CAP red e 28MM/SHORT neck
adapter CAP red f 28MM/long neck
adapter CAP red k 28MM/medium neck
adapter CAP red m 24MM
adapter CAP white b 20MM
adapter CAP white c 22MM
adult mask
adult mask large
alcoh-wipe 12" X 12"
asthma control kit
autoclave paper 36" X 36"
blister pack adhesive label
blister pack/amber 12 cavity
bottle adapters/24MM/press-IN
bottletop dispenser adapter/38MM
bottletop dispenser 0.25-2.0ML
cleanroom tacky mat 18" X36"/60 layer
clear glass vials 2ML
coveralls medium/elastic back/wrist/ankles
deodorant plastic tubes 2.65oz/CAPS
disposable mouthpiece full range
disposable mouthpiece lowrange/pediatric
disposable mouthpiece/low range
disposable mouthpiece/universal range
dropping bottle 30ML
earpopper middle ear inf lation device
empty vial 3ML
enema bottle
filter air pp
filter attachment
filter 0.2 micron/25MM
filter 0.2 micron/25MM/double LUER lock
filter 0.22 micron/73MM/1000ML
flutter
foam ring 2"
glass bottle 15ML
glass bottle 30ML
glass bottle 60ML
glass bottle/30ML/blunt end applicator
glass serum bottles/2ML/type 1
glass vial 2ML
graduated bottle 2oz w/CAP
graduated bottle 4oz w/CAP
head covers 24"/bouffon CAP/irradiated
jar/8oz/white lid
lab coat/disposable/large
lab coat/disposable/medium
lab coat/disposable/small
lab coat/disposable/x-large
lab coat/disposable/XX-large
latex gloves medium
metered nasal spray P.M. 15ML/safety clip
nebulizer
nebulizer air tube/plugs
nebulizer compressor model 2655d
nebulizer compressor/dualfilter/7' tubing/aerosol
t/mthpiece
nebulizer kit/tubing/mouthpiece
nebulizer pediatric mask
nebulizer updraft-style
nebulizer/adult mask
nebulizer/pediatric mask
nitrile gloves/size 10
35
TIER 02
nitrile gloves/size 6.5
nitrile gloves/size 9.5 medium
ointment tube ophthalmic tip 1/8oz/metal
ointment tube/metal/1oz
ointment tube/plastic/1oz
pediatric aerosol mask
pelvic muscle trainer
pillow mask/adult
pillow mask/child
pillow mask/pediatric
plastic bottles/30ML/twist top sifter CAPS
plastic bottles/90ML/twist top sifter CAPS
plastic enema bottle/2oz/20/410 opening
plastic jar 6oz
plastic scoop 1ML/4" handle
pocket chamberQL
pocket spacerQL
polypropylene CAP/liner
replacement air filter
serum bottle stopper 20MM
serum bottle/250ML
silicone mask for breatherite chamber/adult
silicone mask for breatherite chamber/infant
silicone mask for breatherite chamber/pediatric
silicone mask for breathrite chamber/adult
supposistrip mold 1.9gm
suppository mold 60 cavity
suppository shell medium 2.25gm
suppository shell small 1.46gm
tip rectal/vaginal w/perforations
tip CAPS
universal sleeve covers
vaginal suppository applicator
weigh boat/plastic/anti-static
CO monitor
CO monitor calibration
CO monitor replacement t pieces
PREFERRED BRAND
Aerochamber Mini Aerosol ChamberQL
QL
Aerochamber MV
Aerochamber Plus Flow VUQL
Aerochamber Plus Flow-VUQL
Aerochamber Plus Flow-VU/Large MaskQL
Aerochamber Plus Flow-VU/MaskQL
Aerochamber Plus Flow-VU/Medium MaskQL
Aerochamber Plus Flow-VU/Small MaskQL
Aerochamber Z-stat Plus Valved Holding Chamber W/Flow
VUQL
Aerochamber Z-stat Plus/Flowsignal QL
QL
Aerochamber Z-stat Plus/Large Mask
Aerochamber Z-stat Plus/Medium MaskQL
Aerochamber Z-stat Plus/Small MaskQL
Aerochamber/FlowsignalQL
Alcoh-glove Contoured Wipe
QL
Arial Chamber
QL
Breatherite
Breatherite Collapsible Adult Spacer W/MaskQL
Breatherite Collapsible Child Spacer W/MaskQL
Breatherite Collapsible Infant Spacer W/MaskQL
QL
Breatherite Collapsible Small Child Spacer W/Mask
Breatherite Collapsible Spacer W/ Neonate MaskQL
Breatherite Rigid Spacer W/MaskQL
Breatherite W/Large MaskQL
Breatherite W/Medium MaskQL
Breatherite W/Small MaskQL
BD Swabs Single Use
BD Swabs Single Use Butterfly
Curity Alcohol Preps/Medium 2 Ply
Curity Alcohol Swabs
CVS Alcohol Prep Swabs
QL
E-z Spacer
E-z Spacer The Body Guards PackQL
Easivent QL
Easivent/Mask-large QL
Easivent/Mask-mediumQL
QL
Easivent/Mask-small
Easy Touch Alcohol Prep Pads/Medium
Fifty50 Alcohol Prep Pads
Global Alcohol Prep Ease Pads
Gnp Alcohol Swabs
Healthwise Alcohol Prep Pads
Inspirachamber/Anti-static Valved/MouthpieceQL
Inspirachamber/Soothermask/Inspiramask/Medium QL
Inspirachamber/Soothermask/Inspiramask/Small QL
Inspirease Bags
QL
Inspirease Drug Delivery System
Inspirease Mouthpiece
Inspirease Reservoir Bags
Liteaire QL
Mask Vortex/Baby Whirl Duckling
Mask Vortex/Child/Frog
Mask Vortex/Spinner The Duck
Mask Vortex/Toddler/Lady Bug
Meijer Alcohol Swabs Extra-thick
MicrochamberQL
QL
Microspacer
Nessi Spacer/Large MaskQL
Nessi Spacer/Mouthpiece QL
Nessi Spacer/Small/MED MaskQL
Optichamber Advantage QL
QL
Optichamber Advantage/Large Mask
Optichamber Advantage/Medium Face MaskQL
Optichamber Advantage/Small Face MaskQL
Optichamber Diamond QL
Optichamber Diamond/Largeface MaskQL
Optichamber Diamond/Medium Face MaskQL
Optichamber Diamond/Smallface MaskQL
Optichamber Face Mask/Large QL
Optichamber Face Mask/MediumQL
Optichamber Face Mask/Small QL
QL
Optihaler
Optihaler MDI Drug Delivery System QL
Panda Mask Large
Panda Mask Medium
Panda Mask Small
Pediatric Panda Mask
Pharmacist Choice Alcoholprep Pads
Qc Alcohol Swabs
Ra Alcohol Swabs
Reality Swabs
Relion Alcohol Swabs
Riteflo QL
Saps Care Alcohol Prep Pads
Shopko Alcohol Swabs
Sm Alcohol Prep Pads
Sure Comfort Alcohol Prep Pads
Sure-prep Alcohol Prep Pads
SB Alcohol Prep Pads
Tgt Alcohol Swabs
Ultilet Alcohol Swabs
Valved Holding ChamberQL
36
Vortex Valved Holding ChamberQL
WatchhalerQL
Webcol Alcohol Prep Large 1 Ply
Webcol Alcohol Prep Large 2 Ply
Webcol Alcohol Prep Medium 2 Ply
MISCELLANEOUS AGENTS
TIER 01
GENERIC
acetylcysteine
adenosine
alprostadil
amino acids
aminohippurate sodium
aminosyn II 8.5%/electrolytes
aminosyn 8.5%/electrolytes
aminosyn-hf
ammonium molybdate
anhydrous base
antivenin latrodectus mactans
antivenin micrurus fulvius
argyle sterile water 100ML
bacteriostatic water for injection/benzyl alcohol
bacteriostatic water parabens
barium sulfate
base cream with liposome
base w301
benzalkonium chloride
calcium chloride
calcium disodium versenate
calcium gluconate
calcium-folic acid plus d
carbogel 940
carbomer gel aqueous
carbomer gel hydroalcoholic
cherry syrup
chlorhexidine gluconate
chloromag
chromium chloride
clinimix e 4.25%/dextrose 25%
clinimix 4.25%/dextrose 10%
clinisol SF 15%
collodion flexible
copper sulfate
copper trace metal
cosyntropin
cream base
cream concentrate
cyanide antidote pkg
cyanocobalamin/levomefolate calcium/pyridoxine HCL
cysteine HCL
d-xylose
deferoxamine mesylate
dehydrated alcohol
delflex-lm/1.5% dextrose
delflex-sm/1.5% dextrose
delflex-sm/2.5% dextrose
delflex-LC/1.5% dextrose
dextrose 10%
dextrose 10% flex container
dextrose 10%/NACL 0.2%
dextrose 2.5%/sodium chloride 0.45%
dextrose 2.5%/NACL 0.45%
dextrose 20%
dextrose 25%
dextrose 30%
dextrose 30% partial fill
dextrose 40%
dextrose 5%
dextrose 5% /electrolyte #48 viaflex
dextrose 5% viaflex
dextrose 5%/lactated ringers
dextrose 5%/potassium chloride 0.15%
dextrose 5%/ringers
dextrose 5%/sodium chloride 0.2%
dextrose 50%
dextrose 70%
dipyridamole
effer-k
effervescent pot chloride
effervescent potassium
effervescent potassium/chloride
emollient cream
flumazenil
folastin
folbic
fomepizole
forma-ray
formadon
formaldehyde
freamine iii
glutaraldehyde
hepatamine
hepatasol
hsa sterile diluent
hydrogen peroxide
hyperlyte-CR
imogam rabies-ht
indigo carmine
indocyanine green
intralipid
inulin
isolyte-m/dextrose 5%
isosulfan blue
k-effervescent
k-prime
k-sol
k-vescent
kendall sodium chloride flush
kionex
klor-CON
klor-CON m10
klor-CON m20
klor-CON 10
klor-CON 8
klor-CON/EF
l-cysteine HCL
l-methyl-b6-b12
l-methylfolate
l-methylfolate calcium
l-methylfolate CA/p-5-P.M.-CBL
l-methylfolate CA/ME-CBL/NAC
37
lactated ringers
lactated ringers dextrose 5% viaflex
lactated ringers irrigation
lactated ringers viaflex
lanolin
lanolin anhydrous
lecithin
lecithin organogel
levomefolate calcium/acetylcysteine/mecobalamin/algal
powder
levomefolate calcium/algal powder
levomefolate calcium/pyridoxal
phosphate/mecobalamin/algal
lipobase heavy
lipobase regular
liposyn iii
lmthf/pyridoxine HCL/cyanocobalamin
magnesium chloride
magnesium sulfate
magnesium sulfate IN D5W
methylene blue
methylfol-algae-b12-acetylcyst
monoject pharma grade flush syringe
monoject sodium chloride flush
morrhuate sodium
multitrace-4
multitrace-4 concentrate
multitrace-4 neonatal
multitrace-5
multitrace-5 concentrate
n-acetyl-l-cysteine
naloxone HCL
naltrexone HCL
normal saline flush
normal saline flush for flushing vascular access devices
normal saline i.v. flush
normosol -r
normosol-m IN D5W
normosol-r IN D5W
nutrilipid
nutrilyte
nutrilyte II
oral suspend
oral syrup flavored vehicle
oral syrup SF
pentetate calcium trisodium
pentetate zinc trisodium
petrolatum white
petrolatum yellow
phospha 250 neutral
physiolyte
physiosol irrigation
physostigmine salicylate
plo gel - mediflo pre-mixed
plo20 base
polyethylene glycol 8000 base e
potassium acetate
potassium bicarbonate
potassium chloride
potassium chloride CR
potassium chloride ER
potassium chloride SR
potassium chloride 0.15% /NACL 0.45% viaflex
potassium chloride 0.15% w/NACL 0.9% viaflex
potassium chloride 0.15% D5W/NACL 0.33%
potassium chloride 0.15% D5W/NACL 0.45% viaflex
potassium chloride 0.15% NACL 0.9%
potassium chloride 0.15%/D5W
potassium chloride 0.15%/NACL 0.9%
potassium chloride 0.224%/D5W/NACL 0.45%
potassium chloride 0.224%D5W/NACL 0.45% viaflex
potassium chloride 0.3%/ NACL 0.9%
potassium chloride 0.3%/D5W
potassium chloride 0.3%/NACL 0.9%/viaflex
potassium phosphate
potassium phosphates
pralidoxime chloride
premasol
propylene glycol
purified water
raspberry syrup
ringers injection
ringers irrigation
saccharin sodium
saline flush
saline flush zr/sterile field
saline/phenol
scleromate sodium morrhuate
selenium
simple syrup
sodium acetate
sodium bicarbonate
sodium bicarbonate partial fill
sodium chloride
sodium chloride bacteriostatic
sodium chloride bacteriostatic/benzyl alcohol
sodium chloride flush
sodium chloride pab
sodium chloride 0.45%
sodium chloride 0.45% viaflex
sodium lactate
sodium nitrite
sodium phosphate
sodium polystyrene sulfonate
sodium saccharin dihydrate
sodium thiosulfate
sps
stera base
sterile diluent for epoprostenol sodium
sterile water for injection
sterile water irrigation
sterile water irrigation plastic bottle
sterile water irrigation w/hanger
swabflush saline flush
tis-u-sol
tpn electrolytes
triple dye
tryptophan
virt-phos 250 neutral
virt-vite forte
vp-gstn
vp-precip
white petrolatum
xylose
yellow petrolatum
zinc gluconate
zinc sulfate
zinc trace metal
BD posiflush
KCL 0.075%/D5W/NACL 0.45%
KCL 0.15%/D5W/ NACL 0.3%
KCL 0.15%/D5W/lr
KCL 0.15%/D5W/NACL 0.2%
KCL 0.15%/D5W/NACL 0.225%
KCL 0.15%/D5W/NACL 0.45%
KCL 0.15%/D5W/NACL 0.9%
KCL 0.3%/D5W/lr IV lac ring
KCL 0.3%/D5W/NACL 0.45%
KCL 0.3%/D5W/NACL 0.9%
38
TIER 02
TIER 03
TIER 04
MD-gastroview
PREVENTIVE
fluor-a-day
fluoride
fluoritab
flura-drops
karidium
lozi-flur
ludent
nafrinse
nafrinse drops
sodium fluoride
PREFERRED BRAND
Chemet
Chemstrip-k
Cuprimine
Fluor-a-day
Hyperrab S/D
K-phos
NON PREFERRED
Botox Cosmetic
Cerefolin
Depen Titratabs
Effer-k
Fluorabon
Flura-drops
Folbic RF
Foltx
Galzin
Isolyte-s
Klor-CON M15
L-methyl-mc
Magnebind 400
Metafolbic
Phisohex
Plasma-lyte A
Plasma-lyte-148
Vayacog
Vayarin
Vayarol
Vita-respa
SPECIALTY
carimune nanofilteredPA
gamastan s/d PA
gammagard liquidPA
gammagard s/d PA
hepagam b
hyperrho s/d
nabi-HB
PA
Adagen
Benlysta PA
Bivigam PA
Cytogam PA
Exjade PA
FerriproxPA
Flebogamma Dif PA
PA
Gamastan S/D
Gammagard Liquid PA
Gammagard S/DPA
Gammagard S/D Iga Less Than 1mcg/MLPA
Gammaked PA
GammaplexPA
Gamunex-cPA
Hepagam B
Hizentra PA
Hyperhep B S/D
Hyperrho S/D
Hyperrho S/D Mini-dose
Micrhogam Ultra-filtered Plus
Octagam PA
Privigen PA
Rhogam Ultra-filtered Plus
Rhophylac
SynagisPA
Syprine
Thyrogen QL,PA
Vivitrol
Winrho SDF
XiaflexPA
ACA PREVENTIVE DRUGS
ASPIRIN
TIER 01
PREVENTIVE
adult aspirin EC low strength
aspir-low
aspir-81
aspirin
aspirin adult low strength
aspirin childrens
aspirin enteric coated adult low strength
aspirin low dose
aspirin low strength
aspirin EC
aspirin EC low dose
aspirin EC LO-dose
aspirin 81
aspirin 81 low dose
aspirtab
bayer advanced aspirin regular strength
bayer aspirin
bayer aspirin regimen
bayer aspirin EC low dose
bayer chewable low dose
bayer low dose
childrens aspirin
childrens aspirin low strength
ecotrin low strength
ecpirin
enteric coated aspirin
eq adult aspirin low strength
eq aspirin
eq aspirin adult low dose
eq aspirin low dose
eq aspirin EC
eq childrens aspirin
eql adult aspirin low strength
eql aspirin
eql aspirin low dose
eql aspirin EC
eql childrens aspirin
gnp adult aspirin low strength
gnp aspirin
gnp aspirin low dose
gnp childrens aspirin
goodsense aspirin low dose
halfprin
kls aspirin low dose
kls aspirin EC
kp aspirin
meijer aspirin EC
miniprin low dose
norwich aspirin
px aspirin
px enteric aspirin
qc aspirin
qc aspirin low dose
qc childrens aspirin
ra aspirin
ra aspirin adult low dose
39
TIER 02
TIER 03
ra aspirin adult low strength
ra aspirin childrens
ra aspirin EC
ra aspirin EC adult low strength
ra childrens aspirin
sm aspirin
sm aspirin adult low strength
sm aspirin enteric coated
sm aspirin low dose
sm aspirin EC low strength
sm childrens aspirin
st joseph aspirin
tgt aspirin
tgt aspirin low dose
tgt childrens aspirin
tgt enteric-coated aspirin
th aspirin
th aspirin low dose
th enteric aspirin
CVS aspirin
CVS aspirin adult low dose
CVS aspirin adult low strength
CVS aspirin child
CVS aspirin low dose
CVS aspirin low strength
CVS aspirin EC
CVS childrens aspirin
CVS enteric aspirin
EC-81 aspirin
HM aspirin
HM aspirin EC
HM aspirin EC low dose
MM aspirin
SB aspirin
SB aspirin EC
SB childrens aspirin
SB low dose asa EC
1/2halfprin
PREVENTIVE
Halfprin
PREVENTIVE
Adult Aspirin Low Strength
Medi-seltzer
CONTRACEPTIVES
TIER 01
PREVENTIVE
altavera
alyacen 1/35
alyacen 7/7/7
amethia QL
amethia LO QL
amethyst
apri
aranelle
aubra
aviane
azurette
balziva
briellyn
camila
camrese QL
QL
camrese LO
caziant
cesia
chateal
cryselle-28
cyclafem 1/35
cyclafem 7/7/7
dasetta 1/35
dasetta 7/7/7
daysee QL
deblitane
delyla
desogestrel/ethinyl estradiol
drospirenone/ethinyl estradiol
econtra EZ
elinest
emoquette
encare
enpresse-28
enskyce
errin
estarylla
falmina
gianvi
gildagia
gildess FE 1.5/30
gildess FE 1/20
gildess 1.5/30
gildess 1/20
gildess 24 FE
heather
introvale QL
jencycla
jolessa QL
jolivette
junel FE 1.5/30
junel FE 1/20
junel 1.5/30
junel 1/20
kariva
kelnor 1/35
kurvelo
larin FE 1.5/30
larin FE 1/20
larin 1.5/30
larin 1/20
leena
lessina
levonest
levonorgestrel
levonorgestrel and ethinyl estradiol QL
levonorgestrel/ethinyl estradiol
levora 0.15/30-28
lomedia 24 FE
loryna
low-ogestrel
lutera
lyza
marlissa
medroxyprogesterone acetate QL
microgestin FE
microgestin FE 1.5/30
microgestin 1.5/30
microgestin 1/20
mono-linyah
mononessa
my way
myzilra
necon 0.5/35-28
necon 1/35
necon 1/50-28
necon 10/11-28
necon 7/7/7
next choice one dose
nikki
nora-be
norethindrone
norethindrone acetate/ethinyl estradiol
40
TIER 02
