rx drug list - bcbstx

41722-K TX HIM © Prime Therapeutics LLC 10/15

Contents

Introduction .................................................................... I How drugs are selected ................................................... I How member payment is determined .............................. I How to use this list .......................................................... II Drugs used to treat multiple conditions .......................... II Generic drugs ................................................................. II Consider talking to your doctor about generic

drugs ........................................................................... II Coverage considerations ............................................... III Specialty drugs .............................................................. IV Prime Therapeutics Specialty Pharmacy

program ...................................................................... IV Abbreviation key ............................................................. V

Therapeutic Class Drug List ........................................ 1 Anti-Infective Agents ....................................................... 1 Biologicals ..................................................................... 12 Antineoplastic Agents ................................................... 16 Endocrine and Metabolic Drugs ................................... 19 Cardiovascular Agents .................................................. 39 Respiratory Agents ....................................................... 58 Gastrointestinal Agents ................................................. 65 Genitourinary Agents .................................................... 72 Central Nervous System Drugs .................................... 75 Analgesics and Anesthetics .......................................... 93 Neuromuscular Drugs ................................................. 106 Nutritional Products .................................................... 115 Hematological Agents ................................................. 128 Topical Products ......................................................... 137 Miscellaneous Products .............................................. 162 Index ........................................................................... 166

Please consider talking to your doctor about prescribing preferred medications, which may help reduce your out-of-pocket costs. This list may help guide you and your doctor in selecting an appropriate medication for you.

The drug list is regularly updated. Please visit bcbstx.com for the most up-to-date information.

To find a contracting pharmacy, please access the link below: https://www.myprime.com/content/myprime/en/find-pharmacy/find-pharmacy-results.html

To search for a drug name within this PDF document, use the Control and F keys on your keyboard, or go to Edit in the drop-down menu and select Find/Search. Type in the word or phrase you are looking for and click on Search.

October 2015 Health Insurance Marketplace Generics Plus Drug List

https://www.myprime.com/content/myprime/en/find-pharmacy/find-pharmacy-results.html

BCBSTX Health Insurance Marketplace 5 Tier Generics Plus Preferred Drug List October 2015 I

Introduction

Members are encouraged to show this list to their physicians and pharmacists. Physicians are encouraged to prescribe drugs on this list, when right for the member. However decisions regarding therapy and treatment are always between members and their physician.

Drug lists updates – This list is regularly updated as generic drugs become available and changes take place in the pharmaceuticals market. For the most up-to-date information, visit bcbstx.com and log in to Blue Access for MembersSM or call the number on the back of your ID card. Physicians can access the list from the provider portal at bcbstx.com.

How drugs are selected

Drugs on this list are selected based on the recommendations of a committee made up of physicians and pharmacists from throughout the country. The committee, which includes at least one representative from BCBSTX, reviews drugs regulated by the U.S. Food and Drug Administration (FDA).

Both drugs that are newly approved by the FDA as well as those that have been on the market for some time are considered. Drugs are selected based on safety, efficacy, cost and how they compare to other drugs currently on the list.

How member payment is determined

This list shows prescription drug products in tiers. Generally, each drug is placed into one of five member payment tiers: Preferred Generic (Tier 1), Non-preferred Generic (Tier 2), Preferred Brand (Tier 3), Non-preferred Brand (Tier 4) and Specialty (Tier 5). To verify your payment amount for a drug, visit bcbstx.com and log in to Blue Access for Members or call the number on the back of your ID card.

Your pharmacy benefit includes coverage for many prescription drugs, although some exclusions may apply. Generally, if a drug is not listed on the drug list it is not covered. For example, drugs indicated for cosmetic purposes, e.g., Propecia, for hair growth, may not be covered. Drugs that are not FDA-approved for self-administration may be available through your medical benefit.

Some drugs may have limited or $0 member cost-sharing (co-pay or co-insurance) under the Affordable Care Act. Examples of these drug categories include aspirin, breast cancer preventive, fluoride supplements, folic acid supplements, gonorrhea prophylaxis (newborn), iron supplements, tobacco cessation, vaccines, vitamin D supplements, and some contraceptive drugs and devices. Call the customer service number on the back of your ID card to find out if the drug is available over-the-counter or is covered under your medical benefit.

BCBSTX Health Insurance Marketplace 5 Tier Generics Plus Preferred Drug List October 2015 II

How to use this list

Generic drugs are shown in lower-case boldface type. Most generic drugs are followed by a reference brand drug in (parentheses). Some generic products have no reference brand.

Example: atorvastatin (Lipitor – brand is NF)

Brand prescription drugs are shown in capital letters followed by the generic name.

Drugs used to treat multiple conditions

Some drugs in the same dosage form may be used to treat more than one medical condition. In these instances, each medication is classified according to its first FDA-approved use. Please check the index if you do not find your particular medication in the class/condition section that corresponds to your use.

Generic drugs

Using generic drugs, when right for you, can help you save on your out-of-pocket medication costs. Generic drugs must be approved by the FDA just as brand drugs are, and must meet the same standards.

There are two types of generic drugs:

• A generic equivalent is made with the same active ingredient(s) at the same dosage as the reference drug.

• A generic alternative is a drug typically used to treat the same condition, but the active ingredient(s)differs from the brand drug.

According to the FDA, compared to its brand counterpart, an FDA-approved generic drug:

• Is chemically the same

• Works just as well in the body

• Is as safe and effective

• Meets the same standards set by the FDA

The main difference between the reference brand drug and the generic equivalent is that the generic often costs much less.

Preferred brand drugs typically move to a non-preferred brand tier after a generic equivalent becomes available. You may be responsible for the brand member payment amount plus the difference in cost between the brand and generic equivalent if you or your doctor requests the reference brand rather than the generic. Generic drugs have the lowest member payment amount.

Consider talking to your doctor about generic drugs

If your doctor writes a prescription for a brand drug that does not have a generic equivalent, consider asking if an appropriate generic alternative is available.

You can also let your pharmacist know that you would like a generic equivalent for a brand drug, whenever one is available. Your pharmacist can usually substitute a generic equivalent for its brand counterpart without a new prescription from your doctor.

Only your doctor can determine whether a generic alternative is right for you and must prescribe the medication.

BCBSTX Health Insurance Marketplace 5 Tier Generics Plus Preferred Drug List October 2015 III

Coverage considerations

Most prescription drug benefit plans provide coverage for up to a 30-day supply of medication, with some exceptions. Your plan may also provide coverage for up to a 90-day supply of maintenance medications. Maintenance medications are those drugs you may take on an ongoing basis for conditions such as high blood pressure, diabetes or high cholesterol.

Over-the-counter exclusions: Your benefit plan does not provide coverage for prescription medications that have an over-the-counter version. You should refer to your benefit plan materials for details about your particular benefits.

Compounded medications: Your benefit plan does not provide coverage for compounded medications. Please see your plan materials or call the number on the back of your ID card to determine whether compounded medications are covered and/or verify your payment amount.

Repackaged medications: Repackaged versions of medications already available on the market are not covered.

Prior Authorization (PA): Your benefit plan may require prior authorization for certain drugs. This means that your doctor will need to submit a prior authorization request for coverage of these medications, and the request will need to be approved, before the medication will be covered under your plan. For the preferred medications listed in this document, if a prior authorization is commonly required, it will be noted next to the medication with a dot under the prior authorization column. Some plans may have prior authorization on additional medications beyond those noted in this document.

Step Therapy (ST): Your benefit plan may include a step therapy program. This means you may need to try another proven, cost-effective medication before coverage may be available for the drug included in the program. Many brand drugs have less-expensive generic or brand alternatives that might be an option for you. For the preferred medications listed in this document, if a step therapy is commonly required it will generally be noted next to the medication with a dot under the step therapy column. Some plans may have step therapy programs on additional medications beyond those noted in this document.

Dispensing Limits (DL): Drug Dispensing limits are designed to help encourage medication use as intended by the FDA. Coverage limits are placed on medications in certain drug categories. For the preferred medications listed in this document, if a dispensing limit applies, it will generally be noted next to the medication with a dot under the dispensing limits column. Limits may include: quantity of covered medication per prescription, quantity of covered medication in a given time period, coverage only for members within a certain age range, and coverage only for members of a specific gender. If your doctor prescribes a greater quantity of medication than what the dispensing limit allows, you can still get the medication. However, you will be responsible for the full cost of the prescription beyond what your coverage allows.* For a list of medications and their dispensing limits, visit bcbstx.com.

*Please note: For certain controlled substance medications, some state laws may not allow coverage by a health benefit plan of such medication if dispensed in a quantity beyond what the dispensing limit allows. You will be responsible for the full cost of the prescription with no benefits applied if the dispensed quantity exceeds the dispensing limit.

Remember, medication decisions are between you and your doctor. Only you and your doctor can determine which medication is right for you. Discuss any questions or concerns you have about medications you are taking or are prescribed with your doctor. BCBSTX does not provide health care services and, therefore, cannot guarantee any results or outcomes.

BCBSTX Health Insurance Marketplace 5 Tier Generics Plus Preferred Drug List October 2015 IV

Specialty drugs

Specialty drugs are used in the treatment of medical conditions such as hepatitis, hemophilia, multiple sclerosis and rheumatoid arthritis. Specialty drugs may be oral, topical, or injectable medications that can either be self-administered or administered by a health care professional. For a current list of specialty medications, visit myprime.com or bcbstx.com and log in to Blue Access for Members.

Note that some drug classes may be excluded by some plans and therefore may not be covered under your pharmacy benefit. Your plan may have a different coverage level for self-administered specialty drugs. If you have questions about your coverage for specialty medications or your prescription drug benefit, call the number on the back of your ID card.

Prime Therapeutics Specialty Pharmacy Program

Through Prime Therapeutics Specialty Pharmacy, members can have covered specialty medications delivered directly to them or their doctor’s office. When you receive specialty medications through Prime, you also receive at no additional charge the following services:

• Coordination of coverage between you, your doctor and your health plan

• Educational materials about your particular condition and information about managing potential medication side effects

• Syringes, sharps containers and other supplies with every shipment for self-injectables

• 24/7/365 phone access to a pharmacist for urgent medication issues

To order through Prime Therapeutics Specialty Pharmacy:

• Have your doctor call or fax your prescription to Prime Therapeutics Specialty Pharmacy. Your doctor can call 877-627-6337 or fax to 877-828-3939.

• If you have an existing prescription for a covered specialty medication, you can call 877-627-6337 to transfer your prescription.

• A Prime Therapeutics coordinator will contact you to arrange delivery of your medication.

• The prescription can be shipped directly to you or your prescribing doctor’s office. Each package is individually marked for each member. Refrigerated drugs are shipped in temperature-controlled packaging.

If you have questions, please contact Prime Therapeutics Specialty Pharmacy at 877-627-6337, visit www.PrimeTherapeutics.com/specialty, or call the number on the back of your ID card.

• Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (“HCSC”). HCSC is an independent licensee of the Blue Cross Blue Shield Association. HCSC contracts with Prime Therapeutics to provide pharmacy benefit management and mail order pharmacy services and to administer this specialty pharmacy program. HCSC, as well as several other independent Blue Cross and Blue Shield licensees, has an ownership interest in Prime Therapeutics LLC.

BCBSTX Health Insurance Marketplace 5 Tier Generics Plus Preferred Drug List October 2015 V

Abbreviation key

cap ...................................................................... capsules chew .................................................................. chewable conc ............................................................. concentrate cr .......................................................... controlled release dr ............................................................. delayed release ec ................................................................ enteric coated effe................................................................. effervescent equiv ................................................................ equivalent er ........................................................... extended release inhal................................................................... inhalation inj ......................................................................... injection liq .............................................................................. liquid lotn ........................................................................... lotion nebu ................................................................... nebulizer

odt ............................................. orally disintegrating tabs oint ..................................................................... ointment ophth ................................................................. opthalmic osm .......................................................... osmotic release powd ..................................................................... powder sa ............................................................ sustained action sl ...................................................................... sublingual soln ....................................................................... solution sr .......................................................... sustained release suppos ........................................................ suppositories susp ................................................................ suspension tab ...........................................................................tablets td ................................................................... transdermal

You, or your prescribing health care provider, can ask for a Drug List exception if your drug is not on the Drug List (also known as a formulary). To request this exception, you, or your prescriber, can call the number on the back of your ID card to ask for a review. If you have a health condition that may jeopardize your life, health or keep you from regaining function, or your current drug therapy uses a non-covered drug, you, or your prescriber, may be able to ask for an expedited review process. BCBSTX will let you, and your prescriber, know the coverage decision within 24 hours after they receive your request for an expedited review. If the coverage request is denied, BCBSTX will let you and your prescriber know why it was denied and offer you a covered alternative drug (if applicable). Call the number on the back of your ID card if you have any questions.

2015

BCBSTX Health Insurance Marketplace 5 Tier Generics Plus Preferred Drug List October 2015 1

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ANTI-INFECTIVE AGENTS

PENICILLINS

AMOXICILLIN - amoxicillin (trihydrate)chew tab 125 mg

4

AMOXICILLIN - amoxicillin (trihydrate)chew tab 250 mg

4

amoxicillin (trihydrate) cap 250 mg 1

amoxicillin (trihydrate) cap 500 mg 1

amoxicillin (trihydrate) for susp125 mg/5ml

1


1


1


1

amoxicillin (trihydrate) tab 500 mg 1

amoxicillin (trihydrate) tab 875 mg 1

amoxicillin & k clavulanate chew tab200-28.5 mg

2

amoxicillin & k clavulanate chew tab400-57 mg

2

amoxicillin & k clavulanate for susp200-28.5 mg/5ml

2

amoxicillin & k clavulanate for susp250-62.5 mg/5ml (Augmentin)

2

amoxicillin & k clavulanate for susp400-57 mg/5ml

2

amoxicillin & k clavulanate for susp600-42.9 mg/5ml (Augmentin es-600)

2

amoxicillin & k clavulanate tab sr12hr 1000-62.5 mg (Augmentin xr)

2

amoxicillin & k clavulanate tab250-125 mg

2

amoxicillin & k clavulanate tab500-125 mg (Augmentin)

2

amoxicillin & k clavulanate tab875-125 mg (Augmentin)

2

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AMOXICILLIN ER - amoxicillin(trihydrate) tab sr 24hr 775 mg

4

AMPICILLIN - ampicillin for susp 125mg/5ml

4

AMPICILLIN - ampicillin for susp 250mg/5ml

4

ampicillin cap 250 mg 1

ampicillin cap 500 mg 1

AUGMENTIN - amoxicillin & kclavulanate tab 500-125 mg

4

AUGMENTIN - amoxicillin & kclavulanate tab 875-125 mg

4

AUGMENTIN - amoxicillin & kclavulanate for susp 125-31.25mg/5ml

4

AUGMENTIN - amoxicillin & kclavulanate for susp 250-62.5 mg/5ml

4

AUGMENTIN ES-600 - amoxicillin & kclavulanate for susp 600-42.9 mg/5ml

4

AUGMENTIN XR - amoxicillin & kclavulanate tab sr 12hr 1000-62.5 mg

4

dicloxacillin sodium cap 250 mg 1

dicloxacillin sodium cap 500 mg 2

MOXATAG - amoxicillin (trihydrate) tabsr 24hr 775 mg

4

penicillin v potassium for soln125 mg/5ml

1

penicillin v potassium for soln250 mg/5ml

1

penicillin v potassium tab 250 mg 1

penicillin v potassium tab 500 mg 1

CEPHALOSPORINS

CEDAX - ceftibuten cap 400 mg 4

CEDAX - ceftibuten for susp 90 mg/5ml 4

CEDAX - ceftibuten for susp 180mg/5ml

4

CEFACLOR - cefaclor for susp 125mg/5ml

4

2015

2 BCBSTX Health Insurance Marketplace 5 Tier Generics Plus Preferred Drug List October 2015

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4

cefaclor cap 250 mg 2

cefaclor cap 500 mg 2

CEFACLOR ER - cefaclor monohydratetab sr 12hr 500 mg

4

cefadroxil cap 500 mg 1

cefadroxil for susp 250 mg/5ml 2

cefadroxil for susp 500 mg/5ml 2

cefadroxil tab 1 gm 2

cefdinir cap 300 mg 2

cefdinir for susp 125 mg/5ml 2

cefdinir for susp 250 mg/5ml 2

CEFDITOREN PIVOXIL - cefditorenpivoxil tab 200 mg (base equivalent)

4

CEFDITOREN PIVOXIL - cefditorenpivoxil tab 400 mg (base equivalent)

4

cefixime for susp 100 mg/5ml(Suprax)

2

cefixime for susp 200 mg/5ml(Suprax)

2

cefpodoxime proxetil for susp50 mg/5ml

2

cefpodoxime proxetil for susp100 mg/5ml

2

cefpodoxime proxetil tab 100 mg 2

cefpodoxime proxetil tab 200 mg 2

cefprozil for susp 125 mg/5ml 2

cefprozil for susp 250 mg/5ml 2

cefprozil tab 250 mg 2

cefprozil tab 500 mg 2

CEFTIBUTEN - ceftibuten cap 400 mg 4

CEFTIBUTEN - ceftibuten for susp 180mg/5ml

4

CEFTIN - cefuroxime axetil tab 250 mg 4

CEFTIN - cefuroxime axetil tab 500 mg 4

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CEFTIN - cefuroxime axetil for susp 125mg/5ml

3

CEFTIN - cefuroxime axetil for susp 250mg/5ml

4

cefuroxime axetil tab 250 mg (Ceftin) 1

cefuroxime axetil tab 500 mg (Ceftin) 1

CEPHALEXIN - cephalexin tab 250 mg 4

CEPHALEXIN - cephalexin tab 500 mg 4

cephalexin cap 250 mg (Keflex) 1



cephalexin for susp 125 mg/5ml 1

cephalexin for susp 250 mg/5ml 1

KEFLEX - cephalexin cap 250 mg 4



SPECTRACEF - cefditoren pivoxil tab200 mg (base equivalent)

4

SPECTRACEF - cefditoren pivoxil tab400 mg (base equivalent)

4

SUPRAX - cefixime cap 400 mg 4

SUPRAX - cefixime chew tab 100 mg 4

SUPRAX - cefixime chew tab 200 mg 4

SUPRAX - cefixime for susp 100mg/5ml

4


4


4

MACROLIDES

AZITHROMYCIN - azithromycin powdpack for susp 1 gm

4

azithromycin for susp 100 mg/5ml(Zithromax)

2

azithromycin for susp 200 mg/5ml(Zithromax)

1

azithromycin tab 250 mg (Zithromax) 1 •azithromycin tab 500 mg (Zithromax) 1 •

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azithromycin tab 600 mg (Zithromax) 2 •BIAXIN - clarithromycin for susp 250

mg/5ml4

BIAXIN - clarithromycin tab 250 mg 4

BIAXIN - clarithromycin tab 500 mg 4

BIAXIN XL - clarithromycin tab sr 24hr500 mg

4 •

BIAXIN XL PAC - clarithromycin tab sr24hr 500 mg

4 •

clarithromycin for susp 125 mg/5ml 2

clarithromycin for susp 250 mg/5ml(Biaxin)

2

clarithromycin tab sr 24hr 500 mg(Biaxin xl pac)

2 •

clarithromycin tab 250 mg (Biaxin) 2

clarithromycin tab 500 mg (Biaxin) 2

DIFICID - fidaxomicin tab 200 mg 4

E.E.S. GRANULES - erythromycinethylsuccinate for susp 200 mg/5ml

4

E.E.S. 400 - erythromycinethylsuccinate tab 400 mg

4

ERY-TAB - erythromycin tab delayedrelease 250 mg

4


4


4

ERYPED 200 - erythromycinethylsuccinate for susp 200 mg/5ml

4

ERYPED 400 - erythromycinethylsuccinate for susp 400 mg/5ml

4

ERYTHROCIN STEARATE -erythromycin stearate tab 250 mg

4

ERYTHROMYCIN BASE - erythromycintab 250 mg

4

ERYTHROMYCIN BASE - erythromycintab 500 mg

4

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ERYTHROMYCIN ETHYLSUCCINA -erythromycin ethylsuccinate tab 400mg

4

erythromycin w/ delayed releaseparticles cap 250 mg

2

PCE - erythromycin w/ enteric coatedparticles tab 333 mg

4

PCE - erythromycin w/ enteric coatedparticles tab 500 mg

4

ZITHROMAX - azithromycin tab 250 mg 4 •ZITHROMAX - azithromycin tab 500 mg 4 •ZITHROMAX - azithromycin tab 600 mg 4 •ZITHROMAX - azithromycin for susp

100 mg/5ml4

ZITHROMAX - azithromycin for susp200 mg/5ml

4

ZITHROMAX - azithromycin powd packfor susp 1 gm

4

ZITHROMAX TRI-PAK - azithromycintab 500 mg

4 •

ZITHROMAX Z-PAK - azithromycin tab250 mg

4 •

ZMAX - azithromycin extended releasefor oral susp 2 gm

4

TETRACYCLINES

ACTICLATE - doxycycline hyclate tab75 mg

4 •

ACTICLATE - doxycycline hyclate tab150 mg

4 •

ADOXA - doxycycline monohydrate cap150 mg

4 •

ADOXA - doxycycline monohydrate tab50 mg

4 •


4 •


4 •

ADOXA PAK 1/100 - doxycyclinemonohydrate tab 100 mg

4 •

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4 •

AVIDOXY DK - doxycycline tab 100 mg& suncreen & sal acid wash 2% kit

4 •

demeclocycline hcl tab 150 mg 2

demeclocycline hcl tab 300 mg 2

DORYX - doxycycline hyclate tabdelayed release 50 mg

4 •

DORYX - doxycycline hyclate tabdelayed release 200 mg

4 •

doxycycline hyclate cap 50 mg 2

doxycycline hyclate cap 100 mg(Vibramycin)

2

doxycycline hyclate tab delayedrelease 75 mg

2 •

doxycycline hyclate tab delayedrelease 100 mg

2 •

doxycycline hyclate tab delayedrelease 150 mg (Doryx)

2 •

doxycycline hyclate tab 20 mg 2

doxycycline hyclate tab 100 mg 2

doxycycline monohydrate cap 50 mg 2

doxycycline monohydrate cap 75 mg(Monodox)

2

doxycycline monohydrate cap100 mg (Monodox)

2

doxycycline monohydrate cap150 mg (Adoxa)

2

doxycycline monohydrate for susp25 mg/5ml (Vibramycin)

2

doxycycline monohydrate tab 50 mg(Adoxa)

2

doxycycline monohydrate tab 75 mg(Adoxa)

2

doxycycline monohydrate tab100 mg (Adoxa pak 1/100)

2

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doxycycline monohydrate tab150 mg (Adoxa pak 1/150)

2

MINOCIN - minocycline hcl cap 50 mg 4 •MINOCIN - minocycline hcl cap 75 mg 4 •MINOCIN - minocycline hcl cap 100 mg 4 •MINOCIN KIT - minocycline hcl cap 50

mg w/ acne care products kit4 •

MINOCIN KIT - minocycline hcl cap 100mg w/ acne care products kit

4 •

minocycline hcl cap 50 mg (Minocin) 1



minocycline hcl tab sr 24hr 45 mg 2 •minocycline hcl tab sr 24hr 90 mg 2 •minocycline hcl tab sr 24hr 135 mg 2 •minocycline hcl tab 50 mg 2

minocycline hcl tab 75 mg 2

minocycline hcl tab 100 mg 2

MONODOX - doxycycline monohydratecap 75 mg

4 •

MONODOX - doxycycline monohydratecap 100 mg

4 •

MORGIDOX 1X100MG - doxycyclinehyclate cap 1 x 100 mg w/ cleanserkit

4 •

MORGIDOX 2X100MG - doxycyclinehyclate cap 2 x 100 mg w/ cleanserkit

4 •

NUTRIDOX - doxycycline monohyd cap75 mg w/ omega 3-vit e cap kit

4 •

SOLODYN - minocycline hcl tab sr 24hr55 mg

4 •


4 •


4 •


4 •

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TARGADOX - doxycycline hyclate tab50 mg

4 •

TETRACYCLINE HCL - tetracycline hclcap 250 mg

4

TETRACYCLINE HCL - tetracycline hclcap 500 mg

4

VIBRAMYCIN - doxycyclinemonohydrate for susp 25 mg/5ml

4 •

VIBRAMYCIN - doxycycline calciumsyrup 50 mg/5ml

4 •

VIBRAMYCIN - doxycycline hyclate cap100 mg

4 •

FLUOROQUINOLONES

AVELOX - moxifloxacin hcl tab 400 mg(base equiv)

4

AVELOX ABC PACK - moxifloxacin hcltab 400 mg (base equiv)

4

CIPRO - ciprofloxacin for oral susp 250mg/5ml (5%) (5 gm/100ml)

4

CIPRO - ciprofloxacin for oral susp 500mg/5ml (10%) (10 gm/100ml)

4

CIPRO - ciprofloxacin hcl tab 250 mg(base equiv)

4

CIPRO - ciprofloxacin hcl tab 500 mg(base equiv)

4

CIPRO XR - ciprofloxacin-ciprofloxacinhcl tab sr 24hr 500 mg (base eq)

4

CIPRO XR - ciprofloxacin-ciprofloxacinhcl tab sr 24hr 1000 mg(base eq)

4

ciprofloxacin for oral susp250 mg/5ml (5%) (5 gm/100ml)(Cipro)

2

ciprofloxacin for oral susp500 mg/5ml (10%) (10 gm/100ml)(Cipro)

2

CIPROFLOXACIN HCL - ciprofloxacinhcl tab 100 mg (base equiv)

2

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ciprofloxacin hcl tab 250 mg (baseequiv) (Cipro)

1

ciprofloxacin hcl tab 500 mg (baseequiv) (Cipro)

1

ciprofloxacin hcl tab 750 mg (baseequiv)

1

ciprofloxacin-ciprofloxacin hcl tab sr24hr 500 mg (base eq) (Cipro xr)

2

ciprofloxacin-ciprofloxacin hcl tab sr24hr 1000 mg(base eq) (Cipro xr)

2

FACTIVE - gemifloxacin mesylate tab320 mg (base equiv)

4

LEVAQUIN - levofloxacin oral soln 25mg/ml

4

LEVAQUIN - levofloxacin tab 250 mg 4



levofloxacin oral soln 25 mg/ml(Levaquin)

2

levofloxacin tab 250 mg (Levaquin) 1



moxifloxacin hcl tab 400 mg (baseequiv) (Avelox)

2

OFLOXACIN - ofloxacin tab 400 mg 4

AMINOGLYCOSIDES

BETHKIS - tobramycin nebu soln 300mg/4ml

5 • •

KITABIS PAK - tobramycin nebu soln300 mg/5ml

5 • •

neomycin sulfate tab 500 mg 1

paromomycin sulfate cap 250 mg 2

TOBI - tobramycin nebu soln 300mg/5ml

5 • •

TOBI PODHALER - tobramycin inhalcap 28 mg

5 • •

tobramycin nebu soln 300 mg/5ml(Tobi)

5 • •

SULFONAMIDES

2015


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SULFADIAZINE - sulfadiazine tab 500mg

4

ANTIMYCOBACTERIAL AGENTS

CYCLOSERINE - cycloserine cap 250mg

4

ethambutol hcl tab 100 mg(Myambutol)

2

ethambutol hcl tab 400 mg(Myambutol)

2

ISONIAZID - isoniazid syrup 50 mg/5ml 4

isoniazid tab 100 mg 1

isoniazid tab 300 mg 1

MYAMBUTOL - ethambutol hcl tab 100mg

4

MYAMBUTOL - ethambutol hcl tab 400mg

4

MYCOBUTIN - rifabutin cap 150 mg 4

PASER - aminosalicylic acid cr granulespacket 4 gm

4

PRIFTIN - rifapentine tab 150 mg 3

pyrazinamide tab 500 mg 2

rifabutin cap 150 mg (Mycobutin) 2

RIFADIN - rifampin cap 150 mg 4

RIFADIN - rifampin cap 300 mg 4

RIFAMATE - isoniazid & rifampin cap150-300 mg

4

rifampin cap 150 mg (Rifadin) 2

rifampin cap 300 mg (Rifadin) 2

RIFATER - isoniazid-rifampin w/pyrazinamide tab 50-120-300 mg

4

SEROMYCIN - cycloserine cap 250 mg 4

SIRTURO - bedaquiline fumarate tab100 mg (base equiv)

4

TRECATOR - ethionamide tab 250 mg 4

ANTIFUNGALS

ANCOBON - flucytosine cap 250 mg 4

ANCOBON - flucytosine cap 500 mg 4

BIO-STATIN - nystatin cap 500000 unit 4

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BIO-STATIN - nystatin cap 1000000 unit 4

CRESEMBA - isavuconazonium sulfatecap 186 mg

4

DIFLUCAN - fluconazole tab 50 mg 4




DIFLUCAN - fluconazole for susp 10mg/ml

4

DIFLUCAN - fluconazole for susp 40mg/ml

4

fluconazole for susp 10 mg/ml(Diflucan)

1

fluconazole for susp 40 mg/ml(Diflucan)

2

fluconazole tab 50 mg (Diflucan) 1




flucytosine cap 250 mg (Ancobon) 2

flucytosine cap 500 mg (Ancobon) 2

GRIFULVIN V - griseofulvin microsizetab 500 mg

4

GRIS-PEG - griseofulvin ultramicrosizetab 125 mg

4

GRIS-PEG - griseofulvin ultramicrosizetab 250 mg

4

griseofulvin microsize susp125 mg/5ml

2

griseofulvin microsize tab 500 mg(Grifulvin v)

2

griseofulvin ultramicrosize tab125 mg (Gris-peg)

2

griseofulvin ultramicrosize tab250 mg (Gris-peg)

2

itraconazole cap 100 mg (Sporanox) 2

ketoconazole tab 200 mg 1

LAMISIL - terbinafine hcl tab 250 mg 4

2015


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LAMISIL - terbinafine hcl oral granulespacket 125 mg

4

LAMISIL - terbinafine hcl oral granulespacket 187.5 mg

4

NOXAFIL - posaconazole tab delayedrelease 100 mg

4 •

NOXAFIL - posaconazole susp 40 mg/ml

3 •

nystatin oral powder 2

nystatin tab 500000 unit 2

ONMEL - itraconazole tab 200 mg 4

SPORANOX - itraconazole oral soln 10mg/ml

4

SPORANOX - itraconazole cap 100 mg 4

SPORANOX PULSEPAK - itraconazolecap 100 mg

4

terbinafine hcl tab 250 mg (Lamisil) 1

VFEND - voriconazole for susp 40 mg/ml

4 •

VFEND - voriconazole tab 50 mg 4 •VFEND - voriconazole tab 200 mg 4 •voriconazole for susp 40 mg/ml

(Vfend)2 •

voriconazole tab 50 mg (Vfend) 2 •voriconazole tab 200 mg (Vfend) 2 •ANTIVIRALS

abacavir sulfate tab 300 mg (baseequiv) (Ziagen)

2 •

abacavir sulfate-lamivudine-zidovudine tab 300-150-300 mg(Trizivir)

2 •

acyclovir cap 200 mg (Zovirax) 1

acyclovir susp 200 mg/5ml (Zovirax) 2

acyclovir tab 400 mg (Zovirax) 1

acyclovir tab 800 mg (Zovirax) 1

adefovir dipivoxil tab 10 mg(Hepsera)

2

APTIVUS - tipranavir cap 250 mg 3 •

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APTIVUS - tipranavir oral soln 100 mg/ml

3 •

ATRIPLA - efavirenz-emtricitabine-tenofovir df tab 600-200-300 mg

3 •

BARACLUDE - entecavir oral soln 0.05mg/ml

3

BARACLUDE - entecavir tab 0.5 mg 3

BARACLUDE - entecavir tab 1 mg 3

COMBIVIR - lamivudine-zidovudine tab150-300 mg

4 •

COMPLERA - emtricitabine-rilpivirine-tenofovir df tab 200-25-300 mg

4 •

COPEGUS - ribavirin tab 200 mg 5 •CRIXIVAN - indinavir sulfate cap 200

mg3 •

CRIXIVAN - indinavir sulfate cap 400mg

3 •

DAKLINZA - daclatasvir dihydrochloridetab 30 mg (base equivalent)

5 •

DAKLINZA - daclatasvir dihydrochloridetab 60 mg (base equivalent)

5 •

didanosine delayed release capsule125 mg (Videx ec)

2 •


2 •


2 •


2 •

EDURANT - rilpivirine hcl tab 25 mg(base equivalent)

4 •

EMTRIVA - emtricitabine caps 200 mg 3 •EMTRIVA - emtricitabine soln 10 mg/ml 3 •entecavir tab 0.5 mg (Baraclude) 2

entecavir tab 1 mg (Baraclude) 2

EPIVIR - lamivudine tab 150 mg 4 •EPIVIR - lamivudine tab 300 mg 4 •EPIVIR - lamivudine oral soln 10 mg/ml 3 •

2015


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EPIVIR HBV - lamivudine tab 100 mg(hbv)

4

EPIVIR HBV - lamivudine oral soln 5mg/ml (hbv)

4

EPZICOM - abacavir sulfate-lamivudinetab 600-300 mg

3 •

EVOTAZ - atazanavir sulfate-cobicistattab 300-150 mg (base equiv)

5 •

famciclovir tab 125 mg (Famvir) 2



FAMVIR - famciclovir tab 125 mg 4



FLUMADINE - rimantadinehydrochloride tab 100 mg

4

FUZEON - enfuvirtide for inj 90 mg 5 • •HARVONI - ledipasvir-sofosbuvir tab

90-400 mg5 •

HEPSERA - adefovir dipivoxil tab 10 mg 4

INTELENCE - etravirine tab 25 mg 3 •INTELENCE - etravirine tab 100 mg 3 •INTELENCE - etravirine tab 200 mg 3 •INVIRASE - saquinavir mesylate cap

200 mg3 •

INVIRASE - saquinavir mesylate tab500 mg

3 •

ISENTRESS - raltegravir potassium tab400 mg (base equiv)

3 •

ISENTRESS - raltegravir potassiumpacket for susp 100 mg (base equiv)

3 •

ISENTRESS - raltegravir potassiumchew tab 25 mg (base equiv)

3 •

ISENTRESS - raltegravir potassiumchew tab 100 mg (base equiv)

3 •

KALETRA - lopinavir-ritonavir soln400-100 mg/5ml (80-20 mg/ml)

3 •

KALETRA - lopinavir-ritonavir tab100-25 mg

3 •

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KALETRA - lopinavir-ritonavir tab200-50 mg

3 •

lamivudine oral soln 10 mg/ml(Epivir)

2 •

lamivudine tab 100 mg (hbv) (Epivirhbv)

2

lamivudine tab 150 mg (Epivir) 2 •lamivudine tab 300 mg (Epivir) 2 •lamivudine-zidovudine tab

150-300 mg (Combivir)2 •

LEXIVA - fosamprenavir calcium tab700 mg (base equiv)

3 •

LEXIVA - fosamprenavir calcium susp50 mg/ml (base equiv)

3 •

MODERIBA - ribavirin tab 200 mg &ribavirin tab 400 mg dose pack

5 •

MODERIBA - ribavirin tab 400 mg &ribavirin tab 600 mg dose pack

5 •

MODERIBA 1200 DOSE PACK -ribavirin tab 600 mg

5 •

MODERIBA 800 DOSE PACK - ribavirintab 400 mg

5 •

NEVIRAPINE - nevirapine susp 50mg/5ml

4 •

nevirapine tab sr 24hr 400 mg(Viramune xr)

2 •

nevirapine tab 200 mg (Viramune) 2 •NORVIR - ritonavir cap 100 mg 3 •NORVIR - ritonavir tab 100 mg 3 •NORVIR - ritonavir oral soln 80 mg/ml 3 •OLYSIO - simeprevir sodium cap 150

mg (base equivalent)5 •

PEG-INTRON - peginterferon alfa-2b forinj kit 50 mcg/0.5ml

5 •


5 •


5 •

2015


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5 •

PEG-INTRON REDIPEN - peginterferonalfa-2b for inj kit 50 mcg/0.5ml

5 •


5 •


5 •


5 •

PEG-INTRON REDIPEN PAK 4 -peginterferon alfa-2b for inj kit 50mcg/0.5ml

5 •


5 •


5 •


5 •

PEGASYS - peginterferon alfa-2a inj180 mcg/ml

5 •

PEGASYS - peginterferon alfa-2a inj180 mcg/0.5ml

5 •

PEGASYS PROCLICK - peginterferonalfa-2a inj 135 mcg/0.5ml

5 •

PEGASYS PROCLICK - peginterferonalfa-2a inj 180 mcg/0.5ml

5 •

PEGINTRON - peginterferon alfa-2b forinj kit 50 mcg/0.5ml

5 •


5 •


5 •


5 •

PREZCOBIX - darunavir-cobicistat tab800-150 mg

5 •

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PREZISTA - darunavir ethanolate susp100 mg/ml (base equiv)

3 •

PREZISTA - darunavir ethanolate tab 75mg (base equiv)

3 •

PREZISTA - darunavir ethanolate tab150 mg (base equiv)

3 •


3 •


3 •

REBETOL - ribavirin cap 200 mg 5 •REBETOL - ribavirin soln 40 mg/ml 5 •RELENZA DISKHALER - zanamivir

aero powder breath activated 5 mg/blister

4 •

RESCRIPTOR - delavirdine mesylatetab 100 mg

3 •

RESCRIPTOR - delavirdine mesylatetab 200 mg

3 •

RETROVIR - zidovudine cap 100 mg 4 •RETROVIR - zidovudine syrup 10 mg/ml 4 •REYATAZ - atazanavir sulfate oral

powder packet 50 mg (base equiv)3 •

REYATAZ - atazanavir sulfate cap 150mg (base equiv)

3 •


3 •


3 •

RIBASPHERE - ribavirin tab 400 mg 5 •RIBASPHERE - ribavirin tab 600 mg 5 •RIBASPHERE RIBAPAK - ribavirin tab

400 mg5 •

RIBASPHERE RIBAPAK - ribavirin tab600 mg

5 •

RIBASPHERE RIBAPAK - ribavirin tab200 mg & ribavirin tab 400 mg dosepack

5 •

2015


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RIBASPHERE RIBAPAK - ribavirin tab400 mg & ribavirin tab 600 mg dosepack

5 •

RIBATAB - ribavirin tab 400 mg 5 •RIBATAB - ribavirin tab 600 mg 5 •RIBATAB - ribavirin tab 400 mg &

ribavirin tab 600 mg dose pack5 •

ribavirin cap 200 mg (Rebetol) 5 •ribavirin tab 200 mg (Copegus) 5 •rimantadine hydrochloride tab

100 mg (Flumadine)2

SELZENTRY - maraviroc tab 150 mg 3 •SELZENTRY - maraviroc tab 300 mg 3 •SITAVIG - acyclovir buccal tab 50 mg 4

SOVALDI - sofosbuvir tab 400 mg 5 •stavudine cap 15 mg (Zerit) 2 •stavudine cap 20 mg (Zerit) 2 •stavudine cap 30 mg (Zerit) 2 •stavudine cap 40 mg (Zerit) 2 •stavudine for oral soln 1 mg/ml

(Zerit)2 •

STRIBILD - elvitegrav-cobicis-emtricitab-tenofov tab150-150-200-300 mg

3 •

SUSTIVA - efavirenz tab 600 mg 3 •SUSTIVA - efavirenz cap 50 mg 3 •SUSTIVA - efavirenz cap 200 mg 3 •TAMIFLU - oseltamivir phosphate for

susp 6 mg/ml (base equiv)4 •

TAMIFLU - oseltamivir phosphate cap30 mg (base equiv)

4 •


4 •


4 •

TECHNIVIE - ombitasvir-paritaprevir-ritonavir tab 12.5-75-50 mg

5 •

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TIVICAY - dolutegravir sodium tab 50mg (base equiv)

3 •

TRIUMEQ - abacavir-dolutegravir-lamivudine tab 600-50-300 mg

4 •

TRIZIVIR - abacavir sulfate-lamivudine-zidovudine tab 300-150-300 mg

4 •

TRUVADA - emtricitabine-tenofovirdisoproxil fumarate tab 200-300 mg

3 •

TYBOST - cobicistat tab 150 mg 5 •TYZEKA - telbivudine tab 600 mg 4

valacyclovir hcl tab 500 mg (Valtrex) 2

valacyclovir hcl tab 1 gm (Valtrex) 2

VALCYTE - valganciclovir hcl for soln 50mg/ml (base equiv)

3

VALCYTE - valganciclovir hcl tab 450mg (base equivalent)

2

valganciclovir hcl tab 450 mg (baseequivalent) (Valcyte)

2

VALTREX - valacyclovir hcl tab 500 mg 4

VALTREX - valacyclovir hcl tab 1 gm 4

VICTRELIS - boceprevir cap 200 mg 5 •VIDEX - didanosine for soln 2 gm 3 •VIDEX - didanosine for soln 4 gm 3 •VIDEX EC - didanosine delayed release

capsule 125 mg4 •

VIDEX EC - didanosine delayed releasecapsule 200 mg

4 •


4 •


4 •

VIEKIRA PAK - ombitas-paritapre-riton& dasab tab pak 12.5-75-50 & 250mg

5 •

VIRACEPT - nelfinavir mesylate tab 250mg

3 •

VIRACEPT - nelfinavir mesylate tab 625mg

3 •

VIRAMUNE - nevirapine tab 200 mg 4 •

2015


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VIRAMUNE - nevirapine susp 50mg/5ml

3 •

VIRAMUNE XR - nevirapine tab sr 24hr100 mg

3 •

VIRAMUNE XR - nevirapine tab sr 24hr400 mg

4 •

VIRAZOLE - ribavirin for inhal soln 6 gm 4

VIREAD - tenofovir disoproxil fumarateoral powder 40 mg/gm

3 •

VIREAD - tenofovir disoproxil fumaratetab 150 mg

3 •


3 •


3 •


3 •

VITEKTA - elvitegravir tab 85 mg 4 •VITEKTA - elvitegravir tab 150 mg 4 •ZERIT - stavudine for oral soln 1 mg/ml 4 •ZERIT - stavudine cap 15 mg 4 •ZERIT - stavudine cap 20 mg 4 •ZERIT - stavudine cap 30 mg 4 •ZERIT - stavudine cap 40 mg 4 •ZIAGEN - abacavir sulfate tab 300 mg

(base equiv)4 •

ZIAGEN - abacavir sulfate soln 20 mg/ml (base equiv)

3 •

zidovudine cap 100 mg (Retrovir) 2 •zidovudine syrup 10 mg/ml (Retrovir) 2 •zidovudine tab 300 mg 2 •ZOVIRAX - acyclovir cap 200 mg 4

ZOVIRAX - acyclovir susp 200 mg/5ml 4

ZOVIRAX - acyclovir tab 400 mg 4

ZOVIRAX - acyclovir tab 800 mg 4

ANTIMALARIALS

ARALEN - chloroquine phosphate tab500 mg

4

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atovaquone-proguanil hcl tab62.5-25 mg (Malarone)

2

atovaquone-proguanil hcl tab250-100 mg (Malarone)

2

chloroquine phosphate tab 250 mg 2

chloroquine phosphate tab 500 mg(Aralen)

1

COARTEM - artemether-lumefantrinetab 20-120 mg

4

DARAPRIM - pyrimethamine tab 25 mg 3

hydroxychloroquine sulfate tab200 mg (Plaquenil)

1

MALARONE - atovaquone-proguanil hcltab 62.5-25 mg

4

MALARONE - atovaquone-proguanil hcltab 250-100 mg

4

mefloquine hcl tab 250 mg 2

PLAQUENIL - hydroxychloroquinesulfate tab 200 mg

4

PRIMAQUINE PHOSPHATE -primaquine phosphate tab 26.3 mg(15 mg base)

3

QUALAQUIN - quinine sulfate cap 324mg

4

quinine sulfate cap 324 mg(Qualaquin)

2

AMEBICIDES

YODOXIN - iodoquinol tab 210 mg 4

YODOXIN - iodoquinol tab 650 mg 4

ANTHELMINTICS

ALBENZA - albendazole tab 200 mg 3

BILTRICIDE - praziquantel tab 600 mg 3

ivermectin tab 3 mg (Stromectol) 2

STROMECTOL - ivermectin tab 3 mg 3

ANTI-INFECTIVE AGENTS - MISC.

ALINIA - nitazoxanide tab 500 mg 4 •ALINIA - nitazoxanide for susp 100

mg/5ml4 •

2015


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atovaquone susp 750 mg/5ml(Mepron)

2

BACTRIM - sulfamethoxazole-trimethoprim tab 400-80 mg

4

BACTRIM DS - sulfamethoxazole-trimethoprim tab 800-160 mg

4

CAYSTON - aztreonam lysine for inhalsoln 75 mg (base equivalent)

5 • •

CLEOCIN - clindamycin hcl cap 75 mg 4



CLEOCIN PEDIATRIC GRANULE -clindamycin palmitate hcl for soln 75mg/5ml (base equiv)

4

clindamycin hcl cap 75 mg (Cleocin) 1



clindamycin palmitate hcl for soln75 mg/5ml (base equiv) (Cleocinpediatric gr)

2

DAPSONE - dapsone tab 25 mg 3

DAPSONE - dapsone tab 100 mg 3

FLAGYL - metronidazole cap 375 mg 4

FLAGYL - metronidazole tab 250 mg 4

FLAGYL - metronidazole tab 500 mg 4

FLAGYL ER - metronidazole tab sr 24hr750 mg

4

KETEK - telithromycin tab 300 mg 4

KETEK - telithromycin tab 400 mg 4

linezolid tab 600 mg (Zyvox) 2 •MEPRON - atovaquone susp 750

mg/5ml4

metronidazole cap 375 mg (Flagyl) 2

metronidazole tab 250 mg (Flagyl) 1

metronidazole tab 500 mg (Flagyl) 1

NEBUPENT - pentamidine isethionatefor nebulization soln 300 mg

4

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PRIMSOL - trimethoprim hcl oral soln 50mg/5ml (base equiv)

4

SIVEXTRO - tedizolid phosphate tab200 mg

4

sulfamethoxazole-trimethoprim susp200-40 mg/5ml

1

sulfamethoxazole-trimethoprim tab400-80 mg (Bactrim)

1

sulfamethoxazole-trimethoprim tab800-160 mg (Bactrim ds)

1

TINDAMAX - tinidazole tab 250 mg 4

TINDAMAX - tinidazole tab 500 mg 4

tinidazole tab 250 mg (Tindamax) 2

tinidazole tab 500 mg (Tindamax) 2

trimethoprim tab 100 mg 1

VANCOCIN HCL - vancomycin hcl cap125 mg

4

VANCOCIN HCL - vancomycin hcl cap250 mg

4

vancomycin hcl cap 125 mg(Vancocin hcl)

2

vancomycin hcl cap 250 mg(Vancocin hcl)

2

XIFAXAN - rifaximin tab 200 mg 4 •XIFAXAN - rifaximin tab 550 mg 3 •ZYVOX - linezolid tab 600 mg 3 •ZYVOX - linezolid for susp 100 mg/5ml 3 •BIOLOGICALS

VACCINES

AFLURIA PF 2011-2012 - influenzavirus vaccine split pf susp prefsyringe 0.5 ml

4


4


4

2015


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4


4

AFLURIA 2011-2012 - influenza virusvaccine split im susp

4


4


4


4


4

ENGERIX-B - hepatitis b vaccine(recombinant) susp 10 mcg/0.5ml

4

ENGERIX-B - hepatitis b vaccine(recombinant) susp 20 mcg/ml

4

ENGERIX-B - hepatitis b vaccine(recombinant) 10 mcg/0.5ml

4

ENGERIX-B - hepatitis b vaccine(recombinant) 20 mcg/ml

4

FLUARIX QUADRIVALENT 2013 -influenza virus vac split quadrivalentsusp pref syr 0.5ml

4


4


4

FLUARIX 2011-2012 - influenza virusvaccine split pf susp pref syringe 0.5ml

4


4

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4


4

FLUBLOK 2013-2014 - influenza virusvac recombinant hemagglutinin (ha)inj

4


4


4

FLUCELVAX 2012-2013 - influenzavirus vac tiss-cult subunit susp prefsyr 0.5 ml

4


4


4


4

FLULAVAL QUADRIVALENT 201 -influenza virus vac split quadrivalentsusp pref syr 0.5ml

4

FLULAVAL QUADRIVALENT201 - influenza virus vaccine splitquadrivalent im inj

4

FLULAVAL 2011-2012 - influenza virusvaccine split im susp

4


4


4


4

2015


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FLUMIST QUADRIVALENT - influenzavirus vaccine live quadrivalentintranasal susp

4

FLUVIRIN PF 2011-2012 - influenzavirus vac types a & b pf susp prefilledsyr 0.5 ml

4


4


4


4

FLUVIRIN 2011-2012 - influenza virusvaccine types a & b surface antigenim susp

4


4


4


4


4

FLUZONE HIGH-DOSE PF 2012 -influenza virus vac split high-dose pfsusp pref syr 0.5ml

4


4


4


4

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FLUZONE INTRADERMAL QUADR -influenza virus vac split quadintradermal pen 9 mcg/strain

4

FLUZONE PF 2012-2013 - influenzavirus vaccine split pf susp prefsyringe 0.5 ml

4


4


4

FLUZONE QUADRIVALENT 2013 -influenza virus vac split quadrivalentsusp pref syr 0.25 ml

4

FLUZONE QUADRIVALENT 2013 -influenza virus vac split quadrivalentsusp pref syr 0.5ml

4

FLUZONE QUADRIVALENT 2013 -influenza virus vaccine splitquadrivalent inj 0.5 ml

4


4


4

FLUZONE QUADRIVALENT 2014 -influenza virus vaccine splitquadrivalent im inj

4


4


4


4

FLUZONE QUADRIVALENT 2015 -influenza virus vaccine splitquadrivalent im inj

4

2015


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4

FLUZONE SPLIT 2012-2013 - influenzavirus vaccine split im susp

4


4


4


4

IMOVAX RABIES (H.D.C.V.) - rabiesvirus vaccine, hdc inj

4

MEDICAL PROVIDER EZ FLU S -influenza virus vac types a & b pf prefsyringe kit 0.5 ml

4

MEDICAL PROVIDER EZ FLU S -influenza virus vac tiss-cult subunitpref syr kit 0.5 ml

4

PNEUMOVAX 23 - pneumococcalvaccine polyvalent inj 25 mcg/0.5ml

4

PNEUMOVAX 23/1 DOSE -pneumococcal vaccine polyvalent inj25 mcg/0.5ml

4

PNEUMOVAX 23/5 DOSE -pneumococcal vaccine polyvalent inj25 mcg/0.5ml

4

PREVNAR 13 - pneumococcal 13-valentconjugate vaccine inj

4

RABAVERT - rabies vaccine, pcec forinj

4

RECOMBIVAX HB - hepatitis b vaccine(recombinant) susp 5 mcg/0.5ml

4

RECOMBIVAX HB - hepatitis b vaccine(recombinant) susp 10 mcg/ml

4

RECOMBIVAX HB - hepatitis b vaccine(recombinant) susp 40 mcg/ml

4

VIVOTIF BERNA - typhoid vaccine capdelayed release

4

ZOSTAVAX - zoster vaccine live for inj19400 unit/0.65ml

4

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TOXOIDS

ADACEL - tet tox-diph-acell pertuss adinj 5-2-15.5 lf-lf-mcg/0.5ml

4

BOOSTRIX - tet tox-diph-acell pertussad inj 5-2.5-18.5 lf-lf-mcg/0.5ml

4

DAPTACEL - diph, acellular pert & tettox inj 15 lf-10 mcg-5 lf/0.5ml

4

DIPHTHERIA/TETANUS TOXOID -diphtheria-tetanus tox adsorbed (dt)im inj 25-5 unit/0.5ml

4

INFANRIX - diph, acellular pert & tet toxinj 25 lf-58 mcg-10 lf/0.5ml

4

KINRIX - diph-tetanus tox ad-acell pert& polio virus, ipv vac inj

4

PEDIARIX - diph-tetanus tox-acell pert-hepatitis b-polio ipv vac inj

4

PENTACEL - diph-ac per-tet tox ad-poliov-haemoph b poly vac for imsusp

4

QUADRACEL - diph-tetanus tox ad-acell pert & polio virus, ipv vac inj

4

TENIVAC - tetanus-diphtheria toxoids(td) inj 5-2 lfu

4

TETANUS/DIPHTHERIA TOXOID -tetanus-diphtheria toxoids (td) inj 2-2lf/0.5ml

4

PASSIVE IMMUNIZING AGENTS

HEPAGAM B - hepatitis b immuneglobulin (human) inj soln

4

HYPERHEP B S/D - hepatitis b immuneglobulin (human) im inj soln

4

HYPERRAB S/D - rabies immuneglobulin (human) inj 150 unit/ml

4

HYPERTET S/D - tetanus immuneglobulin (human) inj 250 unit/ml

4

HYQVIA - immun glob inj 2.5 gm/25ml-hyaluron inj 200 unt/1.25 ml kit

5

HYQVIA - immun glob inj 5 gm/50ml-hyaluron inj 400 unt/2.5 ml kit

5

2015


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HYQVIA - immun glob inj 10 gm/100ml-hyaluron inj 800 unt/5 ml kit

5


5


5

IMOGAM RABIES-HT - rabies immuneglobulin (human) inj 150 unit/ml

4

NABI-HB - hepatitis b immune globulin(human) im inj soln

4

VARIZIG - varicella-zoster immune glob(human) for im inj 125 unit

4

BIOLOGICALS MISC

GRASTEK - timothy grass pollenallergen ext tab sl 2800 bau

4

ORALAIR - grass mixed pollen ext tab sl300 ir (index of reactivity)

4

ORALAIR ADULT SAMPLE KIT - grassmixed pollen ext tab sl 300 ir (index ofreactivity)

4

ORALAIR ADULT STARTER PAC -grass mixed pollen ext tab sl 300 ir(index of reactivity)

4

ORALAIR CHILDREN/ADOLESCE -grass mixed pollen tab sl therpak 100(3) ir & 300 (6) ir

4

ORALAIR CHILDREN/ADOLESCE -grass mixed pollen ext tab sl 100 ir(index of reactivity)

4 • •

RAGWITEK - short ragweed pollenallergen extract tab sl 12 amb a 1-u

4

ANTINEOPLASTIC AGENTS

ANTINEOPLASTICS

ACTIMMUNE - interferon gamma-1b inj100 mcg/0.5ml (2000000 unit/0.5ml)

5 •

AFINITOR - everolimus tab 2.5 mg 5 • •AFINITOR - everolimus tab 5 mg 5 • •AFINITOR - everolimus tab 7.5 mg 5 • •AFINITOR - everolimus tab 10 mg 5 • •

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AFINITOR DISPERZ - everolimus tabfor oral susp 2 mg

5 • •


5 • •


5 • •

ALKERAN - melphalan tab 2 mg 3

anastrozole tab 1 mg (Arimidex) 1

ARIMIDEX - anastrozole tab 1 mg 4

AROMASIN - exemestane tab 25 mg 4

bexarotene cap 75 mg (Targretin) 5 •bicalutamide tab 50 mg (Casodex) 2

BOSULIF - bosutinib tab 100 mg 5 • •BOSULIF - bosutinib tab 500 mg 5 • •capecitabine tab 150 mg (Xeloda) 5 •capecitabine tab 500 mg (Xeloda) 5 •CAPRELSA - vandetanib tab 100 mg 5 • •CAPRELSA - vandetanib tab 300 mg 5 • •CASODEX - bicalutamide tab 50 mg 4

CEENU - lomustine cap 10 mg 3



COMETRIQ - cabozantinib s-malate cap3 x 20 mg (60 mg dose) kit

5 • •

COMETRIQ - cabozantinib s-mal cap 1x 80 mg & 1 x 20 mg (100 dose) kit

5 • •

COMETRIQ - cabozantinib s-mal cap 1x 80 mg & 3 x 20 mg (140 dose) kit

5 • •

CYCLOPHOSPHAMIDE -cyclophosphamide cap 25 mg

4

CYCLOPHOSPHAMIDE -cyclophosphamide cap 50 mg

4

ELIGARD - leuprolide acetate forsubcutaneous inj kit 7.5 mg

5 •

ELIGARD - leuprolide acetate (3 month)for subcutaneous inj kit 22.5mg

5 •

ELIGARD - leuprolide acetate (4 month)for subcutaneous inj kit 30 mg

5 •

2015


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ELIGARD - leuprolide acetate (6 month)for subcutaneous inj kit 45 mg

5 •

EMCYT - estramustine phosphatesodium cap 140 mg

4

ERIVEDGE - vismodegib cap 150 mg 5 • •ETOPOSIDE - etoposide cap 50 mg 4

exemestane tab 25 mg (Aromasin) 2

FARESTON - toremifene citrate tab 60mg (base equivalent)

4

FARYDAK - panobinostat lactate cap 10mg (base equivalent)

5 • •


5 • •


5 • •

FEMARA - letrozole tab 2.5 mg 4

flutamide cap 125 mg 2

GILOTRIF - afatinib dimaleate tab 20mg (base equivalent)

5 • •


5 • •


5 • •

GLEEVEC - imatinib mesylate tab 100mg (base equivalent)

5 • •

GLEEVEC - imatinib mesylate tab 400mg (base equivalent)

5 • •

GLEOSTINE - lomustine cap 10 mg 4



HEXALEN - altretamine cap 50 mg 5 •HYCAMTIN - topotecan hcl cap 0.25 mg

(base equiv)5 •

HYCAMTIN - topotecan hcl cap 1 mg(base equiv)

5 •

HYDREA - hydroxyurea cap 500 mg 4

hydroxyurea cap 500 mg (Hydrea) 2

IBRANCE - palbociclib cap 75 mg 5 • •

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IBRANCE - palbociclib cap 100 mg 5 • •IBRANCE - palbociclib cap 125 mg 5 • •ICLUSIG - ponatinib hcl tab 15 mg

(base equiv)5 • •

ICLUSIG - ponatinib hcl tab 45 mg(base equiv)

5 • •

IMBRUVICA - ibrutinib cap 140 mg 5 • •INLYTA - axitinib tab 1 mg 5 • •INLYTA - axitinib tab 5 mg 5 • •INTRON A - interferon alfa-2b inj

6000000 unit/ml5 •

INTRON A - interferon alfa-2b inj10000000 unit/ml

5 •

INTRON A - interferon alfa-2b for inj10000000 unit

5 •


5 •


5 •

INTRON A W/DILUENT - interferonalfa-2b for inj 10000000 unit

5 •


5 •


5 •

IRESSA - gefitinib tab 250 mg 5 • •JAKAFI - ruxolitinib phosphate tab 5 mg

(base equivalent)5 • •

JAKAFI - ruxolitinib phosphate tab 10mg (base equivalent)

5 • •


5 • •


5 • •


5 • •

LENVIMA 10MG DAILY DOSE -lenvatinib cap therapy pack 10 mg(10 mg daily dose)

5 • •

2015


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LENVIMA 14MG DAILY DOSE -lenvatinib cap therapy pack 10 & 4mg (14 mg daily dose)

5 • •

LENVIMA 20MG DAILY DOSE -lenvatinib cap therapy pack 10 (2) mg(20 mg daily dose)

5 • •

LENVIMA 24MG DAILY DOSE -lenvatinib cap therapy pack 10 (2) & 4mg (24 mg daily dose)

5 • •

letrozole tab 2.5 mg (Femara) 1

LEUCOVORIN CALCIUM - leucovorincalcium tab 10 mg

3

LEUCOVORIN CALCIUM - leucovorincalcium tab 15 mg

3

leucovorin calcium tab 5 mg 2

leucovorin calcium tab 25 mg 2

LEUKERAN - chlorambucil tab 2 mg 3

leuprolide acetate inj kit 5 mg/ml 5 •LOMUSTINE - lomustine cap 10 mg 4

LOMUSTINE - lomustine cap 40 mg 4

LOMUSTINE - lomustine cap 100 mg 4

LYNPARZA - olaparib cap 50 mg 5 • •LYSODREN - mitotane tab 500 mg 5 •MATULANE - procarbazine hcl cap 50

mg5 •

MEGACE ORAL - megestrol acetatesusp 40 mg/ml

4

megestrol acetate susp 40 mg/ml(Megace oral)

2

megestrol acetate tab 20 mg 1

megestrol acetate tab 40 mg 1

MEKINIST - trametinib dimethylsulfoxide tab 0.5 mg (baseequivalent)

5 • •

MEKINIST - trametinib dimethylsulfoxide tab 2 mg (base equivalent)

5 • •

mercaptopurine tab 50 mg(Purinethol)

2

MESNEX - mesna tab 400 mg 4

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methotrexate sodium for inj 1 gm 2

methotrexate sodium inj pf 25 mg/ml 1

methotrexate sodium inj 25 mg/ml 1

methotrexate sodium tab 2.5 mg(base equiv)

2

MYLERAN - busulfan tab 2 mg 3

NEXAVAR - sorafenib tosylate tab 200mg (base equivalent)

5 • •

NILANDRON - nilutamide tab 150 mg 4

POMALYST - pomalidomide cap 1 mg 5 • •POMALYST - pomalidomide cap 2 mg 5 • •POMALYST - pomalidomide cap 3 mg 5 • •POMALYST - pomalidomide cap 4 mg 5 • •PURIXAN - mercaptopurine susp 2000

mg/100ml (20 mg/ml)4

SOLTAMOX - tamoxifen citrate oral soln10 mg/5ml (base equivalent)

4

SPRYCEL - dasatinib tab 20 mg 5 • •SPRYCEL - dasatinib tab 50 mg 5 • •SPRYCEL - dasatinib tab 70 mg 5 • •SPRYCEL - dasatinib tab 80 mg 5 • •SPRYCEL - dasatinib tab 100 mg 5 • •SPRYCEL - dasatinib tab 140 mg 5 • •STIVARGA - regorafenib tab 40 mg 5 • •SUTENT - sunitinib malate cap 12.5 mg


SUTENT - sunitinib malate cap 25 mg(base equivalent)

5 • •

SUTENT - sunitinib malate cap 37.5 mg(base equivalent)

5 • •

SUTENT - sunitinib malate cap 50 mg(base equivalent)

5 • •

SYLATRON - peginterferon alfa-2b forinj kit 200 mcg

5 •


5 •


5 •

2015


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TABLOID - thioguanine tab 40 mg 4 •TAFINLAR - dabrafenib mesylate cap

50 mg (base equivalent)5 • •

TAFINLAR - dabrafenib mesylate cap75 mg (base equivalent)

5 • •

tamoxifen citrate tab 10 mg (baseequivalent)

1

tamoxifen citrate tab 20 mg (baseequivalent)

1

TARCEVA - erlotinib hcl tab 25 mg(base equivalent)

5 • •


5 • •


5 • •

TARGRETIN - bexarotene cap 75 mg 5 •TASIGNA - nilotinib hcl cap 150 mg


TASIGNA - nilotinib hcl cap 200 mg(base equivalent)

5 • •

TEMODAR - temozolomide cap 5 mg 5 •TEMODAR - temozolomide cap 20 mg 5 •TEMODAR - temozolomide cap 100 mg 5 •TEMODAR - temozolomide cap 140 mg 5 •TEMODAR - temozolomide cap 180 mg 5 •TEMODAR - temozolomide cap 250 mg 5 •temozolomide cap 5 mg (Temodar) 5 •temozolomide cap 20 mg (Temodar) 5 •temozolomide cap 100 mg (Temodar) 5 •temozolomide cap 140 mg (Temodar) 5 •temozolomide cap 180 mg (Temodar) 5 •temozolomide cap 250 mg (Temodar) 5 •tretinoin cap 10 mg 5 •TREXALL - methotrexate sodium tab 5

mg (base equiv)4

TREXALL - methotrexate sodium tab7.5 mg (base equiv)

4

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TREXALL - methotrexate sodium tab 10mg (base equiv)

4

TREXALL - methotrexate sodium tab 15mg (base equiv)

4

TYKERB - lapatinib ditosylate tab 250mg (base equiv)

5 • •

VOTRIENT - pazopanib hcl tab 200 mg(base equiv)

5 • •

XALKORI - crizotinib cap 200 mg 5 • •XALKORI - crizotinib cap 250 mg 5 • •XELODA - capecitabine tab 150 mg 5 •XELODA - capecitabine tab 500 mg 5 •XTANDI - enzalutamide cap 40 mg 5 • •ZELBORAF - vemurafenib tab 240 mg 5 • •ZOLINZA - vorinostat cap 100 mg 5 • •ZYDELIG - idelalisib tab 100 mg 5 • •ZYDELIG - idelalisib tab 150 mg 5 • •ZYKADIA - ceritinib cap 150 mg 5 • •ZYTIGA - abiraterone acetate tab 250

mg5 • •

ENDOCRINE AND METABOLIC DRUGS

CORTICOSTEROIDS

budesonide cap sr 24hr 3 mg(Entocort ec)

2

CORTEF - hydrocortisone tab 5 mg 4



CORTISONE ACETATE - cortisoneacetate tab 25 mg

3

DEXAMETHASONE - dexamethasonesoln 0.5 mg/5ml

4

DEXAMETHASONE - dexamethasonetab 1 mg

4

DEXAMETHASONE - dexamethasonetab 2 mg

4

dexamethasone elixir 0.5 mg/5ml 2

DEXAMETHASONE INTENSOL -dexamethasone conc 1 mg/ml

4

2015


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dexamethasone tab 0.5 mg 1



dexamethasone tab 4 mg 1

dexamethasone tab 6 mg 1

DEXPAK 10 DAY - dexamethasone tab1.5 mg taper pack

4


4


4

ENTOCORT EC - budesonide cap sr24hr 3 mg

4

FLO-PRED - prednisolone acetate oralsusp 16.7 mg/5ml (15 mg/5ml base)

4

fludrocortisone acetate tab 0.1 mg 2

hydrocortisone tab 5 mg (Cortef) 2



INTERARTICULAR JOINT KIT -triamcinolone inj 40 mg/ml & lidocaine1% & ammonia inh kit

4

MEDROL - methylprednisolone tab 2mg

4


4


4


4


4

MEDROL DOSEPAK -methylprednisolone tab 4 mg dosepack

4

methylprednisolone tab 4 mg dosepack (Medrol dosepak)

2

methylprednisolone tab 4 mg(Medrol)

2

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2


2


2

MILLIPRED - prednisolone tab 5 mg 4

MILLIPRED - prednisolone sodphosphate oral soln 10 mg/5ml (baseequiv)

4

MILLIPRED DP - prednisolone tab 5 mgdose pack

4

ORAPRED ODT - prednisolone sodphos orally disintegr tab 10 mg (baseeq)

4


4


4

PEDIAPRED - prednisolone sod phosphoral soln 6.7 mg/5ml (5 mg/5ml base)

4

PHYSICIANS EZ USE JOINT T -triamcinolone inj 40 mg/ml & lidocaine1% & ammonia inh kit

4

prednisolone sod phos orallydisintegr tab 10 mg (base eq)(Orapred odt)

2


2


2

prednisolone sod phosph oralsoln 6.7 mg/5ml (5 mg/5ml base)(Pediapred)

2

prednisolone sod phosphate oralsoln 15 mg/5ml (base equiv)

1

2015


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PREDNISOLONE SODIUM PHOSP -prednisolone sodium phosphate oralsoln 25 mg/5ml (base eq)

4

prednisolone syrup 15 mg/5ml (uspsolution equivalent) (Prelone)

1

PREDNISONE - prednisone tab 50 mg 4

PREDNISONE - prednisone oral soln 5mg/5ml

4

PREDNISONE - prednisone tab 5 mgdose pack

4

PREDNISONE - prednisone tab 10 mgdose pack

4

PREDNISONE INTENSOL - prednisoneconc 5 mg/ml

4

prednisone tab 1 mg 1

prednisone tab 2.5 mg 1




RAYOS - prednisone tab delayedrelease 1 mg

4


4


4

UCERIS - budesonide tab sr 24hr 9 mg 4

VERIPRED 20 - prednisolone sodphosphate oral soln 20 mg/5ml (baseequiv)

4

ANDROGEN-ANABOLIC

ANADROL-50 - oxymetholone tab 50mg

4 •

ANDRODERM - testosterone td patch24hr 2 mg/24hr

4 • •

ANDRODERM - testosterone td patch24hr 4 mg/24hr

4 • •

ANDROGEL - testosterone td gel 25mg/2.5gm (1%)

4 • •

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ANDROGEL - testosterone td gel 50mg/5gm (1%)

4 • •

ANDROGEL - testosterone td gel 20.25mg/1.25gm (1.62%)

4 • •

ANDROGEL - testosterone td gel 40.5mg/2.5gm (1.62%)

4 • •

ANDROGEL PUMP - testosterone td gel12.5 mg/act (1%)

4 • •

ANDROGEL PUMP - testosterone td gel20.25 mg/act (1.62%)

4 • •

ANDROID - methyltestosterone cap 10mg

4 •

AVEED - testosterone undecanoate iminj in oil 750 mg/3ml (250mg/ml)

4 • •

AXIRON - testosterone td soln 30 mg/act

4 • •

danazol cap 50 mg 2 •danazol cap 100 mg 2 •danazol cap 200 mg 2 •DEPO-TESTOSTERONE - testosterone

cypionate im inj in oil 100 mg/ml4 • •

DEPO-TESTOSTERONE - testosteronecypionate im inj in oil 200 mg/ml

4 • •

FORTESTA - testosterone td gel 10mg/act (2%)

4 • •

METHITEST - methyltestosterone oraltab 10 mg

4 •

NATESTO - testosterone nasal gel 5.5mg/act

4 • •

OXANDRIN - oxandrolone tab 2.5 mg 4 •OXANDRIN - oxandrolone tab 10 mg 4 •oxandrolone tab 2.5 mg (Oxandrin) 2 •oxandrolone tab 10 mg (Oxandrin) 2 •STRIANT - testosterone buccal

mucoadhesive system 30 mg4 • •

TESTIM - testosterone td gel 50mg/5gm (1%)

4 • •

TESTOSTERONE - testosterone td gel25 mg/2.5gm (1%)

4 • •

2015


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TESTOSTERONE - testosterone td gel50 mg/5gm (1%)

4 • •

TESTOSTERONE - testosterone td gel10mg/act (2%)

4 • •

TESTOSTERONE - testosteronecypionate im inj in oil 250 mg/ml

4

testosterone cypionate im inj in oil100 mg/ml (Depo-testosterone)

2 • •

testosterone cypionate im inj in oil200 mg/ml (Depo-testosterone)

2 • •

testosterone enanthate im inj in oil200 mg/ml

2 • •

TESTOSTERONE PUMP - testosteronetd gel 12.5 mg/act (1%)

4 • •

TESTRED - methyltestosterone cap 10mg

4 •

VOGELXO - testosterone td gel 50mg/5gm (1%)

4 • •

VOGELXO PUMP - testosterone td gel12.5 mg/act (1%)

4 • •

ESTROGENS

ACTIVELLA - estradiol & norethindroneacetate tab 0.5-0.1 mg

4

ACTIVELLA - estradiol & norethindroneacetate tab 1-0.5 mg

4

ALORA - estradiol td patch twice weekly0.025 mg/24hr

4 •


4 •


4 •


4 •

ANGELIQ - drospirenone-estradiol tab0.25-0.5 mg

4

ANGELIQ - drospirenone-estradiol tab0.5-1 mg

4

CLIMARA - estradiol td patch weekly0.025 mg/24hr

4 •

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CLIMARA - estradiol td patch weekly0.0375 mg/24hr (37.5 mcg/24hr)

4 •


4 •


4 •


4 •

CLIMARA - estradiol td patch weekly 0.1mg/24hr

4 •

CLIMARA PRO - estradiol-levonorgestrel td patch weekly0.045-0.015 mg/day

4

COMBIPATCH - estradiol-norethindroneace td pttw 0.05-0.14 mg/day

3

COMBIPATCH - estradiol-norethindroneace td pttw 0.05-0.25 mg/day

3

DIVIGEL - estradiol td gel 0.25mg/0.25gm (0.1%)

3

DIVIGEL - estradiol td gel 0.5 mg/0.5gm(0.1%)

3

DIVIGEL - estradiol td gel 1 mg/gm(0.1%)

3

DUAVEE - conjugated estrogens-bazedoxifene tab 0.45-20 mg

4

ELESTRIN - estradiol gel 0.06% (0.52mg/0.87 gm metered-dose pump)

4

ENJUVIA - estrogens, conjugatedsynthetic b tab 0.3 mg

4


4


4


4


4

esterified estrogens &methyltestosterone tab0.625-1.25 mg

2

2015


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esterified estrogens &methyltestosterone tab 1.25-2.5 mg

