2016 formulary - common ground healthcare cooperative · 2016-10-26 · 2016 essential health...
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2016 Formulary Reference Guide
FORMERLY
CLICK HERE TO VIEW OUR 2017 FORMULARY
2016 Essential Health Benefits With Oral Chemotherapy Designation
Formulary Reference Guide
Your formulary utilizes a Pharmacy and Therapeutics Committee (P & T Committee), made up of practicing physicians, pharmacists, and nurses to help ensure that our formulary is medically sound and that it supports patient health. This committee reviews and evaluates medications on the formulary based on safety and efficacy to help maintain clinical integrity in all therapeutic categories.
FORMULARY DESIGN
Optum has chosen a closed formulary structure for our Essential Health Benefits Formulary. The formulary structure features generics, preferred and non-preferred brand-name drugs, specialty drugs, oral chemotherapy drugs, and ACA (Affordable Care Act) preventive drugs. A closed formulary limits coverage to only those products listed in these levels. Products not listed on the formulary are generally not covered.
• Generic drugs: Most generic drugs are listed under “GENERIC”. Drugs listed under “GENERIC” have the same active ingredient as the brand-name versions but at a lower cost.
• Preferred drugs: Drugs listed under “PREFERRED” include preferred brand name drugs that will generally have lower co-payments than non-preferred brand name drugs.
• Non-preferred drugs: Drugs listed under “NON PREFERRED” generally have higher co-payments than preferred brand name drugs.
• Specialty drugs: Drugs listed under “SPECIALTY” generally have the highest co-payment and cost. Specialty drugs are prescription medications that are sometimes used to treat complex and chronic conditions. They may require special monitoring or handling.
• ACA preventive drugs: Drugs listed under “PREVENTIVE” may have coverage and no co-payment when health care reform requirements are met for age, gender, and/or risk factors.
• Oral chemotherapy: Drugs listed under “ORAL CHEMO” may have a designated copayment or co-insurance specific to these products based on state laws surrounding oral chemotherapeutic agents.
Essential Health Benefits (with oral chemotherapy designation) Formulary Reference Guide
REASONABLE MEDICAL MANAGEMENT
Optum’s formulary also uses medical and utilization management functions to determine whether a prescription is medically necessary. These industry recognized and accepted management functions include but are not limited to quantity limits, step therapy, and prior authorization and help Optum and its clients determine whether the prescribed medication was prescribed in accordance with generally accepted medical practice standards, is clinically appropriate, and confirm that the prescribed medication is not more costly than an alternative product that is as likely to produce therapeutically equivalent results. As recommended by the United States Department of Labor, Optum’s reasonable medical and utilization management functions apply to ACA preventive drugs.
USING THIS FORMULARY REFERENCE GUIDE TO HELP CONTAIN COSTS
Many health plans use the Optum formulary to help manage the overall cost of providing prescription drug benefits. This formulary offers a wide range of medications from which to choose. We realize that this formulary reference guide may not include every drug from every manufacturer. However, choosing a generic or preferred drug when it is appropriate can provide access to the necessary medications to stay healthy, at a cost that is more affordable.
SAVING ON OUT-OF-POCKET COSTS
Your health plan sets the co-payments for each formulary drug status which include oral chemo, generic, preferred brand-name, non-preferred brand-name, and specialty medications. Co-payments and deductibles for preventive products follow health care reform rules. Health plans often design prescription drug plans to encourage the use of generic and preferred brand-name drugs. Choosing non-preferred drugs (or specialty drugs) may mean paying higher out-of-pocket expenses (such as coinsurance, co-payments, and deductible amounts) or not receiving coverage at all. Patients may also pay less for generic drugs.
PLEASE NOTE: Brand-name drugs may become non-formulary if a generic version becomes available.
CONSULTING THE PRESCRIBER’S OFFICE WHEN APPROPRIATE
When employers and other health plans design their prescription drug plans, they may choose to provide coverage only for certain medications, time periods, doses, quantities, or for a specific indications (e.g. they may exclude coverage for medications
Essential Health Benefits (with oral chemotherapy designation) Formulary Reference Guide
for unapproved, unproven, or cosmetic indications). When coverage for medications is provided based on use or quantity, your pharmacy benefit may contact your prescriber’s office for additional information to determine whether coverage is available under your plan. Patients who are unsure whether these coverage rules apply for a particular medication can consult their prescription drug benefit manual or contact a Member Services representative to determine specific coverage requirements.
KNOWING HOW THE FORMULARY INFORMATION IS ORGANIZED
The following formulary reference guide is designed in the following order: oral chemo, generics, generic preventive, preferred brand name, non-preferred brand name, brand name preventive, specialty drugs. In addition, immediately preceding the index is a section listing ACA preventive drugs by category.
OptumRx specializes in the delivery, clinical management and affordability of prescription medications and consumer health products. We are an OptumTM company — a leading provider of integrated health services. Learn more at optum.com.
All OptumTM
trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or
registered marks of their respective owners. © 2015 Optum, Inc. All rights reserved.
*Formulary Disclaimer: Coverage for some drugs may be limited to specific dosage forms and/or strengths. The benefit design determines what is
covered and the applicable co‐payment. The medications listed on this formulary are subject to change pursuant to the formulary management
activities of Optum. The presence of a medication on this formulary list does not guarantee coverage. To determine the most up‐to‐date formulary
status of your medication, please visit your member website or call member services at the number listed on your ID card.
Table of Contents
ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
PENICILLINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
CEPHALOSPORIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
FIRST GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
SECOND GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
THIRD GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
FOURTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
FIFTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
MACROLIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
TETRACYCLINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
QUINOLONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
AMINOGLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
SULFONAMIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
ANTIMYCOBACTERIAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
ANTIFUNGALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
ANTIVIRALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
ANTIMALARIALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
ANTHELMINTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
MISC. ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
ANTINEOPLASTICS, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
ALKYLATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
ANTIBIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
ANTINEOPLASTIC ENZYMES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
ANTIMETABOLITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
ANGIOGENESIS INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
ANTIBODIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
HORMONAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
MITOTIC INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
ENZYME INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
TOPOISOMERASE I INHIBITOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
ANTINEOPLASTICS MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
CHEMOTHERAPY RESCUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
CHEMOTHERAPY ADJUNCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
ANTINEOPLASTIC COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
CARDIOVASCULAR DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
PHOSPHODIESTERASE INHBTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
CARDIAC GLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
ANTIANGINAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
BETA BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
CALCIUM CHANNEL BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
ANTIARRHYTHMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
ACE INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
ANGIOTENSIN RCPTR BLOCKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
DIRECT RENIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
ANTIHYPERTENSIVES MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
ANTIHYPERTENSIVE COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
DIURETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
VASOPRESSORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
ANTIHYPERLIPIDEMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
CARDIOVASCULAR - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
DERMATOLOGICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ACNE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ROSACEA AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ANTIBIOTICS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ANTIFUNGALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ANTIVIRALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ANTI-INFLAMMATORY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ANTIPRURITICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ANTIPSORIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ANTISEBORRHEIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
CORTICOSTEROIDS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
IMMUNOMODULATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
DERMATOLOGICALS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
ENDOCRINE AND METABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
CORTICOSTEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
ANDROGENS-ANABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
ESTROGENS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
CONTRACEPTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
PROGESTINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
ANTIDIABETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
INSULIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
AMYLIN ANALOGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
INCRETIN MIMETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
SULFONYLUREAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
BIGUANIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
MEGLITINIDE ANALOGUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
DIABETIC OTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
ALPHA-GLUCOSIDASE INHIBIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
DPP-4 INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
INSULIN SENSITIZING AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
ANTIDIABETIC COMBINATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
BISPHOSPHONATES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
CALCITONINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
PARATHYROID HORMONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
RANK LIGAND INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
HORMONE RECEPTOR MDLTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
FERTILITY REGULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
LHRH/GNRH AGONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
GROWTH HORMONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
GHRH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
SOMATOMEDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
SOMATOSTATIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
GH RECEPTOR ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
POSTERIOR PITUITARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
CORTICOTROPIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
PROLACTIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
VASOPRESSIN ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
METABOLIC MODIFIERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
THYROID AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
GASTROINTESTINAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
LAXATIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
ANTIDIARRHEALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
ULCER DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
ANTIEMETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
DIGESTIVE AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
GASTROINTESTINAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
GENITOURINARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
URINARY ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
URINARY ANTISPASMODICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
VAGINAL PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
GENITOURINARY - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
HEMATOLOGICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
HEMATOPOIETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
ANTICOAGULANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
HEMOSTATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
HEMATOLOGICAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
MOUTH/THROAT/DENTAL AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
NEUROLOGY, CNS, PSYCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
ANTIANXIETY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
ANTIDEPRESSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
ANTIPSYCHOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
HYPNOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
ADHD, NARCOLEPSY, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
ANTICONVULSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
ANTIPARKINSON AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
NEUROLOGY, PSYCH - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
NEUROMUSCULAR AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
MUSCULOSKELETAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
ANTIMYASTHENIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
OPHTHALMOLOGY AND OTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
ARTIFICIAL TEAR/LUBRICANT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
BETA-BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
OPHTHALMIC STEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
PROSTAGLANDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
CYCLOPLEGIC MYDRIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
DECONGESTANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
MIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
ADRENERGIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
LOCAL ANESTHETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
OPHTHALMICS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
OTIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
OXYTOCICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
PAIN MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
ANALGESICS - NONNARCOTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
ANALGESICS - OPIOID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
ANTI-INFLAMMATORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
MIGRAINE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
GOUT AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
LOCAL ANESTHETICS-INJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
RESPIRATORY, ALLERGY, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
ANTIHISTAMINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
NASAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
COUGH/COLD/ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
ANTIASTHMATIC/COPD AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
RESPIRATORY AGENTS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
TOXOIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
VACCINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
MULTIVITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
MEDICAL DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
DIABETIC SUPPLIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
MEDICAL DEVICES - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
MISCELLANEOUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
ACA PREVENTIVE DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
ASPIRIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
CONTRACEPTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
FLUORIDE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
FOLIC ACID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
IMMUNIZATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
IRON . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
SMOKING CESSATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
VITAMIN D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
BOWEL PREPARATION AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
BREAST CANCER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
NON PREFERRED
Cedax
Claforan
Suprax
July 2016 FOURTH GENERATION
GENERIC
ANTI-INFECTIVES cefepime
NON PREFERRED
PENICILLINS
Maxipime
GENERIC
FIFTH GENERATION
amoxicillin
NON PREFERRED
amoxicillin/clavulanate potassium
Teflaro
amoxicillin/clavulanate potassium ER
ampicillin
MACROLIDES
ampicillin sodium
GENERIC
ampicillin-sulbactam
azithromycin
dicloxacillin sodium
clarithromycin
nafcillin sodium
clarithromycin ER
oxacillin sodium
erythromycin
penicillin v potassium
Erythromycin Base
penicillin G potassium
NON PREFERRED
piperacillin sodium/ tazobactam sodium
Azithromycin
piperacillin sodium/tazobactam sodium
DificidQL
piperacillin/tazobactam
Ery-TAB
Amoxicillin/Clavulanate Potassium
Erythrocin Lactobionate
Ampicillin-sulbactam
PCE
PREFERRED
Zithromax
Augmentin
NON PREFERRED
TETRACYCLINES
Bactocill IN Dextrose
GENERIC
Bicillin C-R
avidoxy
Bicillin L-a
demeclocycline HCL
Moxatag
doxy 100
Timentin
doxycycline
doxycycline hyclate
CEPHALOSPORIN
doxycycline hyclate DR
FIRST GENERATION
doxycycline monohydrate
GENERIC
minocycline HCL
cefadroxil
minocycline HCL ER
cefazolin sodium
mondoxyne nl
cephalexin
morgidox 1X100MG
SECOND GENERATION
morgidox 2X100MG
GENERIC
tetracycline HCL
cefaclor
Tetracycline HCL
cefotetan
cefoxitin sodium
QUINOLONES
cefprozil
GENERIC
cefuroxime axetil
ciprofloxacin
cefuroxime sodium
ciprofloxacin ER
Cefaclor
ciprofloxacin HCL
Cefotetan
ciprofloxacin I.V.-IN D5W
Cefotetan/Dextrose
levofloxacin
Cefuroxime Sodium
levofloxacin IN D5W
NON PREFERRED
moxifloxacin HCL
Ceftin
ofloxacin
Mefoxin
Ciprofloxacin HCL
Zinacef
Ofloxacin
THIRD GENERATION
PREFERRED
GENERIC
Avelox
cefdinir
NON PREFERRED
cefixime
Factive
cefotaxime sodium
Noroxin
cefpodoxime proxetil
ceftazidime
AMINOGLYCOSIDES
ceftriaxone sodium
tazicef GENERIC
tazidime amikacin sulfate
Cefditoren Pivoxil gentamicin sulfate
Ceftriaxone IN Iso-osmotic Dextrose gentamicin sulfate pediatric
gentamicin sulfate/0.9% sodium chloride
Effective July 1, 2016 v.1
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; All OptumTM trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners. © 2016 Optum, Inc. All rights reserved.
1
isotonic gentamicin ganciclovir
neomycin sulfate lamivudine
paromomycin sulfate lamivudine/zidovudine
tobramycin sulfate nevirapine
Streptomycin Sulfate nevirapine ER
SPECIALTY rimantadine HCL
tobramycinPA stavudine
tobramycin inhalation solution PAKPA valacyclovir HCLQL
Tobi PodhalerQL,PA zidovudine
PREFERRED
SULFONAMIDES Aptivus
AtriplaQL
GENERIC
CompleraQL
Sulfadiazine
Crixivan
Edurant
ANTIMYCOBACTERIAL AGENTS
Emtriva
GENERIC
Epivir HBV
ethambutol HCL
Epzicom
isoniazid
Evotaz
pyrazinamide
FuzeonQL
rifabutin
Intelence
rifampin
Invirase
PREFERRED
Isentress
Isoniazid
Kaletra
Priftin
Lexiva
Sirturo
Nevirapine
NON PREFERRED
Norvir
Capastat Sulfate
Prezcobix
Paser
Prezista
Rifamate
Relenza DiskhalerQL
Rifater
Rescriptor
Trecator
Retrovir IV Infusion
Reyataz
ANTIFUNGALS
SelzentryPA
GENERIC
StribildQL
bio-statin
Sustiva
fluconazole
TamifluQL
fluconazole IN dextrose
Tivicay
fluconazole IN NACL
TriumeqQL
flucytosine
Truvada
griseofulvin microsize
Tybost
griseofulvin ultramicrosize
Videx Pediatric
itraconazolePA
Viracept
ketoconazole
Viramune
nystatin
Viread
terbinafine HCLQL
Vitekta
voriconazole
Ziagen
Amphotericin B
SPECIALTY
PREFERRED
adefovir dipivoxilQL,PA
Cancidas
entecavirQL,PA
Lamisil
moderiba
Mycamine
ribasphere
Noxafil
ribavirin
SporanoxPA
valganciclovir
NON PREFERRED
BaracludeQL,PA
Abelcet
DaklinzaQL,PA
Ambisome
HarvoniPA
Amphotec
Moderiba
Cresemba
Moderiba 1200 Dose Pack
Eraxis
Moderiba 800 Dose Pack
Peg-intronPA
ANTIVIRALS
Peg-intron RedipenPA
GENERIC
Peg-intron Redipen PAK 4PA
abacavir
PegasysPA
abacavir sulfate/lamivudine/zidovudineQL
Pegasys ProclickPA
acyclovir
PegintronPA
acyclovir sodium
Rebetol
cidofovir
Ribasphere
didanosine
Ribasphere Ribapak
famciclovirQL
Ribatab
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 2
SovaldiPA Ketek
TyzekaQL,PA Primsol
Valcyte Vibativ
Victrelis Zyvox
Virazole SPECIALTY
ZepatierQL,PA CaystonPA
ANTIMALARIALS ANTINEOPLASTICS, ETC
GENERIC
ALKYLATING AGENTS
atovaquone/proguanil HCL
ORAL CHEMO
chloroquine phosphate
temozolomidePA
hydroxychloroquine sulfate
Alkeran
mefloquine HCL
Cyclophosphamide
quinine sulfatePA
Gleostine
Primaquine Phosphate
Hexalen
PREFERRED
Leukeran
Coartem
Lomustine
Daraprim
Myleran
SPECIALTY
ANTHELMINTICS
carboplatin
GENERIC
cisplatin
ivermectin
cyclophosphamide
PREFERRED
ifosfamide
Albenza
melphalan hydrochloride
NON PREFERRED
oxaliplatin
Biltricide
Bendeka
Bicnu
MISC. ANTI-INFECTIVES
Busulfex
GENERIC Cisplatin
atovaquone Gliadel Wafer
aztreonam Ifex
baciim Ifosfamide
bacitracin Mustargen
clindamycin Temodar
clindamycin palmitate HCL Treanda
clindamycin phosphate ValchlorPA
clindamycin phosphate add-vantage Yondelis
clindamycin phosphate pharmacy bulk package Zanosar
clindamycin phosphate IN D5W
clindamycin HCL ANTIBIOTICS
colistimethate sodium
GENERIC
e.s.p.
bleomycin sulfate
imipenem/cilastatin
SPECIALTY
lincomycin HCL
adriamycin
linezolidQL
daunorubicin HCL
meropenem
doxorubicin HCL
metronidazole
doxorubicin HCL liposome
metronidazole IN NACL 0.79%
epirubicin HCL
polymyxin b sulfate
idarubicin HCL
sulfamethoxazole/trimethoprim
lipodox
sulfamethoxazole/trimethoprim DS
lipodox 50
sulfatrim pediatric
mitomycin
tinidazole
mitoxantrone HCLQL,PA
trimethoprim
Adriamycin
vancomycin HCL
Daunoxome
Dapsone
Doxorubicin HCL
Linezolid
Epirubicin HCL
PREFERRED
Mitomycin
Alinia
Valstar
Nebupent
SivextroQL
ANTINEOPLASTIC ENZYMES
Tygacil
SPECIALTY
XifaxanPA
Erwinaze
NON PREFERRED
Oncaspar
Azactam IN Iso-osmotic Dextrose
Cubicin
ANTIMETABOLITES
Doribax
ORAL CHEMO
Flagyl ER
capecitabinePA
Invanz
mercaptopurine
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 3
methotrexate SPECIALTY
Tabloid leuprolide acetatePA
Trexall EligardQL,PA
GENERIC Faslodex
methotrexate sodium FirmagonQL,PA
Methotrexate Sodium Lupron DepotQL,PA
SPECIALTY TrelstarQL,PA
adrucil Trelstar MixjectQL,PA
azacitidinePA VantasQL,PA
cladribine ZoladexQL
cytarabine
cytarabine aqueous IMMUNOMODULATORS
decitabinePA
ORAL CHEMO
floxuridine
PomalystPA
fludarabine phosphate
RevlimidPA
fluorouracil
ThalomidPA
gemcitabine
GENERIC
gemcitabine HCL
azathioprine
Alimta
cyclosporine
Arranon
cyclosporine modified
Clolar
gengraf
Cytarabine
hecoria
Depocyt
mycophenolate mofetil
Floxuridine
mycophenolic acid DR
Folotyn
sirolimus
tacrolimus
ANGIOGENESIS INHIBITORS
Azathioprine
SPECIALTY PREFERRED
Avastin Azasan
ZaltrapQL,PA Rapamune
Sandimmune
ANTIBODIES NON PREFERRED
Atgam
SPECIALTY
Cellcept Intravenous
AdcetrisPA
NulojixPA
ArzerraPA
Prograf
BlincytoPA
Simulect
DarzalexPA
Thymoglobulin
EmplicitiPA
ZortressPA
Erbitux
GazyvaPA
MITOTIC INHIBITORS
HerceptinPA
KadcylaPA ORAL CHEMO
OpdivoPA Etoposide
PerjetaPA PREFERRED
PortrazzaPA Teniposide
Rituxan SPECIALTY
Unituxin docetaxel
Vectibix etoposide
YervoyPA paclitaxel
Zevalin Y-90 toposar
vincasar PFS
HORMONAL AGENTS vincristine sulfate
vinorelbine tartrate
ORAL CHEMO
Abraxane
anastrozole
Docefrez
bicalutamide
Docetaxel
exemestane
Docetaxel (non- Alcohol Formula)
flutamide
Docetaxel (non-alcohol Formula)
letrozole
Etopophos
megestrol acetate
HalavenPA
tamoxifen citrate
Ixempra Kit
Emcyt
JevtanaPA
Fareston
Marqibo
Lysodren
Paclitaxel
Nilandron
Vinblastine Sulfate
Soltamox
XtandiPA
ENZYME INHIBITORS
ZytigaPA
PREFERRED ORAL CHEMO
Depo-provera imatinib mesylatePA
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 4
AfinitorQL,PA Intron A W/DiluentPA
Afinitor DisperzPA Nipent
BosulifPA Proleukin
CaprelsaQL,PA SylatronPA
CometriqPA SynriboPA
CotellicQL,PA Theracys
FarydakQL,PA Tice Bcg
GilotrifQL,PA Trisenox
GleevecPA
IbrancePA CHEMOTHERAPY RESCUE
IclusigPA
ORAL CHEMO
ImbruvicaPA
leucovorin calcium
InlytaPA
Leucovorin Calcium
JakafiPA
Mesnex
Lenvima 10MG Daily DosePA
SPECIALTY
Lenvima 14MG Daily DosePA
amifostine
Lenvima 20MG Daily DosePA
dexrazoxane
Lenvima 24MG Daily DosePA
levoleucovorin
LynparzaPA
levoleucovorin calcium
MekinistPA
mesna
NexavarPA
Fusilev
NinlaroQL,PA
Levoleucovorin
SprycelPA
Totect
StivargaPA
Voraxaze
SutentPA
TafinlarPA
CHEMOTHERAPY ADJUNCTS
TagrissoQL,PA
SPECIALTY
TarcevaQL,PA
Elitek
TasignaPA
Kepivance
TykerbPA
VotrientPA
ANTINEOPLASTIC COMBO
XalkoriPA
ORAL CHEMO
ZelborafQL,PA
LonsurfQL,PA
ZolinzaPA
ZydeligPA
CARDIOVASCULAR DRUGS
ZykadiaPA
PHOSPHODIESTERASE INHBTR
SPECIALTY
GENERIC
IstodaxPA
milrinone lactate
KyprolisPA
milrinone IN dextrose
Torisel
VelcadePA
CARDIAC GLYCOSIDES
GENERIC
TOPOISOMERASE I INHIBITOR
digitek
ORAL CHEMO
digox
Hycamtin
digoxin
SPECIALTY
irinotecan
ANTIANGINAL AGENTS
topotecan HCL
GENERIC
Camptosar
isosorbide dinitrate
Irinotecan
isosorbide mononitrate
Onivyde
isosorbide mononitrate ER
Topotecan HCL
minitran
nitro-time
ANTINEOPLASTICS MISC.
nitroglycerin lingual
ORAL CHEMO
nitroglycerin transdermal
bexarotenePA
nitroglycerin ER
hydroxyurea
nitroglycerin IN dextrose 5%
tretinoin
nitroglycerin IN 5% dextrose
ErivedgePA
Isosorbide Dinitrate
Matulane
Nitroglycerin Lingual
PREFERRED
PREFERRED
Photofrin
Dilatrate SR
Uvadex
Nitro-bid
SPECIALTY
Nitrostat
dacarbazine
Ranexa
Actimmune
NON PREFERRED
Alferon N
Nitromist
Dacarbazine
Intron APA
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 5
BETA BLOCKERS quinidine gluconate CR
quinidine gluconate ER
GENERIC
quinidine sulfate
acebutolol HCL
Quinidine Sulfate
atenolol
PREFERRED
betaxolol HCL
Tikosyn
bisoprolol fumarate
NON PREFERRED
carvedilol
Multaq
esmolol HCL
Nexterone
labetalol HCL
Norpace CR
metoprolol succinate ER
metoprolol tartrate
ACE INHIBITORS
nadolol
pindolol GENERIC
propranolol HCL benazepril HCL
propranolol HCL ER captopril
sorine enalapril maleate
sotalol HCL enalaprilat
sotalol HCL (AF) fosinopril sodium
Metoprolol Tartrate lisinopril
Timolol Maleate moexipril HCL
PREFERRED perindopril erbumine
Bystolic quinapril HCL
Coreg CR ramipril
NON PREFERRED trandolapril
Inderal XL
Innopran XL ANGIOTENSIN RCPTR BLOCKER
Levatol
GENERIC
candesartan cilexetilST
CALCIUM CHANNEL BLOCKERS
irbesartan
GENERIC losartan potassium
afeditab CR telmisartan
amlodipine besylate valsartan
cartia XT Eprosartan Mesylate
dilt-XR PREFERRED
diltiazem CD Benicar
diltiazem HCL NON PREFERRED
diltiazem HCL CD EdarbiST
diltiazem HCL ER
felodipine ER DIRECT RENIN INHIBITORS
isradipine
PREFERRED
matzim LA
Tekturna
nicardipine HCL
nifedical XL
ANTIHYPERTENSIVES MISC.
nifedipine
GENERIC
nifedipine ER
clonidine HCL
nimodipine
doxazosin
nisoldipine
doxazosin mesylate
taztia XT
eplerenone
verapamil HCL
fenoldopam mesylate
verapamil HCL ER
guanfacine HCL
verapamil HCL SR
hydralazine HCL
NON PREFERRED
methyldopa
Cardene IV
minoxidil
Cardizem LA
phenoxybenzamine hydrochloride
prazosin HCL
ANTIARRHYTHMICS
terazosin HCL
GENERIC
Methyldopate HCL
adenosine
PREFERRED
amiodarone HCL
Demser
disopyramide phosphate
flecainide acetate
ANTIHYPERTENSIVE COMBO
ibutilide fumarate
GENERIC
lidocaine HCL
amlodipine besylate/benazepril hydrochloride
lidocaine HCL IN D5W
amlodipine besylate/benazepril HCL
lidocaine HCL/dextrose
amlodipine besylate/valsartan
mexiletine HCL
amlodipine/valsartan/hctz
pacerone
atenolol/chlorthalidone
propafenone HCL
benazepril HCL/hydrochlorothiazide
propafenone HCL ER
bisoprolol fumarate/hydrochlorothiazide
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 6
candesartan cilexetil/hydrochlorothiazide Dopamine HCL
enalapril maleate/hydrochlorothiazide Epinephrine
fosinopril sodium/hydrochlorothiazide PREFERRED
irbesartan/hydrochlorothiazide Auvi-q
lisinopril/hydrochlorothiazide Epipen 2-PAK
losartan potassium/hydrochlorothiazide Epipen-JR 2-PAK
metoprolol/hydrochlorothiazide
moexipril/hydrochlorothiazide ANTIHYPERLIPIDEMICS
nadolol/bendroflumethiazide
GENERIC
quinapril/hydrochlorothiazide
atorvastatin calcium
telmisartan/amlodipine
cholestyramine
telmisartan/hydrochlorothiazide
cholestyramine light
trandolapril/verapamil HCL
colestipol HCL
trandolapril/verapamil HCL ER
fenofibrate
valsartan/hydrochlorothiazide
fenofibrate micronized
PREFERRED
fenofibric acid DR
Amturnide
fluvastatin
Azor
fluvastatin sodium ER
Benicar HCT
gemfibrozil
Tekamlo
lovastatin
Tekturna HCT
micronized colestipol HCL
Tribenzor
niacin ER
omega-3-acid ethyl esters
DIURETICS
pravastatin sodium
GENERIC prevalite
acetazolamide rosuvastatin calcium
acetazolamide sodium simvastatin
acetazolamide ER Fenofibric Acid
amiloride HCL PREFERRED
amiloride/hydrochlorothiazide Vascepa
bumetanide Vytorin
chlorothiazide Welchol
chlorothiazide sodium Zetia
ethacrynate sodium NON PREFERRED
furosemide Fenofibrate
hydrochlorothiazide Fenoglide
indapamide Fibricor
mannitol Livalo
methazolamide Triglide
metolazone SPECIALTY
osmitrol viaflex JuxtapidQL,PA
spironolactone PraluentQL,PA
spironolactone/hydrochlorothiazide RepathaQL,PA
torsemide Repatha SureclickQL,PA
triamterene/hydrochlorothiazide
Acetazolamide CARDIOVASCULAR - MISC.
Chlorothiazide
GENERIC
Chlorthalidone
amlodipine besylate/atorvastatin calcium
Methyclothiazide
cardioplegic
Triamterene/Hydrochlorothiazide
papaverine HCL
NON PREFERRED
PREFERRED
Dyrenium
CialisQL
Edecrin
ViagraQL
SPECIALTY
NON PREFERRED
KeveyisQL,PA
Bidil
SPECIALTY
VASOPRESSORS
epoprostenol sodiumPA
GENERIC sildenafilQL,PA
dobutamine HCL sildenafil citrateQL,PA
dobutamine HCL/D5W AdcircaQL,PA
dobutamine/dextrose 5% AdempasQL,PA
dopamine HCL LetairisQL,PA
dopamine HCL-dextrose 5% OpsumitQL,PA
dopamine HCL/dextrose 5% OrenitramPA
dopamine/D5W RemodulinPA
ephedrine sulfate TracleerQL,PA
midodrine HCL TyvasoQL,PA
norepinephrine bitartrate Tyvaso RefillQL,PA
phenylephrine HCL Tyvaso StarterQL,PA
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 7
UptraviQL,PA Doxycycline
VeletriPA PREFERRED
VentavisQL,PA Finacea
Oracea
DERMATOLOGICALS
ANTIBIOTICS - TOPICAL
ACNE PRODUCTS
GENERIC
GENERIC
mupirocin
amnesteem
mupirocin calcium
avar cleanser
NON PREFERRED
avar-e emollient
Altabax
avar-e green
Cortisporin
benzepro
Neo-synalar
benzepro creamy wash
benzepro foaming cloths
ANTIFUNGALS - TOPICAL
benzepro SHORT contact
GENERIC
benziq wash
ciclodan
benzoyl peroxide
ciclopirox
benzoyl peroxide SHORT contact
ciclopirox nail lacquer
bp foam
ciclopirox olamine
bp foaming wash
ciclopirox treatmentPA
bp wash
clotrimazole
bp 10-1
clotrimazole/betamethasone dipropionate
bpo 6% foaming cloths
econazole nitrate
cerisa wash
ketoconazole
claravis
ketodan
claris clarifying wash
naftifine hydrochlorideST
clearplex x
nyamyc
clindacin etz pledgets
nystatin
clindacin-p
nystatin/triamcinolone
clindamax
nystop
clindamycin phosphate
oxiconazole nitrate
clindamycin/benzoyl peroxide
pedi-dri
ery
NON PREFERRED
erythromycin
Cnl8 Nail KitPA
erythromycin/benzoyl peroxide
ErtaczoST
myorisan
ExeldermST
neuac
MentaxST
oscion cleanser
Oxistat
pr benzoyl peroxide wash
Pedipirox-4 NailPA
prascion
XolegelST
prascion fc
rosanil cleanser
ANTIVIRALS - TOPICAL
rosula
se bpo wash GENERIC
se 10-5 ss acyclovir
sodium sulfacetamide PREFERRED
sodium sulfacetamide/sulfur Denavir
sodium sulfacetamide/sulfur cleanser Zovirax
sodium sulfacetamide/sulfur cleansing cloths
sodium sulfacetamide/sulfur green ANTI-INFLAMMATORY AGENTS
sodium sulfacetamide/sulfur w/sunscreen
GENERIC
sodium sulfacetamide/sulfur wash
diclofenac sodiumQL,PA
ss 10-2
diclotral PAK
sss 10-5
klofensaid IIQL,PA
sss 10%-5%
sure result dss premium pack
sulfacetamide sodium
sulfacetamide sodium/sulfur
ANTIPRURITICS
sulfacetamide sodium/sulfur cleanser
GENERIC
sulfacleanse 8/4
Doxepin Hydrochloride
virti-sulf
zenatane
ANTIPSORIATICS
zencia
GENERIC
NON PREFERRED
acitretin
Azelex
calcipotriene
calcitrene
ROSACEA AGENTS
methoxsalen
GENERIC
Calcitriol
metronidazole
PREFERRED
rosadan
TazoracQL,PA
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 8
8-mop DERMATOLOGICALS - MISC.
NON PREFERRED
GENERIC
Vectical
ammonium lactate
anodynz
ANTISEBORRHEIC AGENTS
avalin-RX
GENERIC ceramax
seb-prev wash cerovel
selenium sulfide cidaleaze
sodium sulfacetamide diclofenac sodium
sodium sulfacetamide wash elenzapatch
episone CRE
CORTICOSTEROIDS - TOPICAL fluorouracil
glydo
GENERIC
grafco silver nitrate applicator
ala cort
grafco silver nitrate applicator 12"
alclometasone dipropionate
hypercare
alphatrex
k2k pain relieving patch
augmented betamethasone dipropionate
lactic acid
betamethasone dipropionate
lactic acid e
betamethasone valerate
lactic acid w/vitamin e
calcipotriene/betamethasone dipropionateQL,PA
latrix
clobetasol propionate
lidenza patch
clobetasol propionate e
lidocaine
clobetasol propionate emollient
lidocaine HCL
clodan
lidocaine HCL jelly
cormax scalp application
lidocaine-prilocaine-cream base
desonide
lidocaine/prilocaine
desoximetasone
lidodextrapine
fluocinolone acetonide
lidopin
fluocinolone acetonide body
lindane
fluocinolone acetonide scalp
livixil PAK
fluocinonide
lorenza
fluocinonide-e
mafenide acetate
flurandrenolide
malathion
fluticasone propionate
migryl
halobetasol propionate
permethrin
halonate PAC
podofilox
hydrocortisone
pramox gel
hydrocortisone acetate/aloe
premium lidocaine
hydrocortisone butyrate
provenza
hydrocortisone butyrate (lipid)
rea LO 39
hydrocortisone butyrate (lipophilic)
rea LO 40
hydrocortisone valerate
reciphexamine
hydrocortisone IN absorbase
relador PAK
lokara
relador PAK plus
mometasone furoate
releevia ML
prednicarbate
remeven
scalacort
salacyn
triamcinolone acetonide
salicylic acid
triderm
salicylic acid cream
Amcinonide
salicylic acid lotion
Apexicon E
salicylic acid wart remover
Desoximetasone
silver sulfadiazine
Diflorasone Diacetate
sodium hyaluronate
PREFERRED
ssd
TaclonexQL,PA
synvexia
NON PREFERRED
tetrix
Capex
thermazene
Cordran
tropazone
Cordran Tape
u-kera e
Halog
umecta mousse
Locoid
ure-k
Texacort
urea
urea hydrating
IMMUNOMODULATING AGENTS
urea nail
GENERIC
urea topical
imiquimod
urea IN zinc undecylenate/lactic acid vehicle
tacrolimus
urea 40% nail film
PREFERRED
urea-c40
Elidel
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 9
x-viate PREFERRED
xyphex Androgel
zeruvia Androgel P.M.
Cem-urea Androxy
CARB-o-philic 40 Axiron
CARB-o-philic/40 Methitest
LP lite PAK NON PREFERRED
Salicylic Acid Anadrol-50PA
PREFERRED StriantST
Condylox
Oxsoralen ESTROGENS
RegranexPA
GENERIC
Sulfamylon
estradiol
NON PREFERRED
estradiol valerate
Eurax
estradiol/norethindrone acetate
Fluoroplex
estropipate
Panretin
fyavolv
Picato
jevantique LO
Sklice
jinteli
Ulesfia
lopreeza
Veregen
mimvey
SPECIALTY
mimvey LO
TargretinPA
norethindrone acetate/ethinyl estradiol
ValchlorPA
ortho-est
PREFERRED
ENDOCRINE AND METABOLIC
Cenestin
Combipatch
CORTICOSTEROIDS
Enjuvia
GENERIC
Evamist
baycadron
Premarin
betamethasone sodium phosphate/betamethasone acetate
Premphase
budesonide Prempro
deltasone NON PREFERRED
dexamethasone Menest
dexamethasone sodium phosphate
fludrocortisone acetate CONTRACEPTIVES
hydrocortisone
PREVENTIVE
methylprednisolone
aftera
methylprednisolone acetate
altavera
methylprednisolone dose pack
alyacen 1/35
methylprednisolone sodiumsuccinate
alyacen 7/7/7
prednisolone
amethiaQL
prednisolone sodium phosphate
amethia LOQL
prednisolone sodium phosphate odt
amethyst
prednisone
apri
A-hydrocort
aranelle
Dexamethasone
ashlynaQL
Dexamethasone Sodium Phosphate
aubra
Prednisone
aviane
NON PREFERRED
azurette
Depo-medrol
balziva
Dexamethasone Intensol
bekyree
Dexpak 10 Day
blisovi FE 1.5/30
Dexpak 13 Day
blisovi FE 1/20
Dexpak 6 Day
blisovi 24 FE
Prednisone Intensol
briellyn
Solu-cortef
camila
camreseQL
ANDROGENS-ANABOLIC
camrese LOQL
GENERIC caziant
danazol chateal
methyltestosterone cryselle-28
oxandroloneQL,PA cyclafem 1/35
testosterone cyclafem 7/7/7
testosterone cypionatePA cyred
testosterone enanthatePA dasetta 1/35
testosterone P.M. dasetta 7/7/7
Testosterone dayseeQL
Testosterone P.M. deblitane
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 10
delyla norethindrone
desogestrel/ethinyl estradiol norethindrone & ethinyl estradiol ferrous fumarate
drospirenone/ethinyl estradiol norethindrone acetate/ethinyl estradiol
econtra EZ norethindrone acetate/ethinyl estradiol/ferrous fumarate
elinest norgestimate/ethinyl estradiol
emoquette norlyroc
enpresse-28 nortrel 0.5/35 (28)
enskyce nortrel 1/35
errin nortrel 7/7/7
estarylla ocella
fallback solo opcicon one-step
falmina orsythia
gianvi philith
gildagia pimtrea
gildess FE 1.5/30 pirmella 1/35
gildess FE 1/20 pirmella 7/7/7
gildess 1.5/30 portia-28
gildess 1/20 previfem
gildess 24 FE quasenseQL
heather reclipsen
introvaleQL setlakinQL
jencycla sharobel
jolessaQL sprintec 28
jolivette sronyx
juleber syeda
junel FE 1.5/30 take action
junel FE 1/20 tarina FE 1/20
junel FE 24 tilia FE
junel 1.5/30 tri-estarylla
junel 1/20 tri-legest FE
kaitlib FE tri-linyah
kariva tri-previfem
kelnor 1/35 tri-sprintec
kimidess tri-LO-estarylla
kurvelo tri-LO-marzia
larin FE 1.5/30 tri-LO-sprintec
larin FE 1/20 trinessa
larin 1.5/30 trinessa LO
larin 1/20 trivora-28
larin 24 FE velivet
layolis FE vestura
leena vienva
lessina viorele
levonest vyfemla
levonorgestrel wera
levonorgestrel and ethinyl estradiolQL wymzya FE
levonorgestrel/ethinyl estradiol zarah
levora 0.15/30-28 zenchent
lomedia 24 FE zenchent FE
loryna zovia 1/35e
low-ogestrel Levonorgestrel
lutera Ogestrel
lyza Xulane
marlissa PREFERRED
medroxyprogesterone acetateQL LO Loestrin FE
microgestin FE Minastrin 24 FE
microgestin FE 1.5/30 PREVENTIVE
microgestin 1.5/30 Natazia
microgestin 1/20 NuvaringQL
microgestin 24 FE NON PREFERRED
mono-linyah Depo-subq Provera 104QL
mononessa PREVENTIVE
my way Ella
myzilra PREVENTIVE
necon 0.5/35-28 Implanon
necon 1/35 Liletta
necon 7/7/7 Mirena
next choice one dose Nexplanon
nikki Paragard Intrauterine Copper Contraceptive T380a
nora-be Skyla
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 11
BIGUANIDES
PROGESTINS GENERIC
metformin HCL
GENERIC
metformin HCL ER
medroxyprogesterone acetate
PREFERRED
megestrol acetate
Riomet
norethindrone acetate
MEGLITINIDE ANALOGUES
progesterone
GENERIC
SPECIALTY
nateglinide
MakenaPA
repaglinide
DIABETIC OTHER
ANTIDIABETIC AGENTS
PREFERRED
INSULIN
Glucagen Hypokit
PREFERRED
Glucagon Emergency Kit
Lantus
InvokanaPA
Lantus Solostar
Proglycem
Novolin N
NON PREFERRED
Novolin N Relion
Cycloset
Novolin R
JardianceST
Novolin R Relion
ALPHA-GLUCOSIDASE INHIBIT
Novolin 70/30
GENERIC
Novolin 70/30 Relion
acarbose
Novolog
NON PREFERRED
Novolog Flexpen
Glyset
Novolog Mix 70/30
DPP-4 INHIBITORS
Novolog Mix 70/30 Prefilled Flexpen
GENERIC
Novolog Penfill
Alogliptin
Toujeo Solostar
PREFERRED
NON PREFERRED
Januvia
ApidraST
Onglyza
Apidra SolostarST
NON PREFERRED
HumalogST
Tradjenta
Humalog KwikpenST
INSULIN SENSITIZING AGENT
Humalog Mix 50/50ST
GENERIC
Humalog Mix 50/50 KwikpenST
pioglitazone HCL
Humalog Mix 75/25ST
NON PREFERRED
Humalog Mix 75/25 KwikpenST
Avandia
Humulin NST
ANTIDIABETIC COMBINATIONS
Humulin N KwikpenST
GENERIC
Humulin RST
glipizide/metformin HCL
Humulin R U-500 (concentrated)ST
glyburide/metformin HCL
Humulin 70/30ST
pioglitazone HCL-glimepiride
Humulin 70/30 KwikpenST
pioglitazone HCL/metformin HCL
LevemirST
Alogliptin/Metformin HCL
Levemir FlexpenST
Alogliptin/Pioglitazone
Levemir FlextouchST
Repaglinide/Metformin Hydrochloride
AMYLIN ANALOGS
PREFERRED
PREFERRED
Actoplus Met XR
Symlinpen 120PA
Janumet
Symlinpen 60PA
Janumet XR
INCRETIN MIMETIC AGENTS
Kombiglyze XR
PREFERRED
Bydureon
BISPHOSPHONATES
Byetta
GENERIC
TrulicityQL,ST
alendronate sodium
Victoza
ibandronate sodiumQL
SULFONYLUREAS
risedronate sodiumQL,ST
GENERIC
risedronate sodium DRQL,ST
glimepiride
Etidronate Disodium
glipizide
PREFERRED
glipizide ER
Alendronate Sodium
glipizide XL
Fosamax Plus DQL
glyburide
SPECIALTY
glyburide micronized
pamidronate disodium
tolazamide
zoledronic acidPA
Chlorpropamide
Pamidronate Disodium
Glyburide
Zoledronic AcidPA
Tolazamide
ZometaPA
Tolbutamide
NON PREFERRED
Diabeta
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 12
CALCITONINS vasopressin
SPECIALTY
GENERIC
Stimate
calcitonin salmonQL
calcitonin-salmonQL
CORTICOTROPIN
NON PREFERRED
Miacalcin SPECIALTY
H.p. ActharPA
PARATHYROID HORMONE
PROLACTIN INHIBITORS
SPECIALTY
ForteoQL GENERIC
cabergoline
RANK LIGAND INHIBITORS
VASOPRESSIN ANTAGONISTS
SPECIALTY
ProliaQL,PA SPECIALTY
XgevaPA SamscaQL
HORMONE RECEPTOR MDLTR METABOLIC MODIFIERS
GENERIC GENERIC
raloxifene hydrochloride calcitriol
doxercalciferol
FERTILITY REGULATORS levocarnitine
paricalcitol
SPECIALTY
PREFERRED
chorionic gonadotropinQL
SensiparPA
clomiphene citrate
NON PREFERRED
novarelQL
Hectorol
pregnyl w/diluent benzyl alcohol/NACLQL
SPECIALTY
serophene
sodium phenylbutyrate
AldurazymePA
LHRH/GNRH AGONIST
Buphenyl
SPECIALTY
Carbaglu
Lupron Depot-PEDQL,PA
Cystadane
Supprelin LAQL,PA
ElaprasePA
Synarel
FabrazymePA
KanumaPA
GROWTH HORMONES
KuvanPA
SPECIALTY
LumizymePA
Norditropin CartridgeQL,PA
MyaleptPA
Norditropin FlexproQL,PA
MyozymePA
Norditropin Nordiflex PenQL,PA
NaglazymePA
Nutropin AQ Nuspin 10QL,PA
Orfadin
Nutropin AQ Nuspin 20QL,PA
RavictiPA
Nutropin AQ Nuspin 5QL,PA
StrensiqPA
Nutropin AQ PenQL,PA
VimizimPA
SerostimQL,PA
ZorbtiveQL,PA
THYROID AGENTS
GENERIC
GHRH
levo-t
SPECIALTY
levothyroxine sodium
EgriftaQL,PA
levoxyl
liothyronine sodium
SOMATOMEDINS
methimazole
SPECIALTY
propylthiouracil
IncrelexPA
unithroid
unithroid direct
SOMATOSTATIC AGENTS
NP thyroid
SPECIALTY
NP thyroid 60
octreotide acetatePA
NP thyroid 90
Sandostatin Lar DepotPA
PREFERRED
SigniforQL,PA
Armour Thyroid
Somatuline DepotQL,PA
NON PREFERRED
Thyrolar-1
GH RECEPTOR ANTAGONISTS
Thyrolar-1/2
SPECIALTY
Thyrolar-1/4
SomavertPA
Thyrolar-2
Thyrolar-3
POSTERIOR PITUITARY
GENERIC
GASTROINTESTINAL
desmopressin acetate
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 13
LAXATIVES Gastrinex NF
Nizatidine
GENERIC
PREFERRED
constulose
Carafate
gavilyte-h
NON PREFERRED
lactulose
Aciphex SprinkleQL
peg-prep
Atropen
pegylax
Cantil
polyethylene glycol 3350
Cuvposa
PREVENTIVE
DexilantQL
gavilyte-c
Esomeprazole StrontiumQL
gavilyte-n/flavor pack
NexiumQL
gavilyte-G
Omeclamox-PAK
peg 3350/electrolytes
Pylera
peg-3350/electrolytes
peg-3350/NACL/NA bicarbonate/KCL
ANTIEMETICS
trilyte
PREFERRED GENERIC
Moviprep dronabinolQL,PA
Suprep Bowel Prep granisetron HCLQL
NON PREFERRED meclizine HCL
Osmoprep ondansetron odtQL
Prepopik ondansetron HCLQL
trimethobenzamide HCL
ANTIDIARRHEALS PREFERRED
Aloxi
GENERIC
EmendQL
diphenoxylate/atropine
SancusoQL
lofene
Transderm-scop
loperamide HCL
NON PREFERRED
opium
AkynzeoQL
opium tincture
AnzemetQL
CesametQL,PA
ULCER DRUGS
GranisolQL
GENERIC
atropine sulfate
DIGESTIVE AIDS
chlordiazepoxide HCL/clidinium bromide
PREFERRED
cimetidine
Creon
cimetidine HCL
Pancrelipase
dicyclomine hci
NON PREFERRED
dicyclomine HCL
ZenpepST
ed-spaz
SPECIALTY
esomeprazole magnesiumQL
Sucraid
esomeprazole sodium
famotidine
GASTROINTESTINAL - MISC.
glycopyrrolate
hyomax-SL GENERIC
hyoscyamine sulfate alosetron hydrochloride
hyoscyamine sulfate odt ana-lex
hyoscyamine sulfate ER balsalazide disodium
hyoscyamine sulfate SR calcium acetate
hyosyne colocort
lansoprazoleQL cromolyn sodium
lansoprazole/amoxicillin/clarithromycin enulose
methscopolamine bromide generlac
misoprostol hydrocort ene 100MG
nizatidine hydrocortisone
nulev hydrocortisone acetate/lidocaine HCL
omeprazoleQL hydrocortisone acetate/pramoxine
omeprazole/sodium bicarbonateQL lactulose
oscimin lidazone HC
oscimin SR lidocaine HCL/hydrocortisone acetate
pantoprazole sodiumQL mesalamine
rabeprazole sodiumQL metoclopramide odt
ranitidine HCL metoclopramide HCL
sucralfate pramcort
symax fastabs procto-MED HC
symax-SL procto-PAK
symax-SR proctosol HC
Esomeprazole Sodium proctozone-HC
Famotidine sulfasalazine
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 14
ursodiol oxybutynin chloride
PREFERRED oxybutynin chloride ER
AmitizaQL tolterodine tartrate
Asacol HD tolterodine tartrate ER
Canasa trospium chloride
Chenodal trospium chloride ER
Cortifoam PREFERRED
Delzicol Gelnique
Fosrenol Myrbetriq
Lialda OxytrolQL
LinzessQL Toviaz
Pentasa Vesicare
Rectiv
RelistorQL,PA VAGINAL PRODUCTS
Renvela
GENERIC
Sevelamer Carbonate
clindamycin phosphate
NON PREFERRED
metronidazole vaginal
Dipentum
terconazole
Phoslyra
vandazole
Renagel
zazole
SPECIALTY
PREVENTIVE
CimziaQL,PA
vcf vaginal contraceptivegel
Cimzia Starter KitQL,PA
PREFERRED
GattexPA
Estrace
RemicadeQL,PA
Vagifem
NON PREFERRED
GENITOURINARY
Avc
Gynazole-1
URINARY ANTI-INFECTIVES
PREVENTIVE
GENERIC
Encare
azuphen mb
Options Gynol II Vaginal Contraceptive
hyolev mb
Shur-seal
hyophen
Today Sponge
indiomin mb
Vcf Vaginal Contraceptive Film
me/naphos/mb/hyo 1
Vcf Vaginal Contraceptive Foam
methenamine hippurate
SPECIALTY
methenamine mandelate
Crinone
nitrofurantoin
nitrofurantoin macrocrystals
GENITOURINARY - MISC.