TIER 03
norethindrone acetate/ethinyl estradiol/ferrous fumarate
norgestimate/ethinyl estradiol
norlyroc
nortrel 0.5/35 (28)
nortrel 1/35
nortrel 7/7/7
ocella
ogestrel
orsythia
philith
pimtrea
pirmella 1/35
pirmella 7/7/7
portia-28
previfem
quasense QL
reclipsen
sharobel
solia
sprintec 28
sronyx
syeda
tarina FE 1/20
tilia FE
tri-estarylla
tri-legest FE
tri-linyah
tri-previfem
tri-sprintec
trinessa
trivora-28
vcf vaginal contraceptive foam
velivet
vestura
viorele
vyfemla
wera
wymzya FE
xulane
zarah
zenchent
zenchent FE
zovia 1/35e
zovia 1/50e
PREFERRED BRAND
Beyaz
LO Loestrin FE
Minastrin 24 FE
Safyral
PREVENTIVE
Natazia
Nuvaring QL
NON PREFERRED
Depo-subq Provera 104 QL
PREVENTIVE
Fc Female Condom
Fc2 Female Condom
Femcap
Omniflex Diaphragm
Options Conceptrol Vaginal Contraceptive
Options Gynol II Vaginal Contraceptive
Ortho Diaphragm All-flex/65MM
Ortho Diaphragm Coil Spring Kit 100
Ortho Diaphragm Flat Spring Kit 55
TIER 04
Prentif Cavity-rim Cervical CAP
Prentif Fitting Set
Shur-seal
Vcf Vaginal Contraceptive Film
Wide-seal Silicone Diaphragm Kit 60
PREVENTIVE
Implanon
Mirena
Nexplanon
Skyla
FLUORIDE
TIER 01
TIER 02
TIER 03
PREVENTIVE
fluor-a-day
fluoride
fluoritab
flura-drops
karidium
lozi-flur
ludent
nafrinse
nafrinse drops
sodium fluoride
PREFERRED BRAND
Fluor-a-day
NON PREFERRED
Fluorabon
Flura-drops
FOLIC ACID
TIER 01
GENERIC
m-vit
prenaplus
prenatal low iron
tricare
PREVENTIVE
classic prenatal
eql folic acid
eql prenatal formula
fa-8
folic acid
gnp folic acid
gnp prenatal vitamins
kp folic acid
mission prenatal HP
multi prenatal
nat-rul prenatal vitamins
perry prenatal
pre-natal formula
prenatal
prenatal and iron
prenatal formula
prenatal forte
prenatal vitamins
px folic acid
41
TIER 03
px prenatal multivitamins
ra folic acid
ra prenatal
sm folic acid
sm prenatal vitamins
th folic acid
yl folic acid
CVS folic acid
CVS prenatal
HM folic acid
PREVENTIVE
Atabex Prenatal
CVS Prenatal
Fa-8
Gnp Daily Prenatal
Gnp Prenatal
Goodsense Prenatal Vitamins
HM One Daily Prenatal Combo
HM Prenatal
Kp Prenatal Multivitamins
Mission Prenatal
One-a-day Womens Prenatal
Prenatal
Prenatal Complete
Prenatal Multi +dha
Prenatal One Daily
PA Prenatal Formula
Qc Prenatal
Ra One Daily
Ra Prenatal Formula/Folicacid
Right Step Prenatal
Sm One Daily Prenatal
Sm Prenatal Vitamins
Stuart Prenatal
Stuart Prenatal + DHA
Th Prenatal Vitamins
Flulaval 2012-2013
Flulaval 2013-2014
Flulaval 2014-2015
Flumist Nasal Vaccine 2012-2013
Flumist Quadrivalent
Fluvirin 2012-2013
Fluvirin 2013-2014
Fluvirin 2014-2015
Fluzone Intradermal
Fluzone Intradermal Quadrivalent
Gardasil
Gardasil 9
Havrix
Hiberix
Infanrix
Influenza Vaccine For Safeway Dependants
Ipol Inactivated IPV
Kinrix
M-m-r II W/Diluent 10 Dose
Menactra
Menomune-a/C/Y/W-135
Menveo
Pediarix
Pedvax HIB
Pentacel
Physicians EZ Use Flu Kit 2012-2013
Pneumovax 23
Pneumovax 23/1 Dose
Pneumovax 23/5 Dose
Prevnar 13
Proquad
Recombivax HB
Rotarix
Rotateq
Tenivac
Trumenba
Twinrix
Vaqta
Varivax
Zostavax
IMMUNIZATIONS
TIER 02
PREVENTIVE
diphtheria/tetanus toxoids adsorbed pediatric
influenza a (h1n1) monovalent 2009
pneumovax 23/1 dose
pneumovax 23/5 dose
tetanus/diphtheria toxoids-adsorbed adult
Acthib
Adacel
Afluria 2012-2013
Afluria 2013-2014
Afluria 2014-2015
Bexsero
Boostrix
Cervarix
Comvax
Daptacel
Engerix-b
Fluarix 2012-2013
Fluarix 2013-2014
Fluarix 2014-2015
Flublok 2013-2014
Flublok 2014-2015
Flucelvax 2012-2013
Flucelvax 2013-2014
Flucelvax 2014-2015
IRON
TIER 01
PREVENTIVE
bprotected pedia iron
eq slow-release iron
eql iron supplement therapy
eql slow release iron
42
TIER 03
ezfe 200
feosol
fer-iron
ferate
ferosul
ferretts
ferrex 150
ferric x-150
ferro-bob
ferrocite
ferrotabs
ferrous drops
ferrous fumarate
ferrous fumarate 324
ferrous gluconate
ferrous sulfate
ferrousul
ferus
gnp iron
gnp slow release iron
high potency iron
iferex 150
iron
iron chews pediatric
iron slow release
iron supplement
iron supplement childrens
kp ferrous gluconate
kp ferrous sulfate
meijer ferrous sulfate
myferon 150
nu-iron 150
poly-iron 150
px iron
qc ferrous sulfate
ra high potency iron
ra iron
ra slow release iron
slow iron
slow release iron
sm iron
sm iron slow release
th iron
th slow release iron
wee care
CVS iron
CVS slow release iron
FE aspartate
FE gluconate
FE TABS
HM iron
HM iron slow release
PREVENTIVE
CVS Slow Release Iron
Elite Iron
Femiron
Feosol
Ferretts IPS
Ferrimin 150
Ferro-sequels
Iron Up
Mykidz Iron 10
Novaferrum Pediatric Drops
Perfect Iron
Profe
Proferrin ES
Slow Release Iron
Sm Slow Release Iron
SMOKING CESSATION
TIER 01
TIER 02
TIER 03
PREVENTIVE
buproban QL
bupropion HCL SRQL
QL
eq nicotine
eq nicotine gum refill QL
eq nicotine gum starterQL
eq nicotine polacrilexQL
eq nicotine step 3 QL
QL
eql nicotine
eql nicotine polacrilexQL
eql nicotine polacrilex refillQL
eql nicotine polacrilex starterQL
gnp nicotine polacrilexQL
QL
gnp nicotine polacrilex mini
kls quit2 QL
kls quit4 QL
nicorelief QL
nicotineQL
QL
nicotine polacrilex
nicotine polacrilex refill QL
nicotine polacrilex starter kit QL
nicotine step 1 QL
nicotine step 2 QL
nicotine step 3 QL
nicotine transdermal system QL
px stop smoking aid QL
qc nicotine polacrilexQL
ra mini nicotineQL
ra nicotineQL
ra nicotine polacrilexQL
ra nicotine transdermal system step 3 QL
sm nicotine QL
sm nicotine polacrilexQL
sw nicotine polacrilexQL
tgt nicotine gum QL
tgt nicotine polacrilexQL
tgt nicotine step one QL
tgt nicotine step three QL
tgt nicotine step two QL
thrive QL
CVS nicotine QL
CVS nicotine polacrilexQL
CVS nicotine polacrilex starterQL
CVS nicotine transdermal system QL
CVS nts step 1 QL
QL
HM nicotine polacrilex
HM nicotine transdermal system QL
HM nicotine transdermal system step 3 QL
SR nicotine gumQL
PREVENTIVE
QL,PA,ST
Chantix
Chantix Continuing Month PAK QL,PA,ST
Chantix Starting Month PAK QL,PA,ST
PREVENTIVE
Nicotrol InhalerQL
QL
Nicotrol Ns
VITAMIN D
TIER 01
GENERIC
decara
PREVENTIVE
aqueous vitamin d infants
bio-d-mulsion
bio-d-mulsion forte
bprotected pedia d-vite
d 1000
d 10000
d 2000
43
TIER 03
d 400
d 5000
d-vita
d-1000
d-1000 extra strength
d-3-5
d-400
d-5000
delta d3
dialyvite vitamin d 5000
d2000 ultra strength
d3
d3 adult
d3 high potency
d3 kids
d3 maximum strength
d3 super strength
d3 ultra strength
d3-1000
d3-50
eql childrens vitamin d gummies
eql vitamin d-3
eql vitamin d3
gnp vitamin d
gnp vitamin d maximum strength
gnp vitamin d super strength
gnp vitamin d3 extra strength
healthy kids vitamin d3
just d
kp vitamin d
maximum d3
nat-rul vitamin d
optimal-d
optimal-d pack
opurity vitamin d
pronutrients vitamin d3
ra vitamin d-3
sm vitamin d
sm vitamin d3
th vitamin d3
thera-d rapid repletion
thera-d sport
thera-d 2000
vitamin d
vitamin d high potency
vitamin d 400
vitamin d-1000
vitamin d-1000 maximum strength
vitamin d-3
vitamin d-400
vitamin d3
vitamin d3 adult gummies
vitamin d3 high potency
vitamin d3 maximum strength
vitamin d3 super strength
vitamin d3 400
CVS childrens vitamin d for bone health
CVS vitamin d
CVS vitamin d infants
CVS vitamin d 5000 high-potency
CVS vitamin d3
HM vitamin d
HM vitamin d3
PA vitamin d-3
PA vitamin d-3 gummy
PREVENTIVE
CVS Vitamin D3
Ddrops
Dialyvite Vitamin D3 Max
D3 Dots
HM Vitamin D3
Replesta
Replesta Childrens
Replesta Nx
Sm Vitamin D3 Maximum Strength
Super Daily D3
Thera-d 4000
Vitamelts Vitamin D
Wellesse Vitamin D3
BOWEL PREPARATION AGENTS
TIER 01
TIER 03
PREVENTIVE
gavilyte-c
gavilyte-n/flavor pack
gavilyte-G
peg 3350/electrolytes
peg-3350/electrolytes
peg-3350/NACL/NA bicarbonate/KCL
trilyte
NON PREFERRED
Colyte-flavor Packs
Golytely
44
Index
A
a-hydrocort, 11
a-methapred, 11
abacavir, 2
abacavir sulfate/lamivudine/zidovudine, 2
Abelcet, 2
Abilify, 20
Abilify Discmelt, 20
Abilify Maintena, 20
Abraxane, 4
Absorica, 8
Abstral, 26
acamprosate calcium DR, 21
Acanya, 8
acarbose, 13
Accu-chek Active Glucose Control
Solution, 35
Accu-chek Active Strips, 35
Accu-chek Aviva, 35
Accu-chek Aviva Plus, 35
Accu-chek Combo, 35
Accu-chek Comfort Curve Control
Solution (2 Levels), 35
Accu-chek Comfort Curve Linearity
Solution, 35
Accu-chek Comfort Curve Test Strips, 35
Accu-chek Compact Blue Control
Accu-chek Compact Plus, 35
Accu-chek Compact Plus Care Kit, 35
Accu-chek Compact Plus Clear Control
Accu-chek Compact Strips, 35
Accu-chek Compact Test Drum, 35
Accu-chek Fastclix Lancetdevice Kit, 35
Accu-chek Fastclix Lancets, 31
Accu-chek Instant Glucosecontrol
Accu-chek Multiclix Lanc Et Device Kit,
35
Accu-chek Multiclix Lancets, 31
Accu-chek Nano Smartview, 35
Accu-chek Rapid-d Infusion
Set/24"/10MM, 35
Accu-chek Rapid-d Infusion Set/24"/6MM,
35
35
Set/31"/10MM, 35
35
35
Set/43"/10MM, 35
35
35
Accu-chek Safe-t-pro Lancets, 31
Accu-chek Safe-t-pro Pluslancets, 31
Accu-chek Smartview Control, 35
Accu-chek Smartview Strips, 35
Accu-chek Soft Touch Lancets, 31
Accu-chek Softclix Lancetdevice Kit, 35
Accu-chek Softclix Lancets, 31
Accu-chek Spirit Adapter Kit, 35
Accu-chek Spirit Battery Kit, 35
Accu-chek Spirit Insulin P.M. Kit, 35
Accu-chek Tender II Infusion
Set/24"/13MM, 35
Set/24"/17MM, 35
Set/31"/13MM, 35
Set/31"/17MM, 35
Set/43"/17MM, 35
Accu-chek Voicemate, 35
acd formula a, 18
acd formula b, 18
acd-a noclot-50, 18
acebutolol HCL, 6
acetaminophen/caffeine/dihydrocodeine
bitartrate, 25
acetaminophen/codeine, 25
acetaminophen/codeine #2, 25
acetaminophen/codeine phosphate, 25
acetasol HC, 24
acetazolamide, 7
acetazolamide ER, 7
acetazolamide sodium, 7
acetic acid, 24
acetic acid 0.25%, 17
acetic acid/aluminum acetate, 24
acetylcysteine, 27, 37
Aciphex Sprinkle, 15
acitretin, 9
Actemra, 26
Acthib, 28, 42
Acti-lance Lancets 28G, 31
Acti-lance Lite Safety Lancets 28G, 31
Acti-lance Special Safety Lancets 17G,
31
Acti-lance Special Safetylancets 17G, 31
Acti-lance Universal Safety Lancets 23G,
31
acticin, 10
Actimmune, 5
Actonel, 13
Actoplus Met XR, 13
Acuvail, 24
acyclovir, 2, 9
acyclovir sodium, 2
Adacel, 28, 42
Adagen, 39
adapalene, 8
adapter CAP blue a 18MM, 35
adapter CAP blue b 20MM, 35
adapter CAP blue c 22MM, 35
adapter CAP blue d 24MM, 35
adapter CAP blue e 28MM/SHORT neck,
35
adapter CAP blue f 28MM/long neck, 35
adapter CAP blue k 28MM/medium neck,
35
adapter CAP blue m 24MM, 35
adapter CAP green a 18MM, 35
adapter CAP green b 20MM, 35
adapter CAP green c 22MM, 35
adapter CAP green d 24MM, 35
adapter CAP green e 28MM/SHORT
neck, 35
adapter CAP green f 28MM/long neck,
35
adapter CAP green k 28MM/medium
neck, 35
adapter CAP green m 24MM, 35
adapter CAP red a 18MM, 35
adapter CAP red b 20MM, 35
adapter CAP red c 22MM, 35
adapter CAP red d 24MM, 35
adapter CAP red e 28MM/SHORT neck,
35
adapter CAP red f 28MM/long neck, 35
adapter CAP red k 28MM/medium neck,
35
adapter CAP red m 24MM, 35
adapter CAP white b 20MM, 35
adapter CAP white c 22MM, 35
Adcetris, 4
Adcirca, 8
adefovir dipivoxil, 2
Adempas, 8
adenosine, 6, 37
adriamycin, 3
adrucil, 4
adult aspirin EC low strength, 24, 39
Adult Aspirin Low Strength, 25, 40
adult mask, 35
adult mask large, 35
Advair Diskus, 28
Advair HFA, 28
Advate, 19
Advocate Lancets, 31
Advocate Safety Lancets, 31
aero otic HC, 24
Aerochamber Mini Aerosol Chamber, 36
Aerochamber MV, 36
Aerochamber Plus Flow VU, 36
Aerochamber Plus Flow-VU, 36
Aerochamber Plus Flow-VU/Large Mask,
36
Aerochamber Plus Flow-VU/Mask, 36
Aerochamber Plus Flow-VU/Medium
Mask, 36
Aerochamber Plus Flow-VU/Small Mask,
36
Aerochamber Z-stat Plus Valved Holding
Chamber W/Flow VU, 36
Aerochamber Z-stat Plus/Flowsignal, 36
Aerochamber Z-stat Plus/Large Mask, 36
Aerochamber Z-stat Plus/Medium Mask,
36
Aerochamber Z-stat Plus/Small Mask, 36
Aerochamber/Flowsignal, 36
AF Lancets Super Thin, 31
afeditab CR, 6
Afinitor, 5
Afinitor Disperz, 5
Afluria 2012-2013, 28, 42
Afluria 2013-2014, 28, 42
Afluria 2014-2015, 28, 42
Afluria PF 2012-2013, 28, 42
Afluria PF 2013-2014, 28, 42
Afluria PF 2014-2015, 28, 42
Agamatrix Ultra-thin Lancets 33G, 31
Aggrastat, 19
Aggrenox, 19
airavite, 17
ak-fluor, 23
ak-poly-bac, 22
akorn balanced salt solution, 23
ala cort, 9
albatussin NN, 27
Albenza, 3
albuked 25, 19
albuked 5, 19
albumin human, 19
albumin-zlb, 19
albuminar-25, 19
albuminar-5, 19
alburx, 19
albutein, 19
albuterol sulfate, 27
albuterol sulfate ER, 27
alclometasone dipropionate, 9
Alcoh-glove Contoured Wipe, 36
alcoh-wipe 12" X 12", 35
Aldurazyme, 14
alendronate sodium, 13
alfentanil, 25
Alferon N, 5
alfuzosin HCL ER, 17
ali-flex, 24
Alimta, 4
Alinia, 3
Alkeran, 3
allopurinol, 26
Alocril, 24
Alodox Convenience Kit, 1
Alomide, 24
Alora, 11
Aloxi, 15
alpain, 24
Alphagan P, 23
Alphanate/Von Willebrand Factor
Complex/Human, 19
Alphanine SD, 19
alphaquin HP, 10
alphatrex, 9
alprazolam, 19
alprazolam ER, 19
alprazolam odt, 19
alprazolam XR, 19
alprostadil, 37
Alrex, 23
Alsuma, 26
Altabax, 8
altacaine, 23
altafluor, 23
altafrin, 23
altavera, 11, 40
Altoprev, 7
Alvesco, 28
alyacen 1/35, 11, 40
alyacen 7/7/7, 11, 40
amantadine HCL, 21
Ambisome, 2
amcinonide, 9
amethia, 11, 40
amethia LO, 11, 40
amethyst, 11, 40
amifostine, 5
Amigo Insulin P.M., 31
amikacin sulfate, 2
amiloride HCL, 7
amiloride/hydrochlorothiazide, 7
amino acids, 37
aminoacetic acid, 17
aminobenzoate potassium, 29
aminocaproic acid, 19
aminohippurate sodium, 37
aminophylline, 27
aminosyn 8.5%/electrolytes, 37
aminosyn II 8.5%/electrolytes, 37
aminosyn-hf, 37
amiodarone HCL, 6
Amitiza, 16
amitriptyline HCL, 20
amlodipine besylate, 6
amlodipine besylate/atorvastatin calcium,
7
amlodipine besylate/benazepril HCL, 7
amlodipine besylate/benazepril
hydrochloride, 7
amlodipine besylate/valsartan, 7
amlodipine/valsartan/hctz, 7
ammonium lactate, 10
ammonium molybdate, 37
amnesteem, 8
amoxapine, 20
amoxicillin, 1
amoxicillin ER, 1
amoxicillin/clavulanate potassium, 1
amoxicillin/clavulanate potassium ER, 1
amphetamine/dextroamphetamine, 20
Amphotec, 2
amphotericin b, 2
ampicillin, 1
ampicillin sodium, 1
ampicillin-sulbactam, 1
Ampyra, 22
Amturnide, 7
ana-lex, 16
Anadrol-50, 11
anagrelide hydrochloride, 19
Analpram Advanced, 16
Analpram-HC, 16
anastrozole, 4
Androderm, 11
Androgel, 11
Androgel P.M., 11
Androxy, 11
anhydrous base, 37
Animas Vibe Insulin P.M., 31
Animas Vibe Insulin P.M./Black, 31
Animas Vibe Insulin P.M./Blue, 31
Animas Vibe Insulin P.M./Limelight
Green, 31
Animas Vibe Insulin P.M./Pink Glow, 31
anticoagulant citrate dextrose solution a,
18
anticoagulant sodium citrate, 18
antipyrine/benzocaine, 24
antivenin latrodectus mactans, 37
antivenin micrurus fulvius, 37
anucort-HC, 16
Anzemet, 16
AP-zel, 30
apexicon, 9
apexicon e, 9
Apidra, 12
Apidra Solostar, 13
Aplenzin, 20
Apokyn, 21
apraclonidine, 23
apri, 11, 40
Apriso, 16
Aptivus, 2
aqueous vitamin d infants, 29, 43
Aralast NP, 28
aranelle, 11, 40
Aranesp Albumin Free, 18
arbinoxa, 27
Arcalyst, 26
Arcapta Neohaler, 28
argatroban, 18
argyle sterile saline 100ML, 17
argyle sterile water 100ML, 37
Arial Chamber, 36
Armour Thyroid, 15
arnica flower, 10
Arranon, 4
Arzerra, 4
arzol silver nitrate app licators, 10
Asacol, 16
Asacol HD, 16
ascomp/codeine, 25
ascorbic acid, 29
Asmanex HFA, 28
Asmanex Twisthaler 120 Metered Doses,
28
28
Asmanex Twisthaler 30 Me Tered Doses,
28
28