2

ESTRACE - estradiol tab 0.5 mg 4

ESTRACE - estradiol tab 1 mg 4

ESTRACE - estradiol tab 2 mg 4

estradiol & norethindrone acetatetab 0.5-0.1 mg (Activella)

2

estradiol & norethindrone acetatetab 1-0.5 mg (Activella)

2

estradiol tab 0.5 mg (Estrace) 1

estradiol tab 1 mg (Estrace) 1

estradiol tab 2 mg (Estrace) 1

estradiol td patch twice weekly0.025 mg/24hr (Vivelle-dot)

2 •


2 •


2 •


2 •


2 •

estradiol td patch weekly0.025 mg/24hr (Climara)

2 •

estradiol td patch weekly0.0375 mg/24hr (37.5 mcg/24hr)(Climara)

2 •


2 •


2 •


2 •


2 •

ESTROGEL - estradiol gel 0.06% (0.75mg/1.25 gm metered-dose pump)

4

ESTROPIPATE - estropipate tab 3 mg 4

estropipate tab 0.75 mg 1

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its

estropipate tab 1.5 mg 1

EVAMIST - estradiol transdermal spray1.53 mg/spray

4

FEMHRT LOW DOSE - norethindroneacetate-ethinyl estradiol tab 0.5mg-2.5 mcg

4

MENEST - esterified estrogens tab 0.3mg

4

MENEST - esterified estrogens tab0.625 mg

4


4


4

MENOSTAR - estradiol td patch weekly14 mcg/24hr

4 •

MINIVELLE - estradiol td patch twiceweekly 0.025 mg/24hr

4 •


4 •


4 •


4 •


4 •

norethindrone acetate-ethinylestradiol tab 0.5 mg-2.5 mcg(Femhrt low dose)

2

PREFEST - estradiol tab 1mg(15)/estrad-norgestimate tab1-0.09mg(15)

4

PREMARIN - estrogens, conjugated tab0.3 mg

4


4


4


4

2015


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4

PREMPHASE - conj est 0.625(14)/conjest-medroxypro ac tab 0.625-5mg(14)

4

PREMPRO - conjugated estrogen-medroxyprogest acetate tab 0.3-1.5mg

4

PREMPRO - conjugated estrogen-medroxyprogest acetate tab 0.45-1.5mg

4

PREMPRO - conjugated estrogen-medroxyprogest acetate tab0.625-2.5 mg

4

PREMPRO - conjugated estrogen-medroxyprogest acetate tab 0.625-5mg

4

VIVELLE-DOT - estradiol td patch twiceweekly 0.025 mg/24hr

4 •


4 •


4 •


4 •


4 •

CONTRACEPTIVES

BEYAZ - drospirenone-ethinyl estrad-levomefolate tab 3-0.02-0.451 mg

4 •

BREVICON-28 - norethindrone & ethinylestradiol tab 0.5 mg-35 mcg

4 •

CYCLESSA - desogest-ethin est tab0.1-0.025/0.125-0.025/0.15-0.025mg-mg

4 •

DEPO-PROVERA CONTRACEPTIV -medroxyprogesterone acetate imsusp 150 mg/ml

4

DEPO-SUBQ PROVERA 104 -medroxyprogesterone acetatesubcutaneous susp 104 mg/0.65ml

4

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its

DESOGEN - desogestrel & ethinylestradiol tab 0.15 mg-30 mcg

4 •

desogest-eth estrad & eth estrad tab0.15-0.02/0.01 mg(21/5) (Mircette)

2 •

desogest-ethin est tab0.1-0.025/0.125-0.025/0.15-0.025mg-mg (Cyclessa)

2 •

desogestrel & ethinyl estradiol tab0.15 mg-30 mcg (Desogen)

1 •

drospirenone-ethinyl estradiol tab3-0.02 mg (Yaz)

2 •

drospirenone-ethinyl estradiol tab3-0.03 mg (Yasmin 28)

2 •

ELLA - ulipristal acetate tab 30 mg 3 •ESTROSTEP FE - norethindrone ac-

ethinyl estrad-fe tab 1-20/1-30/1-35mg-mcg

4 •

ethynodiol diacetate & ethinylestradiol tab 1 mg-35 mcg

2 •

FALESSA - levonorgest-eth estrad tab0.1 mg-20 mcg & fa tab 1 mg kit

4 •

FEMCON FE - norethindrone & ethinylestradiol-fe chew tab 0.4 mg-35 mcg

4 •

GENERESS FE - norethindrone &ethinyl estradiol-fe chew tab 0.8mg-25 mcg

4 •

levonorg-eth est tab 0.1-0.02mg(84)& eth est tab 0.01mg(7)(Loseasonique)

2 •

levonorg-eth est tab 0.15-0.03mg(84)& eth est tab 0.01mg(7)(Seasonique)

2 •

levonorgestrel & ethinyl estradiol(91-day) tab 0.15-0.03 mg

2 •

levonorgestrel & ethinyl estradiol tab0.1 mg-20 mcg

1 •

levonorgestrel & ethinyl estradiol tab0.15 mg-30 mcg

2 •

levonorgestrel tab 1.5 mg (Plan bone-step)

2 •

2015


Drug Name Dru

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Dis

pens

ing

Lim

its

levonorgestrel-eth estra tab0.05-30/0.075-40/0.125-30mg-mcg

2 •

levonorgestrel-ethinyl estradiol(continuous) tab 90-20 mcg

2 •

LO LOESTRIN FE - norethin-ethestradiol-fe tab 1 mg-10 mcg (24)/10mcg (2)

4 •

LOESTRIN FE 1.5/30 - norethindroneace & ethinyl estradiol-fe tab 1.5mg-30 mcg

4 •

LOESTRIN FE 1/20 - norethindroneace & ethinyl estradiol-fe tab 1 mg-20mcg

4 •

LOESTRIN 1.5/30-21 - norethindroneace & ethinyl estradiol tab 1.5 mg-30mcg

4 •

LOESTRIN 1/20-21 - norethindrone ace& ethinyl estradiol tab 1 mg-20 mcg

4 •

LOSEASONIQUE - levonorg-eth esttab 0.1-0.02mg(84) & eth est tab0.01mg(7)

4 •

medroxyprogesterone acetate imsusp 150 mg/ml (Depo-proveracontrac)

1

MINASTRIN 24 FE - norethindrone ace-eth estradiol-fe chew tab 1 mg-20mcg (24)

4 •

MIRCETTE - desogest-eth estrad & ethestrad tab 0.15-0.02/0.01 mg(21/5)

4 •

MODICON - norethindrone & ethinylestradiol tab 0.5 mg-35 mcg

4 •

NATAZIA - estradiol valerate-dienogesttab 3 mg /2-2 mg/2-3 mg/1 mg

4 •

NECON 1/50-28 - norethindrone &mestranol tab 1 mg-50 mcg

4 •

NECON 10/11-28 - norethindrone-ethestradiol tab 0.5-35/1-35 mg-mcg(10/11)

4 •

NOR-QD - norethindrone tab 0.35 mg 4 •norelgestromin-ethinyl estradiol td

ptwk 150-35 mcg/24hr (Ortho evra)2 •

Drug Name Dru

g T

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Ste

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Dis

pens

ing

Lim

its

norethindrone & ethinyl estradiol tab0.4 mg-35 mcg (Ovcon-35)

2 •

norethindrone & ethinyl estradiol tab0.5 mg-35 mcg (Brevicon-28)

2 •

norethindrone & ethinyl estradiol tab1 mg-35 mcg (Norinyl 1+35)

2 •

norethindrone & ethinyl estradiol-fechew tab 0.4 mg-35 mcg (Femconfe)

2 •

norethindrone & ethinyl estradiol-fechew tab 0.8 mg-25 mcg (Generessfe)

2 •

norethindrone ac-ethinyl estrad-fe tab 1-20/1-30/1-35 mg-mcg(Estrostep fe)

2 •

norethindrone ace & ethinyl estradioltab 1 mg-20 mcg (Loestrin 1/20-21)

2 •

norethindrone ace & ethinyl estradioltab 1.5 mg-30 mcg (Loestrin1.5/30-21)

2 •

norethindrone ace & ethinylestradiol-fe tab 1 mg-20 mcg(Loestrin fe 1/20)

2 •

norethindrone ace & ethinylestradiol-fe tab 1.5 mg-30 mcg(Loestrin fe 1.5/30)

2 •

norethindrone ace-ethinyl estradiol-fe tab 1 mg-20 mcg (24) (Lomedia24 fe)

2 •

norethindrone tab 0.35 mg (Nor-qd) 2 •norethindrone-eth estradiol tab

0.5-35/0.75-35/1-35 mg-mcg (Ortho-novum 7/7/7)

2 •

norethindrone-eth estradiol tab0.5-35/1-35/0.5-35 mg-mcg (Tri-norinyl 28)

2 •

norgestimate & ethinyl estradiol tab0.25 mg-35 mcg (Ortho-cyclen)

1 •

norgestimate-eth estrad tab0.18-35/0.215-35/0.25-35 mg-mcg(Ortho tri-cyclen)

1 •

2015


Drug Name Dru

g T

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Prio

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p T

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py

Dis

pens

ing

Lim

its

norgestrel & ethinyl estradiol tab0.3 mg-30 mcg

2 •

NORINYL 1+35 - norethindrone &ethinyl estradiol tab 1 mg-35 mcg

4 •

NORINYL 1+50 - norethindrone &mestranol tab 1 mg-50 mcg

4 •

NUVARING - etonogestrel-ethinylestradiol va ring 0.120-0.015 mg/24hr

3 •

OGESTREL - norgestrel & ethinylestradiol tab 0.5 mg-50 mcg

4 •

ORTHO EVRA - norelgestromin-ethinylestradiol td ptwk 150-35 mcg/24hr

4 •

ORTHO MICRONOR - norethindronetab 0.35 mg

4 •

ORTHO TRI-CYCLEN -norgestimate-eth estrad tab0.18-35/0.215-35/0.25-35 mg-mcg

4 •

ORTHO TRI-CYCLEN LO -norgestimate-eth estrad tab0.18-25/0.215-25/0.25-25 mg-mcg

4 •

ORTHO-CEPT - desogestrel & ethinylestradiol tab 0.15 mg-30 mcg

4 •

ORTHO-CYCLEN - norgestimate &ethinyl estradiol tab 0.25 mg-35 mcg

4 •

ORTHO-NOVUM 1/35 - norethindrone &ethinyl estradiol tab 1 mg-35 mcg

4 •

ORTHO-NOVUM 7/7/7 - norethindrone-eth estradiol tab 0.5-35/0.75-35/1-35mg-mcg

4 •

OVCON-35 - norethindrone & ethinylestradiol tab 0.4 mg-35 mcg

4 •

PLAN B ONE-STEP - levonorgestrel tab1.5 mg

4 •

QUARTETTE - levonor-eth est tab0.15-0.02/0.025/0.03 mg &eth est0.01 mg

4 •

SAFYRAL - drospirenone-ethinyl estrad-levomefolate tab 3-0.03-0.451 mg

4 •

SEASONIQUE - levonorg-eth esttab 0.15-0.03mg(84) & eth est tab0.01mg(7)

4 •

Drug Name Dru

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Dis

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ing

Lim

its

TRI-NORINYL 28 - norethindrone-ethestradiol tab 0.5-35/1-35/0.5-35 mg-mcg

4 •

YASMIN 28 - drospirenone-ethinylestradiol tab 3-0.03 mg

4 •

YAZ - drospirenone-ethinyl estradiol tab3-0.02 mg

4 •

ZOVIA 1/50E - ethynodiol diacetate &ethinyl estradiol tab 1 mg-50 mcg

4 •

PROGESTINS

AYGESTIN - norethindrone acetate tab5 mg

4

medroxyprogesterone acetate tab2.5 mg (Provera)

1

medroxyprogesterone acetate tab5 mg (Provera)

1

medroxyprogesterone acetate tab10 mg (Provera)

1

MEGACE ES - megestrol acetate susp625 mg/5ml

4

megestrol acetate susp 625 mg/5ml(Megace es)

4

norethindrone acetate tab 5 mg(Aygestin)

2

progesterone im in oil 50 mg/ml 2

progesterone micronized cap 100 mg(Prometrium)

2

progesterone micronized cap 200 mg(Prometrium)

2

PROMETRIUM - progesteronemicronized cap 100 mg

4

PROMETRIUM - progesteronemicronized cap 200 mg

4

PROVERA - medroxyprogesteroneacetate tab 2.5 mg

4

PROVERA - medroxyprogesteroneacetate tab 5 mg

4

PROVERA - medroxyprogesteroneacetate tab 10 mg

4

ANTIDIABETICS

2015


Drug Name Dru

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Dis

pens

ing

Lim

its

acarbose tab 25 mg (Precose) 2



ACTOPLUS MET - pioglitazone hcl-metformin hcl tab 15-500 mg

4

ACTOPLUS MET - pioglitazone hcl-metformin hcl tab 15-850 mg

4

ACTOPLUS MET XR - pioglitazone hcl-metformin hcl tab sr 24hr 15-1000 mg

4

ACTOPLUS MET XR - pioglitazone hcl-metformin hcl tab sr 24hr 30-1000 mg

4

ACTOS - pioglitazone hcl tab 15 mg(base equiv)

4


4


4

AMARYL - glimepiride tab 1 mg 4



AVANDAMET - rosiglitazone maleate-metformin hcl tab 2-1000 mg

4

AVANDIA - rosiglitazone maleate tab 2mg (base equiv)

4


4


4

BD GLUCOSE - glucose chew tab 5 gm 4

BYDUREON - exenatide extendedrelease for susp pen-injector 2 mg

4 • •

BYDUREON - exenatide extendedrelease for inj susp 2 mg

4 • •

BYETTA - exenatide soln pen-injector 5mcg/0.02ml

4 • •

BYETTA - exenatide soln pen-injector10 mcg/0.04ml

4 • •

CHLORPROPAMIDE - chlorpropamidetab 100 mg

4

Drug Name Dru

g T

ier

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hera

py

Dis

pens

ing

Lim

its

CHLORPROPAMIDE - chlorpropamidetab 250 mg

4

CVS GLUCOSE - glucose chew tab 4gm

4

CVS GLUCOSE - glucose-vitamin cchew tab 4-0.006 gm

4

CVS GLUCOSE BITS - glucose chewtab 1 gm

4

CYCLOSET - bromocriptine mesylatetab 0.8 mg (base equivalent)

4

DEX4 - glucose chew tab 1 gm 4

DEX4 - glucose-vitamin c chew tab4-0.006 gm

4

DEX4 FAST ACTING GLUCOSE -glucose oral liquid 15 gm/59ml

4

DEX4 FAST ACTING GLUCOSE -glucose gel 15 gm/33gm

4

DEX4 FAST ACTING GLUCOSE -glucose-vitamin c chew tab 4-0.006gm

4

DEX4 GLUCOSE - glucose chew tab 4gm

4

DEX4 GLUCOSE - glucose oral liquid15 gm/59ml

4

DEX4 NATURALS - glucose-vitamin cchew tab 4-0.006 gm

4

DEX4 POUCH PACK - glucose-vitaminc chew tab 4-0.006 gm

4

DEX4 QUICK DISSOLVE GLUCO -glucose chew tab 4 gm

4

DIABETA - glyburide tab 1.25 mg 4

DIABETA - glyburide tab 2.5 mg 4

DIABETA - glyburide tab 5 mg 4

DRUG MART GLUCOSE - glucosechew tab 4 gm

4

DRUG MART GLUCOSE - glucose-vitamin c chew tab 4-0.006 gm

4

DUETACT - pioglitazone hcl-glimepiridetab 30-2 mg

4

2015


Drug Name Dru

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Lim

its

DUETACT - pioglitazone hcl-glimepiridetab 30-4 mg

4

FARXIGA - dapagliflozin propanedioltab 10 mg (base equivalent)

4 •

FORTAMET - metformin hcl tab sr 24hrosmotic 500 mg

4

FORTAMET - metformin hcl tab sr 24hrosmotic 1000 mg

4

glimepiride tab 1 mg (Amaryl) 1



glipizide tab sr 24hr 2.5 mg (Glucotrolxl)

1

glipizide tab sr 24hr 5 mg (Glucotrolxl)

1

glipizide tab sr 24hr 10 mg (Glucotrolxl)

1

glipizide tab 5 mg (Glucotrol) 1

glipizide tab 10 mg (Glucotrol) 1

glipizide-metformin hcl tab2.5-250 mg

2

glipizide-metformin hcl tab2.5-500 mg

2

glipizide-metformin hcl tab 5-500 mg 2

GLUCAGEN HYPOKIT - glucagon hcl(rdna) for inj 1 mg (base equiv)

4

GLUCAGON EMERGENCY KIT -glucagon (rdna) for inj kit 1 mg

3

GLUCOPHAGE - metformin hcl tab 500mg

4

GLUCOPHAGE - metformin hcl tab 850mg

4

GLUCOPHAGE - metformin hcl tab1000 mg

4

GLUCOPHAGE XR - metformin hcl tabsr 24hr 500 mg

4

GLUCOPHAGE XR - metformin hcl tabsr 24hr 750 mg

4

GLUCOSE - glucose chew tab 4 gm 4

Drug Name Dru

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Lim

its

GLUCOSE - glucose-vitamin c chew tab4-0.006 gm

4

glucose gel 40% 1

glucose oral liquid 15 gm/59ml 2

GLUCOTROL - glipizide tab 5 mg 4

GLUCOTROL - glipizide tab 10 mg 4

GLUCOTROL XL - glipizide tab sr 24hr2.5 mg

4

GLUCOTROL XL - glipizide tab sr 24hr5 mg

4

GLUCOTROL XL - glipizide tab sr 24hr10 mg

4

GLUCOVANCE - glyburide-metformintab 1.25-250 mg

4

GLUCOVANCE - glyburide-metformintab 2.5-500 mg

4

GLUCOVANCE - glyburide-metformintab 5-500 mg

4

GLUMETZA - metformin hcl tab sr 24hrmodified release 500 mg

4

GLUMETZA - metformin hcl tab sr 24hrmodified release 1000 mg

4

GLYBURIDE - glyburide tab 1.25 mg 4

GLYBURIDE - glyburide tab 2.5 mg 4

GLYBURIDE - glyburide tab 5 mg 4

glyburide micronized tab 1.5 mg(Glynase)

1

glyburide micronized tab 3 mg(Glynase)

1

glyburide micronized tab 6 mg(Glynase)

1

glyburide tab 1.25 mg 1

glyburide tab 2.5 mg 1

glyburide tab 5 mg 1

glyburide-metformin tab 1.25-250 mg(Glucovance)

1

glyburide-metformin tab 2.5-500 mg(Glucovance)

1

2015


Drug Name Dru

g T

ier

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ion

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py

Dis

pens

ing

Lim

its

glyburide-metformin tab 5-500 mg(Glucovance)

1

GLYNASE - glyburide micronized tab1.5 mg

4

GLYNASE - glyburide micronized tab 3mg

4

GLYNASE - glyburide micronized tab 6mg

4

GLYSET - miglitol tab 25 mg 4



GLYXAMBI - empagliflozin-linagliptintab 10-5 mg

4 •

GLYXAMBI - empagliflozin-linagliptintab 25-5 mg

4 •

GNP GLUCOSE - glucose chew tab 4gm

4

GNP GLUCOSE - glucose-vitamin cchew tab 4-0.006 gm

4

GNP QUICK DISSOLVE GLUCOS -glucose chew tab 4 gm

4

HM GLUCOSE - glucose-vitamin c chewtab 4-0.006 gm

4

HY-VEE GLUCOSE - glucose-vitamin cchew tab 4-0.006 gm

4

INSTA-GLUCOSE - glucose gel 77.4% 4

INVOKAMET - canagliflozin-metforminhcl tab 50-500 mg

4 •


4 •


4 •


4 •

INVOKANA - canagliflozin tab 100 mg 4 •INVOKANA - canagliflozin tab 300 mg 4 •JANUMET - sitagliptin-metformin hcl tab

50-500 mg4 •

Drug Name Dru

g T

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ing

Lim

its

JANUMET - sitagliptin-metformin hcl tab50-1000 mg

4 •

JANUMET XR - sitagliptin-metformin hcltab sr 24hr 50-500 mg

4 •


4 •


4 •

JANUVIA - sitagliptin phosphate tab 25mg (base equiv)

4 •


4 •


4 •

JARDIANCE - empagliflozin tab 10 mg 3 •JARDIANCE - empagliflozin tab 25 mg 3 •JENTADUETO - linagliptin-metformin

hcl tab 2.5-500 mg4 •

JENTADUETO - linagliptin-metforminhcl tab 2.5-850 mg

4 •

JENTADUETO - linagliptin-metforminhcl tab 2.5-1000 mg

4 •

KAZANO - alogliptin-metformin hcl tab12.5-500 mg

4 •

KAZANO - alogliptin-metformin hcl tab12.5-1000 mg

4 •

KOMBIGLYZE XR - saxagliptin-metformin hcl tab sr 24hr 2.5-1000mg

4 •

KOMBIGLYZE XR - saxagliptin-metformin hcl tab sr 24hr 5-500 mg

4 •

KOMBIGLYZE XR - saxagliptin-metformin hcl tab sr 24hr 5-1000 mg

4 •

KORLYM - mifepristone tab 300 mg 5 •KROGER GLUCOSE - glucose chew

tab 4 gm4

KROGER GLUCOSE - glucose-vitaminc chew tab 4-0.006 gm

4

LEADER GLUCOSE - glucose chew tab4 gm

4

2015


Drug Name Dru

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ing

Lim

its

LEADER GLUCOSE - glucose-vitamin cchew tab 4-0.006 gm

4

LEADER QUICK DISSOLVE GLU -glucose chew tab 4 gm

4

LONGS GLUCOSE - glucose chew tab4 gm

4

LONGS GLUCOSE - glucose-vitamin cchew tab 4-0.006 gm

4

MEDICINE SHOPPE GLUCOSE -glucose chew tab 4 gm

4

MEIJER GLUCOSE - glucose-vitamin cchew tab 4-0.006 gm

4

metformin hcl tab sr 24hr 500 mg(Glucophage xr)

1

metformin hcl tab sr 24hr 750 mg(Glucophage xr)

1

metformin hcl tab sr 24hr osmotic500 mg (Fortamet)

2

metformin hcl tab sr 24hr osmotic1000 mg (Fortamet)

2

metformin hcl tab 500 mg(Glucophage)

1


1


1

MS QUICK DISSOLVE GLUCOSE -glucose chew tab 4 gm

4

nateglinide tab 60 mg (Starlix) 2

nateglinide tab 120 mg (Starlix) 2

NESINA - alogliptin benzoate tab 6.25mg (base equiv)

4 •

NESINA - alogliptin benzoate tab 12.5mg (base equiv)

4 •

NESINA - alogliptin benzoate tab 25 mg(base equiv)

4 •

ONGLYZA - saxagliptin hcl tab 2.5 mg(base equiv)

4 •

ONGLYZA - saxagliptin hcl tab 5 mg(base equiv)

4 •

Drug Name Dru

g T

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pens

ing

Lim

its

OSENI - alogliptin-pioglitazone tab12.5-15 mg

4 •


4 •


4 •

OSENI - alogliptin-pioglitazone tab25-15 mg

4 •


4 •


4 •

pioglitazone hcl tab 15 mg (baseequiv) (Actos)

1


1


1

pioglitazone hcl-glimepiride tab30-2 mg (Duetact)

2

pioglitazone hcl-glimepiride tab30-4 mg (Duetact)

2

pioglitazone hcl-metformin hcl tab15-500 mg (Actoplus met)

2

pioglitazone hcl-metformin hcl tab15-850 mg (Actoplus met)

2

PRANDIMET - repaglinide-metforminhcl tab 1-500 mg

4

PRANDIMET - repaglinide-metforminhcl tab 2-500 mg

4

PRANDIN - repaglinide tab 0.5 mg 4

PRANDIN - repaglinide tab 1 mg 4

PRANDIN - repaglinide tab 2 mg 4

PRECOSE - acarbose tab 25 mg 4



PREFERRED PLUS GLUCOSE -glucose chew tab 4 gm

4

2015


Drug Name Dru

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Dis

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ing

Lim

its

PREFERRED PLUS GLUCOSE -glucose-vitamin c chew tab 4-0.006gm

4

PROGLYCEM - diazoxide susp 50 mg/ml

4

PX GLUCOSE - glucose-vitamin c chewtab 4-0.006 gm

4

RA GLUCOSE - glucose-vitamin c chewtab 4-0.006 gm

4

RELION GLUCOSE - glucose-vitamin cchew tab 4-0.006 gm

4

repaglinide tab 0.5 mg (Prandin) 2

repaglinide tab 1 mg (Prandin) 2

repaglinide tab 2 mg (Prandin) 2

RIOMET - metformin hcl oral soln 500mg/5ml

4

SM GLUCOSE - glucose chew tab 4 gm 4

SM GLUCOSE - glucose-vitamin c chewtab 4-0.006 gm

4

SMART SENSE GLUCOSE - glucose-vitamin c chew tab 4-0.006 gm

4

STARLIX - nateglinide tab 60 mg 4

STARLIX - nateglinide tab 120 mg 4

SYMLINPEN 120 - pramlintide acetatepen-inj 2700 mcg/2.7ml (1000 mcg/ml)

4 •

SYMLINPEN 60 - pramlintide acetatepen-inj 1500 mcg/1.5ml (1000 mcg/ml)

4 •

TANZEUM - albiglutide for soln pen-injector 30 mg

4 • •

TANZEUM - albiglutide for soln pen-injector 50 mg

4 • •

TGT GLUCOSE - glucose-vitamin cchew tab 4-0.006 gm

4

TOLAZAMIDE - tolazamide tab 500 mg 4

tolazamide tab 250 mg 2

TOLBUTAMIDE - tolbutamide tab 500mg

4

Drug Name Dru

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ier

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Dis

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ing

Lim

its

TRADJENTA - linagliptin tab 5 mg 4 •TRULICITY - dulaglutide soln pen-

injector 0.75 mg/0.5ml4 • •

TRULICITY - dulaglutide soln pen-injector 1.5 mg/0.5ml

4 • •

ULTILET GLUCOSE - glucose chew tab4 gm

4

UP & UP GLUCOSE - glucose-vitamin cchew tab 4-0.006 gm

4

VALUE PLUS GLUCOSE - glucosechew tab 4 gm

4

VALUE PLUS GLUCOSE - glucose-vitamin c chew tab 4-0.006 gm

4

VICTOZA - liraglutide soln pen-injector18 mg/3ml (6 mg/ml)

3 • •

WALGREENS GLUCOSE - glucosechew tab 4 gm

4

WALGREENS GLUCOSE - glucose-vitamin c chew tab 4-0.006 gm

4

XIGDUO XR - dapagliflozin-metforminhcl tab sr 24hr 5-500 mg

4 •


4 •


4 •


4 •

Rapid-Acting Insulins

APIDRA - insulin glulisine inj 100 unit/ml 4 • •APIDRA SOLOSTAR - insulin glulisine

soln pen-injector inj 100 unit/ml4 • •

HUMALOG - insulin lispro (human) solncartridge 100 unit/ml

4 • •

HUMALOG - insulin lispro (human) inj100 unit/ml

4 • •

HUMALOG KWIKPEN - insulin lispro(human) soln pen-injector 100 unit/ml

4 • •

HUMALOG KWIKPEN - insulin lispro(human) soln pen-injector 200 unit/ml

4 • •

2015


Drug Name Dru

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ing

Lim

its

NOVOLOG - insulin aspart inj 100 unit/ml

2 •

NOVOLOG FLEXPEN - insulin aspartsoln pen-injector 100 unit/ml

2 •

NOVOLOG PENFILL - insulin aspartsoln cartridge 100 unit/ml

2 •

NOVOLOG PENFILL - insulin aspart inj100 unit/ml

2 •

Short-Acting Insulins

AFREZZA - insulin regular (human)inhalation powder 4 unit/cartridge

4 • •

AFREZZA - insulin regular (human)inhal powd 4 (30) & 8 (60) unit/cart

4 • •

AFREZZA - insulin regular (human)inhal powd 4 (60) & 8 (30) unit/cart

4 • •

AFREZZA - insulin regular (human) inhpowd 8 (60) & 12 (30) unit/cart

4 • •

HUMULIN R - insulin regular (human) inj100 unit/ml

4 • •

HUMULIN R U-500 (CONCENTR -insulin regular (human) inj 500 unit/ml

4 •

NOVOLIN R - insulin regular (human) inj100 unit/ml

2 •

NOVOLIN R RELION - insulin regular(human) inj 100 unit/ml

2 •

RELION R - insulin regular (human) inj100 unit/ml

3 •

Intermediate-Acting Insulins

HUMALOG MIX 50/50 - insulin lisproprot & lispro (human) inj 100 unit/ml(50-50)

4 • •

HUMALOG MIX 50/50 KWIKPEN -insulin lispro prot & lispro sus pen-inj100 unit/ml (50-50)

4 • •

HUMALOG MIX 75/25 - insulin lisproprot & lispro (human) inj 100 unit/ml(75-25)

4 • •

HUMALOG MIX 75/25 KWIKPEN -insulin lispro prot & lispro sus pen-inj100 unit/ml (75-25)

4 • •

Drug Name Dru

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Lim

its

HUMULIN N - insulin nph (human)(isophane) inj 100 unit/ml

4 • •

HUMULIN N KWIKPEN - insulin nph(human) (isophane) susp pen-injector100 unit/ml

4 • •

HUMULIN N U-100 PEN - insulin nph(human) (isophane) susp pen-injector100 unit/ml

4 • •

HUMULIN 70/30 - insulin nph isophane& regular human inj 100 unit/ml(70-30)

4 • •

HUMULIN 70/30 KWIKPEN - insulin nph& regular susp pen-inj 100 unit/ml(70-30)

4 • •

HUMULIN 70/30 PEN - insulin nph& regular susp pen-inj 100 unit/ml(70-30)

4 • •

NOVOLIN N - insulin nph (human)(isophane) inj 100 unit/ml

2 •

NOVOLIN N RELION - insulin nph(human) (isophane) inj 100 unit/ml

2 •

NOVOLIN 70/30 - insulin nph isophane& regular human inj 100 unit/ml(70-30)

2 •

NOVOLIN 70/30 RELION - insulin nphisophane & regular human inj 100unit/ml (70-30)

2 •

NOVOLOG MIX 70/30 - insulin aspartprot & aspart (human) inj 100 unit/ml(70-30)

2 •

NOVOLOG MIX 70/30 PREFILL - insulinaspart prot & aspart sus pen-inj 100unit/ml (70-30)

2 •

Basal Insulins

LANTUS - insulin glargine inj 100 unit/ml 3 •LANTUS SOLOSTAR - insulin glargine

soln pen-injector 100 unit/ml3 •

LEVEMIR - insulin detemir inj 100 unit/ml

3 •

LEVEMIR FLEXPEN - insulin detemirsoln pen-injector 100 unit/ml

3 •

2015


Drug Name Dru

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ing

Lim

its

LEVEMIR FLEXTOUCH - insulindetemir soln pen-injector 100 unit/ml

3 •

TOUJEO SOLOSTAR - insulin glarginesoln pen-injector 300 unit/ml

3 •

THYROID AGENTS

ARMOUR THYROID - thyroid tab 15 mg(1/4 grain)

4

ARMOUR THYROID - thyroid tab 30 mg(1/2 grain)

4

ARMOUR THYROID - thyroid tab 60 mg(1 grain)

4

ARMOUR THYROID - thyroid tab 90 mg(1 1/2 grain)

4

ARMOUR THYROID - thyroid tab 120mg (2 grain)

4


4


4


4

CYTOMEL - liothyronine sodium tab 5mcg

4


4


4

levothyroxine sodium tab 25 mcg(Synthroid)

1


1


1


1


1


1

Drug Name Dru

g T

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ing

Lim

its


1


1


1


1


1


1

liothyronine sodium tab 5 mcg(Cytomel)

2


2


2

methimazole tab 5 mg (Tapazole) 1

methimazole tab 10 mg (Tapazole) 1

NATURE-THROID - thyroid tab 16.25mg

4

NATURE-THROID - thyroid tab 32.5 mg 4

NATURE-THROID - thyroid tab 48.75mg (3/4 grain)

4

NATURE-THROID - thyroid tab 65 mg 4


4

NATURE-THROID - thyroid tab 97.5 mg 4


4




NATURE-THROID - thyroid tab 325 mg(5 grain)

4


4

2015


Drug Name Dru

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ing

Lim

its

NATURE-THROID NT-2.5 - thyroid tab162.5 mg (2 1/2 grain)

4

propylthiouracil tab 50 mg 2

SYNTHROID - levothyroxine sodium tab25 mcg

4


4


4


4


4


4


4


4


4


4


4


4

TAPAZOLE - methimazole tab 5 mg 4

TAPAZOLE - methimazole tab 10 mg 4

thyroid tab 30 mg (1/2 grain) (Armourthyroid)

1

thyroid tab 60 mg (1 grain) (Armourthyroid)

1

thyroid tab 90 mg (1 1/2 grain)(Armour thyroid)

1

THYROLAR-1 - liotrix (t3-t4) tab 60 mg(12.5-50 mcg)

4

THYROLAR-1/2 - liotrix (t3-t4) tab 30mg (6.25-25 mcg)

4

Drug Name Dru

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Dis

pens

ing

Lim

its

THYROLAR-1/4 - liotrix (t3-t4) tab 15mg (3.1-12.5 mcg)

4

THYROLAR-2 - liotrix (t3-t4) tab 120 mg(25-100 mcg)

4

THYROLAR-3 - liotrix (t3-t4) tab 180 mg(37.5-150 mcg)

4

TIROSINT - levothyroxine sodium cap13 mcg

4


4


4


4


4


4


4


4


4


4

WESTHROID - thyroid tab 16.25 mg 4


WESTHROID - thyroid tab 48.75 mg(3/4 grain)

4

WESTHROID - thyroid tab 65 mg 4





WESTHROID - thyroid tab 162.5 mg (21/2 grain)

4



2015


Drug Name Dru

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Dis

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ing

Lim

its

WESTHROID - thyroid tab 325 mg (5grain)

4


WESTHROID-P - thyroid tab 16.25 mg 4


WESTHROID-P - thyroid tab 48.75 mg(3/4 grain)

4

WESTHROID-P - thyroid tab 65 mg 4


WESTHROID-P - thyroid tab 130 mg 4

WP THYROID - thyroid tab 16.25 mg 4


WP THYROID - thyroid tab 48.75 mg(3/4 grain)

4

WP THYROID - thyroid tab 65 mg 4




WP THYROID - thyroid tab 130 mg 4

OXYTOCICS

CERVIDIL - dinoprostone vaginal inserts10 mg

4

methylergonovine maleate tab0.2 mg

2

PREPIDIL - dinoprostone cervical gel0.5 mg/3gm

4

PROSTIN E2 - dinoprostone vaginalsuppos 20 mg

4

ENDOCRINE and METABOLIC AGENTS - MISC.

ACTHAR HP - corticotropin inj gel 80unit/ml

5 •

ACTONEL - risedronate sodium tab 5mg

4 •


4 •


4 •

Drug Name Dru

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ier

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ing

Lim

its


4 •

ALENDRONATE SODIUM - alendronatesodium oral soln 70 mg/75ml

4 •

ALENDRONATE SODIUM - alendronatesodium tab 40 mg

4 •

alendronate sodium tab 5 mg 1 •alendronate sodium tab 10 mg 1 •alendronate sodium tab 35 mg 1 •alendronate sodium tab 70 mg

(Fosamax)1 •

ATELVIA - risedronate sodium tabdelayed release 35 mg

4 •

BINOSTO - alendronate sodiumeffervescent tab 70 mg

4 •

BONIVA - ibandronate sodium tab 150mg (base equivalent)

4 •

BUPHENYL - sodium phenylbutyratetab 500 mg

5 •

BUPHENYL - sodium phenylbutyrateoral powder 3 gm/teaspoonful

5 •

cabergoline tab 0.5 mg 2

calcitonin (salmon) nasal soln 200unit/act (Miacalcin)

2

calcitriol cap 0.25 mcg (Rocaltrol) 2

calcitriol cap 0.5 mcg (Rocaltrol) 2

calcitriol oral soln 1 mcg/ml(Rocaltrol)

2

CARBAGLU - carglumic acid tab 200mg

5 •

CARNITOR - levocarnitine tab 330 mg 4

CARNITOR - levocarnitine oral soln 1gm/10ml (10%)

4

CARNITOR SF - levocarnitine oral soln1 gm/10ml (10%)

4

CYSTADANE - betaine powder for oralsolution

4

DDAVP - desmopressin acetate nasalsoln 0.01% (refrigerated)

4

2015


Drug Name Dru

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ion

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Dis

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ing

Lim

its

DDAVP - desmopressin acetate nasalspray soln 0.01%

4

DDAVP - desmopressin acetate tab 0.1mg

4

DDAVP - desmopressin acetate tab 0.2mg

4

DDAVP - desmopressin acetate inj 4mcg/ml

4

desmopressin acetate inj 4 mcg/ml(Ddavp)

2

desmopressin acetate nasal soln0.01% (refrigerated) (Ddavp)

2

desmopressin acetate nasal spraysoln 0.01% (Ddavp)

2

desmopressin acetate nasal spraysoln 0.01% (refrigerated)

2

desmopressin acetate tab 0.1 mg(Ddavp)

2

desmopressin acetate tab 0.2 mg(Ddavp)

2

DIDRONEL - etidronate disodium tab400 mg

4

doxercalciferol cap 0.5 mcg(Hectorol)

2

doxercalciferol cap 1 mcg (Hectorol) 2

doxercalciferol cap 2.5 mcg(Hectorol)

2

EGRIFTA - tesamorelin acetate for inj 1mg (base equiv)

5 •

EGRIFTA - tesamorelin acetate for inj 2mg (base equiv)

5 •

ETIDRONATE DISODIUM - etidronatedisodium tab 200 mg

4

ETIDRONATE DISODIUM - etidronatedisodium tab 400 mg

4

EVISTA - raloxifene hcl tab 60 mg 4

FORTEO - teriparatide (recombinant) inj600 mcg/2.4ml

5 • •

FORTICAL - calcitonin (salmon) nasalsoln 200 unit/act

4

Drug Name Dru

g T

ier

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ion

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Dis

pens

ing

Lim

its

FOSAMAX - alendronate sodium tab 70mg

4 •

FOSAMAX PLUS D - alendronatesodium-cholecalciferol tab 70-2800mg-unit

4 •

FOSAMAX PLUS D - alendronatesodium-cholecalciferol tab 70-5600mg-unit

4 •

GENOTROPIN - somatropin forsubcutaneous inj 5 mg

5 •

GENOTROPIN - somatropin for inj 12mg (13.8 mg overfill)

5 •

GENOTROPIN MINIQUICK -somatropin for inj 0.2 mg

5 •


5 •


5 •


5 •

GENOTROPIN MINIQUICK -somatropin for inj 1 mg

5 •


5 •


5 •


5 •


5 •

GENOTROPIN MINIQUICK -somatropin for inj 2 mg

5 •

H.P. ACTHAR - corticotropin inj gel 80unit/ml

5 •

HECTOROL - doxercalciferol cap 0.5mcg

4

HECTOROL - doxercalciferol cap 1 mcg 4

HECTOROL - doxercalciferol cap 2.5mcg

4

HUMATROPE - somatropin for inj 5 mg 5 •

2015


Drug Name Dru

g T

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Dis

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ing

Lim

its

HUMATROPE - somatropin for inj 6 mg(18 unit)

5 •

HUMATROPE - somatropin for inj 12mg (36 unit)

5 •

HUMATROPE - somatropin for inj 24mg

5 •

HUMATROPE COMBO PACK -somatropin for inj 5 mg

5 •

ibandronate sodium tab 150 mg(base equivalent) (Boniva)

2 •

INCRELEX - mecasermin inj 40 mg/4ml(10 mg/ml)

5 •

KUVAN - sapropterin dihydrochloridesoluble tab 100 mg

5 •

KUVAN - sapropterin dihydrochloridepowder packet 100 mg

5 •

KUVAN - sapropterin dihydrochloridepowder packet 500 mg

5 •

levocarnitine oral soln 1 gm/10ml(10%) (Carnitor)

2

levocarnitine tab 330 mg (Carnitor) 2

MIACALCIN - calcitonin (salmon) inj 200unit/ml

4

MIACALCIN - calcitonin (salmon) nasalsoln 200 unit/act

4

MYALEPT - metreleptin forsubcutaneous inj 11.3 mg

5

NATPARA - parathyroid hormone(recombinant) for inj cartridge 25 mcg

5


5


5

NATPARA - parathyroid hormone(recombinant) for inj cartridge 100mcg

5

NORDITROPIN CARTRIDGE -somatropin inj 5 mg/1.5ml

5 •

NORDITROPIN FLEXPRO - somatropininj 5 mg/1.5ml

5 •

Drug Name Dru

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ing

Lim

its


5 •


5 •

NORDITROPIN FLEXPRO - somatropininj 30 mg/3ml

5 •

NORDITROPIN NORDIFLEX PEN -somatropin inj 30 mg/3ml

5 •

NUTROPIN AQ NUSPIN 10 -somatropin inj 10 mg/2ml

5 •

NUTROPIN AQ NUSPIN 20 -somatropin inj 20 mg/2ml

5 •

NUTROPIN AQ NUSPIN 5 - somatropininj 5 mg/2ml

5 •

NUTROPIN AQ PEN - somatropin inj 10mg/2ml

5 •

NUTROPIN AQ PEN - somatropin inj 20mg/2ml

5 •

octreotide acetate inj 50 mcg/ml(0.05 mg/ml) (Sandostatin)

5 •


5 •


5 •


5 •

octreotide acetate inj 1000 mcg/ml(1 mg/ml) (Sandostatin)

5 •

OMNITROPE - somatropin inj 5mg/1.5ml

5 •

OMNITROPE - somatropin inj 10mg/1.5ml

5 •

OMNITROPE - somatropin for inj 5.8 mg 5 •ORFADIN - nitisinone cap 2 mg 5 •ORFADIN - nitisinone cap 5 mg 5 •ORFADIN - nitisinone cap 10 mg 5 •OSPHENA - ospemifene tab 60 mg 4

paricalcitol cap 1 mcg (Zemplar) 2


2015


Drug Name Dru

g T

ier

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ion

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py

Dis

pens

ing

Lim

its


raloxifene hcl tab 60 mg (Evista) 2

RAVICTI - glycerol phenylbutyrate liquid1.1 gm/ml

5 •

risedronate sodium tab delayedrelease 35 mg (Atelvia)

2 •

risedronate sodium tab 5 mg(Actonel)

2 •


2 •


2 •


2 •

ROCALTROL - calcitriol oral soln 1 mcg/ml

4

ROCALTROL - calcitriol cap 0.25 mcg 4

ROCALTROL - calcitriol cap 0.5 mcg 4

SAIZEN - somatropin (non-refrigerated)for inj 5 mg

5 •

SAIZEN - somatropin (non-refrigerated)for inj 8.8 mg

5 •

SAIZEN CLICK.EASY - somatropin(non-refrigerated) for inj 8.8 mg

5 •

SAMSCA - tolvaptan tab 15 mg 5 • •SAMSCA - tolvaptan tab 30 mg 5 • •SANDOSTATIN - octreotide acetate inj

50 mcg/ml (0.05 mg/ml)5 •

SANDOSTATIN - octreotide acetate inj100 mcg/ml (0.1 mg/ml)

5 •


5 •


5 •

SANDOSTATIN - octreotide acetate inj1000 mcg/ml (1 mg/ml)

5 •

SENSIPAR - cinacalcet hcl tab 30 mg(base equiv)

3

Drug Name Dru

g T

ier

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Dis

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ing

Lim

its


3


3

SEROSTIM - somatropin (non-refrigerated) for subcutaneous inj 4mg

5 •


5 •


5 •

SIGNIFOR - pasireotide diaspartate inj0.3 mg/ml (base equiv)

5 • •


5 • •


5 • •

sodium phenylbutyrate oral powder3 gm/teaspoonful (Buphenyl)

5 •

SOMAVERT - pegvisomant for inj 10 mg(as protein)

5 •


5 •


5 •


5


5

STIMATE - desmopressin acetate nasalsoln 1.5 mg/ml

3

SYNAREL - nafarelin acetate nasal soln2 mg/ml

3

TEV-TROPIN - somatropin forsubcutaneous inj 5 mg

5 •

ZEMPLAR - paricalcitol cap 1 mcg 4

ZEMPLAR - paricalcitol cap 2 mcg 4

2015


Drug Name Dru

g T

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ion

Ste

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py

Dis

pens

ing

Lim

its

ZOMACTON - somatropin forsubcutaneous inj 5 mg

5 •

ZOMACTON - somatropin for inj 10 mg 5 •ZORBTIVE - somatropin (non-

refrigerated) for subcutaneous inj 8.8mg

5 •

CARDIOVASCULAR AGENTS

CARDIOTONICS

DIGOXIN - digoxin oral soln 0.05 mg/ml 4

digoxin tab 125 mcg (0.125 mg)(Lanoxin)

1

digoxin tab 250 mcg (0.25 mg)(Lanoxin)

1

LANOXIN - digoxin tab 62.5 mcg(0.0625 mg)

4

LANOXIN - digoxin tab 125 mcg (0.125mg)

4

LANOXIN - digoxin tab 187.5 mcg(0.1875 mg)

4

LANOXIN - digoxin tab 250 mcg (0.25mg)

4

ANTIANGINAL AGENTS

DILATRATE SR - isosorbide dinitratecap cr 40 mg

4

ISORDIL TITRADOSE - isosorbidedinitrate tab 5 mg

4

ISORDIL TITRADOSE - isosorbidedinitrate tab 40 mg

4

ISOSORBIDE DINITRATE - isosorbidedinitrate tab 30 mg

4

isosorbide dinitrate tab cr 40 mg 2

isosorbide dinitrate tab 5 mg (Isordiltitradose)

2

isosorbide dinitrate tab 10 mg 2

isosorbide dinitrate tab 20 mg 2

isosorbide mononitrate tab sr 24hr30 mg (Imdur)

1


1

Drug Name Dru

g T

ier

Prio

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rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


1

isosorbide mononitrate tab 10 mg 1

isosorbide mononitrate tab 20 mg 1

NITRO-BID - nitroglycerin oint 2% 4

NITRO-DUR - nitroglycerin td patch24hr 0.1 mg/hr

4


4


4


4


4


4

nitroglycerin cap cr 2.5 mg 1

nitroglycerin cap cr 6.5 mg 2

nitroglycerin cap cr 9 mg 2

NITROGLYCERIN LINGUAL -nitroglycerin lingual aerosol 400 mcg/spray

4

nitroglycerin td patch 24hr 0.1 mg/hr(Nitro-dur)

2


2


2


2

nitroglycerin tl soln 0.4 mg/spray(400 mcg/spray) (Nitrolingualpumpspr)

2

NITROLINGUAL PUMPSPRAY -nitroglycerin tl soln 0.4 mg/spray (400mcg/spray)

4

NITROMIST - nitroglycerin lingualaerosol 400 mcg/spray

4

NITROSTAT - nitroglycerin sl tab 0.3 mg 3

2015


Drug Name Dru

g T

ier

Prio

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ion

Ste

p T

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py

Dis

pens

ing

Lim

its



RANEXA - ranolazine tab sr 12hr 500mg

4

RANEXA - ranolazine tab sr 12hr 1000mg

4

BETA BLOCKERS

acebutolol hcl cap 200 mg (Sectral) 1

acebutolol hcl cap 400 mg (Sectral) 1

atenolol tab 25 mg (Tenormin) 1



BETAPACE - sotalol hcl tab 80 mg 4



BETAPACE AF - sotalol hcl (afib/afl) tab80 mg

4


4


4

betaxolol hcl tab 10 mg (Kerlone) 2

betaxolol hcl tab 20 mg (Kerlone) 2

bisoprolol fumarate tab 5 mg(Zebeta)

2

bisoprolol fumarate tab 10 mg(Zebeta)

2

BYSTOLIC - nebivolol hcl tab 2.5 mg(base equivalent)

4

BYSTOLIC - nebivolol hcl tab 5 mg(base equivalent)

4


4


4

carvedilol tab 3.125 mg (Coreg) 1



Drug Name Dru

g T

ier

Prio

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ion

Ste

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py

Dis

pens

ing

Lim

its

carvedilol tab 25 mg (Coreg) 1

COREG - carvedilol tab 3.125 mg 4



COREG - carvedilol tab 25 mg 4

COREG CR - carvedilol phosphate capsr 24hr 10 mg

4


4


4


4

CORGARD - nadolol tab 20 mg 4



HEMANGEOL - propranolol hcl oral soln4.28 mg/ml

4

INDERAL LA - propranolol hcl cap sr24hr 60 mg

4


4


4


4

INDERAL XL - propranolol hclsustained-release beads cap sr 24hr80 mg

4

INDERAL XL - propranolol hclsustained-release beads cap sr 24hr120 mg

4

INNOPRAN XL - propranolol hclsustained-release beads cap sr 24hr80 mg

4

INNOPRAN XL - propranolol hclsustained-release beads cap sr 24hr120 mg

4

KERLONE - betaxolol hcl tab 10 mg 4

2015


Drug Name Dru

g T

ier

Prio

r A

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ion

Ste

p T

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py

Dis

pens

ing

Lim

its

KERLONE - betaxolol hcl tab 20 mg 4

labetalol hcl tab 100 mg (Trandate) 2



LEVATOL - penbutolol sulfate tab 20 mg 4

LOPRESSOR - metoprolol tartrate tab50 mg

4

LOPRESSOR - metoprolol tartrate tab100 mg

4

metoprolol succinate tab sr 24hr25 mg (Toprol xl)

2


2


2


2

metoprolol tartrate tab 25 mg 1

metoprolol tartrate tab 50 mg(Lopressor)

1

metoprolol tartrate tab 100 mg(Lopressor)

1

nadolol tab 20 mg (Corgard) 2



pindolol tab 5 mg 2

pindolol tab 10 mg 2

PROPRANOLOL HCL - propranolol hcloral soln 20 mg/5ml

4

PROPRANOLOL HCL - propranolol hcloral soln 40 mg/5ml

4

propranolol hcl cap sr 24hr 60 mg(Inderal la)

2


2


2


2

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

propranolol hcl tab 10 mg 1





SECTRAL - acebutolol hcl cap 200 mg 4

SECTRAL - acebutolol hcl cap 400 mg 4

sotalol hcl (afib/afl) tab 80 mg(Betapace af)

2


2


2

sotalol hcl tab 80 mg (Betapace) 1



sotalol hcl tab 240 mg 2

SOTYLIZE - sotalol hcl oral solution 5mg/ml

4

TENORMIN - atenolol tab 25 mg 4



TIMOLOL MALEATE - timolol maleatetab 5 mg

4


4


4

TOPROL XL - metoprolol succinate tabsr 24hr 25 mg

4


4


4


4

TRANDATE - labetalol hcl tab 100 mg 4


2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


ZEBETA - bisoprolol fumarate tab 5 mg 4

ZEBETA - bisoprolol fumarate tab 10mg

4

CALCIUM CHANNEL BLOCKERS

ADALAT CC - nifedipine tab sr 24hr 30mg

4


4


4

amlodipine besylate tab 2.5 mg(Norvasc)

1

amlodipine besylate tab 5 mg(Norvasc)

1

amlodipine besylate tab 10 mg(Norvasc)

1

CALAN - verapamil hcl tab 80 mg 4

CALAN - verapamil hcl tab 120 mg 4

CALAN SR - verapamil hcl tab cr 120mg

4


4


4

CARDIZEM - diltiazem hcl tab 30 mg 4



CARDIZEM CD - diltiazem hcl coatedbeads cap sr 24hr 120 mg

4


4


4


4


4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

CARDIZEM LA - diltiazem hcl coatedbeads tab sr 24hr 120 mg

4


4


4


4


4


4

diltiazem hcl cap sr 12hr 60 mg 2






diltiazem hcl coated beads cap sr24hr 120 mg (Cardizem cd)

1


1


2


2


2

diltiazem hcl coated beads tab sr24hr 180 mg (Cardizem la)

2


2


2


2


2

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

diltiazem hcl extended release beadscap sr 24hr 120 mg (Tiazac)

2


2


2


2


2


2

diltiazem hcl tab 30 mg (Cardizem) 1


diltiazem hcl tab 90 mg 1


felodipine tab sr 24hr 2.5 mg 2

felodipine tab sr 24hr 5 mg 2

felodipine tab sr 24hr 10 mg 2

ISOPTIN SR - verapamil hcl tab cr 120mg

4


4


4

isradipine cap 2.5 mg 2

isradipine cap 5 mg 2

nicardipine hcl cap 20 mg 2

nicardipine hcl cap 30 mg 2

nifedipine cap 10 mg (Procardia) 2

nifedipine cap 20 mg 2

nifedipine tab sr 24hr 30 mg (Adalatcc)

2


2


2

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

nifedipine tab sr 24hr osmotic 30 mg(Procardia xl)

2


2


2

nimodipine cap 30 mg 2

NISOLDIPINE - nisoldipine tab sr 24hr20 mg

4


4


4

NISOLDIPINE ER - nisoldipine tab sr24hr 25.5 mg

4

nisoldipine tab sr 24hr 8.5 mg (Sular) 2

nisoldipine tab sr 24hr 17 mg (Sular) 2

nisoldipine tab sr 24hr 34 mg (Sular) 2

NORVASC - amlodipine besylate tab2.5 mg

4

NORVASC - amlodipine besylate tab 5mg

4

NORVASC - amlodipine besylate tab 10mg

4

NYMALIZE - nimodipine oral soln 60mg/20ml

4

PROCARDIA - nifedipine cap 10 mg 4

PROCARDIA XL - nifedipine tab sr 24hrosmotic 30 mg

4


4


4

SULAR - nisoldipine tab sr 24hr 8.5 mg 4

SULAR - nisoldipine tab sr 24hr 17 mg 4

SULAR - nisoldipine tab sr 24hr 34 mg 4

TIAZAC - diltiazem hcl extended releasebeads cap sr 24hr 120 mg

4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


4


4


4


4


4

VERAPAMIL HCL - verapamil hcl tab 40mg

4

verapamil hcl cap sr 24hr 100 mg(Verelan pm)

2

verapamil hcl cap sr 24hr 120 mg(Verelan)

2


2


2


2


2


2

verapamil hcl tab cr 120 mg (Calansr)

1


1


1

verapamil hcl tab 80 mg (Calan) 1

verapamil hcl tab 120 mg (Calan) 1

VERELAN - verapamil hcl cap sr 24hr120 mg

4


4


4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


4

VERELAN PM - verapamil hcl cap sr24hr 100 mg

4


4


4

ANTIARRHYTHMICS

amiodarone hcl tab 100 mg 2

amiodarone hcl tab 200 mg(Cordarone)

1

amiodarone hcl tab 400 mg 2

CORDARONE - amiodarone hcl tab 200mg

4

disopyramide phosphate cap 100 mg(Norpace)

2

disopyramide phosphate cap 150 mg(Norpace)

2

flecainide acetate tab 50 mg 2



mexiletine hcl cap 150 mg 2



MULTAQ - dronedarone hcl tab 400 mg(base equivalent)

4

NORPACE - disopyramide phosphatecap 100 mg

4

NORPACE - disopyramide phosphatecap 150 mg

4

NORPACE CR - disopyramidephosphate cap sr 12hr 100 mg

4

NORPACE CR - disopyramidephosphate cap sr 12hr 150 mg

4

propafenone hcl cap sr 12hr 225 mg(Rythmol sr)

2


2

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


2

propafenone hcl tab 150 mg(Rythmol)

2

propafenone hcl tab 225 mg(Rythmol)

2

propafenone hcl tab 300 mg 2

quinidine gluconate tab cr 324 mg 2

QUINIDINE SULFATE - quinidinesulfate tab 200 mg

4

QUINIDINE SULFATE ER - quinidinesulfate tab cr 300 mg

4

quinidine sulfate tab 300 mg 2

RYTHMOL - propafenone hcl tab 150mg

4

RYTHMOL - propafenone hcl tab 225mg

4

RYTHMOL SR - propafenone hcl cap sr12hr 225 mg

4


4


4

TIKOSYN - dofetilide cap 125 mcg(0.125 mg)

4

TIKOSYN - dofetilide cap 250 mcg (0.25mg)

4

TIKOSYN - dofetilide cap 500 mcg (0.5mg)

4

ANTIHYPERTENSIVES

ACCUPRIL - quinapril hcl tab 5 mg 4




ACCURETIC - quinapril-hydrochlorothiazide tab 10-12.5 mg

4

ACCURETIC - quinapril-hydrochlorothiazide tab 20-12.5 mg

4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

ACCURETIC - quinapril-hydrochlorothiazide tab 20-25 mg

4

ACEON - perindopril erbumine tab 4 mg 4

ACEON - perindopril erbumine tab 8 mg 4

ALTACE - ramipril cap 1.25 mg 4

ALTACE - ramipril cap 2.5 mg 4

ALTACE - ramipril cap 5 mg 4

ALTACE - ramipril cap 10 mg 4

amlodipine besylate-benazepril hclcap 2.5-10 mg (Lotrel)

2

amlodipine besylate-benazepril hclcap 5-10 mg (Lotrel)

2


2


2


2


2

amlodipine besylate-valsartan tab5-160 mg (Exforge)

2


2


2


2

amlodipine-valsartan-hydrochlorothiazide tab5-160-12.5 mg (Exforge hct)

2

amlodipine-valsartan-hydrochlorothiazide tab5-160-25 mg (Exforge hct)

2

amlodipine-valsartan-hydrochlorothiazide tab10-160-12.5 mg (Exforge hct)

2


2

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


2

ATACAND - candesartan cilexetil tab 4mg

4


4


4


4

ATACAND HCT - candesartan cilexetil-hydrochlorothiazide tab 16-12.5 mg

4

ATACAND HCT - candesartan cilexetil-hydrochlorothiazide tab 32-12.5 mg

4

ATACAND HCT - candesartan cilexetil-hydrochlorothiazide tab 32-25 mg

4

atenolol & chlorthalidone tab50-25 mg (Tenoretic 50)

1

atenolol & chlorthalidone tab100-25 mg (Tenoretic 100)

1

AVALIDE - irbesartan-hydrochlorothiazide tab 150-12.5 mg

4

AVALIDE - irbesartan-hydrochlorothiazide tab 300-12.5 mg

4

AVAPRO - irbesartan tab 75 mg 4



AZOR - amlodipine besylate-olmesartanmedoxomil tab 5-20 mg

4


4


4


4

benazepril & hydrochlorothiazide tab5-6.25 mg

2

benazepril & hydrochlorothiazide tab10-12.5 mg (Lotensin hct)

2

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

benazepril & hydrochlorothiazide tab20-12.5 mg (Lotensin hct)

2

benazepril & hydrochlorothiazide tab20-25 mg (Lotensin hct)

2

benazepril hcl tab 5 mg 1

benazepril hcl tab 10 mg (Lotensin) 1



BENICAR - olmesartan medoxomil tab 5mg

4

BENICAR - olmesartan medoxomil tab20 mg

4

BENICAR - olmesartan medoxomil tab40 mg

4

BENICAR HCT - olmesartanmedoxomil-hydrochlorothiazide tab20-12.5 mg

4

BENICAR HCT - olmesartanmedoxomil-hydrochlorothiazide tab40-12.5 mg

4

BENICAR HCT - olmesartanmedoxomil-hydrochlorothiazide tab40-25 mg

4

bisoprolol & hydrochlorothiazide tab2.5-6.25 mg (Ziac)

1

bisoprolol & hydrochlorothiazide tab5-6.25 mg (Ziac)

1

bisoprolol & hydrochlorothiazide tab10-6.25 mg (Ziac)

1

candesartan cilexetil tab 4 mg(Atacand)

2


2


2


2

candesartan cilexetil-hydrochlorothiazide tab 16-12.5 mg(Atacand hct)

2

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

candesartan cilexetil-hydrochlorothiazide tab 32-12.5 mg(Atacand hct)

2

candesartan cilexetil-hydrochlorothiazide tab 32-25 mg(Atacand hct)

2

captopril tab 12.5 mg 1

captopril tab 25 mg 1



CAPTOPRIL/HYDROCHLOROTHIA -captopril & hydrochlorothiazide tab25-15 mg

4


4


4


4

CARDURA - doxazosin mesylate tab 1mg

4


4


4


4

CATAPRES - clonidine hcl tab 0.1 mg 4



CATAPRES-TTS-1 - clonidine hcl tdpatch weekly 0.1 mg/24hr

4


4


4

clonidine hcl tab 0.1 mg (Catapres) 1

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its



clonidine hcl td patch weekly0.1 mg/24hr (Catapres-tts-1)

2


2


2

CLORPRES - clonidine & chlorthalidonetab 0.1-15 mg

4


4


4

CORZIDE - nadolol &bendroflumethiazide tab 40-5 mg

4

CORZIDE - nadolol &bendroflumethiazide tab 80-5 mg

4

COZAAR - losartan potassium tab 25mg

4


4


4

DEMSER - metyrosine cap 250 mg 4

DIBENZYLINE - phenoxybenzamine hclcap 10 mg

3

DIOVAN - valsartan tab 40 mg 4




DIOVAN HCT - valsartan-hydrochlorothiazide tab 80-12.5 mg

4


4

DIOVAN HCT - valsartan-hydrochlorothiazide tab 160-25 mg

4


4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

DIOVAN HCT - valsartan-hydrochlorothiazide tab 320-25 mg

4

doxazosin mesylate tab 1 mg(Cardura)

1


1


1


1

DUTOPROL - metoprolol &hydrochlorothiazide tab sr 24hr25-12.5 mg

4


4


4

EDARBI - azilsartan medoxomil tab 40mg

4

EDARBI - azilsartan medoxomil tab 80mg

4

EDARBYCLOR - azilsartan medoxomil-chlorthalidone tab 40-12.5 mg

4

EDARBYCLOR - azilsartan medoxomil-chlorthalidone tab 40-25 mg

4

enalapril maleate &hydrochlorothiazide tab 5-12.5 mg

1

enalapril maleate &hydrochlorothiazide tab 10-25 mg(Vaseretic)

1

enalapril maleate tab 2.5 mg(Vasotec)

1

enalapril maleate tab 5 mg (Vasotec) 1



EPANED - enalapril maleate for oralsoln 1 mg/ml

4

eplerenone tab 25 mg (Inspra) 2

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

eplerenone tab 50 mg (Inspra) 2

EPROSARTAN MESYLATE -eprosartan mesylate tab 600 mg

2

EXFORGE - amlodipine besylate-valsartan tab 5-160 mg

4


4


4


4

EXFORGE HCT - amlodipine-valsartan-hydrochlorothiazide tab 5-160-12.5mg

4

EXFORGE HCT - amlodipine-valsartan-hydrochlorothiazide tab 5-160-25 mg

4

EXFORGE HCT - amlodipine-valsartan-hydrochlorothiazide tab 10-160-12.5mg

4

EXFORGE HCT - amlodipine-valsartan-hydrochlorothiazide tab 10-160-25mg

4

EXFORGE HCT - amlodipine-valsartan-hydrochlorothiazide tab 10-320-25mg

4

fosinopril sodium &hydrochlorothiazide tab 10-12.5 mg

2

fosinopril sodium &hydrochlorothiazide tab 20-12.5 mg

2

fosinopril sodium tab 10 mg 1



guanfacine hcl tab 1 mg (Tenex) 1

guanfacine hcl tab 2 mg (Tenex) 1

hydralazine hcl tab 10 mg 1




2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

HYZAAR - losartan potassium &hydrochlorothiazide tab 50-12.5 mg

4

HYZAAR - losartan potassium &hydrochlorothiazide tab 100-12.5 mg

4

HYZAAR - losartan potassium &hydrochlorothiazide tab 100-25 mg

4

INSPRA - eplerenone tab 25 mg 4

INSPRA - eplerenone tab 50 mg 4

irbesartan tab 75 mg (Avapro) 1



irbesartan-hydrochlorothiazide tab150-12.5 mg (Avalide)

1

irbesartan-hydrochlorothiazide tab300-12.5 mg (Avalide)

1

lisinopril & hydrochlorothiazide tab10-12.5 mg (Zestoretic)

1

lisinopril & hydrochlorothiazide tab20-12.5 mg (Zestoretic)

1

lisinopril & hydrochlorothiazide tab20-25 mg (Zestoretic)

1

lisinopril tab 2.5 mg (Zestril) 1

lisinopril tab 5 mg (Prinivil) 1



lisinopril tab 30 mg (Zestril) 1

lisinopril tab 40 mg (Zestril) 1

LOPRESSOR HCT - metoprolol &hydrochlorothiazide tab 50-25 mg

4

LOPRESSOR HCT - metoprolol &hydrochlorothiazide tab 100-25 mg

4

losartan potassium &hydrochlorothiazide tab 50-12.5 mg(Hyzaar)

1

losartan potassium &hydrochlorothiazide tab100-12.5 mg (Hyzaar)

1

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

losartan potassium &hydrochlorothiazide tab 100-25 mg(Hyzaar)

1

losartan potassium tab 25 mg(Cozaar)

1


1


1

LOTENSIN - benazepril hcl tab 10 mg 4



LOTENSIN HCT - benazepril &hydrochlorothiazide tab 10-12.5 mg

4

LOTENSIN HCT - benazepril &hydrochlorothiazide tab 20-12.5 mg

4

LOTENSIN HCT - benazepril &hydrochlorothiazide tab 20-25 mg

4

LOTREL - amlodipine besylate-benazepril hcl cap 2.5-10 mg

4

LOTREL - amlodipine besylate-benazepril hcl cap 5-10 mg

4


4


4


4

MAVIK - trandolapril tab 1 mg 4



methyldopa tab 250 mg 1

methyldopa tab 500 mg 1

METHYLDOPA/HYDROCHLOROTHI -methyldopa & hydrochlorothiazide tab250-15 mg

4

METHYLDOPA/HYDROCHLOROTHI -methyldopa & hydrochlorothiazide tab250-25 mg

4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

metoprolol & hydrochlorothiazidetab 50-25 mg (Lopressor hct)

2

metoprolol & hydrochlorothiazidetab 100-25 mg (Lopressor hct)

2

metoprolol & hydrochlorothiazidetab 100-50 mg

2

MICARDIS - telmisartan tab 20 mg 4



MICARDIS HCT - telmisartan-hydrochlorothiazide tab 40-12.5 mg

4

MICARDIS HCT - telmisartan-hydrochlorothiazide tab 80-12.5 mg

4

MICARDIS HCT - telmisartan-hydrochlorothiazide tab 80-25 mg

4

MINIPRESS - prazosin hcl cap 1 mg 4



minoxidil tab 2.5 mg 1

minoxidil tab 10 mg 1

moexipril hcl tab 7.5 mg (Univasc) 2

moexipril hcl tab 15 mg (Univasc) 2

moexipril-hydrochlorothiazide tab7.5-12.5 mg

2

moexipril-hydrochlorothiazide tab15-12.5 mg (Uniretic)

2

moexipril-hydrochlorothiazide tab15-25 mg

2

nadolol & bendroflumethiazide tab40-5 mg (Corzide)

2

nadolol & bendroflumethiazide tab80-5 mg (Corzide)

2

perindopril erbumine tab 2 mg 2

perindopril erbumine tab 4 mg(Aceon)

2

perindopril erbumine tab 8 mg(Aceon)

2

prazosin hcl cap 1 mg (Minipress) 1

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its



PRESTALIA - perindopril arginine-amlodipine besylate tab 3.5-2.5 mg

4

PRESTALIA - perindopril arginine-amlodipine besylate tab 7-5 mg

4

PRESTALIA - perindopril arginine-amlodipine besylate tab 14-10 mg

4

PRINIVIL - lisinopril tab 5 mg 4



PRINZIDE - lisinopril &hydrochlorothiazide tab 10-12.5 mg

4

PROPRANOLOL/HYDROCHLOROTH -propranolol & hydrochlorothiazide tab40-25 mg

4

PROPRANOLOL/HYDROCHLOROTH -propranolol & hydrochlorothiazide tab80-25 mg

4

quinapril hcl tab 5 mg (Accupril) 1




quinapril-hydrochlorothiazide tab10-12.5 mg (Accuretic)

2

quinapril-hydrochlorothiazide tab20-12.5 mg (Accuretic)

2

quinapril-hydrochlorothiazide tab20-25 mg (Accuretic)

2

ramipril cap 1.25 mg (Altace) 1

ramipril cap 2.5 mg (Altace) 1

ramipril cap 5 mg (Altace) 1

ramipril cap 10 mg (Altace) 1

RESERPINE - reserpine tab 0.1 mg 4

RESERPINE - reserpine tab 0.25 mg 4

TARKA - trandolapril-verapamil hcl tabcr 1-240 mg

4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


4


4


4

TEKTURNA - aliskiren fumarate tab 150mg (base equivalent)

4

TEKTURNA - aliskiren fumarate tab 300mg (base equivalent)

4

TEKTURNA HCT - aliskiren-hydrochlorothiazide tab 150-12.5 mg

4

TEKTURNA HCT - aliskiren-hydrochlorothiazide tab 150-25 mg

4

TEKTURNA HCT - aliskiren-hydrochlorothiazide tab 300-12.5 mg

4

TEKTURNA HCT - aliskiren-hydrochlorothiazide tab 300-25 mg

4

telmisartan tab 20 mg (Micardis) 2



telmisartan-amlodipine tab 40-5 mg(Twynsta)

2


2


2


2

telmisartan-hydrochlorothiazide tab40-12.5 mg (Micardis hct)

2

telmisartan-hydrochlorothiazide tab80-12.5 mg (Micardis hct)

2

telmisartan-hydrochlorothiazide tab80-25 mg (Micardis hct)

2

TENEX - guanfacine hcl tab 1 mg 4

TENEX - guanfacine hcl tab 2 mg 4

TENORETIC 100 - atenolol &chlorthalidone tab 100-25 mg

4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

TENORETIC 50 - atenolol &chlorthalidone tab 50-25 mg

4

terazosin hcl cap 1 mg 1




TEVETEN - eprosartan mesylate tab600 mg

4

TEVETEN HCT - eprosartan mesylate-hydrochlorothiazide tab 600-25 mg

4

trandolapril tab 1 mg (Mavik) 1



trandolapril-verapamil hcl tab cr1-240 mg (Tarka)

2


2


2


2

TRIBENZOR - olmesartan-amlodipine-hydrochlorothiazide tab 20-5-12.5 mg

4

TRIBENZOR - olmesartan-amlodipine-hydrochlorothiazide tab 40-5-12.5 mg

4

TRIBENZOR - olmesartan-amlodipine-hydrochlorothiazide tab 40-5-25 mg

4

TRIBENZOR - olmesartan-amlodipine-hydrochlorothiazide tab 40-10-12.5mg

4

TRIBENZOR - olmesartan-amlodipine-hydrochlorothiazide tab 40-10-25 mg

4

TWYNSTA - telmisartan-amlodipine tab40-5 mg

4


4


4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


4

valsartan tab 40 mg (Diovan) 2




valsartan-hydrochlorothiazide tab80-12.5 mg (Diovan hct)

2


2

valsartan-hydrochlorothiazide tab160-25 mg (Diovan hct)

2


2

valsartan-hydrochlorothiazide tab320-25 mg (Diovan hct)

2

VASERETIC - enalapril maleate &hydrochlorothiazide tab 10-25 mg

4

VASOTEC - enalapril maleate tab 2.5mg

4

VASOTEC - enalapril maleate tab 5 mg 4

VASOTEC - enalapril maleate tab 10mg

4

VASOTEC - enalapril maleate tab 20mg

4

VECAMYL - mecamylamine hcl tab 2.5mg

4

ZESTORETIC - lisinopril &hydrochlorothiazide tab 10-12.5 mg

4

ZESTORETIC - lisinopril &hydrochlorothiazide tab 20-12.5 mg

4

ZESTORETIC - lisinopril &hydrochlorothiazide tab 20-25 mg

4

ZESTRIL - lisinopril tab 2.5 mg 4

ZESTRIL - lisinopril tab 5 mg 4





Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

ZIAC - bisoprolol & hydrochlorothiazidetab 2.5-6.25 mg

4

ZIAC - bisoprolol & hydrochlorothiazidetab 5-6.25 mg

4

ZIAC - bisoprolol & hydrochlorothiazidetab 10-6.25 mg

4

DIURETICS

ACETAZOLAMIDE - acetazolamide tab125 mg

4

acetazolamide cap sr 12hr 500 mg(Diamox)

2

acetazolamide tab 250 mg 2

ALDACTAZIDE - spironolactone &hydrochlorothiazide tab 25-25 mg

4

ALDACTAZIDE - spironolactone &hydrochlorothiazide tab 50-50 mg

4

ALDACTONE - spironolactone tab 25mg

4


4


4

amiloride & hydrochlorothiazide tab5-50 mg

1

amiloride hcl tab 5 mg 2

bumetanide tab 0.5 mg 1

bumetanide tab 1 mg 1

bumetanide tab 2 mg 1

CHLOROTHIAZIDE - chlorothiazide tab250 mg

4

chlorothiazide tab 500 mg 1

CHLORTHALIDONE - chlorthalidonetab 25 mg

4


4


4

DEMADEX - torsemide tab 5 mg 4


2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


DIAMOX - acetazolamide cap sr 12hr500 mg

4

DIURIL - chlorothiazide susp 250mg/5ml

4

DYAZIDE - triamterene &hydrochlorothiazide cap 37.5-25 mg

4

DYRENIUM - triamterene cap 50 mg 4

DYRENIUM - triamterene cap 100 mg 4

EDECRIN - ethacrynic acid tab 25 mg 4

FUROSEMIDE - furosemide oral soln 8mg/ml

4

furosemide oral soln 10 mg/ml 1

furosemide tab 20 mg (Lasix) 1



hydrochlorothiazide cap 12.5 mg(Microzide)

1

hydrochlorothiazide tab 12.5 mg 1

hydrochlorothiazide tab 25 mg 1

hydrochlorothiazide tab 50 mg 1

indapamide tab 1.25 mg 1

indapamide tab 2.5 mg 1

INTROL - glycerin soln 75% 4

LASIX - furosemide tab 20 mg 4



MAXZIDE - triamterene &hydrochlorothiazide tab 75-50 mg

4

MAXZIDE-25 - triamterene &hydrochlorothiazide tab 37.5-25 mg

4

methazolamide tab 25 mg(Neptazane)

2

methazolamide tab 50 mg(Neptazane)

2

METHYCLOTHIAZIDE -methyclothiazide tab 5 mg

4

metolazone tab 2.5 mg (Zaroxolyn) 2

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metolazone tab 5 mg (Zaroxolyn) 2

metolazone tab 10 mg 2

MICROZIDE - hydrochlorothiazide cap12.5 mg

4

NEPTAZANE - methazolamide tab 25mg

4

NEPTAZANE - methazolamide tab 50mg

4

spironolactone &hydrochlorothiazide tab 25-25 mg(Aldactazide)

2

spironolactone tab 25 mg (Aldactone) 1

spironolactone tab 50 mg (Aldactone) 1

spironolactone tab 100 mg(Aldactone)

2

torsemide tab 5 mg (Demadex) 1




triamterene & hydrochlorothiazidecap 37.5-25 mg (Dyazide)

1

triamterene & hydrochlorothiazidetab 37.5-25 mg (Maxzide-25)

1

triamterene & hydrochlorothiazidetab 75-50 mg (Maxzide)

1

TRIAMTERENE/HYDROCHLOROTH -triamterene & hydrochlorothiazidecap 50-25 mg

4

VASOPRESSORS

ADRENACLICK - epinephrine solutionauto-injector 0.15 mg/0.15ml (1:1000)

4

ADRENACLICK - epinephrine solutionauto-injector 0.3 mg/0.3ml (1:1000)

4

AUVI-Q - epinephrine solution auto-injector 0.15 mg/0.15ml (1:1000)

4

AUVI-Q - epinephrine solution auto-injector 0.3 mg/0.3ml (1:1000)

4

EPINEPHRINE - epinephrine solutionauto-injector 0.15 mg/0.15ml (1:1000)

4

2015


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EPINEPHRINE - epinephrine solutionauto-injector 0.3 mg/0.3ml (1:1000)

4

EPIPEN 2-PAK - epinephrine solutionauto-injector 0.3 mg/0.3ml (1:1000)

3

EPIPEN-JR 2-PAK - epinephrinesolution auto-injector 0.15 mg/0.3ml(1:2000)

3

midodrine hcl tab 2.5 mg 2

midodrine hcl tab 5 mg 2

midodrine hcl tab 10 mg 2

NORTHERA - droxidopa cap 100 mg 4



ANTIHYPERLIPIDEMICS

ADVICOR - niacin-lovastatin tab sr 24hr500-20 mg

4 •


4 •


4 •


4 •

ALTOPREV - lovastatin tab sr 24hr 20mg

4 •


4 •


4 •

ANTARA - fenofibrate micronized cap30 mg

4

ANTARA - fenofibrate micronized cap90 mg

4

atorvastatin calcium tab 10 mg (baseequivalent) (Lipitor)

1


1


1

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1

cholestyramine light powder packets4 gm

2

cholestyramine light powder 4 gm/dose (Questran light)

2

cholestyramine powder packets4 gm (Questran)

2

cholestyramine powder 4 gm/dose(Questran)

2

choline fenofibrate cap dr 45 mg(fenofibric acid equiv) (Trilipix)

2

choline fenofibrate cap dr 135 mg(fenofibric acid equiv) (Trilipix)

2

COLESTID - colestipol hcl tab 1 gm 4

COLESTID - colestipol hcl granules 5gm

4

COLESTID - colestipol hcl granulepackets 5 gm

4

COLESTID FLAVORED - colestipol hclgranules 5 gm

4

COLESTID FLAVORED - colestipol hclgranule packets 5 gm

4

colestipol hcl granule packets 5 gm(Colestid flavored)

2

colestipol hcl granules 5 gm (Colestidflavored)

2

colestipol hcl tab 1 gm (Colestid) 2

CRESTOR - rosuvastatin calcium tab 5mg

3


3


3


3

FENOFIBRATE - fenofibrate cap 50 mg 4

FENOFIBRATE - fenofibrate cap 150mg

4

FENOFIBRATE - fenofibrate tab 120 mg 4

2015


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fenofibrate micronized cap 43 mg 2

fenofibrate micronized cap 67 mg(Lofibra)

2

fenofibrate micronized cap 130 mg 2


2


2

fenofibrate tab 48 mg (Tricor) 2

fenofibrate tab 54 mg (Lofibra) 1

fenofibrate tab 145 mg (Tricor) 2

fenofibrate tab 160 mg (Lofibra) 2

FENOFIBRIC ACID - fenofibric acid tab35 mg

4

FENOFIBRIC ACID - fenofibric acid tab105 mg

4

FENOGLIDE - fenofibrate tab 40 mg 4

FENOGLIDE - fenofibrate tab 120 mg 4

FIBRICOR - fenofibric acid tab 35 mg 4

FIBRICOR - fenofibric acid tab 105 mg 4

fluvastatin sodium cap 20 mg(Lescol)

2

fluvastatin sodium cap 40 mg(Lescol)

2

gemfibrozil tab 600 mg (Lopid) 1

JUXTAPID - lomitapide mesylate cap 5mg (base equiv)

5 • •


5 • •


5 • •


5 • •


5 • •


5 • •

KYNAMRO - mipomersen sodium solnprefilled syringe 200 mg/ml

5 • •

Drug Name Dru

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LESCOL - fluvastatin sodium cap 20 mg 4 •LESCOL - fluvastatin sodium cap 40 mg 4 •LESCOL XL - fluvastatin sodium tab sr

24 hr 80 mg4 •

LIPITOR - atorvastatin calcium tab 10mg (base equivalent)

4 •


4 •


4 •


4 •

LIPOFEN - fenofibrate cap 50 mg 4

LIPOFEN - fenofibrate cap 150 mg 4

LIPTRUZET - ezetimibe-atorvastatin tab10-10 mg

4 •


4 •


4 •


4 •

LIVALO - pitavastatin calcium tab 1 mg(base equiv)

4 •


4 •


4 •

LOFIBRA - fenofibrate tab 54 mg 4

LOFIBRA - fenofibrate tab 160 mg 4

LOFIBRA - fenofibrate micronized cap67 mg

4


4


4

LOPID - gemfibrozil tab 600 mg 4

lovastatin tab 10 mg 1

lovastatin tab 20 mg (Mevacor) 1

2015


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lovastatin tab 40 mg (Mevacor) 1

LOVAZA - omega-3-acid ethyl esterscap 1 gm

4

MEVACOR - lovastatin tab 40 mg 4 •niacin tab cr 500 mg

(antihyperlipidemic) (Niaspan)2

niacin tab cr 750 mg(antihyperlipidemic) (Niaspan)

2

niacin tab cr 1000 mg(antihyperlipidemic) (Niaspan)

2

NIASPAN - niacin tab cr 500 mg(antihyperlipidemic)

4


4


4

omega-3-acid ethyl esters cap 1 gm(Lovaza)

2

PRALUENT - alirocumab subcutaneoussoln pen-injector 75 mg/ml

5 • •

PRALUENT - alirocumab subcutaneoussoln pen-injector 150 mg/ml

5 • •

PRALUENT - alirocumab subcutaneoussoln prefilled syringe 75 mg/ml

5 • •

PRALUENT - alirocumab subcutaneoussoln prefilled syringe 150 mg/ml

5 • •

PRAVACHOL - pravastatin sodium tab20 mg

4 •


4 •


4 •

pravastatin sodium tab 10 mg 1

pravastatin sodium tab 20 mg(Pravachol)

1


1


1

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QUESTRAN - cholestyramine powder 4gm/dose

4

QUESTRAN - cholestyramine powderpackets 4 gm

4

QUESTRAN LIGHT - cholestyraminelight powder 4 gm/dose

4

SIMCOR - niacin-simvastatin tab sr 24hr500-20 mg

4 •


4 •


4 •


4 •


4 •

simvastatin tab 5 mg (Zocor) 1





TRICOR - fenofibrate tab 48 mg 4

TRICOR - fenofibrate tab 145 mg 4

TRIGLIDE - fenofibrate tab 160 mg 4

TRILIPIX - choline fenofibrate cap dr 45mg (fenofibric acid equiv)

4

TRILIPIX - choline fenofibrate cap dr135 mg (fenofibric acid equiv)

4

VASCEPA - icosapent ethyl cap 1 gm 4

VYTORIN - ezetimibe-simvastatin tab10-10 mg

4 •


4 •


4 •


4 •

WELCHOL - colesevelam hcl tab 625mg

4

2015


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WELCHOL - colesevelam hcl packet forsusp 3.75 gm

4

ZETIA - ezetimibe tab 10 mg 4 •ZOCOR - simvastatin tab 5 mg 4 •ZOCOR - simvastatin tab 10 mg 4 •ZOCOR - simvastatin tab 20 mg 4 •ZOCOR - simvastatin tab 40 mg 4 •ZOCOR - simvastatin tab 80 mg 4 •CARDIOVASCULAR AGENTS - MISC.

