Your Sutter Health Plus Formulary February 2016

Transcription

Your Sutter Health Plus Formulary
February 2016
This document is the Sutter Health Plus Formulary, a list of
generic and brand name drugs covered by Sutter Health Plus
under your outpatient prescription drug benefit. The formulary
helps you and your doctor determine the right drug to prescribe
to treat your needs.
Symbol
Guideline
Description
AGE
Age Edit
Drug may not be recommended for
some patients based on age
G
Gender Edit
Drug may not be recommended for
some patients based on gender
The drugs on the formulary are selected by the MedImpact
Pharmacy and Therapeutics (P&T) Committee, and the
Sutter Health Plus P&T Committee reviews and approves
selection. The committee is made up of doctors and pharmacists
who meet regularly to decide which drugs should be included.
Drugs on the formulary are chosen for their safety, effectiveness
and value.
PA
Prior
Requires your doctor to request
Authorization prior authorization to support use
of this drug
QL
Quantity
Limit
ST
Step Therapy Coverage may depend on previous
use of another drug
The formulary is updated regularly and may change. You can
get the most current formulary on the Sutter Health Plus
website at sutterhealthplus.org/pharmacy, or the MedImpact
website for Sutter Health Plus members
at mp.medimpact.com/STH.
How to Use the Formulary
The formulary is a list of preferred drugs available to
Sutter Health Plus members under their pharmacy benefit. All
drugs on the formulary are listed by their generic names and
most common brand name. The formulary may be accessed by
using the index, either by generic or brand name (in capital
letters) and by therapeutic drug category. In situations where a
Food and Drug Administration (FDA) approved generic drug is
available, brand names are listed for reference purposes only.
Brand names usually cost more and are not preferred over
generic alternatives. Any drugs not found in this formulary
listing or any formulary updates published by MedImpact or
Sutter Health Plus are considered non-formulary drugs and
require prior authorization.
All drugs are listed in each category in alphabetical order by
generic name. All drugs have a generic name. If the generic
drug is FDA approved it will appear bolded in the
formulary listing.
Some drugs on the formulary have certain process requirements
or limitations for coverage. These are identified by the letters
listed and explained below. Your Evidence of Coverage and
Disclosure Form (EOC) explains the details of the process
requirements and limitations and how you can ask
for exceptions.
Sutter Health Plus
Coverage may be limited to specific
quantities per prescription and/or
time period
Benefit Coverage and Limitations
This printed formulary does not provide information regarding
the specific coverage and limitations an individual member may
have. Many members have specific benefit inclusions,
exclusions, copays, or a lack of coverage, which are not
reflected in the formulary. For example, drugs for the treatment
of infertility may not be covered. Refer to your EOC for more
information regarding your specific coverage.
The formulary applies only to outpatient drugs provided to
members, and does not apply to drugs used in inpatient settings
or administered by a health care provider in a clinic or office
setting. If you have any specific questions regarding your
prescription coverage, refer to your EOC or contact
Sutter Health Plus at 1-855-315-5800 or MedImpact
at 1-844-282-5330.
Depending on a member’s specific benefit, the following
may apply:
1. Generic Substitution
When available, FDA approved generic drugs are used in
most situations, regardless of the brand name indicated.
Members usually have lower copays when they use
generic drugs.
If a member requests a brand name drug instead of an
approved generic, the member, based on their coverage, is
typically required to pay the difference in cost between the
brand and the generic. Doctors can request prior
authorization if they determine that there is a medical need
for the brand name drug.
Page 1 of 106
2. Four Tier Benefit
The formulary is a four tier benefit design. Tiers are the
different cost levels you pay for a drug. Each tier is
assigned a member cost share. This is how much you pay
when you fill a prescription. The four tiers are:
• Tier 1 – Most generic drugs and low-cost preferred
brands are covered at the lowest cost share level
• Tier 2 – Preferred band name and non-preferred
generic drugs are covered at the second lowest tier cost
share level
• Tier 3 – Non-preferred brand name drugs are covered
at the third-tier cost share level. These generally have a
preferred and often less costly therapeutic alternative
at a lower tier
• Tier 4 – Specialty drugs, self-administered drugs that
require training or clinical monitoring, and
bioengineered drugs are covered at the fourth-tier cost
share level
If your drug is in Tier 2 or 3, look to see if there is a Tier 1
option available. Discuss these options with your doctor. If
your drug is a specialty drug, used to treat rare or complex
medical conditions, a percent-of-cost coinsurance applies.
All preventive care drug categories have products that are
covered with $0 cost share.
Preventive care drugs and products are covered at $0 cost
share when prescribed by a participating doctor and
obtained at a network pharmacy. Preventive care drugs and
products are listed in the print formulary as Tier 5 to help
differentiate this group of drugs that have a $0 cost share.
Refer to your EOC for more information regarding
coverage of preventive care drugs and products.
Drugs prescribed for sexual dysfunction have a 50% cost
share and some, such as Cialis, Levitra or Viagra (or their
generic equivalents) are limited to 8 doses per
30-day supply.
Refer to your plan documents for infertility drug coverage
(if applicable) and cost share information.
Your pharmacy benefits, including tiers and restrictions, are
based on plan year. During your plan year, any changes to
the formulary that benefit you, such as moving a drug to a
lower tier for lower cost share, take effect right away. Most
changes that increase cost share or impose new limits or
processes on a drug you take do not affect you until the
start of your next plan year.
Sutter Health Plus�
It is important to note that drug costs change frequently. If
you have a percent-of-cost coinsurance or deductible,
confirm your cost share by calling your pharmacy or
MedImpact before picking up your prescription.
3. Drug Prior Authorization Process
Depending upon plan benefit design, a medication prior
authorization request process may apply as follows:
A. Formulary Drugs
Drugs that are listed in the formulary with PA require
prior authorization before dispensing at a network
pharmacy. Each request is reviewed on an individual
patient need basis. If the request does not meet
established guidelines it is not approved an alternative
drug may be recommended.
B. Non-Formulary Drugs
Drugs not found in the formulary listing are
considered non-formulary drugs. All non-formulary
drugs require prior authorization for coverage.
MedImpact reviews each prior authorization request
on an individual patient need basis. MedImpact
approves requests if a documented medical need
exists. The following basic guidelines are used:
• The use of formulary drugs is contraindicated in
the patient.
• The patient has failed an appropriate trial of
formulary or related agents.
• The choices available in the formulary are not
suited for the present patient care need, and the
drug selected is required for patient safety.
• The use of a formulary drug may provoke an
underlying condition, which would be detrimental
to patient care.
If the request does not meet the guidelines established
by the P&T Committee, MedImpact will not approve
and alternative therapy may be recommended.
C. Requesting Prior Authorizations
For drugs that require prior authorization for coverage,
providers must submit a request to MedImpact using
one of the following methods:
1. Fax a completed Prescription Drug Prior
Authorization Request Form to MedImpact
at 1-858-790-7100.
2. Call MedImpact at 1-844-282-5330 (option 3) and
provide all necessary information requested.
3. Online at
https://mp.medimpact.com/webtocase/EMRF2.asp
x?client=MI&state=CA
Page 2 of 106
Generic Name
Drug
Representative Brand Name
ALLERGY
2nd Gen Antihistamine & Decongestant
Combinations
T3 desloratadine/pseudoeph CLARINEX-D 12
QL, ST
edrine
HOUR
T1 fexofenadine/pseudoephFEXOFENADINE-PSE
edrine
ER
T3 pseudoephedrine
SEMPREX-D
hcl/acrivas
Tier
T3 grass pollen-perennial
rye,std
T2 grass pollen-timothy,
standard
T3 grass pollen-timothy,
standard
T3 mite-d.farinae, std
T3
T3
Allergenic Extracts, Therapeutics
T3
T3
T3 allerg ex-alternaria
alternata
T3 allerg ext-american
cockroach
T3
T3
ALTERNARIA
AMERICAN
COCKROACH
EXTRACT
PENICILLIUM
NOTATUM
PECAN POLLEN
T3 allerg ext-penicillium
notatum
T3 allerg ext-tree pollenpecan
T3 allergen ext-aspergillus ASPERGILLUS
fumig
FUMIGATUS
T3 allergen extAUREOBASIDIUM(VI
aureoba.pullulans
AL)(10000/ML)
T1 allergen extAUREOBASIDIUM(VI
aureoba.pullulans
AL)(20000/ML)
T3 allergen extCLADOSPORIUM
c.cladosporioides
CLADOSPORIOIDES
T3 allergen extCLADOSPORIUM
c.sphaerospermum
SPHAEROSPERMUM
T3 allergen ext-candida
CANDIDA ALBICANS
albicans
T3 allergen extractDRECHSLERA
d.sorokiniana
T3 allergen extract-s.
SACCHAROMYCES
cerevisiae
CEREVISIAE
T3 allergenic ex-horse
HORSE EPITHELIUM
epithelium
T3 allergenic ext-dog
DOG EPITHELIUM
epithelium
EXTRACT
T3 allergenic ext-mucor
MUCOR
plumbeus
T3 allergenic ext-phoma
PHOMA
herbarum
T3 allergenic ext-rhizopus RHIZOPUS
oryzae
T3 allergenic xt-epicoccum EPICOCCUM
nigrum
T3 cat hair std allergenic ext STANDARDIZED CAT
HAIR
T2 gr pol-orc/sw
ORALAIR
PA
ver/rye/kent/tim
T3 grass pollen-bahia
BAHIA
T3 grass pollen-bermuda, STANDARD
standard
BERMUDA GRASS
POLLEN
T3 grass pollen-johnson
JOHNSON GRASS
T3 grass pollen-june
STANDARDIZED JUNE
grass,std
GRASS POLLEN
T3 grass pollen-orchard
STANDARDIZED
grass,std
ORCHARD GRASS
Sutter Health Plus
Requirements/Limits
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T2
T3
STANDARD RYE
GRASS POLLEN
GRASTEK
PA
STANDARDIZED
TIMOTHY GRASS
D.FARINAE MITE
EXTRACT
mite-d.pteronyssinus, std D.PTERONYSSINUS
MITE EXTRACT
sheep sorrel/yellow dock SHEEP SORREL
YELLOW DOCK
tree pollen-american elm AMERICAN ELM
tree pollen-american
AMERICAN
sycamore
SYCAMORE
tree pollen-bayberry
BAYBERRY
tree pollen-black walnut BLACK WALNUT
POLLEN
tree pollen-box elder
BOX ELDER
tree pollen-eastern
EASTERN
cottonwood
COTTONWOOD
tree pollen-mesquite
MESQUITE
tree pollen-mountain
MOUNTAIN CEDAR
cedar
tree pollen-red birch
RED BIRCH
tree pollen-red cedar
RED CEDAR
tree pollen-shagbark
SHAGBARK HICKORY
hickory
tree pollen-virginia live VIRGINIA LIVE OAK
oak
tree pollen-white ash
WHITE ASH
tree pollen-white oak
WHITE OAK
EXTRACT
weed pollen-english
ENGLISH PLANTAIN
plantain
weed pollenLAMB'S QUARTERS
lambsquarters
weed pollen-mugwort
MUGWORT
weed pollen-rough
ROUGH PIGWEED
pigweed
weed pollen-russian
RUSSIAN THISTLE
thistle
weed pollen-sagebrush SAGEBRUSH
weed pollen-short
RAGWITEK
PA
ragweed
weed pollen-short,tall
MIXED RAGWEED
ragweed
EXTRACT
Antihistamines - 1st Generation
T1 carbinoxamine maleate CARBINOXAMINE
MALEATE
T3 carbinoxamine maleate KARBINAL ER
T1 clemastine fumarate
T1 cyproheptadine hcl
T1 diphenhydramine hcl
T1 hydroxyzine hcl
T1 hydroxyzine pamoate
T1 hydroxyzine pamoate
T1 promethazine hcl
AGE
AGE,
QL, ST
CLEMASTINE
FUMARATE
CYPROHEPTADINE
HCL
DIPHENHYDRAMINE
HCL
HYDROXYZINE HCL
HYDROXYZINE
PAMOATE
VISTARIL
PHENERGAN
Page 3 of 106
T1 promethazine hcl
PROMETHAZINE HCL
Antihistamines - 2nd Generation
T1
T3
T1
T1
T1
T1
cetirizine hcl
desloratadine
desloratadine
desloratadine
fexofenadine hcl
levocetirizine
dihydrochloride
T1 levocetirizine
dihydrochloride
CETIRIZINE HCL
CLARINEX(SYRUP)
CLARINEX(TAB)
DESLORATADINE
FEXOFENADINE HCL
XYZAL(SOLUTION)
QL, ST
QL
QL, ST
T3 ondansetron
QL, ST
XYZAL(TAB)
Nasal Antihistamine
T1 azelastine hcl
T1 azelastine hcl
T1 olopatadine hcl
ASTEPRO
AZELASTINE HCL
PATANASE
QL, ST
QL
QL, ST
Nasal Antihistamine & Anti-inflam. Steroid Comb.
T3 azelastine/fluticasone
DYMISTA
BECONASE AQ
QL, ST
QNASL
QL, ST
QNASL CHILDREN
QL, ST
RHINOCORT AQUA
OMNARIS
ZETONNA
FLUNISOLIDE
VERAMYST
FLUTICASONE
PROPIONATE
T2 mometasone furoate
NASONEX
T1 triamcinolone acetonideTRIAMCINOLONE
ACETONIDE
QL, ST
QL, ST
QL, ST
QL
QL, ST
QL
QL
QL
ANTIEMESIS/ANTIVERTIGO
Antiemetic/antivertigo Agents
T2
T2
T2
T2
T1
T3
T3
T3
T3
T1
T3
T3
T1
T1
T1
T1
aprepitant
aprepitant
aprepitant
aprepitant
dimenhydrinate
dolasetron mesylate
EMEND(CAP DS PK) QL
EMEND(CAP)(125 MG) QL
DIMENHYDRINATE
ANZEMET(TAB)(100 QL, ST
MG)
dolasetron mesylate
ANZEMET(TAB)(50
QL, ST
MG)
dolasetron mesylate
ANZEMET(VIAL)
doxylamine/pyridoxine DICLEGIS
QL
hcl
dronabinol
MARINOL
QL, ST
fosaprepitant
EMEND
dimeglumine
granisetron
SANCUSO
QL, ST
granisetron hcl
GRANISETRON HCL QL, ST
granisetron hcl
GRANISETRON
QL, ST
HCL(TAB)
granisetron hcl
GRANISETRON
HCL(VIAL)
granisetron hcl/pf
GRANISETRON HCL
Sutter Health Plus
T1
T1
T1
T1
T1
T3
T1
T1
T1
QL, ST
Nasal Anti-inflammatory Steroids
T3 beclomethasone
dipropionate
T2 beclomethasone
dipropionate
T2 beclomethasone
dipropionate
T1 budesonide
T3 ciclesonide
T3 ciclesonide
T1 flunisolide
T3 fluticasone furoate
T1 fluticasone propionate
T1 meclizine hcl
T3 nabilone
T2 netupitant/palonosetron
hcl
T1 ondansetron
T3 ondansetron
T1
T1
T3
T3
T1
T1
T3
ondansetron hcl
ondansetron hcl
ondansetron hcl
ondansetron hcl
ondansetron hcl/pf
palonosetron hcl
prochlorperazine
prochlorperazine
edisylate
prochlorperazine
maleate
promethazine hcl
promethazine hcl
rolapitant hydrochloride
scopolamine
trimethobenzamide hcl
ANTIVERT
CESAMET
AKYNZEO
QL, ST
QL
ZOFRAN ODT
ZUPLENZ(FILM)(4
QL, ST
MG)
ZUPLENZ(FILM)(8
QL, ST
MG)
ONDANSETRON HCL
ZOFRAN(SOLUTION) QL
ZOFRAN(TAB)
ZOFRAN(VIAL)
ONDANSETRON HCL
ALOXI
COMPAZINE
PROCHLORPERAZINE
EDISYLATE
COMPAZINE
PHENERGAN
PROMETHEGAN
VARUBI
TRANSDERM-SCOP
TIGAN
TIGAN(CAP)
TIGAN(VIAL)
QL
ASTHMA AND COPD
5-lipoxygenase Inhibitors
T3 zileuton
T3 zileuton
ZYFLO
ZYFLO CR
Adrenergic Agents,catecholamines
T1 dopamine hcl
T1 dopamine hcl/d5w
DOPAMINE HCL
DOPAMINE HCL IN
5% DEXTROSE
T1 epinephrine
ADRENALIN
T1 epinephrine
EPINEPHRINE
T3 epinephrine
EPISNAP
T1 epinephrine hcl/d5w
EPINEPHRINE HCL
D5W
T1 epinephrine hcl/pf
EPINEPHRINE
T1 epinephrine in 0.9 % EPINEPHRINE HCLnacl/pf
0.9% NACL
T3 isoproterenol hcl
ISUPREL
T1 norepinephrine bit/0.9 NOREPINEPHRINE
% nacl
BITAR-0.9% NACL
T1 norepinephrine
LEVOPHED
bitartrate
BITARTRATE
NOREPINEPHRINE
T1 norepinephrine
bitartrate/d5w
BITARTRATE-D5W
Anticholinergics, Orally Inhaled Long Acting
T3 glycopyrrolate
SEEBRI NEOHALER
Beta-adrenergic Agents
T1 albuterol sulfate
T2
T2
T3
T2
albuterol sulfate
albuterol sulfate
albuterol sulfate
albuterol sulfate
ALBUTEROL
SULFATE
PROAIR HFA
PROAIR RESPICLICK
PROVENTIL HFA
VENTOLIN HFA
Page 4 of 106
T1
T3
T3
T2
T3
T1
T3
T1
albuterol sulfate
arformoterol tartrate
formoterol fumarate
formoterol fumarate
indacaterol maleate
levalbuterol hcl
levalbuterol tartrate
metaproterenol sulfate
T2 olodaterol hcl
T2 salmeterol xinafoate
T1 terbutaline sulfate
VOSPIRE ER
BROVANA
QL
FORADIL
QL, ST
PERFOROMIST
QL
ARCAPTA NEOHALERQL, ST
XOPENEX
XOPENEX HFA
METAPROTERENOL
SULFATE
STRIVERDI
QL
RESPIMAT
SEREVENT DISKUS QL
TERBUTALINE
SULFATE
Beta-adrenergic And Anticholinergic Combinations
T3 indacaterol/glycopyrrolat UTIBRON NEOHALER
e
T2 ipratropium/albuterol
COMBIVENT
sulfate
RESPIMAT
T1 ipratropium/albuterol IPRATROPIUMsulfate
ALBUTEROL
T2 tiotropium br/olodaterol STIOLTO RESPIMAT QL
hcl
T3 umeclidinium
ANORO ELLIPTA
QL, ST
brm/vilanterol tr
FLOVENT
DISKUS(BLST
W/DEV)(50 MCG)
FLOVENT HFA(AER
W/ADAP)(110 MCG)
FLOVENT HFA(AER
W/ADAP)(220 MCG)
FLOVENT HFA(AER
W/ADAP)(44 MCG)
ASMANEX
ASMANEX HFA
T1 montelukast sodium
T1 zafirlukast
T1 cromolyn sodium
T1 cromolyn sodium
General Bronchodilator Agents
T3 aclidinium bromide
T2 ipratropium bromide
T2 tiotropium bromide
T2 tiotropium bromide
T3 umeclidinium bromide
TUDORZA PRESSAIR
ATROVENT HFA
IPRATROPIUM
BROMIDE
SPIRIVA
SPIRIVA RESPIMAT
INCRUSE ELLIPTA
QL, ST
QL
QL
QL
QL, ST
Glucocorticoids, Orally Inhaled
T2 beclomethasone
dipropionate
T2 budesonide
T1 budesonide
T1 budesonide
T1 budesonide
T3
T3
T3
T3
ciclesonide
flunisolide
fluticasone furoate
fluticasone propionate
Sutter Health Plus
QL
QL
CROMOLYN SODIUM
GASTROCROM
Monoclonal Antibodies To Immunoglobulin E
T4 omalizumab
XOLAIR
PA
Monoclonal Antibody - Interleukin-5 Antagonists
T4 mepolizumab
(recombinant)
NUCALA
PA
T2 roflumilast
QL
QL
QL
QL
QL, ST
Mast Cell Stabilizers
Phosphodiesterase-4 (pde4) Inhibitors
ADVAIR DISKUS
ADVAIR HFA
BREO ELLIPTA
DULERA
QL, ST
SINGULAIR
ACCOLATE
T3 budesonide/formoterol
fumarate
T2 fluticasone/salmeterol
T2 fluticasone/salmeterol
T2 fluticasone/vilanterol
T2 mometasone/formoterol
QL, ST
QL, ST
Leukotriene Receptor Antagonists
Beta-adrenergic And Glucocorticoid Combinations
SYMBICORT
QL, ST
DALIRESP
QL, ST
Xanthines
T1
T1
T1
T1
aminophylline
AMINOPHYLLINE
caffeine citrated
CAFCIT
caffeine citrated
CAFFEINE CITRATE
caffeine/sodium
CAFFEINE AND
benzoate
SODIUM BENZOATE
T2 theophylline anhydrous THEO-24
T1 theophylline anhydrous THEOPHYLLINE
ANHYDROUS
T1 theophylline/d5w
THEOPHYLLINE IN
5% DEXTROSE
AUTONOMIC NERVOUS SYSTEM
DISORDERS
QVAR
QL
PULMICORT
FLEXHALER
PULMICORT(AMPULNEB)(0.25MG/2ML)
PULMICORT(AMPULNEB)(0.5 MG/2ML)
PULMICORT(AMPULNEB)(1 MG/2 ML)
ALVESCO
AEROSPAN
ARNUITY ELLIPTA
FLOVENT
DISKUS(BLST
W/DEV)(100 MCG)
FLOVENT
DISKUS(BLST
W/DEV)(250 MCG)
QL
QL
QL
QL
QL, ST
QL, ST
QL, ST
QL, ST
Alzheimer's Therapy, Nmda Receptor Antagonists
T2 memantine hcl
T2 memantine hcl
T1 memantine hcl
T1 memantine hcl
T1 memantine hcl
NAMENDA XR(CAP 24 QL
DSPK)
NAMENDA XR(CAP QL
SPR 24)
NAMENDA(SOLUTIO QL
N)
NAMENDA(TAB DS QL
PK)
NAMENDA(TAB)
QL
Alzheimer's Thx,nmda Recept Antag & Cholines
Inhib
QL, ST
T2 memantine hcl/donepezil NAMZARIC
hcl
QL, ST
Page 5 of 106
T3 paroxetine mesylate
T3 paroxetine mesylate
T1 sertraline hcl
Cholinesterase Inhibitors
T1 donepezil hcl
T1 edrophonium chloride
T3 edrophonium
chloride/atropine
T1 galantamine hbr
T1 galantamine hbr
T3 neostigmine
methylsulfate
T1 neostigmine
methylsulfate
T3
T3
T1
T1
T1
T2
T1
T3
T1
T1
ARICEPT
ENLON
ENLON-PLUS
RAZADYNE
RAZADYNE ER
BLOXIVERZ
BRISDELLE
PEXEVA
ZOLOFT
Serotonin-2 Antagonist/reuptake Inhibitors
QL
QL
T1 nefazodone hcl
T3 trazodone hcl
T1 trazodone hcl
NEFAZODONE HCL
OLEPTRO ER
TRAZODONE HCL
T3 desvenlafaxine
DESVENLAFAXINE
ER
T1 desvenlafaxine
KHEDEZLA
T3 desvenlafaxine fumarate DESVENLAFAXINE
FUMARATE ER
T2 desvenlafaxine succinate PRISTIQ ER
T1 duloxetine hcl
CYMBALTA
T1 duloxetine hcl
IRENKA
T3 levomilnacipran
FETZIMA
hydrochloride
T1 venlafaxine hcl
EFFEXOR XR
T1 venlafaxine hcl
VENLAFAXINE HCL
ER
T3 vilazodone hydrochlorideVIIBRYD
Antidepressant
T3 vortioxetine
hydrobromide
BRINTELLIX
Combinatns
Tricyclic Antidepressants & Rel. Non-sel. Ru-inhib
T3 isocarboxazid
MARPLAN
T1 phenelzine sulfate
NARDIL
T1 tranylcypromine sulfatePARNATE
Norepinephrine And Dopamine Reuptake Inhib
T1 paroxetine hcl
T2 paroxetine hcl
T1 paroxetine hcl
Sutter Health Plus
CELEXA
CITALOPRAM HBR
LEXAPRO
FLUOXETINE HCL
SARAFEM
FLUVOXAMINE
MALEATE
PAXIL CR
PAXIL(ORAL SUSP)
PAXIL(TAB)
CHLORDIAZEPOXIDE
-AMITRIPTYLINE
T1 perphenazine/amitripty PERPHENAZINEline hcl
AMITRIPTYLINE
Maois - Non-selective & Irreversible
T1 citalopram
hydrobromide
T1 citalopram
hydrobromide
T1 escitalopram oxalate
T3 fluoxetine hcl
T3 fluoxetine hcl
T1 fluvoxamine maleate
T1 amitrip
hcl/chlordiazepoxide
QL, ST
Tricyclic Antidepressant/phenothiazine Combinatns
MIRTAZAPINE
REMERON
Selective Serotonin Reuptake Inhibitor
QL, ST
QL
QL, ST
QL, ST
Ssri & Serotonin Receptor Modulator
ANTIDEPRESSANTS
APLENZIN
FORFIVO XL
WELLBUTRIN XL
QL, ST
QL, ST
QL, ST
Tricyclic Antidepressant/benzodiazepine
Alpha-2 Receptor Antagonist Antidepressants
QL, ST
Ssri & 5ht1a Partial Agonist Antidepressant
BEHAVIORAL HEALTH
T3 bupropion hbr
T3 bupropion hcl
T1 bupropion hcl
QL, ST
Serotonin-norepinephrine Reuptake-inhib
NEOSTIGMINE
METHYLSULFATE(SY
RINGE)
neostigmine
NEOSTIGMINE
methylsulfate
METHYLSULFATE(VI
AL)(0.5 MG/ML)
neostigmine
NEOSTIGMINE
methylsulfate
METHYLSULFATE(VI
AL)(1 MG/ML)
neostigmine
NEOSTIGMINE
methylsulfate
METHYLSULFATE(VI
AL)(1:1000)
neostigmine
NEOSTIGMINE
methylsulfate
METHYLSULFATE(VI
AL)(1:2000)
physostigmine salicylatePHYSOSTIGMINE
SALICYLATE
pyridostigmine bromide MESTINON(SYRUP)
pyridostigmine bromideMESTINON(TAB)
pyridostigmine bromide REGONOL
rivastigmine
EXELON
QL
rivastigmine tartrate EXELON
T1 mirtazapine
T1 mirtazapine
QL, ST
QL, ST
QL, ST
QL, ST
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T3
T1
amitriptyline hcl
amoxapine
clomipramine hcl
desipramine hcl
doxepin hcl
imipramine hcl
imipramine pamoate
maprotiline hcl
nortriptyline hcl
nortriptyline hcl
protriptyline hcl
trimipramine maleate
trimipramine maleate
AMITRIPTYLINE HCL
AMOXAPINE
ANAFRANIL
NORPRAMIN
DOXEPIN HCL
TOFRANIL
TOFRANIL-PM
MAPROTILINE HCL
NORTRIPTYLINE HCL
PAMELOR
PROTRIPTYLINE HCL
SURMONTIL
TRIMIPRAMINE
MALEATE
BEHAVIORAL HEALTH - OTHER
Adrenergics, Aromatic, Non-catecholamine
T3 amphetamine sulfate
EVEKEO
PA
Page 6 of 106
T1 dextroamphetamine
sulfate
sulfate
DEXTROAMPHETAMI QL
NE SULFATE(TAB)(10
MG)
DEXTROAMPHETAMI QL
NE SULFATE(TAB)(5
MG)
PROCENTRA
QL
sulfate
ZENZEDI(TAB)(15
sulfate
MG)
ZENZEDI(TAB)(2.5
sulfate
MG)
ZENZEDI(TAB)(20
sulfate
MG)
ZENZEDI(TAB)(30
sulfate
MG)
ZENZEDI(TAB)(7.5
sulfate
MG)
T1 dextroamphetamine/am ADDERALL
phetamine
T3 dextroamphetamine/amp DYANAVEL XR
hetamine
T2 lisdexamfetamine
VYVANSE
dimesylate
T1 methamphetamine hcl DESOXYN
T4 loxapine
T1 loxapine succinate
QL
Antipsychotics,atypical,dopamine,& Serotonin
QL
Antag
QL, ST
QL
QL
T3
T3
T3
T3
T1
T4
T1
T1
T1
ALPRAZOLAM
INTENSOL
XANAX
BUSPIRONE HCL
CHLORDIAZEPOXIDE
HCL
CLORAZEPATE
DIPOTASSIUM
TRANXENE T-TAB
T1
T4
T4
T1
T3
T3
DIAZEPAM
VALIUM
ATIVAN
LORAZEPAM
MEPROBAMATE
OXAZEPAM
T1
T1
T4
T1
T3
Anti-mania Drugs
T1 lithium citrate
T3
T4
T4
T4
T3
T3
T3
QL, ST
Anti-anxiety Drugs
T3 carbamazepine
T1 lithium carbonate
ABILIFY
QL, ST
ABILIFY MAINTENA
ARIPIPRAZOLE
QL, ST
ARISTADA
REXULTI
QL, ST
QL, ST
ACAMPROSATE
CALCIUM
T1 disulfiram
ANTABUSE
T4 naltrexone microspheres VIVITROL
T1 clorazepate
dipotassium
T1 clorazepate
dipotassium
T1 diazepam
T1 diazepam
T1 lorazepam
T1 lorazepam
T1 meprobamate
T1 oxazepam
aripiprazole
aripiprazole
aripiprazole
aripiprazole lauroxil
brexpiprazole
Antipsychotics, Dopamine & Serotonin Antagonists
T1 acamprosate calcium
T1 alprazolam
T1 buspirone hcl
T1 chlordiazepoxide hcl
T1
T4
T1
T4
T3
QL
Anti-alcoholic Preparations
T2 alprazolam
Antipsychotics, Atyp, D2 Partial Agonist/5ht Mixed
ADASUVE
LOXAPINE
asenapine maleate
clozapine
clozapine
clozapine
iloperidone
iloperidone
lurasidone hcl
SAPHRIS
QL, ST
CLOZAPINE
QL
CLOZARIL
QL
VERSACLOZ
QL, ST
FANAPT(TAB DS PK) QL, ST
FANAPT(TAB)
QL, ST
LATUDA(TAB)(120
QL, ST
MG)
lurasidone hcl
LATUDA(TAB)(20 MG) QL, ST
lurasidone hcl
lurasidone hcl
lurasidone hcl
olanzapine
ZYPREXA
QL
olanzapine pamoate
ZYPREXA RELPREVV
paliperidone
INVEGA(TAB ER
QL, ST
24H)(1.5 MG)
paliperidone
INVEGA(TAB ER
QL, ST
24H)(3 MG)
paliperidone
INVEGA(TAB ER
QL, ST
24H)(6 MG)
paliperidone
INVEGA(TAB ER
QL, ST
24H)(9 MG)
paliperidone palmitate INVEGA SUSTENNA
paliperidone palmitate INVEGA TRINZA
quetiapine fumarate
SEROQUEL
QL
quetiapine fumarate
SEROQUEL XR(TAB QL, ST
ER 24H)
quetiapine fumarate
SEROQUEL
XR(TAB24HDSPK)
risperidone
RISPERDAL(SOLUTIO QL
N)
risperidone
RISPERDAL(TAB)
QL
risperidone microspheres RISPERDAL CONSTA
ziprasidone hcl
GEODON
QL
ziprasidone mesylate
GEODON
Antipsychotics,dopamine Antagonists,
EQUETRO
LITHIUM
CARBONATE
LITHIUM
Thioxanthenes
T1 thiothixene
THIOTHIXENE
Anti-narcolepsy & Anti-cataplexy,sedative-type Agt
Antipsychotics,dopamine
T4 sodium oxybate
Antagonists,butyrophenones
XYREM
Antipsych,dopamine
Antag.,diphenylbutylpiperidines
T1 pimozide
Sutter Health Plus
ORAP
PA
T1 droperidol
DROPERIDOL
T1 haloperidol
HALOPERIDOL
T1 haloperidol decanoate HALDOL
DECANOATE 50
Page 7 of 106
T1
T1
T1
T1
T3
T1
T1
T1
T1
T1
T3
T3
T1
T3
T1 haloperidol decanoate HALOPERIDOL
DECANOATE
T1 haloperidol lactate
HALOPERIDOL
LACTATE
Antipsychotics,dopamine
Antagonst,dihydroindolones
T1 molindone hcl
MOLINDONE HCL
Anti-psychotics,phenothiazines
T1 chlorpromazine hcl
T1
T1
T1
T1
T1
CHLORPROMAZINE
HCL
fluphenazine decanoate FLUPHENAZINE
DECANOATE
fluphenazine hcl
FLUPHENAZINE HCL
perphenazine
PERPHENAZINE
thioridazine hcl
THIORIDAZINE HCL
trifluoperazine hcl
TRIFLUOPERAZINE
HCL
amobarbital sodium
butabarbital sodium
pentobarbital sodium
phenobarbital
phenobarbital sodium
phenobarbital sodium
T3 secobarbital sodium
Comb
T1 olanzapine/fluoxetine
hcl
AMYTAL SODIUM
BUTISOL SODIUM
NEMBUTAL SODIUM
PHENOBARBITAL
LUMINAL SODIUM
PHENOBARBITAL
SODIUM
SECONAL SODIUM
T1 clonidine hcl
T1 guanfacine hcl
FLUMAZENIL
DOPRAM
Hsdd Agents-mixed Serotonin Agonist/antagonists
T3 flibanserin
ADDYI
PA, QL
Hypnotics, Melatonin Mt1/mt2 Receptor Agonists
T3 ramelteon
T4 tasimelteon
ROZEREM
HETLIOZ
QL, ST
PA
Monoamine Oxidase(mao) Inhibitors
T1 methylphenidate hcl
Narcolepsy And Sleep Disorder Therapy Agents
T3 armodafinil
T1 modafinil
EMSAM
NUVIGIL
PROVIGIL
PA
PA
Narcotic Antagonists
T3
T1
T3
T1
naloxone hcl
naloxone hcl
naloxone hcl
naltrexone hcl
EVZIO
NALOXONE HCL
NARCAN
REVIA
QL
T3
T3
T1
T2
methylphenidate hcl
methylphenidate hcl
methylphenidate hcl
methylphenidate hcl
T2 atomoxetine hcl
T1 dexmedetomidine hcl
T3 dexmedetomidine in 0.9
% nacl
T3 doxepin hcl
T1 estazolam
T1 eszopiclone
T2 atomoxetine hcl
Sutter Health Plus
QL
QL
METHYLIN(SOLUTIO
N)
METHYLIN(TAB
CHEW)
QUILLICHEW ER
QUILLIVANT XR
RITALIN
RITALIN LA
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
QL, ST
AGE,
QL, ST
QL
QL, ST
QL
AGE,
QL
Tx For Attention Deficit-hyperact.(adhd), Nri-type
Sedative-hypnotics,non-barbiturate
PRECEDEX
PRECEDEX
T2 atomoxetine hcl
SILENOR
ESTAZOLAM
LUNESTA
KAPVAY
INTUNIV
T1 dexmethylphenidate hcl FOCALIN XR(CPBP
50-50)(10 MG)
50-50)(15 MG)
50-50)(20 MG)
50-50)(25 MG)
50-50)(30 MG)
50-50)(35 MG)
50-50)(40 MG)
50-50)(5 MG)
T3 methylphenidate
DAYTRANA
APTENSIO XR
QL
T3 selegiline
QL
Tx For Attention Deficit-hyperact(adhd)/narcolepsy
Central Nervous System Stimulants
T1 doxapram hcl
SYMBYAX
Tx For Adhd - Selective Alpha-2a Receptor Agonist
Benzodiazepine Antagonists
T1 flumazenil
FLURAZEPAM HCL
ATIVAN
LORAZEPAM
MIDAZOLAM HCL
BELSOMRA
QL, ST
RESTORIL
HALCION
TRIAZOLAM
SONATA
QL
AMBIEN
QL
EDLUAR
QL, ST
INTERMEZZO
QL, ST
ZOLPIDEM TARTRATEQL
ZOLPIMIST
QL, ST
Ssri &antipsych,atyp,dopamine&serotonin Antag
Barbiturates
T1
T3
T3
T1
T3
T1
flurazepam hcl
lorazepam
lorazepam
midazolam hcl
suvorexant
temazepam
triazolam
triazolam
zaleplon
zolpidem tartrate
zolpidem tartrate
zolpidem tartrate
zolpidem tartrate
zolpidem tartrate
QL, ST
T2 atomoxetine hcl
QL
STRATTERA(CAP)(10 QL
MG)
MG)
MG)
MG)
Page 8 of 106
T2 atomoxetine hcl
T2 atomoxetine hcl
T2 atomoxetine hcl
MG)
MG)
MG)
T1 milrinone lactate/d5w MILRINONE IN 5%
DEXTROSE
CARDIOVASCULAR DISEASE
HYPERTENSION
Ace Inhibitor/calcium Channel Blocker
ARRHYTHMIA
Combination
Antiarrhythmics
T1 amlodipine
LOTREL
besylate/benazepril
T3 perindopril
PRESTALIA
arg/amlodipine bes
T1 trandolapril/verapamil TARKA
hcl
T1
T1
T1
T1
adenosine
adenosine
amiodarone hcl
amiodarone hcl/d5w
T3 amiodarone in
dextrose,iso-osm
T1 disopyramide
phosphate
T2 disopyramide phosphate
T2 dofetilide
T2 dronedarone hcl
T1 flecainide acetate
T1 ibutilide fumarate
T1 lidocaine hcl/d5w/pf
T1
T1
T1
T1
T1
T1
lidocaine hcl/pf
mexiletine hcl
procainamide hcl
propafenone hcl
propafenone hcl
quinidine gluconate
T1 quinidine sulfate
ADENOCARD
ADENOSINE
AMIODARONE HCL
AMIODARONE HCL
D5W
NEXTERONE
NORPACE
NORPACE CR
TIKOSYN
MULTAQ
FLECAINIDE
ACETATE
CORVERT
LIDOCAINE HCL IN
5% DEXTROSE
LIDOCAINE HCL
MEXILETINE HCL
PROCAINAMIDE HCL
PROPAFENONE HCL
RYTHMOL
QUINIDINE
GLUCONATE
QUINIDINE SULFATE
CARDIAC STIMULANT
digoxin
digoxin
digoxin
digoxin
digoxin
digoxin
T3 digoxin
T1 digoxin
T3 digoxin
DIGOXIN
DIGOXIN(SOLUTION)
DIGOXIN(SYRINGE)
LANOXIN PEDIATRIC
LANOXIN(AMPUL)
LANOXIN(TAB)(125
MCG)
LANOXIN(TAB)(187.5
MCG)
LANOXIN(TAB)(250
MCG)
LANOXIN(TAB)(62.5
MCG)
Inotropic Drugs
T1 dobutamine hcl
T1 dobutamine hcl/d5w
T1 milrinone lactate
Sutter Health Plus
Ace Inhibitor/thiazide & Thiazide-like Diuretic
T1 benazepril/hydrochloro BENAZEPRIL
thiazide
HYDROCHLOROTHIA
ZIDE
T1 benazepril/hydrochloro LOTENSIN HCT
thiazide
T1 captopril/hydrochlorothCAPTOPRIL
iazide
HYDROCHLOROTHIA
ZIDE
T1 enalapril/hydrochloroth ENALAPRIL
iazide
HYDROCHLOROTHIA
ZIDE
T1 enalapril/hydrochloroth VASERETIC
iazide
T1 fosinopril/hydrochlorot FOSINOPRIL
hiazide
HYDROCHLOROTHIA
ZIDE
T1 lisinopril/hydrochloroth ZESTORETIC
iazide
T1 moexipril/hydrochlorot MOEXIPRIL
hiazide
HYDROCHLOROTHIA
ZIDE
T1 quinapril/hydrochlorot ACCURETIC
hiazide
Alpha/beta-adrenergic Blocking Agents
Digitalis Glycosides
T2
T2
T1
T3
T1
T1
QL, ST
DOBUTAMINE HCL
DOBUTAMINE HCL IN
DEXTROSE
MILRINONE LACTATE
T1
T2
T1
T1
carvedilol
carvedilol phosphate
labetalol hcl
labetalol hcl
COREG
COREG CR
LABETALOL HCL
TRANDATE
Alpha-adrenergic Blocking Agents
T1
T3
T4
T1
doxazosin mesylate
doxazosin mesylate
phenoxybenzamine hcl
phentolamine mesylate
T1 prazosin hcl
T1 terazosin hcl
CARDURA
CARDURA XL
DIBENZYLINE
PHENTOLAMINE
MESYLATE
MINIPRESS
TERAZOSIN HCL
Angioten.receptr Antag./cal.chanl Blkr/thiazide Cb
T1 amlodipine/valsartan/h EXFORGE HCT
cthiazid
T2 olmesartan/amlodipin/hct TRIBENZOR
hiazid
ST
ST
Page 9 of 106
Angiotensin Receptor Antag./thiazide Diuretic
Antihypertensives, Sympatholytic
Comb
T1
T1
T1
T1
T1
T3 azilsartan
EDARBYCLOR
med/chlorthalidone
T1 candesartan/hydrochlor ATACAND HCT
othiazid
T1 irbesartan/hydrochlorotAVALIDE
hiazide
T1 losartan/hydrochlorothi HYZAAR
azide
T2 olmesartan/hydrochlorot BENICAR HCT
hiazide
T1 telmisartan/hydrochlor MICARDIS HCT
othiazid
T1 valsartan/hydrochlorot DIOVAN HCT
hiazide
ST
T1
T1
T1
ST
T1
T1
clonidine
CATAPRES-TTS 1
clonidine
CATAPRES-TTS 2
clonidine
CATAPRES-TTS 3
clonidine hcl
CATAPRES
clonidine
CLORPRES
hcl/chlorthalidone
guanfacine hcl
TENEX
methyldopa
METHYLDOPA
methyldopa/hydrochlor METHYLDOPA
othiazide
HYDROCHLOROTHIA
ZIDE
methyldopate hcl
METHYLDOPATE HCL
reserpine
RESERPINE
Antihypertensives, Vasodilators
Angiotensin Receptor Antgnst & Calc.channel
T3 fenoldopam mesylate
T1 hydralazine hcl
T1 minoxidil
Blockr
Beta-adrenergic Blocking Agents
T2 amlodipine
AZOR
bes/olmesartan med
T1 amlodipine/valsartan EXFORGE
T1 telmisartan/amlodipine TWYNSTA
ST
ST
Antihypertensives, Ace Inhibitors
T1
T1
T1
T3
benazepril hcl
benazepril hcl
captopril
enalapril maleate
BENAZEPRIL HCL
LOTENSIN
CAPTOPRIL
EPANED
T1
T1
T1
T1
T1
T1
T1
enalapril maleate
enalaprilat dihydrate
fosinopril sodium
lisinopril
moexipril hcl
perindopril erbumine
perindopril erbumine
VASOTEC
ENALAPRILAT
FOSINOPRIL SODIUM
ZESTRIL
MOEXIPRIL HCL
ACEON
PERINDOPRIL
ERBUMINE
ACCUPRIL
ALTACE
MAVIK
T1 quinapril hcl
T1 ramipril
T1 trandolapril
AGE,
QL, ST
Antihypertensives, Angiotensin Receptor
Antagonist
T3 azilsartan medoxomil
T1 candesartan cilexetil
T1 eprosartan mesylate
T1
T1
T2
T1
T1
irbesartan
losartan potassium
olmesartan medoxomil
telmisartan
valsartan
EDARBI
ATACAND
EPROSARTAN
MESYLATE
AVAPRO
COZAAR
BENICAR
MICARDIS
DIOVAN
VECAMYL
Antihypertensives, Miscellaneous
T3 metyrosine
T3 nitroprusside sodium
Sutter Health Plus
DEMSER
NITROPRESS
T1
T1
T1
T1
T1
T3
SECTRAL
TENORMIN
BETAXOLOL HCL
ZEBETA
BREVIBLOC
BREVIBLOC
T1
T2
T3
T1
T3
nadolol
nebivolol hcl
penbutolol sulfate
pindolol
propranolol hcl
TOPROL XL
LOPRESSOR
METOPROLOL
TARTRATE
CORGARD
BYSTOLIC
LEVATOL
PINDOLOL
HEMANGEOL
T3
T3
T1
T1
T1
T3
T3
T1
propranolol hcl
propranolol hcl
propranolol hcl
sotalol hcl
sotalol hcl
sotalol hcl
sotalol hcl
timolol maleate
INDERAL XL
INNOPRAN XL
PROPRANOLOL HCL
BETAPACE
SOTALOL
SOTALOL HCL
SOTYLIZE
QL, ST
TIMOLOL MALEATE
ST
Beta-adrenergic Blocking Agents/thiazide &
ST
Related
ST
Antihypertensives, Ganglionic Blockers
T3 mecamylamine hcl
acebutolol hcl
atenolol
betaxolol hcl
bisoprolol fumarate
esmolol hcl
esmolol in sodium
chloride,iso
T1 metoprolol succinate
T1 metoprolol tartrate
T1 metoprolol tartrate
CORLOPAM
HYDRALAZINE HCL
MINOXIDIL
PA
AGE,
QL, ST
ST
ST
T1 atenolol/chlorthalidone TENORETIC 100
T1 atenolol/chlorthalidone TENORETIC 50
T1 bisoprolol
ZIAC
fumarate/hctz
T3 metoprolol
DUTOPROL
succinate/hctz
T1 metoprolol/hydrochloro LOPRESSOR HCT
thiazide
T1 metoprolol/hydrochloro METOPROLOL
thiazide
HYDROCHLOROTHIA
ZIDE
T1 nadolol/bendroflumethi CORZIDE
azide
Page 10 of 106
T1 propranolol/hydrochlor PROPRANOLOLothiazid
HYDROCHLOROTHIA
ZID
Potassium Sparing Diuretics In Combination
T1 amiloride/hydrochlorot AMILORIDE
hiazide
HYDROCHLOROTHIA
ZIDE
T1 spironolact/hydrochloro ALDACTAZIDE(TAB)
thiazid
(25 MG-25MG)
T3 spironolact/hydrochlorot ALDACTAZIDE(TAB)
hiazid
(50 MG-50MG)
T1 triamterene/hydrochlor DYAZIDE
othiazid
T1 triamterene/hydrochlor MAXZIDE
othiazid
T1 triamterene/hydrochlor MAXZIDE-25 MG
othiazid
T1 triamterene/hydrochlor TRIAMTERENE
othiazid
HYDROCHLOROTHIA
ZID
Calcium Channel Blocking Agents
T1
T3
T3
T1
T1
T1
T1
T1
T3
T1
T1
T3
T3
T1
T1
T1
T4
T1
T1
T1
T1
amlodipine besylate
NORVASC
clevidipine butyrate
CLEVIPREX
diltiazem hcl
CARDIZEM LA
diltiazem hcl
CARTIA XT
diltiazem hcl/d5w
DILTIAZEM-D5W
felodipine
FELODIPINE ER
isradipine
ISRADIPINE
nicardipine hcl
CARDENE I.V.
nicardipine hcl
CARDENE SR
nicardipine hcl
NICARDIPINE HCL
nicardipine hcl in 0.9% NICARDIPINE HCL
nacl
0.9% NACL
nicardipine in
CARDENE I.V.
dextrose,iso-os
nicardipine in nacl, iso- CARDENE I.V.
osm
nifedipine
ADALAT CC
nifedipine
PROCARDIA XL
nimodipine
NIMODIPINE
nimodipine
NYMALIZE
nisoldipine
NISOLDIPINE
nisoldipine
SULAR
verapamil hcl
CALAN SR
verapamil hcl
VERAPAMIL ER
AMMONIUM
CHLORIDE
Loop Diuretics
T1
T1
T3
T1
T1
T1
T1
bumetanide
ethacrynate sodium
ethacrynic acid
furosemide
furosemide
torsemide
torsemide
T3 mannitol
T1 mannitol
T1 mannitol
T3 mannitol
BUMETANIDE
SODIUM EDECRIN
EDECRIN
FUROSEMIDE
LASIX
DEMADEX
TORSEMIDE
MANNITOL
OSMITROL(IV
SOLN)(10 %)
OSMITROL(IV
SOLN)(15 %)
OSMITROL(IV
SOLN)(20 %)
OSMITROL(IV
SOLN)(5 %)
RESECTISOL
Potassium Sparing Diuretics
T1
T1
T1
T3
amiloride hcl
eplerenone
spironolactone
triamterene
T4 riociguat
PA
PA
Pulm.anti-htn,sel.c-gmp Phosphodiesterase T5
Inhib
T4 sildenafil citrate
REVATIO(SUSP
RECON)
REVATIO(TAB)
ADCIRCA
PA
PA
PA
Pulmonary Anti-htn, Endothelin Receptor
AMILORIDE HCL
INSPRA
ALDACTONE
DYRENIUM
T4 ambrisentan
T4 bosentan
T4 macitentan
LETAIRIS
TRACLEER
OPSUMIT
PA
PA
Pulmonary Antihypertensives, Prostacyclin-type
T4 epoprostenol sodium
(arginine)
T4 epoprostenol sodium
(glycine)
T4 iloprost tromethamine
T4 selexipag
T4 treprostinil
T4 treprostinil diolamine
T4 treprostinil sodium
T4 treprostinil/neb
accessories
T4 treprostinil/nebulizer/acc
esor
VELETRI
PA
FLOLAN
PA
VENTAVIS
UPTRAVI
TYVASO
ORENITRAM ER
REMODULIN
TYVASO
PA
PA
PA
PA
PA
PA
TYVASO
PA
TEKTURNA
PA
Renin Inhibitor, Direct
T3 aliskiren hemifumarate
Renin Inhibitor, Direct & Calcium Channel
Blocker
T3 aliskiren/amlodipine
besylate
Sutter Health Plus
ADEMPAS
Antagonist
Osmotic Diuretics
T1 mannitol
T1 mannitol
Stimulator
T1 sildenafil citrate
T4 tadalafil
Inorganic Salt Diuretics
T1 ammonium chloride
Pulm Anti-htn,soluble Guanylate Cyclase
TEKAMLO
PA
Page 11 of 106
Renin Inhibitor, Direct/thiazide Diuretic Comb
T2 rosuvastatin calcium
T3 aliskiren/hydrochlorothia TEKTURNA HCT
zide
PA
Thiazide And Related Diuretics
T1
T3
T1
T1
T1
chlorothiazide
chlorothiazide
chlorothiazide sodium
chlorthalidone
hydrochlorothiazide
T2
T1
T1
T1
T1
T1
T1
T1
T1
T1
hydrochlorothiazide
indapamide
methyclothiazide
metolazone
CHLOROTHIAZIDE
DIURIL
SODIUM DIURIL
CHLORTHALIDONE
HYDROCHLOROTHIA
ZIDE
MICROZIDE
INDAPAMIDE
METHYCLOTHIAZIDE
METOLAZONE
Antihyperlipidemic - Mtp Inhibitor
T4 lomitapide mesylate
T4
T4
T4
T4
T2 isosorb dinit/hydralazine BIDIL
hcl
Vasodilators,miscellaneous
alirocumab
alirocumab
evolocumab
evolocumab
T3 niacin/lovastatin
Antihyperlip.hmg Coa Reduct
Inhib&cholest.ab.inhib
T3 ezetimibe/simvastatin
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
Antihyperlipidemic - Apo B-100 Synthesis Inhibitor
T4 mipomersen sodium
KYNAMRO
PA
Antihyperlipidemic - Hmg Coa Reductase
Inhibitors
T1
T1
T3
T1
T3
T1
T1
atorvastatin calcium
fluvastatin sodium
lovastatin
lovastatin
pitavastatin calcium
pravastatin sodium
pravastatin sodium
Sutter Health Plus
LIPITOR
LESCOL
ALTOPREV
LOVASTATIN
LIVALO
PRAVACHOL
PRAVASTATIN
SODIUM
PRALUENT PEN
PA
PRALUENT SYRINGE PA
REPATHA SURECLICKPA
REPATHA SYRINGE PA
Inhib.&niacin
IRREGULARITY
LIPTRUZET(TAB)(10
MG-10MG)
LIPTRUZET(TAB)(10
MG-20MG)
LIPTRUZET(TAB)(10
MG-40MG)
LIPTRUZET(TAB)(10
MG-80MG)
VYTORIN(TAB)(10
MG-10MG)
VYTORIN(TAB)(10
MG-20MG)
VYTORIN(TAB)(10
MG-40MG)
VYTORIN(TAB)(10
MG-80MG)
PA
Antihyperlipidemic-hmg Coa Reductase
ALPROSTADIL
PROSTIN VR
PEDIATRIC
CARDIOVASCULAR DISEASE - LIPID
T3 ezetimibe/atorvastatin
calcium
calcium
calcium
calcium
JUXTAPID
Antihyperlipidemic - Pcsk9 Inhibitors
Vasodilators, Combination
T1 alprostadil
T3 alprostadil
rosuvastatin calcium
simvastatin
simvastatin
simvastatin
simvastatin
simvastatin
CRESTOR(TAB)(10
QL, ST
MG)
CRESTOR(TAB)(20
QL, ST
MG)
CRESTOR(TAB)(40
QL, ST
MG)
CRESTOR(TAB)(5 MG) QL, ST
ZOCOR(TAB)(10 MG)
ZOCOR(TAB)(20 MG)
ZOCOR(TAB)(40 MG)
ZOCOR(TAB)(5 MG)
ZOCOR(TAB)(80 MG) ST
QL, ST
QL, ST
QL, ST
T2 niacin/simvastatin
ADVICOR(TBMP
24HR)(1000-20MG)
ADVICOR(TBMP
24HR)(1000-40 MG)
ADVICOR(TBMP
24HR)(500MG-20MG)
ADVICOR(TBMP
24HR)(750MG-20MG)
SIMCOR(TBMP
24HR)(1000-20MG)
SIMCOR(TBMP
24HR)(1000-40 MG)
SIMCOR(TBMP
24HR)(500MG-20MG)
SIMCOR(TBMP
24HR)(500MG-40MG)
SIMCOR(TBMP
24HR)(750MG-20MG)
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
Bile Salt Sequestrants
T1 cholestyramine (with QUESTRAN
sugar)
T1 cholestyramine/asparta PREVALITE
me
T1 cholestyramine/asparta QUESTRAN LIGHT
me
T2 colesevelam hcl
WELCHOL
T1 colestipol hcl
COLESTID(GRANULE
S)
T1 colestipol hcl
COLESTID(PACKET)(5
G)
T3 colestipol hcl
COLESTID(PACKET)
(7.5 G)
T1 colestipol hcl
COLESTID(TAB)
Lipotropics
T2 ezetimibe
T1 fenofibrate
T1 fenofibrate
ZETIA
FENOGLIDE
LIPOFEN
QL
Page 12 of 106
T1 fenofibrate
LOFIBRA
T1 fenofibrate
TRICOR
nanocrystallized
T2 fenofibrate
TRIGLIDE
nanocrystallized
T3 fenofibrate,micronized ANTARA
T1 fenofibrate,micronized FENOFIBRATE
T1 fenofibrate,micronized LOFIBRA
T1 fenofibric acid
FIBRICOR
T1 fenofibric acid (choline) TRILIPIX
T1 gemfibrozil
LOPID
T2 icosapent ethyl
VASCEPA
T3 methionine/inositol/choli LIPOCHOL PLUS
ne/fa
T1 niacin
NIASPAN
T1 omega-3 acid ethyl
LOVAZA
esters
T1 nitroglycerin
T2 nitroglycerin
ST
T1 nitroglycerin
ST
T1 nitroglycerin
T2 nitroglycerin
QL
T3 nitroglycerin
T2 nitroglycerin
T1 nitroglycerin/d5w
ST
QL
Vasodilators,peripheral
T1 ergoloid mesylates
T1 isoxsuprine hcl
T1 papaverine hcl
MISCELLANEOUS AGENTS
NORTHERA
MIDODRINE HCL
PA
Angiotensin Recept-neprilysin Inhibitor Comb
T3 sacubitril/valsartan
ENTRESTO
PA, QL
Antianginal & Anti-ischemic Agents,non
hemodynamic
T2 ranolazine
T2 ranolazine
RANEXA(TAB ER
12H)(1000 MG)
RANEXA(TAB ER
12H)(500 MG)
QL
QL
Antianginal, Heart Rate Reducing, I(f) Inhibitor
T2 ivabradine hcl
CORLANOR
PA, QL
Antihyperlip - Hmg-coa&calcium Channel Blocker
Cb
T1 amlodipine/atorvastatinCADUET
VASODILATION
Vasodilators,coronary
T1
T3
T1
T2
T1
T1
amyl nitrite
isosorbide dinitrate
AMYL NITRITE
DILATRATE-SR
ISOCHRON
ISORDIL
ISORDIL TITRADOSE
ISOSORBIDE
DINITRATE
T1 isosorbide mononitrate ISOSORBIDE
MONONITRATE ER
T2 nitroglycerin
NITRO-BID
T1 nitroglycerin
NITRO-DUR(PATCH
TD24)(0.1MG/HR)
Sutter Health Plus
ERGOLOID
MESYLATES
ISOXSUPRINE HCL
PAPAVERINE HCL
CONTRACEPTION/OXYTOCICS
Adrenergic Vasopressor Agents
T4 droxidopa
T1 midodrine hcl
NITRO-DUR(PATCH
TD24)(0.2MG/HR)
NITRO-DUR(PATCH
TD24)(0.3 MG/HR)
NITRO-DUR(PATCH
TD24)(0.4MG/HR)
NITRO-DUR(PATCH
TD24)(0.6MG/HR)
NITRO-DUR(PATCH
TD24)(0.8MG/HR)
NITRONAL
NITROSTAT
NITROGLYCERIN IN
D5W
QL
Contraceptives, Intravaginal, Systemic
T5 etonogestrel/ethinyl
estradiol
NUVARING
G, QL,
ST
Contraceptives,intravaginal
T5 nonoxynol 9
T5 nonoxynol 9
T5 nonoxynol 9
T5 nonoxynol 9
CONCEPTROL(OTC)
GYNOL II(OTC)
TODAY
CONTRACEPTIVE
SPONGE(OTC)
VCF(OTC)
G
G
G
G
AZURETTE
G
APRI
G
BEYAZ
G, ST
SAFYRAL
G, ST
NATAZIA
G, ST
OCELLA
G, ST
KELNOR 1-35
G
MY WAY(OTC)
LEVORA-28
G
G
CAMRESE
G, QL
QUARTETTE
G, QL
Contraceptives,oral
T5 desoge.estradiol/e.estradiol
T5 desogestrel-ethinyl
estradiol
T3 drospir/eth
estra/levomefol ca
T3 drospir/eth
estra/levomefol ca
T3 estradiol
valerate/dienogest
T5 ethinyl
estradiol/drospirenone
T5 ethynodiol d-ethinyl
estradiol
T5 levonorgestrel
T5 levonorgestrel-ethin
estradiol
T5 l-norgest/e.estradione.estrad
T3 l-norgest/e.estradione.estrad
T5 noreth-ethinyl
estradiol/iron
T5 norethindrone
T5 norethindrone ac-eth
estradiol
T5 norethindrone ac-eth
estradiol
NORETHIN-ETH
G
ESTRA FERROUS FUM
NORA-BE
G
LOESTRIN
G
MICROGESTIN
G
Page 13 of 106
T2 norethindronee.estradiol-iron
T5 norethindrone-ethinyl
estrad
T5 norethindrone-ethinyl
estrad
T5 norethindronemestranol
T5 norgestimate-ethinyl
estradiol
T5 norgestrel-ethinyl
estradiol
T5 ulipristal acetate
LO LOESTRIN FE
G, ST
Narcotic Antituss-decongestant-expectorant Comb
MICROGESTIN FE
G
T3 hydrocodone/pseudoephe HYCOFENIX
d/guaif
MINASTRIN 24 FE
G
Narcotic Antitussive-1st Generation Antihistamine
NECON
G
ORTHO-NOVUM
G
NORINYL 1+50
G
SPRINTEC
G
CRYSELLE
G
T3 codeine poli/chlorphenir TUZISTRA XR
polis
T3 hydrocodone/chlorphen TUSSICAPS
p-stirex
T1 hydrocodone/chlorphen TUSSIONEX
p-stirex
T3 hydrocodone/chlorphenir VITUZ
amine
T1 promethazine
PROMETHAZINE
hcl/codeine
CODEINE
ELLA
G
Contraceptives,transdermal
T5 norelgestromin/ethin.es ORTHO EVRA
tradiol
G, QL
CAYA CONTOURED
WIDE SEAL
DIAPHRAGM
T1
T3
T3
T1
T1
Narcotic Antitussive-anticholinergic Comb.
T1 hydrocodone
bit/homatrop me-br
HYDROMET
T3 p-ephed hcl/hydrocodone REZIRA
G
G
Oxytocics
T3
T3
T3
T3
carboprost tromethamine HEMABATE
dinoprostone
CERVIDIL
dinoprostone
PREPIDIL
dinoprostone
PROSTIN E2 VAGINAL
SUPPOSITORY
methylergonovine
METHYLERGONOVIN
maleate
E MALEATE
oxytocin
OXYTOCIN
oxytocin
PITOCIN
oxytocin/0.9 % sodium OXYTOCIN-0.9%
chloride
NACL
oxytocin/ringers lactate OXYTOCIN
LACTATED RINGERS
Narcotic Antitussive-expectorant Combination
T1 guaifenesin/codeine
CHERATUSSIN
phosphate
AC(OTC)
T2 guaifenesin/codeine
PRO-CLEAR
phosphate
CAPS(OTC)
T3 guaifenesin/hydrocodone FLOWTUSS
T3 guaifenesin/hydrocodone OBREDON
decongest
T1 brompheniramine/pseu BROMPHENIRAMINE
doephed/dm
PSEUDOEPHED-DM
T1 chlorpheniramine/phen CENTERGY DM
yleph/dm
Non-narc Antitussive-1st Gen Antihistamine Comb.
T1 promethazine/dextrome PROMETHAZINE-DM
thorphan
1st Gen Antihistamine & Decongestant
Nose Preparations, Vasoconstrictors
T3 epinephrine hcl
Combinations
PROMETHAZINE VC
T3 tetrahydrozoline hcl
ADRENALIN
CHLORIDE
TYZINE
Sympathomimetic Agents
1st Gen Antihist-decongest-anticholinergic Comb
T1 phenylephrine hcl
T1 p-ephed hcl/chlormal/bell alk
DERMATOLOGY - ACNE
RESPA A.R.
Antitussives,non-narcotic
Acne Agents,systemic
T1 benzonatate
T1 benzonatate
T1 benzonatate
T3 isotretinoin
T1 isotretinoin
BENZONATATE
TESSALON PERLE
ZONATUSS
Narcotic Antituss-1st Gen. Antihistamine-decongest
T1 hydrocodone/cpm/pseu ZUTRIPRO
doephed
T1 promethazine/phenylep PROMETHAZINE VCh/codeine
CODEINE
Sutter Health Plus
QL, ST
QL, ST
Non-narc Antituss-1st Gen. Antihistamine
COUGH AND COLD
T1 phenylephrine
hcl/prometh hcl
QL, ST
Narcotic Antitussive-decongestant Combinations
Diaphragms/cervical Cap
T3 diaphragms, contoured
T5 diaphragms, wide seal
QL, ST
VAZCULEP
ABSORICA
CLARAVIS
ST
EPIDUO
AGE,
QL, ST
AGE,
QL, ST
Acne Agents,topical
T3 adapalene/benzoyl
peroxide
T3 adapalene/benzoyl
peroxide
T3 azelaic acid
EPIDUO FORTE
AZELEX
Page 14 of 106
T2 clindamycin
phos/benzoyl perox
T3 clindamycin
phos/benzoyl perox
T1 clindamycin
phos/benzoyl perox
T3 clindamycin
phos/benzoyl perox
T3 clindamycin/benzoyl/em
ol cmb94
T3 clindamycin/tretinoin
T2 clindamycin/tretinoin
T3 dapsone
T1 sulfacetamide sodium
ACANYA
BENZACLIN(GEL
W/PUMP)
BENZACLIN(GEL)
ST
T3 tretinoin
AGE
T1
T1
AGE
AGE
T3
ONEXTON
NEUAC
T1
VELTIN
ZIANA
ACZONE
KLARON
ST
T3
TRETINX(CREAM)(0.075 %)
tretinoin microspheres RETIN-A MICRO
PUMP(GEL
W/PUMP)(0.04 %)
PUMP(GEL
W/PUMP)(0.08 %)
PUMP(GEL
W/PUMP)(0.1 %)
tretinoin/emol cmb9/skin TRETIN-X
cln1
Antibiotics, Miscellaneous, Other
Vitamin A Derivatives, Topical Acne Agents
T1 bacitracin
T2 tazarotene
BACIIM
FABIOR
AGE
AGE
AGE
AGE
Anticorrosive Agents
DERMATOLOGY - ANTIINFECTIVE
T3 butylated hydroxytolueneBUTYLATED
HYDROXYTOLUENE
(BHT)
Antiparasitics
Keratolytic-glucocorticoid Combinations
Topical Antibiotics
T2 benzoyl
VANOXIDE-HC
peroxide/hydrocortison
T3 clindamycin phos/skin
clnsr 19
T3 clindamycin phos/skin
clnsr 19
T1 clindamycin phosphate
T1 erythromycin
base/ethanol
T1 erythromycin
base/ethanol
T1 erythromycin/benzoyl
peroxide
T2 erythromycin/benzoyl
peroxide
T1 gentamicin sulfate
T3 nitazoxanide
Rosacea Agents, Topical
T3
T3
T3
T1
T1
T1
T3
T1
T3
azelaic acid
brimonidine tartrate
ivermectin
metronidazole
metronidazole
metronidazole
metronidazole
metronidazole
metronidazole/skin
cleansr #23
FINACEA
MIRVASO
SOOLANTRA
METROGEL
METROLOTION
METRONIDAZOLE
NORITATE
ROSADAN
ROSADAN
QL
Topical Preparations,antibacterials
T3 cadexomer iodine
IODOFLEX
T3 cadexomer iodine
IODOSORB
T3 clioquinol/hc/emollient DERMASORB AF
cmb#88
T3 clioquinol/hydrocortison ALA-QUIN
e
T3 hydrocortisone/iodoquin/ ALCORTIN A
aloe#2
T1 hydrocortisone/iodoqui HYDROCORTISONE
nol
IODOQUINOL
T1 hydrocortisone/iodoqui VYTONE
nol/aloe
T1 iodine/potassium iodide LUGOL'S
T3 iodoquinol/aloe
ALOQUIN
polysacchar #1
T1 silver nitrate
SILVER NITRATE
T1 mupirocin
T3 mupirocin
T1 mupirocin calcium
adapalene
tretinoin
tretinoin
tretinoin
Sutter Health Plus
DIFFERIN
ATRALIN
RETIN-A
TRETINX(CREAM)(0.0375 %)
CLINDACIN ETZ
CLINDACIN PAC
CLEOCIN T
CLINDACIN P
CLINDAGEL
EVOCLIN
ERYGEL
ERYTHROMYCIN
BENZAMYCIN
BENZAMYCINPAK
GENTAMICIN
SULFATE
BACTROBAN
CENTANY AT
BACTROBAN
Topical Antifungal/antiinflammatory,steriod Agent
T1 clotrimazole/betametha CLOTRIMAZOLE
sone dip
BETAMETHASONE
T1 clotrimazole/betametha LOTRISONE
sone dip
Topical Antifungals
Vitamin A Derivatives
T1
T1
T1
T3
ALINIA
AGE
AGE
AGE
AGE
T3
T1
T1
T1
T1
T1
T3
butenafine hcl
ciclopirox
ciclopirox
ciclopirox
ciclopirox olamine
ciclopirox olamine
ciclopirox/nail lacquer
removr
T3 ciclopirox/skin cleanser
no.28
MENTAX
CICLOPIROX
LOPROX
PENLAC
CICLODAN
CICLOPIROX
CNL 8
CICLODAN
Page 15 of 106
T1 ciclopirox/ure/camph/m CICLODAN
enth/euc
T3 ciclopirox/urea
PEDIPAK
T1 clotrimazole
CLOTRIMAZOLE
T1 econazole nitrate
ECONAZOLE
NITRATE
T3 econazole nitrate
ECOZA
T1 gentian viol/brlnt
TRIPLE DYE
grn/proflav
T3 ketoconazole
EXTINA
T1 ketoconazole
KETOCONAZOLE
T1 ketoconazole
NIZORAL
T3 ketoconazole
XOLEGEL
T3 luliconazole
LUZU
QL, ST
T3 miconazole nitrate/zinc VUSION
ox/pet
T1 naftifine hcl
NAFTIN(CREAM)(1 %)
T2 naftifine hcl
NAFTIN(CREAM)(2 %)
T2 naftifine hcl
NAFTIN(GEL)(1 %)
T3 naftifine hcl
NAFTIN(GEL)(2 %)
T1 nystatin
NYSTATIN
T3 nystatin/emollient combo PEDIADERM AF
no.54
T3 nystatin/emollient combo NYATA
no.88
T1 nystatin/triamcin
NYSTATIN
TRIAMCINOLONE
T3 oxiconazole nitrate
OXISTAT
T3 sertaconazole nitrate
ERTACZO
T1 sodium thiosulfate/sal EXODERM
acid
T2 sulconazole nitrate
EXELDERM
T3 tavaborole
KERYDIN
PA
Topical Antiparasitics
T3
T2
T3
T1
T1
T1
T1
benzyl alcohol
crotamiton
ivermectin
lindane
malathion
permethrin
spinosad
ULESFIA
EURAX
SKLICE
LINDANE
OVIDE
ELIMITE
NATROBA
Topical Antivirals
T2 acyclovir
T1 acyclovir
T3 penciclovir
T3 sulfacetamide
sodium/sulfur
T1 sulfacetamide
sodium/sulfur
T3 sulfacetamide
sodium/sulfur
T3 sulfacetamide
sodium/sulfur
T1 sulfacetamide
sodium/sulfur
T1 sulfacetamide
sodium/sulfur
T1 sulfacetamide
sodium/sulfur
T1 sulfacetamide
sodium/sulfur
T3 sulfacetamide
sodium/sulfur
T3 sulfacetamide
sodium/sulfur
T3 sulfacetamide
sodium/sulfur
T1 sulfacetamide
sodium/sulfur
T1 sulfacetamide
sodium/sulfur
AVAR LS
AVAR(CLEANSER)
AVAR(FOAM)
AVAR(MED PAD)
AVAR-E LS
PLEXION(CLEANSER)
PLEXION(CREAM)
PLEXION(LOTION)
PLEXION(MED PAD)
ROSANIL
ROSULA(CLEANSER)
ROSULA(MED PAD)
SODIUM
SULFACETAMIDE
SULFUR
SS 10-2
T1 sulfacetamide
sodium/sulfur
T1 sulfacetamide
SUMADAN
sodium/sulfur
T1 sulfacetamide
ZENCIA
sodium/sulfur
T1 sulfacetamide/sulfur/cle SODIUM
ansr23
SULFACETAMIDE
SULFUR
T3 sulfacetamide/sulfur/clea SUMADAN
nsr23
T3 sulfacetamide/sulfur/clea SUMAXIN CP
nsr23
T1 sulfact
SUMADAN XLT
sod/sulur/avob/otn/oct
DERMATOLOGY
ZOVIRAX(CREAM)
ZOVIRAX(OINT)
DENAVIR
ANTIINFLAMMATORY
Topical Antivirals/antiinflammatory, Steroid Agent
Topical Antibiotics/antiinflammatory,steroidal
T3 acyclovir/hydrocortisone XERESE
T3 neomycin
NEO-SYNALAR
sulfate/fluocinolone
T2 neomycin/bacitra/polymyCORTISPORIN
xin/hc
T3 neomycin/fluocinolone/e NEO-SYNALAR
mol #65
T2 neomycin/polymyxin b CORTISPORIN
sulf/hc
Topical Genital Wart-hpv Treatment Agents
T3 sinecatechins
VEREGEN
Topical Pleuromutilin Derivatives
T3 retapamulin
ALTABAX
Topical Sulfonamides
T3 mafenide acetate
T1 silver sulfadiazine
T1 sulfacetamide
sod/sulfur/urea
Sutter Health Plus
SULFAMYLON
SILVER
SULFADIAZINE
SODIUM
SULFACETAMIDE
SULFUR
QL, ST
ST
ST
Topical Anti-inflammatory Steroidal
T1 alclometasone
dipropionate
T1 amcinonide
T1 betamethasone
dipropionate
ALCLOMETASONE
DIPROPIONATE
AMCINONIDE
BETAMETHASONE
DIPROPIONATE
Page 16 of 106
T1 betamethasone valerate BETAMETHASONE
VALERATE
T1 betamethasone valerate LUXIQ
T1 betamethasone/propyle DIPROLENE
ne glyc
T1 betamethasone/propyle DIPROLENE AF
ne glyc
T1 clobetasol propionate CLOBETASOL
PROPIONATE
T1 clobetasol propionate CLOBEX
T1 clobetasol propionate CLODAN
T1 clobetasol propionate OLUX
T1 clobetasol propionate TEMOVATE
T1 clobetasol
CLOBETASOL
propionate/emoll
EMOLLIENT
T1 clobetasol
TEMOVATE
propionate/emoll
EMOLLIENT
T3 clobetasol/skin cleanser CLODAN
#28
T1 clocortolone pivalate CLODERM
T3 desonide
DESONATE
T1 desonide
DESONIDE
T1 desonide
DESOWEN
T3 desonide
VERDESO
T1 desoximetasone
TOPICORT(CREAM)
T1 desoximetasone
TOPICORT(GEL)
T1 desoximetasone
TOPICORT(OINT)
T3 desoximetasone
TOPICORT(SPRAY)
ST
T1 diflorasone diacetate DIFLORASONE
DIACETATE
T1 diflorasone diacetate PSORCON
T2 diflorasone
APEXICON E
diacetate/emoll
T3 fluocinolone acetonide CAPEX SHAMPOO
T1 fluocinolone acetonide DERMA-SMOOTHE-FS
T1 fluocinolone acetonide FLUOCINOLONE
ACETONIDE
T1 fluocinolone acetonide SYNALAR
T3 fluocinolone/emol
SYNALAR
cmb#65
T1 fluocinolone/shower capDERMA-SMOOTHE-FS
T3 fluocinolone/skin clnsr28 SYNALAR TS
T1 fluocinonide
FLUOCINONIDE
T1 fluocinonide
VANOS
T1 fluocinonide/emollient FLUOCINONIDE-E
base
T2 flurandrenolide
CORDRAN
T1 fluticasone propionate CUTIVATE
T1 fluticasone propionate FLUTICASONE
PROPIONATE
T3 halcinonide
HALOG
T1 halobetasol propionate ULTRAVATE
T3 halobetasol/lactic acid ULTRAVATE X
T1 hc/mineral
HYDROCORTISONE
oil/petrolat,wht
T2 hydrocort/sal
SCALACORT DK
acid/sulf/shmp#1
T1 hydrocortisone
HYDROCORTISONE
T2 hydrocortisone
TEXACORT
NUCORT
T3 hydrocortisone
acetate/aloe v
T1 hydrocortisone
U-CORT
acetate/urea
Sutter Health Plus
T1 hydrocortisone
LOCOID(CREAM)
butyrate
T3 hydrocortisone butyrate LOCOID(LOTION)
T1 hydrocortisone
LOCOID(OINT)
butyrate
T1 hydrocortisone
LOCOID(SOLUTION)
butyrate
T1 hydrocortisone
LOCOID LIPOCREAM
butyrate/emoll
T2 hydrocortisone probutate PANDEL
T1 hydrocortisone valerate HYDROCORTISONE
VALERATE
T3 hydrocortisone/emol
PEDIADERM HC
no.45
T3 hydrocortisone/skin clnsr AQUA GLYCOLIC HC
#25
T3 hydrocortisone/skin clnsr DERMASORB HC
#35
ELOCON
T1 prednicarbate
DERMATOP
T3 triamcinolone
DERMACINRX
aceton/silicones
SILAZONE
T1 triamcinolone acetonideKENALOG
ACETONIDE
T1 triamcinolone/dimeth/si DERMASILKRX SDS QL, ST
licone
T3 triamcinolone/dimeth/sili WHYTEDERM TDPAK
cone
T3 triamcinolone/dimeth/sili WHYTEDERM
cone
TRILASIL PAK
T3 triamcinolone/emollient PEDIADERM TA
cmb#45
T3 triamcinolone/emollient DERMASORB TA
cmb#86
Topical Anti-inflammatory, Nsaids
T3 diclofenac epolamine
T1 diclofenac sodium
FLECTOR
DICLOFENAC
SODIUM
PENNSAID
VOLTAREN
T3 diclofenac/benzalkonium DS PREP PAK
chlor
ST
DERMATOLOGY - ANTIPRURITIC
DRUGS
Antipruritics,topical
T3 doxepin hcl
T3 doxepin hcl
PRUDOXIN
ZONALON
DERMATOLOGY - MISCELLANEOUS
Antiperspirants
T2 aluminum chloride
DRYSOL
Antiseborrheic Agents
T1
T3
T3
T1
selenium sulfide
selenium sulfide
selenium sulfide
sulfacetamide sodium
SELENIUM SULFIDE
SELRX
TERSI FOAM
OVACE
Page 17 of 106
T3
T3
T3
T2
OVACE
PLUS(CLEANSR ER)
OVACE PLUS(CREAM)
OVACE PLUS(FOAM)
OVACE PLUS(LOTION)ST
OVACE
PLUS(SHAMPOO)
SODIUM
SULFACETAMIDE
Antiseptics,miscellaneous
T3 guaiacol
GUAIACOL
Emollients
T1 ammonium lactate
T3 emollient combination
no.60
T3 emollient combination
no.60
T1 lactic acid
AMMONIUM
LACTATE
ALEVICYN
ANTIPRURITIC SG
CELACYN
LACTIC ACID
Irrigants
T1 acetic acid
ACETIC ACID
T1 mannitol/sorbitol
SORBITOLsolution
MANNITOL
T1 neomycin su/polymyx b NEOSPORIN G.U.
sulf
IRRIGANT
T1 ringers solution
RINGERS IRRIGATION
T3 ringers solution,lactated LACTATED RINGERS
T1 sodium chloride irrig SODIUM CHLORIDE
solution
T1 sorbitol solution
SORBITOL
T1 water for
WATER
irrigation,sterile
Irritants/counter-irritants
T3 capsaicin/menthol
T3 capsaicin/skin cleanser
RELYYT
SINELEE(ADH
PATCH)(0.0375%-5%)
SINELEE(ADH
PATCH)(0.05%-5%)
SOLAICE
QUTENZA
PA
Keratolytics
T1
T3
T3
T3
T1
T3
T3
T2
T1
benzoyl peroxide
benzoyl peroxide
benzoyl peroxide
benzoyl peroxide
benzoyl peroxide
microspheres
benzoyl peroxide/sulfur
benzoyl peroxide/vit e
mix
podofilox
podofilox
T1 podophyllum resin
T1 potassium hydroxide
T3 salicylic ac/benzoyl
per/vit e
Sutter Health Plus
T3 salicylic ac/benzoyl
INOVA 8-2
per/vit e
T3 salicylic acid
BENSAL HP
T1 salicylic acid
KERALYT
T3 salicylic acid
KERALYT SCALP
T1 salicylic acid
SALACYN
T1 salicylic acid
SALEX
T1 salicylic acid
SALICYLIC ACID
T3 salicylic acid
ULTRASAL-ER
T1 salicylic acid
VIRASAL
T1 salicylic acid/ammon SALICYLIC ACID
lact/aloe
T1 salicylic acid/ceramide SALEX
cmb #1
T3 salicylic acid/urea
SALVAX DUO PLUS
T1 silver nitrate applicator SILVER NITRATE
APPLICATOR
T1 urea
ALUVEA
T3 urea
CARB-O-PHILIC
T3 urea
GORDO-UREA
T3 urea
HYDRO 35
T3 urea
KERAFOAM
T1 urea
KERALAC
T1 urea
REA LO 40
T3 urea
UMECTA PD
T3 urea
UMECTA(EMULSN)
T1 urea
UMECTA(NL FM
SUSP)
T1 urea
URAMAXIN(CREAM)
T3 urea
URAMAXIN(FOAM)
T1 urea
URAMAXIN(GEL)
T1 urea
URAMAXIN(LOTION)
T1 urea
UREA
T3 urea
UREVAZ
T3 urea
UTOPIC
T3 urea/emollient cmb no.18DERMASORB XM
T3 urea/emollient
URAMAXIN GT
combination #65
T1 urea/hyaluronate
UREA
sodium
T1 urea/lactic ac/zn
BP-50% UREA
undecylenate
T1 urea/lactic acid/salicylic LATRIX
ac
Protectives
BENZEPRO
PACNEX HP
PACNEX LP
PACNEX MX
BENZEPRO
T1 petrolatum,white
VASELINE WHITE
PETROLEUM
T3 protectives combination TETRIX
no.2
NUOX
INOVA
T1 urea
CONDYLOX(GEL)
CONDYLOX(SOLUTIO
N)
PODOCON-25
POTASSIUM
HYDROXIDE
INOVA 4-1
T2 hydrocortisone/pramoxin ANALPRAM HC
e
T3 hydrocortisone/pramoxin EPIFOAM
e
T2 hydrocortisone/pramoxin PRAMOSONE(CREA
e
M)(1 %-1 %)
T1 hydrocortisone/pramox PRAMOSONE(CREA
ine
M)(2.5 %-1 %)
Topical Agents,miscellaneous
CARB-O-PHILIC
Topical Anti-inflammatory Steroid-local Anesthetic
Page 18 of 106
T2 hydrocortisone/pramoxin PRAMOSONE(LOTIO
e
N)
T2 hydrocortisone/pramoxin PRAMOSONE(OINT)
e
T3 hydrocortisone/pramoxin NOVACORT
e/aloe
T3 hydrocortisone/pramoxin PRAMOSONE E
e/emoll
T1 lidocaine/hydrocortison LIDOCAINEe ac
HYDROCORTISONE
Topical Antineoplastic & Premalignant Lesion
Agnts
T4
T4
T1
T1
T1
T3
T1
T3
T2
T2
T4
alitretinoin
bexarotene
diclofenac sodium
fluorouracil
fluorouracil
fluorouracil
fluorouracil
fluorouracil
ingenol mebutate
ingenol mebutate
mechlorethamine hcl
PANRETIN
TARGRETIN
PA
SOLARAZE
PA, QL
CARAC
EFUDEX
FLUOROPLEX
FLUOROURACIL
TOLAK
PICATO(GEL)(0.015 %) QL
PICATO(GEL)(0.05 %) QL
VALCHLOR
PA
Topical Local Anesthetics
T3
T1
T1
T3
T1
T1
T3
T1
T1
T3
T3
T3
T3
T1
T3
T3
T3
T3
T3
T3
T1
T1
T3
T1
T3
T3
T3
T3
benzocaine
cocaine hcl
ethyl chloride
lidocain/zn/meadowsw
xt/oak xt
lidocaine
lidocaine
lidocaine
lidocaine hcl
lidocaine hcl
ANACAINE
COCAINE HCL
ETHYL CHLORIDE
LDO PLUS
LIDOCAINE
LIDODERM
LIDOVEX
LIDOCAINE HCL
LIDOPIN(CREAM)(3
%)
lidocaine hcl
LIDOPIN(CREAM)
(3.25 %)
lidocaine hcl
LIDORX
lidocaine hcl/menthol
PAIN RELIEF
lidocaine hcl/menthol
SYNVEXIA TC
lidocaine hcl/menthol ZERUVIA
lidocaine/allantoin/petrol SCAR
atum
lidocaine/allantoin/petrol VEXA
atum
lidocaine/benzocain/me- ADAZIN
sal/cap
lidocaine/capsaicin/ment SILVERA
hol
lidocaine/menthol
RELYYKS
lidocaine/methyl
VELMA
sal/menthol
lidocaine/prilocaine
EMLA
lidocaine/prilocaine
RELADOR PAK PLUS
lidocaine/skin cleanser DERMASILKRX
no.37
LIDORXKIT
lidocaine/tetracaine
PLIAGLIS
lidocaine/tetracaine
SYNERA
norflurane/hfc 245fa
PAIN EASE
norflurane/hfc 245fa
SPRAY AND STRETCH
tetracaine hcl
PONTOCAINE
Sutter Health Plus
T3 tetracaine/benzocaine/but CETACAINE
amben
T3 tetracaine/benzocaine/but CETACAINE
amben
ANESTHETIC
Topical Preparations,miscellaneous
T3 povidone-iodine
BETADINE
Topical/mucous Membr./subcut. Enzymes
T3 collagenase clostridium
hist.