28
28
aspir-81, 24, 39
aspir-low, 24, 39
aspirin, 24, 39
aspirin 81, 24, 39
aspirin 81 low dose, 24, 39
aspirin adult low strength, 24, 39
aspirin childrens, 24, 39
aspirin EC, 24, 39
aspirin EC LO-dose, 24, 39
aspirin EC low dose, 24, 39
aspirin enteric coated adult low strength,
24, 39
aspirin low dose, 24, 39
aspirin low strength, 24, 39
aspirin-caffeine-dihydrocodeine, 25
aspirtab, 24, 39
Assure Comfort Lancets Ultra Thin 28G,
31
Assure Comfort Lancets Ultra Thin 30G,
31
Assure Haemolance Plus High Flow 18G,
31
Assure Haemolance Plus Low Flow 25G,
31
Assure Haemolance Plus Micro Flow
28G, 31
Assure Haemolance Plus Normal Flow
21G, 31
Assure Haemolance Plus Pediatric Blade,
31
Assure Lance Lancets, 31
Assure Lancets, 31
asthma control kit, 35
astramorph, 25
AT Last Lancets, 31
Atabex Prenatal, 31, 42
Atelvia, 13
atenolol, 6
atenolol/chlorthalidone, 7
Atgam, 4
atorvastatin calcium, 7
atovaquone, 3
atovaquone/proguanil HCL, 3
atracurium besylate, 22
Atralin, 8
Atripla, 2
Atropen, 15
atropine sulfate, 15, 23
atropine-care, 23
Atrovent HFA, 28
Aubagio, 22
aubra, 11, 40
augmented betamethasone dipropionate,
9
Augmentin, 1
aurax, 24
aurodex, 24
Aurora Lancet Super Thin 30G, 31
Aurora Lancet Thin 23G, 31
auryxia, 16
autoclave paper 36" X 36", 35
Auvi-q, 7
Avage, 10
Avandia, 13
avar cleanser, 8
avar-e emollient, 8
avar-e green, 8
Avastin, 4
Avc, 17
Avelox, 2
aviane, 11, 40
avidoxy, 1
avita, 8
Avodart, 17
Avonex, 22
Avonex Pen, 22
Axert, 26
Axiron, 11
azacitidine, 4
Azactam IN Iso-osmotic Dextrose, 3
Azasan, 4
Azasite, 23
azathioprine, 4
azelastine HCL, 23, 27
Azelex, 8
Azilect, 21
azithromycin, 1
Azopt, 24
Azor, 7
aztreonam, 3
azurette, 11, 40
5ML/31G X 5/16", 31
BD Insulin Syringe Ultrafine
B
II/SHORT/1ML/31G X 5/16", 31
b-6 folic acid, 17
BD Insulin Syringe Ultrafine/0.3ML/30G X
b-complex, 30
1/2", 31
b-complex 100, 30
b-plex, 30
5/16", 31
b-plex plus, 30
baciim, 3
1/2", 31
bacitracin, 3, 22
bacitracin/polymyxin b, 22
5/16", 31
baclofen, 22
BD Insulin Syringe Ultrafine/1ML/30G X
Bacmin, 30
1/2", 31
bacteriostatic water for injection/benzyl
BD Insulin Syringe Ultrafine/1ML/31G X
alcohol, 37
5/16", 31
bacteriostatic water parabens, 37
BD Insulin Syringe Ultrafine/UBactocill IN Dextrose, 1
100/0.3ML/29G X 1/2", 31
Bactroban Nasal, 27
BD Insulin Syringe Ultrafine/Ubalanced salt, 23
100/0.5ML/29G X 1/2", 31
balanced salt solution, 23
BD Insulin Syringe Ultrafine/Ubalsalazide disodium, 16
100/1ML/29G X 1/2", 31
balziva, 11, 40
BD Insulin Syringe Ultrafine/UBanzel, 21
100/1ML/30G X 1/2", 31
Baraclude, 2
BD Insulin Syringe/Detachable Needle/Ubarium sulfate, 37
100/1ML/25G X 1", 31
base cream with liposome, 37
BD Insulin Syringe/Detachable Needle/Ubase w301, 37
100/1ML/25G X 5/8", 31
baycadron, 11
BD Insulin Syringe/Detachable Needle/Ubayer advanced aspirin regular strength, 100/1ML/26G X 1/2", 31
24, 39
BD Insulin Syringe/U-100/0.5ML/30G X
bayer aspirin, 24, 39
1/2", 32
bayer aspirin EC low dose, 24, 39
BD Insulin Syringe/U-100/1ML/27G X
bayer aspirin regimen, 24, 39
1/2", 32
bayer chewable low dose, 24, 39
BD Insulin Syringe/U-100/1ML/28G X
bayer low dose, 24, 39
1/2", 32
Bayer Microlet Lancets, 31
BD Insulin Syringe/U-100/2ML/27.5G X
bcg vaccine, 28
5/8", 32
BD Insulin Syringe LUER-LOK/UBD Insulin Syringe/U-100/2ML/29G X
100/1ML, 31
1/2", 32
BD Insulin Syringe Microfine IV/UBD Lancet Ultrafine 30G, 32
100/0.3ML/28G X 1/2", 31
BD Lancet Ultrafine 33G, 32
BD Insulin Syringe Microfine IV/UBD LO-dose Insulin Syringe Microfine
100/0.5ML/28G X 1/2", 31
IV/0.5ML/28G X 1/2", 32
BD Insulin Syringe Microfine IV/UBD Microtainer Lancets, 32
100/1ML/27G X 5/8", 31
BD Pen Needle/Mini/Ultrafine/31G X
BD Insulin Syringe Microfine IV/U3/16", 32
100/1ML/28G X 1/2", 31
BD Pen Needle/Nano/Ultra Fine/32G X
BD Insulin Syringe Microfine/U4MM, 32
100/0.3ML/28G X 1/2", 31
BD Pen Needle/SHORT/Ultrafine/31G X
BD Insulin Syringe Microfine/U5/16", 32
100/0.5ML/28G X 1/2", 31
BD Pen Needle/Ultrafine/29G X 12.7MM,
BD Insulin Syringe Microfine/U32
100/1ML/27G X 5/8", 31
BD Pen Needle/Ultrafine/29GX1/2"
BD Insulin Syringe Microfine/U12.7MM, 32
100/1ML/28G X 1/2", 31
BD Pen Needles SHORT/Ultrafine/31G X
BD Insulin Syringe
5/16", 32
Safetyglide/0.5ML/29G X 1/2", 31
BD posiflush, 38
BD Insulin Syringe Safetyglide/1ML/29G BD pudendal/local block tray 1%
X 1/2", 31
lidocaine, 27
BD Insulin Syringe Safetyglide/UBD Swabs Single Use, 36
100/0.3ML/31G X 5/16", 31
BD Swabs Single Use Butterfly, 36
BD Insulin Syringe Slip Tip/U-100/1ML,
Bebulin, 19
31
Bebulin VH, 19
BD Insulin Syringe U-40/1ML/25G X 5/8", Beconase AQ, 27
31
belladonna & opium, 15
BD Insulin Syringe Ultrafine Halfbelladonna alkaloids & opium, 15
unit/0.3ML/31G X 5/16", 31
benazepril HCL, 6
BD Insulin Syringe Ultrafine II/SHORT/0. benazepril HCL/hydrochlorothiazide, 7
Benefix, 19
Benicar, 6
Benicar HCT, 7
Benlysta, 39
benzalkonium chloride, 37
benzepro, 8
benzepro SHORT contact, 8
benziq wash, 8
benzoin compound tincture, 10
benzoin tincture, 10
benzonatate, 27
benzoyl peroxide, 8
benzoyl peroxide SHORT contact, 8
benzoyl peroxide wash acne treatment
pack, 8
benzphetamine HCL, 20
benztropine mesylate, 21
Bepreve, 24
Berinert, 19
Besivance, 23
betamethasone dipropionate, 9
betamethasone sodium
phosphate/betamethasone acetate, 11
betamethasone valerate, 9
Betaseron, 22
betaxolol HCL, 6, 23
bethanechol chloride, 16
Betimol, 23
Betoptic-s, 23
Bexsero, 28, 42
Bexxar, 4
Bexxar 131 Iodine, 5
Beyaz, 12, 41
bicalutamide, 4
Bicillin C-R, 1
Bicillin L-a, 1
Bicnu, 3
Bidil, 8
Biltricide, 3
Binosto, 13
bio GLO, 23
bio-d-mulsion, 29, 43
bio-d-mulsion forte, 29, 43
bio-statin, 2
biocel, 30
biogesic, 24
Biothrax, 28
biotuss, 27
biotuss pediatric, 27
bisoprolol fumarate, 6
bisoprolol fumarate/hydrochlorothiazide,
7
Bivigam, 39
bleomycin sulfate, 3
Blephamide S.o.p., 23
blister pack adhesive label, 35
blister pack/amber 12 cavity, 35
Boostrix, 28, 42
boric acid, 10
Bosulif, 5
Botox, 22
Botox Cosmetic, 39
bottle adapters/24MM/press-IN, 35
bottletop dispenser 0.25-2.0ML, 35
bottletop dispenser adapter/38MM, 35
bp 10-1, 8
bp cleansing wash, 8
bp foam, 8
bp foaming wash, 8
bp folinatal plus b, 30
bp multinatal plus, 30
bp vit 3, 17
bp wash, 8
bpm, 27
bpm pseudo, 27
bpo, 8
bpo 3% foaming cloths, 8
bprotected pedia d-vite, 29, 43
bprotected pedia iron, 17, 42
Brainstrong Prenatal, 31
Bravelle, 14
Breatherite, 36
Breatherite Collapsible Adult Spacer
W/Mask, 36
Breatherite Collapsible Child Spacer
W/Mask, 36
Breatherite Collapsible Infant Spacer
W/Mask, 36
Breatherite Collapsible Small Child
Spacer W/Mask, 36
Breatherite Collapsible Spacer W/
Neonate Mask, 36
Breatherite Rigid Spacer W/Mask, 36
Breatherite W/Large Mask, 36
Breatherite W/Medium Mask, 36
Breatherite W/Small Mask, 36
Breo Ellipta, 28
briellyn, 11, 40
Brilinta, 19
brimonidine tartrate, 23
Bromday, 24
bromfed DM, 27
bromfenac, 23
bromocriptine mesylate, 21
bromphen/pseudoephedrine
HCL/dextromethorphan HBR, 27
brompheniramine tannate, 27
Brovana, 28
bss, 23
budeprion SR, 20
budesonide, 11, 27(2)
Bullseye Mini Safety Lancets, 31
Bullseye Safety Lancets, 31
bumetanide, 7
buminate, 19
bupap, 24
Buphenyl, 14
bupivacaine HCL, 26
bupivacaine spinal, 26
bupivacaine/epinephrine, 26
buprenorphine HCL, 25
buprenorphine HCL/naloxone HCL, 25
buproban, 21, 43
bupropion HCL, 20
bupropion HCL ER, 20
bupropion HCL SR, 20, 21, 43
bupropion HCL XL, 20
buspirone HCL, 19
Busulfex, 3
butalbital/acetaminophen, 24
butalbital/acetaminophen/caffeine, 24
butalbital/acetaminophen/caffeine/codein
e, 25
butalbital/apap/caffeine, 24
butalbital/aspirin/caffeine, 24
butalbital/aspirin/caffeine/codeine, 25
butorphanol tartrate, 25
Butrans, 26
Bydureon, 13
Byetta, 13
Bystolic, 6
C
cabergoline, 14
Cafergot, 26
caffeine citrate, 20
caffeine/sodium benzoate, 20
calcipotriene, 9
calcipotriene/betamethasone
dipropionate, 9
calcitonin salmon, 13
calcitonin-salmon, 13
calcitrene, 9
calcitriol, 9, 14
calcium acetate, 16
calcium chloride, 37
calcium disodium versenate, 37
calcium folinate, 5
calcium gluconate, 37
calcium-folic acid plus d, 37
camila, 11, 40
Camptosar, 5
camrese, 11, 40
camrese LO, 11, 40
Canasa, 16
Cancidas, 2
candesartan cilexetil, 6
candesartan cilexetil/hydrochlorothiazide,
7
Cantil, 15
capacet, 24
Capastat Sulfate, 2
capecitabine, 4
Capex, 9
Caprelsa, 5
capsaicin, 10
captopril, 6
captopril/hydrochlorothiazide, 7
Carac, 10
Carafate, 15
CARB-o-philic 40, 10
CARB-o-philic/40, 10
Carbaglu, 14
carbamazepine, 21
carbamazepine ER, 21
carbidopa, 21
carbidopa/levodopa, 21
carbidopa/levodopa ER, 21
carbidopa/levodopa odt, 21
carbidopa/levodopa/entacapone, 21
carbinoxamine maleate, 27
carbogel 940, 37
carbomer gel aqueous, 37
carbomer gel hydroalcoholic, 37
carboplatin, 3
Cardene IV, 6
cardioplegic, 7
Cardizem LA, 6
Cardura XL, 17
Careone Lancet Thin, 32
Careone Lancet Ultra Thin, 32
carimune nanofiltered, 39
carisoprodol, 22
carisoprodol/aspirin, 22
carisoprodol/aspirin/codeine, 22
carteolol HCL, 23
cartia XT, 6
cartridge IR 1000 3ML, 31
cartridge IR 1200, 31
cartridge P.M., 31
carvedilol, 6
cascara sagrada, 15
cavan-EC sod DHA, 30
cavarest, 19
Caverject, 8
Caverject Impulse, 8
cavirinse, 19
Cayston, 3
caziant, 11, 40
Cedax, 1
cefaclor, 1
cefaclor ER, 1
cefadroxil, 1
cefazolin sodium, 1
cefazolin sodium/dextrose, 1
cefdinir, 1
cefditoren pivoxil, 1
cefepime, 1
cefotaxime sodium, 1
cefotetan, 1
cefotetan/dextrose, 1
cefoxitin sodium, 1
cefpodoxime proxetil, 1
cefprozil, 1
ceftazidime, 1
ceftazidime/dextrose, 1
ceftibuten, 1
Ceftin, 1
ceftriaxone IN iso-osmotic dextrose, 1
ceftriaxone sodium, 1
ceftriaxone/dextrose, 1
cefuroxime axetil, 1
cefuroxime sodium, 1
cefuroxime/dextrose, 1
celecoxib, 26
Cellcept Intravenous, 4
Celontin, 21
cem-urea, 10
Cenestin, 11
centany, 8
Centrum Specialist Prenatal, 31
cephalexin, 1
Ceprotin, 19
Cerefolin, 39
Cerezyme, 18
cerisa wash, 8
cerovel, 10
Cervarix, 28, 42
Cesamet, 16
cesia, 11, 40
cetirizine HCL, 27
Cetrotide, 14
cevimeline HCL, 19
Chantix, 22, 43
Chantix Continuing Month PAK, 22, 43
Chantix Starting Month PAK, 22, 43
chateal, 11, 40
Chemet, 39
Chemstrip-k, 39
Chenodal, 16
cherry syrup, 37
childrens aspirin, 24, 39
childrens aspirin low strength, 24, 39
chloramphenicol sodium succinate, 3
chlordiazepoxide HCL, 19
chlordiazepoxide HCL/clidinium bromide,
15
chlordiazepoxide/amitriptyline, 21
chlorhexidine gluconate, 19, 37
chlorhexidine gluconate oral rinse, 19
chloromag, 37
chloroprocaine HCL, 26
chloroquine phosphate, 3
chlorothiazide, 7
chlorothiazide sodium, 7
chlorpromazine HCL, 20
chlorpropamide, 13
chlorthalidone, 7
chlorzoxazone, 22
choice-TABS, 30
cholestyramine, 7
cholestyramine light, 7
choline magnesium trisalicylate, 24
chorionic gonadotropin, 14
chromium chloride, 37
Cialis, 8
ciclodan, 9
ciclopirox, 9
ciclopirox nail lacquer, 9
ciclopirox olamine, 9
ciclopirox topical solution kit, 9
ciclopirox treatment, 9
cidofovir, 2
cilostazol, 19
Ciloxan, 23
cimetidine, 15
cimetidine HCL, 15
Cimzia, 16
Cimzia Starter Kit, 16
Cinryze, 19
Cipro HC, 24
Ciprodex, 24
ciprofloxacin, 1, 24
ciprofloxacin ER, 1
ciprofloxacin HCL, 1, 22
ciprofloxacin I.V.-IN D5W, 1
cisatracurium besylate, 22
cisplatin, 3
citalopram hydrobromide, 20
citric acid/sodium citrate, 17
cladribine, 4
Claforan, 1
claravis, 8
Clarinex, 27
Clarinex-d 12 HOUR, 27
Clarinex-d 24 HOUR, 27
claris clarifying wash, 8
clarithromycin, 1
clarithromycin ER, 1
classic prenatal, 30, 41
Cleanlet Lancets 28G, 32
cleanroom tacky mat 18" X36"/60 layer,
35
clear glass vials 2ML, 35
clearplex x, 8
clemastine fumarate, 27
Cleocin, 17
Clever Chek Lancets Ultrathin, 32
Clever Chek Lancets Ultrathin 30G, 32
clindacin etz pledgets, 8
clindacin-p, 8
clindamax, 8
clindamycin HCL, 3
clindamycin palmitate HCL, 3
clindamycin phosphate, 3, 8, 16
clindamycin phosphate add-vantage, 3
clindamycin phosphate IN D5W, 3
clindamycin phosphate pharmacy bulk
package, 3
clindamycin/benzoyl peroxide, 8
Clindesse, 17
clinimix 4.25%/dextrose 10%, 37
clinimix e 4.25%/dextrose 25%, 37
clinisol SF 15%, 37
clinpro 5000, 19
clobetasol propionate, 9
clobetasol propionate e, 9
clobetasol propionate emollient, 9
clocortolone pivalate, 9
clocortolone pivalate P.M., 9
clodan, 9
Cloderm, 10
Cloderm P.M., 10
Clolar, 4
clomiphene citrate, 14
clomipramine HCL, 20
clonazepam, 21
clonazepam odt, 21
clonidine HCL, 6, 24
clonidine HCL ER, 20
clopidogrel, 19
clorazepate dipotassium, 19
clotrimazole, 9, 19
clotrimazole/betamethasone dipropionate,
9
clozapine, 20
clozapine odt, 20
Cnl8 Nail Kit, 9
CO monitor, 36
CO monitor calibration, 36
CO monitor replacement t pieces, 36
CO-gesic, 26
CO-natal fa, 30
Coaguchek Lancets, 32
coal TAR, 10
Coartem, 3
cocaine HCL, 10
cod liver oil, 30
codeine sulfate, 25
colchicine, 26
Colcrys, 26
colestipol HCL, 7
colestipol HCL for oral suspension, 7
colistimethate sodium, 3
collodion flexible, 37
colocort, 16
Coly-mycin S, 24
Colyte-flavor Packs, 15, 44
Combigan, 23
Combipatch, 11
Combivent, 28
Combivent Respimat, 28
Cometriq, 5
Comfort Assured Lancets Micro Thin
33G, 32
Comfort Assured Lancets Super Thin
28G, 32
Comfort Infusion Set 23"/17MM, 32
Comfort Lancets, 32
Comfort SHORT Infusion Set 23"/13MM,
32
32
32
compazine, 20
Complera, 2
complete natal DHA, 30
completenate, 30
compound 347, 27
compro, 20
Comvax, 28, 42
Concerta, 21
Condylox, 10
constulose, 15
Contact Detach Infusion Set 23"
6MM/29G, 32
8MM/29G, 32
6MM/29G, 32
8MM/29G, 32
controlrx, 19
Conzip, 26
Copaxone, 22
copper sulfate, 37
copper trace metal, 37
Cordran, 10
Cordran Tape, 10
Coreg CR, 6
Corifact, 19
cormax scalp application, 9
cortalo, 9
cortic-nd, 24
Cortifoam, 16
cortisone acetate, 11
Cortisporin, 8
Cortisporin-tc, 24
corvita, 30
corvita 150, 17
corvite free, 30
cosyntropin, 37
covaryx, 11
covaryx HS, 11
coveralls medium/elastic
back/wrist/ankles, 35
cream base, 37
cream concentrate, 37
Creon, 16
Crestor, 7
Crinone, 17
Crixivan, 2
cromolyn sodium, 16, 24, 27
cryselle-28, 11, 40
Cubicin, 3
Cuprimine, 39
Curity Alcohol Preps/Medium 2 Ply, 36
Curity Alcohol Swabs, 36
curity sterile saline, 17
Cuvposa, 15
CVS Alcohol Prep Swabs, 36
CVS aspirin, 25, 40
CVS aspirin adult low dose, 25, 40
CVS aspirin adult low strength, 25, 40
CVS aspirin child, 25, 40
CVS aspirin EC, 25, 40
CVS aspirin low dose, 25, 40
CVS aspirin low strength, 25, 40
CVS childrens aspirin, 25, 40
CVS childrens vitamin d for bone health,
29, 44
CVS enteric aspirin, 25, 40
CVS folic acid, 18, 42
CVS iron, 18, 43
CVS Lancets 21G, 32
CVS Lancets Micro Thin 33G, 32
CVS Lancets Original, 32
CVS Lancets Thin 26G, 32
CVS Lancets Ultra Thin 30G, 32
CVS nicotine, 22, 43
CVS nicotine polacrilex, 22, 43
CVS nicotine polacrilex starter, 22, 43
CVS nicotine transdermal system, 22, 43
CVS nts step 1, 22, 43
CVS prenatal, 30, 42
CVS Prenatal, 31, 42
CVS Prenatal Gummy/DHA/Folic Acid,
31
CVS Prenatal Multi+dha, 31
CVS slow release iron, 18, 43
CVS Slow Release Iron, 18, 43
CVS Ultra Thin Lancets, 32
CVS vitamin d, 29, 44
CVS vitamin d 5000 high-potency, 29, 44
CVS vitamin d infants, 29, 44
CVS vitamin d3, 29, 44
CVS Vitamin D3, 29, 44
cyanide antidote pkg, 37
cyanocobalamin, 17