ADCIRCA - tadalafil tab 20 mg (pah) 5 • •ADEMPAS - riociguat tab 0.5 mg 5 • •ADEMPAS - riociguat tab 1 mg 5 • •ADEMPAS - riociguat tab 1.5 mg 5 • •ADEMPAS - riociguat tab 2 mg 5 • •ADEMPAS - riociguat tab 2.5 mg 5 • •amlodipine besylate-atorvastatin

calcium tab 2.5-10 mg (Caduet)2

amlodipine besylate-atorvastatincalcium tab 2.5-20 mg (Caduet)

2

amlodipine besylate-atorvastatincalcium tab 2.5-40 mg (Caduet)

2

amlodipine besylate-atorvastatincalcium tab 5-10 mg (Caduet)

2


2


2


2


2


2


2


2

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BIDIL - isosorbide dinitrate-hydralazinehcl tab 20-37.5 mg

4

CADUET - amlodipine besylate-atorvastatin calcium tab 2.5-10 mg

4


4


4

CADUET - amlodipine besylate-atorvastatin calcium tab 5-10 mg

4


4


4


4


4


4


4


4

CIALIS - tadalafil tab 2.5 mg 3 • •CIALIS - tadalafil tab 5 mg 3 • •CORLANOR - ivabradine hcl tab 5 mg

(base equiv)4

CORLANOR - ivabradine hcl tab 7.5 mg(base equiv)

4

ENTRESTO - sacubitril-valsartan tab24-26 mg

4 • •


4 • •


4 • •

ISOXSUPRINE HCL - isoxsuprine hcltab 20 mg

4

isoxsuprine hcl tab 10 mg 2

LETAIRIS - ambrisentan tab 5 mg 5 • •

2015


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LETAIRIS - ambrisentan tab 10 mg 5 • •OPSUMIT - macitentan tab 10 mg 5 • •ORENITRAM - treprostinil diolamine tab

cr 0.125 mg (base equiv)5 • •

ORENITRAM - treprostinil diolamine tabcr 0.25 mg (base equiv)

5 • •

ORENITRAM - treprostinil diolamine tabcr 1 mg (base equiv)

5 • •

ORENITRAM - treprostinil diolamine tabcr 2.5 mg (base equiv)

5 • •

REVATIO - sildenafil citrate tab 20 mg 5 • •REVATIO - sildenafil citrate for

suspension 10 mg/ml5 • •

sildenafil citrate tab 20 mg (Revatio) 5 •TRACLEER - bosentan tab 62.5 mg 5 • •TRACLEER - bosentan tab 125 mg 5 • •TYVASO - treprostinil inhalation solution

0.6 mg/ml5 •

TYVASO REFILL - treprostinil inhalationsolution 0.6 mg/ml

5 •

TYVASO STARTER - treprostinilinhalation solution 0.6 mg/ml

5 •

VENTAVIS - iloprost inhalation solution10 mcg/ml

5 •

VENTAVIS - iloprost inhalation solution20 mcg/ml

5 •

ERECTLIE DYSFUNCTION

CIALIS - tadalafil tab 2.5 mg 3 • •CIALIS - tadalafil tab 5 mg 3 • •RESPIRATORY AGENTS

ANTIHISTAMINES

brompheniramine maleate tab sr12hr 6 mg

1

BROMPHENIRAMINE TANNATE -brompheniramine tannate chew tab12 mg

4

carbinoxamine maleate soln4 mg/5ml

1

carbinoxamine maleate tab 4 mg 2

Drug Name Dru

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CLARINEX - desloratadine tab 5 mg 4

CLARINEX - desloratadine syrup 0.5mg/ml

4

CLARINEX REDITABS - desloratadinetab orally disintegrating 2.5 mg

4

CLARINEX REDITABS - desloratadinetab orally disintegrating 5 mg

4

CLEMASTINE FUMARATE - clemastinefumarate syrup 0.67 mg/5ml (0.5mg/5ml base eq)

4

clemastine fumarate tab 2.68 mg 1

cyproheptadine hcl syrup 2 mg/5ml 2

cyproheptadine hcl tab 4 mg 1

desloratadine tab orallydisintegrating 2.5 mg (Clarinexreditabs)

2

desloratadine tab orallydisintegrating 5 mg (Clarinexreditabs)

2

desloratadine tab 5 mg (Clarinex) 2

KARBINAL ER - carbinoxamine maleateer susp 4 mg/5ml

4

levocetirizine dihydrochloride soln2.5 mg/5ml (0.5 mg/ml) (Xyzal)

2

levocetirizine dihydrochloride tab5 mg (Xyzal)

2

promethazine hcl suppos 12.5 mg 2

promethazine hcl suppos 25 mg 2

promethazine hcl suppos 50 mg 2

promethazine hcl syrup 6.25 mg/5ml 1

promethazine hcl tab 12.5 mg 1

promethazine hcl tab 25 mg 1

promethazine hcl tab 50 mg 1

RESPA-BR - brompheniramine maleatetab sr 12hr 11 mg

4

XYZAL - levocetirizine dihydrochloridetab 5 mg

4

XYZAL - levocetirizine dihydrochloridesoln 2.5 mg/5ml (0.5 mg/ml)

4

2015


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NASAL AGENTS - SYSTEMIC and TOPICAL

ADRENALIN - epinephrine hcl nasalsoln 0.1%

4

ASTEPRO - azelastine hcl nasal spray0.15% (205.5 mcg/spray)

4 •

ATROVENT - ipratropium bromide nasalsoln 0.03% (21 mcg/spray)

4 •

ATROVENT - ipratropium bromide nasalsoln 0.06% (42 mcg/spray)

4 •

azelastine hcl nasal spray 0.1%(137 mcg/spray)

2 •

azelastine hcl nasal spray 0.15%(205.5 mcg/spray) (Astepro)

2 •

BACTROBAN NASAL - mupirocincalcium nasal oint 2%

4 •

BECONASE AQ - beclomethasonedipropionate monohyd nasal susp 42mcg/spray

4 •

budesonide nasal susp 32 mcg/act(Rhinocort aqua)

2 •

DYMISTA - azelastine hcl-fluticasoneprop nasal spray 137-50 mcg/act

4 •

FLONASE - fluticasone propionatenasal susp 50 mcg/act

4 •

FLUNISOLIDE - flunisolide nasal soln25 mcg/act (0.025%)

4 •

flunisolide nasal soln 25 mcg/act(0.025%) (Flunisolide)

2 •

fluticasone propionate nasal susp50 mcg/act (Flonase)

1 •

ipratropium bromide nasal soln0.03% (21 mcg/spray) (Atrovent)

2 •

ipratropium bromide nasal soln0.06% (42 mcg/spray) (Atrovent)

2 •

NASONEX - mometasone furoate nasalsusp 50 mcg/act

4 •

olopatadine hcl nasal soln 0.6%(Patanase)

2 •

OMNARIS - ciclesonide nasal susp 50mcg/act

4 •

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PATANASE - olopatadine hcl nasal soln0.6%

4 •

QNASL - beclomethasone dipropionatenasal aerosol 80 mcg/act

4 •

QNASL CHILDRENS - beclomethasonedipropionate nasal aerosol 40 mcg/act

4 •

RHINOCORT AQUA - budesonide nasalsusp 32 mcg/act

4 •

triamcinolone acetonide nasalaerosol suspension 55 mcg/act(Nasacort aq)

2 •

TYZINE - tetrahydrozoline hcl nasal soln0.1%

4

TYZINE PEDIATRIC NASAL DR -tetrahydrozoline hcl nasal soln 0.05%

4

VERAMYST - fluticasone furoate nasalsusp 27.5 mcg/spray

4 •

ZETONNA - ciclesonide nasal aerosolsoln 37 mcg/act (50 mcg/valve)

4 •

COUGH/COLD/ALLERGY

acetylcysteine inhal soln 10% 2

acetylcysteine inhal soln 20% 2

benzonatate cap 100 mg (Tessalonperles)

1

benzonatate cap 150 mg (Zonatuss) 2

benzonatate cap 200 mg 1

brompheniramine &pseudoephedrine tab sr 12hr6-45 mg

1

CAPCOF - phenylephrine-chlorphen w/codeine syrup 5-2-10 mg/5ml

4

CARBAPHEN 12 - phenyleph-chlorphen-carbetapentane liqd10-4-27.5 mg/5ml

4

CARBAPHEN 12 PED - phenyleph-chlorphen-carbetapentane susp2.5-1.25-7.5 mg/ml

4

2015


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CLARINEX-D 12 HOUR - desloratadine& pseudoephedrine tab sr 12hr2.5-120 mg

4

CODAR AR - chlorpheniramine w/codeine liquid 2-8 mg/5ml

4

CODAR D - pseudoephedrine w/codeine liquid 30-8 mg/5ml

4

CPB WC - pseudoephedrine-bromphen-codeine liq 10-1.3-6.3 mg/5ml

4

DECON-A - brompheniramine &phenylephrine elixir 2-5 mg/5ml

4

DECON-G - phenylephrine-brompheniramine-guaifenesin liqd2-1-40 mg/ml

4

DEX-TUSS - guaifenesin-codeine liquid300-10 mg/5ml

4

DEXTROMETHORPHAN HBR/CHLO -phenylephrine-chlorphen-dm liquid1.75-0.75-2.75 mg/ml

4

EXACTUSS - phenylephrine w/ dm-ggliqd 10-28-388 mg/5ml

4

GILPHEX TR - phenylephrine-guaifenesin tab 10-388 mg

4

GILTUSS - phenylephrine w/ dm-gg liqd10-28-388 mg/5ml

4

GILTUSS PED-C - phenylephrine w/codeine-gg liquid 2.5-3-50 mg/ml

4

GILTUSS TR - phenylephrine w/ dm-ggtab 10-28-388 mg

4

guaifenesin-codeine liquid200-8 mg/5ml

2

guaifenesin-codeine liquid225-7.5 mg/5ml

1

guaifenesin-codeine soln100-6.3 mg/5ml

1

guaifenesin-codeine soln100-10 mg/5ml

1

hydrocod polst-chlorphen polstcr susp 10-8 mg/5ml (Tussionexpennkineti)

2

Drug Name Dru

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hydrocodone w/ homatropine syrup5-1.5 mg/5ml

2

hydrocodone w/ homatropine tab5-1.5 mg

2

HYPER-SAL - sodium chloride solnnebu 7%

4

HYPERSAL - sodium chloride soln nebu3.5%

4

HYPERSAL - sodium chloride soln nebu7%

4

LEXUSS 210 - chlorpheniramine w/codeine liquid 2-10 mg/5ml

1

LORTUSS EX - pseudoephedrine w/cod-gg liquid 30-10-100 mg/5ml

4

M-END MAX D - pseudoephedrine-dexbromphen-codeine liqd20-0.667-6 mg/5ml

4

M-END PE - phenylephrine-bromphenw/ codeine liqd 3.33-1.33-6.33mg/5ml

4

MAR-COF BP - pseudoephedrine-bromphen-codeine liqd 30-2-7.5mg/5ml

4

MAR-COF CG EXPECTORANT -guaifenesin-codeine liquid 225-7.5mg/5ml

4

NEBUSAL - sodium chloride soln nebu6%

4

NEOTUSS PLUS - phenylephrine-chlorphen-dm liquid 7.5-4-30 mg/5ml

4

NEOTUSS-D - pseudoephed-chlorphenw/ dm-gg liqd 30-2-30-200 mg/5ml

4

NORTUSS-EX - dextromethorphan-guaifenesin liquid 20-200 mg/5ml

4

NOTUSS-NX - codeine-chlorcyclizineliquid 10-9.375 mg/5ml

4

NOTUSS-NXD - codeine-pseudoephedrine-chlorcyclizine liq10-30-9.375mg/5ml

4

OBREDON - hydrocodone-guaifenesinsoln 2.5-200 mg/5ml

4

2015


Drug Name Dru

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PANATUSS DXP - phenylephrine-dexbromphen-dm-gg liquid5-1-15-100 mg/5ml

4

PEDIATEX TDM - pseudoephed-triprolidine-dm susp 10-0.938-4 mg/ml

4

phenylephrine w/ dm-gg liqd10-30-200 mg/5ml

2

phenylephrine w/ dm-gg liqd2.5-7.5-88 mg/ml

2

phenylephrine-brompheniramine-dmliquid 7.5-4-15 mg/5ml

1

phenylephrine-guaifenesin liqd7.5-100 mg/5ml (1.5-20 mg/ml)

2

phenylephrine-promethazine w/codeine syrup 5-6.25-10 mg/5ml

4

PHENYLHISTINE DH -pseudoephedrine-chlorphen w/codeine liq 30-2-10 mg/5ml

4

POLY-TUSSIN - codeine-chlorcyclizineliquid 10-9.375 mg/5ml

4

POLY-TUSSIN AC - phenylephrine-bromphen w/ codeine liquid 10-4-10mg/5ml

4

POLY-TUSSIN D - codeine-pseudoephedrine-chlorcyclizine liq10-30-9.375mg/5ml

4

PRO-CLEAR AC - codeine-pyrilaminesyrup 9-8.33 mg/5ml

4

PRO-RED AC - phenylephrine-dexchlorphenir-codeine syrup 5-1-9mg/5ml

4

PROMETHAZINE VC PLAIN -promethazine & phenylephrine syrup6.25-5 mg/5ml

4

promethazine w/ codeine syrup6.25-10 mg/5ml

1

promethazine-dm syrup6.25-15 mg/5ml

1

Drug Name Dru

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pseudoeph-chlorphen w/hydrocodone soln 60-4-5 mg/5ml(Zutripro)

2

pseudoephed-bromphen-dm syrup30-2-10 mg/5ml

2

pseudoephedrine w/ cod-gg soln30-10-100 mg/5ml

1

pseudoephedrine w/ cod-gg syrup30-10-100 mg/5ml (Suttar-sf)

1

pseudoephedrine-bromphen-codeineliq 10-1.33-6.33 mg/5ml

1

RELHIST - bromphen tan-phenyleph tanchew tab 6-15 mg

4

RESCON-MX - dexchlorpheniramine-phenylephrine tab sr 12hr 6-40 mg

4

REZIRA - pseudoephedrine w/hydrocodone soln 60-5 mg/5ml

4

RYDEX - pseudoephedrine-bromphen-codeine liq 10-1.33-6.33 mg/5ml

4

SEMPREX-D - acrivastine &pseudoephedrine cap 8-60 mg

4

sodium chloride soln nebu 0.9% 2

sodium chloride soln nebu 3% 2

sodium chloride soln nebu 7%(Hyper-sal)

2

sodium chloride soln nebu 10% 2

STATUSS GREEN - codeine-pseudoephedrine-chlorcyclizine liq9-30-12.5 mg/5ml

4

SUTTAR-SF - pseudoephedrine w/ cod-gg syrup 30-10-100 mg/5ml

4

SUTTAR-2 - pseudoephedrine w/ cod-gg syrup 30-10-100 mg/5ml

4

TESSALON PERLES - benzonatate cap100 mg

4

TGQ 15DM/5PEH/2CPM -phenylephrine-chlorphen-dm syrup5-2-15 mg/5ml

4

2015


Drug Name Dru

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its

TGQ 30PSE/150GFN/15DM -pseudoephedrine w/ dm-gg syrup30-15-150 mg/5ml

4

TGQ 30PSE/3BRM/15DM -pseudoephed-bromphen-dm syrup30-3-15 mg/5ml

4

TGQ 50PSE/3BRM/30DM -pseudoephed-bromphen-dm syrup50-3-30 mg/5ml

4

TRICODE AR - pseudoephedrine-chlorphen w/ codeine liq 30-2-8mg/5ml

4

TRICODE GF - pseudoephedrine w/cod-gg liquid 30-8-200 mg/5ml

4

TUSNEL - brompheniramine w/ dm-ggcap 2-15-200 mg

4

TUSSICAPS - hydrocod polst-chlorphenpolst cap sr 12hr 5-4 mg

4

TUSSICAPS - hydrocod polst-chlorphenpolst cap sr 12hr 10-8 mg

4

TUSSIONEX PENNKINETIC EXT -hydrocod polst-chlorphen polst crsusp 10-8 mg/5ml

4

TUZISTRA XR - codeine polist-chlorphen polist er susp 14.7-2.8mg/5ml

4

VANACOF CD - phenylephrine-dexchlorphenir-codeine liquid 5-1-10mg/5ml

4

VITUZ - hydrocodone-chlorpheniraminesoln 5-4 mg/5ml

4

Z-TUSS AC - chlorpheniramine w/codeine liquid 2-9 mg/5ml

4

ZONATUSS - benzonatate cap 150 mg 4

ZUTRIPRO - pseudoeph-chlorphen w/hydrocodone soln 60-4-5 mg/5ml

4

ANTIASTHMATIC and BRONCHODILATOR AGENTS

ACCOLATE - zafirlukast tab 10 mg 4

ACCOLATE - zafirlukast tab 20 mg 4

Drug Name Dru

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ADVAIR DISKUS - fluticasone-salmeterol aer powder ba 100-50mcg/dose

4 •


4 •


4 •

ADVAIR HFA - fluticasone-salmeterolinhal aerosol 45-21 mcg/act

4 •


4 •


4 •

AEROSPAN - flunisolide hfa inhalaerosol 80 mcg/act

4 •

albuterol sulfate soln nebu 0.083%(2.5 mg/3ml)

2 •

albuterol sulfate soln nebu 0.5%(5 mg/ml)

2 •

albuterol sulfate soln nebu0.63 mg/3ml (base equiv)

2 •

albuterol sulfate soln nebu1.25 mg/3ml (base equiv)

2 •

albuterol sulfate syrup 2 mg/5ml 1

albuterol sulfate tab sr 12hr 4 mg(Vospire er)

2

albuterol sulfate tab sr 12hr 8 mg(Vospire er)

2

albuterol sulfate tab 2 mg 2

albuterol sulfate tab 4 mg 2

ALVESCO - ciclesonide inhal aerosol 80mcg/act

4 •

ALVESCO - ciclesonide inhal aerosol160 mcg/act

4 •

ANORO ELLIPTA - umeclidinium-vilanterol aero powd ba 62.5-25 mcg/inh

4 •

2015


Drug Name Dru

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its

ARCAPTA NEOHALER - indacaterolmaleate inhal powder cap 75 mcg(base equiv)

4 •

ARNUITY ELLIPTA - fluticasone furoateaerosol powder breath activ 100 mcg/act

3 •

ARNUITY ELLIPTA - fluticasone furoateaerosol powder breath activ 200 mcg/act

3 •

ASMANEX HFA - mometasone furoateinhal aerosol suspension 100 mcg/act

4 •

ASMANEX HFA - mometasone furoateinhal aerosol suspension 200 mcg/act

4 •

ASMANEX TWISTHALER 120 ME -mometasone furoate inhal powd 220mcg/inh (breath activated)

4 •

ASMANEX TWISTHALER 30 MET -mometasone furoate inhal powd 110mcg/inh (breath activated)

4 •


4 •


4 •

ATROVENT HFA - ipratropium bromidehfa inhal aerosol 17 mcg/act

4 •

BREO ELLIPTA - fluticasone furoate-vilanterol aero powd ba 100-25 mcg/inh

4 •

BREO ELLIPTA - fluticasone furoate-vilanterol aero powd ba 200-25 mcg/inh

4 •

BROVANA - arformoterol tartrate solnnebu 15 mcg/2ml (base equiv)

4

budesonide inhalation susp0.25 mg/2ml (Pulmicort)

2 •

budesonide inhalation susp0.5 mg/2ml (Pulmicort)

2 •

budesonide inhalation susp1 mg/2ml (Pulmicort)

2

Drug Name Dru

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COMBIVENT RESPIMAT - ipratropium-albuterol inhal aerosol soln 20-100mcg/act

4 •

CROMOLYN SODIUM - cromolynsodium soln nebu 20 mg/2ml

2 •

DALIRESP - roflumilast tab 500 mcg 4

DULERA - mometasone furoate-formoterol fumarate aerosol 100-5mcg/act

4 •

DULERA - mometasone furoate-formoterol fumarate aerosol 200-5mcg/act

4 •

dyphylline-guaifenesin liqd100-100 mg/5ml

1

ELIXOPHYLLIN - theophylline elixir 80mg/15ml

4

FLOVENT DISKUS - fluticasonepropionate aer pow ba 50 mcg/blister

3 •


3 •


3 •

FLOVENT HFA - fluticasone propionatehfa inhal aero 44 mcg/act (50/valve)

3 •

FLOVENT HFA - fluticasone propionatehfa inhal aer 110 mcg/act (125/valve)

3 •

FLOVENT HFA - fluticasone propionatehfa inhal aer 220 mcg/act (250/valve)

3 •

FORADIL AEROLIZER - formoterolfumarate inhal cap 12 mcg

3 •

INCRUSE ELLIPTA - umeclidinium braero powd breath act 62.5 mcg/inh(base eq)

3 •

ipratropium bromide inhal soln0.02%

1 •

ipratropium-albuterol nebu soln0.5-2.5(3) mg/3ml

2 •

levalbuterol hcl soln nebu conc1.25 mg/0.5ml (base equiv)

2 •

2015


Drug Name Dru

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levalbuterol hcl soln nebu0.31 mg/3ml (base equiv) (Xopenex)

2 •


2 •


2 •

LUFYLLIN - dyphylline tab 400 mg 4

METAPROTERENOL SULFATE -metaproterenol sulfate syrup 10mg/5ml

4

METAPROTERENOL SULFATE -metaproterenol sulfate tab 10 mg

4

METAPROTERENOL SULFATE -metaproterenol sulfate tab 20 mg

4

montelukast sodium chew tab 4 mg(base equiv) (Singulair)

1

montelukast sodium chew tab 5 mg(base equiv) (Singulair)

1

montelukast sodium oral granulespacket 4 mg (base equiv) (Singulair)

2

montelukast sodium tab 10 mg (baseequiv) (Singulair)

1

PERFOROMIST - formoterol fumaratesoln nebu 20 mcg/2ml

4

PROAIR HFA - albuterol sulfate inhalaero 108 mcg/act (90mcg base equiv)

3 •

PROAIR RESPICLICK - albuterolsulfate aer pow ba 108 mcg/act (90mcg base equiv)

3 •

PROVENTIL HFA - albuterol sulfateinhal aero 108 mcg/act (90mcg baseequiv)

4 •

PULMICORT - budesonide inhalationsusp 0.25 mg/2ml

4 •

PULMICORT - budesonide inhalationsusp 0.5 mg/2ml

4 •

PULMICORT - budesonide inhalationsusp 1 mg/2ml

4 •

PULMICORT FLEXHALER -budesonide inhal aero powd 90 mcg/act (breath activated)

4 •

Drug Name Dru

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PULMICORT FLEXHALER -budesonide inhal aero powd 180mcg/act (breath activated)

4 •

QVAR - beclomethasone dipropionateinhal aero soln 40 mcg/act

3 •

QVAR - beclomethasone dipropionateinhal aero soln 80 mcg/act

3 •

SEREVENT DISKUS - salmeterolxinafoate aer pow ba 50 mcg/dose(base equiv)

4 •

SINGULAIR - montelukast sodium tab10 mg (base equiv)

4

SINGULAIR - montelukast sodium oralgranules packet 4 mg (base equiv)

4

SINGULAIR - montelukast sodium chewtab 4 mg (base equiv)

4

SINGULAIR - montelukast sodium chewtab 5 mg (base equiv)

4

SPIRIVA HANDIHALER - tiotropiumbromide monohydrate inhal cap 18mcg (base equiv)

3 •

SPIRIVA RESPIMAT - tiotropiumbromide monohydrate inhal aerosol2.5 mcg/act

3 •

STIOLTO RESPIMAT - tiotropium br-olodaterol inhal aero soln 2.5-2.5mcg/act

4 •

STRIVERDI RESPIMAT - olodaterol hclinhal aerosol soln 2.5 mcg/act (baseequiv)

4 •

SYMBICORT - budesonide-formoterolfumarate dihyd aerosol 80-4.5 mcg/act

3 •

SYMBICORT - budesonide-formoterolfumarate dihyd aerosol 160-4.5 mcg/act

3 •

terbutaline sulfate tab 2.5 mg 2

terbutaline sulfate tab 5 mg 2

THEO-24 - theophylline cap sr 24hr 100mg

4

2015


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4


4


4

theophylline soln 80 mg/15ml 2

theophylline tab sr 12hr 100 mg 1






TUDORZA PRESSAIR - aclidiniumbromide aerosol powd breathactivated 400 mcg/act

4 •

VENTOLIN HFA - albuterol sulfate inhalaero 108 mcg/act (90mcg base equiv)

3 •

VOSPIRE ER - albuterol sulfate tab sr12hr 4 mg

4

VOSPIRE ER - albuterol sulfate tab sr12hr 8 mg

4

XOPENEX HFA - levalbuterol tartrateinhal aerosol 45 mcg/act (base equiv)

4 •

zafirlukast tab 10 mg (Accolate) 2

zafirlukast tab 20 mg (Accolate) 2

ZYFLO - zileuton tab 600 mg 4

ZYFLO CR - zileuton tab sr 12hr 600 mg 4

RESPIRATORY AGENTS - MISC.

CUROSURF - poractant alfaintratracheal susp 80 mg/ml

4

ESBRIET - pirfenidone cap 267 mg 5 • •INFASURF - calfactant in nacl 0.9%

intratracheal susp 35 mg/ml4

KALYDECO - ivacaftor tab 150 mg 5 •KALYDECO - ivacaftor packet 50 mg 5 •KALYDECO - ivacaftor packet 75 mg 5 •

Drug Name Dru

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OFEV - nintedanib esylate cap 100 mg(base equivalent)

5 • •

OFEV - nintedanib esylate cap 150 mg(base equivalent)

5 • •

ORKAMBI - lumacaftor-ivacaftor tab200-125 mg

5 • •

PULMOZYME - dornase alfa inhal soln1 mg/ml

5 •

SURFAXIN - lucinactant intratrachealsusp 30 mg/ml

4

SURVANTA INTRATRACHEAL -beractant in nacl 0.9% intratrachealsusp 25 mg/ml

4

GASTROINTESTINAL AGENTS

LAXATIVES

bisacodyl tab & peg 3350-kcl-sodbicarb-nacl for soln kit

2

CASCARA SAGRADA - cascarasagrada fl ext 1 gm/ml

4

COLYTE-FLAVOR PACKS - peg 3350-kcl-na bicarb-nacl-na sulfate for soln227.1 gm

4

COLYTE-FLAVOR PACKS - peg 3350-kcl-na bicarb-nacl-na sulfate for soln240 gm

4

GOLYTELY - peg 3350-kcl-na bicarb-nacl-na sulfate packet 227.1 gm

4

GOLYTELY - peg 3350-kcl-na bicarb-nacl-na sulfate for soln 236 gm

4

KRISTALOSE - lactulose oral crystalpacket 10 gm

4

KRISTALOSE - lactulose oral crystalpacket 20 gm

4

lactulose solution 10 gm/15ml 1

MINERAL OIL HEAVY - mineral oil 4

MOVIPREP - peg 3350-kcl-nacl-nasulfate-na ascorbate-c for soln 100gm

4

2015


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NULYTELY/FLAVOR PACKS - peg3350-kcl-sod bicarb-nacl for soln 420gm

4

OSMOPREP - sod phos mono-sod phosdi tabs 1.102-0.398 gm(1.5gm naphos)

4

PCP 100 - mag cit-bisacodyl-petrolat-peg-metoclopramide-electrol kit

4

peg 3350-kcl-sod bicarb-nacl for soln420 gm (Nulytely/flavor pack)

1

peg 3350-kcl-na bicarb-nacl-nasulfate for soln 236 gm (Golytely)

1

peg 3350-kcl-na bicarb-nacl-nasulfate for soln 240 gm (Colyte-flavor packs)

1

polyethylene glycol 3350 oral packet 2

polyethylene glycol 3350 oralpowder

1

PREPOPIK - sod picosulfate-mg oxide-citric acid pack 10 mg-3.5 gm-12 gm

4

SENNA LEAVES - senna leaves 4

SUPREP BOWEL PREP - sodiumsulfate-potassium sulfate-magnesiumsulfate oral soln

4

ANTIDIARRHEALS

diphenoxylate w/ atropine tab2.5-0.025 mg (Lomotil)

1

DIPHENOXYLATE/ATROPINE -diphenoxylate w/ atropine liq2.5-0.025 mg/5ml

4

FULYZAQ - crofelemer tab delayedrelease 125 mg

4

LOMOTIL - diphenoxylate w/ atropinetab 2.5-0.025 mg

4

MOTOFEN - difenoxin w/ atropine tab1-0.025 mg

4

opium tincture 1% (10 mg/ml)(morphine equiv)

2

RESTORA RX - lactobacillus casei-folicacid cap 60-1.25 mg

4

Drug Name Dru

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ULCER DRUGS

ACIPHEX - rabeprazole sodium ec tab20 mg

4 •

ACIPHEX SPRINKLE - rabeprazolesodium capsule sprinkle dr 5 mg

4 •

ACIPHEX SPRINKLE - rabeprazolesodium capsule sprinkle dr 10 mg

4 •

amoxicillin cap-clarithro tab-lansopraz cap dr therapy pack(Prevpac)

2

ANASPAZ - hyoscyamine sulfate tabdisp 0.125 mg

4

AXID - nizatidine cap 300 mg 4

BELLADONNA & OPIUM - belladonnaalkaloids & opium suppos 16.2-30 mg

4

BELLADONNA ALKALOIDS & OP -belladonna alkaloids & opium suppos16.2-60 mg

4

BENTYL - dicyclomine hcl cap 10 mg 4

BENTYL - dicyclomine hcl tab 20 mg 4

CANTIL - mepenzolate bromide tab 25mg

4

CARAFATE - sucralfate tab 1 gm 4

CARAFATE - sucralfate susp 1 gm/10ml 4

chlordiazepoxide hcl-clidiniumbromide cap 5-2.5 mg (Librax)

2

cimetidine hcl soln 300 mg/5ml 1

cimetidine tab 300 mg 1



CUVPOSA - glycopyrrolate oral soln 1mg/5ml

4

CYTOTEC - misoprostol tab 100 mcg 4

CYTOTEC - misoprostol tab 200 mcg 4

DEXILANT - dexlansoprazole capdelayed release 30 mg

4 •

DEXILANT - dexlansoprazole capdelayed release 60 mg

4 •

dicyclomine hcl cap 10 mg (Bentyl) 1

2015


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dicyclomine hcl oral soln 10 mg/5ml 4

dicyclomine hcl tab 20 mg (Bentyl) 1

DIGEX NF - hyoscyamine-phenyltoloxamine cap 0.0625-15 mg

4

DONNATAL - pb-hyoscy-atrop-scopoltab 16.2-0.1037-0.0194-0.0065 mg

3

DONNATAL - pb-hyoscy-atrop-scopolelix 16.2-0.1037-0.0194-0.0065mg/5ml

4

DONNATAL EXTENTABS - pb-hyoscy-atrop-scopol tab cr48.6-0.3111-0.0582-0.0195 mg

4

esomeprazole magnesium capdelayed release 20 mg (base eq)(Nexium)

2 •

esomeprazole magnesium capdelayed release 40 mg (base eq)(Nexium)

2 •

famotidine for susp 40 mg/5ml(Pepcid)

2

famotidine tab 40 mg (Pepcid) 1

FIRST-LANSOPRAZOLE - lansoprazolesusp 3 mg/ml (compound kit)

4

FIRST-OMEPRAZOLE - omeprazolesusp 2 mg/ml (compound kit)

4

GASTRINEX NF - hyoscyamine-phenyltoloxamine cap 0.0625-15 mg

4

GLYCATE - glycopyrrolate tab 1.5 mg 4

glycopyrrolate tab 1 mg (Robinul) 2

glycopyrrolate tab 2 mg (Robinulforte)

2

hyoscyamine sulfate elixir0.125 mg/5ml

1

hyoscyamine sulfate soln 0.125 mg/ml

2

hyoscyamine sulfate tab disp0.125 mg (Anaspaz)

2

hyoscyamine sulfate tab sl 0.125 mg(Levsin/sl)

2

Drug Name Dru

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its

hyoscyamine sulfate tab sr 12hr0.375 mg (Levbid)

2

hyoscyamine sulfate tab 0.125 mg(Levsin)

2

lansoprazole cap delayed release15 mg (Prevacid)

2 •

lansoprazole cap delayed release30 mg (Prevacid)

2 •

LEVBID - hyoscyamine sulfate tab sr12hr 0.375 mg

4

LEVSIN - hyoscyamine sulfate tab 0.125mg

4

LEVSIN/SL - hyoscyamine sulfate tab sl0.125 mg

4

LIBRAX - chlordiazepoxide hcl-clidiniumbromide cap 5-2.5 mg

4

methscopolamine bromide tab2.5 mg (Pamine)

2

methscopolamine bromide tab 5 mg(Pamine forte)

2

misoprostol tab 100 mcg (Cytotec) 1

misoprostol tab 200 mcg (Cytotec) 1

NEXIUM - esomeprazole magnesium fordelayed release susp pack 2.5 mg

4 •

NEXIUM - esomeprazole magnesium fordelayed release susp packet 5 mg

4 •


4 •


4 •


4 •

NEXIUM - esomeprazole magnesiumcap delayed release 20 mg (base eq)

4 •

NEXIUM - esomeprazole magnesiumcap delayed release 40 mg (base eq)

4 •

nizatidine cap 150 mg 2

nizatidine cap 300 mg (Axid) 2

nizatidine oral soln 15 mg/ml (Axid) 2

2015


Drug Name Dru

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OMECLAMOX-PAK - amoxicillin cap-clarithro tab w/ omepraz cap drtherapy pack

4

OMEPRAZOLE + SYRSPEND SF -omeprazole susp 2 mg/ml (compoundkit)

4

omeprazole cap delayed release10 mg (Prilosec)

2 •


1 •


1 •

omeprazole-sodium bicarbonate cap20-1100 mg (Zegerid)

2 •

omeprazole-sodium bicarbonate cap40-1100 mg (Zegerid)

2 •

PAMINE - methscopolamine bromidetab 2.5 mg

4

PAMINE FORTE - methscopolaminebromide tab 5 mg

4

PAMINE FQ - methscopolamine tab 5mg & misc intestinal flora reg cap

4

pantoprazole sodium ec tab 20 mg(base equiv) (Protonix)

1 •

pantoprazole sodium ec tab 40 mg(base equiv) (Protonix)

1 •

PEPCID - famotidine tab 40 mg 4

PEPCID - famotidine for susp 40mg/5ml

4

PREVACID - lansoprazole cap delayedrelease 15 mg

4 •

PREVACID - lansoprazole cap delayedrelease 30 mg

4 •

PREVACID SOLUTAB - lansoprazoletab delayed release orallydisintegrating 15 mg

4 •

PREVACID SOLUTAB - lansoprazoletab delayed release orallydisintegrating 30 mg

4 •

PREVPAC - amoxicillin cap-clarithrotab-lansopraz cap dr therapy pack

4

Drug Name Dru

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PRILOSEC - omeprazole cap delayedrelease 10 mg

4 •


4 •


4 •

PRILOSEC - omeprazole magnesiumfor delayed release susp packet 2.5mg

4 •

PRILOSEC - omeprazole magnesiumfor delayed release susp packet 10mg

4 •

PROPANTHELINE BROMIDE -propantheline bromide tab 15 mg

4

PROTONIX - pantoprazole sodium fordelayed release susp packet 40 mg

4 •

PROTONIX - pantoprazole sodium ectab 20 mg (base equiv)

4 •

PROTONIX - pantoprazole sodium ectab 40 mg (base equiv)

4 •

PYLERA - bismuth subcit-metronidazole-tetracycline cap140-125-125 mg

4

rabeprazole sodium ec tab 20 mg(Aciphex)

2 •

ranitidine hcl cap 150 mg 2

ranitidine hcl cap 300 mg 2

ranitidine hcl syrup 15 mg/ml(75 mg/5ml)

1

ranitidine hcl tab 300 mg (Zantac) 1

ROBINUL - glycopyrrolate tab 1 mg 4

ROBINUL FORTE - glycopyrrolate tab 2mg

4

sucralfate tab 1 gm (Carafate) 2

SYMAX DUOTAB - hyoscyamine sulfatetab cr 0.375 mg (0.125 mg ir/0.25 mgcr)

4

ZANTAC - ranitidine hcl tab 300 mg 4

ZEGERID - omeprazole-sodiumbicarbonate cap 20-1100 mg

4 •

2015


Drug Name Dru

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ZEGERID - omeprazole-sodiumbicarbonate cap 40-1100 mg

4 •

ZEGERID - omeprazole-sodiumbicarbonate powd pack for susp20-1680 mg

4 •

ZEGERID - omeprazole-sodiumbicarbonate powd pack for susp40-1680 mg

4 •

ANTIEMETICS

AKYNZEO - netupitant-palonosetroncap 300-0.5 mg

4 •

ANZEMET - dolasetron mesylate tab 50mg

4 •

ANZEMET - dolasetron mesylate tab100 mg

4 •

CESAMET - nabilone cap 1 mg 4

DICLEGIS - doxylamine-pyridoxine tabdelayed release 10-10 mg

4

dronabinol cap 2.5 mg (Marinol) 2 •dronabinol cap 5 mg (Marinol) 2 •dronabinol cap 10 mg (Marinol) 2 •EMEND - aprepitant capsule therapy

pack 80 & 125 mg3 •

EMEND - aprepitant capsule 40 mg 3 •EMEND - aprepitant capsule 80 mg 3 •EMEND - aprepitant capsule 125 mg 3 •granisetron hcl tab 1 mg 2 •MARINOL - dronabinol cap 2.5 mg 4 •MARINOL - dronabinol cap 5 mg 4 •MARINOL - dronabinol cap 10 mg 4 •ondansetron hcl oral soln 4 mg/5ml

(Zofran)2 •

ondansetron hcl tab 4 mg (Zofran) 1 •ondansetron hcl tab 8 mg (Zofran) 2 •ondansetron hcl tab 24 mg 2 •ondansetron orally disintegrating tab

4 mg (Zofran odt)2 •

Drug Name Dru

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its

ondansetron orally disintegrating tab8 mg (Zofran odt)

2 •

SANCUSO - granisetron td patch 3.1mg/24hr (contains 34.3 mg)

4 •

TIGAN - trimethobenzamide hcl cap 300mg

4

TRANSDERM-SCOP - scopolamine tdpatch 72hr 1 mg/3days

4

trimethobenzamide hcl cap 300 mg(Tigan)

2

ZOFRAN - ondansetron hcl oral soln 4mg/5ml

4 •

ZOFRAN - ondansetron hcl tab 4 mg 4 •ZOFRAN - ondansetron hcl tab 8 mg 4 •ZOFRAN ODT - ondansetron orally

disintegrating tab 4 mg4 •

ZOFRAN ODT - ondansetron orallydisintegrating tab 8 mg

4 •

ZUPLENZ - ondansetron oral solublefilm 4 mg

4 •

ZUPLENZ - ondansetron oral solublefilm 8 mg

4 •

DIGESTIVE AIDS

CREON - pancrelipase (lip-prot-amyl) drcap 3000-9500-15000 unit

4


4


4


4


4

PANCREAZE - pancrelipase (lip-prot-amyl) dr cap 4200-10000-17500 unit

4


4


4

2015


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4

PANCRELIPASE - pancrelipase (lip-prot-amyl) dr cap 5000-17000-27000unit

4

PERTZYE - pancrelipase (lip-prot-amyl)dr cap 8000-28750-30250 unit

4

PERTZYE - pancrelipase (lip-prot-amyl)dr cap 16000-57500-60500 unit

4

SUCRAID - sacrosidase soln 8500 unit/ml

5 •

ULTRESA - pancrelipase (lip-prot-amyl)dr cap 13800-27600-27600 unit

4


4


4

VIOKACE - pancrelipase (lip-prot-amyl)tab 10440-39150-39150 unit

4

VIOKACE - pancrelipase (lip-prot-amyl)tab 20880-78300-78300 unit

4

ZENPEP - pancrelipase (lip-prot-amyl)dr cap 3000-10000-16000 unit

3


3


3


3


3


3


3

GASTROINTESTINAL AGENTS- MISC.

ACTIGALL - ursodiol cap 300 mg 4

alosetron hcl tab 0.5 mg (base equiv)(Lotronex)

2

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

alosetron hcl tab 1 mg (base equiv)(Lotronex)

2

AMITIZA - lubiprostone cap 8 mcg 4

AMITIZA - lubiprostone cap 24 mcg 4

APRISO - mesalamine cap sr 24hr0.375 gm

4

ASACOL HD - mesalamine tab delayedrelease 800 mg

4

AURYXIA - ferric citrate tab 1 gm (210mg ferric iron)

4

AZULFIDINE - sulfasalazine tab 500 mg 4

AZULFIDINE EN-TABS - sulfasalazinetab delayed release 500 mg

4

balsalazide disodium cap 750 mg(Colazal)

2

calcium acetate (phosphate binder)cap 667 mg (169 mg ca) (Phoslo)

2

calcium acetate (phosphate binder)tab 667 mg (Eliphos)

2

CANASA - mesalamine suppos 1000mg

3

CHENODAL - chenodiol tab 250 mg 5 •CHOLBAM - cholic acid cap 50 mg 5

CHOLBAM - cholic acid cap 250 mg 5

CIMZIA - certolizumab pegol inj kit 2 x200 mg/ml

5 • •

CIMZIA STARTER KIT - certolizumabpegol inj kit 6 x 200 mg/ml

5 • •

COLAZAL - balsalazide disodium cap750 mg

4

cromolyn sodium oral conc100 mg/5ml (Gastrocrom)

2

DELZICOL - mesalamine cap dr 400 mg 4

DIPENTUM - olsalazine sodium cap 250mg

4

ELIPHOS - calcium acetate (phosphatebinder) tab 667 mg

4

ENTEREG - alvimopan cap 12 mg 4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

FOSRENOL - lanthanum carbonatechew tab 500 mg (elemental)

4


4


4

FOSRENOL - lanthanum carbonate oralpowder pack 750 mg (elemental)

4

FOSRENOL - lanthanum carbonate oralpowder pack 1000 mg (elemental)

4

GASTROCROM - cromolyn sodium oralconc 100 mg/5ml

4

GATTEX - teduglutide (rdna) for inj kit 5mg

5 •

GIAZO - balsalazide disodium tab 1.1gm

4

lactulose (encephalopathy) solution10 gm/15ml

1

LIALDA - mesalamine tab delayedrelease 1.2 gm

4

LINZESS - linaclotide cap 145 mcg 4

LINZESS - linaclotide cap 290 mcg 4

LOTRONEX - alosetron hcl tab 0.5 mg(base equiv)

4

LOTRONEX - alosetron hcl tab 1 mg(base equiv)

4

mesalamine enema 4 gm 2

mesalamine rectal enema 4 gm &cleanser wipe kit (Rowasa)

2

metoclopramide hcl orallydisintegrating tab 5 mg (Metozolvodt)

2

metoclopramide hcl soln 5 mg/5ml(10 mg/10ml)

1

metoclopramide hcl tab 5 mg(Reglan)

1

metoclopramide hcl tab 10 mg(Reglan)

1

METOZOLV ODT - metoclopramide hclorally disintegrating tab 5 mg

4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

MOVANTIK - naloxegol oxalate tab 12.5mg (base equivalent)

4

MOVANTIK - naloxegol oxalate tab 25mg (base equivalent)

4

PENTASA - mesalamine cap cr 250 mg 4

PENTASA - mesalamine cap cr 500 mg 4

PHOSLO - calcium acetate (phosphatebinder) cap 667 mg (169 mg ca)

4

PHOSLYRA - calcium acetate(phosphate binder) oral soln 667mg/5ml

4

REGLAN - metoclopramide hcl tab 5 mg 4

REGLAN - metoclopramide hcl tab 10mg

4

RELISTOR - methylnaltrexone bromideinj 8 mg/0.4ml (20 mg/ml)

4

RELISTOR - methylnaltrexone bromideinj 12 mg/0.6ml (20 mg/ml)

4

RENAGEL - sevelamer hcl tab 400 mg 4

RENAGEL - sevelamer hcl tab 800 mg 4

RENVELA - sevelamer carbonate tab800 mg

4

RENVELA - sevelamer carbonatepacket 0.8 gm

4

RENVELA - sevelamer carbonatepacket 2.4 gm

4

ROWASA - mesalamine rectal enema 4gm & cleanser wipe kit

4

SEVELAMER CARBONATE -sevelamer carbonate tab 800 mg

4

SFROWASA - mesalamine sulfite-free(sf) enema 4 gm/60ml

4

sulfasalazine tab delayed release500 mg (Azulfidine en-tabs)

2

sulfasalazine tab 500 mg (Azulfidine) 2

URSO FORTE - ursodiol tab 500 mg 4

URSO 250 - ursodiol tab 250 mg 4

ursodiol cap 300 mg (Actigall) 2

ursodiol tab 250 mg (Urso 250) 2

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

ursodiol tab 500 mg (Urso forte) 2

VELPHORO - sucroferric oxyhydroxidechew tab 500 mg

4

GENITOURINARY AGENTS

URINARY ANTI-INFECTIVES

FURADANTIN - nitrofurantoin susp 25mg/5ml

4

HIPREX - methenamine hippurate tab 1gm

4

MACROBID - nitrofurantoinmonohydrate macrocrystalline cap100 mg

4

MACRODANTIN - nitrofurantoinmacrocrystalline cap 25 mg

4


4


4

methenamine hippurate tab 1 gm(Hiprex)

2

METHENAMINE MANDELATE -methenamine mandelate tab 0.5 gm

4

methenamine mandelate tab 1 gm 2

methenamine-hyos-meth blue-sodphos-phen sal tab 81.6 mg

2

methenamine-hyosc-meth blue-benzacid-phenyl sal tab 81.6mg (Prosed/ds)

2

methenamine-hyosc-meth blue-sodphos-phen sal cap 118 mg

2

methenamine-hyosc-meth blue-sodphos-phen sal cap 120 mg

2

methenamine-hyosc-meth blue-sodphos-phen sal tab 81 mg

2

methenamine-hyoscamine-methblue-sod phos tab 81.6 mg(Urogesic-blue)

2

MONUROL - fosfomycin tromethaminepowd pack 3 gm (base equivalent)

4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

nitrofurantoin macrocrystalline cap50 mg (Macrodantin)

2

nitrofurantoin macrocrystalline cap100 mg (Macrodantin)

2

nitrofurantoin monohydratemacrocrystalline cap 100 mg(Macrobid)

2

nitrofurantoin susp 25 mg/5ml(Furadantin)

2

PROSED/DS - methenamine-hyosc-meth blue-benz acid-phenyl sal tab81.6mg

4

URETRON D/S - methenamine-hyosc-meth blue-sod phos-phen sal tab 120mg

4

UREX - methenamine hippurate tab 1gm

4

URIMAR-T - methenamine-hyosc-methblue-sod phos-phen sal tab 120 mg

4

UROGESIC-BLUE - methenamine-hyoscamine-meth blue-sod phos tab81.6 mg

4

UROQID #2 - methenamine mandelate-sod phosphate monobasic tab500-500 mg

4

UTA - methenamine-hyoscamine-methblue-sod phos cap 120 mg

4

URINARY ANTISPASMODICS

bethanechol chloride tab 5 mg(Urecholine)

2


2


2


2

DETROL - tolterodine tartrate tab 1 mg 4

DETROL - tolterodine tartrate tab 2 mg 4

DETROL LA - tolterodine tartrate cap sr24hr 2 mg

4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

DETROL LA - tolterodine tartrate cap sr24hr 4 mg

4

DITROPAN XL - oxybutynin chloride tabsr 24hr 5 mg

4


4


4

ENABLEX - darifenacin hydrobromidetab sr 24hr 7.5 mg (base equiv)

4

ENABLEX - darifenacin hydrobromidetab sr 24hr 15 mg (base equiv)

4

flavoxate hcl tab 100 mg 2

GELNIQUE - oxybutynin td gel 3% (28mg/act metered-dose pump)

4 •

GELNIQUE - oxybutynin chloride td gel10%

4 •

MYRBETRIQ - mirabegron tab sr 24 hr25 mg

4

MYRBETRIQ - mirabegron tab sr 24 hr50 mg

4

oxybutynin chloride syrup 5 mg/5ml 1

oxybutynin chloride tab sr 24hr 5 mg(Ditropan xl)

2

oxybutynin chloride tab sr 24hr10 mg (Ditropan xl)

2

oxybutynin chloride tab sr 24hr15 mg (Ditropan xl)

2

oxybutynin chloride tab 5 mg 2

OXYTROL - oxybutynin td patch twiceweekly 3.9 mg/24hr

4 •

tolterodine tartrate cap sr 24hr 2 mg(Detrol la)

2

tolterodine tartrate cap sr 24hr 4 mg(Detrol la)

2

tolterodine tartrate tab 1 mg (Detrol) 2

tolterodine tartrate tab 2 mg (Detrol) 2

TOVIAZ - fesoterodine fumarate tab sr24hr 4 mg

4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

TOVIAZ - fesoterodine fumarate tab sr24hr 8 mg

4

trospium chloride cap sr 24hr 60 mg 2

trospium chloride tab 20 mg 2

URECHOLINE - bethanechol chloridetab 5 mg

4


4


4


4

VESICARE - solifenacin succinate tab 5mg

4

VESICARE - solifenacin succinate tab10 mg

4

VAGINAL PRODUCTS

AVC - sulfanilamide vaginal cream 15% 4

CLEOCIN - clindamycin phosphatevaginal cream 2%

4

CLEOCIN - clindamycin phosphatevaginal suppos 100 mg

4

clindamycin phosphate vaginalcream 2% (Cleocin)

2

CLINDESSE - clindamycin phosphate(one dose) vaginal cream 2%

4

ESTRACE - estradiol vaginal cream 0.1mg/gm

3

ESTRING - estradiol vaginal ring 2 mg(7.5 mcg/24hrs)

4

FEM PH - acetic acid-oxyquinolinevaginal gel 0.9-0.025%

4

FEMRING - estradiol acetate vaginalring 0.05 mg/24hr

4

FEMRING - estradiol acetate vaginalring 0.1 mg/24hr

4

GYNAZOLE-1 - butoconazole nitrate(one dose) vaginal cream 2%

4

METROGEL-VAGINAL - metronidazolevaginal gel 0.75%

4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

metronidazole vaginal gel 0.75%(Metrogel-vaginal)

2

miconazole nitrate vaginal supp200 mg & 2% cream 9 gm kit

1

MICONAZOLE 3 - miconazole nitratevaginal suppos 200 mg

4

NUVESSA - metronidazole vaginal gel1.3%

4

PREMARIN - estrogens, conjugatedvaginal cream 0.625 mg/gm

4

RELAGARD - acetic acid-oxyquinolinevaginal gel 0.9-0.025%

4

TERAZOL 3 - terconazole vaginalcream 0.8%

4

TERAZOL 7 - terconazole vaginalcream 0.4%

4

terconazole vaginal cream 0.4%(Terazol 7)

2

terconazole vaginal cream 0.8%(Terazol 3)

2

terconazole vaginal suppos 80 mg 2

VAGIFEM - estradiol vaginal tab 10 mcg 3

GENITOURINARY AGENTS - MISC.

alfuzosin hcl tab sr 24hr 10 mg(Uroxatral)

1

AVODART - dutasteride cap 0.5 mg 4

CARDURA XL - doxazosin mesylate tabsr 24 hr 4 mg (base equiv)

4

CARDURA XL - doxazosin mesylate tabsr 24 hr 8 mg (base equiv)

4

CYSTAGON - cysteamine bitartrate cap50 mg

5 •

CYSTAGON - cysteamine bitartrate cap150 mg

5 •

CYTRA-3 - pot & sod citrates w/ cit acsyrup 550-500-334 mg/5ml

4

ELMIRON - pentosan polysulfatesodium caps 100 mg

4

finasteride tab 5 mg (Proscar) 1

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

FLOMAX - tamsulosin hcl cap 0.4 mg 4

JALYN - dutasteride-tamsulosin hcl cap0.5-0.4 mg

4

K-PHOS NO 2 - potassium & sodiumacid phosphates tab 305-700 mg

4

LITHOSTAT - acetohydroxamic acid tab250 mg

4

ORACIT - sodium citrate & citric acidsoln 490-640 mg/5ml

4

phenazopyridine hcl tab 100 mg(Pyridium)

1

phenazopyridine hcl tab 200 mg(Pyridium)

1

pot & sod citrates w/ cit ac soln550-500-334 mg/5ml

2

potassium citrate & citric acidpowder pack 3300-1002 mg

2

potassium citrate & citric acid soln1100-334 mg/5ml

2

potassium citrate tab cr 5 meq(540 mg) (Urocit-k 5)

2


2


2

PROCYSBI - cysteamine bitartrate capdelayed release 25 mg (base equiv)

5 •

PROCYSBI - cysteamine bitartrate capdelayed release 75 mg (base equiv)

5 •

PROSCAR - finasteride tab 5 mg 4

PYRIDIUM - phenazopyridine hcl tab100 mg

4

PYRIDIUM - phenazopyridine hcl tab200 mg

4

RAPAFLO - silodosin cap 4 mg 4

RAPAFLO - silodosin cap 8 mg 4

SHOHLS SOLUTION MODIFIED -sodium citrate & citric acid soln500-334 mg/5ml

4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

sodium citrate & citric acid soln500-334 mg/5ml (Shohls solutionmodi)

1

tamsulosin hcl cap 0.4 mg (Flomax) 1

THIOLA - tiopronin tab 100 mg 4

UROCIT-K 10 - potassium citrate tab cr10 meq (1080 mg)

4

UROCIT-K 15 - potassium citrate tab cr15 meq (1620 mg)

4

UROCIT-K 5 - potassium citrate tab cr 5meq (540 mg)

4

UROXATRAL - alfuzosin hcl tab sr 24hr10 mg

4

CENTRAL NERVOUS SYSTEM DRUGS

ANTIANXIETY AGENTS

ALPRAZOLAM INTENSOL - alprazolamconc 1 mg/ml

4

alprazolam orally disintegrating tab0.25 mg (Niravam)

2

alprazolam orally disintegrating tab0.5 mg

2

alprazolam orally disintegrating tab1 mg

2

alprazolam orally disintegrating tab2 mg

2

alprazolam tab sr 24hr 0.5 mg (Xanaxxr)

2

alprazolam tab sr 24hr 1 mg (Xanaxxr)

2


2


2

alprazolam tab 0.25 mg (Xanax) 1

alprazolam tab 0.5 mg (Xanax) 1

alprazolam tab 1 mg (Xanax) 1

alprazolam tab 2 mg (Xanax) 1

ATIVAN - lorazepam tab 0.5 mg 4

ATIVAN - lorazepam tab 1 mg 4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

ATIVAN - lorazepam tab 2 mg 4

buspirone hcl tab 5 mg 1

buspirone hcl tab 7.5 mg 2




chlordiazepoxide hcl cap 5 mg 1



clorazepate dipotassium tab 3.75 mg(Tranxene t)

1

clorazepate dipotassium tab 7.5 mg(Tranxene t)

1

clorazepate dipotassium tab 15 mg(Tranxene t)

2

DIAZEPAM - diazepam soln 1 mg/ml 4

diazepam conc 5 mg/ml 2

diazepam tab 2 mg (Valium) 1



hydroxyzine hcl syrup 10 mg/5ml 1

hydroxyzine hcl tab 10 mg 1



HYDROXYZINE PAMOATE -hydroxyzine pamoate cap 100 mg

4

hydroxyzine pamoate cap 25 mg(Vistaril)

1

hydroxyzine pamoate cap 50 mg(Vistaril)

1

lorazepam conc 2 mg/ml (Lorazepamintensol)

2

LORAZEPAM INTENSOL - lorazepamconc 2 mg/ml

4

lorazepam tab 0.5 mg (Ativan) 1

lorazepam tab 1 mg (Ativan) 1

lorazepam tab 2 mg (Ativan) 1

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

meprobamate tab 200 mg 2

meprobamate tab 400 mg 2

NIRAVAM - alprazolam orallydisintegrating tab 0.25 mg

4

oxazepam cap 10 mg 2



TRANXENE T - clorazepatedipotassium tab 3.75 mg

4

TRANXENE T - clorazepatedipotassium tab 7.5 mg

4

TRANXENE T - clorazepatedipotassium tab 15 mg

4

VALIUM - diazepam tab 2 mg 4



VISTARIL - hydroxyzine pamoate cap25 mg

4

VISTARIL - hydroxyzine pamoate cap50 mg

4

XANAX - alprazolam tab 0.25 mg 4

XANAX - alprazolam tab 0.5 mg 4

XANAX - alprazolam tab 1 mg 4

XANAX - alprazolam tab 2 mg 4

XANAX XR - alprazolam tab sr 24hr 0.5mg

4

XANAX XR - alprazolam tab sr 24hr 1mg

4


4


4

ANTIDEPRESSANTS

amitriptyline hcl tab 10 mg 1





Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


AMOXAPINE - amoxapine tab 25 mg 4




ANAFRANIL - clomipramine hcl cap 25mg

4


4


4

APLENZIN - bupropion hbr tab sr 24hr174 mg

4 •


4 •


4 •

BRINTELLIX - vortioxetine hbr tab 5 mg(base equiv)

4 •

BRINTELLIX - vortioxetine hbr tab 10mg (base equiv)

4 •

BRINTELLIX - vortioxetine hbr tab 20mg (base equiv)

4 •

bupropion hcl tab sr 12hr 100 mg(Wellbutrin sr)

2


2


2

bupropion hcl tab sr 24hr 150 mg(Wellbutrin xl)

2

bupropion hcl tab sr 24hr 300 mg(Wellbutrin xl)

2

bupropion hcl tab 75 mg (Wellbutrin) 2

bupropion hcl tab 100 mg (Wellbutrin) 2

CELEXA - citalopram hydrobromide tab10 mg (base equiv)

4 •


4 •

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


4 •

citalopram hydrobromide oral soln10 mg/5ml

2

citalopram hydrobromide tab 10 mg(base equiv) (Celexa)

1


1


1

clomipramine hcl cap 25 mg(Anafranil)

2


2


2

CYMBALTA - duloxetine hcl entericcoated pellets cap 20 mg

4 • •


4 • •


4 • •

desipramine hcl tab 10 mg(Norpramin)

2


2


2


2


2


2

DESVENLAFAXINE ER -desvenlafaxine tab sr 24hr 50 mg

4 •

DESVENLAFAXINE ER -desvenlafaxine tab sr 24hr 100 mg

4 •

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

DESVENLAFAXINE ER -desvenlafaxine fumarate tab sr 24hr50 mg (base equiv)

4 •

DESVENLAFAXINE ER -desvenlafaxine fumarate tab sr 24hr100 mg (base equiv)

4 •

DOXEPIN HCL - doxepin hcl cap 75 mg 4

doxepin hcl cap 10 mg 1





doxepin hcl conc 10 mg/ml 1

DULOXETINE HCL - duloxetine hclenteric coated pellets cap 40 mg

4 • •

duloxetine hcl enteric coated pelletscap 20 mg (Cymbalta)

2 •


2 •


2 •

EFFEXOR XR - venlafaxine hcl cap sr24hr 37.5 mg (base equivalent)

4 •

EFFEXOR XR - venlafaxine hcl cap sr24hr 75 mg (base equivalent)

4 •

EFFEXOR XR - venlafaxine hcl cap sr24hr 150 mg (base equivalent)

4 •

EMSAM - selegiline td patch 24hr 6mg/24hr

4


4


4

escitalopram oxalate soln 5 mg/5ml(base equiv) (Lexapro)

2

escitalopram oxalate tab 5 mg (baseequiv) (Lexapro)

1

escitalopram oxalate tab 10 mg(base equiv) (Lexapro)

1

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

escitalopram oxalate tab 20 mg(base equiv) (Lexapro)

1

FETZIMA - levomilnacipran hcl cap sr24hr 20 mg (base equivalent)

4 •


4 •


4 •


4 •

FETZIMA TITRATION PACK -levomilnacipran hcl cap sr 24hr 20 &40 mg therapy pack

4 •

FLUOXETINE HCL - fluoxetine hcl tab60 mg

4 •

fluoxetine hcl cap delayed release90 mg (Prozac weekly)

2 •

fluoxetine hcl cap 10 mg (Prozac) 1



fluoxetine hcl solution 20 mg/5ml 1

fluoxetine hcl tab 10 mg 1

fluoxetine hcl tab 20 mg 2

fluvoxamine maleate cap sr 24hr100 mg (Luvox cr)

2

fluvoxamine maleate cap sr 24hr150 mg (Luvox cr)

2

fluvoxamine maleate tab 25 mg 2



FORFIVO XL - bupropion hcl tab sr 24hr450 mg

4 •

imipramine hcl tab 10 mg (Tofranil) 1



imipramine pamoate cap 75 mg(Tofranil-pm)

2


2

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


2


2

IRENKA - duloxetine hcl enteric coatedpellets cap 40 mg

4 • •

KHEDEZLA - desvenlafaxine tab sr 24hr50 mg

4 •

KHEDEZLA - desvenlafaxine tab sr 24hr100 mg

4 •

LEXAPRO - escitalopram oxalate soln 5mg/5ml (base equiv)

4 •

LEXAPRO - escitalopram oxalate tab 5mg (base equiv)

4 •


4 •


4 •

MAPROTILINE HCL - maprotiline hcltab 25 mg

4 •


4 •


4 •

MARPLAN - isocarboxazid tab 10 mg 4

mirtazapine orally disintegrating tab15 mg (Remeron soltab)

2


2


2

mirtazapine tab 7.5 mg 2

mirtazapine tab 15 mg (Remeron) 1



NARDIL - phenelzine sulfate tab 15 mg 4

NEFAZODONE HCL - nefazodone hcltab 50 mg

4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


4


4


4

nefazodone hcl tab 250 mg 2

NORPRAMIN - desipramine hcl tab 10mg

4


4


4


4


4


4

NORTRIPTYLINE HCL - nortriptyline hclsoln 10 mg/5ml

4

nortriptyline hcl cap 10 mg (Pamelor) 1




OLEPTRO - trazodone hcl tab sr 24hr150 mg

4 •

OLEPTRO - trazodone hcl tab sr 24hr300 mg

4 •

PAMELOR - nortriptyline hcl cap 10 mg 4




PARNATE - tranylcypromine sulfate tab10 mg

4

paroxetine hcl tab sr 24hr 12.5 mg(Paxil cr)