nitrofurantoin monohydrate
GENERIC
nitrofurantoin monohydrate/macrocrystals
acetic acid 0.25%
phosphasal
alfuzosin HCL ER
ur n-c
aminoacetic acid
uramit mb
argyle sterile saline 100ML
urelle
citric acid/sodium citrate
uretron d/s
curity sterile saline
uribel
cytra k crystals
urin d/s
cytra-k
uro-blue
cytra-2
uro-l
dutasteride
uro-mp
dutasteride/tamsulosin hydrochloride
uroav-b
dutasteride/tamsulosin HCL
uroav-81
finasteride
urolet mb
glycine
urophen mb
neomycin/polymyxin b sulfates
uryl
phenazo
ustell
phenazopyridine HCL
uta
potassium citrate ER
uticap
potassium citrate-citric acid crystals
utira-c
potassium citrate/citric acid
utrona-c
potassium citrate/sodium citrate/citric acid
NON PREFERRED
sodium chloride
Monurol
sodium chloride 0.9%
sodium citrate/citric acid
URINARY ANTISPASMODICS
tamsulosin HCL
GENERIC
taron-crystals
bethanechol chloride
tricitrates
darifenacin hydrobromide ER
virtrate-k
darifenacin ER
virtrate-2
flavoxate HCL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 15
virtrate-3 ferrotabs
PREFERRED ferrous drops
Elmiron ferrous fumarate 324
Rapaflo ferrous gluconate
NON PREFERRED ferrous sulfate
Cardura XL ferrousul
SPECIALTY folic acid
Cystagon gnp folic acid
ProcysbiPA gnp iron
gnp slow release iron
HEMATOLOGICAL high potency iron
iferex 150
HEMATOPOIETIC AGENTS
iron
GENERIC
iron slow release
airavite
iron supplement
corvita 150
iron supplement childrens
cyanocobalamin
kp ferrous gluconate
dexferrum
kp ferrous sulfate
fabb
kp folic acid
ferocon
meijer ferrous sulfate
ferotrinsic
myferon 150
ferrocite plus
nu-iron 150
ferrogels forte
poly-iron 150
folbee
px folic acid
folic acid/vitamin b-6/vitamin b-12
px iron
folplex 2.2
qc ferrous sulfate
foltrin
ra folic acid
hematinic plus vitamins/minerals
ra high potency iron
hematinic/folic acid
ra iron
hematogen
ra slow release iron
hematogen forte
slow iron
hemocyte-f
slow release iron
hemocyte-plus
slow FE
iferex 150 forte
slow-release iron
k-tan plus
sm folic acid
myferon 150 forte
sm iron
nufol
sm iron slow release
poly-iron 150 forte
sm slow release iron
polysaccharide iron forte
th folic acid
purevit dualfe plus
th iron
se-tan plus
th slow release iron
tricon
wee care
trigels-f forte
yl folic acid
virt-gard
CVS folic acid
virt-vite
CVS iron
AV-vite fb
Ferretts
Bp Vit 3
FE gluconate
FE c plus
FE TABS
Iron Asp Gly/ Polysacch Compl/Ascorb CAL/B12/Fa/C Threon/Suc
HM folic acid
HM iron
TL gard RX
HM iron slow release
TL icon
HM slow release iron
TL-hem 150
PREFERRED
PREVENTIVE
Droxia
bprotected pedia iron
Nascobal
eq slow-release iron
PREVENTIVE
eql folic acid
CVS Slow Release Iron
eql iron supplement therapy
Elite Iron
eql slow release iron
Fa-8
ezfe 200
Femiron
fa-8
Feosol
feosol
Ferretts Chewable Iron
fer-iron
Ferretts IPS
ferate
Ferrimin 150
fergon
Ferro-sequels
ferosul
Ferrous Fumarate
ferrex 150
Ferrous Gluconate
ferric x-150
Ferrous Sulfate
ferro-bob
FE Aspartate
ferrocite
High Potency Iron
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 16
Iron albuked 5
Iron Chews Pediatric albumin human
Iron Up albumin-zlb
Mykidz Iron 10 albuminar-25
Novaferrum Pediatric Drops albuminar-5
Perfect Iron alburx
Profe albutein
Proferrin ES anagrelide hydrochloride
Slow Release Iron buminate
Sm Slow Release Iron cilostazol
SPECIALTY clopidogrel
sodium ferric gluconate complex/sucrose dipyridamole
Aranesp Albumin Free eptifibatide
CerezymePA flexbumin
ElelysoPA hetastarch 6%/NACL
EpogenPA human albumin grifols
LeukinePA kedbumin
MozobilQL,PA pentoxifylline ER
NeulastaPA plasbumin-25
Neulasta Onpro KitPA plasbumin-5
NeumegaPA ticlopidine HCL
NeupogenPA Aspirin/Dipyridamole
NplatePA PREFERRED
ProcritPA Aggrenox
PromactaPA Brilinta
VprivPA Effient
ZavescaPA Zontivity
NON PREFERRED
ANTICOAGULANTS Aggrastat
SPECIALTY
GENERIC
Advate
argatroban
Alphanate/Von Willebrand Factor Complex/Human
bivalirudin
Alphanine SD
enoxaparin sodiumQL
Bebulin
fondaparinux sodiumQL
Benefix
hep flush-10
Berinert
heparin lock
Ceprotin
heparin lock flush
Cinryze
heparin lock flush for flushing vascular access devices
Coagadex
heparin lock flush/NACL for flushing vascular access devices
Corifact
heparin sodium
Eloctate
heparin sodium dcu
Feiba
heparin sodium lock flush
Feiba NF
heparin sodium/sodium chloride 0.9% premix
Firazyr
heparin sodium/D5W
Helixate FS
heparin sodium/NACL 0.9%
Hemofil M
jantoven
Humate-p
monoject pharma grade flush syringe/heparin lock
Idelvion
monoject prefill advanced heparin lock flush
Kalbitor
sash kit for flushing vascular access devices
Koate-dvi
warfarin sodium
Kogenate FS
PREFERRED
Kogenate FS Bio-set
EliquisQL
Monoclate-p
PradaxaQL
Mononine
XareltoQL
Novoseven
Xarelto Starter PackQL
Novoseven Rt
NON PREFERRED
Obizur
Argatroban
Profilnine
FragminQL
Profilnine SD
SavaysaQL
Recombinate
Riastap
HEMOSTATICS
Rixubis
GENERIC SolirisPA
aminocaproic acid Thrombate Iii W/10 ML Sterile Water
tranexamic acid Thrombate Iii W/20 ML Sterile Water
Tretten
HEMATOLOGICAL - MISC. Wilate
Xyntha
GENERIC
Xyntha Solofuse
albuked 25
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 17
MOUTH/THROAT/DENTAL AGENT bupropion HCL SRQL
bupropion HCL XLQL
citalopram hydrobromide
GENERIC
clomipramine HCL
cavarest
desipramine HCL
cavirinse
doxepin HCL
cevimeline HCL
duloxetine HCLQL
chlorhexidine gluconate
escitalopram oxalate
chlorhexidine gluconate oral rinse
fluoxetine DRQL
clinpro 5000
fluoxetine HCL
clotrimazole
fluvoxamine maleate
controlrx
fluvoxamine maleate ERQL
denta 5000 plus
imipramine pamoate
dentagel
imipramine HCL
easygel
mirtazapine
fluoridex daily defense
mirtazapine odt
fluoridex daily defense enhanced whitening
nefazodone HCL
fluoridex daily defense sensitivity relief
nortriptyline HCL
karigel
paroxetine HCL
karigel-n
paroxetine HCL ER
lidocaine viscous
phenelzine sulfate
lidocaine HCL viscous
protriptyline HCL
neutragard advanced
sertraline HCL
neutral sodium fluoride
tranylcypromine sulfate
nystatin
trazodone HCL
oralone
trimipramine maleate
paroex
venlafaxine HCL
periogard
venlafaxine HCL ER
phos-flur
Amoxapine
pilocarpine hydrochloride
Doxepin HCL
pilocarpine HCL
Maprotiline HCL
stannous fluoride oral rinse
Nefazodone HCL
topex topical anesthetic
Nortriptyline HCL
triamcinolone acetonide
Venlafaxine HCL ER
triamcinolone IN orabase
PREFERRED
SF
PristiqQL
SF 5000 plus
NON PREFERRED
NON PREFERRED
AplenzinQL
Oravig
Duloxetine HCLQL
EmsamQL
NEUROLOGY, CNS, PSYCH
Marplan
ANTIANXIETY AGENTS
Paxil
GENERIC
ViibrydQL
alprazolam
Viibryd Starter PackQL
alprazolam odt
alprazolam ER
ANTIPSYCHOTICS
alprazolam XR
GENERIC
buspirone HCL
aripiprazoleQL
chlordiazepoxide HCL
chlorpromazine HCL
clorazepate dipotassium
clozapineQL
diazepam
clozapine odtQL
diazepam intensol
compazine
droperidol
compro
gene-xene TAB 15MG
fluphenazine decanoate
gene-xene TAB 3.75MG
fluphenazine HCL
gene-xene TAB 7.5MG
haloperidol
hydroxyzine pamoate
haloperidol decanoate
hydroxyzine HCL
haloperidol lactate
lorazepam
lithium carbonate
lorazepam intensol
lithium carbonate ER
meprobamate
loxapine
oxazepam
loxapine succinate
Diazepam
olanzapineQL
Hydroxyzine Pamoate
olanzapine odtQL
paliperidone ERQL,ST
ANTIDEPRESSANTS
perphenazine
GENERIC
prochlorperazine
amitriptyline HCL
prochlorperazine edisylate
bupropion HCL
prochlorperazine maleate
bupropion HCL ERQL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 18
quetiapine fumarateQL methylphenidate HCL ERQL
risperidoneQL methylphenidate HCL SRQL
risperidone odtQL modafinilQL,PA
risperidone M-TABQL zenzediQL
thioridazine HCL Methylphenidate HCL ER
thiothixene ProcentraQL
trifluoperazine HCL PREFERRED
ziprasidone HCLQL DaytranaQL
Aripiprazole OdtQL NuvigilQL,PA
Clozapine OdtQL Quillivant XRQL
PREFERRED StratteraQL
AbilifyQL VyvanseQL
Abilify DiscmeltQL NON PREFERRED
Abilify Maintena ConcertaQL
LatudaQL Focalin XRQL
Molindone Hydrochloride
Risperdal Consta ANTICONVULSANTS
Seroquel XRQL
GENERIC
NON PREFERRED
carbamazepine
FanaptQL,ST
carbamazepine ER
Fanapt Titration PackQL,ST
clonazepam
FazacloQL
clonazepam odt
Geodon
divalproex sodium
Invega Sustenna
divalproex sodium DR
Invega Trinza
divalproex sodium ER
Lithium
epitol
RexultiQL,ST
ethosuximide
SaphrisQL,ST
felbamate
Zyprexa Relprevv
fosphenytoin sodium
gabapentin
HYPNOTICS
lamotrigine
GENERIC lamotrigine odt
dexmedetomidine HCL lamotrigine titration
estazolam lamotrigine ER
eszopicloneQL levetiracetam
flurazepam HCL levetiracetam ER
phenobarbital oxcarbazepine
temazepam phenytoin
triazolam phenytoin infatabs
zaleplonQL phenytoin sodium
zolpidem tartrateQL phenytoin sodium extended
zolpidem tartrate ERQL primidone
Flurazepam HCL roweepra
Phenobarbital tiagabine hydrochloride
Phenobarbital Sodium topiragen
Quazepam topiramate
Triazolam valproate sodium
PREFERRED valproic acid
RozeremQL zonisamide
SPECIALTY PREFERRED
HetliozQL,PA Banzel
Celontin
ADHD, NARCOLEPSY, ETC. Dilantin
Fycompa
GENERIC
Gabitril
amphetamine/dextroamphetamineQL
LyricaQL
caffeine citrate
Onfi
clonidine HCL ER
Peganone
dexedrineQL
Potiga
dexmethylphenidate HCLQL
Vimpat
dexmethylphenidate HCL ERQL
NON PREFERRED
dextroamphetamine sulfateQL
Lamictal
dextroamphetamine sulfate ERQL
Stavzor
doxapram HCL
SPECIALTY
guanfacine ER
SabrilPA
metadate ERQL
methamphetamine HCLQL
ANTIPARKINSON AGENTS
methylphenidate hydrochloride
methylphenidate HCLQL GENERIC
methylphenidate HCL CDQL amantadine HCL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 19
benztropine mesylate nicotine transdermal system step 2QL
bromocriptine mesylate nicotine transdermal system step 3QL
carbidopa px stop smoking aidQL
carbidopa/levodopa qc nicotine polacrilexQL
carbidopa/levodopa odt ra mini nicotineQL
carbidopa/levodopa ER ra nicotineQL
entacapone ra nicotine polacrilexQL
pramipexole dihydrochloride ra nicotine transdermal system step 3QL
pramipexole dihydrochloride ER sm nicotineQL
ropinirole ER sm nicotine polacrilexQL
ropinirole HCL sm nicotine transdermal systemQL
selegiline HCL sw nicotine polacrilexQL
tolcapone tgt nicotine gumQL
trihexyphenidyl HCL tgt nicotine polacrilexQL
Carbidopa/Levodopa/Entacapone tgt nicotine step oneQL
PREFERRED tgt nicotine step threeQL
Azilect tgt nicotine step twoQL
Mirapex ER thriveQL
NON PREFERRED CVS nicotineQL
NeuproST CVS nicotine lozengeQL
SPECIALTY CVS nicotine polacrilexQL
ApokynQL,PA CVS nicotine polacrilex starterQL
CVS nicotine transdermal systemQL
NEUROLOGY, PSYCH - MISC. CVS nts step 1QL
HM nicotine polacrilexQL
GENERIC
HM nicotine transdermal systemQL
acamprosate calcium DR
HM nicotine transdermal system step 3QL
disulfiram
SR nicotine gumQL
donepezil HCL
PREFERRED
ergoloid mesylates
GraliseQL
galantamine hydrobromide
Gralise StarterQL
memantine hydrochloride
Namenda XRQL
memantine HCL
Namenda XR Titration PackQL
memantine HCL titration PAK
Nuedexta
olanzapine/fluoxetineQL
SavellaQL
pimozide
PREVENTIVE
rivastigmine tartrate
ChantixQL
rivastigmine transdermal system
Chantix Continuing Month PAKQL
Ergoloid Mesylates
Chantix Starting Month PAKQL
Galantamine Hydrobromide
Nicotine Transdermal SystemQL
Perphenazine/Amitriptyline
NON PREFERRED
PREVENTIVE
HorizantQL,PA
buprobanQL
PREVENTIVE
bupropion HCL SRQL
Nicotrol InhalerQL
eq nicotineQL
Nicotrol NsQL
eq nicotine gum refillQL
SPECIALTY
eq nicotine gum starterQL
glatopaQL,PA
eq nicotine polacrilexQL
tetrabenazinePA
eq nicotine step 3QL
AmpyraQL,PA
eql nicotineQL
AubagioQL,PA
eql nicotine polacrilexQL
AvonexQL,PA
eql nicotine polacrilex refillQL
Avonex Pen
eql nicotine polacrilex starterQL
BetaseronQL,PA
gnp nicotine mini lozengeQL
CopaxoneQL,PA
gnp nicotine polacrilexQL
GilenyaQL,PA
gnp nicotine polacrilex miniQL
LemtradaPA
goodsense nicotine gumQL
Rebif
kls quit2QL
Rebif Rebidose
kls quit4QL
Rebif Rebidose Titration Pack
nicoreliefQL
Rebif Titration Pack
nicotineQL
TecfideraQL,PA
nicotine mini lozengeQL
Tecfidera Starter PackQL,PA
nicotine polacrilexQL
TysabriQL,PA
nicotine polacrilex refillQL
XyremQL,PA
nicotine polacrilex starter kitQL
nicotine step 1QL
NEUROMUSCULAR AGENTS
nicotine step 2QL
nicotine step 3QL GENERIC
nicotine transdermal systemQL atracurium besylate
nicotine transdermal system step 1QL cisatracurium besylate
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 20
pancuronium bromide trifluridine
riluzoleQL,PA trimethoprim sulfate/polymyxin b sulfate
rocuronium bromide Bacitracin
vecuronium bromide PREFERRED
SPECIALTY Besivance
BotoxQL,PA Moxeza
DysportQL,PA Natacyn
MyoblocQL,PA Vigamox
XeominQL,PA NON PREFERRED
Ciloxan
MUSCULOSKELETAL AGENTS Tobrex
Zirgan
GENERIC
baclofen
ARTIFICIAL TEAR/LUBRICANT
carisoprodol
carisoprodol/aspirin NON PREFERRED
carisoprodol/aspirin/codeine Lacrisert
chlorzoxazone
cyclobenzaprine HCL BETA-BLOCKERS
dantrolene sodium
GENERIC
metaxall
betaxolol HCL
metaxalone
carteolol HCL
methocarbamol
dorzolamide HCL/timolol maleate
orphenadrine citrate
levobunolol HCL
orphenadrine citrate ER
timolol maleate
revonto
timolol maleate ophthalmic gel forming
tizanidine HCL
Metipranolol
Metaxalone
PREFERRED
Orphenadrine/Asa/Caffeine
Combigan
NON PREFERRED
NON PREFERRED
Lorzone
Betimol
SPECIALTY
MonoviscPA
OPHTHALMIC STEROIDS
OrthoviscPA
GENERIC
SynviscPA
dexamethasone sodium phosphate
Synvisc OnePA
fluorometholone
neo-polycin HC
ANTIMYASTHENIC AGENTS
neomycin/polymyxin/bacitracin/hydrocortisone
GENERIC
neomycin/polymyxin/dexamethasone
neostigmine methylsulfate
poly-dex
pyridostigmine bromide
prednisolone acetate
Guanidine HCL
sulfacetamide sodium/prednisolone sodium phosphate
PREFERRED
tobramycin/dexamethasone
Mestinon
PREFERRED
Alrex
OPHTHALMOLOGY AND OTIC
FML
Lotemax
ANTI-INFECTIVES
Pred Mild
GENERIC
Tobradex
ak-poly-bac
Tobradex ST
bacitracin/polymyxin b
NON PREFERRED
ciprofloxacin HCL
Durezol
erythromycin
Flarex
garamycin
Ozurdex
gatifloxacin
Vexol
gentak
gentamicin sulfate
PROSTAGLANDINS
ilotycin
GENERIC
levofloxacin
latanoprostQL
neo-polycin
BimatoprostQL
neomycin/bacitracin/polymyxin
PREFERRED
neomycin/polymyxin/bacitracin zinc
LumiganQL
neomycin/polymyxin/gramicidin
Travatan ZQL
ofloxacin
polycin
CYCLOPLEGIC MYDRIATICS
polycin b
polymyxin b sulfate/trimethoprim sulfate GENERIC
romycin atropine sulfate
sodium sulfacetamide atropine-care
sulfacetamide sodium cyclopentolate hydrochloride
tobramycin sulfate cyclopentolate HCL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 21
homatropaire IlevroQL
homatropine HBR NevanacQL
mydral Pataday
tropicamide NON PREFERRED
Acuvail
DECONGESTANTS Alocril
Alomide
GENERIC
Azopt
altafrin
Emadine
neofrin
Lastacaft
phenylephrine HCL
SPECIALTY
CystaranQL,PA
MIOTICS
Eylea
GENERIC
Jetrea
pilocarpine HCL
Lucentis
PREFERRED
Macugen
Phospholine Iodide
Visudyne
NON PREFERRED
Isopto Carbachol
OTIC AGENTS
GENERIC
ADRENERGIC AGENTS
acetasol HC
GENERIC
acetic acid
apraclonidine
antipyrine/benzocaine
brimonidine tartrate
aurodex
PREFERRED
fluocinolone acetonide
Alphagan P
fluocinolone acetonide ear drops
NON PREFERRED
hydrocortisone/acetic acid
Iopidine
neomycin/polymyxin/hydrocortisone
neomycin/polymyxin/HC
IMMUNOMODULATORS
ofloxacin
PREFERRED
otic care
RestasisQL,PA
oticin
PREFERRED
LOCAL ANESTHETICS
Ciprodex
GENERIC
NON PREFERRED
altacaine
Coly-mycin S
parcaine
Cortisporin-tc
proparacaine HCL
tetcaine
OXYTOCICS
tetracaine HCL
tetravisc
GENERIC
tetravisc forte
methergine
methylergonovine maleate
OPHTHALMICS - MISC.
oxytocin
GENERIC
ak-fluor
PAIN MANAGEMENT
altafluor
ANALGESICS - NONNARCOTIC
azelastine HCL
balanced salt GENERIC
balanced salt solution alagesic LQ
bio GLO butalbital/acetaminophen
bromfenac butalbital/acetaminophen/caffeine
bss butalbital/aspirin/caffeine
cromolyn sodium capacet
diclofenac sodium choline magnesium trisalicylate
dorzolamide HCL clonidine HCL
epinastine HCL diflunisal
flucaine duraxin
fluor-i-strips a.t. ed-flex
fluorescein-benoxinate esgic
fluorescein/proparacaine margesic
flurbiprofen sodium marten-TAB
flurox salsalate
ful-GLO tencon
green GLO lissamine greenophthalmic strips zebutal
ketorolac tromethamine PREVENTIVE
lissamine green adult aspirin EC low strength
olopatadine HCL aspir-low
PREFERRED aspir-81
Bepreve aspirin
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 22
aspirin adult low dose th enteric aspirin
aspirin adult low strength CVS aspirin
aspirin childrens CVS aspirin adult low dose
aspirin enteric coated adult low strength CVS aspirin adult low strength
aspirin low dose CVS aspirin child
aspirin low strength CVS aspirin low dose
aspirin EC CVS aspirin low strength
aspirin EC low dose CVS aspirin EC
aspirin 81 CVS childrens aspirin
aspirin 81 low dose CVS enteric aspirin
aspirtab EC-81 aspirin
bayer advanced aspirin regular strength HM aspirin
bayer aspirin HM aspirin EC
bayer aspirin regimen HM aspirin EC low dose
bayer aspirin EC low dose MM aspirin
bayer chewable low dose SB aspirin
bayer low dose SB aspirin EC
childrens aspirin SB childrens aspirin
childrens aspirin low strength SB low dose asa EC
coated aspirin PREVENTIVE
ecotrin Aspirin Low Dose
ecotrin low strength SPECIALTY
ecpirin Prialt
enteric coated aspirin
eq adult aspirin low strength ANALGESICS - OPIOID
eq aspirin
GENERIC
eq aspirin adult low dose
acetaminophen/caffeine/dihydrocodeine
eq aspirin low dose
acetaminophen/codeine
eq aspirin EC
acetaminophen/codeine #2
eq childrens aspirin
acetaminophen/codeine #3
eql adult aspirin low strength
acetaminophen/codeine #4
eql aspirin
acetaminophen/codeine phosphate
eql aspirin low dose
alfentanil
eql aspirin EC
ascomp/codeine
eql childrens aspirin
buprenorphine HCLQL,PA
gnp adult aspirin low strength
buprenorphine HCL/naloxone HCLQL,PA
gnp aspirin
butalbital/acetaminophen/caffeine/codeine
gnp aspirin low dose
butalbital/aspirin/caffeine/codeine
goodsense aspirin low dose
butorphanol tartrate
kls aspirin low dose
codeine sulfate
kls aspirin EC
duramorph
kp aspirin
endocet
meijer aspirin EC
endodan
miniprin low dose
fentanylQL
norwich aspirin
fentanyl citrate oral transmucosalQL,PA
px aspirin
hydrocodone bitartrate/acetaminophen
px enteric aspirin
hydrocodone/acetaminophen
qc aspirin
hydrocodone/ibuprofen
qc aspirin low dose
hydromorphone HCL
qc childrens aspirin
hydromorphone HCL dosette
ra aspirin
hydromorphone HCL ERQL
ra aspirin adult low dose
ibudone
ra aspirin adult low strength
lorcet
ra aspirin childrens
lorcet plus
ra aspirin EC
lorcet HD
ra aspirin EC adult low strength
lortab
ra childrens aspirin
meperidine HCL
sm aspirin
methadone HCL
sm aspirin adult low strength
methadone HCL intensol
sm aspirin enteric coated
methadose
sm aspirin EC low strength
morphine sulfate
sm childrens aspirin
morphine sulfate ERQL
st joseph aspirin
nalbuphine HCL
st joseph low dose aspirin
oxycodone HCL
tgt aspirin
oxycodone/acetaminophen
tgt aspirin low dose
oxycodone/aspirin
tgt childrens aspirin
oxycodone/ibuprofen
tgt enteric-coated aspirin
oxymorphone hydrochloride
th aspirin
oxymorphone hydrochloride ERQL
th aspirin low dose
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 23
pentazocine/naloxone HCL Tolmetin Sodium
reprexain PREFERRED
roxicet Ridaura
tramadol hydrochloride/acetaminophen NON PREFERRED
tramadol HCL Nalfon
tramadol HCL ERQL Naprelan
verdrocet Rheumatrex
vicodin SprixQL
vicodin ES SPECIALTY
vicodin HP ArcalystPA
xylon EnbrelQL,PA
zamicet Enbrel SureclickQL,PA
Aspirin-caffeine-dihydrocodeine HumiraPA
FentanylQL Humira Pediatric Crohns Disease Starter PackPA
Hydrocodone/Acetaminophen Humira PenPA
Hydromorphone HCL ERQL Humira Pen-crohns DiseasestarterPA
Hydromorphone HCL/Sodium Chloride Humira Pen-psoriasis StarterPA
Levorphanol Tartrate IlarisQL,PA
Morphine Sulfate KineretPA
Morphine Sulfate ERQL OrenciaQL,PA
Oxycodone HCL ERQL SimponiPA
PREFERRED Simponi AriaQL,PA
ButransQL,PA
LazandaQL,PA MIGRAINE PRODUCTS
Nucynta
GENERIC
Nucynta ERQL
almotriptan malateQL,ST
Opana ER (crush Resistant)QL
dihydroergotamine mesylate
OxycontinQL
frovatriptan succinateQL,ST
SuboxoneQL,PA
naratriptan HCLQL
NON PREFERRED
rizatriptan benzoateQL
EmbedaQL
rizatriptan benzoate odtQL
ExalgoQL
sumatriptan succinateQL
Oxaydo
sumatriptan succinate refillQL
Talwin
zolmitriptanQL
zolmitriptan odtQL
ANTI-INFLAMMATORY
Dihydroergotamine MesylateQL
GENERIC Sumatriptan SuccinateQL
celecoxibQL PREFERRED
diclofenac potassium RelpaxQL
diclofenac sodium DR NON PREFERRED
diclofenac sodium ER Cafergot
diclofenac sodium/misoprostol Ergomar
etodolac ZomigQL,ST
etodolac ER Zomig Nasal SprayQL,ST
flurbiprofen
ibuprofen GOUT AGENTS
ibuprofen lysine
GENERIC
indomethacin
allopurinol
indomethacin ER
probenecid
inflammacin
probenecid/colchicine
ketoprofen
PREFERRED
ketorolac tromethamineQL
Colchicine
leflunomide
Colcrys
mefenamic acid
Uloric
meloxicam
SPECIALTY
nabumetone
KrystexxaPA
naproxen
naproxen kit
LOCAL ANESTHETICS-INJ
naproxen sodium
GENERIC
naproxen sodium CR
bupivacaine spinal
naproxen sodium ER
bupivacaine HCL
naproxen DR
bupivacaine/epinephrine
oxaprozin
chloroprocaine HCL
piroxicam
lidocaine HCL
sulindac
lidocaine/epinephrine
tolmetin sodium
polocaine
Fenoprofen Calcium
polocaine-mpf
Meclofenamate Sodium
ropivacaine
Naproxen
ropivacaine HCL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 24
sensorcaine promethazine/dextromethorphan
sensorcaine-mpf promethazine/phenylephrine
sensorcaine-mpf spinal promethazine/phenylephrine/codeine
sensorcaine-mpf/epinephrine pulmosal
sensorcaine/epinephrine sodium chloride
xylocaine dental tussigon
Tetracaine HCL
ANTIASTHMATIC/COPD AGENTS
RESPIRATORY, ALLERGY, ETC
GENERIC
albuterol
ANTIHISTAMINES
albuterol sulfate
GENERIC
albuterol sulfate ER
arbinoxa
albuterol TAB 4MG
bpm
aminophylline
carbinoxamine maleate
budesonide
cetirizine HCL
difil-G forte
clemastine fumarate
epinephrine HCL
cyproheptadine HCL
ipratropium bromideQL
desloratadine
ipratropium bromide/albuterol sulfateQL
diphenhydramine HCL
levalbuterolQL
levocetirizine dihydrochloride
levalbuterol HCLQL
pharbedryl
montelukast sodium
phenadoz
terbutaline sulfate
phenergan
theochron
promethazine HCL
theophylline
promethazine HCL plain
theophylline CR
promethegan
theophylline ER
Clemastine Fumarate
zafirlukast
Dexchlorpheniramine Maleate
Cromolyn Sodium
NON PREFERRED
Metaproterenol Sulfate
Clarinex
PREFERRED
Desloratadine Odt
Arcapta NeohalerQL
Asmanex HFAQL
NASAL AGENTS
Asmanex Twisthaler 120 Metered DosesQL
GENERIC
Asmanex Twisthaler 14 Metered DosesQL
azelastine HCLQL
Asmanex Twisthaler 30 Metered DosesQL
budesonideQL
Asmanex Twisthaler 60 Metered DosesQL
flunisolideQL
Asmanex Twisthaler 7 Metered DosesQL
fluticasone propionateQL
Atrovent HFAQL
ipratropium bromideQL
Combivent RespimatQL
mometasone furoateQL
Daliresp
olopatadine HCLQL
DuleraQL
triamcinolone acetonideQL
Foradil AerolizerQL
PREFERRED
PerforomistQL
DymistaQL
Proair HFAQL
NON PREFERRED
Proair RespiclickQL
Bactroban Nasal
Pulmicort FlexhalerQL
QvarQL
COUGH/COLD/ALLERGY
Serevent DiskusQL
GENERIC
Spiriva HandihalerQL
acetylcysteine
Spiriva RespimatQL
benzonatate
Stiolto RespimatQL
biotuss
SymbicortQL
biotuss pediatric
Tudorza PressairQL
bpm pseudo
NON PREFERRED
bromfed DM
BrovanaQL
bromphen/pseudoephedrine HCL/dextromethorphan HBR
Elixophyllin
giltuss pediatric
Incruse ElliptaQL
hydrocodone bitartrate/chlorpheniramine maleate/PSE
Lufyllin
hydrocodone bitartrate/homatropine methylbromide
Theo-24
hydrocodone polistirex/chlorpheniramine polistirex
Zyflo CR
hydrocodone/homatropine
SPECIALTY
hydromet
NucalaQL,PA
nebusal
XolairPA
nortuss-DE
phenylephrine/guaifenesin
RESPIRATORY AGENTS - MISC
promethazine VC plain
SPECIALTY
promethazine VC/codeine
Aralast NPPA
promethazine-DM
EsbrietPA
promethazine/codeine
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 25
GlassiaPA Fluvirin 2013-2014
KalydecoPA Fluvirin 2014-2015
OfevPA Fluvirin 2015-2016
Prolastin-cPA Fluzone High-dose PF 2013-2014
PulmozymePA Fluzone High-dose PF 2014-2015
ZemairaPA Fluzone High-dose PF 2015-2016
Fluzone Intradermal
TOXOIDS Fluzone Intradermal Quadrivalent 2015-2016
Fluzone Pediatric PF 2013-2014
Fluzone PF 2013-2014
PREFERRED
Fluzone PF 2014-2015
Tetanus Toxoid Adsorbed
Fluzone Quadrivalent 2013-2014
PREVENTIVE
Fluzone Quadrivalent 2014-2015
Adacel
Fluzone Quadrivalent 2015-2016
Boostrix
Fluzone Split 2013-2014
Daptacel
Fluzone Split 2014-2015
Diphtheria/Tetanus Toxoids Adsorbed Pediatric
Fluzone Split 2015-2016
Infanrix
Gardasil
Kinrix
Gardasil 9
Pediarix
Havrix
Pentacel
Hiberix
Quadracel
Ipol Inactivated IPV
Tenivac
M-m-r II
Tetanus/Diphtheria Toxoids-adsorbed
Medical Provider EZ Flu Shot PF 2013-2014
Tetanus/Diphtheria Toxoids-adsorbed Adult
Medical Provider EZ Flu Shot PF 2014-2015
Medical Provider EZ Flu Shot 2013-2014
VACCINES
Medical Provider EZ Flu Shot 2014-2015
Medical Provider EZ Flu Shot 2015-2016
PREFERRED
Medical Provider Single Use EZ Flu Shot
Bcg Vaccine
Menactra
Biothrax
Menhibrix
Imovax Rabies (h.d.c.v.)
Menomune-a/C/Y/W-135
Ixiaro
Menveo
Rabavert
Pedvax HIB
Typhim VI
Pneumovax 23
Vivotif
Pneumovax 23/1 Dose
Yf-vax
Pneumovax 23/5 Dose
PREVENTIVE
Prevnar 13
Acthib
Proquad
Afluria PF 2012-2013
Recombivax HB
Afluria PF 2013-2014
Rotarix
Afluria PF 2014-2015
Rotateq
Afluria PF 2015-2016
Trumenba
Afluria 2012-2013
Twinrix
Afluria 2013-2014
Vaqta
Afluria 2014-2015
Varivax
Afluria 2015-2016
Zostavax
Bexsero
Cervarix
VITAMINS
Comvax
VITAMINS
Engerix-b
GENERIC
Fluarix Quadrivalent 2013-2014
ascorbic acid
Fluarix Quadrivalent 2014-2015
ergocalciferol
Fluarix Quadrivalent 2015-2016
mega-c/a plus
Fluarix 2013-2014
ortho-CS 250
Fluarix 2014-2015
phytonadione
Flublok 2013-2014
thiamine HCL
Flublok 2014-2015
vitamin c 222MG
Flublok 2015-2016
vitamin d
Flucelvax 2013-2014
vitamin k1
Flucelvax 2014-2015
PREVENTIVE
Flucelvax 2015-2016
aqueous vitamin d infants
Flulaval Quadrivalent 2013-2014
bio-d-mulsion
Flulaval Quadrivalent 2014-2015
bio-d-mulsion forte
Flulaval Quadrivalent 2015-2016
bprotected pedia d-vite
Flulaval 2013-2014
calcidol
Flulaval 2014-2015
calciferol
Flumist Quadrivalent
d 1000
Fluvirin PF 2013-2014
d 10000
Fluvirin PF 2014-2015
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 26
d 2000 PA vitamin d-3
d 400 PA vitamin d-3 gummy
d 5000 PREFERRED
d-vita Mephyton
d-1000 PREVENTIVE
d-1000 extra strength Baby Super Daily D3
d-2000 maximum strength Ddrops
d-3-5 Decara
d-400 D3 Dots
d-5000 HM Vitamin D3
d-5000 maximum strength Optimal D3 M
decara Replesta
delta d3 Replesta Childrens
dialyvite vitamin d 5000 Replesta Nx
dialyvite vitamin d3 max Sm Vitamin D3 Maximum Strength
d2000 ultra strength Super Daily D3
d3 Thera-d 4000
d3 adult Vitamelts Vitamin D
d3 adult gummy Vitamin D2
d3 high potency Vitamin D3
d3 kids Wellesse Vitamin D3
d3 maximum strength
d3 super strength MULTIVITAMINS
d3 ultra strength
GENERIC
d3 2000
b-complex 100
d3-1000
b-plex
d3-50
b-plex plus
eql childrens vitamin d gummies
biocel
eql vitamin d-3
corvita
eql vitamin d3
corvite free
gnp vitamin d
dialyvite
gnp vitamin d maximum strength
floriva plus
gnp vitamin d super strength
folbee plus
gnp vitamin d3 extra strength
folbee plus cz
healthy kids vitamin d3
infuvite
just d
infuvite adult
kp vitamin d
infuvite pediatric
maximum d3
lysiplex plus
nat-rul vitamin d
mult-vitamin/fluoride
natural vitamin d-3
multi vitamin/fluoride
optimal-d
multi-vit/fluoride
optimal-d pack
multi-vit/iron/fluoride
opurity vitamin d
multi-vitamin/fluoride
pronutrients vitamin d3
multi-vitamin/fluoride/iron
ra vitamin d-3
multivitamin with fluoride
sm vitamin d
multivitamin/fluoride
sm vitamin d3
multivitamins/fluoride
th vitamin d3
mynephrocaps
thera-d rapid repletion
nephronex
thera-d sport
niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper
thera-d 2000
nutrifac ZX
vitajoy daily d gummies
rena-vite RX
vitamin d high potency
renal
vitamin d 400
renalpren
vitamin d-1000
reno CAPS
vitamin d-1000 maximum strength
tri-vit/fluoride
vitamin d-3
tri-vitamin/fluoride
vitamin d-400
triphrocaps
vitamin d3
triple-vitamin/fluoride
vitamin d3 adult gummies
urosex
vitamin d3 high potency
v-c forte
vitamin d3 maximum strength
vic-forte
vitamin d3 super strength
virt-vite plus
vitamin d3 400
virt-CAPS
CVS d3
vita s forte
CVS vitamin d
vita-min
CVS vitamin d 5000 high-potency
vitacel
CVS vitamin d3
vitamax pediatric
HM vitamin d
vitamin b-complex 100
HM vitamin d3
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 27
vitamins a/c/d/fluoride Prenatal Vitamins
vol-care RX Px Prenatal Multivitamins
vp-vite RX Ra Prenatal
Bp Folinatal Plus B Sm Prenatal Vitamins
Bp Multinatal Plus PREVENTIVE
Cavan-EC Sod DHA Atabex Prenatal
Complete Natal DHA Brainstrong Prenatal
Completenate Cadeau DHA
CO-natal Fa Centrum Specialist Prenatal
Elite-OB CVS Prenatal
Escavite LQ CVS Prenatal Gummy/DHA/Folic Acid
Inatal Advance CVS Prenatal Multi+dha
Inatal GT Enfamil Expecta
Inatal Ultra Gnp Daily Prenatal
M-vit Gnp Prenatal
Macnatal CN DHA Goodsense Prenatal Vitamins
Mynatal Advance Healthy Mama Be Well Rounded
Mynatal Plus HM One Daily Prenatal Combo
Mynatal Ultracaplet HM Prenatal
Mynatal-z Kp Prenatal Multivitamins
Mynate 90 Plus Mission Prenatal
MVC-fluoride Nat-rul Prenatal Vitamins
Obstetrix EC One A Day Womens Prenatal/DHA
Pr Natal 400 One A Day Womens Prenatal1
Pr Natal 400 EC One-a-day Womens Prenatal
Pr Natal 430 Prenatal Complete
Pr Natal 430 EC Prenatal Multi + DHA
Prenaissance Plus Prenatal Multi +dha
Prenaplus Prenatal Multivitamin + DHA
Prenatabs Fa Prenatal Multivitamin Plus DHA
Prenatabs RX Prenatal One Daily
Prenatal Ad Prenatal Plus DHA
Prenatal Plus Prenatal Vitamin
Prenatal 19 Prenatal/Omega-3/Folic Acid/Iron
Prenatal-u PA Prenatal Formula
PNV-select Qc Prenatal
PNV-DHA Ra One Daily
Quflora Pediatric Ra Prenatal Formula/Folicacid
Se-natal 19 Right Step Prenatal
Se-tan DHA Similac Prenatal Early Shield
Taron-prex Sm One Daily Prenatal
Triadvance Stuart One
Tricare Stuart Prenatal
Trinatal RX 1 Th Prenatal Vitamins
Trinate Your Life Multi Prenatal
Ultimatecare One
Ultimatecare One NF MEDICAL DEVICES
Ultra TABS
DIABETIC SUPPLIES
Vinate C
PREFERRED
Vinate Care
Accu-chek Fastclix LancetsQL
Vinate IC
Accu-chek Multiclix LancetsQL
Vinate II
Accu-chek Safe-t-pro LancetsQL
Vinate M
Accu-chek Safe-t-pro PluslancetsQL
Vinate One
Accu-chek Soft Touch LancetsQL
Vitafol-OB
Accu-chek Softclix LancetsQL
Vp-zel
Acti-lance Lancets 28GQL
PREVENTIVE
Acti-lance Lite Safety Lancets 28GQL
sm prenatal vitamins
Acti-lance Special Safety Lancets 17GQL
Classic Prenatal
Acti-lance Special Safetylancets 17GQL
Eql Prenatal Formula
Acti-lance Universal Safety Lancets 23GQL
Gnp Prenatal Vitamins
Active 1ST Blood Lancets 30G/Easy Twist CAPQL
Mission Prenatal HP
Advocate LancetsQL
Multi Prenatal
Advocate Lancets 30GQL
Perry Prenatal
Advocate Safety LancetsQL
Pre-natal Formula
Advocate Safety Lancets 26GQL
Prenatal
Agamatrix Ultra-thin Lancets 33GQL
Prenatal And Iron
Assure Comfort Lancets Ultra Thin 28GQL
Prenatal Formula
Assure Comfort Lancets Ultra Thin 30GQL
Prenatal Forte
Assure Haemolance Plus High Flow 18GQL
Prenatal Low Iron
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 28
Assure Haemolance Plus Low Flow 25GQL BD Insulin Syringe/U-100/2ML/27.5G X 5/8"QL
Assure Haemolance Plus Micro Flow 28GQL BD Insulin Syringe/U-100/2ML/29G X 1/2"QL
Assure Haemolance Plus Normal Flow 21GQL BD Integra Insulin Syringe/U-100/1ML/29G X 1/2"QL
Assure Haemolance Plus Pediatric BladeQL BD Integra Syringe/Retracting Needle/1ML/25G X 1"QL
Assure Lance LancetsQL BD Lancet Ultrafine 30GQL
Assure Lance Lancets 21GQL BD Lancet Ultrafine 33GQL
Assure Lance Plus Safety Lancets 25GQL BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X 1/2"QL
Assure Lance Plus Safety Lancets 30GQL
BD Microtainer LancetsQL
Assure LancetsQL
BD Pen Needle/Mini/Ultrafine/31G X 3/16"QL
Aurora Lancet Super Thin 30GQL
BD Pen Needle/Nano/Ultra Fine/32G X 4MMQL
Aurora Lancet Thin 23GQL
BD Pen Needle/SHORT/Ultrafine/31G X 5/16"QL
AF Lancets Super ThinQL
BD Pen Needle/Ultrafine/29G X 12.7MMQL
AT Last LancetsQL
BD Pen Needle/Ultrafine/29GX1/2" 12.7MMQL
B-d Insulin Syringe Ultrafine II/0.3ML/31G X 5/16"QL
BD Pen Needles SHORT/Ultrafine/31G X 5/16"QL
B-d Insulin Syringe Ultrafine II/0.5ML/31G X 5/16"QL
BD Safety-glide Insulin Syringe/0.5ML/29G X 1/2"QL
B-d Insulin Syringe Ultrafine II/1ML/31G X 5/16"QL
BD Safety-lok Insulin Syringe/Perm Needle/UF/1ML/29G X 1/2"QL
B-d Insulin Syringe Ultrafine/0.3ML/30G X 1/2"QL
B-d Insulin Syringe Ultrafine/0.5ML/30G X 1/2"QL
BD Safetyglide Insulin Sysyringe/0.5ML/30G X 5/16"QL
B-d Insulin Syringe Ultrafine/1ML/30G X 1/2"QL
BD-insul SYR Mis LO DoseQL
Bayer Microlet LancetsQL
Careone Lancet ThinQL
Bullseye Mini Safety LancetsQL
Careone Lancet Ultra ThinQL
Bullseye Safety LancetsQL
Cleanlet Lancets 28GQL
BD Autoshield Duo 30G X 3/16"QL
Clever Chek Lancets UltrathinQL
BD Autoshield 29G X 3/16"QL
Clever Chek Lancets Ultrathin 30GQL
BD Autoshield 29G X 5/16"QL
Coaguchek LancetsQL
BD Insulin Syringe LUER-LOK/U-100/1MLQL
Comfort Assured Lancets Micro Thin 33GQL
BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2"QL
Comfort Assured Lancets Super Thin 28GQL
BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2"QL
Comfort LancetsQL
BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8"QL
CVS Lancets Micro Thin 33GQL
BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2"QL
CVS Lancets OriginalQL
BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2"QL
CVS Lancets Thin 26GQL
BD Insulin Syringe Microfine/U-100/0.5ML/28G X 1/2"QL
CVS Lancets Ultra Thin 30GQL
BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8"QL
CVS Lancets 21GQL
BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2"QL
CVS Ultra Thin LancetsQL
BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 5/16"QL
Diastar Easy Test II Lancets 30GQL
Diastar Easy Test Lancets30GQL
BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2"QL
Droplet Lancets Ultra Thin 30GQL
BD Insulin Syringe Safetyglide/1ML/29G X 1/2"QL
Drug Mart Lancets ThinQL
BD Insulin Syringe Slip Tip/U-100/1MLQL
Drug Mart Lancets Ultra ThinQL
BD Insulin Syringe U-40/1ML/25G X 5/8"QL
Drug Mart On-the-go Lancets Gentle 30GQL
BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16"QL
Drug Mart Unilet Lancets Super Thin 30GQL
BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X 5/16"QL
Drug Mart Unilet Lancets Ultra Thin 28GQL
BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16"QL Duane Reade Lancet Alternate Site 26GQL
BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2"QL Duane Reade Lancet Super Thin 30GQL
BD Insulin Syringe Ultrafine/U-100/0.3ML/30G X 1/2"QL Duane Reade Lancet Ultra Thin 28GQL
BD Insulin Syringe Ultrafine/U-100/0.3ML/31G X 15/64"QL E-z Ject LancetsQL
BD Insulin Syringe Ultrafine/U-100/0.3ML/31G X 5/16"QL E-z Ject Lancets ColorQL
BD Insulin Syringe Ultrafine/U-100/0.5ML/29G X 1/2"QL E-z Ject Lancets Super ThinQL
BD Insulin Syringe Ultrafine/U-100/0.5ML/30G X 1/2"QL E-z Ject Lancets Super Thin 30GQL
BD Insulin Syringe Ultrafine/U-100/0.5ML/31G X 15/64"QL E-z Ject Lancets Thin 26GQL
BD Insulin Syringe Ultrafine/U-100/0.5ML/31G X 5/16"QL E-z Ject Lancets 21GQL
BD Insulin Syringe Ultrafine/U-100/1ML/29G X 1/2"QL E-ZJECT Lancets Micro-thin 33GQL
BD Insulin Syringe Ultrafine/U-100/1ML/30G X 1/2"QL Easy Comfort LancetsQL
BD Insulin Syringe Ultrafine/U-100/1ML/31G X 15/64"QL Easy Comfort Lancets 30G/Pull TopQL
BD Insulin Syringe Ultrafine/U-100/1ML/31G X 5/16"QL Easy Comfort Lancets 30G/Thin TopQL
BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2"QL Easy Touch Lancets 21G/Pressure ActivatedQL
BD Insulin Syringe Ultrafine/0.3ML/31G X 5/16"QL Easy Touch Lancets 23G/Pressure ActivatedQL
BD Insulin Syringe Ultrafine/0.5ML/30G X 1/2"QL Easy Touch Lancets 26G/Pressure ActivatedQL
BD Insulin Syringe Ultrafine/0.5ML/31G X 5/16"QL Easy Touch Lancets 26G/Pull-topQL
BD Insulin Syringe Ultrafine/1ML/30G X 1/2"QL Easy Touch Lancets 26G/TwistQL
BD Insulin Syringe Ultrafine/1ML/31G X 5/16"QL Easy Touch Lancets 28G/Pressure ActivatedQL
BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 1"QL
Easy Touch Lancets 28G/Pull-topQL
Easy Touch Lancets 28G/TwistQL
BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 5/8"QL
Easy Touch Lancets 30G/Button-activatedQL
Easy Touch Lancets 30G/Pressure ActivatedQL
BD Insulin Syringe/Detachable Needle/U-100/1ML/26G X 1/2"QL
Easy Touch Lancets 30G/Pull-topQL
Easy Touch Lancets 30G/TwistQL
BD Insulin Syringe/U-100/0.5ML/30G X 1/2"QL
Easy Touch Lancets 32G/Pressure ActivatedQL
BD Insulin Syringe/U-100/1ML/27G X 1/2"QL
Easy Touch Lancets 32G/Pull-topQL
BD Insulin Syringe/U-100/1ML/28G X 1/2"QL