cyanocobalamin/levomefolate
calcium/pyridoxine HCL, 37
cyclafem 1/35, 11, 40
cyclafem 7/7/7, 11, 40
cyclobenzaprine HCL, 22
cyclopentolate HCL, 23
cyclophosphamide, 3
cycloserine, 2
Cycloset, 13
cyclosporine, 4
cyclosporine modified, 4
cyotic, 24
cyproheptadine HCL, 27
Cystadane, 14
Cystagon, 17
Cystaran, 24
cysteine HCL, 37
cytarabine, 4
cytarabine aqueous, 4
Cytogam, 39
Cytomel, 15
cytra k crystals, 17
cytra-2, 17
cytra-3, 17
cytra-k, 17
D
d 1000, 29, 43
d 10000, 29, 43
d 2000, 29, 43
d 400, 29, 44
d 5000, 29, 44
d-1000, 29, 44
d-1000 extra strength, 29, 44
d-2000 maximum strength, 29, 44
d-3-5, 29, 44
d-400, 29, 44
d-5000, 29, 44
d-5000 maximum strength, 29, 44
d-vita, 29, 44
d-xylose, 37
d2000 ultra strength, 29, 44
d3, 29, 44
d3 adult, 29, 44
D3 Dots, 29, 44
d3 high potency, 29, 44
d3 kids, 29, 44
d3 maximum strength, 29, 44
d3 super strength, 29, 44
d3 ultra strength, 29, 44
d3-1000, 29, 44
d3-50, 29, 44
dacarbazine, 5
Daliresp, 28
danazol, 11
dantrolene sodium, 22
dapsone, 3
Daptacel, 28, 42
Daraprim, 3
dasetta 1/35, 11, 40
dasetta 7/7/7, 11, 40
daunorubicin HCL, 3
Daunoxome, 3
daysee, 11, 40
Daytrana, 21
Ddrops, 29, 44
deblitane, 11, 40
decara, 29, 43
decitabine, 4
deferoxamine mesylate, 37
dehydrated alcohol, 37
delflex-LC/1.5% dextrose, 37
delflex-lm/1.5% dextrose, 37
delflex-sm/1.5% dextrose, 37
delflex-sm/2.5% dextrose, 37
delta d3, 29, 44
delyla, 11, 40
Delzicol, 16
demeclocycline HCL, 1
Demser, 7
Denavir, 9
denta 5000 plus, 19
dentagel, 19
deodorant plastic tubes 2.65oz/CAPS, 35
Depen Titratabs, 39
Depo-medrol, 11
Depo-provera, 4
Depo-subq Provera 104, 12, 41
Depocyt, 4
Depodur, 26
Dermasorb Ta, 10
dermazene, 9
desipramine HCL, 20
desloratadine, 27
desloratadine odt, 27
desmopressin acetate, 14
desogestrel/ethinyl estradiol, 11, 40
Desonate, 10
desonide, 9
Desowen Cream/Cetaphil Lotion, 10
Desowen Lotion/Cetaphil Cream, 10
Desowen Ointment/Cetaphil Lotion, 10
desoximetasone, 9
desvenlafaxine ER, 20
dexamethasone, 11
Dexamethasone Intensol, 11
dexamethasone sodium phosphate, 11,
23
dexchlorpheniramine maleate, 27
dexedrine, 20
dexferrum, 17
Dexilant, 15
dexmedetomidine HCL, 20
dexmethylphenidate HCL, 20
dexmethylphenidate HCL ER, 20
Dexpak 10 Day, 11
Dexpak 13 Day, 11
Dexpak 6 Day, 11
dexpanthenol, 16
dexrazoxane, 5
dextroamphetamine sulfate, 20
dextroamphetamine sulfate ER, 20
dextromethorphan
HBR/chlorpheniramine/phenylephrine
HCL, 27
dextrose 10%, 37
dextrose 10% flex container, 37
dextrose 10%/NACL 0.2%, 37
dextrose 2.5%/NACL 0.45%, 37
dextrose 2.5%/sodium chloride 0.45%,
37
dextrose 20%, 37
dextrose 25%, 37
dextrose 30%, 37
dextrose 30% partial fill, 37
dextrose 40%, 37
dextrose 5%, 37
dextrose 5% /electrolyte #48 viaflex, 37
dextrose 5% viaflex, 37
dextrose 5%/lactated ringers, 37
dextrose 5%/potassium chloride 0.15%,
37
dextrose 5%/ringers, 37
dextrose 5%/sodium chloride 0.2%, 37
dextrose 50%, 37
dextrose 70%, 37
diab, 10
diab f.d.g. freeze-dried, 10
Diabeta, 13
dialyvite, 30
dialyvite vitamin d 5000, 29, 44
Dialyvite Vitamin D3 Max, 29, 44
Diastar Easy Test II Lancets 30G, 32
Diastar Easy Test Lancets30G, 32
Diastat Pediatric, 21
diazepam, 19, 21
diazepam intensol, 19
Dibenzyline, 7
diclofenac potassium, 26
diclofenac sodium, 9, 10, 24
diclofenac sodium DR, 26
diclofenac sodium ER, 26
diclofenac sodium/misoprostol, 26
dicloxacillin sodium, 1
dicyclomine HCL, 15
didanosine, 2
diethylpropion HCL, 20
diethylpropion HCL ER, 20
Differin, 8
Dificid, 1
difil-G forte, 27
diflorasone diacetate, 9
diflunisal, 24
digitek, 5
digox, 5
digoxin, 5
dihydroergotamine mesylate, 26
Dilantin, 21
Dilatrate SR, 5
dilt-CD, 6
dilt-XR, 6
diltiazem CD, 6
diltiazem HCL, 6
diltiazem HCL CD, 6
diltiazem HCL ER, 6
diltzac, 6
dimenhydrinate, 15
Dipentum, 16
diphenhydramine HCL, 27
diphenoxylate/atropine, 15
diphtheria/tetanus toxoids adsorbed
pediatric, 28, 42
dipyridamole, 19, 37
disopyramide phosphate, 6
disposable mouthpiece full range, 35
disposable mouthpiece
lowrange/pediatric, 35
disposable mouthpiece/low range, 35
disposable mouthpiece/universal range,
35
disulfiram, 21
divalproex sodium, 21
divalproex sodium DR, 21
divalproex sodium ER, 21
dobutamine HCL, 7
dobutamine HCL/D5W, 7
dobutamine/dextrose 5%, 7
Docefrez, 4
docetaxel, 4
dologesic, 24
dolorex, 24
donepezil HCL, 21
Donnatal, 15
Donnatal Extentabs, 15
dopamine HCL, 7
dopamine HCL-dextrose 5%, 7
dopamine HCL/dextrose 5%, 7
dopamine/D5W, 7
Doribax, 3
dorzolamide HCL, 24
dorzolamide HCL/timolol maleate, 23
doxapram HCL, 20
doxazosin mesylate, 6
doxepin HCL, 20
doxercalciferol, 14
doxorubicin HCL, 3
doxorubicin HCL liposome, 3
doxy 100, 1
doxycycline, 1, 8
doxycycline hyclate, 1
doxycycline hyclate DR, 1
doxycycline monohydrate, 1
dritho-creme HP, 9
dronabinol, 15
droperidol, 19
Droplet Lancets Ultra Thin 30G, 32
dropping bottle 30ML, 35
drospirenone/ethinyl estradiol, 11, 40
Droxia, 18
Drug Mart Lancets Thin, 32
Drug Mart Lancets Ultra Thin, 32
Drug Mart On-the-go Lancets Gentle
30G, 32
Drug Mart Unilet Lancets Super Thin
30G, 32
Drug Mart Unilet Lancets Ultra Thin 28G,
32
Duane Reade Lancet Alternate Site 26G,
32
Duane Reade Lancet Super Thin 30G,
32
Duane Reade Lancet Ultra Thin 28G, 32
Dulera, 28
duloxetine HCL, 20
duramorph, 25
duraxin, 24
Durezol, 23
Dymista, 27
Dyrenium, 7
Dysport, 22
E
E-z Ject Lancets, 32
E-z Ject Lancets 21G, 32
E-z Ject Lancets Color, 32
E-z Ject Lancets Super Thin, 32
E-z Ject Lancets Super Thin 30G, 32
E-z Ject Lancets Thin 26G, 32
E-z Spacer, 36
E-z Spacer The Body Guards Pack, 36
E-ZJECT Lancets Micro-thin 33G, 32
e.e.s. 400, 1
e.s.p., 3
earpopper middle ear inf lation device,
35
Easivent, 36
Easivent/Mask-large, 36
Easivent/Mask-medium, 36
Easivent/Mask-small, 36
Easy Comfort Lancets, 32
Easy Comfort Lancets 30G/Pull Top, 32
Easy Comfort Lancets 30G/Thin Top, 32
Easy Touch Alcohol Prep Pads/Medium,
36
Easy Touch Lancets 21G/Pressure
Activated, 32
Activated, 32
Activated, 32
Easy Touch Lancets 26G/Pull-top, 32
Easy Touch Lancets 26G/Twist, 32
Activated, 32
Easy Touch Lancets 30G/Buttonactivated, 32
Activated, 32
Activated, 32
Easy Touch Safety Lancets21G/Pressure
Activated, 32
Activated, 32
Easy Touch Safety Lancets26G/Button
Activated, 32
Activated, 32
Easy Touch Safety Lancets28G/Button
Activated, 32
Activated, 32
easygel, 19
Easytest II Lancets, 32
Easytest Lancets, 32
EC-81 aspirin, 25, 40
econazole nitrate, 9
econtra EZ, 11, 40
ecotrin low strength, 24, 39
ecpirin, 24, 39
ed cyte f, 17
ed-flex, 24
ed-spaz, 15
Edarbi, 6
Edarbyclor, 7
Edecrin, 7
Edurant, 2
eemt, 11
eemt HS, 11
effer-k, 37
Effer-k, 39
effervescent pot chloride, 37
effervescent potassium, 37
effervescent potassium/chloride, 37
Effient, 19
Egrifta, 14
Elaprase, 14
Elelyso, 18
Elidel, 10
Eligard, 4
elinest, 12, 40
Eliquis, 18
Elite Iron, 18, 43
elite-OB, 30
Elitek, 5
Elixophyllin, 28
Ella, 12
Elmiron, 17
Eloxatin, 3
Elspar, 4
Emadine, 24
Embeda, 26
Embrace Lancets Ultra Thin 30G, 32
Emcyt, 4
Emend, 15
emollient cream, 37
emoquette, 12, 40
empty vial 3ML, 35
Emsam, 20
Emtriva, 2
Enablex, 16
enalapril maleate, 6
enalapril maleate/hydrochlorothiazide, 7
enalaprilat, 6
Enbrel, 26
Enbrel Sureclick, 26
encare, 17, 40
endocet, 25
endodan, 25
Endometrin, 17
enema bottle, 35
Enfamil Expecta, 31
Engerix-b, 28, 42
Enjuvia, 11
enovarx-cyclobenzaprine HCL, 22
enoxaparin sodium, 18
enpresse-28, 12, 40
enskyce, 12, 40
entacapone, 21
entecavir, 2
enteric coated aspirin, 24, 39
enulose, 16
ephedrine sulfate, 7
Epiduo, 8
epinastine HCL, 24
epinephrine, 7
epinephrine HCL, 7, 27
Epipen 2-PAK, 7
Epipen-JR 2-PAK, 7
epirubicin HCL, 3
epitol, 21
Epivir HBV, 2
eplerenone, 6
Epogen, 18
epoprostenol sodium, 8
eprosartan mesylate, 6
Epzicom, 2
eq adult aspirin low strength, 24, 39
eq aspirin, 24, 39
eq aspirin adult low dose, 24, 39
eq aspirin EC, 25, 39
eq aspirin low dose, 24, 39
eq childrens aspirin, 25, 39
eq nicotine, 21, 43
eq nicotine gum refill, 21, 43
eq nicotine gum starter, 21, 43
eq nicotine polacrilex, 21, 43
eq nicotine step 3, 21, 43
eq slow-release iron, 17, 42
eql adult aspirin low strength, 25, 39
eql aspirin, 25, 39
eql aspirin EC, 25, 39
eql aspirin low dose, 25, 39
eql childrens aspirin, 25, 39
eql childrens vitamin d gummies, 29, 44
Eql Color Lancets 21G, 32
Eql Color Lancets Micro Thin 33G, 32
eql folic acid, 17, 41
eql iron supplement therapy, 17, 42
eql nicotine, 21, 43
eql nicotine polacrilex, 21, 43
eql nicotine polacrilex refill, 21, 43
eql nicotine polacrilex starter, 21, 43
eql prenatal formula, 30, 41
eql slow release iron, 17, 42
Eql Super Thin Lancets 30G, 32
Eql Thin Lancets 26G, 32
eql vitamin d-3, 29, 44
eql vitamin d3, 29, 44
Eraxis, 2
Erbitux, 4
ergocalciferol, 29
ergoloid mesylates, 21
Ergomar, 26
Erivedge, 5
errin, 12, 40
Ertaczo, 9
Erwinaze, 4
ery, 8
erythrocin lactobionate, 1
Erythrocin Lactobionate, 1
erythromycin, 1, 8, 22
erythromycin base, 1
erythromycin ethylsuccinate, 1
erythromycin/benzoyl peroxide, 8
escitalopram oxalate, 20
esgic, 24
esmolol HCL, 6
esomeprazole magnesium, 15
esomeprazole sodium, 15
esomeprazole strontium, 15
estarylla, 12, 40
estazolam, 20
esterified estrogens/methltestosterone,
11
esterified estrogens/methyltestosterone,
11
DS, 11
HS, 11
Estrace, 17
estradiol, 11
estradiol valerate, 11
estradiol/norethindrone acetate, 11
Estring, 17
Estrogel, 11
estropipate, 11
eszopiclone, 20
ethambutol HCL, 2
ethosuximide, 21
ethyl chloride, 10
ethyl chloride/fine pinpoint, 10
ethyl chloride/fine stream, 10
ethyl chloride/medium jet stream, 10
ethyl chloride/medium stream, 10
ethyl chloride/mist, 10
etidronate disodium, 13
etodolac, 26
etodolac ER, 26
etomidate, 27
Etopophos, 4
etoposide, 4
Euflexxa, 22
Eurax, 10
Evamist, 11
Exalgo, 26
Exelderm, 9
Exelon, 22
exemestane, 4
Exjade, 39
exoderm, 9
exotic-HC, 24
Extavia, 22
exuderm RCD, 10
Eylea, 24
EZ Smart Blood Glucose Lancets, 32
EZ-lets Lancets 21G, 32
EZ-lets Lancets 26G Super-soft, 32
EZ-lets Lancets 28G Ultra-soft, 32
ezfe 200, 17, 43
F
fa-8, 17, 41
Fa-8, 18, 42
fabb, 17
Fabrazyme, 14
Factive, 2
falmina, 12, 40
famciclovir, 2
famotidine, 15
famotidine premixed, 15
Fanapt, 20
Fanapt Titration Pack, 20
Fareston, 4
Faslodex, 4
Fasttake Compact Monitoring System,
32
Fasttake Test Strips, 32
Fazaclo, 20
Fc Female Condom, 41
Fc2 Female Condom, 41
FE aspartate, 18, 43
FE c plus, 17
FE gluconate, 18, 43
FE TABS, 18, 43
Feiba, 19
Feiba NF, 19
felbamate, 21
felodipine ER, 6
Femcap, 41
Femiron, 18, 43
fenofibrate, 7
fenofibrate micronized, 7
fenofibric acid, 7
fenofibric acid DR, 7
Fenoglide, 7
fenoldopam mesylate, 6
fenoprofen calcium, 26
fentanyl, 25
fentanyl citrate, 25
fentanyl citrate oral transmucosal, 25
Fentora, 26
feosol, 17, 43
Feosol, 18, 43
fer-iron, 17, 43
Feraheme, 18
ferate, 17, 43
ferocon, 17
ferosul, 18, 43
ferotrinsic, 17
ferraplus 90, 17
ferretts, 18, 43
Ferretts Chewable Iron, 18
Ferretts IPS, 18, 43
ferrex 150, 18, 43
ferrex 150 forte plus, 17
ferrex 28, 17
ferric x-150, 18, 43
Ferrimin 150, 18, 43
Ferriprox, 39
ferro-bob, 18, 43
Ferro-sequels, 18, 43
ferrocite, 18, 43
ferrocite plus, 17
ferrogels forte, 17
ferrotabs, 18, 43
ferrous drops, 18, 43
ferrous fumarate, 18, 43
ferrous fumarate 324, 18, 43
ferrous gluconate, 18, 43
ferrous sulfate, 18, 43
ferrousul, 18, 43
ferus, 18, 43
Fibricor, 7
Fifty50 Alcohol Prep Pads, 36
Fifty50 Safety Seal Lancets 30G, 32
Fifty50 Safety Seal Lancets 32G, 32
filter 0.2 micron/25MM, 35
filter 0.2 micron/25MM/double LUER lock,
35
filter 0.22 micron/73MM/1000ML, 35
filter air pp, 35
filter attachment, 35
Finacea, 8
finasteride, 10, 17
Fine 30, 32
Fingerstix Lancets, 32
Firazyr, 19
firmagon, 4
Firmagon, 4
First-lansoprazole, 15
Flagyl ER, 3
Flarex, 23
flavoxate HCL, 16
Flebogamma Dif, 39
flecainide acetate, 6
Flector, 9
flexbumin, 19
Flovent Diskus, 28
Flovent HFA, 28
floxuridine, 4
Fluarix 2012-2013, 28, 42
Fluarix 2013-2014, 28, 42
Fluarix 2014-2015, 28, 42
Fluarix Quadrivalent 2013-2014, 28, 42
Fluarix Quadrivalent 2014-2015, 28, 42
Flublok 2013-2014, 28, 42
Flublok 2014-2015, 28, 42
flucaine, 24
Flucelvax 2012-2013, 28, 42
Flucelvax 2013-2014, 28, 42
Flucelvax 2014-2015, 28, 42
fluconazole, 2
fluconazole IN dextrose, 2
fluconazole IN NACL, 2
flucytosine, 2
fludarabine phosphate, 4
fludrocortisone acetate, 11
Flulaval 2012-2013, 28, 42
Flulaval 2013-2014, 28, 42
Flulaval 2014-2015, 28, 42
Flulaval Quadrivalent 2013-2014, 28, 42
Flulaval Quadrivalent 2014-2015, 28, 42
flumazenil, 37
Flumist Nasal Vaccine 2012-2013, 28, 42
Flumist Quadrivalent, 28, 42
flunisolide, 27
fluocinolone acetonide, 9, 24
fluocinolone acetonide body, 9
fluocinolone acetonide ear drops, 24
fluocinolone acetonide scalp, 9
fluocinonide, 9
fluocinonide emollient base, 9
fluocinonide-e, 9
fluor-a-day, 39, 41
Fluor-a-day, 39, 41
fluor-i-strips a.t., 24
Fluorabon, 39, 41
fluorescein-benoxinate, 24
fluorescein/proparacaine, 24
fluorets, 24
fluoride, 39, 41
fluoridex daily defense, 19
fluoridex daily defense enhanced
whitening, 19
fluoridex daily defense sensitivity relief,
19
fluoritab, 39, 41
fluorometholone, 23
Fluoroplex, 10
fluorouracil, 4, 10
fluoxetine, 21
fluoxetine DR, 20
fluoxetine HCL, 20
fluphenazine decanoate, 20
fluphenazine HCL, 20
flura-drops, 39, 41
Flura-drops, 39, 41
flurazepam HCL, 20
flurbiprofen, 26
flurbiprofen sodium, 24
flurox, 24
flutamide, 4
fluticasone propionate, 9, 27
flutter, 35
fluvastatin, 7
Fluvirin 2012-2013, 28, 42
Fluvirin 2013-2014, 28, 42
Fluvirin 2014-2015, 28, 42
Fluvirin PF 2012-2013, 28, 42
Fluvirin PF 2013-2014, 28, 42
Fluvirin PF 2014-2015, 28, 42
fluvoxamine maleate, 20
fluvoxamine maleate ER, 20
Fluzone High-dose PF 2012-2013, 28,
42
42
42
Fluzone Intradermal, 28, 42
Fluzone Intradermal Quadrivalent, 28, 42
Fluzone Pediatric PF 2012-2013, 28, 42
Fluzone Pediatric PF 2013-2014, 28, 42
Fluzone PF 2012-2013, 28, 42
Fluzone PF 2013-2014, 28, 42
Fluzone PF 2014-2015, 28, 42
Fluzone Quadrivalent 2013-2014, 28, 42
Fluzone Quadrivalent 2014-2015, 28, 42
Fluzone Split 2012-2013, 28, 42
Fluzone Split 2013-2014, 28, 42
Fluzone Split 2014-2015, 28, 42
FML, 23
foam ring 2", 35
Focalin XR, 21
folastin, 37
folbecal, 30
folbee, 17
folbee plus, 30
folbee plus cz, 30
folbic, 37
Folbic RF, 39
folcaps, 17
folic acid, 17, 41
folic acid/vitamin b-6/vitamin b-12, 17
Follistim AQ, 14
Folotyn, 4
folplex 2.2, 17
Foltrate, 18
foltrin, 17
Foltx, 39
fomepizole, 37
fondaparinux sodium, 18
Fora Lancets, 32
Foradil Aerolizer, 28
Forfivo XL, 20
forma-ray, 37
formadon, 37
formaldehyde, 37
Fortaz, 1
Forteo, 13
Fortesta, 11
fortical, 13
Fosamax Plus D, 13
foscarnet sodium, 2
fosinopril sodium, 6
fosinopril sodium/hydrochlorothiazide, 7
fosphenytoin sodium, 21
Fosrenol, 16
Fragmin, 18
freamine iii, 37
Freds Pharmacy Unilet Lancets Super
Thin 30G, 32
Freds Pharmacy Unilet Lancets Ultra Thin
28G, 32
Freestyle Lancets, 32
Freestyle Unistick II Lancets, 32
fresenius propoven, 27
Frova, 26
ful-GLO, 24
furosemide, 7
Fusilev, 5
Fuzeon, 2
Fycompa, 21
G
gabapentin, 21
Gabitril, 21
Gablofen, 22
galantamine, 21
galantamine hydrobromide, 21
Galzin, 39
gamastan s/d, 39
Gamastan S/D, 39
gammagard liquid, 39
Gammagard Liquid, 39
gammagard s/d, 39
Gammagard S/D, 39