2

paroxetine hcl tab sr 24hr 25 mg(Paxil cr)

2

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

paroxetine hcl tab sr 24hr 37.5 mg(Paxil cr)

2

paroxetine hcl tab 10 mg (Paxil) 1




PAXIL - paroxetine hcl oral susp 10mg/5ml (base equiv)

4 •

PAXIL - paroxetine hcl tab 10 mg 4 •PAXIL - paroxetine hcl tab 20 mg 4 •PAXIL - paroxetine hcl tab 30 mg 4 •PAXIL - paroxetine hcl tab 40 mg 4 •PAXIL CR - paroxetine hcl tab sr 24hr

12.5 mg4 •

PAXIL CR - paroxetine hcl tab sr 24hr25 mg

4 •

PAXIL CR - paroxetine hcl tab sr 24hr37.5 mg

4 •

PEXEVA - paroxetine mesylate tab 10mg (base equiv)

4 •


4 •


4 •


4 •

phenelzine sulfate tab 15 mg (Nardil) 2

PRISTIQ - desvenlafaxine succinate tabsr 24hr 25 mg (base equiv)

4 • •


4 • •


4 • •

protriptyline hcl tab 5 mg (Vivactil) 2

protriptyline hcl tab 10 mg (Vivactil) 2

PROZAC - fluoxetine hcl cap 10 mg 4 •PROZAC - fluoxetine hcl cap 20 mg 4 •PROZAC - fluoxetine hcl cap 40 mg 4 •

2015


Drug Name Dru

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ion

Ste

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py

Dis

pens

ing

Lim

its

PROZAC WEEKLY - fluoxetine hcl capdelayed release 90 mg

4 • •

REMERON - mirtazapine tab 15 mg 4 •REMERON - mirtazapine tab 30 mg 4 •REMERON - mirtazapine tab 45 mg 4 •REMERON SOLTAB - mirtazapine

orally disintegrating tab 15 mg4 •

REMERON SOLTAB - mirtazapineorally disintegrating tab 30 mg

4 •

REMERON SOLTAB - mirtazapineorally disintegrating tab 45 mg

4 •

sertraline hcl oral conc 20 mg/ml(Zoloft)

2

sertraline hcl tab 25 mg (Zoloft) 1



SURMONTIL - trimipramine maleatecap 25 mg

4


4


4

TOFRANIL - imipramine hcl tab 10 mg 4



TOFRANIL-PM - imipramine pamoatecap 75 mg

4


4


4


4

tranylcypromine sulfate tab 10 mg(Parnate)

2

trazodone hcl tab 50 mg 1



Drug Name Dru

g T

ier

Prio

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ion

Ste

p T

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py

Dis

pens

ing

Lim

its


venlafaxine hcl cap sr 24hr 37.5 mg(base equivalent) (Effexor xr)

1

venlafaxine hcl cap sr 24hr 75 mg(base equivalent) (Effexor xr)

1

venlafaxine hcl cap sr 24hr 150 mg(base equivalent) (Effexor xr)

1

VENLAFAXINE HCL ER - venlafaxinehcl tab sr 24hr 37.5 mg (baseequivalent)

4 •

VENLAFAXINE HCL ER - venlafaxinehcl tab sr 24hr 75 mg (baseequivalent)

4 •


4 •


4 •

venlafaxine hcl tab sr 24hr 37.5 mg(base equivalent) (Venlafaxine hcler)

2

venlafaxine hcl tab sr 24hr 75 mg(base equivalent) (Venlafaxine hcler)

2

venlafaxine hcl tab sr 24hr 150 mg(base equivalent) (Venlafaxine hcler)

2

venlafaxine hcl tab 25 mg 2

venlafaxine hcl tab 37.5 mg 2




VIIBRYD - vilazodone hcl tab starter kit10 (7) & 20 (7) & 40 (16) mg

4 •

VIIBRYD - vilazodone hcl tab 10 mg 4 •VIIBRYD - vilazodone hcl tab 20 mg 4 •VIIBRYD - vilazodone hcl tab 40 mg 4 •WELLBUTRIN - bupropion hcl tab 75

mg4 •

2015


Drug Name Dru

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ion

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py

Dis

pens

ing

Lim

its

WELLBUTRIN - bupropion hcl tab 100mg

4 •

WELLBUTRIN SR - bupropion hcl tab sr12hr 100 mg

4 •


4 •


4 •

WELLBUTRIN XL - bupropion hcl tab sr24hr 150 mg

4 •

WELLBUTRIN XL - bupropion hcl tab sr24hr 300 mg

4 •

ZOLOFT - sertraline hcl oral conc 20mg/ml

4 •

ZOLOFT - sertraline hcl tab 25 mg 4 •ZOLOFT - sertraline hcl tab 50 mg 4 •ZOLOFT - sertraline hcl tab 100 mg 4 •ANTIPSYCHOTICS

ABILIFY - aripiprazole tab 2 mg 4 •ABILIFY - aripiprazole tab 5 mg 4 •ABILIFY - aripiprazole tab 10 mg 4 •ABILIFY - aripiprazole tab 15 mg 4 •ABILIFY - aripiprazole tab 20 mg 4 •ABILIFY - aripiprazole tab 30 mg 4 •ADASUVE - loxapine aerosol powder

breath activated 10 mg4

aripiprazole tab 2 mg (Abilify) 2 •aripiprazole tab 5 mg (Abilify) 2 •aripiprazole tab 10 mg (Abilify) 2 •aripiprazole tab 15 mg (Abilify) 2 •aripiprazole tab 20 mg (Abilify) 2 •aripiprazole tab 30 mg (Abilify) 2 •chlorpromazine hcl tab 10 mg 2

chlorpromazine hcl tab 25 mg 2




Drug Name Dru

g T

ier

Prio

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ion

Ste

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Dis

pens

ing

Lim

its

CLOZAPINE ODT - clozapine orallydisintegrating tab 12.5 mg

4 •

CLOZAPINE ODT - clozapine orallydisintegrating tab 25 mg

4 •


4 •


4 •


4 •

clozapine tab 25 mg (Clozaril) 2 •clozapine tab 50 mg 2 •clozapine tab 100 mg (Clozaril) 2 •clozapine tab 200 mg 2 •CLOZARIL - clozapine tab 25 mg 4 •CLOZARIL - clozapine tab 100 mg 4 •COMPAZINE - prochlorperazine

maleate tab 5 mg (base equivalent)4

COMPAZINE - prochlorperazinemaleate tab 10 mg (base equivalent)

4

EQUETRO - carbamazepine(antipsychotic) cap sr 12hr 100 mg

4


4


4

FANAPT - iloperidone tab 1 mg 4 •FANAPT - iloperidone tab 2 mg 4 •FANAPT - iloperidone tab 4 mg 4 •FANAPT - iloperidone tab 6 mg 4 •FANAPT - iloperidone tab 8 mg 4 •FANAPT - iloperidone tab 10 mg 4 •FANAPT - iloperidone tab 12 mg 4 •FANAPT TITRATION PACK -

iloperidone tab 1 mg & 2 mg & 4 mg& 6 mg titration pak

4 •

FAZACLO - clozapine orallydisintegrating tab 12.5 mg

4 •

2015


Drug Name Dru

g T

ier

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ion

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py

Dis

pens

ing

Lim

its

FAZACLO - clozapine orallydisintegrating tab 25 mg

4 •


4 •


4 •


4 •

FLUPHENAZINE HCL - fluphenazinehcl elixir 2.5 mg/5ml

3

FLUPHENAZINE HCL - fluphenazinehcl oral conc 5 mg/ml

3

fluphenazine hcl tab 1 mg 1

fluphenazine hcl tab 2.5 mg 1



GEODON - ziprasidone hcl cap 20 mg 4 •GEODON - ziprasidone hcl cap 40 mg 4 •GEODON - ziprasidone hcl cap 60 mg 4 •GEODON - ziprasidone hcl cap 80 mg 4 •haloperidol lactate oral conc 2 mg/ml 1

haloperidol tab 0.5 mg 1

haloperidol tab 1 mg 1





INVEGA - paliperidone tab sr 24hr 1.5mg

4 •

INVEGA - paliperidone tab sr 24hr 3 mg 4 •INVEGA - paliperidone tab sr 24hr 6 mg 4 •INVEGA - paliperidone tab sr 24hr 9 mg 4 •LATUDA - lurasidone hcl tab 20 mg 4 •LATUDA - lurasidone hcl tab 40 mg 4 •LATUDA - lurasidone hcl tab 60 mg 4 •LATUDA - lurasidone hcl tab 80 mg 4 •LATUDA - lurasidone hcl tab 120 mg 4 •

Drug Name Dru

g T

ier

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ion

Ste

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Dis

pens

ing

Lim

its

LITHIUM - lithium oral solution 8meq/5ml

4

LITHIUM CARBONATE - lithiumcarbonate cap 150 mg

4

LITHIUM CARBONATE - lithiumcarbonate cap 600 mg

4

lithium carbonate cap 150 mg(Lithium carbonate)

1

lithium carbonate cap 300 mg 1

lithium carbonate cap 600 mg(Lithium carbonate)

1

lithium carbonate tab cr 300 mg(Lithobid)

2

lithium carbonate tab cr 450 mg 2

lithium carbonate tab 300 mg 1

LITHOBID - lithium carbonate tab cr 300mg

4

loxapine succinate cap 5 mg 2




olanzapine orally disintegrating tab5 mg (Zyprexa zydis)

2 •


2 •


2 •


2 •

olanzapine tab 2.5 mg (Zyprexa) 1 •olanzapine tab 5 mg (Zyprexa) 1 •olanzapine tab 7.5 mg (Zyprexa) 1 •olanzapine tab 10 mg (Zyprexa) 2 •olanzapine tab 15 mg (Zyprexa) 2 •olanzapine tab 20 mg (Zyprexa) 2 •perphenazine tab 2 mg 2

perphenazine tab 4 mg 2


2015


Drug Name Dru

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pens

ing

Lim

its


prochlorperazine maleate tab 5 mg(base equivalent) (Compazine)

1

prochlorperazine maleate tab 10 mg(base equivalent) (Compazine)

1

prochlorperazine suppos 25 mg 2

quetiapine fumarate tab 25 mg(Seroquel)

1 •


1 •


1 •


2 •


2 •


2 •

REXULTI - brexpiprazole tab 0.25 mg 4 •REXULTI - brexpiprazole tab 0.5 mg 4 •REXULTI - brexpiprazole tab 1 mg 4 •REXULTI - brexpiprazole tab 2 mg 4 •REXULTI - brexpiprazole tab 3 mg 4 •REXULTI - brexpiprazole tab 4 mg 4 •RISPERDAL - risperidone soln 1 mg/ml 4 •RISPERDAL - risperidone tab 0.25 mg 4 •RISPERDAL - risperidone tab 0.5 mg 4 •RISPERDAL - risperidone tab 1 mg 4 •RISPERDAL - risperidone tab 2 mg 4 •RISPERDAL - risperidone tab 3 mg 4 •RISPERDAL - risperidone tab 4 mg 4 •RISPERDAL M-TAB - risperidone orally

disintegrating tab 0.5 mg4 •

RISPERDAL M-TAB - risperidone orallydisintegrating tab 1 mg

4 •


4 •

Drug Name Dru

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ion

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Dis

pens

ing

Lim

its


4 •


4 •

risperidone orally disintegrating tab0.25 mg

2 •

risperidone orally disintegrating tab0.5 mg (Risperdal m-tab)

2 •

risperidone orally disintegrating tab1 mg (Risperdal m-tab)

2 •


2 •


2 •


2 •

risperidone soln 1 mg/ml (Risperdal) 2 •risperidone tab 0.25 mg (Risperdal) 1 •risperidone tab 0.5 mg (Risperdal) 1 •risperidone tab 1 mg (Risperdal) 1 •risperidone tab 2 mg (Risperdal) 1 •risperidone tab 3 mg (Risperdal) 1 •risperidone tab 4 mg (Risperdal) 1 •SAPHRIS - asenapine maleate sl tab

2.5 mg (base equiv)4 •

SAPHRIS - asenapine maleate sl tab 5mg (base equiv)

4 •

SAPHRIS - asenapine maleate sl tab 10mg (base equiv)

4 •

SEROQUEL - quetiapine fumarate tab25 mg

4 •


4 •


4 •


4 •


4 •

2015


Drug Name Dru

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ion

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Dis

pens

ing

Lim

its


4 •

SEROQUEL XR - quetiapine fumaratetab sr 24hr 50 mg

3 •


3 •


3 •


3 •


3 •

thioridazine hcl tab 10 mg 1




thiothixene cap 1 mg 1




trifluoperazine hcl tab 1 mg 2




VERSACLOZ - clozapine susp 50 mg/ml 4 •ziprasidone hcl cap 20 mg (Geodon) 2 •ziprasidone hcl cap 40 mg (Geodon) 2 •ziprasidone hcl cap 60 mg (Geodon) 2 •ziprasidone hcl cap 80 mg (Geodon) 2 •ZYPREXA - olanzapine tab 2.5 mg 4 •ZYPREXA - olanzapine tab 5 mg 4 •ZYPREXA - olanzapine tab 7.5 mg 4 •ZYPREXA - olanzapine tab 10 mg 4 •ZYPREXA - olanzapine tab 15 mg 4 •ZYPREXA - olanzapine tab 20 mg 4 •ZYPREXA ZYDIS - olanzapine orally

disintegrating tab 5 mg4 •

Drug Name Dru

g T

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ion

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Dis

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ing

Lim

its

ZYPREXA ZYDIS - olanzapine orallydisintegrating tab 10 mg

4 •


4 •


4 •

HYPNOTICS

AMBIEN - zolpidem tartrate tab 5 mg 4 •AMBIEN - zolpidem tartrate tab 10 mg 4 •AMBIEN CR - zolpidem tartrate tab cr

6.25 mg4 •

AMBIEN CR - zolpidem tartrate tab cr12.5 mg

4 •

BELSOMRA - suvorexant tab 5 mg 4 •BELSOMRA - suvorexant tab 10 mg 4 •BELSOMRA - suvorexant tab 15 mg 4 •BELSOMRA - suvorexant tab 20 mg 4 •BUTISOL SODIUM - butabarbital

sodium tab 30 mg4

BUTISOL SODIUM - butabarbitalsodium tab 50 mg

4

DORAL - quazepam tab 15 mg 4

EDLUAR - zolpidem tartrate sl tab 5 mg 4 •EDLUAR - zolpidem tartrate sl tab 10

mg4 •

estazolam tab 1 mg 1

estazolam tab 2 mg 1

eszopiclone tab 1 mg (Lunesta) 2 •eszopiclone tab 2 mg (Lunesta) 2 •eszopiclone tab 3 mg (Lunesta) 2 •FLURAZEPAM HCL - flurazepam hcl

cap 15 mg1

FLURAZEPAM HCL - flurazepam hclcap 30 mg

1

HALCION - triazolam tab 0.25 mg 4

HETLIOZ - tasimelteon capsule 20 mg 4

INTERMEZZO - zolpidem tartrate sl tab1.75 mg

4 •

2015


Drug Name Dru

g T

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ion

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py

Dis

pens

ing

Lim

its

INTERMEZZO - zolpidem tartrate sl tab3.5 mg

4 •

LUNESTA - eszopiclone tab 1 mg 4 •LUNESTA - eszopiclone tab 2 mg 4 •LUNESTA - eszopiclone tab 3 mg 4 •midazolam hcl syrup 2 mg/ml (base

equivalent)1

PHENOBARBITAL - phenobarbital tab15 mg

4


4


4


4

phenobarbital elixir 20 mg/5ml 2

phenobarbital tab 16.2 mg 1




QUAZEPAM - quazepam tab 15 mg 4

RESTORIL - temazepam cap 7.5 mg 4

RESTORIL - temazepam cap 15 mg 4

RESTORIL - temazepam cap 22.5 mg 4

RESTORIL - temazepam cap 30 mg 4

ROZEREM - ramelteon tab 8 mg 4 •SECONAL - secobarbital sodium cap

100 mg4

SILENOR - doxepin hcl (sleep) tab 3 mg(base equiv)

4 •

SILENOR - doxepin hcl (sleep) tab 6 mg(base equiv)

4 •

SONATA - zaleplon cap 5 mg 4 •SONATA - zaleplon cap 10 mg 4 •temazepam cap 7.5 mg (Restoril) 2

temazepam cap 15 mg (Restoril) 1

temazepam cap 22.5 mg (Restoril) 2

Drug Name Dru

g T

ier

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ion

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Dis

pens

ing

Lim

its

temazepam cap 30 mg (Restoril) 1

triazolam tab 0.125 mg 1

triazolam tab 0.25 mg (Halcion) 1

zaleplon cap 5 mg (Sonata) 1 •zaleplon cap 10 mg (Sonata) 1 •zolpidem tartrate tab cr 6.25 mg

(Ambien cr)2 •

zolpidem tartrate tab cr 12.5 mg(Ambien cr)

2 •

zolpidem tartrate tab 5 mg (Ambien) 1 •zolpidem tartrate tab 10 mg (Ambien) 1 •ZOLPIMIST - zolpidem tartrate oral

spray 5 mg/act4 •

ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREXIANTS

ADDERALL - amphetamine-dextroamphetamine tab 5 mg

4 •

ADDERALL - amphetamine-dextroamphetamine tab 7.5 mg

4 •


4 •

ADDERALL - amphetamine-dextroamphetamine tab 12.5 mg

4 •


4 •


4 •


4 •

ADDERALL XR - amphetamine-dextroamphetamine cap sr 24hr 5 mg

4 •

ADDERALL XR - amphetamine-dextroamphetamine cap sr 24hr 10mg

4 •


4 •


4 •

2015


Drug Name Dru

g T

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Dis

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ing

Lim

its


4 •


4 •

amphetamine-dextroamphetaminecap sr 24hr 5 mg (Adderall xr)

2 •


2 •


2 •


2 •


2 •


2 •

amphetamine-dextroamphetaminetab 5 mg (Adderall)

2 •

amphetamine-dextroamphetaminetab 7.5 mg (Adderall)

2 •


2 •

amphetamine-dextroamphetaminetab 12.5 mg (Adderall)

2 •


2 •


2 •


2 •

APTENSIO XR - methylphenidate hclcap er 24hr 10 mg (xr)

4 •


4 •


4 •


4 •

Drug Name Dru

g T

ier

Prio

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ion

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Dis

pens

ing

Lim

its


4 •


4 •


4 •

caffeine citrate oral soln 60 mg/3ml(10 mg/ml base equiv) (Cafcit)

2

clonidine hcl tab sr 12hr 0.1 mg(Kapvay)

2 •

CONCERTA - methylphenidate hcl tabsa osm 18 mg

4 •


4 •


4 •


4 •

DAYTRANA - methylphenidate td patch10 mg/9hr

4 •


4 •


4 •


4 •

DESOXYN - methamphetamine hcl tab5 mg

4 •

DEXEDRINE - dextroamphetaminesulfate cap sr 24hr 5 mg

4 •


4 •


4 •

dexmethylphenidate hcl cap sr 24 hr5 mg (Focalin xr)

2 •


2 •


2 •

2015


Drug Name Dru

g T

ier

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ion

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Dis

pens

ing

Lim

its


2 •


2 •


2 •

dexmethylphenidate hcl tab 2.5 mg(Focalin)

2 •

dexmethylphenidate hcl tab 5 mg(Focalin)

2 •

dexmethylphenidate hcl tab 10 mg(Focalin)

2 •

dextroamphetamine sulfate cap sr24hr 5 mg (Dexedrine)

2 •


2 •


2 •

dextroamphetamine sulfate oralsolution 5 mg/5ml (Procentra)

2 •

dextroamphetamine sulfate tab 5 mg 2 •dextroamphetamine sulfate tab

10 mg2 •

EVEKEO - amphetamine sulfate tab 5mg

4 •

EVEKEO - amphetamine sulfate tab 10mg

4 •

FOCALIN - dexmethylphenidate hcl tab2.5 mg

4 •

FOCALIN - dexmethylphenidate hcl tab5 mg

4 •

FOCALIN - dexmethylphenidate hcl tab10 mg

4 •

FOCALIN XR - dexmethylphenidate hclcap sr 24 hr 5 mg

4 •


4 •


4 •

Drug Name Dru

g T

ier

Prio

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ion

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Dis

pens

ing

Lim

its


4 •


4 •


4 •


4 •


4 •

guanfacine hcl tab sr 24hr 1 mg(base equiv) (Intuniv)

2 •


2 •


2 •


2 •

INTUNIV - guanfacine hcl tab sr 24hr 1mg (base equiv)

3 •


3 •


3 •


3 •

KAPVAY - clonidine hcl tab sr 12hr 0.1mg

4 •

METADATE CD - methylphenidate hclcap cr 10 mg

4 •


4 •


4 •


4 •


4 •


4 •

2015


Drug Name Dru

g T

ier

Prio

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ion

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py

Dis

pens

ing

Lim

its

methamphetamine hcl tab 5 mg(Desoxyn)

2 •

METHYLIN - methylphenidate hcl chewtab 2.5 mg

4 •

METHYLIN - methylphenidate hcl chewtab 5 mg

4 •

METHYLIN - methylphenidate hcl chewtab 10 mg

4 •

METHYLIN - methylphenidate hcl soln 5mg/5ml

4 •

METHYLIN - methylphenidate hcl soln10 mg/5ml

4 •

methylphenidate hcl cap cr 10 mg(Metadate cd)

2 •


2 •


2 •


2 •


2 •


2 •

methylphenidate hcl cap sr 24hr20 mg (la) (Ritalin la)

2 •


2 •


2 •

methylphenidate hcl chew tab 2.5 mg(Methylin)

2 •

methylphenidate hcl chew tab 5 mg(Methylin)

2 •

methylphenidate hcl chew tab 10 mg(Methylin)

2 •

METHYLPHENIDATE HCL ER -methylphenidate hcl tab sa osm 18mg

2 •

Drug Name Dru

g T

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Dis

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ing

Lim

its


2 •


2 •


2 •

methylphenidate hcl soln 5 mg/5ml(Methylin)

2 •

methylphenidate hcl soln 10 mg/5ml(Methylin)

2 •

methylphenidate hcl tab cr 10 mg 4

methylphenidate hcl tab cr 20 mg(Ritalin sr)

2 •

methylphenidate hcl tab 5 mg(Ritalin)

2 •


2 •


2 •

modafinil tab 100 mg (Provigil) 2 •modafinil tab 200 mg (Provigil) 2 •NUVIGIL - armodafinil tab 50 mg 4 •NUVIGIL - armodafinil tab 150 mg 4 •NUVIGIL - armodafinil tab 200 mg 4 • •NUVIGIL - armodafinil tab 250 mg 4 •PROCENTRA - dextroamphetamine

sulfate oral solution 5 mg/5ml4 •

PROVIGIL - modafinil tab 100 mg 4 •PROVIGIL - modafinil tab 200 mg 4 •QUILLIVANT XR - methylphenidate hcl

for er susp 25 mg/5ml (5 mg/ml)4 •

RITALIN - methylphenidate hcl tab 5 mg 4 •RITALIN - methylphenidate hcl tab 10

mg4 •

RITALIN - methylphenidate hcl tab 20mg

4 •

2015


Drug Name Dru

g T

ier

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Dis

pens

ing

Lim

its

RITALIN LA - methylphenidate hcl capsr 24hr 10 mg (la)

4 •


4 •


4 •


4 •


4 •

STRATTERA - atomoxetine hcl cap 10mg (base equiv)

4 •


4 •


4 •


4 •


4 •


4 •


4 •

VYVANSE - lisdexamfetaminedimesylate cap 10 mg

4 •


4 •


4 •


4 •


4 •


4 •


4 •

ZENZEDI - dextroamphetamine sulfatetab 2.5 mg

4 •

Drug Name Dru

g T

ier

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ion

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Dis

pens

ing

Lim

its

ZENZEDI - dextroamphetamine sulfatetab 7.5 mg

4 •

ZENZEDI - dextroamphetamine sulfatetab 15 mg

4 •


4 •


4 •

PSYCHOTHERAPEUTIC and NEUROLOGICALAGENTS - MISC.

acamprosate calcium tab delayedrelease 333 mg (Campral)

2

ACTIVE-PAC/GABAPENTIN -gabapentin oral cap 300 mg &lidocaine-menthol gel ther pk

4

AMPYRA - dalfampridine tab sr 12hr 10mg

5 • •

ANTABUSE - disulfiram tab 250 mg 4

ANTABUSE - disulfiram tab 500 mg 4

ARICEPT - donepezil hydrochloride tab5 mg

4


4


4

AUBAGIO - teriflunomide tab 7 mg 5 • •AUBAGIO - teriflunomide tab 14 mg 5 • •AVONEX - interferon beta-1a for im inj

kit 30mcg (33mcg(6.6 mu)/vial)5 • •

AVONEX - interferon beta-1a im inj kit30 mcg/0.5ml

5 • •

AVONEX PEN - interferon beta-1a im injkit 30 mcg/0.5ml

5 • •

BETASERON - interferon beta-1b for injkit 0.3 mg

5 •

BRISDELLE - paroxetine mesylate cap7.5 mg (base equiv)

4

bupropion hcl (smoking deterrent)tab sr 12hr 150 mg (Zyban)

2

2015


Drug Name Dru

g T

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ion

Ste

p T

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py

Dis

pens

ing

Lim

its

CHANTIX - varenicline tartrate tab 0.5mg (base equiv)

3

CHANTIX - varenicline tartrate tab 1 mg(base equiv)

3

CHANTIX CONTINUING MONTH -varenicline tartrate tab 1 mg (baseequiv)

3

CHANTIX STARTING MONTH PA -varenicline tartrate tab 0.5 mg x 11 &tab 1 mg x 42 pack

3

CHLORDIAZEPOXIDE/AMITRIPT -chlordiazepoxide-amitriptyline tab5-12.5 mg

4

CHLORDIAZEPOXIDE/AMITRIPT -chlordiazepoxide-amitriptyline tab10-25 mg

4

COMMIT - nicotine polacrilex lozenge 2mg

4

COMMIT - nicotine polacrilex lozenge 4mg

4

COPAXONE - glatiramer acetate solnprefilled syringe 20 mg/ml

5 •

COPAXONE - glatiramer acetate solnprefilled syringe 40 mg/ml

5 •

disulfiram tab 250 mg (Antabuse) 2

disulfiram tab 500 mg (Antabuse) 2

donepezil hydrochloride orallydisintegrating tab 5 mg

2

donepezil hydrochloride orallydisintegrating tab 10 mg (Ariceptodt)

2

donepezil hydrochloride tab 5 mg(Aricept)

1


1


2

ergoloid mesylates tab 1 mg 2

EXELON - rivastigmine td patch 24hr4.6 mg/24hr

4

Drug Name Dru

g T

ier

Prio

r A

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ion

Ste

p T

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py

Dis

pens

ing

Lim

its


4


4

EXELON - rivastigmine tartrate cap 1.5mg

4

EXELON - rivastigmine tartrate cap 3mg

4

EXELON - rivastigmine tartrate cap 4.5mg

4

EXELON - rivastigmine tartrate cap 6mg

4

EXTAVIA - interferon beta-1b for inj kit0.3 mg

5 • •

fluoxetine hcl (pmdd) cap 10 mg 2

fluoxetine hcl (pmdd) cap 20 mg 2

GALANTAMINE HYDROBROMIDE -galantamine hydrobromide oral soln 4mg/ml

2

galantamine hydrobromide cap sr24hr 8 mg (Razadyne er)

2


2


2

galantamine hydrobromide tab 4 mg(Razadyne)

2

galantamine hydrobromide tab 8 mg(Razadyne)

2

galantamine hydrobromide tab12 mg (Razadyne)

2

GILENYA - fingolimod hcl cap 0.5 mg(base equiv)

5 • •

glatiramer acetate soln prefilledsyringe 20 mg/ml (Copaxone)

5 •

GRALISE - gabapentin (phn) tab 300mg

4 •

GRALISE - gabapentin (phn) tab 600mg

4 •

2015


Drug Name Dru

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pens

ing

Lim

its

GRALISE STARTER - gabapentin (phn)tab starter pack 300 mg (9) & 600 mg(69)

4 •

HORIZANT - gabapentin enacarbil tabcr 300 mg

4 •

HORIZANT - gabapentin enacarbil tabcr 600 mg

4 •

memantine hcl tab 5 mg (Namenda) 2

memantine hcl tab 10 mg (Namenda) 2

memantine hcl tab 5 mg (28) & 10 mg(21) titration pak (Namenda titrationpa)

2

NAMENDA - memantine hcl oralsolution 2 mg/ml

4

NAMENDA - memantine hcl tab 5 mg 4

NAMENDA - memantine hcl tab 10 mg 4

NAMENDA TITRATION PAK -memantine hcl tab 5 mg (28) & 10 mg(21) titration pak

4

NAMENDA XR - memantine hcl cap sr24hr 7 mg

4


4


4


4

NAMENDA XR TITRATION PACK -memantine hcl cap sr 24hr 7 mg & 14mg & 21 mg & 28 mg pack

4

NAMZARIC - memantine hcl-donepezilhcl cap sr 24hr 14-10 mg

4

NAMZARIC - memantine hcl-donepezilhcl cap sr 24hr 28-10 mg

4

NICODERM CQ - nicotine td patch 24hr7 mg/24hr

4


4


4

Drug Name Dru

g T

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Dis

pens

ing

Lim

its

NICORETTE - nicotine polacrilex gum 2mg

4

NICORETTE - nicotine polacrilex gum 4mg

4

NICORETTE - nicotine polacrilexlozenge 2 mg

4

NICORETTE - nicotine polacrilexlozenge 4 mg

4

NICORETTE MINI - nicotine polacrilexlozenge 2 mg

4

NICORETTE MINI - nicotine polacrilexlozenge 4 mg

4

NICORETTE STARTER KIT - nicotinepolacrilex gum 2 mg

4

NICORETTE STARTER KIT - nicotinepolacrilex gum 4 mg

4

nicotine polacrilex gum 2 mg 2

nicotine polacrilex gum 4 mg 2

nicotine polacrilex lozenge 2 mg 2

nicotine polacrilex lozenge 4 mg 2

nicotine td patch 24hr 7 mg/24hr 2



NICOTINE TRANSDERMAL SYST -nicotine td patch 24 hr kit 21-14-7mg/24hr

4

NICOTROL INHALER - nicotine inhalersystem 10 mg (4 mg delivered)

3

NICOTROL NS - nicotine nasal spray 10mg/ml (0.5 mg/spray)

3

NUEDEXTA - dextromethorphan hbr-quinidine sulfate cap 20-10 mg

3

olanzapine-fluoxetine hcl cap3-25 mg (Symbyax)

2


2


2

2015


Drug Name Dru

g T

ier

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py

Dis

pens

ing

Lim

its


2


2

ORAP - pimozide tab 1 mg 4

ORAP - pimozide tab 2 mg 4

PERPHENAZINE/AMITRIPTYLIN -perphenazine-amitriptyline tab 2-10mg

4


4


4


4


4

PLEGRIDY - peginterferon beta-1a solnpen-injector 125 mcg/0.5ml

5 •

PLEGRIDY - peginterferon beta-1a solnprefilled syringe 125 mcg/0.5ml

5 •

PLEGRIDY STARTER PACK -peginterferon beta-1a soln pen-inj 63& 94 mcg/0.5ml pack

5 •

PLEGRIDY STARTER PACK -peginterferon beta-1a soln pref syr 63& 94 mcg/0.5ml pack

5 •

RAZADYNE - galantaminehydrobromide tab 4 mg

4


4


4

RAZADYNE - galantaminehydrobromide oral soln 4 mg/ml

4

RAZADYNE ER - galantaminehydrobromide cap sr 24hr 8 mg

4

Drug Name Dru

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Dis

pens

ing

Lim

its


4


4

REBIF - interferon beta-1a inj 22mcg/0.5ml (12mu/ml) (44 mcg/ml)

5 •

REBIF - interferon beta-1a inj 44mcg/0.5ml (24mu/ml) (88 mcg/ml)

5 •

REBIF REBIDOSE - interferon beta-1ainj 22 mcg/0.5ml (12mu/ml) (44 mcg/ml)

5 •

REBIF REBIDOSE - interferon beta-1ainj 44 mcg/0.5ml (24mu/ml) (88 mcg/ml)

5 •

REBIF REBIDOSE TITRATION -interferon beta-1a inj 6 x 8.8mcg/0.2ml & 6 x 22 mcg/0.5ml

5 •

REBIF TITRATION PACK - interferonbeta-1a inj 6 x 8.8 mcg/0.2ml & 6 x 22mcg/0.5ml

5 •

rivastigmine tartrate cap 1.5 mg(Exelon)

2

rivastigmine tartrate cap 3 mg(Exelon)

2

rivastigmine tartrate cap 4.5 mg(Exelon)

2

rivastigmine tartrate cap 6 mg(Exelon)

2

SARAFEM - fluoxetine hcl (pmdd) tab10 mg

4

SARAFEM - fluoxetine hcl (pmdd) tab20 mg

4

SAVELLA - milnacipran hcl tab 12.5 mg 4 •SAVELLA - milnacipran hcl tab 25 mg 4 •SAVELLA - milnacipran hcl tab 50 mg 4 •SAVELLA - milnacipran hcl tab 100 mg 4 •SAVELLA TITRATION PACK -

milnacipran hcl tab 12.5 mg (5) & 25mg (8) & 50 mg (42) pak

4 •

2015


Drug Name Dru

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pens

ing

Lim

its

SYMBYAX - olanzapine-fluoxetine hclcap 3-25 mg

4


4


4


4


4

TECFIDERA - dimethyl fumaratecapsule delayed release 120 mg

5 •

TECFIDERA - dimethyl fumaratecapsule delayed release 240 mg

5 •

TECFIDERA STARTER PACK -dimethyl fumarate capsule dr starterpack 120 mg & 240 mg

5 •

XENAZINE - tetrabenazine tab 12.5 mg 5 • •XENAZINE - tetrabenazine tab 25 mg 5 • •XYREM - sodium oxybate oral solution

500 mg/ml5 • •

ZYBAN - bupropion hcl (smokingdeterrent) tab sr 12hr 150 mg

4

ANALGESICS AND ANESTHETICS

ANALGESICS - NON-NARCOTIC

acetaminophen-salicylamide-phenyltoloxamine cap300-200-20mg

1

aspirin chew tab 81 mg 1

ASPIRIN LOW DOSE - aspirin tab 81mg

4

aspirin tab delayed release 81 mg 1

BUPAP - butalbital-acetaminophen tab50-300 mg

4

butalbital-acetaminophen tab50-325 mg

1

butalbital-acetaminophen-caffeinecap 50-300-40 mg (Fioricet)

2

butalbital-acetaminophen-caffeinecap 50-325-40 mg

2

Drug Name Dru

g T

ier

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Dis

pens

ing

Lim

its

butalbital-acetaminophen-caffeinetab 50-325-40 mg (Esgic)

1

butalbital-aspirin-caffeine cap50-325-40 mg (Fiorinal)

2

choline & magnesium salicylates liq500 mg/5ml

2

CHOLINE MAGNESIUM TRISALI -choline & magnesium salicylates tab1000 mg

2

diflunisal tab 500 mg 2

DISALCID - salsalate tab 500 mg 4

DISALCID - salsalate tab 750 mg 4

EQUAGESIC - meprobamate-aspirin tab200-325 mg

4

ESGIC - butalbital-acetaminophen-caffeine tab 50-325-40 mg

4

FIORICET - butalbital-acetaminophen-caffeine cap 50-300-40 mg

4

FIORICET - butalbital-acetaminophen-caffeine tab 50-325-40 mg

4

FIORINAL - butalbital-aspirin-caffeinecap 50-325-40 mg

4

LEVACET - aspirin-apap-salicylamide-caffeine tab 500-250-150-32.5 mg

4

ORBIVAN - butalbital-acetaminophen-caffeine cap 50-300-40 mg

4

ORBIVAN CF - butalbital-acetaminophen tab 50-300 mg

4

salsalate tab 500 mg 2

salsalate tab 750 mg 2

VANATOL LQ - butalbital-acetaminophen-caffeine soln50-325-40 mg/15ml

2

ANALGESICS - NARCOTIC

ABSTRAL - fentanyl citrate sl tab 100mcg (base equiv)

4 • •


4 • •


4 • •

2015


Drug Name Dru

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ing

Lim

its


4 • •


4 • •


4 • •

acetaminophen w/ codeine soln120-12 mg/5ml

1

acetaminophen w/ codeine tab300-15 mg (Tylenol/codeine)

1

acetaminophen w/ codeine tab300-30 mg (Tylenol/codeine #3)

1

acetaminophen w/ codeine tab300-60 mg (Tylenol/codeine #4)

1

ACTIQ - fentanyl citrate lozenge on ahandle 200 mcg

4 • •


4 • •


4 • •


4 • •


4 • •


4 • •

ASPIRIN-CAFFEINE-DIHYDROC -aspirin-caffeine-dihydrocodeine cap356.4-30-16 mg

4

AVINZA - morphine sulfate beads cap sr24hr 30 mg

4 •


4 •


4 •


4 •


4 •

Drug Name Dru

g T

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pens

ing

Lim

its


4 •

BUNAVAIL - buprenorphine-naloxonebuccal film 2.1-0.3 mg (base equiv)

4 • •

BUNAVAIL - buprenorphine-naloxonebuccal film 4.2-0.7 mg (base equiv)

4 • •

BUNAVAIL - buprenorphine-naloxonebuccal film 6.3-1 mg (base equiv)

4 • •

buprenorphine hcl sl tab 2 mg (baseequiv)

2 • •

buprenorphine hcl sl tab 8 mg (baseequiv)

2 • •

buprenorphine hcl-naloxone hcl sltab 2-0.5 mg (base equiv)

2 • •

buprenorphine hcl-naloxone hcl sltab 8-2 mg (base equiv)

2 • •

butalbital-acetaminophen-caff w/cod cap 50-300-40-30 mg (Fioricet/codeine)

2

butalbital-acetaminophen-caff w/ codcap 50-325-40-30 mg

1

butalbital-aspirin-caff w/ codeine cap50-325-40-30 mg (Fiorinal/codeine#3)

2

butorphanol tartrate nasal soln10 mg/ml

2 •

BUTRANS - buprenorphine td patchweekly 5 mcg/hr

4 •

BUTRANS - buprenorphine td patchweekly 7.5 mcg/hr

4 •


4 •


4 •


4 •

CAPITAL/CODEINE - acetaminophenw/ codeine susp 120-12 mg/5ml

4

CODEINE SULFATE - codeine sulfatetab 15 mg

4

2015


Drug Name Dru

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ing

Lim

its


2


2

codeine sulfate tab 15 mg (Codeinesulfate)

2

codeine sulfate tab 30 mg 2

codeine sulfate tab 60 mg 2

CONZIP - tramadol hcl cap sr 24hrbiphasic release 100 mg

4 •


4 •


4 •

DEMEROL - meperidine hcl tab 50 mg 4

DEMEROL - meperidine hcl tab 100 mg 4

DILAUDID - hydromorphone hcl liqd 1mg/ml

4

DILAUDID - hydromorphone hcl tab 2mg

4


4


4

DOLOPHINE - methadone hcl tab 10mg

4

DOLOPHINE HCL - methadone hcl tab5 mg

4

DURAGESIC - fentanyl td patch 72hr 12mcg/hr

4 •


4 •


4 •


4 •

DURAGESIC - fentanyl td patch 72hr100 mcg/hr

4 •

EMBEDA - morphine-naltrexone cap cr20-0.8 mg

4 •

Drug Name Dru

g T

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Lim

its


4 •

EMBEDA - morphine-naltrexone cap cr50-2 mg

4 •


4 •


4 •

EMBEDA - morphine-naltrexone cap cr100-4 mg

4 •

EXALGO - hydromorphone hcl tab er24hr deter 8 mg

4 •


4 •


4 •


4 •

FENTANYL - fentanyl td patch 72hr 37.5mcg/hr

4 •


4 •


4 •

fentanyl citrate lozenge on a handle200 mcg (Actiq)

2 • •


2 • •


2 • •


2 • •


2 • •


2 • •

fentanyl td patch 72hr 12 mcg/hr(Duragesic)

2 •


2 •

2015


Drug Name Dru

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ing

Lim

its


2 •


2 •


2 •

FENTORA - fentanyl citrate buccal tab100 mcg (base equiv)

4 • •


4 • •


4 • •


4 • •


4 • •

FIORICET/CODEINE - butalbital-acetaminophen-caff w/ cod cap50-300-40-30 mg

4

FIORINAL/CODEINE #3 - butalbital-aspirin-caff w/ codeine cap50-325-40-30 mg

4

HYCET - hydrocodone-acetaminophensoln 7.5-325 mg/15ml

4

hydrocodone-acetaminophen soln7.5-325 mg/15ml (Hycet)

2

hydrocodone-acetaminophen tab2.5-325 mg

2

hydrocodone-acetaminophen tab10-325 mg (Norco)

1

hydrocodone-acetaminophen tab5-300 mg (Xodol)

2

hydrocodone-acetaminophen tab7.5-300 mg (Xodol)

2

hydrocodone-acetaminophen tab5-325 mg (Norco)

1

hydrocodone-acetaminophen tab7.5-325 mg (Norco)

1

hydrocodone-acetaminophen tab10-300 mg (Xodol)

2

Drug Name Dru

g T

ier

Prio

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ion

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Dis

pens

ing

Lim

its

hydrocodone-ibuprofen tab2.5-200 mg (Reprexain)

2

hydrocodone-ibuprofen tab 5-200 mg(Reprexain)

2

hydrocodone-ibuprofen tab7.5-200 mg (Vicoprofen)

1

hydrocodone-ibuprofen tab10-200 mg (Ibudone)

2

HYDROCODONE/ACETAMINOPHEN -hydrocodone-acetaminophen soln10-325 mg/15ml

4

HYDROMORPHONE HCL -hydromorphone hcl suppos 3 mg

4

HYDROMORPHONE HCL ER -hydromorphone hcl tab er 24hr deter32 mg

4 •

hydromorphone hcl liqd 1 mg/ml(Dilaudid)

2

hydromorphone hcl tab er 24hr deter8 mg (Exalgo)

2 •


2 •


2 •

hydromorphone hcl tab 2 mg(Dilaudid)

1


1


2

HYSINGLA ER - hydrocodone bitartratetab er 24hr deter 20 mg

4 •


4 •


4 •


4 •


4 •

2015


Drug Name Dru

g T

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ing

Lim

its


4 •


4 •

IBUDONE - hydrocodone-ibuprofen tab10-200 mg

4

IONSYS - fentanyl hcl iontophoretic tdsystem 40 mcg/act (base equiv)

4

KADIAN - morphine sulfate cap sr 24hr10 mg

4 •


4 •


4 •


4 •


4 •


4 •


4 •


4 •


4 •

LAZANDA - fentanyl citrate nasal spray100 mcg/act (base equiv)

4 • •

LAZANDA - fentanyl citrate nasal spray400 mcg/act (base equiv)

4 • •

LEVORPHANOL TARTRATE -levorphanol tartrate tab 2 mg

4

MEPERIDINE HCL - meperidine hcl oralsoln 50 mg/5ml

4

meperidine hcl tab 50 mg (Demerol) 1

meperidine hcl tab 100 mg (Demerol) 2

MEPERIDINE HCL/PROMETHAZI -meperidine w/ promethazine cap50-25 mg

4

Drug Name Dru

g T

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ing

Lim

its

METHADONE HCL - methadone hclsoln 5 mg/5ml

4

METHADONE HCL - methadone hclsoln 10 mg/5ml

4

methadone hcl conc 10 mg/ml(Methadose)

2

methadone hcl soln 5 mg/5ml(Methadone hcl)

2

methadone hcl soln 10 mg/5ml(Methadone hcl)

2

methadone hcl tab for oral susp40 mg

2

methadone hcl tab 5 mg (Dolophinehcl)

1

methadone hcl tab 10 mg (Dolophine) 1

METHADOSE - methadone hcl conc 10mg/ml

4

METHADOSE SUGAR-FREE -methadone hcl conc 10 mg/ml

4

MORPHINE SULFATE - morphinesulfate tab 15 mg

3

MORPHINE SULFATE - morphinesulfate tab 30 mg

3

MORPHINE SULFATE - morphinesulfate suppos 5 mg

3


3


3


3

morphine sulfate (concentrate) oralsoln 20 mg/ml

2

morphine sulfate cap sr 24hr 10 mg(Kadian)

2 •


2 •


2 •

2015


Drug Name Dru

g T

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Dis

pens

ing

Lim

its


2 •


2 •


2 •


2 •

MORPHINE SULFATE ER - morphinesulfate beads cap sr 24hr 30 mg

2 •


2 •


2 •


2 •


2 •


2 •

morphine sulfate oral soln 10 mg/5ml 1

morphine sulfate oral soln 20 mg/5ml 2

morphine sulfate tab cr 15 mg (Mscontin)

2 •


2 •


2 •


2 •


2 •

MS CONTIN - morphine sulfate tab cr15 mg

4 •


4 •


4 •


4 •

Drug Name Dru

g T

ier

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ing

Lim

its


4 •

NORCO - hydrocodone-acetaminophentab 10-325 mg

4

NORCO - hydrocodone-acetaminophentab 5-325 mg

4

NORCO - hydrocodone-acetaminophentab 7.5-325 mg

4

NUCYNTA - tapentadol hcl tab 50 mg 4 •NUCYNTA - tapentadol hcl tab 75 mg 4 •NUCYNTA - tapentadol hcl tab 100 mg 4 •NUCYNTA ER - tapentadol hcl tab sr

12hr 50 mg4 •

NUCYNTA ER - tapentadol hcl tab sr12hr 100 mg

4 •


4 •


4 •


4 •

OPANA - oxymorphone hcl tab 5 mg 4

OPANA - oxymorphone hcl tab 10 mg 4

OPANA ER (CRUSH RESISTANT -oxymorphone hcl tab er 12hr deter 5mg

4 •

OPANA ER (CRUSH RESISTANT -oxymorphone hcl tab er 12hr deter7.5 mg

4 •


4 •


4 •


4 •

2015


Drug Name Dru

g T

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ing

Lim

its


4 •


4 •

OXYCODONE HCL - oxycodone hclconc 100 mg/5ml (20 mg/ml)

4

OXYCODONE HCL - oxycodone hclsoln 5 mg/5ml

4

oxycodone hcl cap 5 mg 2

oxycodone hcl conc 100 mg/5ml(20 mg/ml) (Oxycodone hcl)

2

OXYCODONE HCL ER - oxycodone hcltab er 12hr deter 10 mg

4 •


4 •


4 •


4 •

oxycodone hcl soln 5 mg/5ml(Oxycodone hcl)

2

oxycodone hcl tab 5 mg (Roxicodone) 1

oxycodone hcl tab 10 mg 2

oxycodone hcl tab 15 mg(Roxicodone)

2

oxycodone hcl tab 20 mg 2

oxycodone hcl tab 30 mg(Roxicodone)

2

oxycodone w/ acetaminophen tab2.5-325 mg (Percocet)

2

oxycodone w/ acetaminophen tab5-325 mg (Percocet)

1

oxycodone w/ acetaminophen tab7.5-325 mg (Percocet)

2

oxycodone w/ acetaminophen tab10-325 mg (Percocet)

2

oxycodone-aspirin tab4.8355-325 mg (Percodan)

2

Drug Name Dru

g T

ier

Prio

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ion

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Dis

pens

ing

Lim

its

oxycodone-ibuprofen tab 5-400 mg 2

OXYCONTIN - oxycodone hcl tab er12hr deter 10 mg

3 •


3 •


3 •


3 •


3 •


3 •


3 •

oxymorphone hcl tab sr 12hr 5 mg 2 •oxymorphone hcl tab sr 12hr 7.5 mg 2 •oxymorphone hcl tab sr 12hr 10 mg 2 •oxymorphone hcl tab sr 12hr 15 mg 2 •oxymorphone hcl tab sr 12hr 20 mg 2 •oxymorphone hcl tab sr 12hr 30 mg 2 •oxymorphone hcl tab sr 12hr 40 mg 2 •oxymorphone hcl tab 5 mg (Opana) 2

oxymorphone hcl tab 10 mg (Opana) 2

pentazocine w/ naloxone tab50-0.5 mg

2

PERCOCET - oxycodone w/acetaminophen tab 2.5-325 mg

4

PERCOCET - oxycodone w/acetaminophen tab 5-325 mg

4

PERCOCET - oxycodone w/acetaminophen tab 7.5-325 mg

4

PERCOCET - oxycodone w/acetaminophen tab 10-325 mg

4

PERCODAN - oxycodone-aspirin tab4.8355-325 mg

4

PRIMLEV - oxycodone w/acetaminophen tab 5-300 mg

4

2015


Drug Name Dru

g T

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Prio

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py

Dis

pens

ing

Lim

its

PRIMLEV - oxycodone w/acetaminophen tab 7.5-300 mg

4

PRIMLEV - oxycodone w/acetaminophen tab 10-300 mg

4

REPREXAIN - hydrocodone-ibuprofentab 2.5-200 mg

4

REPREXAIN - hydrocodone-ibuprofentab 5-200 mg

4

ROXICET - oxycodone w/acetaminophen soln 5-325 mg/5ml

4

ROXICODONE - oxycodone hcl tab 5mg

4


4


4

SUBOXONE - buprenorphine hcl-naloxone hcl sl film 2-0.5 mg (baseequiv)

4 • •

SUBOXONE - buprenorphine hcl-naloxone hcl sl film 4-1 mg (baseequiv)

4 • •


4 • •


4 • •

SUBSYS - fentanyl sublingual spray 100mcg

4 • •


4 • •


4 • •


4 • •


4 • •

SUBSYS - fentanyl sublingual spray1200 mcg (600 mcg x 2)

4 • •

Drug Name Dru

g T

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Dis

pens

ing

Lim

its

SUBSYS - fentanyl sublingual spray1600 mcg (800 mcg x 2)

4 • •

SYNALGOS-DC - aspirin-caffeine-dihydrocodeine cap 356.4-30-16 mg

4

TRAMADOL HCL ER - tramadol hcl capsr 24hr biphasic release 100 mg

4 •


4 •


4 •


4 •

tramadol hcl tab sr 24hr 100 mg(Ultram er)

2 •


2 •


2 •

tramadol hcl tab sr 24hr biphasicrelease 100 mg

2 •


2 •


2 •

tramadol hcl tab 50 mg (Ultram) 1 •tramadol-acetaminophen tab

37.5-325 mg (Ultracet)1

TREZIX - acetaminophen-caffeine-dihydrocodeine cap 320.5-30-16 mg

4

TYLENOL/CODEINE - acetaminophenw/ codeine tab 300-15 mg

4

TYLENOL/CODEINE #3 -acetaminophen w/ codeine tab300-30 mg

4

TYLENOL/CODEINE #4 -acetaminophen w/ codeine tab300-60 mg

4

ULTRACET - tramadol-acetaminophentab 37.5-325 mg

4

ULTRAM - tramadol hcl tab 50 mg 4 •

2015


Drug Name Dru

g T

ier

Prio

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rizat

ion

Ste

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py

Dis

pens

ing

Lim

its

ULTRAM ER - tramadol hcl tab sr 24hr100 mg

4 •


4 •


4 •

VICOPROFEN - hydrocodone-ibuprofentab 7.5-200 mg

4

XARTEMIS XR - oxycodone w/acetaminophen tab cr 7.5-325 mg

4

XODOL - hydrocodone-acetaminophentab 5-300 mg

4

XODOL - hydrocodone-acetaminophentab 7.5-300 mg

4

XODOL - hydrocodone-acetaminophentab 10-300 mg

4

ZAMICET - hydrocodone-acetaminophen soln 10-325 mg/15ml

4

ZOHYDRO ER - hydrocodone bitartratecap sr 12hr abuse-deterrent 10 mg

4 •


4 •


4 •


4 •


4 •


4 •

ZUBSOLV - buprenorphine hcl-naloxonehcl sl tab 1.4-0.36 mg (base eq)

4 • •


4 • •


4 • •

ANALGESICS - ANTI-INFLAMMATORY

ACTEMRA - tocilizumab subcutaneoussoln prefilled syringe 162 mg/0.9ml

5 • •

Drug Name Dru

g T

ier

Prio

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ion

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py

Dis

pens

ing

Lim

its

ANAPROX - naproxen sodium tab 275mg

4

ANAPROX DS - naproxen sodium tab550 mg

4

ARAVA - leflunomide tab 10 mg 4

ARAVA - leflunomide tab 20 mg 4

ARCALYST - rilonacept for inj 220 mg 5 • •ARTHROTEC 50 - diclofenac w/

misoprostol tab delayed release50-0.2 mg

4

ARTHROTEC 75 - diclofenac w/misoprostol tab delayed release75-0.2 mg

4

CELEBREX - celecoxib cap 50 mg 4 • •CELEBREX - celecoxib cap 100 mg 4 • •CELEBREX - celecoxib cap 200 mg 4 • •CELEBREX - celecoxib cap 400 mg 4 • •celecoxib cap 50 mg (Celebrex) 2 •celecoxib cap 100 mg (Celebrex) 2 •celecoxib cap 200 mg (Celebrex) 2 •celecoxib cap 400 mg (Celebrex) 2 •DAYPRO - oxaprozin tab 600 mg 4

DERMA SILKRX ANODYNEXA PA -diclofen dr tab 75mg-ranitidine tab150mg-capsaicin cr thpk

4

DERMACINRX ANALGESIC COMB -diclofenac sod tab dr 75 mg & lido-men-methyl sal ptch kit

4

DERMACINRX INFLAMMATRAL P -diclofen dr tab 75mg-ranitidine tab150mg-capsaicin cr thpk

4

diclofenac potassium tab 50 mg(Cataflam)

2

diclofenac sodium tab delayedrelease 25 mg

2


2


2

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

diclofenac sodium tab sr 24hr100 mg (Voltaren-xr)

2

diclofenac w/ misoprostol tabdelayed release 50-0.2 mg(Arthrotec 50)

2

diclofenac w/ misoprostol tabdelayed release 75-0.2 mg(Arthrotec 75)

2

DUEXIS - ibuprofen-famotidine tab800-26.6 mg

4 • •

EC-NAPROSYN - naproxen tab ec 375mg

4

EC-NAPROSYN - naproxen tab ec 500mg

4

ENBREL - etanercept for subcutaneousinj kit 25 mg

5 • •

ENBREL - etanercept subcutaneoussoln prefilled syringe 25 mg/0.5ml

5 • •

ENBREL - etanercept subcutaneoussoln prefilled syringe 50 mg/ml

5 • •

ENBREL SURECLICK - etanerceptsubcutaneous solution auto-injector50 mg/ml

5 • •

etodolac cap 200 mg 2

etodolac cap 300 mg 2

etodolac tab sr 24hr 400 mg 2



etodolac tab 400 mg 2

etodolac tab 500 mg 2

FELDENE - piroxicam cap 10 mg 4

FELDENE - piroxicam cap 20 mg 4

FENOPROFEN CALCIUM - fenoprofencalcium tab 600 mg

4

FENOPROFEN CALCIUM - fenoprofencalcium cap 400 mg

4

flurbiprofen tab 50 mg 1

flurbiprofen tab 100 mg 1

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

HUMIRA - adalimumab prefilled syringekit 10 mg/0.2ml

5 • •


5 • •


5 • •

HUMIRA PEDIATRIC CROHNS D -adalimumab prefilled syringe kit 40mg/0.8ml

5 • •

HUMIRA PEN - adalimumab pen-injector kit 40 mg/0.8ml

5 • •

HUMIRA PEN-CROHNS DISEASE -adalimumab pen-injector kit 40mg/0.8ml

5 • •

HUMIRA PEN-PSORIASIS STAR -adalimumab pen-injector kit 40mg/0.8ml

5 • •

IBUPROFEN COMFORT PAC -ibuprofen tab 800 mg & linimenttopical gel kit

4

ibuprofen tab 400 mg 1



IC 400 - ibuprofen tab 400 mg &caffeine-vitamins cap kit

4

IC 800 - ibuprofen tab 800 mg &caffeine-vitamins cap kit

4

INDOCIN - indomethacin susp 25mg/5ml

4

INDOCIN - indomethacin suppos 50 mg 4

indomethacin cap cr 75 mg 2

indomethacin cap 25 mg 1

indomethacin cap 50 mg 1

ketoprofen cap 50 mg 1

ketoprofen cap 75 mg 1

KETOPROFEN ER - ketoprofen cap sr24hr 200 mg

4

ketorolac tromethamine tab 10 mg 1 •

2015


Drug Name Dru

g T

ier

Prio

r A

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rizat

ion

Ste

p T

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py

Dis

pens

ing

Lim

its

KINERET - anakinra subcutaneous solnprefilled syringe 100 mg/0.67ml

5 • •

leflunomide tab 10 mg (Arava) 1

leflunomide tab 20 mg (Arava) 1

MECLOFENAMATE SODIUM -meclofenamate sodium cap 50 mg

4

MECLOFENAMATE SODIUM -meclofenamate sodium cap 100 mg

4

mefenamic acid cap 250 mg (Ponstel) 2

MELOXICAM - meloxicam susp 7.5mg/5ml

4

MELOXICAM COMFORT PAC -meloxicam tab 15 mg & linimenttopical gel kit

4

meloxicam tab 7.5 mg (Mobic) 1

meloxicam tab 15 mg (Mobic) 1

MOBIC - meloxicam tab 7.5 mg 4

MOBIC - meloxicam tab 15 mg 4

MOBIC - meloxicam susp 7.5 mg/5ml 4

nabumetone tab 500 mg 1

nabumetone tab 750 mg 1

NALFON - fenoprofen calcium cap 400mg

4

NAPRELAN - naproxen sodium tab sr24hr 375 mg (base equiv)

4


4


4

NAPROSYN - naproxen tab 250 mg 4



NAPROSYN - naproxen susp 125mg/5ml

4

NAPROXEN - naproxen susp 125mg/5ml

2

NAPROXEN COMFORT PAC -naproxen tab 500 mg & linimenttopical gel kit

4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

naproxen sodium tab sr 24hr 500 mg(base equiv) (Naprelan)

2

naproxen sodium tab 275 mg(Anaprox)

1

naproxen sodium tab 550 mg(Anaprox ds)

1

naproxen tab ec 375 mg (Ec-naprosyn)

1

naproxen tab ec 500 mg (Ec-naprosyn)

1

naproxen tab 250 mg (Naprosyn) 1



ORENCIA - abatacept subcutaneoussoln prefilled syringe 125 mg/ml

5 • •

OTEZLA - apremilast tab starter therapypack 10 mg & 20 mg & 30 mg

5 • •

OTEZLA - apremilast tab 30 mg 5 • •OTREXUP - methotrexate soln pf auto-

injector 10 mg/0.4ml4

OTREXUP - methotrexate soln pf auto-injector 15 mg/0.4ml

4


4


4

oxaprozin tab 600 mg (Daypro) 2

piroxicam cap 10 mg (Feldene) 2

piroxicam cap 20 mg (Feldene) 2

PONSTEL - mefenamic acid cap 250mg

4

PRASTERA - prasterone cap 200 mg &ibuprofen tab 400 mg kit

4

RASUVO - methotrexate soln pf auto-injector 7.5 mg/0.15ml

4

RASUVO - methotrexate soln pf auto-injector 10 mg/0.2ml

4


4

2015


Drug Name Dru

g T

ier

Prio

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rizat

ion

Ste

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py

Dis

pens

ing

Lim

its


4


4


4


4


4


4


4

RHEUMATREX - methotrexate sodiumtab 2.5 mg (antirheumatic)

4

RIDAURA - auranofin cap 3 mg 4

SIMPONI - golimumab subcutaneoussoln auto-injector 50 mg/0.5ml

5 • •

SIMPONI - golimumab subcutaneoussoln auto-injector 100 mg/ml

5 • •

SIMPONI - golimumab subcutaneoussoln prefilled syringe 50 mg/0.5ml

5 • •

SIMPONI - golimumab subcutaneoussoln prefilled syringe 100 mg/ml

5 • •

SPRIX - ketorolac tromethamine nasalspray 15.75 mg/spray

4 •

sulindac tab 150 mg 1

sulindac tab 200 mg 1

TIVORBEX - indomethacin cap 20 mg 4

TIVORBEX - indomethacin cap 40 mg 4

TOLMETIN SODIUM - tolmetin sodiumtab 200 mg

4

TOLMETIN SODIUM - tolmetin sodiumtab 600 mg

4

tolmetin sodium cap 400 mg 2

VIMOVO - naproxen-esomeprazolemagnesium tab dr 375-20 mg

4 • •

Drug Name Dru

g T

ier

Prio

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utho

rizat

ion

Ste

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py

Dis

pens

ing

Lim

its

VIMOVO - naproxen-esomeprazolemagnesium tab dr 500-20 mg

4 • •

XELJANZ - tofacitinib citrate tab 5 mg(base equivalent)

5 • •

ZIPSOR - diclofenac potassium cap 25mg

4

ZORVOLEX - diclofenac cap 18 mg 4

ZORVOLEX - diclofenac cap 35 mg 4

MIGRAINE PRODUCTS

acetaminophen-isometheptene-dichloral cap 325-65-100 mg

2

almotriptan malate tab 6.25 mg(Axert)

2 •

almotriptan malate tab 12.5 mg(Axert)

2 •

ALSUMA - sumatriptan succinatesolution auto-injector 6 mg/0.5ml

4 •

AMERGE - naratriptan hcl tab 1 mg(base equiv)

4 •

AMERGE - naratriptan hcl tab 2.5 mg(base equiv)

4 •

AXERT - almotriptan malate tab 6.25mg

4 •

AXERT - almotriptan malate tab 12.5mg

4 •

CAFERGOT - ergotamine w/ caffeinetab 1-100 mg

4

CAMBIA - diclofenac potassium packet50 mg

4

DIHYDROERGOTAMINE MESYLAT -dihydroergotamine mesylate nasalspray 4 mg/ml

4 •

ERGOMAR - ergotamine tartrate sl tab2 mg

4

FROVA - frovatriptan succinate tab 2.5mg (base equivalent)

4 •

IMITREX - sumatriptan nasal spray 5mg/act

3 •

IMITREX - sumatriptan nasal spray 20mg/act

3 •

2015


Drug Name Dru

g T

ier

Prio

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ion

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py

Dis

pens

ing

Lim

its

IMITREX - sumatriptan succinate tab 25mg

4 •

IMITREX - sumatriptan succinate tab 50mg

4 •

IMITREX - sumatriptan succinate tab100 mg

4 •

IMITREX - sumatriptan succinate inj 6mg/0.5ml

4 •

IMITREX STATDOSE REFILL -sumatriptan succinate solutioncartridge 4 mg/0.5ml

4 •

IMITREX STATDOSE REFILL -sumatriptan succinate solutioncartridge 6 mg/0.5ml

4 •

IMITREX STATDOSE SYSTEM -sumatriptan succinate solution auto-injector 4 mg/0.5ml

4 •

IMITREX STATDOSE SYSTEM -sumatriptan succinate solution auto-injector 6 mg/0.5ml

4 •

isometheptene-caffeine-acetaminophen tab 65-20-325 mg(Prodrin)

2

MAXALT - rizatriptan benzoate tab 5 mg 4 •MAXALT - rizatriptan benzoate tab 10

mg4 •

MAXALT-MLT - rizatriptan benzoateorally disintegrating tab 5 mg

4 •

MAXALT-MLT - rizatriptan benzoateorally disintegrating tab 10 mg

4 •

MIGERGOT - ergotamine w/ caffeinesuppos 2-100 mg

4

MIGRANAL - dihydroergotaminemesylate nasal spray 4 mg/ml

4 •

naratriptan hcl tab 1 mg (base equiv)(Amerge)

2 •

naratriptan hcl tab 2.5 mg (baseequiv) (Amerge)

2 •

PRODRIN - isometheptene-caffeine-acetaminophen tab 65-20-325 mg

4

Drug Name Dru

g T

ier

Prio

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ion

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Dis

pens

ing

Lim

its

RELPAX - eletriptan hydrobromide tab20 mg (base equivalent)

4 •

RELPAX - eletriptan hydrobromide tab40 mg (base equivalent)

4 •

rizatriptan benzoate orallydisintegrating tab 5 mg (Maxalt-mlt)

2 •

rizatriptan benzoate orallydisintegrating tab 10 mg (Maxalt-mlt)

2 •

rizatriptan benzoate tab 5 mg(Maxalt)

2 •

rizatriptan benzoate tab 10 mg(Maxalt)

2 •

SUMATRIPTAN - sumatriptan nasalspray 5 mg/act

4 •

SUMATRIPTAN - sumatriptan nasalspray 20 mg/act

4 •

SUMATRIPTAN SUCCINATE -sumatriptan succinate solutionprefilled syringe 6 mg/0.5ml

4 •

SUMATRIPTAN SUCCINATE -sumatriptan succinate inj 4 mg/0.5ml

4 •

sumatriptan succinate inj 6 mg/0.5ml(Imitrex)

2 •

sumatriptan succinate solution auto-injector 4 mg/0.5ml (Imitrex statdosesys)

2 •

sumatriptan succinate solution auto-injector 6 mg/0.5ml (Imitrex statdosesys)

2 •

sumatriptan succinate solutioncartridge 4 mg/0.5ml (Imitrexstatdose ref)

2 •

sumatriptan succinate solutioncartridge 6 mg/0.5ml (Imitrexstatdose ref)

2 •

sumatriptan succinate tab 25 mg(Imitrex)

1 •


1 •

2015


Drug Name Dru

g T

ier

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py

Dis

pens

ing

Lim

its


1 •

SUMAVEL DOSEPRO - sumatriptansuccinate solution jet-injector 4mg/0.5ml

4 •

SUMAVEL DOSEPRO - sumatriptansuccinate solution jet-injector 6mg/0.5ml

4 •

TREXIMET - sumatriptan-naproxensodium tab 85-500 mg

4 •

zolmitriptan orally disintegrating tab2.5 mg (Zomig zmt)

2 •

zolmitriptan orally disintegrating tab5 mg (Zomig zmt)

2 •

zolmitriptan tab 2.5 mg (Zomig) 2 •zolmitriptan tab 5 mg (Zomig) 2 •ZOMIG - zolmitriptan tab 2.5 mg 4 •ZOMIG - zolmitriptan tab 5 mg 4 •ZOMIG - zolmitriptan nasal spray 2.5

mg/spray unit4 •

ZOMIG - zolmitriptan nasal spray 5 mg/spray unit

4 •

ZOMIG NASAL SPRAY - zolmitriptannasal spray 5 mg/spray unit

4 •

ZOMIG ZMT - zolmitriptan orallydisintegrating tab 2.5 mg

4 •

ZOMIG ZMT - zolmitriptan orallydisintegrating tab 5 mg

4 •

GOUT AGENTS

allopurinol tab 100 mg (Zyloprim) 1

allopurinol tab 300 mg (Zyloprim) 1

COLCHICINE - colchicine cap 0.6 mg 4

COLCHICINE - colchicine tab 0.6 mg 4

colchicine w/ probenecid tab0.5-500 mg

2

COLCRYS - colchicine tab 0.6 mg 4

MITIGARE - colchicine cap 0.6 mg 4

probenecid tab 500 mg 2

ULORIC - febuxostat tab 40 mg 4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

ULORIC - febuxostat tab 80 mg 4

ZYLOPRIM - allopurinol tab 100 mg 4

ZYLOPRIM - allopurinol tab 300 mg 4

NEUROMUSCULAR DRUGS

ANTICONVULSANTS

APTIOM - eslicarbazepine acetate tab200 mg

4


4


4


4

BANZEL - rufinamide susp 40 mg/ml 4

BANZEL - rufinamide tab 200 mg 4

BANZEL - rufinamide tab 400 mg 4

carbamazepine cap sr 12hr 100 mg(Carbatrol)

2


2


2

carbamazepine chew tab 100 mg 1

carbamazepine susp 100 mg/5ml(Tegretol)

2

carbamazepine tab sr 12hr 200 mg(Tegretol-xr)

2

carbamazepine tab sr 12hr 400 mg(Tegretol-xr)

2

carbamazepine tab 200 mg (Tegretol) 1

CARBATROL - carbamazepine cap sr12hr 100 mg

4


4


4

CELONTIN - methsuximide cap 300 mg 4

clonazepam orally disintegrating tab0.125 mg

2

2015


Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

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hera

py

Dis

pens

ing

Lim

its


2


2

clonazepam orally disintegrating tab1 mg

2

clonazepam orally disintegrating tab2 mg

2

clonazepam tab 0.5 mg (Klonopin) 1

clonazepam tab 1 mg (Klonopin) 1

clonazepam tab 2 mg (Klonopin) 1

DEPAKENE - valproate sodium syrup250 mg/5ml (base equiv)

4

DEPAKENE - valproic acid cap 250 mg 4

DEPAKOTE - divalproex sodium tabdelayed release 125 mg

4


4


4

DEPAKOTE ER - divalproex sodium tabsr 24 hr 250 mg

4

DEPAKOTE ER - divalproex sodium tabsr 24 hr 500 mg

4

DEPAKOTE SPRINKLES - divalproexsodium cap sprinkle 125 mg

4

DIASTAT ACUDIAL - diazepam rectalgel delivery system 10 mg

3

DIASTAT ACUDIAL - diazepam rectalgel delivery system 20 mg

3

DIASTAT PEDIATRIC - diazepam rectalgel delivery system 2.5 mg

3

DIAZEPAM - diazepam rectal geldelivery system 2.5 mg

4

DIAZEPAM - diazepam rectal geldelivery system 10 mg

4

DIAZEPAM - diazepam rectal geldelivery system 20 mg

4

DILANTIN - phenytoin sodium extendedcap 30 mg

4

Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

DILANTIN - phenytoin sodium extendedcap 100 mg

4

DILANTIN INFATABS - phenytoin chewtab 50 mg

4

DILANTIN-125 - phenytoin susp 125mg/5ml

4

divalproex sodium cap sprinkle125 mg (Depakote sprinkles)

2

divalproex sodium tab delayedrelease 125 mg (Depakote)

1


1


2

divalproex sodium tab sr 24 hr250 mg (Depakote er)

2

divalproex sodium tab sr 24 hr500 mg (Depakote er)

2

ethosuximide cap 250 mg (Zarontin) 2

ethosuximide soln 250 mg/5ml(Zarontin)

2

felbamate susp 600 mg/5ml (Felbatol) 2

felbamate tab 400 mg (Felbatol) 2

felbamate tab 600 mg (Felbatol) 2

FELBATOL - felbamate susp 600mg/5ml

4

FELBATOL - felbamate tab 400 mg 4

FELBATOL - felbamate tab 600 mg 4

FYCOMPA - perampanel tab 2 mg 4






gabapentin cap 100 mg (Neurontin) 1



2015


Drug Name Dru

g T

ier

Prio

r A

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rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its

gabapentin oral soln 250 mg/5ml(Neurontin)

2

gabapentin tab 600 mg (Neurontin) 2

gabapentin tab 800 mg (Neurontin) 2

GABITRIL - tiagabine hcl tab 2 mg 4




KEPPRA - levetiracetam oral soln 100mg/ml

4

KEPPRA - levetiracetam tab 250 mg 4




KEPPRA XR - levetiracetam tab sr 24hr500 mg

4

KEPPRA XR - levetiracetam tab sr 24hr750 mg

4

KLONOPIN - clonazepam tab 0.5 mg 4

KLONOPIN - clonazepam tab 1 mg 4

KLONOPIN - clonazepam tab 2 mg 4

LAMICTAL - lamotrigine tab 25 mg 4




LAMICTAL CHEWABLE DISPERS -lamotrigine tab chewable dispersible5 mg

4

LAMICTAL CHEWABLE DISPERS -lamotrigine tab chewable dispersible25 mg

4

LAMICTAL ODT - lamotrigine tab disp25 mg (21) & 50 mg (7) titration kit

4

LAMICTAL ODT - lamotrigine tab disp50 mg (42) & 100 mg (14) titration kit

4

LAMICTAL ODT - lamotrigine tab disp25 (14) & 50 mg (14) & 100 mg (7) kit

4

Drug Name Dru

g T

ier

Prio

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ion

Ste

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py

Dis

pens

ing

Lim

its

LAMICTAL ODT - lamotrigine orallydisintegrating tab 25 mg

4


4


4


4

LAMICTAL STARTER/NOT TAKI -lamotrigine tab 25 mg (42) & 100 mg(7) starter kit

4

LAMICTAL STARTER/TAKING C -lamotrigine tab 25 mg (84) & 100 mg(14) starter kit

4

LAMICTAL STARTER/TAKING V -lamotrigine tab 25 mg (35) starter kit

4

LAMICTAL XR - lamotrigine tab sr 24hr25 mg (21) & 50 mg (7) titration kit

4

LAMICTAL XR - lamotrigine tab sr 24hr25 (14) & 50 mg (14) & 100 mg(7) kit

4

LAMICTAL XR - lamotrigine tab sr 24hr50 (14) & 100 mg(14) & 200 mg(7) kit

4

LAMICTAL XR - lamotrigine tab sr 24hr25 mg

4


4


4


4


4


4

lamotrigine orally disintegrating tab25 mg (Lamictal odt)