T3 hyaluronidase
T3 hyaluronidase, human
recomb.
T3 hyaluronidase,ovine
T1 trypsin/balsam
peru/castor oil
SANTYL
AMPHADASE
HYLENEX
VITRASE
GRANULEX
DERMATOLOGY - PIGMENTATION
DISORDERS
Topical Hyperpigmentation Agents
T2 methoxsalen
OXSORALEN
DERMATOLOGY
PSORIASIS/ECZEMA
Antipsoriatic Agents,systemic
T4
T2
T1
T4
acitretin
methoxsalen
methoxsalen, rapid
secukinumab
T4 secukinumab
T4 secukinumab
T4 secukinumab
SORIATANE
8-MOP
OXSORALEN-ULTRA
COSENTYX (2
SYRINGES)
COSENTYX PEN
COSENTYX PEN (2
PENS)
COSENTYX SYRINGE
PA
PA
PA
PA
Antipsoriatics Agents
T2
T3
T3
T1
T1
T3
T1
T2
anthralin
anthralin
anthralin micronized
calcipotriene
calcipotriene
calcipotriene
calcitriol
tazarotene
DRITHOCREME HP
ZITHRANOL-RR
ZITHRANOL
CALCIPOTRIENE
DOVONEX
SORILUX
VECTICAL
TAZORAC
ST
ST
ST
ST
ST
ST
ST
Topical Agents,miscellaneous
T3 pyrogallol
T3 urea
PYROGALLIC ACID
GORDO-UREA
Topical Immunosuppressive Agents
T3 pimecrolimus
ELIDEL
T1 tacrolimus
PROTOPIC
AGE,
ST
AGE,
ST
Topical Vit D Analog/antiinflammatory, Steroidal
T3 calcipotriene/betamethas ENSTILAR
one
Page 19 of 106
T1 calcipotriene/betamethaTACLONEX(OINT)
ST
sone
T3 calcipotriene/betamethas TACLONEX(SUSPENSI ST
one
ON)
DIABETES
Antihypergly, (dpp-4) Inhibitor & Biguanide Comb.
T3 alogliptin
KAZANO
benz/metformin hcl
T2 linagliptin/metformin hcl JENTADUETO
T3 saxagliptin
KOMBIGLYZE
hcl/metformin hcl
XR(TBMP 24HR)(2.5
1000MG)
T3 saxagliptin
KOMBIGLYZE
hcl/metformin hcl
XR(TBMP 24HR)(5
MG-500MG)
T3 saxagliptin
KOMBIGLYZE
hcl/metformin hcl
XR(TBMP 24HR)(5MG
1000MG)
T2 sitagliptin
JANUMET
phos/metformin hcl
T2 sitagliptin
JANUMET XR(TBMP
phos/metformin hcl
24HR)(100-1000MG)
T2 sitagliptin
JANUMET XR(TBMP
phos/metformin hcl
24HR)(50-1000 MG)
T2 sitagliptin
JANUMET XR(TBMP
phos/metformin hcl
24HR)(50MG-500MG)
QL, ST
QL
QL, ST
QL, ST
QL, ST
QL
QL
QL
QL
T2 pramlintide acetate
SYMLINPEN 60
Antihyperglycemic, Dpp-4 Inhibitors
T3
T2
T3
T2
alogliptin benzoate
linagliptin
saxagliptin hcl
sitagliptin phosphate
NESINA
TRADJENTA
ONGLYZA
JANUVIA
QL, ST
QL
QL, ST
QL
Antihyperglycemic, Insulin-release Stimulant Type
T1
T1
T1
T2
T1
T1
T1
T1
T1
T1
chlorpropamide
glimepiride
glipizide
glyburide
glyburide
glyburide,micronized
nateglinide
repaglinide
tolazamide
tolbutamide
CHLORPROPAMIDE
AMARYL
GLUCOTROL
DIABETA
GLYBURIDE
GLYNASE
STARLIX
PRANDIN
TOLAZAMIDE
TOLBUTAMIDE
Antihyperglycemic, Insulin-response Enhancer
T1 pioglitazone hcl
T3 rosiglitazone maleate
ACTOS
AVANDIA
ST
Antihyperglycemic, Sglt-2 & Dpp-4 Inhibitor Comb.
T2 empagliflozin/linagliptin GLYXAMBI
QL, ST
Antihyperglycemic,biguanide Type
Antihypergly,dpp-4 Enzyme Inhib
T1 metformin hcl
T2 metformin hcl
&thiazolidinedione
Antihyperglycemic,insulin-rel Stim.& Biguanide
T3 alogliptin
benz/pioglitazone
OSENI
QL, ST
Cmb
QL, ST
QL, ST
QL, ST
T1 glipizide/metformin hcl GLIPIZIDE
METFORMIN
T1 glyburide/metformin GLUCOVANCE
hcl
T1 glyburide/metformin GLYBURIDE
hcl
METFORMIN HCL
T1 repaglinide/metformin PRANDIMET
hcl
Antihypergly,incretin Mimetic
T3 albiglutide
T2 dulaglutide
T3 exenatide
TANZEUM
TRULICITY
BYETTA(PEN
INJCTR)(10MCG/0.04)
T3 exenatide
BYETTA(PEN
INJCTR)(5MCG/0.02)
T3 exenatide microspheres BYDUREON
T3 exenatide microspheres BYDUREON PEN
T2 liraglutide
VICTOZA 2-PAK
T2 liraglutide
VICTOZA 3-PAK
GLUCOPHAGE
RIOMET
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
Antihyperglycemic,insulin-response & Release
Comb.
Antihyperglycemc-sod/gluc
T1 pioglitazone
hcl/glimepiride
Cotransport2(sglt2)inhib
Antihyperglycemic-glucocorticoid Receptor Blocker
T2 canagliflozin
T3 dapagliflozin
propanediol
T2 empagliflozin
INVOKANA
FARXIGA
QL, ST
QL, ST
T4 mifepristone
JARDIANCE
QL, ST
Comb
Antihyperglycemic - Dopamine Receptor Agonists
T3 bromocriptine mesylate CYCLOSET
Antihyperglycemic, Alpha-glucosidase Inhib
T1 acarbose
T3 miglitol
PRECOSE
GLYSET
ST
DUETACT
KORLYM
ST
PA
Antihyperglycemic-sglt2 Inhibitor & Biguanide
T2 canagliflozin/metformin INVOKAMET
hcl
T3 dapagliflozin/metformin XIGDUO XR
hcl
T2 empagliflozin/metformin SYNJARDY
hcl
QL, ST
QL, ST
QL, ST
Antihyperglycemic, Amylin Analog-type
T2 pramlintide acetate
Sutter Health Plus
SYMLINPEN 120
Page 20 of 106
Antihyperglycm,insul-resp.enhancer & Biguanide
T3 blood sugar diagnostic
Cmb
T3
T3
T3
T3
T3
T3
T3
blood sugar diagnostic
T3
T3
T3
T3
T1 pioglitazone
ACTOPLUS MET
hcl/metformin hcl
T2 pioglitazone
ACTOPLUS MET XR
hcl/metformin hcl
T3 rosiglitazone/metformin AVANDAMET
hcl
ST
ST
ST
Blood Sugar Diagnostics
T3
T3
T3
T3
T3
Sutter Health Plus
ACCU-CHEK AVIVA ST
PLUS(OTC)
ACCU-CHEK
ST
AVIVA(OTC)
ACCU-CHEK
ST
SMARTVIEW(OTC)
ACCUTREND
ST
GLUCOSE(OTC)
ACURA TEST
STRIPS(OTC)
ADVANCED GLUCOSE
TEST STRIPS(OTC)
ADVOCATE REDI
CODE(OTC)
ADVOCATE REDI
CODE+(OTC)
ADVOCATE TEST
STRIP(OTC)
AGAMATRIX
AMP(OTC)
ASSURE 4(OTC)
ASSURE
PLATINUM(OTC)
ASSURE PRISM
MULTI(OTC)
BG-STAR(OTC)
BLOOD GLUCOSE
TEST STRIP(OTC)
BLOOD GLUCOSE
TEST(OTC)
CARESENS N(OTC)
CHOICEDM CLARUS
TEST STRIPS(OTC)
CLEVER CHOICE
MICRO TEST
STRIP(OTC)
CLEVER CHOICE
PRO(OTC)
CLEVER CHOICE
TALK(OTC)
CLEVER CHOICE
TEST STRIPS(OTC)
CLEVER CHOICE
VOICE+(OTC)
CONTOUR
ST
NEXT(OTC)
CONTOUR(OTC)
ST
CONTROL G3(OTC)
CONTROL(OTC)
DIATRUE PLUS(OTC)
EASY CHECK TEST
STRIP(OTC)
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
EASY GLUCO
G2(OTC)
EASY PLUS II(OTC)
EASY PLUS(OTC)
EASY STEP(OTC)
EASY TALK(OTC)
EASY TOUCH(OTC)
EASY TRAK(OTC)
EASYGLUCO
PLUS(OTC)
EASYGLUCO(OTC)
EASYMAX 15(OTC)
EASYMAX(OTC)
ELEMENT
COMPACT(OTC)
ELEMENT TEST
STRIPS(OTC)
EMBRACE EVO(OTC)
EMBRACE PRO(OTC)
EMBRACE(OTC)
EVENCARE G2(OTC)
EVENCARE G3(OTC)
EVENCARE MINI
GLUCOSE TEST
STR(OTC)
EVENCARE(OTC)
EVOLUTION TEST
STRIPS(OTC)
EZ SMART PLUS(OTC)
EZ SMART(OTC)
FIFTY50 TEST
STRIP(OTC)
FORA D10(OTC)
FORA D15G(OTC)
FORA D20(OTC)
FORA D40-G31 TEST
STRIPS(OTC)
FORA G20(OTC)
FORA G30A(OTC)
FORA GD50 TEST
STRIPS(OTC)
FORA TN'G VOICE
TEST STRIPS(OTC)
FORA V10(OTC)
FORA V12(OTC)
FORA V20(OTC)
FORA V30A(OTC)
FORA(OTC)
FORACARE
GD20(OTC)
FORACARE
GD40(OTC)
FORTISCARE
GLUCOSE TEST
STRIPS(OTC)
FREESTYLE
INSULINX(OTC)
FREESTYLE
LITE(OTC)
FREESTYLE
PRECISION NEO(OTC)
FREESTYLE(OTC)
G-4(OTC)
Page 21 of 106
T3
T3
T3
T3
Sutter Health Plus
GE100 BLOOD
GLUCOSE TEST
STRIP(OTC)
GENSTRIP(OTC)
GENULTIMATE
TEST(OTC)
GLUCO NAVII(OTC)
GLUCOCARD 01
SENSOR PLUS(OTC)
GLUCOCARD
EXPRESSION(OTC)
GLUCOCARD
SHINE(OTC)
GLUCOCARD VITAL
SENSOR(OTC)
GLUCOCOM
GLUCOSE(OTC)
GLUCOSE TEST
STRIP(OTC)
GMATE TEST
STRIPS(OTC)
HEALTHPRO TEST
STRIPS(OTC)
INFINITY TEST
STRIPS(OTC)
LIBERTY TEST
STRIPS(OTC)
MAXIMA(OTC)
MICRO(OTC)
MICRODOT
XTRA(OTC)
MICRODOT(OTC)
MYGLUCOHEALTH(O
TC)
NEUTEK 2TEK TEST
STRIPS(OTC)
NOVA MAX(OTC)
ON CALL EXPRESS
TEST STRIP(OTC)
ON CALL PLUS TEST
STRIP(OTC)
ON CALL VIVID TEST
STRIP(OTC)
ONE TOUCH
VERIO(OTC)
ONETOUCH ULTRA
TEST STRIPS(OTC)
ONETOUCH
VERIO(OTC)
OPTIUM EZ(OTC)
OPTIUM(OTC)
OPTUMRX(OTC)
PHARMACIST
CHOICE(OTC)
PRECISION PCX
PLUS(OTC)
PRECISION PCX(OTC)
PRECISION POINT OF
CARE(OTC)
PRECISION Q-I
D(OTC)
PRECISION
XTRA(OTC)
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T1
T1
T3
T1
T3
T3
T3
T3
T3
T3
T3
T3
T3
PREMIUM BLOOD
GLUCOSE TEST(OTC)
blood sugar diagnostic PREMIUM V10(OTC)
blood sugar diagnostic PRODIGY NO
CODING(OTC)
blood sugar diagnostic QUINTET AC(OTC)
blood sugar diagnostic QUINTET(OTC)
blood sugar diagnostic REFUAH PLUS(OTC)
blood sugar diagnostic RELION CONFIRM
MICRO(OTC)
blood sugar diagnostic RELION PRIME TEST
STRIPS(OTC)
blood sugar diagnostic REVEAL TEST
STRIP(OTC)
blood sugar diagnostic RIGHTEST GS100
TEST STRIPS(OTC)
blood sugar diagnostic RIGHTEST GS250S
TEST STRIPS(OTC)
TEST STRIPS(OTC)
TEST STRIPS(OTC)
TEST STRIPS(OTC)
blood sugar diagnostic SMART SENSE TEST
STRIPS(OTC)
blood sugar diagnostic SMARTEST
TEST(OTC)
blood sugar diagnostic SOLUS V2(OTC)
blood sugar diagnostic SURE-TEST
EASYPLUS MINI(OTC)
blood sugar diagnostic TD GOLD TEST
STRIP(OTC)
blood sugar diagnostic TELCARE(OTC)
blood sugar diagnostic TEST N'GO(OTC)
blood sugar diagnostic TEST STRIPS(OTC)
blood sugar diagnostic TRUE METRIX
GLUCOSE TEST
STRIP(OTC)
blood sugar diagnostic TRUETEST TEST
STRIPS(OTC)
blood sugar diagnostic TRUETRACK SMART
SYSTEM(OTC)
blood sugar diagnostic TRUETRACK TEST
STRIP(OTC)
blood sugar diagnostic ULTIMA(OTC)
blood sugar diagnostic ULTRATRAK
ULTIMATE(OTC)
blood sugar diagnostic ULTRATRAK(OTC)
blood sugar diagnostic UNISTRIP1(OTC)
blood sugar diagnostic WAVESENSE
JAZZ(OTC)
blood sugar diagnostic WAVESENSE
PRESTO(OTC)
blood sugar diagnostic, BREEZE 2(OTC)
ST
disc
blood sugar diagnostic, ACCU-CHEK
ST
drum
COMPACT PLUS(OTC)
blood sugar diagnostic, ACCU-CHEK
ST
drum
COMPACT(OTC)
Diabetic Supplies
T3 blood-gl & bp
meter,adult cuff
FORA D15(OTC)
Page 22 of 106
T3 blood-gl & bp
meter,adult cuff
T3 blood-glu
meter,cont/transmit
T3 blood-gluc.meter& wrist
bp mon
bp mon
bp mon
T3 blood-glucose meter
T3
T3
T3
T3
T3
T3
T3
T3
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
Sutter Health Plus
FORA D40(OTC)
GUARDIAN REAL
TIME
2TEK(OTC)
ADVOCATE
DUO(OTC)
FORA D10(OTC)
ADVANCED GLUCOSE
METER(OTC)
ADVOCATE BLOOD
GLUCOSE
MONITOR(OTC)
ADVOCATE REDI
CODE(OTC)
ADVOCATE REDI
CODE+(OTC)
AGAMATRIX
AMP(OTC)
ASSURE
PLATINUM(OTC)
ASSURE PRISM
MULTI(OTC)
BLOOD GLUCOSE
METER(OTC)
BLOOD GLUCOSE
MONITOR(OTC)
BLOOD GLUCOSE
MONITORING(OTC)
BLOOD-GLUCOSE
METER(OTC)
CARESENS N
VOICE(OTC)
CARESENS N(OTC)
CHOICEDM
CLARUS(OTC)
CLEVER CHEK
BLOOD GLUCOSE
SYST(OTC)
CLEVER CHOICE
BLOOD GLUC
SYS(OTC)
CLEVER CHOICE HD
GLUCOSE SYST(OTC)
CLEVER CHOICE
MICRO(OTC)
CLEVER CHOICE
PRO(OTC)
CLEVER CHOICE
TALK(OTC)
CLEVER
CHOICE(OTC)
CONTROL(OTC)
DIATRUE PLUS(OTC)
EASY CHECK(OTC)
EASY PLUS II(OTC)
EASY PLUS(OTC)
EASY STEP(OTC)
EASY TALK(OTC)
EASY TOUCH
GLUCOSE
MONITOR(OTC)
T3
T3
T3
T3
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
T3
T3
T3
T3
T3
T3
T3
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
T3
T3
T3
T3
T3
T3
T3
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
T3
T3
T3
T3
T3
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
EASY TRAK(OTC)
EASYGLUCO
PLUS(OTC)
EASYGLUCO(OTC)
EASYMAX L(OTC)
EASYMAX NG(OTC)
EASYMAX V
SPEAKING(OTC)
EASYMAX V2(OTC)
ELEMENT BLOOD
GLUCOSE
METER(OTC)
ELEMENT COMPACT
V(OTC)
ELEMENT
COMPACT(OTC)
ELEMENT PLUS(OTC)
EMBRACE EVO(OTC)
EMBRACE PRO(OTC)
EMBRACE(OTC)
EVENCARE G2(OTC)
EVENCARE G3(OTC)
EVENCARE MINI
MONITOR
SYSTEM(OTC)
EVENCARE(OTC)
EVOLUTION BLOOD
GLUCOSE
METER(OTC)
EZ SMART PLUS(OTC)
EZ SMART(OTC)
FORA D20(OTC)
FORA G20(OTC)
FORA G30A(OTC)
FORA GD50(OTC)
FORA TEST N'GO
VOICE(OTC)
FORA TN'G
VOICE(OTC)
FORA V10(OTC)
FORA V12(OTC)
FORA V20(OTC)
FORA V30A(OTC)
FORACARE
GD20(OTC)
FORACARE
GD40A(OTC)
FORACARE
GD40B(OTC)
FORTISCARE BLOOD
GLUCOSE SYST(OTC)
GDRIVE(OTC)
GE100 BLOOD
GLUCOSE
SYSTEM(OTC)
GLUCO NAVII(OTC)
GLUCOCARD 01(OTC)
GLUCOCARD
EXPRESSION(OTC)
GLUCOCARD
SHINE(OTC)
GLUCOCARD
VITAL(OTC)
Page 23 of 106
T3
T3
T3
T3
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
T3
T3
T3
T3
T3
T3
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
Sutter Health Plus
GLUCOCOM BLOOD
GLUCOSE(OTC)
GMATE VOICE
METER(OTC)
GMATE VOICE
STARTER(OTC)
HEALTHPRO
GLUCOSE
MONITOR(OTC)
INFINITY(OTC)
MICRO(OTC)
MICRODOT(OTC)
MYGLUCOHEALTH(O
TC)
NOVA MAX BLOOD
GLUCOSE
METER(OTC)
ON CALL EXPRESS
METER(OTC)
ON CALL PLUS
METER(OTC)
ON CALL VIVID
METER(OTC)
ON CALL VIVID
PAL(OTC)
OPTUMRX(OTC)
PHARMACIST
CHOICE(OTC)
PREMIUM BLOOD
GLUCOSE(OTC)
PREMIUM V10(OTC)
PRESTO PRO(OTC)
PRODIGY
AUTOCODE(OTC)
PRODIGY
POCKET(OTC)
PRODIGY VOICE(OTC)
PRODIGY(OTC)
QUINTET AC(OTC)
QUINTET(OTC)
REFUAH PLUS(OTC)
RELION
CONFIRM(OTC)
RELION MICRO(OTC)
RELION PRIME(OTC)
REVEAL BLOOD
GLUCOSE
METER(OTC)
RIGHTEST GM100
SYSTEM(OTC)
RIGHTEST GM250S
METER(OTC)
RIGHTEST GM260
METER(OTC)
RIGHTEST GM300
SYSTEM(OTC)
RIGHTEST GM550
SYSTEM(OTC)
SMART CARESENS
N(OTC)
SMART SENSE
MONITORING
SYSTEM(OTC)
T3
T3
T3
T1
blood-glucose meter
blood-glucose meter
blood-glucose meter
blood-glucose meter
T3 blood-glucose
meter,continuous
T3 blood-glucose
meter,mobile dev
T3 blood-glucose
meter,mobile dev
T3 lancing device
T3 lancing device
T3 lancing device
SMARTEST
EJECT(OTC)
SMARTEST
PERSONA(OTC)
SMARTEST
PRONTO(OTC)
SMARTEST
PROTEGE(OTC)
SMARTEST SMART
CODE(OTC)
SMARTEST
TALKING(OTC)
SOLUS V2(OTC)
SURE-TEST
EASYPLUS MINI(OTC)
TD GOLD BLOOD
GLUCOSE
MONITOR(OTC)
TD GOLD VOICE
GLUCOSE
MONITOR(OTC)
TELCARE BGM(OTC)
TELCARE(OTC)
TEST N'GO(OTC)
TRUE METRIX AIR
GLUCOSE
METER(OTC)
TRUE2GO BLOOD
GLUCOSE
SYSTEM(OTC)
TRUERESULT BLOOD
GLUCOSE
SYSTM(OTC)
TRUETRACK BLOOD
GLUCOSE
SYSTEM(OTC)
TRUETRACK SMART
SYSTEM(OTC)
ULTIMA(OTC)
ULTRATRAK
PRO(OTC)
ULTRATRAK
ULTIMATE(OTC)
ULTRATRAK(OTC)
WAVESENSE
AMP(OTC)
WAVESENSE
JAZZ(OTC)
WAVESENSE
PRESTO(OTC)
DEXCOM G4
GMATE SMART
METER(OTC)
GMATE SMART
STARTER(OTC)
ADJUSTABLE
QL
LANCING
DEVICE(OTC)
ADVOCATE LANCING QL
DEVICE(OTC)
ADVOCATE RAPID
QL
SAFE(OTC)
Page 24 of 106
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3 lancing device
T3
T3
T3
T3
lancing device
lancing device
lancing device
lancing device
Sutter Health Plus
ALTERNATE SITE
LANCING
DEVICE(OTC)
AQUA LANCE
LANCING
DEVICE(OTC)
AUTO-LANCET
MINI(OTC)
AUTOLET LANCING
DEVICE(OTC)
CARELANCE ULT
LANCING
DEVICE(OTC)
CAREONE(OTC)
CARESENS PREM
LANCING
DEVICE(OTC)
DROPLET LANCING
DEVICE(OTC)
EASY CLICK(OTC)
EASY TOUCH
LANCING
DEVICE(OTC)
FORA LANCING
DEVICE(OTC)
GLUCOLET 2(OTC)
GMATE LANCING
DEVICE(OTC)
HEALTHY ACCENTS
AUTOLET(OTC)
INCONTROL
LANCING
DEVICE(OTC)
LANCET
DEVICE(OTC)
LANCING
DEVICE(OTC)
LANCING
SYSTEM(OTC)
LITE TOUCH(OTC)
MINI LANCING
DEVICE(OTC)
ON CALL LANCING
DEVICE(OTC)
ON CALL PLUS
LANCING
DEVICE(OTC)
PRODIGY LANCING
DEVICE(OTC)
RELIAMED MINI
LANCING
DEVICE(OTC)
RIGHTEST
GD500(OTC)
SMARTDIABETES
VANTAGE(OTC)
SOFTCLIX(OTC)
SURE COMFORT
LANCING PEN(OTC)
SUREFLEX(OTC)
SURE-PEN(OTC)
TRUEDRAW(OTC)
ULTI-LANCE(OTC)
QL
T3 lancing device/lancets
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
ACCU-CHEK
QL
FASTCLIX(OTC)
ACCU-CHEK
QL
SOFTCLIX(OTC)
ACCU-CHEK(OTC)
QL
ADVANCED LANCING QL
DEVICE(OTC)
AUTOLET
QL
IMPRESSION(OTC)
GLUCOLET 2(OTC)
QL
HYPOLANCE(OTC)
QL
LANCING
QL
DEVICE(OTC)
LANZO(OTC)
QL
MICROLET 2(OTC)
QL
ONETOUCH
QL
DELICA(OTC)
PENLET PLUS BLOOD QL
SAMPLER(OTC)
SOLUS V2 LANCING QL
DEVICE(OTC)
SUREFLEX(OTC)
QL
UNISTIK 2
QL
EXTRA(OTC)
UNISTIK 2 NORMAL QL
UNISTIK 2
QL
NORMAL(OTC)
UNISTIK 2(OTC)
QL
UNISTIK 3
QL
COMFORT(OTC)
UNISTIK 3
QL
NEONATAL(OTC)
UNISTIK 3(OTC)
QL
QL
Diabetic Ulcer Preparations,topical
QL
T2 becaplermin
QL
Hyperglycemics
QL
T3 diazoxide
T3 glucagon,human
recombinant
T2 glucagon,human
recombinant
QL
Insulins
QL
QL
REGRANEX
PROGLYCEM
GLUCAGEN
GLUCAGON
EMERGENCY KIT
T3 insulin aspart
T3 insulin aspart
QL
QL
T3
T3
T3
QL
T1
QL
T1
QL
QL
QL
QL
QL
QL
T3
T3
T2
T2
NOVOLOG FLEXPEN QL, ST
NOVOLOG(CARTRIDG QL, ST
E)
insulin aspart
NOVOLOG(VIAL)
QL, ST
insulin aspart protam & NOVOLOG MIX 70-30 QL, ST
aspart
insulin aspart protam & NOVOLOG MIX 70-30 QL, ST
aspart
FLEXPEN
insulin degludec
TRESIBA
FLEXTOUCH U-100
insulin degludec
TRESIBA
FLEXTOUCH U-200
insulin detemir
LEVEMIR
QL, ST
insulin detemir
LEVEMIR
QL, ST
FLEXTOUCH
insulin
LANTUS
QL
glargine,hum.rec.anlog
insulin
LANTUS SOLOSTAR QL
Page 25 of 106
T2 insulin
T3 insulin glulisine
T3 insulin glulisine
T2 insulin lispro
T2 insulin lispro
T2 insulin lispro
T2 insulin lispro
T2 insulin nph hum/reg
insulin hm
insulin hm
insulin hm
T3 insulin nph human
isophane
isophane
isophane
T2 insulin npl/insulin lispro
T2 insulin npl/insulin lispro
TOUJEO SOLOSTAR
QL
T1 hc/pramoxine
hcl/chloroxylenol
APIDRA
APIDRA SOLOSTAR
HUMALOG KWIKPEN
U-100
HUMALOG KWIKPEN
U-200
HUMALOG(CARTRID
GE)
HUMALOG(VIAL)
HUMULIN 70/30
KWIKPEN(OTC)
HUMULIN 70-30(OTC)
QL, ST
QL, ST
QL
Ear Preparations,antibiotics
QL
QL
QL
QL
QL
T1 ciprofloxacin hcl
T3 neomycin
su/colist/hc/thonzon
T3 neomycin
su/colist/hc/thonzon
T1 neomycin/polymyxin b
sulf/hc
OTICIN HC
CETRAXAL
COLY-MYCIN S
CORTISPORIN-TC
NEOMYCIN
POLYMYXIN-HC
Ear Preparations,local Anesthetics
HUMULIN N
KWIKPEN(OTC)
HUMULIN N(OTC)
QL
T3 antipyrine/benzocain/gly/ OTOZIN
zinc
T1 antipyrine/benzocaine ANTIPYRINE
BENZOCAINE
T1 benzocaine
PINNACAINE
QL
Otic Preparations,anti-inflammatory-antibiotics
NOVOLIN N(OTC)
QL, ST
NOVOLIN 70-30(OTC) QL, ST
HUMALOG MIX 50-50
HUMALOG MIX 50-50
KWIKPEN
T2 insulin npl/insulin lispro HUMALOG MIX 75-25
T2 insulin npl/insulin lispro HUMALOG MIX 75-25
KWIKPEN
T3 insulin regular, human AFREZZA(CART
W/DEV)(4 UNIT(30))
W/DEV)(4 UNIT(60))
W/DEV)(4 UNIT)
W/DEV)(8 UNIT(60))
T2 insulin regular, human HUMULIN R U-500
T2 insulin regular, human HUMULIN R(OTC)
T3 insulin regular, human NOVOLIN R(OTC)
QL
QL
T2 ciprofloxacin
CIPRODEX
hcl/dexameth
T3 ciprofloxacin/hydrocortis CIPRO HC
one
Otic,antiinfective-local Anesthetic Combinations
QL
QL
T1 chloroxylenol/pramoxin OTICIN
e hcl
PA, QL
Otic-antiinfective, Local Anesth & Anti-inflam Cmb
PA, QL
T3 chloroxylenol/benzoc/hy TRIOXIN
drocort
PA, QL
ELECTROLYTE REGULATION
PA, QL
Arginine Vasopressin (avp) Receptor Antagonists
QL
QL
QL, ST
T3 conivaptan hcl in 5 %
dextrose
T3 tolvaptan
T3 tolvaptan
VAPRISOL-5%
DEXTROSE
SAMSCA(TAB)(15 MG)QL
SAMSCA(TAB)(30 MG)QL
Urine Glucose Test Aids
Bicarbonate Producing/containing Agents
T3 urine glucose test,strip
T1 sodium acetate
T3 sodium bicarbonate
T1 sodium bicarbonate
DIASTIX
REAGENT(OTC)
T3 urine glucose test,strip NO-STICK
GLUCOSE(OTC)
T2 urine glucose test,tablet CLINITEST
REAGENT(OTC)
EAR - GENERAL DISORDERS
T1 sodium lactate
Drugs Used To Treat Acidosis
T3 tromethamine
Ear Preparations Anti-inflammatory
Electrolyte Depleters
T1 fluocinolone acetonide DERMOTIC
oil
T1
T1
T3
T1
Ear Preparations, Misc. Anti-infectives
T1 acetic acid
T1 acetic acid/aluminum
acetate
T1 acetic
acid/hydrocortisone
T3 hc/pramoxine
hcl/chloroxylenol
Sutter Health Plus
ACETIC ACID
ACETIC ACIDALUMINUM
HYDROCORTISONE
ACETIC ACID
CORTANE-B
SODIUM ACETATE
NEUT
SODIUM
BICARBONATE
SODIUM LACTATE
T3
T3
T3
T2
T2
calcium acetate
calcium acetate
calcium acetate
calcium carbonate/mag
carb/fa
ferric citrate
lanthanum carbonate
patiromer calcium
sorbitex
sevelamer carbonate
sevelamer hcl
THAM
CALCIUM ACETATE
PHOSLO
PHOSLYRA
MAGNEBIND 400 RX
AURYXIA
FOSRENOL
VELTASSA
QL
RENVELA
RENAGEL
Page 26 of 106
T1 sodium polystyrene
KIONEX
sulfonate
T3 sucroferric oxyhydroxide VELPHORO
Electrolyte Maintenance
T3 electrolyte-148 solution
T1 electrolyte-48
solution/d5w
T3 electrolyte-56
solution/d5w
T3 electrolyte-a solution
T3
T3
T3
T3
T3
T3
T3
T3
T3
T1
T3
T3
T3
T3
T3
PLASMA-LYTE 148
DEXTROSE 5%
ELECTROLYTE #48
PLASMA-LYTE 56 IN
DEXTROSE
PLASMA-LYTE A PH
7.4
electrolyte-b
IONOSOL B WITH
solution/d5w
DEXTROSE 5%
electrolyte-m
NORMOSOL-M AND
solution/d5w
DEXTROSE
electrolyte-mb
IONOSOL MB
solution/d5w
DEXTROSE 5%
electrolyte-p
ISOLYTE P WITH
solution/d5w
DEXTROSE
electrolyte-r (ph 7.4)
NORMOSOL-R PH 7.4
electrolyte-r solution
NORMOSOL-R
electrolyte-r
NORMOSOL-R AND
solution/d5w
DEXTROSE
electrolyte-s (ph 7.4)
ISOLYTE S
electrolyte-s solution
ISOLYTE S
ringers solution
RINGERS INJECTION
ringers solution,lactated LACTATED RINGERS
sod/pot/mag/cal/chlo/ace/NUTRILYTE
gluc
sodium/k+/mag/ca/chlor/ HYPERLYTE CR
acetate
sodium/k+/mag/ca/chlor/ TPN ELECTROLYTES
acetate
sodium/k+/mag/ca/chlor/ TPN ELECTROLYTES
acetate
II
Phosphate Replacement
T1 potassium phos in 0.9
% nacl
POTASSIUM
PHOSPHATE-0.9%
NACL
POTASSIUM
PHOSPHATE
GLYCOPHOS
T1 potassium phos,mbasic-d-basic
T1 sodium
glycerophosphate
T1 sodium phos,m-basic-d- SODIUM PHOSPHATE
basic
Potassium Replacement
T1 pot chloride/pot
POTASSIUM
bicarb/cit ac
CHLORIDE
T1 potassium acetate
POTASSIUM ACETATE
T3 potassium bicarbonate/cit EFFER-K(TABLET
ac
EFF)(10 MEQ)
T3 potassium bicarbonate/cit EFFER-K(TABLET
ac
EFF)(20 MEQ)
T1 potassium
EFFER-K(TABLET
bicarbonate/cit ac
EFF)(25 MEQ)
T1 potassium chloride
KLOR
CON(PACKET)(20
MEQ)
KLOR
CON(PACKET)(25
MEQ)
Sutter Health Plus
T1 potassium chloride in
0.9%nacl
d5w
lr-d5
T1 potassium chloride/d50.2%nacl
T1 potassium chloride/d50.45nacl
T1 potassium chloride0.45% nacl
K-SOL
K-TAB ER
POTASSIUM
CHLORIDE
POTASSIUM CHLNORMAL SALINE
DEXTROSE 5%
POTASSIUM
CHLORIDE
POTASSIUM
CHLORIDE IN D5LR
DEXTROSE 5%-0.2%
NACL-KCL
DEXTROSE 5%-0.3%
NACL-KCL
DEXTROSE 5%-0.45%
NACL-KCL
DEXTROSE 5%-NS
KCL
POTASSIUM
CHLORIDE-NACL
Sodium/saline Preparations
T1 0.9 % sodium chloride NORMAL SALINE
FLUSH
T1 sodium chloride
SODIUM CHLORIDE
T1 sodium chloride 0.45 % SODIUM CHLORIDE
T1 sodium chloride 3 % SODIUM CHLORIDE
T1 sodium chloride 5 % SODIUM CHLORIDE
ENDOCRINE DISORDER - FERTILITY
Drugs To Treat Impotency
T3
T3
T3
T3
T2
T2
T3
T2
alprostadil
alprostadil
alprostadil
avanafil
sildenafil citrate
tadalafil
vardenafil hcl
vardenafil hcl
CAVERJECT
EDEX
MUSE
STENDRA
VIAGRA
CIALIS
LEVITRA
STAXYN
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
ENDOCRINE DISORDER - OTHER
Adrenocorticotrophic Hormones
T3 corticorelin ovine
triflutate
T4 corticotropin
ACTHREL
H.P. ACTHAR
PA
Antidiuretic And Vasopressor Hormones
T1 desmopressin
(nonrefrigerated)
T1 desmopressin acetate
T1 vasopressin
T3 vasopressin
DDAVP
DDAVP
DESMOPRESSIN
ACETATE
STIMATE
VASOPRESSIN
VASOSTRICT
Antineoplastic Lhrh(gnrh) Agonist,pituitary Suppr.
T4 goserelin acetate
T4 leuprolide acetate
ZOLADEX
ELIGARD
LEUPROLIDE
ACETATE
PA
PA
Page 27 of 106
T4
T4
T4
T4
leuprolide acetate
triptorelin pamoate
triptorelin pamoate
triptorelin pamoate
LUPRON DEPOT
TRELSTAR
TRELSTAR DEPOT
TRELSTAR LA
Growth Hormone Releasing Hormone (ghrh) &
Analogs
T4 tesamorelin acetate
Bone Formation Stim. Agents - Parathyroid
FORTEO
QL
Bone Resorption Inhibitor & Vitamin D
FOSAMAX PLUS D
Bone Resorption Inhibitors
T1 alendronate sodium
T1
T3
T1
T3
T1
T3
T4
T4
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T4
T4
T4
T4
T4
ALENDRONATE
QL
SODIUM(SOLUTION)
alendronate sodium
ALENDRONATE
SODIUM(TAB)
alendronate sodium
BINOSTO
QL, ST
alendronate sodium
FOSAMAX
calcitonin,salmon,synthet FORTICAL
ic
calcitonin,salmon,synth MIACALCIN(SPRAY/P
etic
UMP)
calcitonin,salmon,synthet MIACALCIN(VIAL)
ic
denosumab
PROLIA
PA
denosumab
XGEVA
PA
etidronate disodium
ETIDRONATE
DISODIUM
ibandronate sodium
BONIVA
ibandronate sodium
BONIVA(SYRINGE)
ST
ibandronate sodium
BONIVA(TAB)
ibandronate sodium
IBANDRONATE
ST
SODIUM
pamidronate disodium PAMIDRONATE
DISODIUM
raloxifene hcl
EVISTA
PA, QL
risedronate sodium
ACTONEL(TAB)(150 QL, ST
MG)
risedronate sodium
ACTONEL(TAB)(30
QL, ST
MG)
risedronate sodium
ACTONEL(TAB)(35
QL, ST
MG)
risedronate sodium
ACTONEL(TAB)(5 MG)QL, ST
zoledronic acid
ZOLEDRONIC ACID
zoledronic acid
ZOMETA
zoledronic
RECLAST
acid/mannitol&water
zoledronic
ZOLEDRONIC ACID
acid/mannitol&water
zoledronic
ZOMETA
acid/mannitol&water
Calcimimetic,parathyroid Calcium Enhancer
T4 cinacalcet hcl
SENSIPAR
Growth Hormone Receptor Antagonists
T4 pegvisomant
Sutter Health Plus
T4 somatropin
T4 somatropin
T4 somatropin
T4 somatropin
T4 somatropin
Combinations
T2 alendronate
sodium/vitamin d3
SOMAVERT
PA
GENOTROPIN
HUMATROPE
NORDITROPIN
FLEXPRO
NUTROPIN AQ
NUTROPIN AQ
NUSPIN
OMNITROPE
SAIZEN
SEROSTIM
ZOMACTON
ZORBTIVE
PA
PA
PA
Growth Hormones
Hormone
T4 teriparatide
EGRIFTA
T4
T4
T4
T4
T4
somatropin
somatropin
somatropin
somatropin
somatropin
PA
PA
PA
PA
PA
PA
PA
Hyperparathyroid Tx Agents - Vitamin D Analogtype
T1
T1
T1
T3
doxercalciferol
doxercalciferol
doxercalciferol
doxercalciferol
T1 doxercalciferol
T1
T3
T1
T3
paricalcitol
paricalcitol
paricalcitol
paricalcitol
DOXERCALCIFEROL
HECTOROL
HECTOROL(CAP)
HECTOROL(VIAL)
(2MCG/ML(1))
HECTOROL(VIAL)
(4MCG/2ML)
PARICALCITOL
PARICALCITOL
ZEMPLAR
ZEMPLAR
Insulin-like Growth Factor-1 (igf-1) Hormones
T4 mecasermin
INCRELEX
PA
Leptin Hormone Analogs
T4 metreleptin
MYALEPT
QL
Lhrh(gnrh) Agonist Analog Pituitary Suppressants
T4 histrelin ac
T4 nafarelin acetate
VANTAS
SYNAREL
Lhrh(gnrh)agnst Pit.sup-central Precocious
Puberty
T4 histrelin ac
SUPPRELIN LA
LUPRON DEPOT-PED
Menopausal Sympt Supp-sel Estrogen Recep
Modulator
T3 ospemifene
OSPHENA
PA, QL
NATPARA
PA
Parathyroid Hormones
T4 parathyroid hormone
Pituitary Suppressive Agents
T1 cabergoline
T1 danazol
CABERGOLINE
DANAZOL
Page 28 of 106
ENDOCRINE DISORDER - THYROID
T2
T3
T3
T1
T2
T2
T2
T1
T1
T1
T3
Antithyroid Preparations
T1 methimazole
T1 propylthiouracil
TAPAZOLE
PROPYLTHIOURACIL
Iodine Containing Agents
T1 potassium iodide
SSKI
T1 potassium iodide/iodine STRONG IODINE
T1 sodium iodide
IODOPEN
Thyroid Hormones
T1 levothyroxine sodium
T1
T3
T1
T1
T1
T3
T3
T3
T3
T3
T2
T1
levothyroxine sodium
liothyronine sodium
liothyronine sodium
liotrix
liotrix
liotrix
liotrix
liotrix
thyroid,pork
thyroid,pork
LEVOTHYROXINE
SODIUM
SYNTHROID
TIROSINT
UNITHROID
CYTOMEL
TRIOSTAT
THYROLAR-1
THYROLAR-1/2
THYROLAR-1/4
THYROLAR-2
THYROLAR-3
ARMOUR THYROID
NATURE-THROID
T2
T2
T2
T2
T1
T2
T1
T3
T3
T2 ganciclovir
T1 trifluridine
T1
T2
T2
T1 benoxinate
FLUROX
hcl/fluorescein na
T3 lidocaine hcl/pf
AKTEN
T1 proparacaine hcl
PROPARACAINE HCL
T1 proparacaine/fluorescei FLUCAINE
n sod
T1 tetracaine hcl
TETCAINE
T3 tetracaine hcl
TETRAVISC
T3 tetracaine hcl
TETRAVISC FORTE
T1 tetracaine hcl/pf
TETRACAINE HCL
PRED-G
MAXITROL
NEOMYCIN
BACITRACIN-POLY
HC
tobramycin/dexamethaso TOBRADEX ST
ne
tobramycin/dexamethasTOBRADEX(DROPS
one
SUSP)
tobramycin/dexamethaso TOBRADEX(OINT)
ne
tobramycin/lotepred etab ZYLET
Eye Sulfonamides
SULFACETAMIDE
SODIUM
T1 sulfacetamide/prednisol SULFACETAMIDEone sp
PREDNISOLONE
T2 sulfacetm na/prednisol acBLEPHAMIDE
T2 sulfacetm na/prednisol acBLEPHAMIDE S.O.P.
Eye Antihistamines
T3
T1
T3
T3
T1
T2
T1
T3
alcaftadine
azelastine hcl
bepotastine besilate
emedastine difumarate
epinastine hcl
olopatadine hcl
olopatadine hcl
olopatadine hcl
LASTACAFT
AZELASTINE HCL
BEPREVE
EMADINE
ELESTAT
PATADAY
PATANOL
PAZEO
Eye Antiinflammatory Agents
T1 bromfenac sodium
T3
T3
T3
T1
bromfenac sodium
dexamethasone
dexamethasone
dexamethasone sod
phosphate
Sutter Health Plus
BROMFENAC
SODIUM
PROLENSA
MAXIDEX
OZURDEX
DEXAMETHASONE
SODIUM PHOSPHATE
ZIRGAN
VIROPTIC
Eye Local Anesthetics
Eye Antibiotic-corticoid Combinations
T3
DICLOFENAC
SODIUM
difluprednate
DUREZOL
fluocinolone acetonide ILUVIEN
fluocinolone acetonide RETISERT
fluorometholone
FML
fluorometholone
FML FORTE
fluorometholone
FML S.O.P.
fluorometholone acetate FLAREX
flurbiprofen sodium
OCUFEN
ketorolac tromethamineACULAR
ketorolac tromethamineACULAR LS
ketorolac
ACUVAIL
tromethamine/pf
loteprednol etabonate
ALREX
loteprednol etabonate
LOTEMAX
nepafenac
ILEVRO
nepafenac
NEVANAC
prednisolone acetate
OMNIPRED
PRED MILD
prednisolone sod
PREDNISOLONE
phosphate
SODIUM PHOSPHATE
rimexolone
VEXOL
triamcinolone
TRIESENCE
acetonide/pf
Eye Antivirals
EYE - GENERAL DISORDERS
T3 gentamicin/prednisol ac
T1 neo/polymyx b
sulf/dexameth
T1 neomycin su/baci
zn/poly/hc
Eye Vasoconstrictors
T1 naphazoline hcl
T1 phenylephrine hcl
QL, ST
NAPHAZOLINE HCL
PHENYLEPHRINE
HCL
Ophthalmic Antibiotics
T3 azithromycin
T1 bacitracin
T1 bacitracin/polymyxin b
sulfate
T2 besifloxacin hcl
T1 erythromycin base
AZASITE
BACITRACIN
BACITRACINPOLYMYXIN
BESIVANCE
CILOXAN(DROPS)
CILOXAN(OINT)
ILOTYCIN
Page 29 of 106
T1
T1
T1
T2
T2
T3
T1
gatifloxacin
gentamicin sulfate
levofloxacin
moxifloxacin hcl
moxifloxacin hcl
natamycin
neomycin
su/bacitra/polymyxin
T1 neomycin/polymyxn
b/gramicidin
T1 ofloxacin
T1 polymyxin b
sulf/trimethoprim
T1 tobramycin
T2 tobramycin
ZYMAXID
GARAMYCIN
LEVOFLOXACIN
MOXEZA
VIGAMOX
NATACYN
NEOMYCINBACITRACIN
POLYMYXIN
NEOSPORIN
OCUFLOX
POLYTRIM
TOBREX(DROPS)
TOBREX(OINT)
Ophthalmic Anti-inflammatory Immunomodulator
type
T2 cyclosporine
RESTASIS
QL
Ophthalmic Mast Cell Stabilizers
T1 cromolyn sodium
T2 lodoxamide
tromethamine
T2 nedocromil sodium
CROMOLYN SODIUM
ALOMIDE
T1 dorzolamide hcl/timolol COSOPT
maleat
T3 dorzolamide/timolol/pf COSOPT PF
T3 echothiophate iodide
PHOSPHOLINE
IODIDE
T1 latanoprost
XALATAN
BETAGAN
T1 levobunolol hcl
T1 metipranolol
METIPRANOLOL
T1 pilocarpine hcl
ISOPTO CARPINE
T3 tafluprost/pf
ZIOPTAN
T2 timolol
BETIMOL
T3 timolol maleate
ISTALOL
T1 timolol maleate
TIMOPTIC
T1 timolol maleate
TIMOPTIC-XE
T3 timolol maleate/pf
TIMOPTIC OCUDOSE
T2 travoprost
TRAVATAN Z
T1 travoprost
TRAVOPROST
(benzalkonium)
T3 unoprostone isopropyl RESCULA
Ophthalmic Proteolytic Enzyme Agents
T1
T3 ocriplasmin/pf
T3
Carbonic Anhydrase Inhibitors
T1
T3
T1
T1
Miotics/other Intraoc. Pressure Reducers
EYE - MISCELLANEOUS
T3 acetylcholine chloride
T3 apraclonidine hcl
Artificial Tears
T1
T1
T2
T1
T2
T2
apraclonidine hcl
betaxolol hcl
betaxolol hcl
bimatoprost
bimatoprost
brimonidine tartrate
T1 brimonidine tartrate
T1 brimonidine tartrate
T2 brimonidine
tartrate/timolol
T2 brinzolamide
AZOPT
T2 brinzolamide/brimonidin SIMBRINZA
e tart
T3 carbachol
MIOSTAT
T1 carteolol hcl
CARTEOLOL HCL
T1 dorzolamide hcl
TRUSOPT
Ophthalmic Antifibrotic Agents
T3 mitomycin
MITOSOL
T3 hydroxypropyl cellulose LACRISERT
Eye Irrigations
T3 balanced salt irrig soln BSS PLUS
no.1
T1 balanced salt irrig soln BALANCED SALT
no.2
Eye Mydriatic And Nsaid Combinations
T3 phenylephrine/ketorolac OMIDRIA
Eye Preparations, Miscellaneous
T3 gelatin
GELFILM
Ocular Photoactivated Vessel-occluding Agents
T4 verteporfin
VISUDYNE
Ophth Vasc. Endothelial Growth Factor
Antagonists
T4 aflibercept
Sutter Health Plus
QL, ST
ATROPINE SULFATE
ISOPTO ATROPINE
CYCLOGYL(DROPS)
(0.5 %)
cyclopentolate hcl
CYCLOGYL(DROPS)(1
%)
cyclopentolate hcl
CYCLOGYL(DROPS)(2
%)
cyclopentolate/phenyleph CYCLOMYDRIL
rine
homatropine hbr
HOMATROPAIRE
hydroxyamphetamine/tro PAREMYD
picamide
tropicamide
MYDRIACYL
tropicamide
TROPICAMIDE
T1 acetazolamide
ACETAZOLAMIDE
T1 acetazolamide
DIAMOX SEQUELS
T1 acetazolamide sodium ACETAZOLAMIDE
SODIUM
T1 methazolamide
NEPTAZANE
MIOCHOL-E
IOPIDINE(DROPERET
TE)
IOPIDINE(DROPS)
BETAXOLOL HCL
BETOPTIC S
BIMATOPROST
QL
LUMIGAN
QL
ALPHAGAN
P(DROPS)(0.1 %)
ALPHAGAN
P(DROPS)(0.15 %)
BRIMONIDINE
TARTRATE
COMBIGAN
QL, ST
QL
QL
T1 atropine sulfate
T1 atropine sulfate
T2 cyclopentolate hcl
T1
EYE - GLAUCOMA
QL, ST
Mydriatics
ALOCRIL
JETREA
QL, ST
EYLEA
PA
Page 30 of 106
T4 pegaptanib sodium
MACUGEN
PA
Ophth. Vegf-a Receptor Antag. Rcmb Mc Antibody
T4 ranibizumab
LUCENTIS
PA
Ophthalmic Cystine Depleting Agents
T4 cysteamine hcl
CYSTARAN
PA
Uricosuric Agents
T1 probenecid
HEMATOLOGICAL DISORDERS
Anticoagulant Reversal Agents
T4 idarucizumab
FLUID REPLACEMENT
PROBENECID
PRAXBIND
Anticoagulants,coumarin Type
Iv Solutions: Dextrose And Lactated Ringers
T1 warfarin sodium
T1 dextrose 5%-lactated
ringers
Antifibrinolytic Agents
DEXTROSE IN
LACTATED RINGERS
T3 aminocaproic acid
T1 aminocaproic acid
Iv Solutions: Dextrose And Ringers
T1 dextrose 5% in ringers DEXTROSE IN
RINGERS INJECTION
T3 fibrinogen
T1 tranexamic acid
T1 tranexamic acid
Iv Solutions: Dextrose-saline
T1 dextrose 10 % and 0.2 DEXTROSE 10%-0.2%
% nacl
NACL
% nacl
NACL
% nacl
NACL
T1 dextrose 2.5 % and 0.45 DEXTROSE 2.5%
% nacl
0.45% NACL
T1 dextrose 5 % and 0.3 % DEXTROSE 5%-0.3%
nacl
NACL
T1 dextrose 5 % and 0.9 % DEXTROSE 5%-0.9%
nacl
NACL
T1 dextrose 5 %-0.2 %
DEXTROSE 5%-0.2%
nacl
NACL
T1 dextrose 5 %-0.45 % DEXTROSE 5%-0.45%
nacl
NACL
dextrose 10 % in water DEXTROSE IN WATER
dextrose 2.5 % in water DEXTROSE IN WATER
GOUT AND RELATED DISEASES
Colchicine
T1 colchicine
T1 colchicine
T1 colchicine/probenecid
COLCRYS
MITIGARE
PROBENECID
COLCHICINE
QL
QL
Hyperuricemia Tx - Purine Inhibitors
T1 allopurinol
T3 allopurinol sodium
T2 febuxostat
ZYLOPRIM
ALOPRIM
ULORIC
QL, ST
Hyperuricemia Tx - Urate-oxidase Enzyme-type
T3 pegloticase
T3 rasburicase
Sutter Health Plus
KRYSTEXXA
ELITEK
AMICAR
AMINOCAPROIC
ACID
RIASTAP
CYKLOKAPRON
LYSTEDA
Antihemophilic Factors
Iv Solutions: Dextrose-water
T1
T1
T1
T1
T1
T1
T1
T1
T1
COUMADIN
T4 antihemo.fviii,full length ADYNOVATE
peg
T4 antihemoph.fviii rec,fc ELOCTATE
fusion
T4 antihemoph.fviii,b-dom NOVOEIGHT
truncat
T4 antihemoph.fviii,bXYNTHA
domain del
T4 antihemoph.fviii,bXYNTHA SOLOFUSE
domain del
T4 antihemoph.fviii,full
ADVATE
length
ADVATE H
length
ADVATE L
length
ADVATE M
length
ADVATE SH
length
ADVATE UH
length
HELIXATE FS
length
KOGENATE FS
length
T4 antihemoph.fviii,hek b- NUWIQ
delete
T4 antihemophilic factor,
RECOMBINATE
hum rec
HEMOFIL M
human
KOATE-DVI
human
MONOCLATE-P
human
T4 antihemophilic
ALPHANATE
factor/vwf
T4 antihemophilic
HUMATE-P
factor/vwf
T4 antihemophilic
WILATE
factor/vwf
Page 31 of 106
T4 antihemophilic fviii,rec OBIZUR
porc
T4 anti-inhibitor coagulant FEIBA NF
comp.
T4 coagulation factor
NOVOSEVEN RT
viia,recomb
Antiporphyria Factors
T4 hemin
PANHEMATIN
Blood Factors,miscellaneous
T4 factor xiii
CORIFACT
Citrates As Anticoagulants
T1 citrate phosphate
CITRATE PHOSPHATE
dextros soln
DEXTROSE
T3 dextrose/sod citrate/citric ACD
ac
T1 sodium citrate
SODIUM CITRATE
T3 sodium citrate dihydrate TRICITRASOL
Coagulants
T1 protamine sulfate
PROTAMINE SULFATE
Direct Factor Xa Inhibitors
T2
T2
T3
T2
T2
apixaban
apixaban
edoxaban tosylate
rivaroxaban
rivaroxaban
T2 rivaroxaban
T2 rivaroxaban
ELIQUIS(TAB)(2.5 MG)QL
ELIQUIS(TAB)(5 MG) QL
SAVAYSA
QL, ST
XARELTO(TAB DS PK) QL
XARELTO(TAB)(10
QL
MG)
XARELTO(TAB)(15
QL
MG)
XARELTO(TAB)(20
QL
MG)
Hematinics,other
T4 darbepoetin alfa in
polysorbat
T4 epoetin alfa
T4 epoetin alfa
T4 methoxy peg-epoetin
beta
T1 pentoxifylline
T4 dalteparin
sodium,porcine
T4 dalteparin
sodium,porcine
T4 dalteparin
sodium,porcine
T4 dalteparin
sodium,porcine
T4 dalteparin
sodium,porcine
T4 dalteparin
sodium,porcine
T4 dalteparin
sodium,porcine
T4 dalteparin
sodium,porcine
T4 enoxaparin sodium
T4
T4
T4 hum prothrombin
cplx(pcc)4fact
T4
T4 factor ix
T4 factor ix
T4 factor ix cplx(pcc)#4,
3factor
T4 factor ix cplx(pcc)#6,
3factor
T4 factor ix human
recomb,thr 148
T4 factor ix human
recombinant
T4 factor ix human
recombinant
T4 factor ix rec, fc fusion
protn
T4
ALPHANINE SD
MONONINE
PROFILNINE
T4
T4
T4
BEBULIN
T4
IXINITY
T4
BENEFIX
T4
RIXUBIS
T1
ALPROLIX
T3
Factor X Preparations
T4 coagulation factor x
COAGADEX
T1
TRETTEN
T3
Factor Xiii Preparations
T4 factor xiii asubunit,recomb
T1
Sutter Health Plus
EPOGEN
PROCRIT
MIRCERA
PA
PA
PA
PENTOXIFYLLINE
Heparin And Related Preparations
T4
Factor Ix Preparations
PA
Hemorrheologic Agents
Factor Ix Complex (pcc) Preparations
KCENTRA
ARANESP
FRAGMIN(SYRINGE)
(10000/ML)
FRAGMIN(SYRINGE)
(12500/0.5)
FRAGMIN(SYRINGE)
(15000/0.6)
FRAGMIN(SYRINGE)
(18000/0.72)
FRAGMIN(SYRINGE)
(2500/0.2ML)
FRAGMIN(SYRINGE)
(5000/0.2ML)
FRAGMIN(SYRINGE)
(7500/0.3ML)
FRAGMIN(VIAL)
QL
LOVENOX(SYRINGE)
(100 MG/ML)
enoxaparin sodium
LOVENOX(SYRINGE)
(120MG/.8ML)
enoxaparin sodium
LOVENOX(SYRINGE)
(150 MG/ML)
enoxaparin sodium
LOVENOX(SYRINGE)
(30MG/0.3ML)
enoxaparin sodium
LOVENOX(SYRINGE)
(40MG/0.4ML)
enoxaparin sodium
LOVENOX(SYRINGE)
(60MG/0.6ML)
enoxaparin sodium
LOVENOX(SYRINGE)
(80MG/0.8ML)
enoxaparin sodium
LOVENOX(VIAL)
fondaparinux sodium ARIXTRA(SYRINGE)
(10MG/0.8ML)
(2.5 MG/0.5)
(5MG/0.4ML)
(7.5MG/0.6)
heparin sod,porcine/0.9 HEPARIN FLUSH
% nacl
heparin sod,pork in
HEPARIN SODIUM IN
0.45% nacl
0.45% NACL(IV
SOLN)(12500/250)
heparin sod,pork in
HEPARIN SODIUM IN
0.45% nacl
0.45% NACL(IV
SOLN)(25000/250)
heparin sod,pork in
HEPARIN SODIUM IN
0.45% nacl
0.45% NACL(IV
SOLN)(25000/500)
heparin sodium,porcine HEPARIN SODIUM
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
Page 32 of 106
T1 heparin
sodium,porcine/d5w
T1 heparin
sodium,porcine/ns/pf
T1 heparin
sodium,porcine/pf
T1 heparin
sodium,porcine/pf
HEPARIN SODIUM
D5W
HEPARIN SODIUM
0.9% NACL
HEPARIN FLUSH
Human Monoclonal Antibody Complement(c5)
clopidogrel bisulfate
clopidogrel bisulfate
dipyridamole
eptifibatide
prasugrel hcl
ticagrelor
ticlopidine hcl
tirofiban-0.9% sodium
chloride
T3 vorapaxar sulfate
Inhibitor
Platelet Proliferation Stimulants
T4 eculizumab
T1
T1
T1
T4
T2
T2
T1
T4
MONOJECT PREFILL
ADVANCED
SOLIRIS
PA
Leukocyte (wbc) Stimulants
T4
T4
T4
T4
T4
filgrastim
filgrastim-sndz
pegfilgrastim
sargramostim
tbo-filgrastim
NEUPOGEN
ZARXIO
NEULASTA
LEUKINE
GRANIX
Plasma Expanders
T3 dextran 40 in 0.9 % nacl LMD 10% WITH 0.9%
SOD CHLORIDE
T3 dextran 40/d5w
LMD 10% WITH 5%
DEXTROSE
T3 hes 130/0.4 in 0.9 % nacl VOLUVEN
T1 hetastarch in 0.9 %
HESPAN
nacl
T3 hetastarch/e-lytes,lactate HEXTEND LACTATED
ELECTROLYTE
Plasma Proteins
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T3
T4
T3
T3
T3
T3
T3
albumin human
albumin human
albumin human
albumin human
albumin human
albumin human
albumin human
albumin human
albumin human
albumin human
albumin human
albumin human
antithrombin iii (hum
plas)
antithrombin iii, human
recomb
plasma human, blood
group a
plasma human, blood
group ab
plasma human, blood
group b
plasma human, blood
group o
plasma protein fraction
ALBUKED-25
ALBUKED-5
ALBUMIN (HUMAN)
ALBUMINAR-25
ALBUMINAR-5
ALBURX
ALBUTEIN
BUMINATE
FLEXBUMIN
KEDBUMIN
PLASBUMIN-25
PLASBUMIN-5
THROMBATE III
abciximab
aspirin/dipyridamole
cangrelor tetrasodium
cilostazol
Sutter Health Plus
PA
PA
PA
PA
PA
T1 anagrelide hcl
T1 anagrelide hcl
T4 protein c concentrate,
human
T3 hydroxyurea
AGRYLIN
ANAGRELIDE HCL
CEPROTIN
DROXIA
Thrombin Inhibitors,sel.,direct,&rev.-hirudin Type
T4 bivalirudin
T4 bivalirudin
T4 desirudin
ANGIOMAX
BIVALIRUDIN
IPRIVASK
PA, QL
Thrombin Inhibitors,selective,direct, & Reversible
T4 argatroban
T4 argatroban in 0.9 % sod
chlor
T4 argatroban in nacl,isoosmotic
T3 dabigatran etexilate
mesylate
ARGATROBAN
ARGATROBAN-0.9%
NACL
ARGATROBAN
SODIUM CHLORIDE
PRADAXA
QL, ST
Thrombolytic Enzymes
T3 alteplase
T3 alteplase
T3 tenecteplase
ACTIVASE
CATHFLO ACTIVASE
TNKASE
Thrombopoietin Receptor Agonists
T4 eltrombopag olamine
T4 romiplostim
T3
T3
T1
T3
OCTAPLAS
T3
OCTAPLAS
REOPRO
AGGRENOX
KENGREAL
PLETAL
NEUMEGA
Sickle Cell Anemia Agents
OCTAPLAS
PLASMANATE
QL
Protein C Preparations
Topical Hemostatics
OCTAPLAS
ZONTIVITY
Platelet Reducing Agents
ATRYN
Platelet Aggregation Inhibitors
T4
T1
T3
T1
T4 oprelvekin
PLAVIX(TAB)(300 MG) QL
PLAVIX(TAB)(75 MG)
PERSANTINE
INTEGRILIN
EFFIENT
QL
BRILINTA
QL
TICLOPIDINE HCL
AGGRASTAT
T3
T3
T3
T3
T1
T3
T3
PROMACTA
NPLATE
PA
cellulose,oxidized
OXYCEL
ferric subsulfate
ASTRINGYN
ferric subsulfate
MONSEL'S
fibrinogen/thrombin(hum EVARREST
an der)
fibrinogen/thrombin(hum TACHOSIL
an der)
microfibrillar collagen AVITENE
microfibrillar collagen ENDO-AVITENE
microfibrillar collagen SYRINGE AVITENE
microfibrillar collagen ULTRAFOAM
thrombin (bovine)
THROMBIN-JMI
thrombin (recombinant) RECOTHROM
thrombin(hum
TISSEEL VHSD
plas)/fib/apro/ca
Page 33 of 106
T3 thrombin(hum
plas)/fibrinog/ca
T3 estradiol valerate
EVICEL
Vitamin K Preparations
T2 phytonadione
T1 phytonadione
MEPHYTON
VITAMIN K1
HORMONAL DEFICIENCY
Androgenic Agents
T1
T2
T1
T1
T3
T3
T2
T2
T2
T1
T2
T1
T3
T3
T3
T1
T1
T3
T1
T3
fluoxymesterone
methyltestosterone
methyltestosterone
oxandrolone
oxymetholone
testosterone
testosterone
ANDROXY
METHITEST
TESTRED
OXANDRIN
ANADROL-50
ANDRODERM
ANDROGEL(GEL MD
PMP)
testosterone
ANDROGEL(GEL
PACKET)(1.25G-1.62)
testosterone
ANDROGEL(GEL
PACKET)(2.5G-1.62%)
testosterone
ANDROGEL(GEL
PACKET)(25MG(1%))
testosterone
AXIRON
testosterone
FORTESTA
testosterone
NATESTO
testosterone
STRIANT
testosterone
TESTOPEL
testosterone
VOGELXO
testosterone cypionate DEPOTESTOSTERONE
testosterone cypionate TESTONE CIK
testosterone enanthate DELATESTRYL
testosterone undecanoate AVEED
QL
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
DELESTROGEN(VIAL)
(10 MG/ML)
DELESTROGEN(VIAL)
(20 MG/ML)
DELESTROGEN(VIAL)
(40 MG/ML)
T3 estradiol/levonorgestrel CLIMARA PRO
QL
T2 estradiol/norethindrone COMBIPATCH
QL
acet
T1 estradiol/norethindrone ESTRADIOL
acet
NORETHINDRONE
ACETAT
T3 estradiol/norgestimate PREFEST
T2 estrogen,con/m-progest PREMPHASE
acet
T2 estrogen,con/m-progest PREMPRO
acet
T2 estrogens, conjugated
PREMARIN
PREMARIN(TAB)
PREMARIN(VIAL)
T3 estrogens,conj.,synthetic ENJUVIA
b
T2 estrogens,esterified
MENEST
T1 estropipate
ESTROPIPATE
T1 estropipate
OGEN
T1 norethindrone ac-eth JINTELI
estradiol
Lhrh (gnrh) Agonist Analog And Progestin Comb
T3 leuprolide/norethindrone LUPANETA PACK
acet
Progestational Agents
Estrogen & Selective Estrogen Recept
T4 hydroxyprogesterone
caproate
T1 medroxyprogesterone
acetate
T1 norethindrone acetate
T1 progesterone
T3 progesterone,micronized
T1 progesterone,micronize
d
Mod(serm)comb
IMMUNIZATION
T2 estrogens,conj/bazedoxif DUAVEE
ene
Antisera
Estrogen/androgen Combinations
T1 botulism antitoxin
7/maltose
PA
Estrogen & Progestin With Antimineralocorticoid
Cb
T3 drospirenone/estradiol
T1 estrogen,ester/metestosterone
ANGELIQ
ESTROGEN
METHYLTESTOSTERO
NE
T3
Estrogenic Agents
T2
T1
T3
T3
T1
T3
T3
T3
T2
T1
T3
estradiol
estradiol
estradiol
estradiol
estradiol
estradiol
estradiol
estradiol
estradiol
estradiol
estradiol cypionate
Sutter Health Plus
ALORA
CLIMARA
DIVIGEL
ELESTRIN
ESTRACE
ESTROGEL
EVAMIST
MENOSTAR
MINIVELLE
VIVELLE-DOT
DEPO-ESTRADIOL
QL
QL
T3
T3
T3
QL
QL
QL
T3
T4
MAKENA
PA
PROVERA
AYGESTIN
PROGESTERONE
CRINONE
PROMETRIUM
BOTULISM
ANTITOXIN
HEPTAVALENT(VIAL)
(4500-3300)
botulism antitoxin
BOTULISM
7/maltose
ANTITOXIN
HEPTAVALENT(VIAL)
(4500-3300)
cytomegalovirus immune CYTOGAM
globuln
hepatitis b immun
HEPAGAM B
glob/maltose
hepatitis b immune
HYPERHEP B S-D
globulin
hepatitis b immune
NABI-HB
globulin
igg/hyaluronidase,recom HYQVIA
PA
binant
Page 34 of 106
T4 imm glob g
(igg)/sorb/iga 0-50
T4 immun glob g
(igg)/gly/iga 50+
T4 immun glob g
(igg)/gly/iga 50+
T4 immun glob g
(igg)/gly/iga 50+
T4 immun glob g
(igg)/gly/iga 50+
T4 immun glob
g(igg)/malt/iga 50+
T4 immun glob
g(igg)/pro/iga 0-50
T4 immun glob
g(igg)/pro/iga 0-50
T4 immun glob
g(igg)/sorb/iga 50+
T4 immun glob
g(igg)/sucr/iga 50+
T4 immun glob
g/gly/gluc/iga 0-50
T4 immun glob
g/sorb/gly/iga 0-50
T4 immune globul g
(igg)/glycine
T4 lymphocyte ig,
antithymocyte
T4 lymphocyte immu
glob.,rabbit
T3 rabies immune
globulin/pf
T3 rabies immune
globulin/pf
T3 rho(d) immune globulin
T3 rho(d) immune globulin
T3
T3
T3
T3
T3
T3
FLEBOGAMMA DIF
PA
Viral/tumorigenic Vaccines
BIVIGAM
PA
GAMMAGARD
LIQUID
GAMMAKED
PA
T3 adenovirus vac live type- ADENOVIRUS TYPE 4
4&7
AND TYPE 7
T3 adenovirus vaccine live ADENOVIRUS TYPE 4
type-4
T3 adenovirus vaccine live ADENOVIRUS TYPE 7
type-7
GAMUNEX-C
PA
OCTAGAM
PA
HIZENTRA
PA
PRIVIGEN
PA
FLEBOGAMMA DIF
PA
CARIMUNE NF
NANOFILTERED
GAMMAGARD S-D
PA
GAMMAPLEX
PA
GAMASTAN S-D
PA
PA
PA
ATGAM
IMMUNOSUPPRESSION/MODULATIO
N
Immunomodulators
T4 aldesleukin
T1 imiquimod
T3 imiquimod
T3 imiquimod
T3 imiquimod
T4 interferon alfa2b,recomb.
T4 interferon alfa-n3
T4 interferon gamma1b,recomb.
PROLEUKIN
ALDARA
ZYCLARA(CREAM
PACK)
ZYCLARA(CRM MD
PMP)(2.5 %)
ZYCLARA(CRM MD
PMP)(3.75 %)
INTRON A
PA, QL
PA, QL
PA, QL
PA, QL
PA
ALFERON N
ACTIMMUNE
THYMOGLOBULIN
Immunosupp - Monoclonal Ab Inhibiting T Lymph
HYPERRAB S-D
Fxn
IMOGAM RABIES-HT
T4 basiliximab
HYPERRHO S-D
MICRHOGAM ULTRA
FILTERED PLUS
rho(d) immune globulin RHOGAM ULTRA
FILTERED PLUS
rho(d) immune globulin RHOPHYLAC
rho(d) immune
WINRHO SDF
globulin/maltose
tetanus immune
HYPERTET S-D
globulin/pf
varicella-zoster
VARIZIG
ig/maltose
varicella-zoster immune VARIZIG
glob
Enteric Virus Vaccines
SIMULECT
Immunosuppressives
T3
T1
T4
T4
T4
T4
T1
T4
T1
T4
T4
T4
T4
azathioprine
azathioprine
belatacept
cyclosporine
cyclosporine, modified
AZASAN
IMURAN
NULOJIX
SANDIMMUNE
CYCLOSPORINE
MODIFIED
everolimus
ZORTRESS
mycophenolate mofetil CELLCEPT
mycophenolate mofetil CELLCEPT
hcl
mycophenolate sodium MYFORTIC
sirolimus
RAPAMUNE
tacrolimus
ASTAGRAF XL
tacrolimus
ENVARSUS XR
tacrolimus
PROGRAF
T3 rotavirus vac,live att, 89- ROTARIX
12
T3 rotavirus vaccine,live
ROTATEQ
oral pv
INFECTIOUS DISEASE - BACTERIAL
Gram (-) Bacilli (non-enteric) Vaccines
Influenza Virus Vaccines
T1 sulfamethoxazole/trime
thoprim
thoprim
thoprim
T5 flu vacc qv live 2015(2- FLUMIST QUAD 2015- AGE,
49yrs)
2016
QL
Betalactams
T3 typhoid
vacc,live,attenuated
VIVOTIF
Absorbable Sulfonamides
T1 aztreonam
T4 aztreonam lysine
Sutter Health Plus
BACTRIM
BACTRIM DS
SULFAMETHOXAZOL
E-TRIMETHOPRIM
AZACTAM
CAYSTON
PA
Page 35 of 106
T3 aztreonam/dextrosewater
AZACTAM-ISO
OSMOTIC DEXTROSE
Carbapenems
T3 doripenem
T3 ertapenem sodium
T1 imipenem/cilastatin
sodium
T1 meropenem
T1 meropenem-0.9%
sodium chloride
DORIBAX
INVANZ
PRIMAXIN
MERREM
MEROPENEM-0.9%
NACL
Cephalosporins - Extended Spectrum, Anti-mrsa
T3 ceftaroline fosamil
acetate
TEFLARO
T3 ceftazidime
T3 ceftazidime in
dextrose5%water
T3 ceftazidime
na/dextrose,iso
T3 ceftazidime/avibactam
T1 ceftibuten
T3 ceftolozane/tazobactam
T1 ceftriaxone
na/dextrose,iso
T3 ceftriaxone
na/dextrose,iso
T3 ceftriaxone
na/dextrose,iso
T1 ceftriaxone sodium
FORTAZ
CEFTAZIDIME
FORTAZ IN ISOOSMOTIC DEXTROSE
AVYCAZ
CEDAX
ZERBAXA
CEFTRIAXONE(PIGG
Y BACK)(1 G/50 ML)
CEFTRIAXONE(PIGG
Y BACK)(2 G/50 ML)
CEFTRIAXONE(PIGG
YBACK)
CEFTRIAXONE
Cephalosporins - 1st Generation
Cephalosporins - 4th Generation
T1 cefadroxil
T1 cefazolin sodium
T1 cefazolin sodium in 0.9
% nacl
T1 cefazolin sodium/d5w
T1 cefazolin
sodium/dextrose,iso
T3 cefazolin
sodium/dextrose,iso
T1 cephalexin
T1 cephalexin
T3 cefepime hcl
CEFADROXIL
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
0.9% NACL
CEFAZOLIN-D5W
CEFAZOLIN
Chemotherapeutics, Antibacterial, Misc.