Gammagard S/D Iga Less Than
1mcg/ML, 39
Gammaked, 39
Gammaplex, 39
Gamunex-c, 39
ganciclovir, 2
ganirelix acetate, 14
Ganite, 14
garamycin, 22
Gardasil, 28, 42
Gardasil 9, 28, 42
gastrinex NF, 15
gatifloxacin, 22
Gattex, 16
gavilyte-c, 15, 44
gavilyte-G, 15, 44
gavilyte-n/flavor pack, 15, 44
Gazyva, 4
Gelnique, 16
gemcitabine, 4
gemcitabine HCL, 4
gemfibrozil, 7
generlac, 16
gengraf, 4
Genotropin, 14
Genotropin Miniquick, 14
gentak, 22
gentamicin sulfate, 2, 8, 22
gentamicin sulfate pediatric, 2
gentamicin sulfate/0.9% sodium chloride,
2
gentamicin sulfate/sodium chloride, 2
Gentle-let GP Lancets, 32
Gentle-let Lancets General Purpose
Style/Fine Point, 32
Gentle-let Lancets General Purpose
Style/Medium Point, 32
Gentle-let Lancets Safety Style/Fine
Point, 32
Gentle-let Lancets Safety Style/Medium
Point, 32
Geodon, 20
gianvi, 12, 40
Giazo, 16
gildagia, 12, 40
gildess 1.5/30, 12, 40
gildess 1/20, 12, 40
gildess 24 FE, 12, 40
gildess FE 1.5/30, 12, 40
gildess FE 1/20, 12, 40
Gilenya, 22
Gilotrif, 5
giltuss pediatric, 27
giltuss TR, 27
glass bottle 15ML, 35
glass bottle/30ML/blunt end applicator,
35
glass serum bottles/20ML/type 1, 35
glass vial 2ML, 35
Glassia, 28
Gleevec, 5
Gleostine, 3
Gliadel Wafer, 3
glimepiride, 13
glipizide, 13
glipizide ER, 13
glipizide XL, 13
glipizide/metformin HCL, 13
Global Alcohol Prep Ease Pads, 36
Global Inject Ease Lancets 28G, 32
Global Inject Ease Lancets 30G, 32
Glucagen, 13
Glucagen Hypokit, 13
Glucagon Emergency Kit, 13
Glucocom Lancets 28G, 32
Glucopro Syringe
Reservoir/3ML/Needle/22G X 3/8", 32
Glucosource Lancets, 32
Glumetza, 13
glutaraldehyde, 37
glyburide, 13
glyburide micronized, 13
glyburide/metformin HCL, 13
glycine, 17
glycolic acid, 9
glycolic acid 70% high purity, 9
glycopyrrolate, 15
glydo, 10
Glyset, 13
Gmate Lancets 30G, 32
gnp adult aspirin low strength, 25, 39
Gnp Alcohol Swabs, 36
gnp aspirin, 25, 39
gnp aspirin low dose, 25, 39
gnp childrens aspirin, 25, 39
Gnp Daily Prenatal, 31, 42
gnp folic acid, 18, 41
gnp iron, 18, 43
Gnp Lancets, 32
Gnp Lancets 21G, 32
Gnp Lancets Micro Thin 33G, 32
Gnp Lancets Super Thin 30G, 32
Gnp Lancets Thin, 32
Gnp Lancets Thin 26G, 32
Gnp Micro Thin Lancets 33G, 32
gnp nicotine polacrilex, 21, 43
gnp nicotine polacrilex mini, 21, 43
Gnp Prenatal, 31, 42
gnp prenatal vitamins, 30, 41
gnp slow release iron, 18, 43
Gnp Super Thin Lancets/30G, 32
gnp vitamin d, 29, 44
gnp vitamin d maximum strength, 29, 44
gnp vitamin d super strength, 29, 44
gnp vitamin d3 extra strength, 29, 44
Golytely, 15, 44
Gonal-f, 14
Gonal-f RFF, 14
Gonal-f RFF Pen, 14
Gonal-f RFF Rediject, 14
goodsense aspirin low dose, 25, 39
Goodsense Prenatal Vitamins, 31, 42
graduated bottle 2oz w/CAP, 35
graduated bottle 4oz w/CAP, 35
grafco silver nitrate applicator, 10
Gralise, 22
Gralise Starter, 22
granisetron HCL, 15
Granisol, 16
green GLO lissamine greenophthalmic
strips, 24
griseofulvin microsize, 2
griseofulvin ultramicrosize, 2
grx hicort 25, 16
guanfacine ER, 20
guanfacine HCL, 6
guanidine HCL, 22
Gynazole-1, 17
H
H&h Thinlet Lancets 26G, 32
H&h Thinlet Super Thin Lancets 30G, 32
H-e-b Incontrol Lancets Super Thin 30G,
32
H-e-b Incontrol Lancets Ultra Thin 28G,
32
H.p. Acthar, 14
Haemolance, 32
Haemolance Low Flow Lancets, 32
Haemolance Plus, 32
Haemolance Plus High Flow, 32
Haemolance Plus Low Flow, 32
Haemolance Plus Max Flow, 32
Haemolance Plus Pediatric Flow, 33
halac, 9
Halaven, 4
Halflytely Bowel Prep/Flavor Packs, 15
halfprin, 25, 39
Halfprin, 25, 40
halobetasol propionate, 9
Halog, 10
halonate PAC, 9
haloperidol, 20
haloperidol decanoate, 20
haloperidol lactate, 20
Harvoni, 2
Havrix, 29, 42
head covers 24"/bouffon CAP/irradiated,
35
Healthwise Alcohol Prep Pads, 36
Healthwise Lancets 30G, 33
Healthy Accents Unilet Lancets Super
Thin 30G, 33
healthy kids vitamin d3, 29, 44
Healthy Mama Be Well Rounded, 31
heather, 12, 40
hecoria, 4
Hectorol, 14
Helidac, 15
Helixate FS, 19
hematinic plus vitamins/minerals, 17
hematinic/folic acid, 17
hematogen, 17
hematogen fa, 17
hematogen forte, 17
hemocyte-f, 17
hemocyte-plus, 17
hemofil m, 19
Hemofil M, 19
hemril-30, 16
hep flush-10, 18
hepagam b, 39
Hepagam B, 39
heparin lock, 18
heparin lock flush, 18
heparin lock flush for flushing vascular
access devices, 18
heparin lock flush/NACL for flushing
vascular access devices, 18
heparin sodium, 18
heparin sodium dcu, 18
heparin sodium lock flush, 18
heparin sodium/D5W, 18
heparin sodium/NACL 0.45%, 18
heparin sodium/NACL 0.9%, 18
heparin sodium/sodium chloride 0.9%,
18
heparin sodium/sodium chloride 0.9%
premix, 18
hepatamine, 37
hepatasol, 37
Herceptin, 4
hetastarch 6%/NACL, 19
Hetlioz, 20
Hexalen, 3
Hiberix, 29, 42
high potency iron, 18, 43
Hizentra, 39
HM aspirin, 25, 40
HM aspirin EC, 25, 40
HM aspirin EC low dose, 25, 40
HM folic acid, 18, 42
HM iron, 18, 43
HM iron slow release, 18, 43
HM Lancets Micro Thin 33G, 33
HM Lancets Ultra Thin 30G, 33
HM nicotine polacrilex, 22, 43
HM nicotine transdermal system, 22, 43
HM nicotine transdermal system step 3,
22, 43
HM One Daily Prenatal Combo, 31, 42
HM Prenatal, 31, 42
HM vitamin d, 29, 44
HM vitamin d3, 29, 44
HM Vitamin D3, 29, 44
homatropaire, 23
homatropine HBR, 23
Horizant, 22
hsa sterile diluent, 37
Humalog, 13
Humalog Kwikpen, 13
Humalog Mix 50/50, 13
Humalog Mix 50/50 Kwikpen, 13
Humalog Mix 75/25, 13
Humalog Mix 75/25 Kwikpen, 13
human albumin grifols, 19
Humate-p, 19
Humatrope, 14
Humatrope Combo Pack, 14
Humira, 26
Humira Pediatric Crohns Disease Starter
Pack, 26
Humira Pen, 26
Humira Pen-crohns Diseasestarter, 26
Humira Pen-psoriasis Starter, 26
Humulin 70/30, 13
Humulin 70/30 Kwikpen, 13
Humulin 70/30 Pen, 13
Humulin N, 13
Humulin N Kwikpen, 13
Humulin N U-100 Pen, 13
Humulin R, 13
Humulin R U-500 (concentrated), 13
Hy-vee Lancets, 33
Hy-vee Thin Lancets, 33
Hyalgan, 22
Hycamtin, 5
hydralazine HCL, 6
hydrochloric acid, 17
hydrochlorothiazide, 7
hydrocodone bitartrate/acetaminophen,
25
hydrocodone bitartrate/chlorpheniramine
maleate/PSE, 27
hydrocodone bitartrate/homatropine
methylbromide, 27
hydrocodone polistirex/chlorpheniramine
polistirex, 27
hydrocodone/acetaminophen, 25
hydrocodone/homatropine, 27
hydrocodone/ibuprofen, 25
hydrocortisone, 9, 11, 16
hydrocortisone acetate, 16
hydrocortisone acetate/aloe, 9
hydrocortisone acetate/lidocaine HCL, 16
hydrocortisone acetate/pramoxine, 9, 16
hydrocortisone acetate/pramoxine HCL,
16
hydrocortisone butyrate, 9
hydrocortisone butyrate (lipid), 9
hydrocortisone butyrate (lipophilic), 9
hydrocortisone IN absorbase, 9
hydrocortisone valerate, 9
hydrocortisone/acetic acid, 24
hydrocortisone/iodoquinol, 9
hydrogen peroxide, 37
hydrogesic, 25
hydromet, 27
hydromorphone HCL, 25
hydromorphone HCL dosette, 25
hydromorphone HCL ER, 25
hydroquinone, 10
hydroquinone time release, 10
hydroxocobalamin, 17
hydroxychloroquine sulfate, 3
hydroxyurea, 5
hydroxyzine HCL, 19
hydroxyzine pamoate, 19
hygel, 10
hyomax-SL, 15
hyophen, 16
hyoscyamine sulfate, 15
hyoscyamine sulfate ER, 15
hyoscyamine sulfate odt, 15
hyoscyamine sulfate SR, 15
hyosyne, 15
hypercare, 10
Hyperhep B S/D, 39
hyperlyte-CR, 37
Hyperrab S/D, 39
hyperrho s/d, 39
Hyperrho S/D, 39
Hyperrho S/D Mini-dose, 39
I
ibandronate sodium, 13
ibudone, 25
ibuprofen, 26
ibutilide fumarate, 6
Iclusig, 5
idarubicin HCL, 3
iferex 150, 18, 43
iferex 150 forte, 17
Ifex, 3
ifosfamide, 3
ifosfamide/mesna, 5
Ilaris, 26
Ilevro, 24
ilotycin, 22
Imbruvica, 5
imipenem/cilastatin, 3
imipramine HCL, 20
imipramine pamoate, 20
imiquimod, 10
imogam rabies-ht, 37
Imovax Rabies (h.d.c.v.), 28
Implanon, 12, 41
inatal advance, 30
inatal GT, 30
inatal ultra, 30
Increlex, 14
indapamide, 7
Inderal XL, 6
indigo carmine, 37
indocyanine green, 37
indomethacin, 26
indomethacin ER, 26
indomethacin sodium, 26
Infanrix, 28, 42
infed, 17
Infergen, 2
influenza a (h1n1) monovalent 2009, 28,
42
Influenza Vaccine For Safeway
Dependants, 29, 42
Infumorph 200, 26
Infumorph 500, 26
infusion catheter soft/23"/60CM, 31
infuvite, 30
infuvite adult, 30
infuvite pediatric, 30
Inlyta, 5
Innopran XL, 6
Inset 30 Infusion Set 23", 33
Inset 30 Infusion Set 43", 33
Inset Infusion Set 23" 6MM, 33
Inspirachamber/Anti-static
Valved/Mouthpiece, 36
Inspirachamber/Soothermask/Inspiramas
k/Medium, 36
Inspirachamber/Soothermask/Inspiramas
k/Small, 36
Inspirease Bags, 36
Inspirease Drug Delivery System, 36
Inspirease Mouthpiece, 36
Inspirease Reservoir Bags, 36
insulin cartridge 3ML, 31
insulin P.M. IR2020 black, 31
insulin P.M. IR2020 blue, 31
insulin P.M. IR2020 green, 31
insulin P.M. IR2020 red, 31
insulin P.M. IR2020 silver, 31
Integrilin, 19
Intelence, 2
Intermezzo, 20
intralipid, 37
Intron A, 5
Intron-a, 5
Intron-a W/Diluent, 5
introvale, 12, 40
inulin, 37
Invanz, 3
Invega, 20
Invega Sustenna, 20
Invirase, 2
Invokana, 13
Iopidine, 23
Ipol Inactivated IPV, 29, 42
ipratropium bromide, 27(2)
ipratropium bromide/albuterol sulfate, 27
irbesartan, 6
irbesartan/hydrochlorothiazide, 7
irinotecan, 5
iron, 18, 43
iron asp gly/ polysacch compl/ascorb
CAL/b12/fa/c threon/suc, 17
iron chews pediatric, 18, 43
iron slow release, 18, 43
iron supplement, 18, 43
iron supplement childrens, 18, 43
Iron Up, 18, 43
Isentress, 2
isoditrate ER, 5
isoflurane, 27
isolyte-m/dextrose 5%, 37
Isolyte-s, 39
isometheptene
mucate/caffeine/acetaminophen, 26
isometheptene/caffeine/acetaminophen,
26
isometheptene/dichloralphenazone/aceta
minophen, 26
isoniazid, 2
Isopto Carbachol, 23
isosorbide dinitrate, 5
isosorbide dinitrate ER, 5
isosorbide mononitrate, 5
isosorbide mononitrate ER, 5
isosulfan blue, 37
isotonic gentamicin, 2
isoxsuprine HCL, 7
isradipine, 6
istalol, 23
Istodax, 5
itraconazole, 2
ivermectin, 3
Ixempra Kit, 4
Ixiaro, 28
J
Jakafi, 5
jantoven, 18
Janumet, 13
Janumet XR, 13
Januvia, 13
jar/8oz/white lid, 35
jencycla, 12, 40
Jentadueto, 13
Jetrea, 24
Jevtana, 4
jinteli, 11
jolessa, 12, 40
jolivette, 12, 40
junel 1.5/30, 12, 40
junel 1/20, 12, 40
junel FE 1.5/30, 12, 40
junel FE 1/20, 12, 40
just d, 29, 44
Juvisync, 13
Juxtapid, 7
K
k-effervescent, 37
K-phos, 39
k-prime, 37
k-sol, 37
k-vescent, 37
Kadcyla, 4
Kadian, 26
Kalbitor, 19
Kaletra, 2
Kalydeco, 28
Kapvay Dose Pack, 21
karidium, 39, 41
karigel, 19
karigel-n, 19
kariva, 12, 40
KCL 0.075%/D5W/NACL 0.45%, 38
KCL 0.15%/D5W/ NACL 0.3%, 38
KCL 0.15%/D5W/lr, 38
KCL 0.15%/D5W/NACL 0.2%, 38
KCL 0.15%/D5W/NACL 0.225%, 38
KCL 0.15%/D5W/NACL 0.45%, 38
KCL 0.15%/D5W/NACL 0.9%, 38
KCL 0.3%/D5W/lr IV lac ring, 38
KCL 0.3%/D5W/NACL 0.45%, 38
KCL 0.3%/D5W/NACL 0.9%, 38
kedbumin, 19
kelnor 1/35, 12, 40
Kenalog, 10
kendall sodium chloride flush, 37
Kepivance, 5
ketamine HCL, 27
Ketek, 3
ketoconazole, 2, 9
ketodan, 9
ketoprofen, 26
ketoprofen ER, 26
ketorolac 2% gel, 9
ketorolac tromethamine, 24, 26
Kineret, 26
Kinney Lancets, 33
Kinney Thin Lancets, 33
Kinrix, 28, 42
kionex, 37
klor-CON, 37
klor-CON 10, 37
klor-CON 8, 37
klor-CON m10, 37
Klor-CON M15, 39
klor-CON m20, 37
klor-CON/EF, 37
kls aspirin EC, 25, 39
kls aspirin low dose, 25, 39
kls quit2, 21, 43
kls quit4, 21, 43
koate-dvi, 19
Koate-dvi, 19
Kogenate FS, 19
Kogenate FS Bio-set, 19
Kombiglyze XR, 13
kp aspirin, 25, 39
kp ferrous gluconate, 18, 43
kp ferrous sulfate, 18, 43
kp folic acid, 18, 41
Kp Prenatal Multivitamins, 31, 42
kp vitamin d, 29, 44
Kristalose, 15
Kroger Lancets, 33
Kroger Lancets 21G, 33
Kroger Lancets Micro Thin33G, 33
Kroger Lancets Super Thin, 33
Kroger Lancets Thin, 33
Kroger Lancets Thin 26G, 33
Kroger Lancets Ultrathin 30G, 33
Krystexxa, 26
kurvelo, 12, 40
Kuvan, 14
Kynamro, 7
Kyprolis, 5
L
l-cysteine HCL, 37
l-methyl-b6-b12, 37
L-methyl-mc, 39
l-methylfolate, 37
l-methylfolate CA/ME-CBL/NAC, 37
l-methylfolate CA/p-5-P.M.-CBL, 37
l-methylfolate calcium, 37
lab coat/disposable/large, 35
lab coat/disposable/medium, 35
lab coat/disposable/small, 35
lab coat/disposable/x-large, 35
lab coat/disposable/XX-large, 35
labetalol HCL, 6
laclotion, 10
Lacrisert, 23
lactated ringers, 38
lactated ringers dextrose 5% viaflex, 38
lactated ringers irrigation, 38
lactated ringers viaflex, 38
lactic acid, 10
lactic acid e, 10
lactic acid w/vitamin e, 10
lactulose, 15, 16
Lady Lite Lancets, 33
Lamictal, 21
Lamictal Odt, 21
Lamisil, 2
lamivudine, 2
lamivudine/zidovudine, 2
lamotrigine, 21
lamotrigine ER, 21
lamotrigine odt, 21
Lancets Micro Thin 33G, 33
Lancets Super Thin 28G, 33
Lancets Thin, 33
Lancets Ultra Fine, 33
Lancets Ultra Thin, 33
Lancets Ultra Thin 30G, 33
lanolin, 38
lanolin anhydrous, 38
Lanoxin, 5
Lanoxin Pediatric, 5
lansoprazole, 15
lansoprazole/amoxicillin/clarithromycin,
15
Lantus, 12
Lantus Solostar, 12
larin 1.5/30, 12, 40
larin 1/20, 12, 40
larin FE 1.5/30, 12, 40
larin FE 1/20, 12, 40
Lastacaft, 24
latanoprost, 23
latex gloves medium, 35
latrix, 10
latrix XM, 10
Latuda, 20
lavoclen-4 acne wash kit, 8
lavoclen-4 creamy wash, 8
lavoclen-8 acne wash kit, 8
lavoclen-8 creamy wash, 8
Lazanda, 26
Leader Lancets Colored, 33
Leader Super Thin Lancet, 33
Leader Thin Lancets, 33
lecithin, 38
lecithin organogel, 38
leena, 12, 40
leflunomide, 26
lessina, 12, 40
Letairis, 8
letrozole, 4
leucovorin calcium, 5
Leukeran, 3
Leukine, 18
leuprolide acetate, 4
levalbuterol, 27
levalbuterol HCL, 27
Levatol, 6
Levemir, 13
Levemir Flexpen, 13
Levemir Flextouch, 13
levetiracetam, 21
levetiracetam ER, 21
levobunolol HCL, 23
levocarnitine, 14
levocetirizine dihydrochloride, 27
levofloxacin, 1, 22
levofloxacin IN D5W, 1
levomefolate
calcium/acetylcysteine/mecobalamin/algal
powder, 38
levomefolate calcium/algal powder, 38
levomefolate calcium/pyridoxal
phosphate/mecobalamin/algal, 38
levonest, 12, 40
levonorgestrel, 12, 40
levonorgestrel and ethinyl estradiol, 12,
40
levonorgestrel/ethinyl estradiol, 12, 40
levophed, 7
levora 0.15/30-28, 12, 40
levorphanol tartrate, 25
levothroid, 14
levothyroxine sodium, 14
levothyroxine sodium TAB 0.075MG, 14
levoxyl, 14
Lexiva, 2
Lialda, 16
Liberty Blood Glucose Meter, 33
Liberty Glucose Control Mid, 33
Liberty Glucose Control Normal, 33
Liberty Mini Lancing Device, 35
Liberty Test Strips, 33
lidazone HC, 16
lidocaine, 10
lidocaine HCL, 6, 10, 19, 26
lidocaine HCL IN D5W, 6
lidocaine HCL jelly, 10
lidocaine HCL viscous, 19
lidocaine HCL-hydrocortisone acetate
with aloe, 16
lidocaine HCL/dextrose, 6, 26
lidocaine HCL/hydrocortisone acetate, 16
lidocaine viscous, 19
lidocaine/epinephrine, 26
lidocaine/prilocaine, 10
lidopin, 10
Lifescan Unistik 2 Deep Penetration, 33
Lifescan Unistik II Lancets, 33
Lincocin, 3
lindane, 10
linezolid, 3
Linzess, 16
Lioresal Intrathecal, 22
liothyronine sodium, 14
lipobase heavy, 38
lipobase regular, 38
lipodox, 3
lipodox 50, 3
Lipofen, 7
liposyn iii, 38
Liptruzet, 7
lisinopril, 6
lisinopril/hydrochlorothiazide, 7
lissamine green, 24
Lite Touch Lancets, 33
Liteaire, 36
Litetouch Lancets Micro Thin 33G, 33
lithium, 20
lithium carbonate, 20
lithium carbonate ER, 20
Livalo, 7
Live Better Lancet Super Thin 30G, 33
Live Better Lancet Ultra Thin 28G, 33
LMD 10% dextrose 5%, 19
LMD 10% sodium chloride 0.9%, 19
lmthf/pyridoxine HCL/cyanocobalamin,
38
LO Loestrin FE, 12, 41
Locoid, 10
lofene, 15
lokara, 9
lomedia 24 FE, 12, 40
lomustine, 3
