optumrx 2022 premium standard formulary

2022 Premium Standard FormularyEffective January 1, 2022

For the most current list of covered medications or if you have questions:

Call the number on your member ID card.

Visit your plan’s website on your member ID card or log on to the OptumRx app to:

• Find a participating retail pharmacy by ZIP code.

• Look up possible lower-cost medication alternatives.

• Compare medication pricing and options.

2

Understanding your formulary

What is a formulary?

A formulary is a list of prescribed medications or other pharmacy care products, services or supplies chosen for their safety, cost, and effectiveness. Medications are listed by categories or classes and are placed into cost levels known as tiers. It includes both brand and generic prescription medications.

To create the list, OptumRx® is guided by the Pharmacy and Therapeutics Committee. This group of doctors and pharmacists reviews which medications will be covered, how well the drugs work, and overall value. They also make sure there are safe and covered options.

How do I use my formulary?

You and your doctor can use the formulary to help you choose the most cost-effective prescription medications. This guide tells you if a medication is generic or brand, and if special rules apply. If your medication is not listed here, please visit your plan’s website or call the number on your member ID card.

What are tiers?

Tiers are the different cost levels you pay for a medication. Each tier is assigned a cost, set by your employer or plan sponsor.

When does the formulary change?

• Medications may move to a lower tier at any time.• Medications may move to a higher tier when a generic

equal becomes available.• Medications may move to a higher tier or be excluded from

coverage on January 1 or July 1 of each year.

If a medication changes tiers, you may have to pay a different amount for that medication.

Why are some medications excluded from coverage?

A medication may be excluded from coverage under your pharmacy benefit when it works the same as or is similar to another prescription or over-the-counter (OTC) medication.

What if I don’t agree with a decision about an excluded medication?

You, your authorized representative, or your doctor can ask for a coverage request by calling the number on your member ID card.

About this formulary

Where differences exist between this list and your benefit plan, the benefit plan documents rule. This is not a complete list of your covered medications. Please review your benefit plan documents for full details. Not all formulary alternatives listed in this document may be appropriate for your specific condition. Please talk to your doctor.

Medication tips

What is the difference between brand-name and generic medications?

Generic medications contain the same active ingredients (offer the same effect) as brand-name medications, but they often cost less. In some situations, brand-name medications could be lower in cost.

What if my doctor writes a brand-name prescription?

If your doctor gives you a prescription for a brand-name medication, ask if a lower-cost option could be right for you.

What if I am taking a specialty medication?

Specialty medications are used to treat complex conditions and are generally higher in cost. Please note, not all specialty medications are listed in the formulary. Our specialty pharmacy can provide most of your specialty medications along with helpful programs and services. Call 1-855-427-4682 and ask how you can have your prescriptions delivered right to your home or doctor’s office.

Over-the-counter medications (OTC)

Talk to your doctor about OTC options. Even though OTC medications may not be covered by your pharmacy benefit, they may cost less than a prescription medication.

3

Reading your formulary

The formulary gives you choices so you and your doctor can decide your best course of treatment. In this formulary, brand-name medications are shown in UPPERCASE (for example, CLOBEX). Generic medications are shown in lowercase (for example, clobetasol).

Tier information

Using lower tier or preferred medications can help you lower your out-of-pocket cost. Your plan may have multiple or no tiers. Please note: If you have a high-deductible plan, the tier cost levels will apply once you meet your deductible.

Drug tier Includes Helpful tips

Tier 1 $ Lower-cost generics and some brand name

Use tier 1 drugs for the lowest out-of-pocket costs.

Tier 2 $$ Mid-range cost preferred brand name

Use tier 2 drugs instead of tier 3 to help reduce your out-of-pocket costs.

Tier 3 $$$ Higher-cost brand name and some generics

Many tier 3 drugs have lower-cost options in tier 1 or 2. Ask your doctor if they could work for you.

Tier E Excluded May not be covered or need prior authorization. Lower-cost options are available and covered.

Drug list information

In this drug list, some medications are noted with letters next to them to help you see which ones may have coverage requirements or limits. Your benefit plan decides how these medications may be covered.

M Authorized generic or cobranded product

PA Prior authorization – Your doctor is required to give OptumRx more information to determine coverage.

QL Quantity limit – Medication may be limited to a certain quantity.

SP Specialty medication – Medication is designated as specialty.

ST Step therapy – Must try lower-cost medication(s) before a higher-cost medication can be covered

3P Tier 3 preferred

++ Benefit design options – Coverage is determined by your prescription medication benefit plan.

4

Analgesics - drugs for pain .................................................. 5

Analgesics - drugs for pain and inflammation ...................... 5

Anesthetics ......................................................................... 6

Anti-addiction / substance abuse treatment agents ............. 6

Antibacterials ...................................................................... 6

Anticoagulants .................................................................... 8

Anticonvulsants - drugs for seizures .................................... 8

Antidementia agents - drugs for Alzheimer’s disease and dementia ..................................................................... 9

Antidepressants .................................................................. 9

Antiemetics - drugs for nausea and vomiting ...................... 9

Antifungals ....................................................................... 10

Antigout agents ................................................................ 10

Antimigraine agents .......................................................... 10

Antimyasthenic agents ...................................................... 10

Antimycobacterials ............................................................ 10

Antineoplastics - drugs for cancer ..................................... 11

Antiparasitics .................................................................... 12

Antiparkinson agents ........................................................ 12

Antiplatelets ..................................................................... 13

Antipsychotics - drugs for mood disorders ......................... 13

Antivirals ........................................................................... 13

Anxiolytics - drugs for anxiety ........................................... 14

Bipolar agents - drugs for mood disorders ......................... 14

Blood products and modifiers - drugs for blood disorders .. 14

Cardiovascular agents - drugs for heart and circulation conditions ........................................................ 15

Central nervous system agents - drugs for attention deficit disorder .................................................................. 17

Central nervous system agents - drugs for multiple sclerosis 17

Central nervous system agents - miscellaneous ................. 17

Dental and oral agents - drugs for mouth and throat conditions ......................................................................... 17

Dermatological agents - drugs for skin conditions ............. 18

Diabetes - antidiabetic agents ........................................... 19

Diabetes - glucose monitoring ........................................... 19

Diabetes - glycemic agents ................................................ 20

Diabetes - insulins ............................................................. 20

Electrolytes / minerals / metals / vitamins ........................... 20

Gastrointestinal agents - drugs for acid reflux and ulcer .... 21

Gastrointestinal agents - drugs for bowel, intestine and stomach conditions .................................................... 21

Genetic or enzyme disorder - drugs for replacement, modification, treatment .................................................... 22

Genitourinary agents - drugs for bladder, genital and kidney conditions .............................................................. 22

Genitourinary agents - drugs for prostate conditions ......... 22

Hormonal agents - adrenal ................................................ 22

Hormonal agents - men’s health ........................................ 23

Hormonal agents - pituitary .............................................. 23

Hormonal agents - selective estrogen receptor modifying agents .............................................................. 23

Hormonal agents - sex hormones and birth control ........... 23

Hormonal agents - thyroid ................................................ 26

Immunological agents - drugs for immune system stimulation or suppression ................................................ 26

Immunological agents - drugs for vaccination ................... 27

Inflammatory bowel disease agents ................................... 27

Metabolic bone disease agents - drugs for osteoporosis .... 28

Metabolic bone disease agents - other .............................. 28

Miscellaneous therapeutic agents ...................................... 28

Ophthalmic agents - drugs for eye allergy, infection and inflammation ............................................................. 29

Ophthalmic agents - drugs for glaucoma .......................... 29

Ophthalmic agents - drugs for miscellaneous eye conditions ......................................................................... 29

Otic agents - drugs for ear conditions ............................... 30

Respiratory tract / pulmonary agents - drugs for allergies, cough, cold ........................................................ 30

Respiratory tract / pulmonary agents - drugs for asthma and other lung conditions ..................................... 30

Respiratory tract / pulmonary agents - drugs for cystic fibrosis ..................................................................... 31

Respiratory tract / pulmonary agents - drugs for pulmonary hypertension ................................................... 31

Skeletal muscle relaxants - drugs for muscle pain and spasm ............................................................................... 31

Sleep disorder agents ........................................................ 32

Contents

5PA: Prior Authorization QL: Quantity Limit SP: Specialty Medication ST: Step Therapy

Drug nameDrug tier Notes

Analgesics - drugs for pain

acetaminophen intravenous solution Generic

acetaminophen-codeine Generic QL

acetaminophen-codeine #2 Generic QL



alfentanil hcl Generic

apap-caff-dihydrocodeine Generic QL

ascomp-codeine Generic

bac Generic

BELBUCA Brand PA; QL

buprenorphine Generic PA; QL

buprenorphine hcl injection Generic

butalbital-acetaminophen Generic

butalbital-apap-caff-cod Generic

butalbital-apap-caffeine Generic

butalbital-asa-caff-codeine Generic

butalbital-aspirin-caffeine Generic

butorphanol tartrate injection Generic

butorphanol tartrate nasal Generic QL

carisoprodol-aspirin-codeine Generic

codeine sulfate Generic QL

duramorph Generic

endocet Generic QL

fentanyl Generic PA; QL

fentanyl citrate buccal lozenge on a handle

Generic PA; QL

fentanyl citrate injection solution prefilled syringe

Generic

hydrocodone bitartrate er oral capsule extended release 12 hour

Generic PA; QL

hydrocodone-acetaminophen Generic QL

hydrocodone-ibuprofen Generic QL

hydromorphone hcl er Generic PA; QL

hydromorphone hcl injection solution 2 mg/ml, 4 mg/ml

Generic

hydromorphone hcl oral Generic QL

hydromorphone hcl pf Generic

hydromorphone hcl solution 1 mg/ml injection

Generic

levorphanol tartrate oral Generic QL

meperidine hcl injection Generic

meperidine hcl oral Generic QL

methadone hcl injection Generic


methadone hcl intensol Generic

methadone hcl oral concentrate Generic

methadone hcl oral solution Generic

methadone hcl oral tablet Generic PA

methadone hcl oral tablet soluble Generic

methadose oral concentrate 10 mg/ml

Generic

methadose oral tablet soluble Generic

methadose sugar-free Generic

mitigo Generic

morphine sulfate (concentrate) oral solution 100 mg/5ml, 20 mg/ml

Generic QL

morphine sulfate (pf) Generic

morphine sulfate er Generic PA; QL

morphine sulfate er beads Generic PA; QL

morphine sulfate injection solution 2 mg/ml, 4 mg/ml

Generic

morphine sulfate intravenous solution 4 mg/ml, 8 mg/ml

Generic

morphine sulfate oral Generic QL

nalbuphine hcl injection Generic

oxycodone hcl oral capsule Generic QL

oxycodone hcl oral concentrate 100 mg/5ml

Generic QL

oxycodone hcl oral solution Generic QL

oxycodone hcl oral tablet Generic QL

oxycodone-acetaminophen oral tablet 10-325 mg, 2.5-325 mg, 5-325 mg, 7.5-325 mg

Generic QL

oxymorphone hcl Generic QL

oxymorphone hcl er Generic PA; QL

pentazocine-naloxone hcl Generic QL

remifentanil hcl Generic

tramadol hcl er (biphasic) Generic PA; QL

tramadol hcl er oral tablet extended release 24 hour

Generic PA; QL

tramadol hcl ir Generic QL

tramadol-acetaminophen Generic QL

XTAMPZA ER Brand PA; QL

Analgesics - drugs for pain and inflammation

celecoxib oral Generic QL

diclofenac potassium Generic

diclofenac sodium er Generic

diclofenac sodium external gel 1 % Generic QL

diclofenac sodium external solution Generic PA



diclofenac sodium oral Generic

diclofenac-misoprostol Generic

diflunisal oral Generic

ec-naproxen Generic

etodolac Generic

etodolac er Generic

fenoprofen calcium oral Generic

fenortho Generic

flurbiprofen oral Generic

ibuprofen lysine Generic

ibuprofen oral suspension 100 mg/5ml

Generic

ibuprofen oral tablet 400 mg, 600 mg, 800 mg

Generic

indomethacin er Generic

indomethacin oral capsule 25 mg, 50 mg

Generic

indomethacin sodium Generic

ketoprofen er Generic

ketoprofen oral Generic

ketorolac tromethamine injection Generic

ketorolac tromethamine intramuscular

Generic

ketorolac tromethamine oral Generic QL

meclofenamate sodium oral Generic

mefenamic acid oral Generic

meloxicam oral Generic

nabumetone oral Generic

naproxen oral Generic

naproxen sodium er oral tablet extended release 24 hour 375 mg, 500 mg

Generic

naproxen sodium oral tablet 275 mg, 550 mg

Generic

naproxen-esomeprazole Generic QL

oxaprozin Generic

piroxicam oral Generic

sulindac oral Generic

Anesthetics

bupivacaine fisiopharma Generic

bupivacaine hcl (pf) Generic

bupivacaine hcl injection solution 0.25 %, 0.5 %

Generic

bupivacaine-epinephrine Generic

bupivacaine-epinephrine (pf) Generic


chloroprocaine hcl (pf) Generic

ethyl chloride Generic

glydo Generic

lidocaine external ointment 5 % Generic

lidocaine external patch 5 % Generic

lidocaine hcl (cardiac) intravenous solution prefilled syringe 50 mg/5ml

Generic

lidocaine hcl (cardiac) pf Generic

lidocaine hcl (cardiac) solution prefilled syringe 100 mg/5ml intravenous

Generic

lidocaine hcl (pf) Generic

lidocaine hcl external solution Generic

lidocaine hcl injection solution Generic

lidocaine hcl urethral/mucosal Generic

lidocaine in d5w intravenous solution 4-5 mg/ml-%, 8-5 mg/ml-%

Generic

lidocaine-epinephrine injection Generic

lidocaine-prilocaine external cream Generic

polocaine Generic

polocaine-mpf Generic

ropivacaine hcl injection solution Generic

tetracaine hcl injection Generic

Anti-addiction / substance abuse treatment agents

acamprosate calcium Generic

buprenorphine hcl sublingual Generic QL

buprenorphine hcl-naloxone hcl Generic QL

bupropion hcl er (smoking det) Generic QL

disulfiram oral Generic

KLOXXADO Brand

naloxone hcl injection Generic

naltrexone hcl oral Generic

NARCAN Brand

ZUBSOLV Brand QL

Antibacterials

amikacin sulfate injection Generic

amoxicillin Generic

amoxicillin-potassium clavulanate Generic

amoxicillin-potassium clavulanate er Generic

ampicillin Generic

ampicillin sodium Generic

ampicillin-sulbactam sodium Generic

avidoxy Generic



azithromycin intravenous Generic

azithromycin oral Generic

aztreonam Generic

bacitracin intramuscular Generic

benzalkonium chloride external solution

Generic

cefaclor Generic

cefaclor er Generic

cefadroxil Generic

cefazolin sodium injection Generic

cefazolin sodium intravenous solution reconstituted

Generic

cefazolin sodium-dextrose intravenous solution 1-4 gm/50ml-%, 2-4 gm/100ml-%

Generic

cefazolin sodium-dextrose intravenous solution reconstituted

Generic

cefdinir Generic

cefepime hcl injection Generic

cefepime hcl intravenous solution Generic

cefepime-dextrose Generic

cefixime Generic

cefotaxime sodium Generic

cefotetan disodium Generic

cefotetan disodium-dextrose Generic

cefoxitin sodium Generic

cefpodoxime proxetil Generic

cefprozil Generic

ceftazidime and dextrose Generic

ceftazidime injection Generic

ceftazidime intravenous Generic

ceftriaxone sodium in dextrose Generic

ceftriaxone sodium injection Generic

ceftriaxone sodium intravenous Generic

ceftriaxone sodium-dextrose Generic

cefuroxime axetil Generic

cefuroxime sodium Generic

cephalexin Generic

chloramphenicol sod succinate Generic

ciprofloxacin hcl oral Generic

ciprofloxacin in d5w Generic

clarithromycin er Generic

clarithromycin oral Generic

clindamycin hcl oral Generic


clindamycin palmitate hcl Generic

clindamycin phosphate in d5w Generic

clindamycin phosphate injection Generic

clindamycin phosphate vaginal Generic

colistimethate sodium (cba) Generic

coremino Generic

daptomycin Generic

demeclocycline hcl Generic

dicloxacillin sodium Generic

doxy 100 Generic

doxycycline hyclate intravenous Generic

doxycycline hyclate oral capsule Generic

doxycycline hyclate oral tablet Generic

doxycycline hyclate oral tablet delayed release 100 mg, 150 mg, 200 mg, 50 mg, 75 mg

Generic

doxycycline monohydrate oral Generic

ertapenem sodium Generic

erythromycin base Generic

erythromycin ethylsuccinate oral Generic

erythromycin oral Generic

fosfomycin tromethamine Generic

gentamicin in saline Generic

gentamicin sulfate external Generic

gentamicin sulfate injection Generic

hydrogen peroxide Generic

imipenem-cilastatin Generic

levofloxacin in d5w Generic

levofloxacin intravenous Generic

levofloxacin oral Generic

lincomycin hcl injection Generic

linezolid in sodium chloride Generic

linezolid intravenous Generic

linezolid oral Generic QL

mafenide acetate external Generic

meropenem Generic

methenamine hippurate Generic

metronidazole in nacl Generic

metronidazole oral Generic

metronidazole vaginal Generic

minocycline hcl er oral tablet extended release 24 hour

Generic

minocycline hcl oral Generic

mondoxyne nl Generic



moxifloxacin hcl in nacl Generic

moxifloxacin hcl oral Generic

mupirocin calcium Generic

mupirocin external Generic

nafcillin sodium Generic

neomycin sulfate oral Generic

neomycin-polymyxin b gu Generic

nitrofurantoin Generic

nitrofurantoin macrocrystal Generic

nitrofurantoin monohydrate macrocrystals

Generic

ofloxacin oral Generic

oxacillin sodium Generic

paromomycin sulfate oral Generic

penicillin g potassium Generic

penicillin g procaine Generic

penicillin g sodium Generic

penicillin v potassium Generic

piperacillin sod-tazobactam so Generic

polymyxin b sulfate injection Generic

silver sulfadiazine external Generic

ssd Generic

streptomycin sulfate intramuscular Generic

sulfadiazine oral Generic

sulfamethoxazole-trimethoprim Generic

sulfatrim pediatric Generic

tazicef injection Generic

tazicef intravenous solution reconstituted

Generic

tetracycline hcl oral Generic

tigecycline Generic

tinidazole oral Generic

tobramycin sulfate injection Generic

trimethoprim oral Generic

vancomycin hcl in dextrose intravenous solution 1-5 gm/200ml-%, 500-5 mg/100ml-%, 750-5 mg/150ml-%