CEPHALEXIN
KEFLEX
T3 fosfomycin
MONUROL
tromethamine
T1 methen/m-blue/sal/na UTA
phos/hyos
T1 methen/sod phos/meth UROGESIC-BLUE
blue/hyos
T1 methenam/me
HYOPHEN
blue/ba/salicy/hyo
T2 methenam/me
PROSED-DS
blue/ba/salicy/hyo
T1 methenamine hippurateHIPREX
T1 methenamine
METHENAMINE
mandelate
MANDELATE
T2 mth/me blue/sod
PHOSPHASAL
phos/phen/hyos
T2 mth/me blue/sod
URETRON D-S
phos/phen/hyos
T1 mth/me blue/sod
URIBEL
phos/phen/hyos
T2 mth/me blue/sod
URIN D.S.
phos/phen/hyos
T2 trimethoprim
PRIMSOL
T1 trimethoprim
TRIMETHOPRIM
T1 cefaclor
CEFACLOR
T1 cefotetan
CEFOTETAN &
disod/dextrose,iso
DEXTROSE
T1 cefotetan disodium
CEFOTETAN
T1 cefoxitin sodium
CEFOXITIN
T3 cefoxitin sodium/d5w
MEFOXIN
T1 cefoxitin
CEFOXITIN SODIUM
sodium/dextrose,iso
T1 cefprozil
CEFPROZIL
T2 cefuroxime axetil
CEFTIN(SUSP RECON)
T1 cefuroxime axetil
CEFTIN(TAB)
T3 cefuroxime sodium
ZINACEF(VIAL PORT)
T1 cefuroxime sodium
ZINACEF(VIAL)
T3 cefuroxime sodium/waterZINACEF
Cephalosporins - 3rd Generation
T1 cefditoren pivoxil
T2 cefixime
T1 cefixime
T1 cefixime
T2 cefixime
T2 cefixime
T3 cefotaxime sodium
T1 cefotaxime sodium
T1 cefpodoxime proxetil
T1 ceftazidime
Sutter Health Plus
T3 cefepime hcl/dextrose,
iso-osm
CEFAZOLIN SODIUM
Cephalosporins - 2nd Generation
T1 cefdinir
T1 cefditoren pivoxil
T1 cefepime hcl
T3 cefepime hcl/d5w
MAXIPIME(VIAL
PORT)
MAXIPIME(VIAL)
CEFEPIME
DEXTROSE
CEFEPIME
CEFDINIR
CEFDITOREN
PIVOXIL
SPECTRACEF
SUPRAX(CAP)
SUPRAX(SUSP
RECON)(100 MG/5ML)
SUPRAX(SUSP
RECON)(200 MG/5ML)
SUPRAX(SUSP
RECON)(500 MG/5ML)
SUPRAX(TAB CHEW)
CLAFORAN(VIAL
PORT)
CLAFORAN(VIAL)
CEFPODOXIME
PROXETIL
CEFTAZIDIME
Cyclic Lipopeptides
T3 daptomycin
CUBICIN
Glycylcyclines
T3 tigecycline
TYGACIL
Ketolides
T2 telithromycin
KETEK
Macrolides
T1
T1
T1
T2
azithromycin
azithromycin
azithromycin
azithromycin
AZITHROMYCIN
ZITHROMAX
ZITHROMAX TRI-PAK
ZMAX
Page 36 of 106
T1
T1
T2
T1
T2
T1
clarithromycin
clarithromycin
erythromycin base
erythromycin base
erythromycin base
erythromycin
ethylsuccinate
T2 erythromycin
ethylsuccinate
T3 erythromycin
lactobionate
T1 erythromycin stearate
T2 fidaxomicin
T3 pen g benz/pen g
procaine
T1 pen g pot/dextrosewater
T3 penicillin g benzathine
T1 penicillin g potassium
T1 penicillin g procaine
BIAXIN
CLARITHROMYCIN
ERY-TAB
ERYTHROMYCIN
PCE
ERYPED 200
ERYPED 400
T1 penicillin g sodium
ERYTHROCIN
LACTOBIONATE
ERYTHROCIN
STEARATE
DIFICID
T1 penicillin v potassium
FURADANTIN
MACRODANTIN
T1 piperacillin
sodium/tazobactam
T1 piperacillin
sodium/tazobactam
T3 piperacillin-tazodextrose,iso
MACROBID
Quinolones
QL, ST
Nitrofuran Derivatives
T1 nitrofurantoin
T1 nitrofurantoin
macrocrystal
T1 nitrofurantoin
monohyd/m-cryst
T1 linezolid
T3 linezolid
T1
T1
T1
T1
T1
T1
T1
Oxazolidinones
T1
T1
T1
T2
T2
T3
ZYVOX
ZYVOX(IV
SOLN)(200MG/0.1L)
linezolid
ZYVOX(IV
SOLN)(600MG/300)
linezolid
ZYVOX(SUSP RECON)
linezolid
ZYVOX(TAB)
PA
linezolid-0.9% sodium LINEZOLID-0.9%
chloride
NACL
tedizolid phosphate
SIVEXTRO
PA
tedizolid phosphate
SIVEXTRO(TAB)
PA
tedizolid phosphate
SIVEXTRO(VIAL)
Penicillins
T1 amoxicillin
AMOXICILLIN
T1 amoxicillin/potassium AMOXICILLIN
clav
CLAVULANATE
POTASS
T1 amoxicillin/potassium AUGMENTIN ES-600
clav
T2 amoxicillin/potassium AUGMENTIN(SUSP
clav
RECON)(125-31.25/)
T1 amoxicillin/potassium AUGMENTIN(SUSP
clav
RECON)(250-62.5/5)
T1 amoxicillin/potassium AUGMENTIN(TAB)
clav
T1 ampicillin sodium
AMPICILLIN SODIUM
T1 ampicillin
AMPICILLIN
sodium/sulbactam na SULBACTAM
T1 ampicillin
UNASYN
sodium/sulbactam na
T1 ampicillin trihydrate AMPICILLIN
TRIHYDRATE
T1 dicloxacillin sodium
DICLOXACILLIN
SODIUM
T1 nafcillin in dextrose,iso- NAFCILLIN
osm
T1 nafcillin sodium
NAFCILLIN SODIUM
T1 oxacillin sodium
OXACILLIN SODIUM
T1 oxacillin
OXACILLIN
sodium/dextrose,iso
Sutter Health Plus
T1
T3
T1
T1
T1
T1
T1
T3
T1
T1
BICILLIN C-R
PENICILLIN GK-ISO
OSM DEXTROSE
BICILLIN L-A
PFIZERPEN
PENICILLIN G
PROCAINE
PENICILLIN G
SODIUM
PENICILLIN V
POTASSIUM
PIPERACILLIN
TAZOBACTAM
ZOSYN
ZOSYN
ciprofloxacin
CIPRO
ciprofloxacin hcl
CIPRO
ciprofloxacin hcl
CIPROFLOXACIN HCL
ciprofloxacin lactate
CIPROFLOXACIN
ciprofloxacin
CIPRO I.V.
lactate/d5w
ciprofloxacin
CIPROFLOXACINlactate/d5w
D5W
ciprofloxacin/ciprofloxa CIPRO XR
hcl
gemifloxacin mesylate FACTIVE
levofloxacin
LEVAQUIN
levofloxacin
LEVOFLOXACIN
levofloxacin/d5w
LEVAQUIN
levofloxacin/d5w
LEVOFLOXACIN-D5W
moxifloxacin hcl
AVELOX
moxifloxacin in nacl
AVELOX IV
(iso-osm)
moxifloxacin/sod.ace,su MOXIFLOXACIN
l/water
ofloxacin
OFLOXACIN
Streptogramins
T3 quinupristin/dalfopristin SYNERCID
Tetracyclines
T1 demeclocycline hcl
T2 doxycycline calcium
T3 doxycycline hyclate
DEMECLOCYCLINE
HCL
VIBRAMYCIN
ACTICLATE
DORYX(TAB DR)(150
MG)
DORYX(TAB DR)(200
MG)
DORYX(TAB DR)(50
MG)
DOXYCYCLINE
HYCLATE
DOXYCYCLINE
HYCLATE(CAP)
DOXYCYCLINE
HYCLATE(TAB DR)
DOXYCYCLINE
HYCLATE(TAB)
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
Page 37 of 106
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T3 doxycycline/benzoyl
peroxide
peroxide
peroxide
peroxide
T3 doxycycline/salicy/oct/zi
nc ox
T3 doxycycline/skin
cleanser #19
T1 minocycline hcl
T1 minocycline hcl
T3 minocycline hcl
T1 minocycline hcl
T3 minocycline hcl/skin cl
no.4
T1 tetracycline hcl
DOXYCYCLINE
HYCLATE(VIAL)
VIBRAMYCIN
ADOXA
QL, ST
QL, ST
AVIDOXY
QL, ST
DOXYCYCLINE
QL
MONOHYDRATE(TAB)
(150 MG)
DOXYCYCLINE
QL, ST
MONOHYDRATE(TAB)
(50 MG)
DOXYCYCLINE
QL
MONOHYDRATE(TAB)
(75 MG)
MONODOX(CAP)(100 QL
MG)
MONODOX(CAP)(50 QL
MG)
MONODOX(CAP)(75 QL, ST
MG)
VIBRAMYCIN
ketoconazole
miconazole
posaconazole
terbinafine hcl
Sutter Health Plus
T3 caspofungin acetate
T1 griseofulvin
ultramicrosize
T1 griseofulvin, microsize
T1 griseofulvin, microsize
T3 micafungin sodium
T1 nystatin
BENZODOX 30
QL, ST
BENZODOX 60
QL, ST
T1
AVIDOXY DK
QL, ST
T1
T1
MORGIDOX
QL, ST
ANCOBON
CRESEMBA
ONMEL
SPORANOX(CAP)
SPORANOX(SOLUTIO
N)
KETOCONAZOLE
ORAVIG
NOXAFIL
LAMISIL(GRAN
PACK)
GRIFULVIN V
GRISEOFULVIN
MYCAMINE
NYSTATIN
Aminoglycosides
QL, ST
CLOTRIMAZOLE
DIFLUCAN
FLUCONAZOLE IN
DEXTROSE
FLUCONAZOLE-NACL
AMBISOME
ERAXIS (WATER
DILUENT)
CANCIDAS
GRIS-PEG
MISCELLANEOUS
BENOXYLDOXY 60
TETRACYCLINE HCL
AMPHOTERICIN B
ABELCET
INFECTIOUS DISEASE
T1 amikacin sulfate
T1 gentamicin in nacl, isoosm
T1 gentamicin sulfate
Antifungal Agents
T1
T3
T3
T2
T1 amphotericin b
T3 amphotericin b lipid
complex
T3 amphotericin b liposome
T3 anidulafungin
QL, ST
MINOCIN
MINOCIN(CAP)
MINOCIN(VIAL)
MINOCYCLINE HCL
MINOCIN
LAMISIL(TAB)
VFEND
VFEND IV
Antifungal Antibiotics
BENOXYLDOXY 30
INFECTIOUS DISEASE - FUNGAL
T1 clotrimazole
T1 fluconazole
T1 fluconazole in
dextrose,iso-os
T1 fluconazole in nacl,isoosm
T1 flucytosine
T3 isavuconazonium sulfate
T3 itraconazole
T1 itraconazole
T2 itraconazole
T1 terbinafine hcl
T1 voriconazole
T1 voriconazole
T4
T4
T4
T1
T4
T1
AMIKACIN SULFATE
GENTAMICIN
SULFATE IN NS
GENTAMICIN
SULFATE
gentamicin sulfate/pf GENTAMICIN
SULFATE
neomycin sulfate
NEOMYCIN SULFATE
streptomycin sulfate
STREPTOMYCIN
SULFATE
tobramycin
BETHKIS
PA
tobramycin
TOBI PODHALER
PA
tobramycin in 0.225% TOBI
PA
nacl
tobramycin sulfate
TOBRAMYCIN
SULFATE
tobramycin/nebulizer KITABIS PAK
PA
tobramycin/sodium
TOBRAMYCIN
chloride
SULFATE IN NS
Antibacterial Agents,miscellaneous
T1 glycine urologic
solution
AMINOACETIC ACID
Antileprotics
T1 dapsone
T4 thalidomide
DAPSONE
THALOMID
PA, QL
Anti-mycobacterium Agents
T3
T1
T1
T3
T1
T1
T1
aminosalicylic acid
ethambutol hcl
ethambutol hcl
ethionamide
isoniazid
pyrazinamide
rifabutin
PASER
ETHAMBUTOL HCL
MYAMBUTOL
TRECATOR
ISONIAZID
PYRAZINAMIDE
MYCOBUTIN
Antitubercular Antibiotics
T4 bedaquiline fumarate
T3 capreomycin sulfate
SIRTURO
PA
CAPASTAT SULFATE
Page 38 of 106
T1 cycloserine
CYCLOSERINE
T3 rifamp/isoniazid/pyrazina RIFATER
mide
T1 rifampin
RIFADIN
T2 rifampin/isoniazid
RIFAMATE
T3 rifapentine
PRIFTIN
Anthelmintics
T3 albendazole
T1 ivermectin
T2 praziquantel
Antimalarial Drugs
Chloramphenicol And Derivatives
T1 chloramphenicol sod
succ
T3 artemether/lumefantrine COARTEM
T1 atovaquone/proguanil MALARONE
hcl
T1 chloroquine phosphate CHLOROQUINE
PHOSPHATE
T1 hydroxychloroquine
PLAQUENIL
sulfate
T1 mefloquine hcl
MEFLOQUINE HCL
T2 primaquine phosphate PRIMAQUINE
T2 pyrimethamine
DARAPRIM
T1 quinine sulfate
QUALAQUIN
CHLORAMPHENICOL
SOD SUCCINATE
Lincosamides
T1 clindamycin hcl
T1 clindamycin palmitate
hcl
T1 clindamycin
phosphate/d5w
T1 lincomycin hcl
CLEOCIN HCL
CLINDAMYCIN
PALMITATE HCL
CLEOCIN PHOSPHATE
CLIN SINGLE USE
CLINDAMYCIN
PHOSPHATE
CLEOCIN PHOSPHATE
IN D5W
LINCOCIN
T1 atovaquone
MEPRON
T2 pentamidine isethionate NEBUPENT
T3 pentamidine isethionate PENTAM 300
INFECTIOUS DISEASE - VIRAL
T3 dalbavancin hcl
DALVANCE
T3 oritavancin diphosphate ORBACTIV
Antiviral Monoclonal Antibodies
Polymyxin And Derivatives
T4 palivizumab
T1 colistin (colistimethate COLY-MYCIN M
na)
PARENTERAL
T1 polymyxin b sulfate
POLYMYXIN B
SULFATE
T2 rifaximin
QL
PA
Vancomycin And Derivatives
T3
T1
T1
T1
T1
telavancin hcl
vancomycin hcl
vancomycin hcl
vancomycin hcl/d5w
vancomycin in
dextrose,iso-osm
T1 vancomycin/0.9 % sod
chloride
VIBATIV
VANCOCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN
QL
VANCOMYCIN HCL0.9% NACL
2nd Gen. Anaerobic Antiprotozoal-antibacterial
TINDAMAX
Amebacides
T1 paromomycin sulfate
T3
T1
T1
T1
T1
T1
T1
T2
acyclovir
acyclovir
acyclovir sodium
cidofovir
famciclovir
foscarnet sodium
ganciclovir sodium
oseltamivir phosphate
T2 oseltamivir phosphate
INFECTIOUS DISEASE - PARASITIC
T1 tinidazole
T3
T2
T1
T1
T3
peramivir/pf
ribavirin
rimantadine hcl
valacyclovir hcl
valganciclovir hcl
T1 valganciclovir hcl
T3 zanamivir
PA
SITAVIG
ZOVIRAX
ACYCLOVIR SODIUM
VISTIDE
FAMVIR
FOSCAVIR
CYTOVENE
TAMIFLU(CAP)(30
MG)
TAMIFLU(CAP)(45
MG)
TAMIFLU(CAP)(75
MG)
TAMIFLU(SUSP
RECON)
RAPIVAB
VIRAZOLE
FLUMADINE
VALTREX
VALCYTE(SOLN
RECON)
VALCYTE(TAB)
RELENZA
QL, ST
QL
QL
QL
QL
QL
Antivirals, Hiv-spec, Non-peptidic Protease Inhib
PAROMOMYCIN
SULFATE
T2 darunavir ethanolate
Anaerobic Antiprotozoal-antibacterial Agents
T1 metronidazole
FLAGYL
T2 metronidazole
FLAGYL ER
T1 metronidazole/sodium METRO IV
chloride
Sutter Health Plus
SYNAGIS
Antivirals, General
Rifamycins And Related Derivative Antibiotics
XIFAXAN(TAB)(200
MG)
XIFAXAN(TAB)(550
MG)
PA
Antiprotozoal Drugs,miscellaneous
Lipoglycopeptide Antibiotic
T3 rifaximin
ALBENZA
STROMECTOL
BILTRICIDE
PREZISTA(ORAL
SUSP)
PREZISTA(TAB)(150
MG)
PREZISTA(TAB)(400
MG)
PREZISTA(TAB)(600
MG)
QL
QL
QL
QL
Page 39 of 106
QL
Antivirals, Hiv-specific, Protease Inhibitor Comb
T2
QL
T2 lopinavir/ritonavir
QL
PA
PA
T2
T2
T2
PREZISTA(TAB)(75
MG)
darunavir ethanolate
PREZISTA(TAB)(800
MG)
darunavir/cobicistat
PREZCOBIX
tipranavir
APTIVUS
tipranavir/vitamin e tpgs APTIVUS
Antivirals, Hiv-spec, Nucleoside-nucleotide Analog
T2 emtricitabine/tenofovir
TRUVADA
QL
Antivirals, Hiv-spec., Nucleoside Analog, Rti Comb
T2 abacavir
EPZICOM
sulfate/lamivudine
T1 abacavir/lamivudine/zi TRIZIVIR
dovudine
T1 lamivudine/zidovudine COMBIVIR
QL
PA
QL
Antivirals, Hiv-specific, Ccr5 Co-receptor Antag.
T2 maraviroc
SELZENTRY
PA
Antivirals, Hiv-specific, Fusion Inhibitors
T2 enfuvirtide
FUZEON
QL, ST
T2
T2
T2
T1
delavirdine mesylate
efavirenz
etravirine
nevirapine
T1 nevirapine
T2 rilpivirine hcl
RESCRIPTOR
SUSTIVA
INTELENCE
VIRAMUNE(ORAL
SUSP)
VIRAMUNE(TAB)
EDURANT
PA
QL
QL
PA
Antivirals, Hiv-specific, Nucleoside Analog, Rti
T2
T1
T2
T1
abacavir sulfate
abacavir sulfate
didanosine
didanosine
T1 didanosine
T1 didanosine
T1 didanosine
T2
T2
T1
T1
T1
T1
T1
T1
T1
T3
T1
emtricitabine
emtricitabine
lamivudine
lamivudine
lamivudine
stavudine
stavudine
zidovudine
zidovudine
zidovudine
zidovudine
ZIAGEN(SOLUTION) QL
ZIAGEN(TAB)
QL
VIDEX
QL
VIDEX EC(CAP
QL
DR)(125 MG)
VIDEX EC(CAP
QL
DR)(200 MG)
VIDEX EC(CAP
DR)(250 MG)
VIDEX EC(CAP
DR)(400 MG)
EMTRIVA(CAP)
QL
EMTRIVA(SOLUTION) QL
EPIVIR(SOLUTION) QL
EPIVIR(TAB)(150 MG) QL
EPIVIR(TAB)(300 MG) QL
ZERIT(CAP)
QL
ZERIT(SOLN RECON) QL
RETROVIR(CAP)
QL
RETROVIR(SYRUP)
QL
RETROVIR(VIAL)
ZIDOVUDINE
QL
Antivirals, Hiv-specific, Nucleotide Analog, Rti
T2 tenofovir disoproxil
fumarate
T2 tenofovir disoproxil
fumarate
VIREAD(POWDER)
QL
VIREAD(TAB)
QL
T2 atazanavir sulfate
T2 atazanavir
sulfate/cobicistat
T2 fosamprenavir calcium
T2 indinavir sulfate
T2 nelfinavir mesylate
T2 ritonavir
T2 ritonavir
T2 ritonavir
T2 saquinavir mesylate
T2 saquinavir mesylate
QL
QL
REYATAZ
EVOTAZ
QL
LEXIVA
CRIXIVAN
VIRACEPT
NORVIR(CAP)
NORVIR(SOLUTION)
NORVIR(TAB)
INVIRASE(CAP)
INVIRASE(TAB)
PA
QL
QL
QL
QL, ST
QL, ST
Antivirals,hiv-1 Integrase Strand Transfer Inhibtr
TIVICAY
VITEKTA
ISENTRESS
PA
QL, ST
Artv Cmb Nucleoside,nucleotide,&non-nucleoside
Rti
T2 efavirenz/emtricitab/teno ATRIPLA
fovir
T2 emtricitab/rilpivirine/ten COMPLERA
ofov
QL
PA
Arv Cmb-nrti,n(t)rti, Integrase Inhibitor
T3 elviteg/cobi/emtric/tenof GENVOYA
o ala
T2 elvitegr/cobicist/emtric/te STRIBILD
nof
QL
Arv Comb-nrtis & Integrase Inhibitor
T2 abacavir/dolutegravir/lamTRIUMEQ
ivudi
QL
Cytochrome P450 Inhibitors
T2 cobicistat
TYBOST
PA
Hep C Virus - Ns5a & Ns5b Polymerase Inhib.
Combo.
T4 ledipasvir/sofosbuvir
HARVONI
PA
Hep C Virus,nucleotide Analog Ns5b Polymerase
Inh
T4 sofosbuvir
SOVALDI
PA
Hepatitis B Treatment Agents
T4 adefovir dipivoxil
T4 entecavir
T2 lamivudine
T1 lamivudine
Sutter Health Plus
QL
Antivirals, Hiv-specific, Protease Inhibitors
T2 dolutegravir sodium
T2 elvitegravir
T2 raltegravir potassium
Antivirals, Hiv-specific, Non-nucleoside, Rti
KALETRA(SOLUTIO
N)
KALETRA(TAB)
(100MG-25MG)
KALETRA(TAB)
(200MG-50MG)
HEPSERA
BARACLUDE
EPIVIR
HBV(SOLUTION)
EPIVIR HBV(TAB)
Page 40 of 106
T4 telbivudine
T4 methotrexate/pf
TYZEKA
Hepatitis C Treatment Agents
T4
T4
T4
T4
T2
T1
T1
peginterferon alfa-2a
peginterferon alfa-2a
peginterferon alfa-2b
peginterferon alfa-2b
ribavirin
ribavirin
ribavirin
T1 ribavirin
T1 ribavirin
PEGASYS
PA
PEGASYS PROCLICK PA
PEGINTRON
PA
PEGINTRON REDIPEN PA
REBETOL
RIBASPHERE(CAP)
RIBASPHERE(TAB)
(200 MG)
RIBASPHERE(TAB)
ST
(400 MG)
RIBASPHERE(TAB)
ST
(600 MG)
Hepatitis C Virus - Ns5a Replication Complex
Inhib
T4 daclatasvir
dihydrochloride
DAKLINZA
PA
RASUVO(AUTO
INJECT)(7.5MG/0.15)
QL, ST
Anti-flam. Interleukin-1 Receptor Antagonist
T4 anakinra
T4 rilonacept
KINERET
ARCALYST
PA
Anti-inflammatory Tumor Necrosis Factor
Inhibitor
T4 adalimumab
T4 adalimumab
T4 adalimumab
T4 adalimumab
T4 adalimumab
T4 etanercept
T4 golimumab
T4 golimumab
HUMIRA
HUMIRA PEDIATRIC
CROHN'S
HUMIRA PEN
HUMIRA PEN
CROHN'S-UC-HS
HUMIRA PEN
PSORIASIS
ENBREL
SIMPONI
SIMPONI ARIA
PA
PA
PA
PA
PA
PA
PA
PA
Hepatitis C Virus - Ns5a, Ns3/4a, Ns5b Inhib Cmb.
Anti-inflammatory, Interleukin-1 Beta Blockers
T4 ombita/paritap/riton/dasa VIEKIRA PAK
buvir
T4 canakinumab/pf
PA
Hepatitis C Virus Ns3/4a Serine Protease Inhib.
T4 simeprevir sodium
OLYSIO
PA
Hepatitis C Virus- Ns5a And Ns3/4a Inhibitor
Comb
Anti-inflammatory, Pyrimidine Synthesis Inhibitor
T1 leflunomide
PA
Inhib.
T4 icatibant acetate
T2 penicillamine
T2 penicillamine
C1 Esterase Inhibitors
CUPRIMINE
DEPEN
Anti-arthritic, Folate Antagonist Agents
T4 methotrexate/pf
T4 methotrexate/pf
T4 methotrexate/pf
T4 methotrexate/pf
T4 methotrexate/pf
T4 methotrexate/pf
T4 methotrexate/pf
T4 methotrexate/pf
Sutter Health Plus
RHEUMATREX
OTREXUP
RASUVO(AUTO
INJECT)(10MG/0.2ML)
RASUVO(AUTO
INJECT)(12.5/0.25)
RASUVO(AUTO
INJECT)(15MG/0.3ML)
RASUVO(AUTO
INJECT)(17.5/0.35)
RASUVO(AUTO
INJECT)(20MG/0.4ML)
RASUVO(AUTO
INJECT)(22.5/0.45)
RASUVO(AUTO
INJECT)(25MG/0.5ML)
RASUVO(AUTO
INJECT)(27.5/0.55)
RASUVO(AUTO
INJECT)(30MG/0.6ML)
PA
ORENCIA
ORENCIA
PA
PA
Bradykinin B2 Receptor Antagonists
Anti-arthritic And Chelating Agents
T2 methotrexate sodium
T4 methotrexate/pf
T4 methotrexate/pf
OTEZLA
Antinflammatory, Sel.costim.mod.,t-cell Inhibitor
T4 abatacept
T4 abatacept/maltose
INFLAMMATORY DISEASE
ARAVA
Anti-inflammatory,phosphodiesterase-4(pde4)
T4 apremilast
T3 elbasvir/grazoprevir
ZEPATIER
T4 ombitasvir/paritaprev/rito TECHNIVIE
nav
ILARIS
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
T4 c1 esterase inhibitor
T4 c1 esterase inhibitor
T4 c1 esterase inhibitor,
recomb
FIRAZYR
PA
BERINERT
CINRYZE
RUCONEST
PA
PA
PA
Glucocorticoids
T3 betamet acet/betamet na
ph
T1 betamet acet/betamet
na ph
T1 budesonide
T3 budesonide
T1 cortisone acetate
T1 dexamethasone
T3 dexamethasone
T3 dexamethasone
T1 dexamethasone sod
phosphate
T1 dexamethasone sod
phosphate/pf
T1 hydrocortisone
BETA 1
CELESTONE
ENTOCORT EC
UCERIS
ST
CORTISONE ACETATE
DEXAMETHASONE
DEXAMETHASONE
INTENSOL
DEXPAK
DEXAMETHASONE
SODIUM PHOSPHATE
DEXAMETHASONE
SODIUM PHOSPHATE
CORTEF
Page 41 of 106
T3 hydrocortisone sod
succ/pf
T1 hydrocortisone sod
succinate
T1 methylprednisolone
acetate
T1
T1
T1
T1
T3
T3
T3
T3
T2
T2
T1
T3
T3
T1
T1
T3
T1
T2
T3
T3
T3
T3
T3
T1
T3
T3
SOLU-CORTEF
Interleukin-6 (il-6) Receptor Inhibitors
SOLU-CORTEF
T4 tocilizumab
MEDROL(TAB DS PK)
MEDROL(TAB)(16 MG)
MEDROL(TAB)(2 MG)
MEDROL(TAB)(32 MG)
MEDROL(TAB)(4 MG)
MEDROL(TAB)(8 MG)
DEPOMEDROL(VIAL)(20
MG/ML)
methylprednisolone
DEPOacetate
MEDROL(VIAL)(40
MG/ML)
methylprednisolone
DEPOacetate
MEDROL(VIAL)(80
MG/ML)
methylprednisolone sod METHYLPREDNISOL
succ
ONE SOD SUCC
methylprednisolone sod SOLU
succ
MEDROL(VIAL)(1000
MG)
succ
MEDROL(VIAL)(2 G)
succ
MEDROL(VIAL)(500
MG)
methylprednisolone sod SOLU-MEDROL
succ/pf
methylprednisolone/bupi PHYSICIANS EZ USE
vacaine
M-PRED
prednisolone
MILLIPRED
prednisolone
MILLIPRED DP
prednisolone
PREDNISOLONE
FLO-PRED
prednisolone sod
MILLIPRED
phosphate
prednisolone sod
PEDIAPRED
phosphate
prednisolone sod
PREDNISOLONE
phosphate
SODIUM PHOSPHATE
prednisolone sod
VERIPRED 20
phosphate
prednisone
PREDNISONE
prednisone
PREDNISONE
INTENSOL
prednisone
RAYOS
ST
triamcinolone acetonide KENALOG-10
triamcinolone acetonide KENALOG-40
triamcinolone acetonide PRO-C-DURE 5
triamcinolone acetonide PRO-C-DURE 6
triamcinolone acetonideTRIAMCINOLONE
ACETONIDE
triamcinolone
ARISTOSPAN
hexacetonide
triamcinolone/lidocaine EZ USE JOINT
TUNNEL-TRIGGER
Gold Salts
T4 auranofin
Sutter Health Plus
RIDAURA
ACTEMRA
PA
Janus Kinase (jak) Inhibitors
T4 tofacitinib citrate
XELJANZ
PA
Mineralocorticoids
T1 fludrocortisone acetate FLUDROCORTISONE
ACETATE
Monoclonal Antibody-human Interleukin 12/23
Inhib
T4 ustekinumab
STELARA
PA
Nasal Nsaids, Cox Non-selective,systemic Analgesic
T3 ketorolac tromethamine SPRIX
QL
Nsaid & Topical Irritant Counter-irritant Comb.
T3 diclofenac/capsicum
DERMASILKRX
DICLOPAK
INFLAMMACIN
COMFORT PAC
IBUPROFEN
COMFORT PAC
MELOXICAM
NAPROPAK COOL
T3 diclofenac/capsicum
T3 ibuprofen/irr cnt-irrit
cmb #2
T3 meloxicam/irr cntr-irr
cmb #2
T3 naproxen
sodium/menthol
T1 naproxen/capsaicin/me NAPROPAX
nthol
T3 naproxen/irr cntr-irrit
COMFORT PAC
cmb #2
NAPROXEN
Nsaids (cox Non-specific Inhib)& Prostaglandin
Cmb
T1 diclofenac
sodium/misoprostol
T1 diclofenac
sodium/misoprostol
ARTHROTEC 50
ARTHROTEC 75
Nsaids, Cyclooxygenase 2 Inhibitor - Type
T1 celecoxib
CELEBREX
Nsaids, Cyclooxygenase Inhibitor-type
T1 diclofenac potassium
T3 diclofenac
submicronized
T1 etodolac
T2 fenoprofen calcium
T1 fenoprofen calcium
T1
T3
T1
T2
T1
flurbiprofen
ibuprofen
ibuprofen
indomethacin
indomethacin
DICLOFENAC
POTASSIUM
ZIPSOR
DICLOFENAC
SODIUM
DYLOJECT
ZORVOLEX
QL, ST
QL, ST
ETODOLAC
FENOPROFEN
CALCIUM(CAP)
FENOPROFEN
CALCIUM(TAB)
FLURBIPROFEN
CALDOLOR
IBUPROFEN
INDOCIN
INDOMETHACIN
Page 42 of 106
T3 indomethacin,
TIVORBEX
submicronized
T1 ketoprofen
KETOPROFEN
T1 ketorolac tromethamineKETOROLAC
TROMETHAMINE
T1 meclofenamate sodium MECLOFENAMATE
SODIUM
T1 mefenamic acid
PONSTEL
T1 meloxicam
MOBIC
T3 meloxicam,
VIVLODEX
submicronized
T1 nabumetone
NABUMETONE
T1 naproxen
EC-NAPROSYN
T1 naproxen
NAPROSYN
T1 naproxen
NAPROXEN
T1 naproxen sodium
ANAPROX
T1 naproxen sodium
ANAPROX DS
T3 naproxen sodium
NAPRELAN
T1 oxaprozin
DAYPRO
T1 piroxicam
FELDENE
T1 sulindac
SULINDAC
T1 tolmetin sodium
TOLMETIN SODIUM
QL, ST
Plasma Kallikrein Inhibitors
T4 ecallantide
KALBITOR
LOCAL ANESTHESIA
Local Anesthetics
T3 articaine/epinephrine
bitart
T3 b-caine/zinc
cl/pine/cpyrd
T1 bupivacaine hcl
T1 bupivacaine hcl/0.9 %
nacl/pf
T1 bupivacaine hcl/dexwater/pf
T1 bupivacaine
hcl/epinephrine
T1 bupivacaine
hcl/epinephrine bi
T1 bupivacaine
hcl/epinephrine/pf
T1 bupivacaine
hcl/epinephrine/pf
T1 bupivacaine hcl/pf
T1 bupivacaine hcl/pf
T3 bupivacaine liposome/pf
T3 chloroprocaine hcl
T1 chloroprocaine hcl/pf
T3
T1
T3
T3
T3
T1
ARTICADENT
DENTAL
BUCALSEP
SENSORCAINE
BUPIVACAINE HCL0.9% NACL
BUPIVACAINE
DEXTROSE
BUPIVACAINE HCL
EPINEPHRINE
BUPIVACAINE HCL
EPINEPHRINE
BUPIVACAINE HCL
EPINEPHRINE
SENSORCAINE-MPF
EPINEPHRINE
BUPIVACAINE HCL
SENSORCAINE-MPF
EXPAREL
NESACAINE
NESACAINE
MPF(VIAL)(20
MG/ML)
chloroprocaine hcl/pf
NESACAINE
MPF(VIAL)(30
MG/ML)
lidocaine hcl
LIDOCAINE HCL
VISCOUS
lidocaine hcl
XYLOCAINE
lidocaine hcl
XYLOCAINE-MPF
lidocaine hcl
ZINGO
lidocaine hcl/d7.5w/pf LIDOCAINE HCL IN
7.5% DEXTROSE
Sutter Health Plus
PA
T1 lidocaine
XYLOCAINE WITH
hcl/epinephrine
EPINEPHRINE
T3 lidocaine hcl/epinephrine LIDOCAINEbit
EPINEPHRINE
T1 lidocaine
XYLOCAINE
hcl/epinephrine bit
DENTAL
EPINEPHRINE
T1 lidocaine
XYLOCAINE WITH
hcl/epinephrine/pf
EPINEPHRINE
T1 lidocaine
XYLOCAINE-MPF
hcl/epinephrine/pf
WITH
EPINEPHRINE(AMPU
L)
T3 lidocaine
XYLOCAINE-MPF
hcl/epinephrine/pf
WITH
EPINEPHRINE(VIAL)
(1 %-1:200K)
T1 lidocaine
XYLOCAINE-MPF
hcl/epinephrine/pf
WITH
EPINEPHRINE(VIAL)
(1.5-1:200K)
T1 lidocaine hcl/pf
LIDOCAINE HCL
T1 lidocaine hcl/pf
XYLOCAINE-MPF
T3 lidocaine with 8.4% sod BUFFERED
bicarb
LIDOCAINE
T1 mepivacaine hcl
CARBOCAINE
T1 mepivacaine hcl/pf
MEPIVACAINE HCL
T3 prilocaine hcl
CITANEST PLAIN
DENTAL
T3 prilocaine
CITANEST FORTE
hcl/epinephrine bit
DENTAL
T1 ropivacaine hcl in
ROPIVACAINE HCL0.9%nacl/pf
0.9% NACL
T3 ropivacaine hcl/pf
NAROPIN(AMPUL)
NAROPIN(INFUSN
BTL)
NAROPIN(PLAST
BAG)
NAROPIN(VIAL)
T1 tetracaine hcl/pf
TETRACAINE HCL
LOWER GASTROINTESTINAL
DISORDERS - BOWEL INFLAMMAT
Bowel Antiinflamatory Agents
T1 sulfadiazine
SULFADIAZINE
Chronic Inflam. Colon Dx, 5-a-salicylat,rectal Tx
T2 mesalamine
CANASA
T1 mesalamine
SFROWASA
T1 mesalamine w/cleansing ROWASA
wipes
Drug Tx-chronic Inflam. Colon Dx,5
aminosalicylat
T1
T3
T2
T3
T3
T2
T2
balsalazide disodium
balsalazide disodium
mesalamine
mesalamine
mesalamine
mesalamine
mesalamine
COLAZAL
GIAZO
APRISO
ASACOL HD
DELZICOL
LIALDA
PENTASA
ST
ST
ST
Page 43 of 106
T3 olsalazine sodium
T1 sulfasalazine
DIPENTUM
SULFASALAZINE
ST
T1 hydrocortisone
T3 hydrocortisone acetate
CORTENEMA
CORTIFOAM
Drugs To Tx Chronic Inflamm. Disease Of Colon
LOWER GASTROINTESTINAL
T4 certolizumab pegol
T4 infliximab
DISORDERS - OTHER
CIMZIA
REMICADE
PA
PA
Hemorrhoidal Prep, Anti-infam Steroid/local
Ammonia Inhibitors
Anesth
T3
T4
T4
T1
T3
acetohydroxamic acid
carglumic acid
glycerol phenylbutyrate
lactulose
sodium benzoate/sod
phenylacet
T4 sodium phenylbutyrate
LITHOSTAT
CARBAGLU
RAVICTI
GENERLAC
AMMONUL
T1 hydrocort/pramoxin/em ANALPRAM E
ol/pram#1
T3 hydrocort/pramoxn/skn ZYPRAM
clnsr#16
T3 hydrocortisone/lidocaine/ ANA-LEX
aloe
T1 hydrocortisone/lidocain LIDOCAINEe/aloe
HYDROCORTISONE
T1 hydrocortisone/pramox ANALPRAM
ine
HC(CREAM/APPL)(1
%-1 %)
T2 hydrocortisone/pramoxin ANALPRAM
e
HC(CREAM/APPL)(1
%-1 %)
ine
HC(CREAM/APPL)(2.5
%-1 %)
ine
HC(CREAM/APPL)(2.5
1%(4G))
T2 hydrocortisone/pramoxin ANALPRAM
e
HC(LOTION)
T3 hydrocortisone/pramoxin PROCORT
e
T2 hydrocortisone/pramoxin PROCTOFOAM-HC
e
T3 lidocaine/hydrocortisone ANA-LEX
ac
T1 lidocaine/hydrocortison LIDOCAINEe ac
HYDROCORTISONE
T3 difenoxin hcl/atropine
sulfate
T1 diphenoxylate
hcl/atropine
T1 diphenoxylate
hcl/atropine
T1 loperamide hcl
T1 opium tincture
T1 paregoric
Ibs Agents,mixed Opioid Recep
Laxatives And Cathartics
VIBERZI
T3 crofelemer
T3
T4
T1
T1
T1
LINZESS
PA
PA
QL
RECTIV
Rectal Preparations
T1 hydrocortisone
PROCTOZONE-HC
T1 hydrocortisone acetate HEMMOREX-HC
T1 hydrocortisone acetate PROCTOCORT
Rectal/lower Bowel Prep.,glucocort.
T3 budesonide
Sutter Health Plus
UCERIS
chenodiol
cholic acid
ursodiol
ursodiol
ursodiol
T1 alosetron hcl
Local Anorectal Nitrate Preparations
T3 nitroglycerin
MOTOFEN
DIPHENOXYLATE
ATROPINE
LOMOTIL
LOPERAMIDE
OPIUM TINCTURE
PAREGORIC
CHENODAL
CHOLBAM
ACTIGALL
URSO
URSO FORTE
PA
Irritable Bowel Synd. Agent,5ht-3 Antagonist-type
Irritable Bowel Agents,guanylate Cylase-c Agonist
T2 linaclotide
QL, ST
Bile Salts
Antibody
ENTYVIO
FULYZAQ
Antidiarrheals
Integrin Receptor Antagonist, Monoclonal
T4 vedolizumab
BUPHENYL
Antidiarrheal - G.i. Chloride Channel Inhibitors
Agonists/antagonists
T3 eluxadoline
PA
ST
LOTRONEX
T1 bisac/nacl/nahco3/kcl/p PEG-PREP
eg 3350
T2 lactulose
KRISTALOSE
T1 lactulose
LACTULOSE
T2 lubiprostone
AMITIZA
T3 naphos m-b m-h/na
OSMOPREP
phos,di-ba
T3 peg 3350/na
COLYTE WITH
sulf,bicarb,cl/kcl
FLAVOR PACKS
T1 peg 3350/na
GAVILYTE-C
sulf,bicarb,cl/kcl
T2 peg 3350/na
GOLYTELY
sulf,bicarb,cl/kcl
T3 peg3350/sod
MOVIPREP
sul/nacl/asb/c/kcl
T1 polyethylene glycol
POLYETHYLENE
3350
GLYCOL 3350
T3 sod picosulf/mag
PREPOPIK
ox/citric ac
T1 sodium
GAVILYTE-N
chloride/nahco3/kcl/peg
T3 sodium,potassium,&mag SUPREP
sulfates
QL
Page 44 of 106
Narcotic Antagonists, Peripherally-acting
T3 alvimopan
T2 methylnaltrexone
bromide
T2 naloxegol oxalate
ENTEREG
RELISTOR
PA
MOVANTIK
QL
Sbs - Glucagon-like Peptide-2 (glp-2) Analogs
T4 teduglutide
GATTEX
PA
MISCELLANEOUS AGENTS
Anaphylaxis Therapy Agents
T1
T3
T2
T2
epinephrine
epinephrine
epinephrine
epinephrine
ADRENACLICK
AUVI-Q
EPIPEN 2-PAK
EPIPEN JR 2-PAK
ST
Metabolic Dx Enzyme Replacement,lyso.acid
Lip.def.
T4 sebelipase alfa
KANUMA
PA
Miscellaneous Agents
Parasympathetic Agents
bethanechol chloride
cevimeline hcl
guanidine hcl
pilocarpine hcl
URECHOLINE
EVOXAC
GUANIDINE HCL
SALAGEN
Systemic Enzyme Inhibitors
T4 alpha-1-proteinase
inhibitor
inhibitor
inhibitor
inhibitor
ARALAST NP
GLASSIA
T4 cyclophosphamide
T4 cyclophosphamide
T1 hydroxyurea
T4 ifosfamide
Sutter Health Plus
QL
QL
QL
PA, QL
PA, QL
PA
Antiandrogenic Agents
T4
T1
T4
T1
T4
abiraterone acetate
bicalutamide
enzalutamide
flutamide
nilutamide
ZYTIGA
CASODEX
XTANDI
FLUTAMIDE
NILANDRON
PA, QL
PA, QL
QL
Antibiotic Antineoplastics
T4 bleomycin sulfate
BLEOMYCIN
SULFATE
COSMEGEN
DAUNOXOME
DAUNORUBICIN HCL
DOXORUBICIN HCL
DOXORUBICIN HCL
LIPOSOME
ELLENCE
EPIRUBICIN HCL
IDAMYCIN PFS
MITOMYCIN
ZANOSAR
VALSTAR
Anti-cd20 (b Lymphocyte) Monoclonal Antibody
ZEMAIRA
T4 obinutuzumab
T4 ofatumumab
T4 rituximab
GAZYVA
ARZERRA
RITUXAN
PA
PA
PA
Antimetabolites
Alkylating Agents
altretamine
bendamustine hcl
bendamustine hcl
busulfan
busulfan
carboplatin
carmustine
carmustine in
polifeprosan 20
T4 chlorambucil
T4 cisplatin
T4 cyclophosphamide
IFOSFAMIDE
IFOSFAMIDE-MESNA
GLEOSTINE
LOMUSTINE
MUSTARGEN
ALKERAN
ALKERAN
ELOXATIN
OXALIPLATIN
TEMODAR
TEMODAR(CAP)
TEMODAR(VIAL)
THIOTEPA
PROLASTIN C
NEOPLASTIC DISEASE
T4
T4
T4
T4
T4
T4
T4
T4
ifosfamide
ifosfamide/mesna
lomustine
lomustine
mechlorethamine hcl
melphalan
melphalan hcl
oxaliplatin
oxaliplatin
temozolomide
temozolomide
temozolomide
thiotepa
T4 dactinomycin
T4 daunorubicin citrate
liposomal
T4 daunorubicin hcl
T1 doxorubicin hcl
T4 doxorubicin hcl pegliposomal
T4 epirubicin hcl
T4 epirubicin hcl
T4 idarubicin hcl
T4 mitomycin
T4 streptozocin
T4 valrubicin
T3 liver extract (beef-pork) NEXAVIR
T1
T1
T1
T1
T4
T4
T4
T4
T4
T2
T4
T4
T4
T4
T4
T4
T4
HEXALEN
BENDEKA
TREANDA
BUSULFEX
MYLERAN
CARBOPLATIN
BICNU
GLIADEL
QL
LEUKERAN
CISPLATIN
CYCLOPHOSPHAMID
E
CYCLOPHOSPHAMID
E(CAP)
CYCLOPHOSPHAMID
E(VIAL)
HYDREA
IFEX
QL
QL
QL
QL
QL
T4 azacitidine
T4 capecitabine
VIDAZA
XELODA(TAB)(150
MG)
T4 capecitabine
XELODA(TAB)(500
MG)
T4 cladribine
CLADRIBINE
T4 clofarabine
CLOLAR
T4 cytarabine
CYTARABINE
T4 cytarabine liposome/pf DEPOCYT
T4 cytarabine/pf
CYTARABINE
T4 decitabine
DACOGEN
T4 floxuridine
FLOXURIDINE
T4 fludarabine phosphate FLUDARABINE
PHOSPHATE
T1 fluorouracil
FLUOROURACIL
T4 gemcitabine hcl
GEMCITABINE HCL
T4 gemcitabine hcl
GEMZAR
T1 mercaptopurine
MERCAPTOPURINE
T4 mercaptopurine
PURIXAN
PA, QL
PA, QL
QL, ST
Page 45 of 106
T1 methotrexate sodium
Antineoplastic - Mtor Kinase Inhibitors
T1
T4 everolimus
T4 everolimus
T2
T1
T4
T4
T4
T4
T4
T4
METHOTREXATE(TA QL
B)
methotrexate sodium METHOTREXATE(VIA
L)
methotrexate sodium
TREXALL
QL
methotrexate sodium/pf METHOTREXATE
SODIUM
nelarabine
ARRANON
pemetrexed disodium
ALIMTA
PA
pentostatin
NIPENT
pralatrexate
FOLOTYN
thioguanine
TABLOID
QL
trifluridine/tipiracil hcl LONSURF
PA, QL
Antineoplast Egf Receptor Blocker Rcmb Mc
Antibody
T4
T4
T4
T4
T4
cetuximab
necitumumab
panitumumab
pertuzumab
trastuzumab
ERBITUX
PORTRAZZA
VECTIBIX
PERJETA
HERCEPTIN
PA
PA
PA
PA
Antineoplast Hum Vegf Inhibitor Recomb Mc
Antibody
T4 bevacizumab
T4 everolimus
T4 everolimus
T4 everolimus
T4 temsirolimus
AFINITOR DISPERZ PA, QL
AFINITOR(TAB)(10
PA, QL
MG)
AFINITOR(TAB)(2.5 PA, QL
MG)
AFINITOR(TAB)(5 MG)PA, QL
AFINITOR(TAB)(7.5 PA, QL
MG)
TORISEL
PA
Antineoplastic - Topoisomerase I Inhibitors
T4
T4
T4
T4
T4
T4
T4
T4
irinotecan hcl
irinotecan hcl
irinotecan liposomal
topotecan hcl
topotecan hcl
topotecan hcl
topotecan hcl
trabectedin
CAMPTOSAR
IRINOTECAN HCL
ONIVYDE
HYCAMTIN
HYCAMTIN(CAP)
HYCAMTIN(VIAL)
TOPOTECAN HCL
YONDELIS
T4 ziv-aflibercept
ZALTRAP
PA
Antineoplastic - Vegfr Antagonist
AVASTIN
PA
T4 ramucirumab
CYRAMZA
Antineoplastic Immunomodulator Agents
T4 daratumumab
T4 lenalidomide
T4 peginterferon alfa-2b
T4 pomalidomide
DARZALEX
Antineoplastic - Anti-slamf7 Monoclonal Antibody
EMPLICITI
ARIMIDEX
AROMASIN
FEMARA
T4 degarelix acetate
PA, QL
Antineoplastic - Epothilones And Analogs
T4 ixabepilone
IXEMPRA
T4 degarelix acetate
PA
Antineoplastic - Hedgehog Pathway Inhibitor
T4 sonidegib phosphate
T4 vismodegib
T4 bosutinib
Antineoplastic - Halichondrin B Analogs
HALAVEN
ODOMZO
ERIVEDGE
PA
PA, QL
PA, QL
Antineoplastic - Immunotherapy, Therapeutic Vac
T4 sipuleucel-t/lactated
ringers
PROVENGE
Antineoplastic - Immunotherapy, Virus-based
Agents
T4 talimogene laherparepvecIMLYGIC
PA
Antineoplastic - Janus Kinase (jak) Inhibitors
T4 ruxolitinib phosphate
JAKAFI
T4
T4
T4
T4
T4
T4
afatinib dimaleate
alectinib hydrochloride
axitinib
axitinib
bortezomib
bosutinib
cabozantinib s-malate
carfilzomib
ceritinib
crizotinib
dabrafenib mesylate
dasatinib
T4 dasatinib
T4 dasatinib
PA, QL
Antineoplastic - Mek1 And Mek2 Kinase Inhibitors
T4 dasatinib
T4 cobimetinib fumarate
T4 dasatinib
Sutter Health Plus
COTELLIC
PA, QL
QL
PA, QL
FIRMAGON(VIAL)(120 QL
MG)
FIRMAGON(VIAL)(80 QL
MG)
Antineoplastic Systemic Enzyme Inhibitors
T4
T4
T4
T4
T4
T4
T4 eribulin mesylate
REVLIMID
SYLATRON
POMALYST
PA
Antineoplastic Lhrh(gnrh) Antagonist,pituit.supprs
Antineoplastic Aromatase Inhibitors
T1 anastrozole
T1 exemestane
T1 letrozole
PA
Antineoplastic - Vegf-a,b & P1gf Inhibitor
Antineoplastic - Anti-cd38 Monoclonal Antibody
T4 elotuzumab
PA
QL
QL
PA, QL
GILOTRIF
ALECENSA
INLYTA(TAB)(1 MG)
INLYTA(TAB)(5 MG)
VELCADE
BOSULIF(TAB)(100
MG)
BOSULIF(TAB)(500
MG)
COMETRIQ
KYPROLIS
ZYKADIA
XALKORI
TAFINLAR
SPRYCEL(TAB)(100
MG)
SPRYCEL(TAB)(140
MG)
SPRYCEL(TAB)(20
MG)
SPRYCEL(TAB)(50
MG)
SPRYCEL(TAB)(70
MG)
PA, QL
PA, QL
PA, QL
PA, QL
PA
PA, QL
PA, QL
PA, QL
PA
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
Page 46 of 106
T4 dasatinib
T4
T4
T4
T4
T4
erlotinib hcl
gefitinib
ibrutinib
idelalisib
imatinib mesylate
T4 imatinib mesylate
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
ixazomib citrate
lapatinib ditosylate
lenvatinib mesylate
nilotinib hcl
olaparib
osimertinib mesylate
palbociclib
pazopanib hcl
ponatinib hcl
ponatinib hcl
regorafenib
sorafenib tosylate
sunitinib malate
trametinib dimethyl
sulfoxide
T4 vandetanib
T4 vandetanib
T4 vemurafenib
SPRYCEL(TAB)(80
PA, QL
MG)
TARCEVA
PA, QL
IRESSA
PA, QL
IMBRUVICA
PA, QL
ZYDELIG
PA, QL
GLEEVEC(TAB)(100 PA, QL
MG)
GLEEVEC(TAB)(400 PA, QL
MG)
NINLARO
PA, QL
TYKERB
PA, QL
LENVIMA
PA, QL
TASIGNA
PA, QL
LYNPARZA
PA, QL
TAGRISSO
PA, QL
IBRANCE
PA, QL
VOTRIENT
PA, QL
ICLUSIG(TAB)(15 MG) PA, QL
ICLUSIG(TAB)(45 MG) PA, QL
STIVARGA
PA, QL
NEXAVAR
PA, QL
SUTENT
PA, QL
MEKINIST
PA, QL
CAPRELSA(TAB)(100 PA, QL
MG)
CAPRELSA(TAB)(300 PA, QL
MG)
ZELBORAF
PA, QL
Antineoplastic,anti-programmed Death-1 (pd-1)
Mab
T4 nivolumab
T4 pembrolizumab
OPDIVO
KEYTRUDA
PA
PA
Antineoplastic,histone Deacetylase Inhibitors,hdis
T4
T4
T4
T4
belinostat
panobinostat lactate
romidepsin
vorinostat
BELEODAQ
FARYDAK
ISTODAX
ZOLINZA
PA
PA, QL
PA
QL
Antineoplastic-interleukin-6(il-6)inhib,antibody
T4 siltuximab
SYLVANT
PA
Antineoplastics Antibody/antibody-drug Complexes
T4 ado-trastuzumab
emtansine
T4 blinatumomab
T4 brentuximab vedotin
T4 dinutuximab
T4 kit for y90/ibritumomab/album
KADCYLA
PA
BLINCYTO
ADCETRIS
UNITUXIN
ZEVALIN
PA
PA
PA
Sutter Health Plus
T4
T4
T4
T4
T4
T4
etoposide
etoposide
etoposide phosphate
mitotane
mitoxantrone hcl
omacetaxine
mepesuccinate
paclitaxel
paclitaxel protein-bound
pegaspargase
procarbazine hcl
teniposide
tretinoin
TRISENOX
ERWINAZE
JEVTANA
DACARBAZINE
DOCEFREZ
DOCETAXEL
ETOPOSIDE
ETOPOSIDE(CAP)
QL
ETOPOSIDE(VIAL)
ETOPOPHOS
LYSODREN
QL
MITOXANTRONE HCLPA
SYNRIBO
PA
PACLITAXEL
ABRAXANE
ONCASPAR
MATULANE
TENIPOSIDE
TRETINOIN
PA
PA
QL
QL
Chemotherapy Rescue/antidote Agents
T1
T1
T4
T1
T4
T4
T3
T3
T1
amifostine crystalline
dexrazoxane hcl
glucarpidase
leucovorin calcium
AMIFOSTINE
ZINECARD
VORAXAZE
LEUCOVORIN
CALCIUM
levoleucovorin calcium FUSILEV
levoleucovorin calcium LEVOLEUCOVORIN
CALCIUM
mesna
MESNEX
mesna
MESNEX(TAB)
mesna
MESNEX(VIAL)
Cytotoxic T-lymphocyte Antigen(ctla-4)rmc
Antibody
T4 ipilimumab
YERVOY
PA
Intrapleural Sclerosing Agents, Antineoplast. Adj.
T3 talc
T1 talc
SCLEROSOL
STERILE TALC
Photoactivated, Antineoplastic Agents
T3 methoxsalen
T4 porfimer sodium
UVADEX
PHOTOFRIN
PA
Photoactivated, Antineopls. & Premalignant
Lesions
T3 aminolevulinic acid hcl LEVULAN
Selective Estrogen Receptor Modulators
T4
T2
T1
T1
fulvestrant
tamoxifen citrate
tamoxifen citrate
tamoxifen citrate
T5 tamoxifen citrate
T4 toremifene citrate
Antineoplastics,miscellaneous
T4 arsenic trioxide
T4 asparaginase (erwinia
chrysan)
T4 cabazitaxel
T1 dacarbazine
T4 docetaxel
T4 docetaxel
T1 etoposide
T1
T1
T3
T4
T4
T4
FASLODEX
PA
SOLTAMOX
TAMOXIFEN CITRATE
TAMOXIFEN
CITRATE(TAB)(10 MG)
TAMOXIFEN
CITRATE(TAB)(20 MG)
FARESTON
PA, QL
Selective Retinoid X Receptor Agonists
T4 bexarotene
PA
TARGRETIN
PA, QL
Steroid Antineoplastics
T4 estramustine phosphate EMCYT
sodium
T1 megestrol acetate
MEGESTROL
ACETATE
QL
QL
Page 47 of 106
T3 gabapentin
Vinca Alkaloids
T4 vinblastine sulfate
T1 vincristine sulfate
T4 vincristine sulfate
liposomal
T4 vinorelbine tartrate
VINBLASTINE
SULFATE
VINCRISTINE
SULFATE
MARQIBO
GRALISE(TAB ER
24H)(600 MG)
QL, ST
Pseudobulbar Affect (pba) Agents, Nmda
Antagonists
PA
NAVELBINE
T3 dextromethorphan
hbr/quinidine
NUEDEXTA
PA
ORAL/PHARYNGEAL DISORDERS
NEUROLOGICAL DISEASE
Dental Aids And Preparations
MISCELLANEOUS
Agents To Treat Multiple Sclerosis
T4
T4
T4
T4
T4
T4
T4
alemtuzumab
dimethyl fumarate
fingolimod hcl
glatiramer acetate
interferon beta-1a
interferon beta-1a
interferon beta1a/albumin
T4 interferon beta1a/albumin
T4 interferon beta1a/albumin
T4 interferon beta-1b
T4 interferon beta-1b
T4 peginterferon beta-1a
T4 peginterferon beta-1a
T4 teriflunomide
T1 chlorhexidine gluconate CHLORHEXIDINE
GLUCONATE
T3 dental
Q-CARE RX
suction/chlor/swb#1/mth
T3 dental
Q-CARE RX
suction/chlorhx/swab #1
ACETONIDE
LEMTRADA
TECFIDERA
GILENYA
COPAXONE
AVONEX
AVONEX PEN
AVONEX
ADMINISTRATION
PACK
REBIF
PA
PA
PA
PA
PA
PA
PA
REBIF REBIDOSE
PA
Nose Preparations, Miscellaneous
BETASERON
EXTAVIA
PLEGRIDY
PLEGRIDY PEN
AUBAGIO
PA
PA
PA
PA
PA
PA
Keratinocyte Growth Factor
T4 palifermin
KEPIVANCE
Nose Preparations Antibiotics
T2 mupirocin calcium
BACTROBAN NASAL
ATROVENT
Periodontal Tetracycline Antiinfective, Local
T3 minocycline hcl
microspheres
ARESTIN
Agts Tx Neuromusc Transmission Dis,pot-chan
OTHER RESPIRATORY DISORDERS
Blkr
Antifibrotic Therapy - Pyridone Analogs
T4 dalfampridine
AMPYRA
PA
T4 pirfenidone
ESBRIET
PA
Amyotrophic Lateral Sclerosis Agents
Cystic Fib.transmemb Conduct.reg.(cftr)potentiator
T4 riluzole
T4 ivacaftor
RILUTEK
KALYDECO
PA
Fibromyalgia Agents,serotonin-norepineph Ru
Cystic Fibrosis-cftr Potentiator & Corrector Comb.
Inhib
T4 lumacaftor/ivacaftor
T2 milnacipran hcl
Ab
T3 gabapentin enacarbil
T4 tetrabenazine
T3 gabapentin
Sutter Health Plus
beractant
calfactant
lucinactant
poractant alfa
SURVANTA
INFASURF
SURFAXIN
CUROSURF
PA
HORIZANT(TAB
ER)(300 MG)
HORIZANT(TAB
ER)(600 MG)
XENAZINE
QL, ST
T1 acetylcysteine
T4 dornase alfa
QL, ST
Pulmonary Fibrosis - Systemic Enzyme Inhibitors
GRALISE(TAB ER
24H)(300 MG)
GRALISE(TAB ER
24H)(300-600 MG)
Mucolytics
T4 nintedanib esylate
PA
Postherpetic Neuralgia Agents
T3 gabapentin
T3
T3
T3
T3
TYSABRI
Movement Disorders
T3 gabapentin enacarbil
PA
Lung Surfactants
SAVELLA
Leukocyte Adhesion Inhib,alpha4-mediat Igg4k Mc
T4 natalizumab
ORKAMBI
QL, ST
QL, ST
ACETYLCYSTEINE
PULMOZYME
OFEV
PA
PA
PAIN MANAGEMENT - ANALGESICS
Analgesic, Non-salicylate & Barbiturate Comb.
T3 butalbital/acetaminophen BUPAP
Page 48 of 106
T1 butalbital/acetaminoph BUTALBITALen
ACETAMINOPHEN
Analgesic, Salicylate, Barbiturate,& Xanthine Cmb
T1 butalbital/aspirin/caffei FIORINAL
ne
Analgesic,non-salicylate,barbiturate,&xanthine
Cmb
T1 butalb/acetaminophen/c BUTALBITAL
affeine
ACETAMINOPHEN
CAFFE
T1 butalb/acetaminophen/c ESGIC
affeine
T1 butalb/acetaminophen/c FIORICET
affeine
T3 butalb/acetaminophen/ca VANATOL LQ
ffeine
Analgesic/antipyretics, Salicylates
T5 aspirin
T1 choline sal/mag
salicylate
T1 diflunisal
T1 salsalate
ASPIRIN EC(OTC)
CHOLINE MAG
TRISALICYLATE
DIFLUNISAL
DISALCID
Analgesic/antipyretics,non-salicylate
T3 acetaminophen
OFIRMEV
Analgesics Narcotic, Anesthetic Adjunct Agents
T1
T1
T1
T3
T1
T1
alfentanil hcl
fentanyl citrate/pf
fentanyl citrate/pf
remifentanil hcl
sufentanil citrate
sufentanil citrate
ALFENTA
FENTANYL CITRATE
SUBLIMAZE
ULTIVA
SUFENTA
SUFENTANIL
CITRATE
Analgesics, Narcotic Agonist And Nsaid
Combination
T1 hydrocodone/ibuprofen HYDROCODONE
IBUPROFEN
T1 hydrocodone/ibuprofen VICOPROFEN
T1 ibuprofen/oxycodone OXYCODONE HCL
hcl
IBUPROFEN
Analgesics, Neuronal-type Calcium Channel
Blockers
T3 ziconotide acetate
PRIALT
Analgesics, Non-narcotics
T1 clonidine hcl/pf
DURACLON
Analgesics,narcotics
T2
T3
T3
T1
buprenorphine
buprenorphine hcl
buprenorphine hcl
butorphanol tartrate
T1 codeine sulfate
Sutter Health Plus
BUTRANS
BELBUCA
BUPRENEX
BUTORPHANOL
TARTRATE
CODEINE SULFATE
QL
T1 codeine/carisoprodol/as CARISOPRODOL
pirin
COMPOUND
CODEINE
T1 dhcodeine
TREZIX
QL
bt/acetaminophn/caff
T1 dihydrocodeine/aspirin/ SYNALGOS-DC
caffein
T1 fentanyl
DURAGESIC
PA, QL
T1 fentanyl
FENTANYL
PA, QL
T3 fentanyl
SUBSYS
PA
T3 fentanyl citrate
ABSTRAL
PA
T1 fentanyl citrate
ACTIQ
PA
T3 fentanyl citrate
FENTORA
PA
T3 fentanyl citrate
LAZANDA
PA
T1 fentanyl citrate/pf
FENTANYL CITRATE
T1 fentanyl citrate-0.9 % FENTANYL CITRATE0.9% NACL
nacl/pf
T3 fentanyl hcl
IONSYS
T1 fentanyl/bupivacaine/ns FENTANYL
/pf
BUPIVACAINE-0.9%
NACL
T1 fentanyl/ropivacaine/ns/ FENTANYLpf
ROPIVACAINE-0.9%
NACL
T3 hydrocodone bitartrate HYSINGLA ER
QL
T3 hydrocodone bitartrate ZOHYDRO ER
QL
T1 hydrocodone/acetamino HYCET
QL
phen
T1 hydrocodone/acetamino HYDROCODONEQL
phen
ACETAMINOPHEN(SO
LUTION)(10-325/15)
QL
T1 hydrocodone/acetamino HYDROCODONEphen
ACETAMINOPHEN(SO
LUTION)(2.5-167/5)
QL
ACETAMINOPHEN(SO
LUTION)(5-163/7.5)
QL
ACETAMINOPHEN(TA
B)(10MG-300MG)
QL
ACETAMINOPHEN(TA
B)(10MG-325MG)
phen
ACETAMINOPHEN(TA
B)(5 MG-325MG)
phen
ACETAMINOPHEN(TA
B)(5MG-300MG)
QL
ACETAMINOPHEN(TA
B)(7.5-300MG)
phen
ACETAMINOPHEN(TA
B)(7.5-325MG)
T3 hydrocodone/acetaminop LORTAB
hen
T1 hydrocodone/acetamino VERDROCET
phen
T3 hydrocodone/acetaminop ZAMICET
QL
hen
T1 hydromorphone hcl
DILAUDID
T1 hydromorphone hcl
HYDROMORPHONE
HCL
Page 49 of 106
T1 hydromorphone hcl in
0.9% nacl
T1 hydromorphone hcl/pf
T1
T1
T1
T1
T1
T1
T1
T3
T1
T1
T1
T1
T1
T1
T3
T1
T3
T1
T1
T1
T2
T1
T1
T1
T1
T1
T1
T1
T1
HYDROMORPHONE
HCL-0.9% NACL
DILAUDID
DILAUDID-HP
HYDROMORPHONE
HCL
hydromorphone/bupiv/ HYDROMORPH0.9nacl/pf
BUPIVAC-0.9% NACL
levorphanol tartrate
LEVORPHANOL
TARTRATE
meperidine hcl
DEMEROL
meperidine hcl
MEPERIDINE
HCL(CARTRIDGE)
meperidine hcl
MEPERIDINE
HCL(SOLUTION)
meperidine hcl
MEPERIDINE
HCL(TAB)
meperidine hcl in 0.9 % MEPERIDINE HCL
nacl
0.9% NACL
meperidine hcl/pf
DEMEROL
meperidine hcl/pf
MEPERIDINE HCL
methadone hcl
DOLOPHINE HCL
methadone hcl
METHADONE HCL
morphine sulfate
KADIAN(CAP ER
PEL)(10 MG)
morphine sulfate
KADIAN(CAP ER
PEL)(100 MG)
morphine sulfate
KADIAN(CAP ER
PEL)(20 MG)
morphine sulfate
KADIAN(CAP ER
PEL)(200 MG)
morphine sulfate
KADIAN(CAP ER
PEL)(30 MG)
morphine sulfate
KADIAN(CAP ER
PEL)(40 MG)
morphine sulfate
KADIAN(CAP ER
PEL)(50 MG)
morphine sulfate
KADIAN(CAP ER
PEL)(60 MG)
morphine sulfate
KADIAN(CAP ER
PEL)(80 MG)
morphine sulfate
MORPHINE SULFATE
morphine sulfate
MORPHINE SULFATE
ER(CPMP 24HR)(120
MG)
morphine sulfate
MORPHINE SULFATE
ER(CPMP 24HR)(30
MG)
morphine sulfate
MORPHINE SULFATE
ER(CPMP 24HR)(45
MG)
morphine sulfate
MORPHINE SULFATE
ER(CPMP 24HR)(60
MG)
morphine sulfate
MORPHINE SULFATE
ER(CPMP 24HR)(75
MG)
morphine sulfate
MORPHINE SULFATE
ER(CPMP 24HR)(90
MG)
morphine sulfate
MS CONTIN
morphine sulfate in 0.9 MORPHINE SULFATE
% nacl
0.9% NACL
Sutter Health Plus
QL
QL
QL
T1 morphine sulfate/0.9%
nacl/pf
T3 morphine
sulfate/naltrexone
T3 morphine
sulfate/naltrexone
T3 morphine
sulfate/naltrexone
T3 morphine
sulfate/naltrexone
T3 morphine
sulfate/naltrexone
T3 morphine
sulfate/naltrexone
T3 morphine sulfate/pf
T1 morphine sulfate/pf
T1 nalbuphine hcl
T1 opium/belladonna
alkaloids
T3 oxycodone hcl
T3 oxycodone hcl
T1 oxycodone hcl
T2 oxycodone hcl
QL
T2 oxycodone hcl
QL
T2 oxycodone hcl
QL
T2 oxycodone hcl
QL
T2 oxycodone hcl
QL
T2 oxycodone hcl
QL
T2 oxycodone hcl
QL
QL
QL
QL
QL
QL
QL
QL
MORPHINE SULFATE0.9% NACL
EMBEDA(CAP ER
QL
PO)(100MG-4MG)
EMBEDA(CAP ER
QL
PO)(20MG-0.8MG)
EMBEDA(CAP ER
QL
PO)(30MG-1.2MG)
EMBEDA(CAP ER
QL
PO)(50 MG-2 MG)
EMBEDA(CAP ER
QL
PO)(60MG-2.4MG)
EMBEDA(CAP ER
QL
PO)(80MG-3.2MG)
INFUMORPH
MORPHINE SULFATE
NALBUPHINE HCL
BELLADONNAOPIUM
OXAYDO
OXECTA
OXYCODONE HCL
OXYCONTIN(TAB ER QL
12H)(10 MG)
OXYCONTIN(TAB ER QL
12H)(15 MG)
OXYCONTIN(TAB ER QL
12H)(20 MG)
OXYCONTIN(TAB ER QL
12H)(30 MG)
OXYCONTIN(TAB ER QL
12H)(40 MG)
OXYCONTIN(TAB ER QL
12H)(60 MG)
OXYCONTIN(TAB ER QL
12H)(80 MG)
ROXICODONE
PERCOCET
QL
T1 oxycodone hcl
T1 oxycodone
hcl/acetaminophen
T3 oxycodone
PRIMLEV
hcl/acetaminophen
T3 oxycodone
XARTEMIS XR
hcl/acetaminophen
T1 oxycodone hcl/aspirin OXYCODONE HCL
ASPIRIN
T3 oxymorphone hcl
OPANA(AMPUL)
T1 oxymorphone hcl
OPANA(TAB)
T1 pentazocine
PENTAZOCINEhcl/naloxone hcl
NALOXONE HCL
T3 pentazocine lactate
TALWIN
T2 tapentadol hcl
NUCYNTA
T2 tapentadol hcl
NUCYNTA ER
T1 tramadol hcl
ULTRAM
T1 tramadol
ULTRACET
hcl/acetaminophen
QL
QL
QL
QL
Antimigraine Preparations
QL
QL
T1 almotriptan malate
T1 dihydroergotamine
mesylate
mesylate
AXERT
CAMBIA
D.H.E.45
QL, ST
QL
QL
DIHYDROERGOTAMI
NE MESYLATE
Page 50 of 106
mesylate
T3 eletriptan hbr
T3 ergotamine tartrate
T2 ergotamine
tartrate/caffeine
T3 ergotamine
tartrate/caffeine
T3 frovatriptan succinate
T1 isomethept/dichlphn/ac
etaminop
MIGRANAL
QL
Narcotic Withdrawal Therapy Agents
RELPAX
ERGOMAR
CAFERGOT
QL, ST
QL
QL
T3 buprenorphine hcl
T1 buprenorphine hcl
MIGERGOT
QL
FROVA
QL, ST
ISOMETHEPT
DICHLORALP
ACETAMIN
T1 isomethepten/caf/aceta ISOMETHEPT-CAFF
minophen
ACETAMINOPHEN
T1 naratriptan hcl
AMERGE
QL
T1 rizatriptan benzoate
MAXALT
QL
T1 rizatriptan benzoate
MAXALT MLT
QL
T1 sumatriptan
IMITREX
QL
T3 sumatriptan
TREXIMET
QL, ST
succ/naproxen sod
T3 sumatriptan succinate
ALSUMA
QL
T1 sumatriptan succinate IMITREX(CARTRIDG QL
E)
T1 sumatriptan succinate IMITREX(PEN
QL
INJCTR)
T1 sumatriptan succinate IMITREX(TAB)
QL
T1 sumatriptan succinate IMITREX(VIAL)
QL
T1 sumatriptan succinate SUMATRIPTAN
QL
SUCCINATE
SUMAVEL
QL, ST
DOSEPRO(NDL FR
INJ)(4 MG/0.5ML)
SUMAVEL
QL, ST
DOSEPRO(NDL FR
INJ)(6 MG/0.5ML)
ZECUITY
QL, ST
T2 zolmitriptan
ZOMIG(SPRAY)(2.5
QL, ST
MG)
T2 zolmitriptan
ZOMIG(SPRAY)(5 MG) QL, ST
T1 zolmitriptan
ZOMIG(TAB)
QL, ST
T3 buprenorphine
hcl/naloxone hcl
T1 buprenorphine
hcl/naloxone hcl
T2 buprenorphine
hcl/naloxone hcl
T3 buprenorphine
hcl/naloxone hcl
T1 benztropine mesylate
T1 benztropine mesylate
T1 trihexyphenidyl hcl
T1
T4
T1
T1
T3
T3
T1
T1
T1
T1
T1
T1
T1
T1 butalbit/acetamin/caff/c BUTALB-CAFF
odeine
ACETAMINOPH
CODEIN
T1
Comb
T1 acetaminophen with
codeine
codeine
codeine
codeine
ACETAMINOPHENCODEINE
CAPITAL W-CODEINE
TYLENOL-CODEINE
NO.3
TYLENOL-CODEINE
NO.4
PA
ZUBSOLV
PA
BENZTROPINE
MESYLATE
COGENTIN
TRIHEXYPHENIDYL
HCL
T1
T1
T3
T2
T1
T2
T1
T1
T3
T1
amantadine hcl
AMANTADINE
apomorphine hcl
APOKYN
bromocriptine mesylate PARLODEL
carbidopa/levodopa
CARBIDOPA
LEVODOPA
carbidopa/levodopa
DUOPA
carbidopa/levodopa
RYTARY
carbidopa/levodopa
SINEMET 10-100
carbidopa/levodopa
SINEMET 25-100
carbidopa/levodopa
SINEMET 25-250
carbidopa/levodopa/ent STALEVO 100
acapone
acapone
acapone
acapone
acapone
acapone
entacapone
COMTAN
pramipexole di-hcl
MIRAPEX
pramipexole di-hcl
MIRAPEX ER
rasagiline mesylate
AZILECT
ropinirole hcl
REQUIP
rotigotine
NEUPRO
selegiline hcl
ELDEPRYL
selegiline hcl
SELEGILINE HCL
selegiline hcl
ZELAPAR
tolcapone
TASMAR
PA, QL
PA
QL, ST
QL, ST
QL
QL, ST
QL
QL, ST
Decarboxylase Inhibitors
T1 carbidopa
LODOSYN
SEIZURE DISORDER
Anticonvulsants
T1 carbamazepine
Sutter Health Plus
PA
Antiparkinsonism Drugs,other
Cmb
Narcotic Analgesic & Non-salicylate Analgesic
BUPRENORPHINE
NALOXONE
SUBOXONE
Antiparkinsonism Drugs,anticholinergic
T1
T1 codeine/butalbital/asa/c FIORINAL WITH
affein
CODEINE #3
PA
PARKINSONS DISEASE
Narc.& Non-sal.analgesic,barbiturate &xanthine
Narcotic & Salicylate Analgesics, Barb.& Xanthine
BUPRENEX
BUPRENORPHINE
HCL
BUNAVAIL
CARBAMAZEPINE
Page 51 of 106
T1
T1
T2
T3
T3
T1
T1
T1
T1
T1
T3
carbamazepine
carbamazepine
carbamazepine
clobazam
clobazam
clonazepam
clonazepam
diazepam
diazepam
divalproex sodium
eslicarbazepine acetate
T3 eslicarbazepine acetate
T1
T3
T3
T3
T3
T3
T1
ethosuximide
ethotoin
ezogabine
ezogabine
ezogabine
ezogabine
felbamate
T1 felbamate
T1 felbamate
T1
T1
T1
T3
T3
T3
T1
T2
T2
T3
T3
fosphenytoin sodium
gabapentin
gabapentin
lacosamide
lacosamide
lacosamide
lamotrigine
lamotrigine
lamotrigine
lamotrigine
lamotrigine
T3 lamotrigine
T1 lamotrigine
T3 lamotrigine
T1 lamotrigine
T1 lamotrigine
T1 levetiracetam
T1 levetiracetam
T1 levetiracetam in nacl
(iso-os)
T3 methsuximide
T3 oxcarbazepine
T3 oxcarbazepine
T3 oxcarbazepine
T1 oxcarbazepine
Sutter Health Plus
CARBATROL
TEGRETOL
TEGRETOL XR
ONFI(ORAL SUSP)
QL, ST
ONFI(TAB)
QL, ST
CLONAZEPAM
KLONOPIN
DIASTAT
QL
DIASTAT ACUDIAL
QL
DEPAKOTE ER
APTIOM(TAB)(200
QL, ST
MG)
APTIOM(TAB)(400
QL, ST
MG)
APTIOM(TAB)(600
QL, ST
MG)
APTIOM(TAB)(800
QL, ST
MG)
ZARONTIN
PEGANONE
POTIGA(TAB)(200 MG)QL, ST
POTIGA(TAB)(50 MG) QL, ST
FELBATOL(ORAL
QL, ST
SUSP)
FELBATOL(TAB)(400 QL, ST
MG)
FELBATOL(TAB)(600 QL, ST
MG)
CEREBYX
GABAPENTIN
NEURONTIN
VIMPAT(SOLUTION) QL, ST
VIMPAT(TAB)
QL, ST
VIMPAT(VIAL)
LAMICTAL (BLUE)
LAMICTAL (GREEN)
LAMICTAL (ORANGE)
LAMICTAL XR (BLUE)ST
LAMICTAL XR
ST
(GREEN)
LAMICTAL XR
ST
(ORANGE)
LAMICTAL(TAB)
LAMICTAL(TB CHW
DSP)(2 MG)
LAMICTAL(TB CHW
DSP)(25 MG)
LAMICTAL(TB CHW
DSP)(5 MG)
KEPPRA
LEVETIRACETAM
LEVETIRACETAM
NACL
CELONTIN
OXTELLAR XR(TAB QL, ST
ER 24H)(150 MG)
ER 24H)(300 MG)
ER 24H)(600 MG)
TRILEPTAL
T3 perampanel
T3 perampanel
T3 perampanel
T3 perampanel
T3 perampanel
T3 perampanel
T1
T1
T1
T1
T1
T2
T1
T2
T1
T3
T3
phenytoin
phenytoin
phenytoin
phenytoin sodium
phenytoin sodium
extended
phenytoin sodium
extended
phenytoin sodium
extended
pregabalin
primidone
rufinamide
rufinamide
T3 rufinamide
T3 tiagabine hcl
T3 tiagabine hcl
T1
T1
T1
T3
tiagabine hcl
tiagabine hcl
topiramate
topiramate
T3 topiramate
T3 topiramate
T3 topiramate
T1 valproic acid
T1 valproic acid (as
sodium salt)
T1 valproic acid (as
sodium salt)
T3 vigabatrin
T1 zonisamide
T1 zonisamide
FYCOMPA(TAB)(10
MG)
FYCOMPA(TAB)(12
MG)
FYCOMPA(TAB)(2
MG)
FYCOMPA(TAB)(4
MG)
FYCOMPA(TAB)(6
MG)
FYCOMPA(TAB)(8
MG)
DILANTIN
DILANTIN-125
PHENYTOIN
PHENYTOIN SODIUM
DILANTIN(CAP)(100
MG)
DILANTIN(CAP)(30
MG)
PHENYTEK
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
LYRICA
MYSOLINE
BANZEL(ORAL SUSP) QL, ST
BANZEL(TAB)(200
QL, ST
MG)
BANZEL(TAB)(400
QL, ST
MG)
GABITRIL(TAB)(12
QL, ST
MG)
GABITRIL(TAB)(16
QL, ST
MG)
GABITRIL(TAB)(2 MG)QL, ST
GABITRIL(TAB)(4 MG)QL, ST
TOPAMAX
TROKENDI XR(CAP QL, ST
ER 24H)(100 MG)
ER 24H)(200 MG)
ER 24H)(25 MG)
ER 24H)(50 MG)
DEPAKENE
DEPAKENE
VALPROIC ACID
SABRIL
ZONEGRAN
ZONISAMIDE
QL
SKELETAL MUSCLE DISORDER
Agents To Tx Periodic Paralysis - Carbon Anhyd
Inh
T4 dichlorphenamide
KEVEYIS
PA
Joint Contracture Therapy, Collagenase Enzyme
T3 collagenase clostridium XIAFLEX
hist.