Longs Lancets Standard, 33
Longs Lancets Thin, 33
Longs Lancets Ultra Thin, 33
lonox, 15
loperamide HCL, 15
lopreeza, 11
lorazepam, 19
lorcet, 25
lorcet HD, 25
lorcet plus, 25
lortab, 25
loryna, 12, 40
Lorzone, 22
losartan potassium, 6
losartan potassium/hydrochlorothiazide,
7
Lotemax, 23
Lotronex, 16
lovastatin, 7
low-ogestrel, 12, 40
loxapine, 20
loxapine succinate, 20
lozi-flur, 39, 41
Lucentis, 24
ludent, 39, 41
Lufyllin, 28
Lumigan, 23
Lumizyme, 14
Lupron Depot, 4
Lupron Depot-PED, 14
lutera, 12, 40
Lyrica, 21
lysiplex plus, 30
Lysodren, 4
lyza, 12, 40
M
M-m-r II W/Diluent 10 Dose, 29, 42
m-vit, 30, 41
M.v.i. Adult, 30
M.v.i. Pediatric, 30
M.v.i.-12 Without Vitamin K, 31
macnatal CN DHA, 30
Macugen, 24
mafenide acetate, 10
Magnebind 400, 39
magnesium chloride, 38
magnesium sulfate, 38
magnesium sulfate IN D5W, 38
Makena, 12
malathion, 10
mannitol, 7
maprotiline HCL, 20
margesic, 24
marlissa, 12, 40
Marplan, 20
Marqibo, 4
marten-TAB, 24
Mask Vortex/Baby Whirl Duckling, 36
Mask Vortex/Child/Frog, 36
Mask Vortex/Spinner The Duck, 36
Mask Vortex/Toddler/Lady Bug, 36
Matulane, 5
matzim LA, 6
Maxair Autohaler, 28
maximum d3, 29, 44
Maxipime, 1
MD-gastroview, 39
meclizine HCL, 15
meclofenamate sodium, 26
Medi-lance Lancets, 33
Medi-seltzer, 25, 40
Medical Provider EZ Flu Shot 2013-2014,
29, 42
Medical Provider EZ Flu Shot 2014-2015,
29, 42
Medical Provider EZ Flu Shot PF 20122013, 29, 42
Medichoice Pre-set Safety Lancet Dual
Use, 33
Medichoice Pre-set Safety Lancet Low
Flow, 33
Medichoice Pre-set Safety Lancet
Medium Flow, 33
Medichoice Pre-set Safety Lancet
Moderate Flow, 33
Medichoice Safety Lancet Extra, 33
Medichoice Safety Lancet Normal, 33
Medicine Shoppe Lancets, 33
Medicine Shoppe Lancets Thin, 33
Medisense Thin Lancets, 33
Medlance Plus Extra Lancets 21G, 33
Medlance Plus Lancets, 33
Medlance Plus Lancets Lite 25G, 33
Medlance Plus Lite Lancets 25G, 33
Medlance Plus Special Lancets 0.8MM,
33
Medlance Plus Superlite 30G, 33
Medlance Plus Superlite 30G/Comfort
Max, 33
Medlance Plus Universal Lancets 21G,
33
Medlance Plus/Lite 25G, 33
Medlance/Extra, 33
Medlance/Lite, 33
Medlance/Universal, 33
medroxyprogesterone acetate, 12(2), 40
mefenamic acid, 26
mefloquine HCL, 3
Mefoxin, 1
mega-c/a plus, 29
Megestrol, 4
megestrol acetate, 4
Meijer Alcohol Swabs Extra-thick, 36
meijer aspirin EC, 25, 39
Meijer Color Lancets Universal 33G, 33
meijer ferrous sulfate, 18, 43
Meijer Lancets, 33
Meijer Lancets Thin, 33
Meijer Lancets Universal 33G, 33
Meijer Super Thin Lancets, 33
Mekinist, 5
meloxicam, 26
melpaque HP, 10
melphalan hydrochloride, 3
melquin 3, 10
melquin HP, 10
Menactra, 29, 42
Menest, 11
Menhibrix, 29
Menomune-a/C/Y/W-135, 29, 42
Menopur, 14
Mentax, 9
Menveo, 29, 42
meperidine HCL, 25
meperidine HCL/promethazine HCL, 25
meperitab, 25
Mephyton, 29
mepivacaine HCL, 26
meprobamate, 19
mercaptopurine, 4
meropenem, 3
mesalamine, 16
mesna, 5
Mesnex, 5
Mestinon, 22
Mestinon Timespan, 22
metadate ER, 20
Metafolbic, 39
metaproterenol sulfate, 27
Metastron, 5
metaxalone, 22
metered nasal spray P.M. 15ML/safety
clip, 35
metformin HCL, 13
metformin HCL ER, 13
methadone HCL, 25
methadone HCL intensol, 25
methadose, 25
methadose sugar-free, 25
methamphetamine HCL, 20
methazolamide, 7
methenamine hippurate, 16
methenamine mandelate, 16
methimazole, 14
Methitest, 11
methocarbamol, 22
methotrexate, 4
methotrexate sodium, 4
methoxsalen, 9
methscopolamine bromide, 15
methyclothiazide, 7
methyldopa, 6
methyldopa/hydrochlorothiazide, 7
methyldopate HCL, 6
methylene blue, 38
methylergonovine maleate, 24
methylfol-algae-b12-acetylcyst, 38
methylphenidate HCL, 20
methylphenidate HCL CD, 20
methylphenidate HCL ER, 20
methylphenidate HCL SR, 21
methylphenidate hydrochloride, 20
methylprednisolone, 11
methylprednisolone acetate, 11
methylprednisolone dose pack, 11
methylprednisolone sodiumsuccinate, 11
metipranolol, 23
metoclopramide HCL, 16
metolazone, 7
metoprolol succinate ER, 6
metoprolol tartrate, 6
metoprolol/hydrochlorothiazide, 7
metronidazole, 3, 8
Metronidazole, 8
metronidazole IN NACL 0.79%, 3
metronidazole vaginal, 17
mexiletine HCL, 6
mi-omega NF, 17
Miacalcin, 13
miconazole 3, 17
Micrhogam Ultra-filtered Plus, 39
Microchamber, 36
microgestin 1.5/30, 12, 40
microgestin 1/20, 12, 40
microgestin FE, 12, 40
microgestin FE 1.5/30, 12, 40
Microlet Lancets, 33
micronized colestipol HCL, 7
Microspacer, 36
Microtainer Safety Flow
Lancet/Sterile/Single-use, 33
midazolam HCL, 20
midodrine HCL, 7
migragesic ida, 26
migralam, 26
Millipred, 11
Millipred DP, 11
milrinone IN dextrose, 5
milrinone lactate, 5
mimvey, 11
mimvey LO, 11
Minastrin 24 FE, 12, 41
mineral oil heavy, 15
miniprin low dose, 25, 39
minitran, 5
Minivelle, 11
minocin, 1
minocycline HCL, 1
minocycline HCL ER, 1
minoxidil, 6
Mirapex ER, 21
Mirena, 12, 41
mirtazapine, 20
mirtazapine odt, 20
misoprostol, 15
Mission Prenatal, 31, 42
mission prenatal HP, 30, 41
mitomycin, 3
mitoxantrone HCL, 3
MM aspirin, 25, 40
modafinil, 21
moderiba, 2
Moderiba, 2
Moderiba 1200 Dose Pack, 3
Moderiba 800 Dose Pack, 3
moexipril HCL, 6
moexipril/hydrochlorothiazide, 7
mometasone furoate, 9
mono-linyah, 12, 40
Monoclate-p, 19
monoject pharma grade flush syringe, 38
monoject pharma grade flush
syringe/heparin lock, 18
monoject prefill advanced heparin lock
flush, 18
monoject sodium chloride flush, 38
Monolet Lancets, 33
Monolet Opd Lancets, 33
Monolettor Safety Lancets, 33
mononessa, 12, 40
Mononine, 19
Monovisc, 22
montelukast sodium, 27
Monurol, 16
morgidox 1X100MG, 1
morgidox 2X100MG, 1
morphine sulfate, 25
morphine sulfate add-vantage, 25
morphine sulfate ER, 25
morrhuate sodium, 38
Motofen, 15
Moviprep, 15
Moxatag, 1
Moxeza, 23
moxifloxacin HCL, 1
Mozobil, 18
mult-vitamin/fluoride, 30
Multaq, 6
multi prenatal, 30, 41
multi vitamin/fluoride, 30
multi-vit/fluoride, 30
multi-vit/iron/fluoride, 30
multi-vitamin/fluoride, 30
multi-vitamin/fluoride/iron, 30
multigen, 17
multigen folic, 17
multigen plus, 17
multitrace-4, 38
multitrace-4 concentrate, 38
multitrace-4 neonatal, 38
multitrace-5, 38
multitrace-5 concentrate, 38
multivitamin with fluoride, 30
multivitamin/fluoride, 30
multivitamins/fluoride, 30
mupirocin, 8
mupirocin calcium, 8
Muse, 8
Mustargen, 3
MV FE asparto gly/FE fum/succ acid/vit
c/threonic acd/b12/fa, 17
MV FE asparto gly/vit c/vit b12/CA
threonate/succ acd/stomac, 17
MVC-fluoride, 30
my way, 12, 40
Myalept, 14
Mycamine, 2
mycophenolate mofetil, 4
mycophenolic acid DR, 4
mydral, 23
myferon 150, 18, 43
myferon 150 forte, 17
Myglucohealth Mgh Softlance Lancets
30G, 33
Mykidz Iron 10, 18, 43
Myleran, 3
mynatal advance, 30
mynatal plus, 30
mynatal ultracaplet, 30
mynatal-z, 30
mynate 90 plus, 30
mynephrocaps, 30
Myobloc, 22
myorisan, 8
myoxin, 24
Myozyme, 14
Myrbetriq, 16
myzilra, 12, 40
N
n-acetyl-l-cysteine, 38
nabi-HB, 39
nabumetone, 26
nadolol, 6
nadolol/bendroflumethiazide, 7
nafcillin sodium, 1
nafrinse, 39, 41
nafrinse drops, 39, 41
Naftin, 9
Naglazyme, 14
nalbuphine HCL, 25
Nalfon, 26
naloxone HCL, 38
naltrexone HCL, 38
Namenda, 22
Namenda Titration PAK, 22
Namenda XR, 22
Namenda XR Titration Pack, 22
naphazoline HCL, 23
Naprelan, 26
naproxen, 26
naproxen DR, 26
naproxen sodium, 26
naratriptan HCL, 26
Nascobal, 18
Nasonex, 27
nat-rul prenatal vitamins, 30, 41
nat-rul vitamin d, 29, 44
Natacyn, 23
Natazia, 12, 41
nateglinide, 13
Natroba, 10
nature-throid, 14
nebulizer, 35
nebulizer air tube/plugs, 35
nebulizer compressor model 2655d, 35
nebulizer compressor/dualfilter/7'
tubing/aerosol t/mthpiece, 35
nebulizer kit/tubing/mouthpiece, 35
nebulizer pediatric mask, 35
nebulizer updraft-style, 35
nebulizer/adult mask, 35
nebulizer/pediatric mask, 35
Nebupent, 3
nebusal, 27
necon 0.5/35-28, 12, 40
necon 1/35, 12, 40
necon 1/50-28, 12, 40
necon 10/11-28, 12, 40
necon 7/7/7, 12, 40
Neevo DHA, 31
nefazodone HCL, 20
neo-polycin, 22
neo-polycin HC, 23
neofrin, 23
neomycin sulfate, 2
neomycin/bacitracin/polymyxin, 22
neomycin/polymyxin b sulfates, 17
neomycin/polymyxin/bacitracin zinc, 22
neomycin/polymyxin/bacitracin/hydrocorti
sone, 23
neomycin/polymyxin/dexamethasone, 23
neomycin/polymyxin/gramicidin, 22
neomycin/polymyxin/HC, 24
neomycin/polymyxin/hydrocortisone, 23,
24
neostigmine methylsulfate, 22
nephronex, 30
Nessi Spacer/Large Mask, 36
Nessi Spacer/Mouthpiece, 36
Nessi Spacer/Small/MED Mask, 36
Netgroup Lancets, 33
neuac, 8
Neulasta, 18
Neulasta Delivery Kit, 18
Neumega, 18
Neupogen, 18
Neupro, 21
neurodep, 30
neutragard advanced, 19
neutral sodium fluoride, 19
Nevanac, 24
nevirapine, 2
nevirapine ER, 2
Nexavar, 5
Nexium, 15
Nexplanon, 12, 41
next choice one dose, 12, 40
Nexterone, 6
niacin ER, 7
niacinamide/azelaic ac/ turmer/fa/b6/zinc
ox/copper, 30
niacor, 7
Nicadan, 31
nicardipine HCL, 6
Nicazel, 31
Nicazel Forte, 31
nicorelief, 21, 43
nicotine, 21, 43
nicotine polacrilex, 21, 43
nicotine polacrilex refill, 21, 43
nicotine polacrilex starter kit, 21, 43
nicotine step 1, 21, 43
nicotine transdermal system, 21, 43
Nicotrol Inhaler, 22, 43
Nicotrol Ns, 22, 43
nifediac CC, 6
nifedical XL, 6
nifedipine, 6
nifedipine ER, 6
nikki, 12, 40
Nilandron, 4
nimodipine, 6
Nipent, 5
nisoldipine, 6
nisoldipine ER, 6
nitrile gloves/size 10, 35
nitrile gloves/size 6.5, 36
nitrile gloves/size 9.5 medium, 36
Nitro-bid, 5
Nitro-dur, 5
nitro-time, 5
nitrofurantoin, 16
nitrofurantoin macrocrystals, 16
nitrofurantoin monohydrate, 16
nitrofurantoin
monohydrate/macrocrystals, 16
nitroglycerin, 5
nitroglycerin ER, 5
nitroglycerin IN 5% dextrose, 5
nitroglycerin IN dextrose 5%, 5
nitroglycerin lingual, 5
nitroglycerin transdermal, 5
Nitromist, 5
Nitrostat, 5
nizatidine, 15
nodolor, 26
nora-be, 12, 40
Norditropin Cartridge, 14
Norditropin Flexpro, 14
Norditropin Nordiflex Pen, 14
norepinephrine bitartrate, 7
norethindrone, 12, 40
norethindrone acetate, 12
norethindrone acetate/ethinyl estradiol,
12, 40
norethindrone acetate/ethinyl
estradiol/ferrous fumarate, 12, 41
norgestimate/ethinyl estradiol, 12, 41
norlyroc, 12, 41
normal saline flush, 38
normal saline flush for flushing vascular
access devices, 38
normal saline i.v. flush, 38
normosol -r, 38
normosol-m IN D5W, 38
normosol-r IN D5W, 38
Noroxin, 2
Norpace CR, 6
nortrel 0.5/35 (28), 12, 41
nortrel 1/35, 12, 41
nortrel 7/7/7, 12, 41
nortriptyline HCL, 20
nortuss-DE, 27
nortuss-EX, 27
Norvir, 2
norwich aspirin, 25, 39
Nova Safety Lancets 23G, 33
Nova Safety Lancets 28G, 33
Nova Sureflex Lancets, 33
Novaferrum Pediatric Drops, 18, 43
novarel, 14
Novofine 30GX8MM, 33
Novofine 32GX6MM, 33
Novofine Autocover 30GX8MM, 33
Novolin 70/30, 13
Novolin 70/30 Relion, 13
Novolin N, 13
Novolin N Relion, 13
Novolin R, 13
Novolin R Relion, 13
Novolog, 13
Novolog Flexpen, 13
Novolog Mix 70/30, 13
Novolog Mix 70/30 Prefilled Flexpen, 13
Novolog Penfill, 12
Novoseven, 19
Novoseven Rt, 19
Novotwist 30GX8MM, 33
Novotwist 32GX5MM, 33
Noxafil, 2
NP thyroid, 15
NP thyroid 30, 15
NP thyroid 60, 15
NP thyroid 90, 15
Nplate, 18
nu-iron 150, 18, 43
Nucynta, 26
Nucynta ER, 26
Nuedexta, 22
nufol, 17
nulev, 15
Nulojix, 4
numoisyn, 19
nuquin HP, 10
nutricap, 30
nutrifac ZX, 30
nutrilipid, 38
nutrilyte, 38
nutrilyte II, 38
Nutropin, 14
Nutropin AQ Nuspin 10, 14
Nutropin AQ Pen, 14
Nuvaring, 12, 41
Nuvigil, 21
nyamyc, 9
nystatin, 2, 9, 19
nystatin/triamcinolone, 9
nystop, 9
O
OB-natal one, 30
obstetrix EC, 30
ocella, 12, 41
Octagam, 39
octreotide acetate, 14
ocucoat viscoadherent, 24
Ocudox, 1
ofloxacin, 1, 22, 24
ogestrel, 12, 41
ointment tube ophthalmic tip 1/8oz/metal,
36
ointment tube/metal/1oz, 36
ointment tube/plastic/1oz, 36
olanzapine, 20
olanzapine odt, 20
olanzapine/fluoxetine, 21
olopatadine HCL, 27
Olysio, 3
Omeclamox-PAK, 15
omega-3-acid ethyl esters, 7
omeprazole, 15
omeprazole/sodium bicarbonate, 15
Omnaris, 27
Omniflex Diaphragm, 41
Omnitrope, 14
On Call Lancets, 33
On Call Plus Lancets, 33
Oncaspar, 4
ondansetron HCL, 15
ondansetron odt, 15
One A Day Womens Prenatal/DHA, 31
One-a-day Womens Prenatal, 31, 42
Onetouch Basic System, 33
Onetouch Basic/Profile Test Strips, 33
Onetouch Club Lancets Fine Point, 33
Onetouch Combo Pack, 33
Onetouch Delica Lancets Extra Fine 33G,
33
Onetouch Delica Lancets Fine 30G, 33
Onetouch Delica Lancing Device, 35
Onetouch Finepoint Lancets, 33
Onetouch Lancets, 33
Onetouch Ping Insulin P.M., 33
Onetouch Ping Meter Remote, 33
Onetouch Profile System, 33
Onetouch Suresoft Lancing Device/18G,
35
35
35
Onetouch Ultra 2, 33
Onetouch Ultra Blue, 33
Onetouch Ultra Control, 33
Onetouch Ultra Mini, 33
Onetouch Ultra System Kit, 33
Onetouch Ultra Test Strips, 33
Onetouch Ultralink System (DEC), 33
Onetouch Ultralink System (hex), 33
Onetouch Ultrasmart, 33
Onetouch Ultrasoft Lancets, 33
Onetouch Verio, 33
Onetouch Verio Control Solution High,
33
Onetouch Verio IQ Blood Glucose
Monitoring System, 33
Onetouch Verio Mid Control Solution, 33
Onetouch Verio Sync Bloodglucose
Onetouch Verio Test Strips, 33
Onfi, 21
Onglyza, 13
Opana ER (crush Resistant), 26
opium, 15
opium tincture, 15
opium tincture (paregoric), 15
Opsumit, 8
Optichamber Advantage, 36
Optichamber Advantage/Large Mask, 36
Optichamber Advantage/Medium Face
Mask, 36
Optichamber Advantage/Small Face
Mask, 36
Optichamber Diamond, 36
Optichamber Diamond/Largeface Mask,
36
Optichamber Diamond/Medium Face
Mask, 36
Optichamber Diamond/Smallface Mask,
36
Optichamber Face Mask/Large, 36
Optichamber Face Mask/Medium, 36
Optichamber Face Mask/Small, 36
Optihaler, 36
Optihaler MDI Drug Delivery System, 36
optimal-d, 29, 44
optimal-d pack, 29, 44
Options Conceptrol Vaginal
Contraceptive, 17, 41
Options Gynol II Vaginal Contraceptive,
17, 41
opurity vitamin d, 29, 44
Oracea, 8
Oracit, 17
oral suspend, 38
oral syrup flavored vehicle, 38
oral syrup SF, 38
oralone, 19
Orap, 22
Orapred Odt, 11
Oravig, 19
Orencia, 26
Orfadin, 14
orphenadrine citrate, 22
orphenadrine citrate ER, 22
orphenadrine/asa/caffeine, 22
orsythia, 12, 41
Ortho Diaphragm All-flex/65MM, 41
Ortho Diaphragm Coil Spring Kit 100, 41
Ortho Diaphragm Flat Spring Kit 55, 41
ortho-CS 250, 29
ortho-est, 11
Orthovisc, 22
oscimin, 15
oscimin SR, 15
oscion cleanser, 8
osmitrol viaflex, 7
Osmoprep, 15
otic care, 24
oticin, 24
oto-end 10, 24
otomax-HC, 24
otozin, 24
Ovace Plus, 9
Ovidrel, 14
oxacillin sodium, 1
oxaliplatin, 3
oxandrolone, 11
oxaprozin, 26
oxazepam, 19
oxcarbazepine, 21
Oxecta, 26
Oxistat, 9
Oxsoralen, 10
oxybutynin chloride, 16
oxybutynin chloride ER, 16
oxycodone HCL, 25
oxycodone HCL ER, 25
oxycodone/acetaminophen, 25
oxycodone/aspirin, 25
oxycodone/ibuprofen, 25
Oxycontin, 26
oxymorphone hydrochloride, 25
oxymorphone hydrochloride ER, 25
oxytocin, 24
Oxytrol, 16
Oxytrol For Women, 16
Ozurdex, 23
P
PA Prenatal Formula, 31, 42
PA vitamin d-3, 29, 44
PA vitamin d-3 gummy, 29, 44
pacerone, 6
paclitaxel, 4
pamidronate disodium, 13
pancrelipase, 16
pancuronium bromide, 22
Panda Mask Large, 36
Panda Mask Medium, 36
Panda Mask Small, 36
Panretin, 10
pantoprazole sodium, 15
papaverine HCL, 8
Paragard Intrauterine Copper
Contraceptive T380a, 12
parcaine, 23
paricalcitol, 14
paroex, 19
paromomycin sulfate, 2
paroxetine HCL, 20