Generic

vancomycin hcl in nacl intravenous solution 1-0.9 gm/200ml-%, 500-0.9 mg/100ml-%

Generic

vancomycin hcl in nacl solution 750-0.9 mg/150ml-% intravenous

Generic

vancomycin hcl intravenous Generic

vancomycin hcl oral Generic


vandazole Generic

Anticoagulants

argatroban Generic

bivalirudin trifluoroacetate Generic

ELIQUIS Brand QL

ELIQUIS DVT/PE STARTER PACK Brand QL

enoxaparin sodium Generic SP; QL

fondaparinux sodium Generic SP; QL

heparin (porcine) in nacl intravenous solution

Generic

heparin sod (porcine) in d5w Generic

heparin sodium (porcine) Generic

heparin sodium (porcine) pf Generic

jantoven Generic

PRADAXA Brand QL

warfarin sodium oral Generic

XARELTO Brand QL

XARELTO STARTER PACK Brand QL

Anticonvulsants - drugs for seizures

carbamazepine er Generic

carbamazepine oral Generic

clobazam Generic PA

diazepam rectal Generic QL

divalproex sodium er Generic

divalproex sodium oral Generic

epitol Generic

ethosuximide oral Generic

felbamate Generic

fosphenytoin sodium Generic

gabapentin oral Generic

lamotrigine er Generic

lamotrigine oral Generic

lamotrigine starter kit-blue Generic

lamotrigine starter kit-green Generic

lamotrigine starter kit-orange Generic

levetiracetam er Generic

levetiracetam in nacl Generic

levetiracetam intravenous Generic

levetiracetam oral Generic

oxcarbazepine Generic

pentobarbital sodium injection Generic

phenobarbital oral Generic

phenobarbital sodium injection Generic

phenytoin infatabs Generic



phenytoin oral Generic

phenytoin sodium extended Generic

phenytoin sodium injection Generic

primidone oral Generic

roweepra Generic

rufinamide Generic PA

subvenite Generic

subvenite starter kit-blue Generic

subvenite starter kit-green Generic

subvenite starter kit-orange Generic

tiagabine hcl Generic

topiramate er Generic

topiramate oral Generic

valproate sodium intravenous Generic

valproic acid oral Generic

vigabatrin Generic PA; SP

vigadrone Generic PA; SP

zonisamide oral Generic

Antidementia agents - drugs for Alzheimer's disease and dementia

donepezil hcl Generic

galantamine hydrobromide Generic

galantamine hydrobromide er Generic

memantine hcl Generic

memantine hcl er Generic QL

NAMZARIC Brand QL

rivastigmine Generic

rivastigmine tartrate Generic

Antidepressants

amitriptyline hcl oral Generic

amoxapine Generic

bupropion hcl er (sr) Generic QL

bupropion hcl er (xl) oral tablet extended release 24 hour 150 mg, 300 mg

Generic QL

bupropion hcl oral Generic

chlordiazepoxide-amitriptyline Generic

citalopram hydrobromide Generic

clomipramine hcl oral Generic

desipramine hcl oral Generic

desvenlafaxine succinate er Generic QL

doxepin hcl oral capsule Generic

doxepin hcl oral concentrate Generic

duloxetine hcl oral Generic QL


escitalopram oxalate Generic

fluoxetine hcl (pmdd) Generic

fluoxetine hcl oral capsule Generic

fluoxetine hcl oral capsule delayed release

Generic QL

fluoxetine hcl oral solution Generic

fluoxetine hcl oral tablet Generic

fluvoxamine maleate Generic

fluvoxamine maleate er Generic QL

imipramine hcl oral Generic

imipramine pamoate Generic

mirtazapine oral Generic

nefazodone hcl Generic

nortriptyline hcl oral Generic

olanzapine-fluoxetine hcl Generic QL

paroxetine hcl Generic

paroxetine hcl er Generic

paroxetine mesylate Generic QL

perphenazine-amitriptyline Generic

phenelzine sulfate oral Generic

protriptyline hcl Generic

sertraline hcl oral concentrate Generic

sertraline hcl oral tablet Generic

tranylcypromine sulfate Generic

trazodone hcl oral Generic

trimipramine maleate oral Generic

venlafaxine hcl Generic

venlafaxine hcl er Generic

Antiemetics - drugs for nausea and vomiting

aprepitant Generic QL

compro Generic

dimenhydrinate injection Generic

doxylamine-pyridoxine Generic PA; QL

dronabinol Generic PA; QL

droperidol injection Generic

fosaprepitant dimeglumine Generic

granisetron hcl intravenous Generic

granisetron hcl oral Generic QL

meclizine hcl oral tablet Generic

metoclopramide hcl injection Generic

metoclopramide hcl oral Generic

ondansetron hcl injection Generic

ondansetron hcl oral solution Generic QL

ondansetron hcl oral tablet 24 mg Generic QL



ondansetron hcl oral tablet 4 mg, 8 mg

Generic

ondansetron odt Generic

palonosetron hcl Generic

perphenazine oral Generic

prochlorperazine Generic

prochlorperazine edisylate injection Generic

prochlorperazine maleate oral Generic

scopolamine Generic

trimethobenzamide hcl oral Generic

Antifungals

amphotericin b intravenous Generic

caspofungin acetate Generic

ciclodan Generic

ciclopirox external Generic

ciclopirox olamine external Generic

clotrimazole external Generic

clotrimazole mouth/throat Generic

clotrimazole-betamethasone Generic

econazole nitrate external Generic

fluconazole in sodium chloride Generic

fluconazole oral Generic

flucytosine oral Generic

griseofulvin microsize oral Generic

griseofulvin ultramicrosize Generic

itraconazole oral Generic PA

ketoconazole external Generic

ketoconazole oral Generic

ketodan external foam Generic

micafungin sodium Generic

miconazole 3 Generic

naftifine hcl Generic

nyamyc Generic

nystatin external Generic

nystatin mouth/throat Generic

nystatin oral Generic

nystatin-triamcinolone Generic

nystop Generic

oxiconazole nitrate Generic

posaconazole Generic PA

tavaborole Generic PA

terbinafine hcl oral Generic QL

terconazole Generic

voriconazole intravenous Generic


voriconazole oral Generic PA

Antigout agents

allopurinol oral Generic

allopurinol sodium Generic

colchicine oral tablet Generic

colchicine-probenecid Generic

febuxostat Generic

probenecid Generic

Antimigraine agents

AIMOVIG SUBCUTANEOUS SOLUTION AUTO-INJECTOR 140 MG/ML, 70 MG/ML

Brand PA; QL

almotriptan malate Generic QL

dihydroergotamine mesylate injection

Generic PA; QL

dihydroergotamine mesylate nasal Generic PA; QL

eletriptan hydrobromide Generic QL

EMGALITY Brand PA; QL

EMGALITY (300 MG DOSE) Brand PA; QL

ergotamine-caffeine Generic PA

frovatriptan succinate Generic QL

naratriptan hcl Generic QL

NURTEC Brand PA; QL

rizatriptan benzoate Generic QL

sumatriptan nasal Generic QL

sumatriptan succinate oral Generic QL

sumatriptan succinate refill Generic QL

sumatriptan succinate subcutaneous Generic QL

sumatriptan-naproxen sodium Generic QL

UBRELVY Brand PA; QL

zolmitriptan oral Generic QL

zolmitriptan solution 5 mg nasal Generic QL

Antimyasthenic agents

neostigmine methylsulfate intravenous solution 10 mg/10ml, 5 mg/10ml

Generic

pyridostigmine bromide er Generic

pyridostigmine bromide oral Generic

Antimycobacterials

cycloserine oral Generic

dapsone oral Generic

ethambutol hcl oral Generic

isoniazid injection Generic

isoniazid oral Generic



pyrazinamide oral Generic

rifabutin Generic

rifampin intravenous Generic

rifampin oral Generic

Antineoplastics - drugs for cancer

abiraterone acetate Generic PA; SP

ABRAXANE Brand SP

ADCETRIS Brand PA; SP

adriamycin Generic SP

ALECENSA Brand PA; SP

ALIMTA Brand SP

ALUNBRIG Brand PA; SP; QL

anastrozole oral Generic

ARRANON Brand SP

arsenic trioxide intravenous Generic SP

ARZERRA Brand PA; SP; QL

azacitidine Generic SP

bexarotene Generic PA; SP

bicalutamide Generic

bleomycin sulfate Generic SP

busulfan Generic SP

CABOMETYX Brand PA; SP

capecitabine Generic PA; SP

CAPRELSA ORAL TABLET 100 MG Brand PA; SP; QL

CAPRELSA ORAL TABLET 300 MG Brand PA; SP

carboplatin Generic SP

carmustine Generic SP

cisplatin intravenous solution Generic SP

cladribine Generic SP

clofarabine Generic SP

cyclophosphamide injection Generic SP

cyclophosphamide oral capsule Generic

CYCLOPHOSPHAMIDE ORAL TABLET Brand

cytarabine Generic SP

cytarabine (pf) Generic SP

dacarbazine Generic SP

dactinomycin Generic SP

daunorubicin hcl Generic SP

decitabine Generic PA; SP

dexrazoxane hcl Generic SP

docetaxel Generic SP

doxorubicin hcl Generic SP

doxorubicin hcl liposomal Generic SP


EMCYT Brand

epirubicin hcl Generic SP

ERBITUX Brand PA; SP

ERIVEDGE Brand PA; SP

erlotinib hcl oral tablet 100 mg, 150 mg

Generic PA; SP

erlotinib hcl oral tablet 25 mg Generic PA; SP; QL

etoposide intravenous Generic SP

etoposide oral Generic SP

everolimus oral tablet 10 mg, 2.5 mg, 5 mg, 7.5 mg

Generic PA; SP; QL

everolimus oral tablet soluble Generic PA; SP

exemestane Generic

floxuridine Generic SP

fludarabine phosphate Generic SP

fluorouracil intravenous Generic SP

flutamide Generic

FOLOTYN Brand PA; SP

fulvestrant Generic SP

gemcitabine hcl Generic SP

HALAVEN Brand PA; SP

hydroxyurea oral Generic

idarubicin hcl Generic SP

ifosfamide Generic SP

imatinib mesylate Generic PA; SP

irinotecan hcl Generic SP

IXEMPRA KIT Brand SP

JAKAFI ORAL TABLET 10 MG Brand PA; SP; QL

JAKAFI ORAL TABLET 15 MG, 20 MG, 25 MG, 5 MG

Brand PA; SP

JEVTANA Brand PA; SP

KANJINTI Brand PA; SP

KYPROLIS Brand PA; SP

lapatinib ditosylate Generic PA; SP

letrozole oral Generic

leucovorin calcium injection Generic

leucovorin calcium oral Generic

LEUKERAN Brand

levoleucovorin calcium Generic SP

levoleucovorin calcium pf Generic SP

LYNPARZA Brand PA; SP

LYSODREN Brand

MATULANE Brand SP

MEKINIST Brand PA; SP



melphalan Generic SP

melphalan hcl Generic SP

mercaptopurine oral Generic

mesna Generic SP

mitomycin intravenous Generic SP

mitoxantrone hcl Generic PA; SP

mutamycin Generic SP

MVASI Brand PA; SP

MYLERAN Brand

NEXAVAR Brand PA; SP

nilutamide Generic SP

ONCASPAR Brand SP

oxaliplatin Generic SP

paclitaxel Generic SP

paraplatin Generic SP

PERJETA Brand PA; SP

PHESGO Brand PA; SP

PROLEUKIN Brand SP

REVLIMID Brand PA; SP

RUBRACA Brand PA; SP

RUXIENCE Brand PA; SP

SPRYCEL Brand PA; SP

sunitinib malate Generic PA; SP

TABLOID Brand SP

TAFINLAR Brand PA; SP

tamoxifen citrate oral Generic

TEMODAR INTRAVENOUS Brand SP

temozolomide Generic PA; SP

THALOMID Brand PA; SP

thiotepa injection Generic SP

toposar Generic SP

topotecan hcl Generic SP

toremifene citrate Generic

TRAZIMERA Brand PA; SP

tretinoin oral Generic SP

valrubicin Generic SP

VELCADE Brand PA; SP

vinblastine sulfate Generic SP

vincristine sulfate Generic SP

vinorelbine tartrate Generic SP

XOFIGO Brand

YERVOY Brand PA; SP

ZALTRAP Brand PA; SP


ZANOSAR Brand SP

ZEJULA Brand PA; SP

ZIRABEV Brand PA; SP

ZOLINZA Brand PA; SP

Antiparasitics

albendazole oral Generic PA

ALINIA ORAL SUSPENSION RECONSTITUTED

Brand

atovaquone Generic

atovaquone-proguanil hcl Generic

chloroquine phosphate oral Generic

crotan Generic

EMVERM Brand

hydroxychloroquine sulfate oral Generic

ivermectin external lotion Generic

ivermectin oral Generic PA; QL

lindane Generic

malathion Generic

mefloquine hcl Generic

nitazoxanide oral Generic

pentamidine isethionate Generic

permethrin external Generic

praziquantel oral Generic

primaquine phosphate Generic

pyrimethamine oral Generic PA; SP

quinine sulfate oral Generic PA

spinosad Generic

sulfurated lime Generic

Antiparkinson agents

amantadine hcl oral Generic

benztropine mesylate Generic

bromocriptine mesylate oral Generic

carbidopa oral Generic

carbidopa-levodopa Generic

carbidopa-levodopa er Generic

carbidopa-levodopa-entacapone Generic

entacapone Generic

pramipexole dihydrochloride Generic

pramipexole dihydrochloride er Generic

rasagiline mesylate oral Generic

ropinirole hcl Generic

ropinirole hcl er Generic

selegiline hcl oral Generic

tolcapone Generic



trihexyphenidyl hcl Generic

Antiplatelets

aspirin-dipyridamole er Generic

BRILINTA Brand

cilostazol Generic

clopidogrel bisulfate oral Generic

dipyridamole oral Generic

eptifibatide Generic

prasugrel hcl Generic

Antipsychotics - drugs for mood disorders

aripiprazole Generic QL

asenapine maleate Generic QL

chlorpromazine hcl injection Generic

chlorpromazine hcl oral Generic

clozapine Generic QL

fluphenazine decanoate injection Generic

fluphenazine hcl Generic

haloperidol decanoate intramuscular Generic

haloperidol lactate Generic

haloperidol oral Generic

loxapine succinate Generic

molindone hcl Generic

olanzapine intramuscular Generic

olanzapine oral Generic QL

paliperidone er Generic QL

pimozide Generic

quetiapine fumarate Generic QL

quetiapine fumarate er Generic QL

risperidone Generic QL

thioridazine hcl oral Generic

thiothixene Generic

trifluoperazine hcl Generic

ziprasidone hcl Generic QL

ziprasidone mesylate Generic

Antivirals

abacavir sulfate Generic

abacavir sulfate-lamivudine Generic

abacavir-lamivudine-zidovudine Generic

acyclovir external Generic

acyclovir oral Generic

acyclovir sodium Generic

adefovir dipivoxil Generic

APTIVUS Brand


atazanavir sulfate Generic

cidofovir intravenous Generic

CIMDUO Brand

COMPLERA Brand

CRIXIVAN Brand

DOVATO Brand

EDURANT Brand

efavirenz Generic

efavirenz-emtricitab-tenofovir Generic

efavirenz-lamivudine-tenofovir Generic

emtricitabine Generic

emtricitabine-tenofovir df Generic

EMTRIVA ORAL SOLUTION Brand

entecavir Generic QL

EPCLUSA Brand PA; SP; QL

EPIVIR HBV ORAL SOLUTION Brand

etravirine Generic

EVOTAZ Brand

famciclovir oral Generic

fosamprenavir calcium Generic

foscarnet sodium Generic

FUZEON Brand

ganciclovir sodium Generic

HARVONI Brand PA; SP; QL

INTELENCE ORAL TABLET 25 MG Brand

INVIRASE Brand

ISENTRESS Brand

ISENTRESS HD Brand

JULUCA Brand

lamivudine Generic

lamivudine-zidovudine Generic

LEXIVA ORAL SUSPENSION Brand

lopinavir-ritonavir Generic

MAVYRET Brand PA; SP; QL

nevirapine Generic

nevirapine er Generic

NORVIR ORAL PACKET Brand

NORVIR ORAL SOLUTION Brand

oseltamivir phosphate oral Generic QL

PEGASYS Brand PA

PREZCOBIX Brand

PREZISTA Brand

RETROVIR INTRAVENOUS Brand



REYATAZ ORAL PACKET Brand

ribavirin inhalation Generic

ribavirin oral Generic SP

rimantadine hcl Generic

ritonavir Generic

RUKOBIA Brand

SELZENTRY Brand PA

stavudine Generic

SYMFI Brand

SYMFI LO Brand

tenofovir disoproxil fumarate Generic

TIVICAY Brand

TIVICAY PD Brand

TRIUMEQ Brand

TYBOST Brand

valacyclovir hcl oral Generic QL

valganciclovir hcl Generic

VIRACEPT Brand

VIREAD ORAL POWDER Brand

VIREAD ORAL TABLET 150 MG, 200 MG, 250 MG

Brand

VOSEVI Brand PA; SP; QL

zidovudine Generic

Anxiolytics - drugs for anxiety

alprazolam er Generic QL

alprazolam intensol Generic QL

alprazolam oral Generic QL

alprazolam xr Generic QL

buspirone hcl oral Generic

chlordiazepoxide hcl Generic QL

clonazepam oral Generic QL

clorazepate dipotassium Generic QL

diazepam injection Generic

diazepam intensol Generic

diazepam intramuscular Generic

diazepam oral Generic

estazolam Generic QL

hydroxyzine hcl intramuscular Generic

hydroxyzine hcl oral Generic

hydroxyzine pamoate oral Generic

lorazepam injection Generic

lorazepam intensol Generic QL

lorazepam oral concentrate 2 mg/ml Generic QL

lorazepam oral tablet Generic QL


meprobamate Generic

oxazepam Generic QL

quazepam Generic QL

triazolam Generic QL

Bipolar agents - drugs for mood disorders

lithium carbonate er Generic

lithium carbonate oral Generic

Blood products and modifiers - drugs for blood disorders

ADVATE Brand SP

ALPHANATE Brand SP

ALPHANINE SD Brand SP

aminocaproic acid intravenous Generic

aminocaproic acid oral Generic

anagrelide hcl Generic

ARANESP (ALBUMIN FREE) Brand PA; SP

BENEFIX Brand SP

CORIFACT Brand SP

FEIBA Brand SP

FIBRYGA Brand SP

hetastarch-nacl Generic

HUMATE-P Brand SP

KOATE Brand SP

KOATE-DVI Brand SP

KOGENATE FS Brand SP

KOVALTRY Brand SP

MONONINE Brand SP

MOZOBIL Brand PA; SP; QL

MULPLETA Brand PA; SP

NIVESTYM Brand PA; SP

NOVOEIGHT Brand SP

NOVOSEVEN RT Brand SP

NUWIQ Brand SP

PROFILNINE Brand SP

protamine sulfate intravenous Generic

RECOMBINATE Brand SP

RETACRIT Brand PA; SP

RIASTAP Brand SP

tranexamic acid intravenous Generic

tranexamic acid oral Generic

WILATE Brand SP

XYNTHA Brand SP

XYNTHA SOLOFUSE Brand SP

ZARXIO Brand PA; SP



Cardiovascular agents - drugs for heart and circulation conditions

acebutolol hcl oral Generic

acetazolamide sodium Generic

adenosine intravenous solution 12 mg/4ml, 6 mg/2ml

Generic

aliskiren fumarate Generic

alprostadil injection Generic

amiloride hcl oral Generic

amiloride-hydrochlorothiazide Generic

amiodarone hcl Generic

amlodipine besylate oral Generic

amlodipine besylate-benazepril hcl Generic

amlodipine besylate-valsartan Generic

amlodipine-atorvastatin Generic

amlodipine-olmesartan Generic

amlodipine-valsartan-hctz Generic

atenolol oral Generic

atenolol-chlorthalidone Generic

atorvastatin calcium oral Generic

benazepril hcl oral Generic

benazepril-hydrochlorothiazide Generic

betaxolol hcl oral Generic

bisoprolol fumarate oral Generic

bisoprolol-hydrochlorothiazide Generic

bumetanide Generic

candesartan cilexetil Generic

candesartan cilexetil-hctz Generic

captopril oral Generic

cartia xt Generic

carvedilol Generic

carvedilol phosphate er Generic

chlorothiazide sodium Generic

chlorthalidone Generic

cholestyramine light Generic

cholestyramine oral Generic

clonidine Generic

clonidine hcl oral Generic

colesevelam hcl Generic

colestipol hcl Generic

digitek Generic

digox Generic

digoxin injection Generic

digoxin oral Generic


diltiazem hcl er Generic

diltiazem hcl er beads Generic

diltiazem hcl er coated beads Generic

diltiazem hcl intravenous Generic

diltiazem hcl oral Generic

dilt-xr Generic

disopyramide phosphate Generic

dobutamine hcl Generic

dobutamine in d5w Generic

dofetilide Generic

dopamine hcl intravenous Generic

dopamine in d5w Generic

doxazosin mesylate oral Generic

droxidopa Generic PA; SP

enalapril maleate oral Generic

enalaprilat Generic

enalapril-hydrochlorothiazide Generic

ENTRESTO Brand QL

ephedrine sulfate intravenous solution 50 mg/ml

Generic

epinephrine intravenous solution prefilled syringe 1 mg/10ml

Generic

epinephrine pf Generic

eplerenone Generic

esmolol hcl intravenous solution 100 mg/10ml

Generic

esmolol hcl-sodium chloride Generic

ethacrynate sodium Generic

ethacrynic acid Generic

ezetimibe Generic

ezetimibe-simvastatin Generic

felodipine er Generic

fenofibrate micronized oral capsule 130 mg, 134 mg, 200 mg, 43 mg, 67 mg

Generic

fenofibrate oral Generic

fenofibric acid Generic

flecainide acetate Generic

fluvastatin sodium Generic

fluvastatin sodium er Generic

fosinopril sodium Generic

fosinopril sodium-hctz Generic

furosemide injection Generic

furosemide oral Generic



gemfibrozil oral Generic

guanfacine hcl Generic

hydralazine hcl injection Generic

hydralazine hcl oral Generic

hydrochlorothiazide oral Generic

ibutilide fumarate Generic

icosapent ethyl Generic

indapamide Generic

irbesartan Generic

irbesartan-hydrochlorothiazide Generic

isosorbide dinitrate Generic