2


2


2

2015


Drug Name Dru

g T

ier

Prio

r A

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rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its


2

lamotrigine tab chewable dispersible5 mg (Lamictal chewable di)

2

lamotrigine tab chewable dispersible25 mg (Lamictal chewable di)

2

lamotrigine tab sr 24hr 25 mg(Lamictal xr)

2


2


2


2


2


2

lamotrigine tab 25 mg (Lamictal) 1




levetiracetam oral soln 100 mg/ml(Keppra)

2

levetiracetam tab sr 24hr 500 mg(Keppra xr)

2

levetiracetam tab sr 24hr 750 mg(Keppra xr)

2

levetiracetam tab 250 mg (Keppra) 2




LYRICA - pregabalin soln 20 mg/ml 4

LYRICA - pregabalin cap 25 mg 4





Drug Name Dru

g T

ier

Prio

r A

utho

rizat

ion

Ste

p T

hera

py

Dis

pens

ing

Lim

its




MYSOLINE - primidone tab 50 mg 4

MYSOLINE - primidone tab 250 mg 4

NEURONTIN - gabapentin oral soln 250mg/5ml

4

NEURONTIN - gabapentin cap 100 mg 4



NEURONTIN - gabapentin tab 600 mg 4

NEURONTIN - gabapentin tab 800 mg 4

ONFI - clobazam suspension 2.5 mg/ml 4

ONFI - clobazam tab 10 mg 4

ONFI - clobazam tab 20 mg 4

oxcarbazepine susp 300 mg/5ml(60 mg/ml) (Trileptal)

2

oxcarbazepine tab 150 mg (Trileptal) 2



OXTELLAR XR - oxcarbazepine tab sr24hr 150 mg

4


4


4

PEGANONE - ethotoin tab 250 mg 4

PHENYTEK - phenytoin sodiumextended cap 200 mg

4

PHENYTEK - phenytoin sodiumextended cap 300 mg

4

phenytoin chew tab 50 mg (Dilantininfatabs)

2

phenytoin sodium extended cap100 mg (Dilantin)

2

phenytoin susp 125 mg/5ml (Dilantin) 2

POTIGA - ezogabine tab 50 mg 4

2015


Drug Name Dru

g T

ier

Prio

r A

utho

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ion

Ste

p T

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py

Dis

pens

ing

Lim

its




primidone tab 50 mg (Mysoline) 1

primidone tab 250 mg (Mysoline) 1

QUDEXY XR - topiramate cap er 24hrsprinkle 25 mg

4


4


4


4


4

SABRIL - vigabatrin tab 500 mg 3

SABRIL - vigabatrin powd pack 500 mg 3

STAVZOR - valproic acid cap delayedrelease 125 mg

4


4


4

TEGRETOL - carbamazepine tab 200mg

4

TEGRETOL - carbamazepine susp 100mg/5ml

4

TEGRETOL-XR - carbamazepine tab sr12hr 100 mg

4


4


4

tiagabine hcl tab 2 mg (Gabitril) 2

tiagabine hcl tab 4 mg (Gabitril) 2

TOPAMAX - topiramate tab 25 mg 4



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TOPAMAX SPRINKLE - topiramatesprinkle cap 15 mg

4

TOPAMAX SPRINKLE - topiramatesprinkle cap 25 mg

4

TOPIRAMATE ER - topiramate cap er24hr sprinkle 25 mg

4


4


4


4


4

topiramate sprinkle cap 15 mg(Topamax sprinkle)

2

topiramate sprinkle cap 25 mg(Topamax sprinkle)

2

topiramate tab 25 mg (Topamax) 1




TRILEPTAL - oxcarbazepine susp 300mg/5ml (60 mg/ml)

4

TRILEPTAL - oxcarbazepine tab 150mg

4


4


4

TROKENDI XR - topiramate cap sr 24hr25 mg

4


4


4


4

2015


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valproate sodium syrup 250 mg/5ml(base equiv) (Depakene)

2

valproic acid cap 250 mg (Depakene) 2

VIMPAT - lacosamide oral solution 10mg/ml

4

VIMPAT - lacosamide tab 50 mg 4




ZARONTIN - ethosuximide cap 250 mg 4

ZARONTIN - ethosuximide soln 250mg/5ml

4

ZONEGRAN - zonisamide cap 25 mg 4

ZONEGRAN - zonisamide cap 100 mg 4

zonisamide cap 25 mg (Zonegran) 2

zonisamide cap 50 mg 2

zonisamide cap 100 mg (Zonegran) 2

ANTIPARKINSON AGENTS

AMANTADINE HCL - amantadine hcltab 100 mg

4

amantadine hcl cap 100 mg 2

amantadine hcl syrup 50 mg/5ml 1

APOKYN - apomorphine hydrochlorideinj 10 mg/ml

5 •

AZILECT - rasagiline mesylate tab 0.5mg (base equiv)

4

AZILECT - rasagiline mesylate tab 1 mg(base equiv)

4

benztropine mesylate tab 0.5 mg 1

benztropine mesylate tab 1 mg 1

benztropine mesylate tab 2 mg 1

bromocriptine mesylate cap 5 mg(Parlodel)

2

bromocriptine mesylate tab 2.5 mg 2

carbidopa & levodopa orallydisintegrating tab 10-100 mg

2


2

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2

carbidopa & levodopa tab cr25-100 mg (Sinemet cr)

2

carbidopa & levodopa tab cr50-200 mg (Sinemet cr)

2

carbidopa & levodopa tab 10-100 mg(Sinemet)

1


2


2

carbidopa tab 25 mg (Lodosyn) 2

CARBIDOPA/LEVODOPA/ENTACA -carbidopa-levodopa-entacapone tabs12.5-50-200 mg

4


4

CARBIDOPA/LEVODOPA/ENTACA -carbidopa-levodopa-entacapone tabs25-100-200 mg

4


4


4

CARBIDOPA/LEVODOPA/ENTACA -carbidopa-levodopa-entacapone tabs50-200-200 mg

4

COMTAN - entacapone tab 200 mg 4

DUOPA - carbidopa-levodopa enteralsusp 4.63-20 mg/ml

4

ELDEPRYL - selegiline hcl cap 5 mg 4

entacapone tab 200 mg (Comtan) 2

LODOSYN - carbidopa tab 25 mg 4

MIRAPEX - pramipexole dihydrochloridetab 0.125 mg

4

2015


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4


4


4

MIRAPEX - pramipexole dihydrochloridetab 1 mg

4


4

MIRAPEX ER - pramipexoledihydrochloride tab sr 24hr 0.375 mg

4


4


4


4

MIRAPEX ER - pramipexoledihydrochloride tab sr 24hr 3 mg

4


4


4

NEUPRO - rotigotine td patch 24hr 1mg/24hr

4


4


4


4


4


4

PARLODEL - bromocriptine mesylatecap 5 mg

4

pramipexole dihydrochloride tab sr24hr 0.375 mg (Mirapex er)

2

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2


2

pramipexole dihydrochloride tab sr24hr 3 mg (Mirapex er)

2

pramipexole dihydrochloride tab0.125 mg (Mirapex)

1


1


1


1

pramipexole dihydrochloride tab1 mg (Mirapex)

1


1

REQUIP - ropinirole hydrochloride tab0.25 mg

4

REQUIP - ropinirole hydrochloride tab0.5 mg

4

REQUIP - ropinirole hydrochloride tab 1mg

4


4


4


4


4

REQUIP XL - ropinirole hydrochloridetab sr 24hr 2 mg (base equivalent)

4


4


4


4

2015


Drug Name Dru

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4

ropinirole hydrochloride tab sr 24hr2 mg (base equivalent) (Requip xl)

2


2


2


2


2

ropinirole hydrochloride tab 0.25 mg(Requip)

1

ropinirole hydrochloride tab 0.5 mg(Requip)

1

ropinirole hydrochloride tab 1 mg(Requip)

1


1


1


1


1

RYTARY - carbidopa & levodopa cap cr23.75-95 mg

4


4


4


4

selegiline hcl cap 5 mg (Eldepryl) 2

selegiline hcl tab 5 mg 2

SINEMET - carbidopa & levodopa tab10-100 mg

4


4

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4

SINEMET CR - carbidopa & levodopatab cr 25-100 mg

4

SINEMET CR - carbidopa & levodopatab cr 50-200 mg

4

STALEVO 100 - carbidopa-levodopa-entacapone tabs 25-100-200 mg

4

STALEVO 125 - carbidopa-levodopa-entacapone tabs 31.25-125-200 mg

4


4

STALEVO 200 - carbidopa-levodopa-entacapone tabs 50-200-200 mg

4


4


4

TASMAR - tolcapone tab 100 mg 4

tolcapone tab 100 mg (Tasmar) 2

trihexyphenidyl hcl elixir 0.4 mg/ml 2

trihexyphenidyl hcl tab 2 mg 1

trihexyphenidyl hcl tab 5 mg 1

ZELAPAR - selegiline hcl orallydisintegrating tab 1.25 mg

4

NEUROMUSCULAR AGENTS

RILUTEK - riluzole tab 50 mg 4

riluzole tab 50 mg (Rilutek) 2

MUSCULOSKELETAL THERAPY AGENTS

AMRIX - cyclobenzaprine hcl cap sr24hr 15 mg

4

AMRIX - cyclobenzaprine hcl cap sr24hr 30 mg

4

baclofen tab 10 mg 1

baclofen tab 20 mg 1

CARISOPRODOL - carisoprodol tab250 mg

4

carisoprodol tab 350 mg (Soma) 1

2015


Drug Name Dru

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carisoprodol w/ aspirin & codeinetab 200-325-16 mg

2

carisoprodol w/ aspirin tab200-325 mg

2

chlorzoxazone tab 500 mg (Parafonforte dsc)

1

CYCLOBENZAPRINE COMFORT P -cyclobenzaprine hcl tab 10 mg &liniment topical gel kit

4

cyclobenzaprine hcl tab 5 mg 1

cyclobenzaprine hcl tab 7.5 mg(Fexmid)

2

cyclobenzaprine hcl tab 10 mg 1

DANTRIUM - dantrolene sodium cap 25mg

4

DANTRIUM - dantrolene sodium cap 50mg

4

DANTRIUM - dantrolene sodium cap100 mg

4

DANTROLENE SODIUM - dantrolenesodium cap 100 mg

4

dantrolene sodium cap 25 mg(Dantrium)

2

dantrolene sodium cap 50 mg(Dantrium)

2

FEXMID - cyclobenzaprine hcl tab 7.5mg

4

LORZONE - chlorzoxazone tab 375 mg 4

LORZONE - chlorzoxazone tab 750 mg 4

METAXALONE - metaxalone tab 400mg

4

metaxalone tab 800 mg (Skelaxin) 2

methocarbamol tab 500 mg (Robaxin) 1

methocarbamol tab 750 mg(Robaxin-750)

1

orphenadrine citrate tab sr 12hr100 mg

2

orphenadrine w/ aspirin & caffeinetab 25-385-30 mg

2

Drug Name Dru

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its

PARAFON FORTE DSC -chlorzoxazone tab 500 mg

4

ROBAXIN - methocarbamol tab 500 mg 4

ROBAXIN-750 - methocarbamol tab 750mg

4

SKELAXIN - metaxalone tab 800 mg 4

SOMA - carisoprodol tab 250 mg 4

SOMA - carisoprodol tab 350 mg 4

TIZANIDINE COMFORT PAC -tizanidine tab 4 mg & liniment topicalgel pack

4

tizanidine hcl cap 2 mg (baseequivalent) (Zanaflex)

2 •


2 •


2 •

tizanidine hcl tab 2 mg (baseequivalent)

1 •

tizanidine hcl tab 4 mg (baseequivalent) (Zanaflex)

1 •

ZANAFLEX - tizanidine hcl tab 4 mg(base equivalent)

4 •

ZANAFLEX - tizanidine hcl cap 2 mg(base equivalent)

4 •


4 •


4 •

ANTIMYASTHENIC AGENTS

GUANIDINE HCL - guanidine hcl tab125 mg

4

MESTINON - pyridostigmine bromidetab 60 mg

4

MESTINON - pyridostigmine bromidesyrup 60 mg/5ml

4

MESTINON TIMESPAN -pyridostigmine bromide tab cr 180 mg

4

pyridostigmine bromide tab cr180 mg (Mestinon timespan)

2

2015


Drug Name Dru

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Lim

its

pyridostigmine bromide tab 60 mg(Mestinon)

2

NUTRITIONAL PRODUCTS

VITAMINS

AMINOBENZOATE POTASSIUM -potassium aminobenzoate packet 2gm

4

BABY DDROPS - cholecalciferol drops400 unit/0.03ml (per drop)

4

cholecalciferol cap 400 unit 2



cholecalciferol chew tab 400 unit 2

cholecalciferol chew tab 1000 unit 1

cholecalciferol drops 5000 unit/ml(1000 unit/0.2ml)

2

cholecalciferol drops 400 unit/0.03ml(per drop)

2

cholecalciferol oral liquid 400 unit/ml 1

cholecalciferol tab 400 unit 1

cholecalciferol tab 1000 unit 1

D-VI-SOL - cholecalciferol oral liquid400 unit/ml

4

DDROPS - cholecalciferol drops 1000unit/0.03ml (per drop)

4

DECARA - cholecalciferol cap 25000unit

4

DRISDOL - ergocalciferol cap 50000unit

4

ergocalciferol cap 50000 unit(Drisdol)

1

MEPHYTON - phytonadione tab 5 mg 3

phytonadione inj 1 mg/0.5ml (2 mg/ml)

2

POTABA - potassium aminobenzoatecap 500 mg

4

POTABA - potassium aminobenzoatetab 500 mg

4

Drug Name Dru

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its

SUPER DAILY D3 - cholecalciferoldrops 1000 unit/0.03ml (per drop)

4

VITAMIN D - cholecalciferol cap 400unit

4

VITAMIN D2 - ergocalciferol tab 400 unit 4

VITAMIN D3 - cholecalciferol spray1000 unit/spray

4

VITAMIN K1 - phytonadione inj 10 mg/ml

4

WELLESSE VITAMIN D3 -cholecalciferol oral liquid 1000unit/10ml

4

MULTIVITAMINS

ACTIVE OB - prenatal w/o a w/fe cbn-fa-dha cap 20-1-320 mg

4

ADRENAL C FORMULA - bioflavonoidproducts tab

4

ADVANCED AM/PM - multiple vitaminsw/ calcium therapy pack

4

ATABEX EC - prenatal vit w/ dss-ironcarbonyl-fa tab dr 29-1 mg

4

b-complex w/ c & folic acid cap 1 mg(Nephrocaps)

1

b-complex w/ c & folic acid tab 1 mg(Nephro-vite rx)

1

b-complex w/ c & folic acid tab 5 mg 1

b-complex w/ c-biotin-minerals &folic acid tab 5 mg (Diatx zn)

1

B-NEXA - prenatal w/ calcium-vit b6-fa-ginger tab 1.22 mg

4

BAL-CARE DHA - prenat w/fe poly-nafered-fa tab 27-1 & omega cap dr430mg

4

BP FOLINATAL PLUS B - prenatal w/calcium carbonate-b6-b12-fa tab 1mg

4

BP MULTINATAL PLUS - prenatal w/o avit w/ fe fumarate-fa tab 30-1 mg

4

BP MULTINATAL PLUS - prenatal w/o avit w/ fe fum-fa tab chew 40-1 mg

4

2015


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its

C-NATE DHA - prenatal vit w/ fe fum-fa-omega 3 cap 28-1-200 mg

4

CALCIUM PNV - prenatal w/o vit a w/ fefum-fa-omega 3 cap 28-1-250 mg

4

CHOICE-OB+DHA - prenatal mv w/fepoly-fa chw 29-1 mg & dha cap 250mg pak

4

CITRANATAL ASSURE - prenat w/oa w/fecbn-fegl-dss-fa tab & dha cap300 mg pack

4

CITRANATAL B-CALM - prenat w/o aw/ fe cbnyl-fa tab 20-1 mg & vit b6 tabpak

4

CITRANATAL B-CALM - prenat w/o aw/fecbn-feglu-fa tab 20-1 mg & vit b6tab pak

4

CITRANATAL DHA - prenat w/o a w/fecbn-fegl-dss-fa tab & dha cap 250mg pack

4

CITRANATAL HARMONY - prenatal w/o a w/fe cbn-dss-fa-dha cap 29-1-265mg

4

CITRANATAL HARMONY - prenat w/o a w/fe fum-fe cbn-dss-fa-dha cap27-1-260 mg

4

CITRANATAL RX - prenatal w/o a w/ fecarbonyl-fe gluc-dss-fa tab 27-1mg

4

CITRANATAL 90 DHA - prenat w/o aw/fecbn-fegl-dss-fa tab 90 &dha cap300mg pak

4

CO-NATAL FA - prenatal vit w/ fefumarate-fa tab 29-1 mg

4

COMPLETE NATAL DHA - prenat-febis-fe prot succ-fa-ca tab & omega 3cap 250 pk

4

COMPLETENATE - prenatal vit w/ fefumarate-fa chew tab 29-1 mg

4

CONCEPT DHA - prenatal w/fe fum-fepoly -fa-omega 3 cap 53.5-38-1 mg

4

CONCEPT OB - prenatal w/o a w/fefum-fe poly-fa cap 130-92.4-1 mg

4

Drug Name Dru

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its

CORVITE - multiple vitamins w/minerals & fa tab 1.25 mg

4

DIALYVITE SUPREME D - multiplevitamins w/ minerals & fa tab 3 mg

4

DIALYVITE 3000 - b-complex w/ c-biotin-e-minerals & folic acid tab 3 mg

4

DIALYVITE 5000 - b-complex w/ c-biotin-e-minerals & folic acid tab 5 mg

4

DIALYVITE/ZINC - b-complex w/ c-zn &folic acid tab 1 mg

4

DIATX ZN - b-complex w/ c-biotin-minerals & folic acid tab 5 mg

4

DUET DHA - prenat w/fe poly-na fered-fa tab 25-1 & omega cap 400 mg

4

DUET DHA BALANCED - prenat w/fepoly-na fered-fa tab 25-1 & omegacap 267 mg

4

DUET DHA BALANCED - prenat w/fepoly-na fered-fa tab 27-1 & omegacap dr 380mg

4

DUET DHA 400 - prenat w/fe poly-nafered-fa tab 25-1 & omega cap 400mg

4

ELITE-OB - prenatal vit w/ iron carbonyl-fa tab 50-1.25 mg

4

ENBRACE HR - prenatal vit w/ fe glycys-fa-omega 3 fatty acids cap

4

ESCAVITE - pediatric multiple vitaminsw/ fl-fe chew tab 0.25-7.5 mg

4

ESCAVITE D - pediatric multiplevitamins w/ fl-fe chew tab 0.25-6 mg

4

ESCAVITE LQ - pediatric multiplevitamins w/ fl-fe drops 0.25-6 mg/ml

1

EXTRA-VIRT PLUS DHA - prenatalw/o vit a w/ fe fum-doc-fa-dha cap29-1.25-350 mg

4

FLORIVA - ped multiple vitamins &minerals w/ fl chew tab 0.5 mg

4

FLORIVA - ped multiple vitamins &minerals w/ fl chew tab 1 mg

4

2015


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its

FOCALGIN CA - prenat w/o a w/fecbn-fegl-dss-fa tab & dha cap 300 mgpack

4

FOCALGIN 90 DHA - prenat w/o a w/fecbn-fegl-dss-fa tab 90 &dha cap300mg pak

4

FOCALGIN-B - prenatal w/ calcium-vitb6-fa-ginger tab 1.22 mg

4

FOLBECAL - prenatal w/ calciumcarbonate-b6-b12-fa tab 1 mg

4

FOLCAL DHA - prenatal w/o vit a w/ fefum-dss-fa-dha cap 27-1.25-300 mg

4

FOLCAPS OMEGA 3 - prenatal vit w/fe cbn-fe asp glyc-fa-omega 3 cap27-1mg

4

FOLET DHA - prenat w/fecbn-bisg-methylf-dss tab dr & dha cap pak

4

FOLET ONE - prenat w/o a w/fecbn-bisg-methylf-dss-dha cap 38-1-225mg

4

FOLGARD OS - multiple vit w/ min &calcium-folic acid tab 500-1.1 mg

4

FOLIVANE-OB - prenatal w/o a w/fefum-fe poly-fa cap 130-92.4-1 mg

4

HEMENATAL OB - prenat vit-fe polycmplx-fe heme poly-fa tab 28-6-1 mg

4

HEMENATAL OB + DHA - prenat-fepoly cmplx-fe heme poly-fa tab &omega 3 cap pck

4

INATAL ADVANCE - prenatal vit w/ dss-iron carbonyl-fa tab 90-1 mg

4

INATAL GT - prenatal vit w/ dss-ironcarbonyl-fa tab 90-1 mg

4

INATAL ULTRA - prenatal vit w/ dss-ironcarbonyl-fa tab 90-1 mg

4

INFANATE BALANCE - prenatal w/o aw/fe cbn-dss-fa-dha cap 29-1-265 mg

4

INFANATE PLUS - prenat w/o a w/fefum-fe cbn-dss-fa-dha cap 27-1-260mg

4

Drug Name Dru

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its

L-METHYLFOLATE PNV DHA - prenatw/fe fum-l methylfolate-fa-dha cap27-1.13-0.4 mg

4

LEVOMEFOLATE DHA - prenat w/fe fum-l methylfolate-fa-dha cap27-1.13-0.4 mg

4

M-VIT - prenatal vit w/ fe fumarate-fa tab27-1 mg

4

MACNATAL CN DHA - prenatal w/o aw/fe cbn-dss-fa-dha cap 28-1-250 mg

4

MARNATAL-F - prenatal w/o vit a w/ fepolysac cmplx-fa cap 60-1 mg

4

multiple vitamins w/ minerals & fatab 1.25 mg (Corvite)

1

MYKIDZ IRON FL - pediatric vitaminsacd fluoride & fe susp 0.25-10mg/2ml

4

MYNATAL - prenatal multivitamins &minerals w/ iron & fa cap 1 mg

4

MYNATAL ADVANCE - prenatal vit w/dss-iron carbonyl-fa tab 90-1 mg

4

MYNATAL PLUS - prenatal vit w/ fefumarate-fa tab 65-1 mg

4

MYNATAL ULTRACAPLET - prenatal vitw/ dss-iron carbonyl-fa tab 90-1 mg

4

MYNATAL-Z - prenatal vit w/ fefumarate-fa tab 65-1 mg

4

MYNATE 90 PLUS - prenatal vit w/ dss-fe fumarate-fa tab cr 90-1 mg

4

NATACHEW - prenatal vit w/ fe fum-febisglycin-fa chew tab 28-1 mg

4

NATAL-V RX - prenatal vit w/ ironcarbonyl-fa tab 29-1 mg

4

NATALVIRT CA - prenat w/o a w/fecbn-fegl-dss-fa tab & dha cap 300 mgpack

4

NATALVIRT 90 DHA - prenat w/o a w/fecbn-fegl-dss-fa tab 90 &dha cap300mg pak

4

NATALVIT - prenatal vit w/ fe fumarate-fa tab 75-1 mg

4

2015


Drug Name Dru

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its

NATELLE ONE - prenatal w/o vit a w/ fefum-fa-omega 3 cap 28-1-250 mg

4

NEEVO DHA - prenat w/o a w/fefum-methylfol-omegas cap 27-1.13 mg

4

NEPHPLEX RX - b-complex w/ c-zn &folic acid tab 1 mg

4

NEPHRO-VITE RX - b-complex w/ c &folic acid tab 1 mg

4

NEPHROCAPS - b-complex w/ c & folicacid cap 1 mg

4

NEPHROCAPS QT - b-complex w/ c-biotin-d & folic acid tab disp 1 mg

4

NESTABS - prenatal vit w/o vit a w/ febisglycinate-fa tab 32-1 mg

4

NESTABS ABC - prenatal w/o vit a w/fepolysac-fa-ca tab & omega 3 cap

4

NESTABS DHA - prenat w/o a w/ febisglyc-fa tab 32-1 mg & omega cappack

4

NEWGEN - prenatal vit w/o vit a w/ febisglycinate-fa tab 32-1 mg

4

NEXA PLUS - prenatal w/o vit a w/ fefum-doc-fa-dha cap 29-1.25-350 mg

4

NEXA SELECT - prenatal w/o vit a w/ fefum-dss-fa-dha cap 29-1.25-325 mg

4

NICOMIDE - niacinamide w/ zn-cu-methylfol-se-cr tab 750-27-2-0.5 mg

4

NIVA-PLUS - prenatal vit w/ fefumarate-fa tab 27-1 mg

4

NUTRI-TAB OB - prenatal vit w/o vit aw/ fe bisglycinate-fa tab 32-1 mg

4

NUTRI-TAB OB + DHA - prenat w/o aw/ fe bisglyc-fa tab 32-1 mg & omegacap pack

4

NUTRIVIT - b-complex w/ lysine-min-fe& fa liqd 800-15-1 mg/15ml

4

O-CAL FA - prenatal vit w/ fe fumarate-fa tab 27-1 mg

4

O-CAL PRENATAL - prenatal vit w/ fefumarate-fa tab 15-1 mg

4

Drug Name Dru

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OB COMPLETE - prenatal vit w/ ironcarbonyl-fa tab 50-1.25 mg

4

OB COMPLETE ONE - prenatal w/o a w/fecbn-fe asp glyc-fa-fish cap50-1-476 mg

4

OB COMPLETE PETITE - prenat w/oa w/fecbn-feaspglyc-fa-omega cap35-5-1-200 mg

4

OB COMPLETE PREMIER - prenatal vitw/ fe cbn-fe asp glyc-fa tab 30-20-1mg

4

OB COMPLETE/DHA - prenat w/iron cbn-fe asp glyc-fa-omega cap30-10-1-200 mg

4

OB-NATAL ONE - prenatal vit w/ fe cbn-fe asp glyc-fa-omega 3 cap 27-1mg

4

OBSTETRIX DHA - prenat w/fecbn-fa-dss tab 29-1 mg & omega 3 cap 387mg pak

4

OBSTETRIX EC - prenatal vit w/ dss-iron carbonyl-fa tab 29-1 mg

4

OCUVEL - multiple vitamins w/ minerals& fa cap 0.5 mg

4

PAIRE OB - prenat w/ fe poly cmplx-feasp-fe gly-fa tab & dha cap pak

4

pediatric multiple vitamins w/ fl-fedrops 0.25-10 mg/ml

1

pediatric multiple vitamins w/fluoride chew tab 0.25 mg

1

pediatric multiple vitamins w/fluoride chew tab 0.5 mg

1

pediatric multiple vitamins w/fluoride chew tab 1 mg

1

pediatric multiple vitamins w/fluoride soln 0.25 mg/ml

1

pediatric multiple vitamins w/fluoride soln 0.5 mg/ml

1

pediatric vitamins acd w/ fluoridesoln 0.25 mg/ml

1

pediatric vitamins acd w/ fluoridesoln 0.5 mg/ml

1

2015


Drug Name Dru

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Lim

its

PNV FERROUS FUMARATE/DOCU -prenatal vit w/ dss-fe fumarate-fa tab29-1 mg

4

PNV FOLIC ACID + IRON MUL -prenatal vit w/ fe fumarate-fa tab 27-1mg

4

PNV OB+DHA - prenat w/o a w/fecbn-fegl-dss-fa tab & dha cap 250 mgpack

4

PNV PRENATAL PLUS MULTIVI -prenatal vit w/ fe fumarate-fa tab 27-1mg

4

PNV TABS 29-1 - prenatal vit w/ ironcarbonyl-fa tab 29-1 mg

4

PNV-DHA - prenat w/o a w/fefum-methfol-fa-dha cap 27-0.6-0.4-300mg

4

PNV-DHA+DOCUSATE - prenatalw/o vit a w/ fe fum-dss-fa-dha cap27-1.25-300 mg

4

PNV-FIRST - prenatal mv w/ fe polysaccmplx-fa-dha cap 29-1-200 mg

4

PNV-OB/DHA - prenatal mv w/fe fum-fatab 65-1 mg & dha cap 250 mg pack

4

PNV-OMEGA - prenat w/o a w/ fefumerate-methylfolate-fa-omega 3cap

4

PNV-SELECT - prenatal vit w/ fe fum-methylfolate-fa tab 27-0.6-0.4 mg

4

PNV-TOTAL - prenat w/ fe cbn-febisglyc-fa-fish oil cap 35-5-1.2 mg

4

PNV-VP-U - prenatal w/o a vit w/ fefumarate-fa cap 106.5-1 mg

4

POLY-VI-FLOR - ped multiple vit w/fluoride biphasic susp 0.25 mg/ml

4

POLY-VI-FLOR - ped multiple vit w/fluoride biphasic chew tab 0.25 mg

4

POLY-VI-FLOR - ped multiple vit w/fluoride biphasic chew tab 0.5 mg

4

POLY-VI-FLOR - ped multiple vit w/fluoride biphasic chew tab 1 mg

4

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POLY-VI-FLOR FS - pediatric multiplevit w/ fluoride oral strip 0.25 mg

4

POLY-VI-FLOR FS - pediatric multiplevit w/ fluoride oral strip 0.5 mg

4

POLY-VI-FLOR FS - pediatric multiplevitamins w/ fluoride oral strip 1 mg

4

POLY-VI-FLOR/IRON - ped multiplevitamin w/ fl-fe biphasic susp 0.25-7mg/ml

4

POLY-VI-FLOR/IRON - ped multiple vitw/ fl-fe biphasic chew tab 0.5-10 mg

4

PR NATAL 400 - prenat-fe bis-fe protsucc-fa-ca tab & omega 3 cap 400 pk

4

PR NATAL 400 EC - prenat-fe bis-feprot succ-fa-ca tab & omega cap dr400 pk

4

PR NATAL 430 - prenat-fe bis-fe protsucc-fa-ca tab & omega 3 cap 430 pk

4

PR NATAL 430 EC - prenat-fe bis-feprot succ-fa-ca tab & omega cap dr430 pk

4

PREFERA OB - prenat vit-fe poly cmplx-fe heme poly-fa tab 28-6-1 mg

4

PREFERA OB + DHA - prenat-fe polycmplx-fe heme poly-fa tab & omega 3cap pck

4

PREFERAOB +DHA - prenat-fe polycmplx 28mg-fe heme poly-fa tab&dhacap pack

4

PREFERAOB ONE - prenat-fe polycmplx-fe heme poly-fa-dha cap22-6-1-200 mg

4

PREFOL-DHA - prenatal w/o vit a w/ fefum-dss-fa-dha cap 26-1.2-300 mg

4

PRENAISSANCE - prenatal w/o vit a w/fe fum-dss-fa-dha cap 29-1.25-325mg

4

PRENAISSANCE BALANCE - prenatalw/o vit a w/ fe cbn-dss-fa-dha cap30-1-260 mg

4

2015


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PRENAISSANCE DHA - prenat w/o a w/fecbn-fegl-dss-fa tab & dha cap 250mg pack

4

PRENAISSANCE HARMONY DHA -prenat w/fe poly-na fered-fa tab 27-1& omega cap dr 380mg

4

PRENAISSANCE NEXT - prenatal w/calcium-vit b6-fa-ginger tab 1.2 mg

4

PRENAISSANCE NEXT-B - prenatal w/calcium-vit b6-fa-ginger tab 1.22 mg

4

PRENAISSANCE PLUS - prenatal w/o aw/fe cbn-dss-fa-dha cap 28-1-250 mg

4

PRENAISSANCE PROMISE - prenat w/o a w/fecbn-fegl-dss-fa tab & dha cap300 mg pack

4

PRENAISSANCE 90 DHA - prenat w/o a w/fecbn-fegl-dss-fa tab 90 &dhacap 300mg pak

4

PRENAPLUS - prenatal vit w/ fefumarate-fa tab 27-1 mg

4

PRENATA - prenatal w/o a vit w/ fe fum-fa tab chew 29-1 mg

4

PRENATABS FA - prenatal vit w/ fefumarate-fa tab 29-1 mg

4

PRENATABS RX - prenatal vit w/ ironcarbonyl-fa tab 29-1 mg

4

PRENATAL - prenatal vit w/ fefumarate-fa tab 27-1 mg

4

PRENATAL AD - prenatal vit w/ dss-ironcarbonyl-fa tab 90-1 mg

4

PRENATAL LOW IRON - prenatal vit w/fe fumarate-fa tab 27-1 mg

4

PRENATAL PLUS - prenatal vit w/ fefumarate-fa tab 27-1 mg

3

PRENATAL PLUS IRON - prenatal vitw/ iron carbonyl-fa tab 29-1 mg

4

PRENATAL VITAMINS PLUS - prenatalvit w/ fe fumarate-fa tab 27-1 mg

3

PRENATAL 19 - prenatal vit w/ fefumarate-fa chew tab 29-1 mg

4

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PRENATAL 19 - prenatal vit w/ dss-fefumarate-fa tab 29-1 mg

4

PRENATAL-U - prenatal w/o a vit w/ fefumarate-fa cap 106.5-1 mg

4

PRENATE - prenat mv & min w/ l-methylfolate-fa chew tab 0.6-0.4 mg

4

PRENATE AM - prenatal w/ calcium-vitb6-vit b12-fa-ginger tab 1 mg

4

PRENATE DHA - prenat w/o a w/fefum-methfol-fa-dha cap 28-0.6-0.4-300mg

4

PRENATE DHA - prenat w/o aw/feaspg-methfol-fa-dha cap18-0.6-0.4-300 mg

4

PRENATE ELITE - prenatal w/ fe aspgly-l methylfol-fa tab 20-0.6-0.4 mg

4

PRENATE ELITE - prenatal vit w/ fefum-methylfolate-fa tab 26-0.6-0.4 mg

4

PRENATE ENHANCE - prenat w/o a w/fefum-methfol-fa-dha cap28-0.6-0.4-400 mg

4

PRENATE ESSENTIAL - prenat w/o a w/feasp-methylf-fa-omeg cap29-0.6-0.4-340 mg

4

PRENATE ESSENTIAL - prenat w/o a w/feaspg-methfol-fa-dha cap18-0.6-0.4-300 mg

4

PRENATE MINI - prenat w/oa w/fecb-feasp-meth-fa-dha cap18-0.6-0.4-350 mg

4

PRENATE PIXIE - prenat w/o aw/feaspg-methfol-fa-dha cap10-0.6-0.4-200 mg

4

PRENATE RESTORE - prenat w/o a w/fefum-methfol-fa-dha cap27-0.6-0.4-400 mg

4

PRENATE STAR - prenatal vit w/ feasparto glycinate-fa tab 20-1 mg

4

PRENA1 CHEW - prenat w/ b2-b6-b12-d3-folic acid chew tab 1.4 mg

4

2015


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PRENA1 PEARL - prenat w/oa w/fefum-na fered-fa-dha cap cr 30-1.4-200 mg

4

PRENA1 PLUS/QUATREFOLIC -prenat w/o a w/ fe chelate-l methylfol-fa tab & dha cap pk

4

PRENA1/QUATREFOLIC - prenatw/o a w/fefum-methfol-fa-dha cap30-0.6-0.4-200 mg

4

PRENEXA - prenatal w/o vit a w/ fe fum-dss-fa-dha cap 27-1.25-300 mg

4

PREPLUS - prenatal vit w/ fe fumarate-fa tab 27-1 mg

4

PREQUE 10 - prenatal mv w/fecarbonyl-dss-fa-dha tab 15-25-0.5-50mg

4

PRETAB - prenatal vit w/ fe fumarate-fatab 29-1 mg

4

PROVIDA DHA - prenat w/o a w/fe fum-fe poly-fa-dha cap 16-16-1.25-110 mg

4

PROVIDA OB - prenatal w/o a w/fe fum-fe poly-fa cap 20-20-1.25 mg

4

PUREFE OB PLUS - prenatal w/o a w/fefum-fe poly-fa cap 162.115.2-1 mg

4

QUFLORA PEDIATRIC - pediatricmultiple vitamins w/ fluoride chew tab0.25 mg

4

QUFLORA PEDIATRIC - pediatricmultiple vitamins w/ fluoride chew tab0.5 mg

4

QUFLORA PEDIATRIC - pediatricmultiple vitamins w/ fluoride chew tab1 mg

4

QUFLORA PEDIATRIC - pediatricmultiple vitamins w/ fluoride soln 0.25mg/ml

4

QUFLORA PEDIATRIC - pediatricmultiple vitamins w/ fluoride soln 0.5mg/ml

4

R-NATAL OB - prenatal w/o a w/fe cbn-fa-dha cap 20-1-320 mg

4

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RELNATE DHA - prenatal vit w/ fe fum-fa-omega 3 cap 28-1-200 mg

4

RENATABS - b-complex w/ c-biotin-vit e& folic acid tab 1 mg

4

RENATABS WITH IRON - b complex-c-biotin-e-fa tab 1mg & fe cbn tab 100mg pack

4

SE-NATAL 19 - prenatal vit w/ fefumarate-fa chew tab 29-1 mg

4

SE-NATAL 19 - prenatal vit w/ dss-fefumarate-fa tab 29-1 mg

4

SE-TAN DHA - prenatal w/fe fum-fe poly-fa-omega 3 cap 15-15-1 mg

4

SELECT-OB - prenatal vit w/ fe polysaccmplx-fa chew tab 29-1 mg

4

SELECT-OB - prenat w/ fepolycmplx-methylfol-fa chew tab 29-0.6-0.4 mg

4

SELECT-OB+DHA - prenatal mv w/fepoly-fa chw 29-1 mg & dha cap 250mg pak

4

SETON ET-EC - prenat-fe bis-fe protsucc-fa-ca tab & omega cap dr 430pk

4

SETONET - prenat-fe bis-fe prot succ-fa-ca tab & omega 3 cap 430 pk

4

STROVITE FORTE - multiple vitaminsw/ minerals & fa syrup 1 mg/15ml

4

SUPERVITE - b-complex w/ lysine-zn &folic acid liquid

4

SUPERVITE EC - multiple vitamins w/minerals & fa tab dr 1 mg

4

SYNAGEX - multiple vitamins w/minerals & fa cap 1.25 mg

4

SYNATEK - multiple vitamins w/minerals & fa cap 1.25 mg

4

TARON-BC - prenat w/o a w/ fe cbnyl-fatab 20-1 mg & vit b6 tab pak

4

TARON-C DHA - prenatal w/fe fum-fepoly -fa-omega 3 cap 53.5-38-1 mg

4

2015


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TARON-DUO EC - prenat-fe bis-fe protsucc-fa-ca tab & omega cap dr 400pk

4

TARON-PREX - prenatal w/o vit a w/ fefum-dss-fa-dha cap 30-1.2-265 mg

4

TEXAVITE LQ - pediatric multivitaminsw/fl-fe-zn drops 0.25-7-3 mg/ml

4

THRIVITE 19 - prenatal vit w/ dss-fefumarate-fa tab 29-1 mg

4

TL FOLATE - prenatal vit w/ fe fum-methylfolate-fa tab 27-0.5-0.5 mg

4

TL G-FOL OS - multiple vit w/ min &calcium-folic acid tab 500-1.1 mg

4

TL-CARE DHA - prenatal w/fe fumarate-fa-dss-fish oil cap 27-1-500 mg

4

TL-FLUORIVITE - pediatric multiplevitamins w/ fl-fe chew tab 0.25-7.5 mg

4

TL-SELECT - prenatal w/o vit a w/ fefum-dss-fa-dha cap 29-1.25-325 mg

4

TL-SELECT DHA - prenatal w/o vit a w/fe fum-doc-fa-dha cap 29-1.25-350mg

4

TRI-TABS DHA - prenat w/o a w/ febisglyc-fa tab 32-1 mg & omega cappack

4

TRI-VI-FLOR - ped vit acd & l-methylfolw/ fl biphasic susp 0.25 mg/ml

4

TRI-VI-FLOR - ped vit acd & l-methylfolw/ fl biphasic susp 0.5 mg/ml

4

TRI-VI-FLORO - ped vit acd & l-methylfol w/ fl biphasic susp 0.25 mg/ml

4

TRI-VI-FLORO - ped vit acd & l-methylfol w/ fl biphasic susp 0.5 mg/ml

4

TRI-VIT/FLUORIDE/IRON - pediatricvitamins acd fluoride & fe drops0.25-10 mg/ml

4

TRIADVANCE - prenatal vit w/ dss-ironcarbonyl-fa tab 90-1 mg

4

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TRICARE - prenatal vit w/ fe fumarate-fatab 27-1 mg

4

TRICARE PRENATAL COMPLEAT -prenat w/o a fefum-fa tab 27-1 mg &fish oil chew cap pak

4

TRICARE PRENATAL DHA ONE -prenatal w/fe fumarate-fa-dss-fish oilcap 27-1-500 mg

4

TRINATAL GT - prenatal vit w/ dss-ironcarbonyl-fa tab 90-1 mg

4

TRINATAL RX 1 - prenatal vit w/ fefumarate-fa tab 60-1 mg

4

TRINATAL ULTRA - prenatal vit w/ dss-iron carbonyl-fa tab 90-1 mg

4

TRINATE - prenatal vit w/ fe fumarate-fatab 28-1 mg

4

TRISTART DHA - prenat w/o a w/fecbn-methylf-fa-dha cap 31-0.6-0.4-200 mg

4

TRIVEEN-DUO DHA - prenat-fe bis-feprot succ-fa-ca tab & omega 3 cap400 pk

4

TRIVEEN-PRX RNF - prenatal w/o vit aw/ fe fum-dss-fa-dha cap 26-1.2-300mg

4

UDAMIN SP - multiple vitamins w/minerals & fa tab 1 mg

4

ULTIMATE OB DHA - prenat w/ fe polycmplx-fe asp-fe gly-fa tab & dha cappak

4

ULTIMATECARE ONE - prenatal vit w/fe cbn-fe asp glyc-fa-omega 3 cap27-1mg

4

ULTIMATECARE ONE NF - prenatalw/fe cbnyl-fe asp glyc-fa-dss-omegacap 20-7-1 mg

4

ULTRA TABS - prenatal vit w/ dss-ironcarbonyl-fa tab 90-1 mg

4

V-NATAL - prenatal vit w/o vit a w/ febisglycinate-fa tab 32-1 mg

4

2015


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V-NATAL DHA - prenat w/o a w/ febisglyc-fa tab 32-1 mg & omega cappack

4

VEMAVITE-PRX 2 - prenatal w/o vit aw/ fe fum-dss-fa-dha cap 27-1.25-300mg

4

VENA-BAL DHA - prenat w/fe poly-nafered-fa tab 27-1 & omega cap dr430mg

4

VENATAL-FA - prenatal vit w/ fefumarate-fa tab 29-1 mg

4

VINACAL - prenatal w/o a w/ fecarbonyl-fe gluc-dss-fa tab 27-1mg

4

VINACAL B - prenat w/o a w/fecbn-feglu-fa tab 20-1 mg & vit b6 tab pak

4

VINATE AZ EXTRA - prenatal vit w/ febisglycinate chelate-fa tab 29-1 mg

4

VINATE C - prenatal w/o a vit w/ fefumarate-fa tab 30-1 mg

4

VINATE CALCIUM - prenatal vit w/ ironcarbonyl-fe gluc-fa tab 27-1 mg

4

VINATE CARE - prenatal w/o a vit w/ fefum-fa tab chew 40-1 mg

4

VINATE DHA RF - prenat w/o a w/fefum-methylfol-omegas cap 27-1.13mg

4

VINATE GT - prenatal vit w/ dss-ironcarbonyl-fa tab 90-1 mg

4

VINATE IC - prenatal w/o a w/fe fum-fepoly-fa cap 162.115.2-1 mg

4

VINATE II - prenatal vit w/ febisglycinate chelate-fa tab 29-1 mg

4

VINATE M - prenatal vit w/ sel-fefumarate-fa tab 27-1 mg

4

VINATE ONE - prenatal vit w/ fefumarate-fa tab 60-1 mg

4

VINATE ULTRA - prenatal vit w/ dss-iron carbonyl-fa tab 90-1 mg

4

VIRT NATE - prenatal vit w/ fe fumarate-fa tab 28-1 mg

4

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VIRT-ADVANCE - prenatal vit w/ dss-iron carbonyl-fa tab 90-1 mg

4

VIRT-BAL DHA PLUS - prenat w/fepoly-na fered-fa tab 27-1 & omegacap dr 380mg

4

VIRT-C DHA - prenatal w/fe fum-fe poly-fa-omega 3 cap 53.5-38-1 mg

4

VIRT-CARE ONE - prenatal vit w/ fecbn-fe asp glyc-fa-omega 3 cap27-1mg

4

VIRT-PN - prenatal vit w/ fe fum-methylfolate-fa tab 27-0.6-0.4 mg

4

VIRT-PN DHA - prenat w/o a w/fefum-methfol-fa-dha cap 27-0.6-0.4-300mg

4

VIRT-PN PLUS - prenat w/o a w/ fefumerate-methylfolate-fa-omega 3cap

4

VIRT-SELECT - prenatal w/o vit a w/ fefum-dss-fa-dha cap 29-1.25-325 mg

4

VIRT-VITE GT - prenatal vit w/ dss-ironcarbonyl-fa tab 90-1 mg

4

VIRTPREX - prenatal w/o vit a w/ fefum-dss-fa-dha cap 26-1.2-300 mg

4

VITA-PREN - prenatal vit w/ docusate-iron-fa tab 65-1 mg

4

VITAFOL ULTRA - prenat w/fe poly-methylfol-fa-dha cap 29-0.6-0.4-200mg

4

VITAFOL-NANO - prenatal w/o a w/fefum-l methylfol-fa tab 18-0.6-0.4 mg

4

VITAFOL-OB - prenatal vit w/ fefumarate-fa tab 65-1 mg

4

VITAFOL-OB+DHA - prenatal mv w/fefum-fa tab 65-1 mg & dha cap 250mg pack

4

VITAFOL-ONE - prenatal mv w/ fepolysac cmplx-fa-dha cap 29-1-200mg

4

VITAFOL-PN - prenatal vit w/ fefumarate-fa tab 65-1 mg

4

2015


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VITAL-D RX - b-complex w/ c-biotin-d-zinc & folic acid tab 1 mg

4

VITAMEDMD ONE RX/QUATREFO -prenat w/o a w/fefum-methfol-fa-dhacap 30-0.6-0.4-200 mg

4

VITAMEDMD PLUS RX/QUATRE -prenat w/o a w/ fe chelate-l methylfol-fa tab & dha cap pk

4

VITAMEDMD REDICHEW RX - prenatw/ b2-b6-b12-d3-folic acid chew tab1.4 mg

4

VITAPEARL - prenat w/oa w/fefum-nafered-fa-dha cap cr 30-1.4-200 mg

4

VIVA DHA - prenatal vit w/ fe fum-fa-omega 3 cap 28-1-200 mg

4

VOL-NATE - prenatal vit w/ fe fumarate-fa tab 28-1 mg

4

VOL-PLUS - prenatal vit w/ fe fumarate-fa tab 27-1 mg

4

VOL-TAB RX - prenatal vit w/ ironcarbonyl-fa tab 29-1 mg

4

VP CH ULTRA - prenat w/o a w/fe fum-fe cbn-dss-fa-dha cap 27-1-260 mg

4

VP-CH PLUS - prenatal w/o a w/fe cbn-dss-fa-dha cap 29-1-265 mg

4

VP-CH-PNV - prenatal w/o vit a w/ fecbn-dss-fa-dha cap 30-1-260 mg

4

VP-GGR-B6 PRENATAL - prenatal w/calcium-vit b6-fa-ginger tab 1.2 mg

4

VP-HEME OB - prenat vit-fe poly cmplx-fe heme poly-fa tab 28-6-1 mg

4

VP-HEME OB + DHA - prenat-fe polycmplx-fe heme poly-fa tab & omega 3cap pck

4

VP-HEME ONE - prenat-fe poly cmplx-fe heme poly-fa-dha cap 22-6-1-200mg

4

VP-PNV-DHA - prenatal vit w/ fe fum-fa-omega 3 cap 28-1-215.8 mg

4

ZATEAN-CH - prenatal w/o a w/fe cbn-dss-fa-dha cap 27-1-250 mg

4

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ZATEAN-PN - prenatal vit w/ fe fum-methylfolate-fa tab 27-0.6-0.4 mg

4

ZATEAN-PN DHA - prenat w/oa w/fefum-methfol-fa-dha cap27-0.6-0.4-300 mg

4

ZATEAN-PN PLUS - prenat w/o a w/fe fumerate-methylfolate-fa-omega 3cap

4

ZINGIBER - prenatal w/ calcium-vit b6-fa-ginger tab 1.2 mg

4

MINERALS and ELECTROLYTES

CALCIFOL - ca carb-folic acid-vit d-b6-b12-boron-mag wafer 1342-1.6 mg

4

CALCIUM-FOLIC ACID PLUS D - cacarb-folic acid-vit d-b6-b12-boron-mag wafer 1342-1 mg

4

EFFER-K - potassium bicarbonate-citricacid effer tab 10 meq

4

EFFER-K - potassium bicarbonate-citricacid effer tab 20 meq

4

FLORICAL - sodium fluoride w/ calciumcarb cap 8.3-364 mg

4

FLORICAL - sodium fluoride w/ calciumcarb tab 8.3-364 mg

4

FLORIVA - sodium fluoride-vitamin dliqd drops 0.25 mg/ml-400 unit/ml

4

FLUOR-A-DAY - sodium fluoride-xylitolchew tab 0.55 (0.25 mg f)-236.79 mg

4

FLUOR-A-DAY - sodium fluoride-xylitolchew tab 1.1 (0.5 mg f)-236.79 mg

4

FLUOR-A-DAY - sodium fluoride-xylitolchew tab 2.2 (1 mg f)-236.79 mg

4

FLUORABON - sodium fluoride soln0.25 mg/0.6ml (from 0.55 mg/0.6mlnaf)

4

FLURA-DROPS - sodium fluoride soln0.25 mg/drop f (from 0.55 mg/dropnaf)

4

GALZIN - zinc acetate cap 25 mg(elemental zinc)

4

2015


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GALZIN - zinc acetate cap 50 mg(elemental zinc)

4

GNP VITAMIN D-400 - calciumcarbonate-cholecalciferol tab 90mg-400 unit

1

GNP VITAMIN D-400 - calciumcarbonate-cholecalciferol tab 90mg-400 unit

4

IODINE STRONG - iodine solutionstrong 5% (lugol's)

4

K-PHOS - potassium phosphatemonobasic tab 500 mg

4

K-PHOS NEUTRAL - pot phosmonobasic w/sod phos di & monobastab 155-852-130mg

4

K-TAB - potassium chloride tab cr 8meq (600 mg)

4

K-TAB - potassium chloride tab cr 10meq

4

K-TAB - potassium chloride tab cr 20meq (1500 mg)

4

KLOR-CON M15 - potassium chloridemicroencapsulated crys cr tab 15meq

4

KLOR-CON 25 - potassium chloridepowder packet 25 meq

4

KLOR-CON/25 - potassium chloridepowder packet 25 meq

4

LOZI-FLUR - sodium fluoride lozenge 1mg f (from 2.2 mg naf)

4

LURIDE - sodium fluoride chew tab 0.25mg f (from 0.55 mg naf)

4

LURIDE - sodium fluoride chew tab 0.5mg f (from 1.1 mg naf)

4

LURIDE - sodium fluoride chew tab 1mg f (from 2.2 mg naf)

4

LURIDE - sodium fluoride soln 0.5 mg/ml f (from 1.1 mg/ml naf)

4

MAGNEBIND 400 - magnesium-calcium-folic acid tab 400-200-1 mg

4

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MICRO-K - potassium chloride cap cr 8meq

4

MICRO-K - potassium chloride cap cr 10meq

4

MONOCAL - sodiummonofluorophosphate-calcium carbtab 22.75-625 mg

4

pot bicarbonate & chloride effer tab25 meq

2

pot phos monobasic w/sod phos di& monobas tab 155-852-130mg (K-phos neutral)

2

potassium bicarbonate effer tab 25meq

2

potassium chloride cap cr 8 meq(Micro-k)

2

potassium chloride cap cr 10 meq(Micro-k)

2

POTASSIUM CHLORIDE ER -potassium chloride tab cr 8 meq (600mg)

1

POTASSIUM CHLORIDE ER -potassium chloride tab cr 20 meq(1500 mg)

4

potassium chloridemicroencapsulated crys cr tab 10meq

1

potassium chloridemicroencapsulated crys cr tab 20meq

1

potassium chloride oral liq 10% (20meq/15ml)

1

potassium chloride oral liq 20% (40meq/15ml)

1

potassium chloride powder packet20 meq

2

potassium chloride tab cr 8 meq(600 mg)

1

potassium chloride tab cr 10 meq (K-tab)

1

2015


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SODIUM FLUORIDE - sodium fluoridetab 0.5 mg f (from 1.1 mg naf)

4

SODIUM FLUORIDE - sodium fluoridetab 1 mg f (from 2.2 mg naf)

4

sodium fluoride chew tab 0.25 mg f(from 0.55 mg naf) (Luride)

1

sodium fluoride chew tab 0.5 mg f(from 1.1 mg naf) (Luride)

1

sodium fluoride chew tab 1 mg f(from 2.2 mg naf) (Luride)

1

sodium fluoride soln 0.125 mg/drop f(0.275 mg/drop naf)

2

sodium fluoride soln 0.5 mg/ml f(from 1.1 mg/ml naf) (Luride)

1

SSKI - potassium iodide soln 1 gm/ml 4

NUTRIENTS

acetylcysteine cap 600 mg 2

CARDIOVID PLUS - dha-epa-vit b6-b12-folic acid cap 240-360-20-0.5-0.8mg

4

LECITHIN - lecithin granules 4

NUTRESTORE - glutamine powd pack5 gm

4

DIETARY PRODUCTS

ALZ-NAC - l-methylfolate-methylcobalamin-acetylcyst tab6-2-600 mg

4

AVAILNEX - carbocysteine chew tab750 mg

4

CARDIOTEK-RX - folic acid-b12-b6-arginine-black pepper tab

4

CEREFOLIN - l-methylfolate w/ vit b12-vit b6-vit b2 tab 6-1-50-5 mg

4

CEREFOLIN NAC - l-methylfolate-methylcobalamin-acetylcyst tab6-2-600 mg

4

CEREFOLIN NAC - l-methylfolate-algae-b12-acetylcyst tab6-90.314-2-600mg

4

Drug Name Dru

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its

CYANOCOBALAMIN/LEVOMEFOLA -l-methylfolate w/ vit b6-vit b12 tab1.13-25-2 mg

4

DEPLIN - l-methylfolate tab 7.5 mg 4

DEPLIN - l-methylfolate tab 15 mg 4

DEPLIN 15 - l-methylfolate-algae cap15-90.314 mg

4

DEPLIN 7.5 - l-methylfolate-algae cap7.5-90.314 mg

4

ELIGEN B12 - cyanocobalamin-salcaprozate sodium tab 1000mcg-100 mg

4

ENTERAGAM - serum-derived bovineimmunoglob/protein isolate 5 gmpacket

4

FALESSA - levomefolate glucosaminetab 1 mg (folate equivalent)

4

flaxseed oil-evening primrose-bilberry cap 1000-500-40 mg (Tearsagain hydrate)

2

FOLBEE AR - folic acid-b12-b6-arginine-black pepper tab

4

FOLBIC RF - l-methylfolate w/ vit b6-vitb12 tab 1.13-25-2 mg

4

folic acid-pyridoxine-cyanocobalamin tab 2.5-25-2 mg

2

FOLTANX - l-methylfolate w/ vit b6-vitb12 tab 3-35-2 mg

4

FOLTANX RF - l-methylfolate-algae-vitb12-b6 cap 3-90.314-2-35 mg

4

FOLTX - l-methylfolate w/ vit b6-vit b12tab 1.13-25-2 mg

4

FOSTEUM - genistein-zinc amino acidchelate-vitamin d cap

4

L-METHYL-B6-B12 - l-methylfolate w/vit b6-vit b12 tab 3-35-2 mg

4

L-METHYL-MC - l-methylfolate w/ vitb12-vit b6-vit b2 tab 6-1-50-5 mg

4

L-METHYL-MC NAC - l-methylfolate-methylcobalamin-acetylcyst tab6-2-600 mg

4

2015


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L-METHYLFOLATE - l-methylfolate tab7.5 mg

4

L-METHYLFOLATE - l-methylfolate tab15 mg

4

L-METHYLFOLATE CA ME-CBL - l-methylfolate-algae-b12-acetylcyst tab6-90.314-2-600mg

4

L-METHYLFOLATE CA/ME-CBL/ -l-methylfolate-methylcobalamin-acetylcyst tab 6-2-600 mg

4

L-METHYLFOLATE CA/P-5-P/M - l-methylfolate w/ vit b6-vit b12 tab3-35-2 mg

4

L-METHYLFOLATE CA/P-5-P/M - l-methylfolate-algae-vit b12-b6 cap3-90.314-2-35 mg

4

L-METHYLFOLATE CALCIUM - l-methylfolate tab 7.5 mg

4

L-METHYLFOLATE CALCIUM - l-methylfolate tab 15 mg

4

L-METHYLFOLATE FORMULA 15 - l-methylfolate-algae cap 15-90.314 mg

4

L-METHYLFOLATE FORMULA 7. - l-methylfolate-algae cap 7.5-90.314 mg

4

L-METHYLFOLATE FORTE - l-methylfolate-algae cap 7.5-90.314 mg

4

L-METHYLFOLATE FORTE - l-methylfolate-algae cap 15-90.314 mg

4

LEVOMEFOLATE CALCIUM/ACET - l-methylfolate-algae-b12-acetylcyst tab6-90.314-2-600mg

4

LEVOMEFOLATE CALCIUM/ALGA - l-methylfolate-algae cap 7.5-90.314 mg

4

LEVOMEFOLATE CALCIUM/ALGA - l-methylfolate-algae cap 15-90.314 mg

4

LEVOMEFOLATE CALCIUM/PYRI -l-methylfolate-algae-vit b12-b6 cap3-90.314-2-35 mg

4

LIMBREL - flavocoxid cap 250 mg 4

LIMBREL - flavocoxid cap 500 mg 4

Drug Name Dru

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LIMBREL250 - flavocoxid-citrated zincbisglycinate cap 250-50 mg

4

LIMBREL500 - flavocoxid-citrated zincbisglycinate cap 500-50 mg

4

LMTHF/PYRIDOXINE HCL/CYAN -l-methylfolate w/ vit b6-vit b12 tab1.13-25-2 mg

4

METAFOLBIC - l-methylfolate w/ vitb12-vit b6-vit b2 tab 6-1-50-5 mg

4

METAFOLBIC PLUS - l-methylfolate-methylcobalamin-acetylcyst tab6-2-600 mg

4

METAFOLBIC PLUS RF - l-methylfolate-algae-b12-acetylcyst tab6-90.314-2-600mg

4

METANX - l-methylfolate w/ vit b6-vitb12 tab 3-35-2 mg

4

METANX - l-methylfolate-algae-vit b12-b6 cap 3-90.314-2-35 mg

4

METHYLFOL-ALGAE-B12-ACETY - l-methylfolate-algae-b12-acetylcyst tab6-90.314-2-600mg

4

PKU EASY MICROTABS - nutritionalsupplement tabs delayed release

4

PODIAPN - l-methylfolate-b12-b6-alphalipoic ac cap 5-2-35-300 mg

4

Q-TABS - levomefolate glucosamine tab1 mg (folate equivalent)

4

TEARS AGAIN HYDRATE - flaxseedoil-evening primrose-bilberry cap1000-500-40 mg

4

VAYACOG - phosphatidylserine-dha-epa cap 100-19.5-6.5 mg

4

VAYARIN - phosphatidylserine-dha-epacap 75-21.5-8.5 mg

4

VAYAROL - phytosterol esters-dha-epacap 630-232.5-92.5 mg

4

VITA-RESPA - folic acid-pyridoxine-cyanocobalamin tab 2.2-25-1.3 mg

4

VITACIRC-B - l-methylfolate w/ vit b6-vitb12 tab 3-35-2 mg

4

2015


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VP-GSTN - genistein-zinc amino acidchelate-vitamin d cap

4

ZYTAZE - zinc citrate-phytase cap25-500 mg

4

HEMATOLOGICAL AGENTS

HEMATOPOIETIC AGENTS

ABANEU-SL - cyanocobalamin-methylcobalamin tab sl 600-600 mcg

4

ACTIVE FE - fe carbonyl-fa-b complex-a-c-d-e-min tab 75-1.25 mg

4

ANIMI-3 - folic acid-vit b6-vit b12-omega3-phytosterols cap 1 mg

4

ANIMI-3 - folic acid-b6-b12-d-omega 3-phytosterols cap 1 mg

4

ANIMI-3/VITAMIN D - folic acid-b6-b12-d-omega 3-phytosterols cap 1 mg

4

ARANESP ALBUMIN FREE -darbepoetin alfa-polysorbate 80 solninj 10 mcg/0.4ml

5 •

ARANESP ALBUMIN FREE -darbepoetin alfa-polysorbate 80 solninj 25 mcg/ml

5 •


5 •


5 •


5 •


5 •


5 •


5 •

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5 •


5 •


5 •


5 •


5 •


5 •


5 •

B-6 FOLIC ACID - cobalaminecombination cap

4

BIFERARX - polysacch fe cmplx-feheme poly-fa-b12 tab 22-6-1-0.025mg

4

BP VIT 3 - folic acid-vit b6-vit b12-omega 3-phytosterols cap 1 mg

4

BP VIT 3 PLUS - folic acid-b6-b12-d-omega 3-phytosterols cap 1 mg

4

carbonyl iron susp 15 mg/1.25ml(elemental iron)

1

CENFOL - folic acid-vitamin b6-vitaminb12 tab 2.3-24.5-2 mg

4

CENTRATEX - ferrous fumarate-fa-bcomplex-c-zn-mg-mn-cu cap 106-1mg

4

CERDELGA - eliglustat tartrate cap 84mg (base equivalent)

5

CIFEREX - folic acid-cholecalciferol cap1 mg-3775 unit

4

2015


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CORVITE FE - iron combination tab 4

CORVITE 150 - iron-folic acid-vit c-vitb6-vit b12-zinc tab 150-1.25 mg

4

CORVITE 150 - iron combination tab 4

cyanocobalamin inj 1000 mcg/ml 1

DIVISTA - folic acid-vit b6-vit b12-omega 3-biotin-cr cap 1 mg

4

DROXIA - hydroxyurea cap 200 mg 4



DURACHOL - folic acid-cholecalciferolcap 1 mg-3775 unit

4

ED CYTE F - ferrous fumarate-folicacid-docusate sodium tab 324-1-50mg

4

EPOGEN - epoetin alfa inj 2000 unit/ml 5 •EPOGEN - epoetin alfa inj 3000 unit/ml 5 •EPOGEN - epoetin alfa inj 4000 unit/ml 5 •EPOGEN - epoetin alfa inj 10000 unit/ml 5 •EPOGEN - epoetin alfa inj 20000 unit/ml 5 •FA-8 - folic acid cap 0.8 mg 4

fe fum-iron polysacch complex-fa-b cmplx-c-zn-mn-cu cap (Tandemplus)

1

fe fumarate w/ b12-vit c-fa-ifc cap110-0.015-75-0.5-240 mg

1

fe fumarate-vit c-vit b12-fa cap 460(151 fe)-60-0.01-1 mg

1

FE 90 PLUS - fe carbonyl-fe gluconate-fa-vit b12-vit c-dss tab 90-1 mg

4

FER-IN-SOL - ferrous sulfate soln 75mg/ml (15 mg/ml elemental fe)

4

FERIVA - fe bisglycin-fe carbonyl-c-fa-b12-biotin-dss cap 75-1 mg

4

FERIVA 21/7 - fe asparto gly-b12-fa-c-dss-succinic acid-zn tab 75-1 mg

4

FERIVAFA - iron-c-fa-b12-biotin-copper-docusate cap 110-1 mg

4

Drug Name Dru

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FERRALET 90 - fe carbonyl-fegluconate-fa-vit b12-vit c-dss tab 90-1mg

4

FERRAPLUS 90 - iron-folic acid-vit b12-vit c-docusate sod tab 90-1 mg

4

FERRETTS CHEWABLE IRON -carbonyl iron chew tab 18 mg(elemental iron)

4

FERREX 150 FORTE PLUS - fe aspgly-fe polysacch-succ ac-c-threon ac-b12-fa cap

4

FERREX 28 - fe asparto gly-fe fum-b12-fa-c-succinic ac tab ther pack

4

FERRO-PLEX HEMATINIC - fe fum-dss-vit c-vit e-vit b12-if-fa tab 115-1mg

4

FERROTRIN - iron w/ b12-vit c-fa-ifccap 36-0.015-75-0.5-240 mg

4

ferrous fumarate-fa-b complex-c-zn-mg-mn-cu tab 106-1 mg

1

ferrous fumarate-folic acid tab324-1 mg

1

FERROUS SULFATE - ferrous sulfatesyrup 300 mg/5ml (60 mg/5mlelemental fe)

4

FERROUS SULFATE - ferrous sulfateliquid 220 mg/5ml (44 mg/5mlelemental fe)

4

ferrous sulfate elixir 220 mg/5ml(44 mg/5ml elemental fe)

1

ferrous sulfate soln 75 mg/ml (15 mg/ml elemental fe)

1

FOCALGIN DSS - fe carbonyl-fegluconate-fa-vit b12-vit c-dss tab 90-1mg

4

FOLGARD RX - folic acid-vitamin b6-vitamin b12 tab 2.2-25-1 mg

4

folic acid tab 400 mcg 1

folic acid tab 800 mcg 1

folic acid tab 1 mg 1

2015


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folic acid-vitamin b6-vitamin b12 tab2.2-25-0.5 mg

1

folic acid-vitamin b6-vitamin b12 tab2.2-25-1 mg (Folgard rx)

1

folic acid-vitamin b6-vitamin b12 tab2.5-25-1 mg

1

FOLIVANE-F - fe fum-fe poly-fa-c-b3cap 62.5-62.5-1-40-3mg(125 mg fe)

4

FOLIVANE-PLUS - fe fum-ironpolysacch complex-fa-b complex-c-biotin cap

4

FUSION PLUS - fe fum-iron poly cmplx-fa-b cmplx-c-biotin-probiotic cap

4

GRANIX - tbo-filgrastim soln prefilledsyringe 300 mcg/0.5ml

4

GRANIX - tbo-filgrastim soln prefilledsyringe 480 mcg/0.8ml

4

HEMATOGEN FA - fe fumarate-vit c-vitb12-fa cap 200-250-0.01-1 mg

4

HEMATRON-AF - iron-docusate-b12-folic acid-c-e-cu-biotin tab 150-1 mg

4

HEMETAB - polysacch fe cmplx-feheme poly-fa-b12 tab 22-6-1-0.025mg

4

HEMOCYTE PLUS - ferrous fumarate-fa-b complex-c-zn-mg-mn-cu cap106-1 mg

4

ICAR - carbonyl iron chew tab 15 mg(elemental iron)

4

ICAR PEDIATRIC - carbonyl iron susp15 mg/1.25ml (elemental iron)

4

ICAR-C PLUS - iron-vit c-vit b12-folicacid tab 100-250-0.025-1 mg

4

INTEGRA F - fe fum-fe poly-fa-c-b3 cap62.5-62.5-1-40-3mg(125 mg fe)

4

INTEGRA PLUS - fe fum-iron polysacchcomplex-fa-b complex-c-biotin cap

4

IRON ASP GLY/ POLYSACCH C - feasp gly-fe polysacch-succ ac-c-threonac-b12-fa cap

4

Drug Name Dru

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IRON CHEWS PEDIATRIC - carbonyliron chew tab 15 mg (elemental iron)

2

iron combination cap 1

iron polysacch complex-vit b12-facap 150-0.025-1 mg

1

iron-docusate-b12-folic acid-c-e-cu-biotin tab 150-1 mg (Hematron-af)

1

iron-folic acid-vit c-vit b6-vit b12-zinctab 150-1.25 mg (Corvite 150)

2

iron-vit c-vit b12-folic acid tab100-250-0.025-1 mg (Icar-c plus)

1

IROSPAN 24/6 - fe bisglyc-fe polys-succacd-b cmplx-c-ca-fa tab ther pk

4

IS 24/6 - fe bisglyc-fe polys-succ acd-bcmplx-c-ca-fa tab ther pk

4

LEUKINE - sargramostim lyophilized forinj 250 mcg

5 •

MAXARON FORTE - fe gly-fe fum-vit c-vit b12-methylfolate tab

4

MAXFE - iron-fa-vit b12-biotin-vit c-docusate-mg-zn tab 160-1 mg

4

MIRCERA - methoxy polyethyleneglycol-epoetin beta inj 50 mcg/0.3ml

4


4


4


4

MULTIGEN - fe asparto gly-succ acd-c-threonic acd-b12-des stom tab

4

MULTIGEN FOLIC - fe asparto gly-succinic acd-vit c-threonic acd-b12-fatab

4

MULTIGEN PLUS - fe aspart gly-fe fum-succ acd-c-threonic acd-b12-fa tab

4

MV FE ASPARTO GLY/FE FUM/ - feaspart gly-fe fum-succ acd-c-threonicacd-b12-fa tab

4

2015


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MV FE ASPARTO GLY/VIT C/V - feasparto gly-succ acd-c-threonic acd-b12-des stom tab

4

MYKIDZ IRON 10 - iron susp 15mg/1.5ml

4

NASCOBAL - cyanocobalamin nasalspray 500 mcg/0.1ml

4

NATALVIRT FLT - fe carbonyl-fegluconate-fa-vit b12-vit c-dss tab 90-1mg

4

NEPHRON FA - ferrous fumarate w/ fa-dss-b complex-vit c tab

4

NEULASTA - pegfilgrastim inj 6mg/0.6ml

5 •

NEULASTA DELIVERY KIT -pegfilgrastim inj 6 mg/0.6ml

5 •

NEUMEGA - oprelvekin for inj 5 mg 5 •NEUPOGEN - filgrastim inj 300 mcg/ml 5 •NEUPOGEN - filgrastim inj 480

mcg/1.6ml (300 mcg/ml)5 •

NEUPOGEN - filgrastim inj 300mcg/0.5ml (600 mcg/ml)

5 •

NEUPOGEN - filgrastim inj 480mcg/0.8ml (600 mcg/ml)

5 •

NEURIN-SL - cyanocobalamin-methylcobalamin tab sl 600-600 mcg

4

NOVAFERRUM - polysacch ironcomplex-vit c-fa for soln 100-60-1mg/5ml

4

PRE-FOLIC - folic acid-vitamin c tab1-100 mg

4

PROCRIT - epoetin alfa inj 2000 unit/ml 5 •PROCRIT - epoetin alfa inj 3000 unit/ml 5 •PROCRIT - epoetin alfa inj 4000 unit/ml 5 •PROCRIT - epoetin alfa inj 10000 unit/

ml5 •

PROCRIT - epoetin alfa inj 20000 unit/ml

5 •

PROCRIT - epoetin alfa inj 40000 unit/ml

5 •

Drug Name Dru

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PROFERRIN-FORTE - iron hemepolypeptide-folic acid tab 12-1 mg (feequiv)

4

PROMACTA - eltrombopag olamine tab12.5 mg (base equiv)

5 • •

PROMACTA - eltrombopag olamine tab25 mg (base equiv)

5 • •


5 • •


5 • •

PROTECTIRON - iron polysacch-fa-bcomplex-vit c-e & minerals tab 60-1mg

4

PUREFE PLUS - ferrous fumarate-fa-b complex-c-zn-mg-mn-cu cap 106-1mg

4

REVESTA - folic acid-cholecalciferolcap 1 mg-5750 unit

4

SPATONE PUR-ABSORB IRON -ferrous sulfate liquid 5 mg/20ml(elemental iron)

4

TANDEM F - ferrous fum-ironpolysacch-fa cap 162-115.2-1 mg(106 mg fe)

4

TANDEM PLUS - fe fum-iron polysacchcomplex-fa-b cmplx-c-zn-mn-cu cap

4

TARON FORTE - fe bisglycinate-fepolysacch-vit c-vit b12-fa cap

4

ZAVESCA - miglustat cap 100 mg 5 •ANTICOAGULANTS

ARIXTRA - fondaparinux sodiumsubcutaneous inj 2.5 mg/0.5ml

4 •

ARIXTRA - fondaparinux sodiumsubcutaneous inj 5 mg/0.4ml

4 •

ARIXTRA - fondaparinux sodiumsubcutaneous inj 7.5 mg/0.6ml

4 •

ARIXTRA - fondaparinux sodiumsubcutaneous inj 10 mg/0.8ml

4 •

COUMADIN - warfarin sodium tab 1 mg 4

2015


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COUMADIN - warfarin sodium tab 2.5mg

4





COUMADIN - warfarin sodium tab 7.5mg

4

COUMADIN - warfarin sodium tab 10mg

4

ELIQUIS - apixaban tab 2.5 mg 4 •ELIQUIS - apixaban tab 5 mg 4 •enoxaparin sodium inj 30 mg/0.3ml

(Lovenox)2 •

enoxaparin sodium inj 40 mg/0.4ml(Lovenox)

2 •


2 •


2 •

enoxaparin sodium inj 100 mg/ml(Lovenox)

2 •


2 •

enoxaparin sodium inj 150 mg/ml(Lovenox)

2 •

enoxaparin sodium inj 300 mg/3ml(Lovenox)

2 •

fondaparinux sodium subcutaneousinj 2.5 mg/0.5ml (Arixtra)

2 •

fondaparinux sodium subcutaneousinj 5 mg/0.4ml (Arixtra)

2 •

fondaparinux sodium subcutaneousinj 7.5 mg/0.6ml (Arixtra)

2 •

fondaparinux sodium subcutaneousinj 10 mg/0.8ml (Arixtra)

2 •

FRAGMIN - dalteparin sodium inj 10000unit/ml

4 •

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its

FRAGMIN - dalteparin sodium inj 2500unit/0.2ml

4 •


4 •


4 •


4 •


4 •


4 •


4 •

HEPARIN SODIUM - heparin sodium(porcine) inj 2000 unit/ml

4

HEPARIN SODIUM - heparin sodium(porcine) inj 2500 unit/ml

4

heparin sodium (porcine) inj 1000unit/ml

2


2


2


2

heparin sodium (porcine) pf inj 5000unit/0.5ml

2

LOVENOX - enoxaparin sodium inj 30mg/0.3ml

4 •


4 •


4 •


4 •

LOVENOX - enoxaparin sodium inj 100mg/ml

4 •


4 •

2015


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its

LOVENOX - enoxaparin sodium inj 150mg/ml

4 •

LOVENOX - enoxaparin sodium inj 300mg/3ml

4 •

PRADAXA - dabigatran etexilatemesylate cap 75 mg (etexilate baseeq)

4 •

PRADAXA - dabigatran etexilatemesylate cap 150 mg (etexilate baseeq)

4 •

SAVAYSA - edoxaban tosylate tab 15mg (base equivalent)

4 •


4 •


4 •

warfarin sodium tab 1 mg (Coumadin) 1


warfarin sodium tab 2.5 mg(Coumadin)

1





warfarin sodium tab 7.5 mg(Coumadin)

1

warfarin sodium tab 10 mg(Coumadin)

1

XARELTO - rivaroxaban tab 10 mg 4 •XARELTO - rivaroxaban tab 15 mg 4 •XARELTO - rivaroxaban tab 20 mg 4 •XARELTO STARTER PACK -

rivaroxaban tab starter therapy pack15 mg & 20 mg

4 •

HEMOSTATICS

AMICAR - aminocaproic acid syrup 25% 4

AMICAR - aminocaproic acid oral soln0.25 gm/ml

4

Drug Name Dru

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AMICAR - aminocaproic acid tab 500mg

4

AMICAR - aminocaproic acid tab 1000mg

4

AMINOCAPROIC ACID - aminocaproicacid tab 1000 mg

4

LYSTEDA - tranexamic acid tab 650 mg 4

tranexamic acid tab 650 mg (Lysteda) 2

HEMATOLOGICAL AGENTS - MISC.