paroxetine HCL ER, 20
Paser, 2
Pataday, 24
Patanol, 24
Paxil, 20
PCE, 1
pedi-dri, 9
Pediaderm HC, 10
Pediaderm Ta, 10
Pediarix, 28, 42
pediatric aerosol mask, 36
Pediatric Panda Mask, 36
Pedipirox-4 Nail, 9
Pedvax HIB, 29, 42
peg 3350/electrolytes, 15, 44
peg-3350/electrolytes, 15, 44
peg-3350/NACL/NA bicarbonate/KCL,
15, 44
Peg-intron, 3
Peg-intron Redipen, 3
Peg-intron Redipen PAK 4, 3
Peganone, 21
Pegasys, 3
Pegasys Proclick, 3
Pegintron, 3
pegylax, 15
pelvic muscle trainer, 36
penicillin G potassium, 1
penicillin G potassium IN iso-osmotic
dextrose, 1
penicillin G procaine, 1
penicillin G sodium, 1
penicillin v potassium, 1
Pennsaid, 9
Pentacel, 28, 42
Pentasa, 16
pentazocine/acetaminophen, 25
pentazocine/naloxone HCL, 25
pentetate calcium trisodium, 38
pentetate zinc trisodium, 38
pentoxifylline ER, 19
Perfect Iron, 18, 43
Perfect Lancets 30G, 33
Perfect Pressure Activated Safety
Lancets 28G, 33
Perforomist, 28
perindopril erbumine, 6
periogard, 19
Perjeta, 4
permethrin, 10
perphenazine, 20
perphenazine/amitriptyline, 21
perry prenatal, 30, 41
Pertzye, 16
petrolatum white, 38
petrolatum yellow, 38
pfizerpen-G, 1
pharbedryl, 27
Pharmacist Choice Alcoholprep Pads, 36
Pharmacist Choice Ultra Thin Lancets,
33
Pharmacist Choice Ultra Thin Lancets
28G, 33
30G, 33
31G, 33
33G, 33
Pharmacy Counter Lancets, 33
phenadoz, 27
phenazo, 17
phenazopyridine HCL, 17
phendimetrazine tartrate, 21
phendimetrazine tartrate ER, 21
phenelzine sulfate, 20
phenergan, 27
phenobarbital, 20
phenobarbital sodium, 20
phentermine HCL, 21
phentolamine mesylate, 6
phenylephrine HCL, 7, 23
phenylephrine/guaifenesin, 27
phenytoin, 21
phenytoin infatabs, 21
phenytoin sodium, 21
phenytoin sodium extended, 21
philith, 12, 41
Phisohex, 39
phos-flur, 19
Phoslyra, 16
phospha 250 neutral, 38
phosphasal, 16
Phospholine Iodide, 23
Photofrin, 5
Physicians EZ Use Flu Kit 2012-2013,
29, 42
physiolyte, 38
physiosol irrigation, 38
physostigmine salicylate, 38
phytonadione, 29
Picato, 11
pillow mask/adult, 36
pillow mask/child, 36
pillow mask/pediatric, 36
pilocarpine HCL, 19, 23
pilocarpine hydrochloride, 19
Pilopine HS, 23
pimtrea, 12, 41
pindolol, 6
pioglitazone HCL, 13
pioglitazone HCL-glimepiride, 13
pioglitazone HCL/metformin HCL, 13
piperacillin sodium/ tazobactam sodium,
1
piperacillin sodium/tazobactam sodium, 1
piperacillin/tazobactam, 1
pirmella 1/35, 12, 41
pirmella 7/7/7, 12, 41
piroxicam, 26
plasbumin-25, 19
plasbumin-5, 19
Plasma-lyte A, 39
Plasma-lyte-148, 39
plastic bottles/30ML/twist top sifter CAPS,
36
plastic bottles/90ML/twist top sifter CAPS,
36
plastic enema bottle/2oz/20/410 opening,
36
plastic jar 6oz, 36
plastic scoop 1ML/4" handle, 36
plo gel - mediflo pre-mixed, 38
plo20 base, 38
Pneumovax 23, 29, 42
pneumovax 23/1 dose, 28, 42
Pneumovax 23/1 Dose, 29, 42
pneumovax 23/5 dose, 28, 42
Pneumovax 23/5 Dose, 29, 42
PNV-DHA, 30
PNV-select, 30
pocket chamber, 36
pocket spacer, 36
podocon 25 IN benzoin tincture, 10
podofilox, 10
polocaine, 26
polocaine-mpf, 26
poly-dex, 23
poly-iron 150, 18, 43
poly-iron 150 forte, 17
polycin, 22
polycin b, 22
polyethylene glycol 3350, 15
polyethylene glycol 8000 base e, 38
polymyxin b sulfate, 3
polymyxin b sulfate/trimethoprim sulfate,
23
polypropylene CAP/liner, 36
polysaccharide iron forte, 17
Pomalyst, 4
portia-28, 12, 41
Potaba, 29
potassium acetate, 38
potassium bicarbonate, 38
potassium chloride, 38
potassium chloride 0.15% /NACL 0.45%
viaflex, 38
potassium chloride 0.15% D5W/NACL
0.33%, 38
0.45%, 38
0.45% viaflex, 38
potassium chloride 0.15% NACL 0.9%,
38
potassium chloride 0.15% w/NACL 0.9%
viaflex, 38
potassium chloride 0.15%/D5W, 38
potassium chloride 0.15%/NACL 0.9%,
38
0.45%, 38
potassium chloride 0.224%/D5W/NACL
0.45%, 38
potassium chloride 0.224%D5W/NACL
0.45% viaflex, 38
potassium chloride 0.3%/ NACL 0.9%,
38
potassium chloride 0.3%/D5W, 38
potassium chloride 0.3%/NACL
0.9%/viaflex, 38
potassium chloride CR, 38
potassium chloride ER, 38
potassium chloride SR, 38
potassium citrate ER, 17
potassium citrate-citric acid crystals, 17
potassium citrate/citric acid, 17
potassium citrate/sodium citrate/citric
acid, 17
potassium phosphate, 38
potassium phosphates, 38
Potiga, 21
pr benzoyl peroxide wash, 8
pr natal 400, 30
pr natal 400 EC, 30
pr natal 430, 30
pr natal 430 EC, 30
Pradaxa, 18
pralidoxime chloride, 38
pramcort, 16
pramipexole dihydrochloride, 21
pramipexole dihydrochloride ER, 21
Pramosone, 9
Pramosone E, 9
pramox gel, 10
pramoxine-HC, 24
Prandimet, 13
prascion, 8
prascion fc, 8
prascion ra with sunscreens, 8
pravastatin sodium, 7
prazosin HCL, 6
pre-natal formula, 30, 41
Precision Thin Lancets, 33
Precision Thins GP Lancet, 33
Precision Ultra Lancet, 33
Pred Mild, 23
prednicarbate, 9
prednisolone, 11
prednisolone acetate, 23
prednisolone sodium phosphate, 11, 23
prednisolone sodium phosphate odt, 11
prednisone, 11
Prednisone Intensol, 11
Prefera OB, 31
Prefera OB + DHA, 31
Preferaob One, 31
Preferred Plus Lancets Colored 21G, 33
Preferred Plus Lancets Super Thin 30G,
33
Preferred Plus Lancets Thin 26G, 33
pregnyl w/diluent benzyl alcohol/NACL,
14
Premarin, 11
premasol, 38
Premphase, 11
Prempro, 11
prenaissance plus, 30
prenaplus, 30, 41
prenatabs fa, 30
prenatabs RX, 30
prenatal, 30, 41
Prenatal, 31, 42
prenatal 19, 30
prenatal ad, 30
prenatal and iron, 30, 41
Prenatal Complete, 31, 42
prenatal formula, 30, 41
Prenatal Formula, 31
prenatal forte, 30, 41
prenatal low iron, 30, 41
Prenatal Multi +dha, 31, 42
Prenatal Multivitamin + DHA, 31
Prenatal One Daily, 31, 42
Prenatal Plus DHA, 31
prenatal vitamins, 30, 41
prenatal-u, 30
Prenatal/Omega-3/Folic Acid/Iron, 31
Prentif Cavity-rim Cervical CAP, 41
Prentif Fitting Set, 41
Prepopik, 15
Prevacid Solutab, 15
prevalite, 7
previfem, 12, 41
Prevnar 13, 29, 42
Prezista, 2
Prialt, 25
Priftin, 2
Prilosec, 15
primaquine phosphate, 3
primidone, 21
Primsol, 3
Pristiq, 20
Privigen, 39
Proair HFA, 28
probenecid, 26
probenecid/colchicine, 26
procainamide HCL, 6
procentra, 21
prochlorperazine, 20
prochlorperazine edisylate, 20
prochlorperazine maleate, 20
Procrit, 18
procto-PAK, 16
proctocream HC, 16
Proctofoam HC, 16
proctosol HC, 16
proctozone-HC, 16
Procysbi, 17
Prodigy Autocode Blood Glucose
Prodigy Autocode Blood Glucose
Monitoring/Talking, 33
Prodigy Autocode Pro Blood Glucose
Prodigy NO Coding Blood Glucose Test
Strips, 33
Prodigy Pocket Blood Glucose Meter Kit,
33
Prodigy Pocket Pro Blood Glucose
Prodigy Pressure Activated Safety
Lancets, 33
Prodigy Twist Top Lancets, 33
Prodigy Voice Blood Glucose Meter Kit,
33
Prodigy Voicepro Blood Glucose
Profe, 18, 43
Proferrin ES, 18, 43
Profilnine SD, 19
progesterone, 12
progesterone 10% kit, 12
Proglycem, 13
Prograf, 4
Prolastin-c, 28
Prolensa, 24
Proleukin, 5
Prolia, 13
promacet, 24
Promacta, 18
promethazine HCL, 27
promethazine HCL plain, 27
promethazine VC, 27
promethazine VC plain, 27
promethazine VC/codeine, 27
promethazine-DM, 27
promethazine/codeine, 27
promethazine/dextromethorphan, 27
promethegan, 27
pronutrients vitamin d3, 29, 44
propafenone HCL, 6
propafenone HCL ER, 6
propantheline bromide, 15
proparacaine HCL, 23
propofol, 27
propranolol HCL, 6
propranolol HCL ER, 6
propranolol/hydrochlorothiazide, 7
propylene glycol, 38
propylthiouracil, 14
Proquad, 29, 42
Prostigmin, 22
protamine sulfate, 19
protriptyline HCL, 20
Provenge, 5
Proventil HFA, 28
prudoxin, 9
prutect, 10
Pss Select GP Lancets, 34
Pss Select Safety Lancets, 34
Pulmicort, 28
Pulmicort Flexhaler, 28
pulmosal, 27
Pulmozyme, 28
purevit dualfe plus, 17
purified water, 38
px aspirin, 25, 39
px enteric aspirin, 25, 39
px folic acid, 18, 41
px iron, 18, 43
Px Lancets, 34
Px Lancets Ultra Thin, 34
px prenatal multivitamins, 30, 42
px stop smoking aid, 21, 43
Pylera, 15
pyrazinamide, 2
pyridostigmine bromide, 22
pyridoxine HCL, 29
pyrogallic acid, 10
Q
Qc Alcohol Swabs, 36
qc aspirin, 25, 39
qc aspirin low dose, 25, 39
qc childrens aspirin, 25, 39
qc ferrous sulfate, 18, 43
Qc Lancets Super Thin, 34
Qc Lancets Ultra Thin, 34
qc nicotine polacrilex, 21, 43
Qc Prenatal, 31, 42
Qnasl, 27
Qnasl Childrens, 27
Quadramet, 5
qualaquin, 3
quasense, 12, 41
quazepam, 20
quetiapine fumarate, 20
quflora pediatric, 30
Quillivant XR, 21
quinapril HCL, 6
quinapril/hydrochlorothiazide, 7
quinidine gluconate, 6
quinidine gluconate CR, 6
quinidine gluconate ER, 6
quinidine sulfate, 6
quinidine sulfate ER, 6
quinine sulfate, 3
Qvar, 28
R
Ra Alcohol Swabs, 36
ra aspirin, 25, 39
ra aspirin adult low dose, 25, 39
ra aspirin adult low strength, 25, 40
ra aspirin childrens, 25, 40
ra aspirin EC, 25, 40
ra aspirin EC adult low strength, 25, 40
ra childrens aspirin, 25, 40
Ra E-ZJECT Color Lancets Micro-thin
33G, 34
Ra E-ZJECT Lancets 28G, 34
Ra E-ZJECT Lancets Thin 26G, 34
Ra E-ZJECT Lancets Thin 28G, 34
Ra E-ZJECT Lancets Ultra Thin 30G, 34
ra folic acid, 18, 42
ra high potency iron, 18, 43
ra iron, 18, 43
ra mini nicotine, 22, 43
ra nicotine, 22, 43
ra nicotine polacrilex, 22, 43
ra nicotine transdermal system step 3,
22, 43
Ra One Daily, 31, 42
ra prenatal, 30, 42
Ra Prenatal Formula/Folicacid, 31, 42
ra slow release iron, 18, 43
ra vitamin d-3, 29, 44
Rabavert, 28
rabeprazole sodium, 15
radiagel, 10
raloxifene hydrochloride, 14
ramipril, 6
Ranexa, 5
ranitidine HCL, 15
Rapaflo, 17
Rapamune, 4
raspberry syrup, 38
Ravicti, 14
Rayos, 11
rea LO 39, 10
rea LO 40, 10
Reality Lancets, 34
Reality Swabs, 36
Reality Trigger Lancets, 34
Rebetol, 3
Rebif, 22
Rebif Rebidose, 22
Rebif Rebidose Titration Pack, 22
Rebif Titration Pack, 22
reclipsen, 12, 41
Recombinate, 19
Recombivax HB, 29, 42
rectacort-HC, 16
Rectiv, 16
Refissa, 11
regonol, 22
Regranex, 10
Relenza Diskhaler, 2
Relion Alcohol Swabs, 36
Relion Lancets, 34
Relion Lancets Micro-thin33G, 34
Relion Lancets Standard 21G, 34
Relion Lancets Thin 26G, 34
Relion Lancets Ultra-thin30G, 34
Relion Thin Lancets, 34
Relion Ultra Thin Lancets, 34
Relion Ultra Thin Lancets30G, 34
Relion Ultra Thin Plus Lancets 32G, 34
Relion Ultra Thin Plus Lancets 33G, 34
Relistor, 16
Relpax, 26
remergent HQ, 10
remeven, 10
Remicade, 16
Remodulin, 8
rena-vite RX, 30
Renacidin, 17
Renagel, 16
renal, 30
renalpren, 30
Renew Advanced Lancing Cartridge
Refills, 34
reno CAPS, 30
Renova, 11
Renova P.M., 11
Renvela, 16
repaglinide, 13
replacement air filter, 36
Replesta, 29, 44
Replesta Childrens, 29, 44
Replesta Nx, 29, 44
reprexain, 25
Repronex, 14
Req 49+, 31
rescon-JR, 27
Rescriptor, 2
reserpine, 6
reservior 3ML, 31
respa-BR, 27
Restasis, 23
Retisert, 23
Retrovir IV Infusion, 2
Revatio, 8
Revlimid, 4
revonto, 22
Rexall Lancets Ultra Thin, 34
Reyataz, 2
Rezira, 27
Rheumatrex, 26
rhinoflex-650, 24
Rhogam Ultra-filtered Plus, 39
Rhophylac, 39
Riastap, 19
ribasphere, 2
ribasphere ribapak, 2
Ribasphere Ribapak, 3
ribatab, 2
ribavirin, 2
Ridaura, 26
rifabutin, 2
Rifamate, 2
rifampin, 2
Rifater, 2
Right Step Prenatal, 31, 42
Rightest Gl300 Lancets, 34
riluzole, 22
rimantadine HCL, 2
ringers injection, 38
ringers irrigation, 38
Riomet, 13
risedronate sodium, 13
Risperdal Consta, 20
risperidone, 20
risperidone M-TAB, 20
risperidone odt, 20
Riteflo, 36
Rituxan, 4
rivastigmine tartrate, 21
Rixubis, 19
rizatriptan benzoate, 26
rizatriptan benzoate odt, 26
rocuronium bromide, 22
romycin, 23
ropinirole ER, 21
ropinirole HCL, 21
ropivacaine, 27
ropivacaine HCL, 27
rosadan, 8
rosanil cleanser, 8
Rotarix, 29, 42
Rotateq, 29, 42
roxicet, 25
Rozerem, 20
Rybix Odt, 26
S
Sabril, 21
saccharin sodium, 38
Safe-t-lance Low Flow 25G, 34
Safe-t-lance Normal Flow 21G, 34
Safe-t-lance Plus Safety Lancet High
Flow, 34
Safe-t-lance Plus Safety Lancet Low
Flow, 34
Safe-t-lance Plus Safety Lancet Normal
Flow, 34
Safety Lancet 2MM, 34
Safety Lancets, 34
Safety Lancets 21G, 34
Safety Let Lancets, 34
Safety Seal Lancets 28G, 34
Safety Seal Lancets 30G, 34
Safyral, 12, 41
Saizen, 14
Saizen Click.easy, 14
salacyn, 10
salicylic acid, 10
salicylic acid cream, 10
salicylic acid IN ammonium lactate
vehicle, 10
salicylic acid lotion, 10
salicylic acid wart remover, 10
saline flush, 38
saline flush zr/sterile field, 38
saline/phenol, 38
salsalate, 24
salvax, 10
Samsca, 14
Sancuso, 15
Sandimmune, 4
Sandostatin Lar Depot, 14
Saphris, 20
Saps Care Alcohol Prep Pads, 36
Sapscare Twist Top Lancets 30G, 34
sash kit for flushing vascular access
devices, 18
Savella, 22
SB Alcohol Prep Pads, 36
SB aspirin, 25, 40
SB aspirin EC, 25, 40
SB childrens aspirin, 25, 40
SB Lancets Thin, 34
SB Lancets Ultra Thin, 34
SB low dose asa EC, 25, 40
scalacort, 9
scar patch, 10
scleromate sodium morrhuate, 38
scopolamine hydrobromide, 15
se 10-5 ss, 8
se bpo 3% foaming cloths, 8
se bpo 7-5.5 wash kit, 8
se bpo wash, 8
se-natal 19, 30
se-tan DHA, 30
se-tan plus, 17
seb-prev, 9
seb-prev wash, 9
selegiline HCL, 21
selenium, 38
selenium sulfide, 9
Selzentry, 2
senna plus, 15
Sensipar, 14
sensorcaine, 27
sensorcaine-mpf, 27
sensorcaine-mpf spinal, 27
sensorcaine-mpf/epinephrine, 27
sensorcaine/epinephrine, 27
Serevent Diskus, 28
Seromycin, 2
serophene, 14
Seroquel XR, 20
Serostim, 14
sertraline HCL, 20
serum bottle stopper 20MM, 36
serum bottle/250ML, 36
seton et-EC, 30
setonet, 30
sevelamer carbonate, 16
sevoflurane, 27
SF, 19
SF 5000 plus, 19
sharobel, 12, 41
Shopko Alcohol Swabs, 36
Shopko On-the-go Comfort Lancets 30G,
34
Shopko Unilet Lancets Super Thin 30G,
34
Shopko Unilet Lancets Ultra Thin 28G,
34
Shur-seal, 17, 41
siderol, 30
Signifor, 14
sildenafil, 8
sildenafil citrate, 8
Silenor, 20
silicone mask for breatherite
chamber/adult, 36
chamber/infant, 36
chamber/pediatric, 36
silicone mask for breathrite
chamber/adult, 36
silver nitrate, 10
silver sulfadiazine, 10
Simcor, 7
Similac Prenatal Early Shield, 31
simple syrup, 38
Simponi, 26
Simponi Aria, 26
Simulect, 4
simvastatin, 7
Single-let, 34
sirolimus, 4
Sirturo, 2
skin bleaching, 10
skin bleaching/sunscreen, 10
Sklice, 11
Skyla, 12, 41
slow iron, 18, 43
slow release iron, 18, 43
Slow Release Iron, 18, 43
Sm Alcohol Prep Pads, 36
sm aspirin, 25, 40
sm aspirin adult low strength, 25, 40
sm aspirin EC low strength, 25, 40
sm aspirin enteric coated, 25, 40
sm aspirin low dose, 25, 40
sm childrens aspirin, 25, 40
sm folic acid, 18, 42
sm iron, 18, 43
sm iron slow release, 18, 43
Sm Lancets 21G, 34
Sm Micro Thin Lancets 33G, 34
sm nicotine, 22, 43
sm nicotine polacrilex, 22, 43
Sm One Daily Prenatal, 31, 42
sm prenatal vitamins, 30, 42
Sm Prenatal Vitamins, 31, 42
Sm Slow Release Iron, 18, 43
Sm Super Thin Lancets 30G, 34
Sm Thin Lancets 26G, 34
sm vitamin d, 29, 44
sm vitamin d3, 29, 44
Sm Vitamin D3 Maximum Strength, 29,
44
Smart Diabetes Vantage Universal
Lancets 30G, 34
Smart Sense Color Lancets Universal
33G, 34
Smart Sense Standard Lancets Universal
21G, 34
Smart Sense Super Thin Lancets
Universal 30G, 34
Smart Sense Thin Lancets Universal
26G, 34
Smartest Lancets 28G, 34
sodium acetate, 38
sodium bicarbonate, 15, 38
sodium bicarbonate partial fill, 38
sodium chloride, 17, 27, 38
sodium chloride 0.45%, 38
sodium chloride 0.45% viaflex, 38
sodium chloride 0.9%, 17
sodium chloride bacteriostatic, 38
sodium chloride bacteriostatic/benzyl