isosorbide mononitrate Generic

isosorbide mononitrate er Generic

isradipine Generic

labetalol hcl intravenous solution Generic

labetalol hcl oral Generic

LANOXIN ORAL Brand

lisinopril oral Generic

lisinopril-hydrochlorothiazide Generic

losartan potassium oral Generic

losartan potassium-hctz Generic

lovastatin oral Generic

mannitol intravenous Generic

matzim la Generic

methyldopa Generic

metolazone Generic

metoprolol succinate er Generic

metoprolol tartrate intravenous Generic

metoprolol tartrate oral Generic

metoprolol-hydrochlorothiazide Generic

metyrosine Generic

mexiletine hcl oral Generic

midodrine hcl Generic

milrinone lactate Generic

milrinone lactate in dextrose Generic

minoxidil oral Generic

moexipril hcl Generic

nadolol oral Generic

nebivolol hcl Generic

NEXLETOL Brand QL

NEXLIZET Brand QL

niacin (antihyperlipidemic) Generic

niacin er (antihyperlipidemic) Generic


niacor Generic

nicardipine hcl Generic

nifedipine er Generic

nifedipine er osmotic release Generic

nifedipine oral Generic

nimodipine oral Generic

nisoldipine er Generic

nitroglycerin Generic

nitroglycerin in d5w Generic

nitroprusside sodium Generic

norepinephrine bitartrate intravenous

Generic

NORPACE CR Brand

olmesartan medoxomil oral Generic

olmesartan medoxomil-hctz Generic

olmesartan-amlodipine-hctz Generic

omega-3-acid ethyl esters Generic

pentoxifylline er Generic

perindopril erbumine Generic

phenoxybenzamine hcl oral Generic

phentolamine mesylate injection Generic

phenylephrine hcl intravenous solution 10 mg/ml

Generic

pindolol Generic

pravastatin sodium Generic

prazosin hcl oral Generic

prevalite Generic

procainamide hcl injection Generic

propafenone hcl Generic

propafenone hcl er Generic

propranolol hcl er Generic

propranolol hcl intravenous Generic

propranolol hcl oral Generic

quinapril hcl Generic

quinapril-hydrochlorothiazide Generic

quinidine gluconate er Generic

quinidine sulfate Generic

ramipril Generic

ranolazine er Generic

REPATHA Brand QL

REPATHA PUSHTRONEX SYSTEM Brand QL

REPATHA SURECLICK Brand QL

rosuvastatin calcium Generic

simvastatin oral Generic



sodium nitroprusside Generic

sorine Generic

sotalol hcl (af) Generic

sotalol hcl oral Generic

spironolactone oral Generic

spironolactone-hctz Generic

taztia xt Generic

TEKTURNA Brand

TEKTURNA HCT Brand

telmisartan Generic

telmisartan-amlodipine Generic

telmisartan-hctz Generic

tiadylt er Generic

timolol maleate oral Generic

torsemide Generic

trandolapril Generic

trandolapril-verapamil hcl er Generic

triamterene oral Generic

triamterene-hctz Generic

valsartan Generic

valsartan-hydrochlorothiazide Generic

VASCEPA Brand

verapamil hcl er Generic

verapamil hcl intravenous Generic

verapamil hcl oral Generic

Central nervous system agents - drugs for attention deficit disorder

amphetamine sulfate Generic QL

amphetamine-dextroamphetamine Generic QL

amphetamine-dextroamphetamine er

Generic QL

atomoxetine hcl Generic QL

clonidine hcl er Generic

dexmethylphenidate hcl Generic QL

dexmethylphenidate hcl er Generic QL

dextroamphetamine sulfate Generic QL

dextroamphetamine sulfate er Generic QL

guanfacine hcl er Generic

methamphetamine hcl Generic QL

methylphenidate hcl er Generic QL

methylphenidate hcl er (cd) Generic QL

methylphenidate hcl er (la) Generic QL

methylphenidate hcl er (xr) Generic QL

methylphenidate hcl oral Generic QL


relexxii Generic QL

VYVANSE Brand ST; QL

Central nervous system agents - drugs for multiple sclerosis

AVONEX PEN Brand PA; SP; QL

AVONEX PREFILLED Brand PA; SP; QL

BAFIERTAM Brand PA; SP; QL

BETASERON Brand PA; SP; QL

COPAXONE Brand PA; SP; QL

dalfampridine er Generic PA; SP; QL

dimethyl fumarate oral Generic PA; SP; QL

dimethyl fumarate starter pack Generic PA; SP; QL

glatiramer acetate Generic PA; SP; QL

glatopa Generic PA; SP; QL

KESIMPTA Brand PA; SP; QL

VUMERITY Brand PA; SP; QL

Central nervous system agents - miscellaneous

atracurium besylate Generic

caffeine citrate Generic

cisatracurium besylate Generic

cisatracurium besylate (pf) Generic

pancuronium bromide Generic

pregabalin Generic QL

pregabalin er Generic QL

riluzole Generic PA; QL

rocuronium bromide intravenous solution

Generic

succinylcholine chloride injection solution

Generic

tetrabenazine Generic PA; SP

vecuronium bromide intravenous solution reconstituted

Generic

Dental and oral agents - drugs for mouth and throat conditions

cevimeline hcl Generic

chlorhexidine gluconate mouth/throat

Generic

KEPIVANCE Brand SP

lidocaine viscous hcl Generic

oralone Generic

periogard Generic

pilocarpine hcl oral Generic

sodium fluoride 5000 enamel Generic

sodium fluoride 5000 sensitive Generic



triamcinolone acetonide mouth/throat

Generic

Dermatological agents - drugs for skin conditions

accutane Generic PA

acitretin Generic

ACZONE EXTERNAL GEL 7.5 % Brand

adapalene external cream Generic PA

adapalene external gel Generic PA

adapalene-benzoyl peroxide external gel

Generic

ala-cort Generic

alclometasone dipropionate Generic

amcinonide Generic

ammonium lactate external Generic

amnesteem Generic PA

azelaic acid external Generic

balsam peru-castor oil Generic

benzoyl peroxide-erythromycin Generic

beser external lotion Generic

betamethasone dipropionate aug Generic

betamethasone dipropionate external

Generic

betamethasone valerate external Generic

calcipotriene external cream Generic

calcipotriene external ointment Generic

calcipotriene external solution Generic

calcipotriene-betameth diprop Generic QL

calcitriol external Generic

claravis Generic PA

clindacin etz external swab Generic

clindacin-p Generic

clindamycin phosphate-benzoyl peroxide

Generic

clindamycin phosphate external Generic

clindamycin-tretinoin Generic

clobetasol prop emollient base Generic

clobetasol propionate e Generic

clobetasol propionate emulsion Generic

clobetasol propionate external Generic

clocortolone pivalate Generic

clodan external shampoo Generic

coal tar external Generic

dapsone external gel 5 % Generic

desonide external Generic


desoximetasone external Generic

desrx Generic

diclofenac sodium external gel 3 % Generic QL

diflorasone diacetate Generic

doxepin hcl external Generic

doxycycline Generic

DUPIXENT Brand PA; SP; QL

ery Generic

erythromycin external Generic

EUCRISA Brand

fluocinolone acetonide body Generic

fluocinolone acetonide external Generic

fluocinolone acetonide scalp Generic

fluocinonide emulsified base Generic

fluocinonide external Generic

FLUOROURACIL EXTERNAL CREAM 0.5 %

Brand

fluorouracil external cream 5 % Generic

fluorouracil external solution Generic

flurandrenolide Generic

fluticasone propionate external Generic

halcinonide Generic

halobetasol propionate external cream

Generic

halobetasol propionate external ointment

Generic

hydrocortisone butyr lipo base Generic

hydrocortisone butyrate Generic

hydrocortisone external cream 1 %, 2.5 %

Generic

hydrocortisone external lotion 2.5 %

Generic

hydrocortisone external ointment 1 %, 2.5 %

Generic

hydrocortisone valerate Generic

imiquimod external Generic

isotretinoin oral Generic PA

ivermectin external cream Generic

lactic acid e Generic

lactic acid external Generic

methoxsalen rapid Generic

metronidazole external Generic

mometasone furoate external Generic

myorisan Generic PA

neuac external gel Generic



nolix Generic

pimecrolimus Generic ST

podofilox external Generic

prednicarbate Generic

RETIN-A MICRO PUMP EXTERNAL GEL 0.06 %, 0.08 %

Brand PA

rosadan external cream Generic

rosadan external gel Generic

selenium sulfide external lotion Generic

sulfacetamide sodium (acne) Generic

tacrolimus external Generic

tazarotene external cream Generic PA

tovet external foam Generic

tretinoin external Generic PA

tretinoin microsphere Generic PA

tretinoin microsphere pump Generic PA

triamcinolone acetonide external aerosol solution

Generic

triamcinolone acetonide external cream

Generic

triamcinolone acetonide external lotion

Generic

triamcinolone acetonide external ointment 0.025 %, 0.1 %, 0.5 %

Generic

triderm Generic

zenatane Generic PA

Diabetes - antidiabetic agents

acarbose oral Generic

BYDUREON BCISE AUTOINJECTOR Brand QL

BYETTA 10 MCG PEN Brand QL

BYETTA 5 MCG PEN Brand QL

FARXIGA Brand

glimepiride Generic

glipizide er Generic

glipizide ir Generic

glipizide xl Generic

glipizide-metformin hcl Generic

glyburide micronized Generic

glyburide oral Generic

glyburide-metformin Generic

GLYXAMBI Brand

JANUMET Brand

JANUMET XR Brand

JANUVIA Brand


JARDIANCE Brand

JENTADUETO Brand

JENTADUETO XR Brand

metformin hcl er Generic

metformin hcl ir Generic

miglitol Generic

nateglinide Generic

OZEMPIC Brand QL

pioglitazone hcl Generic

pioglitazone hcl-glimepiride Generic

pioglitazone hcl-metformin hcl Generic

repaglinide Generic

RYBELSUS Brand QL

SOLIQUA Brand QL

STEGLATRO Brand

SYNJARDY Brand

SYNJARDY XR Brand

TRADJENTA Brand

TRIJARDY XR Brand

TRULICITY Brand QL

VICTOZA Brand QL

XIGDUO XR Brand

Diabetes - glucose monitoring

ACCU-CHEK FASTCLIX LANCET KIT Brand

ACCU-CHEK SOFTCLIX LANCET DEVICE KIT

Brand

DEXCOM G4 PLAT PED RCV/SHARE Brand

DEXCOM G4 PLAT PED RECEIVER Brand

DEXCOM G4 PLATINUM RCV/SHARE

Brand

DEXCOM G4 PLATINUM RECEIVER Brand

DEXCOM G4 PLATINUM TRANSMITTER

Brand

DEXCOM G4 SENSOR Brand

DEXCOM G5 MOB/G4 PLAT SENSOR Brand

DEXCOM G5 MOBILE RECEIVER Brand

DEXCOM G5 MOBILE TRANSMITTER Brand

DEXCOM G5 RECEIVER KIT Brand

DEXCOM G6 RECEIVER Brand

DEXCOM G6 SENSOR Brand

DEXCOM G6 TRANSMITTER Brand

LANCETS Brand

ONETOUCH ULTRA TEST STRIPS Brand QL

ONETOUCH ULTRA 2 KIT W/DEVICE Brand



ONETOUCH ULTRA MINI KIT W/DEVICE

Brand

ONETOUCH VERIO KIT W/DEVICE Brand

ONETOUCH VERIO FLEX SYSTEM Brand

ONETOUCH VERIO TEST STRIPS Brand QL

ONETOUCH VERIO IQ SYSTEM Brand

ONETOUCH VERIO REFLECT Brand

ONETOUCH VERIO SYNC SYSTEM Brand

RELION PREMIER CLASSIC Brand

RELION PREMIER TEST Brand QL

TRUE METRIX BLOOD GLUCOSE TEST

Brand QL

V-GO 20 Brand

V-GO 30 Brand

V-GO 40 Brand

Diabetes - glycemic agents

BAQSIMI ONE PACK Brand

BAQSIMI TWO PACK Brand

diazoxide oral Generic

glucagon emergency kit Generic

GLUCAGON EMERGENCY KIT Brand

GVOKE HYPOPEN 1-PACK Brand

GVOKE HYPOPEN 2-PACK Brand

GVOKE PFS Brand

ZEGALOGUE Brand

Diabetes - insulins

BD AUTOSHIELD DUO PEN NEEDLES Brand

BD ULTRA-FINE INSULIN SYRINGES Brand

BD ULTRA-FINE PEN NEEDLES Brand

DROPLET MICRON Brand

HUMALOG Brand

HUMALOG KWIKPEN Brand

HUMALOG MIX 50/50 KWIKPEN Brand

HUMALOG MIX 50/50 VIAL Brand

HUMALOG MIX 75/25 KWIKPEN Brand

HUMALOG MIX 75/25 VIAL Brand

HUMALOG U-100 JUNIOR KWIKPEN Brand

HUMULIN 70/30 KWIKPEN Brand

HUMULIN 70/30 VIAL Brand

HUMULIN N KWIKPEN Brand

HUMULIN N VIAL Brand

HUMULIN R U-500 KWIKPEN Brand

HUMULIN R U-500 VIAL Brand

HUMULIN R VIAL Brand


INSULIN PEN NEEDLES Brand

INSULIN SYRINGES Brand

LANTUS SOLOSTAR Brand

LANTUS U-100 VIAL Brand

LYUMJEV KWIKPEN Brand

LYUMJEV VIAL Brand

NOVOFINE AUTOCOVER PEN NEEDLE

Brand

NOVOFINE PEN NEEDLE Brand

NOVOFINE PLUS PEN NEEDLE Brand

NOVOLIN 70/30 FLEXPEN RELION Brand

NOVOLIN 70/30 RELION Brand

NOVOLIN N RELION Brand

NOVOLIN R RELION Brand

NOVOTWIST PEN NEEDLE Brand

TOUJEO MAX SOLOSTAR Brand

TOUJEO SOLOSTAR Brand

ULTIGUARD SAFEPACK SYR/NEEDLE Brand

Electrolytes / minerals / metals / vitamins

argyle sterile saline Generic

argyle sterile water Generic

calcium chloride Generic

calcium gluconate intravenous Generic

CARBAGLU Brand SP

chromic chloride intravenous Generic

curity sterile saline Generic

cyanocobalamin injection solution 1000 mcg/ml

Generic

deferasirox Generic PA

deferasirox granules Generic PA

deferiprone Generic PA

dextrose intravenous Generic

effer-k oral tablet effervescent 25 meq

Generic

ergocalciferol oral capsule Generic

ferumoxytol Generic

folic acid injection Generic

folic acid oral tablet 1 mg Generic

hematinic/folic acid Generic

hemocyte-f Generic

hydroxocobalamin acetate Generic

iodine strong oral Generic

klor-con Generic

klor-con 10 Generic



klor-con m10 Generic



klor-con/ef Generic

k-prime Generic

lactated ringers irrigation Generic

levocarnitine oral solution Generic

levocarnitine oral tablet Generic

levocarnitine sf Generic

magnesium chloride injection Generic

magnesium sulfate in d5w Generic

magnesium sulfate injection Generic

magnesium sulfate intravenous Generic

monoject flush syringe Generic

monoject sodium chloride flush Generic

na ferric gluc cplx in sucrose Generic

normal saline flush Generic

phosphorous Generic

phospho-trin 250 neutral Generic

phytonadione injection Generic

phytonadione oral Generic

potassium acetate intravenous Generic

potassium chloride crys er Generic

potassium chloride er Generic

potassium chloride intravenous Generic

potassium chloride oral Generic

potassium citrate er Generic

potassium phosphates(71 meq k) Generic

pyridoxine hcl injection Generic

ringers irrigation Generic

saline bacteriostatic Generic

sod citrate-citric acid Generic

sodium acetate intravenous Generic

sodium bicarbonate intravenous Generic

sodium chloride (pf) Generic

sodium chloride bacteriostatic Generic

sodium chloride flush Generic

sodium chloride injection Generic

sodium chloride intravenous Generic

sodium chloride irrigation Generic

sodium polystyrene sulfonate Generic

sps Generic

sterile water for irrigation Generic


thiamine hcl injection Generic

tis-u-sol Generic

tolvaptan oral tablet 30 mg Generic PA; SP; QL

trientine hcl Generic PA; SP

virt-phos 250 neutral Generic

vitamin d (ergocalciferol) oral capsule 1.25 mg (50000 ut)

Generic

vitamin k1 injection Generic

water for irrigation, sterile Generic

Gastrointestinal agents - drugs for acid reflux and ulcer

cimetidine hcl Generic

cimetidine oral Generic

CYTOTEC Brand

famotidine intravenous Generic

famotidine oral suspension reconstituted

Generic

famotidine oral tablet 20 mg, 40 mg Generic

famotidine premixed Generic

misoprostol oral Generic

nizatidine Generic

sucralfate oral Generic

Gastrointestinal agents - drugs for bowel, intestine and stomach conditions

alosetron hcl Generic PA

alvimopan Generic

amoxicill-clarithro-lansopraz Generic

atropine sulfate injection solution 8 mg/20ml

Generic

atropine sulfate injection solution prefilled syringe

Generic

atropine sulfate intravenous solution Generic

cascara sagrada oral fluid extract Generic

chlordiazepoxide-clidinium Generic

constulose Generic

cromolyn sodium oral Generic

dicyclomine hcl intramuscular Generic

dicyclomine hcl oral Generic

diphenoxylate-atropine Generic

enulose Generic

gavilyte-c Generic

gavilyte-g Generic

gavilyte-n with flavor pack Generic

generlac Generic

glycopyrrolate injection solution Generic



glycopyrrolate oral Generic

glycopyrrolate pf Generic

hyoscyamine sulfate oral Generic

hyoscyamine sulfate sl Generic

hyoscyamine sulfate sublingual Generic

hyosyne Generic

lactulose Generic

lactulose encephalopathy Generic

LINZESS Brand QL

loperamide hcl oral capsule Generic

methscopolamine bromide oral Generic

mineral oil heavy oral Generic

OMECLAMOX-PAK Brand

peg 3350-kcl-na bicarb-nacl Generic

peg-3350/electrolytes Generic

peg-3350/electrolytes/ascorbat Generic

peg-kcl-nacl-nasulf-na asc-c Generic

peg-prep Generic

PYLERA Brand

sodium bicarbonate oral powder Generic

SYMPROIC Brand QL

ursodiol oral capsule 300 mg Generic

ursodiol oral tablet Generic

Genetic or enzyme disorder - drugs for replacement, modification, treatment

ALDURAZYME Brand PA; SP

CREON Brand

ELAPRASE Brand PA; SP

FABRAZYME Brand PA; SP

LUMIZYME Brand PA; SP

miglustat Generic PA; SP

NAGLAZYME Brand PA; SP

nitisinone Generic PA; SP

sapropterin dihydrochloride Generic PA; SP

sod benz-sod phenylacet Generic

sodium phenylbutyrate oral Generic SP

STRENSIQ Brand PA; SP

ZENPEP Brand

Genitourinary agents - drugs for bladder, genital and kidney conditions

acetic acid irrigation Generic

bethanechol chloride oral Generic

calcium acetate (phos binder) Generic

calcium acetate oral tablet 667 mg Generic


darifenacin hydrobromide er Generic

DEPEN TITRATABS Brand SP

flavoxate hcl Generic

glycine irrigation Generic

glycine urologic Generic

lanthanum carbonate Generic

MYRBETRIQ ORAL TABLET EXTENDED RELEASE 24 HOUR

Brand

oxybutynin chloride er Generic

oxybutynin chloride oral Generic

penicillamine oral capsule Generic PA; SP

penicillamine oral tablet Generic SP

phenazo oral tablet 200 mg Generic

phenazopyridine hcl oral tablet 100 mg, 200 mg

Generic

sevelamer carbonate Generic

sevelamer hcl Generic

solifenacin succinate Generic

tiopronin oral Generic SP

tolterodine tartrate Generic

tolterodine tartrate er Generic

trospium chloride Generic

trospium chloride er Generic

Genitourinary agents - drugs for prostate conditions

alfuzosin hcl er Generic

dutasteride oral Generic

dutasteride-tamsulosin hcl Generic

finasteride oral tablet 5 mg Generic

silodosin Generic

tamsulosin hcl Generic

terazosin hcl Generic

Hormonal agents - adrenal

betamethasone sod phos & acet injection suspension 6 (3-3) mg/ml

Generic

dexamethasone intensol Generic

dexamethasone oral Generic

dexamethasone sod phosphate pf Generic

dexamethasone sodium phosphate injection

Generic

fludrocortisone acetate oral Generic

hydrocortisone oral Generic

MEDROL ORAL TABLET 2 MG Brand

methylprednisolone acetate suspension 40 mg/ml injection

Generic



methylprednisolone acetate suspension 80 mg/ml injection

Generic

methylprednisolone oral Generic

methylprednisolone sodium succ Generic

prednisolone oral solution Generic

prednisolone sodium phosphate oral Generic

prednisone intensol Generic

prednisone oral Generic

triamcinolone acetonide suspension 40 mg/ml injection

Generic

Hormonal agents - men's health

ANDRODERM Brand PA

danazol oral Generic

testosterone cypionate intramuscular

Generic PA

testosterone enanthate intramuscular

Generic PA

testosterone transdermal Generic PA

Hormonal agents - pituitary

ACTHAR Brand PA; SP

cabergoline Generic

desmopressin ace spray refrig Generic

desmopressin acetate injection Generic

desmopressin acetate oral Generic

desmopressin acetate pf Generic

desmopressin acetate spray Generic

INCRELEX Brand PA; SP

leuprolide acetate injection Generic PA; SP

LUPRON DEPOT (1-MONTH) INTRAMUSCULAR KIT 7.5 MG

Brand PA; SP

LUPRON DEPOT (3-MONTH) INTRAMUSCULAR KIT 22.5 MG

Brand PA; SP

LUPRON DEPOT (4-MONTH) INTRAMUSCULAR KIT 30MG

Brand PA; SP

LUPRON DEPOT (6-MONTH) INTRAMUSCULAR KIT 45MG

Brand PA; SP

LUPRON DEPOT-PED (1-MONTH) INTRAMUSCULAR KIT 15 MG, 7.5 MG

Brand PA; SP

LUPRON DEPOT-PED (3-MONTH) INTRAMUSCULAR KIT 30 MG (PED)