Page 52 of 106
Skeletal Muscle Relax.& Top.irritant Counter-
UPPER GASTROINTESTINAL
irritant
DISORDERS - DIGESTIVE
T3 cyclobenz hcl/irr cntr-irr COMFORT PAC
cb2
CYCLOBENZAPRINE
T1 cyclobenzaprine/capsai/ FLEXEPAX
menthol
T3 tizanidine/irr cntr-irr cmb COMFORT PAC
#2
TIZANIDINE
Gastric Enzymes
T4 sacrosidase
T1 carisoprodol
T1 carisoprodol/aspirin
T3
T1
T3
T1
chlorzoxazone
chlorzoxazone
cyclobenzaprine hcl
cyclobenzaprine hcl
T1 cyclobenzaprine hcl
T1 dantrolene sodium
T1 dantrolene sodium
T3
T1
T1
T1
T1
T1
dantrolene sodium
metaxalone
metaxalone
methocarbamol
methocarbamol
orphenadrine citrate
T1 tizanidine hcl
T1 tizanidine hcl
T2
T3
T1
T3
T3
T3
T2
BACLOFEN
GABLOFEN
LIORESAL
INTRATHECAL
SOMA
CARISOPRODOL
ASPIRIN
LORZONE
PARAFON FORTE DSC
AMRIX
CYCLOBENZAPRINE
HCL
FEXMID
DANTRIUM
DANTROLENE
SODIUM
RYANODEX
METAXALONE
SKELAXIN
ROBAXIN
ROBAXIN-750
ORPHENADRINE
CITRATE
TIZANIDINE HCL
ZANAFLEX
DISORDERS - SPASTIC DISEASE
Anticholinergics/antispasmodics
T1
T3
T1
T1
T1
T5 nicotine
T5 nicotine
T5 nicotine
T5 nicotine polacrilex
NICODERM CQ(OTC) AGE,
QL
NICOTINE
AGE,
PATCH(PATCH
QL
TD24)(OTC)
NICOTINE
AGE
PATCH(PATCH)(OTC)
NICOTROL
AGE,
QL, ST
NICOTROL NS
AGE,
QL, ST
NICORETTE(OTC)
AGE,
QL
Smoking Deterrent-nicotinic Recept.partial Agonist
T5 varenicline tartrate
CHANTIX
AGE,
QL
Smoking Deterrents, Other
T5 bupropion hcl
Sutter Health Plus
BUPROBAN
dicyclomine hcl
dicyclomine hcl
dicyclomine hcl
dicyclomine hcl
dicyclomine hcl
BENTYL
BENTYL(AMPUL)
BENTYL(CAP)
BENTYL(TAB)
DICYCLOMINE HCL
Belladonna Alkaloids
Smoking Deterrent Agents
T5 nicotine
lipase/protease/amylase CREON
lipase/protease/amylase PANCREAZE
lipase/protease/amylase PANCRELIPASE 5,000
lipase/protease/amylase PERTZYE
lipase/protease/amylase ULTRESA
lipase/protease/amylase VIOKACE
lipase/protease/amylase ZENPEP
SMOKING CESSATION
T5 nicotine
PA
Pancreatic Enzymes
Skeletal Muscle Relaxants
T1 baclofen
T3 baclofen
T3 baclofen
SUCRAID
AGE,
QL
T1 atropine sulfate
ATROPINE SULFATE
T1 atropine sulfate in 0.9% ATROPINE SULFATE
nacl
0.9% NACL
T1 hyoscyamine sulfate
HYOSCYAMINE
SULFATE
LEVSIN
SYMAX DUOTAB
SYMAX-SL
T1 methscopolamine
METHSCOPOLAMINE
bromide
BROMIDE
T2 phenobarb/hyoscy/atropi B-DONNA
ne/scop
T2 phenobarb/hyoscy/atropi DONNATAL
ne/scop
T1 scopolamine
SCOPOLAMINE
hydrobromide
HYDROBROMIDE
DISORDERS - ULCER DISEASE
Anticholinergics,quaternary Ammonium
T1 chlordiazepoxide/clidini LIBRAX
um br
T3 glycopyrrolate
CUVPOSA
T1 glycopyrrolate
GLYCOPYRROLATE
T1 glycopyrrolate
ROBINUL
T1 glycopyrrolate
ROBINUL FORTE
T3 mepenzolate bromide
CANTIL
T1 propantheline bromide PROPANTHELINE
BROMIDE
Page 53 of 106
T1 finasteride
T3 silodosin
T1 tamsulosin hcl
Anti-ulcer Preparations
T1 misoprostol
T2 sucralfate
T1 sucralfate
CYTOTEC
CARAFATE(ORAL
SUSP)
CARAFATE(TAB)
G, ST
Bph Agents,5-alpha-red Inh & Alpha-1-adr Antg
Cmb
Anti-ulcer-h.pylori Agents
T3 bismuth/metronid/tetracy PYLERA
cline
T1 lansoprazole/amoxiciln/ PREVPAC
clarith
T3 omeprazole/clarith/amoxiOMECLAMOX-PAK
cillin
PROSCAR
RAPAFLO
FLOMAX
T1 dutasteride/tamsulosin JALYN
hcl
QL
G, ST
Kidney Stone Agents
T3 cysteamine bitartrate
T4 cysteamine bitartrate
T4 tiopronin
CYSTAGON
PROCYSBI
THIOLA
PA
Histamine H2-receptor Inhibitors
Overactive Bladder Agents, Beta-3 Adrenergic
T1
T1
T1
T1
T1
Recep
T1
T1
T1
T1
cimetidine
cimetidine hcl
famotidine
famotidine
famotidine in nacl,isoosm/pf
famotidine/pf
nizatidine
ranitidine hcl
ranitidine hcl
CIMETIDINE
CIMETIDINE
FAMOTIDINE
PEPCID
FAMOTIDINE
T2 mirabegron
T1 metoclopramide hcl
T3 citric acid/g-lactone/mag
carb
T3 methen mand/naphos mb m-h
T3 na phos,m-b/k
phos,monob
T1 phosphorus #1
FAMOTIDINE
NIZATIDINE
RANITIDINE HCL
ZANTAC
METOCLOPRAMIDE
HCL
REGLAN
T1 potassium citrate
T3 potassium
phosphate,monobasic
Proton-pump Inhibitors
T3 dexlansoprazole
T1 esomeprazole
magnesium
T2 esomeprazole
magnesium
T1 esomeprazole sodium
T1
T1
T2
T1
T3
T1
T3
T3
T3
T1
T1
T3
DEXILANT
NEXIUM(CAP DR)
ST
Urinary Ph Modifiers
Intestinal Motility Stimulants
T1 metoclopramide hcl
MYRBETRIQ
QL, ST
QL, ST
NEXIUM(SUSP DR
QL, ST
PKT)
ESOMEPRAZOLE
SODIUM
esomeprazole sodium NEXIUM I.V.
lansoprazole
PREVACID(CAP DR)
lansoprazole
PREVACID(TAB RAP ST
DR)
omeprazole
PRILOSEC
omeprazole magnesium PRILOSEC
omeprazole/sodium
ZEGERID(CAP)
QL, ST
bicarbonate
omeprazole/sodium
ZEGERID(PACKET)
QL, ST
bicarbonate
pantoprazole sodium
PROTONIX IV
pantoprazole sodium
PROTONIX(GRANPKT ST
DR)
pantoprazole sodium PROTONIX(TAB DR)
rabeprazole sodium
ACIPHEX
QL
rabeprazole sodium
ACIPHEX SPRINKLE QL, ST
UROQID-ACID NO.2
K-PHOS NO.2
PHOSPHA 250
NEUTRAL
UROCIT-K
K-PHOS ORIGINAL
Urinary Tract Analgesic Agents
T3 dimethyl sulfoxide
T2 pentosan polysulfate
sodium
RIMSO-50
ELMIRON
Urinary Tract Anesthetic/analgesic Agnt
T1 phenazopyridine hcl
PYRIDIUM
Urinary Tract Antispasmodic, M(3) Selective Antag.
T3 darifenacin
hydrobromide
T2 solifenacin succinate
ENABLEX
ST
VESICARE
ST
Urinary Tract Antispasmodic/antiincontinence
Agent
T2
T1
T3
T3
T3
T1
fesoterodine fumarate
flavoxate hcl
oxybutynin
oxybutynin
oxybutynin chloride
oxybutynin chloride
T1 tolterodine tartrate
T1 trospium chloride
URINARY TRACT - FUNCTIONAL
RENACIDIN
TOVIAZ
FLAVOXATE HCL
GELNIQUE
OXYTROL
GELNIQUE
OXYBUTYNIN
CHLORIDE
DETROL LA
TROSPIUM
CHLORIDE
ST
ST
ST
ST
ST
ST
DISORDERS
Benign Prostatic Hypertrophy/micturition Agents
T1 alfuzosin hcl
T1 dutasteride
Sutter Health Plus
UROXATRAL
AVODART
G, ST
Page 54 of 106
T1 clindamycin phosphate CLEOCIN(CREAM/AP
PL)
T3 clindamycin phosphate CLEOCIN(SUPP VAG)
T3 clindamycin phosphate CLINDESSE
T1 metronidazole
METROGEL-VAGINAL
T3 metronidazole
NUVESSA
T2 metronidazole
VANDAZOLE
T3 sodium fluoride
T3 sodium fluoride
T1 sodium
fluoride/potassium nit
T3 sodium
T3 sodium
T3 sodium fluoride/vitamin
d3
T3 sodium fluoride/xylitol
Vaginal Antifungals
Folic Acid Preparations
VAGINAL DISORDERS
Vaginal Antibiotics
T2
T1
T1
T1
T1
butoconazole nitrate
miconazole nitrate
terconazole
terconazole
terconazole
T3 fa#7/pc,pe
dha/nac/pap/if/mv46
T1 folic acid
T5 folic acid
GYNAZOLE 1
MICONAZOLE 3
TERAZOL 3
TERAZOL 7
TERCONAZOLE
Vaginal Sulfonamides
T2 sulfanilamide
AVC
VITAMIN AND/OR MINERAL
DEFICIENCY
Antioxidant Multivitamin Combinations
T3 fa/vit
c/e/zinc/copper/lut/zea
T3 fa/vit
T3 fa/vit
MACUVEX
MACUZIN
OCUVEL
Calcium Replacement
T1 calcium chloride
T1 calcium gluconate
CALCIUM CHLORIDE
CALCIUM
GLUCONATE
T1 calcium gluconate in
CALCIUM
0.9% nacl
GLUCONATE-0.9%
NACL
T1 calcium/mag/d3/b12/fa/ FOLGARD OS
b6/boron
Fluoride Preparations
T3
T3
T3
T5
T2
T2
T5
sodium fluoride
sodium fluoride
sodium fluoride
sodium fluoride
sodium fluoride
sodium fluoride
sodium fluoride
Sutter Health Plus
CLINPRO 5000
FLUORABON
FLUOR-A-DAY
FLUORIDE
FLUORITAB
FLURA-DROPS
LUDENT FLUORIDE
FOLIC ACID
FOLIC ACID(OTC)
G
Iron Replacement
Vaginal Estrogen Preparations
ESTRACE
ESTRING
VAGIFEM
FEMRING
PREMARIN
PURALOR CI
T3 mv, min
REQ49+
cmb#16/fa/lutein/lycop
T3 acetic acid/oxyquinoline FEM PH
T3 acetic acid/oxyquinoline RELAGARD
estradiol
estradiol
estradiol
estradiol acetate
estrogens, conjugated
FLUOR-A-DAY
Geriatric Vitamin Preparations
Vaginal Antiseptics
T2
T3
T2
T3
T2
PREVIDENT
PREVIDENT 5000
FLUORIDEX
SENSITIVITY RELIEF
PREVIDENT 5000
ENAMEL PROTECT
PREVIDENT 5000
SENSITIVE
FLORIVA
QL
QL
T1 fe
fumarate/cal/e/fa/multi
vit
T1 fe
fumarate/doss/fa/bcom
p,c
T1 fe fumarate/vit
c/b12/stomc
T1 fe fumarate/vit c/b12if/fa
T3 ferric amcit/lys/vit b
comp/fa
T4 ferric carboxymaltose
T3 ferric pyrophosphate
citrate
T1 ferrous fumarate/folic
acid
T5 ferrous sulfate
VITAFOL
NEPHRON FA
HEMATOGEN
FEROCON
HEMATRON
INJECTAFER
TRIFERIC
HEMOCYTE-F
CHILDREN'S
FERROUS
SULFATE(OTC)
FERAHEME
FERREX 28
T3 ferumoxytol
T1 iron ag&fum/c/fa/mv
cmb11/ca-t
T1 iron
MULTIGEN
ag/c/b12/ca/suc.acid/sto
m
T1 iron
FERREX 150 FORTE
aspgly&ps/c/b12/fa/ca/s PLUS
uc
T1 iron aspgly/c/b12/fa/ca- MULTIGEN FOLIC
th/suc
T1 iron
TARON FORTE
bg,ps/vitc/b12/fa/calciu
m
T3 iron bisgly &
IROSPAN
ps/fa/b&c#12/suc
T1 iron
FERRALET 90
carb,gl/fa/b12/c/docusat
e
T1 iron carb/fa#9/vit
NUFERA
c/d3/b6/b12
Page 55 of 106
T1 iron fum &
MULTIGEN PLUS
ag/c/b12/fa/ca/succ
T1 iron fum & ps
INTEGRA F
cmp/fa/vit c/b3
T1 iron
TANDEM PLUS
fum&polysac#1/fa/mv
no.18
T3 iron fum, ps/fa/vit c/l.
FUSION SPRINKLES
casei
T1 iron fum,ps/fa/vit b
INTEGRA PLUS
with c #9
T1 iron fumarate/vit c/vit TRIGELS-F FORTE
b12/fa
T3 iron gly,fum/c/b12/me- MAXARON FORTE
thfolate
T3 iron heme
PROFERRIN-FORTE
polypeptide/folic ac
T1 iron polysac/iron
BIFERA RX
heme/fa/b12
T1 iron ps cmplx/vit b12/fa POLY-IRON 150 FORTE
T3 iron sucrose complex
VENOFER
T1 iron, carbonyl/fa/c/b- CORVITA 150
6/b12/zn
T1 iron,carb/dss/b12if/fa/m HEMATRON-AF
v-mn
T3 iron,carb/fa#6/mv, min CORVITE FE
no.40
T2 iron,carb/fa#6/mv, min CORVITE 150
no.41
T3 iron,carbonyl/fa/multivit- ACTIVE FE
min
T3 iron,fum&ps/fa/vit
FUSION PLUS
b&c#18/l.ca
T3 iron/fa#1/c/b12/biot/copp FERIVA FA
r/dss
T3 iron/fa#1/vit
FERIVA 21-7
c/b12/zn/dss/suc
T1 iron/fa/b12/c/docusate FERRAPLUS 90
sodium
T1 iron/fa/vit
HEMATINIC PLUS
bcomp,c/minerals
T3 iron/folic
FERIVA
acid/c/b12/biotin
T3 iron/mfolate/b12/c/biot/z MAXFE
n/dss
T1 sodium ferric
FERRLECIT
gluconat/sucrose
T1 selenium
SELENIUM
T1 trace elements comb
ADDAMEL N
no.1
T1 zinc sulf/cuso4 pMULTITRACE-5
hyd/mn/cr/se
T1 zn/cu/mang/selen/fluor/ PEDITRACE
pot iod
T1 znso4/cuso4/mang
MULTITRACE-4
su/chromic cl
Multivitamin Preparations
MAGNESIUM
CHLORIDE
T1 magnesium sulfate
MAGNESIUM
SULFATE
T1 magnesium sulfate in MAGNESIUM
water
SULFATE
T1 magnesium sulfate/d5w MAGNESIUM
SULFATE-D5W
T3 fa/mvi therCORVITA
min/lycopene/lut
T3 fa/mvi therCORVITE
min/lycopene/lut
T1 fe fumarate/fa/vit
DIALYVITE 800 WITH
bcomp,c
IRON
T3 folic acid/mv,fe,other
NUTRICAP
min
T3 lmefolate/b3/copp/zn/sel/ NICOMIDE
chrom
T3 mNICOMIDE
tetrahyrofolate/niacin/cu/
zn
T3 multivit, iron, min #4, fa MULTICHEW
T1 multivit, iron, min #5, STROVITE FORTE
fa
T1 multivit, min
BACMIN
cmb#20/iron/fa
T3 multivit, min no.21/folic SUPERVITE EC
acid
T1 multivitamin no.44/vit MULTIVITAMINS
d3/k
A,B,D,E,K,ZN
T1 multivitamins with min V-C FORTE
no.7/fa
T1 multivits,therap wB-PLEX PLUS
fe,hematin
T3 mv, min cmb
CORVITE FREE
#6/fa/lut/lyco/q10
T3 mv, min cmb#24/iron ps PROTECT IRON
cmp/fa
T3 mv, min cmb#9/fa/saw UDAMIN SP
palmet xt
T3 mv,min #10/fa/d3/alip STROVITE ONE
acid/lut
T3 mv/dietary 4/dna/rna
FORTAVIT
T3 mvi, adult no.1 with vit k M.V.I. ADULT
T3 mvi, adult no.2 without M.V.I.-12
vit k
T3 mvi, adult no.4 with vit k INFUVITE ADULT
T1 om-3/calcium/d3/fa/mv ADVANCED AM/PM
cmb 13
T1 omANIMI-3
3/dha/epa/d3/b12/fa/b
6/phy
T3 prenatal vit
THRIVITE RX
#76/iron,carb/fa
Mineral Replacement,miscellaneous
Pediatric Vitamin Preparations
T1
T1
T1
T1
T1 fluoride/iron/vitamins
a,c,d
T3 iron/fluoride/vits a, c, &
d3
T3 mvi, pedi no.1 with vit k
Magnesium Salts Replacement
T1 magnesium chloride
chromic chloride
cupric chloride
manganese chloride
manganese sulfate
Sutter Health Plus
CHROMIUM
COPPER CHLORIDE
MANGANESE
MANGANESE
SULFATE
TRI-VIT WITH
FLUORIDE-IRON
MYKIDZ IRON FL
INFUVITE
Page 56 of 106
T3 mvi, pedi no.2 with vit k M.V.I. PEDIATRIC
T3 ped
TEXAVITE LQ
multivit#108/iron/fluorid
e
T1 ped mv a,c,d3 #21 w- TRI-VITAMIN WITH
fluoride
FLUORIDE
T3 ped mv a,c,d3 #38 wTRI-VI-FLOR
fluoride
T1 pedi m.vit no.17 with MULTIVITAMIN WITH
fluoride
FLUORIDE
T1 pedi multivit #22/vit
MULTIVITAMINSd3/vit k
A,B,D,E,K,ZN
T3 pedi multivit #37 wPOLY-VI-FLOR
fluoride
T3 pedi multivit
ESCAVITE
#47/iron/fluorid
COMPLETE
d3/vit k
FORMULATION D3000
T1 pedi multivit #63 wQUFLORA
fluoride
MULTIVITAMINSd3/vit k
A,B,D,E,K,ZN
COMPLETE
d3/vit k
FORMULATION
PEDIATRIC
T3 pedi multivit
ESCAVITE D
#78/iron/fluorid
T3 pedi multivit #90 wPOLY-VI-FLOR FS
fluoride
T1 pedi multivit no.2 w- MULTIVITAMINS
fluoride
WITH FLUORIDE
T3 pedi multivit
FLORIVA
no.85/fluoride
T3 pedi
ESCAVITE LQ
multivit#86/iron/fluoride
T3 pedi mv #37 w-fluoride POLY-VI-FLOR WITH
& iron
IRON
T1 pedi mv
MULTIVITAMINS W
#45/fluoride/iron
FLUORIDE-IRON
T1 pedi mv
MULTIVITAMINS W
#75/fluoride/iron
FLUORIDE-IRON
T1 pedi mv no.83 with
QUFLORA
fluoride
T1 pedi mv no.84 with
QUFLORA
fluoride
T1 pedi mvi no.12/sodium MVC-FLUORIDE
fluoride
T1 pedi mvi no.16 with
MULTIVITAMINS
fluoride
WITH FLUORIDE
POLY-VI-FLOR
fluoride
MULTIVITAMINS
fluoride
WITH FLUORIDE
T3 pediatric mv #33 wPOLY-VI-FLOR WITH
fluoride&fe
IRON
Prenatal Vitamin Preparations
T1 iron,carbonyl/vit c/vit
b12/fa
T1 pn vit.w-o ca #7,
iron,fa,dha
T3 pn85/iron cb&asp
g/fa/dha/fish
Sutter Health Plus
ICAR-C PLUS
ELITE OB DHA
OB COMPLETE ONE
T1 pnv #14/ferrous
COMPLETENATE
fum/folic acid
T1 pnv #19/iron
PREFERA-OB ONE
ps&heme/folic/dha
T3 pnv #30/iron
OB COMPLETE WITH
carb&aspg/fa/om3
DHA
T3 pnv #35/iron/fa #6/dha PRENATE ESSENTIAL
T3 pnv #38/iron
PRENATE DHA
fum/folate/dha
T3 pnv #56/iron
OB COMPLETE
carb&aspg/fa/dha
PETITE
T3 pnv #78/iron asp
PRENATE DHA
gly/fa#1/dha
T1 pnv #8/iron ps
PAIRE OB PLUS DHA
cmp&aspg/fa/dha
T3 pnv #86/iron
NESTABS ABC
poly/fa/dha/epa
T1 pnv #87/iron
NESTABS DHA
bisgly/fa/dha
T1 pnv 11-iron fum-folic C-NATE DHA
acid-om3
T3 pnv
PREQUE 10
18/fe,carb/fa/dss/ubi/dha
T3 pnv comb no.3/iron
MAXINATE
fum&gluc/fa
T1 pnv
VITASPIRE
comb.no.44/iron/folic
acid
T3 pnv
ATABEX EC
comb.no43/iron,carb/fa/d
ss
T1 pnv combo
HEMENATAL OB +
#22/iron/fa/om3/dha
DHA
T1 pnv combo#47/iron/fa PNV-DHA
#1/dha
T3 pnv no.106/iron/folate OB COMPLETE GOLD
#6/dha
T1 pnv no.115/iron
PRENATAL 19
fumarate/fa
T1 pnv no.118/iron
SE-NATAL 19
fumarate/fa
T1 pnv no.15/iron fum & CONCEPT OB
ps cmp/fa
T1 pnv no.22/iron
VINACAL
cbn&gluc/fa/dss
T1 pnv
ACTIVE OB
no.66/iron,carbonyl/fa/
dha
T3 pnv
FOLET ONE
no.80/iron/mfolate/dss/d
ha
T3 pnv no.81/iron
CITRANATAL RX
cbn&gluc/fa/dss
T3 pnv
FOLET DHA
no.86/iron/mfolate/dss/d
ha
T3 pnv no.88/iron
PREFERA-OB PLUS
ps,heme/fa/dha
DHA
T3 pnv no.90/iron fum &
PROVIDA DHA
ps/fa/dha
T1 pnv no10/iron
SE-TAN DHA
fum&p/fa/omega-3
Page 57 of 106
T1 pnv
OBTREX DHA
no12/iron,carb/fa/dss/o
m-3
T1 pnv w-ca #40/iron
PNV-SELECT
fum/fa cmb#1
T1 pnv w-ca
ULTIMATECARE ONE
no.37/iron/fa/omega-3
T1 pnv wPNV-IRON
ca8/iron/fa/lmefolate ca
T1 pnv with ca
VIRT-PN PLUS
#68/iron/fa#1/dha
T1 pnv with ca no.65/iron MARNATAL-F
poly/fa
T1 pnv with
VOL-PLUS
ca#74/iron/folic acid
T1 pnv with
TRIVEEN-ONE
ca,no.62/iron/fa/dha
T1 pnv with
NATELLE ONE
ca,no.70/iron/fa/dha
T1 pnv with
PRENATAL PLUS
ca,no.72/iron,carb/fa
T1 pnv with
PRENATAL PLUS
ca,no.72/iron/fa
T1 pnv w-o ca no5/fe
PRENATAL-U
fumarate/fa
T3 pnv#102/iron/folate
VITAFOL FE+
#1/dss/dha
T1 pnv#16/iron fum &
CONCEPT DHA
ps/fa/om-3
T3 pnv#20/iron/fa/ds/fish/dh TRICARE PRENATAL
a/epa
DHA ONE
T1 pnv#21/iron ps& heme HEMENATAL OB
polyp/fa
T3 pnv#26/iron poly/fa/dha VITAFOL-ONE
T1 pnv#64/iron/lmfolate/al NEEVODHA
gal/soy
T3 pnv#67/iron ps/fa
VITAFOL ULTRA
cmb#1/dha
T1 pnv#71/iron/folic
VITAPEARL
acid/dha
T1 pnv#79/iron/fa/lmfolate VINATE DHA
ca/dha
T1 pnv,ca,no.35/iron/fa/ds/ ULTIMATECARE ONE
omeg-3
NF
T1 pnv,ca42/iron/fa/lmefol PNV-DHA PLUS
ca/dha
T1 pnv/ferrous
MYNATE 90 PLUS
fumarate/doss/fa
T1 pnv/ferrous
VINATE-M
fumarate/fa/se
T1 pnv/iron,carbonyl/docu MYNATAL
sate/fa
T1 pnv100/iron
BAL-CARE DHA
edta&ps/fa/omega3
ESSENTIAL
T3 pnv106/iron/fa/om3/dha/ DUET DHA 400
epa
T1 pnv115/iron
PRENATAL 19
fumarate/fa/dss
T3 pnv117/iron/fa/om3/dha/ DUET DHA
epa
BALANCED
T1 pnv119/iron
SE-NATAL 19
fumarate/fa/dss
T1 pnv17/iron/fa/fish
ELITE-OB 400
oil/dha/om
Sutter Health Plus
T1 pnv19/iron bg hc&succ- PR NATAL 400 EC
p/fa/om3
T3 pnv2/iron b-g sucCOMPLETE NATAL
p/fa/omega-3
DHA
T3 pnv2/iron b-g sucTRUST NATAL DHA
p/fa/omega-3
T1 pnv34/iron,carbonyl/fa/ VP-CH-PNV
dss/dha
T1 pnv39/iron
TARON-PREX
fumarate/fa/dss/dha
PRENATAL
T1 pnv53/iron b-g hclTRIVEEN-DUO DHA
p/fa/omega3
T3 pnv53/iron
NEXA PLUS
fum/fa/docusate/dha
T1 pnv54/iron b-g hclPR NATAL 430
p/fa/omega3
T1 pnv55/iron bg hc&succ- PR NATAL 430 EC
p/fa/om3
T3 pnv55/iron fum &
NATACHEW
bisgly/fa
T1 pnv59/iron,carbonyl/fa/ VP-CH PLUS
dss/dha
T1 pnv66/iron
VIRTPREX
fumarate/fa/dss/dha
T1 pnv69/iron,carbonyl/fa/ PRENAISSANCE PLUS
dss/dha
T1 pnv7/fe asp
VINATE PN CARE
gly/docusate/fa
T1 pnv72/iron,carb&glu/fa CITRANATAL 90 DHA
/dss/dha
T1 pnv73/iron,carb&glu/fa CITRANATAL ASSURE
/dss/dha
T3 pnv76/iron,carb&glu/fa/d CITRANATAL DHA
ss/dha
T1 pnv77/sod iron edta& VENATAL COMPLETE
ps/fa/om3
DHA
T1 pnv80/iron
PRENAISSANCE
fumarate/fa/dss/dha
T1 pnv81/sod iron edta& BAL-CARE DHA
ps/fa/om3
T3 pnv83/iron,carb/iron asp OB COMPLETE
gl/fa
PREMIER
T1 prenat vit
VITAFOL-OB+DHA
comb.10/iron/fa/dha
T3 prenatal #103/iron
TRICARE
fumarate/fa
T1 prenatal
KOSHER PRENATAL
#108/iron,carbonyl/fa PLUS IRON
T1 prenatal
EXTRA-VIRT PLUS
#57/iron/fa/dss/dha
DHA
T3 prenatal #79/iron asp
PRENATE ELITE
gly/fa#1
T3 prenatal #92/iron/fa
ENBRACE HR
#8/ps-dha
T1 prenatal comb
VITAMEDMD
no.42/folic acid
REDICHEW RX
T1 prenatal no.13/iron
SELECT-OB
ps/fa cb#1
T3 prenatal no.25/iron/fa
VITAMEDMD ONE RX
#6/dha
VITAMEDMD PLUS
#6/dha
RX
T1 prenatal
VP-PNV-DHA
no.52/iron/fa/dha
Page 58 of 106
T1 prenatal
no.75/iron/folate #1
T3 prenatal no.77/iron asp
gly/fa
T1 prenatal
no.82/iron/folate #2
#9/dha
T3 prenatal vit
#105/iron/fa/dha
T3 prenatal vit
#68/iron/fa#6/dha
T3 prenatal vit
#69/iron/fa#6/dha
T1 prenatal vit
#76/iron,carb/fa
T3 prenatal vit
#83/iron/fa#6/dha
T1 prenatal vit 15/iron
cb/fa/dss
cb/fa/dss
cb/fa/dss
T3 prenatal vit
comb.10/iron/fa
T1 prenatal vit
no.109/iron/fa
T3 prenatal vit no.112/folic
acid
T3 prenatal vit
no.114/fa/ginger
T1 prenatal vit
no.127/iron/fa
T3 prenatal vit
no.44/iron/fa/dha
T1 prenatal vit
no.73/iron/fa
T1 prenatal vit
no.78/iron/fa
T3 prenatal vit
no.87/iron/fa/dha
T3 prenatal vit#36/iron/fa
cmb#6
T1 prenatal vit#4/iron fum
&ps/fa
T3 prenatal vit#65/iron
fum&ps/fa
T3 prenatal
vit#84/iron/fa#1/dha
T3 prenatal
vit#85/iron/fa#1/dha
T1 prenatal vit#86/iron
bisgly/fa
T1 prenatal vit/iron
bisglycin/fa
fumarate/fa
fumarate/fa
T1 prenatal
vit27&calcium/iron/fa
T3 prenatal vit37/iron/folic
acid
Sutter Health Plus
VITAFOL NANO
PRENATE STAR
TL FOLATE
TRISTART DHA
VITATRUE
T3 prenatal vits
#33/iron/fa/dha
T1 prenatal vits#4/iron
fum/fa
T3 pv w-o
cal/fe,carbonyl/doss/fa
T3 pv w-o cal/ferrous
fumarate/fa
T1 pv w-o cal/iron ps
cplx/fa
SELECT-OB + DHA
PUREFE PLUS
OBSTETRIX EC
M-VIT
SELECT-OB
PRENATE ENHANCE
Prenatal Vitamins Without Iron
PRENATE RESTORE
T1 pnv w-o
iron/fa/calcium/b6/b12
T1 pnv/fa/b6/calcium
carb/ginger
T1 pnv/fa/b6/calcium
phos/ginger
VOL-TAB RX
CADEAU DHA
VIRT-ADVANCE
Vitamin A Preparations
VIRT-VITE GT
T3 vitamin a palmitate
INATAL ULTRA
Vitamin B Preparations
VITAFOL-OB
VINATE CARE
PRENATE CHEWABLE
PRENATE AM
O-CAL PRENATAL
PRENATE MINI
TRINATE
PRENATABS FA
PRENATE MINI
PRENATE ELITE
PUREFE OB PLUS
PROVIDA OB
PRENATE ESSENTIAL
PRENATE PIXIE
NESTABS
VINATE II
NATALVIT
FOLBECAL
PRENAISSANCE
NEXT-B
PRENAISSANCE
NEXT
AQUASOL A
T1 b cmplx 4/vit
VITAL-D RX
d3/c/fa/zinc ox
T1 b complex & c
RENO CAPS
no.20/folic acid
T1 cyanocobalamin/fa/pyri FOLBEE
doxine
T3 cyanocobalamin/fa/pyrid VITA-RESPA
oxine
T1 folic acid/b complex & c VIRT-VITE PLUS
no.17
T1 folic acid/b
DIALYVITE 3000
cplx/c/selen/zinc
T1 folic acid/vit bcomp,c DIALYVITE
T1 folic acid/vit
FOLBEE PLUS CZ
bcomp,c/cu/znox
T3 lysine hcl/vit b
SUPERVITE
comp/fa/zinc
T3 multivit,
DIALYVITE 5000
mincmb#11/folic acid
T3 multivitamin, min
DIALYVITE SUPREME
cmb#25/fa/d3
D
T3 potassium
POTABA
aminobenzoate
T1 vit b cmplx 3/fa/vit
RENA-VITE RX
c/biotin
T1 vit b cmplx
NEPHPLEX RX
no3/fa/c/biot/zinc
T3 vit b complex & c
NEPHROCAPS QT
no.13/fa/d3
T1 vit b cplx
DIALYVITE ZINC
#11/fa/c/biot/zn ox
T3 vit
METHAVER
b1/b2/b6/fa/mecobalamin
T1 vitamins b1,b2,b3,b5,& B-COMPLEX
b6
O-CAL FA
Vitamin B1 Preparations
TRINATAL RX 1
T1 thiamine hcl
THIAMINE HCL
PRENATA
Page 59 of 106
T3 cyanocobalamin (vitamin B-12 COMPLIANCE
b-12)
T1 cyanocobalamin
CYANOCOBALAMIN
(vitamin b-12)
INJECTION
T3 cyanocobalamin (vitamin NASCOBAL
b-12)
T3 cyanocobalamin (vitamin PHYSICIANS EZ USE
b-12)
B-12
T1 cyanocobalamin/mecob NEURIN-SL
alamin
T1 hydroxocobalamin
HYDROXOCOBALAMI
N
T1 pyridoxine hcl
PYRIDOXINE HCL
Vitamin C Preparations
T1 ascorbic acid
ASCORBIC ACID
Vitamin D Preparations
T1 calcitriol
CALCITRIOL
T1 calcitriol
ROCALTROL
AGE
T1 cholecalciferol (vitamin VITAMIN
d3)
D3(CAP)(1000
UNIT)(OTC)
T5 cholecalciferol (vitamin VITAMIN D3(CAP)(400 AGE
d3)
UNIT)(OTC)
AGE
T1 cholecalciferol (vitamin VITAMIN D3(TAB
d3)
CHEW)(1000
UNIT)(OTC)
AGE
T5 cholecalciferol (vitamin VITAMIN D3(TAB
d3)
CHEW)(400
UNIT)(OTC)
AGE
T1 cholecalciferol (vitamin VITAMIN
d3)
D3(TAB)(OTC)
T1 ergocalciferol (vitamin DRISDOL
d2)
AGE
T1 ergocalciferol (vitamin VITAMIN D2(OTC)
d2)
T3 vitamin d3/folic acid
CIFEREX
DERMACINRX
PUREFOLIX
DURACHOL
ORTHO D
REVESTA
ZAVARA
Zinc Replacement
T1 zinc chloride
T1 zinc gluconate
T1 zinc sulfate
Sutter Health Plus
ZINC CHLORIDE
ZINC GLUCONATE
ZINC SULFATE
Page 60 of 106
Preferred Drug List Medication Prescribing Limitations
AGE RESTRICTIONS
• APTENSIO XR
<= 18 years
• ATRALIN
<= 25 years;<= 26 years
• BUPROBAN
>= 18 years
• CARBINOXAMINE MALEATE >= 2 years
• CHANTIX
>= 18 years
• DIFFERIN
• ELIDEL
>= 2 years
• EPANED
< 12 years
• EPIDUO
<= 25 years
• EPIDUO FORTE
<= 25 years
• FABIOR
>= 12 years
• FLUMIST QUAD 2015-2016
>= 9 years
• FOCALIN XR(CPBP 50-50)(10
MG)
<= 18 years
MG)
<= 18 years
MG)
<= 18 years
MG)
<= 18 years
MG)
<= 18 years
MG)
<= 18 years
MG)
<= 18 years
• FOCALIN XR(CPBP 50-50)(5 MG) <= 18 years
• HEMANGEOL
< 1 years
• KARBINAL ER
>= 2 years
• NICODERM CQ(OTC)
>= 18 years
• NICORETTE(OTC)
>= 18 years
• NICOTINE PATCH(PATCH
TD24)(OTC)
>= 18 years
• NICOTINE PATCH(PATCH)(OTC) >= 18 years
• NICOTROL
>= 18 years
• NICOTROL NS
>= 18 years
• PROTOPIC
>= 2 years
• RETIN-A
• RETIN-A MICRO
• RETIN-A MICRO PUMP(GEL
W/PUMP)(0.04 %)
W/PUMP)(0.08 %)
W/PUMP)(0.1 %)
• RITALIN LA
<= 18 years
• TRETIN-X
• TRETIN-X(CREAM)(0.0375 %)
• TRETIN-X(CREAM)(0.075 %)
<= 26 years
• VITAMIN D2(OTC)
>= 60 years
• VITAMIN D3(CAP)(1000
UNIT)(OTC)
>= 60 years
• VITAMIN D3(CAP)(400
UNIT)(OTC)
>= 60 years
• VITAMIN D3(TAB CHEW)(1000
UNIT)(OTC)
>= 60 years
• VITAMIN D3(TAB CHEW)(400
UNIT)(OTC)
>= 60 years
• VITAMIN D3(TAB)(OTC)
>= 60 years
Sutter Health Plus
Page 61 of 106
QUANTITY RESTRICTIONS
• ABILIFY
• ACCU-CHEK FASTCLIX(OTC)
• ACCU-CHEK SOFTCLIX(OTC)
• ACCU-CHEK(OTC)
• ACIPHEX
• ACIPHEX SPRINKLE
• ACTICLATE
• ACTONEL(TAB)(150 MG)
• ADDERALL
• ADDYI
• ADJUSTABLE LANCING
DEVICE(OTC)
• ADOXA
• ADVAIR DISKUS
• ADVAIR HFA
• ADVANCED LANCING
DEVICE(OTC)
• ADVICOR(TBMP 24HR)(1000
20MG)
• ADVICOR(TBMP 24HR)(1000-40
MG)
• ADVICOR(TBMP 24HR)(500MG
20MG)
• ADVICOR(TBMP 24HR)(750MG
20MG)
• ADVOCATE LANCING
DEVICE(OTC)
• ADVOCATE RAPID-SAFE(OTC)
• AEROSPAN
• AFINITOR DISPERZ
• AFINITOR(TAB)(10 MG)
• AFINITOR(TAB)(2.5 MG)
• AFREZZA(CART W/DEV)(4
UNIT(30))
UNIT(60))
UNIT)
UNIT(60))
• AKYNZEO
• ALDARA
• ALECENSA
• ALENDRONATE
SODIUM(SOLUTION)
• ALKERAN
• ALORA
• ALSUMA
• ALTERNATE SITE LANCING
DEVICE(OTC)
• ALTOPREV
• ALVESCO
• AMBIEN
1 units per 1 days
3 units per 365 days
1 units per 1 days
1 units per 1 days
2 units per 1 days
1 units per 30 days
1 units per 1 days
1 units per 7 days
1 units per 1 days
2 units per 1 days
8 units per 30 days
2 units per 1 days
12 gm per 30 days
2 units per 1 days
1 units per 1 days
1 units per 1 days
2 units per 1 days
17.8 gm per 30 days
30 days
1 units per 1 days;30
days
days
days
30 days
360 units per 28
days;450 units per 28
days
1 units per 28 days
30 days
75 ml per 7 days
30 days
2 units per 7 days
1 ml per 14 days
1 units per 1 days
12.2 gm per 30 days
1 units per 1 days
• AMERGE
3 units per 5 days
• AMITIZA
2 units per 1 days
• ANDROXY
• ANORO ELLIPTA
• ANZEMET(TAB)(100 MG)
4 units per fill
8 units per fill
• APIDRA
40 ml per 28 days
• APIDRA SOLOSTAR
30 ml per 28 days
• APLENZIN
1 units per 1 days
• APOKYN
2 ml per 1 days
• APTENSIO XR
1 units per 1 days
• APTIOM(TAB)(200 MG)
1 units per 1 days
1 units per 1 days
2 units per 1 days
2 units per 1 days
• AQUA LANCE LANCING
DEVICE(OTC)
• ARCAPTA NEOHALER
1 units per 1 days
• ARIPIPRAZOLE
30 ml per 1 days
•
ARIXTRA(SYRINGE)
(10MG/0.8ML)
8 ml per 30 days
• ARIXTRA(SYRINGE)(2.5 MG/0.5) 5 ml per 30 days
•
ARIXTRA(SYRINGE)(5MG/0.4ML) 4 ml per 30 days
• ARIXTRA(SYRINGE)(7.5MG/0.6) 6 ml per 30 days
• ARNUITY ELLIPTA
• AROMASIN
30 days
• ASMANEX
1 units per 30 days
• ASMANEX HFA
13 gm per 30 days
• ASTEPRO
60 ml per 30 days
• ATRIPLA
• ATROVENT HFA
25.8 gm per 30 days
• AURYXIA
12 units per 1 days
• AUTO-LANCET MINI(OTC)
• AUTOLET IMPRESSION(OTC) 3 units per 365 days
• AUTOLET LANCING
DEVICE(OTC)
• AVIDOXY
2 units per 1 days
• AVIDOXY DK
1 units per 30 days
• AXERT
2 units per 5 days
• AZELASTINE HCL
60 ml per 30 days
• AZILECT
1 units per 1 days
• BANZEL(ORAL SUSP)
80 ml per 1 days
• BANZEL(TAB)(200 MG)
16 units per 1 days
8 units per 1 days
• BECONASE AQ
25 gm per 30 days
• BELSOMRA
1 units per 1 days
• BENOXYLDOXY 30
1 units per 30 days
• BENOXYLDOXY 60
1 units per 30 days
• BENZODOX 30
1 units per 30 days
• BENZODOX 60
1 units per 30 days
• BIMATOPROST
1 ml per 12 days
• BINOSTO
4 units per 28 days
• BOSULIF(TAB)(100 MG)
30 days;4 units per 1
days
days
• BREO ELLIPTA
• BRILINTA
2 units per 1 days
• BRINTELLIX
1 units per 1 days
• BRISDELLE
1 units per 1 days
Page 62 of 106
• BROVANA
• BUPROBAN
• BUTRANS
• BYDUREON
• BYDUREON PEN
• BYETTA(PEN
INJCTR)(10MCG/0.04)
• BYETTA(PEN
INJCTR)(5MCG/0.02)
• CADUET
• CAFERGOT
• CAMBIA
• CAMRESE
• CAPRELSA(TAB)(100 MG)
• CARELANCE ULT LANCING
DEVICE(OTC)
• CAREONE(OTC)
• CARESENS PREM LANCING
DEVICE(OTC)
• CAVERJECT
• CESAMET
• CHANTIX
• CIALIS
• CLARINEX(SYRUP)
• CLARINEX(TAB)
• CLARINEX-D 12 HOUR
• CLIMARA
• CLIMARA PRO
• CLOZAPINE
• CLOZARIL
• COLCRYS
• COMBIPATCH
• COMBIVIR
• COMETRIQ
• CORLANOR
• COSOPT PF
• COTELLIC
• CRESTOR(TAB)(10 MG)
• CYCLOPHOSPHAMIDE
• CYCLOPHOSPHAMIDE(CAP)
• CYMBALTA
• D.H.E.45
• DALIRESP
• DAYTRANA
120 ml per 30 days
2 units per 1 days
1 units per 7 days
1 units per 7 days
1 units per 7 days
2.4 ml per 30 days
1.2 ml per 30 days
1 units per 1 days
10 units per 7 days
3 units per 10 days
days
days
days
8 units per 30 days
6 units per 1 days
2 units per 1 days
8 units per 30 days
10 ml per 1 days
1 units per 1 days
2 units per 1 days
1 units per 7 days
1 units per 7 days
3 units per 1 days
3 units per 1 days
4 units per 1 days
2 units per 7 days
days
2 units per 1 days
2 units per 1 days
30 days
1 units per 1 days
1 units per 1 days
1 units per 1 days
1 units per 1 days
30 days
30 days
2 units per 1 days
15 ml per 14 days
1 units per 1 days
units per 30 days
6 units per 1 days
1 units per 30 days
1 units per 1 days
1 units per 1 days
• DEMEROL
• DERMASILKRX SDS
• DESLORATADINE
• DESOXYN
• DESVENLAFAXINE ER
• DESVENLAFAXINE FUMARATE
1 units per 1 days
ER
1 units per 1 days
• DEXILANT
• DEXTROAMPHETAMINE
SULFATE(TAB)(10 MG)
• DEXTROAMPHETAMINE
SULFATE(TAB)(5 MG)
• DIASTAT
1 units per fill
• DIASTAT ACUDIAL
1 units per fill
• DICLEGIS
4 units per 1 days
• DIFICID
• DORYX(TAB DR)(150 MG)
2 units per 1 days
1 units per 1 days
2 units per 1 days
• DOXYCYCLINE HYCLATE
2 units per 1 days
• DOXYCYCLINE HYCLATE(CAP) 2 units per 1 days
• DOXYCYCLINE HYCLATE(TAB
DR)
2 units per 1 days
• DOXYCYCLINE HYCLATE(TAB) 2 units per 1 days
• DOXYCYCLINE
MONOHYDRATE(TAB)(150 MG) 2 units per 1 days
• DOXYCYCLINE
MONOHYDRATE(TAB)(50 MG)
2 units per 1 days
• DOXYCYCLINE
2 units per 1 days
• DROPLET LANCING
DEVICE(OTC)
• DULERA
13 gm per 30 days
• DURAGESIC
1 units per 3 days
• DYMISTA
23 gm per 30 days
• EASY CLICK(OTC)
• EASY TOUCH LANCING
DEVICE(OTC)
• EDEX
8 units per 30 days
• EDLUAR
1 units per 1 days
• EFFIENT
1 units per 1 days
• ELIQUIS(TAB)(2.5 MG)
2 units per 1 days
• ELIQUIS(TAB)(5 MG)
• EMBEDA(CAP ER PO)(100MG
4MG)
4 units per 1 days
0.8MG)
2 units per 1 days
1.2MG)
2 units per 1 days
• EMBEDA(CAP ER PO)(50 MG-2
MG)
2 units per 1 days
2.4MG)
2 units per 1 days
3.2MG)
2 units per 1 days
• EMCYT
30 days
• EMEND(CAP DS PK)
3 units per 21 days
• EMEND(CAP)(125 MG)
3 units per 21 days
1 units per 28 days
2 units per 21 days
• EMSAM
1 units per 1 days
• EMTRIVA(CAP)
• EMTRIVA(SOLUTION)
720 ml per 30 days
• ENTRESTO
2 units per 1 days
• EPANED
1200 ml per 30 days
• EPIDUO
45 gm per 30 days
• EPIDUO FORTE
45 gm per 30 days
• EPIVIR(SOLUTION)
900 ml per 30 days
• EPIVIR(TAB)(150 MG)
• EPIVIR(TAB)(300 MG)
• EPZICOM
• ERGOMAR
10 units per 7 days
• ERIVEDGE
days
Page 63 of 106
• ESTRING
• ETOPOSIDE
• ETOPOSIDE(CAP)
• EVISTA
• EVOTAZ
• EVZIO
• EXELON
• FANAPT(TAB DS PK)
• FANAPT(TAB)
• FARESTON
• FARXIGA
• FARYDAK
• FELBATOL(ORAL SUSP)
• FELBATOL(TAB)(400 MG)
• FEMRING
days
30 days
30 days
1 units per 1 days
1 units per 1 days
.8 ml per 365 days
8 units per 28 days
2 units per 1 days
30 days
1 units per 1 days
30 days
30 ml per 1 days
9 units per 1 days
6 units per 1 days
days
1 units per 3 days
1 units per 1 days
1 units per 30 days
• FENTANYL
• FETZIMA
• FIRMAGON(VIAL)(120 MG)
• FIRMAGON(VIAL)(80 MG)
• FLOVENT DISKUS(BLST
W/DEV)(100 MCG)
W/DEV)(250 MCG)
W/DEV)(50 MCG)
• FLOVENT HFA(AER
W/ADAP)(110 MCG)
12 gm per 30 days
• FLOVENT HFA(AER
W/ADAP)(220 MCG)
24 gm per 30 days
• FLOVENT HFA(AER W/ADAP)(44
MCG)
21.2 gm per 30 days
• FLOWTUSS
600 ml per 10 days
• FLUMIST QUAD 2015-2016
• FLUNISOLIDE
25 ml per 30 days
• FLUTICASONE PROPIONATE
16 gm per 30 days
MG)
1 units per 1 days
MG)
1 units per 1 days
MG)
1 units per 1 days
MG)
1 units per 1 days
MG)
1 units per 1 days
MG)
1 units per 1 days
MG)
1 units per 1 days
• FOCALIN XR(CPBP 50-50)(5 MG) 1 units per 1 days
• FORA LANCING DEVICE(OTC) 3 units per 365 days
• FORADIL
• FORFIVO XL
1 units per 1 days
• FORTEO
2.4 ml per 28 days
• FRAGMIN(SYRINGE)(10000/ML) 10 ml per 30 days
• FRAGMIN(SYRINGE)(12500/0.5) 5 ml per 30 days
• FRAGMIN(SYRINGE)(15000/0.6) 6 ml per 30 days
• FRAGMIN(SYRINGE)(18000/0.72)7.2 ml per 30 days
•
FRAGMIN(SYRINGE)(2500/0.2ML) 2 ml per 30 days
•
•
• FRAGMIN(VIAL)
7.6 ml per 30 days
• FROVA
3 units per 5 days
2 units per 1 days
• FULYZAQ
• FUZEON
• FYCOMPA(TAB)(10 MG)
• GABITRIL(TAB)(12 MG)
4 units per 1 days
3 units per 1 days
4 units per 1 days
4 units per 1 days
• GEODON
2 units per 1 days
• GILOTRIF
30 days
• GLEEVEC(TAB)(100 MG)
days
days
• GLEOSTINE
30 days
• GLUCOLET 2(OTC)
• GLYXAMBI
1 units per 1 days
• GMATE LANCING DEVICE(OTC) 3 units per 365 days
• GRALISE(TAB ER 24H)(300 MG) 3 units per 1 days
• GRALISE(TAB ER 24H)(300-600
MG)
• GRALISE(TAB ER 24H)(600 MG) 3 units per 1 days
• GRANISETRON HCL
8 units per 30 days
• GRANISETRON HCL(TAB)
8 units per 30 days
• HEALTHY ACCENTS
AUTOLET(OTC)
• HEMANGEOL
360 ml per 30 days
• HEXALEN
30 days
• HORIZANT(TAB ER)(300 MG)
2 units per 1 days
• HUMALOG KWIKPEN U-100
30 ml per 28 days
• HUMALOG KWIKPEN U-200
12 ml per 28 days
• HUMALOG MIX 50-50
40 ml per 28 days
• HUMALOG MIX 50-50 KWIKPEN 30 ml per 28 days
• HUMALOG MIX 75-25
40 ml per 28 days
• HUMALOG MIX 75-25 KWIKPEN 30 ml per 28 days
• HUMALOG(CARTRIDGE)
30 ml per 28 days
• HUMALOG(VIAL)
40 ml per 28 days
• HUMULIN 70/30 KWIKPEN(OTC) 30 ml per 28 days
• HUMULIN 70-30(OTC)
40 ml per 28 days
• HUMULIN N KWIKPEN(OTC)
30 ml per 28 days
• HUMULIN N(OTC)
40 ml per 28 days
• HUMULIN R U-500
40 ml per 28 days
• HUMULIN R(OTC)
40 ml per 28 days
• HYCAMTIN
30 days
• HYCAMTIN(CAP)
30 days
• HYCET
184 ml per 1 days
• HYCOFENIX
473 ml per 30 days
• HYDREA
30 days
• HYDROCODONE
ACETAMINOPHEN(SOLUTION)
(10-325/15)
184 ml per 1 days
Page 64 of 106
• HYDROCODONE
ACETAMINOPHEN(SOLUTION)
(2.5-167/5)
• HYDROCODONE
ACETAMINOPHEN(SOLUTION)(5
163/7.5)
• HYDROCODONE
ACETAMINOPHEN(TAB)(10MG
300MG)
• HYDROCODONE
325MG)
• HYDROCODONE
ACETAMINOPHEN(TAB)(5 MG
325MG)
• HYDROCODONE
300MG)
• HYDROCODONE
ACETAMINOPHEN(TAB)(7.5
300MG)
• HYDROCODONE
ACETAMINOPHEN(TAB)(7.5
325MG)
• HYPOLANCE(OTC)
• HYSINGLA ER
• IBRANCE
• ICLUSIG(TAB)(15 MG)
• IMBRUVICA
• IMITREX
• IMITREX(CARTRIDGE)
• IMITREX(PEN INJCTR)
• IMITREX(TAB)
• IMITREX(VIAL)
• INCONTROL LANCING
DEVICE(OTC)
• INCRUSE ELLIPTA
• INLYTA(TAB)(1 MG)
• INTERMEZZO
• INTUNIV
• INVEGA(TAB ER 24H)(1.5 MG)
• INVEGA(TAB ER 24H)(3 MG)
• INVIRASE(CAP)
• INVIRASE(TAB)
• INVOKAMET
• INVOKANA
• IPRIVASK
• IRENKA
• IRESSA
• JAKAFI
120 ml per 1 days
184 ml per 1 days
13 units per 1 days
12 units per 1 days
12 units per 1 days
13 units per 1 days
13 units per 1 days
12 units per 1 days
1 units per 1 days
30 days
days
days
30 days
6 units per 15 days
1 ml per 14 days
1 ml per 14 days
3 units per 5 days
1 ml per 14 days
days
days
1 units per 1 days
1 units per 1 days
1 units per 1 days
1 units per 1 days
2 units per 1 days
1 units per 1 days
2 units per 1 days
6 units per 30 days
1 units per 1 days
30 days
days
2 units per 1 days
• JANUMET
• JANUMET XR(TBMP 24HR)(100
1 units per 1 days
1000MG)
• JANUMET XR(TBMP 24HR)(50
2 units per 1 days
1000 MG)
Sutter Health Plus
• JANUMET XR(TBMP
24HR)(50MG-500MG)
• JANUVIA
• JARDIANCE
• JENTADUETO
• KADIAN(CAP ER PEL)(10 MG)
• KALETRA(SOLUTION)
• KALETRA(TAB)(100MG-25MG)
• KALETRA(TAB)(200MG-50MG)
• KAPVAY
• KARBINAL ER
• KAZANO
• KHEDEZLA
• KOMBIGLYZE XR(TBMP
24HR)(2.5-1000MG)
24HR)(5 MG-500MG)
24HR)(5MG-1000MG)
• LANCET DEVICE(OTC)
• LANCING DEVICE(OTC)
• LANCING SYSTEM(OTC)
• LANTUS
• LANTUS SOLOSTAR
• LANZO(OTC)
• LATUDA(TAB)(120 MG)
• LENVIMA
• LESCOL
• LEUKERAN
• LEVEMIR
• LEVEMIR FLEXTOUCH
• LEVITRA
• LINZESS
• LIPTRUZET(TAB)(10 MG-10MG)
• LITE TOUCH(OTC)
• LIVALO
• LOMUSTINE
• LONSURF
• LOVAZA
• LOVENOX(SYRINGE)(100
MG/ML)
•
LOVENOX(SYRINGE)
(120MG/.8ML)
• LOVENOX(SYRINGE)(150
MG/ML)
•
LOVENOX(SYRINGE)
(30MG/0.3ML)
2 units per 1 days
1 units per 1 days
1 units per 1 days
2 units per 1 days
2 units per 1 days
2 units per 1 days
2 units per 1 days
4 units per 1 days
2 units per 1 days
2 units per 1 days
2 units per 1 days
2 units per 1 days
2 units per 1 days
390 ml per 30 days
960 ml per 30 days
2 units per 1 days
1 units per 1 days
2 units per 1 days
1 units per 1 days
1 units per 1 days
40 ml per 28 days
30 ml per 28 days
30 days
2 units per 1 days
30 days
40 ml per 28 days
30 ml per 28 days
8 units per 30 days
1 units per 1 days
1 units per 1 days
30 days
30 days
4 units per 1 days
20 ml per 30 days
16 ml per 30 days
20 ml per 30 days
6 ml per 30 days
Page 65 of 106
•
LOVENOX(SYRINGE)
(40MG/0.4ML)
•
LOVENOX(SYRINGE)
(60MG/0.6ML)
•
LOVENOX(SYRINGE)
(80MG/0.8ML)
• LOVENOX(VIAL)
• LUMIGAN
• LUNESTA
• LUZU
• LYNPARZA
• NEXAVAR
8 ml per 30 days
12 ml per 30 days
16 ml per 30 days
30 ml per 30 days
1 ml per 12 days
1 units per 1 days
60 gm per 28 days
days
30 days
• LYSODREN
2 units per 1 days
• MARINOL
30 days
• MATULANE
3 units per 5 days
• MAXALT
3 units per 5 days
• MAXALT MLT
30 days
• MEKINIST
1 units per 7 days
• MENOSTAR
• MEPERIDINE HCL(SOLUTION) 30 ml per 1 days
6 units per 1 days
• MEPERIDINE HCL(TAB)
30 days
• METHOTREXATE(TAB)
• METHYLIN(TAB CHEW)
• MICROLET 2(OTC)
5 units per 7 days
• MIGERGOT
8 ml per 28 days
• MIGRANAL
• MINI LANCING DEVICE(OTC) 3 units per 365 days
2 units per 7 days
• MINIVELLE
1 units per 1 days
• MIRAPEX ER
30 gm per 30 days
• MIRVASO
2 units per 1 days
• MITIGARE
2 units per 1 days
• MONODOX(CAP)(100 MG)
2 units per 1 days
2 units per 1 days
1 units per 30 days
• MORGIDOX
• MORPHINE SULFATE ER(CPMP
2 units per 1 days
24HR)(120 MG)
1 units per 1 days
24HR)(30 MG)
1 units per 1 days
24HR)(45 MG)
1 units per 1 days
24HR)(60 MG)
1 units per 1 days
24HR)(75 MG)
1 units per 1 days
24HR)(90 MG)
1 units per 1 days
• MOVANTIK
3 units per 1 days
• MS CONTIN
8 units per 30 days
• MUSE
1 units per 1 days
• MYALEPT
30 days
• MYLERAN
• NAMENDA XR(CAP 24 DSPK)
• NAMENDA XR(CAP SPR 24)
300 ml per 30 days
• NAMENDA(SOLUTION)
• NAMENDA(TAB DS PK)
• NAMENDA(TAB)
1 units per 1 days
• NAMZARIC
17 gm per 30 days
• NASONEX
1 units per 1 days
• NESINA
1 units per 1 days
• NEUPRO
• NEXIUM(CAP DR)
• NEXIUM(SUSP DR PKT)
• NICODERM CQ(OTC)
• NICORETTE(OTC)
• NICOTINE PATCH(PATCH
TD24)(OTC)
• NICOTROL
• NICOTROL NS
• NILANDRON
days
1 units per 1 days
1 units per 1 days
1 units per 1 days
9 units per 1 days
1 units per 1 days
160 ml per 90 days
150 units after 30
days;30 days
• NINLARO
30 days
• NORVIR(CAP)
• NORVIR(SOLUTION)
450 ml per 30 days
• NORVIR(TAB)
• NOVOLIN 70-30(OTC)
40 ml per 28 days
• NOVOLIN N(OTC)
40 ml per 28 days
• NOVOLIN R(OTC)
40 ml per 28 days
30 ml per 28 days
• NOVOLOG FLEXPEN
• NOVOLOG MIX 70-30
40 ml per 28 days
• NOVOLOG MIX 70-30 FLEXPEN 30 ml per 28 days
• NOVOLOG(CARTRIDGE)
30 ml per 28 days
• NOVOLOG(VIAL)
40 ml per 28 days
• NUCYNTA
6 units per 1 days
• NUCYNTA ER
2 units per 1 days
• NUVARING
1 units per 28 days
• OBREDON
600 ml per 10 days
• ODOMZO
30 days
• OLEPTRO ER
3 units per 2 days
• OMNARIS
5 gm per 12 days
• ON CALL LANCING
DEVICE(OTC)
• ON CALL PLUS LANCING
DEVICE(OTC)
• ONETOUCH DELICA(OTC)
• ONFI(ORAL SUSP)
480 ml per 30 days
• ONFI(TAB)
2 units per 1 days
• ONGLYZA
1 units per 1 days
• ORTHO EVRA
3 units per 28 days
• OSENI
1 units per 1 days
• OSPHENA
1 units per 1 days;8 units
per 30 days
• OTREXUP
1.6 ml per 28 days
• OXTELLAR XR(TAB ER 24H)(150
MG)
1 units per 1 days
MG)
1 units per 1 days
MG)
4 units per 1 days
• OXYCONTIN(TAB ER 12H)(10
MG)
2 units per 1 days
MG)
2 units per 1 days
MG)
2 units per 1 days
MG)
2 units per 1 days
MG)
2 units per 1 days
MG)
2 units per 1 days
MG)
4 units per 1 days
Page 66 of 106
• PATANASE
30.5 gm per 30 days
• PAZEO
2.5 ml per 30 days
• PENLET PLUS BLOOD
SAMPLER(OTC)
• PERCOCET
12 units per 1 days
• PERFOROMIST
120 ml per 30 days
• PEXEVA
1 units per 1 days
• PICATO(GEL)(0.015 %)
3 units per 28 days
• PICATO(GEL)(0.05 %)
2 units per 28 days
• PLAVIX(TAB)(300 MG)
4 units per 30 days
• POMALYST
30 days
• POTIGA(TAB)(200 MG)
3 units per 1 days
3 units per 1 days
3 units per 1 days
9 units per 1 days
• PRADAXA
2 units per 1 days
• PRESTALIA
1 units per 1 days
• PREVPAC
• PREZCOBIX
1 units per 1 days
• PREZISTA(ORAL SUSP)
240 ml per 30 days
• PREZISTA(TAB)(150 MG)
• PRIMLEV
13 units per 1 days
• PRISTIQ ER
1 units per 1 days
• PROCENTRA
1800 ml per 30 days
• PRODIGY LANCING
DEVICE(OTC)
• PULMICORT FLEXHALER
1 units per 30 days
• PULMICORT(AMPUL
NEB)(0.25MG/2ML)
120 ml per 30 days
• PULMICORT(AMPUL-NEB)(0.5
MG/2ML)
120 ml per 30 days
• PULMICORT(AMPUL-NEB)(1
MG/2 ML)
60 ml per 30 days
• PURIXAN
30 days
• QNASL
8.7 gm per 30 days
• QNASL CHILDREN
4.9 gm per 30 days
• QUARTETTE
91 days
• QUILLIVANT XR
2 ml per 1 days
• QVAR
17.4 gm per 30 days
• RANEXA(TAB ER 12H)(1000 MG)60 units per 30 days
• RANEXA(TAB ER 12H)(500 MG) 120 units per 30 days
• RASUVO(AUTO
INJECT)(10MG/0.2ML)
.8 ml per 28 days
• RASUVO(AUTO
INJECT)(12.5/0.25)
1 ml per 28 days
• RASUVO(AUTO
INJECT)(15MG/0.3ML)
1.2 ml per 28 days
• RASUVO(AUTO
INJECT)(17.5/0.35)
1.4 ml per 28 days
• RASUVO(AUTO
INJECT)(20MG/0.4ML)
1.6 ml per 28 days
• RASUVO(AUTO
INJECT)(22.5/0.45)
1.8 ml per 28 days
• RASUVO(AUTO
INJECT)(25MG/0.5ML)
2 ml per 28 days
• RASUVO(AUTO
INJECT)(27.5/0.55)
2.2 ml per 28 days
• RASUVO(AUTO
INJECT)(30MG/0.6ML)
2.4 ml per 28 days
• RASUVO(AUTO
INJECT)(7.5MG/0.15)
• RAZADYNE
• RAZADYNE ER
• RELENZA
• RELIAMED MINI LANCING
DEVICE(OTC)
• RELPAX
• RESCULA
• RESTASIS
• RETROVIR(CAP)
• RETROVIR(SYRUP)
• REVLIMID
• REXULTI
• RHINOCORT AQUA
• RIGHTEST GD500(OTC)
• RISPERDAL(SOLUTION)
• RISPERDAL(TAB)
• RITALIN
• RITALIN LA
• ROZEREM
• RYTARY
• SABRIL
• SAMSCA(TAB)(15 MG)
• SAMSCA(TAB)(30 MG)
• SANCUSO
• SAPHRIS
• SAVAYSA
• SEREVENT DISKUS
• SEROQUEL
• SEROQUEL XR(TAB ER 24H)
• SILENOR
• SIMCOR(TBMP 24HR)(1000
20MG)
• SIMCOR(TBMP 24HR)(1000-40
MG)
• SIMCOR(TBMP 24HR)(500MG
20MG)
40MG)
20MG)
• SITAVIG
• SMARTDIABETES
VANTAGE(OTC)
• SOFTCLIX(OTC)
• SOLARAZE
• SOLUS V2 LANCING
DEVICE(OTC)
• SONATA
• SOTYLIZE
• SPIRIVA
• SPIRIVA RESPIMAT
• SPRIX
• SPRYCEL(TAB)(100 MG)
.6 ml per 28 days
2 units per 5 days
1 ml per 3 days
1800 ml per 30 days
days
1 units per 1 days
43 gm per 75 days
2 ml per 1 days;8 ml per
1 days
2 units per 1 days
1 units per 1 days
1 units per 1 days
10 units per 1 days
6 units per 1 days
1 units per 7 days
2 units per 1 days
3 units per 1 days
1 units per 1 days
1 units per 1 days
2 units per 1 days
1 units per 1 days
1 units per 1 days
1 units per 1 days
2 units per 1 days
100 gm per fill
1 units per 1 days
2000 ml per 30 days
4 gm per 30 days
1 units per 6 days
days
days
days
days
Page 67 of 106
• STAXYN
• STENDRA
• STIOLTO RESPIMAT
• STIVARGA
• STRATTERA(CAP)(10 MG)
• STRIBILD
• STRIVERDI RESPIMAT
• SUMATRIPTAN SUCCINATE
• SUMAVEL DOSEPRO(NDL FR
INJ)(4 MG/0.5ML)
• SUMAVEL DOSEPRO(NDL FR
INJ)(6 MG/0.5ML)
• SURE COMFORT LANCING
PEN(OTC)
• SUREFLEX(OTC)
• SURE-PEN(OTC)
• SUTENT
days
days
8 units per 30 days
8 units per 30 days
4 gm per 30 days
days
4 gm per 30 days
1 ml per 14 days
4 ml per 28 days
1 ml per 14 days
days
• SYLATRON
units per 7 days
10.2 gm per 30 days
• SYMBICORT
1 units per 1 days
• SYMBYAX
2 units per 1 days
• SYNJARDY
30 days
• TABLOID
30 days
• TAFINLAR
30 days
• TAGRISSO
• TAMIFLU(CAP)(30 MG)
360 ml per 183 days
• TAMIFLU(SUSP RECON)
4 units per 28 days
• TANZEUM
• TARCEVA
days
30 days
• TARGRETIN
• TASIGNA
days
3 units per 1 days
• TASMAR
30 days
• TEMODAR
30 days
• TEMODAR(CAP)
• THALOMID
days
2 units per 1 days
• TIMOPTIC OCUDOSE
3 units per 1 days
• TIVORBEX
7.5 ml per 28 days
• TOUJEO SOLOSTAR
1 units per 1 days
• TRADJENTA
1 ml per 12 days
• TRAVATAN Z
1 ml per 12 days
• TRAVOPROST
30 days
• TRETINOIN
30 days
• TREXALL
1 units per 3 days
• TREXIMET
10 units per 1 days
• TREZIX
• TRIAMCINOLONE ACETONIDE 11 gm per 20 days
1 units per 1 days
• TRIUMEQ
• TROKENDI XR(CAP ER 24H)(100
MG)
1 units per 1 days
MG)
2 units per 1 days
MG)
1 units per 1 days
MG)
1 units per 1 days
• TRUEDRAW(OTC)
• TRULICITY
2 ml per 28 days
• TRUVADA
• TUDORZA PRESSAIR
1 units per 30 days
• TUZISTRA XR
200 ml per 10 days
• TYKERB
30 days
• ULORIC
• ULTI-LANCE(OTC)
• UNISTIK 2 EXTRA(OTC)
• UNISTIK 2 NORMAL
• UNISTIK 2 NORMAL(OTC)
• UNISTIK 2(OTC)
• UNISTIK 3 COMFORT(OTC)
• UNISTIK 3 NEONATAL(OTC)
• UNISTIK 3(OTC)
• VANCOCIN HCL
• VARUBI
2 units per 14 days
• VASCEPA
4 units per 1 days
• VERAMYST
10 gm per 30 days
• VERSACLOZ
18 ml per 1 days;3 ml per
1 days
• VIAGRA
8 units per 30 days
• VIBRAMYCIN
2 units per 1 days
• VICTOZA 2-PAK
9 ml per 30 days
• VICTOZA 3-PAK
9 ml per 30 days
• VIDEX
1200 ml per 30 days
• VIDEX EC(CAP DR)(125 MG)
• VIDEX EC(CAP DR)(200 MG)
• VIIBRYD
1 units per 1 days
• VIMPAT(SOLUTION)
1200 ml per 30 days
• VIMPAT(TAB)
2 units per 1 days
• VIRAMUNE(ORAL SUSP)
1200 ml per 30 days
• VIRAMUNE(TAB)
• VIREAD(POWDER)
225 gm per 30 days
• VIREAD(TAB)
• VITEKTA
1 units per 1 days
• VIVELLE-DOT
2 units per 7 days
• VOTRIENT
days
• VYTORIN(TAB)(10 MG-10MG) 1 units per 1 days
• VYVANSE
1 units per 1 days
• XALKORI
days
• XARELTO(TAB DS PK)
• XARELTO(TAB)(10 MG)
1 units per 1 days
15 units after 21 days;2
units per 1 days
1 units per 1 days
• XARTEMIS XR
12 units per 1 days
• XELODA(TAB)(150 MG)
days
days
Page 68 of 106
• XERESE
• XIFAXAN(TAB)(200 MG)
• XIGDUO XR
• XTANDI
10 gm per 365 days
9 units per fill
2 units per 1 days
days
• XYZAL(SOLUTION)
10 ml per 1 days
• ZAMICET
184 ml per 1 days
• ZECUITY
4 units per 28 days
• ZEGERID(CAP)
1 units per 1 days
• ZEGERID(PACKET)
1 units per 1 days
• ZELAPAR
2 units per 1 days
• ZELBORAF
days
• ZENZEDI(TAB)(15 MG)
3 units per 1 days
• ZENZEDI(TAB)(2.5 MG)
2 units per 1 days
2 units per 1 days
• ZERIT(CAP)
• ZERIT(SOLN RECON)
2400 ml per 30 days
• ZETIA
1 units per 1 days
• ZETONNA
6.1 gm per 30 days
• ZIAGEN(SOLUTION)
900 ml per 30 days
• ZIAGEN(TAB)
• ZIDOVUDINE
• ZIOPTAN
1 units per 1 days
• ZIPSOR
4 units per 1 days
• ZOFRAN(SOLUTION)
50 ml per 15 days
• ZOHYDRO ER
2 units per 1 days
• ZOLINZA
30 days
• ZOLPIDEM TARTRATE
1 units per 1 days
• ZOLPIMIST
7.7 ml per 30 days
• ZOMIG(SPRAY)(2.5 MG)
• ZOMIG(SPRAY)(5 MG)
6 units per 15 days
• ZOMIG(TAB)
2 units per 5 days
• ZONTIVITY
1 units per 1 days
• ZORVOLEX
3 units per 1 days
• ZUPLENZ(FILM)(4 MG)
2 units per 3 days
1 units per 3 days
• ZYCLARA(CREAM PACK)
1 units per 1 days
• ZYCLARA(CRM MD PMP)(2.5 %) 7.5 gm per 1 days
• ZYCLARA(CRM MD PMP)(3.75
%)
7.5 gm per 28 days
• ZYDELIG
30 days
• ZYKADIA
30 days
• ZYPREXA
1 units per 1 days
• ZYTIGA
days
Page 69 of 106
STEP THERAPY EDITS
• ABILIFY
Atleast 2 of Prior prescription for Citalopram Hbr in 365 days or Lexapro in 365
days or Paxil Cr in 365 days or Risperidone Odt in 365 days or Risperidone in 365
days or Selfemra in 365 days or Seroquel in 365 days or Venlafaxine Hcl Er in 365
days or Ziprasidone Hcl in 365 days or Zoloft in 365 days or Zyprexa in 365 days
• ABSORICA
Prior prescription for Isotretinoin in 120 days
• ACCU-CHEK AVIVA PLUS(OTC)
Atleast 2 of Prior prescription for in 365 days or Precision Xtra in 365 days
• ACCU-CHEK AVIVA(OTC)
• ACCU-CHEK COMPACT PLUS(OTC)
• ACCU-CHEK COMPACT(OTC)
• ACCU-CHEK SMARTVIEW(OTC)
• ACCUTREND GLUCOSE(OTC)
• ACIPHEX SPRINKLE
Atleast 2 of Prior prescription for Prevacid 24hr in 365 days or Prilosec in 365 days
or Protonix Iv in 365 days
• ACTICLATE
Prior prescription for Doxycycline Monohydrate in 120 days
Atleast 2 of Prior prescription for Fosamax in 365 days or Ibandronate Sodium in
365 days
365 days
365 days
365 days
• ACTOPLUS MET
Prior prescription for Avandamet in 120 days or Avandaryl in 120 days or Avandia in
120 days or Chlorpropamide in 120 days or Glimepiride in 120 days or Glipizide
metformin in 120 days or Glucotrol Xl in 120 days or Glyburide in 120 days or
Glyburide-metformin Hcl in 120 days or Riomet in 120 days or Tolazamide in 120
days or Tolbutamide in 120 days
• ACTOPLUS MET XR
• ADOXA
• ADVICOR(TBMP 24HR)(1000-20MG)
Atleast 2 of Prior prescription for Lipitor in 365 days or Mevacor in 365 days or
Pravastatin Sodium in 365 days or Zocor in 365 days
• ADVICOR(TBMP 24HR)(1000-40 MG) Atleast 2 of Prior prescription for Lipitor in 365 days or Mevacor in 365 days or
• ADVICOR(TBMP 24HR)(500MG-20MG) Atleast 2 of Prior prescription for Lipitor in 365 days or Mevacor in 365 days or
• ADVICOR(TBMP 24HR)(750MG-20MG) Atleast 2 of Prior prescription for Lipitor in 365 days or Mevacor in 365 days or
• AEROSPAN
Atleast 2 of Prior prescription for Asmanex in 365 days or Pulmicort in 365 days or
Qvar in 365 days
• ALTOPREV
• ALVESCO
Qvar in 365 days
• ANORO ELLIPTA
Atleast 2 of Prior prescription for Spiriva in 365 days or Stiolto Respimat in 365 days
• ANTARA
Prior prescription for Fenofibrate in 120 days or Lofibra in 120 days or Lopid in 120
days or Tricor in 120 days or Triglide in 120 days
Prior prescription for Anzemet in 120 days or Ondansetron Hcl in 120 days or Zofran
Odt in 120 days or Zofran in 120 days
Prior prescription for Anzemet in 120 days or Ondansetron Hcl in 120 days or Zofran
Odt in 120 days or Zofran in 120 days
• APIDRA
Prior prescription for Humalog Kwikpen U-200 in 120 days
• APIDRA SOLOSTAR
• APLENZIN
Prior prescription for Zyban in 120 days
• APTENSIO XR
Prior prescription for Dextroamphetamine-amphetamine in 120 days or Ritalin-sr in
120 days
Atleast 2 of Prior prescription for Divalproex Sodium Er in 365 days or Lamotrigine
Odt (orange) in 365 days or Levetiracetam Er in 365 days or Neurontin in 365 days
Page 70 of 106
• ARCAPTA NEOHALER
• ARIPIPRAZOLE
• ARNUITY ELLIPTA
• ASACOL HD
• ASTEPRO
• AUVI-Q
• AVANDAMET
• AVANDIA
• AVIDOXY
• AVIDOXY DK
• AVODART
• AXERT
• AZOR
• BANZEL(ORAL SUSP)
• BECONASE AQ
• BELSOMRA
• BENICAR
• BENICAR HCT
• BENOXYLDOXY 30
• BENOXYLDOXY 60
• BENZACLIN(GEL W/PUMP)
• BENZODOX 30
• BENZODOX 60
• BEYAZ
Sutter Health Plus
or Tegretol Xr in 365 days or Trileptal in 365 days or Trokendi Xr in 365 days or
Valproic Acid in 365 days or Zonisamide in 365 days
Prior prescription for Serevent Diskus in 120 days or Striverdi Respimat in 120 days
Atleast 2 of Prior prescription for Asmanex in 365 days or Pulmicort Flexhaler in
365 days or Qvar in 365 days
Prior prescription for Lialda in 120 days or Pentasa in 120 days
Prior prescription for Azelastine Hcl in 120 days
Prior prescription for Auvi-q in 120 days or Twinject in 120 days
Prior prescription for Tolbutamide in 120 days
Prior prescription for Doxazosin Mesylate in 120 days or Prazosin Hcl in 120 days or
Proscar in 120 days or Rapaflo in 120 days or Tamsulosin Hcl in 120 days or
Terazosin Hcl in 120 days or Uroxatral in 120 days
Prior prescription for Rizatriptan in 180 days or Sumatriptan Succinate in 180 days
Prior prescription for Benicar Hct in 120 days or Benicar in 120 days or Captopril
hydrochlorothiazide in 120 days or Losartan Potassium in 120 days or Tribenzor in
120 days
Prior prescription for Divalproex Sodium Er in 120 days or Lamotrigine Odt (orange)
in 120 days or Trokendi Xr in 120 days or Valproic Acid in 120 days
Prior prescription for 24 Hour Allergy Relief in 120 days or Flunisolide in 120 days
or Fluticasone Propionate in 120 days
Prior prescription for Lunesta in 120 days or Zaleplon in 120 days or Zolpidem
Tartrate in 120 days
Prior prescription for Azor in 120 days or Benicar Hct in 120 days or Captopril
120 days
Prior prescription for Azor in 120 days or Benicar in 120 days or Captopril
120 days
Atleast 2 of Prior prescription for Acanya in 365 days or Ziana in 365 days
Atleast 2 of Prior prescription for Levonorgestrel-eth Estradiol in 365 days or Lo
Loestrin Fe in 365 days or Loseasonique in 365 days or Microgestin Fe in 365 days
or Microgestin in 365 days or Minastrin 24 Fe in 365 days or Necon in 365 days or
Norethin-eth Estra Ferrous Fum in 365 days or Norethindron-ethinyl Estradiol in 365
days or Norinyl 1+50 in 365 days or Ogestrel in 365 days or Ovcon-50 in 365 days
or Pirmella in 365 days or Portia in 365 days or Seasonique in 365 days or Setlakin
in 365 days or Sharobel in 365 days or Sprintec in 365 days or Tarina Fe in 365 days
or Tri-legest Fe in 365 days or Tri-norinyl in 365 days or Trinessa Lo in 365 days or
Page 71 of 106
• BINOSTO
• BONIVA(SYRINGE)
• BREEZE 2(OTC)
• BRINTELLIX
• BRISDELLE
• BYDUREON
• BYDUREON PEN
• BYETTA(PEN INJCTR)(10MCG/0.04)
• BYETTA(PEN INJCTR)(5MCG/0.02)
• CALCIPOTRIENE
• CESAMET
• CLARINEX(SYRUP)
• CLARINEX-D 12 HOUR
• CONTOUR NEXT(OTC)
• CONTOUR(OTC)
• COSOPT PF
• CYCLOSET
• DALIRESP
• DAYTRANA
• DELZICOL
• DERMASILKRX SDS
• DESLORATADINE
• DESVENLAFAXINE ER
• DESVENLAFAXINE FUMARATE ER
• DETROL LA
Sutter Health Plus
Trinessa in 365 days or Trivora-28 in 365 days or Velivet in 365 days or Vienva in
365 days or Viorele in 365 days or Wera in 365 days or Zenchent in 365 days or
Zeosa in 365 days or Zovia 1-50e in 365 days
365 days
Prior prescription for Fosamax in 120 days or Ibandronate Sodium in 120 days
days or Paxil Cr in 365 days or Remeron in 365 days or Selfemra in 365 days or
Venlafaxine Hcl Er in 365 days or Zoloft in 365 days or Zyban in 365 days
Prior prescription for Paxil Cr in 120 days or Venlafaxine Hcl Er in 120 days
Atleast 2 of Prior prescription for Tolbutamide in 365 days or Victoza 3-pak in 365
days
days
Atleast 2 of Prior prescription for Chlorpropamide in 120 days or Glimepiride in 120
days or Glipizide-metformin in 120 days or Glucotrol Xl in 120 days or Glyburide in
120 days or Glyburide-metformin Hcl in 120 days or Glynase in 120 days or
Pioglitazone Hcl in 120 days or Pioglitazone-glimepiride in 120 days or
Pioglitazone-metformin in 120 days or Riomet in 120 days or Tolazamide in 120
days or Tolbutamide in 120 days or Tolbutamide in 365 days or Victoza 3-pak in 365
days
Atleast 2 of Prior prescription for Chlorpropamide in 120 days or Glimepiride in 120
days or Glipizide-metformin in 120 days or Glucotrol Xl in 120 days or Glyburide in
120 days or Glyburide-metformin Hcl in 120 days or Glynase in 120 days or
Pioglitazone Hcl in 120 days or Pioglitazone-glimepiride in 120 days or
Pioglitazone-metformin in 120 days or Riomet in 120 days or Tolazamide in 120
days or Tolbutamide in 120 days or Tolbutamide in 365 days or Victoza 3-pak in 365
days
Prior prescription for Topical Anti-inflammatory Steroidal in 120 days
Prior prescription for Ondansetron Hcl in 120 days or Zofran Odt in 120 days or
Zofran in 120 days
Prior prescription for Desloratadine in 120 days or Xyzal in 120 days
Prior prescription for Dorzolamide-timolol in 120 days
Prior prescription for Lipitor in 120 days
Prior prescription for Glipizide-metformin in 180 days or Glyburide-metformin Hcl
in 180 days or Riomet in 180 days
Prior prescription for Advair Diskus in 120 days or Breo Ellipta in 120 days or
Dulera in 120 days or Serevent Diskus in 120 days or Spiriva Respimat in 120 days
or Spiriva in 120 days
Prior prescription for in 120 days or Methylphenidate Hcl Cd in 120 days or
Methylphenidate Hcl in 120 days or Quillivant Xr in 120 days or Ritalin La in 120
days or Ritalin-sr in 120 days
Atleast 3 of Prior prescription for Secura Dimethicone in 365 days or Silicone Sheet
in 365 days or Triderm in 365 days
Prior prescription for Oxybutynin Chloride Er in 120 days or Oxybutynin Chloride in
120 days
Page 72 of 106
• DEXILANT
• DIFICID
• DIPENTUM
• DOVONEX
• DOXYCYCLINE HYCLATE
• DOXYCYCLINE HYCLATE(CAP)
• DOXYCYCLINE HYCLATE(TAB DR)
• DOXYCYCLINE HYCLATE(TAB)
• DOXYCYCLINE
• DRITHOCREME HP
• DUETACT
• DYMISTA
• EDARBI
• EDARBYCLOR
• EDLUAR
• ELIDEL
• ENABLEX
• EPANED
• EPIDUO
• EPIDUO FORTE
• EPROSARTAN MESYLATE
• EXFORGE
• EXFORGE HCT
• FANAPT(TAB DS PK)
• FANAPT(TAB)
• FARXIGA
• FELBATOL(ORAL SUSP)
• FETZIMA
• FLOVENT DISKUS(BLST W/DEV)(100
MCG)
MCG)
MCG)
MCG)
Prior prescription for Omeprazole in 120 days or Prevacid 24hr in 120 days or
Prevacid in 120 days or Prilosec Otc in 120 days or Prilosec in 120 days or Protonix
in 120 days
Prior prescription for Vancomycin Hcl in 120 days
Prior prescription for Captopril-hydrochlorothiazide in 120 days or Edarbyclor in
120 days or Losartan Potassium in 120 days
Prior prescription for Captopril-hydrochlorothiazide in 120 days or Edarbi in 120
days or Losartan Potassium in 120 days
Prior prescription for Edluar in 180 days or Zolpidem Tartrate Er in 180 days or
Zolpidem Tartrate in 180 days
120 days
Prior prescription for Vasotec in 120 days
Prior prescription for Differin in 120 days
Prior prescription for Differin in 120 days
Prior prescription for Captopril-hydrochlorothiazide in 120 days or Losartan
Potassium in 120 days or Teveten Hct in 120 days
Prior prescription for Captopril-hydrochlorothiazide in 120 days or Exforge Hct in
120 days or Losartan Potassium in 120 days
Prior prescription for Captopril-hydrochlorothiazide in 120 days or Exforge in 120
days or Losartan Potassium in 120 days
Atleast 2 of Prior prescription for Risperidone Odt in 365 days or Risperidone in 365
days or Seroquel in 365 days or Ziprasidone Hcl in 365 days or Zyprexa in 365 days
Atleast 2 of Prior prescription for Invokana in 365 days or Tolbutamide in 365 days
Prior prescription for Lamotrigine Odt (orange) in 120 days or Trokendi Xr in 120
days
days
days
Qvar in 365 days
Qvar in 365 days
Qvar in 365 days
Qvar in 365 days
Page 73 of 106
MCG)
Qvar in 365 days
• FLOVENT HFA(AER W/ADAP)(44 MCG) Atleast 2 of Prior prescription for Asmanex in 365 days or Pulmicort in 365 days or
Qvar in 365 days
Prior prescription for Hydromet in 120 days or Tussigon in 120 days
• FLOWTUSS
Prior prescription for Serevent Diskus in 120 days or Striverdi Respimat in 120 days
• FORADIL
Prior prescription for Wellbutrin Sr in 120 days or Wellbutrin Xl in 120 days or
• FORFIVO XL
Wellbutrin in 120 days or Zyban in 120 days
• FROVA
Prior prescription for Antiretrovirals in 120 days
• FULYZAQ
• FUZEON
Atleast 2 of Prior prescription for Divalproex Sodium Er in 365 days or Fycompa in
365 days or Lamotrigine Odt (orange) in 365 days or Levetiracetam Er in 365 days
or Neurontin in 365 days or Tegretol Xr in 365 days or Trileptal in 365 days or
Trokendi Xr in 365 days or Valproic Acid in 365 days or Zonisamide in 365 days
• GELNIQUE
120 days
• GIAZO
Prior prescription for Chlorpropamide in 120 days or Glimepiride in 120 days or
• GLYXAMBI
Glipizide-metformin in 120 days or Glucotrol Xl in 120 days or Glyburide in 120
days or Glyburide-metformin Hcl in 120 days or Glynase in 120 days or Pioglitazone
Hcl in 120 days or Pioglitazone-glimepiride in 120 days or Pioglitazone-metformin
in 120 days or Riomet in 120 days or Tolazamide in 120 days or Tolbutamide in 120
days
Prior prescription for in 120 days or Gralise in 120 days or Neurontin in 120 days
• GRALISE(TAB ER 24H)(300 MG)
• GRALISE(TAB ER 24H)(300-600 MG)
• GRALISE(TAB ER 24H)(600 MG)
Sutter Health Plus
Page 74 of 106
• GRANISETRON HCL
Zofran in 120 days
• GRANISETRON HCL(TAB)
Zofran in 120 days
• HEMANGEOL
Prior prescription for Propranolol Hcl in 120 days
Prior prescription for Neurontin in 120 days or Pramipexole Dihydrochloride in 120
days or Ropinirole Hcl in 120 days
Prior prescription for Neurontin in 120 days or Pramipexole Dihydrochloride in 120
days or Ropinirole Hcl in 120 days
• HYCOFENIX
Prior prescription for Lortuss Ex in 120 days or Virtussin Dac in 120 days
• IBANDRONATE SODIUM
Prior prescription for Fosamax in 120 days or Ibandronate Sodium in 120 days
• INCRUSE ELLIPTA
Prior prescription for Spiriva Respimat in 120 days or Spiriva in 120 days
• INDERAL XL
Prior prescription for Propranolol Hcl Er in 120 days
• INNOPRAN XL
Prior prescription for Propranolol Hcl Er in 120 days
• INTERMEZZO
Prior prescription for Intermezzo in 120 days or Zolpidem Tartrate in 120 days
• INVEGA(TAB ER 24H)(1.5 MG)
• INVIRASE(CAP)
Prior prescription for Atripla in 120 days or Isentress in 120 days or Prezista in 120
days or Reyataz in 120 days or Sustiva in 120 days
• INVIRASE(TAB)
Prior prescription for Atripla in 120 days or Isentress in 120 days or Prezista in 120
days or Reyataz in 120 days or Sustiva in 120 days
• INVOKAMET
days
• INVOKANA
days
• IRENKA
Prior prescription for Duloxetine Hcl in 120 days
• JALYN
• JARDIANCE
days
• KARBINAL ER
Prior prescription for Palgic in 120 days
• KAZANO
Prior prescription for Janumet Xr in 120 days or Januvia in 120 days or Jentadueto in
120 days or Tradjenta in 120 days
• KHEDEZLA
Atleast 2 of Prior prescription for Citalopram Hbr in 365 days or Desvenlafaxine Er
in 365 days or Khedezla in 365 days or Lexapro in 365 days or Paxil Cr in 365 days
or Remeron in 365 days or Selfemra in 365 days or Venlafaxine Hcl Er in 365 days
or Zoloft in 365 days or Zyban in 365 days
• KOMBIGLYZE XR(TBMP 24HR)(2.5Prior prescription for Janumet Xr in 120 days or Januvia in 120 days or Jentadueto in
1000MG)
• KOMBIGLYZE XR(TBMP 24HR)(5 MG- Prior prescription for Janumet Xr in 120 days or Januvia in 120 days or Jentadueto in
500MG)
• KOMBIGLYZE XR(TBMP 24HR)(5MG- Prior prescription for Janumet Xr in 120 days or Januvia in 120 days or Jentadueto in
1000MG)
• LAMICTAL XR (BLUE)
Prior prescription for Lamictal (green) in 120 days or Lamictal (orange) in 120 days
or Lamotrigine in 120 days
Page 75 of 106
• LAMICTAL XR (GREEN)
• LAMICTAL XR (ORANGE)
• LESCOL
• LEVEMIR
• LEVEMIR FLEXTOUCH
• LIVALO
• LO LOESTRIN FE
• LUZU
• MARINOL
• MIRAPEX ER
• MORGIDOX
• MYRBETRIQ
• NAMZARIC
• NATAZIA
Sutter Health Plus
Prior prescription for Lantus Solostar in 120 days or Lantus in 120 days or Toujeo
Solostar in 120 days
Prior prescription for Lantus Solostar in 120 days or Lantus in 120 days or Toujeo
Solostar in 120 days
Atleast 2 of Prior prescription for Desog-e.estradiol/e.estradiol in 365 days or
Desogestrel-ethinyl Estradiol in 365 days or Ethinyl Estradiol/drospirenone in 365
days or Ethynodiol D-ethinyl Estradiol in 365 days or Etonogestrel/ethinyl Estradiol
in 365 days or L-norgest/e.estradion-e.estrad in 365 days or Levonorgestrel in 365
days or Levonorgestrel-ethin Estradiol in 365 days or Norelgestromin/ethin.estradiol
in 365 days or Noreth-ethinyl Estradiol/iron in 365 days or Norethindrone Ac-eth
Estradiol in 365 days or Norethindrone in 365 days or Norethindrone-e.estradiol-iron
in 365 days or Norethindrone-ethinyl Estrad in 365 days or Norethindrone-mestranol
in 365 days or Norgestimate-ethinyl Estradiol in 365 days or Norgestrel-ethinyl
Estradiol in 365 days
Atleast 2 of Prior prescription for Ketoconazole in 365 days or Ringworm in 365
days
Atleast 3 of Prior prescription for Emend in 365 days or Methylprednisolone in 365
days or Zofran in 365 days
Prior prescription for Pramipexole Dihydrochloride in 120 days or Ropinirole Hcl in
120 days
Prior prescription for Oxybutynin Chloride in 120 days
Atleast 2 of Prior prescription for Donepezil Hcl Odt in 365 days or Namenda Xr in
365 days
Atleast 2 of Prior prescription for in 120 days or Desog-e.estradiol/e.estradiol in 365
days or Desogestrel-ethinyl Estradiol in 365 days or Ethinyl Estradiol/drospirenone
in 365 days or Ethynodiol D-ethinyl Estradiol in 365 days or Etonogestrel/ethinyl
Estradiol in 365 days or L-norgest/e.estradion-e.estrad in 365 days or Levonorgestrel
in 365 days or Levonorgestrel-ethin Estradiol in 365 days or
Norelgestromin/ethin.estradiol in 365 days or Noreth-ethinyl Estradiol/iron in 365
days or Norethindron-ethinyl Estradiol in 120 days or Norethindrone Ac-eth
Estradiol in 365 days or Norethindrone in 365 days or Norethindrone-e.estradiol-iron
in 365 days or Norethindrone-ethinyl Estrad in 365 days or Norethindrone-mestranol
in 365 days or Norgestimate-ethinyl Estradiol in 365 days or Norgestrel-ethinyl
Estradiol in 365 days or Norinyl 1+50 in 120 days or Ogestrel in 120 days or
Seasonique in 120 days or Sharobel in 120 days or Take Action in 120 days or Tri
legest Fe in 120 days or Trinessa Lo in 120 days or Velivet in 120 days or Vienva in
120 days or Viorele in 120 days or Zarah in 120 days or Zenchent in 120 days or
Page 76 of 106
• NEO-SYNALAR
Atleast 2 of Prior prescription for Bacitraycin Plus in 365 days or Synalar in 365
days
• NESINA
• NEUPRO
Prior prescription for Pramipexole Dihydrochloride in 120 days or Ropinirole Hcl in
120 days
• NEXIUM(CAP DR)
in 120 days
• NEXIUM(SUSP DR PKT)
in 120 days
• NIASPAN
Prior prescription for Lipitor in 365 days or Lofibra in 365 days or Lopid in 365 days
or Mevacor in 365 days or Pravastatin Sodium in 365 days or Tricor in 365 days or
Triglide in 365 days or Zocor in 365 days
• NICOTROL
Prior prescription for in 120 days or Nicotine Patch in 120 days or Nts in 120 days
• NICOTROL NS
Prior prescription for in 120 days or Nicotine Patch in 120 days or Nts in 120 days
• NOVOLIN 70-30(OTC)
Prior prescription for Humulin 70-30 in 120 days
• NOVOLIN N(OTC)
Prior prescription for Humulin N in 120 days
• NOVOLIN R(OTC)
Prior prescription for Humulin R in 120 days
• NOVOLOG FLEXPEN
• NOVOLOG MIX 70-30
Prior prescription for Humalog Mix 75-25 in 120 days
• NOVOLOG MIX 70-30 FLEXPEN
Prior prescription for Humalog Mix 75-25 in 120 days
• NOVOLOG(CARTRIDGE)
• NOVOLOG(VIAL)
• NUVARING
Prior prescription for Norgestimate-ethinyl Estradiol in 120 days
• OBREDON
Prior prescription for Hydromet in 120 days or Tussigon in 120 days
• OCELLA
Atleast 2 of Prior prescription for Levonorgestrel-eth Estradiol in 365 days or Lo
Loestrin Fe in 365 days or Loseasonique in 365 days or Microgestin Fe in 365 days
or Microgestin in 365 days or Minastrin 24 Fe in 365 days or Necon in 365 days or
Norethin-eth Estra Ferrous Fum in 365 days or Norethindron-ethinyl Estradiol in 365
days or Norinyl 1+50 in 365 days or Ogestrel in 365 days or Ovcon-50 in 365 days
or Pirmella in 365 days or Portia in 365 days or Seasonique in 365 days or Setlakin
in 365 days or Sharobel in 365 days or Sprintec in 365 days or Tarina Fe in 365 days
or Tri-legest Fe in 365 days or Tri-norinyl in 365 days or Trinessa Lo in 365 days or
Trinessa in 365 days or Trivora-28 in 365 days or Velivet in 365 days or Vienva in
365 days or Viorele in 365 days or Wera in 365 days or Zenchent in 365 days or
• OLEPTRO ER
Prior prescription for Oleptro Er in 120 days or Trazodone Hcl in 120 days
• OMNARIS
• ONFI(ORAL SUSP)
days
• ONFI(TAB)
days
• ONGLYZA
• OSENI
• OTREXUP
Prior prescription for Trexall in 120 days
• OVACE PLUS(LOTION)
Prior prescription for Ketoconazole in 120 days or Loprox in 120 days or Nizoral in
120 days
• OXTELLAR XR(TAB ER 24H)(150 MG) Atleast 2 of Prior prescription for Divalproex Sodium Er in 365 days or Lamotrigine
Page 77 of 106
• OXYTROL
• PATANASE
• PAZEO
• PENNSAID
• PEXEVA
• PRADAXA
• PRESTALIA
• PREVACID(TAB RAP DR)
• PRISTIQ ER
• PROTONIX(GRANPKT DR)
• PROTOPIC
• PURIXAN
• QNASL
• QNASL CHILDREN
• QUILLIVANT XR
• RAPAFLO
• RASUVO(AUTO INJECT)(10MG/0.2ML)
• RASUVO(AUTO INJECT)(12.5/0.25)
• RASUVO(AUTO INJECT)(7.5MG/0.15)
• RAYOS
• RELPAX
• RESCULA
• REXULTI
• RHINOCORT AQUA
• RIBASPHERE(TAB)(400 MG)
• RIBASPHERE(TAB)(600 MG)
120 days
Prior prescription for Azelastine Hcl in 120 days
Prior prescription for Pataday in 120 days
Prior prescription for Voltaren in 120 days
Prior prescription for Paxil Cr in 120 days
Atleast 2 of Prior prescription for Eliquis in 365 days or Xarelto in 365 days
Atleast 2 of Prior prescription for Captopril in 365 days or Norvasc in 365 days
Prevacid in 120 days or Prilosec in 120 days or Protonix in 120 days
Prior prescription for Omeprazole Magnesium in 120 days or Omeprazole in 120
days or Prilosec Otc in 120 days or Prilosec in 120 days or Protonix in 120 days
Prior prescription for Tacrolimus in 120 days or Topical Anti-inflammatory Steroidal
in 120 days
Prior prescription for Purinethol in 120 days
Prior prescription for Methylphenidate Hcl Cd in 120 days or Ritalin La in 120 days
Atleast 2 of Prior prescription for Otrexup in 365 days or Trexall in 365 days
Prior prescription for Prednisone in 120 days or Rayos in 120 days
Atleast 2 of Prior prescription for Travatan Z in 365 days or Xalatan in 365 days
days or Paxil Cr in 365 days or Pexeva in 365 days or Risperidone Odt in 365 days or
Risperidone in 365 days or Selfemra in 365 days or Seroquel in 365 days or
Venlafaxine Hcl Er in 365 days or Ziprasidone Hcl in 365 days or Zoloft in 365 days
or Zyprexa in 365 days
Prior prescription for Ribavirin in 120 days
Prior prescription for Ribavirin in 120 days
Page 78 of 106
• ROZEREM
Prior prescription for Lunesta in 120 days or Zaleplon in 120 days or Zolpidem
Tartrate in 120 days
• RYTARY
Prior prescription for Sinemet Cr in 120 days
• SAFYRAL
Atleast 2 of Prior prescription for in 365 days or Beyaz in 365 days or Lo Loestrin Fe
in 365 days or Loseasonique in 365 days or Microgestin Fe in 365 days or
Microgestin in 365 days or Necon in 365 days or Norethin-eth Estra Ferrous Fum in
365 days or Norethindron-ethinyl Estradiol in 365 days or Norinyl 1+50 in 365 days
or Ogestrel in 365 days or Ovcon-50 in 365 days or Pirmella in 365 days or Portia in
365 days or Seasonique in 365 days or Setlakin in 365 days or Sharobel in 365 days
or Sprintec in 365 days or Tarina Fe in 365 days or Tri-legest Fe in 365 days or Tri
norinyl in 365 days or Trinessa Lo in 365 days or Trinessa in 365 days or Trivora-28
in 365 days or Vienva in 365 days or Viorele in 365 days or Wera in 365 days or
Zenchent in 365 days or Zeosa in 365 days or Zovia 1-50e in 365 days
• SANCUSO
Zofran in 120 days
• SAPHRIS
• SAVAYSA
Atleast 2 of Prior prescription for Eliquis in 365 days or Xarelto in 365 days
• SEROQUEL XR(TAB ER 24H)
• SILENOR
Prior prescription for Lunesta in 120 days or Silenor in 120 days or Zaleplon in 120
days or Zolpidem Tartrate in 120 days
• SIMCOR(TBMP 24HR)(1000-20MG)
• SIMCOR(TBMP 24HR)(1000-40 MG)
• SIMCOR(TBMP 24HR)(500MG-20MG) Atleast 2 of Prior prescription for Lipitor in 365 days or Mevacor in 365 days or
• SITAVIG
Prior prescription for Zovirax in 120 days
• SORILUX
• SOTYLIZE
Prior prescription for Sotalol Af in 120 days or Sotalol in 120 days
• SUMAVEL DOSEPRO(NDL FR INJ)(4
Prior prescription for in 180 days or Sumatriptan Succinate in 180 days or
MG/0.5ML)
Sumatriptan in 180 days
• SUMAVEL DOSEPRO(NDL FR INJ)(6
Prior prescription for in 180 days or Sumatriptan Succinate in 180 days or
MG/0.5ML)
Sumatriptan in 180 days
• SYMBICORT
Prior prescription for Advair Hfa in 120 days or Breo Ellipta in 120 days or Dulera in
120 days
• SYNJARDY
• TACLONEX(OINT)
• TACLONEX(SUSPENSION)
• TANZEUM
days
• TASMAR
Prior prescription for Entacapone in 120 days
• TIMOPTIC OCUDOSE
Prior prescription for Timoptic Ocudose in 120 days or Timoptic in 120 days
• TIVORBEX
Prior prescription for Indomethacin in 120 days
• TOPICORT(SPRAY)
Prior prescription for Betamethasone Dipropionate in 120 days or Fluocinonide in
120 days or Mometasone Furoate in 120 days or Topicort in 120 days
• TOVIAZ
120 days
• TREXIMET
Prior prescription for Sumatriptan in 180 days or Zecuity in 180 days or Zomig Zmt
in 180 days
• TRIBENZOR
Prior prescription for Azor in 120 days or Benicar Hct in 120 days or Benicar in 120
days or Captopril-hydrochlorothiazide in 120 days or Losartan Potassium in 120 days
• TRIGLIDE
Prior prescription for Lofibra in 120 days or Lopid in 120 days or Tricor in 120 days
• TROKENDI XR(CAP ER 24H)(100 MG) Prior prescription for Topiramate in 120 days
Page 79 of 106
• TROSPIUM CHLORIDE
• TRULICITY
• TUDORZA PRESSAIR
• TUZISTRA XR
• UCERIS
• UCERIS
• ULORIC
• VECTICAL
• VELTIN
• VERAMYST
• VERSACLOZ
• VESICARE
• VIBRAMYCIN
• VICTOZA 2-PAK
• VICTOZA 3-PAK
• VIIBRYD
• VIMPAT(SOLUTION)
• VIMPAT(TAB)
• VITEKTA
• VYTORIN(TAB)(10 MG-10MG)
• VYVANSE
• XERESE
• XIGDUO XR
• XYZAL(SOLUTION)
• ZECUITY
• ZEGERID(CAP)
• ZEGERID(PACKET)
• ZETONNA
• ZIOPTAN
• ZIPSOR
Sutter Health Plus
120 days
days
Prior prescription for Spiriva Respimat in 120 days or Spiriva in 120 days
Prior prescription for Promethazine-codeine in 120 days
Prior prescription for Colazal in 120 days
Prior prescription for Mesalamine W/cleansing Wipes in 120 days or Mesalamine in
120 days
Prior prescription for Uloric in 120 days or Zyloprim in 120 days
Atleast 2 of Prior prescription for Acanya in 365 days or Ziana in 365 days
Atleast 2 of Prior prescription for Risperidone Odt in 365 days or Seroquel in 365
days or Ziprasidone Hcl in 365 days or Zyprexa Zydis in 365 days
120 days
Atleast 2 of Prior prescription for in 365 days or Divalproex Sodium Er in 365 days
or Lamotrigine Odt (orange) in 365 days or Levetiracetam Er in 365 days or
Neurontin in 365 days or Tegretol Xr in 365 days or Trileptal in 365 days or
Trokendi Xr in 365 days or Valproic Acid in 365 days
Prior prescription for Zocor in 365 days
Prior prescription for Citalopram Hbr in 120 days or Dextroamphetamine
amphetamine in 120 days or Lexapro in 120 days or Luvox Cr in 120 days or Paxil
Cr in 120 days or Ritalin-sr in 120 days or Selfemra in 120 days or Trokendi Xr in
120 days or Zoloft in 120 days
Prior prescription for Zovirax in 120 days
Atleast 2 of Prior prescription for Invokana in 365 days or Tolbutamide in 365 days
Atleast 2 of Prior prescription for Sumatriptan Succinate in 365 days or Sumatriptan
in 365 days
in 120 days
in 120 days
Prior prescription for Procentra in 120 days or Zenzedi in 120 days
Prior prescription for Procentra in 120 days or Zenzedi in 120 days
Atleast 2 of Prior prescription for Travatan Z in 365 days or Xalatan in 365 days
Prior prescription for Diclofenac Sodium-misoprostol in 120 days or Voltaren-xr in
120 days
Page 80 of 106
• ZITHRANOL
• ZITHRANOL-RR
• ZOCOR(TAB)(80 MG)
• ZOLPIMIST
• ZOMIG(SPRAY)(2.5 MG)
• ZOMIG(SPRAY)(5 MG)
• ZOMIG(TAB)
• ZORVOLEX
Sutter Health Plus
Prior prescription for Vytorin in 365 days
Prior prescription for Zolpidem Tartrate in 120 days
Prior prescription for Voltaren-xr in 120 days
Prior prescription for Zofran in 120 days
Prior prescription for Zofran in 120 days
Page 81 of 106
PRIOR AUTHORIZATION RESTRICTIONS
• ABRAXANE
• ABSTRAL
• ACTEMRA
• ACTIQ
• ADCETRIS
• ADCIRCA
• ADDYI
• ADEMPAS
• AFINITOR DISPERZ
• AFREZZA(CART W/DEV)(4 UNIT(30))
• AFREZZA(CART W/DEV)(4 UNIT)
• ALDARA
• ALECENSA
• ALIMTA
• AMPYRA
• ANADROL-50
• ANDRODERM
• ANDROGEL(GEL MD PMP)
• ANDROGEL(GEL PACKET)(1.25G-1.62)
• ANDROGEL(GEL PACKET)(2.5G-1.62%)
• ANDROGEL(GEL PACKET)(25MG(1%))
• APOKYN
• APTIVUS
• ARANESP
• AROMASIN
• ARZERRA
• AUBAGIO
• AVASTIN
• AVONEX
• AVONEX ADMINISTRATION PACK
• AVONEX PEN
• AXIRON
• BELEODAQ
• BERINERT
• BETASERON
• BETHKIS
• BIVIGAM
• BLINCYTO
• BUNAVAIL
• BUPRENORPHINE-NALOXONE
• CARIMUNE NF NANOFILTERED
• CAVERJECT
• CAYSTON
• CHOLBAM
• CIALIS
• CIMZIA
• CINRYZE
• COMETRIQ
• COMPLERA
• COPAXONE
• CORLANOR
• COSENTYX (2 SYRINGES)
Sutter Health Plus
• COSENTYX PEN
• COSENTYX PEN (2 PENS)
• COSENTYX SYRINGE
• COTELLIC
• CYRAMZA
• CYSTARAN
• DAKLINZA
• DARAPRIM
• DELATESTRYL
• DEPO-TESTOSTERONE
• DUOPA
• DURAGESIC
• EDEX
• EDURANT
• EGRIFTA
• ELIGARD
• ENBREL
• ENTRESTO
• ENTYVIO
• EPOGEN
• ERBITUX
• ERIVEDGE
• ERWINAZE
• ESBRIET
• EVEKEO
• EVISTA
• EXTAVIA
• EYLEA
• FARESTON
• FARYDAK
• FASLODEX
• FENTANYL
• FENTORA
• FIRAZYR
• FLEBOGAMMA DIF
• FLOLAN
• FORTESTA
• GAMASTAN S-D
• GAMMAGARD LIQUID
• GAMMAGARD S-D
• GAMMAKED
• GAMMAPLEX
• GAMUNEX-C
• GATTEX
• GAZYVA
• GENOTROPIN
• GILENYA
• GILOTRIF
• GRANIX
• GRASTEK
• H.P. ACTHAR
• HALAVEN
• HARVONI
• HERCEPTIN
• HETLIOZ
• HIZENTRA
• HUMATROPE
• HUMIRA
• HUMIRA PEDIATRIC CROHN'S
• HUMIRA PEN
Page 82 of 106
• HUMIRA PEN CROHN'S-UC-HS
• HUMIRA PEN PSORIASIS
• HYQVIA
• IBRANCE
• IMBRUVICA
• IMLYGIC
• INCRELEX
• INTELENCE
• INTRON A
• IPRIVASK
• IRESSA
• ISTODAX
• IXEMPRA
• JAKAFI
• JUXTAPID
• KADCYLA
• KALBITOR
• KALYDECO
• KANUMA
• KERYDIN
• KEVEYIS
• KEYTRUDA
• KINERET
• KITABIS PAK
• KORLYM
• KYNAMRO
• KYPROLIS
• LAZANDA
• LEMTRADA
• LENVIMA
• LEUKINE
• LEVITRA
• LEXIVA
• LONSURF
• LUCENTIS
• LYNPARZA
• MACUGEN
• MAKENA
• MARQIBO
• MEKINIST
• MIRCERA
• MITOXANTRONE HCL
• MUSE
• NATESTO
• NATPARA
• NEULASTA
• NEUPOGEN
• NEXAVAR
• NINLARO
• NORDITROPIN FLEXPRO
• NORTHERA
• NUCALA
• NUEDEXTA
• NUTROPIN AQ
• NUTROPIN AQ NUSPIN
• NUVIGIL
• NYMALIZE
• OCTAGAM
• ODOMZO
• OFEV
Sutter Health Plus
• OLYSIO
• OMNITROPE
• ONCASPAR
• ONIVYDE
• OPDIVO
• OPSUMIT
• ORALAIR
• ORENCIA
• ORENITRAM ER
• ORKAMBI
• OSPHENA
• OTEZLA
• OXANDRIN
• PEGASYS
• PEGASYS PROCLICK
• PEGINTRON
• PEGINTRON REDIPEN
• PERJETA
• PHOTOFRIN
• PLEGRIDY
• PLEGRIDY PEN
• POMALYST
• PRALUENT PEN
• PRALUENT SYRINGE
• PRIVIGEN
• PROCRIT
• PROCYSBI
• PROLIA
• PROMACTA
• PROVIGIL
• PULMOZYME
• QUTENZA
• RAGWITEK
• RAVICTI
• REBIF
• REBIF REBIDOSE
• RELISTOR
• REMICADE
• REMODULIN
• REPATHA SURECLICK
• REPATHA SYRINGE
• REVATIO(SUSP RECON)
• REVATIO(TAB)
• REVLIMID
• RITUXAN
• RUCONEST
• SAIZEN
• SELZENTRY
• SEROSTIM
• SIMPONI
• SIMPONI ARIA
• SIRTURO
• SIVEXTRO
• SIVEXTRO(TAB)
• SOLARAZE
• SOLIRIS
• SOVALDI
• STAXYN
Page 83 of 106
• STELARA
• STENDRA
• STIVARGA
• STRIANT
• SUBOXONE
• SUBSYS
• SUCRAID
• SUTENT
• SYLVANT
• SYNAGIS
• SYNRIBO
• TAFINLAR
• TAGRISSO
• TARCEVA
• TARGRETIN
• TARGRETIN
• TASIGNA
• TECFIDERA
• TECHNIVIE
• TEKAMLO
• TEKTURNA
• TEKTURNA HCT
• TEMODAR
• TEMODAR(CAP)
• TEMODAR(VIAL)
• THALOMID
• TIVICAY
• TOBI
• TOBI PODHALER
• TORISEL
• TRACLEER
• TRIZIVIR
• TYBOST
• TYKERB
• TYSABRI
• TYVASO
• UNITUXIN
• UPTRAVI
• VALCHLOR
• VECAMYL
• VECTIBIX
• VELCADE
• VELETRI
• VENTAVIS
• VIAGRA
• VIBERZI
• VIEKIRA PAK
• VOGELXO
• VOTRIENT
• XALKORI
• XELJANZ
• XENAZINE
• XGEVA
• XIFAXAN(TAB)(550 MG)
• XOLAIR
• XTANDI
• XYREM
• YERVOY
• YONDELIS
• ZALTRAP
• ZARXIO
• ZELBORAF
Sutter Health Plus
• ZOLADEX
• ZOMACTON
• ZORBTIVE
• ZUBSOLV
• ZYCLARA(CREAM PACK)
• ZYCLARA(CRM MD PMP)(2.5 %)
• ZYCLARA(CRM MD PMP)(3.75 %)
• ZYDELIG
• ZYKADIA
• ZYTIGA
• ZYVOX(TAB)
Page 84 of 106
GENDER LIMITS
• APRI
• AVODART
• AZURETTE
• BEYAZ
• CAMRESE
• CAYA CONTOURED
• CONCEPTROL(OTC)
• CRYSELLE
• ELLA
• FOLIC ACID(OTC)
• GYNOL II(OTC)
• JALYN
• KELNOR 1-35
• LEVORA-28
• LO LOESTRIN FE
• LOESTRIN
• MICROGESTIN
• MICROGESTIN FE
• MINASTRIN 24 FE
• MY WAY(OTC)
• NATAZIA
• NECON
• NORA-BE
• NORETHIN-ETH ESTRA
FERROUS FUM
• NORINYL 1+50
• NUVARING
• OCELLA
• ORTHO EVRA
• ORTHO-NOVUM
• QUARTETTE
• RAPAFLO
• SAFYRAL
• SPRINTEC
• TODAY CONTRACEPTIVE
SPONGE(OTC)
• VCF(OTC)
• WIDE SEAL DIAPHRAGM
Sutter Health Plus
Female Only,
Male Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Male Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Male Only,
Female Only,
Female Only,
Female Only,
Female Only,
Female Only,
Page 85 of 106
Index
-#
0.9 % SODIUM CHLORIDE............................................ 27
2TEK(OTC)....................................................................... 23
8-MOP............................................................................... 19
-A
ABACAVIR SULFATE..................................................... 40
ABACAVIR SULFATE/LAMIVUDINE...........................40
ABACAVIR/DOLUTEGRAVIR/LAMIVUDI.................. 40
ABACAVIR/LAMIVUDINE/ZIDOVUDINE...................40
ABATACEPT..................................................................... 41
ABATACEPT/MALTOSE................................................. 41
ABCIXIMAB.................................................................... 33
ABELCET......................................................................... 38
ABILIFY..................................................................7, 62, 70
ABILIFY MAINTENA....................................................... 7
ABIRATERONE ACETATE............................................. 45
ABRAXANE............................................................... 47, 82
ABSORICA................................................................. 14, 70
ABSTRAL................................................................... 49, 82
ACAMPROSATE CALCIUM............................................. 7
ACANYA........................................................................... 15
ACARBOSE...................................................................... 20
ACCOLATE.........................................................................5
ACCU-CHEK AVIVA PLUS(OTC)............................ 21, 70
ACCU-CHEK AVIVA(OTC).......................................21, 70
ACCU-CHEK COMPACT PLUS(OTC)..................... 22, 70
ACCU-CHEK COMPACT(OTC)................................ 22, 70
ACCU-CHEK FASTCLIX(OTC)................................ 25, 62
ACCU-CHEK SMARTVIEW(OTC)........................... 21, 70
ACCU-CHEK SOFTCLIX(OTC)................................25, 62
ACCU-CHEK(OTC).................................................... 25, 62
ACCUPRIL........................................................................ 10
ACCURETIC....................................................................... 9
ACCUTREND GLUCOSE(OTC)............................... 21, 70
ACD................................................................................... 32
ACEBUTOLOL HCL........................................................ 10
ACEON.............................................................................. 10
ACETAMINOPHEN......................................................... 49
ACETAMINOPHEN WITH CODEINE........................... 51
ACETAMINOPHEN-CODEINE.......................................51
ACETAZOLAMIDE.......................................................... 30
ACETAZOLAMIDE SODIUM......................................... 30
ACETIC ACID............................................................ 18, 26
ACETIC ACID/ALUMINUM ACETATE .........................26
ACETIC ACID/HYDROCORTISONE............................. 26
ACETIC ACID/OXYQUINOLINE...................................55
ACETIC ACID-ALUMINUM...........................................26
ACETOHYDROXAMIC ACID........................................ 44
ACETYLCHOLINE CHLORIDE..................................... 30
ACETYLCYSTEINE........................................................ 48
ACIPHEX.................................................................... 54, 62
ACIPHEX SPRINKLE.......................................... 54, 62, 70
ACITRETIN...................................................................... 19
ACLIDINIUM BROMIDE.................................................. 5
ACTEMRA.................................................................. 42, 82
ACTHREL......................................................................... 27
ACTICLATE.......................................................... 37, 62, 70
ACTIGALL....................................................................... 44
ACTIMMUNE................................................................... 35
ACTIQ......................................................................... 49, 82
ACTIVASE........................................................................ 33
ACTIVE FE....................................................................... 56
ACTIVE OB...................................................................... 57
ACTONEL(TAB)(150 MG).................................. 28, 62, 70
ACTONEL(TAB)(30 MG).................................... 28, 62, 70
ACTONEL(TAB)(35 MG).................................... 28, 62, 70
ACTONEL(TAB)(5 MG)...................................... 28, 62, 70
ACTOPLUS MET....................................................... 21, 70
ACTOPLUS MET XR................................................. 21, 70
ACTOS.............................................................................. 20
ACULAR........................................................................... 29
ACULAR LS..................................................................... 29
ACURA TEST STRIPS(OTC).......................................... 21
ACUVAIL.......................................................................... 29
ACYCLOVIR.............................................................. 16, 39
ACYCLOVIR SODIUM....................................................39
ACYCLOVIR/HYDROCORTISONE............................... 16
ACZONE........................................................................... 15
ADALAT CC..................................................................... 11
ADALIMUMAB............................................................... 41
ADAPALENE.................................................................... 15
ADAPALENE/BENZOYL PEROXIDE............................14
ADASUVE.......................................................................... 7
ADAZIN............................................................................ 19
ADCETRIS.................................................................. 47, 82
ADCIRCA................................................................... 11, 82
ADDAMEL N....................................................................56
ADDERALL.................................................................. 7, 62
ADDYI..................................................................... 8, 62, 82
ADEFOVIR DIPIVOXIL.................................................. 40
ADEMPAS...................................................................11, 82
ADENOCARD.................................................................... 9
Sutter Health Plus
ADENOSINE...................................................................... 9
ADENOVIRUS TYPE 4....................................................35
ADENOVIRUS TYPE 4 AND TYPE 7............................ 35
ADENOVIRUS TYPE 7....................................................35
ADENOVIRUS VAC LIVE TYPE-4 & 7......................... 35
ADENOVIRUS VACCINE LIVE TYPE-4....................... 35
ADENOVIRUS VACCINE LIVE TYPE-7....................... 35
ADJUSTABLE LANCING DEVICE(OTC)............... 24, 62
ADO-TRASTUZUMAB EMTANSINE............................47
ADOXA................................................................. 38, 62, 70
ADRENACLICK............................................................... 45
ADRENALIN...................................................................... 4
ADRENALIN CHLORIDE............................................... 14
ADVAIR DISKUS......................................................... 5, 62
ADVAIR HFA................................................................ 5, 62
ADVANCED AM/PM....................................................... 56
ADVANCED GLUCOSE METER(OTC)......................... 23
ADVANCED GLUCOSE TEST STRIPS(OTC)............... 21
ADVANCED LANCING DEVICE(OTC).................. 25, 62
ADVATE............................................................................ 31
ADVATE H........................................................................ 31
ADVATE L.........................................................................31
ADVATE M....................................................................... 31
ADVATE SH...................................................................... 31
ADVATE UH..................................................................... 31
ADVICOR(TBMP 24HR)(1000-20MG)...............12, 62, 70
ADVICOR(TBMP 24HR)(1000-40 MG)..............12, 62, 70
ADVICOR(TBMP 24HR)(500MG-20MG).......... 12, 62, 70
ADVICOR(TBMP 24HR)(750MG-20MG).......... 12, 62, 70
ADVOCATE BLOOD GLUCOSE MONITOR(OTC)......
23
ADVOCATE DUO(OTC).................................................. 23
ADVOCATE LANCING DEVICE(OTC)................... 24, 62
ADVOCATE RAPID-SAFE(OTC)............................. 24, 62
ADVOCATE REDI-CODE(OTC)............................... 21, 23
ADVOCATE REDI-CODE+(OTC)............................. 21, 23
ADVOCATE TEST STRIP(OTC)..................................... 21
ADYNOVATE....................................................................31
AEROSPAN............................................................. 5, 62, 70
AFATINIB DIMALEATE................................................. 46
AFINITOR DISPERZ........................................... 46, 62, 82
AFINITOR(TAB)(10 MG).................................... 46, 62, 82
AFINITOR(TAB)(2.5 MG)................................... 46, 62, 82
AFINITOR(TAB)(5 MG)...................................... 46, 62, 82
AFINITOR(TAB)(7.5 MG)................................... 46, 62, 82
AFLIBERCEPT................................................................. 30
AFREZZA(CART W/DEV)(4 UNIT(30))............ 26, 62, 82
AFREZZA(CART W/DEV)(4 UNIT)...................26, 62, 82
AGAMATRIX AMP(OTC)......................................... 21, 23
AGGRASTAT.................................................................... 33
AGGRENOX..................................................................... 33
AGRYLIN.......................................................................... 33
AKTEN.............................................................................. 29
AKYNZEO.................................................................... 4, 62
ALA-QUIN........................................................................ 15
ALBENDAZOLE.............................................................. 39
ALBENZA......................................................................... 39
ALBIGLUTIDE................................................................. 20
ALBUKED-25................................................................... 33
ALBUKED-5..................................................................... 33
ALBUMIN (HUMAN)...................................................... 33
ALBUMIN HUMAN.........................................................33
ALBUMINAR-25.............................................................. 33
ALBUMINAR-5................................................................ 33
ALBURX........................................................................... 33
ALBUTEIN....................................................................... 33
ALBUTEROL SULFATE................................................ 4, 5
ALCAFTADINE................................................................ 29
ALCLOMETASONE DIPROPIONATE........................... 16
ALCORTIN A................................................................... 15
ALDACTAZIDE(TAB)(25 MG-25MG)............................11
ALDACTAZIDE(TAB)(50 MG-50MG)............................11
ALDACTONE................................................................... 11
ALDARA............................................................... 35, 62, 82
ALDESLEUKIN................................................................35
ALECENSA.......................................................... 46, 62, 82
ALECTINIB HYDROCHLORIDE................................... 46
ALEMTUZUMAB............................................................ 48
ALENDRONATE SODIUM............................................. 28
ALENDRONATE SODIUM(SOLUTION).................28, 62
ALENDRONATE SODIUM(TAB)................................... 28
ALENDRONATE SODIUM/VITAMIN D3......................28
ALEVICYN ANTIPRURITIC SG.................................... 18
ALFENTA......................................................................... 49
ALFENTANIL HCL.......................................................... 49
ALFERON N..................................................................... 35
ALFUZOSIN HCL............................................................ 54
ALIMTA...................................................................... 46, 82
ALINIA..............................................................................15
ALIROCUMAB.................................................................12
ALISKIREN HEMIFUMARATE..................................... 11
ALISKIREN/AMLODIPINE BESYLATE....................... 11
ALISKIREN/HYDROCHLOROTHIAZIDE.................... 12
ALITRETINOIN............................................................... 19
ALKERAN.................................................................. 45, 62
ALLERG EX-ALTERNARIA ALTERNATA..................... 3
ALLERG EXT-AMERICAN COCKROACH.....................3
ALLERG EXT-PENICILLIUM NOTATUM...................... 3
ALLERG EXT-TREE POLLEN-PECAN........................... 3
ALLERGEN EXT-ASPERGILLUS FUMIG...................... 3
ALLERGEN EXT-AUREOBA.PULLULANS................... 3
ALLERGEN EXT-C.CLADOSPORIOIDES...................... 3
ALLERGEN EXT-C.SPHAEROSPERMUM..................... 3
ALLERGEN EXT-CANDIDA ALBICANS....................... 3
ALLERGEN EXTRACT-D.SOROKINIANA.....................3
ALLERGEN EXTRACT-S. CEREVISIAE........................ 3
ALLERGENIC EX-HORSE EPITHELIUM...................... 3
ALLERGENIC EXT-DOG EPITHELIUM.........................3
ALLERGENIC EXT-MUCOR PLUMBEUS..................... 3
ALLERGENIC EXT-PHOMA HERBARUM.....................3
ALLERGENIC EXT-RHIZOPUS ORYZAE...................... 3
ALLERGENIC XT-EPICOCCUM NIGRUM.....................3
ALLOPURINOL............................................................... 31
ALLOPURINOL SODIUM...............................................31
ALMOTRIPTAN MALATE.............................................. 50
ALOCRIL.......................................................................... 30
ALOGLIPTIN BENZ/METFORMIN HCL...................... 20
ALOGLIPTIN BENZ/PIOGLITAZONE.......................... 20
ALOGLIPTIN BENZOATE.............................................. 20
ALOMIDE......................................................................... 30
ALOPRIM......................................................................... 31
ALOQUIN......................................................................... 15
ALORA........................................................................34, 62
ALOSETRON HCL........................................................... 44
ALOXI................................................................................. 4
ALPHA-1-PROTEINASE INHIBITOR............................ 45
ALPHAGAN P(DROPS)(0.1 %)....................................... 30
ALPHAGAN P(DROPS)(0.15 %)..................................... 30
ALPHANATE.................................................................... 31
ALPHANINE SD.............................................................. 32
ALPRAZOLAM.................................................................. 7
ALPRAZOLAM INTENSOL............................................. 7
ALPROLIX........................................................................ 32
ALPROSTADIL...........................................................12, 27
ALREX.............................................................................. 29
ALSUMA.................................................................... 51, 62
ALTABAX......................................................................... 16
ALTACE............................................................................ 10
ALTEPLASE..................................................................... 33
ALTERNARIA.................................................................... 3
ALTERNATE SITE LANCING DEVICE(OTC)........ 25, 62
ALTOPREV........................................................... 12, 62, 70
ALTRETAMINE................................................................45
ALUMINUM CHLORIDE................................................ 17
ALUVEA........................................................................... 18
ALVESCO............................................................... 5, 62, 70
ALVIMOPAN.................................................................... 45
AMANTADINE.................................................................51
AMANTADINE HCL........................................................51
AMARYL.......................................................................... 20
AMBIEN........................................................................8, 62
AMBISOME...................................................................... 38
AMBRISENTAN............................................................... 11
AMCINONIDE..................................................................16
AMERGE.................................................................... 51, 62
AMERICAN COCKROACH EXTRACT........................... 3
AMERICAN ELM...............................................................3
AMERICAN SYCAMORE................................................. 3
AMICAR........................................................................... 31
AMIFOSTINE................................................................... 47
AMIFOSTINE CRYSTALLINE....................................... 47
AMIKACIN SULFATE..................................................... 38
AMILORIDE HCL............................................................ 11
AMILORIDE/HYDROCHLOROTHIAZIDE................... 11
AMILORIDE-HYDROCHLOROTHIAZIDE...................11
AMINOACETIC ACID..................................................... 38
AMINOCAPROIC ACID.................................................. 31