Easy Touch Lancets 32G/TwistQL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 29
Easy Touch Lancets 33G/TwistQL HM Lancets Ultra Thin 30GQL
Easy Touch Safety Lancets21G/Pressure ActivatedQL IN Touch Diabetes Management Software
Easy Touch Safety Lancets23G/Pressure ActivatedQL IN Touch Sterile Lancets 30GQL
Easy Touch Safety Lancets26G/Button ActivatedQL Kinney LancetsQL
Easy Touch Safety Lancets26G/Pressure ActivatedQL Kinney Thin LancetsQL
Easy Touch Safety Lancets28G/Button ActivatedQL Kroger LancetsQL
Easy Touch Safety Lancets28G/Pressure ActivatedQL Kroger Lancets Micro Thin33GQL
Easy Twist & CAP LancetsQL Kroger Lancets Super ThinQL
Easytest II LancetsQL Kroger Lancets ThinQL
Easytest LancetsQL Kroger Lancets Thin 26GQL
Embrace Lancets Ultra Thin 30GQL Kroger Lancets Ultrathin 30GQL
Eql Color Lancets Micro Thin 33GQL Kroger Lancets 21GQL
Eql Color Lancets 21GQL LancetsQL
Eql Super Thin Lancets 30GQL Lancets Bullseye SafetyQL
Eql Thin Lancets 26GQL Lancets Micro Thin 33GQL
EZ Smart Blood Glucose LancetsQL Lancets Safety Seal 21GQL
EZ-lets Lancets 21GQL Lancets Safety Seal 26GQL
EZ-lets Lancets 23GQL Lancets Safety Seal 28GQL
EZ-lets Lancets 26G Super-softQL Lancets Safety Seal 30GQL
EZ-lets Lancets 28G Ultra-softQL Lancets Super Thin 28GQL
EZ-lets Lancets 30GQL Lancets ThinQL
Fifty50 Safety Seal Lancets 30GQL Lancets Twist TopQL
Fifty50 Safety Seal Lancets 32GQL Lancets Ultra FineQL
Fifty50 Unilet Lancets 33GQL Lancets Ultra ThinQL
Fine 30QL Lancets Ultra Thin 30GQL
Fingerstix LancetsQL Lancets 26G Twist TopQL
Fora LancetsQL Lancets 28GQL
Freds Pharmacy Unilet Lancets Super Thin 30GQL Lancets 30GQL
Freds Pharmacy Unilet Lancets Ultra Thin 28GQL Lancets 30G Twist TopQL
Freestyle LancetsQL Lancets 30G/Twist TopQL
Freestyle Unistick II LancetsQL Lancets 31G Twist TopQL
Gentle-let GP LancetsQL Lancets 33G Universal DesignQL
Gentle-let Lancets General Purpose Style/Fine PointQL Leader Lancets ColoredQL
Gentle-let Lancets General Purpose Style/Medium PointQL Leader Super Thin LancetQL
Gentle-let Lancets Safety Style/Fine PointQL Leader Thin LancetsQL
Gentle-let Lancets Safety Style/Medium PointQL Liberty Blood Glucose MeterQL
Global Inject Ease Lancets 28GQL Liberty Glucose Control Mid
Global Inject Ease Lancets 30GQL Liberty Glucose Control Normal
Glucocom Lancets 28GQL Liberty Medical Lancets 30GQL
Glucocom Lancets 30GQL Liberty Mini Lancing Device
Glucocom Lancets 33GQL Liberty Test StripsQL
Glucose Control Normal Lifescan Unistik II LancetsQL
Glucose Control Solution Lifescan Unistik 2 Deep PenetrationQL
Glucosource LancetsQL Lite Touch LancetsQL
Gmate Lancets 30GQL Litetouch Lancets Micro Thin 33GQL
Gnp LancetsQL Live Better Lancet Super Thin 30GQL
Gnp Lancets Micro Thin 33GQL Live Better Lancet Ultra Thin 28GQL
Gnp Lancets Super Thin 30GQL Longs Lancets StandardQL
Gnp Lancets ThinQL Longs Lancets ThinQL
Gnp Lancets Thin 26GQL Longs Lancets Ultra ThinQL
Gnp Lancets 21GQL Medichoice Pre-set Safety Lancet Dual UseQL
Gnp Micro Thin Lancets 33GQL Medichoice Pre-set Safety Lancet Low FlowQL
Gnp Super Thin Lancets/30GQL Medichoice Pre-set Safety Lancet Medium FlowQL
H&h Thinlet Lancets 26GQL Medichoice Pre-set Safety Lancet Moderate FlowQL
H&h Thinlet Super Thin Lancets 30GQL Medichoice Safety Lancet ExtraQL
H-e-b Incontrol Lancets Micro Thin 33GQL Medichoice Safety Lancet NormalQL
H-e-b Incontrol Lancets Super Thin 30GQL Medicine Shoppe LancetsQL
H-e-b Incontrol Lancets Ultra Thin 28GQL Medicine Shoppe Lancets ThinQL
HaemolanceQL Medisense Thin LancetsQL
Haemolance Low Flow LancetsQL Medlance Plus Extra Lancets 21GQL
Haemolance PlusQL Medlance Plus LancetsQL
Haemolance Plus High FlowQL Medlance Plus Lancets Lite 25GQL
Haemolance Plus Low FlowQL Medlance Plus Lite Lancets 25GQL
Haemolance Plus Max FlowQL Medlance Plus Special Lancets 0.8MMQL
Haemolance Plus Pediatric FlowQL Medlance Plus Superlite 30GQL
Healthwise Lancets 30GQL Medlance Plus Superlite 30G/Comfort MaxQL
Healthy Accents Unilet Lancets Super Thin 30GQL Medlance Plus Universal Lancets 21GQL
Hy-vee LancetsQL Medlance Plus/Lite 25GQL
Hy-vee Thin LancetsQL Medlance/ExtraQL
HM Lancets Micro Thin 33GQL Medlance/LiteQL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 30
Medlance/UniversalQL Qc LancetsQL
Meijer Color Lancets Universal 33GQL Qc Lancets Super ThinQL
Meijer LancetsQL Qc Lancets ThinQL
Meijer Lancets ThinQL Qc Lancets Ultra ThinQL
Meijer Lancets Universal 33GQL Qc Unilet Lancets 28G/Ultra ThinQL
Meijer Super Thin LancetsQL Qc Unilet Lancets 33G/Micro ThinQL
Microlet LancetsQL Ra E-ZJECT Color Lancets Micro-thin 33GQL
Microtainer Safety Flow Lancet/Sterile/Single-useQL Ra E-ZJECT Lancets Thin 26GQL
Monolet LancetsQL Ra E-ZJECT Lancets Thin 28GQL
Monolet Opd LancetsQL Ra E-ZJECT Lancets Ultra Thin 30GQL
Monolettor Safety LancetsQL Ra E-ZJECT Lancets 28GQL
Myglucohealth Mgh Softlance Lancets 30GQL Reality LancetsQL
Netgroup LancetsQL Reality Trigger LancetsQL
Nova Safety Lancets 23GQL Relion Lancets Micro-thin33GQL
Nova Safety Lancets 28GQL Relion Lancets Standard 21GQL
Nova Sureflex LancetsQL Relion Lancets Thin 26GQL
On Call LancetsQL Relion Lancets Ultra-thin30GQL
On Call Plus LancetsQL Relion Thin LancetsQL
Onetouch Club Lancets Fine PointQL Relion Ultra Thin LancetsQL
Onetouch Combo PackQL Relion Ultra Thin Lancets30GQL
Onetouch Delica Lancets Extra Fine 33GQL Relion Ultra Thin Plus Lancets 32GQL
Onetouch Delica Lancets Fine 30GQL Relion Ultra Thin Plus Lancets 33GQL
Onetouch Delica Lancing Device Renew Advanced Lancing Cartridge RefillsQL
Onetouch Finepoint LancetsQL Rexall Lancets Ultra ThinQL
Onetouch LancetsQL Rightest Gl300 LancetsQL
Onetouch Ping Meter Remote Safe-t-lance Low Flow 25GQL
Onetouch Suresoft Lancing Device/18G Safe-t-lance Normal Flow 21GQL
Onetouch Suresoft Lancing Device/21G Safe-t-lance Plus Safety Lancet High FlowQL
Onetouch Suresoft Lancing Device/28G Safe-t-lance Plus Safety Lancet Low FlowQL
Onetouch Ultra BlueQL Safe-t-lance Plus Safety Lancet Normal FlowQL
Onetouch Ultra Control Safety Lancet 21G/Pressure ActivatedQL
Onetouch Ultra MiniQL Safety Lancet 28G/Pressure ActivatedQL
Onetouch Ultra 2QL Safety LancetsQL
Onetouch Ultralink System (hex)QL Safety Lancets 21GQL
Onetouch Ultralink System (DEC)QL Safety Lancets 28GQL
Onetouch Ultrasoft LancetsQL Safety Let LancetsQL
Onetouch VerioQL Safety Seal Lancets 28GQL
Onetouch Verio Control Solution High Safety Seal Lancets 30GQL
Onetouch Verio Flex Bloodglucose Monitoring SystemQL Safety-glide Insulin Syringe/0.3ML/29G X 1/2"QL
Onetouch Verio IQ Blood Glucose Monitoring SystemQL Sapscare Twist Top Lancets 30GQL
Onetouch Verio Mid Control Solution Shopko On-the-go Comfort Lancets 30GQL
Onetouch Verio Sync Bloodglucose Monitoring SystemQL Shopko Unilet Lancets Super Thin 30GQL
Onetouch Verio Test StripsQL Shopko Unilet Lancets Ultra Thin 28GQL
Penlet II Automatic Bloodsampler Side Button Safety Lancet21GQL
Penlet II Replacement CAPS Single-letQL
Penlet II Replacement CAPS-deep Sm Lancets 21GQL
Penlet II Replacement CAPS-regular Sm Micro Thin Lancets 33GQL
Perfect Lancets 30GQL Sm Super Thin LancetsQL
Perfect Pressure Activated Safety Lancets 28GQL Sm Super Thin Lancets 30GQL
Pharmacist Choice Ultra Thin LancetsQL Sm Thin Lancets 26GQL
Pharmacist Choice Ultra Thin Lancets 28GQL Smart Diabetes Vantage Universal Lancets 30GQL
Pharmacist Choice Ultra Thin Lancets 30GQL Smart Sense Color Lancets Universal 33GQL
Pharmacist Choice Ultra Thin Lancets 31GQL Smart Sense Standard Lancets Universal 21GQL
Pharmacist Choice Ultra Thin Lancets 33GQL Smart Sense Super Thin Lancets Universal 30GQL
Pharmacy Counter LancetsQL Smart Sense Thin Lancets Universal 26GQL
Precision Thin LancetsQL Smartest Lancets 28GQL
Precision Thins GP LancetQL Solus V2 Pressure Activated Safety Lancets 28GQL
Precision Ultra LancetQL Solus V2 Twist Lancets 30GQL
Preferred Plus Lancets Colored 21GQL Sterilance TLQL
Preferred Plus Lancets Super Thin 30GQL Super Thin LancetsQL
Preferred Plus Lancets Thin 26GQL Sure Comfort Lancets 28GQL
Pressure Activated Safetylancet 21GQL Sure Comfort Lancets 30GQL
Prodigy Pressure Activated Safety LancetsQL Sure-lance Flat LancetsQL
Prodigy Safety LancetsQL Sure-lance Lancets 26GQL
Prodigy Twist Top LancetsQL Sure-lance Thin Lancets 28GQL
Pss Select GP LancetsQL Sure-lance Ultra Thin LancetsQL
Pss Select Safety LancetsQL Sure-touch Lancets UniversalQL
Push Button Safety Lancets 21GQL Surelite LancetsQL
Push Button Safety Lancets 28GQL Surestep Glucose Control
Px Lancets Ultra ThinQL Surestep Glucose Control Solution
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 31
Surestep Pro High Glucosecontrol Vitalet Pro LancetsQL
Surestep Pro Linearity Kit Vitalet Pro Plus LancetsQL
Surestep Pro Low Glucose Control W&f Lancets Colored 21GQL
Surestep Pro Normal Glucose Control W&f Lancets 26GQL
SB Lancets ThinQL Walgreens Advanced Travellancets 28GQL
SB Lancets Ultra ThinQL Walgreens Comfort Assuredlancets Micro Thin/33GQL
Techlite AST LancetsQL Walgreens Comfort Assuredlancets Super Thin/28GQL
Techlite LancetsQL Walgreens LancetsQL
Techlite Lancets 30GQL Walgreens Thin LancetsQL
Tgt Lancet Alternate SiteQL Walgreens Ultra Thin LancetsQL
Tgt Lancet Micro Thin 33GQL 1ST Choice Lancets Super ThinQL
Tgt Lancet Super Thin 30GQL 1ST Choice Lancets ThinQL
Tgt Lancet Thin 23GQL 1ST Choice Lancets Ultra ThinQL
Tgt Lancet Thin 26GQL 1ST Tier Unilet Comfortouch Lancets 28GQL
Tgt Lancet Ultra Thin 28GQL 1ST Tier Unilet Comfortouch Lancets 30GQL
Tgt Lancet Ultra Thin 30GQL NON PREFERRED
Thinlets GP LancetsQL Accu-chek Active Glucose Control Solution
Thinlets LancetQL Accu-chek Active StripsQL
Todays Health Super Thin Lancets 30GQL Accu-chek AvivaQL
Todays Health Ultra Thin Lancets 28GQL Accu-chek Aviva PlusQL
Travel Lancets 30GQL Accu-chek Comfort Curve Control Solution (2 Levels)
Trueplus Lancets 26GQL Accu-chek Comfort Curve Linearity Solution
Trueplus Lancets 28GQL Accu-chek Comfort Curve Test StripsQL
Trueplus Lancets 28G Super ThinQL Accu-chek Compact Blue Control Solution (2 Levels)
Trueplus Lancets 30GQL Accu-chek Compact PlusQL
Trueplus Lancets 30G Ultra ThinQL Accu-chek Compact Plus Care KitQL
Trueplus Lancets 33GQL Accu-chek Compact Plus Clear Control Solution (2 Levels)
Trueplus Lancets 33G Micro ThinQL Accu-chek Compact Test DrumQL
Trueplus Safety Lancets 28GQL Accu-chek Fastclix Lancetdevice Kit
Ulticare Thin Lancets 30GQL Accu-chek Instant Glucosecontrol Solution (2 Levels)
Ultilet Classic LancetsQL Accu-chek Multiclix Lanc Et Device Kit
Ultilet LancetsQL Accu-chek Nano SmartviewQL
Ultilet Lancets 33GQL Accu-chek Smartview Control
Ultilet Safety Lancets 23GQL Accu-chek Smartview StripsQL
Ultra Thin Lancets 28GQL Accu-chek Softclix Lancetdevice
Ultra Thin Lancets 30GQL Accu-chek Softclix Lancetdevice Kit
Ultra-thin II Auto LancetQL Accu-chek VoicemateQL
Ultra-thin II Lancets 28GQL Adjustable Lancing Device
Ultra-thin II Lancets 30GQL Advocate Insulin Pen Needles 29GX12.7MMQL
Ultra-thin II Safety Autolancets 26GQL Advocate Insulin Pen Needles 31GX5MMQL
Unilet Comfortouch LancetQL Advocate Insulin Pen Needles 31GX8MMQL
Unilet ExceliteQL Advocate Insulin Syringe/U-100/0.3ML/29GX1/2"QL
Unilet Excelite IIQL Advocate Insulin Syringe/U-100/0.3ML/30GX5/16"QL
Unilet G.p. LancetQL Advocate Insulin Syringe/U-100/0.3ML/31GX5/16"QL
Unilet G.p. Superlite LancetQL Advocate Insulin Syringe/U-100/0.5ML/29GX1/2"QL
Unilet GP 28 Ultra ThinQL Advocate Insulin Syringe/U-100/0.5ML/30GX5/16"QL
Unilet LancetQL Advocate Insulin Syringe/U-100/0.5ML/31GX5/16"QL
Unilet Lancets Micro-thin33GQL Advocate Insulin Syringe/U-100/1ML/29GX1/2"QL
Unilet Lancets Super-thin30GQL Advocate Insulin Syringe/U-100/1ML/30GX5/16"QL
Unilet Lancets Ultra-thin 28GQL Advocate Insulin Syringe/U-100/1ML/31GX5/16"QL
Unilet Superlite LancetQL Advocate Lancing Device
Unistik Safety Lancets 28GQL Advocate Rapid-safe Lancing Device
Unistik Safety Lancets 30GQL Alternate Site Lancing Device
Unistik Touch Safety Lancets 21GQL Anti-stick Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Unistik Touch Safety Lancets 23GQL Anti-stick Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Unistik Touch Safety Lancets 28GQL Anti-stick Insulin Syringe/U-100/1ML/29G X 1/2"QL
Unistik Touch Safety Lancets 30GQL Aqua Lance Adjustable Lancing Device
Unistik 3 GentleQL Assure ID Insulin Safety Syringe/U-100/0.5ML/29G X 1/2"QL
Universal 1 Lancets Thin 26GQL
Assure ID Insulin Safety Syringe/U-100/1ML/29G X 1/2"QL
Universal 1 Lancets Ultra Thin 30GQL
Aurora Pen Needles 29GX12MMQL
V-go 20
Aurora Pen Needles 31G X 6MMQL
V-go 30
Aurora Pen Needles 31G X 8MMQL
V-go 40
Aurora Unifine Pentips/Mini/31GX3/16"QL
Value Plus Lancets Standard 21GQL
Aurora Unifine Pentips/32GX5/32"QL
Value Plus Lancets Super Thin 30GQL
Auto-lancet
Value Plus Lancets Thin 26GQL
Auto-lancet Mini
Valumark Lancet Super Thin 30GQL
Autolet Impression
Valumark Lancet Ultra Thin 28GQL
Autolet Impression Lancing Device
Vida Mia Unilet Lancets Super Thin 30GQL
Autolet II Clinisafe
Vida Mia Unilet Lancets Ultra Thin 28GQL
Autolet Lite Clinisafe
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 32
Autolet Lite Starter Pack Clickfine Pen Needle Universal/31GX1/4"QL
Autolet Mini Clickfine Pen Needle Universal/31GX5/16"QL
Autolet Platforms Clickfine Pen Needle 32GX5/32"QL
Bayer Microlet 2 Lancing Device Clickfine Pen Needles/31GX1/4"QL
BD Lancet Device Clickfine Pen Needles/31GX5/16"QL
Cardiocom Lancing Device Clickfine Universal Pen Needles 31GX5/16"QL
Carefine Pen Needle 32GX4MMQL Closercare
Carefine Pen Needles 29GX1/2"QL Comfort Assist Insulin Syringe 0.3ML/29G X 1/2"QL
Carefine Pen Needles 30GX5/16"QL Comfort Assist Insulin Syringe/0.3ML/30G X 5/16"QL
Carefine Pen Needles 31GX6MMQL Comfort Assist Insulin Syringe/0.3ML/31G X 5/16"QL
Carefine Pen Needles 31GX8MMQL Comfort Assist Insulin Syringe/0.5ML/29G X 1/2"QL
Carefine Pen Needles 32GX5MMQL Comfort Assist Insulin Syringe/0.5ML/30G X 5/16"QL
Carefine Pen Needles 32GX6MMQL Comfort Assist Insulin Syringe/0.5ML/31G X 5/16"QL
Careone Advanced Lancing Device Comfort Assist Insulin Syringe/1ML/29G X 1/2"QL
Careone Insulin Syringes/0.3ML/30G X 1/2"QL Comfort Assist Insulin Syringe/1ML/30G X 5/16"QL
Careone Insulin Syringes/0.3ML/31G X 5/16"QL Comfort Assist Insulin Syringe/1ML/31G X 5/16"QL
Careone Insulin Syringes/0.5ML/30G X 1/2"QL CVS Insulin Syringe/0.3ML/29G X 1/2"QL
Careone Insulin Syringes/0.5ML/31G X 5/16"QL CVS Insulin Syringe/0.3ML/30G X 1/2"QL
Careone Insulin Syringes/1ML/30G X 1/2"QL CVS Insulin Syringe/0.5ML/29G X 1/2"QL
Careone Insulin Syringes/1ML/31GX5/16"QL CVS Insulin Syringe/0.5ML/30G X 1/2"QL
Careone Unifine Pentips Pen Needles 32GX4MMQL CVS Insulin Syringe/1ML/29G X 1/2"QL
Careone Unifine Pentips Plus Pen Needles 29GX12MMQL CVS Lancing Device
Careone Unifine Pentips Plus Pen Needles 31GX5MMQL Diascreen Liquid Urine Controls
Careone Unifine Pentips Plus Pen Needles 31GX6MMQL Diascreen 1b
Careone Unifine Pentips Plus Pen Needles 31GX8MMQL Diascreen 1k
Careone Unifine Pentips Plus Pen Needles 32GX4MMQL Diascreen 1G
Careone Unifine Pentips 29GX12MMQL Diascreen 10
Careone Unifine Pentips 31GX5MMQL Diascreen 2GK
Careone Unifine Pentips 31GX6MMQL Diascreen 2GP
Careone Unifine Pentips 31GX8MMQL Diascreen 3
Chemstrip Bg Log Book Diascreen 4nl
Clever Choice Comfort EZ Insulin Pen Needles 31GX8MMQL
Diascreen 4obl
Diascreen 4PH
Clever Choice Comfort EZ Insulin Syringe/U-100/1ML/31GX5/16"QL
Diascreen 5
Diascreen 6
Clever Choice Comfort EZ Insulin Syringe/0.3ML/29G X 1/2"QL
Diascreen 7
Diascreen 8
Clever Choice Comfort EZ Insulin Syringe/0.3ML/30G X 1/2"QL
Diascreen 9
Droplet Lancing Device
Clever Choice Comfort EZ Insulin Syringe/0.3ML/30G X 5/16"QL
Droplet Pen Needles 29GX10MMQL
Clever Choice Comfort EZ Insulin Syringe/0.3ML/31G X 5/16"QL
Droplet Pen Needles 29GX12MMQL
Droplet Pen Needles 31GX5MMQL
Clever Choice Comfort EZ Insulin Syringe/0.5ML/28G X 1/2"QL
Droplet Pen Needles 31GX6MMQL
Droplet Pen Needles 31GX8MMQL
Clever Choice Comfort EZ Insulin Syringe/0.5ML/29G X 1/2"QL
Droplet Pen Needles 32GX4MMQL
Droplet Pen Needles 32GX5MMQL
Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 1/2"QL
Droplet Pen Needles 32GX6MMQL
Droplet Pen Needles 32GX8MMQL
Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 5/16"QL
Drug Mart Adjustable Lancing Device
Clever Choice Comfort EZ Insulin Syringe/0.5ML/31G X 5/16"QL
Drug Mart Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2"QL
Clever Choice Comfort EZ Insulin Syringe/1.0ML/30G X 1/2"QL
Drug Mart Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16"QL
Clever Choice Comfort EZ Insulin Syringe/1ML/28G X 1/2"QL
Drug Mart Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16"QL
Clever Choice Comfort EZ Insulin Syringe/1ML/29G X 1/2"QL
Drug Mart Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16"QL
Clever Choice Comfort EZ Insulin Syringe/1ML/30G X 5/16"QL
Drug Mart Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16"QL
Clever Choice Comfort EZ Pen Needles 29GX12MMQL Drug Mart Ultra Comfort Insulin Syringe/1ML/29G X 1/2"QL
Clever Choice Comfort EZ Pen Needles 31GX5MMQL Drug Mart Ultra Comfort Insulin Syringe/1ML/30G X 5/16"QL
Clever Choice Comfort EZ Pen Needles 31GX6MMQL
Drug Mart Unifine Pentips 31GX5MMQL
Clever Choice Comfort EZ Pen Needles 31GX8MMQL
Drug Mart Unifine Pentipsplus 32GX4MMQL
Clever Choice Comfort EZ Pen Needles 32GX4MMQL
Drug Mart Unifine Pentips29G X 12MMQL
Clever Choice Comfort EZ Pen Needles 32GX5MMQL
Drug Mart Unifine Pentips31GX6MMQL
Clever Choice Comfort EZ Pen Needles 32GX6MMQL
Drug Mart Unifine Pentips31GX8MMQL
Clever Choice Comfort EZ Pen Needles 32GX8MMQL
Drug Mart Unifine Pentips32GX4MMQL
Clever Choice Comfort EZ Pen Needles 33GX4MMQL
Duane Reade Unifine Pentips 29G X 12MMQL
Clever Choice Comfort EZ Pen Needles 33GX5MMQL
Duane Reade Unifine Pentips 31G X 6MM Ultra SHORTQL
Clever Choice Comfort EZ Pen Needles 33GX6MMQL
Duane Reade Unifine Pentips 31G X 8MM SHORTQL
Clever Choice Comfort EZ Pen Needles 33GX8MMQL
Easy Comfort Insulin Syringe/U-100/0.5ML/30G X 1/2"QL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 33
Easy Comfort Insulin Syringe/U-100/1ML/30G X 1/2"QL Eql Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Easy Comfort Insulin Syringe/0.3ML/30G X 5/16"QL Eql Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Easy Comfort Insulin Syringe/0.5ML/30G X 5/16"QL Eql Insulin Syringe/U-100/1ML/29G X 1/2"QL
Easy Comfort Insulin Syringe/0.5ML/31G X 5/16"QL Eql Insulin Syringe/0.3ML/29G X 1/2"QL
Easy Comfort Insulin Syringe/1ML/30G X 5/16"QL Eql Insulin Syringe/0.3ML/30G X 5/16"QL
Easy Comfort Insulin Syringe/1ML/31G X 5/16"QL Eql Insulin Syringe/0.3ML/31G X 5/16"QL
Easy Comfort Pen Needles 31GX1/4"QL Eql Insulin Syringe/0.5ML/29G X 1/2"QL
Easy Comfort Pen Needles 31GX3/16"QL Eql Insulin Syringe/0.5ML/30G X 5/16"QL
Easy Comfort Pen Needles 31GX5/16"QL Eql Insulin Syringe/0.5ML/31G X 5/16"QL
Easy Comfort Pen Needles 32GX5/32"QL Eql Insulin Syringe/1ML/29G X 1/2"QL
Easy Mini Eject Lancing Device Eql Insulin Syringe/1ML/30G X 5/16"QL
Easy Mini Lancing Device Eql Insulin Syringe/1ML/31G X 5/16"QL
Easy Touch Fliplock Safety Insulin Syringe 1ML/29GX1/2"QL
Eql SHORT Pen Needles 31G X 8MMQL
Eql Ultra Comfort Insulinsyringe/0.3ML/31G X 5/16"QL
Easy Touch Fliplock Safety Insulin Syringe 1ML/30GX1/2"QL
Eql Ultra Comfort Insulinsyringe/1ML/30G X 5/16"QL
Eql Ultra SHORT Pen Needles 31G X 6MMQL
Easy Touch Fliplock Safety Insulin Syringe 1ML/30GX5/16"QL
Excel Comfort Point Insulin Pen Needles 31G X 4MMQL
Exel Comfort Point Insulin Pen Needles 29G X 12MMQL
Easy Touch Fliplock Safety Insulin Syringe 1ML/31GX5/16"QL
Exel Comfort Point Insulin Pen Needles 31G X 6MMQL
Exel Comfort Point Insulin Pen Needles 31G X 8MMQL
Easy Touch Insulin Syringe/Safety/U-100/0.5ML/29G X 1/2"QL
Exel Comfort Point Insulin Syringe/0.3ML/29G X 1/2"QL
Easy Touch Insulin Syringe/Safety/U-100/0.5ML/30G X 5/16"QL
Exel Comfort Point Insulin Syringe/0.3ML/30G X 5/16"QL
Exel Comfort Point Insulin Syringe/0.5ML/28G X 1/2"QL
Easy Touch Insulin Syringe/Safety/U-100/1ML/29G X 1/2"QL
Exel Comfort Point Insulin Syringe/0.5ML/29G X 1/2"QL
Exel Comfort Point Insulin Syringe/0.5ML/30G X 5/16"QL
Easy Touch Insulin Syringe/Safety/U-100/1ML/30G X 1/2"QL
Exel Comfort Point Insulin Syringe/1ML/28G X 1/2"QL
Exel Comfort Point Insulin Syringe/1ML/29G X 1/2"QL
Easy Touch Insulin Syringe/U-100/0.3ML/30G X 1/2"QL
Exel Comfort Point Insulin Syringe/1ML/30G X 5/16"QL
Easy Touch Insulin Syringe/U-100/0.5ML/27G X 1/2"QL
Fifty50 Lancing Device
Easy Touch Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Fifty50 Pen Needles 31G X3/16" (5MM)QL
Easy Touch Insulin Syringe/U-100/0.5ML/30G X 1/2"QL
Fifty50 Pen Needles 31G X5/16" (8MM)QL
Easy Touch Insulin Syringe/U-100/0.5ML/31G X 5/16"QL
Fifty50 Pen Needles 31GX5MMQL
Easy Touch Insulin Syringe/U-100/1ML/27G X 1/2"QL
Fifty50 Pen Needles/31GX8MMQL
Easy Touch Insulin Syringe/U-100/1ML/28G X 1/2"QL
Fifty50 Pen Needles/32GX4MMQL
Easy Touch Insulin Syringe/U-100/1ML/29G X 1/2"QL
Fifty50 Pen Needles/32GX6MMQL
Easy Touch Insulin Syringe/U-100/1ML/30G X 1/2"QL
Fifty50 Superior Comfort Insulin Syringe/0.3ML/31G X 5/16"QL
Easy Touch Insulin Syringe/U-100/1ML/31G X 5/16"QL
Easy Touch Insulin Syringe/0.3ML/30G X 5/16"QL
Fifty50 Superior Comfort Insulin Syringe/0.5ML/31G X 5/16"QL
Easy Touch Insulin Syringe/0.3ML/31G X 5/16"QL
Easy Touch Insulin Syringe/0.5ML/29G X 1/2"QL
Fifty50 Superior Comfort Insulin Syringe/1ML/31G X 5/16"QL
Easy Touch Insulin Syringe/0.5ML/30G X 5/16"QL
Easy Touch Insulin Syringe/1ML/30G X 5/16"QL Fora Lancing Device
Easy Touch Lancing Device/Ejector Fora Lancing Device/Clearcap
Easy Touch Pen Needles 29GX1/2"QL Freds Pharmacy Autolet Lancing Device
Easy Touch Pen Needles 31GX1/4"QL Freds Pharmacy Unifine Pentips Pen Needles 32GX4MMQL
Easy Touch Pen Needles 31GX5/16"QL
Freds Pharmacy Unifine Pentips Plus 31GX5MMQL
Easy Touch Pen Needles 32GX1/4"QL
Freds Pharmacy Unifine Pentips Plus 31GX8MMQL
Easy Touch Pen Needles 32GX3/16"QL
Freestyle Precision Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Easy Touch Pen Needles 32GX5/32"QL
Easy Touch Pen Needles/31G X 3/16"QL
Freestyle Precision Insulin Syringe/U-100/0.5ML/31G X 5/16"QL
Easy Touch Sheathlock Safety Insulin Syringe 1ML/29GX1/2"QL
Freestyle Precision Insulin Syringe/U-100/1ML/31G X 5/16"QL
Easy Touch Sheathlock Safety Insulin Syringe 1ML/30GX5/16"QL
Freestyle Precision Insulin Syringes/U-100/1ML/30G X 5/16"QL
Easy Touch Sheathlock Safety Insulin Syringe 1ML/31GX5/16"QL
Gentle-let Platforms 2.4MM
Easy Touch Sheathlock Safety Syringe 1ML/30GX1/2"QL
Gentle-let Platforms 3.0MM
Easy Touch 32GX5MMQL
Global Ease Inject Pen Needles 29GX12MMQL
Easy Touch 32GX6MMQL
Global Ease Inject Pen Needles 31GX8MMQL
Elite-thin Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Global Ease Inject Pen Needles 32GX4MMQL
Elite-thin Insulin Syringe/U-100/0.5ML/28G X 5/16"QL
Global Ease Inject Pen Neeedles 31GX5MMQL
Elite-thin Insulin Syringe/U-100/0.5ML/29G X 5/16"QL
Global Inject Ease Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Elite-thin Insulin Syringe/U-100/0.5ML/31G X 5/16"QL
Elite-thin Insulin Syringe/U-100/1ML/28G X 1/2"QL
Global Inject Ease Insulin Syringe/U-100/0.3ML/30G X 1/2"QL
Elite-thin Insulin Syringe/U-100/1ML/28G X 5/16"QL
Elite-thin Insulin Syringe/U-100/1ML/29G X 1/2"QL
Global Inject Ease Insulin Syringe/U-100/0.3ML/30G X 5/16"QL
Elite-thin Insulin Syringe/U-100/1ML/31G X 5/16"QL
Elite-thin Insulin Syringe/0.3ML/31G X 5/16"QL Global Inject Ease Insulin Syringe/U-100/0.3ML/31G X 5/16"QL
Elite-thin Insulin Syringe/0.5ML/29G X 1/2"QL
Global Inject Ease Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Elite-thin Insulin Syringe/0.5ML/30G X 5/16"QL
Elite-thin Insulin Syringe/1ML/29G X 5/16"QL
Elite-thin Insulin Syringe/1ML/30G X 5/16"QL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 34
Global Inject Ease Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Healthwise Mini Pen Needles 31GX6MMQL
Healthwise Pen Needles 29GX12MMQL
Global Inject Ease Insulin Syringe/U-100/0.5ML/30G X 1/2"QL
Healthwise SHORT Pen Needles 31GX8MMQL
Healthwise Unifine Pentips Pen Needles 32GX4MMQL
Global Inject Ease Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Healthy Accents Autolet Impression Lancing Device
Healthy Accents Unifine Pentips Pen Needles 29GX12MMQL
Global Inject Ease Insulin Syringe/U-100/0.5ML/31G X 5/16"QL
Healthy Accents Unifine Pentips Pen Needles 31GX5MMQL
Global Inject Ease Insulin Syringe/U-100/1ML/28G X 1/2"QL
Healthy Accents Unifine Pentips Pen Needles 31GX6MMQL
Global Inject Ease Insulin Syringe/U-100/1ML/29G X 1/2"QL
Healthy Accents Unifine Pentips Pen Needles 31GX8MMQL
Global Inject Ease Insulin Syringe/U-100/1ML/30G X 1/2"QL
Healthy Accents Unifine Pentips Pen Needles 32GX4MMQL
Global Inject Ease Insulin Syringe/U-100/1ML/30G X 5/16"QL
Hypolance AST Lancing Kit
Global Inject Ease Insulin Syringe/U-100/1ML/31G X 5/16"QL
Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Global Lancing Device
Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Glucocom Autolink Telemonitoring System
Insulin Syringe/U-100/1ML/28G X 1/2"QL
Glucolet 2 Automatic Lancing Device
Insulin Syringe/U-100/1ML/29G X 1/2"QL
Glucopro Insulin Syringe/U-100/0.3ML/30G X 1/2"QL
Insulin Syringe/U-100/1ML/30G X 5/16"QL
Glucopro Insulin Syringe/U-100/0.3ML/30G X 5/16"QL
Insulin Syringe/U-100/1ML/31G X 5/16"QL
Glucopro Insulin Syringe/U-100/0.3ML/31G X 5/16"QL
Insulin Syringe/0.3ML/29G X 1/2"QL
Glucopro Insulin Syringe/U-100/0.5ML/30G X 1/2"QL
Insulin Syringe/0.3ML/29G X 1"QL
Glucopro Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Insulin Syringe/0.3ML/30G X 5/16"QL
Glucopro Insulin Syringe/U-100/0.5ML/31G X 5/16"QL
Insulin Syringe/0.3ML/31G X 5/16"QL
Glucopro Insulin Syringe/U-100/1ML/30G X 1/2"QL
Insulin Syringe/0.5ML/27G X 1/2"QL
Glucopro Insulin Syringe/U-100/1ML/30G X 5/16"QL
Insulin Syringe/0.5ML/28G X 1/2"QL
Glucopro Insulin Syringe/U-100/1ML/31G X 5/16"QL
Insulin Syringe/0.5ML/29G X 1/2"QL
Glucosource Lancet Device
Insulin Syringe/0.5ML/30G X 1/2"QL
Gmate Lancing Device
Insulin Syringe/0.5ML/30G X 5/16"QL
Gnp Clickfine Pen Needle Universal/31GX5/16"QL
Insulin Syringe/0.5ML/31G X 5/16"QL
Gnp Clickfine Universal Pen Needles 31GX1/4"QL
Insulin Syringe/1ML/28G X 1/2"QL
Gnp Clickfine Universal Pen Needles 31GX5/16"QL
Insulin Syringe/1ML/29G X 1/2"QL
Gnp Insulin Syringe/0.3ML/29G X 1/2"QL
Insulin Syringe/1ML/30G X 5/16"QL
Gnp Insulin Syringe/0.3ML/30G X 5/16"QL
Insulin Syringe/1ML/31G X 5/16"QL
Gnp Insulin Syringe/0.3ML/31G X 5/16"QL
Insupen Pen Needles 32G X4MMQL
Gnp Insulin Syringe/0.5ML/28G X 1/2"QL
Insupen Sensitive 32GX6MMQL
Gnp Insulin Syringe/0.5ML/29G X 1/2"QL
Insupen Sensitive 32GX8MMQL
Gnp Insulin Syringe/0.5ML/30G X 5/16"QL
Insupen Ultrafin 29GX12MMQL
Gnp Insulin Syringe/0.5ML/31G X 5/16"QL
Insupen Ultrafin 30GX8MMQL
Gnp Insulin Syringe/1ML/28G X 1/2"QL
Insupen Ultrafin 31GX6MMQL
Gnp Insulin Syringe/1ML/29G X 1/2"QL
Insupen Ultrafin 31GX8MMQL
Gnp Insulin Syringe/1ML/30G X 5/16"QL
Insupen 33GX4MMQL
Gnp Insulin Syringe/1ML/31G X 5/16"QL
IN Touch Lancing Device
Gnp Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2"QL
Kinray Insulin Syringe Preferred Plus/0.3ML/31G X 5/16"QL
Gnp Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16" SHORTQL
Kinray Insulin Syringe Preferred Plus/0.5ML/31G X 5/16"QL
Gnp Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16" SHORTQL
Kinray Insulin Syringe Preferred Plus/1ML/31G X 5/16"QL
Kinray Insulin Syringe/0.5ML/29G X 1/2"QL
Gnp Ultra Comfort Insulin Syringe/0.5ML/28G X 1/2"QL
Kmart Valu Plus Insulin Syringe/0.3ML/30GQL
Gnp Ultra Comfort Insulin Syringe/0.5ML/29G X 1/2"QL
Kmart Valu Plus Insulin Syringe/0.5ML/29GQL
Gnp Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16" SHORTQL
Kmart Valu Plus Insulin Syringe/0.5ML/30GQL
Kmart Valu Plus Insulin Syringe/1ML/29GQL
Gnp Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16" SHORTQL
Kmart Valu Plus Insulin Syringe/1ML/30GQL
Kroger Insulin Syringe/0.3ML/29G X 1/2"QL
Gnp Ultra Comfort Insulin Syringe/1ML/28G X 1/2"QL
Kroger Insulin Syringe/0.3ML/30G X 5/16"QL
Gnp Ultra Comfort Insulin Syringe/1ML/29G X 1/2"QL
Kroger Insulin Syringe/0.3ML/31G X 5/16"QL
Gnp Ultra Comfort Insulin Syringe/1ML/30G X 5/16" SHORTQL
Kroger Insulin Syringe/0.5ML/29G X 1/2"QL
Kroger Insulin Syringe/0.5ML/30G X 5/16"QL
Gnp Ultra Comfort Insulin Syringe/1ML/31G X 5/16" SHORTQL
Kroger Insulin Syringe/0.5ML/31G X 5/16"QL
H-e-b Incontrol Advanced Lancing Device Kroger Insulin Syringe/1ML/29G X 1/2"QL
H-e-b Incontrol Pen Needles 29GX12MMQL Kroger Insulin Syringe/1ML/30G X 5/16"QL
H-e-b IN Control Pen Needles 31GX5MMQL Kroger Insulin Syringe/1ML/31G X 5/16"QL
H-e-b IN Control Pen Needles 31GX6MMQL Kroger Lancing Device
H-e-b IN Control Pen Needles 31GX8MMQL Kroger Pen Needles 29G X 12MMQL
H-e-b IN Control Pen Needles/Nano/32GX4MMQL Kroger Pen Needles 31G X 8MMQL
H-e-b IN Control Unifine Pentips Plus 31GX5MMQL Kroger Pen Needles 31GX1/4"QL
H-e-b IN Control Unifine Pentips Plus 32GX4MMQL Lancet Device Adjustable
Health Care Lancing Device Lancet Device With Ejector
Healthwise Lancing Pen Lancet Transporter Case
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 35
Lancing Device Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29GX1/2"QL
Lancing Device Adjustable
Monoject Insulin Syringe/Safety/Perm Needle/0.5ML/29G X 1/2"QL
Lanzo
Leader Advanced Lancing Device
Monoject Insulin Syringe/Safety/Perm Needle/1ML/29G X 1/2"QL
Leader Insulin Syringe/0.3ML/29G X 1/2"QL
Leader Insulin Syringe/0.3ML/30G X 5/16"QL
Monoject Insulin Syringe/Softpack/U-100/0.5ML/28G X 1/2"QL
Leader Insulin Syringe/0.3ML/31G X 5/16"QL
Leader Insulin Syringe/0.5ML/28G X 1/2"QL
Monoject Insulin Syringe/Softpack/1ML/27G X 1/2"QL
Leader Insulin Syringe/0.5ML/29G X 1/2"QL
Monoject Insulin Syringe/U-100/0.3ML/30G X 5/16"QL
Leader Insulin Syringe/0.5ML/30G X 5/16"QL
Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Leader Insulin Syringe/0.5ML/31G X 5/16"QL
Monoject Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Leader Insulin Syringe/1ML/28G X 1/2"QL
Monoject Insulin Syringe/U-100/1ML/28G X 1/2"QL
Leader Insulin Syringe/1ML/29G X 1/2"QL
Monoject Insulin Syringe/U-100/1ML/30G X 5/16"QL
Leader Insulin Syringe/1ML/30G X 5/16"QL
Monoject Insulin Syringe/1MLQL
Leader Insulin Syringe/1ML/31G X 5/16"QL
Monoject Insulin Syringe/1ML/31G X 5/16"QL
Leader Unifine Pentips Plus/Mini/31GX3/16"QL
Monoject Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2"QL
Leader Unifine Pentips Plus/SHORT/31GX5/16"QL
Leader Unifine Pentips/Mini/31GX3/16"QL Monoject Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16"QL
Leader Unifine Pentips/Nano/32GX5/32"QL
Monoject Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16"QL
Leader Unifine Pentips/Plus/32GX5/32"QL
Lite Touch Lancing Device
Monoject Ultra Comfort Insulin Syringe/0.5ML/28G X 1/2"QL
Lite Touch Lancing Pen
Lite Touch Pen Needles/31G X 3/16"QL
Monoject Ultra Comfort Insulin Syringe/0.5ML/29G X 1/2"QL
Litetouch Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Litetouch Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Monoject Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16"QL
Litetouch Insulin Syringe/U-100/1ML/28G X 1/2"QL
Litetouch Insulin Syringe/U-100/1ML/29G X 1/2"QL Monoject Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16"QL
Litetouch Insulin Syringe/U-100/1ML/31G X 5/16"QL
Monoject Ultra Comfort Insulin Syringe/1ML/28G X 1/2"QL
Litetouch Insulin Syringe/0.3ML/29G X 1/2"QL
Monoject Ultra Comfort Insulin Syringe/1ML/29G X 1/2"QL
Litetouch Insulin Syringe/0.3ML/30G X 5/16"QL
Monoject Ultra Comfort Insulin Syringe/1ML/30G X 5/16"QL
Litetouch Insulin Syringe/0.3ML/31G X 5/16"QL
Monojector End CAPS
Litetouch Insulin Syringe/0.5ML/30G X 5/16"QL
Monojector Opd End CAPS
Litetouch Insulin Syringe/0.5ML/31G X 5/16"QL
Moore MED Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Litetouch Insulin Syringe/1ML/30G X 5/16"QL
Litetouch Pen Needles 29GX12.7MMQL
Moore MED Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Litetouch Pen Needles 31G X 6MMQL
Litetouch Pen Needles 31GX8MM SHORTQL
Moore MED Monoject Insulin Syringe/U-100/1ML/28G X 1/2"QL
Live Better Advanced Lancing Device
Live Better Pen Needles 29G X 12MMQL
Moore MED Monoject Insulin Syringe/U-100/1ML/29G X 1/2"QL
Live Better Pen Needles 31G X 12MMQL
Live Better Pen Needles 31G X 6MMQL Multi-lancet Device
Longs Insulin Syringe/0.5ML/31G X 5/16"QL Multi-lancet Device 2
Magellan Insulin Safety Syringe/U-100/0.3ML/29G X 1/2"QL
MS Insulin Syringe/0.3ML/29G X 1/2"QL
MS Insulin Syringe/0.3ML/30G X 5/16"QL
Magellan Insulin Safety Syringe/U-100/0.3ML/30G X 5/16"QL
MS Insulin Syringe/0.3ML/31G X 5/16"QL
MS Insulin Syringe/0.5ML/29G X 1/2"QL
Magellan Insulin Safety Syringe/U-100/0.5ML/29G X 1/2"QL
MS Insulin Syringe/0.5ML/30G X 5/16"QL
MS Insulin Syringe/0.5ML/31G X 5/16"QL
Magellan Insulin Safety Syringe/U-100/0.5ML/30G X 5/16"QL
MS Insulin Syringe/1ML/29G X 1/2"QL
MS Insulin Syringe/1ML/30G X 5/16"QL
Magellan Insulin Safety Syringe/U-100/1ML/29G X 1/2"QL
MS Insulin Syringe/1ML/31G X 5/16"QL
Magellan Insulin Safety Syringe/U-100/1ML/30G X 5/16"QL
Nova Sureflex Lancing Device
Maxi-comfort Insulin Syringe/U-100/0.5ML/28GX1/2"QL
Novofine Autocover 30GX8MMQL
Maxi-comfort Insulin Syringe/U-100/1ML/28GX1/2"QL
Novofine Plus 32GX4MMQL
Medic Insulin Syringe/0.3ML/30G X 5/16"QL
Novofine 30GX8MMQL
Medic Insulin Syringe/0.5ML/30G X 5/16"QL
Novofine 32GX6MMQL
Medicine Shoppe Pen Needles 29G X 12MMQL
Novotwist 30GX8MMQL
Medicine Shoppe Pen Needles 31G X 6MMQL
Novotwist 32GX5MMQL
Medicine Shoppe Pen Needles 31G X 8MMQL
On Call Lancing Device
Meijer Pen Needles 29G X 12MMQL
On Call Plus Lancing Device
Meijer Pen Needles 31G X 6MMQL
Pen Needles 29G X 12MMQL
Meijer Pen Needles 31G X 8MMQL
Pen Needles 29GX1/2"QL
Mini Lancing Device
Pen Needles 30GX5/16"QL
Monoject Insulin Syringe Regular LUER Tip/Softpack/1MLQL
Pen Needles 31G X 1/4" SHORTQL
Monoject Insulin Syringe/Detach Needle/1ML/25G X 5/8"QL Pen Needles 31G X 3/16"QL
Monoject Insulin Syringe/Detach Needle/1ML/27G X 1/2"QL Pen Needles 31G X 5MMQL
Monoject Insulin Syringe/Perm Needle/U-100/0.5ML/28G X 1/2"QL
Pen Needles 31G X 6MMQL
Pen Needles 31GX5/16"QL
Monoject Insulin Syringe/Perm Needle/1ML/28G X 1/2"QL
Pen Needles 31GX8MMQL
Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29G X 1/2"QL
Pen Needles 32GX4MMQL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 36
Pentips 31GX5MMQL Ra Pen Needles 31G X 5MM 3/16"QL
Pentips 31GX8MMQL Ra Pen Needles 31G X 8MM 5/16"QL
Pentips 32GX4MMQL Reality Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Precision Sure-dose Insulin Syringe/0.3ML/30G X 5/16"QL Reality Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Precision Sure-dose Insulin Syringe/0.5ML/28G X 1/2"QL Reality Insulin Syringe/U-100/1ML/28G X 1/2"QL
Precision Sure-dose Insulin Syringe/0.5ML/29G X 1/2"QL Reality Insulin Syringe/U-100/1ML/29G X 1/2"QL
Precision Sure-dose Insulin Syringe/0.5ML/30G X 3/8"QL Relion Insulin Syringe/U -100/0.5ML/29GQL
Precision Sure-dose Insulin Syringe/1ML/28G X 1/2"QL Relion Insulin Syringe/U-00/1ML/29G X 1/2"QL
Precision Sure-dose Plus Insulin Syringe/0.3ML/29G X 1/2"QL
Relion Insulin Syringe/U-100/0.3ML/29GQL
Relion Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Precision Sure-dose Plus Insulin Syringe/1ML/29G X 1/2"QL
Relion Insulin Syringe/U-100/0.3ML/30GQL
Relion Insulin Syringe/U-100/0.3ML/30G X 5/16"QL
Preferred Plus Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Relion Insulin Syringe/U-100/0.3ML/31G X 5/16"QL
Preferred Plus Insulin Syringe/U-100/0.3ML/30G X 5/16"QL
Relion Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Preferred Plus Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Relion Insulin Syringe/U-100/0.5ML/30GQL
Preferred Plus Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Relion Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Preferred Plus Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Relion Insulin Syringe/U-100/0.5ML/31G X 5/16"QL
Preferred Plus Insulin Syringe/U-100/1ML/28G X 1/2"QL
Relion Insulin Syringe/U-100/1ML/30GQL
Preferred Plus Insulin Syringe/U-100/1ML/29G X 1/2"QL
Relion Insulin Syringe/U-100/1ML/30G X 5/16"QL