Brand PA; SP

octreotide acetate Generic PA; SP

OMNITROPE Brand PA; SP

ORILISSA Brand QL

oxytocin injection Generic

SUPPRELIN LA Brand PA; SP; QL


SYNAREL Brand

ZOLADEX SUBCUTANEOUS IMPLANT 3.6 MG

Brand SP; QL

Hormonal agents - selective estrogen receptor modifying agents

raloxifene hcl Generic

Hormonal agents - sex hormones and birth control

afirmelle Generic

altavera Generic

alyacen 1/35 Generic

alyacen 7/7/7 Generic

amabelz Generic

amethia Generic QL

amethyst Generic

apri Generic

aranelle Generic

ashlyna Generic QL

aubra Generic

aubra eq Generic

aurovela 1.5/30 Generic

aurovela 1/20 Generic

aurovela 24 fe Generic

aurovela fe 1.5/30 Generic

aurovela fe 1/20 Generic

aviane Generic

ayuna Generic

azurette Generic

balziva Generic

blisovi 24 fe Generic

blisovi fe 1.5/30 Generic

blisovi fe 1/20 Generic

briellyn Generic

camila Generic

camrese Generic QL

camrese lo Generic QL

caziant Generic

charlotte 24 fe Generic

chateal Generic

chateal eq Generic

CLIMARA PRO Brand

cryselle-28 Generic

cyclafem 1/35 Generic

cyclafem 7/7/7 Generic

cyred Generic



cyred eq Generic

dasetta 1/35 Generic

dasetta 7/7/7 Generic

daysee Generic QL

deblitane Generic

delyla Generic

desogestrel-ethinyl estradiol Generic

dolishale Generic

dotti Generic

drospiren-eth estrad-levomefol Generic

drospirenone-ethinyl estradiol Generic

DUAVEE Brand

elinest Generic

eluryng Generic

emoquette Generic

ENDOMETRIN Brand

enpresse-28 Generic

enskyce Generic

errin Generic

estarylla Generic

estradiol oral Generic

estradiol transdermal Generic

estradiol vaginal Generic

estradiol valerate intramuscular Generic

estradiol-norethindrone acet Generic

ethynodiol diac-eth estradiol Generic

etonogestrel-ethinyl estradiol Generic

falmina Generic

fayosim Generic QL

femynor Generic

fyavolv Generic

gemmily Generic

hailey 1.5/30 Generic

hailey 24 fe Generic

hailey fe 1.5/30 Generic

hailey fe 1/20 Generic

heather Generic

hydroxyprogesterone caproate intramuscular

Generic PA; SP

iclevia Generic QL

IMVEXXY MAINTENANCE PACK Brand

IMVEXXY STARTER PACK Brand

incassia Generic

introvale Generic QL


isibloom Generic

jaimiess Generic QL

jasmiel Generic

jencycla Generic

jinteli Generic

jolessa Generic QL

juleber Generic

junel 1.5/30 Generic

junel 1/20 Generic

junel fe 1.5/30 Generic

junel fe 1/20 Generic

junel fe 24 Generic

kaitlib fe Generic

kalliga Generic

kariva Generic

kelnor 1/35 Generic

kelnor 1/50 Generic

kurvelo Generic

larin 1.5/30 Generic

larin 1/20 Generic

larin 24 fe Generic

larin fe 1.5/30 Generic

larin fe 1/20 Generic

larissia Generic

layolis fe Generic

leena Generic

lessina Generic

levonest Generic

levonorgest-eth est & eth est Generic QL

levonorgest-eth estrad 91-day Generic QL

levonorgestrel-ethinyl estrad Generic

levonorg-eth estrad triphasic Generic

levora 0.15/30 (28) Generic

lillow Generic

lojaimiess Generic QL

loryna Generic

low-ogestrel Generic

lo-zumandimine Generic

lutera Generic

lyleq Generic

lyllana Generic

lyza Generic

MAKENA Brand PA; SP



marlissa Generic

medroxyprogesterone acetate intramuscular

Generic QL

medroxyprogesterone acetate oral Generic

megestrol acetate oral Generic

MENEST Brand

merzee Generic

mibelas 24 fe Generic

microgestin 1.5/30 Generic

microgestin 1/20 Generic

microgestin 24 fe Generic

microgestin fe 1.5/30 Generic

microgestin fe 1/20 Generic

mili Generic

mimvey Generic

mono-linyah Generic

MYFEMBREE Brand QL

NATAZIA Brand

necon 0.5/35 (28) Generic

nikki Generic

nora-be Generic

norethin ace-eth estrad-fe Generic

norethindrone acetate oral Generic

norethindrone acet-ethinyl est Generic

norethindrone oral Generic

norethindrone-eth estradiol Generic

norethin-eth estradiol-fe Generic

norgestimate-eth estradiol Generic

norgestimate-ethinyl estradiol triphasic

Generic

norlyda Generic

norlyroc Generic

nortrel 0.5/35 (28) Generic

nortrel 1/35 (21) Generic

nortrel 1/35 (28) Generic

nortrel 7/7/7 Generic

nylia 7/7/7 Generic

nymyo Generic

ocella Generic

ORIAHNN Brand QL

orsythia Generic

philith Generic

pimtrea Generic

pirmella 1/35 Generic


pirmella 7/7/7 Generic

portia-28 Generic

PREMARIN ORAL Brand

PREMARIN VAGINAL Brand

PREMPHASE Brand

PREMPRO Brand

previfem Generic

progesterone intramuscular Generic

progesterone oral Generic

reclipsen Generic

rivelsa Generic QL

setlakin Generic QL

sharobel Generic

simliya Generic

simpesse Generic QL

sprintec 28 Generic

sronyx Generic

syeda Generic

tarina 24 fe Generic

tarina fe 1/20 Generic

tarina fe 1/20 eq Generic

taysofy Generic

tilia fe Generic

tri femynor Generic

tri-estarylla Generic

tri-legest fe Generic

tri-linyah Generic

tri-lo-estarylla Generic

tri-lo-marzia Generic

tri-lo-mili Generic

tri-lo-sprintec Generic

tri-mili Generic

tri-nymyo Generic

tri-previfem Generic

tri-sprintec Generic

trivora (28) Generic

tri-vylibra Generic

tri-vylibra lo Generic

tulana Generic

tyblume Generic

tydemy Generic

velivet Generic

vestura Generic



vienva Generic

viorele Generic

volnea Generic

vyfemla Generic

vylibra Generic

wera Generic

wymzya fe Generic

xulane Generic

yuvafem Generic

zafemy Generic

zarah Generic

zovia 1/35 (28) Generic

zovia 1/35e (28) Generic

zumandimine Generic

Hormonal agents - thyroid

euthyrox Generic

levo-t Generic

levothyroxine sodium intravenous Generic

levothyroxine sodium oral tablet Generic

levoxyl Generic

liothyronine sodium intravenous Generic

liothyronine sodium oral Generic

methimazole oral Generic

np thyroid Generic

propylthiouracil oral Generic

unithroid Generic

Immunological agents - drugs for immune system stimulation or suppression

ACTIMMUNE Brand PA; SP

ALFERON N Brand SP

ATGAM Brand

AVSOLA Brand PA; SP

azathioprine oral Generic

azathioprine sodium Generic

CIMZIA Brand PA; SP

CIMZIA PREFILLED KIT Brand PA; SP

CIMZIA STARTER KIT Brand PA; SP

CUVITRU Brand PA; SP

cyclosporine intravenous Generic

cyclosporine modified Generic

cyclosporine oral Generic

CYTOGAM Brand PA; SP

everolimus oral tablet 0.25 mg, 0.5 mg, 0.75 mg

Generic


GAMASTAN Brand PA; SP

GAMMAGARD Brand PA; SP

GAMMAKED Brand PA; SP

GAMUNEX-C Brand PA; SP

gengraf Generic

HIZENTRA SUBCUTANEOUS SOLUTION

Brand PA; SP

HUMIRA Brand PA; SP

HUMIRA PEDIATRIC CROHNS START Brand PA; SP

HUMIRA PEN Brand PA; SP

HUMIRA PEN-CD/UC/HS STARTER Brand PA; SP

HUMIRA PEN-PEDIATRIC UC START Brand PA; SP

HUMIRA PEN-PS/UV/ADOL HS START

Brand PA; SP

HUMIRA PEN-PSOR/UVEIT STARTER Brand PA; SP

HYPERRHO S/D Brand SP

icatibant acetate Generic PA; SP; QL

ILARIS Brand PA; SP; QL

INFLECTRA Brand PA; SP

leflunomide oral Generic

methotrexate oral Generic

methotrexate sodium Generic

methotrexate sodium (pf) Generic

MICRHOGAM ULTRA-FILTERED PLUS Brand SP

mycophenolate mofetil hcl Generic

mycophenolate mofetil intravenous Generic

mycophenolate mofetil oral Generic

mycophenolate sodium Generic

OTEZLA Brand PA; SP

RASUVO Brand PA; QL

RHOGAM ULTRA-FILTERED PLUS Brand SP

RHOPHYLAC Brand

RINVOQ Brand PA; SP

sajazir Generic PA; SP; QL

SANDIMMUNE INTRAVENOUS Brand

SANDIMMUNE ORAL SOLUTION Brand

SIMPONI Brand PA; SP

SIMPONI ARIA Brand PA; SP

sirolimus oral Generic

SKYRIZI Brand PA; SP; QL

SKYRIZI (150 MG DOSE) Brand PA; SP; QL

SKYRIZI PEN Brand PA; SP; QL

STELARA INTRAVENOUS Brand PA; SP

STELARA SUBCUTANEOUS Brand PA; SP; QL



SYNAGIS Brand PA; SP

tacrolimus oral Generic

temsirolimus Generic SP

TICE BCG Brand SP

TREMFYA Brand PA; SP

WINRHO SDF Brand SP

XELJANZ Brand PA; SP

XELJANZ XR Brand PA; SP

Immunological agents - drugs for vaccination

ACTHIB Brand

ADACEL Brand

AFLURIA QUADRIVALENT Brand

BCG VACCINE Brand

BEXSERO Brand

BIOTHRAX Brand

BOOSTRIX Brand

DAPTACEL Brand

DIPHTHERIA-TETANUS TOXOIDS DT Brand

ENGERIX-B Brand

FLUAD QUADRIVALENT Brand

FLUARIX QUADRIVALENT Brand

FLUBLOK QUADRIVALENT Brand

FLUCELVAX QUADRIVALENT Brand

FLULAVAL QUADRIVALENT Brand

FLUMIST QUADRIVALENT Brand

FLUZONE HIGH-DOSE QUADRIVALENT

Brand

FLUZONE QUADRIVALENT Brand

GARDASIL 9 Brand

HAVRIX Brand

HEPLISAV-B Brand

HIBERIX Brand

IMOVAX RABIES Brand

INFANRIX Brand

IPOL Brand

IXIARO Brand

JANSSEN COVID-19 VACCINE Brand

KINRIX Brand

MENACTRA Brand

MENQUADFI Brand

MENVEO Brand

M-M-R II Brand

MODERNA COVID-19 VACCINE Brand

PEDIARIX Brand


PEDVAX HIB Brand

PENTACEL Brand

PFIZER COVID-19 VAC-TRIS 5-11Y Brand

PFIZER-BIONT COVID-19 VAC-TRIS Brand

PFIZER-BIONTECH COVID-19 VACC Brand

PNEUMOVAX 23 Brand

PREVNAR 13 Brand

PREVNAR 20 Brand

PROQUAD Brand

QUADRACEL Brand

RABAVERT Brand

RECOMBIVAX HB Brand

ROTARIX Brand

ROTATEQ Brand

SHINGRIX Brand

STAMARIL Brand

TDVAX Brand

TENIVAC Brand

TETANUS-DIPHTHERIA TOXOIDS TD Brand

TICOVAC Brand

TRUMENBA Brand

TWINRIX Brand

TYPHIM VI Brand

VAQTA Brand

VARIVAX Brand

VAXCHORA Brand

VAXELIS Brand

VAXNEUVANCE Brand

YF-VAX Brand

Inflammatory bowel disease agents

balsalazide disodium Generic

budesonide er Generic

budesonide oral Generic

hydrocortisone (perianal) Generic

hydrocortisone ace-pramoxine external cream 1-1 %

Generic

hydrocortisone rectal Generic

mesalamine er oral capsule 0.375 gm

Generic

mesalamine oral Generic

mesalamine rectal Generic

mesalamine-cleanser Generic

PROCTOFOAM HC Brand

procto-med hc Generic



procto-pak Generic

proctosol hc Generic

proctozone-hc Generic

SFROWASA Brand

sulfasalazine oral Generic

Metabolic bone disease agents - drugs for osteoporosis

alendronate sodium oral solution Generic

alendronate sodium oral tablet 10 mg, 5 mg

Generic

alendronate sodium oral tablet 35 mg, 70 mg

Generic QL

calcitonin (salmon) injection Generic

calcitonin (salmon) nasal Generic QL

ibandronate sodium Generic QL

pamidronate disodium Generic SP

PROLIA Brand PA; SP; QL

risedronate sodium oral tablet 150 mg, 35 mg

Generic QL

risedronate sodium oral tablet 30 mg, 5 mg

Generic

risedronate sodium oral tablet delayed release

Generic QL

TERIPARATIDE (RECOMBINANT) Brand PA; SP

TYMLOS Brand PA; SP

XGEVA Brand PA; SP

zoledronic acid Generic SP

Metabolic bone disease agents - other

calcitriol intravenous Generic

calcitriol oral Generic

cinacalcet hcl Generic PA

doxercalciferol Generic

paricalcitol Generic

Miscellaneous therapeutic agents

acetylcysteine intravenous Generic

AEROCHAMBER MINI CHAMBER Brand

AEROCHAMBER MV Brand

AEROCHAMBER PLUS FLO-VU Brand

AEROCHAMBER PLUS FLOW VU Brand

AEROCHAMBER W/FLOWSIGNAL Brand

bal in oil Generic

BOTOX Brand PA; SP

BREATHE EASE LARGE Brand

BREATHE EASE MEDIUM Brand

BREATHE EASE SMALL Brand


CLEVER CHOICE HOLDING CHAMBER

Brand

COMPACT SPACE CHAMBER Brand

COMPACT SPACE CHAMBER/LG MASK

Brand

COMPACT SPACE CHAMBER/MED MASK

Brand

COMPACT SPACE CHAMBER/SM MASK

Brand

deferoxamine mesylate Generic

dexmedetomidine hcl in nacl intravenous solution

Generic

dexmedetomidine hcl intravenous solution 200 mcg/2ml

Generic

diluent for treprostinil Generic

DUROLANE Brand PA; SP

EASIVENT Brand

ergoloid mesylates oral Generic

EUFLEXXA Brand PA; SP

FLEXICHAMBER Brand

FLEXICHAMBER ADULT MASK/SMALL

Brand

FLEXICHAMBER CHILD MASK/LARGE

Brand

FLEXICHAMBER CHILD MASK/SMALL

Brand

flumazenil intravenous Generic

fomepizole Generic

formaldehyde external solution 37 %

Generic

GELSYN-3 Brand PA; SP

glutaraldehyde external Generic

heparin lock flush Generic

heparin sodium lock flush Generic

INSPIREASE RESERVOIR BAGS Brand

methergine Generic QL

methylergonovine maleate injection Generic

methylergonovine maleate oral Generic QL

MICROCHAMBER Brand

OPTICHAMBER DIAMOND Brand

OPTICHAMBER DIAMOND-LG MASK

Brand

OPTICHAMBER DIAMOND-MD MASK

Brand

OPTICHAMBER DIAMOND-SM MASK

Brand



PANDA MASK LARGE Brand

PANDA MASK MEDIUM Brand

PANDA MASK SMALL Brand

PEDIATRIC PANDA MASK Brand

POCKET SPACER Brand

PRO COMFORT SPACER ADULT Brand

PRO COMFORT SPACER CHILD Brand

PRO COMFORT SPACER INFANT Brand

PROCARE SPACER/ADULT MASK Brand

PROCARE SPACER/CHILD MASK Brand

sodium nitrite intravenous Generic

sodium saccharin powder Generic

sodium thiosulfate intravenous Generic

sorbitol-mannitol Generic

sterile diluent/epoprostenol Generic

sterile water for injection Generic

VORTEX VALVED HOLDING CHAMBER

Brand

XIAFLEX Brand PA; SP

Ophthalmic agents - drugs for eye allergy, infection and inflammation

azelastine hcl ophthalmic Generic

bacitracin ophthalmic Generic

bepotastine besilate Generic

bromfenac sodium (once-daily) Generic QL

ciprofloxacin hcl ophthalmic Generic

cromolyn sodium ophthalmic Generic

dexamethasone sodium phosphate ophthalmic

Generic

diclofenac sodium ophthalmic Generic

difluprednate Generic

epinastine hcl Generic

erythromycin ophthalmic Generic

fluorometholone Generic

flurbiprofen sodium Generic

FML Brand

gatifloxacin ophthalmic Generic

gentak Generic

gentamicin sulfate ophthalmic Generic

ketorolac tromethamine ophthalmic Generic

levofloxacin ophthalmic Generic

loteprednol etabonate ophthalmic gel

Generic QL


loteprednol etabonate ophthalmic suspension

Generic

MOXEZA Brand

moxifloxacin hcl (2x day) Generic

moxifloxacin hcl ophthalmic solution Generic

NATACYN Brand

ofloxacin ophthalmic Generic

olopatadine hcl ophthalmic Generic

prednisolone acetate ophthalmic Generic

prednisolone sodium phosphate ophthalmic

Generic

PROLENSA Brand QL

sulfacetamide sodium ophthalmic Generic

tobramycin ophthalmic Generic

trifluridine Generic

Ophthalmic agents - drugs for glaucoma

acetazolamide er Generic

acetazolamide oral Generic

ALPHAGAN P OPHTHALMIC SOLUTION 0.1 %

Brand

apraclonidine hcl Generic

betaxolol hcl ophthalmic Generic

bimatoprost ophthalmic Generic QL

brimonidine tartrate ophthalmic Generic

brinzolamide Generic

carteolol hcl Generic

COMBIGAN Brand

dorzolamide hcl ophthalmic Generic

dorzolamide hcl-timolol mal Generic

dorzolamide hcl-timolol mal pf Generic

latanoprost ophthalmic Generic

levobunolol hcl Generic

LUMIGAN Brand QL

methazolamide oral Generic

pilocarpine hcl ophthalmic Generic

SIMBRINZA Brand

timolol maleate (once-daily) Generic

timolol maleate ocudose Generic

timolol maleate ophthalmic Generic

timolol maleate pf Generic

travoprost (bak free) Generic QL

Ophthalmic agents - drugs for miscellaneous eye conditions

ak-poly-bac Generic



altafrin Generic

atropine sulfate ophthalmic ointment

Generic

atropine sulfate ophthalmic solution 1 %

Generic

bacitracin-polymyxin b ophthalmic Generic

bacitra-neomycin-polymyxin-hc Generic

cyclopentolate hcl ophthalmic Generic

homatropaire Generic

LUCENTIS Brand PA; SP

neomycin-bacitracin zn-polymyx Generic

neomycin-polymyxin-dexameth ophthalmic ointment

Generic

neomycin-polymyxin-dexameth ophthalmic suspension 3.5-10000-0.1

Generic

neomycin-polymyxin-gramicidin Generic

neomycin-polymyxin-hc ophthalmic Generic

neo-polycin Generic

neo-polycin hc Generic

phenylephrine hcl ophthalmic Generic

polycin Generic

polymyxin b-trimethoprim Generic

proparacaine hcl ophthalmic Generic

RESTASIS Brand PA

RESTASIS MULTIDOSE Brand PA

sulfacetamide-prednisolone ophthalmic solution

Generic

tetracaine hcl ophthalmic Generic

tobramycin-dexamethasone Generic

XIIDRA Brand PA

Otic agents - drugs for ear conditions

acetic acid otic Generic

ciprofloxacin hcl otic Generic

ciprofloxacin-dexamethasone Generic

cortic-nd Generic

flac Generic

fluocinolone acetonide otic Generic

hydrocortisone-acetic acid Generic

neomycin-polymyxin-hc otic Generic

ofloxacin otic Generic

Respiratory tract / pulmonary agents - drugs for allergies, cough, cold

azelastine hcl nasal Generic QL

azelastine-fluticasone Generic QL


benzonatate Generic

carbinoxamine maleate Generic

clemastine fumarate oral syrup Generic

clemastine fumarate oral tablet 2.68 mg

Generic

cyproheptadine hcl oral Generic

dexchlorpheniramine maleate oral Generic

di-phen Generic

diphen oral elixir Generic

diphenhydramine hcl injection Generic

diphenhydramine hcl oral elixir Generic

DYMISTA Brand QL

FASENRA Brand PA; SP

FASENRA PEN Brand PA; SP

flunisolide nasal Generic QL

fluticasone propionate nasal Generic

guaiatussin ac Generic PA; QL

guaifenesin ac Generic PA; QL

hydrocodone polst-chlorphen polst er susp

Generic PA; QL

hydrocodone-homatropine Generic PA; QL

hydromet Generic PA; QL

ipratropium bromide nasal Generic

maxi-tuss ac Generic PA; QL

mometasone furoate nasal Generic QL

NUCALA Brand PA; SP; QL

olopatadine hcl nasal Generic QL

promethazine hcl injection Generic

promethazine hcl oral Generic

promethazine hcl rectal Generic

promethazine vc Generic

promethazine vc/codeine Generic PA; QL

promethazine-codeine Generic PA; QL

promethazine-dm Generic

promethazine-phenyleph-codeine Generic PA; QL

promethazine-phenylephrine Generic

promethegan Generic

pseudoephedrine-bromphen-dm Generic

ryvent Generic

sodium chloride inhalation Generic

virtussin ac w/alc Generic PA; QL

XOLAIR Brand PA; SP

Respiratory tract / pulmonary agents - drugs for asthma and other lung conditions



acetylcysteine inhalation Generic

ADVAIR HFA Brand QL

albuterol sulfate hfa Generic QL

albuterol sulfate inhalation nebulization solution (2.5 mg/3ml) 0.083%, 0.63 mg/3ml, 1.25 mg/3ml