AMINOLEVULINIC ACID HCL.....................................47
AMINOPHYLLINE............................................................ 5
AMINOSALICYLIC ACID.............................................. 38
AMIODARONE HCL......................................................... 9
AMIODARONE HCL/D5W................................................9
AMIODARONE HCL-D5W............................................... 9
AMIODARONE IN DEXTROSE,ISO-OSM...................... 9
AMITIZA.................................................................... 44, 62
AMITRIP HCL/CHLORDIAZEPOXIDE...........................6
AMITRIPTYLINE HCL..................................................... 6
AMLODIPINE BES/OLMESARTAN MED.................... 10
AMLODIPINE BESYLATE............................................. 11
AMLODIPINE BESYLATE/BENAZEPRIL...................... 9
AMLODIPINE/ATORVASTATIN.....................................13
AMLODIPINE/VALSARTAN.......................................... 10
Page 86 of 106
�
Index
AMLODIPINE/VALSARTAN/HCTHIAZID..................... 9
AMMONIUM CHLORIDE...............................................11
AMMONIUM LACTATE..................................................18
AMMONUL...................................................................... 44
AMOBARBITAL SODIUM................................................ 8
AMOXAPINE..................................................................... 6
AMOXICILLIN................................................................. 37
AMOXICILLIN/POTASSIUM CLAV.............................. 37
AMOXICILLIN-CLAVULANATE POTASS................... 37
AMPHADASE...................................................................19
AMPHETAMINE SULFATE.............................................. 6
AMPHOTERICIN B..........................................................38
AMPHOTERICIN B LIPID COMPLEX.......................... 38
AMPHOTERICIN B LIPOSOME.....................................38
AMPICILLIN SODIUM................................................... 37
AMPICILLIN SODIUM/SULBACTAM NA....................37
AMPICILLIN TRIHYDRATE.......................................... 37
AMPICILLIN-SULBACTAM........................................... 37
AMPYRA.................................................................... 48, 82
AMRIX.............................................................................. 53
AMYL NITRITE............................................................... 13
AMYTAL SODIUM............................................................ 8
ANACAINE....................................................................... 19
ANADROL-50............................................................. 34, 82
ANAFRANIL...................................................................... 6
ANAGRELIDE HCL......................................................... 33
ANAKINRA...................................................................... 41
ANA-LEX.......................................................................... 44
ANALPRAM E..................................................................44
ANALPRAM HC.............................................................. 18
ANALPRAM HC(CREAM/APPL)(1 %-1 %).................. 44
ANALPRAM HC(CREAM/APPL)(2.5 %-1 %)............... 44
ANALPRAM HC(CREAM/APPL)(2.5-1%(4G)).............44
ANALPRAM HC(LOTION)............................................. 44
ANAPROX........................................................................ 43
ANAPROX DS.................................................................. 43
ANASTROZOLE.............................................................. 46
ANCOBON........................................................................38
ANDRODERM............................................................ 34, 82
ANDROGEL(GEL MD PMP).....................................34, 82
ANDROGEL(GEL PACKET)(1.25G-1.62)................ 34, 82
ANDROGEL(GEL PACKET)(2.5G-1.62%)...............34, 82
ANDROGEL(GEL PACKET)(25MG(1%))................34, 82
ANDROXY.................................................................. 34, 62
ANGELIQ..........................................................................34
ANGIOMAX..................................................................... 33
ANIDULAFUNGIN.......................................................... 38
ANIMI-3............................................................................ 56
ANORO ELLIPTA.................................................. 5, 62, 70
ANTABUSE........................................................................ 7
ANTARA..................................................................... 13, 70
ANTHRALIN.................................................................... 19
ANTHRALIN MICRONIZED.......................................... 19
ANTIHEMO.FVIII,FULL LENGTH PEG....................... 31
ANTIHEMOPH.FVIII REC,FC FUSION.........................31
ANTIHEMOPH.FVIII,B-DOM TRUNCAT..................... 31
ANTIHEMOPH.FVIII,B-DOMAIN DEL.........................31
ANTIHEMOPH.FVIII,FULL LENGTH...........................31
ANTIHEMOPH.FVIII,HEK B-DELETE......................... 31
ANTIHEMOPHILIC FACTOR, HUM REC.....................31
ANTIHEMOPHILIC FACTOR, HUMAN........................31
ANTIHEMOPHILIC FACTOR/VWF...............................31
ANTIHEMOPHILIC FVIII,REC PORC...........................32
ANTI-INHIBITOR COAGULANT COMP.......................32
ANTIPYRINE/BENZOCAIN/GLY/ZINC........................26
ANTIPYRINE/BENZOCAINE......................................... 26
ANTIPYRINE-BENZOCAINE........................................ 26
ANTITHROMBIN III (HUM PLAS)................................ 33
ANTITHROMBIN III, HUMAN RECOMB.....................33
ANTIVERT..........................................................................4
ANZEMET(TAB)(100 MG).................................... 4, 62, 70
ANZEMET(TAB)(50 MG)...................................... 4, 62, 70
ANZEMET(VIAL).............................................................. 4
APEXICON E.................................................................... 17
APIDRA................................................................ 26, 62, 70
APIDRA SOLOSTAR........................................... 26, 62, 70
APIXABAN....................................................................... 32
APLENZIN.............................................................. 6, 62, 70
APOKYN............................................................... 51, 62, 82
APOMORPHINE HCL..................................................... 51
APRACLONIDINE HCL.................................................. 30
APREMILAST.................................................................. 41
APREPITANT..................................................................... 4
APRI............................................................................ 13, 85
APRISO............................................................................. 43
APTENSIO XR................................................. 8, 61, 62, 70
APTIOM(TAB)(200 MG)......................................52, 62, 70
APTIOM(TAB)(400 MG)......................................52, 62, 71
APTIOM(TAB)(600 MG)......................................52, 62, 71
APTIOM(TAB)(800 MG)......................................52, 62, 71
APTIVUS.................................................................... 40, 82
AQUA GLYCOLIC HC..................................................... 17
Sutter Health Plus
AQUA LANCE LANCING DEVICE(OTC)...............25, 62
AQUASOL A.....................................................................59
ARALAST NP................................................................... 45
ARANESP................................................................... 32, 82
ARAVA.............................................................................. 41
ARCALYST.......................................................................41
ARCAPTA NEOHALER........................................ 5, 62, 71
ARESTIN.......................................................................... 48
ARFORMOTEROL TARTRATE........................................ 5
ARGATROBAN................................................................ 33
ARGATROBAN IN 0.9 % SOD CHLOR......................... 33
ARGATROBAN IN NACL,ISO-OSMOTIC.....................33
ARGATROBAN-0.9% NACL........................................... 33
ARGATROBAN-SODIUM CHLORIDE.......................... 33
ARICEPT............................................................................. 6
ARIMIDEX....................................................................... 46
ARIPIPRAZOLE..................................................... 7, 62, 71
ARIPIPRAZOLE LAUROXIL............................................ 7
ARISTADA..........................................................................7
ARISTOSPAN................................................................... 42
ARIXTRA(SYRINGE)(10MG/0.8ML)...................... 32, 62
ARIXTRA(SYRINGE)(2.5 MG/0.5).......................... 32, 62
ARIXTRA(SYRINGE)(5MG/0.4ML)........................ 32, 62
ARIXTRA(SYRINGE)(7.5MG/0.6)........................... 32, 62
ARMODAFINIL................................................................. 8
ARMOUR THYROID....................................................... 29
ARNUITY ELLIPTA.............................................. 5, 62, 71
AROMASIN.......................................................... 46, 62, 82
ARRANON........................................................................46
ARSENIC TRIOXIDE...................................................... 47
ARTEMETHER/LUMEFANTRINE................................. 39
ARTHROTEC 50............................................................... 42
ARTHROTEC 75............................................................... 42
ARTICADENT DENTAL................................................. 43
ARTICAINE/EPINEPHRINE BITART............................ 43
ARZERRA................................................................... 45, 82
ASACOL HD............................................................... 43, 71
ASCORBIC ACID.............................................................60
ASENAPINE MALEATE....................................................7
ASMANEX....................................................................5, 62
ASMANEX HFA........................................................... 5, 62
ASPARAGINASE (ERWINIA CHRYSAN)..................... 47
ASPERGILLUS FUMIGATUS........................................... 3
ASPIRIN............................................................................ 49
ASPIRIN EC(OTC)........................................................... 49
ASPIRIN/DIPYRIDAMOLE............................................ 33
ASSURE 4(OTC).............................................................. 21
ASSURE PLATINUM(OTC)...................................... 21, 23
ASSURE PRISM MULTI(OTC)................................. 21, 23
ASTAGRAF XL................................................................ 35
ASTEPRO................................................................ 4, 62, 71
ASTRINGYN.................................................................... 33
ATABEX EC...................................................................... 57
ATACAND......................................................................... 10
ATACAND HCT................................................................ 10
ATAZANAVIR SULFATE................................................. 40
ATAZANAVIR SULFATE/COBICISTAT......................... 40
ATENOLOL...................................................................... 10
ATENOLOL/CHLORTHALIDONE................................. 10
ATGAM............................................................................. 35
ATIVAN........................................................................... 7, 8
ATOMOXETINE HCL.................................................... 8, 9
ATORVASTATIN CALCIUM........................................... 12
ATOVAQUONE................................................................. 39
ATOVAQUONE/PROGUANIL HCL................................ 39
ATRALIN.................................................................... 15, 61
ATRIPLA..................................................................... 40, 62
ATROPINE SULFATE................................................ 30, 53
ATROPINE SULFATE IN 0.9% NACL............................ 53
ATROPINE SULFATE-0.9% NACL................................. 53
ATROVENT.......................................................................48
ATROVENT HFA.......................................................... 5, 62
ATRYN.............................................................................. 33
AUBAGIO................................................................... 48, 82
AUGMENTIN ES-600...................................................... 37
AUGMENTIN(SUSP RECON)(125-31.25/).................... 37
AUGMENTIN(SUSP RECON)(250-62.5/5).................... 37
AUGMENTIN(TAB)......................................................... 37
AURANOFIN.................................................................... 42
AUREOBASIDIUM(VIAL)(10000/ML)............................ 3
AUREOBASIDIUM(VIAL)(20000/ML)............................ 3
AURYXIA................................................................... 26, 62
AUTO-LANCET MINI(OTC)..................................... 25, 62
AUTOLET IMPRESSION(OTC)................................ 25, 62
AUTOLET LANCING DEVICE(OTC)...................... 25, 62
AUVI-Q....................................................................... 45, 71
AVALIDE...........................................................................10
AVANAFIL........................................................................ 27
AVANDAMET............................................................. 21, 71
AVANDIA.................................................................... 20, 71
AVAPRO............................................................................ 10
AVAR LS........................................................................... 16
AVAR(CLEANSER).......................................................... 16
AVAR(FOAM)................................................................... 16
AVAR(MED PAD)............................................................. 16
AVAR-E LS........................................................................16
AVASTIN..................................................................... 46, 82
AVC................................................................................... 55
AVEED.............................................................................. 34
AVELOX............................................................................37
AVELOX IV...................................................................... 37
AVIDOXY............................................................. 38, 62, 71
AVIDOXY DK.......................................................38, 62, 71
AVITENE...........................................................................33
AVODART............................................................. 54, 71, 85
AVONEX..................................................................... 48, 82
AVONEX ADMINISTRATION PACK.......................48, 82
AVONEX PEN.............................................................48, 82
AVYCAZ........................................................................... 36
AXERT.................................................................. 50, 62, 71
AXIRON...................................................................... 34, 82
AXITINIB..........................................................................46
AYGESTIN........................................................................ 34
AZACITIDINE.................................................................. 45
AZACTAM........................................................................ 35
AZACTAM-ISO-OSMOTIC DEXTROSE....................... 36
AZASAN........................................................................... 35
AZASITE........................................................................... 29
AZATHIOPRINE.............................................................. 35
AZELAIC ACID..........................................................14, 15
AZELASTINE HCL................................................ 4, 29, 62
AZELASTINE/FLUTICASONE........................................ 4
AZELEX............................................................................ 14
AZILECT..................................................................... 51, 62
AZILSARTAN MED/CHLORTHALIDONE................... 10
AZILSARTAN MEDOXOMIL......................................... 10
AZITHROMYCIN.......................................................29, 36
AZOPT.............................................................................. 30
AZOR.......................................................................... 10, 71
AZTREONAM.................................................................. 35
AZTREONAM LYSINE....................................................35
AZTREONAM/DEXTROSE-WATER..............................36
AZURETTE................................................................. 13, 85
-B
B CMPLX 4/VIT D3/C/FA/ZINC OX.............................. 59
B COMPLEX & C NO.20/FOLIC ACID..........................59
B-12 COMPLIANCE........................................................ 60
BACIIM............................................................................. 15
BACITRACIN............................................................. 15, 29
BACITRACIN/POLYMYXIN B SULFATE..................... 29
BACITRACIN-POLYMYXIN.......................................... 29
BACLOFEN...................................................................... 53
BACMIN............................................................................56
BACTRIM......................................................................... 35
BACTRIM DS................................................................... 35
BACTROBAN................................................................... 15
BACTROBAN NASAL..................................................... 48
BAHIA................................................................................. 3
BALANCED SALT........................................................... 30
BALANCED SALT IRRIG SOLN NO.1.......................... 30
BALANCED SALT IRRIG SOLN NO.2.......................... 30
BAL-CARE DHA.............................................................. 58
BAL-CARE DHA ESSENTIAL....................................... 58
BALSALAZIDE DISODIUM........................................... 43
BANZEL(ORAL SUSP)........................................52, 62, 71
BANZEL(TAB)(200 MG)..................................... 52, 62, 71
BANZEL(TAB)(400 MG)..................................... 52, 62, 71
BARACLUDE................................................................... 40
BASILIXIMAB................................................................. 35
BAYBERRY........................................................................ 3
B-CAINE/ZINC CL/PINE/CPYRD.................................. 43
B-COMPLEX.................................................................... 59
B-DONNA......................................................................... 53
BEBULIN.......................................................................... 32
BECAPLERMIN............................................................... 25
BECLOMETHASONE DIPROPIONATE...................... 4, 5
BECONASE AQ......................................................4, 62, 71
BEDAQUILINE FUMARATE.......................................... 38
BELATACEPT................................................................... 35
BELBUCA......................................................................... 49
BELEODAQ................................................................ 47, 82
BELINOSTAT................................................................... 47
BELLADONNA-OPIUM.................................................. 50
BELSOMRA............................................................8, 62, 71
BENAZEPRIL HCL.......................................................... 10
BENAZEPRIL/HYDROCHLOROTHIAZIDE................... 9
BENAZEPRIL-HYDROCHLOROTHIAZIDE...................9
BENDAMUSTINE HCL................................................... 45
BENDEKA........................................................................ 45
BENEFIX.......................................................................... 32
BENICAR.................................................................... 10, 71
BENICAR HCT........................................................... 10, 71
BENOXINATE HCL/FLUORESCEIN NA...................... 29
BENOXYLDOXY 30............................................ 38, 62, 71
Page 87 of 106
�
Index
BENOXYLDOXY 60............................................ 38, 62, 71
BENSAL HP...................................................................... 18
BENTYL............................................................................53
BENTYL(AMPUL)........................................................... 53
BENTYL(CAP)................................................................. 53
BENTYL(TAB)................................................................. 53
BENZACLIN(GEL W/PUMP)....................................15, 71
BENZACLIN(GEL).......................................................... 15
BENZAMYCIN................................................................. 15
BENZAMYCINPAK......................................................... 15
BENZEPRO....................................................................... 18
BENZOCAINE............................................................ 19, 26
BENZODOX 30.................................................... 38, 62, 71
BENZODOX 60.................................................... 38, 62, 71
BENZONATATE............................................................... 14
BENZOYL PEROXIDE.................................................... 18
BENZOYL PEROXIDE MICROSPHERES..................... 18
BENZOYL PEROXIDE/HYDROCORTISON................. 15
BENZOYL PEROXIDE/SULFUR.................................... 18
BENZOYL PEROXIDE/VIT E MIX................................ 18
BENZTROPINE MESYLATE.......................................... 51
BENZYL ALCOHOL....................................................... 16
BEPOTASTINE BESILATE..............................................29
BEPREVE..........................................................................29
BERACTANT.................................................................... 48
BERINERT.................................................................. 41, 82
BESIFLOXACIN HCL...................................................... 29
BESIVANCE..................................................................... 29
BETA 1.............................................................................. 41
BETADINE........................................................................ 19
BETAGAN......................................................................... 30
BETAMET ACET/BETAMET NA PH............................. 41
BETAMETHASONE DIPROPIONATE........................... 16
BETAMETHASONE VALERATE................................... 17
BETAMETHASONE/PROPYLENE GLYC..................... 17
BETAPACE........................................................................10
BETASERON.............................................................. 48, 82
BETAXOLOL HCL..................................................... 10, 30
BETHANECHOL CHLORIDE.........................................45
BETHKIS.................................................................... 38, 82
BETIMOL..........................................................................30
BETOPTIC S..................................................................... 30
BEVACIZUMAB............................................................... 46
BEXAROTENE........................................................... 19, 47
BEYAZ.................................................................. 13, 71, 85
BG-STAR(OTC)................................................................ 21
BIAXIN............................................................................. 37
BICALUTAMIDE............................................................. 45
BICILLIN C-R...................................................................37
BICILLIN L-A...................................................................37
BICNU............................................................................... 45
BIDIL................................................................................. 12
BIFERA RX.......................................................................56
BILTRICIDE..................................................................... 39
BIMATOPROST.......................................................... 30, 62
BINOSTO.............................................................. 28, 62, 72
BISAC/NACL/NAHCO3/KCL/PEG 3350........................ 44
BISMUTH/METRONID/TETRACYCLINE.................... 54
BISOPROLOL FUMARATE............................................ 10
BISOPROLOL FUMARATE/HCTZ................................. 10
BIVALIRUDIN.................................................................. 33
BIVIGAM.................................................................... 35, 82
BLACK WALNUT POLLEN..............................................3
BLEOMYCIN SULFATE.................................................. 45
BLEPHAMIDE..................................................................29
BLEPHAMIDE S.O.P........................................................29
BLINATUMOMAB........................................................... 47
BLINCYTO................................................................. 47, 82
BLOOD GLUCOSE METER(OTC)................................. 23
BLOOD GLUCOSE MONITOR(OTC)............................ 23
BLOOD GLUCOSE MONITORING(OTC).....................23
BLOOD GLUCOSE TEST STRIP(OTC)......................... 21
BLOOD GLUCOSE TEST(OTC)..................................... 21
BLOOD SUGAR DIAGNOSTIC................................ 21, 22
BLOOD SUGAR DIAGNOSTIC, DISC...........................22
BLOOD SUGAR DIAGNOSTIC, DRUM........................22
BLOOD-GL & BP METER,ADULT CUFF............... 22, 23
BLOOD-GLU METER,CONT/TRANSMIT.................... 23
BLOOD-GLUC.METER& WRIST BP MON.................. 23
BLOOD-GLUCOSE METER..................................... 23, 24
BLOOD-GLUCOSE METER(OTC)................................. 23
BLOOD-GLUCOSE METER,CONTINUOUS................ 24
BLOOD-GLUCOSE METER,MOBILE DEV..................24
BLOXIVERZ....................................................................... 6
BONIVA............................................................................ 28
BONIVA(SYRINGE).................................................. 28, 72
BONIVA(TAB).................................................................. 28
BORTEZOMIB..................................................................46
BOSENTAN...................................................................... 11
BOSULIF(TAB)(100 MG).................................... 46, 62, 82
BOSULIF(TAB)(500 MG).................................... 46, 62, 82
BOSUTINIB...................................................................... 46
Sutter Health Plus
BOTULISM ANTITOXIN 7/MALTOSE..........................34
BOTULISM ANTITOXIN HEPTAVALENT(VIAL)(4500
3300).................................................................................. 34
BOX ELDER....................................................................... 3
BP-50% UREA.................................................................. 18
B-PLEX PLUS...................................................................56
BREEZE 2(OTC)......................................................... 22, 72
BRENTUXIMAB VEDOTIN........................................... 47
BREO ELLIPTA............................................................ 5, 62
BREVIBLOC..................................................................... 10
BREXPIPRAZOLE............................................................. 7
BRILINTA................................................................... 33, 62
BRIMONIDINE TARTRATE......................................15, 30
BRIMONIDINE TARTRATE/TIMOLOL........................ 30
BRINTELLIX.......................................................... 6, 62, 72
BRINZOLAMIDE............................................................. 30
BRINZOLAMIDE/BRIMONIDINE TART...................... 30
BRISDELLE............................................................ 6, 62, 72
BROMFENAC SODIUM.................................................. 29
BROMOCRIPTINE MESYLATE............................... 20, 51
BROMPHENIRAMINE/PSEUDOEPHED/DM............... 14
BROMPHENIRAMINE-PSEUDOEPHED-DM...............14
BROVANA.....................................................................5, 63
BSS PLUS......................................................................... 30
BUCALSEP....................................................................... 43
BUDESONIDE.................................................... 4, 5, 41, 44
BUDESONIDE/FORMOTEROL FUMARATE................. 5
BUFFERED LIDOCAINE................................................ 43
BUMETANIDE................................................................. 11
BUMINATE....................................................................... 33
BUNAVAIL.................................................................. 51, 82
BUPAP............................................................................... 48
BUPHENYL...................................................................... 44
BUPIVACAINE HCL........................................................ 43
BUPIVACAINE HCL/0.9 % NACL/PF............................ 43
BUPIVACAINE HCL/DEX-WATER/PF.......................... 43
BUPIVACAINE HCL/EPINEPHRINE............................. 43
BUPIVACAINE HCL/EPINEPHRINE BI........................ 43
BUPIVACAINE HCL/EPINEPHRINE/PF....................... 43
BUPIVACAINE HCL/PF.................................................. 43
BUPIVACAINE HCL-0.9% NACL................................... 43
BUPIVACAINE HCL-EPINEPHRINE............................. 43
BUPIVACAINE LIPOSOME/PF...................................... 43
BUPIVACAINE-DEXTROSE........................................... 43
BUPRENEX................................................................ 49, 51
BUPRENORPHINE.......................................................... 49
BUPRENORPHINE HCL........................................... 49, 51
BUPRENORPHINE HCL/NALOXONE HCL................. 51
BUPRENORPHINE-NALOXONE............................. 51, 82
BUPROBAN.......................................................... 53, 61, 63
BUPROPION HBR..............................................................6
BUPROPION HCL........................................................ 6, 53
BUSPIRONE HCL.............................................................. 7
BUSULFAN.......................................................................45
BUSULFEX....................................................................... 45
BUTABARBITAL SODIUM...............................................8
BUTALB/ACETAMINOPHEN/CAFFEINE.................... 49
BUTALB-CAFF-ACETAMINOPH-CODEIN.................. 51
BUTALBIT/ACETAMIN/CAFF/CODEINE.................... 51
BUTALBITAL/ACETAMINOPHEN.......................... 48, 49
BUTALBITAL/ASPIRIN/CAFFEINE.............................. 49
BUTALBITAL-ACETAMINOPHEN................................49
BUTALBITAL-ACETAMINOPHEN-CAFFE.................. 49
BUTENAFINE HCL......................................................... 15
BUTISOL SODIUM............................................................ 8
BUTOCONAZOLE NITRATE......................................... 55
BUTORPHANOL TARTRATE.........................................49
BUTRANS................................................................... 49, 63
BUTYLATED HYDROXYTOLUENE.............................15
BUTYLATED HYDROXYTOLUENE(BHT).................. 15
BYDUREON......................................................... 20, 63, 72
BYDUREON PEN.................................................20, 63, 72
BYETTA(PEN INJCTR)(10MCG/0.04)............... 20, 63, 72
BYETTA(PEN INJCTR)(5MCG/0.02)................. 20, 63, 72
BYSTOLIC........................................................................ 10
-C
C1 ESTERASE INHIBITOR............................................ 41
C1 ESTERASE INHIBITOR, RECOMB..........................41
CABAZITAXEL................................................................ 47
CABERGOLINE............................................................... 28
CABOZANTINIB S-MALATE.........................................46
CADEAU DHA................................................................. 59
CADEXOMER IODINE................................................... 15
CADUET..................................................................... 13, 63
CAFCIT............................................................................... 5
CAFERGOT................................................................ 51, 63
CAFFEINE AND SODIUM BENZOATE.......................... 5
CAFFEINE CITRATE......................................................... 5
CAFFEINE CITRATED...................................................... 5
CAFFEINE/SODIUM BENZOATE....................................5
CALAN SR........................................................................ 11
CALCIPOTRIENE...................................................... 19, 72
CALCIPOTRIENE/BETAMETHASONE.................. 19, 20
CALCITONIN,SALMON,SYNTHETIC..........................28
CALCITRIOL..............................................................19, 60
CALCIUM ACETATE.......................................................26
CALCIUM CARBONATE/MAG CARB/FA....................26
CALCIUM CHLORIDE.................................................... 55
CALCIUM GLUCONATE................................................ 55
CALCIUM GLUCONATE IN 0.9% NACL......................55
CALCIUM GLUCONATE-0.9% NACL...........................55
CALCIUM/MAG/D3/B12/FA/B6/BORON...................... 55
CALDOLOR......................................................................42
CALFACTANT.................................................................. 48
CAMBIA..................................................................... 50, 63
CAMPTOSAR................................................................... 46
CAMRESE............................................................ 13, 63, 85
CANAGLIFLOZIN........................................................... 20
CANAGLIFLOZIN/METFORMIN HCL......................... 20
CANAKINUMAB/PF....................................................... 41
CANASA........................................................................... 43
CANCIDAS....................................................................... 38
CANDESARTAN CILEXETIL......................................... 10
CANDESARTAN/HYDROCHLOROTHIAZID...............10
CANDIDA ALBICANS...................................................... 3
CANGRELOR TETRASODIUM..................................... 33
CANTIL............................................................................. 53
CAPASTAT SULFATE...................................................... 38
CAPECITABINE............................................................... 45
CAPEX SHAMPOO.......................................................... 17
CAPITAL W-CODEINE................................................... 51
CAPRELSA(TAB)(100 MG)................................ 47, 63, 82
CAPRELSA(TAB)(300 MG)................................ 47, 63, 82
CAPREOMYCIN SULFATE............................................ 38
CAPSAICIN/MENTHOL..................................................18
CAPSAICIN/SKIN CLEANSER...................................... 18
CAPTOPRIL......................................................................10
CAPTOPRIL/HYDROCHLOROTHIAZIDE......................9
CAPTOPRIL-HYDROCHLOROTHIAZIDE..................... 9
CARAC.............................................................................. 19
CARAFATE(ORAL SUSP)............................................... 54
CARAFATE(TAB)............................................................. 54
CARBACHOL................................................................... 30
CARBAGLU......................................................................44
CARBAMAZEPINE............................................... 7, 51, 52
CARBATROL.................................................................... 52
CARBIDOPA.....................................................................51
CARBIDOPA/LEVODOPA.............................................. 51
CARBIDOPA/LEVODOPA/ENTACAPONE................... 51
CARBIDOPA-LEVODOPA.............................................. 51
CARBINOXAMINE MALEATE.................................. 3, 61
CARBOCAINE................................................................. 43
CARB-O-PHILIC.............................................................. 18
CARBOPLATIN................................................................ 45
CARBOPROST TROMETHAMINE................................ 14
CARDENE I.V...................................................................11
CARDENE SR...................................................................11
CARDIZEM LA................................................................ 11
CARDURA.......................................................................... 9
CARDURA XL................................................................... 9
CARELANCE ULT LANCING DEVICE(OTC)........25, 63
CAREONE(OTC)........................................................ 25, 63
CARESENS N VOICE(OTC)........................................... 23
CARESENS N(OTC).................................................. 21, 23
CARESENS PREM LANCING DEVICE(OTC)........25, 63
CARFILZOMIB................................................................ 46
CARGLUMIC ACID.........................................................44
CARIMUNE NF NANOFILTERED........................... 35, 82
CARISOPRODOL............................................................. 53
CARISOPRODOL COMPOUND-CODEINE.................. 49
CARISOPRODOL/ASPIRIN............................................ 53
CARISOPRODOL-ASPIRIN............................................ 53
CARMUSTINE................................................................. 45
CARMUSTINE IN POLIFEPROSAN 20......................... 45
CARTEOLOL HCL........................................................... 30
CARTIA XT...................................................................... 11
CARVEDILOL.................................................................... 9
CARVEDILOL PHOSPHATE............................................ 9
CASODEX........................................................................ 45
CASPOFUNGIN ACETATE............................................. 38
CAT HAIR STD ALLERGENIC EXT................................3
CATAPRES........................................................................ 10
CATAPRES-TTS 1............................................................ 10
CATAPRES-TTS 2............................................................ 10
CATAPRES-TTS 3............................................................ 10
CATHFLO ACTIVASE..................................................... 33
CAVERJECT......................................................... 27, 63, 82
CAYA CONTOURED................................................. 14, 85
CAYSTON................................................................... 35, 82
CEDAX.............................................................................. 36
CEFACLOR....................................................................... 36
CEFADROXIL...................................................................36
CEFAZOLIN..................................................................... 36
CEFAZOLIN SODIUM.....................................................36
Page 88 of 106
�
Index
CEFAZOLIN SODIUM IN 0.9 % NACL......................... 36
CEFAZOLIN SODIUM/D5W........................................... 36
CEFAZOLIN SODIUM/DEXTROSE,ISO....................... 36
CEFAZOLIN SODIUM-0.9% NACL............................... 36
CEFAZOLIN-D5W........................................................... 36
CEFDINIR......................................................................... 36
CEFDITOREN PIVOXIL.................................................. 36
CEFEPIME........................................................................ 36
CEFEPIME HCL............................................................... 36
CEFEPIME HCL/D5W..................................................... 36
CEFEPIME HCL/DEXTROSE, ISO-OSM.......................36
CEFEPIME-DEXTROSE.................................................. 36
CEFIXIME........................................................................ 36
CEFOTAXIME SODIUM................................................. 36
CEFOTETAN.....................................................................36
CEFOTETAN & DEXTROSE........................................... 36
CEFOTETAN DISOD/DEXTROSE,ISO.......................... 36
CEFOTETAN DISODIUM................................................36
CEFOXITIN...................................................................... 36
CEFOXITIN SODIUM......................................................36
CEFOXITIN SODIUM/D5W............................................ 36
CEFOXITIN SODIUM/DEXTROSE,ISO........................ 36
CEFPODOXIME PROXETIL........................................... 36
CEFPROZIL...................................................................... 36
CEFTAROLINE FOSAMIL ACETATE............................36
CEFTAZIDIME................................................................. 36
CEFTAZIDIME IN DEXTROSE5%WATER................... 36
CEFTAZIDIME NA/DEXTROSE,ISO............................. 36
CEFTAZIDIME/AVIBACTAM......................................... 36
CEFTIBUTEN................................................................... 36
CEFTIN(SUSP RECON)...................................................36
CEFTIN(TAB)................................................................... 36
CEFTOLOZANE/TAZOBACTAM................................... 36
CEFTRIAXONE................................................................36
CEFTRIAXONE NA/DEXTROSE,ISO............................36
CEFTRIAXONE SODIUM............................................... 36
CEFTRIAXONE(PIGGY BACK)(1 G/50 ML)................ 36
CEFTRIAXONE(PIGGY BACK)(2 G/50 ML)................ 36
CEFTRIAXONE(PIGGYBACK)...................................... 36
CEFUROXIME AXETIL.................................................. 36
CEFUROXIME SODIUM................................................. 36
CEFUROXIME SODIUM/WATER.................................. 36
CELACYN.........................................................................18
CELEBREX....................................................................... 42
CELECOXIB..................................................................... 42
CELESTONE.................................................................... 41
CELEXA..............................................................................6
CELLCEPT........................................................................35
CELLULOSE,OXIDIZED................................................ 33
CELONTIN....................................................................... 52
CENTANY AT...................................................................15
CENTERGY DM...............................................................14
CEPHALEXIN.................................................................. 36
CEPROTIN........................................................................ 33
CEREBYX......................................................................... 52
CERITINIB........................................................................46
CERTOLIZUMAB PEGOL.............................................. 44
CERVIDIL......................................................................... 14
CESAMET............................................................... 4, 63, 72
CETACAINE..................................................................... 19
CETACAINE ANESTHETIC............................................19
CETIRIZINE HCL.............................................................. 4
CETRAXAL...................................................................... 26
CETUXIMAB....................................................................46
CEVIMELINE HCL.......................................................... 45
CHANTIX............................................................. 53, 61, 63
CHENODAL..................................................................... 44
CHENODIOL.................................................................... 44
CHERATUSSIN AC(OTC)............................................... 14
CHILDREN'S FERROUS SULFATE(OTC)..................... 55
CHLORAMBUCIL........................................................... 45
CHLORAMPHENICOL SOD SUCC............................... 39
CHLORAMPHENICOL SOD SUCCINATE....................39
CHLORDIAZEPOXIDE HCL............................................ 7
CHLORDIAZEPOXIDE/CLIDINIUM BR...................... 53
CHLORDIAZEPOXIDE-AMITRIPTYLINE..................... 6
CHLORHEXIDINE GLUCONATE.................................. 48
CHLOROPROCAINE HCL.............................................. 43
CHLOROPROCAINE HCL/PF......................................... 43
CHLOROQUINE PHOSPHATE....................................... 39
CHLOROTHIAZIDE.........................................................12
CHLOROTHIAZIDE SODIUM........................................ 12
CHLOROXYLENOL/BENZOC/HYDROCORT..............26
CHLOROXYLENOL/PRAMOXINE HCL.......................26
CHLORPHENIRAMINE/PHENYLEPH/DM.................. 14
CHLORPROMAZINE HCL................................................8
CHLORPROPAMIDE....................................................... 20
CHLORTHALIDONE....................................................... 12
CHLORZOXAZONE........................................................ 53
CHOICEDM CLARUS TEST STRIPS(OTC).................. 21
CHOICEDM CLARUS(OTC)........................................... 23
CHOLBAM................................................................. 44, 82
Sutter Health Plus
CHOLECALCIFEROL (VITAMIN D3)........................... 60
CHOLESTYRAMINE (WITH SUGAR).......................... 12
CHOLESTYRAMINE/ASPARTAME.............................. 12
CHOLIC ACID..................................................................44
CHOLINE MAG TRISALICYLATE................................ 49
CHOLINE SAL/MAG SALICYLATE.............................. 49
CHROMIC CHLORIDE....................................................56
CHROMIUM..................................................................... 56
CIALIS.................................................................. 27, 63, 82
CICLESONIDE............................................................... 4, 5
CICLODAN................................................................. 15, 16
CICLOPIROX.................................................................... 15
CICLOPIROX OLAMINE................................................ 15
CICLOPIROX/NAIL LACQUER REMOVR................... 15
CICLOPIROX/SKIN CLEANSER NO.28........................15
CICLOPIROX/URE/CAMPH/MENTH/EUC...................16
CICLOPIROX/UREA........................................................ 16
CIDOFOVIR...................................................................... 39
CIFEREX........................................................................... 60
CILOSTAZOL................................................................... 33
CILOXAN(DROPS).......................................................... 29
CILOXAN(OINT)............................................................. 29
CIMETIDINE.................................................................... 54
CIMETIDINE HCL........................................................... 54
CIMZIA....................................................................... 44, 82
CINACALCET HCL......................................................... 28
CINRYZE.................................................................... 41, 82
CIPRO................................................................................ 37
CIPRO HC......................................................................... 26
CIPRO I.V.......................................................................... 37
CIPRO XR......................................................................... 37
CIPRODEX....................................................................... 26
CIPROFLOXACIN............................................................ 37
CIPROFLOXACIN HCL....................................... 26, 29, 37
CIPROFLOXACIN HCL/DEXAMETH........................... 26
CIPROFLOXACIN LACTATE..........................................37
CIPROFLOXACIN LACTATE/D5W................................37
CIPROFLOXACIN/CIPROFLOXA HCL.........................37
CIPROFLOXACIN/HYDROCORTISONE...................... 26
CIPROFLOXACIN-D5W.................................................. 37
CISPLATIN....................................................................... 45
CITALOPRAM HBR.......................................................... 6
CITALOPRAM HYDROBROMIDE.................................. 6
CITANEST FORTE DENTAL.......................................... 43
CITANEST PLAIN DENTAL........................................... 43
CITRANATAL 90 DHA.................................................... 58
CITRANATAL ASSURE.................................................. 58
CITRANATAL DHA......................................................... 58
CITRANATAL RX............................................................ 57
CITRATE PHOSPHATE DEXTROS SOLN.................... 32
CITRATE PHOSPHATE DEXTROSE............................. 32
CITRIC ACID/G-LACTONE/MAG CARB......................54
CLADOSPORIUM CLADOSPORIOIDES........................3
CLADOSPORIUM SPHAEROSPERMUM....................... 3
CLADRIBINE................................................................... 45
CLAFORAN(VIAL PORT)...............................................36
CLAFORAN(VIAL)..........................................................36
CLARAVIS........................................................................ 14
CLARINEX(SYRUP).............................................. 4, 63, 72
CLARINEX(TAB)......................................................... 4, 63
CLARINEX-D 12 HOUR........................................3, 63, 72
CLARITHROMYCIN....................................................... 37
CLEMASTINE FUMARATE............................................. 3
CLEOCIN HCL................................................................. 39
CLEOCIN PHOSPHATE.................................................. 39
CLEOCIN PHOSPHATE IN D5W................................... 39
CLEOCIN T.......................................................................15
CLEOCIN(CREAM/APPL).............................................. 55
CLEOCIN(SUPP VAG).....................................................55
CLEVER CHEK BLOOD GLUCOSE SYST(OTC)........ 23
CLEVER CHOICE BLOOD GLUC SYS(OTC).............. 23
CLEVER CHOICE HD GLUCOSE SYST(OTC)............ 23
CLEVER CHOICE MICRO TEST STRIP(OTC)............. 21
CLEVER CHOICE MICRO(OTC)................................... 23
CLEVER CHOICE PRO(OTC)................................... 21, 23
CLEVER CHOICE TALK(OTC)................................ 21, 23
CLEVER CHOICE TEST STRIPS(OTC).........................21
CLEVER CHOICE VOICE+(OTC).................................. 21
CLEVER CHOICE(OTC)................................................. 23
CLEVIDIPINE BUTYRATE.............................................11
CLEVIPREX..................................................................... 11
CLIMARA................................................................... 34, 63
CLIMARA PRO.......................................................... 34, 63
CLIN SINGLE USE.......................................................... 39
CLINDACIN ETZ............................................................. 15
CLINDACIN P.................................................................. 15
CLINDACIN PAC............................................................. 15
CLINDAGEL..................................................................... 15
CLINDAMYCIN HCL...................................................... 39
CLINDAMYCIN PALMITATE HCL................................39
CLINDAMYCIN PHOS/BENZOYL PEROX.................. 15
CLINDAMYCIN PHOS/SKIN CLNSR 19...................... 15
CLINDAMYCIN PHOSPHATE........................... 15, 39, 55
CLINDAMYCIN PHOSPHATE/D5W..............................39
CLINDAMYCIN/BENZOYL/EMOL CMB94................. 15
CLINDAMYCIN/TRETINOIN.........................................15
CLINDESSE...................................................................... 55
CLINITEST REAGENT(OTC)......................................... 26
CLINPRO 5000................................................................. 55
CLIOQUINOL/HC/EMOLLIENT CMB#88.................... 15
CLIOQUINOL/HYDROCORTISONE............................. 15
CLOBAZAM..................................................................... 52
CLOBETASOL EMOLLIENT.......................................... 17
CLOBETASOL PROPIONATE.........................................17
CLOBETASOL PROPIONATE/EMOLL..........................17
CLOBETASOL/SKIN CLEANSER #28...........................17
CLOBEX........................................................................... 17
CLOCORTOLONE PIVALATE........................................ 17
CLODAN........................................................................... 17
CLODERM........................................................................ 17
CLOFARABINE................................................................45
CLOLAR........................................................................... 45
CLOMIPRAMINE HCL..................................................... 6
CLONAZEPAM................................................................ 52
CLONIDINE......................................................................10
CLONIDINE HCL.........................................................8, 10
CLONIDINE HCL/CHLORTHALIDONE....................... 10
CLONIDINE HCL/PF....................................................... 49
CLOPIDOGREL BISULFATE.......................................... 33
CLORAZEPATE DIPOTASSIUM...................................... 7
CLORPRES....................................................................... 10
CLOTRIMAZOLE...................................................... 16, 38
CLOTRIMAZOLE/BETAMETHASONE DIP................. 15
CLOTRIMAZOLE-BETAMETHASONE........................ 15
CLOZAPINE................................................................. 7, 63
CLOZARIL....................................................................7, 63
C-NATE DHA....................................................................57
CNL 8................................................................................ 15
COAGADEX..................................................................... 32
COAGULATION FACTOR VIIA,RECOMB................... 32
COAGULATION FACTOR X........................................... 32
COARTEM........................................................................ 39
COBICISTAT.....................................................................40
COBIMETINIB FUMARATE...........................................46
COCAINE HCL.................................................................19
CODEINE POLI/CHLORPHENIR POLIS.......................14
CODEINE SULFATE........................................................ 49
CODEINE/BUTALBITAL/ASA/CAFFEIN..................... 51
CODEINE/CARISOPRODOL/ASPIRIN......................... 49
COGENTIN....................................................................... 51
COLAZAL......................................................................... 43
COLCHICINE................................................................... 31
COLCHICINE/PROBENECID......................................... 31
COLCRYS................................................................... 31, 63
COLESEVELAM HCL..................................................... 12
COLESTID(GRANULES)................................................ 12
COLESTID(PACKET)(5 G).............................................. 12
COLESTID(PACKET)(7.5 G)........................................... 12
COLESTID(TAB).............................................................. 12
COLESTIPOL HCL.......................................................... 12
COLISTIN (COLISTIMETHATE NA).............................39
COLLAGENASE CLOSTRIDIUM HIST...................19, 52
COLY-MYCIN M PARENTERAL................................... 39
COLY-MYCIN S............................................................... 26
COLYTE WITH FLAVOR PACKS...................................44
COMBIGAN......................................................................30
COMBIPATCH............................................................ 34, 63
COMBIVENT RESPIMAT................................................. 5
COMBIVIR................................................................. 40, 63
COMETRIQ.......................................................... 46, 63, 82
COMFORT PAC-CYCLOBENZAPRINE........................ 53
COMFORT PAC-IBUPROFEN.........................................42
COMFORT PAC-MELOXICAM...................................... 42
COMFORT PAC-NAPROXEN......................................... 42
COMFORT PAC-TIZANIDINE........................................ 53
COMPAZINE...................................................................... 4
COMPLERA................................................................40, 82
COMPLETE FORMULATION D3000.............................57
COMPLETE FORMULATION PEDIATRIC................... 57
COMPLETE NATAL DHA............................................... 58
COMPLETENATE............................................................ 57
COMTAN.......................................................................... 51
CONCEPT DHA............................................................... 58
CONCEPT OB...................................................................57
CONCEPTROL(OTC)................................................. 13, 85
CONDYLOX(GEL)...........................................................18
CONDYLOX(SOLUTION)...............................................18
CONIVAPTAN HCL IN 5 % DEXTROSE....................... 26
CONTOUR NEXT(OTC)............................................ 21, 72
CONTOUR(OTC)........................................................21, 72
CONTROL G3(OTC)........................................................ 21
CONTROL(OTC)........................................................ 21, 23
COPAXONE................................................................ 48, 82
COPPER CHLORIDE....................................................... 56
Page 89 of 106
�
Index
CORDRAN........................................................................ 17
COREG................................................................................ 9
COREG CR......................................................................... 9
CORGARD........................................................................ 10
CORIFACT........................................................................ 32
CORLANOR......................................................... 13, 63, 82
CORLOPAM..................................................................... 10
CORTANE-B..................................................................... 26
CORTEF............................................................................ 41
CORTENEMA................................................................... 44
CORTICORELIN OVINE TRIFLUTATE.........................27
CORTICOTROPIN............................................................ 27
CORTIFOAM.................................................................... 44
CORTISONE ACETATE...................................................41
CORTISPORIN................................................................. 16
CORTISPORIN-TC........................................................... 26
CORVERT........................................................................... 9
CORVITA.......................................................................... 56
CORVITA 150................................................................... 56
CORVITE.......................................................................... 56
CORVITE 150................................................................... 56
CORVITE FE..................................................................... 56
CORVITE FREE................................................................56
CORZIDE.......................................................................... 10
COSENTYX (2 SYRINGES)...................................... 19, 82
COSENTYX PEN....................................................... 19, 82
COSENTYX PEN (2 PENS)....................................... 19, 82
COSENTYX SYRINGE.............................................. 19, 82
COSMEGEN..................................................................... 45
COSOPT............................................................................ 30
COSOPT PF...........................................................30, 63, 72
COTELLIC............................................................ 46, 63, 82
COUMADIN..................................................................... 31
COZAAR........................................................................... 10
CREON.............................................................................. 53
CRESEMBA...................................................................... 38
CRESTOR(TAB)(10 MG)..................................... 12, 63, 72
CRESTOR(TAB)(20 MG)..................................... 12, 63, 72
CRESTOR(TAB)(40 MG)..................................... 12, 63, 72
CRESTOR(TAB)(5 MG)....................................... 12, 63, 72
CRINONE..........................................................................34
CRIXIVAN........................................................................ 40
CRIZOTINIB..................................................................... 46
CROFELEMER................................................................. 44
CROMOLYN SODIUM................................................ 5, 30
CROTAMITON................................................................. 16
CRYSELLE................................................................. 14, 85
CUBICIN........................................................................... 36
CUPRIC CHLORIDE........................................................ 56
CUPRIMINE..................................................................... 41
CUROSURF...................................................................... 48
CUTIVATE........................................................................ 17
CUVPOSA......................................................................... 53
CYANOCOBALAMIN (VITAMIN B-12)........................60
CYANOCOBALAMIN INJECTION................................ 60
CYANOCOBALAMIN/FA/PYRIDOXINE...................... 59
CYANOCOBALAMIN/MECOBALAMIN...................... 60
CYCLOBENZ HCL/IRR CNTR-IRR CB2.......................53
CYCLOBENZAPRINE HCL............................................ 53
CYCLOBENZAPRINE/CAPSAI/MENTHOL.................53
CYCLOGYL(DROPS)(0.5 %).......................................... 30
CYCLOGYL(DROPS)(1 %)............................................. 30
CYCLOGYL(DROPS)(2 %)............................................. 30
CYCLOMYDRIL.............................................................. 30
CYCLOPENTOLATE HCL.............................................. 30
CYCLOPENTOLATE/PHENYLEPHRINE..................... 30
CYCLOPHOSPHAMIDE........................................... 45, 63
CYCLOPHOSPHAMIDE(CAP)................................. 45, 63
CYCLOPHOSPHAMIDE(VIAL)..................................... 45
CYCLOSERINE................................................................ 39
CYCLOSET................................................................. 20, 72
CYCLOSPORINE....................................................... 30, 35
CYCLOSPORINE MODIFIED.........................................35
CYCLOSPORINE, MODIFIED........................................35
CYKLOKAPRON............................................................. 31
CYMBALTA.................................................................. 6, 63
CYPROHEPTADINE HCL................................................. 3
CYRAMZA................................................................. 46, 82
CYSTAGON...................................................................... 54
CYSTARAN................................................................ 31, 82
CYSTEAMINE BITARTRATE......................................... 54
CYSTEAMINE HCL.........................................................31
CYTARABINE.................................................................. 45
CYTARABINE LIPOSOME/PF....................................... 45
CYTARABINE/PF............................................................ 45
CYTOGAM....................................................................... 34
CYTOMEGALOVIRUS IMMUNE GLOBULN.............. 34
CYTOMEL........................................................................ 29
CYTOTEC......................................................................... 54
CYTOVENE...................................................................... 39
-D
D.FARINAE MITE EXTRACT.......................................... 3
Sutter Health Plus
D.H.E.45...................................................................... 50, 63
D.PTERONYSSINUS MITE EXTRACT........................... 3
DABIGATRAN ETEXILATE MESYLATE..................... 33
DABRAFENIB MESYLATE............................................ 46
DACARBAZINE............................................................... 47
DACLATASVIR DIHYDROCHLORIDE.........................41
DACOGEN........................................................................ 45
DACTINOMYCIN............................................................ 45
DAKLINZA................................................................. 41, 82
DALBAVANCIN HCL...................................................... 39
DALFAMPRIDINE........................................................... 48
DALIRESP.............................................................. 5, 63, 72
DALTEPARIN SODIUM,PORCINE................................ 32
DALVANCE...................................................................... 39
DANAZOL........................................................................ 28
DANTRIUM...................................................................... 53
DANTROLENE SODIUM................................................ 53
DAPAGLIFLOZIN PROPANEDIOL................................ 20
DAPAGLIFLOZIN/METFORMIN HCL.......................... 20
DAPSONE................................................................... 15, 38
DAPTOMYCIN................................................................. 36
DARAPRIM................................................................ 39, 82
DARATUMUMAB............................................................ 46
DARBEPOETIN ALFA IN POLYSORBAT..................... 32
DARIFENACIN HYDROBROMIDE............................... 54
DARUNAVIR ETHANOLATE................................... 39, 40
DARUNAVIR/COBICISTAT............................................ 40
DARZALEX...................................................................... 46
DASATINIB................................................................ 46, 47
DAUNORUBICIN CITRATE LIPOSOMAL....................45
DAUNORUBICIN HCL.................................................... 45
DAUNOXOME.................................................................. 45
DAYPRO............................................................................43
DAYTRANA............................................................8, 63, 72
DDAVP.............................................................................. 27
DECITABINE.................................................................... 45
DEGARELIX ACETATE.................................................. 46
DELATESTRYL.......................................................... 34, 82
DELAVIRDINE MESYLATE........................................... 40
DELESTROGEN(VIAL)(10 MG/ML)............................. 34
DELZICOL.................................................................. 43, 72
DEMADEX....................................................................... 11
DEMECLOCYCLINE HCL.............................................. 37
DEMEROL.................................................................. 50, 63
DEMSER........................................................................... 10
DENAVIR.......................................................................... 16
DENOSUMAB.................................................................. 28
DENTAL SUCTION/CHLOR/SWB#1/MTH...................48
DENTAL SUCTION/CHLORHX/SWAB #1....................48
DEPAKENE.......................................................................52
DEPAKOTE ER................................................................. 52
DEPEN.............................................................................. 41
DEPOCYT......................................................................... 45
DEPO-ESTRADIOL......................................................... 34
DEPO-MEDROL(VIAL)(20 MG/ML)............................. 42
DEPO-TESTOSTERONE........................................... 34, 82
DERMACINRX PUREFOLIX..........................................60
DERMACINRX SILAZONE............................................ 17
DERMASILKRX DICLOPAK..........................................42
DERMASILKRX LIDORXKIT........................................ 19
DERMASILKRX SDS.......................................... 17, 63, 72
DERMA-SMOOTHE-FS...................................................17
DERMASORB AF............................................................ 15
DERMASORB HC............................................................ 17
DERMASORB TA............................................................ 17
DERMASORB XM........................................................... 18
DERMATOP...................................................................... 17
DERMOTIC.......................................................................26
DESIPRAMINE HCL......................................................... 6
DESIRUDIN...................................................................... 33
DESLORATADINE................................................. 4, 63, 72
DESLORATADINE/PSEUDOEPHEDRINE...................... 3
DESMOPRESSIN (NONREFRIGERATED)................... 27
DESMOPRESSIN ACETATE........................................... 27
DESOG-E.ESTRADIOL/E.ESTRADIOL........................ 13
DESOGESTREL-ETHINYL ESTRADIOL..................... 13
DESONATE....................................................................... 17
DESONIDE....................................................................... 17
DESOWEN........................................................................ 17
DESOXIMETASONE....................................................... 17
DESOXYN.................................................................... 7, 63
DESVENLAFAXINE.......................................................... 6
DESVENLAFAXINE ER........................................ 6, 63, 72
DESVENLAFAXINE FUMARATE................................... 6
DESVENLAFAXINE FUMARATE ER................. 6, 63, 72
DESVENLAFAXINE SUCCINATE................................... 6
DETROL LA............................................................... 54, 72
DEXAMETHASONE..................................................29, 41
DEXAMETHASONE INTENSOL................................... 41
DEXAMETHASONE SOD PHOSPHATE.................29, 41
DEXAMETHASONE SOD PHOSPHATE/PF................. 41
DEXAMETHASONE SODIUM PHOSPHATE......... 29, 41
DEXCOM G4.................................................................... 24
DEXILANT........................................................... 54, 63, 73
DEXLANSOPRAZOLE.................................................... 54
DEXMEDETOMIDINE HCL............................................. 8
DEXMEDETOMIDINE IN 0.9 % NACL........................... 8
DEXMETHYLPHENIDATE HCL......................................8
DEXPAK........................................................................... 41
DEXRAZOXANE HCL.................................................... 47
DEXTRAN 40 IN 0.9 % NACL........................................ 33
DEXTRAN 40/D5W......................................................... 33
DEXTROAMPHETAMINE SULFATE.............................. 7
DEXTROAMPHETAMINE SULFATE(TAB)(10 MG)......
7,
63
DEXTROAMPHETAMINE SULFATE(TAB)(5 MG)...... 7,
63
DEXTROAMPHETAMINE/AMPHETAMINE.................. 7
DEXTROMETHORPHAN HBR/QUINIDINE................ 48
DEXTROSE 10 % AND 0.2 % NACL..............................31
DEXTROSE 10 % AND 0.45 % NACL............................31
DEXTROSE 10 % AND 0.9 % NACL..............................31
DEXTROSE 10 % IN WATER..........................................31
DEXTROSE 10%-0.2% NACL......................................... 31
DEXTROSE 10%-0.45% NACL....................................... 31
DEXTROSE 10%-0.9% NACL......................................... 31
DEXTROSE 2.5 % AND 0.45 % NACL...........................31
DEXTROSE 2.5 % IN WATER.........................................31
DEXTROSE 2.5%-0.45% NACL...................................... 31
DEXTROSE 5 % AND 0.3 % NACL................................31
DEXTROSE 5 % AND 0.9 % NACL................................31
DEXTROSE 5 % IN WATER............................................31
DEXTROSE 5 %-0.2 % NACL......................................... 31
DEXTROSE 5 %-0.45 % NACL....................................... 31
DEXTROSE 5% IN RINGERS......................................... 31
DEXTROSE 5%-0.2% NACL........................................... 31
DEXTROSE 5%-0.2% NACL-KCL..................................27
DEXTROSE 5%-0.3% NACL........................................... 31
DEXTROSE 5%-0.3% NACL-KCL..................................27
DEXTROSE 5%-0.45% NACL......................................... 31
DEXTROSE 5%-0.45% NACL-KCL................................ 27
DEXTROSE 5%-0.9% NACL........................................... 31
DEXTROSE 5%-ELECTROLYTE #48............................ 27
DEXTROSE 5%-LACTATED RINGERS.........................31
DEXTROSE 5%-NS-KCL................................................ 27
DEXTROSE 5%-POTASSIUM CHLORIDE....................27
DEXTROSE IN LACTATED RINGERS.......................... 31
DEXTROSE IN RINGERS INJECTION..........................31
DEXTROSE IN WATER................................................... 31
DEXTROSE/SOD CITRATE/CITRIC AC....................... 32
DHCODEINE BT/ACETAMINOPHN/CAFF.................. 49
DIABETA.......................................................................... 20
DIALYVITE...................................................................... 59
DIALYVITE 3000............................................................. 59
DIALYVITE 5000............................................................. 59
DIALYVITE 800 WITH IRON......................................... 56
DIALYVITE SUPREME D............................................... 59
DIALYVITE ZINC............................................................ 59
DIAMOX SEQUELS.........................................................30
DIAPHRAGMS, CONTOURED...................................... 14
DIAPHRAGMS, WIDE SEAL..........................................14
DIASTAT..................................................................... 52, 63
DIASTAT ACUDIAL.................................................. 52, 63
DIASTIX REAGENT(OTC)............................................. 26
DIATRUE PLUS(OTC)............................................... 21, 23
DIAZEPAM................................................................... 7, 52
DIAZOXIDE..................................................................... 25
DIBENZYLINE................................................................... 9
DICHLORPHENAMIDE.................................................. 52
DICLEGIS..................................................................... 4, 63
DICLOFENAC EPOLAMINE.......................................... 17
DICLOFENAC POTASSIUM..................................... 42, 50
DICLOFENAC SODIUM............................... 17, 19, 29, 42
DICLOFENAC SODIUM/MISOPROSTOL.....................42
DICLOFENAC SUBMICRONIZED.................................42
DICLOFENAC/BENZALKONIUM CHLOR...................17
DICLOFENAC/CAPSICUM............................................. 42
DICLOXACILLIN SODIUM............................................ 37
DICYCLOMINE HCL...................................................... 53
DIDANOSINE................................................................... 40
DIFENOXIN HCL/ATROPINE SULFATE.......................44
DIFFERIN................................................................... 15, 61
DIFICID................................................................. 37, 63, 73
DIFLORASONE DIACETATE......................................... 17
Page 90 of 106
�
Index
DIFLORASONE DIACETATE/EMOLL.......................... 17
DIFLUCAN....................................................................... 38
DIFLUNISAL.................................................................... 49
DIFLUPREDNATE........................................................... 29
DIGOXIN............................................................................ 9
DIGOXIN(SOLUTION)...................................................... 9
DIGOXIN(SYRINGE)........................................................ 9
DIHYDROCODEINE/ASPIRIN/CAFFEIN..................... 49
DIHYDROERGOTAMINE MESYLATE................... 50, 51
DILANTIN........................................................................ 52
DILANTIN(CAP)(100 MG).............................................. 52
DILANTIN(CAP)(30 MG)................................................ 52
DILANTIN-125................................................................. 52
DILATRATE-SR................................................................13
DILAUDID.................................................................. 49, 50
DILAUDID-HP..................................................................50
DILTIAZEM HCL............................................................. 11
DILTIAZEM HCL/D5W................................................... 11
DILTIAZEM-D5W............................................................ 11
DIMENHYDRINATE......................................................... 4
DIMETHYL FUMARATE................................................ 48
DIMETHYL SULFOXIDE............................................... 54
DINOPROSTONE............................................................. 14
DINUTUXIMAB............................................................... 47
DIOVAN............................................................................ 10
DIOVAN HCT................................................................... 10
DIPENTUM................................................................. 44, 73
DIPHENHYDRAMINE HCL............................................. 3
DIPHENOXYLATE HCL/ATROPINE............................. 44
DIPHENOXYLATE-ATROPINE...................................... 44
DIPROLENE..................................................................... 17
DIPROLENE AF............................................................... 17
DIPYRIDAMOLE............................................................. 33
DISALCID......................................................................... 49
DISOPYRAMIDE PHOSPHATE....................................... 9
DISULFIRAM..................................................................... 7
DIURIL.............................................................................. 12
DIVALPROEX SODIUM.................................................. 52
DIVIGEL........................................................................... 34
DOBUTAMINE HCL.......................................................... 9
DOBUTAMINE HCL IN DEXTROSE...............................9
DOBUTAMINE HCL/D5W................................................ 9
DOCEFREZ....................................................................... 47
DOCETAXEL.................................................................... 47
DOFETILIDE...................................................................... 9
DOG EPITHELIUM EXTRACT........................................ 3
DOLASETRON MESYLATE............................................. 4
DOLOPHINE HCL........................................................... 50
DOLUTEGRAVIR SODIUM............................................ 40
DONEPEZIL HCL.............................................................. 6
DONNATAL...................................................................... 53
DOPAMINE HCL................................................................4
DOPAMINE HCL IN 5% DEXTROSE.............................. 4
DOPAMINE HCL/D5W...................................................... 4
DOPRAM............................................................................ 8
DORIBAX......................................................................... 36
DORIPENEM.................................................................... 36
DORNASE ALFA............................................................. 48
DORYX(TAB DR)(150 MG)................................ 37, 63, 73
DORYX(TAB DR)(200 MG)................................ 37, 63, 73
DORYX(TAB DR)(50 MG).................................. 37, 63, 73
DORZOLAMIDE HCL..................................................... 30
DORZOLAMIDE HCL/TIMOLOL MALEAT.................30
DORZOLAMIDE/TIMOLOL/PF..................................... 30
DOVONEX.................................................................. 19, 73
DOXAPRAM HCL..............................................................8
DOXAZOSIN MESYLATE................................................ 9
DOXEPIN HCL......................................................... 6, 8, 17
DOXERCALCIFEROL..................................................... 28
DOXORUBICIN HCL....................................................... 45
DOXORUBICIN HCL LIPOSOME.................................. 45
DOXORUBICIN HCL PEG-LIPOSOMAL......................45
DOXYCYCLINE CALCIUM........................................... 37
DOXYCYCLINE HYCLATE......................... 37, 38, 63, 73
DOXYCYCLINE HYCLATE(CAP)..................... 37, 63, 73
DOXYCYCLINE HYCLATE(TAB DR)...............37, 63, 73
DOXYCYCLINE HYCLATE(TAB)..................... 37, 63, 73
DOXYCYCLINE HYCLATE(VIAL)............................... 38
DOXYCYCLINE MONOHYDRATE...............................38
DOXYCYCLINE MONOHYDRATE(TAB)(150 MG)......
38,
63
38,
63,
73
38,
63
DOXYCYCLINE/BENZOYL PEROXIDE.......................38
DOXYCYCLINE/SALICY/OCT/ZINC OX.....................38
DOXYCYCLINE/SKIN CLEANSER #19....................... 38
DOXYLAMINE/PYRIDOXINE HCL................................ 4
DRECHSLERA................................................................... 3
DRISDOL.......................................................................... 60
DRITHOCREME HP.................................................. 19, 73
Sutter Health Plus
DRONABINOL................................................................... 4
DRONEDARONE HCL...................................................... 9
DROPERIDOL.................................................................... 7
DROPLET LANCING DEVICE(OTC)...................... 25, 63
DROSPIR/ETH ESTRA/LEVOMEFOL CA.................... 13
DROSPIRENONE/ESTRADIOL...................................... 34
DROXIA............................................................................ 33
DROXIDOPA.................................................................... 13
DRYSOL............................................................................17
DS PREP PAK................................................................... 17
DUAVEE............................................................................34
DUET DHA 400................................................................ 58
DUET DHA BALANCED................................................ 58
DUETACT................................................................... 20, 73
DULAGLUTIDE............................................................... 20
DULERA....................................................................... 5, 63
DULOXETINE HCL........................................................... 6
DUOPA........................................................................ 51, 82
DURACHOL..................................................................... 60
DURACLON..................................................................... 49
DURAGESIC.........................................................49, 63, 82
DUREZOL......................................................................... 29
DUTASTERIDE................................................................ 54
DUTASTERIDE/TAMSULOSIN HCL.............................54
DUTOPROL...................................................................... 10
DYANAVEL XR.................................................................. 7
DYAZIDE.......................................................................... 11
DYLOJECT....................................................................... 42
DYMISTA................................................................ 4, 63, 73
DYRENIUM...................................................................... 11
-E
EASTERN COTTONWOOD.............................................. 3
EASY CHECK TEST STRIP(OTC)................................. 21
EASY CHECK(OTC)........................................................ 23
EASY CLICK(OTC)................................................... 25, 63
EASY GLUCO G2(OTC).................................................. 21
EASY PLUS II(OTC).................................................. 21, 23
EASY PLUS(OTC)......................................................21, 23
EASY STEP(OTC)...................................................... 21, 23
EASY TALK(OTC)..................................................... 21, 23
EASY TOUCH GLUCOSE MONITOR(OTC).................23
EASY TOUCH LANCING DEVICE(OTC)............... 25, 63
EASY TOUCH(OTC)........................................................21
EASY TRAK(OTC).................................................... 21, 23
EASYGLUCO PLUS(OTC)........................................ 21, 23
EASYGLUCO(OTC)...................................................21, 23
EASYMAX 15(OTC)........................................................ 21
EASYMAX L(OTC)..........................................................23
EASYMAX NG(OTC)...................................................... 23
EASYMAX V SPEAKING(OTC).................................... 23
EASYMAX V2(OTC)....................................................... 23
EASYMAX(OTC)............................................................. 21
ECALLANTIDE................................................................43
ECHOTHIOPHATE IODIDE............................................ 30
EC-NAPROSYN................................................................43
ECONAZOLE NITRATE.................................................. 16
ECOZA.............................................................................. 16
ECULIZUMAB................................................................. 33
EDARBI.......................................................................10, 73
EDARBYCLOR.......................................................... 10, 73
EDECRIN.......................................................................... 11
EDEX..................................................................... 27, 63, 82
EDLUAR................................................................. 8, 63, 73
EDOXABAN TOSYLATE................................................ 32
EDROPHONIUM CHLORIDE........................................... 6
EDROPHONIUM CHLORIDE/ATROPINE...................... 6
EDURANT.................................................................. 40, 82
EFAVIRENZ...................................................................... 40
EFAVIRENZ/EMTRICITAB/TENOFOVIR..................... 40
EFFER-K(TABLET EFF)(10 MEQ)................................. 27
EFFEXOR XR..................................................................... 6
EFFIENT..................................................................... 33, 63
EFUDEX............................................................................19
EGRIFTA..................................................................... 28, 82
ELBASVIR/GRAZOPREVIR........................................... 41
ELDEPRYL....................................................................... 51
ELECTROLYTE-148 SOLUTION................................... 27
ELECTROLYTE-48 SOLUTION/D5W............................27
ELECTROLYTE-56 SOLUTION/D5W............................27
ELECTROLYTE-A SOLUTION...................................... 27
ELECTROLYTE-B SOLUTION/D5W.............................27
ELECTROLYTE-M SOLUTION/D5W............................ 27
ELECTROLYTE-MB SOLUTION/D5W......................... 27
ELECTROLYTE-P SOLUTION/D5W............................. 27
ELECTROLYTE-R (PH 7.4)............................................. 27
ELECTROLYTE-R SOLUTION....................................... 27
ELECTROLYTE-R SOLUTION/D5W.............................27
ELECTROLYTE-S (PH 7.4)............................................. 27
ELECTROLYTE-S SOLUTION....................................... 27
ELEMENT BLOOD GLUCOSE METER(OTC)............. 23
ELEMENT COMPACT V(OTC)...................................... 23
ELEMENT COMPACT(OTC).................................... 21, 23
ELEMENT PLUS(OTC)................................................... 23
ELEMENT TEST STRIPS(OTC)..................................... 21
ELESTAT........................................................................... 29
ELESTRIN........................................................................ 34
ELETRIPTAN HBR.......................................................... 51
ELIDEL................................................................. 19, 61, 73
ELIGARD.................................................................... 27, 82
ELIMITE........................................................................... 16
ELIQUIS(TAB)(2.5 MG)............................................ 32, 63
ELIQUIS(TAB)(5 MG)............................................... 32, 63
ELITE OB DHA................................................................ 57
ELITEK............................................................................. 31
ELITE-OB 400.................................................................. 58
ELLA........................................................................... 14, 85
ELLENCE..........................................................................45
ELMIRON......................................................................... 54
ELOCON........................................................................... 17
ELOCTATE....................................................................... 31
ELOTUZUMAB................................................................ 46