Preferred Plus Insulin Syringe/U-100/1ML/30G X 5/16"QL
Relion Insulin Syringe/U-100/1ML/31G X 5/16"QL
Preferred Plus Unifine Pentips 29G X 12MMQL
Relion Lancing Device
Preferred Plus Unifine Pentips 31G X 6MM Ultra SHORTQL
Relion Mini Pen Needles 31GX6MMQL
Relion Pen Needles 29GX12MMQL
Preferred Plus Unifine Pentips 31G X 8MM SHORTQL
Relion Pen Needles 31GX8MMQL
Preferred Plus Unifine Pentips 32GX4MMQL
Relion Pen Needles 32GX4MMQL
Preferred Plus Unifine Pentips/Mini/31GX5MMQL
Relion SHORT Pen Needles 31GX8MMQL
Prodigy Insulin Mini Pen Needles/31G X 3/16"QL
Relion 2-IN-1 Lancing Device 25G
Prodigy Insulin Pen Needles/29G X 1/2"QL
Relion 2-IN-1 Lancing Device 30G
Prodigy Insulin Syring/U-100/0.3ML/31G X 5/16"QL
Renew Advanced Lancing Device
Prodigy Insulin Syringe/1/2ML/31G X 5/16"QL
Rightest GD-L500 Alternate Site Adapter
Prodigy Insulin Syringe/1ML/28G X 1/2"QL
Rightest GD500 Lancing Device
Prodigy Insulin SHORT Penneedles/31G X 5/16"QL
Safesnap Insulin Syringe/0.3ML/30G X 5/16"QL
Prodigy Lancing Device
Safesnap Insulin Syringe/0.5ML/29G X 1/2"QL
Pss Select Platforms
Safesnap Insulin Syringe/0.5ML/30G X 5/16"QL
Px Advanced Lancing Device
Safesnap Insulin Syringe/1ML/28G X 1/2"QL
Px Extra SHORT Pen Needles 31GX6MMQL
Safesnap Insulin Syringe/1ML/29G X 1/2"QL
Px Insulin Syringe/U-100/0.3ML/30G X 1/2"QL
Schnucks Insulin Syringe Ulti-fine/U-100/0.5ML/29G X 1/2"QL
Px Insulin Syringe/U-100/0.3ML/31G X 5/16"QL
Px Insulin Syringe/U-100/0.5ML/30G X 1/2"QL
Schnucks Insulin Syringe Ulti-fine/U-100/0.5ML/30G X 5/16"QL
Px Insulin Syringe/U-100/0.5ML/31G X 5/16"QL
Px Insulin Syringe/U-100/1ML/30G X 1/2"QL
Select-lite Device/Lancets
Px Insulin Syringe/U-100/1ML/31G X 5/16"QL
Select-lite Lancing Device
Px Lancet Auto Injector
Shopko Autolet Lancing Device
Px Mini Pen Needles 31GX5MMQL
Shopko Unifine Pentips Pen Needles/Micro/32GX4MMQL
Px Pen Needle 29GX12MMQL
Shopko Unifine Pentips Pen Needles/Mini/31GX5MMQL
Px Pen Needle 31GX8MMQL
Shopko Unifine Pentips Pen Needles/Original/29GX12MMQL
Px Shortlength Pen Needles/31GX8MMQL
PC Unifine Pentips 29G X 1/2"QL Shopko Unifine Pentips Pen Needles/SHORT/31GX8MMQL
PC Unifine Pentips 31G X 5MM MiniQL
Simple Diagnostics Lancing Device
PC Unifine Pentips 31G X 6MM Ultra SHORTQL
Sm Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
PC Unifine Pentips 31G X 8MM SHORTQL
Sm Insulin Syringe/U-100/0.3ML/30G X 5/16"QL
Qc Advanced Lancing Device
Sm Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Qc Insulin Syringe 0.5ML/29GQL
Sm Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Qc Insulin Syringe 0.5ML/30GQL
Sm Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Qc Insulin Syringe 1ML/29GQL
Sm Insulin Syringe/U-100/1ML/28G X 1/2"QL
Qc Insulin Syringe/0.3ML/29GQL
Sm Insulin Syringe/U-100/1ML/29G X 1/2"QL
Qc Insulin Syringe/0.3ML/29G X 1/2"QL
Sm Insulin Syringe/U-100/1ML/30G X 5/16"QL
Qc Insulin Syringe/0.5ML/29G X 1/2"QL
Sm Insulin Syringe/0.3ML/31G X 5/16"QL
Qc Insulin Syringe/0.5ML/31G X 5/16"QL
Sm Insulin Syringe/0.5ML/31G X 5/16"QL
Qc Insulin Syringe/1ML/29G X 1/2"QL
Sm Insulin Syringe/1ML/31G X 5/16"QL
Qc Insulin Syringe/1ML/30GQL
Smart Diabetes Vantage Lancing Device
Qc Insulin Syringe/1ML/31G X 5/16"QL
Solus V2 Lancing Device
Qc Pen Needles 29G X 12MMQL
Sterilance PA
Qc Pen Needles 31G X 6MMQL
Supreme II Confidence Paddles
Qc Pen Needles 31G X 8MMQL
Sure Comfort Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Qc Unifine Pentips 32GX4MMQL
Sure Comfort Insulin Syringe/U-100/0.3ML/30G X 1/2"QL
Ra Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Sure Comfort Insulin Syringe/U-100/0.3ML/30G X 5/16"QL
Ra Insulin Syringe/U-100/1 ML/30G X 5/16"QL
Sure Comfort Insulin Syringe/U-100/0.3ML/31G X 5/16QL
Ra Insulin Syringe/0.5ML/29G X 1/2"QL
Sure Comfort Insulin Syringe/U-100/0.3ML/31G X 5/16"QL
Ra Insulin Syringe/1ML/29G X 1/2"QL
Sure Comfort Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Ra Lancing Device
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 37
Sure Comfort Insulin Syringe/U-100/0.5ML/29G X 1/2"QL Todays Health Advanced Lancing Device
Sure Comfort Insulin Syringe/U-100/0.5ML/30G X 1/2"QL Todays Health Mini Pen Needles 31G X 1/4"QL
Sure Comfort Insulin Syringe/U-100/0.5ML/30G X 5/16"QL Todays Health Original Pen Needles 29G X 1/2"QL
Sure Comfort Insulin Syringe/U-100/0.5ML/31G X 5/16QL Todays Health SHORT Pen Needles 31G X 5/16"QL
Sure Comfort Insulin Syringe/U-100/1ML/28G X 1/2"QL Topcare Clickfine Universal Pen Eedles 31GX1/4"QL
Sure Comfort Insulin Syringe/U-100/1ML/29G X 1/2"QL Topcare Clickfine Universal Pen Eedles 31GX5/16"QL
Sure Comfort Insulin Syringe/U-100/1ML/30G X 1/2"QL Topcare Ultra Comfort Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Sure Comfort Insulin Syringe/U-100/1ML/30G X 5/16"QL
Topcare Ultra Comfort Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Sure Comfort Insulin Syringe/U-100/1ML/31G X 5/16"QL
Sure Comfort Lancing Pen
Topcare Ultra Comfort Insulin Syringe/U-100/1ML/29G X 1/2"QL
Sure Comfort Pen Needles 29GX1/2" 12.7MMQL
Sure Comfort Pen Needles 30GX5/16" SHORTQL
Topcare Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16"QL
Sure Comfort Pen Needles 31GX3/16" (5MM)QL
Sure Comfort Pen Needles 31GX5/16" (8MM)QL
Topcare Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16"QL
Sure Comfort Pen Needles 32GX5/32"QL
Sure Comfort Pen Needles 32GX6MMQL Topcare Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16"QL
Sure-fine Pen Needles 29GX1/2" 12.7MMQL
Topcare Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16"QL
Sure-fine Pen Needles 31GX3/16" 5MMQL
Sure-fine Pen Needles 31GX5/16" 8MMQL
Topcare Ultra Comfort Insulin Syringe/1ML/30G X 5/16"QL
Sure-ject Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Topcare Ultra Comfort Insulin Syringe/1ML/31G X 5/16"QL
Sure-ject Insulin Syringe/U-100/0.3ML/30G X 5/16"QL
Topco Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Sure-ject Insulin Syringe/U-100/0.3ML/31G X 5/16"QL
Topco Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Sure-ject Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Topco Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Sure-ject Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Topco Insulin Syringe/U-100/1ML/28G X 1/2"QL
Sure-ject Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Topco Insulin Syringe/U-100/1ML/29G X 1/2"QL
Sure-ject Insulin Syringe/U-100/0.5ML/31G X 5/16"QL
Tracer II 3 Volt Battery
Sure-ject Insulin Syringe/U-100/1ML/28G X 1/2"QL
Truedraw Lancing Device
Sure-ject Insulin Syringe/U-100/1ML/29G X 1/2"QL
Trueplus Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Sure-ject Insulin Syringe/U-100/1ML/30G X 5/16"QL
Trueplus Insulin Syringe/U-100/0.3ML/30G X 5/16"QL
Sure-ject Insulin Syringe/U-100/1ML/31G X 5/16"QL
Trueplus Insulin Syringe/U-100/0.3ML/31G X 5/16"QL
Sure-pen
Trueplus Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
SB Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Trueplus Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
SB Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Trueplus Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
SB Insulin Syringe/U-100/1ML/29G X 1/2"QL
Trueplus Insulin Syringe/U-100/0.5ML/31G X 5/16"QL
SB Insulin Syringe/U-100/1ML/30G X 5/16"QL
Trueplus Insulin Syringe/U-100/1ML/28G X 1/2"QL
SB Insulin Syringe/U-100/1ML/31G X 5/16"QL
Trueplus Insulin Syringe/U-100/1ML/29G X 1/2"QL
Techlite Pen Needles/31G X 5MMQL
Trueplus Insulin Syringe/U-100/1ML/30G X 5/16"QL
Techlite Pen Needles/31G X 6 MMQL
Trueplus Insulin Syringe/U-100/1ML/31G X 5/16"QL
Techlite Pen Needles/31G X 8MMQL
Ulti-lance Automatic/ Clear Tip
Techlite Pen Needles/32G X 4MMQL
Ulticare Insulin Safety Syringe/0.5ML/29G X 1/2"QL
Techlite Pen Needles/32G X 6MMQL
Ulticare Insulin Safety Syringe/1ML/29G X 1/2"QL
Techlite Pen Needles/32G X 8MMQL
Ulticare Insulin Syringe Ultrafine U-100/0.3ML/31G X 5/16"QL
Terumo Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Terumo Insulin Syringe/U-100/0.5ML/27G X 1/2"QL
Ulticare Insulin Syringe Ultrafine U-100/0.5ML/31G X 5/16"QL
Terumo Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Terumo Insulin Syringe/U-100/1ML/28G X 1/2"QL
Ulticare Insulin Syringe Ultrafine U-100/1ML/31G X 5/16"QL
Terumo Insulin Syringe/0.3ML/30G X 3/8"QL
Ulticare Insulin Syringe 1CC/28G U-100 1/2"QL
Terumo Insulin Syringe/0.5ML/29G X 1/2"QL
Ulticare Insulin Syringe/SHORT/0.3ML/30G X 5/16"QL
Terumo Insulin Syringe/0.5ML/30G X 3/8"QL
Ulticare Insulin Syringe/SHORT/0.3ML/31G X 5/16"QL
Terumo Insulin Syringe/1ML/27G X 1/2"QL
Ulticare Insulin Syringe/SHORT/0.5ML/30G X 5/16"QL
Terumo Insulin Syringe/1ML/29G X 1/2"QL
Ulticare Insulin Syringe/SHORT/0.5ML/31G X 5/16"QL
Terumo Insulin Syringe/1ML/30G X 3/8"QL
Ulticare Insulin Syringe/SHORT/1ML/30G X 5/16"QL
Terumo Surguard Insulin Syringe/0.3ML/29G X 1/2"QL
Ulticare Insulin Syringe/SHORT/1ML/31G X 5/16"QL
Terumo Surguard Insulin Syringe/0.5ML/28G X 1/2"QL
Ulticare Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Terumo Surguard Insulin Syringe/0.5ML/29G X 1/2"QL
Ulticare Insulin Syringe/U-100/0.3ML/30G X 1/2"QL
Terumo Surguard Insulin Syringe/1ML/28G X 1/2"QL
Ulticare Insulin Syringe/U-100/0.3ML/30G X 5/16"QL
Terumo Surguard Insulin Syringe/1ML/29G X 1/2"QL
Ulticare Insulin Syringe/U-100/0.3ML/31G X 5/16"QL
Tgt Advanced Lancing Device
Ulticare Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Tgt Lancing Device
Ulticare Insulin Syringe/U-100/0.5ML/30G X 1/2"QL
Thinpro Insulin Syringe/0.3ML/29G X 1/2"QL
Ulticare Insulin Syringe/U-100/0.5ML/30G X 5/16"QL
Thinpro Insulin Syringe/0.3ML/30G X 3/8"QL
Ulticare Insulin Syringe/U-100/0.5ML/31G X 5/16"QL
Thinpro Insulin Syringe/0.3ML/31G X 3/8"QL
Ulticare Insulin Syringe/U-100/1ML/29G X 1/2"QL
Thinpro Insulin Syringe/0.5ML/28G X 1/2"QL
Ulticare Insulin Syringe/U-100/1ML/30G X 1/2"QL
Thinpro Insulin Syringe/0.5ML/29G X 1/2"QL
Ulticare Insulin Syringe/U-100/1ML/30G X 5/16"QL
Thinpro Insulin Syringe/0.5ML/30G X 3/8"QL
Ulticare Insulin Syringe/U-100/1ML/31G X 5/16"QL
Thinpro Insulin Syringe/0.5ML/31G X 3/8"QL
Ulticare Insulin Syringe/0.3ML/29G X 1/2"QL
Thinpro Insulin Syringe/1ML/28G X 1/2"QL
Ulticare Insulin Syringe/0.3ML/30G X 1/2"QL
Thinpro Insulin Syringe/1ML/29G X 1/2"QL
Ulticare Insulin Syringe/0.3ML/30G X 5/16"QL
Thinpro Insulin Syringe/1ML/30G X 3/8"QL
Ulticare Insulin Syringe/0.5ML/28G X 1/2"QL
Thinpro Insulin Syringe/1ML/31G X 3/8"QL
Ulticare Insulin Syringe/0.5ML/29G X 1/2"QL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 38
Ulticare Insulin Syringe/0.5ML/30G X 1/2"QL Unifine Pentips Plus 31GX6MMQL
Ulticare Insulin Syringe/0.5ML/30G X 5/16"QL Unifine Pentips Plus 31GX8MMQL
Ulticare Insulin Syringe/1ML/28G X 1/2"QL Unifine Pentips Plus 32GX4MMQL
Ulticare Insulin Syringe/1ML/29G X 1/2"QL Unifine Pentips 29GX12MMQL
Ulticare Insulin Syringe/1ML/30G X 1/2"QL Unifine Pentips 31G X 3/16"QL
Ulticare Insulin Syringe/1ML/30G X 5/16"QL Unifine Pentips 31G X 6MMQL
Ulticare Micro Pen Needles 31G X 8MMQL Unifine Pentips 31G X 8MMQL
Ulticare Micro Pen Needles 32G X 4MMQL Unifine Pentips 31GX5MMQL
Ulticare Micro Pen Needles/31G X 8MMQL Unifine Pentips 31GX6MMQL
Ulticare Micro Pen Needles/32G X 4MMQL Unifine Pentips 31GX8MMQL
Ulticare Mini Pen Needles Ulti-fine IVQL Unifine Pentips 32GX4MMQL
Ulticare Mini Pen Needles 31GX6MMQL Unistik CZT Comfort
Ulticare Mini Pen Needles/31G X 6MMQL Unistik CZT Normal
Ulticare Mini Pen Needles31GX6MMQL Unistik 1
Ulticare Original Pen Needles Ulti-fineQL Unistik 2
Ulticare Pen Needles/29G X 12.7MMQL Unistik 2 Comfort
Ulticare SHORT Pen Needles Ulti-fine IVQL Unistik 2 Extra
Ulticare SHORT Pen Needles 31GX8MMQL Unistik 2 Neonatal
Ulticare SHORT Pen Needles/31G X 8MMQL Unistik 2 Normal
Ulticare U-100 Insulin Syringes/0.3ML/31G X 1/4"QL Unistik 2 Super
Ulticare U-100 Insulin Syringes/0.3ML/31G X1/4"QL Unistik 3
Ulticare U-100 Insulin Syringes/0.5ML/31G X 1/4"QL Unistik 3 Comfort
Ulticare U-100 Insulin Syringes/1ML/31G X 1/4"QL Unistik 3 Extra
Ultiguard Insulin Syringe/U-100/0.3ML/29G X 1/2"QL Unistik 3 Neonatal
Ultiguard Insulin Syringe/U-100/0.3ML/30G X 5/16"QL Unistik 3 Normal
Ultiguard Insulin Syringe/U-100/0.5ML/29G X 1/2"QL Urin-tek
Ultiguard Insulin Syringe/U-100/0.5ML/30G X 5/16"QL V-r Monoject Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Ultiguard Insulin Syringe/U-100/1ML/29G X 1/2"QL V-r Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2"QL
Ultiguard Insulin Syringe/U-100/1ML/30G X 5/16"QL V-r Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Ultilet Insulin Syringe/SHORT/0.3ML/30G X 5/16"QL V-r Monoject Insulin Syringe/U-100/1ML/28G X 1/2"QL
Ultilet Insulin Syringe/SHORT/0.3ML/31G X 5/16"QL V-r Monoject Insulin Syringe/U-100/1ML/29G X 1/2"QL
Ultilet Insulin Syringe/SHORT/0.5ML/30G X 5/16"QL Value Health Insulin Syringe/U-100/0.5ML/29G X 1/2"QL
Ultilet Insulin Syringe/SHORT/0.5ML/31G X 5/16"QL Value Health Insulin Syringe/U-100/1ML/29G X 1/2"QL
Ultilet Insulin Syringe/SHORT/1ML/30G X 5/16"QL Value Plus Lancing Device
Ultilet Insulin Syringe/SHORT/1ML/31G X 5/16"QL Valumark Pen Needles 29GX12MMQL
Ultilet Pen Needle 32GX4MM/SHORTQL Valumark Pen Needles 31G X 6MMQL
Ultilet SHORT Pen Needles 31GX5/16"QL Valumark Pen Needles 31G X 8MMQL
Ultilet SHORT Pen Needles31GX3/16"QL Vanishpoint Insulin Syringe/0.5ML/30G X 1/2"QL
Ultra Comfort Insulin Syringe/U-100/0.3ML/30G X 5/16"QL Vanishpoint Insulin Syringe/1ML/29G X 1/2"QL
Ultra Comfort Insulin Syringe/U-100/0.5ML/28G X 1/2"QL Vida Mia Autolet Lancing Device
Ultra-comfort Insulin Syringe/U-100/0.3ML/29G X 1/2"QL Vida Mia Unifine Pentips Mini 31GX6MMQL
Ultra-comfort Insulin Syringe/U-100/0.3ML/30G X 5/16"QL Vida Mia Unifine Pentips Original 29GX12MMQL
Ultra-comfort Insulin Syringe/U-100/0.3ML/31G X 5/16"QL Vida Mia Unifine Pentips 32GX4MMQL
Ultra-comfort Insulin Syringe/U-100/0.5ML/28G X 1/2"QL Vida Mia Unipfine Pentipsshort 31GX8MMQL
Ultra-comfort Insulin Syringe/U-100/0.5ML/29G X 1/2"QL Vp Insulin Syringe/U-100/0.3ML/29G X 1/2"QL
Ultra-comfort Insulin Syringe/U-100/0.5ML/30G X 5/16"QL Wd Medic Insulin Syringe/0.3ML/29G X 1/2"QL
Ultra-comfort Insulin Syringe/U-100/0.5ML/31G X 5/16"QL Wd Medic Insulin Syringe/0.3ML/30G X 5/16"QL
Ultra-comfort Insulin Syringe/U-100/1ML/28G X 1/2"QL Wd Medic Insulin Syringe/0.5ML/29G X 1/2"QL
Ultra-comfort Insulin Syringe/U-100/1ML/29G X 1/2"QL Wd Medic Insulin Syringe/0.5ML/30G X 5/16"QL
Ultra-comfort Insulin Syringe/U-100/1ML/30G X 5/16"QL Wd Medic Insulin Syringe/1ML/29G X 1/2"QL
Ultra-comfort Insulin Syringe/U-100/1ML/31G X 5/16"QL Wd Medic Insulin Syringe/1ML/30G X 5/16"QL
Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/30GX5/16"QL
Wegmans Unifine Pentips Plus 32GX4MMQL
Wegmans Unifine Pentips Plus/Mini/31GX5MMQL
Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/31GX5/16"QL
Wegmans Unifine Pentips Plus/SHORT/31GX8MMQL
Wegmans Unifine Pentips Plus/Ultra SHORT/31GX6MMQL
Ultra-thin II Insulin Syringe SHORT/U-100/0.5ML/30GX5/16"QL
1ST Tier Unifine Pentips /Mini/31GX5MMQL
1ST Tier Unifine Pentips Plus 31GX8MMQL
Ultra-thin II Insulin Syringe SHORT/U-100/0.5ML/31GX5/16"QL
1ST Tier Unifine Pentips Plus 32GX4MMQL
1ST Tier Unifine Pentips Plus/Mini/31GX5MMQL
Ultra-thin II Insulin Syringe SHORT/U-100/1ML/30GX5/16"QL
1ST Tier Unifine Pentips Plus/Original/29GX12MMQL
Ultra-thin II Insulin Syringe SHORT/U-100/1ML/31GX5/16"QL
1ST Tier Unifine Pentips Plus/Ultra SHORT/31GX6MMQL
1ST Tier Unifine Pentips 29GX12MMQL
Ultra-thin II Insulin Syringe/U-100/0.3ML/29GX1/2"QL
1ST Tier Unifine Pentips 31GX6MMQL
Ultra-thin II Insulin Syringe/U-100/0.5ML/29GX1/2"QL
1ST Tier Unifine Pentips 31GX8MMQL
Ultra-thin II Insulin Syringe/U-100/1ML/29GX1/2"QL
1ST Tier Unifine Pentips 32GX4MMQL
Ultra-thin II Mini Pen Neeedles/31GX3/16"QL
Ultra-thin II Pen Needles 29GX1/2"QL
MEDICAL DEVICES - MISC
Ultra-thin II Pen Needles/SHORT/31GX5/16"QL
PREFERRED
Ultralance
Aerochamber Mini Aerosol ChamberQL
Unifine Pentips Plus 29GX12MMQL
Unifine Pentips Plus 31GX5MMQL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 39
Aerochamber MVQL MicrospacerQL
Aerochamber Plus Flow VUQL Nessi Spacer/Large MaskQL
Aerochamber Plus Flow-VUQL Nessi Spacer/MouthpieceQL
Aerochamber Plus Flow-VU/Large MaskQL Nessi Spacer/Small/MED MaskQL
Aerochamber Plus Flow-VU/MaskQL Optichamber AdvantageQL
Aerochamber Plus Flow-VU/Medium MaskQL Optichamber DiamondQL
Aerochamber Plus Flow-VU/Small MaskQL Optichamber Diamond/Largeface MaskQL
Aerochamber Z-stat Plus Valved Holding Chamber W/Flow VUQL
Optichamber Diamond/Medium Face MaskQL
Optichamber Diamond/Smallface MaskQL
Aerochamber Z-stat Plus/FlowsignalQL
OptihalerQL
Aerochamber Z-stat Plus/Large MaskQL
Optihaler MDI Drug Delivery SystemQL
Aerochamber Z-stat Plus/Medium MaskQL
Panda Mask Large
Aerochamber Z-stat Plus/Small MaskQL
Panda Mask Medium
Aerochamber/FlowsignalQL
Panda Mask Small
Aerovent Plus Holding Chamber/CollapsibleQL
Pediatric Panda Mask
Alcoh-glove Contoured Wipe
Pharmacist Choice Alcoholprep Pads
Alcoh-wipe 12" X 12"
Pocket ChamberQL
Alcohol Pads
Pocket SpacerQL
Alcohol Prep Pads
Qc Alcohol Swabs
Alcohol Preps
Ra Alcohol Swabs
Alcohol Swabs
Reality Swabs
Alcohol Swabstick
Relion Alcohol Swabs
Alcohol Wipes
RitefloQL
Arial ChamberQL
Saps Care Alcohol Prep Pads
BreatheriteQL
Shopko Alcohol Swabs
Breatherite Collapsible Adult Spacer W/MaskQL
Sm Alcohol Prep Pads
Breatherite Collapsible Child Spacer W/MaskQL
Sure Comfort Alcohol Prep Pads
Breatherite Collapsible Infant Spacer W/MaskQL
Sure-prep Alcohol Prep Pads
Breatherite Collapsible Small Child Spacer W/MaskQL
SB Alcohol Prep Pads
Breatherite Collapsible Spacer W/ Neonate MaskQL
Tgt Alcohol Swabs
Breatherite Rigid Spacer W/MaskQL
Valved Holding ChamberQL
Breatherite W/Large MaskQL
Vortex Valved Holding ChamberQL
Breatherite W/Medium MaskQL
WatchhalerQL
Breatherite W/Small MaskQL
Webcol Alcohol Prep Large 1 Ply
BD Swabs Single Use
Webcol Alcohol Prep Large 2 Ply
BD Swabs Single Use Butterfly
Webcol Alcohol Prep Medium 2 Ply
Curity Alcohol Preps/Medium 2 Ply
Curity Alcohol Swabs
MISCELLANEOUS
CVS Alcohol Prep Swabs
CVS Alcohol Swabs
GENERIC
CVS Prep Pads
acetylcysteine
E-z SpacerQL
adenosine
E-z Spacer The Body Guards PackQL
alprostadil
EasiventQL
aminorelief rms
Easivent/Mask-largeQL
aminosyn II 8.5%/electrolytes
Easivent/Mask-mediumQL
aminosyn 8.5%/electrolytes
Easivent/Mask-smallQL
argyle sterile water 100ML
Easy Touch Alcohol Prep Pads/Medium
calcium chloride
Fifty50 Alcohol Prep Pads
calcium gluconate
FlexichamberQL
chloromag
Flexichamber Adult Mask/Small
clinisol SF 15%
Flexichamber Child Mask/Large
cosyntropin
Flexichamber Child Mask/Small
cysteine HCL
Global Alcohol Prep Ease Pads
deferoxamine mesylate
Gnp Alcohol Swabs
dehydrated alcohol
Healthwise Alcohol Prep Pads
delflex-lm/1.5% dextrose
Inspirachamber/Anti-static Valved/MouthpieceQL
dextrose 10%
Inspirachamber/LargeQL
dextrose 10% flex container
Inspirachamber/Soothermask/Inspiramask/MediumQL
dextrose 2.5%/sodium chloride 0.45%
Inspirachamber/Soothermask/Inspiramask/SmallQL
dextrose 2.5%/NACL 0.45%
Inspirease Bags
dextrose 30% partial fill
Inspirease Drug Delivery SystemQL
dextrose 5%
Inspirease Mouthpiece
dextrose 5% viaflex
Inspirease Reservoir Bags
dextrose 5%/lactated ringers
LiteaireQL
dextrose 5%/potassium chloride 0.15%
Mask Vortex/Baby Whirl Duckling
dextrose 5%/ringers
Mask Vortex/Child/Frog
dextrose 5%/sodium chloride 0.2%
Mask Vortex/Spinner The Duck
dextrose 5%/sodium chloride 0.33%
Mask Vortex/Toddler/Lady Bug
dextrose 5%/sodium chloride 0.45%
Meijer Alcohol Swabs Extra-thick
MicrochamberQL
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 40
dextrose 5%/sodium chloride 0.9% potassium chloride 0.15% D5W/NACL 0.45%
dextrose 5%/NACL 0.2% potassium chloride 0.15% D5W/NACL 0.45% viaflex
dextrose 5%/NACL 0.33% potassium chloride 0.15% NACL 0.9%
dextrose 5%/NACL 0.45% potassium chloride 0.15%/D5W
dextrose 5%/NACL 0.9% potassium chloride 0.15%/NACL 0.9%
dextrose 50% potassium chloride 0.22% D5W/NACL 0.45%
dextrose 70% potassium chloride 0.224%/D5W/NACL 0.45%
dipyridamole potassium chloride 0.224%D5W/NACL 0.45% viaflex
effer-k potassium chloride 0.3%/ NACL 0.9%
effervescent pot chloride potassium chloride 0.3%/D5W
effervescent potassium potassium chloride 0.3%/NACL 0.9%/viaflex
effervescent potassium/chloride potassium phosphate
flumazenil potassium phosphates
fomepizole premasol
formadon ringers injection
formaldehyde ringers irrigation
indigo carmine saline flush
indocyanine green saline flush zr/sterile field
intralipid sodium acetate
isolyte-m/dextrose 5% sodium bicarbonate
isosulfan blue sodium bicarbonate partial fill
k-effervescent sodium chloride
k-prime sodium chloride bacteriostatic
k-sol sodium chloride flush
k-vescent sodium chloride pab
kendall sodium chloride flush sodium chloride 0.45%
kionex sodium chloride 0.45% viaflex
klor-CON sodium phosphate
klor-CON m10 sodium polystyrene sulfonate
klor-CON m20 sodium thiosulfate
klor-CON sprinkle sps
klor-CON 10 sterile diluent for epoprostenol sodium
klor-CON 8 sterile water for injection
klor-CON/EF sterile water irrigation
l-cysteine HCL sterile water irrigation plastic bottle
lactated ringers sterile water irrigation w/hanger
lactated ringers dextrose 5% viaflex swabflush saline flush
lactated ringers irrigation tis-u-sol
lactated ringers viaflex tpn electrolytes
lanolin virt-phos 250 neutral
liposyn iii AV-phos 250 neutral
magnesium chloride BD posiflush
magnesium sulfate Delflex-lm/2.5% Dextrose
methylene blue Delflex-lm/4.25% Dextrose
monoject pharma grade flush syringe Delflex-sm/1.5% Dextrose
monoject sodium chloride flush Delflex-sm/2.5% Dextrose
morrhuate sodium KCL 0.075%/D5W/NACL 0.45%
multitrace-4 concentrate KCL 0.15%/D5W/ NACL 0.3%
multitrace-5 concentrate KCL 0.15%/D5W/NACL 0.2%
n-acetyl-l-cysteine KCL 0.15%/D5W/NACL 0.45%
naloxone HCL KCL 0.15%/D5W/NACL 0.9%
naltrexone HCL KCL 0.3%/D5W/NACL 0.45%
normal saline flush MD-gastroview
normal saline flush for flushing vascular access devices Naloxone HCL
normal saline i.v. flush Potassium Chloride ER
nutrilipid PREVENTIVE
nutrilyte fluor-a-day
nutrilyte II fluoride
phospha 250 neutral fluoritab
physiolyte flura-drops
physiosol irrigation karidium
plenamine ludent
potassium acetate nafrinse
potassium chloride nafrinse drops
potassium chloride CR sodium fluoride
potassium chloride ER PREFERRED
potassium chloride SR Chemet
potassium chloride 0.15% /NACL 0.45% viaflex Chemstrip-k
potassium chloride 0.15% w/NACL 0.9% viaflex Cuprimine
potassium chloride 0.15% D5W/NACL 0.33% Fluor-a-day
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 41
Hyperrab S/D aspirin EC low dose
K-phos aspirin 81
NON PREFERRED aspirin 81 low dose
Acetest aspirtab
Chek-stix Combo PAK Urinalysis Control bayer advanced aspirin regular strength
Chek-stix Control bayer aspirin
Depen Titratabs bayer aspirin regimen
Effer-k bayer aspirin EC low dose
Isolyte-s bayer chewable low dose
Ketocare bayer low dose
Ketone Test Strips childrens aspirin
Ketostix childrens aspirin low strength
Klor-CON M15 coated aspirin
Narcan ecotrin
Plasma-lyte A ecotrin low strength
Plasma-lyte-148 ecpirin
Plasma-lyte-56/D5W enteric coated aspirin
Relion Ketone eq adult aspirin low strength
Relion Ketone Test Strips eq aspirin
Veltassa eq aspirin adult low dose
SPECIALTY eq aspirin low dose
Adagen eq aspirin EC
BenlystaPA eq childrens aspirin
BivigamPA eql adult aspirin low strength
Carimune NanofilteredPA eql aspirin
CytogamPA eql aspirin low dose
ExjadePA eql aspirin EC
FerriproxPA eql childrens aspirin
Flebogamma DifPA gnp adult aspirin low strength
Gamastan S/DPA gnp aspirin
Gammagard LiquidPA gnp aspirin low dose
Gammagard S/DPA goodsense aspirin low dose
Gammagard S/D Iga Less Than 1mcg/MLPA kls aspirin low dose
GammakedPA kls aspirin EC
GammaplexPA kp aspirin
Gamunex-cPA meijer aspirin EC
Hepagam B miniprin low dose
HizentraPA norwich aspirin
Hyperhep B S/D px aspirin
Hyperrho S/D px enteric aspirin
Hyperrho S/D Mini-dose qc aspirin
JadenuPA qc aspirin low dose
Micrhogam Ultra-filtered Plus qc childrens aspirin
Nabi-HB ra aspirin
OctagamPA ra aspirin adult low dose
PrivigenPA ra aspirin adult low strength
Rhogam Ultra-filtered Plus ra aspirin childrens
Rhophylac ra aspirin EC
SynagisPA ra aspirin EC adult low strength
Syprine ra childrens aspirin
ThyrogenQL,PA sm aspirin
Vivitrol sm aspirin adult low strength
Winrho SDF sm aspirin enteric coated
XiaflexPA sm aspirin EC low strength
sm childrens aspirin
ACA PREVENTIVE DRUGS st joseph aspirin
st joseph low dose aspirin
ASPIRIN
tgt aspirin
PREVENTIVE
tgt aspirin low dose
adult aspirin EC low strength
tgt childrens aspirin
aspir-low
tgt enteric-coated aspirin
aspir-81
th aspirin
aspirin
th aspirin low dose
aspirin adult low dose
th enteric aspirin
aspirin adult low strength
CVS aspirin
aspirin childrens
CVS aspirin adult low dose
aspirin enteric coated adult low strength
CVS aspirin adult low strength
aspirin low dose
CVS aspirin child
aspirin low strength
CVS aspirin low dose
aspirin EC
CVS aspirin low strength
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 42
CVS aspirin EC introvaleQL
CVS childrens aspirin jencycla
CVS enteric aspirin jolessaQL
EC-81 aspirin jolivette
HM aspirin juleber
HM aspirin EC junel FE 1.5/30
HM aspirin EC low dose junel FE 1/20
MM aspirin junel FE 24
SB aspirin junel 1.5/30
SB aspirin EC junel 1/20
SB childrens aspirin kaitlib FE
SB low dose asa EC kariva
PREVENTIVE kelnor 1/35
Aspirin Low Dose kimidess
kurvelo
CONTRACEPTIVES larin FE 1.5/30
larin FE 1/20
PREVENTIVE
larin 1.5/30
aftera
larin 1/20
altavera
larin 24 FE
alyacen 1/35
layolis FE
alyacen 7/7/7
leena
amethiaQL
lessina
amethia LOQL
levonest
amethyst
levonorgestrel
apri
levonorgestrel and ethinyl estradiolQL
aranelle
levonorgestrel/ethinyl estradiol
ashlynaQL
levora 0.15/30-28
aubra
lomedia 24 FE
aviane
loryna
azurette
low-ogestrel
balziva
lutera
bekyree
lyza
blisovi FE 1.5/30
marlissa
blisovi FE 1/20
medroxyprogesterone acetateQL
blisovi 24 FE
microgestin FE
briellyn
microgestin FE 1.5/30
camila
microgestin 1.5/30
camreseQL
microgestin 1/20
camrese LOQL
microgestin 24 FE
caziant
mono-linyah
chateal
mononessa
cryselle-28
my way
cyclafem 1/35
myzilra
cyclafem 7/7/7
necon 0.5/35-28
cyred
necon 1/35
dasetta 1/35
necon 7/7/7
dasetta 7/7/7
next choice one dose
dayseeQL
nikki
deblitane
nora-be
delyla
norethindrone
desogestrel/ethinyl estradiol
norethindrone & ethinyl estradiol ferrous fumarate
drospirenone/ethinyl estradiol
norethindrone acetate/ethinyl estradiol
econtra EZ
norethindrone acetate/ethinyl estradiol/ferrous fumarate
elinest
norgestimate/ethinyl estradiol
emoquette
norlyroc
enpresse-28
nortrel 0.5/35 (28)
enskyce
nortrel 1/35
errin
nortrel 7/7/7
estarylla
ocella
fallback solo
opcicon one-step
falmina
orsythia
gianvi
philith
gildagia
pimtrea
gildess FE 1.5/30
pirmella 1/35
gildess FE 1/20
pirmella 7/7/7
gildess 1.5/30
portia-28
gildess 1/20
previfem
gildess 24 FE
quasenseQL
heather
reclipsen
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 43
setlakinQL Wide-seal Silicone Diaphragm Kit 75
sharobel Wide-seal Silicone Diaphragm Kit 80
sprintec 28 Wide-seal Silicone Diaphragm Kit 85
sronyx Wide-seal Silicone Diaphragm Kit 90
syeda Wide-seal Silicone Diaphragm Kit 95
take action PREVENTIVE
tarina FE 1/20 Implanon
tilia FE Liletta
tri-estarylla Mirena
tri-legest FE Nexplanon
tri-linyah Skyla
tri-previfem
tri-sprintec FLUORIDE
tri-LO-estarylla
PREVENTIVE
tri-LO-marzia
fluor-a-day
tri-LO-sprintec
fluoride
trinessa
fluoritab
trinessa LO
flura-drops
trivora-28
karidium
vcf vaginal contraceptivegel
ludent
velivet
nafrinse
vestura
nafrinse drops
vienva
sodium fluoride
viorele
PREFERRED
vyfemla
Fluor-a-day
wera
wymzya FE
FOLIC ACID
zarah
GENERIC
zenchent
M-vit
zenchent FE
Prenaplus
zovia 1/35e
Prenatal Plus
Levonorgestrel
Tricare
Ogestrel
PREVENTIVE
Xulane
eql folic acid
PREFERRED
fa-8
LO Loestrin FE
folic acid
Minastrin 24 FE
gnp folic acid
PREVENTIVE
kp folic acid
Natazia
px folic acid
NuvaringQL
ra folic acid
NON PREFERRED
sm folic acid
Depo-subq Provera 104QL
sm prenatal vitamins
PREVENTIVE
th folic acid
Caya
yl folic acid
Encare
Classic Prenatal
Fc Female Condom
CVS folic acid
Fc2 Female Condom
Eql Prenatal Formula
Femcap
Gnp Prenatal Vitamins
Omniflex Diaphragm
HM folic acid
Options Gynol II Vaginal Contraceptive
Mission Prenatal HP
Ortho Diaphragm Coil Spring Kit 100
Multi Prenatal
Ortho Diaphragm Coil Spring Kit 105
Perry Prenatal
Ortho Diaphragm Coil Spring Kit 50
Pre-natal Formula
Ortho Diaphragm Flat Spring Kit 55
Prenatal
Ortho Diaphragm Flat Spring Kit 60
Prenatal And Iron
Ortho Diaphragm Flat Spring Kit 65
Prenatal Formula
Ortho Diaphragm Flat Spring Kit 70
Prenatal Forte
Ortho Diaphragm Flat Spring Kit 75
Prenatal Low Iron
Ortho Diaphragm Flat Spring Kit 80
Prenatal Vitamins
Ortho Diaphragm Flat Spring Kit 85
Px Prenatal Multivitamins
Ortho Diaphragm Flat Spring Kit 90
Ra Prenatal
Ortho Diaphragm Flat Spring Kit 95
Sm Prenatal Vitamins
Prentif Cavity-rim Cervical CAP
PREVENTIVE
Prentif Fitting Set
Atabex Prenatal
Shur-seal
CVS Prenatal
Vcf Vaginal Contraceptive Film
Fa-8
Vcf Vaginal Contraceptive Foam
Gnp Daily Prenatal
Wide-seal Silicone Diaphragm Kit 60
Gnp Prenatal
Wide-seal Silicone Diaphragm Kit 65
Goodsense Prenatal Vitamins
Wide-seal Silicone Diaphragm Kit 70
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 44
HM One Daily Prenatal Combo Fluzone Quadrivalent 2014-2015
HM Prenatal Fluzone Quadrivalent 2015-2016
Kp Prenatal Multivitamins Fluzone Split 2013-2014
Mission Prenatal Fluzone Split 2014-2015
Nat-rul Prenatal Vitamins Fluzone Split 2015-2016
One-a-day Womens Prenatal Gardasil
Prenatal Complete Gardasil 9
Prenatal Multi +dha Havrix
Prenatal One Daily Hiberix
Prenatal Vitamin Infanrix
PA Prenatal Formula Ipol Inactivated IPV
Qc Prenatal Kinrix
Ra One Daily M-m-r II
Ra Prenatal Formula/Folicacid Medical Provider EZ Flu Shot PF 2013-2014
Right Step Prenatal Medical Provider EZ Flu Shot PF 2014-2015
Sm One Daily Prenatal Medical Provider EZ Flu Shot 2013-2014
Stuart Prenatal Medical Provider EZ Flu Shot 2014-2015
Th Prenatal Vitamins Medical Provider EZ Flu Shot 2015-2016
Medical Provider Single Use EZ Flu Shot
IMMUNIZATIONS Menactra
Menomune-a/C/Y/W-135
PREVENTIVE
Menveo
Acthib
Pediarix
Adacel
Pedvax HIB
Afluria PF 2012-2013
Pentacel
Afluria PF 2013-2014
Pneumovax 23
Afluria PF 2014-2015
Pneumovax 23/1 Dose
Afluria PF 2015-2016
Pneumovax 23/5 Dose
Afluria 2012-2013
Prevnar 13
Afluria 2013-2014
Proquad
Afluria 2014-2015
Quadracel
Afluria 2015-2016
Recombivax HB
Bexsero
Rotarix
Boostrix
Rotateq
Cervarix
Tenivac
Comvax
Tetanus/Diphtheria Toxoids-adsorbed
Daptacel
Tetanus/Diphtheria Toxoids-adsorbed Adult
Diphtheria/Tetanus Toxoids Adsorbed Pediatric
Trumenba
Engerix-b
Twinrix
Fluarix Quadrivalent 2013-2014
Vaqta
Fluarix Quadrivalent 2014-2015
Varivax
Fluarix Quadrivalent 2015-2016
Zostavax
Fluarix 2013-2014
Fluarix 2014-2015
IRON
Flublok 2013-2014
Flublok 2014-2015 PREVENTIVE
Flublok 2015-2016 bprotected pedia iron
Flucelvax 2013-2014 eq slow-release iron
Flucelvax 2014-2015 eql iron supplement therapy
Flucelvax 2015-2016 eql slow release iron
Flulaval Quadrivalent 2013-2014 ezfe 200
Flulaval Quadrivalent 2014-2015 feosol
Flulaval Quadrivalent 2015-2016 fer-iron
Flulaval 2013-2014 ferate
Flulaval 2014-2015 fergon
Flumist Quadrivalent ferosul
Fluvirin PF 2013-2014 ferrex 150
Fluvirin PF 2014-2015 ferric x-150
Fluvirin 2013-2014 ferro-bob
Fluvirin 2014-2015 ferrotabs
Fluvirin 2015-2016 ferrous drops
Fluzone High-dose PF 2013-2014 ferrous gluconate
Fluzone High-dose PF 2014-2015 ferrous sulfate
Fluzone High-dose PF 2015-2016 ferrousul
Fluzone Intradermal gnp iron
Fluzone Intradermal Quadrivalent 2015-2016 gnp slow release iron
Fluzone Pediatric PF 2013-2014 high potency iron
Fluzone PF 2013-2014 iferex 150
Fluzone PF 2014-2015 iron
Fluzone Quadrivalent 2013-2014 iron slow release
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 45
iron supplement gnp nicotine polacrilex miniQL
iron supplement childrens goodsense nicotine gumQL
kp ferrous gluconate kls quit2QL
kp ferrous sulfate kls quit4QL
meijer ferrous sulfate nicoreliefQL
myferon 150 nicotineQL
nu-iron 150 nicotine mini lozengeQL
poly-iron 150 nicotine polacrilexQL
px iron nicotine polacrilex refillQL
qc ferrous sulfate nicotine polacrilex starter kitQL
ra high potency iron nicotine step 1QL
ra iron nicotine step 2QL
ra slow release iron nicotine step 3QL
slow iron nicotine transdermal systemQL
slow release iron nicotine transdermal system step 1QL
slow FE nicotine transdermal system step 2QL
slow-release iron nicotine transdermal system step 3QL
sm iron px stop smoking aidQL
sm iron slow release qc nicotine polacrilexQL
sm slow release iron ra mini nicotineQL
th iron ra nicotineQL
th slow release iron ra nicotine polacrilexQL
wee care ra nicotine transdermal system step 3QL
CVS iron sm nicotineQL
Ferretts sm nicotine polacrilexQL
FE gluconate sm nicotine transdermal systemQL
FE TABS sw nicotine polacrilexQL
HM iron tgt nicotine gumQL
HM iron slow release tgt nicotine polacrilexQL
HM slow release iron tgt nicotine step oneQL
PREVENTIVE tgt nicotine step threeQL
CVS Slow Release Iron tgt nicotine step twoQL
Elite Iron thriveQL
Femiron CVS nicotineQL
Feosol CVS nicotine lozengeQL
Ferretts IPS CVS nicotine polacrilexQL
Ferrimin 150 CVS nicotine polacrilex starterQL
Ferro-sequels CVS nicotine transdermal systemQL
Ferrous Fumarate CVS nts step 1QL
Ferrous Gluconate HM nicotine polacrilexQL
Ferrous Sulfate HM nicotine transdermal systemQL
FE Aspartate HM nicotine transdermal system step 3QL
High Potency Iron SR nicotine gumQL
Iron PREVENTIVE
Iron Chews Pediatric ChantixQL
Iron Up Chantix Continuing Month PAKQL
Mykidz Iron 10 Chantix Starting Month PAKQL
Novaferrum Pediatric Drops Nicotine Transdermal SystemQL
Perfect Iron PREVENTIVE
Profe Nicotrol InhalerQL
Proferrin ES Nicotrol NsQL
Slow Release Iron
Sm Slow Release Iron VITAMIN D
PREVENTIVE
SMOKING CESSATION
aqueous vitamin d infants
PREVENTIVE bio-d-mulsion
buprobanQL bio-d-mulsion forte
bupropion HCL SRQL bprotected pedia d-vite
eq nicotineQL d 1000
eq nicotine gum refillQL d 10000
eq nicotine gum starterQL d 2000
eq nicotine polacrilexQL d 400
eq nicotine step 3QL d 5000
eql nicotineQL d-vita
eql nicotine polacrilexQL d-1000
eql nicotine polacrilex refillQL d-1000 extra strength
eql nicotine polacrilex starterQL d-2000 maximum strength
gnp nicotine mini lozengeQL d-3-5
gnp nicotine polacrilexQL d-400
Effective July 1, 2016
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 46
d-5000 Optimal D3 M
d-5000 maximum strength Replesta
decara Replesta Childrens
delta d3 Replesta Nx
dialyvite vitamin d 5000 Sm Vitamin D3 Maximum Strength
dialyvite vitamin d3 max Super Daily D3
d2000 ultra strength Thera-d 4000
d3 Vitamelts Vitamin D
d3 adult Vitamin D3
d3 adult gummy Wellesse Vitamin D3
d3 high potency
d3 kids BOWEL PREPARATION AGENTS
d3 maximum strength
PREVENTIVE
d3 super strength
gavilyte-c
d3 ultra strength
gavilyte-n/flavor pack
d3 2000
gavilyte-G
d3-1000
peg 3350/electrolytes
d3-50
peg-3350/electrolytes
eql childrens vitamin d gummies
peg-3350/NACL/NA bicarbonate/KCL
eql vitamin d-3
trilyte
eql vitamin d3
gnp vitamin d
BREAST CANCER
gnp vitamin d maximum strength
ORAL CHEMO
gnp vitamin d super strength
tamoxifen citrate
gnp vitamin d3 extra strength
healthy kids vitamin d3
just d
kp vitamin d
maximum d3
nat-rul vitamin d
natural vitamin d-3
optimal-d
optimal-d pack
opurity vitamin d
pronutrients vitamin d3
ra vitamin d-3
sm vitamin d
sm vitamin d3
th vitamin d3
thera-d rapid repletion
thera-d sport
thera-d 2000
vitajoy daily d gummies
vitamin d
vitamin d high potency
vitamin d 400
vitamin d-1000
vitamin d-1000 maximum strength
vitamin d-3
vitamin d-400
vitamin d3
vitamin d3 adult gummies
vitamin d3 high potency
vitamin d3 maximum strength
vitamin d3 super strength
vitamin d3 400
CVS d3
CVS vitamin d
CVS vitamin d 5000 high-potency
CVS vitamin d3
HM vitamin d
HM vitamin d3
PA vitamin d-3
PA vitamin d-3 gummy
PREVENTIVE
Baby Super Daily D3
Ddrops
Decara
D3 Dots
HM Vitamin D3
Effective July 1, 2016 v.1
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; All OptumTM trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners. © 2016 Optum, Inc. All rights reserved.