Generic QL

albuterol sulfate inhalation nebulization solution (5 mg/ml) 0.5%, 2.5 mg/0.5ml

Generic

albuterol sulfate oral Generic

aminophylline Generic

ANORO ELLIPTA Brand QL

arformoterol tartrate Generic QL

ARNUITY ELLIPTA Brand QL

BREO ELLIPTA Brand QL

BREZTRI AEROSPHERE Brand QL

budesonide inhalation Generic QL

COMBIVENT RESPIMAT Brand QL

cromolyn sodium inhalation Generic

DULERA Brand QL

ELIXOPHYLLIN Brand

epinephrine (anaphylaxis) Generic

epinephrine injection solution auto-injector

Generic

FLOVENT DISKUS Brand QL

FLOVENT HFA Brand QL

fluticasone-salmeterol inhalation aerosol powder breath activated 100-50 mcg/dose, 250-50 mcg/dose, 500-50 mcg/dose

Generic QL

FLUTICASONE-SALMETEROL INHALATION AEROSOL POWDER BREATH ACTIVATED 113-14 MCG/ACT, 232-14 MCG/ACT, 55-14 MCG/ACT

Generic QL

formoterol fumarate inhalation Generic QL

ipratropium bromide inhalation Generic QL

ipratropium-albuterol Generic QL

isoproterenol hcl injection Generic

levalbuterol hcl inhalation Generic QL

montelukast sodium oral Generic

PULMICORT FLEXHALER Brand QL

SEREVENT DISKUS Brand QL

SPIRIVA HANDIHALER Brand QL

SPIRIVA RESPIMAT Brand QL

STIOLTO RESPIMAT Brand QL


STRIVERDI RESPIMAT Brand QL

SYMBICORT Brand QL

terbutaline sulfate injection Generic

terbutaline sulfate oral Generic

theophylline Generic

theophylline er Generic

TRELEGY ELLIPTA Brand QL

TUDORZA PRESSAIR Brand QL

wixela inhub Generic QL

zafirlukast Generic

zileuton er Generic

Respiratory tract / pulmonary agents - drugs for cystic fibrosis

PULMOZYME Brand PA; SP

tobramycin inhalation Generic SP

Respiratory tract / pulmonary agents - drugs for pulmonary hypertension

ADEMPAS Brand PA; SP; QL

alyq Generic PA; SP; QL

ambrisentan Generic PA; SP; QL

bosentan Generic PA; SP; QL

epoprostenol sodium Generic PA; SP

OPSUMIT Brand PA; SP; QL

sildenafil citrate intravenous Generic PA; SP

sildenafil citrate oral suspension reconstituted

Generic PA; SP; QL

sildenafil citrate oral tablet 20 mg Generic PA; SP; QL

tadalafil (pah) Generic PA; SP; QL

treprostinil Generic PA; SP

Skeletal muscle relaxants - drugs for muscle pain and spasm

baclofen oral Generic

carisoprodol oral Generic

chlorzoxazone Generic

cyclobenzaprine hcl er Generic

cyclobenzaprine hcl oral Generic

dantrolene sodium intravenous Generic

dantrolene sodium oral Generic

metaxalone Generic

methocarbamol injection Generic

methocarbamol oral Generic

orphenadrine citrate er Generic

orphenadrine citrate injection Generic

orphenadrine-asa-caffeine Generic



revonto Generic

tizanidine hcl oral Generic

Sleep disorder agents

armodafinil Generic PA; QL

doxepin hcl oral tablet Generic QL

eszopiclone Generic QL

flurazepam hcl Generic PA; QL

modafinil Generic PA; QL

ramelteon Generic QL

SUNOSI Brand PA; QL

temazepam Generic QL

zaleplon Generic QL

zolpidem tartrate Generic QL

zolpidem tartrate er Generic QL

33

Index

abacavir sulfate-lamivudine ......................13abacavir sulfate ........................................13abacavir-lamivudine-zidovudine ................13abiraterone acetate ..................................11ABRAXANE ..............................................11acamprosate calcium .................................6acarbose oral ...........................................19ACCU-CHEK FASTCLIX LANCET KIT .........19ACCU-CHEK SOFTCLIX LANCET DEVICE KIT ..............................................19accutane ..................................................18acebutolol hcl oral ...................................15acetaminophen intravenous solution ..........5acetaminophen-codeine #2 ........................5acetaminophen-codeine #3 ........................5acetaminophen-codeine #4 ........................5acetaminophen-codeine .............................5acetazolamide er ......................................29acetazolamide oral ...................................29acetazolamide sodium .............................15acetic acid irrigation .................................22acetic acid otic .........................................30acetylcysteine inhalation ..........................31acetylcysteine intravenous ........................28acitretin ...................................................18ACTHAR ..................................................23ACTHIB ....................................................27ACTIMMUNE ...........................................26acyclovir external .....................................13acyclovir oral ............................................13acyclovir sodium ......................................13ACZONE EXTERNAL GEL 7.5 % ................18ADACEL ...................................................27adapalene external cream ........................18adapalene external gel .............................18adapalene-benzoyl peroxide external gel ..18ADCETRIS ................................................11adefovir dipivoxil ......................................13ADEMPAS ................................................31adenosine intravenous solution 12 mg/4ml, 6 mg/2ml ...................................15adriamycin ...............................................11ADVAIR HFA ............................................31ADVATE ...................................................14AEROCHAMBER MINI CHAMBER .............28AEROCHAMBER MV ................................28AEROCHAMBER PLUS FLO-VU .................28AEROCHAMBER PLUS FLOW VU ..............28AEROCHAMBER W/FLOWSIGNAL ............28afirmelle ..................................................23AFLURIA QUADRIVALENT .........................27AIMOVIG SUBCUTANEOUS SOLUTION AUTO-INJECTOR 140 MG/ML, 70 MG/ML 10ak-poly-bac ..............................................29ala-cort ....................................................18albendazole oral ......................................12albuterol sulfate hfa .................................31albuterol sulfate inhalation nebulization solution (2.5 mg/3ml) 0.083%, 0.63 mg/3ml, 1.25 mg/3ml .......31

albuterol sulfate inhalation nebulization solution (5 mg/ml) 0.5%, 2.5 mg/0.5ml ...........................................31albuterol sulfate oral ................................31alclometasone dipropionate .....................18ALDURAZYME .........................................22ALECENSA ...............................................11alendronate sodium oral solution .............28alendronate sodium oral tablet 10 mg, 5 mg ........................................................28alendronate sodium oral tablet 35 mg, 70 mg ......................................................28alfentanil hcl ..............................................5ALFERON N ..............................................26alfuzosin hcl er .........................................22ALIMTA ....................................................11ALINIA ORAL SUSPENSION RECONSTITUTED ......................................12aliskiren fumarate ....................................15allopurinol oral .........................................10allopurinol sodium ...................................10almotriptan malate ..................................10alosetron hcl ............................................21ALPHAGAN P OPHTHALMIC SOLUTION 0.1 % .....................................29ALPHANATE .............................................14ALPHANINE SD ........................................14alprazolam er ...........................................14alprazolam intensol ..................................14alprazolam oral ........................................14alprazolam xr ...........................................14alprostadil injection ..................................15altafrin .....................................................30altavera ....................................................23ALUNBRIG ...............................................11alvimopan ................................................21alyacen 1/35 ............................................23alyacen 7/7/7 ...........................................23alyq .........................................................31amabelz ...................................................23amantadine hcl oral .................................12ambrisentan .............................................31amcinonide ..............................................18amethia ...................................................23amethyst ..................................................23amikacin sulfate injection ...........................6amiloride hcl oral .....................................15amiloride-hydrochlorothiazide ..................15aminocaproic acid intravenous .................14aminocaproic acid oral .............................14aminophylline ..........................................31amiodarone hcl ........................................15amitriptyline hcl oral ..................................9amlodipine besylate oral ..........................15amlodipine besylate-benazepril hcl ...........15amlodipine besylate-valsartan ..................15amlodipine-atorvastatin ...........................15amlodipine-olmesartan ............................15amlodipine-valsartan-hctz ........................15ammonium lactate external......................18amnesteem ..............................................18amoxapine .................................................9

amoxicill-clarithro-lansopraz .....................21amoxicillin-potassium clavulanate er ...........6amoxicillin-potassium clavulanate ...............6amoxicillin ..................................................6amphetamine sulfate ...............................17amphetamine-dextroamphetamine er ......17amphetamine-dextroamphetamine ..........17amphotericin b intravenous ......................10ampicillin sodium .......................................6ampicillin-sulbactam sodium ......................6ampicillin ...................................................6anagrelide hcl ..........................................14anastrozole oral .......................................11ANDRODERM ..........................................23ANORO ELLIPTA .......................................31apap-caff-dihydrocodeine ..........................5apraclonidine hcl ......................................29aprepitant ..................................................9apri ..........................................................23APTIVUS ..................................................13aranelle ....................................................23ARANESP (ALBUMIN FREE) .......................14arformoterol tartrate ................................31argatroban .................................................8argyle sterile saline ...................................20argyle sterile water ...................................20aripiprazole ..............................................13armodafinil ..............................................32ARNUITY ELLIPTA .....................................31ARRANON ...............................................11arsenic trioxide intravenous ......................11ARZERRA .................................................11ascomp-codeine .........................................5asenapine maleate ...................................13ashlyna ....................................................23aspirin-dipyridamole er .............................13atazanavir sulfate .....................................13atenolol oral ............................................15atenolol-chlorthalidone ............................15ATGAM ...................................................26atomoxetine hcl .......................................17atorvastatin calcium oral ..........................15atovaquone-proguanil hcl ........................12atovaquone .............................................12atracurium besylate ..................................17atropine sulfate injection solution 8 mg/20ml ..................................................21atropine sulfate injection solution prefilled syringe .......................................21atropine sulfate intravenous solution ........21atropine sulfate ophthalmic ointment.......30atropine sulfate ophthalmic solution 1 % .30aubra eq ..................................................23aubra .......................................................23aurovela 1.5/30 ........................................23aurovela 1/20 ...........................................23aurovela 24 fe ..........................................23aurovela fe 1.5/30 ....................................23aurovela fe 1/20 .......................................23aviane ......................................................23avidoxy ......................................................6AVONEX PEN ...........................................17

34

AVONEX PREFILLED ..................................17AVSOLA ...................................................26ayuna ......................................................23azacitidine ...............................................11azathioprine oral ......................................26azathioprine sodium ................................26azelaic acid external .................................18azelastine hcl nasal ..................................30azelastine hcl ophthalmic .........................29azelastine-fluticasone ...............................30azithromycin intravenous ...........................7azithromycin oral .......................................7aztreonam .................................................7azurette ...................................................23bac ............................................................5bacitra-neomycin-polymyxin-hc ................30bacitracin intramuscular .............................7bacitracin ophthalmic ...............................29bacitracin-polymyxin b ophthalmic ...........30baclofen oral ............................................31BAFIERTAM ..............................................17bal in oil ...................................................28balsalazide disodium ................................27balsam peru-castor oil ..............................18balziva .....................................................23BAQSIMI ONE PACK .................................20BAQSIMI TWO PACK ................................20BCG VACCINE .........................................27BD AUTOSHIELD DUO PEN NEEDLES ........20BD ULTRA-FINE INSULIN SYRINGES ...........20BD ULTRA-FINE PEN NEEDLES ...................20BELBUCA ...................................................5benazepril hcl oral ....................................15benazepril-hydrochlorothiazide ................15BENEFIX ...................................................14benzalkonium chloride external solution ....7benzonatate ............................................30benzoyl peroxide-erythromycin.................18benztropine mesylate ...............................12bepotastine besilate .................................29beser external lotion ................................18betamethasone dipropionate aug ............18betamethasone dipropionate external ......18betamethasone sod phos & acet injection suspension 6 (3-3) mg/ml ...........22betamethasone valerate external..............18BETASERON .............................................17betaxolol hcl ophthalmic ..........................29betaxolol hcl oral .....................................15bethanechol chloride oral .........................22bexarotene ..............................................11BEXSERO .................................................27bicalutamide ............................................11bimatoprost ophthalmic ...........................29BIOTHRAX ...............................................27bisoprolol fumarate oral ...........................15bisoprolol-hydrochlorothiazide .................15bivalirudin trifluoroacetate .........................8bleomycin sulfate .....................................11blisovi 24 fe .............................................23blisovi fe 1.5/30 .......................................23blisovi fe 1/20 ..........................................23BOOSTRIX ................................................27bosentan .................................................31BOTOX ....................................................28

BREATHE EASE LARGE .............................28BREATHE EASE MEDIUM ..........................28BREATHE EASE SMALL .............................28BREO ELLIPTA ...........................................31BREZTRI AEROSPHERE ..............................31briellyn .....................................................23BRILINTA ..................................................13brimonidine tartrate ophthalmic ...............29brinzolamide ............................................29bromfenac sodium (once-daily) ................29bromocriptine mesylate oral .....................12budesonide er ..........................................27budesonide inhalation ..............................31budesonide oral .......................................27bumetanide .............................................15bupivacaine fisiopharma ............................6bupivacaine hcl (pf) ....................................6bupivacaine hcl injection solution 0.25 %, 0.5 % ..................................................6bupivacaine-epinephrine (pf) ......................6bupivacaine-epinephrine ............................6buprenorphine hcl injection .......................5buprenorphine hcl sublingual .....................6buprenorphine hcl-naloxone hcl .................6buprenorphine ...........................................5bupropion hcl er (smoking det) ..................6bupropion hcl er (sr) ...................................9bupropion hcl er (xl) oral tablet extended release 24 hour 150 mg, 300 mg 9bupropion hcl oral .....................................9buspirone hcl oral ....................................14busulfan ..................................................11butalbital-acetaminophen ..........................5butalbital-apap-caff-cod .............................5butalbital-apap-caffeine .............................5butalbital-asa-caff-codeine .........................5butalbital-aspirin-caffeine ...........................5butorphanol tartrate injection ....................5butorphanol tartrate nasal .........................5BYDUREON BCISE AUTOINJECTOR ...........19BYETTA 10 MCG PEN ...............................19BYETTA 5 MCG PEN .................................19cabergoline ..............................................23CABOMETYX ...........................................11caffeine citrate .........................................17calcipotriene external cream .....................18calcipotriene external ointment ................18calcipotriene external solution ..................18calcipotriene-betameth diprop .................18calcitonin (salmon) injection .....................28calcitonin (salmon) nasal ..........................28calcitriol external ......................................18calcitriol intravenous ................................28calcitriol oral ............................................28calcium acetate (phos binder) ...................22calcium acetate oral tablet 667 mg ..........22calcium chloride .......................................20calcium gluconate intravenous .................20camila ......................................................23camrese lo ...............................................23camrese ...................................................23candesartan cilexetil-hctz .........................15candesartan cilexetil .................................15capecitabine ............................................11CAPRELSA ORAL TABLET 100 MG ............11

CAPRELSA ORAL TABLET 300 MG ............11captopril oral ...........................................15CARBAGLU ..............................................20carbamazepine er ......................................8carbamazepine oral ....................................8carbidopa oral ..........................................12carbidopa-levodopa er .............................12carbidopa-levodopa-entacapone ..............12carbidopa-levodopa .................................12carbinoxamine maleate ............................30carboplatin ..............................................11carisoprodol oral ......................................31carisoprodol-aspirin-codeine ......................5carmustine ...............................................11carteolol hcl .............................................29cartia xt ...................................................15carvedilol phosphate er ............................15carvedilol .................................................15cascara sagrada oral fluid extract .............21caspofungin acetate .................................10caziant .....................................................23cefaclor er ..................................................7cefaclor ......................................................7cefadroxil ...................................................7cefazolin sodium injection ..........................7cefazolin sodium intravenous solution reconstituted .............................................7cefazolin sodium-dextrose intravenous solution 1-4 gm/50ml-%, 2-4 gm/100ml-% .............................................7cefazolin sodium-dextrose intravenous solution reconstituted ................................7cefdinir ......................................................7cefepime hcl injection ................................7cefepime hcl intravenous solution ..............7cefepime-dextrose .....................................7cefixime .....................................................7cefotaxime sodium .....................................7cefotetan disodium-dextrose ......................7cefotetan disodium ....................................7cefoxitin sodium ........................................7cefpodoxime proxetil .................................7cefprozil .....................................................7ceftazidime and dextrose ...........................7ceftazidime injection ..................................7ceftazidime intravenous .............................7ceftriaxone sodium in dextrose ...................7ceftriaxone sodium injection ......................7ceftriaxone sodium intravenous ..................7ceftriaxone sodium-dextrose ......................7cefuroxime axetil ........................................7cefuroxime sodium ....................................7celecoxib oral .............................................5cephalexin .................................................7cevimeline hcl ..........................................17charlotte 24 fe .........................................23chateal eq ................................................23chateal .....................................................23chloramphenicol sod succinate ...................7chlordiazepoxide hcl ................................14chlordiazepoxide-amitriptyline ....................9chlordiazepoxide-clidinium .......................21chlorhexidine gluconate mouth/throat .....17chloroprocaine hcl (pf) ...............................6chloroquine phosphate oral .....................12