ELOXATIN........................................................................ 45
ELTROMBOPAG OLAMINE........................................... 33
ELUXADOLINE............................................................... 44
ELVITEG/COBI/EMTRIC/TENOFO ALA......................40
ELVITEGR/COBICIST/EMTRIC/TENOF.......................40
ELVITEGRAVIR............................................................... 40
EMADINE......................................................................... 29
EMBEDA(CAP ER PO)(100MG-4MG)..................... 50, 63
EMBEDA(CAP ER PO)(20MG-0.8MG).................... 50, 63
EMBEDA(CAP ER PO)(50 MG-2 MG)..................... 50, 63
EMBRACE EVO(OTC)...............................................21, 23
EMBRACE PRO(OTC)............................................... 21, 23
EMBRACE(OTC)........................................................ 21, 23
EMCYT....................................................................... 47, 63
EMEDASTINE DIFUMARATE....................................... 29
EMEND............................................................................... 4
EMEND(CAP DS PK).................................................. 4, 63
EMEND(CAP)(125 MG)...............................................4, 63
EMEND(CAP)(40 MG).................................................4, 63
EMEND(CAP)(80 MG).................................................4, 63
EMLA................................................................................ 19
EMOLLIENT COMBINATION NO.60............................18
EMPAGLIFLOZIN............................................................ 20
EMPAGLIFLOZIN/LINAGLIPTIN.................................. 20
EMPAGLIFLOZIN/METFORMIN HCL..........................20
EMPLICITI........................................................................46
EMSAM......................................................................... 8, 63
EMTRICITAB/RILPIVIRINE/TENOFOV....................... 40
EMTRICITABINE.............................................................40
EMTRICITABINE/TENOFOVIR..................................... 40
EMTRIVA(CAP)......................................................... 40, 63
EMTRIVA(SOLUTION)............................................. 40, 63
ENABLEX................................................................... 54, 73
ENALAPRIL MALEATE..................................................10
ENALAPRIL/HYDROCHLOROTHIAZIDE..................... 9
ENALAPRILAT................................................................ 10
ENALAPRILAT DIHYDRATE........................................ 10
ENALAPRIL-HYDROCHLOROTHIAZIDE..................... 9
ENBRACE HR.................................................................. 58
ENBREL...................................................................... 41, 82
ENDO-AVITENE.............................................................. 33
ENFUVIRTIDE................................................................. 40
ENGLISH PLANTAIN........................................................3
ENJUVIA.......................................................................... 34
ENLON................................................................................ 6
ENLON-PLUS..................................................................... 6
ENOXAPARIN SODIUM................................................. 32
ENSTILAR........................................................................ 19
ENTACAPONE................................................................. 51
ENTECAVIR..................................................................... 40
ENTEREG......................................................................... 45
ENTOCORT EC................................................................ 41
ENTRESTO........................................................... 13, 63, 82
ENTYVIO....................................................................44, 82
ENVARSUS XR................................................................ 35
ENZALUTAMIDE............................................................ 45
EPANED.......................................................... 10, 61, 63, 73
EPICOCCUM...................................................................... 3
EPIDUO........................................................... 14, 61, 63, 73
EPIDUO FORTE............................................. 14, 61, 63, 73
EPIFOAM.......................................................................... 18
EPINASTINE HCL........................................................... 29
EPINEPHRINE..............................................................4, 45
EPINEPHRINE HCL.........................................................14
EPINEPHRINE HCL/D5W................................................. 4
EPINEPHRINE HCL/PF..................................................... 4
EPINEPHRINE HCL-0.9% NACL..................................... 4
EPINEPHRINE HCL-D5W.................................................4
Page 91 of 106
�
Index
EPINEPHRINE IN 0.9 % NACL/PF................................... 4
EPIPEN 2-PAK.................................................................. 45
EPIPEN JR 2-PAK.............................................................45
EPIRUBICIN HCL............................................................ 45
EPISNAP............................................................................. 4
EPIVIR HBV(SOLUTION).............................................. 40
EPIVIR HBV(TAB)........................................................... 40
EPIVIR(SOLUTION).................................................. 40, 63
EPIVIR(TAB)(150 MG).............................................. 40, 63
EPIVIR(TAB)(300 MG).............................................. 40, 63
EPLERENONE..................................................................11
EPOETIN ALFA............................................................... 32
EPOGEN......................................................................32, 82
EPOPROSTENOL SODIUM (ARGININE)..................... 11
EPOPROSTENOL SODIUM (GLYCINE)....................... 11
EPROSARTAN MESYLATE...................................... 10, 73
EPTIFIBATIDE................................................................. 33
EPZICOM.................................................................... 40, 63
EQUETRO........................................................................... 7
ERAXIS (WATER DILUENT)..........................................38
ERBITUX.................................................................... 46, 82
ERGOCALCIFEROL (VITAMIN D2)............................. 60
ERGOLOID MESYLATES............................................... 13
ERGOMAR................................................................. 51, 63
ERGOTAMINE TARTRATE.............................................51
ERGOTAMINE TARTRATE/CAFFEINE........................ 51
ERIBULIN MESYLATE................................................... 46
ERIVEDGE........................................................... 46, 63, 82
ERLOTINIB HCL............................................................. 47
ERTACZO.......................................................................... 16
ERTAPENEM SODIUM................................................... 36
ERWINAZE................................................................. 47, 82
ERYGEL............................................................................ 15
ERYPED 200..................................................................... 37
ERYPED 400..................................................................... 37
ERY-TAB........................................................................... 37
ERYTHROCIN LACTOBIONATE................................... 37
ERYTHROCIN STEARATE............................................. 37
ERYTHROMYCIN......................................................15, 37
ERYTHROMYCIN BASE.......................................... 29, 37
ERYTHROMYCIN BASE/ETHANOL............................ 15
ERYTHROMYCIN ETHYLSUCCINATE........................37
ERYTHROMYCIN LACTOBIONATE............................ 37
ERYTHROMYCIN STEARATE.......................................37
ERYTHROMYCIN/BENZOYL PEROXIDE................... 15
ESBRIET..................................................................... 48, 82
ESCAVITE.........................................................................57
ESCAVITE D..................................................................... 57
ESCAVITE LQ.................................................................. 57
ESCITALOPRAM OXALATE............................................ 6
ESGIC................................................................................ 49
ESLICARBAZEPINE ACETATE..................................... 52
ESMOLOL HCL............................................................... 10
ESMOLOL IN SODIUM CHLORIDE,ISO......................10
ESOMEPRAZOLE MAGNESIUM.................................. 54
ESOMEPRAZOLE SODIUM........................................... 54
ESTAZOLAM..................................................................... 8
ESTRACE.................................................................... 34, 55
ESTRADIOL............................................................... 34, 55
ESTRADIOL ACETATE...................................................55
ESTRADIOL CYPIONATE.............................................. 34
ESTRADIOL VALERATE................................................ 34
ESTRADIOL VALERATE/DIENOGEST........................ 13
ESTRADIOL/LEVONORGESTREL............................... 34
ESTRADIOL/NORETHINDRONE ACET.......................34
ESTRADIOL/NORGESTIMATE..................................... 34
ESTRADIOL-NORETHINDRONE ACETAT..................34
ESTRAMUSTINE PHOSPHATE SODIUM.................... 47
ESTRING.................................................................... 55, 64
ESTROGEL....................................................................... 34
ESTROGEN,CON/M-PROGEST ACET.......................... 34
ESTROGEN,ESTER/ME-TESTOSTERONE...................34
ESTROGEN-METHYLTESTOSTERONE.......................34
ESTROGENS, CONJUGATED.................................. 34, 55
ESTROGENS,CONJ.,SYNTHETIC B............................. 34
ESTROGENS,CONJ/BAZEDOXIFENE.......................... 34
ESTROGENS,ESTERIFIED............................................. 34
ESTROPIPATE.................................................................. 34
ESZOPICLONE.................................................................. 8
ETANERCEPT.................................................................. 41
ETHACRYNATE SODIUM.............................................. 11
ETHACRYNIC ACID....................................................... 11
ETHAMBUTOL HCL....................................................... 38
ETHINYL ESTRADIOL/DROSPIRENONE................... 13
ETHIONAMIDE............................................................... 38
ETHOSUXIMIDE............................................................. 52
ETHOTOIN....................................................................... 52
ETHYL CHLORIDE......................................................... 19
ETHYNODIOL D-ETHINYL ESTRADIOL....................13
ETIDRONATE DISODIUM.............................................. 28
ETODOLAC...................................................................... 42
ETONOGESTREL/ETHINYL ESTRADIOL...................13
Sutter Health Plus
ETOPOPHOS.................................................................... 47
ETOPOSIDE................................................................47, 64
ETOPOSIDE PHOSPHATE.............................................. 47
ETOPOSIDE(CAP)..................................................... 47, 64
ETOPOSIDE(VIAL)......................................................... 47
ETRAVIRINE.................................................................... 40
EURAX..............................................................................16
EVAMIST.......................................................................... 34
EVARREST....................................................................... 33
EVEKEO....................................................................... 6, 82
EVENCARE G2(OTC)................................................21, 23
EVENCARE G3(OTC)................................................21, 23
EVENCARE MINI GLUCOSE TEST STR(OTC)........... 21
EVENCARE MINI MONITOR SYSTEM(OTC)............. 23
EVENCARE(OTC)..................................................... 21, 23
EVEROLIMUS............................................................ 35, 46
EVICEL............................................................................. 34
EVISTA................................................................. 28, 64, 82
EVOCLIN.......................................................................... 15
EVOLOCUMAB............................................................... 12
EVOLUTION BLOOD GLUCOSE METER(OTC)......... 23
EVOLUTION TEST STRIPS(OTC)................................. 21
EVOTAZ...................................................................... 40, 64
EVOXAC........................................................................... 45
EVZIO........................................................................... 8, 64
EXELDERM......................................................................16
EXELON....................................................................... 6, 64
EXEMESTANE................................................................. 46
EXENATIDE..................................................................... 20
EXENATIDE MICROSPHERES...................................... 20
EXFORGE................................................................... 10, 73
EXFORGE HCT............................................................ 9, 73
EXODERM........................................................................16
EXPAREL.......................................................................... 43
EXTAVIA.................................................................... 48, 82
EXTINA.............................................................................16
EXTRA-VIRT PLUS DHA............................................... 58
EYLEA........................................................................ 30, 82
EZ SMART PLUS(OTC).............................................21, 23
EZ SMART(OTC)....................................................... 21, 23
EZ USE JOINT-TUNNEL-TRIGGER.............................. 42
EZETIMIBE...................................................................... 12
EZETIMIBE/ATORVASTATIN CALCIUM..................... 12
EZETIMIBE/SIMVASTATIN........................................... 12
EZOGABINE.................................................................... 52
-F
FA#7/PC,PE DHA/NAC/PAP/IF/MV46............................55
FA/MVI THER-MIN/LYCOPENE/LUT...........................56
FA/VIT C/E/ZINC/COPPER/LUT/ZEA........................... 55
FABIOR....................................................................... 15, 61
FACTIVE........................................................................... 37
FACTOR IX....................................................................... 32
FACTOR IX CPLX(PCC)#4, 3FACTOR.......................... 32
FACTOR IX CPLX(PCC)#6, 3FACTOR.......................... 32
FACTOR IX HUMAN RECOMB,THR 148.....................32
FACTOR IX HUMAN RECOMBINANT.........................32
FACTOR IX REC, FC FUSION PROTN.......................... 32
FACTOR XIII.................................................................... 32
FACTOR XIII A-SUBUNIT,RECOMB............................ 32
FAMCICLOVIR................................................................ 39
FAMOTIDINE................................................................... 54
FAMOTIDINE IN NACL,ISO-OSM/PF........................... 54
FAMOTIDINE/PF............................................................. 54
FAMVIR............................................................................ 39
FANAPT(TAB DS PK)............................................ 7, 64, 73
FANAPT(TAB)........................................................ 7, 64, 73
FARESTON........................................................... 47, 64, 82
FARXIGA.............................................................. 20, 64, 73
FARYDAK............................................................. 47, 64, 82
FASLODEX................................................................. 47, 82
FE FUMARATE/CAL/E/FA/MULTIVIT......................... 55
FE FUMARATE/DOSS/FA/BCOMP,C............................ 55
FE FUMARATE/FA/VIT BCOMP,C................................ 56
FE FUMARATE/VIT C/B12/STOMC.............................. 55
FE FUMARATE/VIT C/B12-IF/FA.................................. 55
FEBUXOSTAT.................................................................. 31
FEIBA NF.......................................................................... 32
FELBAMATE.................................................................... 52
FELBATOL(ORAL SUSP)................................... 52, 64, 73
FELBATOL(TAB)(400 MG)................................. 52, 64, 73
FELBATOL(TAB)(600 MG)................................. 52, 64, 73
FELDENE..........................................................................43
FELODIPINE.................................................................... 11
FELODIPINE ER.............................................................. 11
FEM PH............................................................................. 55
FEMARA........................................................................... 46
FEMRING................................................................... 55, 64
FENOFIBRATE........................................................... 12, 13
FENOFIBRATE NANOCRYSTALLIZED....................... 13
FENOFIBRATE,MICRONIZED....................................... 13
FENOFIBRIC ACID......................................................... 13
FENOFIBRIC ACID (CHOLINE).................................... 13
FENOGLIDE..................................................................... 12
FENOLDOPAM MESYLATE.......................................... 10
FENOPROFEN CALCIUM.............................................. 42
FENOPROFEN CALCIUM(CAP).................................... 42
FENOPROFEN CALCIUM(TAB).................................... 42
FENTANYL...........................................................49, 64, 82
FENTANYL CITRATE..................................................... 49
FENTANYL CITRATE/PF................................................49
FENTANYL CITRATE-0.9 % NACL/PF......................... 49
FENTANYL CITRATE-0.9% NACL................................49
FENTANYL HCL..............................................................49
FENTANYL/BUPIVACAINE/NS/PF............................... 49
FENTANYL/ROPIVACAINE/NS/PF............................... 49
FENTANYL-BUPIVACAINE-0.9% NACL......................49
FENTANYL-ROPIVACAINE-0.9% NACL......................49
FENTORA................................................................... 49, 82
FERAHEME...................................................................... 55
FERIVA............................................................................. 56
FERIVA 21-7..................................................................... 56
FERIVA FA........................................................................56
FEROCON......................................................................... 55
FERRALET 90.................................................................. 55
FERRAPLUS 90................................................................ 56
FERREX 150 FORTE PLUS............................................. 55
FERREX 28....................................................................... 55
FERRIC AMCIT/LYS/VIT B COMP/FA......................... 55
FERRIC CARBOXYMALTOSE...................................... 55
FERRIC CITRATE............................................................ 26
FERRIC PYROPHOSPHATE CITRATE..........................55
FERRIC SUBSULFATE.................................................... 33
FERRLECIT...................................................................... 56
FERROUS FUMARATE/FOLIC ACID............................55
FERROUS SULFATE........................................................ 55
FERUMOXYTOL............................................................. 55
FESOTERODINE FUMARATE....................................... 54
FETZIMA................................................................ 6, 64, 73
FEXMID............................................................................ 53
FEXOFENADINE HCL...................................................... 4
FEXOFENADINE/PSEUDOEPHEDRINE........................ 3
FEXOFENADINE-PSE ER................................................. 3
FIBRICOR......................................................................... 13
FIBRINOGEN................................................................... 31
FIBRINOGEN/THROMBIN(HUMAN DER).................. 33
FIDAXOMICIN.................................................................37
FIFTY50 TEST STRIP(OTC)........................................... 21
FILGRASTIM................................................................... 33
FILGRASTIM-SNDZ........................................................33
FINACEA.......................................................................... 15
FINASTERIDE.................................................................. 54
FINGOLIMOD HCL......................................................... 48
FIORICET......................................................................... 49
FIORINAL......................................................................... 49
FIORINAL WITH CODEINE #3......................................51
FIRAZYR.................................................................... 41, 82
FIRMAGON(VIAL)(120 MG).................................... 46, 64
FIRMAGON(VIAL)(80 MG)...................................... 46, 64
FLAGYL............................................................................ 39
FLAGYL ER......................................................................39
FLAREX............................................................................ 29
FLAVOXATE HCL............................................................54
FLEBOGAMMA DIF................................................. 35, 82
FLECAINIDE ACETATE....................................................9
FLECTOR..........................................................................17
FLEXBUMIN.................................................................... 33
FLEXEPAX....................................................................... 53
FLIBANSERIN................................................................... 8
FLOLAN......................................................................11, 82
FLOMAX.......................................................................... 54
FLO-PRED........................................................................ 42
FLORIVA.....................................................................55, 57
FLOVENT DISKUS(BLST W/DEV)(100 MCG)...... 5, 64,
73
73
73
FLOVENT HFA(AER W/ADAP)(110 MCG).........5, 64, 73
FLOVENT HFA(AER W/ADAP)(220 MCG).........5, 64, 74
FLOVENT HFA(AER W/ADAP)(44 MCG)...........5, 64, 74
FLOWTUSS.......................................................... 14, 64, 74
FLOXURIDINE.................................................................45
FLU VACC QV LIVE 2015(2-49YRS).............................35
FLUCAINE........................................................................29
FLUCONAZOLE.............................................................. 38
FLUCONAZOLE IN DEXTROSE................................... 38
FLUCONAZOLE IN DEXTROSE,ISO-OS..................... 38
FLUCONAZOLE IN NACL,ISO-OSM............................ 38
FLUCONAZOLE-NACL.................................................. 38
FLUCYTOSINE................................................................ 38
FLUDARABINE PHOSPHATE........................................45
FLUDROCORTISONE ACETATE................................... 42
FLUMADINE.................................................................... 39
Page 92 of 106
�
Index
FLUMAZENIL.................................................................... 8
FLUMIST QUAD 2015-2016................................35, 61, 64
FLUNISOLIDE......................................................... 4, 5, 64
FLUOCINOLONE ACETONIDE...............................17, 29
FLUOCINOLONE ACETONIDE OIL............................. 26
FLUOCINOLONE/EMOL CMB#65................................ 17
FLUOCINOLONE/SHOWER CAP..................................17
FLUOCINOLONE/SKIN CLNSR28................................ 17
FLUOCINONIDE..............................................................17
FLUOCINONIDE/EMOLLIENT BASE.......................... 17
FLUOCINONIDE-E.......................................................... 17
FLUORABON................................................................... 55
FLUOR-A-DAY.................................................................55
FLUORIDE........................................................................55
FLUORIDE/IRON/VITAMINS A,C,D............................. 56
FLUORIDEX SENSITIVITY RELIEF.............................55
FLUORITAB..................................................................... 55
FLUOROMETHOLONE...................................................29
FLUOROMETHOLONE ACETATE................................ 29
FLUOROPLEX................................................................. 19
FLUOROURACIL....................................................... 19, 45
FLUOXETINE HCL............................................................6
FLUOXYMESTERONE................................................... 34
FLUPHENAZINE DECANOATE.......................................8
FLUPHENAZINE HCL...................................................... 8
FLURA-DROPS................................................................ 55
FLURANDRENOLIDE.................................................... 17
FLURAZEPAM HCL.......................................................... 8
FLURBIPROFEN.............................................................. 42
FLURBIPROFEN SODIUM............................................. 29
FLUROX............................................................................ 29
FLUTAMIDE.....................................................................45
FLUTICASONE FUROATE........................................... 4, 5
FLUTICASONE PROPIONATE......................... 4, 5, 17, 64
FLUTICASONE/SALMETEROL.......................................5
FLUTICASONE/VILANTEROL........................................ 5
FLUVASTATIN SODIUM................................................ 12
FLUVOXAMINE MALEATE............................................. 6
FML................................................................................... 29
FML FORTE...................................................................... 29
FML S.O.P......................................................................... 29
FOCALIN XR(CPBP 50-50)(10 MG).....................8, 61, 64
FOCALIN XR(CPBP 50-50)(5 MG).......................8, 61, 64
FOLBECAL....................................................................... 59
FOLBEE............................................................................ 59
FOLBEE PLUS CZ........................................................... 59
FOLET DHA..................................................................... 57
FOLET ONE...................................................................... 57
FOLGARD OS.................................................................. 55
FOLIC ACID..................................................................... 55
FOLIC ACID(OTC).....................................................55, 85
FOLIC ACID/B COMPLEX & C NO.17..........................59
FOLIC ACID/B CPLX/C/SELEN/ZINC.......................... 59
FOLIC ACID/MV,FE,OTHER MIN................................. 56
FOLIC ACID/VIT BCOMP,C........................................... 59
FOLIC ACID/VIT BCOMP,C/CU/ZNOX........................ 59
FOLOTYN......................................................................... 46
FONDAPARINUX SODIUM............................................32
FORA D10(OTC)........................................................ 21, 23
FORA D15(OTC).............................................................. 22
FORA D15G(OTC)........................................................... 21
FORA D20(OTC)........................................................ 21, 23
FORA D40(OTC).............................................................. 23
FORA D40-G31 TEST STRIPS(OTC)............................. 21
FORA G20(OTC)........................................................ 21, 23
FORA G30A(OTC)..................................................... 21, 23
FORA GD50 TEST STRIPS(OTC)...................................21
FORA GD50(OTC)........................................................... 23
FORA LANCING DEVICE(OTC)............................. 25, 64
FORA TEST N'GO VOICE(OTC).................................... 23
FORA TN'G VOICE TEST STRIPS(OTC)...................... 21
FORA TN'G VOICE(OTC)............................................... 23
FORA V10(OTC)........................................................ 21, 23
FORA V12(OTC)........................................................ 21, 23
FORA V20(OTC)........................................................ 21, 23
FORA V30A(OTC)..................................................... 21, 23
FORA(OTC)...................................................................... 21
FORACARE GD20(OTC)........................................... 21, 23
FORACARE GD40(OTC)................................................. 21
FORACARE GD40A(OTC).............................................. 23
FORACARE GD40B(OTC).............................................. 23
FORADIL................................................................ 5, 64, 74
FORFIVO XL.......................................................... 6, 64, 74
FORMOTEROL FUMARATE............................................ 5
FORTAVIT......................................................................... 56
FORTAZ............................................................................ 36
Sutter Health Plus
FORTAZ IN ISO-OSMOTIC DEXTROSE.......................36
FORTEO...................................................................... 28, 64
FORTESTA.................................................................. 34, 82
FORTICAL........................................................................ 28
FORTISCARE BLOOD GLUCOSE SYST(OTC)............23
FORTISCARE GLUCOSE TEST STRIPS(OTC)............ 21
FOSAMAX........................................................................ 28
FOSAMAX PLUS D......................................................... 28
FOSAMPRENAVIR CALCIUM....................................... 40
FOSAPREPITANT DIMEGLUMINE................................ 4
FOSCARNET SODIUM................................................... 39
FOSCAVIR........................................................................ 39
FOSFOMYCIN TROMETHAMINE................................ 36
FOSINOPRIL SODIUM................................................... 10
FOSINOPRIL/HYDROCHLOROTHIAZIDE.................... 9
FOSINOPRIL-HYDROCHLOROTHIAZIDE.................... 9
FOSPHENYTOIN SODIUM............................................ 52
FOSRENOL....................................................................... 26
FRAGMIN(SYRINGE)(10000/ML)........................... 32, 64
FRAGMIN(SYRINGE)(12500/0.5)............................ 32, 64
FRAGMIN(SYRINGE)(15000/0.6)............................ 32, 64
FRAGMIN(SYRINGE)(18000/0.72).......................... 32, 64
FRAGMIN(SYRINGE)(2500/0.2ML)........................ 32, 64
FRAGMIN(VIAL)....................................................... 32, 64
FREESTYLE INSULINX(OTC)....................................... 21
FREESTYLE LITE(OTC)................................................. 21
FREESTYLE PRECISION NEO(OTC)............................21
FREESTYLE(OTC)...........................................................21
FROVA................................................................... 51, 64, 74
FROVATRIPTAN SUCCINATE........................................ 51
FULVESTRANT............................................................... 47
FULYZAQ............................................................. 44, 64, 74
FURADANTIN................................................................. 37
FUROSEMIDE.................................................................. 11
FUSILEV........................................................................... 47
FUSION PLUS.................................................................. 56
FUSION SPRINKLES.......................................................56
FUZEON................................................................40, 64, 74
FYCOMPA(TAB)(10 MG).................................... 52, 64, 74
FYCOMPA(TAB)(12 MG).................................... 52, 64, 74
FYCOMPA(TAB)(2 MG)...................................... 52, 64, 74
FYCOMPA(TAB)(4 MG)...................................... 52, 64, 74
FYCOMPA(TAB)(6 MG)...................................... 52, 64, 74
FYCOMPA(TAB)(8 MG)...................................... 52, 64, 74
-G
G-4(OTC)...........................................................................21
GABAPENTIN............................................................ 48, 52
GABAPENTIN ENACARBIL.......................................... 48
GABITRIL(TAB)(12 MG).................................... 52, 64, 74
GABITRIL(TAB)(16 MG).................................... 52, 64, 74
GABITRIL(TAB)(2 MG)...................................... 52, 64, 74
GABITRIL(TAB)(4 MG)...................................... 52, 64, 74
GABLOFEN...................................................................... 53
GALANTAMINE HBR....................................................... 6
GAMASTAN S-D........................................................35, 82
GAMMAGARD LIQUID............................................ 35, 82
GAMMAGARD S-D................................................... 35, 82
GAMMAKED............................................................. 35, 82
GAMMAPLEX............................................................35, 82
GAMUNEX-C............................................................. 35, 82
GANCICLOVIR................................................................ 29
GANCICLOVIR SODIUM............................................... 39
GARAMYCIN................................................................... 30
GASTROCROM.................................................................. 5
GATIFLOXACIN.............................................................. 30
GATTEX...................................................................... 45, 82
GAVILYTE-C.................................................................... 44
GAVILYTE-N.................................................................... 44
GAZYVA..................................................................... 45, 82
GDRIVE(OTC).................................................................. 23
GE100 BLOOD GLUCOSE SYSTEM(OTC).................. 23
GE100 BLOOD GLUCOSE TEST STRIP(OTC).............22
GEFITINIB........................................................................ 47
GELATIN.......................................................................... 30
GELFILM.......................................................................... 30
GELNIQUE................................................................. 54, 74
GEMCITABINE HCL....................................................... 45
GEMFIBROZIL.................................................................13
GEMIFLOXACIN MESYLATE....................................... 37
GEMZAR.......................................................................... 45
GENERLAC...................................................................... 44
GENOTROPIN............................................................ 28, 82
GENSTRIP(OTC).............................................................. 22
GENTAMICIN IN NACL, ISO-OSM............................... 38
GENTAMICIN SULFATE.....................................15, 30, 38
GENTAMICIN SULFATE IN NS..................................... 38
GENTAMICIN SULFATE/PF........................................... 38
GENTAMICIN/PREDNISOL AC.....................................29
GENTIAN VIOL/BRLNT GRN/PROFLAV.....................16
GENULTIMATE TEST(OTC).......................................... 22
GENVOYA........................................................................ 40
GEODON...................................................................... 7, 64
GIAZO......................................................................... 43, 74
GILENYA.................................................................... 48, 82
GILOTRIF............................................................. 46, 64, 82
GLASSIA.......................................................................... 45
GLATIRAMER ACETATE............................................... 48
GLEEVEC(TAB)(100 MG)................................... 47, 64, 82
GLEEVEC(TAB)(400 MG)................................... 47, 64, 82
GLEOSTINE............................................................... 45, 64
GLIADEL.......................................................................... 45
GLIMEPIRIDE.................................................................. 20
GLIPIZIDE........................................................................ 20
GLIPIZIDE/METFORMIN HCL...................................... 20
GLIPIZIDE-METFORMIN............................................... 20
GLUCAGEN..................................................................... 25
GLUCAGON EMERGENCY KIT................................... 25
GLUCAGON,HUMAN RECOMBINANT.......................25
GLUCARPIDASE............................................................. 47
GLUCO NAVII(OTC)................................................. 22, 23
GLUCOCARD 01 SENSOR PLUS(OTC)........................22
GLUCOCARD 01(OTC)................................................... 23
GLUCOCARD EXPRESSION(OTC)......................... 22, 23
GLUCOCARD SHINE(OTC)..................................... 22, 23
GLUCOCARD VITAL SENSOR(OTC)........................... 22
GLUCOCARD VITAL(OTC)........................................... 23
GLUCOCOM BLOOD GLUCOSE(OTC)........................24
GLUCOCOM GLUCOSE(OTC)...................................... 22
GLUCOLET 2(OTC)................................................... 25, 64
GLUCOPHAGE................................................................ 20
GLUCOSE TEST STRIP(OTC)........................................ 22
GLUCOTROL................................................................... 20
GLUCOVANCE................................................................ 20
GLYBURIDE..................................................................... 20
GLYBURIDE,MICRONIZED........................................... 20
GLYBURIDE/METFORMIN HCL...................................20
GLYBURIDE-METFORMIN HCL.................................. 20
GLYCEROL PHENYLBUTYRATE................................. 44
GLYCINE UROLOGIC SOLUTION................................38
GLYCOPHOS....................................................................27
GLYCOPYRROLATE................................................... 4, 53
GLYNASE......................................................................... 20
GLYSET............................................................................ 20
GLYXAMBI.......................................................... 20, 64, 74
GMATE LANCING DEVICE(OTC).......................... 25, 64
GMATE SMART METER(OTC)...................................... 24
GMATE SMART STARTER(OTC).................................. 24
GMATE TEST STRIPS(OTC).......................................... 22
GMATE VOICE METER(OTC)....................................... 24
GMATE VOICE STARTER(OTC)....................................24
GOLIMUMAB.................................................................. 41
GOLYTELY....................................................................... 44
GORDO-UREA........................................................... 18, 19
GOSERELIN ACETATE...................................................27
GR POL-ORC/SW VER/RYE/KENT/TIM........................ 3
GRALISE(TAB ER 24H)(300 MG)...................... 48, 64, 74
GRALISE(TAB ER 24H)(300-600 MG)...............48, 64, 74
GRALISE(TAB ER 24H)(600 MG)...................... 48, 64, 74
GRANISETRON................................................................. 4
GRANISETRON HCL............................................ 4, 64, 75
GRANISETRON HCL(TAB).................................. 4, 64, 75
GRANISETRON HCL(VIAL)............................................ 4
GRANISETRON HCL/PF................................................... 4
GRANIX...................................................................... 33, 82
GRANULEX..................................................................... 19
GRASS POLLEN-BAHIA.................................................. 3
GRASS POLLEN-BERMUDA, STANDARD....................3
GRASS POLLEN-JOHNSON.............................................3
GRASS POLLEN-JUNE GRASS,STD...............................3
GRASS POLLEN-ORCHARD GRASS,STD.....................3
GRASS POLLEN-PERENNIAL RYE,STD....................... 3
GRASS POLLEN-TIMOTHY, STANDARD......................3
GRASTEK..................................................................... 3, 82
GRIFULVIN V.................................................................. 38
GRISEOFULVIN...............................................................38
GRISEOFULVIN ULTRAMICROSIZE........................... 38
GRISEOFULVIN, MICROSIZE....................................... 38
GRIS-PEG......................................................................... 38
GUAIACOL....................................................................... 18
GUAIFENESIN/CODEINE PHOSPHATE.......................14
GUAIFENESIN/HYDROCODONE................................. 14
GUANFACINE HCL..................................................... 8, 10
GUANIDINE HCL............................................................ 45
GUARDIAN REAL-TIME................................................23
GYNAZOLE 1................................................................... 55
GYNOL II(OTC)......................................................... 13, 85
-H
H.P. ACTHAR............................................................. 27, 82
HALAVEN...................................................................46, 82
HALCINONIDE................................................................ 17
HALCION........................................................................... 8
HALDOL DECANOATE 50............................................... 7
Page 93 of 106
�
Index
HALOBETASOL PROPIONATE..................................... 17
HALOBETASOL/LACTIC ACID.....................................17
HALOG............................................................................. 17
HALOPERIDOL................................................................. 7
HALOPERIDOL DECANOATE.................................... 7, 8
HALOPERIDOL LACTATE............................................... 8
HARVONI................................................................... 40, 82
HC/MINERAL OIL/PETROLAT,WHT............................ 17
HC/PRAMOXINE HCL/CHLOROXYLENOL................ 26
HEALTHPRO GLUCOSE MONITOR(OTC)...................24
HEALTHPRO TEST STRIPS(OTC).................................22
HEALTHY ACCENTS AUTOLET(OTC) .................. 25, 64
HECTOROL...................................................................... 28
HECTOROL(CAP)............................................................ 28
HECTOROL(VIAL)(2MCG/ML(1))................................ 28
HECTOROL(VIAL)(4MCG/2ML)................................... 28
HELIXATE FS...................................................................31
HEMABATE...................................................................... 14
HEMANGEOL................................................ 10, 61, 64, 75
HEMATINIC PLUS...........................................................56
HEMATOGEN.................................................................. 55
HEMATRON..................................................................... 55
HEMATRON-AF............................................................... 56
HEMENATAL OB............................................................. 58
HEMENATAL OB + DHA................................................ 57
HEMIN.............................................................................. 32
HEMMOREX-HC............................................................. 44
HEMOCYTE-F..................................................................55
HEMOFIL M..................................................................... 31
HEPAGAM B.................................................................... 34
HEPARIN FLUSH....................................................... 32, 33
HEPARIN SOD,PORCINE/0.9 % NACL......................... 32
HEPARIN SOD,PORK IN 0.45% NACL..........................32
HEPARIN SODIUM..........................................................32
HEPARIN SODIUM IN 0.45% NACL(IV
SOLN)(12500/250)............................................................ 32
SOLN)(25000/250)............................................................ 32
SOLN)(25000/500)............................................................ 32
HEPARIN SODIUM,PORCINE....................................... 32
HEPARIN SODIUM,PORCINE/D5W..............................33
HEPARIN SODIUM,PORCINE/NS/PF............................33
HEPARIN SODIUM,PORCINE/PF.................................. 33
HEPARIN SODIUM-0.9% NACL.................................... 33
HEPARIN SODIUM-D5W................................................33
HEPATITIS B IMMUN GLOB/MALTOSE......................34
HEPATITIS B IMMUNE GLOBULIN............................. 34
HEPSERA..........................................................................40
HERCEPTIN............................................................... 46, 82
HES 130/0.4 IN 0.9 % NACL........................................... 33
HESPAN............................................................................ 33
HETASTARCH IN 0.9 % NACL...................................... 33
HETASTARCH/E-LYTES,LACTATE.............................. 33
HETLIOZ...................................................................... 8, 82
HEXALEN.................................................................. 45, 64
HEXTEND LACTATED ELECTROLYTE.......................33
HIPREX............................................................................. 36
HISTRELIN AC................................................................ 28
HIZENTRA................................................................. 35, 82
HOMATROPAIRE............................................................ 30
HOMATROPINE HBR......................................................30
HORIZANT(TAB ER)(300 MG).......................... 48, 64, 75
HORIZANT(TAB ER)(600 MG).......................... 48, 64, 75
HORSE EPITHELIUM....................................................... 3
HUM PROTHROMBIN CPLX(PCC)4FACT................... 32
HUMALOG KWIKPEN U-100.................................. 26, 64
HUMALOG KWIKPEN U-200.................................. 26, 64
HUMALOG MIX 50-50.............................................. 26, 64
HUMALOG MIX 50-50 KWIKPEN.......................... 26, 64
HUMALOG MIX 75-25.............................................. 26, 64
HUMALOG MIX 75-25 KWIKPEN.......................... 26, 64
HUMALOG(CARTRIDGE)........................................26, 64
HUMALOG(VIAL)..................................................... 26, 64
HUMATE-P....................................................................... 31
HUMATROPE............................................................. 28, 82
HUMIRA..................................................................... 41, 82
HUMIRA PEDIATRIC CROHN'S..............................41, 82
HUMIRA PEN.............................................................41, 82
HUMIRA PEN CROHN'S-UC-HS............................. 41, 83
HUMIRA PEN PSORIASIS........................................41, 83
HUMULIN 70/30 KWIKPEN(OTC).......................... 26, 64
HUMULIN 70-30(OTC)..............................................26, 64
HUMULIN N KWIKPEN(OTC).................................26, 64
HUMULIN N(OTC).................................................... 26, 64
HUMULIN R U-500....................................................26, 64
HUMULIN R(OTC).................................................... 26, 64
HYALURONIDASE.......................................................... 19
HYALURONIDASE, HUMAN RECOMB.......................19
HYALURONIDASE,OVINE............................................. 19
HYCAMTIN................................................................ 46, 64
HYCAMTIN(CAP)..................................................... 46, 64
Sutter Health Plus
HYCAMTIN(VIAL)..........................................................46
HYCET........................................................................ 49, 64
HYCOFENIX........................................................ 14, 64, 75
HYDRALAZINE HCL...................................................... 10
HYDREA..................................................................... 45, 64
HYDRO 35........................................................................ 18
HYDROCHLOROTHIAZIDE.......................................... 12
HYDROCODONE BIT/HOMATROP ME-BR.................14
HYDROCODONE BITARTRATE....................................49
HYDROCODONE/ACETAMINOPHEN..........................49
HYDROCODONE/CHLORPHEN P-STIREX................. 14
HYDROCODONE/CHLORPHENIRAMINE.................. 14
HYDROCODONE/CPM/PSEUDOEPHED..................... 14
HYDROCODONE/IBUPROFEN..................................... 49
HYDROCODONE/PSEUDOEPHED/GUAIF..................14
HYDROCODONE-ACETAMINOPHEN(SOLUTION)(10
325/15)......................................................................... 49, 64
HYDROCODONE
ACETAMINOPHEN(SOLUTION)(2.5-167/5)...........49, 65
HYDROCODONE-ACETAMINOPHEN(SOLUTION)(5
163/7.5)........................................................................ 49, 65
HYDROCODONE-ACETAMINOPHEN(TAB)(10MG
300MG)........................................................................49, 65
325MG)........................................................................49, 65
HYDROCODONE-ACETAMINOPHEN(TAB)(5 MG
325MG)........................................................................49, 65
300MG)........................................................................49, 65
HYDROCODONE-ACETAMINOPHEN(TAB)(7.5
300MG)........................................................................49, 65
HYDROCODONE-ACETAMINOPHEN(TAB)(7.5
325MG)........................................................................49, 65
HYDROCODONE-IBUPROFEN..................................... 49
HYDROCORT/PRAMOXIN/EMOL/PRAM#1................44
HYDROCORT/PRAMOXN/SKN CLNSR#16.................44
HYDROCORT/SAL ACID/SULF/SHMP#1.....................17
HYDROCORTISONE........................................... 17, 41, 44
HYDROCORTISONE ACETATE.....................................44
HYDROCORTISONE ACETATE/ALOE V ..................... 17
HYDROCORTISONE ACETATE/UREA.........................17
HYDROCORTISONE BUTYRATE................................. 17
HYDROCORTISONE BUTYRATE/EMOLL.................. 17
HYDROCORTISONE PROBUTATE............................... 17
HYDROCORTISONE SOD SUCC/PF............................. 42
HYDROCORTISONE SOD SUCCINATE....................... 42
HYDROCORTISONE VALERATE.................................. 17
HYDROCORTISONE/EMOL NO.45............................... 17
HYDROCORTISONE/IODOQUIN/ALOE#2.................. 15
HYDROCORTISONE/IODOQUINOL.............................15
HYDROCORTISONE/IODOQUINOL/ALOE.................15
HYDROCORTISONE/LIDOCAINE/ALOE.................... 44
HYDROCORTISONE/PRAMOXINE.................. 18, 19, 44
HYDROCORTISONE/PRAMOXINE/ALOE...................19
HYDROCORTISONE/PRAMOXINE/EMOLL............... 19
HYDROCORTISONE/SKIN CLNSR #25........................17
HYDROCORTISONE/SKIN CLNSR #35........................17
HYDROCORTISONE-ACETIC ACID.............................26
HYDROCORTISONE-IODOQUINOL............................ 15
HYDROMET..................................................................... 14
HYDROMORPH-BUPIVAC-0.9% NACL........................50
HYDROMORPHONE HCL........................................ 49, 50
HYDROMORPHONE HCL IN 0.9% NACL....................50
HYDROMORPHONE HCL/PF........................................ 50
HYDROMORPHONE HCL-0.9% NACL.........................50
HYDROMORPHONE/BUPIV/0.9NACL/PF................... 50
HYDROXOCOBALAMIN................................................60
HYDROXYAMPHETAMINE/TROPICAMIDE...............30
HYDROXYCHLOROQUINE SULFATE......................... 39
HYDROXYPROGESTERONE CAPROATE................... 34
HYDROXYPROPYL CELLULOSE.................................30
HYDROXYUREA....................................................... 33, 45
HYDROXYZINE HCL........................................................3
HYDROXYZINE PAMOATE............................................. 3
HYLENEX........................................................................ 19
HYOPHEN........................................................................ 36
HYOSCYAMINE SULFATE.............................................53
HYPERHEP B S-D............................................................34
HYPERLYTE CR.............................................................. 27
HYPERRAB S-D...............................................................35
HYPERRHO S-D.............................................................. 35
HYPERTET S-D................................................................ 35
HYPOLANCE(OTC)...................................................25, 65
HYQVIA......................................................................34, 83
HYSINGLA ER........................................................... 49, 65
HYZAAR........................................................................... 10
-I
IBANDRONATE SODIUM.........................................28, 75
IBRANCE.............................................................. 47, 65, 83
IBRUTINIB....................................................................... 47
IBUPROFEN..................................................................... 42
IBUPROFEN/IRR CNT-IRRIT CMB #2.......................... 42
IBUPROFEN/OXYCODONE HCL.................................. 49
IBUTILIDE FUMARATE................................................... 9
ICAR-C PLUS................................................................... 57
ICATIBANT ACETATE.................................................... 41
ICLUSIG(TAB)(15 MG)....................................... 47, 65, 83
ICLUSIG(TAB)(45 MG)....................................... 47, 65, 83
ICOSAPENT ETHYL....................................................... 13
IDAMYCIN PFS............................................................... 45
IDARUBICIN HCL........................................................... 45
IDARUCIZUMAB.............................................................31
IDELALISIB..................................................................... 47
IFEX.................................................................................. 45
IFOSFAMIDE....................................................................45
IFOSFAMIDE/MESNA..................................................... 45
IFOSFAMIDE-MESNA.................................................... 45
IGG/HYALURONIDASE,RECOMBINANT................... 34
ILARIS.............................................................................. 41
ILEVRO............................................................................. 29
ILOPERIDONE................................................................... 7
ILOPROST TROMETHAMINE....................................... 11
ILOTYCIN.........................................................................29
ILUVIEN........................................................................... 29
IMATINIB MESYLATE................................................... 47
IMBRUVICA.........................................................47, 65, 83
IMIPENEM/CILASTATIN SODIUM............................... 36
IMIPRAMINE HCL............................................................ 6
IMIPRAMINE PAMOATE.................................................. 6
IMIQUIMOD..................................................................... 35
IMITREX..................................................................... 51, 65
IMITREX(CARTRIDGE)........................................... 51, 65
IMITREX(PEN INJCTR)............................................ 51, 65
IMITREX(TAB).......................................................... 51, 65
IMITREX(VIAL)........................................................ 51, 65
IMLYGIC.....................................................................46, 83
IMM GLOB G (IGG)/SORB/IGA 0-50............................ 35
IMMUN GLOB G (IGG)/GLY/IGA 50+.......................... 35
IMMUN GLOB G(IGG)/MALT/IGA 50+........................ 35
IMMUN GLOB G(IGG)/PRO/IGA 0-50.......................... 35
IMMUN GLOB G(IGG)/SORB/IGA 50+........................ 35
IMMUN GLOB G(IGG)/SUCR/IGA 50+........................ 35
IMMUN GLOB G/GLY/GLUC/IGA 0-50........................35
IMMUN GLOB G/SORB/GLY/IGA 0-50........................ 35
IMMUNE GLOBUL G (IGG)/GLYCINE.........................35
IMOGAM RABIES-HT.................................................... 35
IMURAN........................................................................... 35
INATAL ULTRA............................................................... 59
INCONTROL LANCING DEVICE(OTC)................. 25, 65
INCRELEX..................................................................28, 83
INCRUSE ELLIPTA................................................5, 65, 75
INDACATEROL MALEATE.............................................. 5
INDACATEROL/GLYCOPYRROLATE............................ 5
INDAPAMIDE...................................................................12
INDERAL XL............................................................. 10, 75
INDINAVIR SULFATE..................................................... 40
INDOCIN.......................................................................... 42
INDOMETHACIN............................................................ 42
INDOMETHACIN, SUBMICRONIZED..........................43
INFASURF........................................................................ 48
INFINITY TEST STRIPS(OTC).......................................22
INFINITY(OTC)............................................................... 24
INFLAMMACIN............................................................... 42
INFLIXIMAB.................................................................... 44
INFUMORPH.................................................................... 50
INFUVITE......................................................................... 56
INFUVITE ADULT...........................................................56
INGENOL MEBUTATE....................................................19
INJECTAFER.................................................................... 55
INLYTA(TAB)(1 MG)........................................... 46, 65, 83
INLYTA(TAB)(5 MG)........................................... 46, 65, 83
INNOPRAN XL.......................................................... 10, 75
INOVA............................................................................... 18
INOVA 4-1......................................................................... 18
INOVA 8-2......................................................................... 18
INSPRA............................................................................. 11
INSULIN ASPART............................................................25
INSULIN ASPART PROTAM & ASPART .......................25
INSULIN DEGLUDEC..................................................... 25
INSULIN DETEMIR.........................................................25
INSULIN GLARGINE,HUM.REC.ANLOG..............25, 26
INSULIN GLULISINE..................................................... 26
INSULIN LISPRO............................................................. 26
INSULIN NPH HUM/REG INSULIN HM...................... 26
INSULIN NPH HUMAN ISOPHANE............................. 26
INSULIN NPL/INSULIN LISPRO................................... 26
INSULIN REGULAR, HUMAN...................................... 26
INTEGRA F.......................................................................56
INTEGRA PLUS............................................................... 56
INTEGRILIN..................................................................... 33
INTELENCE............................................................... 40, 83
INTERFERON ALFA-2B,RECOMB................................35
INTERFERON ALFA-N3................................................. 35
INTERFERON BETA-1A................................................. 48
Page 94 of 106
�
Index
INTERFERON BETA-1A/ALBUMIN..............................48
INTERFERON BETA-1B..................................................48
INTERFERON GAMMA-1B,RECOMB.......................... 35
INTERMEZZO........................................................ 8, 65, 75
INTRON A.................................................................. 35, 83
INTUNIV....................................................................... 8, 65
INVANZ.............................................................................36
INVEGA SUSTENNA........................................................ 7
INVEGA TRINZA.............................................................. 7
INVEGA(TAB ER 24H)(1.5 MG)...........................7, 65, 75
INVEGA(TAB ER 24H)(3 MG)..............................7, 65, 75
INVEGA(TAB ER 24H)(6 MG)..............................7, 65, 75
INVEGA(TAB ER 24H)(9 MG)..............................7, 65, 75
INVIRASE(CAP).................................................. 40, 65, 75
INVIRASE(TAB).................................................. 40, 65, 75
INVOKAMET....................................................... 20, 65, 75
INVOKANA.......................................................... 20, 65, 75
IODINE/POTASSIUM IODIDE........................................15
IODOFLEX....................................................................... 15
IODOPEN.......................................................................... 29
IODOQUINOL/ALOE POLYSACCHAR #1................... 15
IODOSORB....................................................................... 15
IONOSOL B WITH DEXTROSE 5%...............................27
IONOSOL MB-DEXTROSE 5%...................................... 27
IONSYS............................................................................. 49
IOPIDINE(DROPERETTE).............................................. 30
IOPIDINE(DROPS)...........................................................30
IPILIMUMAB................................................................... 47
IPRATROPIUM BROMIDE..........................................5, 48
IPRATROPIUM/ALBUTEROL SULFATE........................ 5
IPRATROPIUM-ALBUTEROL.......................................... 5
IPRIVASK............................................................. 33, 65, 83
IRBESARTAN................................................................... 10
IRBESARTAN/HYDROCHLOROTHIAZIDE.................10
IRENKA.................................................................. 6, 65, 75
IRESSA..................................................................47, 65, 83
IRINOTECAN HCL.......................................................... 46
IRINOTECAN LIPOSOMAL........................................... 46
IRON AG&FUM/C/FA/MV CMB11/CA-T......................55
IRON AG/C/B12/CA/SUC.ACID/STOM......................... 55
IRON ASPGLY&PS/C/B12/FA/CA/SUC......................... 55
IRON ASPGLY/C/B12/FA/CA-TH/SUC..........................55
IRON BG,PS/VITC/B12/FA/CALCIUM.......................... 55
IRON BISGLY & PS/FA/B&C#12/SUC...........................55
IRON CARB,GL/FA/B12/C/DOCUSATE........................ 55
IRON CARB/FA#9/VIT C/D3/B6/B12............................. 55
IRON FUM & AG/C/B12/FA/CA/SUCC..........................56
IRON FUM & PS CMP/FA/VIT C/B3.............................. 56
IRON FUM&POLYSAC#1/FA/MV NO.18...................... 56
IRON FUM, PS/FA/VIT C/L. CASEI............................... 56
IRON FUM,PS/FA/VIT B WITH C #9............................. 56
IRON FUMARATE/VIT C/VIT B12/FA.......................... 56
IRON GLY,FUM/C/B12/ME-THFOLATE....................... 56
IRON HEME POLYPEPTIDE/FOLIC AC....................... 56
IRON POLYSAC/IRON HEME/FA/B12.......................... 56
IRON PS CMPLX/VIT B12/FA........................................ 56
IRON SUCROSE COMPLEX........................................... 56
IRON, CARBONYL/FA/C/B-6/B12/ZN...........................56
IRON,CARB/DSS/B12IF/FA/MV-MN............................. 56
IRON,CARB/FA#6/MV, MIN NO.40............................... 56
IRON,CARB/FA#6/MV, MIN NO.41............................... 56
IRON,CARBONYL/FA/MULTIVIT-MIN........................ 56
IRON,CARBONYL/VIT C/VIT B12/FA..........................57
IRON,FUM&PS/FA/VIT B&C#18/L.CA......................... 56
IRON/FA#1/C/B12/BIOT/COPPR/DSS............................56
IRON/FA#1/VIT C/B12/ZN/DSS/SUC.............................56
IRON/FA/B12/C/DOCUSATE SODIUM......................... 56
IRON/FA/VIT BCOMP,C/MINERALS............................ 56
IRON/FLUORIDE/VITS A, C, & D3............................... 56
IRON/FOLIC ACID/C/B12/BIOTIN................................ 56
IRON/MFOLATE/B12/C/BIOT/ZN/DSS......................... 56
IROSPAN........................................................................... 55
ISAVUCONAZONIUM SULFATE...................................38
ISENTRESS...................................................................... 40
ISOCARBOXAZID............................................................. 6
ISOCHRON....................................................................... 13
ISOLYTE P WITH DEXTROSE.......................................27
ISOLYTE S........................................................................ 27
ISOMETHEPT/DICHLPHN/ACETAMINOP.................. 51
ISOMETHEPT-CAFF-ACETAMINOPHEN.................... 51
ISOMETHEPT-DICHLORALP-ACETAMIN.................. 51
ISOMETHEPTEN/CAF/ACETAMINOPHEN................. 51
ISONIAZID....................................................................... 38
ISOPROTERENOL HCL.................................................... 4
ISOPTO ATROPINE......................................................... 30
ISOPTO CARPINE........................................................... 30
ISORDIL............................................................................13
ISORDIL TITRADOSE.................................................... 13
ISOSORB DINIT/HYDRALAZINE HCL........................12
ISOSORBIDE DINITRATE.............................................. 13
ISOSORBIDE MONONITRATE...................................... 13
ISOSORBIDE MONONITRATE ER................................13
Sutter Health Plus
ISOTRETINOIN................................................................ 14
ISOXSUPRINE HCL........................................................ 13
ISRADIPINE..................................................................... 11
ISTALOL........................................................................... 30
ISTODAX.................................................................... 47, 83
ISUPREL............................................................................. 4
ITRACONAZOLE............................................................. 38
IVABRADINE HCL.......................................................... 13
IVACAFTOR..................................................................... 48
IVERMECTIN....................................................... 15, 16, 39
IXABEPILONE................................................................. 46
IXAZOMIB CITRATE...................................................... 47
IXEMPRA................................................................... 46, 83
IXINITY............................................................................ 32
-J
JAKAFI.................................................................. 46, 65, 83
JALYN................................................................... 54, 75, 85
JANUMET................................................................... 20, 65
JANUMET XR(TBMP 24HR)(100-1000MG)............20, 65
JANUMET XR(TBMP 24HR)(50-1000 MG).............20, 65
JANUMET XR(TBMP 24HR)(50MG-500MG)......... 20, 65
JANUVIA.................................................................... 20, 65
JARDIANCE......................................................... 20, 65, 75
JENTADUETO............................................................ 20, 65
JETREA............................................................................. 30
JEVTANA.......................................................................... 47
JINTELI............................................................................. 34
JOHNSON GRASS............................................................. 3
JUXTAPID...................................................................12, 83
-K
KADCYLA.................................................................. 47, 83
KADIAN(CAP ER PEL)(10 MG)............................... 50, 65
KADIAN(CAP ER PEL)(100 MG)............................. 50, 65
KADIAN(CAP ER PEL)(200 MG)............................. 50, 65
KALBITOR................................................................. 43, 83
KALETRA(SOLUTION)............................................ 40, 65
KALETRA(TAB)(100MG-25MG)............................. 40, 65
KALETRA(TAB)(200MG-50MG)............................. 40, 65
KALYDECO................................................................ 48, 83
KANUMA................................................................... 45, 83
KAPVAY........................................................................8, 65
KARBINAL ER................................................. 3, 61, 65, 75
KAZANO.............................................................. 20, 65, 75
KCENTRA........................................................................ 32
KEDBUMIN...................................................................... 33
KEFLEX............................................................................ 36
KELNOR 1-35............................................................. 13, 85
KENALOG........................................................................ 17
KENALOG-10................................................................... 42
KENALOG-40................................................................... 42
KENGREAL...................................................................... 33
KEPIVANCE..................................................................... 48
KEPPRA............................................................................ 52
KERAFOAM..................................................................... 18
KERALAC.........................................................................18
KERALYT......................................................................... 18
KERALYT SCALP............................................................18
KERYDIN....................................................................16, 83
KETEK.............................................................................. 36
KETOCONAZOLE..................................................... 16, 38
KETOPROFEN..................................................................43
KETOROLAC TROMETHAMINE...................... 29, 42, 43
KETOROLAC TROMETHAMINE/PF.............................29
KEVEYIS.................................................................... 52, 83
KEYTRUDA................................................................ 47, 83
KHEDEZLA............................................................ 6, 65, 75
KINERET.................................................................... 41, 83
KIONEX............................................................................ 27
KIT FOR Y-90/IBRITUMOMAB/ALBUM......................47
KITABIS PAK............................................................. 38, 83
KLARON........................................................................... 15
KLONOPIN....................................................................... 52
KLOR-CON(PACKET)(20 MEQ).................................... 27
KLOR-CON(PACKET)(25 MEQ).................................... 27
KOATE-DVI...................................................................... 31
KOGENATE FS................................................................. 31
KOMBIGLYZE XR(TBMP 24HR)(2.5-1000MG)...... 20,
65,
75
KOMBIGLYZE XR(TBMP 24HR)(5 MG-500MG)...... 20,
65,
75
KOMBIGLYZE XR(TBMP 24HR)(5MG-1000MG)...... 20,
65,
75
KORLYM.................................................................... 20, 83
KOSHER PRENATAL PLUS IRON................................. 58
K-PHOS NO.2................................................................... 54
K-PHOS ORIGINAL......................................................... 54
KRISTALOSE................................................................... 44
KRYSTEXXA................................................................... 31
K-SOL................................................................................27
K-TAB ER......................................................................... 27
KYNAMRO................................................................. 12, 83
KYPROLIS.................................................................. 46, 83
-L
LABETALOL HCL............................................................. 9
LACOSAMIDE................................................................. 52
LACRISERT...................................................................... 30
LACTATED RINGERS............................................... 18, 27
LACTIC ACID.................................................................. 18
LACTULOSE.................................................................... 44
LAMB'S QUARTERS......................................................... 3
LAMICTAL (BLUE)......................................................... 52
LAMICTAL (GREEN)...................................................... 52
LAMICTAL (ORANGE)................................................... 52
LAMICTAL XR (BLUE)............................................ 52, 75
LAMICTAL XR (GREEN)......................................... 52, 76
LAMICTAL XR (ORANGE)...................................... 52, 76
LAMICTAL(TAB)............................................................. 52
LAMICTAL(TB CHW DSP)(2 MG)................................ 52
LAMICTAL(TB CHW DSP)(25 MG).............................. 52
LAMICTAL(TB CHW DSP)(5 MG)................................ 52
LAMISIL(GRAN PACK).................................................. 38
LAMISIL(TAB)................................................................. 38
LAMIVUDINE.................................................................. 40
LAMIVUDINE/ZIDOVUDINE........................................ 40
LAMOTRIGINE................................................................ 52
LANCET DEVICE(OTC)........................................... 25, 65
LANCING DEVICE.................................................... 24, 25
LANCING DEVICE(OTC)......................................... 25, 65
LANCING DEVICE/LANCETS.......................................25
LANCING SYSTEM(OTC)........................................ 25, 65
LANOXIN PEDIATRIC...................................................... 9
LANOXIN(AMPUL)...........................................................9
LANOXIN(TAB)(125 MCG).............................................. 9
LANOXIN(TAB)(187.5 MCG)........................................... 9
LANOXIN(TAB)(250 MCG).............................................. 9
LANOXIN(TAB)(62.5 MCG)............................................. 9
LANSOPRAZOLE............................................................ 54
LANSOPRAZOLE/AMOXICILN/CLARITH..................54
LANTHANUM CARBONATE......................................... 26
LANTUS......................................................................25, 65
LANTUS SOLOSTAR................................................ 25, 65
LANZO(OTC)............................................................. 25, 65
LAPATINIB DITOSYLATE.............................................. 47
LASIX................................................................................11
LASTACAFT..................................................................... 29
LATANOPROST............................................................... 30
LATRIX............................................................................. 18
LATUDA(TAB)(120 MG)....................................... 7, 65, 76
LATUDA(TAB)(20 MG)......................................... 7, 65, 76
LATUDA(TAB)(40 MG)......................................... 7, 65, 76
LATUDA(TAB)(60 MG)......................................... 7, 65, 76
LATUDA(TAB)(80 MG)......................................... 7, 65, 76
LAZANDA.................................................................. 49, 83
LDO PLUS........................................................................ 19
LEDIPASVIR/SOFOSBUVIR.......................................... 40
LEFLUNOMIDE............................................................... 41
LEMTRADA............................................................... 48, 83
LENALIDOMIDE............................................................. 46
LENVATINIB MESYLATE.............................................. 47
LENVIMA............................................................. 47, 65, 83
LESCOL................................................................ 12, 65, 76
LETAIRIS.......................................................................... 11
LETROZOLE.................................................................... 46
LEUCOVORIN CALCIUM.............................................. 47
LEUKERAN................................................................ 45, 65
LEUKINE.................................................................... 33, 83
LEUPROLIDE ACETATE...........................................27, 28
LEUPROLIDE/NORETHINDRONE ACET.................... 34
LEVALBUTEROL HCL..................................................... 5
LEVALBUTEROL TARTRATE..........................................5
LEVAQUIN....................................................................... 37
LEVATOL.......................................................................... 10
LEVEMIR..............................................................25, 65, 76
LEVEMIR FLEXTOUCH..................................... 25, 65, 76
LEVETIRACETAM.......................................................... 52
LEVETIRACETAM IN NACL (ISO-OS)......................... 52
LEVETIRACETAM-NACL.............................................. 52
LEVITRA.............................................................. 27, 65, 83
LEVOBUNOLOL HCL..................................................... 30
LEVOCETIRIZINE DIHYDROCHLORIDE..................... 4
LEVOFLOXACIN....................................................... 30, 37
LEVOFLOXACIN/D5W................................................... 37
LEVOFLOXACIN-D5W................................................... 37
LEVOLEUCOVORIN CALCIUM.................................... 47
LEVOMILNACIPRAN HYDROCHLORIDE.................... 6
LEVONORGESTREL....................................................... 13
LEVONORGESTREL-ETHIN ESTRADIOL.................. 13
LEVOPHED BITARTRATE................................................4
Page 95 of 106
�
Index
LEVORA-28................................................................ 13, 85
LEVORPHANOL TARTRATE......................................... 50
LEVOTHYROXINE SODIUM......................................... 29
LEVSIN............................................................................. 53
LEVULAN........................................................................ 47
LEXAPRO........................................................................... 6
LEXIVA....................................................................... 40, 83
LIALDA.............................................................................43
LIBERTY TEST STRIPS(OTC)....................................... 22
LIBRAX............................................................................ 53
LIDOCAIN/ZN/MEADOWSW XT/OAK XT..................19
LIDOCAINE......................................................................19
LIDOCAINE HCL...................................................9, 19, 43
LIDOCAINE HCL IN 5% DEXTROSE............................. 9
LIDOCAINE HCL IN 7.5% DEXTROSE........................ 43
LIDOCAINE HCL VISCOUS.......................................... 43
LIDOCAINE HCL/D5W/PF............................................... 9
LIDOCAINE HCL/D7.5W/PF.......................................... 43
LIDOCAINE HCL/EPINEPHRINE.................................. 43
LIDOCAINE HCL/EPINEPHRINE BIT.......................... 43
LIDOCAINE HCL/EPINEPHRINE/PF............................ 43
LIDOCAINE HCL/MENTHOL........................................ 19
LIDOCAINE HCL/PF............................................. 9, 29, 43
LIDOCAINE WITH 8.4% SOD BICARB........................43
LIDOCAINE/ALLANTOIN/PETROLATUM.................. 19
LIDOCAINE/BENZOCAIN/ME-SAL/CAP.................... 19
LIDOCAINE/CAPSAICIN/MENTHOL...........................19
LIDOCAINE/HYDROCORTISONE AC....................19, 44
LIDOCAINE/MENTHOL................................................. 19
LIDOCAINE/METHYL SAL/MENTHOL.......................19
LIDOCAINE/PRILOCAINE............................................. 19
LIDOCAINE/SKIN CLEANSER NO.37..........................19
LIDOCAINE/TETRACAINE........................................... 19
LIDOCAINE-EPINEPHRINE.......................................... 43
LIDOCAINE-HYDROCORTISONE.......................... 19, 44
LIDODERM...................................................................... 19
LIDOPIN(CREAM)(3 %)................................................. 19
LIDOPIN(CREAM)(3.25 %)............................................ 19
LIDORX............................................................................ 19
LIDOVEX.......................................................................... 19
LINACLOTIDE................................................................. 44
LINAGLIPTIN.................................................................. 20
LINAGLIPTIN/METFORMIN HCL................................ 20
LINCOCIN........................................................................ 39
LINCOMYCIN HCL......................................................... 39
LINDANE.......................................................................... 16
LINEZOLID...................................................................... 37
LINEZOLID-0.9% NACL................................................. 37
LINEZOLID-0.9% SODIUM CHLORIDE.......................37
LINZESS..................................................................... 44, 65
LIORESAL INTRATHECAL........................................... 53
LIOTHYRONINE SODIUM............................................. 29
LIOTRIX........................................................................... 29
LIPASE/PROTEASE/AMYLASE..................................... 53
LIPITOR............................................................................ 12
LIPOCHOL PLUS............................................................. 13
LIPOFEN........................................................................... 12
LIPTRUZET(TAB)(10 MG-10MG)...................... 12, 65, 76
LIRAGLUTIDE................................................................. 20
LISDEXAMFETAMINE DIMESYLATE...........................7
LISINOPRIL......................................................................10
LISINOPRIL/HYDROCHLOROTHIAZIDE......................9
LITE TOUCH(OTC)................................................... 25, 65
LITHIUM............................................................................ 7
LITHIUM CARBONATE....................................................7
LITHIUM CITRATE........................................................... 7
LITHOSTAT...................................................................... 44
LIVALO................................................................. 12, 65, 76
LIVER EXTRACT (BEEF-PORK)...................................45
LMD 10% WITH 0.9% SOD CHLORIDE....................... 33
LMD 10% WITH 5% DEXTROSE...................................33
LMEFOLATE/B3/COPP/ZN/SEL/CHROM.....................56
L-NORGEST/E.ESTRADION-E.ESTRAD......................13
LO LOESTRIN FE................................................ 14, 76, 85
LOCOID LIPOCREAM.................................................... 17
LOCOID(CREAM)........................................................... 17
LOCOID(LOTION)........................................................... 17
LOCOID(OINT)................................................................ 17
LOCOID(SOLUTION)......................................................17
LODOSYN........................................................................ 51
LODOXAMIDE TROMETHAMINE............................... 30
LOESTRIN.................................................................. 13, 85
LOFIBRA.......................................................................... 13
LOMITAPIDE MESYLATE............................................. 12
LOMOTIL......................................................................... 44
LOMUSTINE.............................................................. 45, 65
LONSURF............................................................. 46, 65, 83
LOPERAMIDE..................................................................44
LOPERAMIDE HCL.........................................................44
Sutter Health Plus
LOPID................................................................................13
LOPINAVIR/RITONAVIR................................................ 40
LOPRESSOR..................................................................... 10
LOPRESSOR HCT............................................................ 10
LOPROX............................................................................ 15
LORAZEPAM................................................................. 7, 8
LORTAB............................................................................ 49
LORZONE......................................................................... 53
LOSARTAN POTASSIUM............................................... 10
LOSARTAN/HYDROCHLOROTHIAZIDE.....................10
LOTEMAX........................................................................ 29
LOTENSIN........................................................................ 10
LOTENSIN HCT................................................................. 9
LOTEPREDNOL ETABONATE....................................... 29
LOTREL.............................................................................. 9
LOTRISONE..................................................................... 15
LOTRONEX...................................................................... 44
LOVASTATIN....................................................................12
LOVAZA......................................................................13, 65
LOVENOX(SYRINGE)(100 MG/ML)....................... 32, 65
LOVENOX(SYRINGE)(120MG/.8ML)..................... 32, 65
LOVENOX(SYRINGE)(150 MG/ML)....................... 32, 65
LOVENOX(SYRINGE)(30MG/0.3ML)..................... 32, 65
LOVENOX(VIAL)...................................................... 32, 66
LOXAPINE......................................................................... 7
LOXAPINE SUCCINATE...................................................7
LUBIPROSTONE..............................................................44
LUCENTIS.................................................................. 31, 83
LUCINACTANT................................................................48
LUDENT FLUORIDE.......................................................55
LUGOL'S........................................................................... 15
LULICONAZOLE............................................................. 16
LUMACAFTOR/IVACAFTOR......................................... 48
LUMIGAN.................................................................. 30, 66
LUMINAL SODIUM.......................................................... 8
LUNESTA..................................................................... 8, 66
LUPANETA PACK............................................................ 34
LUPRON DEPOT.............................................................. 28
LUPRON DEPOT-PED..................................................... 28
LURASIDONE HCL........................................................... 7
LUXIQ............................................................................... 17
LUZU..................................................................... 16, 66, 76
LYMPHOCYTE IG, ANTITHYMOCYTE...................... 35
LYMPHOCYTE IMMU GLOB.,RABBIT....................... 35
LYNPARZA........................................................... 47, 66, 83
LYRICA............................................................................. 52
LYSINE HCL/VIT B COMP/FA/ZINC............................ 59
LYSODREN................................................................ 47, 66
LYSTEDA.......................................................................... 31
-M
M.V.I. ADULT...................................................................56
M.V.I. PEDIATRIC............................................................57
M.V.I.-12............................................................................56
MACITENTAN................................................................. 11
MACROBID...................................................................... 37
MACRODANTIN.............................................................. 37
MACUGEN................................................................. 31, 83
MACUVEX....................................................................... 55
MACUZIN......................................................................... 55
MAFENIDE ACETATE.................................................... 16
MAGNEBIND 400 RX..................................................... 26
MAGNESIUM CHLORIDE..............................................56
MAGNESIUM SULFATE................................................. 56
MAGNESIUM SULFATE IN WATER............................. 56
MAGNESIUM SULFATE/D5W....................................... 56
MAGNESIUM SULFATE-D5W....................................... 56
MAKENA.................................................................... 34, 83
MALARONE..................................................................... 39
MALATHION....................................................................16
MANGANESE.................................................................. 56
MANGANESE CHLORIDE............................................. 56
MANGANESE SULFATE................................................ 56
MANNITOL...................................................................... 11
MANNITOL/SORBITOL SOLUTION............................ 18
MAPROTILINE HCL..........................................................6