47
Index
A
Acti-lance Lancets 28G, 28 Mask, 40
Acti-lance Lite Safety Lancets 28G, 28 Aerochamber Plus Flow-VU/Small Mask, 40
A-hydrocort, 10
Acti-lance Special Safety Lancets 17G, 28
abacavir, 2
Aerochamber Z-stat Plus Valved Holding Chamber W/Flow VU, 40
abacavir sulfate/lamivudine/zidovudine, 2
Acti-lance Special Safetylancets 17G, 28
Abelcet, 2
Acti-lance Universal Safety Lancets 23G, 28
Aerochamber Z-stat Plus/Flowsignal, 40
Abilify, 19
Aerochamber Z-stat Plus/Large Mask, 40
Abilify Discmelt, 19
Actimmune, 5 Aerochamber Z-stat Plus/Medium Mask, 40
Abilify Maintena, 19
Active 1ST Blood Lancets 30G/Easy Twist CAP, 28
Abraxane, 4
Aerochamber Z-stat Plus/Small Mask, 40
acamprosate calcium DR, 20
Actoplus Met XR, 12 Aerochamber/Flowsignal, 40
acarbose, 12
Acuvail, 22 Aerovent Plus Holding Chamber/Collapsible, 40
Accu-chek Active Glucose Control Solution, 32
acyclovir, 2, 8
acyclovir sodium, 2 AF Lancets Super Thin, 29
Accu-chek Active Strips, 32
Adacel, 26, 45 afeditab CR, 6
Accu-chek Aviva, 32
Adagen, 42 Afinitor, 5
Accu-chek Aviva Plus, 32
Adcetris, 4 Afinitor Disperz, 5
Accu-chek Comfort Curve Control Solution (2 Levels), 32
Adcirca, 7 Afluria 2012-2013, 26, 45
adefovir dipivoxil, 2 Afluria 2013-2014, 26, 45
Accu-chek Comfort Curve Linearity Solution, 32
Adempas, 7 Afluria 2014-2015, 26, 45
adenosine, 6, 40 Afluria 2015-2016, 26, 45
Accu-chek Comfort Curve Test Strips, 32
Adjustable Lancing Device, 32 Afluria PF 2012-2013, 26, 45
Accu-chek Compact Blue Control Solution (2 Levels), 32
adriamycin, 3 Afluria PF 2013-2014, 26, 45
Adriamycin, 3 Afluria PF 2014-2015, 26, 45
Accu-chek Compact Plus, 32
adrucil, 4 Afluria PF 2015-2016, 26, 45
Accu-chek Compact Plus Care Kit, 32
adult aspirin EC low strength, 22, 42 aftera, 10, 43
Accu-chek Compact Plus Clear Control Solution (2 Levels), 32
Advate, 17 Agamatrix Ultra-thin Lancets 33G, 28
Advocate Insulin Pen Needles 29GX12.7MM, 32
Aggrastat, 17
Accu-chek Compact Test Drum, 32
Aggrenox, 17
Accu-chek Fastclix Lancetdevice Kit, 32
Advocate Insulin Pen Needles 31GX5MM, 32
airavite, 16
Accu-chek Fastclix Lancets, 28
ak-fluor, 22
Accu-chek Instant Glucosecontrol Solution (2 Levels), 32
Advocate Insulin Pen Needles 31GX8MM, 32
ak-poly-bac, 21
Akynzeo, 14
Accu-chek Multiclix Lanc Et Device Kit, 32
Advocate Insulin Syringe/U-100/0.3ML/29GX1/2", 32
ala cort, 9
alagesic LQ, 22
Accu-chek Multiclix Lancets, 28
Advocate Insulin Syringe/U-100/0.3ML/30GX5/16", 32
Albenza, 3
Accu-chek Nano Smartview, 32
albuked 25, 17
Accu-chek Safe-t-pro Lancets, 28
Advocate Insulin Syringe/U-100/0.3ML/31GX5/16", 32
albuked 5, 17
Accu-chek Safe-t-pro Pluslancets, 28
albumin human, 17
Accu-chek Smartview Control, 32
Advocate Insulin Syringe/U-100/0.5ML/29GX1/2", 32
albumin-zlb, 17
Accu-chek Smartview Strips, 32
albuminar-25, 17
Accu-chek Soft Touch Lancets, 28
Advocate Insulin Syringe/U-100/0.5ML/30GX5/16", 32
albuminar-5, 17
Accu-chek Softclix Lancetdevice, 32
alburx, 17
Accu-chek Softclix Lancetdevice Kit, 32
Advocate Insulin Syringe/U-100/0.5ML/31GX5/16", 32
albutein, 17
Accu-chek Softclix Lancets, 28
albuterol, 25
Accu-chek Voicemate, 32
Advocate Insulin Syringe/U-100/1ML/29GX1/2", 32
albuterol sulfate, 25
acebutolol HCL, 6
albuterol sulfate ER, 25
acetaminophen/caffeine/dihydrocodeine, 23
Advocate Insulin Syringe/U-100/1ML/30GX5/16", 32
albuterol TAB 4MG, 25
alclometasone dipropionate, 9
acetaminophen/codeine, 23
Advocate Insulin Syringe/U-100/1ML/31GX5/16", 32
Alcoh-glove Contoured Wipe, 40
acetaminophen/codeine #2, 23
Alcoh-wipe 12" X 12", 40
acetaminophen/codeine #3, 23
Advocate Lancets, 28 Alcohol Pads, 40
acetaminophen/codeine #4, 23
Advocate Lancets 30G, 28 Alcohol Prep Pads, 40
acetaminophen/codeine phosphate, 23
Advocate Lancing Device, 32 Alcohol Preps, 40
acetasol HC, 22
Advocate Rapid-safe Lancing Device, 32 Alcohol Swabs, 40
acetazolamide, 7
Advocate Safety Lancets, 28 Alcohol Swabstick, 40
Acetazolamide, 7
Advocate Safety Lancets 26G, 28 Alcohol Wipes, 40
acetazolamide ER, 7
Aerochamber Mini Aerosol Chamber, 39 Aldurazyme, 13
acetazolamide sodium, 7
Aerochamber MV, 40 alendronate sodium, 12
Acetest, 42
Aerochamber Plus Flow VU, 40 Alendronate Sodium, 12
acetic acid, 22
Aerochamber Plus Flow-VU, 40 alfentanil, 23
acetic acid 0.25%, 15
Aerochamber Plus Flow-VU/Large Mask, 40
Alferon N, 5
acetylcysteine, 25, 40
alfuzosin HCL ER, 15
Aciphex Sprinkle, 14
Aerochamber Plus Flow-VU/Mask, 40 Alimta, 4
acitretin, 8
Aerochamber Plus Flow-VU/Medium Alinia, 3
Acthib, 26, 45
Alkeran, 3
ampicillin-sulbactam, 1 aspirin adult low strength, 23, 42
allopurinol, 24
Ampicillin-sulbactam, 1 aspirin childrens, 23, 42
almotriptan malate, 24
Ampyra, 20 aspirin EC, 23, 42
Alocril, 22
Amturnide, 7 aspirin EC low dose, 23, 42
Alogliptin, 12
ana-lex, 14 aspirin enteric coated adult low strength, 23, 42
Alogliptin/Metformin HCL, 12
Anadrol-50, 10
Alogliptin/Pioglitazone, 12
anagrelide hydrochloride, 17 aspirin low dose, 23, 42
Alomide, 22
anastrozole, 4 Aspirin Low Dose, 23, 43
alosetron hydrochloride, 14
Androgel, 10 aspirin low strength, 23, 42
Aloxi, 14
Androgel P.M., 10 Aspirin-caffeine-dihydrocodeine, 24
Alphagan P, 22
Androxy, 10 Aspirin/Dipyridamole, 17
Alphanate/Von Willebrand Factor Complex/Human, 17
anodynz, 9 aspirtab, 23, 42
Anti-stick Insulin Syringe/U-100/0.5ML/28G X 1/2", 32
Assure Comfort Lancets Ultra Thin 28G, 28
Alphanine SD, 17
alphatrex, 9
Anti-stick Insulin Syringe/U-100/0.5ML/29G X 1/2", 32
Assure Comfort Lancets Ultra Thin 30G, 28
alprazolam, 18
alprazolam ER, 18
Anti-stick Insulin Syringe/U-100/1ML/29G X 1/2", 32
Assure Haemolance Plus High Flow 18G, 28
alprazolam odt, 18
alprazolam XR, 18
antipyrine/benzocaine, 22 Assure Haemolance Plus Low Flow 25G, 29
alprostadil, 40
Anzemet, 14
Alrex, 21
Apexicon E, 9 Assure Haemolance Plus Micro Flow 28G, 29
Altabax, 8
Apidra, 12
altacaine, 22
Apidra Solostar, 12 Assure Haemolance Plus Normal Flow 21G, 29
altafluor, 22
Aplenzin, 18
altafrin, 22
Apokyn, 20 Assure Haemolance Plus Pediatric Blade, 29
altavera, 10, 43
apraclonidine, 22
Alternate Site Lancing Device, 32
apri, 10, 43 Assure ID Insulin Safety Syringe/U-100/0.5ML/29G X 1/2", 32
alyacen 1/35, 10, 43
Aptivus, 2
alyacen 7/7/7, 10, 43
Aqua Lance Adjustable Lancing Device, 32
Assure ID Insulin Safety Syringe/U-100/1ML/29G X 1/2", 32
amantadine HCL, 19
Ambisome, 2
aqueous vitamin d infants, 26, 46 Assure Lance Lancets, 29
Amcinonide, 9
Aralast NP, 25 Assure Lance Lancets 21G, 29
amethia, 10, 43
aranelle, 10, 43 Assure Lance Plus Safety Lancets 25G, 29
amethia LO, 10, 43
Aranesp Albumin Free, 17
amethyst, 10, 43
arbinoxa, 25 Assure Lance Plus Safety Lancets 30G, 29
amifostine, 5
Arcalyst, 24
amikacin sulfate, 1
Arcapta Neohaler, 25 Assure Lancets, 29
amiloride HCL, 7
argatroban, 17 AT Last Lancets, 29
amiloride/hydrochlorothiazide, 7
Argatroban, 17 Atabex Prenatal, 28, 44
aminoacetic acid, 15
argyle sterile saline 100ML, 15 atenolol, 6
aminocaproic acid, 17
argyle sterile water 100ML, 40 atenolol/chlorthalidone, 6
aminophylline, 25
Arial Chamber, 40 Atgam, 4
aminorelief rms, 40
aripiprazole, 18 atorvastatin calcium, 7
aminosyn 8.5%/electrolytes, 40
Aripiprazole Odt, 19 atovaquone, 3
aminosyn II 8.5%/electrolytes, 40
Armour Thyroid, 13 atovaquone/proguanil HCL, 3
amiodarone HCL, 6
Arranon, 4 atracurium besylate, 20
Amitiza, 15
Arzerra, 4 Atripla, 2
amitriptyline HCL, 18
Asacol HD, 15 Atropen, 14
amlodipine besylate, 6
ascomp/codeine, 23 atropine sulfate, 14, 21
amlodipine besylate/atorvastatin calcium, 7
ascorbic acid, 26 atropine-care, 21
ashlyna, 10, 43 Atrovent HFA, 25
amlodipine besylate/benazepril HCL, 6
Asmanex HFA, 25 Aubagio, 20
amlodipine besylate/benazepril hydrochloride, 6
Asmanex Twisthaler 120 Metered Doses, 25
aubra, 10, 43
augmented betamethasone dipropionate, 9
amlodipine besylate/valsartan, 6
Asmanex Twisthaler 14 Metered Doses, 25
amlodipine/valsartan/hctz, 6
Augmentin, 1
ammonium lactate, 9
Asmanex Twisthaler 30 Metered Doses, 25
aurodex, 22
amnesteem, 8
Aurora Lancet Super Thin 30G, 29
Amoxapine, 18
Asmanex Twisthaler 60 Metered Doses, 25
Aurora Lancet Thin 23G, 29
amoxicillin, 1
Aurora Pen Needles 29GX12MM, 32
amoxicillin/clavulanate potassium, 1
Asmanex Twisthaler 7 Metered Doses, 25
Aurora Pen Needles 31G X 6MM, 32
Amoxicillin/Clavulanate Potassium, 1
Aurora Pen Needles 31G X 8MM, 32
amoxicillin/clavulanate potassium ER, 1
aspir-81, 22, 42 Aurora Unifine Pentips/32GX5/32", 32
amphetamine/dextroamphetamine, 19
aspir-low, 22, 42 Aurora Unifine Pentips/Mini/31GX3/16", 32
Amphotec, 2
aspirin, 22, 42
Amphotericin B, 2
aspirin 81, 23, 42 Auto-lancet, 32
ampicillin, 1
aspirin 81 low dose, 23, 42 Auto-lancet Mini, 32
ampicillin sodium, 1
aspirin adult low dose, 23, 42 Autolet II Clinisafe, 32
Autolet Impression, 32
bayer advanced aspirin regular strength, 23, 42
5ML/29G X 1/2", 29
Autolet Impression Lancing Device, 32
BD Insulin Syringe Ultrafine/U-100/0.5ML/30G X 1/2", 29
Autolet Lite Clinisafe, 32
bayer aspirin, 23, 42
Autolet Lite Starter Pack, 33
bayer aspirin EC low dose, 23, 42 BD Insulin Syringe Ultrafine/U-100/0.5ML/31G X 15/64", 29
Autolet Mini, 33
bayer aspirin regimen, 23, 42
Autolet Platforms, 33
bayer chewable low dose, 23, 42 BD Insulin Syringe Ultrafine/U-100/0.5ML/31G X 5/16", 29
Auvi-q, 7
bayer low dose, 23, 42
AV-phos 250 neutral, 41
Bayer Microlet 2 Lancing Device, 33 BD Insulin Syringe Ultrafine/U-100/1ML/29G X 1/2", 29
AV-vite fb, 16
Bayer Microlet Lancets, 29
avalin-RX, 9
Bcg Vaccine, 26 BD Insulin Syringe Ultrafine/U-100/1ML/30G X 1/2", 29
Avandia, 12
BD Autoshield 29G X 3/16", 29
avar cleanser, 8
BD Autoshield 29G X 5/16", 29 BD Insulin Syringe Ultrafine/U-100/1ML/31G X 15/64", 29
avar-e emollient, 8
BD Autoshield Duo 30G X 3/16", 29
avar-e green, 8
BD Insulin Syringe LUER-LOK/U-100/1ML, 29
BD Insulin Syringe Ultrafine/U-100/1ML/31G X 5/16", 29
Avastin, 4
Avc, 15
BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2", 29
BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 1", 29
Avelox, 1
aviane, 10, 43
BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2", 29
BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 5/8", 29
avidoxy, 1
Avonex, 20
BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8", 29
BD Insulin Syringe/Detachable Needle/U-100/1ML/26G X 1/2", 29
Avonex Pen, 20
Axiron, 10
BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2", 29
BD Insulin Syringe/U-100/0.5ML/30G X 1/2", 29
azacitidine, 4
Azactam IN Iso-osmotic Dextrose, 3
BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2", 29
BD Insulin Syringe/U-100/1ML/27G X 1/2", 29
Azasan, 4
azathioprine, 4
BD Insulin Syringe Microfine/U-100/0.5ML/28G X 1/2", 29
BD Insulin Syringe/U-100/1ML/28G X 1/2", 29
Azathioprine, 4
azelastine HCL, 22, 25
BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8", 29
BD Insulin Syringe/U-100/2ML/27.5G X 5/8", 29
Azelex, 8
Azilect, 20
BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2", 29
BD Insulin Syringe/U-100/2ML/29G X 1/2", 29
azithromycin, 1
Azithromycin, 1
BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2", 29
BD Integra Insulin Syringe/U-100/1ML/29G X 1/2", 29
Azopt, 22
Azor, 7
BD Insulin Syringe Safetyglide/1ML/29G X 1/2", 29
BD Integra Syringe/Retracting Needle/1ML/25G X 1", 29
aztreonam, 3
azuphen mb, 15
BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 5/16", 29
BD Lancet Device, 33
azurette, 10, 43
BD Lancet Ultrafine 30G, 29
B
BD Insulin Syringe Slip Tip/U-100/1ML, 29
BD Lancet Ultrafine 33G, 29
BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X 1/2", 29
b-complex 100, 27
BD Insulin Syringe U-40/1ML/25G X 5/8", 29
B-d Insulin Syringe Ultrafine II/0.3ML/31G X 5/16", 29
BD Microtainer Lancets, 29
BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16", 29
BD Pen Needle/Mini/Ultrafine/31G X 3/16", 29
B-d Insulin Syringe Ultrafine II/0.5ML/31G X 5/16", 29
BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X 5/16", 29
BD Pen Needle/Nano/Ultra Fine/32G X 4MM, 29
B-d Insulin Syringe Ultrafine II/1ML/31G X 5/16", 29
BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16", 29
BD Pen Needle/SHORT/Ultrafine/31G X 5/16", 29
B-d Insulin Syringe Ultrafine/0.3ML/30G X 1/2", 29
BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2", 29
BD Pen Needle/Ultrafine/29G X 12.7MM, 29
B-d Insulin Syringe Ultrafine/0.5ML/30G X 1/2", 29
BD Insulin Syringe Ultrafine/0.3ML/31G X 5/16", 29
BD Pen Needle/Ultrafine/29GX1/2" 12.7MM, 29
B-d Insulin Syringe Ultrafine/1ML/30G X 1/2", 29
BD Insulin Syringe Ultrafine/0.5ML/30G X 1/2", 29
BD Pen Needles SHORT/Ultrafine/31G X 5/16", 29
b-plex, 27
b-plex plus, 27
BD Insulin Syringe Ultrafine/0.5ML/31G X 5/16", 29
BD posiflush, 41
Baby Super Daily D3, 27, 47
BD Safety-glide Insulin Syringe/0.5ML/29G X 1/2", 29
baciim, 3
BD Insulin Syringe Ultrafine/1ML/30G X 1/2", 29
bacitracin, 3
BD Safety-lok Insulin Syringe/Perm Needle/UF/1ML/29G X 1/2", 29
Bacitracin, 21
BD Insulin Syringe Ultrafine/1ML/31G X 5/16", 29
bacitracin/polymyxin b, 21
BD Safetyglide Insulin Sysyringe/0.5ML/30G X 5/16", 29
baclofen, 21
BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2", 29
Bactocill IN Dextrose, 1
BD Swabs Single Use, 40
Bactroban Nasal, 25
BD Insulin Syringe Ultrafine/U-100/0.3ML/30G X 1/2", 29
BD Swabs Single Use Butterfly, 40
balanced salt, 22
BD-insul SYR Mis LO Dose, 29
balanced salt solution, 22
BD Insulin Syringe Ultrafine/U-100/0.3ML/31G X 15/64", 29
Bebulin, 17
balsalazide disodium, 14
bekyree, 10, 43
balziva, 10, 43
BD Insulin Syringe Ultrafine/U-100/0.3ML/31G X 5/16", 29
benazepril HCL, 6
Banzel, 19
benazepril HCL/hydrochlorothiazide, 6
Baraclude, 2
BD Insulin Syringe Ultrafine/U-100/0. Bendeka, 3
baycadron, 10
Benefix, 17
Breatherite Collapsible Adult Spacer W/Mask, 40
calcium acetate, 14
Benicar, 6
calcium chloride, 40
Benicar HCT, 7
Breatherite Collapsible Child Spacer W/Mask, 40
calcium gluconate, 40
Benlysta, 42
camila, 10, 43
benzepro, 8
Breatherite Collapsible Infant Spacer W/Mask, 40
Camptosar, 5
benzepro creamy wash, 8
camrese, 10, 43
benzepro foaming cloths, 8
Breatherite Collapsible Small Child Spacer W/Mask, 40
camrese LO, 10, 43
benzepro SHORT contact, 8
Canasa, 15
benziq wash, 8
Breatherite Collapsible Spacer W/ Neonate Mask, 40
Cancidas, 2
benzonatate, 25
candesartan cilexetil, 6
benzoyl peroxide, 8
Breatherite Rigid Spacer W/Mask, 40 candesartan cilexetil/hydrochlorothiazide, 7
benzoyl peroxide SHORT contact, 8
Breatherite W/Large Mask, 40
benztropine mesylate, 20
Breatherite W/Medium Mask, 40 Cantil, 14
Bepreve, 22
Breatherite W/Small Mask, 40 capacet, 22
Berinert, 17
briellyn, 10, 43 Capastat Sulfate, 2
Besivance, 21
Brilinta, 17 capecitabine, 3
betamethasone dipropionate, 9
brimonidine tartrate, 22 Capex, 9
betamethasone sodium phosphate/betamethasone acetate, 10
bromfed DM, 25 Caprelsa, 5
bromfenac, 22 captopril, 6
betamethasone valerate, 9
bromocriptine mesylate, 20 Carafate, 14
Betaseron, 20
bromphen/pseudoephedrine HCL/dextromethorphan HBR, 25
CARB-o-philic 40, 10
betaxolol HCL, 6, 21
CARB-o-philic/40, 10
bethanechol chloride, 15
Brovana, 25 Carbaglu, 13
Betimol, 21
bss, 22 carbamazepine, 19
bexarotene, 5
budesonide, 10, 25(2) carbamazepine ER, 19
Bexsero, 26, 45
Bullseye Mini Safety Lancets, 29 carbidopa, 20
bicalutamide, 4
Bullseye Safety Lancets, 29 carbidopa/levodopa, 20
Bicillin C-R, 1
bumetanide, 7 carbidopa/levodopa ER, 20
Bicillin L-a, 1
buminate, 17 carbidopa/levodopa odt, 20
Bicnu, 3
Buphenyl, 13 Carbidopa/Levodopa/Entacapone, 20
Bidil, 7
bupivacaine HCL, 24 carbinoxamine maleate, 25
Biltricide, 3
bupivacaine spinal, 24 carboplatin, 3
Bimatoprost, 21
bupivacaine/epinephrine, 24 Cardene IV, 6
bio GLO, 22
buprenorphine HCL, 23 Cardiocom Lancing Device, 33
bio-d-mulsion, 26, 46
buprenorphine HCL/naloxone HCL, 23 cardioplegic, 7
bio-d-mulsion forte, 26, 46
buproban, 20, 46 Cardizem LA, 6
bio-statin, 2
bupropion HCL, 18 Cardura XL, 16
biocel, 27
bupropion HCL ER, 18 Carefine Pen Needle 32GX4MM, 33
Biothrax, 26
bupropion HCL SR, 18, 20, 46 Carefine Pen Needles 29GX1/2", 33
biotuss, 25
bupropion HCL XL, 18 Carefine Pen Needles 30GX5/16", 33
biotuss pediatric, 25
buspirone HCL, 18 Carefine Pen Needles 31GX6MM, 33
bisoprolol fumarate, 6
Busulfex, 3 Carefine Pen Needles 31GX8MM, 33
bisoprolol fumarate/hydrochlorothiazide, 6
butalbital/acetaminophen, 22 Carefine Pen Needles 32GX5MM, 33
butalbital/acetaminophen/caffeine, 22 Carefine Pen Needles 32GX6MM, 33
bivalirudin, 17
butalbital/acetaminophen/caffeine/codeine, 23
Careone Advanced Lancing Device, 33
Bivigam, 42
Careone Insulin Syringes/0.3ML/30G X 1/2", 33
bleomycin sulfate, 3
butalbital/aspirin/caffeine, 22
Blincyto, 4
butalbital/aspirin/caffeine/codeine, 23 Careone Insulin Syringes/0.3ML/31G X 5/16", 33
blisovi 24 FE, 10, 43
butorphanol tartrate, 23
blisovi FE 1.5/30, 10, 43
Butrans, 24 Careone Insulin Syringes/0.5ML/30G X 1/2", 33
blisovi FE 1/20, 10, 43
Bydureon, 12
Boostrix, 26, 45
Byetta, 12 Careone Insulin Syringes/0.5ML/31G X 5/16", 33
Bosulif, 5
Bystolic, 6
Botox, 21
C Careone Insulin Syringes/1ML/30G X 1/2", 33
bp 10-1, 8
cabergoline, 13
bp foam, 8
Careone Insulin Syringes/1ML/31GX5/16", 33
Cadeau DHA, 28
bp foaming wash, 8
Cafergot, 24
Bp Folinatal Plus B, 28
Careone Lancet Thin, 29
caffeine citrate, 19
Bp Multinatal Plus, 28
Careone Lancet Ultra Thin, 29
calcidol, 26
Bp Vit 3, 16
Careone Unifine Pentips 29GX12MM, 33
calciferol, 26
bp wash, 8
Careone Unifine Pentips 31GX5MM, 33
calcipotriene, 8
bpm, 25
Careone Unifine Pentips 31GX6MM, 33
calcipotriene/betamethasone dipropionate, 9
bpm pseudo, 25
Careone Unifine Pentips 31GX8MM, 33
bpo 6% foaming cloths, 8
Careone Unifine Pentips Pen Needles 32GX4MM, 33
calcitonin salmon, 13
bprotected pedia d-vite, 26, 46
calcitonin-salmon, 13
bprotected pedia iron, 16, 45
Careone Unifine Pentips Plus Pen Needles 29GX12MM, 33
calcitrene, 8
Brainstrong Prenatal, 28
Calcitriol, 8
Breatherite, 40
Careone Unifine Pentips Plus Pen
calcitriol, 13
Needles 31GX5MM, 33
Chemstrip-k, 41 Syringe/0.3ML/30G X 1/2", 33
Careone Unifine Pentips Plus Pen Needles 31GX6MM, 33
Chenodal, 15 Clever Choice Comfort EZ Insulin Syringe/0.3ML/30G X 5/16", 33
childrens aspirin, 23, 42
Careone Unifine Pentips Plus Pen Needles 31GX8MM, 33
childrens aspirin low strength, 23, 42 Clever Choice Comfort EZ Insulin Syringe/0.3ML/31G X 5/16", 33
chlordiazepoxide HCL, 18
Careone Unifine Pentips Plus Pen Needles 32GX4MM, 33
chlordiazepoxide HCL/clidinium bromide, 14
Clever Choice Comfort EZ Insulin Syringe/0.5ML/28G X 1/2", 33
Carimune Nanofiltered, 42
chlorhexidine gluconate, 18 Clever Choice Comfort EZ Insulin Syringe/0.5ML/29G X 1/2", 33
carisoprodol, 21
chlorhexidine gluconate oral rinse, 18
carisoprodol/aspirin, 21
chloromag, 40 Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 1/2", 33
carisoprodol/aspirin/codeine, 21
chloroprocaine HCL, 24
carteolol HCL, 21
chloroquine phosphate, 3 Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 5/16", 33
cartia XT, 6
chlorothiazide, 7
carvedilol, 6
Chlorothiazide, 7 Clever Choice Comfort EZ Insulin Syringe/0.5ML/31G X 5/16", 33
Cavan-EC Sod DHA, 28
chlorothiazide sodium, 7
cavarest, 18
chlorpromazine HCL, 18 Clever Choice Comfort EZ Insulin Syringe/1.0ML/30G X 1/2", 33
cavirinse, 18
Chlorpropamide, 12
Caya, 44
Chlorthalidone, 7 Clever Choice Comfort EZ Insulin Syringe/1ML/28G X 1/2", 33
Cayston, 3
chlorzoxazone, 21
caziant, 10, 43
cholestyramine, 7 Clever Choice Comfort EZ Insulin Syringe/1ML/29G X 1/2", 33
Cedax, 1
cholestyramine light, 7
cefaclor, 1
choline magnesium trisalicylate, 22 Clever Choice Comfort EZ Insulin Syringe/1ML/30G X 5/16", 33
Cefaclor, 1
chorionic gonadotropin, 13
cefadroxil, 1
Cialis, 7 Clever Choice Comfort EZ Insulin Syringe/U-100/1ML/31GX5/16", 33
cefazolin sodium, 1
ciclodan, 8
cefdinir, 1
ciclopirox, 8 Clever Choice Comfort EZ Pen Needles 29GX12MM, 33
Cefditoren Pivoxil, 1
ciclopirox nail lacquer, 8
cefepime, 1
ciclopirox olamine, 8 Clever Choice Comfort EZ Pen Needles 31GX5MM, 33
cefixime, 1
ciclopirox treatment, 8
cefotaxime sodium, 1
cidaleaze, 9 Clever Choice Comfort EZ Pen Needles 31GX6MM, 33
cefotetan, 1
cidofovir, 2
Cefotetan, 1
cilostazol, 17 Clever Choice Comfort EZ Pen Needles 31GX8MM, 33
Cefotetan/Dextrose, 1
Ciloxan, 21
cefoxitin sodium, 1
cimetidine, 14 Clever Choice Comfort EZ Pen Needles 32GX4MM, 33
cefpodoxime proxetil, 1
cimetidine HCL, 14
cefprozil, 1
Cimzia, 15 Clever Choice Comfort EZ Pen Needles 32GX5MM, 33
ceftazidime, 1
Cimzia Starter Kit, 15
Ceftin, 1
Cinryze, 17 Clever Choice Comfort EZ Pen Needles 32GX6MM, 33
Ceftriaxone IN Iso-osmotic Dextrose, 1
Ciprodex, 22
ceftriaxone sodium, 1
ciprofloxacin, 1 Clever Choice Comfort EZ Pen Needles 32GX8MM, 33
cefuroxime axetil, 1
ciprofloxacin ER, 1
cefuroxime sodium, 1
ciprofloxacin HCL, 1, 21 Clever Choice Comfort EZ Pen Needles 33GX4MM, 33
Cefuroxime Sodium, 1
Ciprofloxacin HCL, 1
celecoxib, 24
ciprofloxacin I.V.-IN D5W, 1 Clever Choice Comfort EZ Pen Needles 33GX5MM, 33
Cellcept Intravenous, 4
cisatracurium besylate, 20
Celontin, 19
cisplatin, 3 Clever Choice Comfort EZ Pen Needles 33GX6MM, 33
Cem-urea, 10
Cisplatin, 3
Cenestin, 10
citalopram hydrobromide, 18 Clever Choice Comfort EZ Pen Needles 33GX8MM, 33
Centrum Specialist Prenatal, 28
citric acid/sodium citrate, 15
cephalexin, 1
cladribine, 4 Clickfine Pen Needle 32GX5/32", 33
Ceprotin, 17
Claforan, 1 Clickfine Pen Needle Universal/31GX1/4", 33
ceramax, 9
claravis, 8
Cerezyme, 17
Clarinex, 25 Clickfine Pen Needle Universal/31GX5/16", 33
cerisa wash, 8
claris clarifying wash, 8
cerovel, 9
clarithromycin, 1 Clickfine Pen Needles/31GX1/4", 33
Cervarix, 26, 45
clarithromycin ER, 1 Clickfine Pen Needles/31GX5/16", 33
Cesamet, 14
Classic Prenatal, 28, 44 Clickfine Universal Pen Needles 31GX5/16", 33
cetirizine HCL, 25
Cleanlet Lancets 28G, 29
cevimeline HCL, 18
clearplex x, 8 clindacin etz pledgets, 8
Chantix, 20, 46
clemastine fumarate, 25 clindacin-p, 8
Chantix Continuing Month PAK, 20, 46
Clemastine Fumarate, 25 clindamax, 8
Chantix Starting Month PAK, 20, 46
Clever Chek Lancets Ultrathin, 29 clindamycin, 3
chateal, 10, 43
Clever Chek Lancets Ultrathin 30G, 29 clindamycin HCL, 3
Chek-stix Combo PAK Urinalysis Control, 42
Clever Choice Comfort EZ Insulin Pen Needles 31GX8MM, 33
clindamycin palmitate HCL, 3
clindamycin phosphate, 3, 8, 15
Chek-stix Control, 42
Clever Choice Comfort EZ Insulin Syringe/0.3ML/29G X 1/2", 33
clindamycin phosphate add-vantage, 3
Chemet, 41
clindamycin phosphate IN D5W, 3
Chemstrip Bg Log Book, 33
Clever Choice Comfort EZ Insulin clindamycin phosphate pharmacy bulk
package, 3
compro, 18 CVS Prenatal, 28, 44
clindamycin/benzoyl peroxide, 8
Comvax, 26, 45 CVS Prenatal Gummy/DHA/Folic Acid, 28
clinisol SF 15%, 40
Concerta, 19
clinpro 5000, 18
Condylox, 10 CVS Prenatal Multi+dha, 28
clobetasol propionate, 9
constulose, 14 CVS Prep Pads, 40
clobetasol propionate e, 9
controlrx, 18 CVS Slow Release Iron, 16, 46
clobetasol propionate emollient, 9
Copaxone, 20 CVS Ultra Thin Lancets, 29
clodan, 9
Cordran, 9 CVS vitamin d, 27, 47
Clolar, 4
Cordran Tape, 9 CVS vitamin d 5000 high-potency, 27, 47
clomiphene citrate, 13
Coreg CR, 6 CVS vitamin d3, 27, 47
clomipramine HCL, 18
Corifact, 17 cyanocobalamin, 16
clonazepam, 19
cormax scalp application, 9 cyclafem 1/35, 10, 43
clonazepam odt, 19
Cortifoam, 15 cyclafem 7/7/7, 10, 43
clonidine HCL, 6, 22
Cortisporin, 8 cyclobenzaprine HCL, 21
clonidine HCL ER, 19
Cortisporin-tc, 22 cyclopentolate HCL, 21
clopidogrel, 17
corvita, 27 cyclopentolate hydrochloride, 21
clorazepate dipotassium, 18
corvita 150, 16 Cyclophosphamide, 3
Closercare, 33
corvite free, 27 cyclophosphamide, 3
clotrimazole, 8, 18
cosyntropin, 40 Cycloset, 12
clotrimazole/betamethasone dipropionate, 8
Cotellic, 5 cyclosporine, 4
Creon, 14 cyclosporine modified, 4
clozapine, 18
Cresemba, 2 cyproheptadine HCL, 25
clozapine odt, 18
Crinone, 15 cyred, 10, 43
Clozapine Odt, 19
Crixivan, 2 Cystadane, 13
Cnl8 Nail Kit, 8
cromolyn sodium, 14, 22 Cystagon, 16
CO-natal Fa, 28
Cromolyn Sodium, 25 Cystaran, 22
Coagadex, 17
cryselle-28, 10, 43 cysteine HCL, 40
Coaguchek Lancets, 29
Cubicin, 3 cytarabine, 4
Coartem, 3
Cuprimine, 41 Cytarabine, 4
coated aspirin, 23, 42
Curity Alcohol Preps/Medium 2 Ply, 40 cytarabine aqueous, 4
codeine sulfate, 23
Curity Alcohol Swabs, 40 Cytogam, 42
Colchicine, 24
curity sterile saline, 15 cytra k crystals, 15
Colcrys, 24
Cuvposa, 14 cytra-2, 15
colestipol HCL, 7
CVS Alcohol Prep Swabs, 40 cytra-k, 15
colistimethate sodium, 3
CVS Alcohol Swabs, 40 D
colocort, 14
CVS aspirin, 23, 42
d 1000, 26, 46
Coly-mycin S, 22
CVS aspirin adult low dose, 23, 42
d 10000, 26, 46
Combigan, 21
CVS aspirin adult low strength, 23, 42
d 2000, 27, 46
Combipatch, 10
CVS aspirin child, 23, 42
d 400, 27, 46
Combivent Respimat, 25
CVS aspirin EC, 23, 43
d 5000, 27, 46
Cometriq, 5
CVS aspirin low dose, 23, 42
d-1000, 27, 46
Comfort Assist Insulin Syringe 0.3ML/29G X 1/2", 33
CVS aspirin low strength, 23, 42
d-1000 extra strength, 27, 46
CVS childrens aspirin, 23, 43
d-2000 maximum strength, 27, 46
Comfort Assist Insulin Syringe/0.3ML/30G X 5/16", 33
CVS d3, 27, 47
d-3-5, 27, 46
CVS enteric aspirin, 23, 43
d-400, 27, 46
Comfort Assist Insulin Syringe/0.3ML/31G X 5/16", 33
CVS folic acid, 16, 44
d-5000, 27, 47
CVS Insulin Syringe/0.3ML/29G X 1/2", 33
d-5000 maximum strength, 27, 47
Comfort Assist Insulin Syringe/0.5ML/29G X 1/2", 33
d-vita, 27, 46
CVS Insulin Syringe/0.3ML/30G X 1/2", 33
d2000 ultra strength, 27, 47
Comfort Assist Insulin Syringe/0.5ML/30G X 5/16", 33
d3, 27, 47
CVS Insulin Syringe/0.5ML/29G X 1/2", 33
d3 2000, 27, 47
Comfort Assist Insulin Syringe/0.5ML/31G X 5/16", 33
d3 adult, 27, 47
CVS Insulin Syringe/0.5ML/30G X 1/2", 33
d3 adult gummy, 27, 47
Comfort Assist Insulin Syringe/1ML/29G X 1/2", 33
D3 Dots, 27, 47
CVS Insulin Syringe/1ML/29G X 1/2", 33
d3 high potency, 27, 47
Comfort Assist Insulin Syringe/1ML/30G X 5/16", 33
CVS iron, 16, 46
d3 kids, 27, 47
CVS Lancets 21G, 29
d3 maximum strength, 27, 47
Comfort Assist Insulin Syringe/1ML/31G X 5/16", 33
CVS Lancets Micro Thin 33G, 29
d3 super strength, 27, 47
CVS Lancets Original, 29
d3 ultra strength, 27, 47
Comfort Assured Lancets Micro Thin 33G, 29
CVS Lancets Thin 26G, 29
d3-1000, 27, 47
CVS Lancets Ultra Thin 30G, 29
d3-50, 27, 47
Comfort Assured Lancets Super Thin 28G, 29
CVS Lancing Device, 33
dacarbazine, 5
CVS nicotine, 20, 46
Dacarbazine, 5
Comfort Lancets, 29
CVS nicotine lozenge, 20, 46
Daklinza, 2
compazine, 18
CVS nicotine polacrilex, 20, 46
Daliresp, 25
Complera, 2
CVS nicotine polacrilex starter, 20, 46
danazol, 10
Complete Natal DHA, 28
CVS nicotine transdermal system, 20, 46
dantrolene sodium, 21
Completenate, 28
CVS nts step 1, 20, 46
Dapsone, 3
Daptacel, 26, 45
40 diltiazem HCL ER, 6
Daraprim, 3
dextrose 30% partial fill, 40 Dipentum, 15
darifenacin ER, 15
dextrose 5%, 40 diphenhydramine HCL, 25
darifenacin hydrobromide ER, 15
dextrose 5% viaflex, 40 diphenoxylate/atropine, 14
Darzalex, 4
dextrose 5%/lactated ringers, 40 Diphtheria/Tetanus Toxoids Adsorbed Pediatric, 26, 45
dasetta 1/35, 10, 43
dextrose 5%/NACL 0.2%, 41
dasetta 7/7/7, 10, 43
dextrose 5%/NACL 0.33%, 41 dipyridamole, 17, 41
daunorubicin HCL, 3
dextrose 5%/NACL 0.45%, 41 disopyramide phosphate, 6
Daunoxome, 3
dextrose 5%/NACL 0.9%, 41 disulfiram, 20
daysee, 10, 43
dextrose 5%/potassium chloride 0.15%, 40
divalproex sodium, 19
Daytrana, 19
divalproex sodium DR, 19
Ddrops, 27, 47
dextrose 5%/ringers, 40 divalproex sodium ER, 19
deblitane, 10, 43
dextrose 5%/sodium chloride 0.2%, 40 dobutamine HCL, 7
decara, 27, 47
dextrose 5%/sodium chloride 0.33%, 40 dobutamine HCL/D5W, 7
Decara, 27, 47
dextrose 5%/sodium chloride 0.45%, 40 dobutamine/dextrose 5%, 7
decitabine, 4
dextrose 5%/sodium chloride 0.9%, 41 Docefrez, 4
deferoxamine mesylate, 40
dextrose 50%, 41 docetaxel, 4
dehydrated alcohol, 40
dextrose 70%, 41 Docetaxel, 4
delflex-lm/1.5% dextrose, 40
Diabeta, 12 Docetaxel (non- Alcohol Formula), 4
Delflex-lm/2.5% Dextrose, 41
dialyvite, 27 Docetaxel (non-alcohol Formula), 4
Delflex-lm/4.25% Dextrose, 41
dialyvite vitamin d 5000, 27, 47 donepezil HCL, 20
Delflex-sm/1.5% Dextrose, 41
dialyvite vitamin d3 max, 27, 47 dopamine HCL, 7
Delflex-sm/2.5% Dextrose, 41
Diascreen 10, 33 Dopamine HCL, 7
delta d3, 27, 47
Diascreen 1b, 33 dopamine HCL-dextrose 5%, 7
deltasone, 10
Diascreen 1G, 33 dopamine HCL/dextrose 5%, 7
delyla, 11, 43
Diascreen 1k, 33 dopamine/D5W, 7
Delzicol, 15
Diascreen 2GK, 33 Doribax, 3
demeclocycline HCL, 1
Diascreen 2GP, 33 dorzolamide HCL, 22
Demser, 6
Diascreen 3, 33 dorzolamide HCL/timolol maleate, 21
Denavir, 8
Diascreen 4nl, 33 doxapram HCL, 19
denta 5000 plus, 18
Diascreen 4obl, 33 doxazosin, 6
dentagel, 18
Diascreen 4PH, 33 doxazosin mesylate, 6
Depen Titratabs, 42
Diascreen 5, 33 doxepin HCL, 18
Depo-medrol, 10
Diascreen 6, 33 Doxepin HCL, 18
Depo-provera, 4
Diascreen 7, 33 Doxepin Hydrochloride, 8
Depo-subq Provera 104, 11, 44
Diascreen 8, 33 doxercalciferol, 13
Depocyt, 4
Diascreen 9, 33 doxorubicin HCL, 3
desipramine HCL, 18
Diascreen Liquid Urine Controls, 33 Doxorubicin HCL, 3
desloratadine, 25
Diastar Easy Test II Lancets 30G, 29 doxorubicin HCL liposome, 3
Desloratadine Odt, 25
Diastar Easy Test Lancets30G, 29 doxy 100, 1
desmopressin acetate, 13
diazepam, 18 doxycycline, 1
desogestrel/ethinyl estradiol, 11, 43
Diazepam, 18 Doxycycline, 8
desonide, 9
diazepam intensol, 18 doxycycline hyclate, 1
desoximetasone, 9
diclofenac potassium, 24 doxycycline hyclate DR, 1
Desoximetasone, 9
diclofenac sodium, 8, 9, 22 doxycycline monohydrate, 1
dexamethasone, 10
diclofenac sodium DR, 24 dronabinol, 14
Dexamethasone, 10
diclofenac sodium ER, 24 droperidol, 18
Dexamethasone Intensol, 10
diclofenac sodium/misoprostol, 24 Droplet Lancets Ultra Thin 30G, 29
dexamethasone sodium phosphate, 10, 21
diclotral PAK, 8 Droplet Lancing Device, 33
dicloxacillin sodium, 1 Droplet Pen Needles 29GX10MM, 33
Dexamethasone Sodium Phosphate, 10
dicyclomine hci, 14 Droplet Pen Needles 29GX12MM, 33
Dexchlorpheniramine Maleate, 25
dicyclomine HCL, 14 Droplet Pen Needles 31GX5MM, 33
dexedrine, 19
didanosine, 2 Droplet Pen Needles 31GX6MM, 33
dexferrum, 16
Dificid, 1 Droplet Pen Needles 31GX8MM, 33
Dexilant, 14
difil-G forte, 25 Droplet Pen Needles 32GX4MM, 33
dexmedetomidine HCL, 19
Diflorasone Diacetate, 9 Droplet Pen Needles 32GX5MM, 33
dexmethylphenidate HCL, 19
diflunisal, 22 Droplet Pen Needles 32GX6MM, 33
dexmethylphenidate HCL ER, 19
digitek, 5 Droplet Pen Needles 32GX8MM, 33
Dexpak 10 Day, 10
digox, 5 drospirenone/ethinyl estradiol, 11, 43
Dexpak 13 Day, 10
digoxin, 5 Droxia, 16
Dexpak 6 Day, 10
dihydroergotamine mesylate, 24 Drug Mart Adjustable Lancing Device, 33
dexrazoxane, 5
Dihydroergotamine Mesylate, 24 Drug Mart Lancets Thin, 29
dextroamphetamine sulfate, 19
Dilantin, 19 Drug Mart Lancets Ultra Thin, 29
dextroamphetamine sulfate ER, 19
Dilatrate SR, 5 Drug Mart On-the-go Lancets Gentle 30G, 29
dextrose 10%, 40
dilt-XR, 6
dextrose 10% flex container, 40
diltiazem CD, 6 Drug Mart Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2", 33
dextrose 2.5%/NACL 0.45%, 40
diltiazem HCL, 6
dextrose 2.5%/sodium chloride 0.45%,
diltiazem HCL CD, 6 Drug Mart Ultra Comfort Insulin
Syringe/0.3ML/30G X 5/16", 33
5/16", 34 100/1ML/31G X 5/16", 34
Drug Mart Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16", 33
Easy Comfort Insulin Syringe/1ML/31G X 5/16", 34
Easy Touch Lancets 21G/Pressure Activated, 29
Drug Mart Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16", 33
Easy Comfort Insulin Syringe/U-100/0.5ML/30G X 1/2", 33
Easy Touch Lancets 23G/Pressure Activated, 29
Drug Mart Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16", 33
Easy Comfort Insulin Syringe/U-100/1ML/30G X 1/2", 34
Easy Touch Lancets 26G/Pressure Activated, 29
Drug Mart Ultra Comfort Insulin Syringe/1ML/29G X 1/2", 33
Easy Comfort Lancets, 29 Easy Touch Lancets 26G/Pull-top, 29
Easy Comfort Lancets 30G/Pull Top, 29 Easy Touch Lancets 26G/Twist, 29
Drug Mart Ultra Comfort Insulin Syringe/1ML/30G X 5/16", 33
Easy Comfort Lancets 30G/Thin Top, 29 Easy Touch Lancets 28G/Pressure Activated, 29
Easy Comfort Pen Needles 31GX1/4", 34
Drug Mart Unifine Pentips 31GX5MM, 33
Easy Comfort Pen Needles 31GX3/16", 34
Easy Touch Lancets 28G/Pull-top, 29
Drug Mart Unifine Pentips29G X 12MM, 33
Easy Touch Lancets 28G/Twist, 29
Easy Comfort Pen Needles 31GX5/16", 34
Easy Touch Lancets 30G/Button-activated, 29
Drug Mart Unifine Pentips31GX6MM, 33
Drug Mart Unifine Pentips31GX8MM, 33
Easy Comfort Pen Needles 32GX5/32", 34
Easy Touch Lancets 30G/Pressure Activated, 29
Drug Mart Unifine Pentips32GX4MM, 33
Drug Mart Unifine Pentipsplus 32GX4MM, 33
Easy Mini Eject Lancing Device, 34 Easy Touch Lancets 30G/Pull-top, 29
Easy Mini Lancing Device, 34 Easy Touch Lancets 30G/Twist, 29
Drug Mart Unilet Lancets Super Thin 30G, 29
Easy Touch 32GX5MM, 34 Easy Touch Lancets 32G/Pressure Activated, 29
Easy Touch 32GX6MM, 34
Drug Mart Unilet Lancets Ultra Thin 28G, 29
Easy Touch Alcohol Prep Pads/Medium, 40
Easy Touch Lancets 32G/Pull-top, 29
Easy Touch Lancets 32G/Twist, 29
Duane Reade Lancet Alternate Site 26G, 29
Easy Touch Fliplock Safety Insulin Syringe 1ML/29GX1/2", 34
Easy Touch Lancets 33G/Twist, 30
Easy Touch Lancing Device/Ejector, 34
Duane Reade Lancet Super Thin 30G, 29
Easy Touch Fliplock Safety Insulin Syringe 1ML/30GX1/2", 34
Easy Touch Pen Needles 29GX1/2", 34
Easy Touch Pen Needles 31GX1/4", 34
Duane Reade Lancet Ultra Thin 28G, 29
Easy Touch Fliplock Safety Insulin Syringe 1ML/30GX5/16", 34
Easy Touch Pen Needles 31GX5/16", 34
Duane Reade Unifine Pentips 29G X 12MM, 33
Easy Touch Pen Needles 32GX1/4", 34
Easy Touch Fliplock Safety Insulin Syringe 1ML/31GX5/16", 34
Easy Touch Pen Needles 32GX3/16", 34
Duane Reade Unifine Pentips 31G X 6MM Ultra SHORT, 33
Easy Touch Pen Needles 32GX5/32", 34
Easy Touch Insulin Syringe/0.3ML/30G X 5/16", 34
Easy Touch Pen Needles/31G X 3/16", 34
Duane Reade Unifine Pentips 31G X 8MM SHORT, 33
Easy Touch Insulin Syringe/0.3ML/31G X 5/16", 34
Easy Touch Safety Lancets21G/Pressure Activated, 30
Dulera, 25
duloxetine HCL, 18
Easy Touch Insulin Syringe/0.5ML/29G X 1/2", 34
Easy Touch Safety Lancets23G/Pressure Activated, 30
Duloxetine HCL, 18
duramorph, 23
Easy Touch Insulin Syringe/0.5ML/30G X 5/16", 34
Easy Touch Safety Lancets26G/Button Activated, 30
duraxin, 22
Durezol, 21
Easy Touch Insulin Syringe/1ML/30G X 5/16", 34
Easy Touch Safety Lancets26G/Pressure Activated, 30
dutasteride, 15
dutasteride/tamsulosin HCL, 15
Easy Touch Insulin Syringe/Safety/U-100/0.5ML/29G X 1/2", 34
Easy Touch Safety Lancets28G/Button Activated, 30
dutasteride/tamsulosin hydrochloride, 15