35

chlorothiazide sodium ..............................15chlorpromazine hcl injection ....................13chlorpromazine hcl oral ............................13chlorthalidone ..........................................15chlorzoxazone ..........................................31cholestyramine light .................................15cholestyramine oral ..................................15chromic chloride intravenous ...................20ciclodan ...................................................10ciclopirox external ....................................10ciclopirox olamine external .......................10cidofovir intravenous ................................13cilostazol ..................................................13CIMDUO ..................................................13cimetidine hcl ..........................................21cimetidine oral .........................................21CIMZIA PREFILLED KIT ..............................26CIMZIA STARTER KIT ................................26CIMZIA ....................................................26cinacalcet hcl ...........................................28ciprofloxacin hcl ophthalmic .....................29ciprofloxacin hcl oral ..................................7ciprofloxacin hcl otic ................................30ciprofloxacin in d5w ...................................7ciprofloxacin-dexamethasone ...................30cisatracurium besylate (pf) ........................17cisatracurium besylate ..............................17cisplatin intravenous solution ...................11citalopram hydrobromide ...........................9cladribine .................................................11claravis .....................................................18clarithromycin er ........................................7clarithromycin oral .....................................7clemastine fumarate oral syrup ................30clemastine fumarate oral tablet 2.68 mg ..30CLEVER CHOICE HOLDING CHAMBER .....28CLIMARA PRO .........................................23clindacin etz external swab ......................18clindacin-p ...............................................18clindamycin hcl oral ...................................7clindamycin palmitate hcl ...........................7clindamycin phosphate external ...............18clindamycin phosphate in d5w ...................7clindamycin phosphate injection ................7clindamycin phosphate vaginal ...................7clindamycin phosphate-benzoyl peroxide .18clindamycin-tretinoin ...............................18clobazam ...................................................8clobetasol prop emollient base .................18clobetasol propionate e ............................18clobetasol propionate emulsion ................18clobetasol propionate external .................18clocortolone pivalate ................................18clodan external shampoo .........................18clofarabine ...............................................11clomipramine hcl oral .................................9clonazepam oral ......................................14clonidine hcl er ........................................17clonidine hcl oral ......................................15clonidine ..................................................15clopidogrel bisulfate oral ..........................13clorazepate dipotassium ...........................14clotrimazole external ................................10clotrimazole mouth/throat .......................10clotrimazole-betamethasone ....................10

clozapine .................................................13coal tar external .......................................18codeine sulfate ..........................................5colchicine oral tablet ................................10colchicine-probenecid ..............................10colesevelam hcl ........................................15colestipol hcl ............................................15colistimethate sodium (cba) ........................7COMBIGAN .............................................29COMBIVENT RESPIMAT ............................31COMPACT SPACE CHAMBER/LG MASK ...28COMPACT SPACE CHAMBER/MED MASK 28COMPACT SPACE CHAMBER/SM MASK...28COMPACT SPACE CHAMBER ...................28COMPLERA ..............................................13compro ......................................................9constulose ...............................................21COPAXONE ..............................................17coremino ...................................................7CORIFACT ................................................14cortic-nd ..................................................30CREON ....................................................22CRIXIVAN .................................................13cromolyn sodium inhalation .....................31cromolyn sodium ophthalmic ...................29cromolyn sodium oral ..............................21crotan ......................................................12cryselle-28 ...............................................23curity sterile saline ....................................20CUVITRU ..................................................26cyanocobalamin injection solution 1000 mcg/ml ...........................................20cyclafem 1/35 ..........................................23cyclafem 7/7/7 .........................................23cyclobenzaprine hcl er ..............................31cyclobenzaprine hcl oral ...........................31cyclopentolate hcl ophthalmic ..................30cyclophosphamide injection .....................11cyclophosphamide oral capsule ................11CYCLOPHOSPHAMIDE ORAL TABLET .......11cycloserine oral ........................................10cyclosporine intravenous ..........................26cyclosporine modified ..............................26cyclosporine oral ......................................26cyproheptadine hcl oral ............................30cyred eq ...................................................24cyred .......................................................23cytarabine (pf) ..........................................11cytarabine ................................................11CYTOGAM ..............................................26CYTOTEC .................................................21dacarbazine .............................................11dactinomycin ...........................................11dalfampridine er ......................................17danazol oral .............................................23dantrolene sodium intravenous ................31dantrolene sodium oral ............................31dapsone external gel 5 % ........................18dapsone oral ............................................10DAPTACEL ...............................................27daptomycin ................................................7darifenacin hydrobromide er ....................22dasetta 1/35 ............................................24dasetta 7/7/7 ...........................................24daunorubicin hcl ......................................11

daysee .....................................................24deblitane .................................................24decitabine ................................................11deferasirox granules .................................20deferasirox ...............................................20deferiprone ..............................................20deferoxamine mesylate ............................28delyla .......................................................24demeclocycline hcl .....................................7DEPEN TITRATABS ....................................22desipramine hcl oral ...................................9desmopressin ace spray refrig...................23desmopressin acetate injection .................23desmopressin acetate oral ........................23desmopressin acetate pf ..........................23desmopressin acetate spray ......................23desogestrel-ethinyl estradiol .....................24desonide external ....................................18desoximetasone external ..........................18desrx ........................................................18desvenlafaxine succinate er ........................9dexamethasone intensol ..........................22dexamethasone oral .................................22dexamethasone sod phosphate pf ............22dexamethasone sodium phosphate injection ...................................................22dexamethasone sodium phosphate ophthalmic ..............................................29dexchlorpheniramine maleate oral ...........30DEXCOM G4 PLAT PED RCV/SHARE .........19DEXCOM G4 PLAT PED RECEIVER ............19DEXCOM G4 PLATINUM RCV/SHARE .......19DEXCOM G4 PLATINUM RECEIVER ..........19DEXCOM G4 PLATINUM TRANSMITTER ...19DEXCOM G4 SENSOR ..............................19DEXCOM G5 MOB/G4 PLAT SENSOR .......19DEXCOM G5 MOBILE RECEIVER ...............19DEXCOM G5 MOBILE TRANSMITTER ........19DEXCOM G5 RECEIVER KIT ......................19DEXCOM G6 RECEIVER ............................19DEXCOM G6 SENSOR ..............................19DEXCOM G6 TRANSMITTER .....................19dexmedetomidine hcl in nacl intravenous solution .................................28dexmedetomidine hcl intravenous solution 200 mcg/2ml ..............................28dexmethylphenidate hcl er .......................17dexmethylphenidate hcl ...........................17dexrazoxane hcl .......................................11dextroamphetamine sulfate er..................17dextroamphetamine sulfate......................17dextrose intravenous ................................20di-phen ....................................................30diazepam injection ...................................14diazepam intensol ....................................14diazepam intramuscular ...........................14diazepam oral ..........................................14diazepam rectal .........................................8diazoxide oral ..........................................20diclofenac potassium .................................5diclofenac sodium er ..................................5diclofenac sodium external gel 1 % ...........5diclofenac sodium external gel 3 % .........18diclofenac sodium external solution ...........5diclofenac sodium ophthalmic ..................29

36

diclofenac sodium oral ...............................6diclofenac-misoprostol ...............................6dicloxacillin sodium ....................................7dicyclomine hcl intramuscular ..................21dicyclomine hcl oral .................................21diflorasone diacetate ................................18diflunisal oral .............................................6difluprednate ...........................................29digitek .....................................................15digox .......................................................15digoxin injection ......................................15digoxin oral ..............................................15dihydroergotamine mesylate injection ......10dihydroergotamine mesylate nasal ...........10dilt-xr .......................................................15diltiazem hcl er beads ..............................15diltiazem hcl er coated beads ...................15diltiazem hcl er ........................................15diltiazem hcl intravenous ..........................15diltiazem hcl oral ......................................15diluent for treprostinil ..............................28dimenhydrinate injection ............................9dimethyl fumarate oral .............................17dimethyl fumarate starter pack ................17diphen oral elixir ......................................30diphenhydramine hcl injection .................30diphenhydramine hcl oral elixir .................30diphenoxylate-atropine ............................21DIPHTHERIA-TETANUS TOXOIDS DT .........27dipyridamole oral .....................................13disopyramide phosphate ..........................15disulfiram oral ............................................6divalproex sodium er ..................................8divalproex sodium oral ...............................8dobutamine hcl ........................................15dobutamine in d5w .................................15docetaxel .................................................11dofetilide .................................................15dolishale ..................................................24donepezil hcl .............................................9dopamine hcl intravenous ........................15dopamine in d5w .....................................15dorzolamide hcl ophthalmic .....................29dorzolamide hcl-timolol mal pf .................29dorzolamide hcl-timolol mal .....................29dotti ........................................................24DOVATO ..................................................13doxazosin mesylate oral ...........................15doxepin hcl external .................................18doxepin hcl oral capsule .............................9doxepin hcl oral concentrate ......................9doxepin hcl oral tablet .............................32doxercalciferol ..........................................28doxorubicin hcl liposomal .........................11doxorubicin hcl ........................................11doxy 100 ...................................................7doxycycline hyclate intravenous ..................7doxycycline hyclate oral capsule .................7doxycycline hyclate oral tablet delayed release 100 mg, 150 mg, 200 mg, 50 mg, 75 mg .................................................7doxycycline hyclate oral tablet ....................7doxycycline monohydrate oral ....................7doxycycline ..............................................18doxylamine-pyridoxine ...............................9

dronabinol .................................................9droperidol injection ....................................9DROPLET MICRON ...................................20drospiren-eth estrad-levomefol.................24drospirenone-ethinyl estradiol ..................24droxidopa ................................................15DUAVEE ...................................................24DULERA ...................................................31duloxetine hcl oral .....................................9DUPIXENT ................................................18duramorph ................................................5DUROLANE ..............................................28dutasteride oral ........................................22dutasteride-tamsulosin hcl .......................22DYMISTA .................................................30EASIVENT .................................................28ec-naproxen ...............................................6econazole nitrate external ........................10EDURANT ................................................13efavirenz-emtricitab-tenofovir ..................13efavirenz-lamivudine-tenofovir .................13efavirenz ..................................................13effer-k oral tablet effervescent 25 meq .....20ELAPRASE ................................................22eletriptan hydrobromide ..........................10elinest ......................................................24ELIQUIS DVT/PE STARTER PACK ..................8ELIQUIS ......................................................8ELIXOPHYLLIN ..........................................31eluryng ....................................................24EMCYT ....................................................11EMGALITY (300 MG DOSE) ......................10EMGALITY ...............................................10emoquette ...............................................24emtricitabine-tenofovir df ........................13emtricitabine ............................................13EMTRIVA ORAL SOLUTION .......................13EMVERM .................................................12enalapril maleate oral ...............................15enalapril-hydrochlorothiazide ...................15enalaprilat ................................................15endocet .....................................................5ENDOMETRIN ..........................................24ENGERIX-B ...............................................27enoxaparin sodium ....................................8enpresse-28 .............................................24enskyce ....................................................24entacapone ..............................................12entecavir ..................................................13ENTRESTO ................................................15enulose ....................................................21EPCLUSA .................................................13ephedrine sulfate intravenous solution 50 mg/ml .................................................15epinastine hcl ...........................................29epinephrine (anaphylaxis) .........................31epinephrine injection solution auto-injector ....................................................31epinephrine intravenous solution prefilled syringe 1 mg/10ml ......................15epinephrine pf .........................................15epirubicin hcl ...........................................11epitol .........................................................8EPIVIR HBV ORAL SOLUTION ....................13eplerenone ..............................................15

epoprostenol sodium ...............................31eptifibatide ..............................................13ERBITUX ...................................................11ergocalciferol oral capsule ........................20ergoloid mesylates oral ............................28ergotamine-caffeine .................................10ERIVEDGE ................................................11erlotinib hcl oral tablet 100 mg, 150 mg ..11erlotinib hcl oral tablet 25 mg ..................11errin .........................................................24ertapenem sodium .....................................7ery ...........................................................18erythromycin base ......................................7erythromycin ethylsuccinate oral ................7erythromycin external ..............................18erythromycin ophthalmic .........................29erythromycin oral .......................................7escitalopram oxalate ..................................9esmolol hcl intravenous solution 100 mg/10ml ..................................................15esmolol hcl-sodium chloride .....................15estarylla ...................................................24estazolam ................................................14estradiol oral ............................................24estradiol transdermal ...............................24estradiol vaginal .......................................24estradiol valerate intramuscular ................24estradiol-norethindrone acet ....................24eszopiclone ..............................................32ethacrynate sodium .................................15ethacrynic acid .........................................15ethambutol hcl oral ..................................10ethosuximide oral ......................................8ethyl chloride .............................................6ethynodiol diac-eth estradiol ....................24etodolac er ................................................6etodolac ....................................................6etonogestrel-ethinyl estradiol ...................24etoposide intravenous ..............................11etoposide oral ..........................................11etravirine .................................................13EUCRISA ..................................................18EUFLEXXA ................................................28euthyrox ..................................................26everolimus oral tablet 0.25 mg, 0.5 mg, 0.75 mg ............................................26everolimus oral tablet 10 mg, 2.5 mg, 5 mg, 7.5 mg ...........................................11everolimus oral tablet soluble ...................11EVOTAZ ...................................................13exemestane .............................................11ezetimibe-simvastatin ...............................15ezetimibe .................................................15FABRAZYME ............................................22falmina ....................................................24famciclovir oral ........................................13famotidine intravenous ............................21famotidine oral suspension reconstituted .21famotidine oral tablet 20 mg, 40 mg .......21famotidine premixed ................................21FARXIGA ..................................................19FASENRA PEN ..........................................30FASENRA .................................................30fayosim ....................................................24febuxostat ...............................................10

37

FEIBA .......................................................14felbamate ..................................................8felodipine er ............................................15femynor ...................................................24fenofibrate micronized oral capsule 130 mg, 134 mg, 200 mg, 43 mg, 67 mg 15fenofibrate oral ........................................15fenofibric acid ..........................................15fenoprofen calcium oral .............................6fenortho ....................................................6fentanyl citrate buccal lozenge on a handle 5fentanyl citrate injection solution prefilled syringe .........................................5fentanyl .....................................................5ferumoxytol .............................................20FIBRYGA ..................................................14finasteride oral tablet 5 mg ......................22flac ..........................................................30flavoxate hcl ............................................22flecainide acetate .....................................15FLEXICHAMBER ADULT MASK/SMALL ......28FLEXICHAMBER CHILD MASK/LARGE .......28FLEXICHAMBER CHILD MASK/SMALL .......28FLEXICHAMBER .......................................28FLOVENT DISKUS .....................................31FLOVENT HFA ..........................................31floxuridine ...............................................11FLUAD QUADRIVALENT ............................27FLUARIX QUADRIVALENT .........................27FLUBLOK QUADRIVALENT ........................27FLUCELVAX QUADRIVALENT ....................27fluconazole in sodium chloride .................10fluconazole oral .......................................10flucytosine oral ........................................10fludarabine phosphate .............................11fludrocortisone acetate oral .....................22FLULAVAL QUADRIVALENT .......................27flumazenil intravenous .............................28FLUMIST QUADRIVALENT .........................27flunisolide nasal .......................................30fluocinolone acetonide body ....................18fluocinolone acetonide external ...............18fluocinolone acetonide otic ......................30fluocinolone acetonide scalp ....................18fluocinonide emulsified base ....................18fluocinonide external ...............................18fluorometholone ......................................29FLUOROURACIL EXTERNAL CREAM 0.5 % ......................................................18fluorouracil external cream 5 % ...............18fluorouracil external solution ....................18fluorouracil intravenous ...........................11fluoxetine hcl (pmdd) .................................9fluoxetine hcl oral capsule delayed release .9fluoxetine hcl oral capsule ..........................9fluoxetine hcl oral solution .........................9fluoxetine hcl oral tablet ............................9fluphenazine decanoate injection .............13fluphenazine hcl ......................................13flurandrenolide ........................................18flurazepam hcl .........................................32flurbiprofen oral .........................................6flurbiprofen sodium .................................29flutamide .................................................11fluticasone propionate external ................18

fluticasone propionate nasal ....................30fluticasone-salmeterol inhalation aerosol powder breath activated 100-50 mcg/dose, 250-50 mcg/dose, 500-50 mcg/dose .....................................31FLUTICASONE-SALMETEROL INHALATION AEROSOL POWDER BREATH ACTIVATED 113-14 MCG/ACT, 232-14 MCG/ACT, 55-14 MCG/ACT 31fluvastatin sodium er ................................15fluvastatin sodium ....................................15fluvoxamine maleate er ..............................9fluvoxamine maleate ..................................9FLUZONE HIGH-DOSE QUADRIVALENT .....27FLUZONE QUADRIVALENT ........................27FML .........................................................29folic acid injection ....................................20folic acid oral tablet 1 mg ........................20FOLOTYN .................................................11fomepizole ...............................................28fondaparinux sodium .................................8formaldehyde external solution 37 % ......28formoterol fumarate inhalation ................31fosamprenavir calcium .............................13fosaprepitant dimeglumine ........................9foscarnet sodium .....................................13fosfomycin tromethamine ..........................7fosinopril sodium-hctz ..............................15fosinopril sodium .....................................15fosphenytoin sodium .................................8frovatriptan succinate ..............................10fulvestrant ...............................................11furosemide injection ................................15furosemide oral ........................................15FUZEON ...................................................13fyavolv .....................................................24gabapentin oral .........................................8galantamine hydrobromide er ....................9galantamine hydrobromide ........................9GAMASTAN .............................................26GAMMAGARD ........................................26GAMMAKED ...........................................26GAMUNEX-C ...........................................26ganciclovir sodium ...................................13GARDASIL 9 .............................................27gatifloxacin ophthalmic ............................29gavilyte-c .................................................21gavilyte-g .................................................21gavilyte-n with flavor pack .......................21GELSYN-3 ................................................28gemcitabine hcl .......................................11gemfibrozil oral ........................................16gemmily ...................................................24generlac ...................................................21gengraf ....................................................26gentak .....................................................29gentamicin in saline ...................................7gentamicin sulfate external ........................7gentamicin sulfate injection .......................7gentamicin sulfate ophthalmic .................29glatiramer acetate ....................................17glatopa ....................................................17glimepiride ...............................................19glipizide er ...............................................19glipizide ir ................................................19

glipizide xl ................................................19glipizide-metformin hcl ............................19glucagon emergency kit ...........................20GLUCAGON EMERGENCY KIT ..................20glutaraldehyde external............................28glyburide micronized ................................19glyburide oral ...........................................19glyburide-metformin ................................19glycine irrigation ......................................22glycine urologic ........................................22glycopyrrolate injection solution ...............21glycopyrrolate oral ...................................22glycopyrrolate pf ......................................22glydo .........................................................6GLYXAMBI ...............................................19granisetron hcl intravenous ........................9granisetron hcl oral ....................................9griseofulvin microsize oral ........................10griseofulvin ultramicrosize ........................10guaiatussin ac ..........................................30guaifenesin ac ..........................................30guanfacine hcl er .....................................17guanfacine hcl .........................................16GVOKE HYPOPEN 1-PACK .......................20GVOKE HYPOPEN 2-PACK .......................20GVOKE PFS ..............................................20hailey 1.5/30 ............................................24hailey 24 fe ..............................................24hailey fe 1.5/30 ........................................24hailey fe 1/20 ...........................................24HALAVEN.................................................11halcinonide ..............................................18halobetasol propionate external cream .....18halobetasol propionate external ointment 18haloperidol decanoate intramuscular ........13haloperidol lactate ...................................13haloperidol oral ........................................13HARVONI .................................................13HAVRIX ....................................................27heather ....................................................24hematinic/folic acid ..................................20hemocyte-f ..............................................20heparin (porcine) in nacl intravenous solution .....................................................8heparin lock flush ....................................28heparin sod (porcine) in d5w ......................8heparin sodium (porcine) pf .......................8heparin sodium (porcine) ...........................8heparin sodium lock flush ........................28HEPLISAV-B ..............................................27hetastarch-nacl ........................................14HIBERIX ....................................................27HIZENTRA SUBCUTANEOUS SOLUTION ....26homatropaire ...........................................30HUMALOG KWIKPEN ...............................20HUMALOG MIX 50/50 KWIKPEN ..............20HUMALOG MIX 50/50 VIAL .....................20HUMALOG MIX 75/25 KWIKPEN ..............20HUMALOG MIX 75/25 VIAL .....................20HUMALOG U-100 JUNIOR KWIKPEN ........20HUMALOG ..............................................20HUMATE-P ...............................................14HUMIRA PEDIATRIC CROHNS START ........26HUMIRA PEN-CD/UC/HS STARTER ............26HUMIRA PEN-PEDIATRIC UC START ..........26

38

HUMIRA PEN-PS/UV/ADOL HS START .......26HUMIRA PEN-PSOR/UVEIT STARTER ..........26HUMIRA PEN ...........................................26HUMIRA ..................................................26HUMULIN 70/30 KWIKPEN .......................20HUMULIN 70/30 VIAL ..............................20HUMULIN N KWIKPEN .............................20HUMULIN N VIAL .....................................20HUMULIN R U-500 KWIKPEN ...................20HUMULIN R U-500 VIAL ...........................20HUMULIN R VIAL .....................................20hydralazine hcl injection ...........................16hydralazine hcl oral ..................................16hydrochlorothiazide oral ..........................16hydrocodone bitartrate er oral capsule extended release 12 hour ...........................5hydrocodone polst-chlorphen polst er susp .........................................................30hydrocodone-acetaminophen ....................5hydrocodone-homatropine ......................30hydrocodone-ibuprofen .............................5hydrocortisone (perianal) ..........................27hydrocortisone ace-pramoxine external cream 1-1 % ..............................27hydrocortisone butyr lipo base .................18hydrocortisone butyrate ...........................18hydrocortisone external cream 1 %, 2.5 % ......................................................18hydrocortisone external lotion 2.5 % .......18hydrocortisone external ointment 1 %, 2.5 % ................................................18hydrocortisone oral ..................................22hydrocortisone rectal ...............................27hydrocortisone valerate ............................18hydrocortisone-acetic acid ........................30hydrogen peroxide .....................................7hydromet .................................................30hydromorphone hcl er ...............................5hydromorphone hcl injection solution 2 mg/ml, 4 mg/ml ......................................5hydromorphone hcl oral .............................5hydromorphone hcl pf ...............................5hydromorphone hcl solution 1 mg/ml injection .....................................................5hydroxocobalamin acetate .......................20hydroxychloroquine sulfate oral ................12hydroxyprogesterone caproate intramuscular ...........................................24hydroxyurea oral ......................................11hydroxyzine hcl intramuscular ..................14hydroxyzine hcl oral .................................14hydroxyzine pamoate oral ........................14hyoscyamine sulfate oral ..........................22hyoscyamine sulfate sl ..............................22hyoscyamine sulfate sublingual ................22hyosyne ...................................................22HYPERRHO S/D ........................................26ibandronate sodium .................................28ibuprofen lysine .........................................6ibuprofen oral suspension 100 mg/5ml ......6ibuprofen oral tablet 400 mg, 600 mg, 800 mg ...............................................6ibutilide fumarate ....................................16icatibant acetate ......................................26iclevia ......................................................24

icosapent ethyl .........................................16idarubicin hcl ...........................................11ifosfamide ................................................11ILARIS ......................................................26imatinib mesylate .....................................11imipenem-cilastatin ....................................7imipramine hcl oral ....................................9imipramine pamoate ..................................9imiquimod external ..................................18IMOVAX RABIES .......................................27IMVEXXY MAINTENANCE PACK ...............24IMVEXXY STARTER PACK .........................24incassia ....................................................24INCRELEX .................................................23indapamide ..............................................16indomethacin er .........................................6indomethacin oral capsule 25 mg, 50 mg ..6indomethacin sodium ................................6INFANRIX .................................................27INFLECTRA ...............................................26INSPIREASE RESERVOIR BAGS ..................28INSULIN PEN NEEDLES ..............................20INSULIN SYRINGES ...................................20INTELENCE ORAL TABLET 25 MG .............13introvale ..................................................24INVIRASE .................................................13iodine strong oral .....................................20IPOL .........................................................27ipratropium bromide inhalation ................31ipratropium bromide nasal .......................30ipratropium-albuterol ...............................31irbesartan-hydrochlorothiazide .................16irbesartan ................................................16irinotecan hcl ...........................................11ISENTRESS HD ..........................................13ISENTRESS ................................................13isibloom ...................................................24isoniazid injection ....................................10isoniazid oral ............................................10isoproterenol hcl injection ........................31isosorbide dinitrate ..................................16isosorbide mononitrate er ........................16isosorbide mononitrate ............................16isotretinoin oral ........................................18isradipine .................................................16itraconazole oral ......................................10ivermectin external cream ........................18ivermectin external lotion .........................12ivermectin oral .........................................12IXEMPRA KIT ............................................11IXIARO .....................................................27jaimiess ....................................................24JAKAFI ORAL TABLET 10 MG ...................11JAKAFI ORAL TABLET 15 MG, 20 MG, 25 MG, 5 MG ..........................................11JANSSEN COVID-19 VACCINE ..................27jantoven ....................................................8JANUMET XR ...........................................19JANUMET ................................................19JANUVIA ..................................................19JARDIANCE ..............................................19jasmiel .....................................................24jencycla ....................................................24JENTADUETO XR ......................................19JENTADUETO ...........................................19