ADVATE - antihemophilic factor rahf-pfm for inj 250 unit

5 •


5 •


5 •


5 •


5 •


5 •


5 •

AGGRENOX - aspirin-dipyridamole capsr 12hr 25-200 mg

4

AGRYLIN - anagrelide hcl cap 0.5 mg 4

ALPHANATE/VON WILLEBRAND -antihemophilic factor/vwf (human) forinj 250 unit

5 •


5 •


5 •


5 •

2015


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5 •

ALPHANINE SD - coagulation factor ixfor inj 500 unit

5 •


5 •


5 •

ALPROLIX - coagulation factor ix(recomb) (rfixfc) for inj 500 unit

5 •


5 •


5 •


5 •

anagrelide hcl cap 0.5 mg (Agrylin) 2

anagrelide hcl cap 1 mg 2

ASPIRIN/DIPYRIDAMOLE - aspirin-dipyridamole cap sr 12hr 25-200 mg

4

BEBULIN - factor ix complex for inj200-1200 unit

5 •

BEBULIN VH - factor ix complex for inj200-1200 unit

5 •

BENEFIX - coagulation factor ix(recombinant) for inj 250 unit

5 •


5 •


5 •


5 •


5 •

BERINERT - c1 esterase inhibitor(human) for iv inj kit 500 unit

5 •

BRILINTA - ticagrelor tab 90 mg 4

cilostazol tab 50 mg (Pletal) 1

cilostazol tab 100 mg (Pletal) 1

Drug Name Dru

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clopidogrel bisulfate tab 75 mg (baseequiv) (Plavix)

1

clopidogrel bisulfate tab 300 mg(base equiv) (Plavix)

2

CORIFACT - factor xiii concentrate(human) for inj kit 1000-1600 unit

5 •

dipyridamole tab 25 mg (Persantine) 1



EFFIENT - prasugrel hcl tab 5 mg (baseequiv)

4

EFFIENT - prasugrel hcl tab 10 mg(base equiv)

4

ELOCTATE - antihemophilic factor(recomb) rfviiifc for inj 250 unit

5 •


5 •


5 •


5 •


5 •


5 •


5 •

FEIBA - antiinhibitor coagulant complexfor inj

5 •

FEIBA NF - antiinhibitor coagulantcomplex for inj

5 •

FIRAZYR - icatibant acetate inj 30mg/3ml (base equivalent)

5 • •

HELIXATE FS - antihemophilic factor(recombinant) for inj kit 250 unit

5 •


5 •


5 •

2015


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5 •


5 •

HEMOFIL M - antihemophilic factor(human) for inj 220-400 unit

5 •

HEMOFIL M - antihemophilic factor(human) for inj 250 unit

5 •


5 •


5 •


5 •


5 •


5 •


5 •

HUMATE-P - antihemophilic factor/vwf(human) for inj 250-600 unit

5 •


5 •


5 •

IXINITY - coagulation factor ix(recombinant) for inj 500 unit

5 •


5 •


5 •

KOATE-DVI - antihemophilic factor(human) for inj 250 unit

5 •


5 •


5 •

KOGENATE FS - antihemophilic factor(recombinant) for inj kit 250 unit

5 •

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5 •


5 •


5 •


5 •

KOGENATE FS BIO-SET -antihemophilic factor (recombinant)for inj kit 250 unit

5 •


5 •


5 •


5 •


5 •

MONOCLATE-P - antihemophilic factor(human) for inj kit 250 unit

5 •


5 •


5 •


5 •

MONONINE - coagulation factor ix forinj 250 unit

5 •


5 •


5 •

NOVOEIGHT - antihemophilic factor(recombinant) for inj 250 unit

5 •


5 •

2015


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5 •


5 •


5 •


5 •

NOVOSEVEN - coagulation factor viia(recomb) for inj 2.4 mg (2400 mcg)

5 •

NOVOSEVEN RT - coagulation factorviia (recomb) for inj 1 mg (1000 mcg)

5 •


5 •


5 •


5 •

pentoxifylline tab cr 400 mg 1

PERSANTINE - dipyridamole tab 25 mg 4



PLAVIX - clopidogrel bisulfate tab 75 mg(base equiv)

4

PLAVIX - clopidogrel bisulfate tab 300mg (base equiv)

4

PLETAL - cilostazol tab 50 mg 4

PLETAL - cilostazol tab 100 mg 4

PROFILNINE - factor ix complex for inj500 unit

5 •


5 •


5 •

PROFILNINE SD - factor ix complex forinj 500 unit

5 •


5 •

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5 •

RECOMBINATE - antihemophilic factor(recombinant) for inj 220-400 unit

5 •


5 •


5 •


5 •


5 •

RIXUBIS - coagulation factor ix(recombinant) for inj 250 unit

5 •


5 •


5 •


5 •


5 •

ticlopidine hcl tab 250 mg 2

TRETTEN - coagulation factor xiii a-subunit for inj 2000-3125 unit

5 •

WILATE - antihemophilic factor/vwf(human) for inj 500-500 unit

5 •

WILATE - antihemophilic factor/vwf(human) for inj 1000-1000 unit

5 •

XYNTHA - antihemophilic factorrecombinant paf for inj kit 250 unit

5 •


5 •


5 •


5 •

XYNTHA SOLOFUSE - antihemophilicfactor recombinant paf for inj kit 250unit

5 •

2015


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5 •


5 •


5 •


5 •

ZONTIVITY - vorapaxar sulfate tab 2.08mg (base equivalent)

4

TOPICAL PRODUCTS

OPHTHALMIC AGENTS

ACULAR - ketorolac tromethamineophth soln 0.5%

4

ACULAR LS - ketorolac tromethamineophth soln 0.4%

4

ACUVAIL - ketorolac tromethamineophth soln 0.45%

4

AKTEN - lidocaine hcl ophth gel 3.5% 4

ALCAINE - proparacaine hcl ophth soln0.5%

4

ALOCRIL - nedocromil sodium ophthsoln 2%

4

ALOMIDE - lodoxamide tromethamineophth soln 0.1%

4

ALPHAGAN P - brimonidine tartrateophth soln 0.1%

4

ALPHAGAN P - brimonidine tartrateophth soln 0.15%

4

ALREX - loteprednol etabonate ophthsusp 0.2%

4

apraclonidine hcl ophth soln 0.5%(base equivalent) (Iopidine)

2

ATROPINE SULFATE - atropine sulfateophth oint 1%

4

Drug Name Dru

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atropine sulfate ophth soln 1%(Isopto atropine)

1

AZASITE - azithromycin ophth soln 1% 4

azelastine hcl ophth soln 0.05%(Optivar)

2

AZOPT - brinzolamide ophth susp 1% 4

BACITRACIN - bacitracin ophth oint 500unit/gm

3

bacitracin-polymyxin b ophth oint 1

bacitracin-polymyxin-neomycin-hcophth oint 1%

2

BEPREVE - bepotastine besilate ophthsoln 1.5%

4

BESIVANCE - besifloxacin hcl ophthsusp 0.6% (base equiv)

4

BETADINE OPHTHALMIC PREP -povidone-iodine ophth soln 5%

4

BETAGAN - levobunolol hcl ophth soln0.5%

4

betaxolol hcl ophth soln 0.5% 2

BETIMOL - timolol ophth soln 0.25% 4

BETIMOL - timolol ophth soln 0.5% 4

BETOPTIC-S - betaxolol hcl ophth susp0.25%

4

BIMATOPROST - bimatoprost ophthsoln 0.03%

4 •

BLEPH-10 - sulfacetamide sodiumophth soln 10%

4

BLEPHAMIDE - sulfacetamide sodium-prednisolone ophth susp 10-0.2%

4

BLEPHAMIDE S.O.P. - sulfacetamidesodium-prednisolone ophth oint10-0.2%

4

brimonidine tartrate ophth soln0.15% (Alphagan p)

2

brimonidine tartrate ophth soln 0.2% 1

bromfenac sodium ophth soln 0.09%(base equivalent)

2

2015


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bromfenac sodium ophth soln 0.09%(base equiv) (once-daily)

2

carteolol hcl ophth soln 1% 1

CILOXAN - ciprofloxacin hcl ophth soln0.3%

4

CILOXAN - ciprofloxacin hcl ophth oint0.3%

4

ciprofloxacin hcl ophth soln 0.3%(Ciloxan)

1

COMBIGAN - brimonidine tartrate-timolol maleate ophth soln 0.2-0.5%

4

COSOPT - dorzolamide hcl-timololmaleate ophth soln 22.3-6.8 mg/ml

4

COSOPT PF - dorzolamide hcl-timololmaleate ophth sol 22.3-6.8 mg/ml pf

4

cromolyn sodium ophth soln 4% 1

CYCLOGYL - cyclopentolate hcl ophthsoln 0.5%

4

CYCLOGYL - cyclopentolate hcl ophthsoln 1%

4

CYCLOGYL - cyclopentolate hcl ophthsoln 2%

4

CYCLOMYDRIL - cyclopentolate w/phenylephrine ophth soln 0.2-1%

4

cyclopentolate hcl ophth soln 1%(Cyclogyl)

1

cyclopentolate hcl ophth soln 2%(Cyclogyl)

2

CYSTARAN - cysteamine hcl ophth soln0.44% (base equivalent)

5 •

dexamethasone sodium phosphateophth soln 0.1%

1

diclofenac sodium ophth soln 0.1% 1

dorzolamide hcl ophth soln 2%(Trusopt)

2

dorzolamide hcl-timolol maleateophth soln 22.3-6.8 mg/ml (Cosopt)

1

DUREZOL - difluprednate ophthemulsion 0.05%

4

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ELESTAT - epinastine hcl ophth soln0.05%

4

EMADINE - emedastine difumarateophth soln 0.05% (base equiv)

4

epinastine hcl ophth soln 0.05%(Elestat)

2

erythromycin ophth oint 5 mg/gm 1

FLAREX - fluorometholone acetateophth susp 0.1%

4

fluorometholone ophth susp 0.1%(Fml liquifilm)

1

flurbiprofen sodium ophth soln0.03% (Ocufen)

1

FML - fluorometholone ophth oint 0.1% 4

FML FORTE - fluorometholone ophthsusp 0.25%

4

FML LIQUIFILM - fluorometholoneophth susp 0.1%

4

GARAMYCIN - gentamicin sulfate ophthsoln 0.3%

4

gatifloxacin ophth soln 0.5%(Zymaxid)

2

GELFILM OP - gelatin adsorbable ophthfilm

4

gentamicin sulfate ophth oint 0.3% 1

gentamicin sulfate ophth soln 0.3%(Garamycin)

1

homatropine hbr ophth soln 5%(Isopto homatropine)

1

ILEVRO - nepafenac ophth susp 0.3% 4

IOPIDINE - apraclonidine hcl ophth soln0.5% (base equivalent)

4

IOPIDINE - apraclonidine hcl ophth soln1% (base equivalent)

4

ISOPTO ATROPINE - atropine sulfateophth soln 1%

4

ISOPTO CARBACHOL - carbacholophth soln 1.5%

4

ISOPTO CARBACHOL - carbacholophth soln 3%

4

2015


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ISOPTO CARPINE - pilocarpine hclophth soln 1%

4


4


4

ISOPTO HOMATROPINE - homatropinehbr ophth soln 2%

4

ISOPTO HOMATROPINE - homatropinehbr ophth soln 5%

4

ISOPTO HYOSCINE - scopolamine hbrophth soln 0.25%

4

ISTALOL - timolol maleate ophth soln0.5% (once-daily)

4

ketorolac tromethamine ophth soln0.4% (Acular ls)

2

ketorolac tromethamine ophth soln0.5% (Acular)

2

LACRISERT - artificial tear ophth insert 4

LASTACAFT - alcaftadine ophth soln0.25%

4

latanoprost ophth soln 0.005%(Xalatan)

1 •

LEVOBUNOLOL HCL - levobunolol hclophth soln 0.25%

4

levobunolol hcl ophth soln 0.5%(Betagan)

1

levofloxacin ophth soln 0.5% 2

LOTEMAX - loteprednol etabonateophth gel 0.5%

4

LOTEMAX - loteprednol etabonateophth oint 0.5%

4

LOTEMAX - loteprednol etabonateophth susp 0.5%

4

LUMIGAN - bimatoprost ophth soln0.01%

4 •

MAXIDEX - dexamethasone ophth susp0.1%

4

MAXITROL - neomycin-polymyxin-dexamethasone ophth susp 0.1%

4

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MAXITROL - neomycin-polymyxin-dexamethasone ophth oint 0.1%

4

METIPRANOLOL - metipranolol ophthsoln 0.3%

4

MITOSOL - mitomycin for ophth soln kit0.2 mg

4

MOXEZA - moxifloxacin hcl ophth soln0.5% (base eq) (2 times daily)

4

MYDRIACYL - tropicamide ophth soln1%

4

NAPHAZOLINE HCL - naphazoline hclophth soln 0.1%

4

NATACYN - natamycin ophth susp 5% 3

neomycin-bacitrac zn-polymyx5(3.5)mg-400unt-10000unt op oin

2

neomycin-polymy-gramicid op sol1.75-10000-0.025mg-unt-mg/ml(Neosporin)

2

neomycin-polymyxin-dexamethasone ophth oint 0.1%(Maxitrol)

1

neomycin-polymyxin-dexamethasone ophth susp 0.1%(Maxitrol)

1

NEOMYCIN/POLYMYXIN/HYDROC -neomycin-polymyxin-hc ophth susp

4

NEOSPORIN - neomycin-polymy-gramicid op sol 1.75-10000-0.025mg-unt-mg/ml

4

NEVANAC - nepafenac ophth susp0.1%

4

OCUFEN - flurbiprofen sodium ophthsoln 0.03%

4

OCUFLOX - ofloxacin ophth soln 0.3% 4

ofloxacin ophth soln 0.3% (Ocuflox) 1

OMNIPRED - prednisolone acetateophth susp 1%

4

PATADAY - olopatadine hcl ophth soln0.2%

4

2015


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PATANOL - olopatadine hcl ophth soln0.1%

4

PAZEO - olopatadine hcl ophth soln0.7% (base equivalent)

4

phenylephrine hcl ophth soln 2.5% 1

phenylephrine hcl ophth soln 10% 1

PHOSPHOLINE IODIDE -echothiophate iodide ophth for soln0.125%

4

pilocarpine hcl ophth soln 1% (Isoptocarpine)

2


2


2

polymyxin b-trimethoprim ophthsoln 10000 unit/ml-0.1% (Polytrim)

1

POLYTRIM - polymyxin b-trimethoprimophth soln 10000 unit/ml-0.1%

4

PRED FORTE - prednisolone acetateophth susp 1%

4

PRED MILD - prednisolone acetateophth susp 0.12%

4

PRED-G - gentamicin-prednisolone aceophth susp 0.3-1%

4

PRED-G S.O.P. - gentamicin-prednisolone ace ophth oint 0.3-0.6%

4

prednisolone acetate ophth susp 1%(Pred forte)

2

PREDNISOLONE SODIUM PHOSP -prednisolone sodium phosphateophth soln 1%

4

PROLENSA - bromfenac sodium ophthsoln 0.07% (base equivalent)

4

proparacaine hcl ophth soln 0.5%(Alcaine)

1

RESCULA - unoprostone isopropylophth soln 0.15%

4

RESTASIS - cyclosporine (ophth)emulsion 0.05%

4

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SIMBRINZA - brinzolamide-brimonidinetartrate ophth susp 1-0.2%

4

SULFACETAMIDE SODIUM -sulfacetamide sodium ophth oint 10%

4

sulfacetamide sodium ophth soln10% (Bleph-10)

2

sulfacetamide sodium-prednisoloneophth soln 10-0.23(0.25)%

1

tetracaine hcl ophth soln 0.5% 1

timolol maleate ophth gel formingsoln 0.25% (Timoptic-xe)

2

timolol maleate ophth gel formingsoln 0.5% (Timoptic-xe)

2

timolol maleate ophth soln 0.25%(Timoptic)

1

timolol maleate ophth soln 0.5%(Timoptic)

1

TIMOPTIC - timolol maleate ophth soln0.25%

4

TIMOPTIC - timolol maleate ophth soln0.5%

4

TIMOPTIC OCUDOSE - timolol maleatepreservative free ophth soln 0.25%

4

TIMOPTIC OCUDOSE - timolol maleatepreservative free ophth soln 0.5%

4

TIMOPTIC-XE - timolol maleate ophthgel forming soln 0.25%

4

TIMOPTIC-XE - timolol maleate ophthgel forming soln 0.5%

4

TOBRADEX - tobramycin-dexamethasone ophth oint 0.3-0.1%

4

TOBRADEX - tobramycin-dexamethasone ophth susp 0.3-0.1%

4

TOBRADEX ST - tobramycin-dexamethasone ophth susp0.3-0.05%

4

tobramycin ophth soln 0.3% (Tobrex) 1

tobramycin-dexamethasone ophthsusp 0.3-0.1% (Tobradex)

2

TOBREX - tobramycin ophth soln 0.3% 4

2015


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TOBREX - tobramycin ophth oint 0.3% 4

TRAVATAN Z - travoprost ophth soln0.004% (benzalkonium free) (bakfree)

4 •

TRAVOPROST - travoprost ophth soln0.004%

4 •

trifluridine ophth soln 1% (Viroptic) 2

tropicamide ophth soln 0.5% 1

tropicamide ophth soln 1%(Mydriacyl)

1

TRUSOPT - dorzolamide hcl ophth soln2%

4

VEXOL - rimexolone ophth susp 1% 4

VIGAMOX - moxifloxacin hcl ophth soln0.5% (base equiv)

4

VIROPTIC - trifluridine ophth soln 1% 4

XALATAN - latanoprost ophth soln0.005%

4 •

ZIOPTAN - tafluprost ophth soln0.0015%

4 •

ZIRGAN - ganciclovir ophth gel 0.15% 4

ZYLET - loteprednol etabonate-tobramycin ophth susp 0.5-0.3%

4

ZYMAXID - gatifloxacin ophth soln 0.5% 4

OTIC AGENTS

acetic acid otic soln 2% 2

ACETIC ACID/ALUMINUM ACET -acetic acid 2% in aluminum acetateotic soln

4

antipyrine-benzocaine otic soln54-14 mg/ml (5.4-1.4%)

1

antipyrine-benzocaine-polycosanolotic sol 5.4-1.4-0.0097% (Treaganotic)

2

ANTIPYRINE/BENZOCAINE -antipyrine-benzocaine otic soln 55-14mg/ml (5.5-1.4%)

4

AURALGAN - antipyrine-benzocaineotic soln 55-14 mg/ml (5.5-1.4%)

4

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CETRAXAL - ciprofloxacin hcl otic soln0.2% (base equivalent)

4

CIPRO HC - ciprofloxacin-hydrocortisone otic susp 0.2-1%

4

CIPRODEX - ciprofloxacin-dexamethasone otic susp 0.3-0.1%

4

CIPROFLOXACIN - ciprofloxacin hclotic soln 0.2% (base equivalent)

4

COLY-MYCIN S - neomycin-colistin-hc-thonzonium otic susp 3.3-3-10-0.5mg/ml

4

CORTANE-B AQUEOUS - pramoxine-hc-chloroxylenol aqueous otic soln10-10-1 mg/ml

4

CORTANE-B-OTIC - pramoxine-hc-chloroxylenol otic soln 10-10-1 mg/ml

4

CORTISPORIN - neomycin-polymyxin-hc otic soln 1%

4

CORTISPORIN-TC - neomycin-colistin-hc-thonzonium otic susp 3.3-3-10-0.5mg/ml

4

DERMOTIC - fluocinolone acetonide(otic) oil 0.01%

4

fluocinolone acetonide (otic) oil0.01% (Dermotic)

2

hydrocortisone w/ acetic acid oticsoln 1-2% (Vosol hc)

2

MYOXIN - benzocaine-chloroxylenol-hcotic susp 15-1-10 mg/ml

4

neomycin-polymyxin-hc otic soln 1%(Cortisporin)

2

neomycin-polymyxin-hc otic susp3.5 mg/ml-10000 unit/ml-1%

2

ofloxacin otic soln 0.3% 2

OTICIN HC NR - pramoxine-hc-chloroxylenol otic soln 10-10-1 mg/ml

4

OTOZIN - antipyrine-benzocaine-glycerin-zinc ace otic liqd 5.4-1-2-1%

4

PINNACAINE OTIC - benzocaine oticsoln 20%

4

2015


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PRAMOTIC - pramoxine-chloroxylenolotic liquid 1-0.1%

4

pramoxine-chloroxylenol otic liquid1-0.1% (Pramotic)

2

pramoxine-hc-chloroxylenol oticsoln 10-10-1 mg/ml (Cortane-b-otic)

1

TREAGAN OTIC - antipyrine-benzocaine-polycosanol otic sol5.4-1.4-0.0097%

4

MOUTH/THROAT/DENTAL AGENTS

ACT TOTAL CARE DRY MOUTH -sodium fluoride rinse 0.02%

4

AQUORAL - artificial saliva - aero soln 4

benzocaine dental soln 20% 1

CAPHOSOL - artificial saliva - solution 4

cevimeline hcl cap 30 mg (Evoxac) 2

chlorhexidine gluconate soln 0.12%(Peridex)

1

clotrimazole troche 10 mg 2

COLGATE DRY MOUTH RELIEF -sodium fluoride mouthwash 2.1mg/10ml

4

DEBACTEROL - sulfuric acid-sulfonatedphenolics soln 30-50%

4

EVOXAC - cevimeline hcl cap 30 mg 4

FLUORIDEX DAILY DEFENSE S -sodium fluoride-potassium nitrate gel1.1-5%

4

GEL-KAM - stannous fluoride gel 0.4% 4

GEL-KAM ORAL CARE RINSE -stannous fluoride conc 0.63%

4

GELCLAIR - povidone-sodiumhyaluronate-glycyrrhetinic acid gel

4

GELX - oral wound care products - gel 4

lidocaine hcl laryngotracheal soln4% (Lta 360 kit)

2

lidocaine hcl viscous soln 2% 1

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its

LISTERINE ESSENTIAL CARE - sodmonofluorophosph-eucal-men-methylsal-thymol gel 0.76%

4

LISTERINE RESTORING - sodiumfluoride rinse 0.0221% (0.01% f)

4

LISTERINE SMART RINSE - sodiumfluoride rinse 0.0221% (0.01% f)

4

LISTERINE SMART RINSE ANT -sodium fluoride rinse 0.02%

4

LISTERINE TOOTH DEFENSE -sodium fluoride rinse 0.0221%(0.01% f)

4

LISTERINE TOTAL CARE - sodiumfluoride rinse 0.0221% (0.01% f)

4

LISTERINE TOTAL CARE PLUS -sodium fluoride rinse 0.0221%(0.01% f)

4

LISTERINE TOTAL CARE ZERO -sodium fluoride rinse 0.02%

4

LISTERINE WHITENING/RESTO -sodium fluoride rinse 0.0221%(0.01% f)

4

LTA 360 KIT - lidocaine hcllaryngotracheal soln 4%

4

mouthwashes - liquid 2

MUCOTROL - oral wound care products- wafer

4

NAFRINSE DAILY/ACIDULATED -sodium fluoride-phosphoric acid forsoln 1 mg/5ml (f equiv)

4

NAFRINSE DAILY/NEUTRAL - sodiumfluoride for soln rinse 0.05%

4

NAFRINSE WEEKLY - sodium fluoridefor soln rinse 0.2%

4

NEUTRASAL - artificial saliva - packet 4

NUMOISYN - artificial saliva - lozenge 4

NUMOISYN - artificial saliva - solution 4

nystatin susp 100000 unit/ml 2

OMNI GEL - stannous fluoride gel 0.4% 4

2015


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its

ORAFATE - sucralfate-malate paste10%

4

ORAMAGICRX - oral wound careproducts - for susp rinse

4

ORAVIG - miconazole buccal tab 50 mg(mouth-throat)

4

PERIDEX - chlorhexidine gluconate soln0.12%

4

PHOS FLUR - sodium fluoride rinse0.044%

4

PHOS-FLUR ORTHO DEFENSE -sodium fluoride rinse 0.044%

4

pilocarpine hcl tab 5 mg (Salagen) 2

pilocarpine hcl tab 7.5 mg (Salagen) 2

PREVIDENT - sodium fluoride rinse0.2%

4

PREVIDENT FLUORIDE - sodiumfluoride gel 1.1% (0.5% f)

4

PREVIDENT 5000 BOOSTER - sodiumfluoride paste 1.1%

4

PREVIDENT 5000 BOOSTER PL -sodium fluoride paste 1.1%

4

PREVIDENT 5000 DRY MOUTH -sodium fluoride gel 1.1% (0.5% f)

4

PREVIDENT 5000 ENAMEL PRO -sodium fluoride-potassium nitratepaste 1.1-5%

4

PREVIDENT 5000 PLUS - sodiumfluoride cream 1.1%

4

PREVIDENT 5000 SENSITIVE - sodiumfluoride-potassium nitrate paste1.1-5%

4

PROTHELIAL - sucralfate-malate paste10%

4

REACH KIDS - sodium fluoride paste0.15%

4

REMBRANDT CANKER SORE -sodium fluoride paste 0.243%

4

Drug Name Dru

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REMBRANDT DEEPLY WHITE+PE -sodium monofluorophosphate paste0.884%

4

REMBRANDT INTENSE STAIN -sodium fluoride paste 0.243%

4

REMBRANDT WHITENING - sodiumfluoride rinse 0.02%

4

SALAGEN - pilocarpine hcl tab 5 mg 4

SALAGEN - pilocarpine hcl tab 7.5 mg 4

SALICEPT - oral wound care products -for susp rinse

4

sodium fluoride cream 1.1%(Prevident 5000 plus)

1

sodium fluoride gel 1.1% (0.5% f)(Prevident fluoride)

1

sodium fluoride paste 1.1%(Prevident 5000 boost)

1

sodium fluoride rinse 0.0221%(0.01% f)

2

sodium fluoride rinse 0.05% 2

sodium fluoride rinse 0.2%(Prevident)

1

sodium fluoride-potassium nitratepaste 1.1-5% (Prevident 5000 sensi)

1

stannous fluoride conc 0.63% (Gel-kam oral care ri)

1

stannous fluoride gel 0.4% 2

STANNOUS FLUORIDE RINSE -stannous fluoride liq 0.1%

4

THERA-FLUR-N - sodium fluoride gel1.1% (0.5% f)

4

triamcinolone acetonide dental paste0.1%

2

ANORECTAL AGENTS

ANALPRAM ADVANCED - hc-pramoxine cr & diet manage prod tab& cleans wipe kit

4

ANALPRAM E - hc-pramoxine emolcream 2.5-1% & pramoxine wipe 1%kit

4

2015


Drug Name Dru

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ANALPRAM-HC - hydrocortisoneacetate w/ pramoxine rectal lotn2.5-1%

4

ANALPRAM-HC - hydrocortisoneacetate w/ pramoxine rectal cream1-1%

4

ANALPRAM-HC - hydrocortisoneacetate w/ pramoxine rectal cream2.5-1%

4

ANALPRAM-HC SINGLES -hydrocortisone acetate w/ pramoxinerectal cream 1-1%

4

ANALPRAM-HC SINGLES -hydrocortisone acetate w/ pramoxinerectal cream 2.5-1%

4

ANUSOL-HC - hydrocortisone rectalcream 2.5%

4

ANUSOL-HC - hydrocortisone acetatesuppos 25 mg

4

CORTENEMA - hydrocortisone enema100 mg/60ml

4

CORTIFOAM - hydrocortisone acetaterectal foam 90 mg/dose

3

hc-pramoxine emol cream 2.5-1% &pramoxine wipe 1% kit (Analpram e)

2

hydrocortisone acetate suppos25 mg (Anusol-hc)

2

hydrocortisone acetate suppos30 mg (Proctocort)

2

hydrocortisone acetate w/ pramoxinerectal cream 1-1% (Analpram-hc)

2

hydrocortisone acetate w/ pramoxinerectal cream 2.5-1% (Analpram-hc)

2

hydrocortisone enema 100 mg/60ml(Cortenema)

2

hydrocortisone rectal cream 1%(Proctocort)

2

hydrocortisone rectal cream 2.5%(Anusol-hc)

1

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LIDOCAINE HCL-HYDROCORTIS -lidocaine-hydrocortisone acetaterectal gel 2.8-0.55%

4

lidocaine-hydrocortisone acetaterectal cream kit 2-2%

2

lidocaine-hydrocortisone acetaterectal cream kit 3-0.5%

2

lidocaine-hydrocortisone acetaterectal cream kit 3-1%

2

lidocaine-hydrocortisone acetaterectal cream 3-0.5%

2

lidocaine-hydrocortisone acetaterectal gel kit 3-2.5%

2

PROCORT - hydrocortisone acetate w/pramoxine rectal cream 1.85-1.15%

4

PROCTOCORT - hydrocortisone rectalcream 1%

4

PROCTOCORT - hydrocortisoneacetate suppos 30 mg

4

PROCTOFOAM HC - hydrocortisoneacetate w/ pramoxine rectal foam1-1%

4

RECTIV - nitroglycerin oint 0.4% 4

UCERIS - budesonide rectal foam 2 mg/act

4

DERMATOLOGICALS

ABSORICA - isotretinoin cap 10 mg 4






ACANYA - clindamycin phosphate-benzoyl peroxide gel 1.2-2.5%

4

acitretin cap 10 mg (Soriatane) 2

acitretin cap 17.5 mg (Soriatane) 2

acitretin cap 25 mg (Soriatane) 2

ACLOVATE - alclometasonedipropionate cream 0.05%

4

2015


Drug Name Dru

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its

ACUICYN DAILY EYELID & EY - eyelidcleansers - liquid

4

acyclovir oint 5% (Zovirax) 2

ACZONE - dapsone gel 5% 4

ADAPALENE - adapalene lotion 0.1% 4

adapalene cream 0.1% (Differin) 2

adapalene gel 0.1% (Differin) 2

adapalene gel 0.3% (Differin) 2

ADAZIN - benzo-capsaicin-lido-methylsalicylate cream 2-0.035-2-10%

4

ADVANCED ALLERGY COLLECTI -hydrocortisone cream kit 2.5%

4

ALA QUIN - clioquinol-hc cream 3-0.5% 4

ALA SCALP - hydrocortisone lotion 2% 4

alclometasone dipropionate cream0.05% (Aclovate)

2

alclometasone dipropionate oint0.05%

2

ALCORTIN A - iodoquinol-hydrocortisone-aloe polysaccharidegel 1-2-1%

4

ALDARA - imiquimod cream 5% 4 •ALEGENIX - capsaicin-menthol disk

0.0375-5%4

ALEVEER - capsaicin-menthol topicalpatch 0.0375-5%

4

ALEVICYN DERMAL SPRAY - wounddressings - soln

4

ALLEVYN AG ADHESIVE - wounddressings - pads

4

ALLEVYN AG GENTLE BORDER -wound dressings - pads

4

ALLEVYN AG NON-ADHESIVE - wounddressings - pads

4

ALLEVYN AG SACRUM - wounddressings - pads

4

ALLEVYN GENTLE - wound dressings -pads

4

Drug Name Dru

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ALOQUIN - iodoquinol-aloepolysaccharides gel 1.25-1%

4

ALTABAX - retapamulin oint 1% 4

ALUMINUM ACETATE - aluminumacetate soln

4

ALUVEA - urea cream 39% 4

AMCINONIDE - amcinonide cream0.1%

2

AMCINONIDE - amcinonide lotion 0.1% 4

AMCINONIDE - amcinonide oint 0.1% 4

ANACAINE - benzocaine oint 10% 4

ANODYNERX - capsaicin-lidocaine-menthol patch 0.05-2.5-5%

4

ANODYNZ - capsaicin-menthol disk0.0375-5%

4

APEXICON E - diflorasone diacetateemollient base cream 0.05%

4

ARZOL SILVER NITRATE APP - silvernitrate-potassium nitrate applicator75-25%

4

ATENDIA - lidocaine-menthol patch4-3%

4

ATOPICLAIR - dermatological productsmisc - cream

4

ATRALIN - tretinoin gel 0.05% 4

ATRAPRO CP - wound dressings - kit 4

ATRAPRO DERMAL SPRAY - woundcleansers - liquid

4

AURSTAT - dermatological productsmisc - kit

4

AURSTAT ANTI-ITCH HYDROGE -dermatological products misc - kit

4

AVALIN-RX - lidocaine-menthol patch4-1%

4

AVAR - sulfacetamide sodium w/ sulfurfoam 9.5-5%

4

AVAR - sulfacetamide sodium w/ sulfurcleansing pad 9.5-5%

4

2015


Drug Name Dru

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AVAR LS - sulfacetamide sodium w/sulfur foam 10-2%

4

AVAR LS - sulfacetamide sodium w/sulfur cleansing pad 10-2%

4

AVAR LS CLEANSER - sulfacetamidesodium w/ sulfur cleanser 10-2%

4

AVAR-E LS - sulfacetamide sodium w/sulfur cream 10-2%

4

AVENOVA - hypochlorous acid cleansersoln 0.01%

4

AZELEX - azelaic acid cream 20% 4

BACTROBAN - mupirocin calciumcream 2%

4

BACTROBAN - mupirocin oint 2% 4

BENSAL HP - salicylic acid & benzoicacid oint 3-6%

4

BENZACLIN - clindamycin phosphate-benzoyl peroxide gel 1-5%

4

BENZACLIN WITH PUMP - clindamycinphosphate-benzoyl peroxide gel 1-5%

4

BENZAMYCIN - benzoyl peroxide-erythromycin gel 5-3%

4

BENZAMYCINPAK - benzoyl peroxide-erythromycin gel pack 5-3%

4

BENZEFOAM - benzoyl peroxide foam5.3%

4

BENZEFOAMULTRA - benzoyl peroxidefoam 9.8%

4

BENZIQ - benzoyl peroxide gel 5.25 % 4

BENZIQ LS - benzoyl peroxide gel2.75%

4

benzoyl peroxide creamy wash 4%&benzoyl peroxide bar 5% kit

2

benzoyl peroxide creamy wash 8%&benzoyl peroxide bar 5% kit (Bpocreamy wash comp)

2

benzoyl peroxide foam 5.3%(Benzefoam)

2

benzoyl peroxide foam 9.8%(Benzefoamultra)

2

Drug Name Dru

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benzoyl peroxide liq 2.5% 2

benzoyl peroxide liq 7% 2

benzoyl peroxide liq 5.25% 2

benzoyl peroxide lotion 6% 2

benzoyl peroxide-erythromycin gel5-3% (Benzamycin)

2

betamethasone dipropionateaugmented cream 0.05% (Diproleneaf)

2

betamethasone dipropionateaugmented gel 0.05%

2

betamethasone dipropionateaugmented lotion 0.05% (Diprolene)

2

betamethasone dipropionateaugmented oint 0.05% (Diprolene)

2

betamethasone dipropionate cream0.05%

2

betamethasone dipropionate lotion0.05%

2

betamethasone dipropionate oint0.05%

2

betamethasone valerate aerosolfoam 0.12% (Luxiq)

2

betamethasone valerate cream 0.1% 2

betamethasone valerate lotion 0.1% 2

betamethasone valerate oint 0.1% 2

BP CLEANSING WASH - sulfacetamidesodium-sulfur in urea emulsion 10-4%

2

BPO - benzoyl peroxide gel 4% 4

BPO - benzoyl peroxide gel 8% 4

BPO CREAMY WASH COMPLETE -benzoyl peroxide creamy wash 8%&benzoyl peroxide bar 5% kit

4

BPO 3% FOAMING CLOTHS - benzoylperoxide cloth 3%

4

BPO 9% FOAMING CLOTHS - benzoylperoxide cloth 9%

4

calcipotriene cream 0.005%(Dovonex)

2

2015


Drug Name Dru

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its

calcipotriene oint 0.005% 2

calcipotriene soln 0.005% (50 mcg/ml)

2

calcipotriene-betamethasonedipropionate oint 0.005-0.064%(Taclonex)

2

CALCITRIOL - calcitriol oint 3 mcg/gm 4

CAMPHOMEX - camphor-histamine-menthol liqd spray 4-0.025-10%

4

CAPEX - fluocinolone acetonideshampoo 0.01%

4

CAPSIDERM - capsaicin-mentholtopical patch 0.0375-5%

4

CAPTRACIN - capsaicin-menthol topicalpatch 0.0375-5%

4

CARAC - fluorouracil cream 0.5% 4

CEM-UREA - urea soln 45% 4

CENTANY - mupirocin oint 2% 4

CENTANY AT - mupirocin oint kit 2% 4

CETACAINE - butamben-tetracaine-benzocaine aerosol spray 2-2-14%

4

CICLODAN CREAM KIT - ciclopiroxolamine cream 0.77% (base equiv) &cleanser kit

4

CICLODAN SOLUTION KIT - ciclopiroxsolution kit 8%

4

ciclopirox gel 0.77% 2

ciclopirox olamine cream 0.77%(base equiv)

2

ciclopirox olamine susp 0.77% (baseequiv)

2

ciclopirox shampoo 1% (Loproxshampoo)

2

ciclopirox solution kit 8% (Ciclodansolution ki)

2

ciclopirox solution 8% (Penlac NailLacquer)

2

CICLOPIROX TOPICAL SOLUTI -ciclopirox solution 8% & vitamin e 5%topical kit

4

Drug Name Dru

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its

CLARAVIS - isotretinoin cap 30 mg 4

CLARIFOAM EF - sulfacetamide sodiumw/ sulfur foam 10-5%

4

CLEOCIN-T - clindamycin phosphatesoln 1%

4

CLEOCIN-T - clindamycin phosphatelotion 1%

4

CLEOCIN-T - clindamycin phosphateswab 1%

4

CLEOCIN-T - clindamycin phosphategel 1%

4

CLEVER CHOICE COMFORT EZ -methyl salicylate-lidocaine-mentholpatch 2-4-1%

4

CLEVER CHOICE COMFORT EZ -methyl salicylate-lidocaine-mentholpatch 20-4-1%

4

CLINDACIN ETZ - clindamycinphosphate swab 1% & cleanser kit

4

CLINDACIN PAC - clindamycinphosphate swab 1% & cleanser kit

4

CLINDAGEL - clindamycin phosphategel 1%

4

clindamycin phosph-benzoylperoxide (refrig) gel 1.2 (1)-5%(Duac)

2

clindamycin phosphate foam 1%(Evoclin)

2

clindamycin phosphate gel 1%(Cleocin-t)

2

clindamycin phosphate lotion 1%(Cleocin-t)

2

clindamycin phosphate soln 1%(Cleocin-t)

2

clindamycin phosphate swab 1%(Cleocin-t)

2

clindamycin phosphate-benzoylperoxide gel 1-5% (Benzaclin)

2

clobetasol propionate cream 0.05%(Temovate)

2

2015


Drug Name Dru

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its

clobetasol propionate emollient basecream 0.05% (Temovate e)

2

clobetasol propionate emulsionfoam 0.05% (Olux-e)

2

clobetasol propionate foam 0.05%(Olux)

2

clobetasol propionate gel 0.05%(Temovate)

2

clobetasol propionate lotion 0.05%(Clobex)

2

clobetasol propionate oint 0.05%(Temovate)

2

clobetasol propionate shampoo0.05% (Clobex)

2

clobetasol propionate soln 0.05%(Temovate)

2

clobetasol propionate spray 0.05%(Clobex)

2

CLOBEX - clobetasol propionate spray0.05%

4

CLOBEX - clobetasol propionate lotion0.05%

4

CLOBEX - clobetasol propionateshampoo 0.05%

4

CLOCORTOLONE PIVALATE -clocortolone pivalate cream 0.1%

4

CLOCORTOLONE PIVALATE PUM -clocortolone pivalate cream 0.1%

4

CLODAN KIT - clobetasol propionateshampoo 0.05% & cleanser kit

4

CLODERM - clocortolone pivalatecream 0.1%

4

CLODERM PUMP - clocortolonepivalate cream 0.1%

4

clotrimazole w/ betamethasonecream 1-0.05% (Lotrisone)

2

clotrimazole w/ betamethasonelotion 1-0.05%

2

CNL8 NAIL KIT - ciclopirox soln 8% &lacquer removal pads kit

4

Drug Name Dru

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its

COAL TAR - coal tar soln 20% 4

COCAINE HCL - cocaine hcl soln 4% 4

COCAINE HCL - cocaine hcl soln 10% 4

CONDYLOX - podofilox soln 0.5% 4

CONDYLOX - podofilox gel 0.5% 4

COPASIL - emollient - gel 4

CORDRAN - flurandrenolide cream0.05%

4

CORDRAN - flurandrenolide lotion0.05%

4

CORDRAN - flurandrenolide oint 0.05% 4

CORDRAN TAPE - flurandrenolide tape4 mcg/sqcm

4

CORTALO - hydrocortisone acetate-aloe vera gel 2%

2

CORTANE-B - hydrocortisone-pramoxine-chloroxylenol lot10-10-1mg/ml

4

CORTISPORIN - neomycin-polymyxin-hc cream 0.5%

4

CORTISPORIN - bacitracin-polymyxin-neomycin hc oint 1%

4

COSENTYX - secukinumabsubcutaneous soln prefilled syringe150 mg/ml

4 • •

COSENTYX SENSOREADY PEN -secukinumab subcutaneous solnauto-injector 150 mg/ml

4 • •

CURITY HYPERTONIC SODIUM -wound dressings - misc

4

CURITY SODIUM CHLORIDE DR -wound dressings - pads

4

CUTIVATE - fluticasone propionatecream 0.05%

4

CUTIVATE - fluticasone propionatelotion 0.05%

4

DENAVIR - penciclovir cream 1% 4

DERMA SILKRX SDS PAK -triamcinolone acet cr 0.1% & dimethcr 5% & silicone tape

4

2015


Drug Name Dru

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its

DERMA-SMOOTHE/FS BODY -fluocinolone acetonide oil 0.01%(body oil)

4

DERMA-SMOOTHE/FS BODY OIL -fluocinolone acetonide oil 0.01%(body oil)

4

DERMA-SMOOTHE/FS SCALP -fluocinolone acetonide oil 0.01%(scalp oil)

4

DERMA-SMOOTHE/FS SCALP OI -fluocinolone acetonide oil 0.01%(scalp oil)

4

DERMACINRX DUOPATCH PHARM -lidocaine patch 5% & menthol-methylsal patch 3-10% ther pak

4

DERMACINRX LEXITRAL PHARM -diclofenac sod soln 1.5% & capsaicincream 0.025% ther pack

4

DERMACINRX NEUROTRAL PHAR -lidocaine patch 5% & capsaicincream 0.025% therapy pack

4

DERMACINRX SILAPAK -triamcinolone acet cr 0.1% & dimethcr 5% & silicone tape

4

DERMACINRX SURGICAL COMBO -chlorhexidine soln-dimeth cr-siliconetape-homeopathic kit

4

DERMACINRX SURGICAL PHARM -chlorhexidine sol-mupirocin cr-dimethcr-silicone tape kit

4

DERMASORB AF - clioquinol-hc cream3-0.5% & emollient liqd kit

4

DERMASORB HC - hydrocortisone lot2% & cleanser liq kit

4

DERMASORB TA - triamcinolone cream0.1% & emollient cream kit

4

DERMASORB XM - urea cream 39% &emollient cream kit

4

DERMATOP - prednicarbate cream0.1%

4

DERMATOP - prednicarbate oint 0.1% 4

Drug Name Dru

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its

DESONATE - desonide gel 0.05% 4

desonide cream 0.05% (Desowen) 2

desonide lotion 0.05% (Desowen) 2

desonide oint 0.05% (Desowen) 2

DESOWEN - desonide cream 0.05% 4

DESOWEN - desonide lotion 0.05% 4

DESOWEN - desonide oint 0.05% 4

DESOXIMETASONE - desoximetasonecream 0.05%

4

DESOXIMETASONE - desoximetasoneoint 0.05%

4

desoximetasone cream 0.25%(Topicort)

2

desoximetasone gel 0.05% (Topicort) 2

desoximetasone oint 0.25% (Topicort) 2

diclofenac sodium (actinickeratoses) gel 3% (Solaraze)

2

diclofenac sodium soln 1.5%(Pennsaid)

2

DIFFERIN - adapalene cream 0.1% 4

DIFFERIN - adapalene gel 0.1% 4

DIFFERIN - adapalene gel 0.3% 4

DIFFERIN - adapalene lotion 0.1% 4

DIFLORASONE DIACETATE -diflorasone diacetate oint 0.05%

2

DIFLORASONE DIACETATE -diflorasone diacetate cream 0.05%

4

DIPROLENE - betamethasonedipropionate augmented lotion 0.05%

4

DIPROLENE - betamethasonedipropionate augmented oint 0.05%

4

DIPROLENE AF - betamethasonedipropionate augmented cream0.05%

4

DOVONEX - calcipotriene cream0.005%

4

DOXYCYCLINE - doxycycline (rosacea)cap delayed release 40 mg

4 •

2015


Drug Name Dru

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its

DRITHO-CREME HP - anthralin cream1%

4

DRYSOL - aluminum chloride soln 20% 4

DUAC - clindamycin phosph-benzoylperoxide (refrig) gel 1.2 (1)-5%

4

econazole nitrate cream 1% 2

ECOZA - econazole nitrate foam 1% 4

EFUDEX - fluorouracil cream 5% 4

ELENZAPATCH - lidocaine-mentholpatch 4-1%

4

ELETONE - dermatological productsmisc - cream

4

ELETONE TWINPACK - dermatologicalproducts misc - cream

4

ELIDEL - pimecrolimus cream 1% 4

ELIMITE - permethrin cream 5% 4

ELOCON - mometasone furoatesolution 0.1% (lotion)

4

ELOCON - mometasone furoate cream0.1%

4

ELOCON - mometasone furoate oint0.1%

4

EMLA - lidocaine-prilocaine cream2.5-2.5%

4

EMULSION SB - dermatologicalproducts misc - emulsion

4

EPICERAM - dermatological productsmisc - emulsion

4

EPIDUO - adapalene-benzoyl peroxidegel 0.1-2.5%

4

EPIDUO FORTE - adapalene-benzoylperoxide gel 0.3-2.5%

4

EPIFOAM - pramoxine-hc aerosol foam1-1%

4

ERTACZO - sertaconazole nitratecream 2%

4

ERYGEL - erythromycin gel 2% 4

erythromycin gel 2% (Erygel) 2

erythromycin pads 2% 2

Drug Name Dru

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Lim

its

erythromycin soln 2% 2

ESSENTRA WIPES 9X9" CLEAN -isopropyl alcohol wipes 70%

4

ETHYL CHLORIDE - ethyl chlorideaerosol spray

4

ETHYL CHLORIDE/FINE PINPO - ethylchloride aerosol spray

4

ETHYL CHLORIDE/FINE STREA - ethylchloride aerosol spray

4

ETHYL CHLORIDE/MEDIUM JET -ethyl chloride aerosol spray

4

ETHYL CHLORIDE/MEDIUM STR -ethyl chloride aerosol spray

4

ETHYL CHLORIDE/MIST - ethylchloride aerosol spray

4

EURAX - crotamiton cream 10% 4

EURAX - crotamiton lotion 10% 4

EVOCLIN - clindamycin phosphate foam1%

4

EXELDERM - sulconazole nitratesolution 1%

4

EXELDERM - sulconazole nitrate cream1%

4

EXODERM - sodium thiosulfate-salicylicacid lotion 25-1%

2

EXTINA - ketoconazole foam 2% 4

FABIOR - tazarotene (acne) foam 0.1% 4

FINACEA - azelaic acid gel 15% 3

FIRST-HYDROCORTISONE -hydrocortisone gel 10% (cmpd kit)

4

FLECTOR - diclofenac epolamine patch1.3%

4

FLEXIN - capsaicin-menthol topicalpatch 0.0375-5%

4

fluocinolone acetonide cream 0.01% 2

fluocinolone acetonide cream0.025% (Synalar)

2

fluocinolone acetonide oil 0.01%(body oil) (Derma-smoothe/fs bod)

2

2015


Drug Name Dru

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Lim

its

fluocinolone acetonide oil 0.01%(scalp oil) (Derma-smoothe/fs sca)

2

fluocinolone acetonide oint 0.025%(Synalar)

2

fluocinolone acetonide soln 0.01%(Synalar)

2

fluocinonide cream 0.05% 2

fluocinonide cream 0.1% (Vanos) 2

fluocinonide emulsified base cream0.05%

2

fluocinonide gel 0.05% 2

fluocinonide oint 0.05% 2

fluocinonide soln 0.05% 2

FLUORAC - fluorouracil-diclofenacsodium cream 5-1%

4

FLUOROPLEX - fluorouracil cream 1% 4

FLUOROURACIL - fluorouracil cream0.5%

4

fluorouracil cream 5% (Efudex) 2

fluorouracil soln 2% 2

fluorouracil soln 5% 2

fluticasone propionate cream 0.05%(Cutivate)

2

fluticasone propionate lotion 0.05%(Cutivate)

2

fluticasone propionate oint 0.005%(Cutivate)

2

GEBAUERS PAIN EASE -pentafluoropropane-tetrafluoroethaneaero spray

4

GEBAUERS SPRAY AND STRETC -pentafluoropropane-tetrafluoroethaneaero spray

4

GENADUR - dermatological productsmisc - liquid

4

GENADUR KIT - dermatologicalproducts misc topical/oral - kit

4

GENTAMICIN SULFATE - gentamicinsulfate cream 0.1%

4

Drug Name Dru

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its

GENTAMICIN SULFATE - gentamicinsulfate oint 0.1%

4

GORDOFILM - salicylic & lactic acidssoln 16.7-16.7%

4

GORDONS UREA - urea ointment 40% 4

GRANULEX - trypsin w/ castor oil &peruvian balsam spray

4

HALAC - halobetasol prop oint 0.05% &ammonium lactate lot 12% kit

2

halobetasol propionate cream 0.05%(Ultravate)

2

halobetasol propionate oint 0.05%(Ultravate)

2

HALOG - halcinonide cream 0.1% 4

HALOG - halcinonide oint 0.1% 4

HALOTIN - haloprogin cream 1% 4

HPR - emollient - aerosol foam 4

HPR PLUS - emollient - aerosol foam 4

HPR PLUS - dermatological productsmisc - cream

4

HPR PLUS HYDROGEL KIT -dermatological products misc - kit

4

HPR PLUS/MB HYDROGEL - emollientfoam & wound dressing gel kit

4

hyaluronate sodium (emollient) gel0.2% (Hylira)

2

HYDRO 35 - urea in lactic acid vehiclefoam 35%

4

HYDRO 40 FOAM - urea foam 40% 4

hydrocortisone butyrate cream 0.1%(Locoid)

2

hydrocortisone butyrate hydrophiliclipo base cream 0.1% (Locoidlipocream)

2

hydrocortisone butyrate oint 0.1%(Locoid)

2

hydrocortisone butyrate soln 0.1%(Locoid)

1

hydrocortisone cream 2.5% 1

2015


Drug Name Dru

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Lim

its

hydrocortisone lotion 2% (Ala scalp) 2

hydrocortisone lotion 2.5% 2

hydrocortisone oint 2.5% 1

hydrocortisone valerate cream 0.2% 2

hydrocortisone valerate oint 0.2%(Westcort)

2

HYDROFERA BLUE FOAM DRESS -wound dressings - pads

4

HYDROFERA BLUE HEAVY DRAI -wound dressings - pads

4

HYDROFERA BLUE READY FOAM -wound dressings - pads

4

HYDROFERA BLUE 4"X4" - wounddressings - pads

4

HYLASE WOUND - hyaluronate sodiumgel

4

HYLATOPIC - emollient - aerosol foam 4

HYLATOPIC PLUS - emollient - aerosolfoam

4

HYLATOPIC PLUS - dermatologicalproducts misc - cream

4

HYLIRA - hyaluronate sodium(emollient) gel 0.2%

4

HYLIRA - hyaluronate sodium(emollient) lotion 0.1%

4

imiquimod cream 5% (Aldara) 2 •INOVA - benzoyl peroxide pad 4% &

vitamin e topical 5% kit4

INOVA - benzoyl peroxide pad 8% &vitamin e topical 5% kit

4

INOVA 4/1 ACNE CONTROL TH -benzoyl perox pad 4% & salicylic acpad 1% & vit e 5% kit

4

INOVA 8/2 ACNE CONTROL TH -benzoyl perox pad 8% & salicylic acpad 2% & vit e 5% kit

4

iodoquinol-hc cream 1% 2

iodoquinol-hydrocortisone in aloevehicle cream 1-1.9% (Vytone)

2

Drug Name Dru

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Lim

its

isotretinoin cap 10 mg 2



JUBLIA - efinaconazole soln 10% 4

KENALOG - triamcinolone acetonideaerosol soln

4

KENDALL HYDROGEL IMPREGNA -hydroactive (sterile) dressing

4

KENDALL HYDROGEL WOUND DR -hydroactive (sterile) dressing

4

KENDALL ZINC CALCIUM ALGI -wound dressings - pads

4

KENDALL ZINC CALCIUM ALGI -wound dressings - misc

4

KERAFOAM - urea foam 30% 4

KERAFOAM 42 - urea foam 42% 4

KERALAC - urea cream 47% 4

KERALYT - salicylic acid gel 6% 4

KERALYT SCALP - salicylic acidshampoo 6% & salicylic acid gel 6%kit

4

KERYDIN - tavaborole soln 5% 4

ketoconazole cream 2% 1

ketoconazole foam 2% (Extina) 2

ketoconazole shampoo 2% (Nizoral) 2

KETODAN KIT - ketoconazole foam 2%& cleanser kit

4

KLARON - sulfacetamide sodium lotion10% (acne)

4

K2K PAIN RELIEVING PATCH -lidocaine-menthol patch 4-4%

4

LAC-HYDRIN - lactic acid (ammoniumlactate) lotion 12%

4

LAC-HYDRIN - lactic acid (ammoniumlactate) cream 12%

4

lactic acid (ammonium lactate)cream 12% (Lac-hydrin)

1

lactic acid (ammonium lactate) lotion10%

1

2015


Drug Name Dru

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its

lactic acid (ammonium lactate) lotion12% (Lac-hydrin)

1

lactic acid w/ vitamin e cream10%-3500 unit/30gm

1

LATRIX XM - urea in zinc undecylenate-lactic acid vehicle emulsion 45%

4

LAVARE WOUND WASH - woundcleansers - gel

4

LAVOCLEN-4 CREAMY WASH -benzoyl peroxide liq 4%

4

LAVOCLEN-8 CREAMY WASH -benzoyl peroxide liq 8%

4

LEVATIO PATCH - capsaicin-mentholtopical patch 0.03-5%

4

LEVULAN KERASTICK - aminolevulinicacid hcl for soln 20% (stick applicator)

4

LIDENZA PATCH - lidocaine-mentholpatch 4-1%

4

LIDOCAINE AND TETRACAINE -lidocaine-tetracaine cream 7-7%

4

LIDOCAINE HCL - lidocaine hcl lotion3%

4

lidocaine hcl cream 3% 2

lidocaine hcl gel 2% 1

lidocaine hcl soln 4% (Xylocaine) 1

lidocaine oint 5% 2

lidocaine patch 5% (700 mg)(Lidoderm)

2

lidocaine-menthol patch 4-5% 2

lidocaine-prilocaine cream 2.5-2.5%(Emla)

2

lidocaine-prilocaine kit 2.5-2.5% 2

lidocaine-prilocaine kit 2.5-2.5% 4

LIDOCIN - lidocaine hcl gel 3% 4

LIDODERM - lidocaine patch 5% (700mg)

4

LIDODEXTRAPINE - lidocaine-mentholpatch 4-1%

4

LIDOPIN - lidocaine hcl cream 3.25% 4

Drug Name Dru

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its

LIDORX - lidocaine hcl gel 3% 4

LIDOTHOL - lidocaine-menthol patch4.5-5%

4

LIDOVEX - lidocaine cream 3.75% 4

LIDOVIN - lidocaine hcl cream 3.95% 4

LIDOZOL - lidocaine hcl cream 3.75% 4

lindane lotion 1% 2

lindane shampoo 1% 2

LOCOID - hydrocortisone butyrate soln0.1%

4

LOCOID - hydrocortisone butyratecream 0.1%

4

LOCOID - hydrocortisone butyrate lotion0.1%

4

LOCOID - hydrocortisone butyrate oint0.1%

4

LOCOID LIPOCREAM - hydrocortisonebutyrate hydrophilic lipo base cream0.1%

4

LOPROX SHAMPOO - ciclopiroxshampoo 1%

4

LORENZA - lidocaine-menthol patch4-1%

4

LOTRIMIN ULTRA - butenafine hclcream 1%

4

LOTRISONE - clotrimazole w/betamethasone cream 1-0.05%

4

LOUTREX - antiseborrheic productsmisc - cream

4

LUXIQ - betamethasone valerateaerosol foam 0.12%

4

LUZU - luliconazole cream 1% 4

LYCELLE - nit remover - gel 4

MAC PATCH - capsaicin-mentholtopical patch 0.0375-5%

4

malathion lotion 0.5% (Ovide) 2

MB HYDROGEL - dermatologicalproducts misc - kit

4

2015


Drug Name Dru

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its

MEDI-DERM-RX - capsaicin-menthol-methyl salicylate cream 0.035-5-20%

4

MEDI-DERM/L-RX - lidocaine-capsaicin-menthol-methyl sal cream2-0.035-5-20%

4

MEDI-PATCH RX - lidocaine-capsaicin-menthol-methyl sal patch0.5-0.035-5-20%

4

MEDIHONEY CALCIUM ALGINAT -wound dressings - pads

4

MEDIHONEY WOUND & BURN DR -wound dressings - pads

4

MEDROX-RX - capsaicin-menthol-methyl salicylate oint 0.05-7-20%

4

MEGRIX - capsaicin-menthol disk0.0375-5%

4

MENTAX - butenafine hcl cream 1% 4

MENTHOCIN PATCH/LIDOCAINE -lidocaine-capsaicin-menthol-methylsal patch 0.5-0.035-5-20%

4

MENTHOCIN PATCH/LIDOCAINE -lidocaine-capsaicin-men-methyl salpatch 0.5-0.0375-5-20%

4

MENTHOLIX - lidocaine-menthol liquidspray 4-1%

4

methoxsalen rapid cap 10 mg(Oxsoralen ultra)

2

METROCREAM - metronidazole cream0.75%

4

METROGEL - metronidazole gel 1% 4

METROLOTION - metronidazole lotion0.75%

4

metronidazole cream 0.75%(Metrocream)

2

metronidazole gel 0.75% 2

metronidazole gel 1% (Metrogel) 2

metronidazole lotion 0.75%(Metrolotion)

2

METVIXIA - methyl aminolevulinate hclcream 16.8% (base equiv)

4

Drug Name Dru

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its

MIGRYL - capsaicin-menthol disk0.0375-5%

4

MIRVASO - brimonidine tartrate gel0.33% (base equivalent)

4

mometasone furoate cream 0.1%(Elocon)

2

mometasone furoate oint 0.1%(Elocon)

2

mometasone furoate solution 0.1%(lotion) (Elocon)

2

mupirocin calcium cream 2%(Bactroban)

2

mupirocin oint 2% (Bactroban) 1

naftifine hcl cream 1% (Naftin) 2

NAFTIN - naftifine hcl cream 1% 4

NAFTIN - naftifine hcl cream 2% 4

NAFTIN - naftifine hcl gel 1% 4

NAFTIN - naftifine hcl gel 2% 4

NATROBA - spinosad susp 0.9% 4

NEO-SYNALAR - neomycin-fluocinolone cream 0.35-0.025%

4

NEO-SYNALAR KIT - neomycin-fluocinolone cream 0.35-0.025% &emollient cr kit

4

NEOSALUS - emollient - aerosol foam 4

NEOSALUS - emollient - lotion 4

NEOSALUS - dermatological productsmisc - cream

4

NEOSALUS CP - dermatologicalproducts misc - cream

4

NEUAC KIT - clindamycin-benzoylperox gel 1.2-5% & moisturizer cr kit

4

NEUVAXIN - capsaicin-menthol topicalpatch 0.0375-5%

4

NIVATOPIC PLUS - dermatologicalproducts misc - cream

4

NIZORAL - ketoconazole shampoo 2% 4

NOBLE MYSTIQUE EMU-LAC - lacticacid (ammonium lactate) cream 10%

4

2015


Drug Name Dru

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its

NORITATE - metronidazole cream 1% 4

NOVACORT - hydrocortisone ace-pramoxine-aloe polysacch gel 2-1-1%

4

NUCORT - hydrocortisone acetate lotion2%

4

NUOX - benzoyl peroxide-sulfur gel6-3%

4

NUVAIL - dermatological products misc- solution

4

NUZON - hydrocortisone acetate-aloevera gel 2%

4

nystatin cream 100000 unit/gm 2

nystatin oint 100000 unit/gm 2

nystatin topical powder 2

nystatin-triamcinolone cream100000-0.1 unit/gm-%

2

nystatin-triamcinolone oint100000-0.1 unit/gm-%

2

OLUX - clobetasol propionate foam0.05%

4

OLUX-E - clobetasol propionateemulsion foam 0.05%

4

ONEXTON - clindamycin phosphate-benzoyl peroxide gel 1.2-3.75%

4

OPTASE - trypsin w/ castor oil &peruvian balsam gel

4

ORACEA - doxycycline (rosacea) capdelayed release 40 mg

4 •

OVACE PLUS - sulfacetamide sodiumcream 10%

4

OVACE PLUS - sulfacetamide sodiumfoam 9.8%

4

OVACE PLUS - sulfacetamide sodiumshampoo 10%

4

OVACE PLUS - sulfacetamide sodiumlotion 9.8%

4

OVACE PLUS WASH - sulfacetamidesodium cleansing gel 10%

4

OVACE PLUS WASH - sulfacetamidesodium liquid 10%

4

Drug Name Dru

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its

OVACE WASH - sulfacetamide sodiumliquid 10%

4

OVIDE - malathion lotion 0.5% 4

OXISTAT - oxiconazole nitrate cream1%

4

OXISTAT - oxiconazole nitrate lotion 1% 4

OXSORALEN - methoxsalen lotion 1% 4

OXSORALEN ULTRA - methoxsalenrapid cap 10 mg

4

PAIN RELIEF PATCH - capsaicin-menthol topical patch 0.0375-5%

4

PAIN RELIEF PATCH - lidocaine-menthol patch 5-1%

4

PANDEL - hydrocortisone probutatecream 0.1%

4

PANRETIN - alitretinoin gel 0.1% 4

PEDIADERM AF COMPLETE KIT -nystatin cream 100000 unit/gm &diaper rash cream kit

4

PEDIADERM HC - hydrocortisone lot2% & emollient cream kit

4

PEDIADERM TA - triamcinolone cream0.1% & emollient cream kit

4

PENLAC NAIL LACQUER - ciclopiroxsolution 8%

4

PENNSAID - diclofenac sodium soln 2% 4

PERMAVAN EXTERNAL PATCH -lidocaine-dm-trolamine salicylatepatch 4-4-10%

4

permethrin cream 5% (Elimite) 2

PHARMACIST CHOICE TSX PAT -methyl salicylate-lidocaine-mentholpatch 2-4-1%

4

PICATO - ingenol mebutate gel 0.015% 4 •PICATO - ingenol mebutate gel 0.05% 4 •PICO SINGLE USE NEGATIVE - wound

dressings - kit4

PLEXION - sulfacetamide sodium w/sulfur lotion 9.8-4.8%

4

2015


Drug Name Dru

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its

PLEXION - sulfacetamide sodium w/sulfur cream 9.8-4.8%

4

PLEXION CLEANSER - sulfacetamidesodium w/ sulfur cleanser 9.8-4.8%

4

PLEXION CLEANSING CLOTHS -sulfacetamide sodium w/ sulfurcleansing cloth 9.8-4.8%

4

PLIAGLIS - lidocaine-tetracaine cream7-7%

4

PODOCON 25 IN BENZOIN TIN -podophyllum resin soln 25%

4

podofilox soln 0.5% (Condylox) 2

PR CREAM - dermatological productsmisc - kit

4

PRAMOSONE - pramoxine-hc cream1-1%

4

PRAMOSONE - pramoxine-hc cream1-2.5%

4

PRAMOSONE - pramoxine-hc lotion1-1%

4

PRAMOSONE - pramoxine-hc lotion1-2.5%

4

PRAMOSONE - pramoxine-hc oint 1-1% 4

PRAMOSONE - pramoxine-hc oint1-2.5%

4

PRAMOSONE E - pramoxine-hcemollient base cream 1-2.5%

4

pramoxine hcl gel 1% 1

pramoxine-hc cream 1-2.5%(Pramosone)

2

PRASCION RA WITH SUNSCREE -sulfacetamide sodium-sulfur-sunscreen cream 10-5%

2

prednicarbate cream 0.1%(Dermatop)

2

prednicarbate oint 0.1% (Dermatop) 2

PREMIUM SCAR PATCH - allantoin-lidocaine-petrolatum patch 2-4-30%

4

PRESERA - emollient - aerosol foam 4

Drug Name Dru

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its

PROLIDA - lidocaine-menthol patch4-1%

4

PROMISEB - antiseborrheic productsmisc - cream

4

PROMISEB COMPLETE -antiseborrheic products misc - kit

4

PROTOPIC - tacrolimus oint 0.03% 4

PROTOPIC - tacrolimus oint 0.1% 4

PROVENZA - lidocaine-menthol patch4-1%

4

PROZENA - lidocaine patch 4% 4

PRUCLAIR - dermatological productsmisc - cream

4

PRUDOXIN - doxepin hcl cream 5% 4

PRUMYX - dermatological productsmisc - cream

4

PSORCON - diflorasone diacetatecream 0.05%

4

PYROGALLIC ACID - pyrogallol-chlorobutanol oint 25-2%

4

QROXIN - capsaicin-menthol topicalpatch 0.0375-5%

4

QUTENZA - capsaicin patch 8% &cleansing gel kit

4

RECIPHEXAMINE - lidocaine-mentholpatch 4-1%

4

REGENECARE - lidocaine hcl-collagen-aloe vera gel 2%

4

REGRANEX - becaplermin gel 0.01% 4 •RELEEVIA - capsaicin-menthol topical

patch 0.0375-5%4

RELEEVIA MC - capsaicin-mentholtopical patch 0.0375-5%

4

RELEEVIA ML - lidocaine-mentholpatch 4-1%

4

RELYYT - capsaicin-menthol topicalpatch 0.025-5%

4

REMATEX - capsaicin-menthol-methylsalicylate cream 0.035-6-30%

4

2015


Drug Name Dru

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its

REMAXAZON EXTERNAL PATCH -lidocaine-capsaicin-chondroitin-glucos patch 4-0.0285-3-5%

4

RENOVO - capsaicin-menthol topicalpatch 0.0375-5%

4

RENOVO LIDO 5 - lidocaine-capsaicincream 5-0.05%

4

RENUU NL - allantoin-petrolatum patch2-30%

4

RENUU PATCH - allantoin-lidocaine-petrolatum patch 2-5-30%

4

RESTORE SILVER DRESSING 2 -wound dressings - pads

4


4


4

RETIN-A - tretinoin cream 0.025% 4



RETIN-A - tretinoin gel 0.01% 4

RETIN-A - tretinoin gel 0.025% 4

RETIN-A MICRO - tretinoin microspheregel 0.04%

4

RETIN-A MICRO - tretinoin microspheregel 0.1%

4

RETIN-A MICRO PUMP - tretinoinmicrosphere gel 0.04%

4


4


4

REXAPHENAC - diclofenac sodiumcream 1%

4

RIAX - benzoyl peroxide foam 5.5% 4

RIAX - benzoyl peroxide foam 9.5% 4

ROSADAN KIT - metronidazole gel0.75% w/ cleanser kit

4

Drug Name Dru

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its

ROSADAN KIT - metronidazole cream0.75% w/ cleanser kit

4

ROSANIL - sulfacetamide sod-sulfuremul 10-5% & skin cleanser kit

4

ROSULA - sulfacetamide sodium w/sulfur wash 10-4.5%

4

RTD WOUND CARE DRESSING -wound dressings - pads

4

SALEX - salicylic acid shampoo 6% 4

SALEX CREAM - salicylic acid cream6% & cleanser liqd kit

4

SALEX LOTION - salicylic acid lotion6% & cleanser liqd kit

4

SALICYLIC ACID - salicylic acid soln26%

4

salicylic acid cream 6% 2

salicylic acid cream 6% & cleanserliqd kit (Salex cream)