MARAVIROC....................................................................40
MARINOL............................................................... 4, 66, 76
MARNATAL-F.................................................................. 58
MARPLAN.......................................................................... 6
MARQIBO.................................................................. 48, 83
MATULANE............................................................... 47, 66
MAVIK.............................................................................. 10
MAXALT.....................................................................51, 66
MAXALT MLT........................................................... 51, 66
MAXARON FORTE......................................................... 56
MAXFE............................................................................. 56
MAXIDEX........................................................................ 29
MAXIMA(OTC)................................................................ 22
MAXINATE.......................................................................57
MAXIPIME(VIAL PORT)................................................ 36
MAXIPIME(VIAL)........................................................... 36
MAXITROL...................................................................... 29
MAXZIDE......................................................................... 11
MAXZIDE-25 MG............................................................ 11
MECAMYLAMINE HCL................................................. 10
MECASERMIN................................................................. 28
MECHLORETHAMINE HCL.................................... 19, 45
MECLIZINE HCL............................................................... 4
MECLOFENAMATE SODIUM....................................... 43
MEDROL(TAB DS PK).................................................... 42
MEDROL(TAB)(16 MG).................................................. 42
MEDROL(TAB)(2 MG).................................................... 42
MEDROL(TAB)(32 MG).................................................. 42
MEDROL(TAB)(4 MG).................................................... 42
MEDROL(TAB)(8 MG).................................................... 42
MEDROXYPROGESTERONE ACETATE...................... 34
MEFENAMIC ACID.........................................................43
MEFLOQUINE HCL........................................................ 39
MEFOXIN......................................................................... 36
MEGESTROL ACETATE................................................. 47
MEKINIST............................................................ 47, 66, 83
MELOXICAM................................................................... 43
MELOXICAM, SUBMICRONIZED................................ 43
MELOXICAM/IRR CNTR-IRR CMB #2........................ 42
MELPHALAN................................................................... 45
MELPHALAN HCL.......................................................... 45
MEMANTINE HCL............................................................ 5
MEMANTINE HCL/DONEPEZIL HCL............................5
MENEST........................................................................... 34
MENOSTAR................................................................ 34, 66
MENTAX...........................................................................15
MEPENZOLATE BROMIDE........................................... 53
MEPERIDINE HCL.......................................................... 50
MEPERIDINE HCL IN 0.9 % NACL............................... 50
MEPERIDINE HCL(CARTRIDGE).................................50
MEPERIDINE HCL(SOLUTION)............................. 50, 66
MEPERIDINE HCL(TAB).......................................... 50, 66
MEPERIDINE HCL/PF.....................................................50
MEPERIDINE HCL-0.9% NACL..................................... 50
MEPHYTON..................................................................... 34
MEPIVACAINE HCL....................................................... 43
MEPIVACAINE HCL/PF.................................................. 43
MEPOLIZUMAB (RECOMBINANT)............................... 5
MEPROBAMATE............................................................... 7
MEPRON........................................................................... 39
MERCAPTOPURINE....................................................... 45
MEROPENEM.................................................................. 36
MEROPENEM-0.9% NACL............................................. 36
MEROPENEM-0.9% SODIUM CHLORIDE...................36
MERREM.......................................................................... 36
MESALAMINE................................................................. 43
MESALAMINE W/CLEANSING WIPES....................... 43
MESNA............................................................................. 47
MESNEX........................................................................... 47
MESNEX(TAB).................................................................47
MESNEX(VIAL)............................................................... 47
MESQUITE......................................................................... 3
MESTINON(SYRUP)......................................................... 6
MESTINON(TAB).............................................................. 6
METAPROTERENOL SULFATE....................................... 5
METAXALONE................................................................ 53
METFORMIN HCL.......................................................... 20
METHADONE HCL......................................................... 50
METHAMPHETAMINE HCL............................................ 7
METHAVER...................................................................... 59
METHAZOLAMIDE........................................................ 30
METHEN MAND/NAPHOS M-B M-H........................... 54
METHEN/M-BLUE/SAL/NA PHOS/HYOS....................36
METHEN/SOD PHOS/METH BLUE/HYOS...................36
METHENAM/ME BLUE/BA/SALICY/HYO.................. 36
METHENAMINE HIPPURATE....................................... 36
METHENAMINE MANDELATE.................................... 36
METHIMAZOLE.............................................................. 29
METHIONINE/INOSITOL/CHOLINE/FA...................... 13
METHITEST..................................................................... 34
METHOCARBAMOL.......................................................53
METHOTREXATE SODIUM..................................... 41, 46
METHOTREXATE SODIUM/PF..................................... 46
METHOTREXATE(TAB)........................................... 46, 66
METHOTREXATE(VIAL)............................................... 46
METHOTREXATE/PF...................................................... 41
METHOXSALEN....................................................... 19, 47
METHOXSALEN, RAPID............................................... 19
METHOXY PEG-EPOETIN BETA.................................. 32
METHSCOPOLAMINE BROMIDE................................ 53
METHSUXIMIDE............................................................ 52
METHYCLOTHIAZIDE...................................................12
METHYLDOPA................................................................ 10
METHYLDOPA/HYDROCHLOROTHIAZIDE.............. 10
METHYLDOPA-HYDROCHLOROTHIAZIDE.............. 10
METHYLDOPATE HCL................................................... 10
Page 96 of 106
�
Index
METHYLERGONOVINE MALEATE............................. 14
METHYLIN(SOLUTION).................................................. 8
METHYLIN(TAB CHEW)........................................... 8, 66
METHYLNALTREXONE BROMIDE............................. 45
METHYLPHENIDATE....................................................... 8
METHYLPHENIDATE HCL.............................................. 8
METHYLPREDNISOLONE............................................ 42
METHYLPREDNISOLONE ACETATE.......................... 42
METHYLPREDNISOLONE SOD SUCC........................ 42
METHYLPREDNISOLONE SOD SUCC/PF.................. 42
METHYLPREDNISOLONE/BUPIVACAINE................. 42
METHYLTESTOSTERONE............................................. 34
METIPRANOLOL............................................................ 30
METOCLOPRAMIDE HCL............................................. 54
METOLAZONE................................................................ 12
METOPROLOL SUCCINATE.......................................... 10
METOPROLOL SUCCINATE/HCTZ.............................. 10
METOPROLOL TARTRATE............................................10
METOPROLOL/HYDROCHLOROTHIAZIDE...............10
METOPROLOL-HYDROCHLOROTHIAZIDE.............. 10
METRELEPTIN................................................................ 28
METRO IV........................................................................ 39
METROGEL...................................................................... 15
METROGEL-VAGINAL................................................... 55
METROLOTION............................................................... 15
METRONIDAZOLE............................................. 15, 39, 55
METRONIDAZOLE/SKIN CLEANSR #23.....................15
METRONIDAZOLE/SODIUM CHLORIDE................... 39
METYROSINE.................................................................. 10
MEXILETINE HCL............................................................ 9
MIACALCIN(SPRAY/PUMP).......................................... 28
MIACALCIN(VIAL).........................................................28
MICAFUNGIN SODIUM................................................. 38
MICARDIS........................................................................ 10
MICARDIS HCT............................................................... 10
MICONAZOLE................................................................. 38
MICONAZOLE 3.............................................................. 55
MICONAZOLE NITRATE............................................... 55
MICONAZOLE NITRATE/ZINC OX/PET...................... 16
MICRHOGAM ULTRA-FILTERED PLUS..................... 35
MICRO(OTC).............................................................. 22, 24
MICRODOT XTRA(OTC)................................................ 22
MICRODOT(OTC)...................................................... 22, 24
MICROFIBRILLAR COLLAGEN................................... 33
MICROGESTIN.......................................................... 13, 85
MICROGESTIN FE.................................................... 14, 85
MICROLET 2(OTC)....................................................25, 66
MICROZIDE..................................................................... 12
MIDAZOLAM HCL............................................................8
MIDODRINE HCL........................................................... 13
MIFEPRISTONE............................................................... 20
MIGERGOT................................................................ 51, 66
MIGLITOL........................................................................ 20
MIGRANAL................................................................ 51, 66
MILLIPRED...................................................................... 42
MILLIPRED DP................................................................ 42
MILNACIPRAN HCL....................................................... 48
MILRINONE IN 5% DEXTROSE......................................9
MILRINONE LACTATE..................................................... 9
MILRINONE LACTATE/D5W........................................... 9
MINASTRIN 24 FE.....................................................14, 85
MINI LANCING DEVICE(OTC)............................... 25, 66
MINIPRESS........................................................................ 9
MINIVELLE................................................................34, 66
MINOCIN.......................................................................... 38
MINOCIN(CAP)............................................................... 38
MINOCIN(VIAL)..............................................................38
MINOCYCLINE HCL...................................................... 38
MINOCYCLINE HCL MICROSPHERES....................... 48
MINOCYCLINE HCL/SKIN CL NO.4............................ 38
MINOXIDIL...................................................................... 10
MIOCHOL-E..................................................................... 30
MIOSTAT.......................................................................... 30
MIPOMERSEN SODIUM................................................ 12
MIRABEGRON.................................................................54
MIRAPEX......................................................................... 51
MIRAPEX ER....................................................... 51, 66, 76
MIRCERA................................................................... 32, 83
MIRTAZAPINE................................................................... 6
MIRVASO.................................................................... 15, 66
MISOPROSTOL................................................................ 54
MITE-D.FARINAE, STD.................................................... 3
MITE-D.PTERONYSSINUS, STD..................................... 3
MITIGARE.................................................................. 31, 66
MITOMYCIN.............................................................. 30, 45
MITOSOL..........................................................................30
MITOTANE....................................................................... 47
MITOXANTRONE HCL............................................ 47, 83
MIXED RAGWEED EXTRACT........................................ 3
MOBIC.............................................................................. 43
MODAFINIL....................................................................... 8
MOEXIPRIL HCL.............................................................10
Sutter Health Plus
MOEXIPRIL/HYDROCHLOROTHIAZIDE......................9
MOEXIPRIL-HYDROCHLOROTHIAZIDE..................... 9
MOLINDONE HCL............................................................ 8
MOMETASONE FUROATE..................................... 4, 5, 17
MOMETASONE/FORMOTEROL......................................5
MONOCLATE-P............................................................... 31
MONODOX(CAP)(100 MG)...................................... 38, 66
MONODOX(CAP)(50 MG)........................................ 38, 66
MONODOX(CAP)(75 MG).................................. 38, 66, 76
MONOJECT PREFILL ADVANCED.............................. 33
MONONINE......................................................................32
MONSEL'S........................................................................ 33
MONTELUKAST SODIUM...............................................5
MONUROL....................................................................... 36
MORGIDOX......................................................... 38, 66, 76
MORPHINE SULFATE.....................................................50
MORPHINE SULFATE ER(CPMP 24HR)(120 MG)......
50,
66
MORPHINE SULFATE ER(CPMP 24HR)(30 MG)...... 50,
66
66
66
66
66
MORPHINE SULFATE IN 0.9 % NACL......................... 50
MORPHINE SULFATE/0.9% NACL/PF.......................... 50
MORPHINE SULFATE/NALTREXONE......................... 50
MORPHINE SULFATE/PF............................................... 50
MORPHINE SULFATE-0.9% NACL............................... 50
MOTOFEN........................................................................ 44
MOUNTAIN CEDAR..........................................................3
MOVANTIK................................................................ 45, 66
MOVIPREP....................................................................... 44
MOXEZA.......................................................................... 30
MOXIFLOXACIN............................................................. 37
MOXIFLOXACIN HCL.............................................. 30, 37
MOXIFLOXACIN IN NACL (ISO-OSM)........................ 37
MOXIFLOXACIN/SOD.ACE,SUL/WATER.................... 37
MS CONTIN............................................................... 50, 66
M-TETRAHYROFOLATE/NIACIN/CU/ZN................... 56
MTH/ME BLUE/SOD PHOS/PHEN/HYOS.................... 36
MUCOR............................................................................... 3
MUGWORT........................................................................ 3
MULTAQ............................................................................. 9
MULTICHEW................................................................... 56
MULTIGEN....................................................................... 55
MULTIGEN FOLIC.......................................................... 55
MULTIGEN PLUS............................................................ 56
MULTITRACE-4............................................................... 56
MULTITRACE-5............................................................... 56
MULTIVIT, IRON, MIN #4, FA....................................... 56
MULTIVIT, IRON, MIN #5, FA....................................... 56
MULTIVIT, MIN CMB#20/IRON/FA.............................. 56
MULTIVIT, MIN NO.21/FOLIC ACID............................56
MULTIVIT, MINCMB#11/FOLIC ACID.........................59
MULTIVITAMIN NO.44/VIT D3/K.................................56
MULTIVITAMIN WITH FLUORIDE..............................57
MULTIVITAMIN, MIN CMB#25/FA/D3........................ 59
MULTIVITAMINS W-FLUORIDE-IRON....................... 57
MULTIVITAMINS WITH FLUORIDE............................57
MULTIVITAMINS WITH MIN NO.7/FA........................ 56
MULTIVITAMINS-A,B,D,E,K,ZN............................ 56, 57
MULTIVITS,THERAP W-FE,HEMATIN........................ 56
MUPIROCIN..................................................................... 15
MUPIROCIN CALCIUM............................................15, 48
MUSE.................................................................... 27, 66, 83
MUSTARGEN................................................................... 45
MV, MIN CMB #6/FA/LUT/LYCO/Q10.......................... 56
MV, MIN CMB#16/FA/LUTEIN/LYCOP........................ 55
MV, MIN CMB#24/IRON PS CMP/FA............................ 56
MV, MIN CMB#9/FA/SAW PALMET XT....................... 56
MV,MIN #10/FA/D3/ALIP ACID/LUT............................ 56
MV/DIETARY 4/DNA/RNA............................................. 56
MVC-FLUORIDE............................................................. 57
MVI, ADULT NO.1 WITH VIT K ....................................56
MVI, ADULT NO.2 WITHOUT VIT K ........................... 56
MVI, ADULT NO.4 WITH VIT K ....................................56
MVI, PEDI NO.1 WITH VIT K........................................56
MVI, PEDI NO.2 WITH VIT K........................................57
M-VIT................................................................................ 59
MY WAY(OTC)...........................................................13, 85
MYALEPT................................................................... 28, 66
MYAMBUTOL.................................................................. 38
MYCAMINE..................................................................... 38
MYCOBUTIN................................................................... 38
MYCOPHENOLATE MOFETIL...................................... 35
MYCOPHENOLATE MOFETIL HCL............................. 35
MYCOPHENOLATE SODIUM....................................... 35
MYDRIACYL................................................................... 30
MYFORTIC....................................................................... 35
MYGLUCOHEALTH(OTC)....................................... 22, 24
MYKIDZ IRON FL........................................................... 56
MYLERAN..................................................................45, 66
MYNATAL........................................................................ 58
MYNATE 90 PLUS........................................................... 58
MYRBETRIQ.............................................................. 54, 76
MYSOLINE....................................................................... 52
-N
NA PHOS,M-B/K PHOS,MONOB...................................54
NABI-HB........................................................................... 34
NABILONE......................................................................... 4
NABUMETONE................................................................43
NADOLOL........................................................................ 10
NADOLOL/BENDROFLUMETHIAZIDE.......................10
NAFARELIN ACETATE...................................................28
NAFCILLIN...................................................................... 37
NAFCILLIN IN DEXTROSE,ISO-OSM.......................... 37
NAFCILLIN SODIUM......................................................37
NAFTIFINE HCL.............................................................. 16
NAFTIN(CREAM)(1 %)................................................... 16
NAFTIN(CREAM)(2 %)................................................... 16
NAFTIN(GEL)(1 %)......................................................... 16
NAFTIN(GEL)(2 %)......................................................... 16
NALBUPHINE HCL......................................................... 50
NALOXEGOL OXALATE................................................ 45
NALOXONE HCL.............................................................. 8
NALTREXONE HCL.......................................................... 8
NALTREXONE MICROSPHERES.................................... 7
NAMENDA XR(CAP 24 DSPK).................................. 5, 66
NAMENDA XR(CAP SPR 24)..................................... 5, 66
NAMENDA(SOLUTION).............................................5, 66
NAMENDA(TAB DS PK)............................................. 5, 66
NAMENDA(TAB)......................................................... 5, 66
NAMZARIC............................................................ 5, 66, 76
NAPHAZOLINE HCL...................................................... 29
NAPHOS M-B M-H/NA PHOS,DI-BA............................ 44
NAPRELAN...................................................................... 43
NAPROPAK COOL...........................................................42
NAPROPAX...................................................................... 42
NAPROSYN...................................................................... 43
NAPROXEN...................................................................... 43
NAPROXEN SODIUM..................................................... 43
NAPROXEN SODIUM/MENTHOL.................................42
NAPROXEN/CAPSAICIN/MENTHOL........................... 42
NAPROXEN/IRR CNTR-IRRIT CMB #2........................42
NARATRIPTAN HCL....................................................... 51
NARCAN.............................................................................8
NARDIL.............................................................................. 6
NAROPIN(AMPUL)......................................................... 43
NAROPIN(INFUSN BTL)................................................ 43
NAROPIN(PLAST BAG).................................................. 43
NAROPIN(VIAL)..............................................................43
NASCOBAL...................................................................... 60
NASONEX.................................................................... 4, 66
NATACHEW......................................................................58
NATACYN......................................................................... 30
NATALIZUMAB............................................................... 48
NATALVIT........................................................................ 59
NATAMYCIN.................................................................... 30
NATAZIA.............................................................. 13, 76, 85
NATEGLINIDE................................................................. 20
NATELLE ONE................................................................. 58
NATESTO.................................................................... 34, 83
NATPARA................................................................... 28, 83
NATROBA......................................................................... 16
NATURE-THROID........................................................... 29
NAVELBINE..................................................................... 48
NEBIVOLOL HCL............................................................10
NEBUPENT...................................................................... 39
NECITUMUMAB............................................................. 46
NECON........................................................................14, 85
NEDOCROMIL SODIUM................................................ 30
NEEVODHA..................................................................... 58
NEFAZODONE HCL.......................................................... 6
NELARABINE.................................................................. 46
NELFINAVIR MESYLATE.............................................. 40
NEMBUTAL SODIUM....................................................... 8
NEO/POLYMYX B SULF/DEXAMETH.........................29
NEOMYCIN SU/BACI ZN/POLY/HC............................. 29
NEOMYCIN SU/BACITRA/POLYMYXIN.....................30
NEOMYCIN SU/COLIST/HC/THONZON..................... 26
NEOMYCIN SU/POLYMYX B SULF.............................18
NEOMYCIN SULFATE.................................................... 38
NEOMYCIN SULFATE/FLUOCINOLONE.................... 16
NEOMYCIN/BACITRA/POLYMYXIN/HC.................... 16
NEOMYCIN/FLUOCINOLONE/EMOL #65.................. 16
NEOMYCIN/POLYMYXIN B SULF/HC.................. 16, 26
NEOMYCIN/POLYMYXN B/GRAMICIDIN................. 30
NEOMYCIN-BACITRACIN-POLY-HC...........................29
NEOMYCIN-BACITRACIN-POLYMYXIN....................30
Page 97 of 106
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Index
NEOMYCIN-POLYMYXIN-HC...................................... 26
NEOSPORIN..................................................................... 30
NEOSPORIN G.U. IRRIGANT........................................ 18
NEOSTIGMINE METHYLSULFATE............................... 6
NEOSTIGMINE METHYLSULFATE(SYRINGE)........... 6
NEOSTIGMINE METHYLSULFATE(VIAL)(0.5
MG/ML).............................................................................. 6
NEOSTIGMINE METHYLSULFATE(VIAL)(1 MG/ML)
............................................................................................. 6
NEOSTIGMINE METHYLSULFATE(VIAL)(1:1000)......
6
NEOSTIGMINE METHYLSULFATE(VIAL)(1:2000)......
6
NEO-SYNALAR......................................................... 16, 77
NEPAFENAC.................................................................... 29
NEPHPLEX RX................................................................ 59
NEPHROCAPS QT........................................................... 59
NEPHRON FA................................................................... 55
NEPTAZANE.................................................................... 30
NESACAINE..................................................................... 43
NESACAINE-MPF(VIAL)(20 MG/ML).......................... 43
NESACAINE-MPF(VIAL)(30 MG/ML).......................... 43
NESINA................................................................. 20, 66, 77
NESTABS.......................................................................... 59
NESTABS ABC.................................................................57
NESTABS DHA................................................................ 57
NETUPITANT/PALONOSETRON HCL........................... 4
NEUAC.............................................................................. 15
NEULASTA.................................................................33, 83
NEUMEGA....................................................................... 33
NEUPOGEN................................................................ 33, 83
NEUPRO............................................................... 51, 66, 77
NEURIN-SL...................................................................... 60
NEURONTIN.................................................................... 52
NEUT................................................................................. 26
NEUTEK 2TEK TEST STRIPS(OTC)............................. 22
NEVANAC.........................................................................29
NEVIRAPINE................................................................... 40
NEXA PLUS..................................................................... 58
NEXAVAR............................................................. 47, 66, 83
NEXAVIR.......................................................................... 45
NEXIUM I.V......................................................................54
NEXIUM(CAP DR).............................................. 54, 66, 77
NEXIUM(SUSP DR PKT).................................... 54, 66, 77
NEXTERONE..................................................................... 9
NIACIN............................................................................. 13
NIACIN/LOVASTATIN.....................................................12
NIACIN/SIMVASTATIN...................................................12
NIASPAN.................................................................... 13, 77
NICARDIPINE HCL......................................................... 11
NICARDIPINE HCL IN 0.9% NACL...............................11
NICARDIPINE HCL-0.9% NACL................................... 11
NICARDIPINE IN DEXTROSE,ISO-OS......................... 11
NICARDIPINE IN NACL, ISO-OSM.............................. 11
NICODERM CQ(OTC)......................................... 53, 61, 66
NICOMIDE....................................................................... 56
NICORETTE(OTC)...............................................53, 61, 66
NICOTINE.........................................................................53
NICOTINE PATCH(PATCH TD24)(OTC)........... 53, 61, 66
NICOTINE PATCH(PATCH)(OTC)............................ 53, 61
NICOTINE POLACRILEX............................................... 53
NICOTROL..................................................... 53, 61, 66, 77
NICOTROL NS............................................... 53, 61, 66, 77
NIFEDIPINE..................................................................... 11
NILANDRON.............................................................. 45, 66
NILOTINIB HCL.............................................................. 47
NILUTAMIDE...................................................................45
NIMODIPINE....................................................................11
NINLARO............................................................. 47, 66, 83
NINTEDANIB ESYLATE................................................ 48
NIPENT............................................................................. 46
NISOLDIPINE.................................................................. 11
NITAZOXANIDE.............................................................. 15
NITRO-BID....................................................................... 13
NITRO-DUR(PATCH TD24)(0.1MG/HR)....................... 13
NITRO-DUR(PATCH TD24)(0.3 MG/HR)...................... 13
NITROFURANTOIN........................................................ 37
NITROFURANTOIN MACROCRYSTAL....................... 37
NITROFURANTOIN MONOHYD/M-CRYST................37
NITROGLYCERIN..................................................... 13, 44
NITROGLYCERIN IN D5W.............................................13
NITROGLYCERIN/D5W.................................................. 13
NITRONAL....................................................................... 13
NITROPRESS................................................................... 10
NITROPRUSSIDE SODIUM............................................ 10
NITROSTAT...................................................................... 13
NIVOLUMAB................................................................... 47
NIZATIDINE..................................................................... 54
Sutter Health Plus
NIZORAL.......................................................................... 16
NONOXYNOL 9............................................................... 13
NORA-BE....................................................................13, 85
NORDITROPIN FLEXPRO........................................ 28, 83
NORELGESTROMIN/ETHIN.ESTRADIOL.................. 14
NOREPINEPHRINE BIT/0.9 % NACL..............................4
NOREPINEPHRINE BITAR-0.9% NACL......................... 4
NOREPINEPHRINE BITARTRATE.................................. 4
NOREPINEPHRINE BITARTRATE/D5W........................ 4
NOREPINEPHRINE BITARTRATE-D5W........................ 4
NORETH-ETHINYL ESTRADIOL/IRON...................... 13
NORETHINDRONE......................................................... 13
NORETHINDRONE ACETATE....................................... 34
NORETHINDRONE AC-ETH ESTRADIOL.............13, 34
NORETHINDRONE-E.ESTRADIOL-IRON................... 14
NORETHINDRONE-ETHINYL ESTRAD...................... 14
NORETHINDRONE-MESTRANOL............................... 14
NORETHIN-ETH ESTRA FERROUS FUM..............13, 85
NORFLURANE/HFC 245FA............................................ 19
NORGESTIMATE-ETHINYL ESTRADIOL...................14
NORGESTREL-ETHINYL ESTRADIOL....................... 14
NORINYL 1+50.......................................................... 14, 85
NORITATE........................................................................ 15
NORMAL SALINE FLUSH............................................. 27
NORMOSOL-M AND DEXTROSE.................................27
NORMOSOL-R................................................................. 27
NORMOSOL-R AND DEXTROSE................................. 27
NORMOSOL-R PH 7.4..................................................... 27
NORPACE........................................................................... 9
NORPACE CR..................................................................... 9
NORPRAMIN..................................................................... 6
NORTHERA................................................................ 13, 83
NORTRIPTYLINE HCL..................................................... 6
NORVASC......................................................................... 11
NORVIR(CAP)............................................................ 40, 66
NORVIR(SOLUTION)................................................ 40, 66
NORVIR(TAB)............................................................ 40, 66
NO-STICK GLUCOSE(OTC)........................................... 26
NOVA MAX BLOOD GLUCOSE METER(OTC)...........24
NOVA MAX(OTC)............................................................ 22
NOVACORT...................................................................... 19
NOVOEIGHT.................................................................... 31
NOVOLIN 70-30(OTC).........................................26, 66, 77
NOVOLIN N(OTC)............................................... 26, 66, 77
NOVOLIN R(OTC)............................................... 26, 66, 77
NOVOLOG FLEXPEN......................................... 25, 66, 77
NOVOLOG MIX 70-30......................................... 25, 66, 77
NOVOLOG MIX 70-30 FLEXPEN...................... 25, 66, 77
NOVOLOG(CARTRIDGE)...................................25, 66, 77
NOVOLOG(VIAL)................................................ 25, 66, 77
NOVOSEVEN RT............................................................. 32
NOXAFIL.......................................................................... 38
NPLATE............................................................................ 33
NUCALA....................................................................... 5, 83
NUCORT........................................................................... 17
NUCYNTA.................................................................. 50, 66
NUCYNTA ER............................................................ 50, 66
NUEDEXTA................................................................ 48, 83
NUFERA........................................................................... 55
NULOJIX.......................................................................... 35
NUOX................................................................................ 18
NUTRICAP....................................................................... 56
NUTRILYTE..................................................................... 27
NUTROPIN AQ...........................................................28, 83
NUTROPIN AQ NUSPIN........................................... 28, 83
NUVARING.....................................................13, 66, 77, 85
NUVESSA......................................................................... 55
NUVIGIL....................................................................... 8, 83
NUWIQ..............................................................................31
NYATA...............................................................................16
NYMALIZE................................................................ 11, 83
NYSTATIN.................................................................. 16, 38
NYSTATIN/EMOLLIENT COMBO NO.54.....................16
NYSTATIN/EMOLLIENT COMBO NO.88.....................16
NYSTATIN/TRIAMCIN................................................... 16
NYSTATIN-TRIAMCINOLONE..................................... 16
-O
OB COMPLETE GOLD....................................................57
OB COMPLETE ONE...................................................... 57
OB COMPLETE PETITE................................................. 57
OB COMPLETE PREMIER............................................. 58
OB COMPLETE WITH DHA...........................................57
OBINUTUZUMAB........................................................... 45
OBIZUR............................................................................ 32
OBREDON............................................................ 14, 66, 77
OBSTETRIX EC............................................................... 59
OBTREX DHA.................................................................. 58
O-CAL FA......................................................................... 59
O-CAL PRENATAL.......................................................... 59
OCELLA................................................................13, 77, 85
OCRIPLASMIN/PF........................................................... 30
OCTAGAM..................................................................35, 83
OCTAPLAS....................................................................... 33
OCUFEN........................................................................... 29
OCUFLOX.........................................................................30
OCUVEL........................................................................... 55
ODOMZO.............................................................. 46, 66, 83
OFATUMUMAB............................................................... 45
OFEV........................................................................... 48, 83
OFIRMEV......................................................................... 49
OFLOXACIN...............................................................30, 37
OGEN................................................................................ 34
OLANZAPINE.................................................................... 7
OLANZAPINE PAMOATE.................................................7
OLANZAPINE/FLUOXETINE HCL................................. 8
OLAPARIB........................................................................ 47
OLEPTRO ER......................................................... 6, 66, 77
OLMESARTAN MEDOXOMIL....................................... 10
OLMESARTAN/AMLODIPIN/HCTHIAZID.................... 9
OLMESARTAN/HYDROCHLOROTHIAZIDE...............10
OLODATEROL HCL.......................................................... 5
OLOPATADINE HCL................................................... 4, 29
OLSALAZINE SODIUM.................................................. 44
OLUX................................................................................ 17
OLYSIO....................................................................... 41, 83
OM-3/CALCIUM/D3/FA/MV CMB 13............................56
OM-3/DHA/EPA/D3/B12/FA/B-6/PHY............................56
OMACETAXINE MEPESUCCINATE............................. 47
OMALIZUMAB.................................................................. 5
OMBITA/PARITAP/RITON/DASABUVIR..................... 41
OMBITASVIR/PARITAPREV/RITONAV....................... 41
OMECLAMOX-PAK........................................................ 54
OMEGA-3 ACID ETHYL ESTERS................................. 13
OMEPRAZOLE................................................................ 54
OMEPRAZOLE MAGNESIUM....................................... 54
OMEPRAZOLE/CLARITH/AMOXICILLIN.................. 54
OMEPRAZOLE/SODIUM BICARBONATE...................54
OMIDRIA.......................................................................... 30
OMNARIS............................................................... 4, 66, 77
OMNIPRED...................................................................... 29
OMNITROPE.............................................................. 28, 83
ON CALL EXPRESS METER(OTC)............................... 24
ON CALL EXPRESS TEST STRIP(OTC)....................... 22
ON CALL LANCING DEVICE(OTC)....................... 25, 66
ON CALL PLUS LANCING DEVICE(OTC)............ 25, 66
ON CALL PLUS METER(OTC)...................................... 24
ON CALL PLUS TEST STRIP(OTC).............................. 22
ON CALL VIVID METER(OTC).....................................24
ON CALL VIVID PAL(OTC)........................................... 24
ON CALL VIVID TEST STRIP(OTC).............................22
ONCASPAR................................................................ 47, 83
ONDANSETRON................................................................ 4
ONDANSETRON HCL....................................................... 4
ONDANSETRON HCL/PF................................................. 4
ONE TOUCH VERIO(OTC).............................................22
ONETOUCH DELICA(OTC)..................................... 25, 66
ONETOUCH ULTRA TEST STRIPS(OTC).................... 22
ONETOUCH VERIO(OTC)..............................................22
ONEXTON........................................................................ 15
ONFI(ORAL SUSP).............................................. 52, 66, 77
ONFI(TAB)............................................................ 52, 66, 77
ONGLYZA............................................................ 20, 66, 77
ONIVYDE................................................................... 46, 83
ONMEL............................................................................. 38
OPANA(AMPUL)............................................................. 50
OPANA(TAB).................................................................... 50
OPDIVO...................................................................... 47, 83
OPIUM TINCTURE..........................................................44
OPIUM/BELLADONNA ALKALOIDS.......................... 50
OPRELVEKIN...................................................................33
OPSUMIT.................................................................... 11, 83
OPTIUM EZ(OTC)............................................................22
OPTIUM(OTC)................................................................. 22
OPTUMRX(OTC)....................................................... 22, 24
ORALAIR......................................................................3, 83
ORAP................................................................................... 7
ORAVIG............................................................................ 38
ORBACTIV....................................................................... 39
ORENCIA....................................................................41, 83
ORENITRAM ER....................................................... 11, 83
ORITAVANCIN DIPHOSPHATE..................................... 39
ORKAMBI.................................................................. 48, 83
ORPHENADRINE CITRATE........................................... 53
ORTHO D.......................................................................... 60
ORTHO EVRA...................................................... 14, 66, 85
ORTHO-NOVUM........................................................14, 85
OSELTAMIVIR PHOSPHATE......................................... 39
OSENI....................................................................20, 66, 77
OSIMERTINIB MESYLATE............................................ 47
OSMITROL(IV SOLN)(10 %).......................................... 11
OSMITROL(IV SOLN)(15 %).......................................... 11
OSMITROL(IV SOLN)(20 %).......................................... 11
OSMITROL(IV SOLN)(5 %)............................................ 11
OSMOPREP...................................................................... 44
Page 98 of 106
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Index
OSPEMIFENE................................................................... 28
OSPHENA............................................................. 28, 66, 83
OTEZLA...................................................................... 41, 83
OTICIN.............................................................................. 26
OTICIN HC....................................................................... 26
OTOZIN............................................................................. 26
OTREXUP............................................................. 41, 66, 77
OVACE.............................................................................. 17
OVACE PLUS(CLEANSR ER)......................................... 18
OVACE PLUS(CREAM)................................................... 18
OVACE PLUS(FOAM)......................................................18
OVACE PLUS(LOTION)............................................ 18, 77
OVACE PLUS(SHAMPOO)............................................. 18
OVIDE............................................................................... 16
OXACILLIN...................................................................... 37
OXACILLIN SODIUM..................................................... 37
OXACILLIN SODIUM/DEXTROSE,ISO........................37
OXALIPLATIN................................................................. 45
OXANDRIN................................................................ 34, 83
OXANDROLONE............................................................. 34
OXAPROZIN.....................................................................43
OXAYDO...........................................................................50
OXAZEPAM........................................................................7
OXCARBAZEPINE.......................................................... 52
OXECTA............................................................................50
OXICONAZOLE NITRATE............................................. 16
OXISTAT........................................................................... 16
OXSORALEN................................................................... 19
OXSORALEN-ULTRA..................................................... 19
OXTELLAR XR(TAB ER 24H)(150 MG)........... 52, 66, 77
OXYBUTYNIN................................................................. 54
OXYBUTYNIN CHLORIDE............................................ 54
OXYCEL........................................................................... 33
OXYCODONE HCL......................................................... 50
OXYCODONE HCL/ACETAMINOPHEN...................... 50
OXYCODONE HCL/ASPIRIN........................................ 50
OXYCODONE HCL-ASPIRIN........................................ 50
OXYCODONE HCL-IBUPROFEN..................................49
OXYCONTIN(TAB ER 12H)(10 MG)....................... 50, 66
OXYMETHOLONE.......................................................... 34
OXYMORPHONE HCL................................................... 50
OXYTOCIN....................................................................... 14
OXYTOCIN/0.9 % SODIUM CHLORIDE...................... 14
OXYTOCIN/RINGERS LACTATE.................................. 14
OXYTOCIN-0.9% NACL................................................. 14
OXYTOCIN-LACTATED RINGERS............................... 14
OXYTROL...................................................................54, 78
OZURDEX........................................................................ 29
-P
PACLITAXEL....................................................................47
PACLITAXEL PROTEIN-BOUND.................................. 47
PACNEX HP...................................................................... 18
PACNEX LP...................................................................... 18
PACNEX MX.................................................................... 18
PAIN EASE....................................................................... 19
PAIN RELIEF.................................................................... 19
PAIRE OB PLUS DHA..................................................... 57
PALBOCICLIB................................................................. 47
PALIFERMIN.................................................................... 48
PALIPERIDONE................................................................. 7
PALIPERIDONE PALMITATE...........................................7
PALIVIZUMAB................................................................ 39
PALONOSETRON HCL..................................................... 4
PAMELOR...........................................................................6
PAMIDRONATE DISODIUM.......................................... 28
PANCREAZE.................................................................... 53
PANCRELIPASE 5,000..................................................... 53
PANDEL............................................................................ 17
PANHEMATIN.................................................................. 32
PANITUMUMAB............................................................. 46
PANOBINOSTAT LACTATE............................................47
PANRETIN........................................................................ 19
PANTOPRAZOLE SODIUM............................................ 54
PAPAVERINE HCL........................................................... 13
PARAFON FORTE DSC................................................... 53
PARATHYROID HORMONE.......................................... 28
PAREGORIC..................................................................... 44
PAREMYD........................................................................ 30
PARICALCITOL............................................................... 28
PARLODEL....................................................................... 51
PARNATE............................................................................ 6
PAROMOMYCIN SULFATE............................................39
PAROXETINE HCL............................................................ 6
PAROXETINE MESYLATE............................................... 6
Sutter Health Plus
PASER............................................................................... 38
PATADAY.......................................................................... 29
PATANASE.............................................................. 4, 67, 78
PATANOL.......................................................................... 29
PATIROMER CALCIUM SORBITEX............................. 26
PAXIL CR............................................................................6
PAXIL(ORAL SUSP).......................................................... 6
PAXIL(TAB)........................................................................6
PAZEO................................................................... 29, 67, 78
PAZOPANIB HCL.............................................................47
PCE.................................................................................... 37
PECAN POLLEN................................................................ 3
PED MULTIVIT#108/IRON/FLUORIDE........................ 57
PED MV A,C,D3 #21 W-FLUORIDE.............................. 57
PED MV A,C,D3 #38 W-FLUORIDE.............................. 57
PEDI M.VIT NO.17 WITH FLUORIDE.......................... 57
PEDI MULTIVIT #22/VIT D3/VIT K.............................. 57
PEDI MULTIVIT #37 W-FLUORIDE..............................57
PEDI MULTIVIT #47/IRON/FLUORID.......................... 57
PEDI MULTIVIT #78/IRON/FLUORID.......................... 57
PEDI MULTIVIT NO.2 W-FLUORIDE........................... 57
PEDI MULTIVIT NO.85/FLUORIDE..............................57
PEDI MULTIVIT#86/IRON/FLUORIDE.........................57
PEDI MV #37 W-FLUORIDE & IRON............................57
PEDI MV #45/FLUORIDE/IRON.................................... 57
PEDI MV #75/FLUORIDE/IRON.................................... 57
PEDI MV NO.83 WITH FLUORIDE............................... 57
PEDI MV NO.84 WITH FLUORIDE............................... 57
PEDI MVI NO.12/SODIUM FLUORIDE........................ 57
PEDI MVI NO.16 WITH FLUORIDE..............................57
PEDIADERM AF..............................................................16
PEDIADERM HC............................................................. 17
PEDIADERM TA.............................................................. 17
PEDIAPRED..................................................................... 42
PEDIATRIC MV #33 W-FLUORIDE&FE....................... 57
PEDIPAK........................................................................... 16
PEDITRACE..................................................................... 56
PEG 3350/NA SULF,BICARB,CL/KCL.......................... 44
PEG3350/SOD SUL/NACL/ASB/C/KCL.........................44
PEGANONE...................................................................... 52
PEGAPTANIB SODIUM.................................................. 31
PEGASPARGASE............................................................. 47
PEGASYS....................................................................41, 83
PEGASYS PROCLICK............................................... 41, 83
PEGFILGRASTIM............................................................ 33
PEGINTERFERON ALFA-2A..........................................41
PEGINTERFERON ALFA-2B....................................41, 46
PEGINTERFERON BETA-1A.......................................... 48
PEGINTRON............................................................... 41, 83
PEGINTRON REDIPEN............................................. 41, 83
PEGLOTICASE.................................................................31
PEG-PREP......................................................................... 44
PEGVISOMANT............................................................... 28
PEMBROLIZUMAB......................................................... 47
PEMETREXED DISODIUM............................................ 46
PEN G BENZ/PEN G PROCAINE................................... 37
PEN G POT/DEXTROSE-WATER................................... 37
PENBUTOLOL SULFATE............................................... 10
PENCICLOVIR................................................................. 16
PENICILLAMINE............................................................ 41
PENICILLIN G BENZATHINE........................................37
PENICILLIN G POTASSIUM.......................................... 37
PENICILLIN G PROCAINE.............................................37
PENICILLIN G SODIUM................................................. 37
PENICILLIN GK-ISO-OSM DEXTROSE....................... 37
PENICILLIN V POTASSIUM.......................................... 37
PENICILLIUM NOTATUM................................................ 3
PENLAC............................................................................ 15
PENLET PLUS BLOOD SAMPLER(OTC)............... 25, 67
PENNSAID..................................................................17, 78
PENTAM 300.................................................................... 39
PENTAMIDINE ISETHIONATE...................................... 39
PENTASA.......................................................................... 43
PENTAZOCINE HCL/NALOXONE HCL....................... 50
PENTAZOCINE LACTATE.............................................. 50
PENTAZOCINE-NALOXONE HCL................................ 50
PENTOBARBITAL SODIUM............................................ 8
PENTOSAN POLYSULFATE SODIUM..........................54
PENTOSTATIN................................................................. 46
PENTOXIFYLLINE..........................................................32
PEPCID..............................................................................54
P-EPHED HCL/CHLOR-MAL/BELL ALK.....................14
P-EPHED HCL/HYDROCODONE.................................. 14
PERAMIVIR/PF................................................................ 39
PERAMPANEL................................................................. 52
PERCOCET................................................................. 50, 67
PERFOROMIST............................................................ 5, 67
PERINDOPRIL ARG/AMLODIPINE BES........................9
PERINDOPRIL ERBUMINE........................................... 10
PERJETA..................................................................... 46, 83
PERMETHRIN.................................................................. 16
PERPHENAZINE................................................................ 8
PERPHENAZINE/AMITRIPTYLINE HCL.......................6
PERPHENAZINE-AMITRIPTYLINE............................... 6
PERSANTINE................................................................... 33
PERTUZUMAB................................................................ 46
PERTZYE.......................................................................... 53
PETROLATUM,WHITE................................................... 18
PEXEVA.................................................................. 6, 67, 78
PFIZERPEN...................................................................... 37
PHARMACIST CHOICE(OTC)................................. 22, 24
PHENAZOPYRIDINE HCL............................................. 54
PHENELZINE SULFATE................................................... 6
PHENERGAN................................................................. 3, 4
PHENOBARB/HYOSCY/ATROPINE/SCOP.................. 53
PHENOBARBITAL............................................................ 8
PHENOBARBITAL SODIUM............................................ 8
PHENOXYBENZAMINE HCL.......................................... 9
PHENTOLAMINE MESYLATE........................................ 9
PHENYLEPHRINE HCL............................................ 14, 29
PHENYLEPHRINE HCL/PROMETH HCL.....................14
PHENYLEPHRINE/KETOROLAC.................................. 30
PHENYTEK...................................................................... 52
PHENYTOIN.................................................................... 52
PHENYTOIN SODIUM.................................................... 52
PHENYTOIN SODIUM EXTENDED............................. 52
PHOMA............................................................................... 3
PHOSLO............................................................................ 26
PHOSLYRA.......................................................................26
PHOSPHA 250 NEUTRAL.............................................. 54
PHOSPHASAL..................................................................36
PHOSPHOLINE IODIDE................................................. 30
PHOSPHORUS #1............................................................ 54
PHOTOFRIN............................................................... 47, 83
PHYSICIANS EZ USE B-12............................................ 60
PHYSICIANS EZ USE M-PRED..................................... 42
PHYSOSTIGMINE SALICYLATE....................................6
PHYTONADIONE............................................................ 34
PICATO(GEL)(0.015 %)............................................. 19, 67
PICATO(GEL)(0.05 %)............................................... 19, 67
PILOCARPINE HCL.................................................. 30, 45
PIMECROLIMUS............................................................. 19
PIMOZIDE.......................................................................... 7
PINDOLOL....................................................................... 10
PINNACAINE................................................................... 26
PIOGLITAZONE HCL......................................................20
PIOGLITAZONE HCL/GLIMEPIRIDE........................... 20
PIOGLITAZONE HCL/METFORMIN HCL................... 21
PIPERACILLIN SODIUM/TAZOBACTAM.................... 37
PIPERACILLIN-TAZOBACTAM.....................................37
PIPERACILLIN-TAZO-DEXTROSE,ISO....................... 37
PIRFENIDONE................................................................. 48
PIROXICAM..................................................................... 43
PITAVASTATIN CALCIUM............................................. 12
PITOCIN............................................................................14
PLAQUENIL..................................................................... 39
PLASBUMIN-25............................................................... 33
PLASBUMIN-5................................................................. 33
PLASMA HUMAN, BLOOD GROUP A......................... 33
PLASMA HUMAN, BLOOD GROUP AB...................... 33
PLASMA HUMAN, BLOOD GROUP B......................... 33
PLASMA HUMAN, BLOOD GROUP O......................... 33
PLASMA PROTEIN FRACTION..................................... 33
PLASMA-LYTE 148......................................................... 27
PLASMA-LYTE 56 IN DEXTROSE................................ 27
PLASMA-LYTE A PH 7.4................................................ 27
PLASMANATE................................................................. 33
PLAVIX(TAB)(300 MG)............................................. 33, 67
PLAVIX(TAB)(75 MG)..................................................... 33
PLEGRIDY.................................................................. 48, 83
PLEGRIDY PEN......................................................... 48, 83
PLETAL............................................................................. 33
PLEXION(CLEANSER)................................................... 16
PLEXION(CREAM)......................................................... 16
PLEXION(LOTION)......................................................... 16
PLEXION(MED PAD)...................................................... 16
PLIAGLIS.......................................................................... 19
PN VIT.W-O CA #7, IRON,FA,DHA............................... 57
PN85/IRON CB&ASP G/FA/DHA/FISH......................... 57
PNV #14/FERROUS FUM/FOLIC ACID........................ 57
PNV #19/IRON PS&HEME/FOLIC/DHA....................... 57
PNV #30/IRON CARB&ASPG/FA/OM3.........................57
PNV #35/IRON/FA #6/DHA............................................. 57
PNV #38/IRON FUM/FOLATE/DHA.............................. 57
PNV #56/IRON CARB&ASPG/FA/DHA.........................57
PNV #78/IRON ASP GLY/FA#1/DHA.............................57
PNV #8/IRON PS CMP&ASPG/FA/DHA........................57
Page 99 of 106
�
Index
PNV #86/IRON POLY/FA/DHA/EPA...............................57
PNV #87/IRON BISGLY/FA/DHA................................... 57
PNV 11-IRON FUM-FOLIC ACID-OM3........................ 57
PNV 18/FE,CARB/FA/DSS/UBI/DHA............................ 57
PNV COMB NO.3/IRON FUM&GLUC/FA.................... 57
PNV COMB.NO.44/IRON/FOLIC ACID.........................57
PNV COMB.NO43/IRON,CARB/FA/DSS.......................57
PNV COMBO #22/IRON/FA/OM3/DHA.........................57
PNV COMBO#47/IRON/FA #1/DHA.............................. 57
PNV NO.106/IRON/FOLATE #6/DHA............................ 57
PNV NO.115/IRON FUMARATE/FA.............................. 57
PNV NO.118/IRON FUMARATE/FA.............................. 57
PNV NO.15/IRON FUM & PS CMP/FA.......................... 57
PNV NO.22/IRON CBN&GLUC/FA/DSS....................... 57
PNV NO.66/IRON,CARBONYL/FA/DHA...................... 57
PNV NO.80/IRON/MFOLATE/DSS/DHA....................... 57
PNV NO.81/IRON CBN&GLUC/FA/DSS....................... 57
PNV NO.86/IRON/MFOLATE/DSS/DHA....................... 57
PNV NO.88/IRON PS,HEME/FA/DHA........................... 57
PNV NO.90/IRON FUM & PS/FA/DHA..........................57
PNV NO10/IRON FUM&P/FA/OMEGA-3......................57
PNV NO12/IRON,CARB/FA/DSS/OM-3.........................58
PNV W-CA #40/IRON FUM/FA CMB#1.........................58
PNV W-CA NO.37/IRON/FA/OMEGA-3........................ 58
PNV W-CA8/IRON/FA/LMEFOLATE CA...................... 58
PNV WITH CA #68/IRON/FA#1/DHA............................58
PNV WITH CA NO.65/IRON POLY/FA..........................58
PNV WITH CA#74/IRON/FOLIC ACID......................... 58
PNV WITH CA,NO.62/IRON/FA/DHA........................... 58
PNV WITH CA,NO.70/IRON/FA/DHA........................... 58
PNV WITH CA,NO.72/IRON,CARB/FA......................... 58
PNV WITH CA,NO.72/IRON/FA.....................................58
PNV W-O CA NO5/FE FUMARATE/FA......................... 58
PNV W-O IRON/FA/CALCIUM/B6/B12......................... 59
PNV#102/IRON/FOLATE #1/DSS/DHA......................... 58
PNV#16/IRON FUM & PS/FA/OM-3...............................58
PNV#20/IRON/FA/DS/FISH/DHA/EPA...........................58
PNV#21/IRON PS& HEME POLYP/FA.......................... 58
PNV#26/IRON POLY/FA/DHA........................................ 58
PNV#64/IRON/LMFOLATE/ALGAL/SOY..................... 58
PNV#67/IRON PS/FA CMB#1/DHA................................58
PNV#71/IRON/FOLIC ACID/DHA..................................58
PNV#79/IRON/FA/LMFOLATE CA/DHA...................... 58
PNV,CA,NO.35/IRON/FA/DS/OMEG-3.......................... 58
PNV,CA42/IRON/FA/LMEFOL CA/DHA....................... 58
PNV/FA/B6/CALCIUM CARB/GINGER........................ 59
PNV/FA/B6/CALCIUM PHOS/GINGER.........................59
PNV/FERROUS FUMARATE/DOSS/FA.........................58
PNV/FERROUS FUMARATE/FA/SE.............................. 58
PNV/IRON,CARBONYL/DOCUSATE/FA......................58
PNV100/IRON EDTA&PS/FA/OMEGA3........................ 58
PNV106/IRON/FA/OM3/DHA/EPA................................. 58
PNV115/IRON FUMARATE/FA/DSS.............................. 58
PNV117/IRON/FA/OM3/DHA/EPA................................. 58
PNV119/IRON FUMARATE/FA/DSS.............................. 58
PNV17/IRON/FA/FISH OIL/DHA/OM............................58
PNV19/IRON BG HC&SUCC-P/FA/OM3.......................58
PNV2/IRON B-G SUC-P/FA/OMEGA-3......................... 58
PNV34/IRON,CARBONYL/FA/DSS/DHA..................... 58
PNV39/IRON FUMARATE/FA/DSS/DHA......................58
PNV53/IRON B-G HCL-P/FA/OMEGA3........................ 58
PNV53/IRON FUM/FA/DOCUSATE/DHA..................... 58
PNV54/IRON B-G HCL-P/FA/OMEGA3........................ 58
PNV55/IRON BG HC&SUCC-P/FA/OM3.......................58
PNV55/IRON FUM & BISGLY/FA.................................. 58
PNV7/FE ASP GLY/DOCUSATE/FA.............................. 58
PNV72/IRON,CARB&GLU/FA/DSS/DHA..................... 58
PNV77/SOD IRON EDTA& PS/FA/OM3........................ 58
PNV81/SOD IRON EDTA& PS/FA/OM3........................ 58
PNV83/IRON,CARB/IRON ASP GL/FA......................... 58
PNV-DHA.......................................................................... 57
PNV-DHA PLUS............................................................... 58
PNV-IRON......................................................................... 58
PNV-SELECT.................................................................... 58
PODOCON-25................................................................... 18
PODOFILOX..................................................................... 18
PODOPHYLLUM RESIN.................................................18
POLYETHYLENE GLYCOL 3350...................................44
POLY-IRON 150 FORTE.................................................. 56
POLYMYXIN B SULF/TRIMETHOPRIM......................30
POLYMYXIN B SULFATE.............................................. 39
POLYTRIM....................................................................... 30
POLY-VI-FLOR.................................................................57
POLY-VI-FLOR FS........................................................... 57
POLY-VI-FLOR WITH IRON...........................................57
POMALIDOMIDE............................................................ 46
Sutter Health Plus
POMALYST.......................................................... 46, 67, 83
PONATINIB HCL............................................................. 47
PONSTEL.......................................................................... 43
PONTOCAINE.................................................................. 19
PORACTANT ALFA.........................................................48
PORFIMER SODIUM.......................................................47
PORTRAZZA.................................................................... 46
POSACONAZOLE............................................................ 38
POT CHLORIDE/POT BICARB/CIT AC........................ 27
POTABA............................................................................ 59
POTASSIUM ACETATE................................................... 27
POTASSIUM AMINOBENZOATE.................................. 59
POTASSIUM BICARBONATE/CIT AC.......................... 27
POTASSIUM CHL-NORMAL SALINE.......................... 27
POTASSIUM CHLORIDE................................................ 27
POTASSIUM CHLORIDE IN 0.9%NACL.......................27
POTASSIUM CHLORIDE IN D5LR................................27
POTASSIUM CHLORIDE IN D5W................................. 27
POTASSIUM CHLORIDE IN LR-D5.............................. 27
POTASSIUM CHLORIDE/D5-0.2%NACL......................27
POTASSIUM CHLORIDE/D5-0.45NACL....................... 27
POTASSIUM CHLORIDE-0.45% NACL.........................27
POTASSIUM CHLORIDE-NACL.................................... 27
POTASSIUM CITRATE.................................................... 54
POTASSIUM HYDROXIDE............................................. 18
POTASSIUM IODIDE...................................................... 29
POTASSIUM IODIDE/IODINE........................................29
POTASSIUM PHOS IN 0.9 % NACL...............................27
POTASSIUM PHOS,M-BASIC-D-BASIC....................... 27
POTASSIUM PHOSPHATE............................................. 27
POTASSIUM PHOSPHATE,MONOBASIC.....................54
POTASSIUM PHOSPHATE-0.9% NACL........................ 27
POTIGA(TAB)(200 MG)...................................... 52, 67, 78
POTIGA(TAB)(300 MG)...................................... 52, 67, 78
POTIGA(TAB)(400 MG)...................................... 52, 67, 78
POTIGA(TAB)(50 MG)........................................ 52, 67, 78
POVIDONE-IODINE........................................................ 19
PR NATAL 400 EC............................................................ 58
PR NATAL 430.................................................................. 58
PR NATAL 430 EC............................................................ 58
PRADAXA............................................................ 33, 67, 78
PRALATREXATE............................................................. 46
PRALUENT PEN........................................................ 12, 83
PRALUENT SYRINGE.............................................. 12, 83
PRAMIPEXOLE DI-HCL................................................. 51
PRAMLINTIDE ACETATE.............................................. 20
PRAMOSONE E............................................................... 19
PRAMOSONE(CREAM)(1 %-1 %)................................. 18
PRAMOSONE(CREAM)(2.5 %-1 %).............................. 18
PRAMOSONE(LOTION)................................................. 19
PRAMOSONE(OINT)...................................................... 19
PRANDIMET.................................................................... 20
PRANDIN..........................................................................20
PRASUGREL HCL........................................................... 33
PRAVACHOL.................................................................... 12
PRAVASTATIN SODIUM................................................. 12
PRAXBIND....................................................................... 31
PRAZIQUANTEL............................................................. 39
PRAZOSIN HCL................................................................. 9
PRECEDEX......................................................................... 8
PRECISION PCX PLUS(OTC).........................................22
PRECISION PCX(OTC)................................................... 22
PRECISION POINT OF CARE(OTC)..............................22
PRECISION Q-I-D(OTC)................................................. 22
PRECISION XTRA(OTC)................................................ 22
PRECOSE.......................................................................... 20
PRED MILD...................................................................... 29
PRED-G............................................................................. 29
PREDNICARBATE........................................................... 17
PREDNISOLONE............................................................. 42
PREDNISOLONE ACETATE.....................................29, 42
PREDNISOLONE SOD PHOSPHATE...................... 29, 42
PREDNISOLONE SODIUM PHOSPHATE...............29, 42
PREDNISONE.................................................................. 42
PREDNISONE INTENSOL.............................................. 42
PREFERA-OB ONE.......................................................... 57
PREFERA-OB PLUS DHA.............................................. 57
PREFEST........................................................................... 34
PREGABALIN.................................................................. 52
PREMARIN................................................................. 34, 55
PREMARIN(TAB)............................................................ 34
PREMARIN(VIAL).......................................................... 34
PREMIUM BLOOD GLUCOSE TEST(OTC)................. 22
PREMIUM BLOOD GLUCOSE(OTC)............................ 24
PREMIUM V10(OTC)................................................ 22, 24
PREMPHASE.................................................................... 34
PREMPRO......................................................................... 34
PRENAISSANCE.............................................................. 58
PRENAISSANCE NEXT.................................................. 59
PRENAISSANCE NEXT-B.............................................. 59
PRENAISSANCE PLUS................................................... 58
PRENAT VIT COMB.10/IRON/FA/DHA........................ 58
PRENATA.......................................................................... 59
PRENATABS FA............................................................... 59
PRENATAL #103/IRON FUMARATE/FA....................... 58
PRENATAL #108/IRON,CARBONYL/FA.......................58
PRENATAL #57/IRON/FA/DSS/DHA............................. 58
PRENATAL #79/IRON ASP GLY/FA#1...........................58
PRENATAL #92/IRON/FA #8/PS-DHA........................... 58
PRENATAL 19............................................................ 57, 58
PRENATAL COMB NO.42/FOLIC ACID........................58
PRENATAL NO.13/IRON PS/FA CB#1........................... 58
PRENATAL NO.25/IRON/FA #6/DHA............................ 58
PRENATAL NO.52/IRON/FA/DHA................................. 58
PRENATAL NO.75/IRON/FOLATE #1............................59
PRENATAL NO.77/IRON ASP GLY/FA..........................59
PRENATAL NO.82/IRON/FOLATE #2............................59
PRENATAL PLUS.............................................................58
PRENATAL VIT #105/IRON/FA/DHA............................ 59
PRENATAL VIT #68/IRON/FA#6/DHA.......................... 59
PRENATAL VIT #76/IRON,CARB/FA...................... 56, 59
PRENATAL VIT 15/IRON CB/FA/DSS........................... 59
PRENATAL VIT COMB.10/IRON/FA............................. 59
PRENATAL VIT NO.109/IRON/FA................................. 59
PRENATAL VIT NO.112/FOLIC ACID ...........................59
PRENATAL VIT NO.114/FA/GINGER............................59
PRENATAL VIT NO.127/IRON/FA................................. 59
PRENATAL VIT NO.44/IRON/FA/DHA......................... 59
PRENATAL VIT NO.73/IRON/FA................................... 59
PRENATAL VIT NO.78/IRON/FA................................... 59
PRENATAL VIT NO.87/IRON/FA/DHA......................... 59
PRENATAL VIT#36/IRON/FA CMB#6........................... 59
PRENATAL VIT#4/IRON FUM &PS/FA.........................59
PRENATAL VIT#65/IRON FUM&PS/FA........................59
PRENATAL VIT#84/IRON/FA#1/DHA........................... 59
PRENATAL VIT#85/IRON/FA#1/DHA........................... 59
PRENATAL VIT#86/IRON BISGLY/FA.......................... 59
PRENATAL VIT/IRON BISGLYCIN/FA......................... 59
PRENATAL VIT/IRON FUMARATE/FA........................ 59
PRENATAL VIT27&CALCIUM/IRON/FA..................... 59
PRENATAL VIT37/IRON/FOLIC ACID ..........................59
PRENATAL VITS #33/IRON/FA/DHA............................ 59
PRENATAL VITS#4/IRON FUM/FA............................... 59
PRENATAL-U................................................................... 58
PRENATE AM.................................................................. 59
PRENATE CHEWABLE................................................... 59
PRENATE DHA................................................................ 57
PRENATE ELITE........................................................ 58, 59
PRENATE ENHANCE...................................................... 59
PRENATE ESSENTIAL..............................................57, 59
PRENATE MINI................................................................ 59
PRENATE PIXIE............................................................... 59
PRENATE RESTORE....................................................... 59
PRENATE STAR............................................................... 59
PREPIDIL.......................................................................... 14
PREPOPIK........................................................................ 44
PREQUE 10....................................................................... 57
PRESTALIA............................................................ 9, 67, 78
PRESTO PRO(OTC)......................................................... 24
PREVACID(CAP DR)....................................................... 54
PREVACID(TAB RAP DR)........................................ 54, 78
PREVALITE...................................................................... 12
PREVIDENT..................................................................... 55
PREVIDENT 5000............................................................ 55
PREVIDENT 5000 ENAMEL PROTECT........................ 55
PREVIDENT 5000 SENSITIVE....................................... 55
PREVPAC.................................................................... 54, 67
PREZCOBIX............................................................... 40, 67
PREZISTA(ORAL SUSP)........................................... 39, 67
PREZISTA(TAB)(150 MG).........................................39, 67
PREZISTA(TAB)(400 MG).........................................39, 67
PREZISTA(TAB)(600 MG).........................................39, 67
PREZISTA(TAB)(75 MG)...........................................40, 67
PREZISTA(TAB)(800 MG).........................................40, 67
PRIALT.............................................................................. 49
PRIFTIN............................................................................ 39
PRILOCAINE HCL...........................................................43
PRILOCAINE HCL/EPINEPHRINE BIT........................ 43
PRILOSEC........................................................................ 54
PRIMAQUINE.................................................................. 39
PRIMAQUINE PHOSPHATE........................................... 39
PRIMAXIN........................................................................36
PRIMIDONE..................................................................... 52
PRIMLEV.................................................................... 50, 67
PRIMSOL.......................................................................... 36
PRISTIQ ER............................................................ 6, 67, 78
Page 100 of 106
�
Index
PRIVIGEN................................................................... 35, 83
PROAIR HFA...................................................................... 4
PROAIR RESPICLICK....................................................... 4
PROBENECID.................................................................. 31
PROBENECID-COLCHICINE......................................... 31
PROCAINAMIDE HCL...................................................... 9
PROCARBAZINE HCL.................................................... 47
PROCARDIA XL.............................................................. 11
PRO-C-DURE 5................................................................ 42
PRO-C-DURE 6................................................................ 42
PROCENTRA................................................................ 7, 67
PROCHLORPERAZINE..................................................... 4
PROCHLORPERAZINE EDISYLATE.............................. 4
PROCHLORPERAZINE MALEATE................................. 4
PRO-CLEAR CAPS(OTC)................................................ 14
PROCORT......................................................................... 44
PROCRIT.....................................................................32, 83
PROCTOCORT................................................................. 44
PROCTOFOAM-HC......................................................... 44
PROCTOZONE-HC.......................................................... 44
PROCYSBI.................................................................. 54, 83
PRODIGY AUTOCODE(OTC)........................................ 24
PRODIGY LANCING DEVICE(OTC).......................25, 67
PRODIGY NO CODING(OTC)........................................ 22
PRODIGY POCKET(OTC)............................................... 24
PRODIGY VOICE(OTC).................................................. 24
PRODIGY(OTC)............................................................... 24
PROFERRIN-FORTE........................................................ 56
PROFILNINE.................................................................... 32
PROGESTERONE.............................................................34
PROGESTERONE,MICRONIZED...................................34
PROGLYCEM................................................................... 25
PROGRAF......................................................................... 35
PROLASTIN C.................................................................. 45
PROLENSA....................................................................... 29
PROLEUKIN..................................................................... 35
PROLIA....................................................................... 28, 83
PROMACTA................................................................ 33, 83
PROMETHAZINE HCL................................................. 3, 4
PROMETHAZINE HCL/CODEINE................................. 14
PROMETHAZINE VC......................................................14
PROMETHAZINE VC-CODEINE................................... 14
PROMETHAZINE/DEXTROMETHORPHAN............... 14
PROMETHAZINE/PHENYLEPH/CODEINE................. 14
PROMETHAZINE-CODEINE......................................... 14
PROMETHAZINE-DM.....................................................14
PROMETHEGAN............................................................... 4
PROMETRIUM................................................................. 34
PROPAFENONE HCL........................................................ 9
PROPANTHELINE BROMIDE........................................ 53
PROPARACAINE HCL.................................................... 29
PROPARACAINE/FLUORESCEIN SOD........................ 29
PROPRANOLOL HCL..................................................... 10
PROPRANOLOL/HYDROCHLOROTHIAZID...............11
PROPRANOLOL-HYDROCHLOROTHIAZID...............11
PROPYLTHIOURACIL.................................................... 29
PROSCAR......................................................................... 54
PROSED-DS...................................................................... 36
PROSTIN E2 VAGINAL SUPPOSITORY....................... 14
PROSTIN VR PEDIATRIC...............................................12
PROTAMINE SULFATE................................................... 32
PROTECT IRON............................................................... 56
PROTECTIVES COMBINATION NO.2.......................... 18
PROTEIN C CONCENTRATE, HUMAN........................ 33
PROTONIX IV.................................................................. 54
PROTONIX(GRANPKT DR)..................................... 54, 78
PROTONIX(TAB DR)....................................................... 54
PROTOPIC............................................................ 19, 61, 78
PROTRIPTYLINE HCL...................................................... 6
PROVENGE...................................................................... 46
PROVENTIL HFA............................................................... 4
PROVERA......................................................................... 34
PROVIDA DHA................................................................ 57
PROVIDA OB................................................................... 59
PROVIGIL..................................................................... 8, 83
PRUDOXIN....................................................................... 17
PSEUDOEPHEDRINE HCL/ACRIVAS.............................3
PSORCON......................................................................... 17
PULMICORT FLEXHALER........................................ 5, 67
PULMICORT(AMPUL-NEB)(0.25MG/2ML)............. 5, 67
PULMICORT(AMPUL-NEB)(0.5 MG/2ML).............. 5, 67
PULMICORT(AMPUL-NEB)(1 MG/2 ML)................ 5, 67
PULMOZYME............................................................ 48, 83
PURALOR CI.................................................................... 55
PUREFE OB PLUS........................................................... 59
PUREFE PLUS.................................................................. 59
PURIXAN..............................................................45, 67, 78
PV W-O CAL/FE,CARBONYL/DOSS/FA...................... 59
PV W-O CAL/FERROUS FUMARATE/FA..................... 59
PV W-O CAL/IRON PS CPLX/FA................................... 59
PYLERA............................................................................ 54
PYRAZINAMIDE............................................................. 38
Sutter Health Plus
PYRIDIUM........................................................................54
PYRIDOSTIGMINE BROMIDE........................................ 6
PYRIDOXINE HCL.......................................................... 60
PYRIMETHAMINE.......................................................... 39
PYROGALLIC ACID........................................................19
PYROGALLOL................................................................. 19
-Q
Q-CARE RX...................................................................... 48
QNASL.................................................................... 4, 67, 78
QNASL CHILDREN............................................... 4, 67, 78
QUALAQUIN.................................................................... 39
QUARTETTE........................................................ 13, 67, 85
QUESTRAN...................................................................... 12
QUESTRAN LIGHT......................................................... 12
QUETIAPINE FUMARATE............................................... 7
QUFLORA........................................................................ 57
QUILLICHEW ER.............................................................. 8
QUILLIVANT XR................................................... 8, 67, 78
QUINAPRIL HCL............................................................. 10
QUINAPRIL/HYDROCHLOROTHIAZIDE...................... 9
QUINIDINE GLUCONATE................................................9
QUINIDINE SULFATE....................................................... 9
QUININE SULFATE......................................................... 39
QUINTET AC(OTC)................................................... 22, 24
QUINTET(OTC)..........................................................22, 24
QUINUPRISTIN/DALFOPRISTIN.................................. 37
QUTENZA.................................................................. 18, 83
QVAR.............................................................................5, 67
-R
RABEPRAZOLE SODIUM.............................................. 54
RABIES IMMUNE GLOBULIN/PF................................ 35
RAGWITEK.................................................................. 3, 83
RALOXIFENE HCL......................................................... 28
RALTEGRAVIR POTASSIUM......................................... 40
RAMELTEON..................................................................... 8
RAMIPRIL........................................................................ 10
RAMUCIRUMAB............................................................. 46
RANEXA(TAB ER 12H)(1000 MG).......................... 13, 67
RANEXA(TAB ER 12H)(500 MG)............................ 13, 67
RANIBIZUMAB............................................................... 31
RANITIDINE HCL........................................................... 54
RANOLAZINE..................................................................13
RAPAFLO............................................................. 54, 78, 85
RAPAMUNE..................................................................... 35
RAPIVAB.......................................................................... 39
RASAGILINE MESYLATE..............................................51
RASBURICASE................................................................ 31
RASUVO(AUTO INJECT)(10MG/0.2ML).......... 41, 67, 78
RASUVO(AUTO INJECT)(12.5/0.25)................. 41, 67, 78
RASUVO(AUTO INJECT)(7.5MG/0.15)............. 41, 67, 78
RAVICTI......................................................................44, 83
RAYOS........................................................................ 42, 78
RAZADYNE..................................................................6, 67
RAZADYNE ER........................................................... 6, 67
REA LO 40........................................................................ 18