JEVTANA ..................................................11jinteli .......................................................24jolessa ......................................................24juleber .....................................................24JULUCA ...................................................13junel 1.5/30 .............................................24junel 1/20 ................................................24junel fe 1.5/30 .........................................24junel fe 1/20 ............................................24junel fe 24 ...............................................24k-prime ....................................................21kaitlib fe ..................................................24kalliga ......................................................24KANJINTI ..................................................11kariva .......................................................24kelnor 1/35 ..............................................24kelnor 1/50 ..............................................24KEPIVANCE ..............................................17KESIMPTA ................................................17ketoconazole external ..............................10ketoconazole oral ....................................10ketodan external foam .............................10ketoprofen er .............................................6ketoprofen oral ..........................................6ketorolac tromethamine injection ...............6ketorolac tromethamine intramuscular .......6ketorolac tromethamine ophthalmic.........29ketorolac tromethamine oral ......................6KINRIX .....................................................27klor-con 10 ..............................................20klor-con m10 ...........................................21klor-con m15 ...........................................21klor-con m20 ...........................................21klor-con/ef ...............................................21klor-con ...................................................20KLOXXADO ...............................................6KOATE-DVI ..............................................14KOATE .....................................................14KOGENATE FS ..........................................14KOVALTRY ...............................................14kurvelo ....................................................24KYPROLIS .................................................11labetalol hcl intravenous solution .............16labetalol hcl oral ......................................16lactated ringers irrigation .........................21lactic acid e ..............................................18lactic acid external ...................................18lactulose encephalopathy .........................22lactulose ..................................................22lamivudine-zidovudine .............................13lamivudine ...............................................13lamotrigine er ............................................8lamotrigine oral .........................................8lamotrigine starter kit-blue .........................8lamotrigine starter kit-green .......................8lamotrigine starter kit-orange .....................8LANCETS .................................................19LANOXIN ORAL ........................................16lanthanum carbonate ...............................22LANTUS SOLOSTAR ..................................20LANTUS U-100 VIAL .................................20lapatinib ditosylate ...................................11larin 1.5/30 ..............................................24larin 1/20 .................................................24larin 24 fe ................................................24

39

larin fe 1.5/30 ..........................................24larin fe 1/20 .............................................24larissia ......................................................24latanoprost ophthalmic ............................29layolis fe ..................................................24leena .......................................................24leflunomide oral .......................................26lessina ......................................................24letrozole oral ............................................11leucovorin calcium injection .....................11leucovorin calcium oral ............................11LEUKERAN ...............................................11leuprolide acetate injection ......................23levalbuterol hcl inhalation ........................31levetiracetam er .........................................8levetiracetam in nacl ..................................8levetiracetam intravenous ..........................8levetiracetam oral ......................................8levo-t .......................................................26levobunolol hcl ........................................29levocarnitine oral solution ........................21levocarnitine oral tablet............................21levocarnitine sf ........................................21levofloxacin in d5w ....................................7levofloxacin intravenous .............................7levofloxacin ophthalmic ...........................29levofloxacin oral .........................................7levoleucovorin calcium pf .........................11levoleucovorin calcium .............................11levonest ...................................................24levonorg-eth estrad triphasic ....................24levonorgest-eth est & eth est ...................24levonorgest-eth estrad 91-day ..................24levonorgestrel-ethinyl estrad ....................24levora 0.15/30 (28) ..................................24levorphanol tartrate oral ............................5levothyroxine sodium intravenous ............26levothyroxine sodium oral tablet ..............26levoxyl .....................................................26LEXIVA ORAL SUSPENSION .......................13lidocaine external ointment 5 % ................6lidocaine external patch 5 %......................6lidocaine hcl (cardiac) intravenous solution prefilled syringe 50 mg/5ml ..........6lidocaine hcl (cardiac) pf .............................6lidocaine hcl (cardiac) solution prefilled syringe 100 mg/5ml intravenous ................6lidocaine hcl (pf) ........................................6lidocaine hcl external solution ....................6lidocaine hcl injection solution ...................6lidocaine hcl urethral/mucosal ....................6lidocaine in d5w intravenous solution 4-5 mg/ml-%, 8-5 mg/ml-% ......................6lidocaine viscous hcl .................................17lidocaine-epinephrine injection ...................6lidocaine-prilocaine external cream ............6lillow ........................................................24lincomycin hcl injection ..............................7lindane ....................................................12linezolid in sodium chloride ........................7linezolid intravenous ..................................7linezolid oral ..............................................7LINZESS ....................................................22liothyronine sodium intravenous ..............26liothyronine sodium oral ..........................26

lisinopril oral ............................................16lisinopril-hydrochlorothiazide....................16lithium carbonate er .................................14lithium carbonate oral ..............................14lo-zumandimine .......................................24lojaimiess .................................................24loperamide hcl oral capsule ......................22lopinavir-ritonavir .....................................13lorazepam injection ..................................14lorazepam intensol ...................................14lorazepam oral concentrate 2 mg/ml ........14lorazepam oral tablet ...............................14loryna ......................................................24losartan potassium oral ............................16losartan potassium-hctz ...........................16loteprednol etabonate ophthalmic gel ......29loteprednol etabonate ophthalmic suspension ...............................................29lovastatin oral ..........................................16low-ogestrel .............................................24loxapine succinate ....................................13LUCENTIS .................................................30LUMIGAN ................................................29LUMIZYME ...............................................22LUPRON DEPOT (1-MONTH) INTRAMUSCULAR KIT 7.5 MG .................23LUPRON DEPOT (3-MONTH) INTRAMUSCULAR KIT 22.5 MG ...............23LUPRON DEPOT (4-MONTH) INTRAMUSCULAR KIT 30MG ...................23LUPRON DEPOT (6-MONTH) INTRAMUSCULAR KIT 45MG ...................23LUPRON DEPOT-PED (1-MONTH) INTRAMUSCULAR KIT 15 MG, 7.5 MG .....23LUPRON DEPOT-PED (3-MONTH) INTRAMUSCULAR KIT 30 MG (PED) .........23lutera .......................................................24lyleq .........................................................24lyllana ......................................................24LYNPARZA ................................................11LYSODREN ...............................................11LYUMJEV KWIKPEN ..................................20LYUMJEV VIAL .........................................20lyza ..........................................................24M-M-R II ..................................................27mafenide acetate external ..........................7magnesium chloride injection ...................21magnesium sulfate in d5w .......................21magnesium sulfate injection .....................21magnesium sulfate intravenous ................21MAKENA .................................................24malathion ................................................12mannitol intravenous ...............................16marlissa ...................................................25MATULANE ..............................................11matzim la .................................................16MAVYRET ................................................13maxi-tuss ac .............................................30meclizine hcl oral tablet .............................9meclofenamate sodium oral .......................6MEDROL ORAL TABLET 2 MG ..................22medroxyprogesterone acetate intramuscular ...........................................25medroxyprogesterone acetate oral ...........25mefenamic acid oral ...................................6

mefloquine hcl .........................................12megestrol acetate oral .............................25MEKINIST .................................................11meloxicam oral ..........................................6melphalan hcl ..........................................12melphalan ................................................12memantine hcl er .......................................9memantine hcl ...........................................9MENACTRA .............................................27MENEST ...................................................25MENQUADFI ............................................27MENVEO ..................................................27meperidine hcl injection .............................5meperidine hcl oral ....................................5meprobamate ..........................................14mercaptopurine oral ................................12meropenem ...............................................7merzee ....................................................25mesalamine er oral capsule 0.375 gm ......27mesalamine oral .......................................27mesalamine rectal ....................................27mesalamine-cleanser ................................27mesna ......................................................12metaxalone ..............................................31metformin hcl er ......................................19metformin hcl ir .......................................19methadone hcl injection .............................5methadone hcl intensol ..............................5methadone hcl oral concentrate .................5methadone hcl oral solution .......................5methadone hcl oral tablet soluble ..............5methadone hcl oral tablet ..........................5methadose oral concentrate 10 mg/ml .......5methadose oral tablet soluble ....................5methadose sugar-free ................................5methamphetamine hcl .............................17methazolamide oral .................................29methenamine hippurate .............................7methergine ..............................................28methimazole oral .....................................26methocarbamol injection .........................31methocarbamol oral .................................31methotrexate oral ....................................26methotrexate sodium (pf) .........................26methotrexate sodium ...............................26methoxsalen rapid ...................................18methscopolamine bromide oral ................22methyldopa .............................................16methylergonovine maleate injection .........28methylergonovine maleate oral ................28methylphenidate hcl er (cd) ......................17methylphenidate hcl er (la) .......................17methylphenidate hcl er (xr) .......................17methylphenidate hcl er ............................17methylphenidate hcl oral ..........................17methylprednisolone acetate suspension 40 mg/ml injection .................22methylprednisolone acetate suspension 80 mg/ml injection .................23methylprednisolone oral ...........................23methylprednisolone sodium succ ..............23metoclopramide hcl injection .....................9metoclopramide hcl oral ............................9metolazone ..............................................16metoprolol succinate er ............................16

40

metoprolol tartrate intravenous ................16metoprolol tartrate oral ............................16metoprolol-hydrochlorothiazide ...............16metronidazole external ............................18metronidazole in nacl .................................7metronidazole oral .....................................7metronidazole vaginal ................................7metyrosine ...............................................16mexiletine hcl oral ....................................16mibelas 24 fe ...........................................25micafungin sodium ..................................10miconazole 3 ...........................................10MICRHOGAM ULTRA-FILTERED PLUS ........26MICROCHAMBER ....................................28microgestin 1.5/30 ...................................25microgestin 1/20 ......................................25microgestin 24 fe .....................................25microgestin fe 1.5/30 ...............................25microgestin fe 1/20 ..................................25midodrine hcl ...........................................16miglitol ....................................................19miglustat .................................................22mili ..........................................................25milrinone lactate in dextrose ....................16milrinone lactate ......................................16mimvey ....................................................25mineral oil heavy oral ...............................22minocycline hcl er oral tablet extended release 24 hour ..........................................7minocycline hcl oral ...................................7minoxidil oral ...........................................16mirtazapine oral .........................................9misoprostol oral .......................................21mitigo ........................................................5mitomycin intravenous .............................12mitoxantrone hcl ......................................12modafinil .................................................32MODERNA COVID-19 VACCINE ...............27moexipril hcl ............................................16molindone hcl ..........................................13mometasone furoate external ..................18mometasone furoate nasal .......................30mondoxyne nl ............................................7mono-linyah ............................................25monoject flush syringe .............................21monoject sodium chloride flush ...............21MONONINE .............................................14montelukast sodium oral ..........................31morphine sulfate (concentrate) oral solution 100 mg/5ml, 20 mg/ml .................5morphine sulfate (pf) .................................5morphine sulfate er beads ..........................5morphine sulfate er ....................................5morphine sulfate injection solution 2 mg/ml, 4 mg/ml .........................................5morphine sulfate intravenous solution 4 mg/ml, 8 mg/ml ......................................5morphine sulfate oral .................................5MOXEZA ..................................................29moxifloxacin hcl (2x day) ..........................29moxifloxacin hcl in nacl ..............................8moxifloxacin hcl ophthalmic solution ........29moxifloxacin hcl oral ..................................8MOZOBIL .................................................14MULPLETA ...............................................14

mupirocin calcium ......................................8mupirocin external .....................................8mutamycin ...............................................12MVASI .....................................................12mycophenolate mofetil hcl .......................26mycophenolate mofetil intravenous .........26mycophenolate mofetil oral .....................26mycophenolate sodium ............................26MYFEMBREE ............................................25MYLERAN ................................................12myorisan ..................................................18MYRBETRIQ ORAL TABLET EXTENDED RELEASE 24 HOUR ...................................22na ferric gluc cplx in sucrose ....................21nabumetone oral .......................................6nadolol oral .............................................16nafcillin sodium ..........................................8naftifine hcl .............................................10NAGLAZYME ...........................................22nalbuphine hcl injection .............................5naloxone hcl injection ................................6naltrexone hcl oral .....................................6NAMZARIC ................................................9naproxen oral ............................................6naproxen sodium er oral tablet extended release 24 hour 375 mg, 500 mg 6naproxen sodium oral tablet 275 mg, 550 mg ......................................................6naproxen-esomeprazole .............................6naratriptan hcl .........................................10NARCAN ....................................................6NATACYN ................................................29NATAZIA ..................................................25nateglinide ...............................................19nebivolol hcl ............................................16necon 0.5/35 (28) ....................................25nefazodone hcl ..........................................9neo-polycin hc .........................................30neo-polycin ..............................................30neomycin sulfate oral .................................8neomycin-bacitracin zn-polymyx ..............30neomycin-polymyxin b gu ..........................8neomycin-polymyxin-dexameth ophthalmic ointment ...............................30neomycin-polymyxin-dexameth ophthalmic suspension 3.5-10000-0.1 .....30neomycin-polymyxin-gramicidin ...............30neomycin-polymyxin-hc ophthalmic .........30neomycin-polymyxin-hc otic .....................30neostigmine methylsulfate intravenous solution 10 mg/10ml, 5 mg/10ml .............10neuac external gel ...................................18nevirapine er ............................................13nevirapine ................................................13NEXAVAR.................................................12NEXLETOL ................................................16NEXLIZET .................................................16niacin (antihyperlipidemic) ........................16niacin er (antihyperlipidemic) ....................16niacor ......................................................16nicardipine hcl .........................................16nifedipine er osmotic release ....................16nifedipine er ............................................16nifedipine oral ..........................................16nikki ........................................................25

nilutamide ...............................................12nimodipine oral ........................................16nisoldipine er ...........................................16nitazoxanide oral .....................................12nitisinone .................................................22nitrofurantoin macrocrystal ........................8nitrofurantoin monohydrate macrocrystals .8nitrofurantoin ............................................8nitroglycerin in d5w .................................16nitroglycerin .............................................16nitroprusside sodium ................................16NIVESTYM ...............................................14nizatidine .................................................21nolix ........................................................19nora-be ....................................................25norepinephrine bitartrate intravenous ......16norethin ace-eth estrad-fe ........................25norethin-eth estradiol-fe ..........................25norethindrone acet-ethinyl est..................25norethindrone acetate oral .......................25norethindrone oral ...................................25norethindrone-eth estradiol .....................25norgestimate-eth estradiol .......................25norgestimate-ethinyl estradiol triphasic ....25norlyda ....................................................25norlyroc ...................................................25normal saline flush ...................................21NORPACE CR ...........................................16nortrel 0.5/35 (28) ...................................25nortrel 1/35 (21) ......................................25nortrel 1/35 (28) ......................................25nortrel 7/7/7 ............................................25nortriptyline hcl oral ...................................9NORVIR ORAL PACKET .............................13NORVIR ORAL SOLUTION .........................13NOVOEIGHT ............................................14NOVOFINE AUTOCOVER PEN NEEDLE ......20NOVOFINE PEN NEEDLE ...........................20NOVOFINE PLUS PEN NEEDLE ...................20NOVOLIN 70/30 FLEXPEN RELION .............20NOVOLIN 70/30 RELION ...........................20NOVOLIN N RELION .................................20NOVOLIN R RELION ..................................20NOVOSEVEN RT .......................................14NOVOTWIST PEN NEEDLE ........................20np thyroid ................................................26NUCALA ..................................................30NURTEC ...................................................10NUWIQ ....................................................14nyamyc ....................................................10nylia 7/7/7 ................................................25nymyo .....................................................25nystatin external ......................................10nystatin mouth/throat ..............................10nystatin oral .............................................10nystatin-triamcinolone .............................10nystop .....................................................10ocella .......................................................25octreotide acetate ....................................23ofloxacin ophthalmic ................................29ofloxacin oral .............................................8ofloxacin otic ...........................................30olanzapine intramuscular .........................13olanzapine oral ........................................13olanzapine-fluoxetine hcl ...........................9