Dymista, 25
Easy Touch Insulin Syringe/Safety/U-100/0.5ML/30G X 5/16", 34
Easy Touch Safety Lancets28G/Pressure Activated, 30
Dyrenium, 7
Dysport, 21
Easy Touch Insulin Syringe/Safety/U-100/1ML/29G X 1/2", 34
Easy Touch Sheathlock Safety Insulin Syringe 1ML/29GX1/2", 34
E
Easy Touch Insulin Syringe/Safety/U-100/1ML/30G X 1/2", 34
Easy Touch Sheathlock Safety Insulin Syringe 1ML/30GX5/16", 34
E-z Ject Lancets, 29
E-z Ject Lancets 21G, 29
Easy Touch Insulin Syringe/U-100/0.3ML/30G X 1/2", 34
Easy Touch Sheathlock Safety Insulin Syringe 1ML/31GX5/16", 34
E-z Ject Lancets Color, 29
E-z Ject Lancets Super Thin, 29
Easy Touch Insulin Syringe/U-100/0.5ML/27G X 1/2", 34
Easy Touch Sheathlock Safety Syringe 1ML/30GX1/2", 34
E-z Ject Lancets Super Thin 30G, 29
E-z Ject Lancets Thin 26G, 29
Easy Touch Insulin Syringe/U-100/0.5ML/28G X 1/2", 34
Easy Twist & CAP Lancets, 30
E-z Spacer, 40
easygel, 18
E-z Spacer The Body Guards Pack, 40
Easy Touch Insulin Syringe/U-100/0.5ML/30G X 1/2", 34
Easytest II Lancets, 30
E-ZJECT Lancets Micro-thin 33G, 29
Easytest Lancets, 30
e.s.p., 3
Easy Touch Insulin Syringe/U-100/0.5ML/31G X 5/16", 34
EC-81 aspirin, 23, 43
Easivent, 40
econazole nitrate, 8
Easivent/Mask-large, 40
Easy Touch Insulin Syringe/U-100/1ML/27G X 1/2", 34
econtra EZ, 11, 43
Easivent/Mask-medium, 40
ecotrin, 23, 42
Easivent/Mask-small, 40
Easy Touch Insulin Syringe/U-100/1ML/28G X 1/2", 34
ecotrin low strength, 23, 42
Easy Comfort Insulin Syringe/0.3ML/30G X 5/16", 34
ecpirin, 23, 42
Easy Touch Insulin Syringe/U-100/1ML/29G X 1/2", 34
ed-flex, 22
Easy Comfort Insulin Syringe/0.5ML/30G X 5/16", 34
ed-spaz, 14
Easy Touch Insulin Syringe/U-100/1ML/30G X 1/2", 34
Edarbi, 6
Easy Comfort Insulin Syringe/0.5ML/31G X 5/16", 34
Edecrin, 7
Easy Touch Insulin Syringe/U- Edurant, 2
Easy Comfort Insulin Syringe/1ML/30G X
effer-k, 41
enpresse-28, 11, 43 Eql Prenatal Formula, 28, 44
Effer-k, 42
enskyce, 11, 43 Eql SHORT Pen Needles 31G X 8MM, 34
effervescent pot chloride, 41
entacapone, 20
effervescent potassium, 41
entecavir, 2 eql slow release iron, 16, 45
effervescent potassium/chloride, 41
enteric coated aspirin, 23, 42 Eql Super Thin Lancets 30G, 30
Effient, 17
enulose, 14 Eql Thin Lancets 26G, 30
Egrifta, 13
ephedrine sulfate, 7 Eql Ultra Comfort Insulinsyringe/0.3ML/31G X 5/16", 34
Elaprase, 13
epinastine HCL, 22
Elelyso, 17
Epinephrine, 7 Eql Ultra Comfort Insulinsyringe/1ML/30G X 5/16", 34
elenzapatch, 9
epinephrine HCL, 25
Elidel, 9
Epipen 2-PAK, 7 Eql Ultra SHORT Pen Needles 31G X 6MM, 34
Eligard, 4
Epipen-JR 2-PAK, 7
elinest, 11, 43
epirubicin HCL, 3 eql vitamin d-3, 27, 47
Eliquis, 17
Epirubicin HCL, 3 eql vitamin d3, 27, 47
Elite Iron, 16, 46
episone CRE, 9 Eraxis, 2
Elite-OB, 28
epitol, 19 Erbitux, 4
Elite-thin Insulin Syringe/0.3ML/31G X 5/16", 34
Epivir HBV, 2 ergocalciferol, 26
eplerenone, 6 ergoloid mesylates, 20
Elite-thin Insulin Syringe/0.5ML/29G X 1/2", 34
Epogen, 17 Ergoloid Mesylates, 20
epoprostenol sodium, 7 Ergomar, 24
Elite-thin Insulin Syringe/0.5ML/30G X 5/16", 34
Eprosartan Mesylate, 6 Erivedge, 5
eptifibatide, 17 errin, 11, 43
Elite-thin Insulin Syringe/1ML/29G X 5/16", 34
Epzicom, 2 Ertaczo, 8
eq adult aspirin low strength, 23, 42 Erwinaze, 3
Elite-thin Insulin Syringe/1ML/30G X 5/16", 34
eq aspirin, 23, 42 ery, 8
eq aspirin adult low dose, 23, 42 Ery-TAB, 1
Elite-thin Insulin Syringe/U-100/0.5ML/28G X 1/2", 34
eq aspirin EC, 23, 42 Erythrocin Lactobionate, 1
eq aspirin low dose, 23, 42 erythromycin, 1, 8, 21
Elite-thin Insulin Syringe/U-100/0.5ML/28G X 5/16", 34
eq childrens aspirin, 23, 42 Erythromycin Base, 1
eq nicotine, 20, 46 erythromycin/benzoyl peroxide, 8
Elite-thin Insulin Syringe/U-100/0.5ML/29G X 5/16", 34
eq nicotine gum refill, 20, 46 Esbriet, 25
eq nicotine gum starter, 20, 46 Escavite LQ, 28
Elite-thin Insulin Syringe/U-100/0.5ML/31G X 5/16", 34
eq nicotine polacrilex, 20, 46 escitalopram oxalate, 18
eq nicotine step 3, 20, 46 esgic, 22
Elite-thin Insulin Syringe/U-100/1ML/28G X 1/2", 34
eq slow-release iron, 16, 45 esmolol HCL, 6
eql adult aspirin low strength, 23, 42 esomeprazole magnesium, 14
Elite-thin Insulin Syringe/U-100/1ML/28G X 5/16", 34
eql aspirin, 23, 42 esomeprazole sodium, 14
eql aspirin EC, 23, 42 Esomeprazole Sodium, 14
Elite-thin Insulin Syringe/U-100/1ML/29G X 1/2", 34
eql aspirin low dose, 23, 42 Esomeprazole Strontium, 14
eql childrens aspirin, 23, 42 estarylla, 11, 43
Elite-thin Insulin Syringe/U-100/1ML/31G X 5/16", 34
eql childrens vitamin d gummies, 27, 47 estazolam, 19
Eql Color Lancets 21G, 30 Estrace, 15
Elitek, 5
Eql Color Lancets Micro Thin 33G, 30 estradiol, 10
Elixophyllin, 25
eql folic acid, 16, 44 estradiol valerate, 10
Ella, 11
Eql Insulin Syringe/0.3ML/29G X 1/2", 34 estradiol/norethindrone acetate, 10
Elmiron, 16
Eql Insulin Syringe/0.3ML/30G X 5/16", 34
estropipate, 10
Eloctate, 17
eszopiclone, 19
Emadine, 22
Eql Insulin Syringe/0.3ML/31G X 5/16", 34
ethacrynate sodium, 7
Embeda, 24
ethambutol HCL, 2
Embrace Lancets Ultra Thin 30G, 30
Eql Insulin Syringe/0.5ML/29G X 1/2", 34 ethosuximide, 19
Emcyt, 4
Eql Insulin Syringe/0.5ML/30G X 5/16", 34
Etidronate Disodium, 12
Emend, 14
etodolac, 24
emoquette, 11, 43
Eql Insulin Syringe/0.5ML/31G X 5/16", 34
etodolac ER, 24
Empliciti, 4
Etopophos, 4
Emsam, 18
Eql Insulin Syringe/1ML/29G X 1/2", 34 Etoposide, 4
Emtriva, 2
Eql Insulin Syringe/1ML/30G X 5/16", 34 etoposide, 4
enalapril maleate, 6
Eql Insulin Syringe/1ML/31G X 5/16", 34 Eurax, 10
enalapril maleate/hydrochlorothiazide, 7
Eql Insulin Syringe/U-100/0.3ML/29G X 1/2", 34
Evamist, 10
enalaprilat, 6
Evotaz, 2
Enbrel, 24
Eql Insulin Syringe/U-100/0.5ML/29G X 1/2", 34
Exalgo, 24
Enbrel Sureclick, 24
Excel Comfort Point Insulin Pen Needles 31G X 4MM, 34
Encare, 15, 44
Eql Insulin Syringe/U-100/1ML/29G X 1/2", 34
endocet, 23
Exel Comfort Point Insulin Pen Needles 29G X 12MM, 34
endodan, 23
eql iron supplement therapy, 16, 45
Enfamil Expecta, 28
eql nicotine, 20, 46 Exel Comfort Point Insulin Pen Needles 31G X 6MM, 34
Engerix-b, 26, 45
eql nicotine polacrilex, 20, 46
Enjuvia, 10
eql nicotine polacrilex refill, 20, 46 Exel Comfort Point Insulin Pen Needles 31G X 8MM, 34
enoxaparin sodium, 17
eql nicotine polacrilex starter, 20, 46
Exel Comfort Point Insulin Syringe/0.3ML/29G X 1/2", 34
Feosol, 16, 46 Fluarix 2014-2015, 26, 45
fer-iron, 16, 45 Fluarix Quadrivalent 2013-2014, 26, 45
Exel Comfort Point Insulin Syringe/0.3ML/30G X 5/16", 34
ferate, 16, 45 Fluarix Quadrivalent 2014-2015, 26, 45
fergon, 16, 45 Fluarix Quadrivalent 2015-2016, 26, 45
Exel Comfort Point Insulin Syringe/0.5ML/28G X 1/2", 34
ferocon, 16 Flublok 2013-2014, 26, 45
ferosul, 16, 45 Flublok 2014-2015, 26, 45
Exel Comfort Point Insulin Syringe/0.5ML/29G X 1/2", 34
ferotrinsic, 16 Flublok 2015-2016, 26, 45
Ferretts, 16, 46 flucaine, 22
Exel Comfort Point Insulin Syringe/0.5ML/30G X 5/16", 34
Ferretts Chewable Iron, 16 Flucelvax 2013-2014, 26, 45
Ferretts IPS, 16, 46 Flucelvax 2014-2015, 26, 45
Exel Comfort Point Insulin Syringe/1ML/28G X 1/2", 34
ferrex 150, 16, 45 Flucelvax 2015-2016, 26, 45
ferric x-150, 16, 45 fluconazole, 2
Exel Comfort Point Insulin Syringe/1ML/29G X 1/2", 34
Ferrimin 150, 16, 46 fluconazole IN dextrose, 2
Ferriprox, 42 fluconazole IN NACL, 2
Exel Comfort Point Insulin Syringe/1ML/30G X 5/16", 34
ferro-bob, 16, 45 flucytosine, 2
Ferro-sequels, 16, 46 fludarabine phosphate, 4
Exelderm, 8
ferrocite, 16 fludrocortisone acetate, 10
exemestane, 4
ferrocite plus, 16 Flulaval 2013-2014, 26, 45
Exjade, 42
ferrogels forte, 16 Flulaval 2014-2015, 26, 45
Eylea, 22
ferrotabs, 16, 45 Flulaval Quadrivalent 2013-2014, 26, 45
EZ Smart Blood Glucose Lancets, 30
ferrous drops, 16, 45 Flulaval Quadrivalent 2014-2015, 26, 45
EZ-lets Lancets 21G, 30
Ferrous Fumarate, 16, 46 Flulaval Quadrivalent 2015-2016, 26, 45
EZ-lets Lancets 23G, 30
ferrous fumarate 324, 16 flumazenil, 41
EZ-lets Lancets 26G Super-soft, 30
ferrous gluconate, 16, 45 Flumist Quadrivalent, 26, 45
EZ-lets Lancets 28G Ultra-soft, 30
Ferrous Gluconate, 16, 46 flunisolide, 25
EZ-lets Lancets 30G, 30
ferrous sulfate, 16, 45 fluocinolone acetonide, 9, 22
ezfe 200, 16, 45
Ferrous Sulfate, 16, 46 fluocinolone acetonide body, 9
F
ferrousul, 16, 45 fluocinolone acetonide ear drops, 22
Fibricor, 7 fluocinolone acetonide scalp, 9
fa-8, 16, 44
Fifty50 Alcohol Prep Pads, 40 fluocinonide, 9
Fa-8, 16, 44
Fifty50 Lancing Device, 34 fluocinonide-e, 9
fabb, 16
Fifty50 Pen Needles 31G X3/16" (5MM), 34
fluor-a-day, 41, 44
Fabrazyme, 13
Fluor-a-day, 41, 44
Factive, 1
Fifty50 Pen Needles 31G X5/16" (8MM), 34
fluor-i-strips a.t., 22
fallback solo, 11, 43
fluorescein-benoxinate, 22
falmina, 11, 43
Fifty50 Pen Needles 31GX5MM, 34 fluorescein/proparacaine, 22
famciclovir, 2
Fifty50 Pen Needles/31GX8MM, 34 fluoride, 41, 44
famotidine, 14
Fifty50 Pen Needles/32GX4MM, 34 fluoridex daily defense, 18
Famotidine, 14
Fifty50 Pen Needles/32GX6MM, 34 fluoridex daily defense enhanced whitening, 18
Fanapt, 19
Fifty50 Safety Seal Lancets 30G, 30
Fanapt Titration Pack, 19
Fifty50 Safety Seal Lancets 32G, 30 fluoridex daily defense sensitivity relief, 18
Fareston, 4
Fifty50 Superior Comfort Insulin Syringe/0.3ML/31G X 5/16", 34
Farydak, 5
fluoritab, 41, 44
Faslodex, 4
Fifty50 Superior Comfort Insulin Syringe/0.5ML/31G X 5/16", 34
fluorometholone, 21
Fazaclo, 19
Fluoroplex, 10
Fc Female Condom, 44
Fifty50 Superior Comfort Insulin Syringe/1ML/31G X 5/16", 34
fluorouracil, 4, 9
Fc2 Female Condom, 44
fluoxetine DR, 18
FE Aspartate, 16, 46
Fifty50 Unilet Lancets 33G, 30 fluoxetine HCL, 18
FE c plus, 16
Finacea, 8 fluphenazine decanoate, 18
FE gluconate, 16, 46
finasteride, 15 fluphenazine HCL, 18
FE TABS, 16, 46
Fine 30, 30 flura-drops, 41, 44
Feiba, 17
Fingerstix Lancets, 30 flurandrenolide, 9
Feiba NF, 17
Firazyr, 17 flurazepam HCL, 19
felbamate, 19
Firmagon, 4 Flurazepam HCL, 19
felodipine ER, 6
Flagyl ER, 3 flurbiprofen, 24
Femcap, 44
Flarex, 21 flurbiprofen sodium, 22
Femiron, 16, 46
flavoxate HCL, 15 flurox, 22
fenofibrate, 7
Flebogamma Dif, 42 flutamide, 4
Fenofibrate, 7
flecainide acetate, 6 fluticasone propionate, 9, 25
fenofibrate micronized, 7
flexbumin, 17 fluvastatin, 7
Fenofibric Acid, 7
Flexichamber, 40 fluvastatin sodium ER, 7
fenofibric acid DR, 7
Flexichamber Adult Mask/Small, 40 Fluvirin 2013-2014, 26, 45
Fenoglide, 7
Flexichamber Child Mask/Large, 40 Fluvirin 2014-2015, 26, 45
fenoldopam mesylate, 6
Flexichamber Child Mask/Small, 40 Fluvirin 2015-2016, 26, 45
Fenoprofen Calcium, 24
floriva plus, 27 Fluvirin PF 2013-2014, 26, 45
fentanyl, 23
floxuridine, 4 Fluvirin PF 2014-2015, 26, 45
Fentanyl, 24
Floxuridine, 4 fluvoxamine maleate, 18
fentanyl citrate oral transmucosal, 23
Fluarix 2013-2014, 26, 45 fluvoxamine maleate ER, 18
feosol, 16, 45
Fluzone High-dose PF 2013-2014, 26, 45
Fusilev, 5 Gleostine, 3
Fuzeon, 2 Gliadel Wafer, 3
Fluzone High-dose PF 2014-2015, 26, 45
fyavolv, 10 glimepiride, 12
Fycompa, 19 glipizide, 12
Fluzone High-dose PF 2015-2016, 26, 45
G glipizide ER, 12
glipizide XL, 12
gabapentin, 19
Fluzone Intradermal, 26, 45
glipizide/metformin HCL, 12
Gabitril, 19
Fluzone Intradermal Quadrivalent 2015-2016, 26, 45
Global Alcohol Prep Ease Pads, 40
galantamine hydrobromide, 20
Global Ease Inject Pen Needles 29GX12MM, 34
Galantamine Hydrobromide, 20
Fluzone Pediatric PF 2013-2014, 26, 45
Gamastan S/D, 42
Fluzone PF 2013-2014, 26, 45
Global Ease Inject Pen Needles 31GX8MM, 34
Gammagard Liquid, 42
Fluzone PF 2014-2015, 26, 45
Gammagard S/D, 42
Fluzone Quadrivalent 2013-2014, 26, 45
Global Ease Inject Pen Needles 32GX4MM, 34
Gammagard S/D Iga Less Than 1mcg/ML, 42
Fluzone Quadrivalent 2014-2015, 26, 45
Fluzone Quadrivalent 2015-2016, 26, 45
Global Ease Inject Pen Neeedles 31GX5MM, 34
Gammaked, 42
Fluzone Split 2013-2014, 26, 45
Gammaplex, 42
Fluzone Split 2014-2015, 26, 45
Global Inject Ease Insulin Syringe/U-100/0.3ML/29G X 1/2", 34
Gamunex-c, 42
Fluzone Split 2015-2016, 26, 45
ganciclovir, 2
FML, 21
Global Inject Ease Insulin Syringe/U-100/0.3ML/30G X 1/2", 34
garamycin, 21
Focalin XR, 19
Gardasil, 26, 45
folbee, 16
Global Inject Ease Insulin Syringe/U-100/0.3ML/30G X 5/16", 34
Gardasil 9, 26, 45
folbee plus, 27
Gastrinex NF, 14
folbee plus cz, 27
Global Inject Ease Insulin Syringe/U-100/0.3ML/31G X 5/16", 34
gatifloxacin, 21
folic acid, 16, 44
Gattex, 15
folic acid/vitamin b-6/vitamin b-12, 16
Global Inject Ease Insulin Syringe/U-100/0.5ML/28G X 1/2", 34
gavilyte-c, 14, 47
Folotyn, 4
gavilyte-G, 14, 47
folplex 2.2, 16
Global Inject Ease Insulin Syringe/U-100/0.5ML/29G X 1/2", 34
gavilyte-h, 14
foltrin, 16
gavilyte-n/flavor pack, 14, 47
fomepizole, 41
Global Inject Ease Insulin Syringe/U-100/0.5ML/30G X 1/2", 35
Gazyva, 4
fondaparinux sodium, 17
Gelnique, 15
Fora Lancets, 30
Global Inject Ease Insulin Syringe/U-100/0.5ML/30G X 5/16", 35
gemcitabine, 4
Fora Lancing Device, 34
gemcitabine HCL, 4
Fora Lancing Device/Clearcap, 34
Global Inject Ease Insulin Syringe/U-100/0.5ML/31G X 5/16", 35
gemfibrozil, 7
Foradil Aerolizer, 25
gene-xene TAB 15MG, 18
formadon, 41
Global Inject Ease Insulin Syringe/U-100/1ML/28G X 1/2", 35
gene-xene TAB 3.75MG, 18
formaldehyde, 41
gene-xene TAB 7.5MG, 18
Forteo, 13
Global Inject Ease Insulin Syringe/U-100/1ML/29G X 1/2", 35
generlac, 14
Fosamax Plus D, 12
gengraf, 4
fosinopril sodium, 6
Global Inject Ease Insulin Syringe/U-100/1ML/30G X 1/2", 35
gentak, 21
fosinopril sodium/hydrochlorothiazide, 7
gentamicin sulfate, 1, 21
fosphenytoin sodium, 19
Global Inject Ease Insulin Syringe/U-100/1ML/30G X 5/16", 35
gentamicin sulfate pediatric, 1
Fosrenol, 15
gentamicin sulfate/0.9% sodium chloride, 1
Fragmin, 17
Global Inject Ease Insulin Syringe/U-100/1ML/31G X 5/16", 35
Freds Pharmacy Autolet Lancing Device, 34
Gentle-let GP Lancets, 30
Global Inject Ease Lancets 28G, 30
Gentle-let Lancets General Purpose Style/Fine Point, 30
Freds Pharmacy Unifine Pentips Pen Needles 32GX4MM, 34
Global Inject Ease Lancets 30G, 30
Global Lancing Device, 35
Gentle-let Lancets General Purpose Style/Medium Point, 30
Freds Pharmacy Unifine Pentips Plus 31GX5MM, 34
Glucagen Hypokit, 12
Glucagon Emergency Kit, 12
Gentle-let Lancets Safety Style/Fine Point, 30
Freds Pharmacy Unifine Pentips Plus 31GX8MM, 34
Glucocom Autolink Telemonitoring System, 35
Gentle-let Lancets Safety Style/Medium Point, 30
Freds Pharmacy Unilet Lancets Super Thin 30G, 30
Glucocom Lancets 28G, 30
Glucocom Lancets 30G, 30
Gentle-let Platforms 2.4MM, 34
Freds Pharmacy Unilet Lancets Ultra Thin 28G, 30
Glucocom Lancets 33G, 30
Gentle-let Platforms 3.0MM, 34
Glucolet 2 Automatic Lancing Device, 35
Geodon, 19
Freestyle Lancets, 30
Glucopro Insulin Syringe/U-100/0.3ML/30G X 1/2", 35
gianvi, 11, 43
Freestyle Precision Insulin Syringe/U-100/0.5ML/30G X 5/16", 34
gildagia, 11, 43
Glucopro Insulin Syringe/U-100/0.3ML/30G X 5/16", 35
gildess 1.5/30, 11, 43
Freestyle Precision Insulin Syringe/U-100/0.5ML/31G X 5/16", 34
gildess 1/20, 11, 43
Glucopro Insulin Syringe/U-100/0.3ML/31G X 5/16", 35
gildess 24 FE, 11, 43
Freestyle Precision Insulin Syringe/U-100/1ML/31G X 5/16", 34
gildess FE 1.5/30, 11, 43
Glucopro Insulin Syringe/U-100/0.5ML/30G X 1/2", 35
gildess FE 1/20, 11, 43
Freestyle Precision Insulin Syringes/U-100/1ML/30G X 5/16", 34
Gilenya, 20
Glucopro Insulin Syringe/U-100/0.5ML/30G X 5/16", 35
Gilotrif, 5
Freestyle Unistick II Lancets, 30
giltuss pediatric, 25
frovatriptan succinate, 24
Glucopro Insulin Syringe/U-100/0.5ML/31G X 5/16", 35
Glassia, 26
ful-GLO, 22
glatopa, 20
furosemide, 7
Glucopro Insulin Syringe/U-100/1ML/30G
Gleevec, 5
X 1/2", 35
Gnp Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16" SHORT, 35
Haemolance Plus High Flow, 30
Glucopro Insulin Syringe/U-100/1ML/30G X 5/16", 35
Haemolance Plus Low Flow, 30
Gnp Ultra Comfort Insulin Syringe/0.5ML/28G X 1/2", 35
Haemolance Plus Max Flow, 30
Glucopro Insulin Syringe/U-100/1ML/31G X 5/16", 35
Haemolance Plus Pediatric Flow, 30
Gnp Ultra Comfort Insulin Syringe/0.5ML/29G X 1/2", 35
Halaven, 4
Glucose Control Normal, 30
halobetasol propionate, 9
Glucose Control Solution, 30
Gnp Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16" SHORT, 35
Halog, 9
Glucosource Lancet Device, 35
halonate PAC, 9
Glucosource Lancets, 30
Gnp Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16" SHORT, 35
haloperidol, 18
glyburide, 12
haloperidol decanoate, 18
Glyburide, 12
Gnp Ultra Comfort Insulin Syringe/1ML/28G X 1/2", 35
haloperidol lactate, 18
glyburide micronized, 12
Harvoni, 2
glyburide/metformin HCL, 12
Gnp Ultra Comfort Insulin Syringe/1ML/29G X 1/2", 35
Havrix, 26, 45
glycine, 15
Health Care Lancing Device, 35
glycopyrrolate, 14
Gnp Ultra Comfort Insulin Syringe/1ML/30G X 5/16" SHORT, 35
Healthwise Alcohol Prep Pads, 40
glydo, 9
Healthwise Lancets 30G, 30
Glyset, 12
Gnp Ultra Comfort Insulin Syringe/1ML/31G X 5/16" SHORT, 35
Healthwise Lancing Pen, 35
Gmate Lancets 30G, 30
Healthwise Mini Pen Needles 31GX6MM, 35
Gmate Lancing Device, 35
gnp vitamin d, 27, 47
gnp adult aspirin low strength, 23, 42
gnp vitamin d maximum strength, 27, 47 Healthwise Pen Needles 29GX12MM, 35
Gnp Alcohol Swabs, 40
gnp vitamin d super strength, 27, 47 Healthwise SHORT Pen Needles 31GX8MM, 35
gnp aspirin, 23, 42
gnp vitamin d3 extra strength, 27, 47
gnp aspirin low dose, 23, 42
goodsense aspirin low dose, 23, 42 Healthwise Unifine Pentips Pen Needles 32GX4MM, 35
Gnp Clickfine Pen Needle Universal/31GX5/16", 35
goodsense nicotine gum, 20, 46
Goodsense Prenatal Vitamins, 28, 44 Healthy Accents Autolet Impression Lancing Device, 35
Gnp Clickfine Universal Pen Needles 31GX1/4", 35
grafco silver nitrate applicator, 9
grafco silver nitrate applicator 12", 9 Healthy Accents Unifine Pentips Pen Needles 29GX12MM, 35
Gnp Clickfine Universal Pen Needles 31GX5/16", 35
Gralise, 20
Gralise Starter, 20 Healthy Accents Unifine Pentips Pen Needles 31GX5MM, 35
Gnp Daily Prenatal, 28, 44
granisetron HCL, 14
gnp folic acid, 16, 44
Granisol, 14 Healthy Accents Unifine Pentips Pen Needles 31GX6MM, 35
Gnp Insulin Syringe/0.3ML/29G X 1/2", 35
green GLO lissamine greenophthalmic strips, 22
Healthy Accents Unifine Pentips Pen Needles 31GX8MM, 35
Gnp Insulin Syringe/0.3ML/30G X 5/16", 35
griseofulvin microsize, 2
griseofulvin ultramicrosize, 2 Healthy Accents Unifine Pentips Pen Needles 32GX4MM, 35
Gnp Insulin Syringe/0.3ML/31G X 5/16", 35
guanfacine ER, 19
guanfacine HCL, 6 Healthy Accents Unilet Lancets Super Thin 30G, 30
Gnp Insulin Syringe/0.5ML/28G X 1/2", 35
Guanidine HCL, 21
Gynazole-1, 15 healthy kids vitamin d3, 27, 47
Gnp Insulin Syringe/0.5ML/29G X 1/2", 35
H Healthy Mama Be Well Rounded, 28
heather, 11, 43
H&h Thinlet Lancets 26G, 30
Gnp Insulin Syringe/0.5ML/30G X 5/16", 35
hecoria, 4
H&h Thinlet Super Thin Lancets 30G, 30
Hectorol, 13
H-e-b IN Control Pen Needles 31GX5MM, 35
Gnp Insulin Syringe/0.5ML/31G X 5/16", 35
Helixate FS, 17
hematinic plus vitamins/minerals, 16
H-e-b IN Control Pen Needles 31GX6MM, 35
Gnp Insulin Syringe/1ML/28G X 1/2", 35
hematinic/folic acid, 16
Gnp Insulin Syringe/1ML/29G X 1/2", 35
hematogen, 16
H-e-b IN Control Pen Needles 31GX8MM, 35
Gnp Insulin Syringe/1ML/30G X 5/16", 35
hematogen forte, 16
Gnp Insulin Syringe/1ML/31G X 5/16", 35
hemocyte-f, 16
H-e-b IN Control Pen Needles/Nano/32GX4MM, 35
gnp iron, 16, 45
hemocyte-plus, 16
Gnp Lancets, 30
Hemofil M, 17
H-e-b IN Control Unifine Pentips Plus 31GX5MM, 35
Gnp Lancets 21G, 30
hep flush-10, 17
Gnp Lancets Micro Thin 33G, 30
Hepagam B, 42
H-e-b IN Control Unifine Pentips Plus 32GX4MM, 35
Gnp Lancets Super Thin 30G, 30
heparin lock, 17
Gnp Lancets Thin, 30
heparin lock flush, 17
H-e-b Incontrol Advanced Lancing Device, 35
Gnp Lancets Thin 26G, 30
heparin lock flush for flushing vascular access devices, 17
Gnp Micro Thin Lancets 33G, 30
H-e-b Incontrol Lancets Micro Thin 33G, 30
gnp nicotine mini lozenge, 20, 46
heparin lock flush/NACL for flushing vascular access devices, 17
gnp nicotine polacrilex, 20, 46
H-e-b Incontrol Lancets Super Thin 30G, 30
gnp nicotine polacrilex mini, 20, 46
heparin sodium, 17
Gnp Prenatal, 28, 44
heparin sodium dcu, 17
H-e-b Incontrol Lancets Ultra Thin 28G, 30
Gnp Prenatal Vitamins, 28, 44
heparin sodium lock flush, 17
gnp slow release iron, 16, 45
heparin sodium/D5W, 17
H-e-b Incontrol Pen Needles 29GX12MM, 35
Gnp Super Thin Lancets/30G, 30
heparin sodium/NACL 0.9%, 17
Gnp Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2", 35
heparin sodium/sodium chloride 0.9% premix, 17
H.p. Acthar, 13
Haemolance, 30
Gnp Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16" SHORT, 35
Herceptin, 4
Haemolance Low Flow Lancets, 30
hetastarch 6%/NACL, 17
Haemolance Plus, 30
Hetlioz, 19
hydrocortisone acetate/pramoxine, 14 indapamide, 7
Hexalen, 3
hydrocortisone butyrate, 9 Inderal XL, 6
Hiberix, 26, 45
hydrocortisone butyrate (lipid), 9 indigo carmine, 41
high potency iron, 16, 45
hydrocortisone butyrate (lipophilic), 9 indiomin mb, 15
High Potency Iron, 16, 46
hydrocortisone IN absorbase, 9 indocyanine green, 41
Hizentra, 42
hydrocortisone valerate, 9 indomethacin, 24
HM aspirin, 23, 43
hydrocortisone/acetic acid, 22 indomethacin ER, 24
HM aspirin EC, 23, 43
hydromet, 25 Infanrix, 26, 45
HM aspirin EC low dose, 23, 43
hydromorphone HCL, 23 inflammacin, 24
HM folic acid, 16, 44
hydromorphone HCL dosette, 23 infuvite, 27
HM iron, 16, 46
hydromorphone HCL ER, 23 infuvite adult, 27
HM iron slow release, 16, 46
Hydromorphone HCL ER, 24 infuvite pediatric, 27
HM Lancets Micro Thin 33G, 30
Hydromorphone HCL/Sodium Chloride, 24
Inlyta, 5
HM Lancets Ultra Thin 30G, 30
Innopran XL, 6
HM nicotine polacrilex, 20, 46
hydroxychloroquine sulfate, 3 Inspirachamber/Anti-static Valved/Mouthpiece, 40
HM nicotine transdermal system, 20, 46
hydroxyurea, 5
HM nicotine transdermal system step 3, 20, 46
hydroxyzine HCL, 18 Inspirachamber/Large, 40
hydroxyzine pamoate, 18 Inspirachamber/Soothermask/Inspiramask/Medium, 40
HM One Daily Prenatal Combo, 28, 45
Hydroxyzine Pamoate, 18
HM Prenatal, 28, 45
hyolev mb, 15 Inspirachamber/Soothermask/Inspiramask/Small, 40
HM slow release iron, 16, 46
hyomax-SL, 14
HM vitamin d, 27, 47
hyophen, 15 Inspirease Bags, 40
HM vitamin d3, 27, 47
hyoscyamine sulfate, 14 Inspirease Drug Delivery System, 40
HM Vitamin D3, 27, 47
hyoscyamine sulfate ER, 14 Inspirease Mouthpiece, 40
homatropaire, 22
hyoscyamine sulfate odt, 14 Inspirease Reservoir Bags, 40
homatropine HBR, 22
hyoscyamine sulfate SR, 14 Insulin Syringe/0.3ML/29G X 1", 35
Horizant, 20
hyosyne, 14 Insulin Syringe/0.3ML/29G X 1/2", 35
Humalog, 12
hypercare, 9 Insulin Syringe/0.3ML/30G X 5/16", 35
Humalog Kwikpen, 12
Hyperhep B S/D, 42 Insulin Syringe/0.3ML/31G X 5/16", 35
Humalog Mix 50/50, 12
Hyperrab S/D, 42 Insulin Syringe/0.5ML/27G X 1/2", 35
Humalog Mix 50/50 Kwikpen, 12
Hyperrho S/D, 42 Insulin Syringe/0.5ML/28G X 1/2", 35
Humalog Mix 75/25, 12
Hyperrho S/D Mini-dose, 42 Insulin Syringe/0.5ML/29G X 1/2", 35
Humalog Mix 75/25 Kwikpen, 12
Hypolance AST Lancing Kit, 35 Insulin Syringe/0.5ML/30G X 1/2", 35
human albumin grifols, 17
I Insulin Syringe/0.5ML/30G X 5/16", 35
Humate-p, 17
Insulin Syringe/0.5ML/31G X 5/16", 35
ibandronate sodium, 12
Humira, 24
Insulin Syringe/1ML/28G X 1/2", 35
Ibrance, 5
Humira Pediatric Crohns Disease Starter Pack, 24
Insulin Syringe/1ML/29G X 1/2", 35
ibudone, 23
Insulin Syringe/1ML/30G X 5/16", 35
ibuprofen, 24
Humira Pen, 24
Insulin Syringe/1ML/31G X 5/16", 35
ibuprofen lysine, 24
Humira Pen-crohns Diseasestarter, 24
Insulin Syringe/U-100/0.3ML/29G X 1/2", 35
ibutilide fumarate, 6
Humira Pen-psoriasis Starter, 24
Iclusig, 5
Humulin 70/30, 12
Insulin Syringe/U-100/0.5ML/28G X 1/2", 35
idarubicin HCL, 3
Humulin 70/30 Kwikpen, 12
Idelvion, 17
Humulin N, 12
Insulin Syringe/U-100/0.5ML/29G X 1/2", 35
iferex 150, 16, 45
Humulin N Kwikpen, 12
iferex 150 forte, 16
Humulin R, 12
Insulin Syringe/U-100/1ML/28G X 1/2", 35
Ifex, 3
Humulin R U-500 (concentrated), 12
ifosfamide, 3
Hy-vee Lancets, 30
Insulin Syringe/U-100/1ML/29G X 1/2", 35
Ifosfamide, 3
Hy-vee Thin Lancets, 30
Ilaris, 24
Hycamtin, 5
Insulin Syringe/U-100/1ML/30G X 5/16", 35
Ilevro, 22
hydralazine HCL, 6
ilotycin, 21
hydrochlorothiazide, 7
Insulin Syringe/U-100/1ML/31G X 5/16", 35
imatinib mesylate, 4
hydrocodone bitartrate/acetaminophen, 23
Imbruvica, 5
Insupen 33GX4MM, 35
imipenem/cilastatin, 3
hydrocodone bitartrate/chlorpheniramine maleate/PSE, 25
Insupen Pen Needles 32G X4MM, 35
imipramine HCL, 18
Insupen Sensitive 32GX6MM, 35
imipramine pamoate, 18
hydrocodone bitartrate/homatropine methylbromide, 25
Insupen Sensitive 32GX8MM, 35
imiquimod, 9
Insupen Ultrafin 29GX12MM, 35
Imovax Rabies (h.d.c.v.), 26
hydrocodone polistirex/chlorpheniramine polistirex, 25
Insupen Ultrafin 30GX8MM, 35
Implanon, 11, 44
Insupen Ultrafin 31GX6MM, 35
IN Touch Diabetes Management Software, 30
hydrocodone/acetaminophen, 23
Insupen Ultrafin 31GX8MM, 35
Hydrocodone/Acetaminophen, 24
Intelence, 2
IN Touch Lancing Device, 35
hydrocodone/homatropine, 25
intralipid, 41
IN Touch Sterile Lancets 30G, 30
hydrocodone/ibuprofen, 23
Intron A, 5
Inatal Advance, 28
hydrocort ene 100MG, 14
Intron A W/Diluent, 5
Inatal GT, 28
hydrocortisone, 9, 10, 14
introvale, 11, 43
Inatal Ultra, 28
hydrocortisone acetate/aloe, 9
Invanz, 3
Increlex, 13
hydrocortisone acetate/lidocaine HCL, 14
Invega Sustenna, 19
Incruse Ellipta, 25
Invega Trinza, 19
k-vescent, 41 Koate-dvi, 17
Invirase, 2
k2k pain relieving patch, 9 Kogenate FS, 17
Invokana, 12
Kadcyla, 4 Kogenate FS Bio-set, 17
Iopidine, 22
kaitlib FE, 11, 43 Kombiglyze XR, 12
Ipol Inactivated IPV, 26, 45
Kalbitor, 17 kp aspirin, 23, 42
ipratropium bromide, 25(2)
Kaletra, 2 kp ferrous gluconate, 16, 46
ipratropium bromide/albuterol sulfate, 25
Kalydeco, 26 kp ferrous sulfate, 16, 46
irbesartan, 6
Kanuma, 13 kp folic acid, 16, 44
irbesartan/hydrochlorothiazide, 7
karidium, 41, 44 Kp Prenatal Multivitamins, 28, 45
irinotecan, 5
karigel, 18 kp vitamin d, 27, 47
Irinotecan, 5
karigel-n, 18 Kroger Insulin Syringe/0.3ML/29G X 1/2", 35
iron, 16, 45
kariva, 11, 43
Iron, 17, 46
KCL 0.075%/D5W/NACL 0.45%, 41 Kroger Insulin Syringe/0.3ML/30G X 5/16", 35
Iron Asp Gly/ Polysacch Compl/Ascorb CAL/B12/Fa/C Threon/Suc, 16
KCL 0.15%/D5W/ NACL 0.3%, 41
KCL 0.15%/D5W/NACL 0.2%, 41 Kroger Insulin Syringe/0.3ML/31G X 5/16", 35
Iron Chews Pediatric, 17, 46
KCL 0.15%/D5W/NACL 0.45%, 41
iron slow release, 16, 45
KCL 0.15%/D5W/NACL 0.9%, 41 Kroger Insulin Syringe/0.5ML/29G X 1/2", 35
iron supplement, 16, 46
KCL 0.3%/D5W/NACL 0.45%, 41
iron supplement childrens, 16, 46
kedbumin, 17 Kroger Insulin Syringe/0.5ML/30G X 5/16", 35
Iron Up, 17, 46
kelnor 1/35, 11, 43
Isentress, 2
kendall sodium chloride flush, 41 Kroger Insulin Syringe/0.5ML/31G X 5/16", 35
isolyte-m/dextrose 5%, 41
Kepivance, 5
Isolyte-s, 42
Ketek, 3 Kroger Insulin Syringe/1ML/29G X 1/2", 35
isoniazid, 2
Ketocare, 42
Isoniazid, 2
ketoconazole, 2, 8 Kroger Insulin Syringe/1ML/30G X 5/16", 35
Isopto Carbachol, 22
ketodan, 8
isosorbide dinitrate, 5
Ketone Test Strips, 42 Kroger Insulin Syringe/1ML/31G X 5/16", 35
Isosorbide Dinitrate, 5
ketoprofen, 24
isosorbide mononitrate, 5
ketorolac tromethamine, 22, 24 Kroger Lancets, 30
isosorbide mononitrate ER, 5
Ketostix, 42 Kroger Lancets 21G, 30
isosulfan blue, 41
Keveyis, 7 Kroger Lancets Micro Thin33G, 30
isotonic gentamicin, 2
kimidess, 11, 43 Kroger Lancets Super Thin, 30
isradipine, 6
Kineret, 24 Kroger Lancets Thin, 30
Istodax, 5
Kinney Lancets, 30 Kroger Lancets Thin 26G, 30
itraconazole, 2
Kinney Thin Lancets, 30 Kroger Lancets Ultrathin 30G, 30
ivermectin, 3
Kinray Insulin Syringe Preferred Plus/0.3ML/31G X 5/16", 35
Kroger Lancing Device, 35
Ixempra Kit, 4
Kroger Pen Needles 29G X 12MM, 35
Ixiaro, 26
Kinray Insulin Syringe Preferred Plus/0.5ML/31G X 5/16", 35
Kroger Pen Needles 31G X 8MM, 35
J
Kroger Pen Needles 31GX1/4", 35
Kinray Insulin Syringe Preferred Plus/1ML/31G X 5/16", 35
Krystexxa, 24
Jadenu, 42
kurvelo, 11, 43
Jakafi, 5
Kinray Insulin Syringe/0.5ML/29G X 1/2", 35
Kuvan, 13
jantoven, 17
Kyprolis, 5
Janumet, 12
Kinrix, 26, 45 L
Janumet XR, 12
kionex, 41
Januvia, 12
l-cysteine HCL, 41
klofensaid II, 8
Jardiance, 12
labetalol HCL, 6
klor-CON, 41
jencycla, 11, 43
Lacrisert, 21
klor-CON 10, 41
Jetrea, 22
lactated ringers, 41
klor-CON 8, 41
jevantique LO, 10
lactated ringers dextrose 5% viaflex, 41
klor-CON m10, 41
Jevtana, 4
lactated ringers irrigation, 41
Klor-CON M15, 42
jinteli, 10
lactated ringers viaflex, 41
klor-CON m20, 41
jolessa, 11, 43
lactic acid, 9
klor-CON sprinkle, 41
jolivette, 11, 43
lactic acid e, 9
klor-CON/EF, 41
juleber, 11, 43
lactic acid w/vitamin e, 9
kls aspirin EC, 23, 42
junel 1.5/30, 11, 43
lactulose, 14(2)
kls aspirin low dose, 23, 42
junel 1/20, 11, 43
Lamictal, 19
kls quit2, 20, 46
junel FE 1.5/30, 11, 43
Lamisil, 2
kls quit4, 20, 46
junel FE 1/20, 11, 43
lamivudine, 2
Kmart Valu Plus Insulin Syringe/0.3ML/30G, 35
junel FE 24, 11, 43
lamivudine/zidovudine, 2
just d, 27, 47
lamotrigine, 19
Kmart Valu Plus Insulin Syringe/0.5ML/29G, 35
Juxtapid, 7
lamotrigine ER, 19
K
lamotrigine odt, 19
Kmart Valu Plus Insulin Syringe/0.5ML/30G, 35
lamotrigine titration, 19
k-effervescent, 41
Lancet Device Adjustable, 35
Kmart Valu Plus Insulin Syringe/1ML/29G, 35
K-phos, 42
Lancet Device With Ejector, 35
k-prime, 41
Lancet Transporter Case, 35
Kmart Valu Plus Insulin Syringe/1ML/30G, 35
k-sol, 41
Lancets, 30
k-tan plus, 16
Lancets 26G Twist Top, 30
Lancets 28G, 30
Leader Unifine Pentips/Mini/31GX3/16", 36
lidocaine/prilocaine, 9
Lancets 30G, 30
lidodextrapine, 9
Lancets 30G Twist Top, 30
Leader Unifine Pentips/Nano/32GX5/32", 36
lidopin, 9
Lancets 30G/Twist Top, 30
Lifescan Unistik 2 Deep Penetration, 30
Lancets 31G Twist Top, 30
Leader Unifine Pentips/Plus/32GX5/32", 36
Lifescan Unistik II Lancets, 30
Lancets 33G Universal Design, 30
Liletta, 11, 44
Lancets Bullseye Safety, 30
leena, 11, 43 lincomycin HCL, 3
Lancets Micro Thin 33G, 30
leflunomide, 24 lindane, 9
Lancets Safety Seal 21G, 30
Lemtrada, 20 linezolid, 3
Lancets Safety Seal 26G, 30
Lenvima 10MG Daily Dose, 5 Linezolid, 3
Lancets Safety Seal 28G, 30
Lenvima 14MG Daily Dose, 5 Linzess, 15
Lancets Safety Seal 30G, 30
Lenvima 20MG Daily Dose, 5 liothyronine sodium, 13
Lancets Super Thin 28G, 30
Lenvima 24MG Daily Dose, 5 lipodox, 3
Lancets Thin, 30
lessina, 11, 43 lipodox 50, 3
Lancets Twist Top, 30
Letairis, 7 liposyn iii, 41
Lancets Ultra Fine, 30
letrozole, 4 lisinopril, 6
Lancets Ultra Thin, 30
leucovorin calcium, 5 lisinopril/hydrochlorothiazide, 7
Lancets Ultra Thin 30G, 30
Leucovorin Calcium, 5 lissamine green, 22
Lancing Device, 36
Leukeran, 3 Lite Touch Lancets, 30
Lancing Device Adjustable, 36
Leukine, 17 Lite Touch Lancing Device, 36
lanolin, 41
leuprolide acetate, 4 Lite Touch Lancing Pen, 36
lansoprazole, 14
levalbuterol, 25 Lite Touch Pen Needles/31G X 3/16", 36
lansoprazole/amoxicillin/clarithromycin, 14
levalbuterol HCL, 25 Liteaire, 40
Levatol, 6 Litetouch Insulin Syringe/0.3ML/29G X 1/2", 36
Lantus, 12
Levemir, 12
Lantus Solostar, 12
Levemir Flexpen, 12 Litetouch Insulin Syringe/0.3ML/30G X 5/16", 36
Lanzo, 36
Levemir Flextouch, 12
larin 1.5/30, 11, 43
levetiracetam, 19 Litetouch Insulin Syringe/0.3ML/31G X 5/16", 36
larin 1/20, 11, 43
levetiracetam ER, 19
larin 24 FE, 11, 43
levo-t, 13 Litetouch Insulin Syringe/0.5ML/30G X 5/16", 36
larin FE 1.5/30, 11, 43
levobunolol HCL, 21
larin FE 1/20, 11, 43
levocarnitine, 13 Litetouch Insulin Syringe/0.5ML/31G X 5/16", 36
Lastacaft, 22
levocetirizine dihydrochloride, 25
latanoprost, 21
levofloxacin, 1, 21 Litetouch Insulin Syringe/1ML/30G X 5/16", 36
latrix, 9
levofloxacin IN D5W, 1
Latuda, 19
levoleucovorin, 5 Litetouch Insulin Syringe/U-100/0.5ML/28G X 1/2", 36
layolis FE, 11, 43
Levoleucovorin, 5
Lazanda, 24
levoleucovorin calcium, 5 Litetouch Insulin Syringe/U-100/0.5ML/29G X 1/2", 36
Leader Advanced Lancing Device, 36
levonest, 11, 43
Leader Insulin Syringe/0.3ML/29G X 1/2", 36
levonorgestrel, 11, 43 Litetouch Insulin Syringe/U-100/1ML/28G X 1/2", 36
Levonorgestrel, 11, 44
Leader Insulin Syringe/0.3ML/30G X 5/16", 36
levonorgestrel and ethinyl estradiol, 11, 43
Litetouch Insulin Syringe/U-100/1ML/29G X 1/2", 36
Leader Insulin Syringe/0.3ML/31G X 5/16", 36
levonorgestrel/ethinyl estradiol, 11, 43 Litetouch Insulin Syringe/U-100/1ML/31G X 5/16", 36
levora 0.15/30-28, 11, 43
Leader Insulin Syringe/0.5ML/28G X 1/2", 36
Levorphanol Tartrate, 24 Litetouch Lancets Micro Thin 33G, 30
levothyroxine sodium, 13 Litetouch Pen Needles 29GX12.7MM, 36
Leader Insulin Syringe/0.5ML/29G X 1/2", 36
levoxyl, 13 Litetouch Pen Needles 31G X 6MM, 36
Lexiva, 2 Litetouch Pen Needles 31GX8MM SHORT, 36
Leader Insulin Syringe/0.5ML/30G X 5/16", 36
Lialda, 15
Liberty Blood Glucose Meter, 30 Lithium, 19
Leader Insulin Syringe/0.5ML/31G X 5/16", 36
Liberty Glucose Control Mid, 30 lithium carbonate, 18
Liberty Glucose Control Normal, 30 lithium carbonate ER, 18
Leader Insulin Syringe/1ML/28G X 1/2", 36
Liberty Medical Lancets 30G, 30 Livalo, 7
Liberty Mini Lancing Device, 30 Live Better Advanced Lancing Device, 36
Leader Insulin Syringe/1ML/29G X 1/2", 36
Liberty Test Strips, 30 Live Better Lancet Super Thin 30G, 30
lidazone HC, 14 Live Better Lancet Ultra Thin 28G, 30
Leader Insulin Syringe/1ML/30G X 5/16", 36
lidenza patch, 9 Live Better Pen Needles 29G X 12MM, 36
lidocaine, 9
Leader Insulin Syringe/1ML/31G X 5/16", 36
lidocaine HCL, 6, 9, 24 Live Better Pen Needles 31G X 12MM, 36
lidocaine HCL IN D5W, 6
Leader Lancets Colored, 30
lidocaine HCL jelly, 9 Live Better Pen Needles 31G X 6MM, 36
Leader Super Thin Lancet, 30
lidocaine HCL viscous, 18 livixil PAK, 9
Leader Thin Lancets, 30
lidocaine HCL/dextrose, 6 LO Loestrin FE, 11, 44
Leader Unifine Pentips Plus/Mini/31GX3/16", 36
lidocaine HCL/hydrocortisone acetate, 14 Locoid, 9
lidocaine viscous, 18 lofene, 14
Leader Unifine Pentips Plus/SHORT/31GX5/16", 36
lidocaine-prilocaine-cream base, 9 lokara, 9
lidocaine/epinephrine, 24 lomedia 24 FE, 11, 43
Lomustine, 3
marten-TAB, 22 mefenamic acid, 24
Longs Insulin Syringe/0.5ML/31G X 5/16", 36
Mask Vortex/Baby Whirl Duckling, 40 mefloquine HCL, 3
Mask Vortex/Child/Frog, 40 Mefoxin, 1
Longs Lancets Standard, 30
Mask Vortex/Spinner The Duck, 40 mega-c/a plus, 26
Longs Lancets Thin, 30
Mask Vortex/Toddler/Lady Bug, 40 megestrol acetate, 4, 12
Longs Lancets Ultra Thin, 30
Matulane, 5 Meijer Alcohol Swabs Extra-thick, 40
Lonsurf, 5
matzim LA, 6 meijer aspirin EC, 23, 42
loperamide HCL, 14
Maxi-comfort Insulin Syringe/U-100/0.5ML/28GX1/2", 36
Meijer Color Lancets Universal 33G, 31
lopreeza, 10
meijer ferrous sulfate, 16, 46
lorazepam, 18
Maxi-comfort Insulin Syringe/U-100/1ML/28GX1/2", 36
Meijer Lancets, 31