REBETOL......................................................................... 41
REBIF.......................................................................... 48, 83
REBIF REBIDOSE..................................................... 48, 83
RECLAST..........................................................................28
RECOMBINATE............................................................... 31
RECOTHROM...................................................................33
RECTIV............................................................................. 44
RED BIRCH........................................................................ 3
RED CEDAR....................................................................... 3
REFUAH PLUS(OTC)................................................ 22, 24
REGLAN........................................................................... 54
REGONOL.......................................................................... 6
REGORAFENIB............................................................... 47
REGRANEX......................................................................25
RELADOR PAK PLUS..................................................... 19
RELAGARD...................................................................... 55
RELENZA................................................................... 39, 67
RELIAMED MINI LANCING DEVICE(OTC)......... 25, 67
RELION CONFIRM(OTC)............................................... 24
RELION CONFIRM-MICRO(OTC).................................22
RELION MICRO(OTC).................................................... 24
RELION PRIME TEST STRIPS(OTC)............................ 22
RELION PRIME(OTC)..................................................... 24
RELISTOR.................................................................. 45, 83
RELPAX................................................................ 51, 67, 78
RELYYKS......................................................................... 19
RELYYT............................................................................ 18
REMERON.......................................................................... 6
REMICADE................................................................ 44, 83
REMIFENTANIL HCL..................................................... 49
REMODULIN............................................................. 11, 83
RENACIDIN......................................................................54
RENAGEL......................................................................... 26
RENA-VITE RX................................................................59
RENO CAPS..................................................................... 59
RENVELA......................................................................... 26
REOPRO............................................................................ 33
REPAGLINIDE................................................................. 20
REPAGLINIDE/METFORMIN HCL............................... 20
REPATHA SURECLICK............................................ 12, 83
REPATHA SYRINGE................................................. 12, 83
REQ49+............................................................................. 55
REQUIP............................................................................. 51
RESCRIPTOR................................................................... 40
RESCULA............................................................. 30, 67, 78
RESECTISOL....................................................................11
RESERPINE...................................................................... 10
RESPA A.R........................................................................14
RESTASIS................................................................... 30, 67
RESTORIL.......................................................................... 8
RETAPAMULIN............................................................... 16
RETIN-A..................................................................... 15, 61
RETIN-A MICRO....................................................... 15, 61
RETIN-A MICRO PUMP(GEL W/PUMP)(0.04 %)...... 15,
61
61
61
RETISERT......................................................................... 29
RETROVIR(CAP)....................................................... 40, 67
RETROVIR(SYRUP).................................................. 40, 67
RETROVIR(VIAL)........................................................... 40
REVATIO(SUSP RECON).......................................... 11, 83
REVATIO(TAB).......................................................... 11, 83
REVEAL BLOOD GLUCOSE METER(OTC)................ 24
REVEAL TEST STRIP(OTC)...........................................22
REVESTA.......................................................................... 60
REVIA................................................................................. 8
REVLIMID............................................................ 46, 67, 83
REXULTI.................................................................7, 67, 78
REYATAZ.......................................................................... 40
REZIRA............................................................................. 14
RHEUMATREX................................................................ 41
RHINOCORT AQUA.............................................. 4, 67, 78
RHIZOPUS.......................................................................... 3
RHO(D) IMMUNE GLOBULIN...................................... 35
RHO(D) IMMUNE GLOBULIN/MALTOSE...................35
RHOGAM ULTRA-FILTERED PLUS............................. 35
RHOPHYLAC................................................................... 35
RIASTAP........................................................................... 31
RIBASPHERE(CAP).........................................................41
RIBASPHERE(TAB)(200 MG).........................................41
RIBASPHERE(TAB)(400 MG)...................................41, 78
RIBASPHERE(TAB)(600 MG)...................................41, 78
RIBAVIRIN................................................................. 39, 41
RIDAURA......................................................................... 42
RIFABUTIN...................................................................... 38
RIFADIN........................................................................... 39
RIFAMATE........................................................................39
RIFAMP/ISONIAZID/PYRAZINAMIDE........................ 39
RIFAMPIN........................................................................ 39
RIFAMPIN/ISONIAZID................................................... 39
RIFAPENTINE.................................................................. 39
RIFATER........................................................................... 39
RIFAXIMIN...................................................................... 39
RIGHTEST GD500(OTC)........................................... 25, 67
RIGHTEST GM100 SYSTEM(OTC)............................... 24
RIGHTEST GM250S METER(OTC)............................... 24
RIGHTEST GM260 METER(OTC)................................. 24
RIGHTEST GS100 TEST STRIPS(OTC).........................22
RIGHTEST GS250S TEST STRIPS(OTC)...................... 22
RILONACEPT................................................................... 41
RILPIVIRINE HCL........................................................... 40
RILUTEK.......................................................................... 48
RILUZOLE........................................................................ 48
RIMANTADINE HCL...................................................... 39
RIMEXOLONE................................................................. 29
RIMSO-50......................................................................... 54
RINGERS INJECTION..................................................... 27
RINGERS IRRIGATION.................................................. 18
RINGERS SOLUTION............................................... 18, 27
RINGERS SOLUTION,LACTATED.......................... 18, 27
RIOCIGUAT...................................................................... 11
RIOMET............................................................................ 20
RISEDRONATE SODIUM............................................... 28
RISPERDAL CONSTA....................................................... 7
Page 101 of 106
�
Index
RISPERDAL(SOLUTION)........................................... 7, 67
RISPERDAL(TAB)....................................................... 7, 67
RISPERIDONE................................................................... 7
RISPERIDONE MICROSPHERES.................................... 7
RITALIN........................................................................ 8, 67
RITALIN LA........................................................... 8, 61, 67
RITONAVIR...................................................................... 40
RITUXAN................................................................... 45, 83
RITUXIMAB..................................................................... 45
RIVAROXABAN............................................................... 32
RIVASTIGMINE................................................................. 6
RIVASTIGMINE TARTRATE............................................ 6
RIXUBIS........................................................................... 32
RIZATRIPTAN BENZOATE............................................ 51
ROBAXIN......................................................................... 53
ROBAXIN-750.................................................................. 53
ROBINUL.......................................................................... 53
ROBINUL FORTE............................................................ 53
ROCALTROL.................................................................... 60
ROFLUMILAST................................................................. 5
ROLAPITANT HYDROCHLORIDE................................. 4
ROMIDEPSIN................................................................... 47
ROMIPLOSTIM................................................................ 33
ROPINIROLE HCL........................................................... 51
ROPIVACAINE HCL IN 0.9%NACL/PF......................... 43
ROPIVACAINE HCL/PF.................................................. 43
ROPIVACAINE HCL-0.9% NACL................................... 43
ROSADAN........................................................................ 15
ROSANIL.......................................................................... 16
ROSIGLITAZONE MALEATE........................................ 20
ROSIGLITAZONE/METFORMIN HCL.......................... 21
ROSULA(CLEANSER).................................................... 16
ROSULA(MED PAD)....................................................... 16
ROSUVASTATIN CALCIUM........................................... 12
ROTARIX.......................................................................... 35
ROTATEQ.......................................................................... 35
ROTAVIRUS VAC,LIVE ATT, 89-12 ................................35
ROTAVIRUS VACCINE,LIVE ORAL PV........................35
ROTIGOTINE....................................................................51
ROUGH PIGWEED............................................................ 3
ROWASA........................................................................... 43
ROXICODONE................................................................. 50
ROZEREM.............................................................. 8, 67, 79
RUCONEST................................................................ 41, 83
RUFINAMIDE.................................................................. 52
RUSSIAN THISTLE........................................................... 3
RUXOLITINIB PHOSPHATE.......................................... 46
RYANODEX......................................................................53
RYTARY................................................................ 51, 67, 79
RYTHMOL.......................................................................... 9
-S
SABRIL....................................................................... 52, 67
SACCHAROMYCES CEREVISIAE.................................. 3
SACROSIDASE................................................................ 53
SACUBITRIL/VALSARTAN............................................ 13
SAFYRAL............................................................. 13, 79, 85
SAGEBRUSH...................................................................... 3
SAIZEN....................................................................... 28, 83
SALACYN.........................................................................18
SALAGEN......................................................................... 45
SALEX.............................................................................. 18
SALICYLIC AC/BENZOYL PER/VIT E.........................18
SALICYLIC ACID............................................................18
SALICYLIC ACID/AMMON LACT/ALOE....................18
SALICYLIC ACID/CERAMIDE CMB #1....................... 18
SALICYLIC ACID/UREA................................................18
SALMETEROL XINAFOATE............................................ 5
SALSALATE..................................................................... 49
SALVAX DUO PLUS........................................................18
SAMSCA(TAB)(15 MG)............................................ 26, 67
SAMSCA(TAB)(30 MG)............................................ 26, 67
SANCUSO............................................................... 4, 67, 79
SANDIMMUNE................................................................ 35
SANTYL............................................................................19
SAPHRIS................................................................. 7, 67, 79
SAQUINAVIR MESYLATE............................................. 40
SARAFEM.......................................................................... 6
SARGRAMOSTIM........................................................... 33
SAVAYSA.............................................................. 32, 67, 79
SAVELLA.......................................................................... 48
SAXAGLIPTIN HCL........................................................ 20
SAXAGLIPTIN HCL/METFORMIN HCL...................... 20
SCALACORT DK............................................................. 17
SCAR................................................................................. 19
SCLEROSOL.....................................................................47
SCOPOLAMINE................................................................. 4
SCOPOLAMINE HYDROBROMIDE..............................53
SEBELIPASE ALFA......................................................... 45
SECOBARBITAL SODIUM............................................... 8
SECONAL SODIUM.......................................................... 8
SECTRAL..........................................................................10
SECUKINUMAB.............................................................. 19
Sutter Health Plus
SEEBRI NEOHALER......................................................... 4
SELECT-OB................................................................ 58, 59
SELECT-OB + DHA......................................................... 59
SELEGILINE...................................................................... 8
SELEGILINE HCL........................................................... 51
SELENIUM....................................................................... 56
SELENIUM SULFIDE...................................................... 17
SELEXIPAG...................................................................... 11
SELRX............................................................................... 17
SELZENTRY............................................................... 40, 83
SEMPREX-D....................................................................... 3
SE-NATAL 19.............................................................. 57, 58
SENSIPAR......................................................................... 28
SENSORCAINE................................................................ 43
SENSORCAINE-MPF...................................................... 43
SENSORCAINE-MPF EPINEPHRINE............................43
SEREVENT DISKUS................................................... 5, 67
SEROQUEL...................................................................7, 67
SEROQUEL XR(TAB ER 24H).............................. 7, 67, 79
SEROQUEL XR(TAB24HDSPK)....................................... 7
SEROSTIM.................................................................. 28, 83
SERTACONAZOLE NITRATE........................................ 16
SERTRALINE HCL............................................................ 6
SE-TAN DHA.................................................................... 57
SEVELAMER CARBONATE.......................................... 26
SEVELAMER HCL.......................................................... 26
SFROWASA...................................................................... 43
SHAGBARK HICKORY..................................................... 3
SHEEP SORREL/YELLOW DOCK...................................3
SHEEP SORREL-YELLOW DOCK.................................. 3
SILDENAFIL CITRATE............................................. 11, 27
SILENOR................................................................ 8, 67, 79
SILODOSIN...................................................................... 54
SILTUXIMAB................................................................... 47
SILVER NITRATE............................................................ 15
SILVER NITRATE APPLICATOR...................................18
SILVER SULFADIAZINE................................................ 16
SILVERA........................................................................... 19
SIMBRINZA..................................................................... 30
SIMCOR(TBMP 24HR)(1000-20MG)................. 12, 67, 79
SIMCOR(TBMP 24HR)(1000-40 MG)................ 12, 67, 79
SIMCOR(TBMP 24HR)(500MG-20MG)............. 12, 67, 79
SIMEPREVIR SODIUM................................................... 41
SIMPONI..................................................................... 41, 83
SIMPONI ARIA.......................................................... 41, 83
SIMULECT....................................................................... 35
SIMVASTATIN..................................................................12
SINECATECHINS............................................................ 16
SINELEE(ADH PATCH)(0.0375%-5%)...........................18
SINELEE(ADH PATCH)(0.05%-5%)............................... 18
SINEMET 10-100.............................................................. 51
SINEMET 25-100.............................................................. 51
SINEMET 25-250.............................................................. 51
SINGULAIR........................................................................ 5
SIPULEUCEL-T/LACTATED RINGERS........................ 46
SIROLIMUS...................................................................... 35
SIRTURO.....................................................................38, 83
SITAGLIPTIN PHOS/METFORMIN HCL...................... 20
SITAGLIPTIN PHOSPHATE............................................ 20
SITAVIG................................................................ 39, 67, 79
SIVEXTRO.................................................................. 37, 83
SIVEXTRO(TAB)....................................................... 37, 83
SIVEXTRO(VIAL)........................................................... 37
SKELAXIN....................................................................... 53
SKLICE............................................................................. 16
SMART CARESENS N(OTC).......................................... 24
SMART SENSE MONITORING SYSTEM(OTC)...........24
SMART SENSE TEST STRIPS(OTC)............................. 22
SMARTDIABETES VANTAGE(OTC).......................25, 67
SMARTEST EJECT(OTC)................................................24
SMARTEST PERSONA(OTC)......................................... 24
SMARTEST PRONTO(OTC)........................................... 24
SMARTEST PROTEGE(OTC)......................................... 24
SMARTEST SMART CODE(OTC)..................................24
SMARTEST TALKING(OTC)..........................................24
SMARTEST TEST(OTC)..................................................22
SOD PICOSULF/MAG OX/CITRIC AC..........................44
SOD/POT/MAG/CAL/CHLO/ACE/GLUC...................... 27
SODIUM ACETATE......................................................... 26
SODIUM BENZOATE/SOD PHENYLACET..................44
SODIUM BICARBONATE............................................... 26
SODIUM CHLORIDE................................................ 18, 27
SODIUM CHLORIDE 0.45 %.......................................... 27
SODIUM CHLORIDE 3 %............................................... 27
SODIUM CHLORIDE 5 %............................................... 27
SODIUM CHLORIDE IRRIG SOLUTION..................... 18
SODIUM CHLORIDE/NAHCO3/KCL/PEG................... 44
SODIUM CITRATE.......................................................... 32
SODIUM CITRATE DIHYDRATE.................................. 32
SODIUM DIURIL............................................................. 12
SODIUM EDECRIN......................................................... 11
SODIUM FERRIC GLUCONAT/SUCROSE................... 56
SODIUM FLUORIDE....................................................... 55
SODIUM FLUORIDE/POTASSIUM NIT........................55
SODIUM FLUORIDE/VITAMIN D3............................... 55
SODIUM FLUORIDE/XYLITOL.................................... 55
SODIUM GLYCEROPHOSPHATE..................................27
SODIUM IODIDE............................................................. 29
SODIUM LACTATE......................................................... 26
SODIUM OXYBATE.......................................................... 7
SODIUM PHENYLBUTYRATE...................................... 44
SODIUM PHOS,M-BASIC-D-BASIC..............................27
SODIUM PHOSPHATE.................................................... 27
SODIUM POLYSTYRENE SULFONATE.......................27
SODIUM SULFACETAMIDE.......................................... 18
SODIUM SULFACETAMIDE-SULFUR......................... 16
SODIUM THIOSULFATE/SAL ACID.............................16
SODIUM,POTASSIUM,&MAG SULFATES................... 44
SODIUM/K+/MAG/CA/CHLOR/ACETATE................... 27
SOFOSBUVIR.................................................................. 40
SOFTCLIX(OTC)........................................................ 25, 67
SOLAICE.......................................................................... 18
SOLARAZE.......................................................... 19, 67, 83
SOLIFENACIN SUCCINATE...........................................54
SOLIRIS...................................................................... 33, 83
SOLTAMOX...................................................................... 47
SOLU-CORTEF................................................................ 42
SOLU-MEDROL............................................................... 42
SOLU-MEDROL(VIAL)(1000 MG)................................ 42
SOLU-MEDROL(VIAL)(2 G).......................................... 42
SOLU-MEDROL(VIAL)(500 MG).................................. 42
SOLUS V2 LANCING DEVICE(OTC)......................25, 67
SOLUS V2(OTC)........................................................ 22, 24
SOMA................................................................................ 53
SOMATROPIN.................................................................. 28
SOMAVERT...................................................................... 28
SONATA........................................................................ 8, 67
SONIDEGIB PHOSPHATE.............................................. 46
SOOLANTRA................................................................... 15
SORAFENIB TOSYLATE................................................47
SORBITOL........................................................................ 18
SORBITOL SOLUTION................................................... 18
SORBITOL-MANNITOL................................................. 18
SORIATANE..................................................................... 19
SORILUX.................................................................... 19, 79
SOTALOL..........................................................................10
SOTALOL HCL.................................................................10
SOTYLIZE............................................................ 10, 67, 79
SOVALDI.................................................................... 40, 83
SPECTRACEF...................................................................36
SPINOSAD........................................................................ 16
SPIRIVA........................................................................ 5, 67
SPIRIVA RESPIMAT.................................................... 5, 67
SPIRONOLACT/HYDROCHLOROTHIAZID.................11
SPIRONOLACTONE........................................................ 11
SPORANOX(CAP)........................................................... 38
SPORANOX(SOLUTION)............................................... 38
SPRAY AND STRETCH.................................................. 19
SPRINTEC.................................................................. 14, 85
SPRIX.......................................................................... 42, 67
SPRYCEL(TAB)(100 MG)....................................46, 67, 83
SPRYCEL(TAB)(140 MG)....................................46, 67, 83
SPRYCEL(TAB)(20 MG)......................................46, 67, 83
SPRYCEL(TAB)(50 MG)......................................46, 67, 83
SPRYCEL(TAB)(70 MG)......................................46, 68, 83
SPRYCEL(TAB)(80 MG)......................................47, 68, 83
SS 10-2...............................................................................16
SSKI................................................................................... 29
STALEVO 100...................................................................51
STALEVO 125...................................................................51
STALEVO 150...................................................................51
STALEVO 200...................................................................51
STALEVO 50.....................................................................51
STALEVO 75.....................................................................51
STANDARD BERMUDA GRASS POLLEN..................... 3
STANDARD RYE GRASS POLLEN................................. 3
STANDARDIZED CAT HAIR............................................ 3
STANDARDIZED JUNE GRASS POLLEN...................... 3
STANDARDIZED ORCHARD GRASS.............................3
STANDARDIZED TIMOTHY GRASS..............................3
STARLIX........................................................................... 20
STAVUDINE..................................................................... 40
STAXYN............................................................... 27, 68, 83
STELARA................................................................... 42, 84
STENDRA.............................................................27, 68, 84
STERILE TALC................................................................ 47
STIMATE.......................................................................... 27
STIOLTO RESPIMAT................................................... 5, 68
STIVARGA............................................................ 47, 68, 84
STRATTERA(CAP)(10 MG)........................................ 8, 68
STRATTERA(CAP)(100 MG)...................................... 8, 68
STRATTERA(CAP)(18 MG)........................................ 8, 68
Page 102 of 106
�
Index
STRATTERA(CAP)(25 MG)........................................ 8, 68
STRATTERA(CAP)(40 MG)........................................ 9, 68
STRATTERA(CAP)(60 MG)........................................ 9, 68
STRATTERA(CAP)(80 MG)........................................ 9, 68
STREPTOMYCIN SULFATE........................................... 38
STREPTOZOCIN.............................................................. 45
STRIANT.................................................................... 34, 84
STRIBILD................................................................... 40, 68
STRIVERDI RESPIMAT.............................................. 5, 68
STROMECTOL................................................................. 39
STRONG IODINE............................................................. 29
STROVITE FORTE........................................................... 56
STROVITE ONE............................................................... 56
SUBLIMAZE.................................................................... 49
SUBOXONE................................................................ 51, 84
SUBSYS...................................................................... 49, 84
SUCRAID.................................................................... 53, 84
SUCRALFATE.................................................................. 54
SUCROFERRIC OXYHYDROXIDE............................... 27
SUFENTA.......................................................................... 49
SUFENTANIL CITRATE..................................................49
SULAR.............................................................................. 11
SULCONAZOLE NITRATE............................................. 16
SULFACETAMIDE SOD/SULFUR/UREA..................... 16
SULFACETAMIDE SODIUM........................ 15, 17, 18, 29
SULFACETAMIDE SODIUM/SULFUR..........................16
SULFACETAMIDE/PREDNISOLONE SP...................... 29
SULFACETAMIDE/SULFUR/CLEANSR23................... 16
SULFACETAMIDE-PREDNISOLONE........................... 29
SULFACETM NA/PREDNISOL AC................................29
SULFACT SOD/SULUR/AVOB/OTN/OCT.....................16
SULFADIAZINE............................................................... 43
SULFAMETHOXAZOLE/TRIMETHOPRIM................. 35
SULFAMETHOXAZOLE-TRIMETHOPRIM................. 35
SULFAMYLON................................................................ 16
SULFANILAMIDE........................................................... 55
SULFASALAZINE........................................................... 44
SULINDAC....................................................................... 43
SUMADAN....................................................................... 16
SUMADAN XLT............................................................... 16
SUMATRIPTAN................................................................ 51
SUMATRIPTAN SUCC/NAPROXEN SOD.....................51
SUMATRIPTAN SUCCINATE................................... 51, 68
SUMAVEL DOSEPRO(NDL FR INJ)(4 MG/0.5ML)......
51,
68,
79
SUMAVEL DOSEPRO(NDL FR INJ)(6 MG/0.5ML)......
51,
68,
79
SUMAXIN CP................................................................... 16
SUNITINIB MALATE...................................................... 47
SUPERVITE...................................................................... 59
SUPERVITE EC................................................................ 56
SUPPRELIN LA................................................................ 28
SUPRAX(CAP)................................................................. 36
SUPRAX(SUSP RECON)(100 MG/5ML)........................36
SUPRAX(TAB CHEW).................................................... 36
SUPREP............................................................................. 44
SURE COMFORT LANCING PEN(OTC)................. 25, 68
SUREFLEX(OTC).......................................................25, 68
SURE-PEN(OTC)........................................................ 25, 68
SURE-TEST EASYPLUS MINI(OTC)...................... 22, 24
SURFAXIN........................................................................48
SURMONTIL...................................................................... 6
SURVANTA....................................................................... 48
SUSTIVA........................................................................... 40
SUTENT................................................................ 47, 68, 84
SUVOREXANT.................................................................. 8
SYLATRON.................................................................46, 68
SYLVANT....................................................................47, 84
SYMAX DUOTAB............................................................ 53
SYMAX-SL....................................................................... 53
SYMBICORT.......................................................... 5, 68, 79
SYMBYAX.................................................................... 8, 68
SYMLINPEN 120............................................................. 20
SYMLINPEN 60............................................................... 20
SYNAGIS.................................................................... 39, 84
SYNALAR.........................................................................17
SYNALAR TS...................................................................17
SYNALGOS-DC............................................................... 49
SYNAREL......................................................................... 28
SYNERA........................................................................... 19
SYNERCID....................................................................... 37
SYNJARDY........................................................... 20, 68, 79
SYNRIBO.................................................................... 47, 84
SYNTHROID.................................................................... 29
SYNVEXIA TC.................................................................19
SYRINGE AVITENE........................................................ 33
-T
TABLOID.................................................................... 46, 68
TACHOSIL........................................................................ 33
TACLONEX(OINT).................................................... 20, 79
Sutter Health Plus
TACLONEX(SUSPENSION)..................................... 20, 79
TACROLIMUS............................................................ 19, 35
TADALAFIL............................................................... 11, 27
TAFINLAR............................................................ 46, 68, 84
TAFLUPROST/PF............................................................. 30
TAGRISSO............................................................ 47, 68, 84
TALC................................................................................. 47
TALIMOGENE LAHERPAREPVEC............................... 46
TALWIN............................................................................ 50
TAMIFLU(CAP)(30 MG)........................................... 39, 68
TAMIFLU(CAP)(45 MG)........................................... 39, 68
TAMIFLU(CAP)(75 MG)........................................... 39, 68
TAMIFLU(SUSP RECON)......................................... 39, 68
TAMOXIFEN CITRATE................................................... 47
TAMOXIFEN CITRATE(TAB)(10 MG).......................... 47
TAMOXIFEN CITRATE(TAB)(20 MG).......................... 47
TAMSULOSIN HCL......................................................... 54
TANDEM PLUS................................................................ 56
TANZEUM............................................................ 20, 68, 79
TAPAZOLE....................................................................... 29
TAPENTADOL HCL.........................................................50
TARCEVA............................................................. 47, 68, 84
TARGRETIN................................................... 19, 47, 68, 84
TARKA................................................................................ 9
TARON FORTE................................................................. 55
TARON-PREX PRENATAL..............................................58
TASIGNA.............................................................. 47, 68, 84
TASIMELTEON.................................................................. 8
TASMAR............................................................... 51, 68, 79
TAVABOROLE.................................................................. 16
TAZAROTENE............................................................15, 19
TAZORAC......................................................................... 19
TBO-FILGRASTIM.......................................................... 33
TD GOLD BLOOD GLUCOSE MONITOR(OTC)..........24
TD GOLD TEST STRIP(OTC)......................................... 22
TD GOLD VOICE GLUCOSE MONITOR(OTC)........... 24
TECFIDERA............................................................... 48, 84
TECHNIVIE................................................................ 41, 84
TEDIZOLID PHOSPHATE...............................................37
TEDUGLUTIDE............................................................... 45
TEFLARO......................................................................... 36
TEGRETOL....................................................................... 52
TEGRETOL XR................................................................ 52
TEKAMLO.................................................................. 11, 84
TEKTURNA................................................................ 11, 84
TEKTURNA HCT....................................................... 12, 84
TELAVANCIN HCL..........................................................39
TELBIVUDINE................................................................. 41
TELCARE BGM(OTC)..................................................... 24
TELCARE(OTC)......................................................... 22, 24
TELITHROMYCIN...........................................................36
TELMISARTAN................................................................ 10
TELMISARTAN/AMLODIPINE...................................... 10
TELMISARTAN/HYDROCHLOROTHIAZID................ 10
TEMAZEPAM..................................................................... 8
TEMODAR............................................................ 45, 68, 84
TEMODAR(CAP)................................................. 45, 68, 84
TEMODAR(VIAL)..................................................... 45, 84
TEMOVATE...................................................................... 17
TEMOVATE EMOLLIENT...............................................17
TEMOZOLOMIDE........................................................... 45
TEMSIROLIMUS............................................................. 46
TENECTEPLASE............................................................. 33
TENEX.............................................................................. 10
TENIPOSIDE.................................................................... 47
TENOFOVIR DISOPROXIL FUMARATE......................40
TENORETIC 100.............................................................. 10
TENORETIC 50................................................................ 10
TENORMIN...................................................................... 10
TERAZOL 3...................................................................... 55
TERAZOL 7...................................................................... 55
TERAZOSIN HCL.............................................................. 9
TERBINAFINE HCL........................................................ 38
TERBUTALINE SULFATE................................................ 5
TERCONAZOLE.............................................................. 55
TERIFLUNOMIDE........................................................... 48
TERIPARATIDE............................................................... 28
TERSI FOAM.................................................................... 17
TESAMORELIN ACETATE.............................................28
TESSALON PERLE.......................................................... 14
TEST N'GO(OTC)....................................................... 22, 24
TEST STRIPS(OTC)......................................................... 22
TESTONE CIK.................................................................. 34
TESTOPEL........................................................................ 34
TESTOSTERONE............................................................. 34
TESTOSTERONE CYPIONATE...................................... 34
TESTOSTERONE ENANTHATE.................................... 34
TESTOSTERONE UNDECANOATE.............................. 34
TESTRED.......................................................................... 34
TETANUS IMMUNE GLOBULIN/PF.............................35
TETCAINE........................................................................ 29
TETRABENAZINE...........................................................48
TETRACAINE HCL............................................. 19, 29, 43
TETRACAINE HCL/PF.............................................. 29, 43
TETRACAINE/BENZOCAINE/BUTAMBEN.................19
TETRACYCLINE HCL.................................................... 38
TETRAHYDROZOLINE HCL......................................... 14
TETRAVISC...................................................................... 29
TETRAVISC FORTE........................................................ 29
TETRIX............................................................................. 18
TEXACORT...................................................................... 17
TEXAVITE LQ.................................................................. 57
THALIDOMIDE............................................................... 38
THALOMID.......................................................... 38, 68, 84
THAM................................................................................26
THEO-24............................................................................. 5
THEOPHYLLINE ANHYDROUS..................................... 5
THEOPHYLLINE IN 5% DEXTROSE.............................. 5
THEOPHYLLINE/D5W..................................................... 5
THIAMINE HCL...............................................................59
THIOGUANINE................................................................ 46
THIOLA............................................................................ 54
THIORIDAZINE HCL........................................................ 8
THIOTEPA........................................................................ 45
THIOTHIXENE...................................................................7
THRIVITE RX.................................................................. 56
THROMBATE III.............................................................. 33
THROMBIN (BOVINE)....................................................33
THROMBIN (RECOMBINANT)..................................... 33
THROMBIN(HUM PLAS)/FIB/APRO/CA......................33
THROMBIN(HUM PLAS)/FIBRINOG/CA.....................34
THROMBIN-JMI.............................................................. 33
THYMOGLOBULIN........................................................ 35
THYROID,PORK.............................................................. 29
THYROLAR-1.................................................................. 29
THYROLAR-1/2............................................................... 29
THYROLAR-1/4............................................................... 29
THYROLAR-2.................................................................. 29
THYROLAR-3.................................................................. 29
TIAGABINE HCL............................................................. 52
TICAGRELOR.................................................................. 33
TICLOPIDINE HCL......................................................... 33
TIGAN................................................................................. 4
TIGAN(CAP)...................................................................... 4
TIGAN(VIAL).....................................................................4
TIGECYCLINE................................................................. 36
TIKOSYN............................................................................ 9
TIMOLOL......................................................................... 30
TIMOLOL MALEATE................................................ 10, 30
TIMOLOL MALEATE/PF................................................ 30
TIMOPTIC........................................................................ 30
TIMOPTIC OCUDOSE.........................................30, 68, 79
TIMOPTIC-XE.................................................................. 30
TINDAMAX...................................................................... 39
TINIDAZOLE................................................................... 39
TIOPRONIN...................................................................... 54
TIOTROPIUM BR/OLODATEROL HCL.......................... 5
TIOTROPIUM BROMIDE.................................................. 5
TIPRANAVIR.................................................................... 40
TIPRANAVIR/VITAMIN E TPGS................................... 40
TIROFIBAN-0.9% SODIUM CHLORIDE.......................33
TIROSINT......................................................................... 29
TISSEEL VHSD................................................................33
TIVICAY..................................................................... 40, 84
TIVORBEX........................................................... 43, 68, 79
TIZANIDINE HCL........................................................... 53
TIZANIDINE/IRR CNTR-IRR CMB #2.......................... 53
TL FOLATE.......................................................................59
TNKASE............................................................................33
TOBI............................................................................ 38, 84
TOBI PODHALER...................................................... 38, 84
TOBRADEX ST................................................................ 29
TOBRADEX(DROPS SUSP)............................................ 29
TOBRADEX(OINT)......................................................... 29
TOBRAMYCIN.......................................................... 30, 38
TOBRAMYCIN IN 0.225% NACL.................................. 38
TOBRAMYCIN SULFATE............................................... 38
TOBRAMYCIN SULFATE IN NS................................... 38
TOBRAMYCIN/DEXAMETHASONE............................29
TOBRAMYCIN/LOTEPRED ETAB................................ 29
TOBRAMYCIN/NEBULIZER......................................... 38
TOBRAMYCIN/SODIUM CHLORIDE.......................... 38
TOBREX(DROPS)............................................................ 30
TOBREX(OINT)............................................................... 30
TOCILIZUMAB................................................................ 42
TODAY CONTRACEPTIVE SPONGE(OTC)........... 13, 85
TOFACITINIB CITRATE................................................. 42
TOFRANIL..........................................................................6
TOFRANIL-PM.................................................................. 6
TOLAK.............................................................................. 19
TOLAZAMIDE................................................................. 20
TOLBUTAMIDE............................................................... 20
TOLCAPONE....................................................................51
TOLMETIN SODIUM...................................................... 43
Page 103 of 106
�
Index
TOLTERODINE TARTRATE........................................... 54
TOLVAPTAN..................................................................... 26
TOPAMAX........................................................................ 52
TOPICORT(CREAM)....................................................... 17
TOPICORT(GEL).............................................................. 17
TOPICORT(OINT)............................................................ 17
TOPICORT(SPRAY)................................................... 17, 79
TOPIRAMATE.................................................................. 52
TOPOTECAN HCL........................................................... 46
TOPROL XL...................................................................... 10
TOREMIFENE CITRATE.................................................47
TORISEL..................................................................... 46, 84
TORSEMIDE.................................................................... 11
TOUJEO SOLOSTAR................................................. 26, 68
TOVIAZ....................................................................... 54, 79
TPN ELECTROLYTES..................................................... 27
TPN ELECTROLYTES II................................................. 27
TRABECTEDIN................................................................46
TRACE ELEMENTS COMB NO.1.................................. 56
TRACLEER................................................................. 11, 84
TRADJENTA...............................................................20, 68
TRAMADOL HCL............................................................ 50
TRAMADOL HCL/ACETAMINOPHEN.........................50
TRAMETINIB DIMETHYL SULFOXIDE......................47
TRANDATE........................................................................ 9
TRANDOLAPRIL............................................................. 10
TRANDOLAPRIL/VERAPAMIL HCL..............................9
TRANEXAMIC ACID...................................................... 31
TRANSDERM-SCOP......................................................... 4
TRANXENE T-TAB............................................................7
TRANYLCYPROMINE SULFATE.................................... 6
TRASTUZUMAB............................................................. 46
TRAVATAN Z.............................................................. 30, 68
TRAVOPROST............................................................ 30, 68
TRAVOPROST (BENZALKONIUM).............................. 30
TRAZODONE HCL............................................................ 6
TREANDA........................................................................ 45
TRECATOR....................................................................... 38
TREE POLLEN-AMERICAN ELM................................... 3
TREE POLLEN-AMERICAN SYCAMORE..................... 3
TREE POLLEN-BAYBERRY............................................. 3
TREE POLLEN-BLACK WALNUT.................................. 3
TREE POLLEN-BOX ELDER........................................... 3
TREE POLLEN-EASTERN COTTONWOOD.................. 3
TREE POLLEN-MESQUITE............................................. 3
TREE POLLEN-MOUNTAIN CEDAR..............................3
TREE POLLEN-RED BIRCH............................................ 3
TREE POLLEN-RED CEDAR........................................... 3
TREE POLLEN-SHAGBARK HICKORY......................... 3
TREE POLLEN-VIRGINIA LIVE OAK............................3
TREE POLLEN-WHITE ASH............................................3
TREE POLLEN-WHITE OAK........................................... 3
TRELSTAR....................................................................... 28
TRELSTAR DEPOT.......................................................... 28
TRELSTAR LA................................................................. 28
TREPROSTINIL............................................................... 11
TREPROSTINIL DIOLAMINE........................................ 11
TREPROSTINIL SODIUM............................................... 11
TREPROSTINIL/NEB ACCESSORIES...........................11
TREPROSTINIL/NEBULIZER/ACCESOR.....................11
TRESIBA FLEXTOUCH U-100.......................................25
TRESIBA FLEXTOUCH U-200....................................... 25
TRETINOIN.......................................................... 15, 47, 68
TRETINOIN MICROSPHERES....................................... 15
TRETINOIN/EMOL CMB9/SKIN CLN1........................ 15
TRETIN-X................................................................... 15, 61
TRETIN-X(CREAM)(0.0375 %)................................ 15, 61
TRETIN-X(CREAM)(0.075 %).................................. 15, 61
TRETTEN..........................................................................32
TREXALL................................................................... 46, 68
TREXIMET........................................................... 51, 68, 79
TREZIX....................................................................... 49, 68
TRIAMCINOLONE ACETON/SILICONES................... 17
TRIAMCINOLONE ACETONIDE............ 4, 17, 42, 48, 68
TRIAMCINOLONE ACETONIDE/PF.............................29
TRIAMCINOLONE HEXACETONIDE.......................... 42
TRIAMCINOLONE/DIMETH/SILICONE...................... 17
TRIAMCINOLONE/EMOLLIENT CMB#45.................. 17
TRIAMCINOLONE/EMOLLIENT CMB#86.................. 17
TRIAMCINOLONE/LIDOCAINE................................... 42
TRIAMTERENE............................................................... 11
TRIAMTERENE/HYDROCHLOROTHIAZID................11
TRIAMTERENE-HYDROCHLOROTHIAZID............... 11
TRIAZOLAM...................................................................... 8
TRIBENZOR................................................................. 9, 79
TRICARE.......................................................................... 58
TRICARE PRENATAL DHA ONE.................................. 58
TRICITRASOL................................................................. 32
TRICOR.............................................................................13
TRIESENCE...................................................................... 29
TRIFERIC..........................................................................55
TRIFLUOPERAZINE HCL................................................ 8
Sutter Health Plus
TRIFLURIDINE................................................................ 29
TRIFLURIDINE/TIPIRACIL HCL.................................. 46
TRIGELS-F FORTE.......................................................... 56
TRIGLIDE................................................................... 13, 79
TRIHEXYPHENIDYL HCL............................................. 51
TRILEPTAL...................................................................... 52
TRILIPIX........................................................................... 13
TRIMETHOBENZAMIDE HCL........................................ 4
TRIMETHOPRIM............................................................. 36
TRIMIPRAMINE MALEATE............................................ 6
TRINATAL RX 1............................................................... 59
TRINATE........................................................................... 59
TRIOSTAT......................................................................... 29
TRIOXIN........................................................................... 26
TRIPLE DYE..................................................................... 16
TRIPTORELIN PAMOATE.............................................. 28
TRISENOX........................................................................ 47
TRISTART DHA............................................................... 59
TRIUMEQ................................................................... 40, 68
TRIVEEN-DUO DHA.......................................................58
TRIVEEN-ONE................................................................. 58
TRI-VI-FLOR.................................................................... 57
TRI-VIT WITH FLUORIDE-IRON..................................56
TRI-VITAMIN WITH FLUORIDE.................................. 57
TRIZIVIR.................................................................... 40, 84
TROKENDI XR(CAP ER 24H)(100 MG)............ 52, 68, 79
TROKENDI XR(CAP ER 24H)(200 MG)............ 52, 68, 79
TROKENDI XR(CAP ER 24H)(25 MG).............. 52, 68, 79
TROKENDI XR(CAP ER 24H)(50 MG).............. 52, 68, 79
TROMETHAMINE........................................................... 26
TROPICAMIDE................................................................ 30
TROSPIUM CHLORIDE............................................ 54, 80
TRUE METRIX AIR GLUCOSE METER(OTC)............ 24
TRUE METRIX GLUCOSE TEST STRIP(OTC)............ 22
TRUE2GO BLOOD GLUCOSE SYSTEM(OTC)............24
TRUEDRAW(OTC)..................................................... 25, 68
TRUERESULT BLOOD GLUCOSE SYSTM(OTC)....... 24
TRUETEST TEST STRIPS(OTC).................................... 22
TRUETRACK BLOOD GLUCOSE SYSTEM(OTC)......
24
TRUETRACK SMART SYSTEM(OTC)....................22, 24
TRUETRACK TEST STRIP(OTC)...................................22
TRULICITY.......................................................... 20, 68, 80
TRUSOPT.......................................................................... 30
TRUST NATAL DHA........................................................58
TRUVADA...................................................................40, 68
TRYPSIN/BALSAM PERU/CASTOR OIL......................19
TUDORZA PRESSAIR...........................................5, 68, 80
TUSSICAPS...................................................................... 14
TUSSIONEX..................................................................... 14
TUZISTRA XR..................................................... 14, 68, 80
TWYNSTA........................................................................ 10
TYBOST...................................................................... 40, 84
TYGACIL.......................................................................... 36
TYKERB............................................................... 47, 68, 84
TYLENOL-CODEINE NO.3............................................ 51
TYLENOL-CODEINE NO.4............................................ 51
TYPHOID VACC,LIVE,ATTENUATED..........................35
TYSABRI.................................................................... 48, 84
TYVASO......................................................................11, 84
TYZEKA........................................................................... 41
TYZINE............................................................................. 14
-U
UCERIS................................................................. 41, 44, 80
U-CORT............................................................................. 17
UDAMIN SP......................................................................56
ULESFIA........................................................................... 16
ULIPRISTAL ACETATE...................................................14
ULORIC................................................................ 31, 68, 80
ULTI-LANCE(OTC)................................................... 25, 68
ULTIMA(OTC)............................................................22, 24
ULTIMATECARE ONE.................................................... 58
ULTIMATECARE ONE NF.............................................. 58
ULTIVA............................................................................. 49
ULTRACET....................................................................... 50
ULTRAFOAM................................................................... 33
ULTRAM........................................................................... 50
ULTRASAL-ER................................................................ 18
ULTRATRAK PRO(OTC)................................................. 24
ULTRATRAK ULTIMATE(OTC)............................... 22, 24
ULTRATRAK(OTC)................................................... 22, 24
ULTRAVATE..................................................................... 17
ULTRAVATE X................................................................. 17
ULTRESA.......................................................................... 53
UMECLIDINIUM BRM/VILANTEROL TR.....................5
UMECLIDINIUM BROMIDE............................................ 5
UMECTA PD..................................................................... 18
UMECTA(EMULSN)........................................................ 18
UMECTA(NL FM SUSP)................................................. 18
UNASYN........................................................................... 37
UNISTIK 2 EXTRA(OTC)......................................... 25, 68
UNISTIK 2 NORMAL................................................ 25, 68
UNISTIK 2 NORMAL(OTC)..................................... 25, 68
UNISTIK 2(OTC)........................................................ 25, 68
UNISTIK 3 COMFORT(OTC).................................... 25, 68
UNISTIK 3 NEONATAL(OTC).................................. 25, 68
UNISTIK 3(OTC)........................................................ 25, 68
UNISTRIP1(OTC)............................................................. 22
UNITHROID..................................................................... 29
UNITUXIN.................................................................. 47, 84
UNOPROSTONE ISOPROPYL........................................30
UPTRAVI.....................................................................11, 84
URAMAXIN GT............................................................... 18
URAMAXIN(CREAM).................................................... 18
URAMAXIN(FOAM)....................................................... 18
URAMAXIN(GEL)........................................................... 18
URAMAXIN(LOTION).................................................... 18
UREA.......................................................................... 18, 19
UREA/EMOLLIENT CMB NO.18...................................18
UREA/EMOLLIENT COMBINATION #65.....................18
UREA/HYALURONATE SODIUM..................................18
UREA/LACTIC AC/ZN UNDECYLENATE....................18
UREA/LACTIC ACID/SALICYLIC AC .......................... 18
URECHOLINE.................................................................. 45
URETRON D-S................................................................. 36
UREVAZ............................................................................ 18
URIBEL............................................................................. 36
URIN D.S.......................................................................... 36
URINE GLUCOSE TEST,STRIP..................................... 26
URINE GLUCOSE TEST,TABLET................................. 26
UROCIT-K......................................................................... 54
UROGESIC-BLUE............................................................ 36
UROQID-ACID NO.2....................................................... 54
UROXATRAL................................................................... 54
URSO................................................................................. 44
URSO FORTE................................................................... 44
URSODIOL....................................................................... 44
USTEKINUMAB.............................................................. 42
UTA................................................................................... 36
UTIBRON NEOHALER..................................................... 5
UTOPIC............................................................................. 18
UVADEX........................................................................... 47
-V
VAGIFEM..........................................................................55
VALACYCLOVIR HCL.................................................... 39
VALCHLOR................................................................ 19, 84
VALCYTE(SOLN RECON)..............................................39
VALCYTE(TAB)............................................................... 39
VALGANCICLOVIR HCL............................................... 39
VALIUM.............................................................................. 7
VALPROIC ACID............................................................. 52
VALPROIC ACID (AS SODIUM SALT)......................... 52
VALRUBICIN................................................................... 45
VALSARTAN.................................................................... 10
VALSARTAN/HYDROCHLOROTHIAZIDE.................. 10
VALSTAR.......................................................................... 45
VALTREX..........................................................................39
VANATOL LQ................................................................... 49
VANCOCIN HCL........................................................ 39, 68
VANCOMYCIN................................................................ 39
VANCOMYCIN HCL....................................................... 39
VANCOMYCIN HCL/D5W..............................................39
VANCOMYCIN HCL-0.9% NACL.................................. 39
VANCOMYCIN IN DEXTROSE,ISO-OSM....................39
VANCOMYCIN/0.9 % SOD CHLORIDE........................39
VANDAZOLE................................................................... 55
VANDETANIB.................................................................. 47
VANOS.............................................................................. 17
VANOXIDE-HC................................................................ 15
VANTAS............................................................................ 28
VAPRISOL-5% DEXTROSE............................................ 26
VARDENAFIL HCL......................................................... 27
VARENICLINE TARTRATE............................................ 53
VARICELLA-ZOSTER IG/MALTOSE............................ 35
VARICELLA-ZOSTER IMMUNE GLOB....................... 35
VARIZIG........................................................................... 35
VARUBI......................................................................... 4, 68
VASCEPA.................................................................... 13, 68
VASELINE WHITE PETROLEUM..................................18
VASERETIC........................................................................ 9
VASOPRESSIN................................................................. 27
VASOSTRICT................................................................... 27
VASOTEC..........................................................................10
VAZCULEP....................................................................... 14
V-C FORTE....................................................................... 56
VCF(OTC)................................................................... 13, 85
VECAMYL..................................................................10, 84
VECTIBIX................................................................... 46, 84
VECTICAL..................................................................19, 80
VEDOLIZUMAB.............................................................. 44
VELCADE................................................................... 46, 84
VELETRI..................................................................... 11, 84
VELMA............................................................................. 19
VELPHORO...................................................................... 27
Page 104 of 106
�
Index
VELTASSA........................................................................26
VELTIN....................................................................... 15, 80
VEMURAFENIB.............................................................. 47
VENATAL COMPLETE DHA..........................................58
VENLAFAXINE HCL........................................................ 6
VENLAFAXINE HCL ER.................................................. 6
VENOFER......................................................................... 56
VENTAVIS.................................................................. 11, 84
VENTOLIN HFA................................................................ 4
VERAMYST........................................................... 4, 68, 80
VERAPAMIL ER.............................................................. 11
VERAPAMIL HCL........................................................... 11
VERDESO......................................................................... 17
VERDROCET................................................................... 49
VEREGEN......................................................................... 16
VERIPRED 20................................................................... 42
VERSACLOZ.......................................................... 7, 68, 80
VERTEPORFIN................................................................ 30
VESICARE.................................................................. 54, 80
VEXA................................................................................ 19
VEXOL.............................................................................. 29
VFEND.............................................................................. 38
VFEND IV......................................................................... 38
VIAGRA................................................................ 27, 68, 84
VIBATIV........................................................................... 39
VIBERZI......................................................................44, 84
VIBRAMYCIN................................................37, 38, 68, 80
VICOPROFEN.................................................................. 49
VICTOZA 2-PAK.................................................. 20, 68, 80
VICTOZA 3-PAK.................................................. 20, 68, 80
VIDAZA............................................................................ 45
VIDEX......................................................................... 40, 68
VIDEX EC(CAP DR)(125 MG).................................. 40, 68
VIDEX EC(CAP DR)(200 MG).................................. 40, 68
VIDEX EC(CAP DR)(250 MG)........................................ 40
VIDEX EC(CAP DR)(400 MG)........................................ 40
VIEKIRA PAK............................................................ 41, 84
VIGABATRIN................................................................... 52
VIGAMOX........................................................................ 30
VIIBRYD................................................................. 6, 68, 80
VILAZODONE HYDROCHLORIDE................................ 6
VIMPAT(SOLUTION).......................................... 52, 68, 80
VIMPAT(TAB)...................................................... 52, 68, 80
VIMPAT(VIAL).................................................................52
VINACAL..........................................................................57
VINATE CARE................................................................. 59
VINATE DHA................................................................... 58
VINATE II......................................................................... 59
VINATE PN CARE........................................................... 58
VINATE-M........................................................................ 58
VINBLASTINE SULFATE............................................... 48
VINCRISTINE SULFATE................................................ 48
VINCRISTINE SULFATE LIPOSOMAL........................ 48
VINORELBINE TARTRATE............................................48
VIOKACE......................................................................... 53
VIRACEPT........................................................................ 40
VIRAMUNE(ORAL SUSP)........................................ 40, 68
VIRAMUNE(TAB)..................................................... 40, 68
VIRASAL.......................................................................... 18
VIRAZOLE....................................................................... 39
VIREAD(POWDER)................................................... 40, 68
VIREAD(TAB)............................................................ 40, 68
VIRGINIA LIVE OAK....................................................... 3
VIROPTIC......................................................................... 29
VIRT-ADVANCE.............................................................. 59
VIRT-PN PLUS................................................................. 58
VIRTPREX........................................................................ 58
VIRT-VITE GT.................................................................. 59
VIRT-VITE PLUS............................................................. 59
VISMODEGIB.................................................................. 46
VISTARIL........................................................................... 3
VISTIDE............................................................................ 39
VISUDYNE....................................................................... 30
VIT B CMPLX 3/FA/VIT C/BIOTIN............................... 59
VIT B CMPLX NO3/FA/C/BIOT/ZINC........................... 59
VIT B COMPLEX & C NO.13/FA/D3............................. 59
VIT B CPLX #11/FA/C/BIOT/ZN OX..............................59
VIT B1/B2/B6/FA/MECOBALAMIN.............................. 59
VITAFOL...........................................................................55
VITAFOL FE+................................................................... 58
VITAFOL NANO.............................................................. 59
VITAFOL ULTRA.............................................................58
VITAFOL-OB.................................................................... 59
VITAFOL-OB+DHA......................................................... 58
VITAFOL-ONE................................................................. 58
VITAL-D RX..................................................................... 59
VITAMEDMD ONE RX................................................... 58
VITAMEDMD PLUS RX................................................. 58
VITAMEDMD REDICHEW RX...................................... 58
VITAMIN A PALMITATE................................................ 59
VITAMIN D2(OTC).................................................... 60, 61
VITAMIN D3(CAP)(1000 UNIT)(OTC).................... 60, 61
Sutter Health Plus
VITAMIN D3(CAP)(400 UNIT)(OTC)...................... 60, 61
VITAMIN D3(TAB CHEW)(1000 UNIT)(OTC)........60, 61
VITAMIN D3(TAB CHEW)(400 UNIT)(OTC)..........60, 61
VITAMIN D3(TAB)(OTC).......................................... 60, 61
VITAMIN D3/FOLIC ACID............................................. 60
VITAMIN K1.................................................................... 34
VITAMINS B1,B2,B3,B5,& B6........................................ 59
VITAPEARL..................................................................... 58
VITA-RESPA..................................................................... 59
VITASPIRE....................................................................... 57
VITATRUE........................................................................ 59
VITEKTA.............................................................. 40, 68, 80
VITRASE.......................................................................... 19
VITUZ............................................................................... 14
VIVELLE-DOT........................................................... 34, 68
VIVITROL...........................................................................7
VIVLODEX....................................................................... 43
VIVOTIF............................................................................ 35
VOGELXO.................................................................. 34, 84
VOL-PLUS........................................................................ 58
VOL-TAB RX.................................................................... 59
VOLTAREN....................................................................... 17
VOLUVEN........................................................................ 33
VORAPAXAR SULFATE................................................. 33
VORAXAZE..................................................................... 47
VORICONAZOLE............................................................ 38
VORINOSTAT................................................................... 47
VORTIOXETINE HYDROBROMIDE............................... 6
VOSPIRE ER....................................................................... 5
VOTRIENT............................................................ 47, 68, 84
VP-CH PLUS.....................................................................58
VP-CH-PNV...................................................................... 58
VP-PNV-DHA................................................................... 58
VUSION............................................................................ 16
VYTONE........................................................................... 15
VYTORIN(TAB)(10 MG-10MG)......................... 12, 68, 80
VYTORIN(TAB)(10 MG-20MG)......................... 12, 68, 80
VYTORIN(TAB)(10 MG-40MG)......................... 12, 68, 80
VYTORIN(TAB)(10 MG-80MG)......................... 12, 68, 80
VYVANSE............................................................... 7, 68, 80
-W
WARFARIN SODIUM...................................................... 31
WATER.............................................................................. 18
WATER FOR IRRIGATION,STERILE............................ 18
WAVESENSE AMP(OTC)................................................ 24
WAVESENSE JAZZ(OTC)..........................................22, 24
WAVESENSE PRESTO(OTC).................................... 22, 24
WEED POLLEN-ENGLISH PLANTAIN.......................... 3
WEED POLLEN-LAMBSQUARTERS..............................3
WEED POLLEN-MUGWORT........................................... 3
WEED POLLEN-ROUGH PIGWEED............................... 3
WEED POLLEN-RUSSIAN THISTLE.............................. 3
WEED POLLEN-SAGEBRUSH......................................... 3
WEED POLLEN-SHORT RAGWEED.............................. 3
WEED POLLEN-SHORT,TALL RAGWEED....................3
WELCHOL........................................................................ 12
WELLBUTRIN XL............................................................. 6
WHITE ASH....................................................................... 3
WHITE OAK EXTRACT....................................................3
WHYTEDERM TDPAK................................................... 17
WHYTEDERM TRILASIL PAK......................................17
WIDE SEAL DIAPHRAGM....................................... 14, 85
WILATE............................................................................ 31
WINRHO SDF...................................................................35
-X
XALATAN......................................................................... 30
XALKORI............................................................. 46, 68, 84
XANAX............................................................................... 7
XARELTO(TAB DS PK).............................................32, 68
XARELTO(TAB)(10 MG)........................................... 32, 68
XARELTO(TAB)(15 MG)........................................... 32, 68
XARELTO(TAB)(20 MG)........................................... 32, 68
XARTEMIS XR...........................................................50, 68
XELJANZ.................................................................... 42, 84
XELODA(TAB)(150 MG)..................................... 45, 68, 84
XELODA(TAB)(500 MG)..................................... 45, 68, 84
XENAZINE................................................................. 48, 84
XERESE................................................................ 16, 69, 80
XGEVA........................................................................ 28, 84
XIAFLEX.......................................................................... 52
XIFAXAN(TAB)(200 MG)......................................... 39, 69
XIFAXAN(TAB)(550 MG)......................................... 39, 84
XIGDUO XR......................................................... 20, 69, 80
XOLAIR........................................................................ 5, 84
XOLEGEL......................................................................... 16
XOPENEX........................................................................... 5
XOPENEX HFA.................................................................. 5
XTANDI................................................................ 45, 69, 84
XYLOCAINE.................................................................... 43
XYLOCAINE DENTAL-EPINEPHRINE........................ 43
XYLOCAINE WITH EPINEPHRINE..............................43
XYLOCAINE-MPF........................................................... 43
XYLOCAINE-MPF WITH EPINEPHRINE(AMPUL)......
43
XYLOCAINE-MPF WITH EPINEPHRINE(VIAL)(1 %
1:200K).............................................................................. 43
XYLOCAINE-MPF WITH EPINEPHRINE(VIAL)(1.5
1:200K).............................................................................. 43
XYNTHA.......................................................................... 31
XYNTHA SOLOFUSE..................................................... 31
XYREM......................................................................... 7, 84
XYZAL(SOLUTION)............................................. 4, 69, 80
XYZAL(TAB)..................................................................... 4
-Y
YERVOY..................................................................... 47, 84
YONDELIS................................................................. 46, 84
-Z
ZAFIRLUKAST.................................................................. 5
ZALEPLON......................................................................... 8
ZALTRAP.................................................................... 46, 84
ZAMICET....................................................................49, 69
ZANAFLEX...................................................................... 53
ZANAMIVIR.....................................................................39
ZANOSAR........................................................................ 45
ZANTAC............................................................................54
ZARONTIN....................................................................... 52
ZARXIO...................................................................... 33, 84
ZAVARA............................................................................ 60
ZEBETA............................................................................ 10
ZECUITY.............................................................. 51, 69, 80
ZEGERID(CAP).................................................... 54, 69, 80
ZEGERID(PACKET).............................................54, 69, 80
ZELAPAR.................................................................... 51, 69
ZELBORAF........................................................... 47, 69, 84
ZEMAIRA......................................................................... 45
ZEMPLAR......................................................................... 28
ZENCIA............................................................................. 16
ZENPEP............................................................................. 53
ZENZEDI(TAB)(15 MG).............................................. 7, 69
ZENZEDI(TAB)(2.5 MG)....................................... 7, 69, 80
ZENZEDI(TAB)(20 MG).............................................. 7, 69
ZENZEDI(TAB)(30 MG).............................................. 7, 69
ZENZEDI(TAB)(7.5 MG)....................................... 7, 69, 80
ZEPATIER......................................................................... 41
ZERBAXA.........................................................................36
ZERIT(CAP)................................................................40, 69
ZERIT(SOLN RECON).............................................. 40, 69
ZERUVIA.......................................................................... 19
ZESTORETIC..................................................................... 9
ZESTRIL........................................................................... 10
ZETIA.......................................................................... 12, 69
ZETONNA............................................................... 4, 69, 80
ZEVALIN...........................................................................47
ZIAC.................................................................................. 10
ZIAGEN(SOLUTION)................................................ 40, 69
ZIAGEN(TAB)............................................................ 40, 69
ZIANA............................................................................... 15
ZICONOTIDE ACETATE................................................. 49
ZIDOVUDINE............................................................. 40, 69
ZILEUTON..........................................................................4
ZINACEF........................................................................... 36
ZINACEF(VIAL PORT)....................................................36
ZINACEF(VIAL).............................................................. 36
ZINC CHLORIDE............................................................. 60
ZINC GLUCONATE......................................................... 60
ZINC SULF/CUSO4 P-HYD/MN/CR/SE........................ 56
ZINC SULFATE................................................................ 60
ZINECARD....................................................................... 47
ZINGO............................................................................... 43
ZIOPTAN...............................................................30, 69, 80
ZIPRASIDONE HCL.......................................................... 7
ZIPRASIDONE MESYLATE............................................. 7
ZIPSOR..................................................................42, 69, 80
ZIRGAN............................................................................ 29
ZITHRANOL.............................................................. 19, 81
ZITHRANOL-RR........................................................ 19, 81
ZITHROMAX................................................................... 36
ZITHROMAX TRI-PAK................................................... 36
ZIV-AFLIBERCEPT......................................................... 46
ZMAX................................................................................36
ZN/CU/MANG/SELEN/FLUOR/POT IOD......................56
ZNSO4/CUSO4/MANG SU/CHROMIC CL.................... 56
ZOCOR(TAB)(10 MG)..................................................... 12
ZOCOR(TAB)(20 MG)..................................................... 12
ZOCOR(TAB)(40 MG)..................................................... 12
ZOCOR(TAB)(5 MG)....................................................... 12
ZOCOR(TAB)(80 MG)............................................... 12, 81
ZOFRAN ODT.................................................................... 4
ZOFRAN(SOLUTION)................................................. 4, 69
ZOFRAN(TAB)................................................................... 4
ZOFRAN(VIAL)................................................................. 4
ZOHYDRO ER............................................................ 49, 69
ZOLADEX.................................................................. 27, 84
ZOLEDRONIC ACID....................................................... 28
Page 105 of 106
�
Index
ZOLEDRONIC ACID/MANNITOL&WATER.................28
ZOLINZA.................................................................... 47, 69
ZOLMITRIPTAN.............................................................. 51
ZOLOFT.............................................................................. 6
ZOLPIDEM TARTRATE.............................................. 8, 69
ZOLPIMIST............................................................ 8, 69, 81
ZOMACTON............................................................... 28, 84
ZOMETA........................................................................... 28
ZOMIG(SPRAY)(2.5 MG).................................... 51, 69, 81
ZOMIG(SPRAY)(5 MG)....................................... 51, 69, 81
ZOMIG(TAB)........................................................ 51, 69, 81
ZONALON........................................................................ 17
ZONATUSS....................................................................... 14
ZONEGRAN..................................................................... 52
ZONISAMIDE.................................................................. 52
ZONTIVITY................................................................ 33, 69
ZORBTIVE..................................................................28, 84
ZORTRESS........................................................................35
ZORVOLEX.......................................................... 42, 69, 81
ZOSYN.............................................................................. 37
ZOVIRAX..........................................................................39
ZOVIRAX(CREAM)......................................................... 16
ZOVIRAX(OINT)............................................................. 16
ZUBSOLV................................................................... 51, 84
ZUPLENZ(FILM)(4 MG)....................................... 4, 69, 81
ZUPLENZ(FILM)(8 MG)....................................... 4, 69, 81
ZUTRIPRO........................................................................ 14
ZYCLARA(CREAM PACK)................................ 35, 69, 84
ZYCLARA(CRM MD PMP)(2.5 %).................... 35, 69, 84
ZYCLARA(CRM MD PMP)(3.75 %).................. 35, 69, 84
ZYDELIG.............................................................. 47, 69, 84
ZYFLO................................................................................ 4
ZYFLO CR.......................................................................... 4
ZYKADIA............................................................. 46, 69, 84
ZYLET............................................................................... 29
ZYLOPRIM....................................................................... 31
ZYMAXID........................................................................ 30
ZYPRAM........................................................................... 44
ZYPREXA..................................................................... 7, 69
ZYPREXA RELPREVV..................................................... 7
ZYTIGA................................................................ 45, 69, 84
ZYVOX.............................................................................. 37
ZYVOX(IV SOLN)(200MG/0.1L).................................... 37
ZYVOX(IV SOLN)(600MG/300)..................................... 37
ZYVOX(SUSP RECON)................................................... 37
ZYVOX(TAB)............................................................. 37, 84
Sutter Health Plus
Page 106 of 106
�

Your Sutter Health Plus Formulary February 2016

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