41

olmesartan medoxomil oral ......................16olmesartan medoxomil-hctz .....................16olmesartan-amlodipine-hctz .....................16olopatadine hcl nasal ...............................30olopatadine hcl ophthalmic ......................29OMECLAMOX-PAK ..................................22omega-3-acid ethyl esters ........................16OMNITROPE .............................................23ONCASPAR ..............................................12ondansetron hcl injection ...........................9ondansetron hcl oral solution .....................9ondansetron hcl oral tablet 24 mg .............9ondansetron hcl oral tablet 4 mg, 8 mg ...10ondansetron odt ......................................10ONETOUCH ULTRA 2 KIT W/DEVICE .........19ONETOUCH ULTRA MINI KIT W/DEVICE....20ONETOUCH ULTRA TEST STRIPS ...............19ONETOUCH VERIO FLEX SYSTEM .............20ONETOUCH VERIO IQ SYSTEM .................20ONETOUCH VERIO KIT W/DEVICE ............20ONETOUCH VERIO REFLECT .....................20ONETOUCH VERIO SYNC SYSTEM ...........20ONETOUCH VERIO TEST STRIPS ................20OPSUMIT .................................................31OPTICHAMBER DIAMOND-LG MASK .......28OPTICHAMBER DIAMOND-MD MASK ......28OPTICHAMBER DIAMOND-SM MASK ......28OPTICHAMBER DIAMOND .......................28oralone ....................................................17ORIAHNN .................................................25ORILISSA ..................................................23orphenadrine citrate er ............................31orphenadrine citrate injection ..................31orphenadrine-asa-caffeine .......................31orsythia ....................................................25oseltamivir phosphate oral .......................13OTEZLA ....................................................26oxacillin sodium .........................................8oxaliplatin ................................................12oxaprozin ...................................................6oxazepam ................................................14oxcarbazepine ............................................8oxiconazole nitrate ...................................10oxybutynin chloride er ..............................22oxybutynin chloride oral ...........................22oxycodone hcl oral capsule ........................5oxycodone hcl oral concentrate 100 mg/5ml ......................................................5oxycodone hcl oral solution ........................5oxycodone hcl oral tablet ...........................5oxycodone-acetaminophen oral tablet 10-325 mg, 2.5-325 mg, 5-325 mg, 7.5-325 mg ...............................................5oxymorphone hcl er ...................................5oxymorphone hcl .......................................5oxytocin injection .....................................23OZEMPIC .................................................19paclitaxel .................................................12paliperidone er .........................................13palonosetron hcl ......................................10pamidronate disodium .............................28pancuronium bromide .............................17PANDA MASK LARGE ..............................29PANDA MASK MEDIUM ...........................29PANDA MASK SMALL ..............................29

paraplatin ................................................12paricalcitol ...............................................28paromomycin sulfate oral ...........................8paroxetine hcl er ........................................9paroxetine hcl ............................................9paroxetine mesylate ...................................9PEDIARIX .................................................27PEDIATRIC PANDA MASK .........................29PEDVAX HIB .............................................27peg 3350-kcl-na bicarb-nacl .....................22peg-3350/electrolytes/ascorbat ................22peg-3350/electrolytes ..............................22peg-kcl-nacl-nasulf-na asc-c .....................22peg-prep ..................................................22PEGASYS .................................................13penicillamine oral capsule ........................22penicillamine oral tablet ...........................22penicillin g potassium .................................8penicillin g procaine ...................................8penicillin g sodium .....................................8penicillin v potassium .................................8PENTACEL ................................................27pentamidine isethionate ...........................12pentazocine-naloxone hcl ..........................5pentobarbital sodium injection ...................8pentoxifylline er .......................................16perindopril erbumine ...............................16periogard .................................................17PERJETA ...................................................12permethrin external .................................12perphenazine oral ....................................10perphenazine-amitriptyline .........................9PFIZER COVID-19 VAC-TRIS 5-11Y ...........27PFIZER-BIONT COVID-19 VAC-TRIS ...........27PFIZER-BIONTECH COVID-19 VACC ..........27phenazo oral tablet 200 mg .....................22phenazopyridine hcl oral tablet 100 mg, 200 mg .............................................22phenelzine sulfate oral ...............................9phenobarbital oral .....................................8phenobarbital sodium injection ..................8phenoxybenzamine hcl oral ......................16phentolamine mesylate injection ..............16phenylephrine hcl intravenous solution 10 mg/ml .................................................16phenylephrine hcl ophthalmic ..................30phenytoin infatabs .....................................8phenytoin oral ...........................................9phenytoin sodium extended .......................9phenytoin sodium injection ........................9PHESGO ...................................................12philith ......................................................25phospho-trin 250 neutral .........................21phosphorous ............................................21phytonadione injection ............................21phytonadione oral ....................................21pilocarpine hcl ophthalmic .......................29pilocarpine hcl oral ...................................17pimecrolimus ...........................................19pimozide ..................................................13pimtrea ....................................................25pindolol ...................................................16pioglitazone hcl-glimepiride .....................19pioglitazone hcl-metformin hcl .................19pioglitazone hcl .......................................19

piperacillin sod-tazobactam so ...................8pirmella 1/35 ...........................................25pirmella 7/7/7 ..........................................25piroxicam oral ............................................6PNEUMOVAX 23 ......................................27POCKET SPACER ......................................29podofilox external ....................................19polocaine-mpf ...........................................6polocaine ...................................................6polycin .....................................................30polymyxin b sulfate injection ......................8polymyxin b-trimethoprim ........................30portia-28 .................................................25posaconazole ...........................................10potassium acetate intravenous .................21potassium chloride crys er ........................21potassium chloride er ...............................21potassium chloride intravenous ................21potassium chloride oral ............................21potassium citrate er .................................21potassium phosphates(71 meq k) .............21PRADAXA ..................................................8pramipexole dihydrochloride er ................12pramipexole dihydrochloride ....................12prasugrel hcl ............................................13pravastatin sodium ...................................16praziquantel oral ......................................12prazosin hcl oral .......................................16prednicarbate ..........................................19prednisolone acetate ophthalmic .............29prednisolone oral solution ........................23prednisolone sodium phosphate ophthalmic ..............................................29prednisolone sodium phosphate oral ........23prednisone intensol ..................................23prednisone oral ........................................23pregabalin er ...........................................17pregabalin ...............................................17PREMARIN ORAL ......................................25PREMARIN VAGINAL ................................25PREMPHASE .............................................25PREMPRO ................................................25prevalite ...................................................16previfem ..................................................25PREVNAR 13 ............................................27PREVNAR 20 ............................................27PREZCOBIX ..............................................13PREZISTA ..................................................13primaquine phosphate .............................12primidone oral ...........................................9PRO COMFORT SPACER ADULT ................29PRO COMFORT SPACER CHILD ................29PRO COMFORT SPACER INFANT ...............29probenecid ..............................................10procainamide hcl injection .......................16PROCARE SPACER/ADULT MASK ..............29PROCARE SPACER/CHILD MASK ..............29prochlorperazine edisylate injection ..........10prochlorperazine maleate oral ..................10prochlorperazine ......................................10procto-med hc .........................................27procto-pak ...............................................28PROCTOFOAM HC ...................................27proctosol hc .............................................28proctozone-hc .........................................28

42

PROFILNINE ..............................................14progesterone intramuscular......................25progesterone oral ....................................25PROLENSA ...............................................29PROLEUKIN ..............................................12PROLIA ....................................................28promethazine hcl injection .......................30promethazine hcl oral ..............................30promethazine hcl rectal ............................30promethazine vc/codeine .........................30promethazine vc ......................................30promethazine-codeine .............................30promethazine-dm ....................................30promethazine-phenyleph-codeine ............30promethazine-phenylephrine ...................30promethegan ...........................................30propafenone hcl er ..................................16propafenone hcl ......................................16proparacaine hcl ophthalmic ....................30propranolol hcl er ....................................16propranolol hcl intravenous ......................16propranolol hcl oral ..................................16propylthiouracil oral .................................26PROQUAD ...............................................27protamine sulfate intravenous ..................14protriptyline hcl ..........................................9pseudoephedrine-bromphen-dm ..............30PULMICORT FLEXHALER ...........................31PULMOZYME ...........................................31PYLERA ....................................................22pyrazinamide oral ....................................11pyridostigmine bromide er .......................10pyridostigmine bromide oral ....................10pyridoxine hcl injection ............................21pyrimethamine oral ..................................12QUADRACEL ............................................27quazepam ................................................14quetiapine fumarate er ............................13quetiapine fumarate ................................13quinapril hcl .............................................16quinapril-hydrochlorothiazide ...................16quinidine gluconate er .............................16quinidine sulfate ......................................16quinine sulfate oral ..................................12RABAVERT ...............................................27raloxifene hcl ...........................................23ramelteon ................................................32ramipril ....................................................16ranolazine er ............................................16rasagiline mesylate oral ............................12RASUVO ..................................................26reclipsen ..................................................25RECOMBINATE .........................................14RECOMBIVAX HB .....................................27relexxii .....................................................17RELION PREMIER CLASSIC ........................20RELION PREMIER TEST ..............................20remifentanil hcl ..........................................5repaglinide ...............................................19REPATHA PUSHTRONEX SYSTEM ..............16REPATHA SURECLICK ...............................16REPATHA .................................................16RESTASIS MULTIDOSE ...............................30RESTASIS ..................................................30RETACRIT .................................................14

RETIN-A MICRO PUMP EXTERNAL GEL 0.06 %, 0.08 % ......................................19RETROVIR INTRAVENOUS .........................13REVLIMID .................................................12revonto ....................................................32REYATAZ ORAL PACKET ...........................14RHOGAM ULTRA-FILTERED PLUS ..............26RHOPHYLAC ............................................26RIASTAP ...................................................14ribavirin inhalation ...................................14ribavirin oral .............................................14rifabutin ...................................................11rifampin intravenous ................................11rifampin oral ............................................11riluzole .....................................................17rimantadine hcl ........................................14ringers irrigation ......................................21RINVOQ ...................................................26risedronate sodium oral tablet 150 mg, 35 mg ...............................................28risedronate sodium oral tablet 30 mg, 5 mg ........................................................28risedronate sodium oral tablet delayed release .....................................................28risperidone ...............................................13ritonavir ...................................................14rivastigmine tartrate ...................................9rivastigmine ...............................................9rivelsa ......................................................25rizatriptan benzoate .................................10rocuronium bromide intravenous solution 17ropinirole hcl er ........................................12ropinirole hcl ............................................12ropivacaine hcl injection solution ................6rosadan external cream ............................19rosadan external gel .................................19rosuvastatin calcium .................................16ROTARIX ..................................................27ROTATEQ .................................................27roweepra ...................................................9RUBRACA ................................................12rufinamide .................................................9RUKOBIA .................................................14RUXIENCE ................................................12RYBELSUS ................................................19ryvent ......................................................30sajazir ......................................................26saline bacteriostatic ..................................21SANDIMMUNE INTRAVENOUS .................26SANDIMMUNE ORAL SOLUTION ..............26sapropterin dihydrochloride .....................22scopolamine ............................................10selegiline hcl oral .....................................12selenium sulfide external lotion ................19SELZENTRY ..............................................14SEREVENT DISKUS ....................................31sertraline hcl oral concentrate ....................9sertraline hcl oral tablet ..............................9setlakin ....................................................25sevelamer carbonate ................................22sevelamer hcl ...........................................22SFROWASA ..............................................28sharobel ...................................................25SHINGRIX .................................................27sildenafil citrate intravenous .....................31

sildenafil citrate oral suspension reconstituted ...........................................31sildenafil citrate oral tablet 20 mg ............31silodosin ..................................................22silver sulfadiazine external ..........................8SIMBRINZA ..............................................29simliya .....................................................25simpesse ..................................................25SIMPONI ARIA ..........................................26SIMPONI ..................................................26simvastatin oral ........................................16sirolimus oral ...........................................26SKYRIZI (150 MG DOSE) ...........................26SKYRIZI PEN .............................................26SKYRIZI ....................................................26sod benz-sod phenylacet ..........................22sod citrate-citric acid ................................21sodium acetate intravenous .....................21sodium bicarbonate intravenous ..............21sodium bicarbonate oral powder ..............22sodium chloride (pf) .................................21sodium chloride bacteriostatic ..................21sodium chloride flush ...............................21sodium chloride inhalation .......................30sodium chloride injection .........................21sodium chloride intravenous ....................21sodium chloride irrigation ........................21sodium fluoride 5000 enamel ..................17sodium fluoride 5000 sensitive .................17sodium nitrite intravenous ........................29sodium nitroprusside ................................17sodium phenylbutyrate oral ......................22sodium polystyrene sulfonate ...................21sodium saccharin powder ........................29sodium thiosulfate intravenous ................29solifenacin succinate ................................22SOLIQUA .................................................19sorbitol-mannitol .....................................29sorine ......................................................17sotalol hcl (af) ..........................................17sotalol hcl oral .........................................17spinosad ..................................................12SPIRIVA HANDIHALER ..............................31SPIRIVA RESPIMAT ....................................31spironolactone oral ..................................17spironolactone-hctz .................................17sprintec 28 ...............................................25SPRYCEL ..................................................12sps ...........................................................21sronyx ......................................................25ssd .............................................................8STAMARIL ................................................27stavudine .................................................14STEGLATRO .............................................19STELARA INTRAVENOUS ..........................26STELARA SUBCUTANEOUS .......................26sterile diluent/epoprostenol ......................29sterile water for injection .........................29sterile water for irrigation .........................21STIOLTO RESPIMAT ...................................31STRENSIQ .................................................22streptomycin sulfate intramuscular .............8STRIVERDI RESPIMAT ................................31subvenite starter kit-blue ............................9subvenite starter kit-green .........................9

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subvenite starter kit-orange .......................9subvenite ...................................................9succinylcholine chloride injection solution 17sucralfate oral ..........................................21sulfacetamide sodium (acne) ....................19sulfacetamide sodium ophthalmic ............29sulfacetamide-prednisolone ophthalmic solution .................................30sulfadiazine oral .........................................8sulfamethoxazole-trimethoprim .................8sulfasalazine oral ......................................28sulfatrim pediatric ......................................8sulfurated lime .........................................12sulindac oral ..............................................6sumatriptan nasal ....................................10sumatriptan succinate oral .......................10sumatriptan succinate refill ......................10sumatriptan succinate subcutaneous ........10sumatriptan-naproxen sodium .................10sunitinib malate .......................................12SUNOSI ....................................................32SUPPRELIN LA ..........................................23syeda .......................................................25SYMBICORT .............................................31SYMFI LO .................................................14SYMFI ......................................................14SYMPROIC ...............................................22SYNAGIS ..................................................27SYNAREL .................................................23SYNJARDY XR ..........................................19SYNJARDY ...............................................19TABLOID ..................................................12tacrolimus external ...................................19tacrolimus oral .........................................27tadalafil (pah) ...........................................31TAFINLAR .................................................12tamoxifen citrate oral ...............................12tamsulosin hcl ..........................................22tarina 24 fe ..............................................25tarina fe 1/20 eq ......................................25tarina fe 1/20 ...........................................25tavaborole ...............................................10taysofy .....................................................25tazarotene external cream ........................19tazicef injection ..........................................8tazicef intravenous solution reconstituted ..8taztia xt ...................................................17TDVAX .....................................................27TEKTURNA HCT .......................................17TEKTURNA ...............................................17telmisartan-amlodipine ............................17telmisartan-hctz .......................................17telmisartan ...............................................17temazepam ..............................................32TEMODAR INTRAVENOUS ........................12temozolomide ..........................................12temsirolimus ............................................27TENIVAC ..................................................27tenofovir disoproxil fumarate ...................14terazosin hcl ............................................22terbinafine hcl oral ...................................10terbutaline sulfate injection ......................31terbutaline sulfate oral .............................31terconazole ..............................................10TERIPARATIDE (RECOMBINANT) ...............28

testosterone cypionate intramuscular .......23testosterone enanthate intramuscular ......23testosterone transdermal .........................23TETANUS-DIPHTHERIA TOXOIDS TD .........27tetrabenazine ...........................................17tetracaine hcl injection ...............................6tetracaine hcl ophthalmic .........................30tetracycline hcl oral ....................................8THALOMID ..............................................12theophylline er .........................................31theophylline .............................................31thiamine hcl injection ...............................21thioridazine hcl oral .................................13thiotepa injection .....................................12thiothixene ..............................................13tiadylt er ..................................................17tiagabine hcl ..............................................9TICE BCG .................................................27TICOVAC .................................................27tigecycline ..................................................8tilia fe ......................................................25timolol maleate (once-daily) .....................29timolol maleate ocudose ..........................29timolol maleate ophthalmic ......................29timolol maleate oral .................................17timolol maleate pf ....................................29tinidazole oral ............................................8tiopronin oral ...........................................22tis-u-sol ....................................................21TIVICAY PD ..............................................14TIVICAY ...................................................14tizanidine hcl oral .....................................32tobramycin inhalation ..............................31tobramycin ophthalmic ............................29tobramycin sulfate injection .......................8tobramycin-dexamethasone .....................30tolcapone ................................................12tolterodine tartrate er ..............................22tolterodine tartrate ..................................22tolvaptan oral tablet 30 mg ......................21topiramate er .............................................9topiramate oral ..........................................9toposar ....................................................12topotecan hcl ...........................................12toremifene citrate ....................................12torsemide ................................................17TOUJEO MAX SOLOSTAR .........................20TOUJEO SOLOSTAR ..................................20tovet external foam..................................19TRADJENTA ..............................................19tramadol hcl er (biphasic) ...........................5tramadol hcl er oral tablet extended release 24 hour ..........................................5tramadol hcl ir ...........................................5tramadol-acetaminophen ...........................5trandolapril-verapamil hcl er .....................17trandolapril ..............................................17tranexamic acid intravenous .....................14tranexamic acid oral .................................14tranylcypromine sulfate ..............................9travoprost (bak free) ................................29TRAZIMERA .............................................12trazodone hcl oral ......................................9TRELEGY ELLIPTA .....................................31TREMFYA .................................................27

treprostinil ...............................................31tretinoin external .....................................19tretinoin microsphere pump .....................19tretinoin microsphere ...............................19tretinoin oral ............................................12tri femynor ...............................................25tri-estarylla ...............................................25tri-legest fe ..............................................25tri-linyah ..................................................25tri-lo-estarylla ...........................................25tri-lo-marzia .............................................25tri-lo-mili ..................................................25tri-lo-sprintec ...........................................25tri-mili ......................................................25tri-nymyo .................................................25tri-previfem ..............................................25tri-sprintec ...............................................25tri-vylibra lo ..............................................25tri-vylibra .................................................25triamcinolone acetonide external aerosol solution .......................................19triamcinolone acetonide external cream ...19triamcinolone acetonide external lotion....19triamcinolone acetonide external ointment 0.025 %, 0.1 %, 0.5 % ............19triamcinolone acetonide mouth/throat .....18triamcinolone acetonide suspension 40 mg/ml injection ...................................23triamterene oral .......................................17triamterene-hctz ......................................17triazolam .................................................14triderm ....................................................19trientine hcl .............................................21trifluoperazine hcl ....................................13trifluridine ................................................29trihexyphenidyl hcl ...................................13TRIJARDY XR ............................................19trimethobenzamide hcl oral .....................10trimethoprim oral .......................................8trimipramine maleate oral ..........................9TRIUMEQ .................................................14trivora (28) ...............................................25trospium chloride er .................................22trospium chloride .....................................22TRUE METRIX BLOOD GLUCOSE TEST ......20TRULICITY ................................................19TRUMENBA ..............................................27TUDORZA PRESSAIR .................................31tulana ......................................................25TWINRIX ..................................................27tyblume ...................................................25TYBOST ...................................................14tydemy ....................................................25TYMLOS ..................................................28TYPHIM VI ...............................................27UBRELVY ..................................................10ULTIGUARD SAFEPACK SYR/NEEDLE .........20unithroid ..................................................26ursodiol oral capsule 300 mg ...................22ursodiol oral tablet ...................................22V-GO 20 ..................................................20V-GO 30 ..................................................20V-GO 40 ..................................................20valacyclovir hcl oral ..................................14valganciclovir hcl ......................................14

44

valproate sodium intravenous ....................9valproic acid oral ........................................9valrubicin .................................................12valsartan-hydrochlorothiazide...................17valsartan ..................................................17vancomycin hcl in dextrose intravenous solution 1-5 gm/200ml-%, 500-5 mg/100ml-%, 750-5 mg/150ml-% ...................................8vancomycin hcl in nacl intravenous solution 1-0.9 gm/200ml-%, 500-0.9 mg/100ml-% .............................................8vancomycin hcl in nacl solution 750-0.9 mg/150ml-% intravenous ....................8vancomycin hcl intravenous .......................8vancomycin hcl oral ...................................8vandazole ..................................................8VAQTA .....................................................27VARIVAX ..................................................27VASCEPA .................................................17VAXCHORA .............................................27VAXELIS ...................................................27VAXNEUVANCE .......................................27vecuronium bromide intravenous solution reconstituted ..............................17VELCADE .................................................12velivet ......................................................25venlafaxine hcl er .......................................9venlafaxine hcl ...........................................9verapamil hcl er .......................................17verapamil hcl intravenous .........................17verapamil hcl oral .....................................17vestura .....................................................25VICTOZA ..................................................19vienva ......................................................26vigabatrin ..................................................9vigadrone ..................................................9vinblastine sulfate ....................................12vincristine sulfate .....................................12vinorelbine tartrate ..................................12viorele ......................................................26VIRACEPT ................................................14VIREAD ORAL POWDER ...........................14VIREAD ORAL TABLET 150 MG, 200 MG, 250 MG ...........................................14virt-phos 250 neutral ...............................21virtussin ac w/alc ......................................30vitamin d (ergocalciferol) oral capsule 1.25 mg (50000 ut) .................................21vitamin k1 injection ..................................21volnea ......................................................26voriconazole intravenous ..........................10voriconazole oral ......................................10VORTEX VALVED HOLDING CHAMBER .....29VOSEVI ....................................................14VUMERITY ...............................................17vyfemla ....................................................26vylibra ......................................................26VYVANSE .................................................17warfarin sodium oral ..................................8water for irrigation, sterile ........................21wera ........................................................26WILATE ....................................................14WINRHO SDF ...........................................27wixela inhub ............................................31

wymzya fe ...............................................26XARELTO STARTER PACK ............................8XARELTO ...................................................8XELJANZ XR .............................................27XELJANZ ..................................................27XGEVA .....................................................28XIAFLEX ...................................................29XIGDUO XR .............................................19XIIDRA .....................................................30XOFIGO ...................................................12XOLAIR ....................................................30XTAMPZA ER .............................................5xulane ......................................................26XYNTHA SOLOFUSE .................................14XYNTHA ..................................................14YERVOY...................................................12YF-VAX ....................................................27yuvafem ...................................................26zafemy .....................................................26zafirlukast ................................................31zaleplon ...................................................32ZALTRAP ..................................................12ZANOSAR ................................................12zarah .......................................................26ZARXIO ....................................................14ZEGALOGUE ............................................20ZEJULA ....................................................12zenatane ..................................................19ZENPEP ....................................................22zidovudine ...............................................14zileuton er ...............................................31ziprasidone hcl .........................................13ziprasidone mesylate ................................13ZIRABEV ...................................................12ZOLADEX SUBCUTANEOUS IMPLANT 3.6 MG ....................................................23zoledronic acid .........................................28ZOLINZA ..................................................12zolmitriptan oral ......................................10zolmitriptan solution 5 mg nasal ..............10zolpidem tartrate er .................................32zolpidem tartrate .....................................32zonisamide oral ..........................................9zovia 1/35 (28) .........................................26zovia 1/35e (28) .......................................26ZUBSOLV ...................................................6zumandimine ...........................................26

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