alcohol, 38
sodium chloride flush, 38
sodium chloride pab, 38
sodium citrate/citric acid, 17
Sodium Edecrin, 7
sodium ferric gluconate complex/sucrose,
18
sodium fluoride, 39, 41
sodium hyaluronate, 10
sodium lactate, 38
sodium nitrite, 38
sodium phenylbutyrate, 14
sodium phosphate, 38
sodium polystyrene sulfonate, 38
sodium saccharin dihydrate, 38
sodium sulfacetamide, 8, 9, 23
sodium sulfacetamide wash, 9
sodium sulfacetamide/sulfur, 8
sodium sulfacetamide/sulfur cleanser, 8
sodium sulfacetamide/sulfur cleanser IN
urea, 8
sodium sulfacetamide/sulfur cleansing
cloths, 8
sodium sulfacetamide/sulfur green, 8
sodium sulfacetamide/sulfur IN urea, 8
sodium sulfacetamide/sulfur w/sunscreen,
8
sodium sulfacetamide/sulfur wash, 8
sodium thiosulfate, 38
sojourn, 27
solia, 12, 41
Soliris, 19
Solodyn, 1
Soltamox, 4
Solu-cortef, 11
Solus V2 Pressure Activated Safety
Lancets 28G, 34
Solus V2 Twist Lancets 30G, 34
Somatuline Depot, 14
Somavert, 14
sonafine, 10
sorbitol, 17
sorbitol-mannitol, 17
sorine, 6
sotalol HCL, 6
sotalol HCL (AF), 6
sotalol hydrochloride, 6
Sovaldi, 3
Spectracef, 1
spinosad, 10
Spiriva Handihaler, 28
Spiriva Respimat, 28
spironolactone, 7
spironolactone/hydrochlorothiazide, 7
Sporanox, 2
sprintec 28, 12, 41
Sprix, 26
Sprycel, 5
sps, 38
SR nicotine gum, 22, 43
sronyx, 12, 41
ss 10-2, 8
ssd, 10
sss 10%-5%, 8
sss 10-5, 8
st joseph aspirin, 25, 40
stagesic, 25
stannous fluoride oral rinse, 19
stavudine, 2
Stavzor, 21
Stelara, 9
stera base, 38
Sterilance TL, 34
sterile diluent for epoprostenol sodium,
38
sterile water for injection, 38
sterile water irrigation, 38
sterile water irrigation plastic bottle, 38
sterile water irrigation w/hanger, 38
Stimate, 14
Stivarga, 5
Strattera, 21
streptomycin sulfate, 2
Striant, 11
Stribild, 2
strovite forte, 30
Strovite One, 31
strovite plus, 30
Stuart One, 31
Stuart Prenatal, 31, 42
Stuart Prenatal + DHA, 31, 42
Suboxone, 26
Subsys, 26
Suclear, 15
Sucraid, 16
sucralfate, 15
sufentanil citrate, 25
sulfacetamide sodium, 8, 23
sulfacetamide sodium/prednisolone
sodium phosphate, 23
sulfacetamide sodium/sulfur cleanser, 8
sulfacleanse 8/4, 8
sulfadiazine, 2
sulfamethoxazole/trimethoprim, 3
sulfamethoxazole/trimethoprim DS, 3
Sulfamylon, 10
sulfasalazine, 16
sulfatrim pediatric, 3
sulfazine, 16
sulfazine EC, 16
sulfurated lime, 10
sulindac, 26
sumatriptan, 26
sumatriptan succinate, 26
sumatriptan succinate refill, 26
Sumavel Dosepro, 26
Supartz, 22
Super Daily D3, 29, 44
supposistrip mold 1.9gm, 36
suppository mold 60 cavity, 36
suppository shell medium 2.25gm, 36
suppository shell small 1.46gm, 36
Supprelin LA, 14
Suprax, 1
Suprep Bowel Prep, 15
Sure Comfort Alcohol Prep Pads, 36
Sure Comfort Lancets 28G, 34
Sure Comfort Lancets 30G, 34
Sure-lance Flat Lancets, 34
Sure-lance Lancets 26G, 34
Sure-lance Thin Lancets 28G, 34
Sure-lance Ultra Thin Lancets, 34
Sure-prep Alcohol Prep Pads, 36
Sure-touch Lancets Universal, 34
Surelite Lancets, 34
Surestep Glucose Control, 34
Surestep Glucose Control Solution, 34
Surestep Pro High Glucosecontrol, 34
Surestep Pro Low Glucose Control, 34
Surestep Pro Normal Glucose Control,
34
Surestep Pro Test Strips, 34
Surestep Test Strips, 34
Sustiva, 2
Sutent, 5
sw nicotine polacrilex, 22, 43
swabflush saline flush, 38
syeda, 12, 41
Sylatron, 5
symax fastabs, 15
symax-SL, 15
symax-SR, 15
Symbicort, 28
Symlinpen 120, 13
Symlinpen 60, 13
Synagis, 39
synalar, 9
Synarel, 14
Synera, 11
Synribo, 5
Synthroid, 15
Synvisc, 22
Synvisc One, 22
Syprine, 39
T
Tabloid, 4
Taclonex, 9
tacrolimus, 4, 10
Tafinlar, 5
Talwin, 26
Tamiflu, 2
tamoxifen citrate, 4
tamsulosin HCL, 17
tandem f, 17
Tarceva, 5
Targretin, 5, 11
tarina FE 1/20, 12, 41
Tarka, 7
taron-crystals, 17
taron-prex, 30
Tasigna, 5
Tasmar, 21
tazicef, 1
Tazorac, 9
taztia XT, 6
Tecfidera, 22
Tecfidera Starter Pack, 22
Techlite AST Lancets, 34
Techlite Lancets, 34
Techlite Lancets 30G, 34
Teflaro, 1
Tegretol-XR, 21
Tekamlo, 7
Tekturna, 6
Tekturna HCT, 7
telmisartan, 6
telmisartan/amlodipine, 7
telmisartan/hydrochloroth, 7
telmisartan/hydrochlorothiazide, 7
temazepam, 20
Temodar, 3
temozolomide, 3
tencon, 24
teniposide, 4
Tenivac, 28, 42
terazosin HCL, 6
terbinafine HCL, 2
Terbinex, 2
terbutaline sulfate, 27
terconazole, 17
terrell, 27
Testim, 11
testosterone, 11
testosterone cypionate, 11
testosterone enanthate, 11
testosterone P.M., 11
tetanus toxoid adsorbed, 28
tetanus/diphtheria toxoids-adsorbed
adult, 28, 42
tetcaine, 23
tetracaine HCL, 23, 27
tetracycline HCL, 1
tetravisc, 23
tetravisc forte, 23
Tev-tropin, 14
Teveten, 6
Teveten HCT, 7
Texacort, 10
tgq 15DM/5PEH/2CPM, 27
tgq 30PSE/150GFN/15DM, 27
tgq 30PSE/3BRM/15DM, 27
tgq 50PSE/3BRM/30DM, 27
tgq 7.5PEH/4BRM/15DM, 27
Tgt Alcohol Swabs, 36
tgt aspirin, 25, 40
tgt aspirin low dose, 25, 40
tgt childrens aspirin, 25, 40
tgt enteric-coated aspirin, 25, 40
Tgt Lancet Alternate Site, 34
Tgt Lancet Micro Thin 33G, 34
Tgt Lancet Super Thin 30G, 34
Tgt Lancet Thin 23G, 34
Tgt Lancet Thin 26G, 34
Tgt Lancet Ultra Thin 28G, 34
Tgt Lancet Ultra Thin 30G, 34
tgt nicotine gum, 22, 43
tgt nicotine polacrilex, 22, 43
tgt nicotine step one, 22, 43
tgt nicotine step three, 22, 43
tgt nicotine step two, 22, 43
th aspirin, 25, 40
th aspirin low dose, 25, 40
th enteric aspirin, 25, 40
th folic acid, 18, 42
th iron, 18, 43
Th Prenatal Vitamins, 31, 42
th slow release iron, 18, 43
th vitamin d3, 29, 44
Thalomid, 4
Theo-24, 28
theochron, 27
theophylline, 27
theophylline CR, 27
theophylline ER, 27
theophylline/D5W, 27
thera-d 2000, 29, 44
Thera-d 4000, 29, 44
thera-d rapid repletion, 29, 44
thera-d sport, 29, 44
Theracys, 5
thermazene, 10
thiamine HCL, 29
Thinlets GP Lancets, 34
Thinlets Lancet, 34
thioridazine HCL, 20
thiothixene, 20
thrive, 22, 43
Thrombate Iii W/10 ML Sterile Water, 19
Thrombate Iii W/20 ML Sterile Water, 19
Thymoglobulin, 4
Thyrogen, 39
Thyrolar-1, 15
Thyrolar-1/2, 15
Thyrolar-1/4, 15
Thyrolar-2, 15
Thyrolar-3, 15
tiagabine hydrochloride, 21
Tice Bcg, 5
ticlopidine HCL, 19
Tikosyn, 6
tilia FE, 12, 41
Timentin, 1
timolol maleate, 6, 23
timolol maleate ophthalmic gel forming,
23
tinidazole, 3
tip CAPS, 36
tip rectal/vaginal w/perforations, 36
tis-u-sol, 38
Tivicay, 3
tizanidine HCL, 22
TL gard RX, 17
TL hydroquinone, 10
TL icon, 17
TL-fol 500, 17
TL-hem 150, 17
Tobi Podhaler, 2
Tobradex, 23
Tobradex ST, 23
tobramycin, 2
tobramycin sulfate, 2, 23
tobramycin sulfate/sodium chloride, 2
tobramycin/dexamethasone, 23
Tobrex, 23
Today Sponge, 17
Todays Health Super Thin Lancets 30G,
34
Todays Health Ultra Thin Lancets 28G,
34
tolazamide, 13
tolbutamide, 13
tolmetin sodium, 26
tolterodine tartrate, 16
tolterodine tartrate ER, 16
topex topical anesthetic, 19
topiragen, 21
topiramate, 21
topiramate ER, 21
toposar, 4
topotecan HCL, 5
Torisel, 5
torsemide, 7
Totect, 5
Toviaz, 16
tpn electrolytes, 38
Tracleer, 8
Tradjenta, 13
tramadol HCL, 25
tramadol HCL ER, 25
tramadol hydrochloride/acetaminophen,
25
trandolapril, 6
tranexamic acid, 19
Transderm-scop, 15
tranylcypromine sulfate, 20
Travatan Z, 23
Travel Lancets 30G, 34
travoprost, 23
trazodone HCL, 20
Treanda, 3
Trecator, 2
Trelstar Depot, 4
Trelstar Depot Mixject, 4
Trelstar LA, 4
Trelstar LA Mixject, 4
Trelstar Mixject, 4
Tretin-x, 8
tretinoin, 5, 8
tretinoin emollient, 10
tretinoin microsphere, 8
tretinoin microsphere P.M., 8
Tretten, 19
Trexall, 4
Treximet, 26
trezix, 25
tri-estarylla, 12, 41
tri-legest FE, 12, 41
tri-linyah, 12, 41
tri-previfem, 12, 41
tri-sprintec, 12, 41
tri-vit/fluoride, 30
tri-vit/fluoride/iron, 30
tri-vitamin/fluoride, 30
Tri-zel, 31
triadvance, 30
triamcinolone acetonide, 9, 19, 27
triamcinolone IN orabase, 19
triamterene/hydrochlorothiazide, 7
trianex, 9
triazolam, 20
Tribenzor, 7
tricare, 30, 41
tricitrates, 17
tricon, 17
triderm, 9
trifluoperazine HCL, 20
trifluridine, 23
trigels-f forte, 17
Triglide, 7
trihexyphenidyl HCL, 21
trilyte, 15, 44
trimethobenzamide HCL, 15
trimethoprim, 3
trimethoprim sulfate/polymyxin b sulfate,
23
trimipramine maleate, 20
trinatal RX 1, 30
trinate, 30
trinessa, 12, 41
triphrocaps, 30
triple dye, 38
triple-vitamin/fluoride, 30
Trisenox, 5
trivora-28, 12, 41
tropazone, 10
tropicamide, 23
trospium chloride, 16
trospium chloride ER, 16
Trueplus Lancets 26G, 34
Trueplus Lancets 28G Super Thin, 34
Trueplus Lancets 30G Ultra Thin, 34
Trueplus Lancets 33G Micro Thin, 34
Trueplus Safety Lancets 28G, 34
Trumenba, 29, 42
Truvada, 2
tryptophan, 38
Tucks Anti-itch, 9
Tudorza Pressair, 28
tussafed EX, 27
Tussicaps, 27
tussigon, 27
Twinrix, 29, 42
Tygacil, 3
Tykerb, 5
Typhim VI, 28
Tysabri, 22
Tyvaso, 8
Tyvaso Refill, 8
Tyvaso Starter, 8
Tyzeka, 3
Tyzine, 27
Tyzine Pediatric Nasal Drops, 27
uro-blue, 16
uro-l, 16
uro-mp, 16
urosex, 30
ursodiol, 16
uryl, 16
ustell, 16
uta, 16
uticap, 16
utira-c, 16
utrona-c, 16
Uvadex, 5
U
V
u-cort, 9
u-kera e, 10
Uceris, 11
Ulesfia, 11
Uloric, 26
Ulticare Thin Lancets 30G, 34
Ultilet Alcohol Swabs, 36
Ultilet Basic Lancets 30G, 34
Ultilet Classic Lancets, 34
Ultilet Lancets, 34
Ultilet Lancets 33G, 34
Ultilet Safety Lancets 23G, 34
ultimatecare one, 30
ultimatecare one NF, 30
ultra TABS, 30
Ultra Thin Lancets 28G, 34
Ultra Thin Lancets 30G, 34
Ultra-thin II Auto Lancet, 34
Ultra-thin II Lancets 28G, 34
Ultra-thin II Lancets 30G, 34
Ultra-thin II Safety Autolancets 26G, 34
Ultravate PAC, 10
Ultresa, 16
umecta mousse, 10
Unilet Comfortouch Lancet, 34
Unilet Excelite, 34
Unilet Excelite II, 34
Unilet G.p. Lancet, 34
Unilet G.p. Superlite Lancet, 34
Unilet GP 28 Ultra Thin, 34
Unilet Lancet, 34
Unilet Superlite Lancet, 34
Unistik 3 Gentle, 34
unithroid, 14
unithroid direct, 14
Universal 1 Lancets Thin 26G, 34
Universal 1 Lancets Ultra Thin 30G, 34
universal sleeve covers, 36
univert, 15
ur n-c, 16
uramaxin, 10
urea, 10
urea 40% nail film, 10
urea hydrating, 10
urea IN zinc undecylenate/lactic acid
vehicle, 10
urea nail, 10
urea nail kit, 10
urea topical, 10
urea-c40, 10
urelle, 16
uretron d/s, 16
uribel, 16
urimar-t, 16
urin d/s, 16
v-c forte, 30
V-go 20, 34
V-go 30, 34
V-go 40, 34
Vagifem, 17
vaginal suppository applicator, 36
valacyclovir HCL, 2
Valchlor, 3, 11
Valcyte, 3
valganciclovir, 2
valproate sodium, 21
valproic acid, 21
valsartan, 6
valsartan/hydrochlorothiazide, 7
Valstar, 3
Value Plus Lancets Standard 21G, 34
Value Plus Lancets Super Thin 30G, 34
Value Plus Lancets Thin 26G, 34
Valumark Lancet Super Thin 30G, 34
Valumark Lancet Ultra Thin 28G, 34
Valved Holding Chamber, 36
vancomycin, 3
vancomycin HCL, 3
vancomycin HCL IN dextrose, 3
vandazole, 17
Vantas, 4
Vaqta, 29, 42
Varivax, 29, 42
Vascepa, 7
vasopressin, 14
Vayacog, 39
Vayarin, 39
Vayarol, 39
Vcf Vaginal Contraceptive Film, 17, 41
vcf vaginal contraceptive foam, 17, 41
Vectibix, 4
Vectical, 9
vecuronium bromide, 22
Velcade, 5
veletri, 8
Veletri, 8
velivet, 12, 41
Veltin, 8
venlafaxine HCL, 20
venlafaxine HCL ER, 20
Venofer, 18
Ventavis, 8
Ventolin HFA, 28
Veramyst, 27
verapamil HCL, 6
verapamil HCL ER, 6
verapamil HCL SR, 6
Verdeso, 10
verdrocet, 25
Veregen, 11
verelan, 6
verelan PM, 6
Veripred 20, 11
versiclear, 9
Vesicare, 16
vestura, 12, 41
Vexol, 23
Viagra, 8
Vibativ, 3
vic-forte, 30
vicodin, 26
vicodin ES, 26
vicodin HP, 26
Victoza, 13
Victrelis, 3
Vida Mia Unilet Lancets Super Thin 30G,
34
Vida Mia Unilet Lancets Ultra Thin 28G,
34
Videx Pediatric, 2
Vigamox, 23
Viibryd, 20
Vimizim, 14
Vimovo, 26
Vimpat, 21
vinate c, 30
vinate care, 30
Vinate DHA RF, 31
vinate GT, 30
vinate IC, 30
vinate II, 30
vinate m, 30
vinate one, 30
vinate pn care, 30
vinate ultra, 30
vinblastine sulfate, 4
vincasar PFS, 4
vincristine sulfate, 4
vinorelbine tartrate, 4
Viokace, 16
viorele, 12, 41
Viracept, 2
Viramune, 2
Viramune XR, 2
Virazole, 3
Viread, 2
virt-CAPS, 30
virt-phos 250 neutral, 38
virt-vite, 17
virt-vite forte, 38
virt-vite plus, 30
virti-sulf, 8
virtrate-3, 17
Visudyne, 24
vita s forte, 30
vita-min, 30
Vita-respa, 39
vitacel, 30
vitafol-OB, 30
Vitalet Pro Lancets, 34
Vitalet Pro Plus Lancets, 34
vitamax pediatric, 30
Vitamelts Vitamin D, 29, 44
vitamin b-complex 100, 30
vitamin c 222MG, 29
vitamin d, 29, 44
vitamin d 400, 29, 44
vitamin d high potency, 29, 44
vitamin d-1000, 29, 44
vitamin d-1000 maximum strength, 29,
44
vitamin d-3, 29, 44
vitamin d-400, 29, 44
vitamin d3, 29, 44
vitamin d3 400, 29, 44
vitamin d3 adult gummies, 29, 44
vitamin d3 high potency, 29, 44
vitamin d3 maximum strength, 29, 44
vitamin d3 super strength, 29, 44
vitamin k1, 29
vitamins a/c/d/fluoride, 30
Vivitrol, 39
Vivotif Berna, 28
Vogelxo, 11
Vogelxo P.M., 11
vol-care RX, 30
Voltaren, 9
Voraxaze, 5
voriconazole, 2
Vortex Valved Holding Chamber, 37
Votrient, 5
vp-gstn, 38
vp-precip, 38
vp-zel, 30
Vpriv, 18
Vumon, 4
vyfemla, 12, 41
Vytorin, 7
Vyvanse, 21
W
W&f Lancets 26G, 34
W&f Lancets Colored 21G, 34
Walgreens Advanced Travellancets 28G,
34
Walgreens Comfort Assuredlancets Micro
Thin/33G, 34
Walgreens Comfort Assuredlancets
Super Thin/28G, 34
Walgreens Lancets, 34
Walgreens Thin Lancets, 34
Walgreens Ultra Thin Lancets, 34
warfarin sodium, 18
Watchhaler, 37
Webcol Alcohol Prep Large 1 Ply, 37
Webcol Alcohol Prep Large 2 Ply, 37
Webcol Alcohol Prep Medium 2 Ply, 37
wee care, 18, 43
weigh boat/plastic/anti-static, 36
Welchol, 7
Wellesse Vitamin D3, 29, 44
wera, 12, 41
westhroid, 15
wheat germ, 29
white petrolatum, 38
Wide-seal Silicone Diaphragm Kit 60, 41
Wilate, 19
Winrho SDF, 39
witch hazel, 10
wymzya FE, 12, 41
X
x-viate, 10
Xalkori, 5
Xarelto, 18
Xarelto Starter Pack, 18
xclair, 10
Xeljanz, 26
Xenazine, 22
Xenical, 21
Xeomin, 22
Xgeva, 13
Xiaflex, 39
Xifaxan, 3
Xofigo, 5
Xolair, 28
Xolegel, 9
Xopenex HFA, 28
Xtandi, 4
xulane, 12, 41
xylocaine dental, 27
xylon, 26
xylose, 38
Xyntha, 19
Xyntha Solofuse, 19
Xyrem, 22
Y
yellow petrolatum, 38
Yervoy, 4
yf-vax, 28
yl folic acid, 18, 42
Yodoxin, 3
Your Life Multi Prenatal, 31
Z
zaclir cleansing, 8
zafirlukast, 28
zaleplon, 20
Zaltrap, 4
zamicet, 26
Zanosar, 3
zarah, 12, 41
Zavesca, 18
zazole, 17
zebutal, 24
Zegerid, 15
Zelboraf, 5
Zemaira, 28
Zemplar, 14
zenatane, 8
zenchent, 12, 41
zenchent FE, 12, 41
zencia, 8
Zenpep, 16
zenzedi, 21
Zetia, 7
Zetonna, 27
Zevalin Y-90, 4
zflex, 24
zgesic, 24
Ziagen, 2
Ziana, 8
zidovudine, 2
zinacef, 1
Zinacef, 1
Zinacef IN Iso-osmotic Dextrose, 1
Zinacef IN Iso-osmotic Diluent, 1
zinc gluconate, 38
zinc sulfate, 38
zinc trace metal, 38
Zioptan, 23
ziprasidone HCL, 20
Zirgan, 23
Zithromax, 1
Zoladex, 4
zoledronic acid, 13
Zolinza, 5
zolmitriptan, 26
zolmitriptan odt, 26
zolpidem tartrate, 20
zolpidem tartrate ER, 20
Zometa, 13
Zomig, 26
Zomig Nasal Spray, 26
Zonalon, 9
zonisamide, 21
Zorbtive, 14
Zortress, 4
Zostavax, 29, 42
Zosyn, 1
zovia 1/35e, 12, 41
zovia 1/50e, 12, 41
Zovirax, 9
Zuplenz, 16
Zyclara, 10
Zyclara P.M., 10
Zyflo, 28
Zyflo CR, 28
Zylet, 23
Zytiga, 4
Zyvox, 3
1
1/2halfprin, 25, 40
1ST Choice Lancets Super Thin, 34
1ST Choice Lancets Thin, 34
1ST Choice Lancets Ultra Thin, 35
1ST Tier Unilet Comfortouch Lancets
28G, 35
1ST Tier Unilet Comfortouch Lancets
30G, 35
8
8-mop, 9

Union Star - Nevada Health CO-OP

Transcription

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