2

salicylic acid film forming liquid27.5% (Virasal)

2

salicylic acid film-forming soln28.5% (Ultrasal-er)

2

salicylic acid foam 6% (Salvax) 2

salicylic acid gel 6% (Keralyt) 2

SALICYLIC ACID IN AMMONIU -salicylic acid in ammonium lactatevehicle foam 6%

4

salicylic acid lotion 6% 2

salicylic acid lotion 6% & cleanserliqd kit (Salex lotion)

2

salicylic acid shampoo 6% (Salex) 2

SALKERA - salicylic acid in ammoniumlactate vehicle foam 6%

4

SALVAX - salicylic acid foam 6% 4

SALVAX DUO PLUS - salicylic acidfoam 6% & urea in lactic acid foam35% kit

4

SANTYL - collagenase oint 250 unit/gm 4

2015


Drug Name Dru

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its

SCALACORT DK - hc lot 2% & sal acid-sulfur shampoo 2-2% & shampoo kit

4

SCAR PATCH - allantoin-lidocaine-petrolatum patch 2-4-30%

4

SCAR PATCH - allantoin-lidocaine-petrolatum patch 2-5-30%

4

scar treatment products - gel 2

selenium sulfide lotion 2.5% 1

SELRX - selenium sulfide-pyrithionezinc in urea shampoo 2.3%

4

SILMANIX PAIN RELIEIVING -capsaicin-menthol-histamine cream0.0375-3-0.035%

4

SILVADENE - silver sulfadiazine cream1%

4

SILVER NITRATE - silver nitrate oint10%

4

SILVER NITRATE - silver nitrate soln0.5%

4

SILVER NITRATE - silver nitrate soln10%

4


4


4

silver nitrate-potassium nitrateapplicator 75-25% (Arzol silvernitrate)

1

silver sulfadiazine cream 1%(Silvadene)

1

SILVERA PAIN RELIEF - capsaicin-lidocaine-menthol patch 0.0375-1-5%

4

SILVERSEAL HYDROGEL DRESS -silver - pad 2"x3"

4

SILVERSEAL HYDROGEL DRESS -silver - pad 4"x5"

4

SILVRSTAT WOUND DRESSING -silver - gel

4

SINELEE - capsaicin-menthol topicalpatch 0.0375-5%

4

Drug Name Dru

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SINELEE - capsaicin-menthol topicalpatch 0.05-5%

4

SKLICE - ivermectin lotion 0.5% 4

SODIUM SULFACETAMIDE WASH -sulfacetamide sodium in bakuchiolvehicle wash 10%

4

SODIUM SULFACETAMIDE/SULF -sulfacetamide sodium-sulfur in ureagel 10-5%

4

SODIUM SULFACETAMIDE/SULF -sulfacetamide sodium w/ sulfur susp10-5%

4

SODIUM SULFACETAMIDE/SULF -sulfacetamide sodium-sulfur in ureaemulsion 10-5%

4

SOLAICE - capsaicin-menthol topicalpatch 0.05-5%

4

SOLARAZE - diclofenac sodium (actinickeratoses) gel 3%

4

SOOLANTRA - ivermectin cream 1% 4

SOOTHEE - lidocaine-capsaicin-men-methyl sal patch 0.5-0.0375-5-20%

4

SORIATANE - acitretin cap 10 mg 4

SORIATANE - acitretin cap 17.5 mg 4

SORIATANE - acitretin cap 25 mg 4

SORILUX - calcipotriene foam 0.005% 4

SPINOSAD - spinosad susp 0.9% 4

STELARA - ustekinumab soln prefilledsyringe 45 mg/0.5ml

5 • •

STELARA - ustekinumab soln prefilledsyringe 90 mg/ml

5 • •

sulfacetamide sod-sulfur wash9-4.5% & skin cleanser kit(Sumadan kit)

2

sulfacetamide sod-sulfur wash9-4.5% & sunscreen kit (Sumadanxlt)

2

sulfacetamide sodium cleansing gel10% (Ovace plus wash)

2

2015


Drug Name Dru

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its

sulfacetamide sodium liquid 10%(Ovace wash)

2

sulfacetamide sodium lotion 10%(acne) (Klaron)

2

sulfacetamide sodium shampoo 10%(Ovace plus)

2

sulfacetamide sodium w/ sulfurcleanser 9.8-4.8% (Plexion cleanser)

2

sulfacetamide sodium w/ sulfurcleanser 10-2% (Avar ls cleanser)

2

sulfacetamide sodium w/ sulfurcleansing cloth 10-5%

2

sulfacetamide sodium w/ sulfurcleansing pad 10-4% (Sumaxin)

2

sulfacetamide sodium w/ sulfurcream 9.8-4.8% (Plexion)

2

sulfacetamide sodium w/ sulfurcream 10-2% (Avar-e ls)

2

sulfacetamide sodium w/ sulfurcream 10-5%

2

sulfacetamide sodium w/ sulfuremulsion 10-1%

2

sulfacetamide sodium w/ sulfuremulsion 10-5%

2

sulfacetamide sodium w/ sulfur foam10-5% (Clarifoam ef)

2

sulfacetamide sodium w/ sulfurlotion 9.8-4.8% (Plexion)

2

sulfacetamide sodium w/ sulfurlotion 10-5%

2

sulfacetamide sodium w/ sulfur susp8-4% (Sumaxin ts)

2

sulfacetamide sodium w/ sulfur wash9-4% (Sumaxin wash)

2

sulfacetamide sodium w/ sulfur wash9-4.5% (Sumadan wash)

2

SULFAMYLON - mafenide acetatepacket for topical soln 5% (50 gm)

4

SULFAMYLON - mafenide acetatecream 85 mg/gm

4

Drug Name Dru

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SULFOAM - sulfur shampoo 2% 4

SULFURATED LIME - sulfurated limesolution

4

SUMADAN KIT - sulfacetamide sod-sulfur wash 9-4.5% & skin cleanserkit

4

SUMADAN WASH - sulfacetamidesodium w/ sulfur wash 9-4.5%

4

SUMADAN XLT - sulfacetamide sod-sulfur wash 9-4.5% & sunscreen kit

4

SUMAXIN - sulfacetamide sodium w/sulfur cleansing pad 10-4%

4

SUMAXIN CP KIT - sulfacetamide sod-sulfur pad 10-4% & skin cleanser kit

4

SUMAXIN TS - sulfacetamide sodium w/sulfur susp 8-4%

4

SUMAXIN WASH - sulfacetamidesodium w/ sulfur wash 9-4%

4

SYNALAR - fluocinolone acetonide soln0.01%

4

SYNALAR - fluocinolone acetonidecream 0.025%

4

SYNALAR - fluocinolone acetonide oint0.025%

4

SYNALAR CREAM KIT - fluocinolonecream 0.025%-emollient cream kit

4

SYNALAR OINTMENT KIT -fluocinolone oint 0.025%-emollientcream kit

4

SYNALAR TS - fluocinolone acetonidesoln 0.01% & cleanser kit

4

SYNERA - lidocaine-tetracaine topicalpatch 70-70 mg

4

SYNVEXIA - lidocaine-menthol patch4-1%

4

SYNVEXIA TC - lidocaine-mentholcream 4-1%

4

TACLONEX - calcipotriene-betamethasone dipropionate susp0.005-0.064%

4

2015


Drug Name Dru

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TACLONEX - calcipotriene-betamethasone dipropionate oint0.005-0.064%

4

tacrolimus oint 0.03% (Protopic) 2

tacrolimus oint 0.1% (Protopic) 2

TARGRETIN - bexarotene gel 1% 5 •TAZORAC - tazarotene cream 0.05% 3

TAZORAC - tazarotene cream 0.1% 3

TAZORAC - tazarotene gel 0.05% 3

TAZORAC - tazarotene gel 0.1% 3

TEGADERM AG MESH DRESSING -wound dressings - pads

4

TEMOVATE - clobetasol propionatesoln 0.05%

4

TEMOVATE - clobetasol propionatecream 0.05%

4

TEMOVATE - clobetasol propionate gel0.05%

4

TEMOVATE - clobetasol propionate oint0.05%

4

TEMOVATE E - clobetasol propionateemollient base cream 0.05%

4

TERSI FOAM - selenium sulfide foam2.25%

4

TETRAMEX - tetracaine-menthol-camphor liqd spray 2-1-3%

4

TETRIX - dermatological products misc- kit

4

TEXACORT - hydrocortisone soln 2.5% 4

TL TRISEB - antiseborrheic productsmisc - cream

4

TL-CERMIDE - dermatological productsmisc - emulsion

4

TOPICORT - desoximetasone spray0.25%

4

TOPICORT - desoximetasone gel0.05%

4

TOPICORT - desoximetasone cream0.05%

4

Drug Name Dru

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TOPICORT - desoximetasone cream0.25%

4

TOPICORT - desoximetasone oint0.05%

4

TOPICORT - desoximetasone oint0.25%

4

TRETIN-X - tretinoin cream 0.075% 4

TRETIN-X - tretinoin cream 0.025% w/cleanser & moisturizer kit

4


4


4

tretinoin cream 0.025% (Retin-a) 2



tretinoin gel 0.01% (Retin-a) 2

tretinoin gel 0.025% (Retin-a) 2

tretinoin microsphere gel 0.04%(Retin-a micro)

2

tretinoin microsphere gel 0.1%(Retin-a micro)

2

TRI-CHLOR - trichloroacetic acid liqd80%

4

TRIAMCINOLONE ACETONIDE -triamcinolone acetonide oint 0.5%

4

triamcinolone acetonide aerosol soln(Kenalog)

2

triamcinolone acetonide cream0.025%

1

triamcinolone acetonide cream 0.1% 1

triamcinolone acetonide cream 0.5% 1

triamcinolone acetonide lotion0.025%

2

triamcinolone acetonide lotion 0.1% 2

triamcinolone acetonide oint 0.025% 1

triamcinolone acetonide oint 0.1% 1

TRIANEX - triamcinolone acetonide oint0.05%

4

2015


Drug Name Dru

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its

TROPAZONE - emollient - lotion 4

trypsin w/ castor oil & peruvianbalsam spray (Granulex)

1

ULESFIA - benzyl alcohol lotion 5% 4

ULTRASAL-ER - salicylic acid film-forming soln 28.5%

4

ULTRAVATE - halobetasol propionatecream 0.05%

4

ULTRAVATE - halobetasol propionateoint 0.05%

4

ULTRAVATE X - halobetasol propcream 0.05% & lactic acid cream10% kit

4

ULTRAVATE X - halobetasol prop oint0.05% & lactic acid cream 10% kit

4

UMECTA - urea emulsion 40% 4

UMECTA - urea suspension 40% 4

UMECTA NAIL FILM - urea suspension40%

4

UMECTA PD - urea-hyaluronate sodiumemulsion 40-0.3%

4

UMECTA PD - urea-hyaluronate sodiumsusp 40-0.3%

4

URAMAXIN - urea lotion 45% 4

URAMAXIN - urea in ammonium lactatevehicle foam 20%

4

URAMAXIN - urea cream 45% 4

URAMAXIN - urea gel 45% 4

URAMAXIN GT - urea gel 45% 4

URAMAXIN GT KIT - urea gel 45% &emollient cream kit

4

urea cream 39% (Aluvea) 2

urea cream 40% 2

urea cream 45% (Uramaxin) 2

urea cream 47% (Keralac) 2

urea cream 50% 2

urea foam 40% (Hydro 40 foam) 2

urea gel 40% 2

Drug Name Dru

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its

urea gel 45% (Uramaxin) 2

urea in lactic acid vehicle foam 35%(Hydro 35)

2

urea in lactic acid-salicylic acidvehicle susp 50%

2

urea in zinc undecylenate-lactic acidvehicle emulsion 50%

2

urea lotion 40% 2

urea lotion 45% (Uramaxin) 2

UREA NAIL - urea in zinc undecylenate-lactic acid vehicle stick 50%

4

UREA NAIL KIT - urea susp 40% &hyaluronate sodium gel 0.2% kit

4

urea suspension 40% (Umecta) 2

UREVAZ - urea cream 44% 4

UTOPIC - urea cream 41% 4

VALCHLOR - mechlorethamine hcl gel0.016% (base equivalent)

5 •

VANOS - fluocinonide cream 0.1% 4

VANOXIDE-HC - benzoyl peroxide-hclotion 5-0.5%

4

VASCUDERM STASIS KIT - wounddressings - kit

4

VECTICAL - calcitriol oint 3 mcg/gm 4

VELMA PAIN RELIEF - methylsalicylate-lidocaine-menthol patch16-4-2%

4

VELTIN - clindamycin phosphate-tretinoin gel 1.2-0.025%

4

VENELEX - balsam peru-castor oil oint 4

VERDESO - desonide foam 0.05% 4

VEREGEN - sinecatechins oint 15% 4

VEXA - allantoin-lidocaine-petrolatumpatch 2-4-30%

4

VIRASAL - salicylic acid film formingliquid 27.5%

4

VOLTAREN - diclofenac sodium gel 1% 4

VUSION - miconazole-zinc oxide-whitepetrolatum oint 0.25-15-81.35%

4

2015


Drug Name Dru

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VYTONE - iodoquinol-hydrocortisone inaloe vehicle cream 1-1.9%

4

WESTCORT - hydrocortisone valerateoint 0.2%

4

WITCH HAZEL - witch hazel(hamamelis virginiana) liqd(hamamelis water)

4

wound dressings - cream 2

XCLAIR - dermatological products misc- cream

4

XENADERM - trypsin w/ castor oil &peruvian balsam oint

4

XERAC AC - aluminum chloride inalcohol solution 6.25%

4

XERESE - acyclovir-hydrocortisonecream 5-1%

4

XEROFORM NON-OCCLUSIVE OI -bismuth tribromophenate-petrolatumdressing pads

4

XEROFORM NON-OCCLUSIVE OI -bismuth tribromophenate-petrolatumdressing - misc

4

XEROFORM OCCLUSIVE PETROL -bismuth tribromophenate-petrolatumdressing pads

4

XEROFORM OCCLUSIVE PETROL -bismuth tribromophenate-petrolatumdressing - misc

4

XEROFORM PETROLATUM DRESS -bismuth tribromophenate-petrolatumdressing pads

4

XEROFORM PETROLATUM DRESS -bismuth tribromophenate-petrolatumdressing - misc

4

XOLEGEL - ketoconazole gel 2% 4

XOLEGEL COREPAK - ketoconazolegel 2% & hydrocortisone gel 1% kit

4

XOLEGEL DUO/HEAD & SHOULD -ketoconazole gel 2% & pyrithionezinc shampoo 1% kit

4

Drug Name Dru

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XOLEGEL DUO/XOLEX - ketoconazolegel 2% & pyrithione zinc shampoo 1%kit

4

XYLOCAINE - lidocaine hcl soln 4% 4

XYPHEX - capsaicin-menthol disk0.0375-5%

4

ZACARE 4% KIT - benzoyl peroxidelotion 4% & hyaluronate sodium gel0.2% kit

4

ZACARE 8% KIT - benzoyl peroxidelotion 8% & hyaluronate sodium gel0.2% kit

4

ZACLIR CLEANSING - benzoylperoxide lotion 8%

4

ZENATANE - isotretinoin cap 30 mg 4

ZERUVIA - lidocaine-menthol patch4-1%

4

ZIANA - clindamycin phosphate-tretinoingel 1.2-0.025%

4

ZITHRANOL - anthralin shampoo 1% 4

ZITHRANOL-RR - anthralin cream 1.2% 4

ZONALON - doxepin hcl cream 5% 4

ZOVIRAX - acyclovir cream 5% 4

ZOVIRAX - acyclovir oint 5% 4

ZYCLARA - imiquimod cream 3.75% 4 •ZYCLARA PUMP - imiquimod cream

2.5%4 •

ZYCLARA PUMP - imiquimod cream3.75%

4 •

8-MOP - methoxsalen cap 10 mg 4

MISCELLANEOUS PRODUCTS

ANTISEPTICS & DISINFECTANTS

ANASEPT - sodium hypochlorite liquid0.057%

4

BENZALKONIUM CHLORIDE -benzalkonium chloride soln

4

BENZALKONIUM CHLORIDE -benzalkonium chloride soln 50%

4

2015


Drug Name Dru

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its

FORMA-RAY - formaldehyde solution20%

4

formaldehyde solution 10% 2

GLUTARALDEHYDE - glutaral soln25%

4

IODINE TINCTURE - iodine tincture 4

IODINE TINCTURE MILD - iodinetincture

4

IODINE TINCTURE STRONG - iodinetincture strong

4

IODINE TINCTURE STRONG DE -iodine tincture strong

4

KERR TRIPLE DYE - triple dye swabs 4

LUGOLS STRONG IODINE - iodinesolution

4

TRIPLE DYE - triple dye solution 4

ANTIDOTES

CHEMET - succimer cap 100 mg 3

EVZIO - naloxone hcl solution auto-injector 0.4 mg/0.4ml

4

EXJADE - deferasirox tab for oral susp125 mg

5 •


5 •


5 •

FERRIPROX - deferiprone tab 500 mg 5 •JADENU - deferasirox tab 90 mg 5

JADENU - deferasirox tab 180 mg 5

JADENU - deferasirox tab 360 mg 5

naltrexone hcl tab 50 mg (Revia) 2

PENTETATE CALCIUM TRISODI -pentetate calcium trisodium iv orinhalation soln 200 mg/ml

4

PENTETATE ZINC TRISODIUM -pentetate zinc trisodium iv orinhalation soln 200 mg/ml

4

RADIOGARDASE - prussian blueinsoluble cap 0.5 gm

4

Drug Name Dru

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its

REVIA - naltrexone hcl tab 50 mg 4

DIAGNOSTIC PRODUCTS

ASCENSIA AUTODISC TEST ST -glucose blood test disk

2 •

BAYER BREEZE 2 TEST DISC -glucose blood test disk

2 •

BAYER CONTOUR BLOOD GLUCO -glucose blood test strip

2 •

BAYER CONTOUR NEXT BLOOD -glucose blood test strip

2 •

GLUCAGEN DIAGNOSTIC - glucagonhcl (rdna) diagnostic for inj 1 mg(base equiv)

4

GLUCOSE BLOOD TEST STRIPS –VARIOUS

4 • •

KETONE BLOOD TEST STRIPS –VARIOUS

4

URINE TEST STRIPS – VARIOUS 4

ALTERNATIVE MEDICINES

CITRUS BERGAMOT - citrus bergamotoral powder 250 mg/0.25 gm

4

QUINZYME - coenzyme q10 tab disp 90mg

4

MEDICAL DEVICES

BLOOD GLUCOSE CALIBRATIONLIQUID – VARIOUS

4

HURRISEAL - dental desensitizingproduct - solution

4

INSULIN PEN NEEDLES-VARIOUS 3 •INSULIN SYRINGES-VARIOUS 4 •LANCETS-VARIOUS 3

RESPIRATORY THERAPY SUPPLIES– VARIOUS

4

SPACERS – VARIOUS 4

SANARE SCAR THERAPY - creambase

4

ASSORTED CLASSES

ASTAGRAF XL - tacrolimus cap sr 24hr0.5 mg

4 •

2015


Drug Name Dru

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its

ASTAGRAF XL - tacrolimus cap sr 24hr1 mg

4 •

ASTAGRAF XL - tacrolimus cap sr 24hr5 mg

4 •

ATGAM - lymphocyte immune globulinanti-thymocyte g inj 50 mg/ml(eq)

4

AZASAN - azathioprine tab 75 mg 4

AZASAN - azathioprine tab 100 mg 4

azathioprine tab 50 mg (Imuran) 2

CELLCEPT - mycophenolate mofetil cap250 mg

4

CELLCEPT - mycophenolate mofetil tab500 mg

4

CELLCEPT - mycophenolate mofetil fororal susp 200 mg/ml

3

CUPRIMINE - penicillamine cap 250 mg 5 •cyclosporine cap 25 mg

(Sandimmune)2

cyclosporine cap 100 mg(Sandimmune)

2

CYCLOSPORINE MODIFIED -cyclosporine modified cap 50 mg

3

cyclosporine modified cap 25 mg(Neoral)

2

cyclosporine modified cap 100 mg(Neoral)

2

cyclosporine modified oral soln100 mg/ml (Neoral)

2

DEPEN TITRATABS - penicillamine tab250 mg

5 •

IMURAN - azathioprine tab 50 mg 4

KAYEXALATE - sodium polystyrenesulfonate powder

4

mycophenolate mofetil cap 250 mg(Cellcept)

2

mycophenolate mofetil for oral susp200 mg/ml (Cellcept)

2

mycophenolate mofetil tab 500 mg(Cellcept)

2

Drug Name Dru

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its

mycophenolate sodium tab dr180 mg (mycophenolic acid equiv)(Myfortic)

2

mycophenolate sodium tab dr360 mg (mycophenolic acid equiv)(Myfortic)

2

MYFORTIC - mycophenolate sodiumtab dr 180 mg (mycophenolic acidequiv)

4

MYFORTIC - mycophenolate sodiumtab dr 360 mg (mycophenolic acidequiv)

4

NEORAL - cyclosporine modified oralsoln 100 mg/ml

4

NEORAL - cyclosporine modified cap 25mg

4

NEORAL - cyclosporine modified cap100 mg

4

PROGRAF - tacrolimus cap 0.5 mg 4

PROGRAF - tacrolimus cap 1 mg 4

PROGRAF - tacrolimus cap 5 mg 4

RAPAMUNE - sirolimus oral soln 1 mg/ml

3

RAPAMUNE - sirolimus tab 0.5 mg 4

RAPAMUNE - sirolimus tab 1 mg 3

RAPAMUNE - sirolimus tab 2 mg 3

REVLIMID - lenalidomide caps 2.5 mg 5 • •REVLIMID - lenalidomide cap 5 mg 5 • •REVLIMID - lenalidomide cap 10 mg 5 • •REVLIMID - lenalidomide cap 15 mg 5 • •REVLIMID - lenalidomide cap 20 mg 5 • •REVLIMID - lenalidomide cap 25 mg 5 • •SANDIMMUNE - cyclosporine oral soln

100 mg/ml4

SANDIMMUNE - cyclosporine cap 25mg

4

SANDIMMUNE - cyclosporine cap 100mg

4

sirolimus tab 0.5 mg (Rapamune) 2

2015


Drug Name Dru

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Lim

its

sirolimus tab 1 mg (Rapamune) 2

sirolimus tab 2 mg (Rapamune) 2

sodium polystyrene sulfonate oralsusp 15 gm/60ml (Sps)

2

sodium polystyrene sulfonatepowder (Kayexalate)

2

sodium polystyrene sulfonate rectalsusp 30 gm/120ml

2

SPS - sodium polystyrene sulfonate oralsusp 15 gm/60ml

4

SYPRINE - trientine hcl cap 250 mg 5 •tacrolimus cap 0.5 mg (Prograf) 2

tacrolimus cap 1 mg (Prograf) 2

tacrolimus cap 5 mg (Prograf) 2

THALOMID - thalidomide cap 50 mg 5 • •THALOMID - thalidomide cap 100 mg 5 • •THALOMID - thalidomide cap 150 mg 5 • •THALOMID - thalidomide cap 200 mg 5 • •ZORTRESS - everolimus tab 0.25 mg 4

ZORTRESS - everolimus tab 0.5 mg 4

ZORTRESS - everolimus tab 0.75 mg 4

2015


INDEX

8-MOP -methoxsalen cap 10 mg.....................................162

A

abacavir sulfate-lamivudine-zidovudine tab300-150-300 mg (Trizivir).................................................7

abacavir sulfate tab 300 mg (base equiv) (Ziagen)......... 7ABANEU-SL -cyanocobalamin-methylcobalamin tab sl600-600 mcg.................................................................. 128

ABILIFY -aripiprazole tab 10 mg....................................... 81ABILIFY -aripiprazole tab 15 mg....................................... 81ABILIFY -aripiprazole tab 20 mg....................................... 81ABILIFY -aripiprazole tab 2 mg......................................... 81ABILIFY -aripiprazole tab 30 mg....................................... 81ABILIFY -aripiprazole tab 5 mg......................................... 81ABSORICA -isotretinoin cap 10 mg.................................144ABSORICA -isotretinoin cap 20 mg.................................144ABSORICA -isotretinoin cap 25 mg.................................144ABSORICA -isotretinoin cap 30 mg.................................144ABSORICA -isotretinoin cap 35 mg.................................144ABSORICA -isotretinoin cap 40 mg.................................144ABSTRAL -fentanyl citrate sl tab 100 mcg (baseequiv)................................................................................93

ABSTRAL -fentanyl citrate sl tab 200 mcg (baseequiv)................................................................................93





acamprosate calcium tab delayed release 333 mg(Campral).........................................................................89

ACANYA -clindamycin phosphate-benzoyl peroxide gel1.2-2.5%......................................................................... 144

acarbose tab 100 mg (Precose)..................................... 27acarbose tab 25 mg (Precose)....................................... 27acarbose tab 50 mg (Precose)....................................... 27ACCOLATE -zafirlukast tab 10 mg....................................62ACCOLATE -zafirlukast tab 20 mg....................................62ACCUPRIL -quinapril hcl tab 10 mg..................................45ACCUPRIL -quinapril hcl tab 20 mg..................................45ACCUPRIL -quinapril hcl tab 40 mg..................................45ACCUPRIL -quinapril hcl tab 5 mg....................................45ACCURETIC -quinapril-hydrochlorothiazide tab 10-12.5mg.................................................................................... 45

ACCURETIC -quinapril-hydrochlorothiazide tab 20-12.5mg.................................................................................... 45

ACCURETIC -quinapril-hydrochlorothiazide tab 20-25mg.................................................................................... 45

acebutolol hcl cap 200 mg (Sectral).............................. 40acebutolol hcl cap 400 mg (Sectral).............................. 40

ACEON -perindopril erbumine tab 4 mg............................45ACEON -perindopril erbumine tab 8 mg............................45acetaminophen-isometheptene-dichloral cap325-65-100 mg.............................................................. 104

acetaminophen-salicylamide-phenyltoloxamine cap300-200-20mg..................................................................93

acetaminophen w/ codeine soln 120-12 mg/5ml........... 94acetaminophen w/ codeine tab 300-15 mg (Tylenol/codeine)...........................................................................94

acetaminophen w/ codeine tab 300-30 mg (Tylenol/codeine #3)..................................................................... 94

acetaminophen w/ codeine tab 300-60 mg (Tylenol/codeine #4)..................................................................... 94

ACETAZOLAMIDE -acetazolamide tab 125 mg................ 52acetazolamide cap sr 12hr 500 mg (Diamox)................ 52acetazolamide tab 250 mg.............................................. 52ACETIC ACID/ALUMINUM ACET -acetic acid 2% inaluminum acetate otic soln............................................ 141

acetic acid otic soln 2%................................................141acetylcysteine cap 600 mg........................................... 126acetylcysteine inhal soln 10%........................................59acetylcysteine inhal soln 20%........................................59ACIPHEX -rabeprazole sodium ec tab 20 mg................... 66ACIPHEX SPRINKLE -rabeprazole sodium capsulesprinkle dr 10 mg.............................................................66

ACIPHEX SPRINKLE -rabeprazole sodium capsulesprinkle dr 5 mg...............................................................66

acitretin cap 10 mg (Soriatane).................................... 144acitretin cap 17.5 mg (Soriatane)................................. 144acitretin cap 25 mg (Soriatane).................................... 144ACLOVATE -alclometasone dipropionate cream0.05%............................................................................. 144

ACTEMRA -tocilizumab subcutaneous soln prefilledsyringe 162 mg/0.9ml.................................................... 101

ACTHAR HP -corticotropin inj gel 80 unit/ml..................... 35ACTICLATE -doxycycline hyclate tab 150 mg.....................3ACTICLATE -doxycycline hyclate tab 75 mg.......................3ACTIGALL -ursodiol cap 300 mg...................................... 70ACTIMMUNE -interferon gamma-1b inj 100 mcg/0.5ml(2000000 unit/0.5ml)........................................................ 16

ACTIQ -fentanyl citrate lozenge on a handle 1200mcg...................................................................................94

ACTIQ -fentanyl citrate lozenge on a handle 1600mcg...................................................................................94

ACTIQ -fentanyl citrate lozenge on a handle 200 mcg...... 94ACTIQ -fentanyl citrate lozenge on a handle 400 mcg...... 94ACTIQ -fentanyl citrate lozenge on a handle 600 mcg...... 94ACTIQ -fentanyl citrate lozenge on a handle 800 mcg...... 94ACTIVE FE -fe carbonyl-fa-b complex-a-c-d-e-min tab75-1.25 mg.....................................................................128

ACTIVELLA -estradiol & norethindrone acetate tab 0.5-0.1mg.................................................................................... 22

ACTIVELLA -estradiol & norethindrone acetate tab 1-0.5mg.................................................................................... 22

2015


ACTIVE OB -prenatal w/o a w/fe cbn-fa-dha cap 20-1-320mg.................................................................................. 115

ACTIVE-PAC/GABAPENTIN -gabapentin oral cap 300 mg& lidocaine-menthol gel ther pk....................................... 89

ACTONEL -risedronate sodium tab 150 mg......................35ACTONEL -risedronate sodium tab 30 mg........................35ACTONEL -risedronate sodium tab 35 mg........................35ACTONEL -risedronate sodium tab 5 mg..........................35ACTOPLUS MET -pioglitazone hcl-metformin hcl tab15-500 mg........................................................................27

ACTOPLUS MET -pioglitazone hcl-metformin hcl tab15-850 mg........................................................................27

ACTOPLUS MET XR -pioglitazone hcl-metformin hcl tab sr24hr 15-1000 mg............................................................. 27

ACTOPLUS MET XR -pioglitazone hcl-metformin hcl tab sr24hr 30-1000 mg............................................................. 27

ACTOS -pioglitazone hcl tab 15 mg (base equiv)..............27ACTOS -pioglitazone hcl tab 30 mg (base equiv)..............27ACTOS -pioglitazone hcl tab 45 mg (base equiv)..............27ACT TOTAL CARE DRY MOUTH -sodium fluoride rinse0.02%............................................................................. 142

ACUICYN DAILY EYELID & EY -eyelid cleansers -liquid............................................................................... 145

ACULAR -ketorolac tromethamine ophth soln 0.5%........137ACULAR LS -ketorolac tromethamine ophth soln0.4%............................................................................... 137

ACUVAIL -ketorolac tromethamine ophth soln 0.45%..... 137acyclovir cap 200 mg (Zovirax)........................................7acyclovir oint 5% (Zovirax)...........................................145acyclovir susp 200 mg/5ml (Zovirax)...............................7acyclovir tab 400 mg (Zovirax).........................................7acyclovir tab 800 mg (Zovirax).........................................7ACZONE -dapsone gel 5%............................................. 145ADACEL -tet tox-diph-acell pertuss ad inj 5-2-15.5 lf-lf-mcg/0.5ml.........................................................................15

ADALAT CC -nifedipine tab sr 24hr 30 mg....................... 42ADALAT CC -nifedipine tab sr 24hr 60 mg....................... 42ADALAT CC -nifedipine tab sr 24hr 90 mg....................... 42ADAPALENE -adapalene lotion 0.1%............................. 145adapalene cream 0.1% (Differin).................................. 145adapalene gel 0.1% (Differin)........................................145adapalene gel 0.3% (Differin)........................................145ADASUVE -loxapine aerosol powder breath activated 10mg.................................................................................... 81

ADAZIN -benzo-capsaicin-lido-methyl salicylate cream2-0.035-2-10%................................................................145

ADCIRCA -tadalafil tab 20 mg (pah)................................. 57ADDERALL -amphetamine-dextroamphetamine tab 10mg.................................................................................... 85

ADDERALL -amphetamine-dextroamphetamine tab 12.5mg.................................................................................... 85

ADDERALL -amphetamine-dextroamphetamine tab 15mg.................................................................................... 85




ADDERALL -amphetamine-dextroamphetamine tab 7.5mg.................................................................................... 85

ADDERALL XR -amphetamine-dextroamphetamine cap sr24hr 10 mg...................................................................... 85





ADDERALL XR -amphetamine-dextroamphetamine cap sr24hr 5 mg........................................................................ 85

adefovir dipivoxil tab 10 mg (Hepsera)........................... 7ADEMPAS -riociguat tab 0.5 mg....................................... 57ADEMPAS -riociguat tab 1.5 mg.......................................57ADEMPAS -riociguat tab 1 mg..........................................57ADEMPAS -riociguat tab 2.5 mg.......................................57ADEMPAS -riociguat tab 2 mg..........................................57ADOXA -doxycycline monohydrate cap 150 mg..................3ADOXA -doxycycline monohydrate tab 100 mg.................. 3ADOXA -doxycycline monohydrate tab 50 mg.................... 3ADOXA -doxycycline monohydrate tab 75 mg.................... 3ADOXA PAK 1/100 -doxycycline monohydrate tab 100mg...................................................................................... 3

ADOXA PAK 1/150 -doxycycline monohydrate tab 150mg...................................................................................... 4

ADOXA PAK 2/100 -doxycycline monohydrate tab 100mg...................................................................................... 4

ADRENACLICK -epinephrine solution auto-injector 0.15mg/0.15ml (1:1000)..........................................................53

ADRENACLICK -epinephrine solution auto-injector 0.3mg/0.3ml (1:1000)............................................................53

ADRENAL C FORMULA -bioflavonoid products tab........115ADRENALIN -epinephrine hcl nasal soln 0.1%................. 59ADVAIR DISKUS -fluticasone-salmeterol aer powder ba100-50 mcg/dose............................................................. 62

ADVAIR DISKUS -fluticasone-salmeterol aer powder ba250-50 mcg/dose............................................................. 62

ADVAIR DISKUS -fluticasone-salmeterol aer powder ba500-50 mcg/dose............................................................. 62

ADVAIR HFA -fluticasone-salmeterol inhal aerosol 115-21mcg/act.............................................................................62



ADVANCED ALLERGY COLLECTI -hydrocortisone creamkit 2.5%.......................................................................... 145

2015


ADVANCED AM/PM -multiple vitamins w/ calcium therapypack................................................................................115

ADVATE -antihemophilic factor rahf-pfm for inj 1000unit..................................................................................133







ADVICOR -niacin-lovastatin tab sr 24hr 1000-20 mg........ 54ADVICOR -niacin-lovastatin tab sr 24hr 1000-40 mg........ 54ADVICOR -niacin-lovastatin tab sr 24hr 500-20 mg.......... 54ADVICOR -niacin-lovastatin tab sr 24hr 750-20 mg.......... 54AEROSPAN -flunisolide hfa inhal aerosol 80 mcg/act.......62AFINITOR DISPERZ -everolimus tab for oral susp 2mg.................................................................................... 16

AFINITOR DISPERZ -everolimus tab for oral susp 3mg.................................................................................... 16

AFINITOR DISPERZ -everolimus tab for oral susp 5mg.................................................................................... 16

AFINITOR -everolimus tab 10 mg..................................... 16AFINITOR -everolimus tab 2.5 mg.................................... 16AFINITOR -everolimus tab 5 mg....................................... 16AFINITOR -everolimus tab 7.5 mg.................................... 16AFLURIA 2011-2012 -influenza virus vaccine split imsusp..................................................................................13

AFLURIA 2012-2013 -influenza virus vaccine split imsusp..................................................................................13




AFLURIA PF 2011-2012 -influenza virus vaccine split pfsusp pref syringe 0.5 ml.................................................. 12





AFREZZA -insulin regular (human) inhalation powder 4unit/cartridge.....................................................................32

AFREZZA -insulin regular (human) inhal powd 4 (30) & 8(60) unit/cart.....................................................................32

AFREZZA -insulin regular (human) inhal powd 4 (60) & 8(30) unit/cart.....................................................................32

AFREZZA -insulin regular (human) inh powd 8 (60) & 12(30) unit/cart.....................................................................32

AGGRENOX -aspirin-dipyridamole cap sr 12hr 25-200mg.................................................................................. 133

AGRYLIN -anagrelide hcl cap 0.5 mg............................. 133AKTEN -lidocaine hcl ophth gel 3.5%............................. 137AKYNZEO -netupitant-palonosetron cap 300-0.5 mg........69ALA QUIN -clioquinol-hc cream 3-0.5%.......................... 145ALA SCALP -hydrocortisone lotion 2%........................... 145ALBENZA -albendazole tab 200 mg................................. 11albuterol sulfate soln nebu 0.083% (2.5 mg/3ml).......... 62albuterol sulfate soln nebu 0.5% (5 mg/ml)...................62albuterol sulfate soln nebu 0.63 mg/3ml (baseequiv)...............................................................................62

albuterol sulfate soln nebu 1.25 mg/3ml (baseequiv)...............................................................................62

albuterol sulfate syrup 2 mg/5ml................................... 62albuterol sulfate tab 2 mg...............................................62albuterol sulfate tab 4 mg...............................................62albuterol sulfate tab sr 12hr 4 mg (Vospire er)............. 62albuterol sulfate tab sr 12hr 8 mg (Vospire er)............. 62ALCAINE -proparacaine hcl ophth soln 0.5%..................137alclometasone dipropionate cream 0.05%(Aclovate)...................................................................... 145

alclometasone dipropionate oint 0.05%...................... 145ALCORTIN A -iodoquinol-hydrocortisone-aloepolysaccharide gel 1-2-1%.............................................145

ALDACTAZIDE -spironolactone & hydrochlorothiazide tab25-25 mg..........................................................................52

ALDACTAZIDE -spironolactone & hydrochlorothiazide tab50-50 mg..........................................................................52

ALDACTONE -spironolactone tab 100 mg........................ 52ALDACTONE -spironolactone tab 25 mg.......................... 52ALDACTONE -spironolactone tab 50 mg.......................... 52ALDARA -imiquimod cream 5%...................................... 145ALEGENIX -capsaicin-menthol disk 0.0375-5%.............. 145ALENDRONATE SODIUM -alendronate sodium oral soln70 mg/75ml...................................................................... 35

ALENDRONATE SODIUM -alendronate sodium tab 40mg.................................................................................... 35

alendronate sodium tab 10 mg...................................... 35alendronate sodium tab 35 mg...................................... 35alendronate sodium tab 5 mg........................................ 35alendronate sodium tab 70 mg (Fosamax)....................35ALEVEER -capsaicin-menthol topical patch0.0375-5%...................................................................... 145

ALEVICYN DERMAL SPRAY -wound dressings -soln.................................................................................145

alfuzosin hcl tab sr 24hr 10 mg (Uroxatral)...................74ALINIA -nitazoxanide for susp 100 mg/5ml....................... 11ALINIA -nitazoxanide tab 500 mg......................................11ALKERAN -melphalan tab 2 mg........................................16ALLEVYN AG ADHESIVE -wound dressings - pads....... 145

2015


ALLEVYN AG GENTLE BORDER -wound dressings -pads................................................................................145

ALLEVYN AG NON-ADHESIVE -wound dressings -pads................................................................................145

ALLEVYN AG SACRUM -wound dressings - pads..........145ALLEVYN GENTLE -wound dressings - pads................. 145allopurinol tab 100 mg (Zyloprim)................................106allopurinol tab 300 mg (Zyloprim)................................106almotriptan malate tab 12.5 mg (Axert)....................... 104almotriptan malate tab 6.25 mg (Axert)....................... 104ALOCRIL -nedocromil sodium ophth soln 2%................. 137ALOMIDE -lodoxamide tromethamine ophth soln0.1%............................................................................... 137

ALOQUIN -iodoquinol-aloe polysaccharides gel1.25-1%.......................................................................... 145

ALORA -estradiol td patch twice weekly 0.025mg/24hr............................................................................ 22

ALORA -estradiol td patch twice weekly 0.05 mg/24hr......22ALORA -estradiol td patch twice weekly 0.075mg/24hr............................................................................ 22

ALORA -estradiol td patch twice weekly 0.1 mg/24hr........22alosetron hcl tab 0.5 mg (base equiv) (Lotronex)......... 70alosetron hcl tab 1 mg (base equiv) (Lotronex)............70ALPHAGAN P -brimonidine tartrate ophth soln 0.1%...... 137ALPHAGAN P -brimonidine tartrate ophth soln0.15%............................................................................. 137

ALPHANATE/VON WILLEBRAND -antihemophilic factor/vwf (human) for inj 1000 unit.........................................133



ALPHANATE/VON WILLEBRAND -antihemophilic factor/vwf (human) for inj 250 unit...........................................133

ALPHANATE/VON WILLEBRAND -antihemophilic factor/vwf (human) for inj 500 unit...........................................133

ALPHANINE SD -coagulation factor ix for inj 1000unit..................................................................................134

ALPHANINE SD -coagulation factor ix for inj 1500unit..................................................................................134

ALPHANINE SD -coagulation factor ix for inj 500 unit.....134ALPRAZOLAM INTENSOL -alprazolam conc 1 mg/ml......75alprazolam orally disintegrating tab 0.25 mg(Niravam).........................................................................75

alprazolam orally disintegrating tab 0.5 mg..................75alprazolam orally disintegrating tab 1 mg.....................75alprazolam orally disintegrating tab 2 mg.....................75alprazolam tab 0.25 mg (Xanax).....................................75alprazolam tab 0.5 mg (Xanax).......................................75alprazolam tab 1 mg (Xanax)..........................................75alprazolam tab 2 mg (Xanax)..........................................75alprazolam tab sr 24hr 0.5 mg (Xanax xr)..................... 75alprazolam tab sr 24hr 1 mg (Xanax xr)........................ 75alprazolam tab sr 24hr 2 mg (Xanax xr)........................ 75alprazolam tab sr 24hr 3 mg (Xanax xr)........................ 75

ALPROLIX -coagulation factor ix (recomb) (rfixfc) for inj1000 unit........................................................................ 134



ALPROLIX -coagulation factor ix (recomb) (rfixfc) for inj500 unit.......................................................................... 134

ALREX -loteprednol etabonate ophth susp 0.2%............ 137ALSUMA -sumatriptan succinate solution auto-injector 6mg/0.5ml.........................................................................104

ALTABAX -retapamulin oint 1%...................................... 145ALTACE -ramipril cap 1.25 mg......................................... 45ALTACE -ramipril cap 10 mg............................................ 45ALTACE -ramipril cap 2.5 mg........................................... 45ALTACE -ramipril cap 5 mg.............................................. 45ALTOPREV -lovastatin tab sr 24hr 20 mg.........................54ALTOPREV -lovastatin tab sr 24hr 40 mg.........................54ALTOPREV -lovastatin tab sr 24hr 60 mg.........................54ALUMINUM ACETATE -aluminum acetate soln..............145ALUVEA -urea cream 39%..............................................145ALVESCO -ciclesonide inhal aerosol 160 mcg/act............62ALVESCO -ciclesonide inhal aerosol 80 mcg/act..............62ALZ-NAC -l-methylfolate-methylcobalamin-acetylcyst tab6-2-600 mg.....................................................................126

AMANTADINE HCL -amantadine hcl tab 100 mg............111amantadine hcl cap 100 mg......................................... 111amantadine hcl syrup 50 mg/5ml.................................111AMARYL -glimepiride tab 1 mg.........................................27AMARYL -glimepiride tab 2 mg.........................................27AMARYL -glimepiride tab 4 mg.........................................27AMBIEN CR -zolpidem tartrate tab cr 12.5 mg..................84AMBIEN CR -zolpidem tartrate tab cr 6.25 mg..................84AMBIEN -zolpidem tartrate tab 10 mg...............................84AMBIEN -zolpidem tartrate tab 5 mg.................................84AMCINONIDE -amcinonide cream 0.1%......................... 145AMCINONIDE -amcinonide lotion 0.1%.......................... 145AMCINONIDE -amcinonide oint 0.1%............................. 145AMERGE -naratriptan hcl tab 1 mg (base equiv)............ 104AMERGE -naratriptan hcl tab 2.5 mg (base equiv)..........104AMICAR -aminocaproic acid oral soln 0.25 gm/ml.......... 133AMICAR -aminocaproic acid syrup 25%......................... 133AMICAR -aminocaproic acid tab 1000 mg...................... 133AMICAR -aminocaproic acid tab 500 mg........................ 133amiloride & hydrochlorothiazide tab 5-50 mg...............52amiloride hcl tab 5 mg.................................................... 52AMINOBENZOATE POTASSIUM -potassiumaminobenzoate packet 2 gm..........................................115

AMINOCAPROIC ACID -aminocaproic acid tab 1000mg.................................................................................. 133

amiodarone hcl tab 100 mg............................................44amiodarone hcl tab 200 mg (Cordarone).......................44amiodarone hcl tab 400 mg............................................44AMITIZA -lubiprostone cap 24 mcg...................................70AMITIZA -lubiprostone cap 8 mcg.....................................70

2015


amitriptyline hcl tab 100 mg...........................................76amitriptyline hcl tab 10 mg.............................................76amitriptyline hcl tab 150 mg...........................................76amitriptyline hcl tab 25 mg.............................................76amitriptyline hcl tab 50 mg.............................................76amitriptyline hcl tab 75 mg.............................................76amlodipine besylate-atorvastatin calcium tab 10-10 mg(Caduet)...........................................................................57

amlodipine besylate-atorvastatin calcium tab 10-20 mg(Caduet)...........................................................................57



amlodipine besylate-atorvastatin calcium tab 2.5-10mg (Caduet).................................................................... 57







amlodipine besylate-benazepril hcl cap 10-20 mg(Lotrel)............................................................................. 45


amlodipine besylate-benazepril hcl cap 2.5-10 mg(Lotrel)............................................................................. 45




amlodipine besylate tab 10 mg (Norvasc).....................42amlodipine besylate tab 2.5 mg (Norvasc)....................42amlodipine besylate tab 5 mg (Norvasc).......................42amlodipine besylate-valsartan tab 10-160 mg(Exforge)..........................................................................45

amlodipine besylate-valsartan tab 10-320 mg(Exforge)..........................................................................45



amlodipine-valsartan-hydrochlorothiazide tab10-160-12.5 mg (Exforge hct)........................................45

amlodipine-valsartan-hydrochlorothiazide tab10-160-25 mg (Exforge hct)...........................................45

amlodipine-valsartan-hydrochlorothiazide tab10-320-25 mg (Exforge hct)...........................................46

amlodipine-valsartan-hydrochlorothiazide tab5-160-12.5 mg (Exforge hct)..........................................45

amlodipine-valsartan-hydrochlorothiazide tab 5-160-25mg (Exforge hct)............................................................ 45

AMOXAPINE -amoxapine tab 100 mg.............................. 76AMOXAPINE -amoxapine tab 150 mg.............................. 76AMOXAPINE -amoxapine tab 25 mg................................ 76AMOXAPINE -amoxapine tab 50 mg................................ 76amoxicillin (trihydrate) cap 250 mg................................. 1amoxicillin (trihydrate) cap 500 mg................................. 1amoxicillin (trihydrate) for susp 125 mg/5ml.................. 1amoxicillin (trihydrate) for susp 200 mg/5ml.................. 1amoxicillin (trihydrate) for susp 250 mg/5ml.................. 1amoxicillin (trihydrate) for susp 400 mg/5ml.................. 1amoxicillin (trihydrate) tab 500 mg.................................. 1amoxicillin (trihydrate) tab 875 mg.................................. 1amoxicillin & k clavulanate chew tab 200-28.5 mg......... 1amoxicillin & k clavulanate chew tab 400-57 mg............ 1amoxicillin & k clavulanate for susp 200-28.5mg/5ml...............................................................................1

amoxicillin & k clavulanate for susp 250-62.5 mg/5ml(Augmentin)...................................................................... 1

amoxicillin & k clavulanate for susp 400-57 mg/5ml...... 1amoxicillin & k clavulanate for susp 600-42.9 mg/5ml(Augmentin es-600)..........................................................1

amoxicillin & k clavulanate tab 250-125 mg....................1amoxicillin & k clavulanate tab 500-125 mg(Augmentin)...................................................................... 1

amoxicillin & k clavulanate tab 875-125 mg(Augmentin)...................................................................... 1

amoxicillin & k clavulanate tab sr 12hr 1000-62.5 mg(Augmentin xr)................................................................. 1

AMOXICILLIN -amoxicillin (trihydrate) chew tab 125 mg.....1AMOXICILLIN -amoxicillin (trihydrate) chew tab 250 mg.....1amoxicillin cap-clarithro tab-lansopraz cap dr therapypack (Prevpac)............................................................... 66

AMOXICILLIN ER -amoxicillin (trihydrate) tab sr 24hr 775mg...................................................................................... 1

amphetamine-dextroamphetamine cap sr 24hr 10 mg(Adderall xr)....................................................................86






amphetamine-dextroamphetamine tab 10 mg(Adderall).........................................................................86

2015


amphetamine-dextroamphetamine tab 12.5 mg(Adderall).........................................................................86





amphetamine-dextroamphetamine tab 7.5 mg(Adderall).........................................................................86

AMPICILLIN -ampicillin for susp 125 mg/5ml...................... 1AMPICILLIN -ampicillin for susp 250 mg/5ml...................... 1ampicillin cap 250 mg....................................................... 1ampicillin cap 500 mg....................................................... 1AMPYRA -dalfampridine tab sr 12hr 10 mg...................... 89AMRIX -cyclobenzaprine hcl cap sr 24hr 15 mg..............113AMRIX -cyclobenzaprine hcl cap sr 24hr 30 mg..............113ANACAINE -benzocaine oint 10%...................................145ANADROL-50 -oxymetholone tab 50 mg.......................... 21ANAFRANIL -clomipramine hcl cap 25 mg....................... 76ANAFRANIL -clomipramine hcl cap 50 mg....................... 76ANAFRANIL -clomipramine hcl cap 75 mg....................... 76anagrelide hcl cap 0.5 mg (Agrylin).............................134anagrelide hcl cap 1 mg............................................... 134ANALPRAM ADVANCED -hc-pramoxine cr & diet manageprod tab & cleans wipe kit............................................. 143

ANALPRAM E -hc-pramoxine emol cream 2.5-1% &pramoxine wipe 1% kit...................................................143

ANALPRAM-HC -hydrocortisone acetate w/ pramoxinerectal cream 1-1%..........................................................144

ANALPRAM-HC -hydrocortisone acetate w/ pramoxinerectal cream 2.5-1%.......................................................144

ANALPRAM-HC -hydrocortisone acetate w/ pramoxinerectal lotn 2.5-1%...........................................................144

ANALPRAM-HC SINGLES -hydrocortisone acetate w/pramoxine rectal cream 1-1%........................................144

ANALPRAM-HC SINGLES -hydrocortisone acetate w/pramoxine rectal cream 2.5-1%.....................................144

ANAPROX DS -naproxen sodium tab 550 mg................ 101ANAPROX -naproxen sodium tab 275 mg...................... 101ANASEPT -sodium hypochlorite liquid 0.057%............... 162ANASPAZ -hyoscyamine sulfate tab disp 0.125 mg..........66anastrozole tab 1 mg (Arimidex)....................................16ANCOBON -flucytosine cap 250 mg................................... 6ANCOBON -flucytosine cap 500 mg................................... 6ANDRODERM -testosterone td patch 24hr 2 mg/24hr...... 21ANDRODERM -testosterone td patch 24hr 4 mg/24hr...... 21ANDROGEL PUMP -testosterone td gel 12.5 mg/act(1%)..................................................................................21

ANDROGEL PUMP -testosterone td gel 20.25 mg/act(1.62%).............................................................................21

ANDROGEL -testosterone td gel 20.25 mg/1.25gm(1.62%).............................................................................21

ANDROGEL -testosterone td gel 25 mg/2.5gm (1%)........ 21ANDROGEL -testosterone td gel 40.5 mg/2.5gm(1.62%).............................................................................21

ANDROGEL -testosterone td gel 50 mg/5gm (1%)........... 21ANDROID -methyltestosterone cap 10 mg........................21ANGELIQ -drospirenone-estradiol tab 0.25-0.5 mg...........22ANGELIQ -drospirenone-estradiol tab 0.5-1 mg................22ANIMI-3/VITAMIN D -folic acid-b6-b12-d-omega 3-phytosterols cap 1 mg................................................... 128

ANIMI-3 -folic acid-b6-b12-d-omega 3-phytosterols cap 1mg.................................................................................. 128

ANIMI-3 -folic acid-vit b6-vit b12-omega 3-phytosterols cap1 mg...............................................................................128

ANODYNERX -capsaicin-lidocaine-menthol patch0.05-2.5-5%....................................................................145

ANODYNZ -capsaicin-menthol disk 0.0375-5%.............. 145ANORO ELLIPTA -umeclidinium-vilanterol aero powd ba62.5-25 mcg/inh............................................................... 62

ANTABUSE -disulfiram tab 250 mg.................................. 89ANTABUSE -disulfiram tab 500 mg.................................. 89ANTARA -fenofibrate micronized cap 30 mg.....................54ANTARA -fenofibrate micronized cap 90 mg.....................54ANTIPYRINE/BENZOCAINE -antipyrine-benzocaine oticsoln 55-14 mg/ml (5.5-1.4%)......................................... 141

antipyrine-benzocaine otic soln 54-14 mg/ml(5.4-1.4%).......................................................................141

antipyrine-benzocaine-polycosanol otic sol5.4-1.4-0.0097% (Treagan otic)....................................141

ANUSOL-HC -hydrocortisone acetate suppos 25 mg......144ANUSOL-HC -hydrocortisone rectal cream 2.5%............ 144ANZEMET -dolasetron mesylate tab 100 mg.................... 69ANZEMET -dolasetron mesylate tab 50 mg...................... 69APEXICON E -diflorasone diacetate emollient base cream0.05%............................................................................. 145

APIDRA -insulin glulisine inj 100 unit/ml........................... 31APIDRA SOLOSTAR -insulin glulisine soln pen-injector inj100 unit/ml....................................................................... 31

APLENZIN -bupropion hbr tab sr 24hr 174 mg................. 76APLENZIN -bupropion hbr tab sr 24hr 348 mg................. 76APLENZIN -bupropion hbr tab sr 24hr 522 mg................. 76APOKYN -apomorphine hydrochloride inj 10 mg/ml........111apraclonidine hcl ophth soln 0.5% (base equivalent)(Iopidine)....................................................................... 137

APRISO -mesalamine cap sr 24hr 0.375 gm.................... 70APTENSIO XR -methylphenidate hcl cap er 24hr 10 mg(xr).................................................................................... 86

APTENSIO XR -methylphenidate hcl cap er 24hr 15 mg(xr).................................................................................... 86




2015




APTIOM -eslicarbazepine acetate tab 200 mg................ 106APTIOM -eslicarbazepine acetate tab 400 mg................ 106APTIOM -eslicarbazepine acetate tab 600 mg................ 106APTIOM -eslicarbazepine acetate tab 800 mg................ 106APTIVUS -tipranavir cap 250 mg........................................ 7APTIVUS -tipranavir oral soln 100 mg/ml............................7AQUORAL -artificial saliva - aero soln............................ 142ARALEN -chloroquine phosphate tab 500 mg...................11ARANESP ALBUMIN FREE -darbepoetin alfa-polysorbate80 soln inj 100 mcg/0.5ml..............................................128

ARANESP ALBUMIN FREE -darbepoetin alfa-polysorbate80 soln inj 100 mcg/ml...................................................128

ARANESP ALBUMIN FREE -darbepoetin alfa-polysorbate80 soln inj 10 mcg/0.4ml................................................128

ARANESP ALBUMIN FREE -darbepoetin alfa-polysorbate80 soln inj 150 mcg/0.3ml..............................................128




ARANESP ALBUMIN FREE -darbepoetin alfa-polysorbate80 soln inj 25 mcg/ml.................................................... 128








ARAVA -leflunomide tab 10 mg.......................................101ARAVA -leflunomide tab 20 mg.......................................101ARCALYST -rilonacept for inj 220 mg.............................101ARCAPTA NEOHALER -indacaterol maleate inhal powdercap 75 mcg (base equiv)................................................. 63

ARICEPT -donepezil hydrochloride tab 10 mg.................. 89ARICEPT -donepezil hydrochloride tab 23 mg.................. 89ARICEPT -donepezil hydrochloride tab 5 mg....................89ARIMIDEX -anastrozole tab 1 mg..................................... 16aripiprazole tab 10 mg (Abilify)...................................... 81aripiprazole tab 15 mg (Abilify)...................................... 81aripiprazole tab 20 mg (Abilify)...................................... 81aripiprazole tab 2 mg (Abilify)........................................81

aripiprazole tab 30 mg (Abilify)...................................... 81aripiprazole tab 5 mg (Abilify)........................................81ARIXTRA -fondaparinux sodium subcutaneous inj 10mg/0.8ml.........................................................................131

ARIXTRA -fondaparinux sodium subcutaneous inj 2.5mg/0.5ml.........................................................................131

ARIXTRA -fondaparinux sodium subcutaneous inj 5mg/0.4ml.........................................................................131

ARIXTRA -fondaparinux sodium subcutaneous inj 7.5mg/0.6ml.........................................................................131

ARMOUR THYROID -thyroid tab 120 mg (2 grain)........... 33ARMOUR THYROID -thyroid tab 15 mg (1/4 grain).......... 33ARMOUR THYROID -thyroid tab 180 mg (3 grain)........... 33ARMOUR THYROID -thyroid tab 240 mg (4 grain)........... 33ARMOUR THYROID -thyroid tab 300 mg (5 grain)........... 33ARMOUR THYROID -thyroid tab 30 mg (1/2 grain).......... 33ARMOUR THYROID -thyroid tab 60 mg (1 grain)............. 33ARMOUR THYROID -thyroid tab 90 mg (1 1/2 grain)....... 33ARNUITY ELLIPTA -fluticasone furoate aerosol powderbreath activ 100 mcg/act................................................. 63

ARNUITY ELLIPTA -fluticasone furoate aerosol powderbreath activ 200 mcg/act................................................. 63

AROMASIN -exemestane tab 25 mg.................................16ARTHROTEC 50 -diclofenac w/ misoprostol tab delayedrelease 50-0.2 mg..........................................................101

ARTHROTEC 75 -diclofenac w/ misoprostol tab delayedrelease 75-0.2 mg..........................................................101

ARZOL SILVER NITRATE APP -silver nitrate-potassiumnitrate applicator 75-25%...............................................145

ASACOL HD -mesalamine tab delayed release 800mg.................................................................................... 70

ASCENSIA AUTODISC TEST ST -glucose blood testdisk................................................................................. 163

ASMANEX HFA -mometasone furoate inhal aerosolsuspension 100 mcg/act.................................................. 63

ASMANEX HFA -mometasone furoate inhal aerosolsuspension 200 mcg/act.................................................. 63

ASMANEX TWISTHALER 120 ME -mometasone furoateinhal powd 220 mcg/inh (breath activated)...................... 63

ASMANEX TWISTHALER 30 MET -mometasone furoateinhal powd 110 mcg/inh (breath activated)...................... 63



ASPIRIN/DIPYRIDAMOLE -aspirin-dipyridamole cap sr12hr 25-200 mg............................................................. 134

ASPIRIN-CAFFEINE-DIHYDROC -aspirin-caffeine-dihydrocodeine cap 356.4-30-16 mg............................... 94

aspirin chew tab 81 mg.................................................. 93ASPIRIN LOW DOSE -aspirin tab 81 mg..........................93aspirin tab delayed release 81 mg.................................93ASTAGRAF XL -tacrolimus cap sr 24hr 0.5 mg.............. 163ASTAGRAF XL -tacrolimus cap sr 24hr 1 mg................. 164ASTAGRAF XL -tacrolimus cap sr 24hr 5 mg................. 164

2015


ASTEPRO -azelastine hcl nasal spray 0.15% (205.5 mcg/spray)............................................................................... 59

ATABEX EC -prenatal vit w/ dss-iron carbonyl-fa tab dr29-1 mg..........................................................................115

ATACAND -candesartan cilexetil tab 16 mg......................46ATACAND -candesartan cilexetil tab 32 mg......................46ATACAND -candesartan cilexetil tab 4 mg........................46ATACAND -candesartan cilexetil tab 8 mg........................46ATACAND HCT -candesartan cilexetil-hydrochlorothiazidetab 16-12.5 mg................................................................ 46

ATACAND HCT -candesartan cilexetil-hydrochlorothiazidetab 32-12.5 mg................................................................ 46

ATACAND HCT -candesartan cilexetil-hydrochlorothiazidetab 32-25 mg................................................................... 46

ATELVIA -risedronate sodium tab delayed release 35mg.................................................................................... 35

ATENDIA -lidocaine-menthol patch 4-3%........................145atenolol & chlorthalidone tab 100-25 mg (Tenoretic100).................................................................................. 46

atenolol & chlorthalidone tab 50-25 mg (Tenoretic50).................................................................................... 46

atenolol tab 100 mg (Tenormin)..................................... 40atenolol tab 25 mg (Tenormin)....................................... 40atenolol tab 50 mg (Tenormin)....................................... 40ATGAM -lymphocyte immune globulin anti-thymocyte g inj50 mg/ml(eq)..................................................................164

ATIVAN -lorazepam tab 0.5 mg........................................ 75ATIVAN -lorazepam tab 1 mg........................................... 75ATIVAN -lorazepam tab 2 mg........................................... 75ATOPICLAIR -dermatological products misc - cream......145atorvastatin calcium tab 10 mg (base equivalent)(Lipitor)............................................................................54

atorvastatin calcium tab 20 mg (base equivalent)(Lipitor)............................................................................54



atovaquone-proguanil hcl tab 250-100 mg(Malarone)....................................................................... 11

atovaquone-proguanil hcl tab 62.5-25 mg(Malarone)....................................................................... 11

atovaquone susp 750 mg/5ml (Mepron)........................ 12ATRALIN -tretinoin gel 0.05%......................................... 145ATRAPRO CP -wound dressings - kit............................. 145ATRAPRO DERMAL SPRAY -wound cleansers -liquid............................................................................... 145

ATRIPLA -efavirenz-emtricitabine-tenofovir df tab600-200-300 mg.................................................................7

ATROPINE SULFATE -atropine sulfate ophth oint1%.................................................................................. 137

atropine sulfate ophth soln 1% (Isopto atropine)....... 137ATROVENT HFA -ipratropium bromide hfa inhal aerosol17 mcg/act....................................................................... 63

ATROVENT -ipratropium bromide nasal soln 0.03% (21mcg/spray)........................................................................59

ATROVENT -ipratropium bromide nasal soln 0.06% (42mcg/spray)........................................................................59

AUBAGIO -teriflunomide tab 14 mg.................................. 89AUBAGIO -teriflunomide tab 7 mg.................................... 89AUGMENTIN -amoxicillin & k clavulanate for susp125-31.25 mg/5ml.............................................................. 1

AUGMENTIN -amoxicillin & k clavulanate for susp250-62.5 mg/5ml................................................................ 1

AUGMENTIN -amoxicillin & k clavulanate tab 500-125mg...................................................................................... 1

AUGMENTIN -amoxicillin & k clavulanate tab 875-125mg...................................................................................... 1

AUGMENTIN ES-600 -amoxicillin & k clavulanate for susp600-42.9 mg/5ml................................................................ 1

AUGMENTIN XR -amoxicillin & k clavulanate tab sr 12hr1000-62.5 mg.....................................................................1

AURALGAN -antipyrine-benzocaine otic soln 55-14 mg/ml(5.5-1.4%).......................................................................141

AURSTAT ANTI-ITCH HYDROGE -dermatologicalproducts misc - kit......................................................... 145

AURSTAT -dermatological products misc - kit................ 145AURYXIA -ferric citrate tab 1 gm (210 mg ferric iron)........70AUVI-Q -epinephrine solution auto-injector 0.15 mg/0.15ml(1:1000)............................................................................ 53

AUVI-Q -epinephrine solution auto-injector 0.3 mg/0.3ml(1:1000)............................................................................ 53

AVAILNEX -carbocysteine chew tab 750 mg.................. 126AVALIDE -irbesartan-hydrochlorothiazide tab 150-12.5mg.................................................................................... 46

AVALIDE -irbesartan-hydrochlorothiazide tab 300-12.5mg.................................................................................... 46

AVALIN-RX -lidocaine-menthol patch 4-1%.................... 145AVANDAMET -rosiglitazone maleate-metformin hcl tab2-1000 mg........................................................................27

AVANDIA -rosiglitazone maleate tab 2 mg (baseequiv)................................................................................27



AVAPRO -irbesartan tab 150 mg...................................... 46AVAPRO -irbesartan tab 300 mg...................................... 46AVAPRO -irbesartan tab 75 mg........................................ 46AVAR-E LS -sulfacetamide sodium w/ sulfur cream10-2%............................................................................. 146

AVAR LS CLEANSER -sulfacetamide sodium w/ sulfurcleanser 10-2%.............................................................. 146

AVAR LS -sulfacetamide sodium w/ sulfur cleansing pad10-2%............................................................................. 146

AVAR LS -sulfacetamide sodium w/ sulfur foam10-2%............................................................................. 146

AVAR -sulfacetamide sodium w/ sulfur cleansing pad9.5-5%............................................................................ 145

2015


AVAR -sulfacetamide sodium w/ sulfur foam 9.5-5%...... 145AVC -sulfanilamide vaginal cream 15%............................ 73AVEED -testosterone undecanoate im inj in oil 750 mg/3ml(250mg/ml)....................................................................... 21

AVELOX ABC PACK -moxifloxacin hcl tab 400 mg (baseequiv)..................................................................................5

AVELOX -moxifloxacin hcl tab 400 mg (base equiv)........... 5AVENOVA -hypochlorous acid cleanser soln 0.01%....... 146AVIDOXY DK -doxycycline tab 100 mg & suncreen & salacid wash 2% kit................................................................4

AVINZA -morphine sulfate beads cap sr 24hr 120 mg...... 94AVINZA -morphine sulfate beads cap sr 24hr 30 mg........ 94AVINZA -morphine sulfate beads cap sr 24hr 45 mg........ 94AVINZA -morphine sulfate beads cap sr 24hr 60 mg........ 94AVINZA -morphine sulfate beads cap sr 24hr 75 mg........ 94AVINZA -morphine sulfate beads cap sr 24hr 90 mg........ 94AVODART -dutasteride cap 0.5 mg.................................. 74AVONEX -interferon beta-1a for im inj kit 30mcg(33mcg(6.6 mu)/vial)........................................................ 89

AVONEX -interferon beta-1a im inj kit 30 mcg/0.5ml.........89AVONEX PEN -interferon beta-1a im inj kit 30mcg/0.5ml.........................................................................89

AXERT -almotriptan malate tab 12.5 mg.........................104AXERT -almotriptan malate tab 6.25 mg.........................104AXID -nizatidine cap 300 mg.............................................66AXIRON -testosterone td soln 30 mg/act.......................... 21AYGESTIN -norethindrone acetate tab 5 mg.................... 26AZASAN -azathioprine tab 100 mg................................. 164AZASAN -azathioprine tab 75 mg................................... 164AZASITE -azithromycin ophth soln 1%........................... 137azathioprine tab 50 mg (Imuran).................................. 164azelastine hcl nasal spray 0.1% (137 mcg/spray)......... 59azelastine hcl nasal spray 0.15% (205.5 mcg/spray)(Astepro)......................................................................... 59

azelastine hcl ophth soln 0.05% (Optivar)...................137AZELEX -azelaic acid cream 20%.................................. 146AZILECT -rasagiline mesylate tab 0.5 mg (baseequiv)..............................................................................111

AZILECT -rasagiline mesylate tab 1 mg (base equiv)......111AZITHROMYCIN -azithromycin powd pack for susp 1gm...................................................................................... 2

azithromycin for susp 100 mg/5ml (Zithromax).............. 2azithromycin for susp 200 mg/5ml (Zithromax).............. 2azithromycin tab 250 mg (Zithromax)..............................2azithromycin tab 500 mg (Zithromax)..............................2azithromycin tab 600 mg (Zithromax)..............................3AZOPT -brinzolamide ophth susp 1%............................. 137AZOR -amlodipine besylate-olmesartan medoxomil tab10-20 mg..........................................................................46

AZOR -amlodipine besylate-olmesartan medoxomil tab10-40 mg..........................................................................46

AZOR -amlodipine besylate-olmesartan medoxomil tab5-20 mg............................................................................46

AZOR -amlodipine besylate-olmesartan medoxomil tab5-40 mg............................................................................46

AZULFIDINE EN-TABS -sulfasalazine tab delayed release500 mg.............................................................................70

AZULFIDINE -sulfasalazine tab 500 mg............................70

B

B-6 FOLIC ACID -cobalamine combination cap.............. 128BABY DDROPS -cholecalciferol drops 400 unit/0.03ml(per drop)....................................................................... 115

BACITRACIN -bacitracin ophth oint 500 unit/gm.............137bacitracin-polymyxin b ophth oint...............................137bacitracin-polymyxin-neomycin-hc ophth oint 1%..... 137baclofen tab 10 mg........................................................113baclofen tab 20 mg........................................................113BACTRIM DS -sulfamethoxazole-trimethoprim tab 800-160mg.................................................................................... 12

BACTRIM -sulfamethoxazole-trimethoprim tab 400-80mg.................................................................................... 12

BACTROBAN -mupirocin calcium cream 2%.................. 146BACTROBAN -mupirocin oint 2%................................... 146BACTROBAN NASAL -mupirocin calcium nasal oint2%.................................................................................... 59

BAL-CARE DHA -prenat w/fe poly-na fered-fa tab 27-1 &omega cap dr 430mg.....................................................115

balsalazide disodium cap 750 mg (Colazal).................. 70BANZEL -rufinamide susp 40 mg/ml............................... 106BANZEL -rufinamide tab 200 mg.................................... 106BANZEL -rufinamide tab 400 mg.................................... 106BARACLUDE -entecavir oral soln 0.05 mg/ml.................... 7BARACLUDE -entecavir tab 0.5 mg....................................7BARACLUDE -entecavir tab 1 mg.......................................7BAYER BREEZE 2 TEST DISC -glucose blood testdisk................................................................................. 163

BAYER CONTOUR BLOOD GLUCO -glucose blood teststrip.................................................................................163

BAYER CONTOUR NEXT BLOOD -glucose blood teststrip.................................................................................163

b-complex w/ c & folic acid cap 1 mg(Nephrocaps)................................................................ 115

b-complex w/ c & folic acid tab 1 mg (Nephro-viterx)...................................................................................115

b-complex w/ c & folic acid tab 5 mg.......................... 115b-complex w/ c-biotin-minerals & folic acid tab 5 mg(Diatx zn).......................................................................115

BD GLUCOSE -glucose chew tab 5 gm............................27BEBULIN -factor ix complex for inj 200-1200 unit........... 134BEBULIN VH -factor ix complex for inj 200-1200 unit......134BECONASE AQ -beclomethasone dipropionate monohydnasal susp 42 mcg/spray.................................................59

BELLADONNA & OPIUM -belladonna alkaloids & opiumsuppos 16.2-30 mg.......................................................... 66

BELLADONNA ALKALOIDS & OP -belladonna alkaloids &opium suppos 16.2-60 mg............................................... 66

BELSOMRA -suvorexant tab 10 mg..................................84BELSOMRA -suvorexant tab 15 mg..................................84BELSOMRA -suvorexant tab 20 mg..................................84BELSOMRA -suvorexant tab 5 mg....................................84

2015


benazepril & hydrochlorothiazide tab 10-12.5 mg(Lotensin hct)................................................................. 46

benazepril & hydrochlorothiazide tab 20-12.5 mg(Lotensin hct)................................................................. 46

benazepril & hydrochlorothiazide tab 20-25 mg(Lotensin hct)................................................................. 46

benazepril & hydrochlorothiazide tab 5-6.25 mg.......... 46benazepril hcl tab 10 mg (Lotensin).............................. 46benazepril hcl tab 20 mg (Lotensin).............................. 46benazepril hcl tab 40 mg (Lotensin).............................. 46benazepril hcl tab 5 mg.................................................. 46BENEFIX -coagulation factor ix (recombinant) for inj 1000unit..................................................................................134

BENEFIX -coagulation factor ix (recombinant) for inj 2000unit..................................................................................134




BENICAR HCT -olmesartan medoxomil-hydrochlorothiazide tab 20-12.5 mg................................ 46

BENICAR HCT -olmesartan medoxomil-hydrochlorothiazide tab 40-12.5 mg................................ 46

BENICAR HCT -olmesartan medoxomil-hydrochlorothiazide tab 40-25 mg................................... 46