lorazepam intensol, 18
Meijer Lancets Thin, 31
lorcet, 23
maximum d3, 27, 47 Meijer Lancets Universal 33G, 31
lorcet HD, 23
Maxipime, 1 Meijer Pen Needles 29G X 12MM, 36
lorcet plus, 23
MD-gastroview, 41 Meijer Pen Needles 31G X 6MM, 36
lorenza, 9
me/naphos/mb/hyo 1, 15 Meijer Pen Needles 31G X 8MM, 36
lortab, 23
meclizine HCL, 14 Meijer Super Thin Lancets, 31
loryna, 11, 43
Meclofenamate Sodium, 24 Mekinist, 5
Lorzone, 21
Medic Insulin Syringe/0.3ML/30G X 5/16", 36
meloxicam, 24
losartan potassium, 6
melphalan hydrochloride, 3
losartan potassium/hydrochlorothiazide, 7
Medic Insulin Syringe/0.5ML/30G X 5/16", 36
memantine HCL, 20
memantine HCL titration PAK, 20
Lotemax, 21
Medical Provider EZ Flu Shot 2013-2014, 26, 45
memantine hydrochloride, 20
lovastatin, 7
Menactra, 26, 45
low-ogestrel, 11, 43
Medical Provider EZ Flu Shot 2014-2015, 26, 45
Menest, 10
loxapine, 18
Menhibrix, 26
loxapine succinate, 18
Medical Provider EZ Flu Shot 2015-2016, 26, 45
Menomune-a/C/Y/W-135, 26, 45
LP lite PAK, 10
Mentax, 8
Lucentis, 22
Medical Provider EZ Flu Shot PF 2013-2014, 26, 45
Menveo, 26, 45
ludent, 41, 44
meperidine HCL, 23
Lufyllin, 25
Medical Provider EZ Flu Shot PF 2014-2015, 26, 45
Mephyton, 27
Lumigan, 21
meprobamate, 18
Lumizyme, 13
Medical Provider Single Use EZ Flu Shot, 26, 45
mercaptopurine, 3
Lupron Depot, 4
meropenem, 3
Lupron Depot-PED, 13
Medichoice Pre-set Safety Lancet Dual Use, 30
mesalamine, 14
lutera, 11, 43
mesna, 5
Lynparza, 5
Medichoice Pre-set Safety Lancet Low Flow, 30
Mesnex, 5
Lyrica, 19
Mestinon, 21
lysiplex plus, 27
Medichoice Pre-set Safety Lancet Medium Flow, 30
metadate ER, 19
Lysodren, 4
Metaproterenol Sulfate, 25
lyza, 11, 43
Medichoice Pre-set Safety Lancet Moderate Flow, 30
metaxall, 21
M
metaxalone, 21
Medichoice Safety Lancet Extra, 30 Metaxalone, 21
M-m-r II, 26, 45
Medichoice Safety Lancet Normal, 30 metformin HCL, 12
M-vit, 28, 44
Medicine Shoppe Lancets, 30 metformin HCL ER, 12
Macnatal CN DHA, 28
Medicine Shoppe Lancets Thin, 30 methadone HCL, 23
Macugen, 22
Medicine Shoppe Pen Needles 29G X 12MM, 36
methadone HCL intensol, 23
mafenide acetate, 9
methadose, 23
Magellan Insulin Safety Syringe/U-100/0.3ML/29G X 1/2", 36
Medicine Shoppe Pen Needles 31G X 6MM, 36
methamphetamine HCL, 19
methazolamide, 7
Magellan Insulin Safety Syringe/U-100/0.3ML/30G X 5/16", 36
Medicine Shoppe Pen Needles 31G X 8MM, 36
methenamine hippurate, 15
methenamine mandelate, 15
Magellan Insulin Safety Syringe/U-100/0.5ML/29G X 1/2", 36
Medisense Thin Lancets, 30 methergine, 22
Medlance Plus Extra Lancets 21G, 30 methimazole, 13
Magellan Insulin Safety Syringe/U-100/0.5ML/30G X 5/16", 36
Medlance Plus Lancets, 30 Methitest, 10
Medlance Plus Lancets Lite 25G, 30 methocarbamol, 21
Magellan Insulin Safety Syringe/U-100/1ML/29G X 1/2", 36
Medlance Plus Lite Lancets 25G, 30 methotrexate, 4
Medlance Plus Special Lancets 0.8MM, 30
methotrexate sodium, 4
Magellan Insulin Safety Syringe/U-100/1ML/30G X 5/16", 36
Methotrexate Sodium, 4
Medlance Plus Superlite 30G, 30 methoxsalen, 8
magnesium chloride, 41
Medlance Plus Superlite 30G/Comfort Max, 30
methscopolamine bromide, 14
magnesium sulfate, 41
Methyclothiazide, 7
Makena, 12
Medlance Plus Universal Lancets 21G, 30
methyldopa, 6
malathion, 9
Methyldopate HCL, 6
mannitol, 7
Medlance Plus/Lite 25G, 30 methylene blue, 41
Maprotiline HCL, 18
Medlance/Extra, 30 methylergonovine maleate, 22
margesic, 22
Medlance/Lite, 30 methylphenidate HCL, 19
marlissa, 11, 43
Medlance/Universal, 31 methylphenidate HCL CD, 19
Marplan, 18
medroxyprogesterone acetate, 11, 12, 43 methylphenidate HCL ER, 19
Marqibo, 4
Methylphenidate HCL ER, 19
Monoclate-p, 17 Mononine, 17
methylphenidate HCL SR, 19
Monoject Insulin Syringe Regular LUER Tip/Softpack/1ML, 36
Monovisc, 21
methylphenidate hydrochloride, 19
montelukast sodium, 25
methylprednisolone, 10
Monoject Insulin Syringe/1ML, 36 Monurol, 15
methylprednisolone acetate, 10
Monoject Insulin Syringe/1ML/31G X 5/16", 36
Moore MED Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2", 36
methylprednisolone dose pack, 10
methylprednisolone sodiumsuccinate, 10
Monoject Insulin Syringe/Detach Needle/1ML/25G X 5/8", 36
Moore MED Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2", 36
methyltestosterone, 10
Metipranolol, 21
Monoject Insulin Syringe/Detach Needle/1ML/27G X 1/2", 36
Moore MED Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 36
metoclopramide HCL, 14
metoclopramide odt, 14
Monoject Insulin Syringe/Perm Needle/1ML/28G X 1/2", 36
Moore MED Monoject Insulin Syringe/U-100/1ML/29G X 1/2", 36
metolazone, 7
metoprolol succinate ER, 6
Monoject Insulin Syringe/Perm Needle/U-100/0.5ML/28G X 1/2", 36
morgidox 1X100MG, 1
metoprolol tartrate, 6
morgidox 2X100MG, 1
Metoprolol Tartrate, 6
Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29G X 1/2", 36
morphine sulfate, 23
metoprolol/hydrochlorothiazide, 7
Morphine Sulfate, 24
metronidazole, 3, 8
Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29GX1/2", 36
morphine sulfate ER, 23
metronidazole IN NACL 0.79%, 3
Morphine Sulfate ER, 24
metronidazole vaginal, 15
Monoject Insulin Syringe/Safety/Perm Needle/0.5ML/29G X 1/2", 36
morrhuate sodium, 41
mexiletine HCL, 6
Moviprep, 14
Miacalcin, 13
Monoject Insulin Syringe/Safety/Perm Needle/1ML/29G X 1/2", 36
Moxatag, 1
Micrhogam Ultra-filtered Plus, 42
Moxeza, 21
Microchamber, 40
Monoject Insulin Syringe/Softpack/1ML/27G X 1/2", 36
moxifloxacin HCL, 1
microgestin 1.5/30, 11, 43
Mozobil, 17
microgestin 1/20, 11, 43
Monoject Insulin Syringe/Softpack/U-100/0.5ML/28G X 1/2", 36
MS Insulin Syringe/0.3ML/29G X 1/2", 36
microgestin 24 FE, 11, 43
MS Insulin Syringe/0.3ML/30G X 5/16", 36
microgestin FE, 11, 43
Monoject Insulin Syringe/U-100/0.3ML/30G X 5/16", 36
microgestin FE 1.5/30, 11, 43
MS Insulin Syringe/0.3ML/31G X 5/16", 36
Microlet Lancets, 31
Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2", 36
micronized colestipol HCL, 7
MS Insulin Syringe/0.5ML/29G X 1/2", 36
Microspacer, 40
Monoject Insulin Syringe/U-100/0.5ML/30G X 5/16", 36
MS Insulin Syringe/0.5ML/30G X 5/16", 36
Microtainer Safety Flow Lancet/Sterile/Single-use, 31
Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 36
MS Insulin Syringe/0.5ML/31G X 5/16", 36
midodrine HCL, 7
migryl, 9
Monoject Insulin Syringe/U-100/1ML/30G X 5/16", 36
MS Insulin Syringe/1ML/29G X 1/2", 36
milrinone IN dextrose, 5
MS Insulin Syringe/1ML/30G X 5/16", 36
milrinone lactate, 5
monoject pharma grade flush syringe, 41 MS Insulin Syringe/1ML/31G X 5/16", 36
mimvey, 10
monoject pharma grade flush syringe/heparin lock, 17
mult-vitamin/fluoride, 27
mimvey LO, 10
Multaq, 6
Minastrin 24 FE, 11, 44
monoject prefill advanced heparin lock flush, 17
Multi Prenatal, 28, 44
Mini Lancing Device, 36
multi vitamin/fluoride, 27
miniprin low dose, 23, 42
monoject sodium chloride flush, 41 Multi-lancet Device, 36
minitran, 5
Monoject Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2", 36
Multi-lancet Device 2, 36
minocycline HCL, 1
multi-vit/fluoride, 27
minocycline HCL ER, 1
Monoject Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16", 36
multi-vit/iron/fluoride, 27
minoxidil, 6
multi-vitamin/fluoride, 27
Mirapex ER, 20
Monoject Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16", 36
multi-vitamin/fluoride/iron, 27
Mirena, 11, 44
multitrace-4 concentrate, 41
mirtazapine, 18
Monoject Ultra Comfort Insulin Syringe/0.5ML/28G X 1/2", 36
multitrace-5 concentrate, 41
mirtazapine odt, 18
multivitamin with fluoride, 27
misoprostol, 14
Monoject Ultra Comfort Insulin Syringe/0.5ML/29G X 1/2", 36
multivitamin/fluoride, 27
Mission Prenatal, 28, 45
multivitamins/fluoride, 27
Mission Prenatal HP, 28, 44
Monoject Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16", 36
mupirocin, 8
mitomycin, 3
mupirocin calcium, 8
Mitomycin, 3
Monoject Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16", 36
Mustargen, 3
mitoxantrone HCL, 3
MVC-fluoride, 28
MM aspirin, 23, 43
Monoject Ultra Comfort Insulin Syringe/1ML/28G X 1/2", 36
my way, 11, 43
modafinil, 19
Myalept, 13
moderiba, 2
Monoject Ultra Comfort Insulin Syringe/1ML/29G X 1/2", 36
Mycamine, 2
Moderiba, 2
mycophenolate mofetil, 4
Moderiba 1200 Dose Pack, 2
Monoject Ultra Comfort Insulin Syringe/1ML/30G X 5/16", 36
mycophenolic acid DR, 4
Moderiba 800 Dose Pack, 2
mydral, 22
moexipril HCL, 6
Monojector End CAPS, 36 myferon 150, 16, 46
moexipril/hydrochlorothiazide, 7
Monojector Opd End CAPS, 36 myferon 150 forte, 16
Molindone Hydrochloride, 19
Monolet Lancets, 31 Myglucohealth Mgh Softlance Lancets 30G, 31
mometasone furoate, 9, 25
Monolet Opd Lancets, 31
mondoxyne nl, 1
Monolettor Safety Lancets, 31 Mykidz Iron 10, 17, 46
mono-linyah, 11, 43
mononessa, 11, 43 Myleran, 3
Mynatal Advance, 28
nephronex, 27 Nitrostat, 5
Mynatal Plus, 28
Nessi Spacer/Large Mask, 40 nizatidine, 14
Mynatal Ultracaplet, 28
Nessi Spacer/Mouthpiece, 40 Nizatidine, 14
Mynatal-z, 28
Nessi Spacer/Small/MED Mask, 40 nora-be, 11, 43
Mynate 90 Plus, 28
Netgroup Lancets, 31 Norditropin Cartridge, 13
mynephrocaps, 27
neuac, 8 Norditropin Flexpro, 13
Myobloc, 21
Neulasta, 17 Norditropin Nordiflex Pen, 13
myorisan, 8
Neulasta Onpro Kit, 17 norepinephrine bitartrate, 7
Myozyme, 13
Neumega, 17 norethindrone, 11, 43
Myrbetriq, 15
Neupogen, 17 norethindrone & ethinyl estradiol ferrous fumarate, 11, 43
myzilra, 11, 43
Neupro, 20
N
neutragard advanced, 18 norethindrone acetate, 12
neutral sodium fluoride, 18 norethindrone acetate/ethinyl estradiol, 10, 11, 43
n-acetyl-l-cysteine, 41
Nevanac, 22
Nabi-HB, 42
nevirapine, 2 norethindrone acetate/ethinyl estradiol/ferrous fumarate, 11, 43
nabumetone, 24
Nevirapine, 2
nadolol, 6
nevirapine ER, 2 norgestimate/ethinyl estradiol, 11, 43
nadolol/bendroflumethiazide, 7
Nexavar, 5 norlyroc, 11, 43
nafcillin sodium, 1
Nexium, 14 normal saline flush, 41
nafrinse, 41, 44
Nexplanon, 11, 44 normal saline flush for flushing vascular access devices, 41
nafrinse drops, 41, 44
next choice one dose, 11, 43
naftifine hydrochloride, 8
Nexterone, 6 normal saline i.v. flush, 41
Naglazyme, 13
niacin ER, 7 Noroxin, 1
nalbuphine HCL, 23
niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper, 27
Norpace CR, 6
Nalfon, 24
nortrel 0.5/35 (28), 11, 43
naloxone HCL, 41
nicardipine HCL, 6 nortrel 1/35, 11, 43
Naloxone HCL, 41
nicorelief, 20, 46 nortrel 7/7/7, 11, 43
naltrexone HCL, 41
nicotine, 20, 46 nortriptyline HCL, 18
Namenda XR, 20
nicotine mini lozenge, 20, 46 Nortriptyline HCL, 18
Namenda XR Titration Pack, 20
nicotine polacrilex, 20, 46 nortuss-DE, 25
Naprelan, 24
nicotine polacrilex refill, 20, 46 Norvir, 2
naproxen, 24
nicotine polacrilex starter kit, 20, 46 norwich aspirin, 23, 42
Naproxen, 24
nicotine step 1, 20, 46 Nova Safety Lancets 23G, 31
naproxen DR, 24
nicotine step 2, 20, 46 Nova Safety Lancets 28G, 31
naproxen kit, 24
nicotine step 3, 20, 46 Nova Sureflex Lancets, 31
naproxen sodium, 24
nicotine transdermal system, 20, 46 Nova Sureflex Lancing Device, 36
naproxen sodium CR, 24
Nicotine Transdermal System, 20, 46 Novaferrum Pediatric Drops, 17, 46
naproxen sodium ER, 24
nicotine transdermal system step 1, 20, 46
novarel, 13
naratriptan HCL, 24
Novofine 30GX8MM, 36
Narcan, 42
nicotine transdermal system step 2, 20, 46
Novofine 32GX6MM, 36
Nascobal, 16
Novofine Autocover 30GX8MM, 36
Nat-rul Prenatal Vitamins, 28, 45
nicotine transdermal system step 3, 20, 46
Novofine Plus 32GX4MM, 36
nat-rul vitamin d, 27, 47
Novolin 70/30, 12
Natacyn, 21
Nicotrol Inhaler, 20, 46 Novolin 70/30 Relion, 12
Natazia, 11, 44
Nicotrol Ns, 20, 46 Novolin N, 12
nateglinide, 12
nifedical XL, 6 Novolin N Relion, 12
natural vitamin d-3, 27, 47
nifedipine, 6 Novolin R, 12
Nebupent, 3
nifedipine ER, 6 Novolin R Relion, 12
nebusal, 25
nikki, 11, 43 Novolog, 12
necon 0.5/35-28, 11, 43
Nilandron, 4 Novolog Flexpen, 12
necon 1/35, 11, 43
nimodipine, 6 Novolog Mix 70/30, 12
necon 7/7/7, 11, 43
Ninlaro, 5 Novolog Mix 70/30 Prefilled Flexpen, 12
nefazodone HCL, 18
Nipent, 5 Novolog Penfill, 12
Nefazodone HCL, 18
nisoldipine, 6 Novoseven, 17
neo-polycin, 21
Nitro-bid, 5 Novoseven Rt, 17
neo-polycin HC, 21
nitro-time, 5 Novotwist 30GX8MM, 36
Neo-synalar, 8
nitrofurantoin, 15 Novotwist 32GX5MM, 36
neofrin, 22
nitrofurantoin macrocrystals, 15 Noxafil, 2
neomycin sulfate, 2
nitrofurantoin monohydrate, 15 NP thyroid, 13
neomycin/bacitracin/polymyxin, 21
nitrofurantoin monohydrate/macrocrystals, 15
NP thyroid 60, 13
neomycin/polymyxin b sulfates, 15
NP thyroid 90, 13
neomycin/polymyxin/bacitracin zinc, 21
nitroglycerin ER, 5 Nplate, 17
neomycin/polymyxin/bacitracin/hydrocortisone, 21
nitroglycerin IN 5% dextrose, 5 nu-iron 150, 16, 46
nitroglycerin IN dextrose 5%, 5 Nucala, 25
neomycin/polymyxin/dexamethasone, 21
nitroglycerin lingual, 5 Nucynta, 24
neomycin/polymyxin/gramicidin, 21
Nitroglycerin Lingual, 5 Nucynta ER, 24
neomycin/polymyxin/HC, 22
nitroglycerin transdermal, 5 Nuedexta, 20
neomycin/polymyxin/hydrocortisone, 22
Nitromist, 5 nufol, 16
neostigmine methylsulfate, 21
nulev, 14
Onetouch Verio Control Solution High, 31
oxaliplatin, 3
Nulojix, 4
oxandrolone, 10
nutrifac ZX, 27
Onetouch Verio Flex Bloodglucose Monitoring System, 31
oxaprozin, 24
nutrilipid, 41
Oxaydo, 24
nutrilyte, 41
Onetouch Verio IQ Blood Glucose Monitoring System, 31
oxazepam, 18
nutrilyte II, 41
oxcarbazepine, 19
Nutropin AQ Nuspin 10, 13
Onetouch Verio Mid Control Solution, 31 oxiconazole nitrate, 8
Nutropin AQ Nuspin 20, 13
Onetouch Verio Sync Bloodglucose Monitoring System, 31
Oxistat, 8
Nutropin AQ Nuspin 5, 13
Oxsoralen, 10
Nutropin AQ Pen, 13
Onetouch Verio Test Strips, 31 oxybutynin chloride, 15
Nuvaring, 11, 44
Onfi, 19 oxybutynin chloride ER, 15
Nuvigil, 19
Onglyza, 12 oxycodone HCL, 23
nyamyc, 8
Onivyde, 5 Oxycodone HCL ER, 24
nystatin, 2, 8, 18
Opana ER (crush Resistant), 24 oxycodone/acetaminophen, 23
nystatin/triamcinolone, 8
opcicon one-step, 11, 43 oxycodone/aspirin, 23
nystop, 8
Opdivo, 4 oxycodone/ibuprofen, 23
O
opium, 14 Oxycontin, 24
opium tincture, 14 oxymorphone hydrochloride, 23
Obizur, 17
Opsumit, 7 oxymorphone hydrochloride ER, 23
Obstetrix EC, 28
Optichamber Advantage, 40 oxytocin, 22
ocella, 11, 43
Optichamber Diamond, 40 Oxytrol, 15
Octagam, 42
Optichamber Diamond/Largeface Mask, 40
Ozurdex, 21
octreotide acetate, 13
P
Ofev, 26
Optichamber Diamond/Medium Face Mask, 40
ofloxacin, 1, 21, 22
PA Prenatal Formula, 28, 45
Ofloxacin, 1
PA vitamin d-3, 27, 47
Optichamber Diamond/Smallface Mask, 40
Ogestrel, 11, 44
PA vitamin d-3 gummy, 27, 47
olanzapine, 18
pacerone, 6
Optihaler, 40
olanzapine odt, 18
paclitaxel, 4
Optihaler MDI Drug Delivery System, 40
olanzapine/fluoxetine, 20
Paclitaxel, 4
Optimal D3 M, 27, 47
olopatadine HCL, 22, 25
paliperidone ER, 18
optimal-d, 27, 47
Omeclamox-PAK, 14
pamidronate disodium, 12
optimal-d pack, 27, 47
omega-3-acid ethyl esters, 7
Pamidronate Disodium, 12
Options Gynol II Vaginal Contraceptive, 15, 44
omeprazole, 14
Pancrelipase, 14
omeprazole/sodium bicarbonate, 14
pancuronium bromide, 21
opurity vitamin d, 27, 47
Omniflex Diaphragm, 44
Panda Mask Large, 40
Oracea, 8
On Call Lancets, 31
Panda Mask Medium, 40
oralone, 18
On Call Lancing Device, 36
Panda Mask Small, 40
Oravig, 18
On Call Plus Lancets, 31
Panretin, 10
Orencia, 24
On Call Plus Lancing Device, 36
pantoprazole sodium, 14
Orenitram, 7
Oncaspar, 3
papaverine HCL, 7
Orfadin, 13
ondansetron HCL, 14
Paragard Intrauterine Copper Contraceptive T380a, 11
orphenadrine citrate, 21
ondansetron odt, 14
orphenadrine citrate ER, 21
One A Day Womens Prenatal/DHA, 28
parcaine, 22
Orphenadrine/Asa/Caffeine, 21
One A Day Womens Prenatal1, 28
paricalcitol, 13
orsythia, 11, 43
One-a-day Womens Prenatal, 28, 45
paroex, 18
Ortho Diaphragm Coil Spring Kit 100, 44
Onetouch Club Lancets Fine Point, 31
paromomycin sulfate, 2
Ortho Diaphragm Coil Spring Kit 105, 44
Onetouch Combo Pack, 31
paroxetine HCL, 18
Ortho Diaphragm Coil Spring Kit 50, 44
Onetouch Delica Lancets Extra Fine 33G, 31
paroxetine HCL ER, 18
Ortho Diaphragm Flat Spring Kit 55, 44
Paser, 2
Ortho Diaphragm Flat Spring Kit 60, 44
Onetouch Delica Lancets Fine 30G, 31
Pataday, 22
Ortho Diaphragm Flat Spring Kit 65, 44
Onetouch Delica Lancing Device, 31
Paxil, 18
Ortho Diaphragm Flat Spring Kit 70, 44
Onetouch Finepoint Lancets, 31
PC Unifine Pentips 29G X 1/2", 37
Ortho Diaphragm Flat Spring Kit 75, 44
Onetouch Lancets, 31
PC Unifine Pentips 31G X 5MM Mini, 37
Ortho Diaphragm Flat Spring Kit 80, 44
Onetouch Ping Meter Remote, 31
PC Unifine Pentips 31G X 6MM Ultra SHORT, 37
Ortho Diaphragm Flat Spring Kit 85, 44
Onetouch Suresoft Lancing Device/18G, 31
Ortho Diaphragm Flat Spring Kit 90, 44
PC Unifine Pentips 31G X 8MM SHORT, 37
Ortho Diaphragm Flat Spring Kit 95, 44
Onetouch Suresoft Lancing Device/21G, 31
ortho-CS 250, 26
PCE, 1
ortho-est, 10
Onetouch Suresoft Lancing Device/28G, 31
pedi-dri, 8
Orthovisc, 21
Pediarix, 26, 45
oscimin, 14
Onetouch Ultra 2, 31
Pediatric Panda Mask, 40
oscimin SR, 14
Onetouch Ultra Blue, 31
Pedipirox-4 Nail, 8
oscion cleanser, 8
Onetouch Ultra Control, 31
Pedvax HIB, 26, 45
osmitrol viaflex, 7
Onetouch Ultra Mini, 31
peg 3350/electrolytes, 14, 47
Osmoprep, 14
Onetouch Ultralink System (DEC), 31
peg-3350/electrolytes, 14, 47
otic care, 22
Onetouch Ultralink System (hex), 31
peg-3350/NACL/NA bicarbonate/KCL, 14, 47
oticin, 22
Onetouch Ultrasoft Lancets, 31
oxacillin sodium, 1
Onetouch Verio, 31
Peg-intron, 2
Peg-intron Redipen, 2
phenytoin infatabs, 19 potassium chloride 0.15% NACL 0.9%, 41
Peg-intron Redipen PAK 4, 2
phenytoin sodium, 19
peg-prep, 14
phenytoin sodium extended, 19 potassium chloride 0.15% w/NACL 0.9% viaflex, 41
Peganone, 19
philith, 11, 43
Pegasys, 2
phos-flur, 18 potassium chloride 0.15%/D5W, 41
Pegasys Proclick, 2
Phoslyra, 15 potassium chloride 0.15%/NACL 0.9%, 41
Pegintron, 2
phospha 250 neutral, 41
pegylax, 14
phosphasal, 15 potassium chloride 0.22% D5W/NACL 0.45%, 41
Pen Needles 29G X 12MM, 36
Phospholine Iodide, 22
Pen Needles 29GX1/2", 36
Photofrin, 5 potassium chloride 0.224%/D5W/NACL 0.45%, 41
Pen Needles 30GX5/16", 36
physiolyte, 41
Pen Needles 31G X 1/4" SHORT, 36
physiosol irrigation, 41 potassium chloride 0.224%D5W/NACL 0.45% viaflex, 41
Pen Needles 31G X 3/16", 36
phytonadione, 26
Pen Needles 31G X 5MM, 36
Picato, 10 potassium chloride 0.3%/ NACL 0.9%, 41
Pen Needles 31G X 6MM, 36
pilocarpine HCL, 18, 22
Pen Needles 31GX5/16", 36
pilocarpine hydrochloride, 18 potassium chloride 0.3%/D5W, 41
Pen Needles 31GX8MM, 36
pimozide, 20 potassium chloride 0.3%/NACL 0.9%/viaflex, 41
Pen Needles 32GX4MM, 36
pimtrea, 11, 43
penicillin G potassium, 1
pindolol, 6 potassium chloride CR, 41
penicillin v potassium, 1
pioglitazone HCL, 12 potassium chloride ER, 41
Penlet II Automatic Bloodsampler, 31
pioglitazone HCL-glimepiride, 12 Potassium Chloride ER, 41
Penlet II Replacement CAPS, 31
pioglitazone HCL/metformin HCL, 12 potassium chloride SR, 41
Penlet II Replacement CAPS-deep, 31
piperacillin sodium/ tazobactam sodium, 1
potassium citrate ER, 15
Penlet II Replacement CAPS-regular, 31
potassium citrate-citric acid crystals, 15
Pentacel, 26, 45
piperacillin sodium/tazobactam sodium, 1 potassium citrate/citric acid, 15
Pentasa, 15
piperacillin/tazobactam, 1 potassium citrate/sodium citrate/citric acid, 15
pentazocine/naloxone HCL, 24
pirmella 1/35, 11, 43
Pentips 31GX5MM, 37
pirmella 7/7/7, 11, 43 potassium phosphate, 41
Pentips 31GX8MM, 37
piroxicam, 24 potassium phosphates, 41
Pentips 32GX4MM, 37
plasbumin-25, 17 Potiga, 19
pentoxifylline ER, 17
plasbumin-5, 17 pr benzoyl peroxide wash, 8
Perfect Iron, 17, 46
Plasma-lyte A, 42 Pr Natal 400, 28
Perfect Lancets 30G, 31
Plasma-lyte-148, 42 Pr Natal 400 EC, 28
Perfect Pressure Activated Safety Lancets 28G, 31
Plasma-lyte-56/D5W, 42 Pr Natal 430, 28
plenamine, 41 Pr Natal 430 EC, 28
Perforomist, 25
Pneumovax 23, 26, 45 Pradaxa, 17
perindopril erbumine, 6
Pneumovax 23/1 Dose, 26, 45 Praluent, 7
periogard, 18
Pneumovax 23/5 Dose, 26, 45 pramcort, 14
Perjeta, 4
PNV-DHA, 28 pramipexole dihydrochloride, 20
permethrin, 9
PNV-select, 28 pramipexole dihydrochloride ER, 20
perphenazine, 18
Pocket Chamber, 40 pramox gel, 9
Perphenazine/Amitriptyline, 20
Pocket Spacer, 40 prascion, 8
Perry Prenatal, 28, 44
podofilox, 9 prascion fc, 8
pharbedryl, 25
polocaine, 24 pravastatin sodium, 7
Pharmacist Choice Alcoholprep Pads, 40
polocaine-mpf, 24 prazosin HCL, 6
Pharmacist Choice Ultra Thin Lancets, 31
poly-dex, 21 Pre-natal Formula, 28, 44
poly-iron 150, 16, 46 Precision Sure-dose Insulin Syringe/0.3ML/30G X 5/16", 37
Pharmacist Choice Ultra Thin Lancets 28G, 31
poly-iron 150 forte, 16
polycin, 21 Precision Sure-dose Insulin Syringe/0.5ML/28G X 1/2", 37
Pharmacist Choice Ultra Thin Lancets 30G, 31
polycin b, 21
polyethylene glycol 3350, 14 Precision Sure-dose Insulin Syringe/0.5ML/29G X 1/2", 37
Pharmacist Choice Ultra Thin Lancets 31G, 31
polymyxin b sulfate, 3
polymyxin b sulfate/trimethoprim sulfate, 21
Precision Sure-dose Insulin Syringe/0.5ML/30G X 3/8", 37
Pharmacist Choice Ultra Thin Lancets 33G, 31
polysaccharide iron forte, 16 Precision Sure-dose Insulin Syringe/1ML/28G X 1/2", 37
Pharmacy Counter Lancets, 31
Pomalyst, 4
phenadoz, 25
portia-28, 11, 43 Precision Sure-dose Plus Insulin Syringe/0.3ML/29G X 1/2", 37
phenazo, 15
Portrazza, 4
phenazopyridine HCL, 15
potassium acetate, 41 Precision Sure-dose Plus Insulin Syringe/1ML/29G X 1/2", 37
phenelzine sulfate, 18
potassium chloride, 41
phenergan, 25
potassium chloride 0.15% /NACL 0.45% viaflex, 41
Precision Thin Lancets, 31
phenobarbital, 19
Precision Thins GP Lancet, 31
Phenobarbital, 19
potassium chloride 0.15% D5W/NACL 0.33%, 41
Precision Ultra Lancet, 31
Phenobarbital Sodium, 19
Pred Mild, 21
phenoxybenzamine hydrochloride, 6
potassium chloride 0.15% D5W/NACL 0.45%, 41
prednicarbate, 9
phenylephrine HCL, 7, 22
prednisolone, 10
phenylephrine/guaifenesin, 25
potassium chloride 0.15% D5W/NACL 0.45% viaflex, 41
prednisolone acetate, 21
phenytoin, 19
prednisolone sodium phosphate, 10
prednisolone sodium phosphate odt, 10
prevalite, 7 propranolol HCL, 6
prednisone, 10
previfem, 11, 43 propranolol HCL ER, 6
Prednisone, 10
Prevnar 13, 26, 45 propylthiouracil, 13
Prednisone Intensol, 10
Prezcobix, 2 Proquad, 26, 45
Preferred Plus Insulin Syringe/U-100/0.3ML/29G X 1/2", 37
Prezista, 2 protriptyline HCL, 18
Prialt, 23 provenza, 9
Preferred Plus Insulin Syringe/U-100/0.3ML/30G X 5/16", 37
Priftin, 2 Pss Select GP Lancets, 31
Primaquine Phosphate, 3 Pss Select Platforms, 37
Preferred Plus Insulin Syringe/U-100/0.5ML/28G X 1/2", 37
primidone, 19 Pss Select Safety Lancets, 31
Primsol, 3 Pulmicort Flexhaler, 25
Preferred Plus Insulin Syringe/U-100/0.5ML/29G X 1/2", 37
Pristiq, 18 pulmosal, 25
Privigen, 42 Pulmozyme, 26
Preferred Plus Insulin Syringe/U-100/0.5ML/30G X 5/16", 37
Proair HFA, 25 purevit dualfe plus, 16
Proair Respiclick, 25 Push Button Safety Lancets 21G, 31
Preferred Plus Insulin Syringe/U-100/1ML/28G X 1/2", 37
probenecid, 24 Push Button Safety Lancets 28G, 31
probenecid/colchicine, 24 Px Advanced Lancing Device, 37
Preferred Plus Insulin Syringe/U-100/1ML/29G X 1/2", 37
Procentra, 19 px aspirin, 23, 42
prochlorperazine, 18 px enteric aspirin, 23, 42
Preferred Plus Insulin Syringe/U-100/1ML/30G X 5/16", 37
prochlorperazine edisylate, 18 Px Extra SHORT Pen Needles 31GX6MM, 37
prochlorperazine maleate, 18
Preferred Plus Lancets Colored 21G, 31
Procrit, 17 px folic acid, 16, 44
Preferred Plus Lancets Super Thin 30G, 31
procto-MED HC, 14 Px Insulin Syringe/U-100/0.3ML/30G X 1/2", 37
procto-PAK, 14
Preferred Plus Lancets Thin 26G, 31
proctosol HC, 14 Px Insulin Syringe/U-100/0.3ML/31G X 5/16", 37
Preferred Plus Unifine Pentips 29G X 12MM, 37
proctozone-HC, 14
Procysbi, 16 Px Insulin Syringe/U-100/0.5ML/30G X 1/2", 37
Preferred Plus Unifine Pentips 31G X 6MM Ultra SHORT, 37
Prodigy Insulin Mini Pen Needles/31G X 3/16", 37
Px Insulin Syringe/U-100/0.5ML/31G X 5/16", 37
Preferred Plus Unifine Pentips 31G X 8MM SHORT, 37
Prodigy Insulin Pen Needles/29G X 1/2", 37
Px Insulin Syringe/U-100/1ML/30G X 1/2", 37
Preferred Plus Unifine Pentips 32GX4MM, 37
Prodigy Insulin SHORT Penneedles/31G X 5/16", 37
Px Insulin Syringe/U-100/1ML/31G X 5/16", 37
Preferred Plus Unifine Pentips/Mini/31GX5MM, 37
Prodigy Insulin Syring/U-100/0.3ML/31G X 5/16", 37
px iron, 16, 46
pregnyl w/diluent benzyl alcohol/NACL, 13
Prodigy Insulin Syringe/1/2ML/31G X 5/16", 37
Px Lancet Auto Injector, 37
Px Lancets Ultra Thin, 31
Premarin, 10
Prodigy Insulin Syringe/1ML/28G X 1/2", 37
Px Mini Pen Needles 31GX5MM, 37
premasol, 41
Px Pen Needle 29GX12MM, 37
premium lidocaine, 9
Prodigy Lancing Device, 37 Px Pen Needle 31GX8MM, 37
Premphase, 10
Prodigy Pressure Activated Safety Lancets, 31
Px Prenatal Multivitamins, 28, 44
Prempro, 10
Px Shortlength Pen Needles/31GX8MM, 37
Prenaissance Plus, 28
Prodigy Safety Lancets, 31
Prenaplus, 28, 44
Prodigy Twist Top Lancets, 31 px stop smoking aid, 20, 46
Prenatabs Fa, 28
Profe, 17, 46 Pylera, 14
Prenatabs RX, 28
Proferrin ES, 17, 46 pyrazinamide, 2
Prenatal, 28, 44
Profilnine, 17 pyridostigmine bromide, 21
Prenatal 19, 28
Profilnine SD, 17 Q
Prenatal Ad, 28
progesterone, 12
Qc Advanced Lancing Device, 37
Prenatal And Iron, 28, 44
Proglycem, 12
Qc Alcohol Swabs, 40
Prenatal Complete, 28, 45
Prograf, 4
qc aspirin, 23, 42
Prenatal Formula, 28, 44
Prolastin-c, 26
qc aspirin low dose, 23, 42
Prenatal Forte, 28, 44
Proleukin, 5
qc childrens aspirin, 23, 42
Prenatal Low Iron, 28, 44
Prolia, 13
qc ferrous sulfate, 16, 46
Prenatal Multi + DHA, 28
Promacta, 17
Qc Insulin Syringe 0.5ML/29G, 37
Prenatal Multi +dha, 28, 45
promethazine HCL, 25
Qc Insulin Syringe 0.5ML/30G, 37
Prenatal Multivitamin + DHA, 28
promethazine HCL plain, 25
Qc Insulin Syringe 1ML/29G, 37
Prenatal Multivitamin Plus DHA, 28
promethazine VC plain, 25
Qc Insulin Syringe/0.3ML/29G, 37
Prenatal One Daily, 28, 45
promethazine VC/codeine, 25
Qc Insulin Syringe/0.3ML/29G X 1/2", 37
Prenatal Plus, 28, 44
promethazine-DM, 25
Qc Insulin Syringe/0.5ML/29G X 1/2", 37
Prenatal Plus DHA, 28
promethazine/codeine, 25
Qc Insulin Syringe/0.5ML/31G X 5/16", 37
Prenatal Vitamin, 28, 45
promethazine/dextromethorphan, 25
Prenatal Vitamins, 28, 44
promethazine/phenylephrine, 25
Qc Insulin Syringe/1ML/29G X 1/2", 37
Prenatal-u, 28
promethazine/phenylephrine/codeine, 25
Qc Insulin Syringe/1ML/30G, 37
Prenatal/Omega-3/Folic Acid/Iron, 28
promethegan, 25
Qc Insulin Syringe/1ML/31G X 5/16", 37
Prentif Cavity-rim Cervical CAP, 44
pronutrients vitamin d3, 27, 47
Qc Lancets, 31
Prentif Fitting Set, 44
propafenone HCL, 6
Qc Lancets Super Thin, 31
Prepopik, 14
propafenone HCL ER, 6
Qc Lancets Thin, 31
Pressure Activated Safetylancet 21G, 31
proparacaine HCL, 22
Qc Lancets Ultra Thin, 31
qc nicotine polacrilex, 20, 46
rea LO 39, 9 Relion Pen Needles 31GX8MM, 37
Qc Pen Needles 29G X 12MM, 37
rea LO 40, 9 Relion Pen Needles 32GX4MM, 37
Qc Pen Needles 31G X 6MM, 37
Reality Insulin Syringe/U-100/0.5ML/28G X 1/2", 37
Relion SHORT Pen Needles 31GX8MM, 37
Qc Pen Needles 31G X 8MM, 37
Qc Prenatal, 28, 45
Reality Insulin Syringe/U-100/0.5ML/29G X 1/2", 37
Relion Thin Lancets, 31
Qc Unifine Pentips 32GX4MM, 37
Relion Ultra Thin Lancets, 31
Qc Unilet Lancets 28G/Ultra Thin, 31
Reality Insulin Syringe/U-100/1ML/28G X 1/2", 37
Relion Ultra Thin Lancets30G, 31
Qc Unilet Lancets 33G/Micro Thin, 31
Relion Ultra Thin Plus Lancets 32G, 31
Quadracel, 26, 45
Reality Insulin Syringe/U-100/1ML/29G X 1/2", 37
Relion Ultra Thin Plus Lancets 33G, 31
quasense, 11, 43
Relistor, 15
Quazepam, 19
Reality Lancets, 31 Relpax, 24
quetiapine fumarate, 19
Reality Swabs, 40 remeven, 9
Quflora Pediatric, 28
Reality Trigger Lancets, 31 Remicade, 15
Quillivant XR, 19
Rebetol, 2 Remodulin, 7
quinapril HCL, 6
Rebif, 20 rena-vite RX, 27
quinapril/hydrochlorothiazide, 7
Rebif Rebidose, 20 Renagel, 15
quinidine gluconate CR, 6
Rebif Rebidose Titration Pack, 20 renal, 27
quinidine gluconate ER, 6
Rebif Titration Pack, 20 renalpren, 27
quinidine sulfate, 6
reciphexamine, 9 Renew Advanced Lancing Cartridge Refills, 31
Quinidine Sulfate, 6
reclipsen, 11, 43
quinine sulfate, 3
Recombinate, 17 Renew Advanced Lancing Device, 37
Qvar, 25
Recombivax HB, 26, 45 reno CAPS, 27
R
Rectiv, 15 Renvela, 15
Regranex, 10 repaglinide, 12
Ra Alcohol Swabs, 40
relador PAK, 9 Repaglinide/Metformin Hydrochloride, 12
ra aspirin, 23, 42
relador PAK plus, 9 Repatha, 7
ra aspirin adult low dose, 23, 42
releevia ML, 9 Repatha Sureclick, 7
ra aspirin adult low strength, 23, 42
Relenza Diskhaler, 2 Replesta, 27, 47
ra aspirin childrens, 23, 42
Relion 2-IN-1 Lancing Device 25G, 37 Replesta Childrens, 27, 47
ra aspirin EC, 23, 42
Relion 2-IN-1 Lancing Device 30G, 37 Replesta Nx, 27, 47
ra aspirin EC adult low strength, 23, 42
Relion Alcohol Swabs, 40 reprexain, 24
ra childrens aspirin, 23, 42
Relion Insulin Syringe/U -100/0.5ML/29G, 37
Rescriptor, 2
Ra E-ZJECT Color Lancets Micro-thin 33G, 31
Restasis, 22
Relion Insulin Syringe/U-00/1ML/29G X 1/2", 37
Retrovir IV Infusion, 2
Ra E-ZJECT Lancets 28G, 31
Revlimid, 4
Ra E-ZJECT Lancets Thin 26G, 31
Relion Insulin Syringe/U-100/0.3ML/29G, 37
revonto, 21
Ra E-ZJECT Lancets Thin 28G, 31
Rexall Lancets Ultra Thin, 31
Ra E-ZJECT Lancets Ultra Thin 30G, 31
Relion Insulin Syringe/U-100/0.3ML/29G X 1/2", 37
Rexulti, 19
ra folic acid, 16, 44
Reyataz, 2
ra high potency iron, 16, 46
Relion Insulin Syringe/U-100/0.3ML/30G, 37
Rheumatrex, 24
Ra Insulin Syringe/0.5ML/29G X 1/2", 37
Rhogam Ultra-filtered Plus, 42
Ra Insulin Syringe/1ML/29G X 1/2", 37
Relion Insulin Syringe/U-100/0.3ML/30G X 5/16", 37
Rhophylac, 42
Ra Insulin Syringe/U-100/0.5ML/30G X 5/16", 37
Riastap, 17
Relion Insulin Syringe/U-100/0.3ML/31G X 5/16", 37
ribasphere, 2
Ra Insulin Syringe/U-100/1 ML/30G X 5/16", 37
Ribasphere, 2
Relion Insulin Syringe/U-100/0.5ML/29G X 1/2", 37
Ribasphere Ribapak, 2
ra iron, 16, 46
Ribatab, 2
Ra Lancing Device, 37
Relion Insulin Syringe/U-100/0.5ML/30G, 37
ribavirin, 2
ra mini nicotine, 20, 46
Ridaura, 24
ra nicotine, 20, 46
Relion Insulin Syringe/U-100/0.5ML/30G X 5/16", 37
rifabutin, 2
ra nicotine polacrilex, 20, 46
Rifamate, 2
ra nicotine transdermal system step 3, 20, 46
Relion Insulin Syringe/U-100/0.5ML/31G X 5/16", 37
rifampin, 2
Rifater, 2
Ra One Daily, 28, 45
Relion Insulin Syringe/U-100/1ML/30G, 37
Right Step Prenatal, 28, 45
Ra Pen Needles 31G X 5MM 3/16", 37
Rightest GD-L500 Alternate Site Adapter, 37
Ra Pen Needles 31G X 8MM 5/16", 37
Relion Insulin Syringe/U-100/1ML/30G X 5/16", 37
Ra Prenatal, 28, 44
Rightest GD500 Lancing Device, 37
Ra Prenatal Formula/Folicacid, 28, 45
Relion Insulin Syringe/U-100/1ML/31G X 5/16", 37
Rightest Gl300 Lancets, 31
ra slow release iron, 16, 46
riluzole, 21
ra vitamin d-3, 27, 47
Relion Ketone, 42 rimantadine HCL, 2
Rabavert, 26
Relion Ketone Test Strips, 42 ringers injection, 41
rabeprazole sodium, 14
Relion Lancets Micro-thin33G, 31 ringers irrigation, 41
raloxifene hydrochloride, 13
Relion Lancets Standard 21G, 31 Riomet, 12
ramipril, 6
Relion Lancets Thin 26G, 31 risedronate sodium, 12
Ranexa, 5
Relion Lancets Ultra-thin30G, 31 risedronate sodium DR, 12
ranitidine HCL, 14
Relion Lancing Device, 37 Risperdal Consta, 19
Rapaflo, 16
Relion Mini Pen Needles 31GX6MM, 37 risperidone, 19
Rapamune, 4
Relion Pen Needles 29GX12MM, 37 risperidone M-TAB, 19
Ravicti, 13
risperidone odt, 19
Saphris, 19 Shopko Unilet Lancets Super Thin 30G, 31
Riteflo, 40
Saps Care Alcohol Prep Pads, 40
Rituxan, 4
Sapscare Twist Top Lancets 30G, 31 Shopko Unilet Lancets Ultra Thin 28G, 31
rivastigmine tartrate, 20
sash kit for flushing vascular access devices, 17
rivastigmine transdermal system, 20
Shur-seal, 15, 44
Rixubis, 17
Savaysa, 17 Side Button Safety Lancet21G, 31
rizatriptan benzoate, 24
Savella, 20 Signifor, 13
rizatriptan benzoate odt, 24
SB Alcohol Prep Pads, 40 sildenafil, 7
rocuronium bromide, 21
SB aspirin, 23, 43 sildenafil citrate, 7
romycin, 21
SB aspirin EC, 23, 43 silver sulfadiazine, 9
ropinirole ER, 20
SB childrens aspirin, 23, 43 Similac Prenatal Early Shield, 28
ropinirole HCL, 20
SB Insulin Syringe/U-100/0.5ML/29G X 1/2", 38
Simple Diagnostics Lancing Device, 37
ropivacaine, 24
Simponi, 24
ropivacaine HCL, 24
SB Insulin Syringe/U-100/0.5ML/30G X 5/16", 38
Simponi Aria, 24
rosadan, 8
Simulect, 4
rosanil cleanser, 8
SB Insulin Syringe/U-100/1ML/29G X 1/2", 38
simvastatin, 7
rosula, 8
Single-let, 31
rosuvastatin calcium, 7
SB Insulin Syringe/U-100/1ML/30G X 5/16", 38
sirolimus, 4
Rotarix, 26, 45
Sirturo, 2
Rotateq, 26, 45
SB Insulin Syringe/U-100/1ML/31G X 5/16", 38
Sivextro, 3
roweepra, 19
Sklice, 10
roxicet, 24
SB Lancets Thin, 32 Skyla, 11, 44
Rozerem, 19
SB Lancets Ultra Thin, 32 slow FE, 16, 46
S
SB low dose asa EC, 23, 43 slow iron, 16, 46
scalacort, 9 slow release iron, 16, 46
Sabril, 19
Schnucks Insulin Syringe Ulti-fine/U-100/0.5ML/29G X 1/2", 37
Slow Release Iron, 17, 46
Safe-t-lance Low Flow 25G, 31
slow-release iron, 16, 46
Safe-t-lance Normal Flow 21G, 31
Schnucks Insulin Syringe Ulti-fine/U-100/0.5ML/30G X 5/16", 37
Sm Alcohol Prep Pads, 40
Safe-t-lance Plus Safety Lancet High Flow, 31
sm aspirin, 23, 42
se 10-5 ss, 8 sm aspirin adult low strength, 23, 42
Safe-t-lance Plus Safety Lancet Low Flow, 31
se bpo wash, 8 sm aspirin EC low strength, 23, 42
Se-natal 19, 28 sm aspirin enteric coated, 23, 42
Safe-t-lance Plus Safety Lancet Normal Flow, 31
Se-tan DHA, 28 sm childrens aspirin, 23, 42
se-tan plus, 16 sm folic acid, 16, 44
Safesnap Insulin Syringe/0.3ML/30G X 5/16", 37
seb-prev wash, 9 Sm Insulin Syringe/0.3ML/31G X 5/16", 37
Select-lite Device/Lancets, 37
Safesnap Insulin Syringe/0.5ML/29G X 1/2", 37
Select-lite Lancing Device, 37 Sm Insulin Syringe/0.5ML/31G X 5/16", 37
selegiline HCL, 20
Safesnap Insulin Syringe/0.5ML/30G X 5/16", 37
selenium sulfide, 9 Sm Insulin Syringe/1ML/31G X 5/16", 37
Selzentry, 2 Sm Insulin Syringe/U-100/0.3ML/29G X 1/2", 37
Safesnap Insulin Syringe/1ML/28G X 1/2", 37
Sensipar, 13
sensorcaine, 25 Sm Insulin Syringe/U-100/0.3ML/30G X 5/16", 37
Safesnap Insulin Syringe/1ML/29G X 1/2", 37
sensorcaine-mpf, 25
sensorcaine-mpf spinal, 25 Sm Insulin Syringe/U-100/0.5ML/28G X 1/2", 37
Safety Lancet 21G/Pressure Activated, 31
sensorcaine-mpf/epinephrine, 25
sensorcaine/epinephrine, 25 Sm Insulin Syringe/U-100/0.5ML/29G X 1/2", 37
Safety Lancet 28G/Pressure Activated, 31
Serevent Diskus, 25
serophene, 13 Sm Insulin Syringe/U-100/0.5ML/30G X 5/16", 37
Safety Lancets, 31
Seroquel XR, 19
Safety Lancets 21G, 31
Serostim, 13 Sm Insulin Syringe/U-100/1ML/28G X 1/2", 37
Safety Lancets 28G, 31
sertraline HCL, 18
Safety Let Lancets, 31
setlakin, 11, 44 Sm Insulin Syringe/U-100/1ML/29G X 1/2", 37
Safety Seal Lancets 28G, 31
Sevelamer Carbonate, 15
Safety Seal Lancets 30G, 31
SF, 18 Sm Insulin Syringe/U-100/1ML/30G X 5/16", 37
Safety-glide Insulin Syringe/0.3ML/29G X 1/2", 31
SF 5000 plus, 18
sharobel, 11, 44 sm iron, 16, 46
salacyn, 9
Shopko Alcohol Swabs, 40 sm iron slow release, 16, 46
salicylic acid, 9
Shopko Autolet Lancing Device, 37 Sm Lancets 21G, 31
Salicylic Acid, 10
Shopko On-the-go Comfort Lancets 30G, 31
Sm Micro Thin Lancets 33G, 31
salicylic acid cream, 9
sm nicotine, 20, 46
salicylic acid lotion, 9
Shopko Unifine Pentips Pen Needles/Micro/32GX4MM, 37
sm nicotine polacrilex, 20, 46
salicylic acid wart remover, 9
sm nicotine transdermal system, 20, 46
saline flush, 41
Shopko Unifine Pentips Pen Needles/Mini/31GX5MM, 37
Sm One Daily Prenatal, 28, 45
saline flush zr/sterile field, 41
sm prenatal vitamins, 28, 44
salsalate, 22
Shopko Unifine Pentips Pen Needles/Original/29GX12MM, 37
Sm Prenatal Vitamins, 28, 44
Samsca, 13
sm slow release iron, 16, 46
Sancuso, 14
Shopko Unifine Pentips Pen Needles/SHORT/31GX8MM, 37
Sm Slow Release Iron, 17, 46
Sandimmune, 4
Sm Super Thin Lancets, 31
Sandostatin Lar Depot, 13
Sm Super Thin Lancets 30G, 31
Sprycel, 5 5ML/28G X 1/2", 37
Sm Thin Lancets 26G, 31
sps, 41 Sure Comfort Insulin Syringe/U-100/0.5ML/29G X 1/2", 38
sm vitamin d, 27, 47
SR nicotine gum, 20, 46
sm vitamin d3, 27, 47
sronyx, 11, 44 Sure Comfort Insulin Syringe/U-100/0.5ML/30G X 1/2", 38
Sm Vitamin D3 Maximum Strength, 27, 47
ss 10-2, 8
ssd, 9 Sure Comfort Insulin Syringe/U-100/0.5ML/30G X 5/16", 38
Smart Diabetes Vantage Lancing Device, 37
sss 10%-5%, 8
sss 10-5, 8 Sure Comfort Insulin Syringe/U-100/0.5ML/31G X 5/16, 38
Smart Diabetes Vantage Universal Lancets 30G, 31
st joseph aspirin, 23, 42
st joseph low dose aspirin, 23, 42 Sure Comfort Insulin Syringe/U-100/1ML/28G X 1/2", 38
Smart Sense Color Lancets Universal 33G, 31
stannous fluoride oral rinse, 18
stavudine, 2 Sure Comfort Insulin Syringe/U-100/1ML/29G X 1/2", 38
Smart Sense Standard Lancets Universal 21G, 31
Stavzor, 19
Sterilance PA, 37 Sure Comfort Insulin Syringe/U-100/1ML/30G X 1/2", 38
Smart Sense Super Thin Lancets Universal 30G, 31
Sterilance TL, 31
sterile diluent for epoprostenol sodium, 41
Sure Comfort Insulin Syringe/U-100/1ML/30G X 5/16", 38
Smart Sense Thin Lancets Universal 26G, 31
sterile water for injection, 41 Sure Comfort Insulin Syringe/U-100/1ML/31G X 5/16", 38
Smartest Lancets 28G, 31
sterile water irrigation, 41
sodium acetate, 41
sterile water irrigation plastic bottle, 41 Sure Comfort Lancets 28G, 31
sodium bicarbonate, 41
sterile water irrigation w/hanger, 41 Sure Comfort Lancets 30G, 31
sodium bicarbonate partial fill, 41
Stimate, 13 Sure Comfort Lancing Pen, 38
sodium chloride, 15, 25, 41
Stiolto Respimat, 25 Sure Comfort Pen Needles 29GX1/2" 12.7MM, 38
sodium chloride 0.45%, 41
Stivarga, 5
sodium chloride 0.45% viaflex, 41
Strattera, 19 Sure Comfort Pen Needles 30GX5/16" SHORT, 38
sodium chloride 0.9%, 15
Strensiq, 13
sodium chloride bacteriostatic, 41
Streptomycin Sulfate, 2 Sure Comfort Pen Needles 31GX3/16" (5MM), 38
sodium chloride flush, 41
Striant, 10
sodium chloride pab, 41
Stribild, 2 Sure Comfort Pen Needles 31GX5/16" (8MM), 38
sodium citrate/citric acid, 15
Stuart One, 28
sodium ferric gluconate complex/sucrose, 17
Stuart Prenatal, 28, 45 Sure Comfort Pen Needles 32GX5/32", 38
Suboxone, 24
sodium fluoride, 41, 44
Sucraid, 14 Sure Comfort Pen Needles 32GX6MM, 38
sodium hyaluronate, 9
sucralfate, 14
sodium phenylbutyrate, 13
sulfacetamide sodium, 8, 21 sure result dss premium pack, 8
sodium phosphate, 41
sulfacetamide sodium/prednisolone sodium phosphate, 21
Sure-fine Pen Needles 29GX1/2" 12.7MM, 38
sodium polystyrene sulfonate, 41
sodium sulfacetamide, 8, 9, 21
sulfacetamide sodium/sulfur, 8 Sure-fine Pen Needles 31GX3/16" 5MM, 38
sodium sulfacetamide wash, 9
sulfacetamide sodium/sulfur cleanser, 8
sodium sulfacetamide/sulfur, 8
sulfacleanse 8/4, 8 Sure-fine Pen Needles 31GX5/16" 8MM, 38
sodium sulfacetamide/sulfur cleanser, 8
Sulfadiazine, 2
sodium sulfacetamide/sulfur cleansing cloths, 8
sulfamethoxazole/trimethoprim, 3 Sure-ject Insulin Syringe/U-100/0.3ML/29G X 1/2", 38
sulfamethoxazole/trimethoprim DS, 3
sodium sulfacetamide/sulfur green, 8
Sulfamylon, 10 Sure-ject Insulin Syringe/U-100/0.3ML/30G X 5/16", 38
sodium sulfacetamide/sulfur w/sunscreen, 8
sulfasalazine, 14
sulfatrim pediatric, 3 Sure-ject Insulin Syringe/U-100/0.3ML/31G X 5/16", 38
sodium sulfacetamide/sulfur wash, 8
sulindac, 24
sodium thiosulfate, 41
sumatriptan succinate, 24 Sure-ject Insulin Syringe/U-100/0.5ML/28G X 1/2", 38
Soliris, 17
Sumatriptan Succinate, 24
Soltamox, 4
sumatriptan succinate refill, 24 Sure-ject Insulin Syringe/U-100/0.5ML/29G X 1/2", 38
Solu-cortef, 10
Super Daily D3, 27, 47
Solus V2 Lancing Device, 37
Super Thin Lancets, 31 Sure-ject Insulin Syringe/U-100/0.5ML/30G X 5/16", 38
Solus V2 Pressure Activated Safety Lancets 28G, 31
Supprelin LA, 13
Suprax, 1 Sure-ject Insulin Syringe/U-100/0.5ML/31G X 5/16", 38
Solus V2 Twist Lancets 30G, 31
Supreme II Confidence Paddles, 37
Somatuline Depot, 13
Suprep Bowel Prep, 14 Sure-ject Insulin Syringe/U-100/1ML/28G X 1/2", 38
Somavert, 13
Sure Comfort Alcohol Prep Pads, 40
sorine, 6
Sure Comfort Insulin Syringe/U-100/0.3ML/29G X 1/2", 37
Sure-ject Insulin Syringe/U-100/1ML/29G X 1/2", 38
sotalol HCL, 6
sotalol HCL (AF), 6
Sure Comfort Insulin Syringe/U-100/0.3ML/30G X 1/2", 37
Sure-ject Insulin Syringe/U-100/1ML/30G X 5/16", 38
Sovaldi, 3
Spiriva Handihaler, 25
Sure Comfort Insulin Syringe/U-100/0.3ML/30G X 5/16", 37
Sure-ject Insulin Syringe/U-100/1ML/31G X 5/16", 38
Spiriva Respimat, 25
spironolactone, 7
Sure Comfort Insulin Syringe/U-100/0.3ML/31G X 5/16, 37
Sure-lance Flat Lancets, 31
spironolactone/hydrochlorothiazide, 7
Sure-lance Lancets 26G, 31
Sporanox, 2
Sure Comfort Insulin Syringe/U-100/0.3ML/31G X 5/16", 37
Sure-lance Thin Lancets 28G, 31
sprintec 28, 11, 44
Sure-lance Ultra Thin Lancets, 31
Sprix, 24
Sure Comfort Insulin Syringe/U-100/0. Sure-pen, 38
Sure-prep Alcohol Prep Pads, 40
temazepam, 19 Tgt Lancet Micro Thin 33G, 32
Sure-touch Lancets Universal, 31
Temodar, 3 Tgt Lancet Super Thin 30G, 32
Surelite Lancets, 31
temozolomide, 3 Tgt Lancet Thin 23G, 32
Surestep Glucose Control, 31
tencon, 22 Tgt Lancet Thin 26G, 32
Surestep Glucose Control Solution, 31
Teniposide, 4 Tgt Lancet Ultra Thin 28G, 32
Surestep Pro High Glucosecontrol, 32
Tenivac, 26, 45 Tgt Lancet Ultra Thin 30G, 32
Surestep Pro Linearity Kit, 32
terazosin HCL, 6 Tgt Lancing Device, 38
Surestep Pro Low Glucose Control, 32
terbinafine HCL, 2 tgt nicotine gum, 20, 46
Surestep Pro Normal Glucose Control, 32
terbutaline sulfate, 25 tgt nicotine polacrilex, 20, 46
terconazole, 15 tgt nicotine step one, 20, 46
Sustiva, 2
Terumo Insulin Syringe/0.3ML/30G X 3/8", 38
tgt nicotine step three, 20, 46
Sutent, 5
tgt nicotine step two, 20, 46
sw nicotine polacrilex, 20, 46
Terumo Insulin Syringe/0.5ML/29G X 1/2", 38
th aspirin, 23, 42
swabflush saline flush, 41
th aspirin low dose, 23, 42
syeda, 11, 44
Terumo Insulin Syringe/0.5ML/30G X 3/8", 38
th enteric aspirin, 23, 42
Sylatron, 5
th folic acid, 16, 44
symax fastabs, 14
Terumo Insulin Syringe/1ML/27G X 1/2", 38
th iron, 16, 46
symax-SL, 14
Th Prenatal Vitamins, 28, 45
symax-SR, 14
Terumo Insulin Syringe/1ML/29G X 1/2", 38
th slow release iron, 16, 46
Symbicort, 25
th vitamin d3, 27, 47
Symlinpen 120, 12
Terumo Insulin Syringe/1ML/30G X 3/8", 38
Thalomid, 4
Symlinpen 60, 12
Theo-24, 25
Synagis, 42
Terumo Insulin Syringe/U-100/0.3ML/29G X 1/2", 38
theochron, 25
Synarel, 13
theophylline, 25
Synribo, 5
Terumo Insulin Syringe/U-100/0.5ML/27G X 1/2", 38
theophylline CR, 25
synvexia, 9
theophylline ER, 25
Synvisc, 21
Terumo Insulin Syringe/U-100/0.5ML/28G X 1/2", 38
thera-d 2000, 27, 47
Synvisc One, 21
Thera-d 4000, 27, 47
Syprine, 42
Terumo Insulin Syringe/U-100/1ML/28G X 1/2", 38
thera-d rapid repletion, 27, 47
T
thera-d sport, 27, 47
Terumo Surguard Insulin Syringe/0.3ML/29G X 1/2", 38
Theracys, 5
Tabloid, 4
thermazene, 9
Taclonex, 9
Terumo Surguard Insulin Syringe/0.5ML/28G X 1/2", 38
thiamine HCL, 26
tacrolimus, 4, 9
Thinlets GP Lancets, 32
Tafinlar, 5
Terumo Surguard Insulin Syringe/0.5ML/29G X 1/2", 38
Thinlets Lancet, 32
Tagrisso, 5
Thinpro Insulin Syringe/0.3ML/29G X 1/2", 38
take action, 11, 44
Terumo Surguard Insulin Syringe/1ML/28G X 1/2", 38
Talwin, 24
Thinpro Insulin Syringe/0.3ML/30G X 3/8", 38
Tamiflu, 2
Terumo Surguard Insulin Syringe/1ML/29G X 1/2", 38
tamoxifen citrate, 4, 47
Thinpro Insulin Syringe/0.3ML/31G X 3/8", 38
tamsulosin HCL, 15
testosterone, 10
Tarceva, 5
Testosterone, 10 Thinpro Insulin Syringe/0.5ML/28G X 1/2", 38
Targretin, 10
testosterone cypionate, 10
tarina FE 1/20, 11, 44
testosterone enanthate, 10 Thinpro Insulin Syringe/0.5ML/29G X 1/2", 38
taron-crystals, 15
testosterone P.M., 10
Taron-prex, 28
Testosterone P.M., 10 Thinpro Insulin Syringe/0.5ML/30G X 3/8", 38
Tasigna, 5
Tetanus Toxoid Adsorbed, 26
tazicef, 1
Tetanus/Diphtheria Toxoids-adsorbed, 26, 45
Thinpro Insulin Syringe/0.5ML/31G X 3/8", 38
tazidime, 1
Tazorac, 8
Tetanus/Diphtheria Toxoids-adsorbed Adult, 26, 45
Thinpro Insulin Syringe/1ML/28G X 1/2", 38
taztia XT, 6
Tecfidera, 20
tetcaine, 22 Thinpro Insulin Syringe/1ML/29G X 1/2", 38
Tecfidera Starter Pack, 20
tetrabenazine, 20
Techlite AST Lancets, 32
tetracaine HCL, 22 Thinpro Insulin Syringe/1ML/30G X 3/8", 38
Techlite Lancets, 32
Tetracaine HCL, 25
Techlite Lancets 30G, 32
tetracycline HCL, 1 Thinpro Insulin Syringe/1ML/31G X 3/8", 38
Techlite Pen Needles/31G X 5MM, 38
Tetracycline HCL, 1
Techlite Pen Needles/31G X 6 MM, 38
tetravisc, 22 thioridazine HCL, 19
Techlite Pen Needles/31G X 8MM, 38
tetravisc forte, 22 thiothixene, 19
Techlite Pen Needles/32G X 4MM, 38
tetrix, 9 thrive, 20, 46
Techlite Pen Needles/32G X 6MM, 38
Texacort, 9 Thrombate Iii W/10 ML Sterile Water, 17
Techlite Pen Needles/32G X 8MM, 38
Tgt Advanced Lancing Device, 38 Thrombate Iii W/20 ML Sterile Water, 17
Teflaro, 1
Tgt Alcohol Swabs, 40 Thymoglobulin, 4
Tekamlo, 7
tgt aspirin, 23, 42 Thyrogen, 42
Tekturna, 6
tgt aspirin low dose, 23, 42 Thyrolar-1, 13
Tekturna HCT, 7
tgt childrens aspirin, 23, 42 Thyrolar-1/2, 13
telmisartan, 6
tgt enteric-coated aspirin, 23, 42 Thyrolar-1/4, 13
telmisartan/amlodipine, 7
Tgt Lancet Alternate Site, 32 Thyrolar-2, 13
telmisartan/hydrochlorothiazide, 7
Thyrolar-3, 13
100/1ML/29G X 1/2", 38 trifluoperazine HCL, 19
tiagabine hydrochloride, 19
Topco Insulin Syringe/U-100/0.3ML/29G X 1/2", 38
trifluridine, 21
Tice Bcg, 5
trigels-f forte, 16
ticlopidine HCL, 17
Topco Insulin Syringe/U-100/0.5ML/28G X 1/2", 38
Triglide, 7
Tikosyn, 6
trihexyphenidyl HCL, 20
tilia FE, 11, 44
Topco Insulin Syringe/U-100/0.5ML/29G X 1/2", 38
trilyte, 14, 47
Timentin, 1
trimethobenzamide HCL, 14
Timolol Maleate, 6
Topco Insulin Syringe/U-100/1ML/28G X 1/2", 38
trimethoprim, 3
timolol maleate, 21
trimethoprim sulfate/polymyxin b sulfate, 21
timolol maleate ophthalmic gel forming, 21
Topco Insulin Syringe/U-100/1ML/29G X 1/2", 38
trimipramine maleate, 18
tinidazole, 3
topex topical anesthetic, 18 Trinatal RX 1, 28
tis-u-sol, 41
topiragen, 19 Trinate, 28
Tivicay, 2
topiramate, 19 trinessa, 11, 44
tizanidine HCL, 21
toposar, 4 trinessa LO, 11, 44
TL gard RX, 16
topotecan HCL, 5 triphrocaps, 27
TL icon, 16
Topotecan HCL, 5 triple-vitamin/fluoride, 27
TL-hem 150, 16
Torisel, 5 Trisenox, 5
Tobi Podhaler, 2
torsemide, 7 Triumeq, 2
Tobradex, 21
Totect, 5 trivora-28, 11, 44
Tobradex ST, 21
Toujeo Solostar, 12 tropazone, 9
tobramycin, 2
Toviaz, 15 tropicamide, 22
tobramycin inhalation solution PAK, 2
tpn electrolytes, 41 trospium chloride, 15
tobramycin sulfate, 2, 21
Tracer II 3 Volt Battery, 38 trospium chloride ER, 15
tobramycin/dexamethasone, 21
Tracleer, 7 Truedraw Lancing Device, 38
Tobrex, 21
Tradjenta, 12 Trueplus Insulin Syringe/U-100/0.3ML/29G X 1/2", 38
Today Sponge, 15
tramadol HCL, 24
Todays Health Advanced Lancing Device, 38
tramadol HCL ER, 24 Trueplus Insulin Syringe/U-100/0.3ML/30G X 5/16", 38
tramadol hydrochloride/acetaminophen, 24
Todays Health Mini Pen Needles 31G X 1/4", 38
Trueplus Insulin Syringe/U-100/0.3ML/31G X 5/16", 38
trandolapril, 6
Todays Health Original Pen Needles 29G X 1/2", 38
trandolapril/verapamil HCL, 7 Trueplus Insulin Syringe/U-100/0.5ML/28G X 1/2", 38
trandolapril/verapamil HCL ER, 7
Todays Health SHORT Pen Needles 31G X 5/16", 38
tranexamic acid, 17 Trueplus Insulin Syringe/U-100/0.5ML/29G X 1/2", 38
Transderm-scop, 14
Todays Health Super Thin Lancets 30G, 32
tranylcypromine sulfate, 18 Trueplus Insulin Syringe/U-100/0.5ML/30G X 5/16", 38
Travatan Z, 21
Todays Health Ultra Thin Lancets 28G, 32
Travel Lancets 30G, 32 Trueplus Insulin Syringe/U-100/0.5ML/31G X 5/16", 38
trazodone HCL, 18
tolazamide, 12
Treanda, 3 Trueplus Insulin Syringe/U-100/1ML/28G X 1/2", 38
Tolazamide, 12
Trecator, 2
Tolbutamide, 12
Trelstar, 4 Trueplus Insulin Syringe/U-100/1ML/29G X 1/2", 38
tolcapone, 20
Trelstar Mixject, 4
tolmetin sodium, 24
tretinoin, 5 Trueplus Insulin Syringe/U-100/1ML/30G X 5/16", 38
Tolmetin Sodium, 24
Tretten, 17
tolterodine tartrate, 15
Trexall, 4 Trueplus Insulin Syringe/U-100/1ML/31G X 5/16", 38
tolterodine tartrate ER, 15
tri-estarylla, 11, 44
Topcare Clickfine Universal Pen Eedles 31GX1/4", 38
tri-legest FE, 11, 44 Trueplus Lancets 26G, 32
tri-linyah, 11, 44 Trueplus Lancets 28G, 32
Topcare Clickfine Universal Pen Eedles 31GX5/16", 38
tri-LO-estarylla, 11, 44 Trueplus Lancets 28G Super Thin, 32
tri-LO-marzia, 11, 44 Trueplus Lancets 30G, 32
Topcare Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16", 38
tri-LO-sprintec, 11, 44 Trueplus Lancets 30G Ultra Thin, 32
tri-previfem, 11, 44 Trueplus Lancets 33G, 32
Topcare Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16", 38
tri-sprintec, 11, 44 Trueplus Lancets 33G Micro Thin, 32
tri-vit/fluoride, 27 Trueplus Safety Lancets 28G, 32
Topcare Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16", 38
tri-vitamin/fluoride, 27 Trulicity, 12
Triadvance, 28 Trumenba, 26, 45
Topcare Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16", 38
triamcinolone acetonide, 9, 18, 25 Truvada, 2
triamcinolone IN orabase, 18 Tudorza Pressair, 25
Topcare Ultra Comfort Insulin Syringe/1ML/30G X 5/16", 38
triamterene/hydrochlorothiazide, 7 tussigon, 25
Triamterene/Hydrochlorothiazide, 7 Twinrix, 26, 45
Topcare Ultra Comfort Insulin Syringe/1ML/31G X 5/16", 38
triazolam, 19 Tybost, 2
Triazolam, 19 Tygacil, 3
Topcare Ultra Comfort Insulin Syringe/U-100/0.3ML/29G X 1/2", 38
Tribenzor, 7 Tykerb, 5
Tricare, 28, 44 Typhim VI, 26
Topcare Ultra Comfort Insulin Syringe/U-100/0.5ML/29G X 1/2", 38
tricitrates, 15 Tysabri, 20
tricon, 16 Tyvaso, 7
Topcare Ultra Comfort Insulin Syringe/U-
triderm, 9 Tyvaso Refill, 7
Tyvaso Starter, 7
X 5/16", 38 39
Tyzeka, 3
Ulticare Insulin Syringe/U-100/1ML/29G X 1/2", 38
Ultilet Safety Lancets 23G, 32
U
Ultilet SHORT Pen Needles 31GX5/16", 39
Ulticare Insulin Syringe/U-100/1ML/30G X 1/2", 38
u-kera e, 9
Ultilet SHORT Pen Needles31GX3/16", 39
Ulesfia, 10
Ulticare Insulin Syringe/U-100/1ML/30G X 5/16", 38
Uloric, 24
Ultimatecare One, 28
Ulti-lance Automatic/ Clear Tip, 38
Ulticare Insulin Syringe/U-100/1ML/31G X 5/16", 38
Ultimatecare One NF, 28
Ulticare Insulin Safety Syringe/0.5ML/29G X 1/2", 38
Ultra Comfort Insulin Syringe/U-100/0.3ML/30G X 5/16", 39
Ulticare Micro Pen Needles 31G X 8MM, 39
Ulticare Insulin Safety Syringe/1ML/29G X 1/2", 38
Ultra Comfort Insulin Syringe/U-100/0.5ML/28G X 1/2", 39
Ulticare Micro Pen Needles 32G X 4MM, 39
Ulticare Insulin Syringe 1CC/28G U-100 1/2", 38
Ultra TABS, 28
Ulticare Micro Pen Needles/31G X 8MM, 39
Ultra Thin Lancets 28G, 32
Ulticare Insulin Syringe Ultrafine U-100/0.3ML/31G X 5/16", 38
Ultra Thin Lancets 30G, 32
Ulticare Micro Pen Needles/32G X 4MM, 39
Ultra-comfort Insulin Syringe/U-100/0.3ML/29G X 1/2", 39
Ulticare Insulin Syringe Ultrafine U-100/0.5ML/31G X 5/16", 38
Ulticare Mini Pen Needles 31GX6MM, 39 Ultra-comfort Insulin Syringe/U-100/0.3ML/30G X 5/16", 39
Ulticare Insulin Syringe Ultrafine U-100/1ML/31G X 5/16", 38
Ulticare Mini Pen Needles Ulti-fine IV, 39
Ulticare Mini Pen Needles/31G X 6MM, 39
Ultra-comfort Insulin Syringe/U-100/0.3ML/31G X 5/16", 39
Ulticare Insulin Syringe/0.3ML/29G X 1/2", 38
Ulticare Mini Pen Needles31GX6MM, 39 Ultra-comfort Insulin Syringe/U-100/0.5ML/28G X 1/2", 39
Ulticare Insulin Syringe/0.3ML/30G X 1/2", 38
Ulticare Original Pen Needles Ulti-fine, 39
Ultra-comfort Insulin Syringe/U-100/0.5ML/29G X 1/2", 39
Ulticare Insulin Syringe/0.3ML/30G X 5/16", 38
Ulticare Pen Needles/29G X 12.7MM, 39
Ulticare SHORT Pen Needles 31GX8MM, 39
Ultra-comfort Insulin Syringe/U-100/0.5ML/30G X 5/16", 39
Ulticare Insulin Syringe/0.5ML/28G X 1/2", 38
Ulticare SHORT Pen Needles Ulti-fine IV, 39
Ultra-comfort Insulin Syringe/U-100/0.5ML/31G X 5/16", 39
Ulticare Insulin Syringe/0.5ML/29G X 1/2", 38
Ulticare SHORT Pen Needles/31G X 8MM, 39
Ultra-comfort Insulin Syringe/U-100/1ML/28G X 1/2", 39
Ulticare Insulin Syringe/0.5ML/30G X 1/2", 39
Ulticare Thin Lancets 30G, 32 Ultra-comfort Insulin Syringe/U-100/1ML/29G X 1/2", 39
Ulticare Insulin Syringe/0.5ML/30G X 5/16", 39
Ulticare U-100 Insulin Syringes/0.3ML/31G X 1/4", 39
Ultra-comfort Insulin Syringe/U-100/1ML/30G X 5/16", 39
Ulticare Insulin Syringe/1ML/28G X 1/2", 39
Ulticare U-100 Insulin Syringes/0.3ML/31G X1/4", 39
Ultra-comfort Insulin Syringe/U-100/1ML/31G X 5/16", 39
Ulticare Insulin Syringe/1ML/29G X 1/2", 39
Ulticare U-100 Insulin Syringes/0.5ML/31G X 1/4", 39
Ultra-thin II Auto Lancet, 32
Ulticare Insulin Syringe/1ML/30G X 1/2", 39
Ulticare U-100 Insulin Syringes/1ML/31G X 1/4", 39
Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/30GX5/16", 39
Ulticare Insulin Syringe/1ML/30G X 5/16", 39
Ultiguard Insulin Syringe/U-100/0.3ML/29G X 1/2", 39
Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/31GX5/16", 39
Ulticare Insulin Syringe/SHORT/0.3ML/30G X 5/16", 38
Ultiguard Insulin Syringe/U-100/0.3ML/30G X 5/16", 39
Ultra-thin II Insulin Syringe SHORT/U-100/0.5ML/30GX5/16", 39
Ulticare Insulin Syringe/SHORT/0.3ML/31G X 5/16", 38
Ultiguard Insulin Syringe/U-100/0.5ML/29G X 1/2", 39
Ultra-thin II Insulin Syringe SHORT/U-100/0.5ML/31GX5/16", 39
Ulticare Insulin Syringe/SHORT/0.5ML/30G X 5/16", 38
Ultiguard Insulin Syringe/U-100/0.5ML/30G X 5/16", 39
Ultra-thin II Insulin Syringe SHORT/U-100/1ML/30GX5/16", 39
Ulticare Insulin Syringe/SHORT/0.5ML/31G X 5/16", 38
Ultiguard Insulin Syringe/U-100/1ML/29G X 1/2", 39
Ultra-thin II Insulin Syringe SHORT/U-100/1ML/31GX5/16", 39
Ulticare Insulin Syringe/SHORT/1ML/30G X 5/16", 38
Ultiguard Insulin Syringe/U-100/1ML/30G X 5/16", 39
Ultra-thin II Insulin Syringe/U-100/0.3ML/29GX1/2", 39
Ulticare Insulin Syringe/SHORT/1ML/31G X 5/16", 38
Ultilet Classic Lancets, 32 Ultra-thin II Insulin Syringe/U-100/0.5ML/29GX1/2", 39
Ultilet Insulin Syringe/SHORT/0.3ML/30G X 5/16", 39
Ulticare Insulin Syringe/U-100/0.3ML/29G X 1/2", 38
Ultra-thin II Insulin Syringe/U-100/1ML/29GX1/2", 39
Ultilet Insulin Syringe/SHORT/0.3ML/31G X 5/16", 39
Ulticare Insulin Syringe/U-100/0.3ML/30G X 1/2", 38
Ultra-thin II Lancets 28G, 32
Ultilet Insulin Syringe/SHORT/0.5ML/30G X 5/16", 39
Ultra-thin II Lancets 30G, 32
Ulticare Insulin Syringe/U-100/0.3ML/30G X 5/16", 38
Ultra-thin II Mini Pen Neeedles/31GX3/16", 39
Ultilet Insulin Syringe/SHORT/0.5ML/31G X 5/16", 39
Ulticare Insulin Syringe/U-100/0.3ML/31G X 5/16", 38
Ultra-thin II Pen Needles 29GX1/2", 39
Ultilet Insulin Syringe/SHORT/1ML/30G X 5/16", 39
Ultra-thin II Pen Needles/SHORT/31GX5/16", 39
Ulticare Insulin Syringe/U-100/0.5ML/29G X 1/2", 38
Ultilet Insulin Syringe/SHORT/1ML/31G X 5/16", 39
Ultra-thin II Safety Autolancets 26G, 32
Ulticare Insulin Syringe/U-100/0.5ML/30G X 1/2", 38
Ultralance, 39
Ultilet Lancets, 32 umecta mousse, 9
Ulticare Insulin Syringe/U-100/0.5ML/30G X 5/16", 38
Ultilet Lancets 33G, 32 Unifine Pentips 29GX12MM, 39
Ultilet Pen Needle 32GX4MM/SHORT, Unifine Pentips 31G X 3/16", 39
Ulticare Insulin Syringe/U-100/0.5ML/31G
Unifine Pentips 31G X 6MM, 39
uroav-81, 15 vecuronium bromide, 21
Unifine Pentips 31G X 8MM, 39
uroav-b, 15 Velcade, 5
Unifine Pentips 31GX5MM, 39
urolet mb, 15 Veletri, 8
Unifine Pentips 31GX6MM, 39
urophen mb, 15 velivet, 11, 44
Unifine Pentips 31GX8MM, 39
urosex, 27 Veltassa, 42
Unifine Pentips 32GX4MM, 39
ursodiol, 15 venlafaxine HCL, 18
Unifine Pentips Plus 29GX12MM, 39
uryl, 15 venlafaxine HCL ER, 18
Unifine Pentips Plus 31GX5MM, 39
ustell, 15 Venlafaxine HCL ER, 18
Unifine Pentips Plus 31GX6MM, 39
uta, 15 Ventavis, 8
Unifine Pentips Plus 31GX8MM, 39
uticap, 15 verapamil HCL, 6
Unifine Pentips Plus 32GX4MM, 39
utira-c, 15 verapamil HCL ER, 6
Unilet Comfortouch Lancet, 32
utrona-c, 15 verapamil HCL SR, 6
Unilet Excelite, 32
Uvadex, 5 verdrocet, 24
Unilet Excelite II, 32
V Veregen, 10
Unilet G.p. Lancet, 32
Vesicare, 15
v-c forte, 27
Unilet G.p. Superlite Lancet, 32
vestura, 11, 44
V-go 20, 32
Unilet GP 28 Ultra Thin, 32
Vexol, 21
V-go 30, 32
Unilet Lancet, 32
Viagra, 7
V-go 40, 32
Unilet Lancets Micro-thin33G, 32
Vibativ, 3
V-r Monoject Insulin Syringe/U-100/0.3ML/29G X 1/2", 39
Unilet Lancets Super-thin30G, 32
vic-forte, 27
Unilet Lancets Ultra-thin 28G, 32
vicodin, 24
V-r Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2", 39
Unilet Superlite Lancet, 32
vicodin ES, 24
Unistik 1, 39
vicodin HP, 24
V-r Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2", 39
Unistik 2, 39
Victoza, 12
Unistik 2 Comfort, 39
Victrelis, 3
V-r Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 39
Unistik 2 Extra, 39
Vida Mia Autolet Lancing Device, 39
Unistik 2 Neonatal, 39
Vida Mia Unifine Pentips 32GX4MM, 39
V-r Monoject Insulin Syringe/U-100/1ML/29G X 1/2", 39
Unistik 2 Normal, 39
Vida Mia Unifine Pentips Mini 31GX6MM, 39
Unistik 2 Super, 39
Vagifem, 15
Unistik 3, 39
Vida Mia Unifine Pentips Original 29GX12MM, 39
valacyclovir HCL, 2
Unistik 3 Comfort, 39
Valchlor, 3, 10
Unistik 3 Extra, 39
Vida Mia Unilet Lancets Super Thin 30G, 32
Valcyte, 3
Unistik 3 Gentle, 32
valganciclovir, 2
Unistik 3 Neonatal, 39
Vida Mia Unilet Lancets Ultra Thin 28G, 32
valproate sodium, 19
Unistik 3 Normal, 39
valproic acid, 19
Unistik CZT Comfort, 39
Vida Mia Unipfine Pentipsshort 31GX8MM, 39
valsartan, 6
Unistik CZT Normal, 39
valsartan/hydrochlorothiazide, 7
Unistik Safety Lancets 28G, 32
Videx Pediatric, 2
Valstar, 3
Unistik Safety Lancets 30G, 32
vienva, 11, 44
Value Health Insulin Syringe/U-100/0.5ML/29G X 1/2", 39
Unistik Touch Safety Lancets 21G, 32
Vigamox, 21
Unistik Touch Safety Lancets 23G, 32
Viibryd, 18
Value Health Insulin Syringe/U-100/1ML/29G X 1/2", 39
Unistik Touch Safety Lancets 28G, 32
Viibryd Starter Pack, 18
Unistik Touch Safety Lancets 30G, 32
Vimizim, 13
Value Plus Lancets Standard 21G, 32
unithroid, 13
Vimpat, 19
Value Plus Lancets Super Thin 30G, 32
unithroid direct, 13
Vinate C, 28
Value Plus Lancets Thin 26G, 32
Unituxin, 4
Vinate Care, 28
Value Plus Lancing Device, 39
Universal 1 Lancets Thin 26G, 32
Vinate IC, 28
Valumark Lancet Super Thin 30G, 32
Universal 1 Lancets Ultra Thin 30G, 32
Vinate II, 28
Valumark Lancet Ultra Thin 28G, 32
Uptravi, 8
Vinate M, 28
Valumark Pen Needles 29GX12MM, 39
ur n-c, 15
Vinate One, 28
Valumark Pen Needles 31G X 6MM, 39
uramit mb, 15
Vinblastine Sulfate, 4
Valumark Pen Needles 31G X 8MM, 39
ure-k, 9
vincasar PFS, 4
Valved Holding Chamber, 40
urea, 9
vincristine sulfate, 4
vancomycin HCL, 3
urea 40% nail film, 9
vinorelbine tartrate, 4
vandazole, 15
urea hydrating, 9
viorele, 11, 44
Vanishpoint Insulin Syringe/0.5ML/30G X 1/2", 39
urea IN zinc undecylenate/lactic acid vehicle, 9
Viracept, 2
Viramune, 2
Vanishpoint Insulin Syringe/1ML/29G X 1/2", 39
urea nail, 9
Virazole, 3
urea topical, 9
Viread, 2
Vantas, 4
urea-c40, 9
virt-CAPS, 27
Vaqta, 26, 45
urelle, 15
virt-gard, 16
Varivax, 26, 45
uretron d/s, 15
virt-phos 250 neutral, 41
Vascepa, 7
uribel, 15
virt-vite, 16
vasopressin, 13
urin d/s, 15
virt-vite plus, 27
Vcf Vaginal Contraceptive Film, 15, 44
Urin-tek, 39
virti-sulf, 8
Vcf Vaginal Contraceptive Foam, 15, 44
uro-blue, 15
virtrate-2, 15
vcf vaginal contraceptivegel, 15, 44
uro-l, 15
virtrate-3, 16
Vectibix, 4
uro-mp, 15
virtrate-k, 15
Vectical, 9
Visudyne, 22
Wd Medic Insulin Syringe/1ML/29G X 1/2", 39
zenatane, 8
vita s forte, 27
zenchent, 11, 44
vita-min, 27
Wd Medic Insulin Syringe/1ML/30G X 5/16", 39
zenchent FE, 11, 44
vitacel, 27
zencia, 8
Vitafol-OB, 28
Webcol Alcohol Prep Large 1 Ply, 40 Zenpep, 14
vitajoy daily d gummies, 27, 47
Webcol Alcohol Prep Large 2 Ply, 40 zenzedi, 19
Vitalet Pro Lancets, 32
Webcol Alcohol Prep Medium 2 Ply, 40 Zepatier, 3
Vitalet Pro Plus Lancets, 32
wee care, 16, 46 zeruvia, 10
vitamax pediatric, 27
Wegmans Unifine Pentips Plus 32GX4MM, 39
Zetia, 7
Vitamelts Vitamin D, 27, 47
Zevalin Y-90, 4
vitamin b-complex 100, 27
Wegmans Unifine Pentips Plus/Mini/31GX5MM, 39
Ziagen, 2
vitamin c 222MG, 26
zidovudine, 2
vitamin d, 26, 47
Wegmans Unifine Pentips Plus/SHORT/31GX8MM, 39
Zinacef, 1
vitamin d 400, 27, 47
ziprasidone HCL, 19
vitamin d high potency, 27, 47
Wegmans Unifine Pentips Plus/Ultra SHORT/31GX6MM, 39
Zirgan, 21
vitamin d-1000, 27, 47
Zithromax, 1
vitamin d-1000 maximum strength, 27, 47
Welchol, 7 Zoladex, 4
Wellesse Vitamin D3, 27, 47 zoledronic acid, 12
vitamin d-3, 27, 47
wera, 11, 44 Zoledronic Acid, 12
vitamin d-400, 27, 47
Wide-seal Silicone Diaphragm Kit 60, 44 Zolinza, 5
Vitamin D2, 27
Wide-seal Silicone Diaphragm Kit 65, 44 zolmitriptan, 24
vitamin d3, 27, 47
Wide-seal Silicone Diaphragm Kit 70, 44 zolmitriptan odt, 24
Vitamin D3, 27, 47
Wide-seal Silicone Diaphragm Kit 75, 44 zolpidem tartrate, 19
vitamin d3 400, 27, 47
Wide-seal Silicone Diaphragm Kit 80, 44 zolpidem tartrate ER, 19
vitamin d3 adult gummies, 27, 47
Wide-seal Silicone Diaphragm Kit 85, 44 Zometa, 12
vitamin d3 high potency, 27, 47
Wide-seal Silicone Diaphragm Kit 90, 44 Zomig, 24
vitamin d3 maximum strength, 27, 47
Wide-seal Silicone Diaphragm Kit 95, 44 Zomig Nasal Spray, 24
vitamin d3 super strength, 27, 47
Wilate, 17 zonisamide, 19
vitamin k1, 26
Winrho SDF, 42 Zontivity, 17
vitamins a/c/d/fluoride, 28
wymzya FE, 11, 44 Zorbtive, 13
Vitekta, 2
X Zortress, 4
Vivitrol, 42
Zostavax, 26, 45
x-viate, 10
Vivotif, 26
zovia 1/35e, 11, 44
Xalkori, 5
vol-care RX, 28
Zovirax, 8
Xarelto, 17
Voraxaze, 5
Zydelig, 5
Xarelto Starter Pack, 17
voriconazole, 2
Zyflo CR, 25
Xeomin, 21
Vortex Valved Holding Chamber, 40
Zykadia, 5
Xgeva, 13
Votrient, 5
Zyprexa Relprevv, 19
Xiaflex, 42
Vp Insulin Syringe/U-100/0.3ML/29G X 1/2", 39
Zytiga, 4
Xifaxan, 3
Zyvox, 3
Xolair, 25
vp-vite RX, 28
1
Xolegel, 8
Vp-zel, 28
Xtandi, 4 1ST Choice Lancets Super Thin, 32
Vpriv, 17
Xulane, 11, 44 1ST Choice Lancets Thin, 32
vyfemla, 11, 44
xylocaine dental, 25 1ST Choice Lancets Ultra Thin, 32
Vytorin, 7
xylon, 24 1ST Tier Unifine Pentips /Mini/31GX5MM, 39
Vyvanse, 19
Xyntha, 17
W
Xyntha Solofuse, 17 1ST Tier Unifine Pentips 29GX12MM, 39
W&f Lancets 26G, 32
xyphex, 10 1ST Tier Unifine Pentips 31GX6MM, 39
W&f Lancets Colored 21G, 32
Xyrem, 20 1ST Tier Unifine Pentips 31GX8MM, 39
Walgreens Advanced Travellancets 28G, 32
Y 1ST Tier Unifine Pentips 32GX4MM, 39
1ST Tier Unifine Pentips Plus 31GX8MM, 39
Yervoy, 4
Walgreens Comfort Assuredlancets Micro Thin/33G, 32
Yf-vax, 26
1ST Tier Unifine Pentips Plus 32GX4MM, 39
yl folic acid, 16, 44
Walgreens Comfort Assuredlancets Super Thin/28G, 32
Yondelis, 3
1ST Tier Unifine Pentips Plus/Mini/31GX5MM, 39
Your Life Multi Prenatal, 28
Walgreens Lancets, 32
Z
Walgreens Thin Lancets, 32
1ST Tier Unifine Pentips Plus/Original/29GX12MM, 39
Walgreens Ultra Thin Lancets, 32
zafirlukast, 25
warfarin sodium, 17
1ST Tier Unifine Pentips Plus/Ultra SHORT/31GX6MM, 39
zaleplon, 19
Watchhaler, 40
Zaltrap, 4
Wd Medic Insulin Syringe/0.3ML/29G X 1/2", 39
1ST Tier Unilet Comfortouch Lancets 28G, 32
zamicet, 24
Zanosar, 3
Wd Medic Insulin Syringe/0.3ML/30G X 5/16", 39
1ST Tier Unilet Comfortouch Lancets 30G, 32
zarah, 11, 44
Zavesca, 17
Wd Medic Insulin Syringe/0.5ML/29G X 1/2", 39
8
zazole, 15
zebutal, 22
8-mop, 9
Wd Medic Insulin Syringe/0.5ML/30G X 5/16", 39
Zelboraf, 5
Zemaira, 26
SpanishSi usted, o alguien a quien usted está ayudando, tiene preguntas acerca de Common Ground Healthcare Cooperative, tiene derecho a obtener ayuda e información en su idioma sin costo alguno. Para hablar con un intérprete, llame al 1-877-514-2442.
HmongYog koj, los yog tej tus neeg uas koj pab ntawd, muaj lus nug txog Common Ground Healthcare Cooperative, koj muaj cai kom lawv muab cov ntshiab lus qhia uas tau muab sau ua koj hom lus pub dawb rau koj. Yog koj xav nrog ib tug neeg txhais lus tham, hu rau [insert number here].
Chinese如果您,或是您正在協助的對象,有關於Common Ground Healthcare Cooperative 方面的問題,您 有權利免費以您的母語得到幫助和訊息。洽詢一位翻譯員,請撥電話 在此插入數字 1-877-514-2442
GermanFalls Sie oder jemand, dem Sie helfen, Fragen zum Common Ground Healthcare Cooperative haben, haben Sie das Recht, kostenlose Hilfe und Informationen in Ihrer Sprache zu erhalten. Um mit einem Dolmetscher zu sprechen, rufen Sie bitte die Nummer 1-877-514-2442 an.
Arabic ةدعاسملا ىلع لوصحلا يف قحلا كيدلف Common Ground Healthcare Cooperative صوصخب ةلئسأ هدعاست صخش ىدل وأ كيدل ناك نإ
تامولعملاو2442-514-877-1 ـب لصتا مجرتم عم ثدحتلل .ةفلكت ةيا نود نم كتغلب ةيرورضلا
RussianЕсли у вас или лица, которому вы помогаете, имеются вопросы по поводу Common Ground Healthcare Cooperative, то вы имеете право на бесплатное получение помощи и информации на вашем языке. Для разговора с переводчиком позвоните по телефону 1-877-514-2442.
Korean만약 귀하 또는 귀하가 돕고 있는 어떤 사람이 Common Ground Healthcare Cooperative 에 관해서 질문이 있다면 귀하는 그러한 도움과 정보를 귀하의 언어로 비용 부담없이 얻을 수 있는 권리가 있습니다. 그렇게 통역사와 얘기하기 위해서는 1-877-514-2442로 전화하십시오.
Vietnamese Nếu quý vị, hay người mà quý vị đang giúp đỡ, có câu hỏi về Common Ground Healthcare Cooperative, quý vị sẽ có quyền được giúp và có thêm thông tin bằng ngôn ngữ của mình miễn phí. Để nói chuyện với một thông dịch viên, xin gọi 1-877-514-2442.
Pennsylvania DutchWann du hoscht en Froog, odder ebber, wu du helfscht, hot en Froog baut Common Ground Healthcare Cooperative, hoscht du es Recht fer Hilf un Information in deinre eegne Schprooch griege, un die Hilf koschtet nix. Wann du mit me Interpreter schwetze witt, kannscht du 1-877-514-2442 uffrufe.
Laotianຖ້າທ່ານ, ຫ ຼືຄົນທ ່ທ່ານກໍາລັງຊ່ວຍເຫ ຼືອ, ມ ຄໍາຖາມກ່ຽວກັບ Common Ground Healthcare Cooperative, ທ່ານມ ສິດທ ່ຈະໄດ້ຮັບການຊ່ວຍເຫ ຼືອແລະຂໍ້ມູນຂ່າວສານທ ່ເປັນພາສາຂອງທ່ານບໍ່ມ ຄ່າໃຊ້ຈ່າຍ. ການໂອ້ລົມກັບນາຍພາສາ, ໃຫ້ໂທຫາ 1-877-514-2442.
FrenchSi vous, ou quelqu’un que vous êtes en train d’aider, a des questions à propos de Common Ground Healthcare Cooperative, vous avez le droit d’obtenir de l’aide et l’information dans votre langue à aucun coût. Pour parler à un interprète, appelez 1-877-514-2442.
Polish Jeśli Ty lub osoba, której pomagasz ,macie pytania odnośnie Common Ground Healthcare Cooperative, masz prawo do uzyskania bezpłatnej informacji i pomocy we własnym języku .Aby porozmawiać z tłumaczem, zadzwoń pod numer 1-877-514-2442
Hindi
यदि आपके ,या आप द्वारा सहायता ककए जा रहे ककसी व्यक्तत के Common Ground Healthcare Cooperative[] के बारे में प्रश्न हैं ,तो आपके पास अपनी भाषा में मुफ्त में सहायता और सूचना प्राप्त करने का अधिकार है। ककसी िुभाषषए से बात करने के लिए ,1-877-514-2442 पर कॉि करें।
AlbanianNëse ju, ose dikush që po ndihmoni, ka pyetje për Common Ground Healthcare Cooperative, keni të drejtë të merrni ndihmë dhe informacion falas në gjuhën tuaj. Për të folur me një përkthyes, telefononi numrin 1-877-514-2442.TagalogKung ikaw, o ang iyong tinutulangan, ay may mga katanungan tungkol sa Common Ground Healthcare Cooperative, may karapatan ka na makakuha ng tulong at impormasyon sa iyong wika ng walang gastos. Upang makausap ang isang tagasalin, tumawag sa 1-877-514-2442.
CGHC.EO.1076-2016
NOTICE OF FOREIGN LANGUAGE ASSISTANCE
Common Ground Healthcare Cooperative (CGHC) is required by law to include the following information with any significant document we provide you: Notice of Nondiscrimination and Availability of Language Assistance Services CGHC complies with applicable Federal civil rights laws and does not discriminate. This means that we do not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. CGHC:
• Provides free aids and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o Written information in other formats (large print, audio, accessible electronic formats, other
formats) • Provides free language services to people whose primary language is not English, such as:
o Qualified interpreters o Information written in other languages
If you need these services, please call 877-514-2442. If you believe that CGHC has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance by contacting:
Civil Rights Coordinator: Wayne Creggett Telephone Number: 414-269-4684 Mailing Address: 120 Bishop’s Way, Suite 150 Brookfield, WI 53005-6271 Fax Number: 262-754-9690 Email Address: civilrights@commongroundhealthcare.org
You can file a grievance in person, by mail, fax, or email. If you need help filing a grievance, Wayne Creggett, Civil Rights Coordinator, is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
CGHC.EO.1074-2016
Foreign Language Assistance Spanish ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-514-2442. Hmong LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau 1-877-514-2442. Chinese 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-877-514-2442。
German ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-877-514-2442. Arabic
ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 1-877-514-2442
Russian ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-877-514-2442. Korean 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-877-514-2442 번으로
전화해 주십시오. Vietnamese CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-877-514-2442. Pennsylvania Dutch Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call 1-877-514-2442. Laotian ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ້າພາສາ ລາວ, ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 1-877-514-2442.. French ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-877-514-2442. Polish UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-877-514-2442. Hindi ध्यान द�: य�द आप िहंदी बोलते ह� तो आपके िलए मुफ्त म� भाषा सहायता सेवाएं उपलब्ध ह�। 1-877-514-2442. पर कॉल कर�। Albanian KUJDES: Nëse flitni shqip, për ju ka në dispozicion shërbime të asistencës gjuhësore, pa pagesë. Telefononi në 1-877-514-2442. Tagalog PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-877-514-2442.
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