BENICAR -olmesartan medoxomil tab 20 mg................... 46BENICAR -olmesartan medoxomil tab 40 mg................... 46BENICAR -olmesartan medoxomil tab 5 mg..................... 46BENSAL HP -salicylic acid & benzoic acid oint 3-6%...... 146BENTYL -dicyclomine hcl cap 10 mg................................ 66BENTYL -dicyclomine hcl tab 20 mg.................................66BENZACLIN -clindamycin phosphate-benzoyl peroxide gel1-5%............................................................................... 146

BENZACLIN WITH PUMP -clindamycin phosphate-benzoyl peroxide gel 1-5%............................................ 146

BENZALKONIUM CHLORIDE -benzalkonium chloridesoln.................................................................................162

BENZALKONIUM CHLORIDE -benzalkonium chloride soln50%................................................................................ 162

BENZAMYCIN -benzoyl peroxide-erythromycin gel5-3%............................................................................... 146

BENZAMYCINPAK -benzoyl peroxide-erythromycin gelpack 5-3%...................................................................... 146

BENZEFOAM -benzoyl peroxide foam 5.3%...................146BENZEFOAMULTRA -benzoyl peroxide foam 9.8%....... 146BENZIQ -benzoyl peroxide gel 5.25 %............................146BENZIQ LS -benzoyl peroxide gel 2.75%....................... 146benzocaine dental soln 20%.........................................142benzonatate cap 100 mg (Tessalon perles)...................59benzonatate cap 150 mg (Zonatuss)..............................59benzonatate cap 200 mg.................................................59benzoyl peroxide creamy wash 4% &benzoyl peroxidebar 5% kit......................................................................146

benzoyl peroxide creamy wash 8% &benzoyl peroxidebar 5% kit (Bpo creamy wash comp)......................... 146

benzoyl peroxide-erythromycin gel 5-3%(Benzamycin)................................................................ 146

benzoyl peroxide foam 5.3% (Benzefoam).................. 146benzoyl peroxide foam 9.8% (Benzefoamultra).......... 146benzoyl peroxide liq 2.5%.............................................146benzoyl peroxide liq 5.25%...........................................146benzoyl peroxide liq 7%................................................146benzoyl peroxide lotion 6%.......................................... 146benztropine mesylate tab 0.5 mg.................................111benztropine mesylate tab 1 mg....................................111benztropine mesylate tab 2 mg....................................111BEPREVE -bepotastine besilate ophth soln 1.5%...........137BERINERT -c1 esterase inhibitor (human) for iv inj kit 500unit..................................................................................134

BESIVANCE -besifloxacin hcl ophth susp 0.6% (baseequiv)..............................................................................137

BETADINE OPHTHALMIC PREP -povidone-iodine ophthsoln 5%.......................................................................... 137

BETAGAN -levobunolol hcl ophth soln 0.5%...................137betamethasone dipropionate augmented cream 0.05%(Diprolene af)................................................................146

betamethasone dipropionate augmented gel0.05%............................................................................. 146

betamethasone dipropionate augmented lotion 0.05%(Diprolene).................................................................... 146

betamethasone dipropionate augmented oint 0.05%(Diprolene).................................................................... 146

betamethasone dipropionate cream 0.05%.................146betamethasone dipropionate lotion 0.05%..................146betamethasone dipropionate oint 0.05%.....................146betamethasone valerate aerosol foam 0.12%(Luxiq)........................................................................... 146

betamethasone valerate cream 0.1%........................... 146betamethasone valerate lotion 0.1%............................146betamethasone valerate oint 0.1%...............................146BETAPACE AF -sotalol hcl (afib/afl) tab 120 mg...............40BETAPACE AF -sotalol hcl (afib/afl) tab 160 mg...............40BETAPACE AF -sotalol hcl (afib/afl) tab 80 mg.................40BETAPACE -sotalol hcl tab 120 mg..................................40BETAPACE -sotalol hcl tab 160 mg..................................40BETAPACE -sotalol hcl tab 80 mg....................................40BETASERON -interferon beta-1b for inj kit 0.3 mg............89betaxolol hcl ophth soln 0.5%......................................137betaxolol hcl tab 10 mg (Kerlone)..................................40betaxolol hcl tab 20 mg (Kerlone)..................................40bethanechol chloride tab 10 mg (Urecholine)...............72bethanechol chloride tab 25 mg (Urecholine)...............72bethanechol chloride tab 50 mg (Urecholine)...............72bethanechol chloride tab 5 mg (Urecholine).................72BETHKIS -tobramycin nebu soln 300 mg/4ml..................... 5BETIMOL -timolol ophth soln 0.25%............................... 137BETIMOL -timolol ophth soln 0.5%................................. 137BETOPTIC-S -betaxolol hcl ophth susp 0.25%............... 137

2015


bexarotene cap 75 mg (Targretin)..................................16BEYAZ -drospirenone-ethinyl estrad-levomefolate tab3-0.02-0.451 mg...............................................................24

BIAXIN -clarithromycin for susp 250 mg/5ml.......................3BIAXIN -clarithromycin tab 250 mg..................................... 3BIAXIN -clarithromycin tab 500 mg..................................... 3BIAXIN XL -clarithromycin tab sr 24hr 500 mg....................3BIAXIN XL PAC -clarithromycin tab sr 24hr 500 mg............3bicalutamide tab 50 mg (Casodex)................................ 16BIDIL -isosorbide dinitrate-hydralazine hcl tab 20-37.5mg.................................................................................... 57

BIFERARX -polysacch fe cmplx-fe heme poly-fa-b12 tab22-6-1-0.025 mg............................................................ 128

BILTRICIDE -praziquantel tab 600 mg.............................. 11BIMATOPROST -bimatoprost ophth soln 0.03%............. 137BINOSTO -alendronate sodium effervescent tab 70mg.................................................................................... 35

BIO-STATIN -nystatin cap 1000000 unit............................. 6BIO-STATIN -nystatin cap 500000 unit............................... 6bisacodyl tab & peg 3350-kcl-sod bicarb-nacl for solnkit..................................................................................... 65

bisoprolol & hydrochlorothiazide tab 10-6.25 mg(Ziac)................................................................................46

bisoprolol & hydrochlorothiazide tab 2.5-6.25 mg(Ziac)................................................................................46

bisoprolol & hydrochlorothiazide tab 5-6.25 mg(Ziac)................................................................................46

bisoprolol fumarate tab 10 mg (Zebeta)........................ 40bisoprolol fumarate tab 5 mg (Zebeta).......................... 40BLEPH-10 -sulfacetamide sodium ophth soln 10%......... 137BLEPHAMIDE S.O.P. -sulfacetamide sodium-prednisoloneophth oint 10-0.2%.........................................................137

BLEPHAMIDE -sulfacetamide sodium-prednisolone ophthsusp 10-0.2%................................................................. 137

BLOOD GLUCOSE CALIBRATION LIQUID –VARIOUS....................................................................... 163

B-NEXA -prenatal w/ calcium-vit b6-fa-ginger tab 1.22mg.................................................................................. 115

BONIVA -ibandronate sodium tab 150 mg (baseequivalent)........................................................................35

BOOSTRIX -tet tox-diph-acell pertuss ad inj 5-2.5-18.5 lf-lf-mcg/0.5ml......................................................................15

BOSULIF -bosutinib tab 100 mg....................................... 16BOSULIF -bosutinib tab 500 mg....................................... 16BP CLEANSING WASH -sulfacetamide sodium-sulfur inurea emulsion 10-4%.....................................................146

BP FOLINATAL PLUS B -prenatal w/ calcium carbonate-b6-b12-fa tab 1 mg........................................................ 115

BP MULTINATAL PLUS -prenatal w/o a vit w/ fe fumarate-fa tab 30-1 mg............................................................... 115

BP MULTINATAL PLUS -prenatal w/o a vit w/ fe fum-fa tabchew 40-1 mg................................................................ 115

BPO 3% FOAMING CLOTHS -benzoyl peroxide cloth3%.................................................................................. 146

BPO 9% FOAMING CLOTHS -benzoyl peroxide cloth9%.................................................................................. 146

BPO -benzoyl peroxide gel 4%....................................... 146BPO -benzoyl peroxide gel 8%....................................... 146BPO CREAMY WASH COMPLETE -benzoyl peroxidecreamy wash 8% &benzoyl peroxide bar 5% kit............ 146

BP VIT 3 -folic acid-vit b6-vit b12-omega 3-phytosterolscap 1 mg........................................................................128

BP VIT 3 PLUS -folic acid-b6-b12-d-omega 3-phytosterolscap 1 mg........................................................................128

BREO ELLIPTA -fluticasone furoate-vilanterol aero powdba 100-25 mcg/inh...........................................................63

BREO ELLIPTA -fluticasone furoate-vilanterol aero powdba 200-25 mcg/inh...........................................................63

BREVICON-28 -norethindrone & ethinyl estradiol tab 0.5mg-35 mcg....................................................................... 24

BRILINTA -ticagrelor tab 90 mg...................................... 134brimonidine tartrate ophth soln 0.15% (Alphaganp).................................................................................... 137

brimonidine tartrate ophth soln 0.2%.......................... 137BRINTELLIX -vortioxetine hbr tab 10 mg (base equiv)......76BRINTELLIX -vortioxetine hbr tab 20 mg (base equiv)......76BRINTELLIX -vortioxetine hbr tab 5 mg (base equiv)........76BRISDELLE -paroxetine mesylate cap 7.5 mg (baseequiv)................................................................................89

bromfenac sodium ophth soln 0.09% (base equiv)(once-daily)................................................................... 138

bromfenac sodium ophth soln 0.09% (baseequivalent).................................................................... 137

bromocriptine mesylate cap 5 mg (Parlodel).............. 111bromocriptine mesylate tab 2.5 mg............................. 111brompheniramine & pseudoephedrine tab sr 12hr 6-45mg.................................................................................... 59

brompheniramine maleate tab sr 12hr 6 mg................. 58BROMPHENIRAMINE TANNATE -brompheniraminetannate chew tab 12 mg..................................................58

BROVANA -arformoterol tartrate soln nebu 15 mcg/2ml(base equiv)..................................................................... 63

budesonide cap sr 24hr 3 mg (Entocort ec)..................19budesonide inhalation susp 0.25 mg/2ml(Pulmicort)...................................................................... 63

budesonide inhalation susp 0.5 mg/2ml(Pulmicort)...................................................................... 63

budesonide inhalation susp 1 mg/2ml (Pulmicort).......63budesonide nasal susp 32 mcg/act (Rhinocortaqua)................................................................................59

bumetanide tab 0.5 mg................................................... 52bumetanide tab 1 mg...................................................... 52bumetanide tab 2 mg...................................................... 52BUNAVAIL -buprenorphine-naloxone buccal film 2.1-0.3mg (base equiv)...............................................................94

BUNAVAIL -buprenorphine-naloxone buccal film 4.2-0.7mg (base equiv)...............................................................94

BUNAVAIL -buprenorphine-naloxone buccal film 6.3-1 mg(base equiv)..................................................................... 94

2015


BUPAP -butalbital-acetaminophen tab 50-300 mg............ 93BUPHENYL -sodium phenylbutyrate oral powder 3 gm/teaspoonful.......................................................................35

BUPHENYL -sodium phenylbutyrate tab 500 mg.............. 35buprenorphine hcl-naloxone hcl sl tab 2-0.5 mg (baseequiv)...............................................................................94

buprenorphine hcl-naloxone hcl sl tab 8-2 mg (baseequiv)...............................................................................94

buprenorphine hcl sl tab 2 mg (base equiv)................. 94buprenorphine hcl sl tab 8 mg (base equiv)................. 94bupropion hcl (smoking deterrent) tab sr 12hr 150 mg(Zyban)............................................................................ 89

bupropion hcl tab 100 mg (Wellbutrin)..........................76bupropion hcl tab 75 mg (Wellbutrin)............................76bupropion hcl tab sr 12hr 100 mg (Wellbutrin sr).........76bupropion hcl tab sr 12hr 150 mg (Wellbutrin sr).........76bupropion hcl tab sr 12hr 200 mg (Wellbutrin sr).........76bupropion hcl tab sr 24hr 150 mg (Wellbutrin xl)......... 76bupropion hcl tab sr 24hr 300 mg (Wellbutrin xl)......... 76buspirone hcl tab 10 mg.................................................75buspirone hcl tab 15 mg.................................................75buspirone hcl tab 30 mg.................................................75buspirone hcl tab 5 mg...................................................75buspirone hcl tab 7.5 mg................................................75butalbital-acetaminophen-caffeine cap 50-300-40 mg(Fioricet).......................................................................... 93

butalbital-acetaminophen-caffeine cap 50-325-40mg.................................................................................... 93

butalbital-acetaminophen-caffeine tab 50-325-40 mg(Esgic)............................................................................. 93

butalbital-acetaminophen-caff w/ cod cap 50-300-40-30mg (Fioricet/codeine).....................................................94

butalbital-acetaminophen-caff w/ cod cap 50-325-40-30mg.................................................................................... 94

butalbital-acetaminophen tab 50-325 mg...................... 93butalbital-aspirin-caffeine cap 50-325-40 mg(Fiorinal).......................................................................... 93

butalbital-aspirin-caff w/ codeine cap 50-325-40-30 mg(Fiorinal/codeine #3)...................................................... 94

BUTISOL SODIUM -butabarbital sodium tab 30 mg..........84BUTISOL SODIUM -butabarbital sodium tab 50 mg..........84butorphanol tartrate nasal soln 10 mg/ml..................... 94BUTRANS -buprenorphine td patch weekly 10 mcg/hr......94BUTRANS -buprenorphine td patch weekly 15 mcg/hr......94BUTRANS -buprenorphine td patch weekly 20 mcg/hr......94BUTRANS -buprenorphine td patch weekly 5 mcg/hr........94BUTRANS -buprenorphine td patch weekly 7.5 mcg/hr.....94BYDUREON -exenatide extended release for inj susp 2mg.................................................................................... 27

BYDUREON -exenatide extended release for susp pen-injector 2 mg.................................................................... 27

BYETTA -exenatide soln pen-injector 10 mcg/0.04ml....... 27BYETTA -exenatide soln pen-injector 5 mcg/0.02ml......... 27BYSTOLIC -nebivolol hcl tab 10 mg (base equivalent)......40BYSTOLIC -nebivolol hcl tab 2.5 mg (base equivalent).....40

BYSTOLIC -nebivolol hcl tab 20 mg (base equivalent)......40BYSTOLIC -nebivolol hcl tab 5 mg (base equivalent)........40

C

cabergoline tab 0.5 mg................................................... 35CADUET -amlodipine besylate-atorvastatin calcium tab10-10 mg..........................................................................57

CADUET -amlodipine besylate-atorvastatin calcium tab10-20 mg..........................................................................57



CADUET -amlodipine besylate-atorvastatin calcium tab2.5-10 mg.........................................................................57



CADUET -amlodipine besylate-atorvastatin calcium tab5-10 mg............................................................................57




CAFERGOT -ergotamine w/ caffeine tab 1-100 mg........ 104caffeine citrate oral soln 60 mg/3ml (10 mg/ml baseequiv) (Cafcit)................................................................. 86

CALAN SR -verapamil hcl tab cr 120 mg..........................42CALAN SR -verapamil hcl tab cr 180 mg..........................42CALAN SR -verapamil hcl tab cr 240 mg..........................42CALAN -verapamil hcl tab 120 mg....................................42CALAN -verapamil hcl tab 80 mg......................................42CALCIFOL -ca carb-folic acid-vit d-b6-b12-boron-magwafer 1342-1.6 mg.........................................................124

calcipotriene-betamethasone dipropionate oint0.005-0.064% (Taclonex)..............................................147

calcipotriene cream 0.005% (Dovonex)....................... 146calcipotriene oint 0.005%..............................................147calcipotriene soln 0.005% (50 mcg/ml)........................147calcitonin (salmon) nasal soln 200 unit/act(Miacalcin).......................................................................35

CALCITRIOL -calcitriol oint 3 mcg/gm.............................147calcitriol cap 0.25 mcg (Rocaltrol)................................. 35calcitriol cap 0.5 mcg (Rocaltrol)................................... 35calcitriol oral soln 1 mcg/ml (Rocaltrol)........................ 35calcium acetate (phosphate binder) cap 667 mg (169mg ca) (Phoslo)..............................................................70

calcium acetate (phosphate binder) tab 667 mg(Eliphos).......................................................................... 70

CALCIUM-FOLIC ACID PLUS D -ca carb-folic acid-vit d-b6-b12-boron-mag wafer 1342-1 mg............................. 124

CALCIUM PNV -prenatal w/o vit a w/ fe fum-fa-omega 3cap 28-1-250 mg............................................................116

2015


CAMBIA -diclofenac potassium packet 50 mg.................104CAMPHOMEX -camphor-histamine-menthol liqd spray4-0.025-10%...................................................................147

CANASA -mesalamine suppos 1000 mg...........................70candesartan cilexetil-hydrochlorothiazide tab 16-12.5mg (Atacand hct)........................................................... 46

candesartan cilexetil-hydrochlorothiazide tab 32-12.5mg (Atacand hct)........................................................... 47

candesartan cilexetil-hydrochlorothiazide tab 32-25mg (Atacand hct)........................................................... 47

candesartan cilexetil tab 16 mg (Atacand)....................46candesartan cilexetil tab 32 mg (Atacand)....................46candesartan cilexetil tab 4 mg (Atacand)......................46candesartan cilexetil tab 8 mg (Atacand)......................46CANTIL -mepenzolate bromide tab 25 mg........................ 66CAPCOF -phenylephrine-chlorphen w/ codeine syrup5-2-10 mg/5ml..................................................................59

capecitabine tab 150 mg (Xeloda)..................................16capecitabine tab 500 mg (Xeloda)..................................16CAPEX -fluocinolone acetonide shampoo 0.01%............147CAPHOSOL -artificial saliva - solution............................ 142CAPITAL/CODEINE -acetaminophen w/ codeine susp120-12 mg/5ml................................................................. 94

CAPRELSA -vandetanib tab 100 mg................................ 16CAPRELSA -vandetanib tab 300 mg................................ 16CAPSIDERM -capsaicin-menthol topical patch0.0375-5%...................................................................... 147

CAPTOPRIL/HYDROCHLOROTHIA -captopril &hydrochlorothiazide tab 25-15 mg................................... 47




captopril tab 100 mg....................................................... 47captopril tab 12.5 mg...................................................... 47captopril tab 25 mg......................................................... 47captopril tab 50 mg......................................................... 47CAPTRACIN -capsaicin-menthol topical patch0.0375-5%...................................................................... 147

CARAC -fluorouracil cream 0.5%.................................... 147CARAFATE -sucralfate susp 1 gm/10ml........................... 66CARAFATE -sucralfate tab 1 gm...................................... 66CARBAGLU -carglumic acid tab 200 mg...........................35carbamazepine cap sr 12hr 100 mg (Carbatrol).......... 106carbamazepine cap sr 12hr 200 mg (Carbatrol).......... 106carbamazepine cap sr 12hr 300 mg (Carbatrol).......... 106carbamazepine chew tab 100 mg.................................106carbamazepine susp 100 mg/5ml (Tegretol)............... 106carbamazepine tab 200 mg (Tegretol)......................... 106carbamazepine tab sr 12hr 200 mg (Tegretol-xr)........ 106carbamazepine tab sr 12hr 400 mg (Tegretol-xr)........ 106CARBAPHEN 12 PED -phenyleph-chlorphen-carbetapentane susp 2.5-1.25-7.5 mg/ml........................ 59

CARBAPHEN 12 -phenyleph-chlorphen-carbetapentaneliqd 10-4-27.5 mg/5ml...................................................... 59

CARBATROL -carbamazepine cap sr 12hr 100 mg........ 106CARBATROL -carbamazepine cap sr 12hr 200 mg........ 106CARBATROL -carbamazepine cap sr 12hr 300 mg........ 106CARBIDOPA/LEVODOPA/ENTACA -carbidopa-levodopa-entacapone tabs 12.5-50-200 mg..................................111

CARBIDOPA/LEVODOPA/ENTACA -carbidopa-levodopa-entacapone tabs 18.75-75-200 mg................................111

CARBIDOPA/LEVODOPA/ENTACA -carbidopa-levodopa-entacapone tabs 25-100-200 mg...................................111

CARBIDOPA/LEVODOPA/ENTACA -carbidopa-levodopa-entacapone tabs 31.25-125-200 mg..............................111

CARBIDOPA/LEVODOPA/ENTACA -carbidopa-levodopa-entacapone tabs 37.5-150-200 mg................................111

CARBIDOPA/LEVODOPA/ENTACA -carbidopa-levodopa-entacapone tabs 50-200-200 mg...................................111

carbidopa & levodopa orally disintegrating tab 10-100mg.................................................................................. 111



carbidopa & levodopa tab 10-100 mg (Sinemet)......... 111carbidopa & levodopa tab 25-100 mg (Sinemet)......... 111carbidopa & levodopa tab 25-250 mg (Sinemet)......... 111carbidopa & levodopa tab cr 25-100 mg (Sinemetcr)...................................................................................111

carbidopa & levodopa tab cr 50-200 mg (Sinemetcr)...................................................................................111

carbidopa tab 25 mg (Lodosyn)................................... 111carbinoxamine maleate soln 4 mg/5ml..........................58carbinoxamine maleate tab 4 mg...................................58carbonyl iron susp 15 mg/1.25ml (elemental iron)......128CARDIOTEK-RX -folic acid-b12-b6-arginine-black peppertab.................................................................................. 126

CARDIOVID PLUS -dha-epa-vit b6-b12-folic acid cap240-360-20-0.5-0.8 mg.................................................. 126

CARDIZEM CD -diltiazem hcl coated beads cap sr 24hr120 mg.............................................................................42


CARDIZEM CD -diltiazem hcl coated beads cap sr 24hr240 mg............................................................................. 42


CARDIZEM CD -diltiazem hcl coated beads cap sr 24hr360 mg............................................................................. 42

CARDIZEM -diltiazem hcl tab 120 mg...............................42CARDIZEM -diltiazem hcl tab 30 mg.................................42CARDIZEM -diltiazem hcl tab 60 mg.................................42CARDIZEM LA -diltiazem hcl coated beads tab sr 24hr120 mg.............................................................................42

CARDIZEM LA -diltiazem hcl coated beads tab sr 24hr180 mg............................................................................. 42

2015


CARDIZEM LA -diltiazem hcl coated beads tab sr 24hr240 mg.............................................................................42

CARDIZEM LA -diltiazem hcl coated beads tab sr 24hr300 mg............................................................................. 42



CARDURA -doxazosin mesylate tab 1 mg........................ 47CARDURA -doxazosin mesylate tab 2 mg........................ 47CARDURA -doxazosin mesylate tab 4 mg........................ 47CARDURA -doxazosin mesylate tab 8 mg........................ 47CARDURA XL -doxazosin mesylate tab sr 24 hr 4 mg(base equiv)..................................................................... 74

CARDURA XL -doxazosin mesylate tab sr 24 hr 8 mg(base equiv)..................................................................... 74

CARISOPRODOL -carisoprodol tab 250 mg................... 113carisoprodol tab 350 mg (Soma)..................................113carisoprodol w/ aspirin & codeine tab 200-325-16mg.................................................................................. 114

carisoprodol w/ aspirin tab 200-325 mg...................... 114CARNITOR -levocarnitine oral soln 1 gm/10ml (10%).......35CARNITOR -levocarnitine tab 330 mg.............................. 35CARNITOR SF -levocarnitine oral soln 1 gm/10ml(10%)................................................................................35

carteolol hcl ophth soln 1%......................................... 138carvedilol tab 12.5 mg (Coreg)....................................... 40carvedilol tab 25 mg (Coreg)..........................................40carvedilol tab 3.125 mg (Coreg)..................................... 40carvedilol tab 6.25 mg (Coreg).......................................40CASCARA SAGRADA -cascara sagrada fl ext 1 gm/ml......................................................................................65

CASODEX -bicalutamide tab 50 mg................................. 16CATAPRES -clonidine hcl tab 0.1 mg............................... 47CATAPRES -clonidine hcl tab 0.2 mg............................... 47CATAPRES -clonidine hcl tab 0.3 mg............................... 47CATAPRES-TTS-1 -clonidine hcl td patch weekly 0.1mg/24hr............................................................................ 47

CATAPRES-TTS-2 -clonidine hcl td patch weekly 0.2mg/24hr............................................................................ 47

CATAPRES-TTS-3 -clonidine hcl td patch weekly 0.3mg/24hr............................................................................ 47

CAYSTON -aztreonam lysine for inhal soln 75 mg (baseequivalent)........................................................................12

CEDAX -ceftibuten cap 400 mg.......................................... 1CEDAX -ceftibuten for susp 180 mg/5ml.............................1CEDAX -ceftibuten for susp 90 mg/5ml...............................1CEENU -lomustine cap 100 mg........................................ 16CEENU -lomustine cap 10 mg.......................................... 16CEENU -lomustine cap 40 mg.......................................... 16cefaclor cap 250 mg..........................................................2cefaclor cap 500 mg..........................................................2CEFACLOR -cefaclor for susp 125 mg/5ml.........................1CEFACLOR -cefaclor for susp 250 mg/5ml.........................2CEFACLOR -cefaclor for susp 375 mg/5ml.........................2

CEFACLOR ER -cefaclor monohydrate tab sr 12hr 500mg...................................................................................... 2

cefadroxil cap 500 mg.......................................................2cefadroxil for susp 250 mg/5ml........................................2cefadroxil for susp 500 mg/5ml........................................2cefadroxil tab 1 gm........................................................... 2cefdinir cap 300 mg...........................................................2cefdinir for susp 125 mg/5ml........................................... 2cefdinir for susp 250 mg/5ml........................................... 2CEFDITOREN PIVOXIL -cefditoren pivoxil tab 200 mg(base equivalent)............................................................... 2

CEFDITOREN PIVOXIL -cefditoren pivoxil tab 400 mg(base equivalent)............................................................... 2

cefixime for susp 100 mg/5ml (Suprax)...........................2cefixime for susp 200 mg/5ml (Suprax)...........................2cefpodoxime proxetil for susp 100 mg/5ml.....................2cefpodoxime proxetil for susp 50 mg/5ml.......................2cefpodoxime proxetil tab 100 mg.................................... 2cefpodoxime proxetil tab 200 mg.................................... 2cefprozil for susp 125 mg/5ml..........................................2cefprozil for susp 250 mg/5ml..........................................2cefprozil tab 250 mg..........................................................2cefprozil tab 500 mg..........................................................2CEFTIBUTEN -ceftibuten cap 400 mg................................ 2CEFTIBUTEN -ceftibuten for susp 180 mg/5ml...................2CEFTIN -cefuroxime axetil for susp 125 mg/5ml.................2CEFTIN -cefuroxime axetil for susp 250 mg/5ml.................2CEFTIN -cefuroxime axetil tab 250 mg............................... 2CEFTIN -cefuroxime axetil tab 500 mg............................... 2cefuroxime axetil tab 250 mg (Ceftin)..............................2cefuroxime axetil tab 500 mg (Ceftin)..............................2CELEBREX -celecoxib cap 100 mg................................ 101CELEBREX -celecoxib cap 200 mg................................ 101CELEBREX -celecoxib cap 400 mg................................ 101CELEBREX -celecoxib cap 50 mg.................................. 101celecoxib cap 100 mg (Celebrex).................................101celecoxib cap 200 mg (Celebrex).................................101celecoxib cap 400 mg (Celebrex).................................101celecoxib cap 50 mg (Celebrex)...................................101CELEXA -citalopram hydrobromide tab 10 mg (baseequiv)................................................................................76

CELEXA -citalopram hydrobromide tab 20 mg (baseequiv)................................................................................76

CELEXA -citalopram hydrobromide tab 40 mg (baseequiv)................................................................................77

CELLCEPT -mycophenolate mofetil cap 250 mg............ 164CELLCEPT -mycophenolate mofetil for oral susp 200 mg/ml....................................................................................164

CELLCEPT -mycophenolate mofetil tab 500 mg............. 164CELONTIN -methsuximide cap 300 mg.......................... 106CEM-UREA -urea soln 45%............................................ 147CENFOL -folic acid-vitamin b6-vitamin b12 tab 2.3-24.5-2mg.................................................................................. 128

CENTANY AT -mupirocin oint kit 2%.............................. 147CENTANY -mupirocin oint 2%.........................................147

2015


CENTRATEX -ferrous fumarate-fa-b complex-c-zn-mg-mn-cu cap 106-1 mg............................................................128

cephalexin cap 250 mg (Keflex).......................................2cephalexin cap 500 mg (Keflex).......................................2cephalexin cap 750 mg (Keflex).......................................2CEPHALEXIN -cephalexin tab 250 mg............................... 2CEPHALEXIN -cephalexin tab 500 mg............................... 2cephalexin for susp 125 mg/5ml...................................... 2cephalexin for susp 250 mg/5ml...................................... 2CERDELGA -eliglustat tartrate cap 84 mg (baseequivalent)......................................................................128

CEREFOLIN -l-methylfolate w/ vit b12-vit b6-vit b2 tab6-1-50-5 mg................................................................... 126

CEREFOLIN NAC -l-methylfolate-algae-b12-acetylcyst tab6-90.314-2-600mg..........................................................126

CEREFOLIN NAC -l-methylfolate-methylcobalamin-acetylcyst tab 6-2-600 mg............................................. 126

CERVIDIL -dinoprostone vaginal inserts 10 mg................ 35CESAMET -nabilone cap 1 mg......................................... 69CETACAINE -butamben-tetracaine-benzocaine aerosolspray 2-2-14%................................................................147

CETRAXAL -ciprofloxacin hcl otic soln 0.2% (baseequivalent)......................................................................141

cevimeline hcl cap 30 mg (Evoxac)............................. 142CHANTIX CONTINUING MONTH -varenicline tartrate tab1 mg (base equiv)............................................................90

CHANTIX STARTING MONTH PA -varenicline tartrate tab0.5 mg x 11 & tab 1 mg x 42 pack.................................. 90

CHANTIX -varenicline tartrate tab 0.5 mg (base equiv).....90CHANTIX -varenicline tartrate tab 1 mg (base equiv)........90CHEMET -succimer cap 100 mg.....................................163CHENODAL -chenodiol tab 250 mg..................................70CHLORDIAZEPOXIDE/AMITRIPT -chlordiazepoxide-amitriptyline tab 10-25 mg............................................... 90

CHLORDIAZEPOXIDE/AMITRIPT -chlordiazepoxide-amitriptyline tab 5-12.5 mg.............................................. 90

chlordiazepoxide hcl cap 10 mg.................................... 75chlordiazepoxide hcl cap 25 mg.................................... 75chlordiazepoxide hcl cap 5 mg...................................... 75chlordiazepoxide hcl-clidinium bromide cap 5-2.5 mg(Librax)............................................................................ 66

chlorhexidine gluconate soln 0.12% (Peridex)............142chloroquine phosphate tab 250 mg...............................11chloroquine phosphate tab 500 mg (Aralen).................11CHLOROTHIAZIDE -chlorothiazide tab 250 mg................52chlorothiazide tab 500 mg.............................................. 52chlorpromazine hcl tab 100 mg......................................81chlorpromazine hcl tab 10 mg........................................81chlorpromazine hcl tab 200 mg......................................81chlorpromazine hcl tab 25 mg........................................81chlorpromazine hcl tab 50 mg........................................81CHLORPROPAMIDE -chlorpropamide tab 100 mg...........27CHLORPROPAMIDE -chlorpropamide tab 250 mg...........27CHLORTHALIDONE -chlorthalidone tab 100 mg.............. 52CHLORTHALIDONE -chlorthalidone tab 25 mg................ 52

CHLORTHALIDONE -chlorthalidone tab 50 mg................ 52chlorzoxazone tab 500 mg (Parafon forte dsc)........... 114CHOICE-OB+DHA -prenatal mv w/fe poly-fa chw 29-1 mg& dha cap 250 mg pak.................................................. 116

CHOLBAM -cholic acid cap 250 mg..................................70CHOLBAM -cholic acid cap 50 mg....................................70cholecalciferol cap 1000 unit........................................115cholecalciferol cap 400 unit..........................................115cholecalciferol cap 50000 unit......................................115cholecalciferol chew tab 1000 unit.............................. 115cholecalciferol chew tab 400 unit................................ 115cholecalciferol drops 400 unit/0.03ml (per drop)........ 115cholecalciferol drops 5000 unit/ml (1000unit/0.2ml)..................................................................... 115

cholecalciferol oral liquid 400 unit/ml......................... 115cholecalciferol tab 1000 unit........................................ 115cholecalciferol tab 400 unit.......................................... 115cholestyramine light powder 4 gm/dose (Questranlight).................................................................................54

cholestyramine light powder packets 4 gm.................. 54cholestyramine powder 4 gm/dose (Questran).............54cholestyramine powder packets 4 gm (Questran)........54choline & magnesium salicylates liq 500 mg/5ml.........93choline fenofibrate cap dr 135 mg (fenofibric acidequiv) (Trilipix)............................................................... 54

choline fenofibrate cap dr 45 mg (fenofibric acid equiv)(Trilipix)........................................................................... 54

CHOLINE MAGNESIUM TRISALI -choline & magnesiumsalicylates tab 1000 mg................................................... 93

CIALIS -tadalafil tab 2.5 mg.............................................. 57CIALIS -tadalafil tab 2.5 mg.............................................. 58CIALIS -tadalafil tab 5 mg................................................. 57CIALIS -tadalafil tab 5 mg................................................. 58CICLODAN CREAM KIT -ciclopirox olamine cream 0.77%(base equiv) & cleanser kit............................................ 147

CICLODAN SOLUTION KIT -ciclopirox solution kit8%.................................................................................. 147

ciclopirox gel 0.77%...................................................... 147ciclopirox olamine cream 0.77% (base equiv).............147ciclopirox olamine susp 0.77% (base equiv)...............147ciclopirox shampoo 1% (Loprox shampoo)................ 147ciclopirox solution 8% (Penlac Nail Lacquer)............. 147ciclopirox solution kit 8% (Ciclodan solution ki)........ 147CICLOPIROX TOPICAL SOLUTI -ciclopirox solution 8% &vitamin e 5% topical kit..................................................147

CIFEREX -folic acid-cholecalciferol cap 1 mg-3775unit..................................................................................128

cilostazol tab 100 mg (Pletal)....................................... 134cilostazol tab 50 mg (Pletal)......................................... 134CILOXAN -ciprofloxacin hcl ophth oint 0.3%................... 138CILOXAN -ciprofloxacin hcl ophth soln 0.3%.................. 138cimetidine hcl soln 300 mg/5ml..................................... 66cimetidine tab 300 mg.....................................................66cimetidine tab 400 mg.....................................................66cimetidine tab 800 mg.....................................................66

2015


CIMZIA -certolizumab pegol inj kit 2 x 200 mg/ml............. 70CIMZIA STARTER KIT -certolizumab pegol inj kit 6 x 200mg/ml................................................................................70

CIPRO -ciprofloxacin for oral susp 250 mg/5ml (5%) (5gm/100ml).......................................................................... 5

CIPRO -ciprofloxacin for oral susp 500 mg/5ml (10%) (10gm/100ml).......................................................................... 5

CIPRO -ciprofloxacin hcl tab 250 mg (base equiv)..............5CIPRO -ciprofloxacin hcl tab 500 mg (base equiv)..............5CIPRODEX -ciprofloxacin-dexamethasone otic susp0.3-0.1%......................................................................... 141

CIPROFLOXACIN -ciprofloxacin hcl otic soln 0.2% (baseequivalent)......................................................................141

ciprofloxacin-ciprofloxacin hcl tab sr 24hr 1000mg(base eq) (Cipro xr).................................................... 5

ciprofloxacin-ciprofloxacin hcl tab sr 24hr 500 mg(base eq) (Cipro xr)......................................................... 5

ciprofloxacin for oral susp 250 mg/5ml (5%) (5gm/100ml) (Cipro)............................................................ 5

ciprofloxacin for oral susp 500 mg/5ml (10%) (10gm/100ml) (Cipro)............................................................ 5

CIPROFLOXACIN HCL -ciprofloxacin hcl tab 100 mg(base equiv)....................................................................... 5

ciprofloxacin hcl ophth soln 0.3% (Ciloxan)............... 138ciprofloxacin hcl tab 250 mg (base equiv) (Cipro)..........5ciprofloxacin hcl tab 500 mg (base equiv) (Cipro)..........5ciprofloxacin hcl tab 750 mg (base equiv)...................... 5CIPRO HC -ciprofloxacin-hydrocortisone otic susp0.2-1%............................................................................ 141

CIPRO XR -ciprofloxacin-ciprofloxacin hcl tab sr 24hr 1000mg(base eq).......................................................................5

CIPRO XR -ciprofloxacin-ciprofloxacin hcl tab sr 24hr 500mg (base eq)..................................................................... 5

citalopram hydrobromide oral soln 10 mg/5ml.............77citalopram hydrobromide tab 10 mg (base equiv)(Celexa)........................................................................... 77

citalopram hydrobromide tab 20 mg (base equiv)(Celexa)........................................................................... 77

citalopram hydrobromide tab 40 mg (base equiv)(Celexa)........................................................................... 77

CITRANATAL 90 DHA -prenat w/o a w/fecbn-fegl-dss-fatab 90 &dha cap 300mg pak......................................... 116

CITRANATAL ASSURE -prenat w/o a w/fecbn-fegl-dss-fatab & dha cap 300 mg pack.......................................... 116

CITRANATAL B-CALM -prenat w/o a w/fecbn-feglu-fa tab20-1 mg & vit b6 tab pak...............................................116

CITRANATAL B-CALM -prenat w/o a w/ fe cbnyl-fa tab20-1 mg & vit b6 tab pak...............................................116

CITRANATAL DHA -prenat w/o a w/fecbn-fegl-dss-fa tab &dha cap 250 mg pack....................................................116

CITRANATAL HARMONY -prenatal w/o a w/fe cbn-dss-fa-dha cap 29-1-265 mg.................................................... 116

CITRANATAL HARMONY -prenat w/o a w/fe fum-fe cbn-dss-fa-dha cap 27-1-260 mg..........................................116

CITRANATAL RX -prenatal w/o a w/ fe carbonyl-fe gluc-dss-fa tab 27-1mg..........................................................116

CITRUS BERGAMOT -citrus bergamot oral powder 250mg/0.25 gm.................................................................... 163

CLARAVIS -isotretinoin cap 30 mg................................. 147CLARIFOAM EF -sulfacetamide sodium w/ sulfur foam10-5%............................................................................. 147

CLARINEX-D 12 HOUR -desloratadine &pseudoephedrine tab sr 12hr 2.5-120 mg........................60

CLARINEX -desloratadine syrup 0.5 mg/ml...................... 58CLARINEX -desloratadine tab 5 mg..................................58CLARINEX REDITABS -desloratadine tab orallydisintegrating 2.5 mg....................................................... 58

CLARINEX REDITABS -desloratadine tab orallydisintegrating 5 mg.......................................................... 58

clarithromycin for susp 125 mg/5ml................................3clarithromycin for susp 250 mg/5ml (Biaxin).................. 3clarithromycin tab 250 mg (Biaxin)..................................3clarithromycin tab 500 mg (Biaxin)..................................3clarithromycin tab sr 24hr 500 mg (Biaxin xl pac)..........3CLEMASTINE FUMARATE -clemastine fumarate syrup0.67 mg/5ml (0.5 mg/5ml base eq)..................................58

clemastine fumarate tab 2.68 mg...................................58CLEOCIN -clindamycin hcl cap 150 mg............................ 12CLEOCIN -clindamycin hcl cap 300 mg............................ 12CLEOCIN -clindamycin hcl cap 75 mg.............................. 12CLEOCIN -clindamycin phosphate vaginal cream 2%.......73CLEOCIN -clindamycin phosphate vaginal suppos 100mg.................................................................................... 73

CLEOCIN PEDIATRIC GRANULE -clindamycin palmitatehcl for soln 75 mg/5ml (base equiv)................................ 12

CLEOCIN-T -clindamycin phosphate gel 1%...................147CLEOCIN-T -clindamycin phosphate lotion 1%...............147CLEOCIN-T -clindamycin phosphate soln 1%.................147CLEOCIN-T -clindamycin phosphate swab 1%............... 147CLEVER CHOICE COMFORT EZ -methyl salicylate-lidocaine-menthol patch 20-4-1%.................................. 147

CLEVER CHOICE COMFORT EZ -methyl salicylate-lidocaine-menthol patch 2-4-1%.................................... 147

CLIMARA -estradiol td patch weekly 0.025 mg/24hr......... 22CLIMARA -estradiol td patch weekly 0.0375 mg/24hr (37.5mcg/24hr)......................................................................... 22

CLIMARA -estradiol td patch weekly 0.05 mg/24hr........... 22CLIMARA -estradiol td patch weekly 0.06 mg/24hr........... 22CLIMARA -estradiol td patch weekly 0.075 mg/24hr......... 22CLIMARA -estradiol td patch weekly 0.1 mg/24hr............. 22CLIMARA PRO -estradiol-levonorgestrel td patch weekly0.045-0.015 mg/day......................................................... 22

CLINDACIN ETZ -clindamycin phosphate swab 1% &cleanser kit.....................................................................147

CLINDACIN PAC -clindamycin phosphate swab 1% &cleanser kit.....................................................................147

CLINDAGEL -clindamycin phosphate gel 1%..................147clindamycin hcl cap 150 mg (Cleocin)...........................12clindamycin hcl cap 300 mg (Cleocin)...........................12

2015


clindamycin hcl cap 75 mg (Cleocin)............................ 12clindamycin palmitate hcl for soln 75 mg/5ml (baseequiv) (Cleocin pediatric gr)......................................... 12

clindamycin phosphate-benzoyl peroxide gel 1-5%(Benzaclin).................................................................... 147

clindamycin phosphate foam 1% (Evoclin).................147clindamycin phosphate gel 1% (Cleocin-t)..................147clindamycin phosphate lotion 1% (Cleocin-t)............. 147clindamycin phosphate soln 1% (Cleocin-t)................147clindamycin phosphate swab 1% (Cleocin-t)..............147clindamycin phosphate vaginal cream 2%(Cleocin).......................................................................... 73

clindamycin phosph-benzoyl peroxide (refrig) gel 1.2(1)-5% (Duac)................................................................ 147

CLINDESSE -clindamycin phosphate (one dose) vaginalcream 2%.........................................................................73

clobetasol propionate cream 0.05% (Temovate).........147clobetasol propionate emollient base cream 0.05%(Temovate e).................................................................148

clobetasol propionate emulsion foam 0.05% (Olux-e).................................................................................... 148

clobetasol propionate foam 0.05% (Olux)................... 148clobetasol propionate gel 0.05% (Temovate)..............148clobetasol propionate lotion 0.05% (Clobex).............. 148clobetasol propionate oint 0.05% (Temovate).............148clobetasol propionate shampoo 0.05% (Clobex)........ 148clobetasol propionate soln 0.05% (Temovate)............148clobetasol propionate spray 0.05% (Clobex).............. 148CLOBEX -clobetasol propionate lotion 0.05%................. 148CLOBEX -clobetasol propionate shampoo 0.05%........... 148CLOBEX -clobetasol propionate spray 0.05%.................148CLOCORTOLONE PIVALATE -clocortolone pivalatecream 0.1%....................................................................148

CLOCORTOLONE PIVALATE PUM -clocortolone pivalatecream 0.1%....................................................................148

CLODAN KIT -clobetasol propionate shampoo 0.05% &cleanser kit.....................................................................148

CLODERM -clocortolone pivalate cream 0.1%................148CLODERM PUMP -clocortolone pivalate cream 0.1%.....148clomipramine hcl cap 25 mg (Anafranil)....................... 77clomipramine hcl cap 50 mg (Anafranil)....................... 77clomipramine hcl cap 75 mg (Anafranil)....................... 77clonazepam orally disintegrating tab 0.125 mg.......... 106clonazepam orally disintegrating tab 0.25 mg............ 107clonazepam orally disintegrating tab 0.5 mg.............. 107clonazepam orally disintegrating tab 1 mg................. 107clonazepam orally disintegrating tab 2 mg................. 107clonazepam tab 0.5 mg (Klonopin).............................. 107clonazepam tab 1 mg (Klonopin)................................. 107clonazepam tab 2 mg (Klonopin)................................. 107clonidine hcl tab 0.1 mg (Catapres)...............................47clonidine hcl tab 0.2 mg (Catapres)...............................47clonidine hcl tab 0.3 mg (Catapres)...............................47clonidine hcl tab sr 12hr 0.1 mg (Kapvay).....................86

clonidine hcl td patch weekly 0.1 mg/24hr (Catapres-tts-1).................................................................................47



clopidogrel bisulfate tab 300 mg (base equiv)(Plavix)...........................................................................134

clopidogrel bisulfate tab 75 mg (base equiv)(Plavix)...........................................................................134

clorazepate dipotassium tab 15 mg (Tranxene t)..........75clorazepate dipotassium tab 3.75 mg (Tranxene t).......75clorazepate dipotassium tab 7.5 mg (Tranxene t).........75CLORPRES -clonidine & chlorthalidone tab 0.1-15 mg.....47CLORPRES -clonidine & chlorthalidone tab 0.2-15 mg.....47CLORPRES -clonidine & chlorthalidone tab 0.3-15 mg.....47clotrimazole troche 10 mg............................................ 142clotrimazole w/ betamethasone cream 1-0.05%(Lotrisone).....................................................................148

clotrimazole w/ betamethasone lotion 1-0.05%...........148CLOZAPINE ODT -clozapine orally disintegrating tab 100mg.................................................................................... 81

CLOZAPINE ODT -clozapine orally disintegrating tab 12.5mg.................................................................................... 81

CLOZAPINE ODT -clozapine orally disintegrating tab 150mg.................................................................................... 81



clozapine tab 100 mg (Clozaril)......................................81clozapine tab 200 mg...................................................... 81clozapine tab 25 mg (Clozaril)........................................81clozapine tab 50 mg........................................................ 81CLOZARIL -clozapine tab 100 mg.................................... 81CLOZARIL -clozapine tab 25 mg...................................... 81C-NATE DHA -prenatal vit w/ fe fum-fa-omega 3 cap28-1-200 mg...................................................................116

CNL8 NAIL KIT -ciclopirox soln 8% & lacquer removalpads kit...........................................................................148

COAL TAR -coal tar soln 20%........................................ 148COARTEM -artemether-lumefantrine tab 20-120 mg........ 11COCAINE HCL -cocaine hcl soln 10%............................148COCAINE HCL -cocaine hcl soln 4%..............................148CODAR AR -chlorpheniramine w/ codeine liquid 2-8mg/5ml..............................................................................60

CODAR D -pseudoephedrine w/ codeine liquid 30-8mg/5ml..............................................................................60

CODEINE SULFATE -codeine sulfate tab 15 mg..............94CODEINE SULFATE -codeine sulfate tab 30 mg..............95CODEINE SULFATE -codeine sulfate tab 60 mg..............95codeine sulfate tab 15 mg (Codeine sulfate).................95codeine sulfate tab 30 mg.............................................. 95codeine sulfate tab 60 mg.............................................. 95COLAZAL -balsalazide disodium cap 750 mg...................70

2015


COLCHICINE -colchicine cap 0.6 mg..............................106COLCHICINE -colchicine tab 0.6 mg.............................. 106colchicine w/ probenecid tab 0.5-500 mg....................106COLCRYS -colchicine tab 0.6 mg................................... 106COLESTID -colestipol hcl granule packets 5 gm...............54COLESTID -colestipol hcl granules 5 gm..........................54COLESTID -colestipol hcl tab 1 gm.................................. 54COLESTID FLAVORED -colestipol hcl granule packets 5gm.................................................................................... 54

COLESTID FLAVORED -colestipol hcl granules 5 gm...... 54colestipol hcl granule packets 5 gm (Colestidflavored).......................................................................... 54

colestipol hcl granules 5 gm (Colestid flavored).......... 54colestipol hcl tab 1 gm (Colestid)..................................54COLGATE DRY MOUTH RELIEF -sodium fluoridemouthwash 2.1 mg/10ml................................................142

COLY-MYCIN S -neomycin-colistin-hc-thonzonium oticsusp 3.3-3-10-0.5 mg/ml................................................141

COLYTE-FLAVOR PACKS -peg 3350-kcl-na bicarb-nacl-na sulfate for soln 227.1 gm............................................65

COLYTE-FLAVOR PACKS -peg 3350-kcl-na bicarb-nacl-na sulfate for soln 240 gm...............................................65

COMBIGAN -brimonidine tartrate-timolol maleate ophthsoln 0.2-0.5%................................................................. 138

COMBIPATCH -estradiol-norethindrone ace td pttw0.05-0.14 mg/day............................................................. 22

COMBIPATCH -estradiol-norethindrone ace td pttw0.05-0.25 mg/day............................................................. 22

COMBIVENT RESPIMAT -ipratropium-albuterol inhalaerosol soln 20-100 mcg/act............................................63

COMBIVIR -lamivudine-zidovudine tab 150-300 mg........... 7COMETRIQ -cabozantinib s-malate cap 3 x 20 mg (60 mgdose) kit........................................................................... 16

COMETRIQ -cabozantinib s-mal cap 1 x 80 mg & 1 x 20mg (100 dose) kit.............................................................16

COMETRIQ -cabozantinib s-mal cap 1 x 80 mg & 3 x 20mg (140 dose) kit.............................................................16

COMMIT -nicotine polacrilex lozenge 2 mg.......................90COMMIT -nicotine polacrilex lozenge 4 mg.......................90COMPAZINE -prochlorperazine maleate tab 10 mg (baseequivalent)........................................................................81

COMPAZINE -prochlorperazine maleate tab 5 mg (baseequivalent)........................................................................81

COMPLERA -emtricitabine-rilpivirine-tenofovir df tab200-25-300 mg...................................................................7

COMPLETE NATAL DHA -prenat-fe bis-fe prot succ-fa-catab & omega 3 cap 250 pk............................................ 116

COMPLETENATE -prenatal vit w/ fe fumarate-fa chew tab29-1 mg..........................................................................116

COMTAN -entacapone tab 200 mg.................................111CO-NATAL FA -prenatal vit w/ fe fumarate-fa tab 29-1mg.................................................................................. 116

CONCEPT DHA -prenatal w/fe fum-fe poly -fa-omega 3cap 53.5-38-1 mg...........................................................116

CONCEPT OB -prenatal w/o a w/fe fum-fe poly-fa cap130-92.4-1 mg................................................................116

CONCERTA -methylphenidate hcl tab sa osm 18 mg....... 86CONCERTA -methylphenidate hcl tab sa osm 27 mg....... 86CONCERTA -methylphenidate hcl tab sa osm 36 mg....... 86CONCERTA -methylphenidate hcl tab sa osm 54 mg....... 86CONDYLOX -podofilox gel 0.5%.....................................148CONDYLOX -podofilox soln 0.5%................................... 148CONZIP -tramadol hcl cap sr 24hr biphasic release 100mg.................................................................................... 95

CONZIP -tramadol hcl cap sr 24hr biphasic release 200mg.................................................................................... 95

CONZIP -tramadol hcl cap sr 24hr biphasic release 300mg.................................................................................... 95

COPASIL -emollient - gel................................................ 148COPAXONE -glatiramer acetate soln prefilled syringe 20mg/ml................................................................................90

COPAXONE -glatiramer acetate soln prefilled syringe 40mg/ml................................................................................90

COPEGUS -ribavirin tab 200 mg.........................................7CORDARONE -amiodarone hcl tab 200 mg..................... 44CORDRAN -flurandrenolide cream 0.05%...................... 148CORDRAN -flurandrenolide lotion 0.05%........................148CORDRAN -flurandrenolide oint 0.05%...........................148CORDRAN TAPE -flurandrenolide tape 4 mcg/sqcm...... 148COREG -carvedilol tab 12.5 mg........................................40COREG -carvedilol tab 25 mg...........................................40COREG -carvedilol tab 3.125 mg......................................40COREG -carvedilol tab 6.25 mg........................................40COREG CR -carvedilol phosphate cap sr 24hr 10 mg...... 40COREG CR -carvedilol phosphate cap sr 24hr 20 mg...... 40COREG CR -carvedilol phosphate cap sr 24hr 40 mg...... 40COREG CR -carvedilol phosphate cap sr 24hr 80 mg...... 40CORGARD -nadolol tab 20 mg......................................... 40CORGARD -nadolol tab 40 mg......................................... 40CORGARD -nadolol tab 80 mg......................................... 40CORIFACT -factor xiii concentrate (human) for inj kit1000-1600 unit............................................................... 134

CORLANOR -ivabradine hcl tab 5 mg (base equiv).......... 57CORLANOR -ivabradine hcl tab 7.5 mg (base equiv)....... 57CORTALO -hydrocortisone acetate-aloe vera gel 2%..... 148CORTANE-B AQUEOUS -pramoxine-hc-chloroxylenolaqueous otic soln 10-10-1 mg/ml.................................. 141

CORTANE-B -hydrocortisone-pramoxine-chloroxylenol lot10-10-1mg/ml................................................................. 148

CORTANE-B-OTIC -pramoxine-hc-chloroxylenol otic soln10-10-1 mg/ml................................................................141

CORTEF -hydrocortisone tab 10 mg.................................19CORTEF -hydrocortisone tab 20 mg.................................19CORTEF -hydrocortisone tab 5 mg...................................19CORTENEMA -hydrocortisone enema 100 mg/60ml.......144CORTIFOAM -hydrocortisone acetate rectal foam 90 mg/dose................................................................................144

CORTISONE ACETATE -cortisone acetate tab 25 mg......19

2015


CORTISPORIN -bacitracin-polymyxin-neomycin hc oint1%.................................................................................. 148

CORTISPORIN -neomycin-polymyxin-hc cream0.5%............................................................................... 148

CORTISPORIN -neomycin-polymyxin-hc otic soln1%.................................................................................. 141

CORTISPORIN-TC -neomycin-colistin-hc-thonzonium oticsusp 3.3-3-10-0.5 mg/ml................................................141

CORVITE 150 -iron combination tab...............................129CORVITE 150 -iron-folic acid-vit c-vit b6-vit b12-zinc tab150-1.25 mg...................................................................129

CORVITE FE -iron combination tab................................ 129CORVITE -multiple vitamins w/ minerals & fa tab 1.25mg.................................................................................. 116

CORZIDE -nadolol & bendroflumethiazide tab 40-5mg.................................................................................... 47

CORZIDE -nadolol & bendroflumethiazide tab 80-5mg.................................................................................... 47

COSENTYX -secukinumab subcutaneous soln prefilledsyringe 150 mg/ml......................................................... 148

COSENTYX SENSOREADY PEN -secukinumabsubcutaneous soln auto-injector 150 mg/ml.................. 148

COSOPT -dorzolamide hcl-timolol maleate ophth soln22.3-6.8 mg/ml............................................................... 138

COSOPT PF -dorzolamide hcl-timolol maleate ophth sol22.3-6.8 mg/ml pf...........................................................138

COUMADIN -warfarin sodium tab 10 mg........................ 132COUMADIN -warfarin sodium tab 1 mg.......................... 131COUMADIN -warfarin sodium tab 2.5 mg....................... 132COUMADIN -warfarin sodium tab 2 mg.......................... 132COUMADIN -warfarin sodium tab 3 mg.......................... 132COUMADIN -warfarin sodium tab 4 mg.......................... 132COUMADIN -warfarin sodium tab 5 mg.......................... 132COUMADIN -warfarin sodium tab 6 mg.......................... 132COUMADIN -warfarin sodium tab 7.5 mg....................... 132COZAAR -losartan potassium tab 100 mg........................ 47COZAAR -losartan potassium tab 25 mg.......................... 47COZAAR -losartan potassium tab 50 mg.......................... 47CPB WC -pseudoephedrine-bromphen-codeine liq10-1.3-6.3 mg/5ml............................................................60

CREON -pancrelipase (lip-prot-amyl) dr cap12000-38000-60000 unit..................................................69

CREON -pancrelipase (lip-prot-amyl) dr cap24000-76000-120000 unit................................................69

CREON -pancrelipase (lip-prot-amyl) dr cap3000-9500-15000 unit......................................................69

CREON -pancrelipase (lip-prot-amyl) dr cap36000-114000-180000 unit..............................................69

CREON -pancrelipase (lip-prot-amyl) dr cap6000-19000-30000 unit....................................................69

CRESEMBA -isavuconazonium sulfate cap 186 mg........... 6CRESTOR -rosuvastatin calcium tab 10 mg..................... 54CRESTOR -rosuvastatin calcium tab 20 mg..................... 54CRESTOR -rosuvastatin calcium tab 40 mg..................... 54CRESTOR -rosuvastatin calcium tab 5 mg....................... 54

CRIXIVAN -indinavir sulfate cap 200 mg............................ 7CRIXIVAN -indinavir sulfate cap 400 mg............................ 7CROMOLYN SODIUM -cromolyn sodium soln nebu 20mg/2ml..............................................................................63

cromolyn sodium ophth soln 4%.................................138cromolyn sodium oral conc 100 mg/5ml(Gastrocrom)...................................................................70

CUPRIMINE -penicillamine cap 250 mg..........................164CURITY HYPERTONIC SODIUM -wound dressings -misc................................................................................ 148

CURITY SODIUM CHLORIDE DR -wound dressings -pads................................................................................148

CUROSURF -poractant alfa intratracheal susp 80 mg/ml......................................................................................65

CUTIVATE -fluticasone propionate cream 0.05%............148CUTIVATE -fluticasone propionate lotion 0.05%.............148CUVPOSA -glycopyrrolate oral soln 1 mg/5ml.................. 66CVS GLUCOSE BITS -glucose chew tab 1 gm.................27CVS GLUCOSE -glucose chew tab 4 gm......................... 27CVS GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 27

CYANOCOBALAMIN/LEVOMEFOLA -l-methylfolate w/ vitb6-vit b12 tab 1.13-25-2 mg.......................................... 126

cyanocobalamin inj 1000 mcg/ml.................................129CYCLESSA -desogest-ethin est tab0.1-0.025/0.125-0.025/0.15-0.025mg-mg.........................24

CYCLOBENZAPRINE COMFORT P -cyclobenzaprine hcltab 10 mg & liniment topical gel kit................................114

cyclobenzaprine hcl tab 10 mg.................................... 114cyclobenzaprine hcl tab 5 mg...................................... 114cyclobenzaprine hcl tab 7.5 mg (Fexmid)....................114CYCLOGYL -cyclopentolate hcl ophth soln 0.5%............138CYCLOGYL -cyclopentolate hcl ophth soln 1%...............138CYCLOGYL -cyclopentolate hcl ophth soln 2%...............138CYCLOMYDRIL -cyclopentolate w/ phenylephrine ophthsoln 0.2-1%.................................................................... 138

cyclopentolate hcl ophth soln 1% (Cyclogyl)..............138cyclopentolate hcl ophth soln 2% (Cyclogyl)..............138CYCLOPHOSPHAMIDE -cyclophosphamide cap 25mg.................................................................................... 16

CYCLOPHOSPHAMIDE -cyclophosphamide cap 50mg.................................................................................... 16

CYCLOSERINE -cycloserine cap 250 mg...........................6CYCLOSET -bromocriptine mesylate tab 0.8 mg (baseequivalent)........................................................................27

cyclosporine cap 100 mg (Sandimmune).................... 164cyclosporine cap 25 mg (Sandimmune)......................164cyclosporine modified cap 100 mg (Neoral)............... 164cyclosporine modified cap 25 mg (Neoral)................. 164CYCLOSPORINE MODIFIED -cyclosporine modified cap50 mg.............................................................................164

cyclosporine modified oral soln 100 mg/ml(Neoral)..........................................................................164

CYMBALTA -duloxetine hcl enteric coated pellets cap 20mg.................................................................................... 77

2015




cyproheptadine hcl syrup 2 mg/5ml.............................. 58cyproheptadine hcl tab 4 mg......................................... 58CYSTADANE -betaine powder for oral solution................ 35CYSTAGON -cysteamine bitartrate cap 150 mg............... 74CYSTAGON -cysteamine bitartrate cap 50 mg................. 74CYSTARAN -cysteamine hcl ophth soln 0.44% (baseequivalent)......................................................................138

CYTOMEL -liothyronine sodium tab 25 mcg..................... 33CYTOMEL -liothyronine sodium tab 50 mcg..................... 33CYTOMEL -liothyronine sodium tab 5 mcg....................... 33CYTOTEC -misoprostol tab 100 mcg................................66CYTOTEC -misoprostol tab 200 mcg................................66CYTRA-3 -pot & sod citrates w/ cit ac syrup 550-500-334mg/5ml..............................................................................74

D

DAKLINZA -daclatasvir dihydrochloride tab 30 mg (baseequivalent)..........................................................................7

DAKLINZA -daclatasvir dihydrochloride tab 60 mg (baseequivalent)..........................................................................7

DALIRESP -roflumilast tab 500 mcg................................. 63danazol cap 100 mg........................................................ 21danazol cap 200 mg........................................................ 21danazol cap 50 mg.......................................................... 21DANTRIUM -dantrolene sodium cap 100 mg.................. 114DANTRIUM -dantrolene sodium cap 25 mg.................... 114DANTRIUM -dantrolene sodium cap 50 mg.................... 114dantrolene sodium cap 25 mg (Dantrium)...................114dantrolene sodium cap 50 mg (Dantrium)...................114DANTROLENE SODIUM -dantrolene sodium cap 100mg.................................................................................. 114

DAPSONE -dapsone tab 100 mg......................................12DAPSONE -dapsone tab 25 mg........................................12DAPTACEL -diph, acellular pert & tet tox inj 15 lf-10 mcg-5lf/0.5ml..............................................................................15

DARAPRIM -pyrimethamine tab 25 mg.............................11DAYPRO -oxaprozin tab 600 mg.................................... 101DAYTRANA -methylphenidate td patch 10 mg/9hr............86DAYTRANA -methylphenidate td patch 15 mg/9hr............86DAYTRANA -methylphenidate td patch 20 mg/9hr............86DAYTRANA -methylphenidate td patch 30 mg/9hr............86DDAVP -desmopressin acetate inj 4 mcg/ml.....................36DDAVP -desmopressin acetate nasal soln 0.01%(refrigerated).....................................................................35

DDAVP -desmopressin acetate nasal spray soln0.01%............................................................................... 36

DDAVP -desmopressin acetate tab 0.1 mg.......................36DDAVP -desmopressin acetate tab 0.2 mg.......................36DDROPS -cholecalciferol drops 1000 unit/0.03ml (perdrop)............................................................................... 115

DEBACTEROL -sulfuric acid-sulfonated phenolics soln30-50%........................................................................... 142

DECARA -cholecalciferol cap 25000 unit........................ 115DECON-A -brompheniramine & phenylephrine elixir 2-5mg/5ml..............................................................................60

DECON-G -phenylephrine-brompheniramine-guaifenesinliqd 2-1-40 mg/ml.............................................................60

DELZICOL -mesalamine cap dr 400 mg........................... 70DEMADEX -torsemide tab 10 mg......................................52DEMADEX -torsemide tab 20 mg......................................53DEMADEX -torsemide tab 5 mg........................................52demeclocycline hcl tab 150 mg........................................4demeclocycline hcl tab 300 mg........................................4DEMEROL -meperidine hcl tab 100 mg............................ 95DEMEROL -meperidine hcl tab 50 mg.............................. 95DEMSER -metyrosine cap 250 mg................................... 47DENAVIR -penciclovir cream 1%.................................... 148DEPAKENE -valproate sodium syrup 250 mg/5ml (baseequiv)..............................................................................107

DEPAKENE -valproic acid cap 250 mg...........................107DEPAKOTE -divalproex sodium tab delayed release 125mg.................................................................................. 107

DEPAKOTE -divalproex sodium tab delayed release 250mg.................................................................................. 107

DEPAKOTE -divalproex sodium tab delayed release 500mg.................................................................................. 107

DEPAKOTE ER -divalproex sodium tab sr 24 hr 250mg.................................................................................. 107

DEPAKOTE ER -divalproex sodium tab sr 24 hr 500mg.................................................................................. 107

DEPAKOTE SPRINKLES -divalproex sodium cap sprinkle125 mg........................................................................... 107

DEPEN TITRATABS -penicillamine tab 250 mg..............164DEPLIN 15 -l-methylfolate-algae cap 15-90.314 mg....... 126DEPLIN 7.5 -l-methylfolate-algae cap 7.5-90.314 mg......126DEPLIN -l-methylfolate tab 15 mg...................................126DEPLIN -l-methylfolate tab 7.5 mg..................................126DEPO-PROVERA CONTRACEPTIV -medroxyprogesterone acetate im susp 150 mg/ml.......... 24

DEPO-SUBQ PROVERA 104 -medroxyprogesteroneacetate subcutaneous susp 104 mg/0.65ml.................... 24

DEPO-TESTOSTERONE -testosterone cypionate im inj inoil 100 mg/ml................................................................... 21

DEPO-TESTOSTERONE -testosterone cypionate im inj inoil 200 mg/ml................................................................... 21

DERMACINRX ANALGESIC COMB -diclofenac sod tab dr75 mg & lido-men-methyl sal ptch kit.............................101

DERMACINRX DUOPATCH PHARM -lidocaine patch 5%& menthol-methyl sal patch 3-10% ther pak.................. 149

DERMACINRX INFLAMMATRAL P -diclofen dr tab 75mg-ranitidine tab 150mg-capsaicin cr thpk.......................... 101

DERMACINRX LEXITRAL PHARM -diclofenac sod soln1.5% & capsaicin cream 0.025% ther pack................... 149

DERMACINRX NEUROTRAL PHAR -lidocaine patch 5%& capsaicin cream 0.025% therapy pack.......................149

DERMACINRX SILAPAK -triamcinolone acet cr 0.1% &dimeth cr 5% & silicone tape.........................................149

2015


DERMACINRX SURGICAL COMBO -chlorhexidine soln-dimeth cr-silicone tape-homeopathic kit.........................149

DERMACINRX SURGICAL PHARM -chlorhexidine sol-mupirocin cr-dimeth cr-silicone tape kit..........................149

DERMA SILKRX ANODYNEXA PA -diclofen dr tab 75mg-ranitidine tab 150mg-capsaicin cr thpk.......................... 101

DERMA SILKRX SDS PAK -triamcinolone acet cr 0.1% &dimeth cr 5% & silicone tape.........................................148

DERMA-SMOOTHE/FS BODY -fluocinolone acetonide oil0.01% (body oil).............................................................149

DERMA-SMOOTHE/FS BODY OIL -fluocinoloneacetonide oil 0.01% (body oil)....................................... 149

DERMA-SMOOTHE/FS SCALP -fluocinolone acetonide oil0.01% (scalp oil)............................................................ 149

DERMA-SMOOTHE/FS SCALP OI -fluocinolone acetonideoil 0.01% (scalp oil)....................................................... 149

DERMASORB AF -clioquinol-hc cream 3-0.5% & emollientliqd kit.............................................................................149

DERMASORB HC -hydrocortisone lot 2% & cleanser liqkit....................................................................................149

DERMASORB TA -triamcinolone cream 0.1% & emollientcream kit........................................................................ 149

DERMASORB XM -urea cream 39% & emollient creamkit....................................................................................149

DERMATOP -prednicarbate cream 0.1%........................ 149DERMATOP -prednicarbate oint 0.1%............................ 149DERMOTIC -fluocinolone acetonide (otic) oil 0.01%....... 141desipramine hcl tab 100 mg (Norpramin)......................77desipramine hcl tab 10 mg (Norpramin)........................77desipramine hcl tab 150 mg (Norpramin)......................77desipramine hcl tab 25 mg (Norpramin)........................77desipramine hcl tab 50 mg (Norpramin)........................77desipramine hcl tab 75 mg (Norpramin)........................77desloratadine tab 5 mg (Clarinex)..................................58desloratadine tab orally disintegrating 2.5 mg(Clarinex reditabs)......................................................... 58

desloratadine tab orally disintegrating 5 mg (Clarinexreditabs).......................................................................... 58

desmopressin acetate inj 4 mcg/ml (Ddavp).................36desmopressin acetate nasal soln 0.01% (refrigerated)(Ddavp)............................................................................ 36

desmopressin acetate nasal spray soln 0.01%(Ddavp)............................................................................ 36

desmopressin acetate nasal spray soln 0.01%(refrigerated)................................................................... 36

desmopressin acetate tab 0.1 mg (Ddavp)....................36desmopressin acetate tab 0.2 mg (Ddavp)....................36DESOGEN -desogestrel & ethinyl estradiol tab 0.15 mg-30mcg...................................................................................24

desogest-eth estrad & eth estrad tab 0.15-0.02/0.01mg(21/5) (Mircette)......................................................... 24

desogest-ethin est tab0.1-0.025/0.125-0.025/0.15-0.025mg-mg (Cyclessa).....24

desogestrel & ethinyl estradiol tab 0.15 mg-30 mcg(Desogen)........................................................................24

DESONATE -desonide gel 0.05%................................... 149desonide cream 0.05% (Desowen)...............................149desonide lotion 0.05% (Desowen)................................149desonide oint 0.05% (Desowen)...................................149DESOWEN -desonide cream 0.05%............................... 149DESOWEN -desonide lotion 0.05%................................ 149DESOWEN -desonide oint 0.05%................................... 149desoximetasone cream 0.25% (Topicort).................... 149DESOXIMETASONE -desoximetasone cream 0.05%.....149DESOXIMETASONE -desoximetasone oint 0.05%.........149desoximetasone gel 0.05% (Topicort)......................... 149desoximetasone oint 0.25% (Topicort)........................ 149DESOXYN -methamphetamine hcl tab 5 mg.................... 86DESVENLAFAXINE ER -desvenlafaxine fumarate tab sr24hr 100 mg (base equiv)............................................... 77

DESVENLAFAXINE ER -desvenlafaxine fumarate tab sr24hr 50 mg (base equiv)................................................. 77

DESVENLAFAXINE ER -desvenlafaxine tab sr 24hr 100mg.................................................................................... 77

DESVENLAFAXINE ER -desvenlafaxine tab sr 24hr 50mg.................................................................................... 77

DETROL LA -tolterodine tartrate cap sr 24hr 2 mg........... 72DETROL LA -tolterodine tartrate cap sr 24hr 4 mg........... 73DETROL -tolterodine tartrate tab 1 mg............................. 72DETROL -tolterodine tartrate tab 2 mg............................. 72DEX4 FAST ACTING GLUCOSE -glucose gel 15gm/33gm.......................................................................... 27

DEX4 FAST ACTING GLUCOSE -glucose oral liquid 15gm/59ml............................................................................27

DEX4 FAST ACTING GLUCOSE -glucose-vitamin c chewtab 4-0.006 gm................................................................ 27

DEX4 -glucose chew tab 1 gm..........................................27DEX4 GLUCOSE -glucose chew tab 4 gm....................... 27DEX4 GLUCOSE -glucose oral liquid 15 gm/59ml............ 27DEX4 -glucose-vitamin c chew tab 4-0.006 gm.................27DEX4 NATURALS -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 27

DEX4 POUCH PACK -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 27

DEX4 QUICK DISSOLVE GLUCO -glucose chew tab 4gm.................................................................................... 27

DEXAMETHASONE -dexamethasone soln 0.5mg/5ml..............................................................................19

DEXAMETHASONE -dexamethasone tab 1 mg............... 19DEXAMETHASONE -dexamethasone tab 2 mg............... 19dexamethasone elixir 0.5 mg/5ml.................................. 19DEXAMETHASONE INTENSOL -dexamethasone conc 1mg/ml................................................................................19

dexamethasone sodium phosphate ophth soln0.1%............................................................................... 138

dexamethasone tab 0.5 mg............................................ 20dexamethasone tab 0.75 mg.......................................... 20dexamethasone tab 1.5 mg............................................ 20dexamethasone tab 4 mg............................................... 20dexamethasone tab 6 mg............................................... 20

2015


DEXEDRINE -dextroamphetamine sulfate cap sr 24hr 10mg.................................................................................... 86



DEXILANT -dexlansoprazole cap delayed release 30mg.................................................................................... 66

DEXILANT -dexlansoprazole cap delayed release 60mg.................................................................................... 66

dexmethylphenidate hcl cap sr 24 hr 10 mg (Focalinxr).....................................................................................86






dexmethylphenidate hcl tab 10 mg (Focalin)................ 87dexmethylphenidate hcl tab 2.5 mg (Focalin)............... 87dexmethylphenidate hcl tab 5 mg (Focalin).................. 87DEXPAK 10 DAY -dexamethasone tab 1.5 mg taperpack..................................................................................20

DEXPAK 13 DAY -dexamethasone tab 1.5 mg taperpack..................................................................................20

DEXPAK 6 DAY -dexamethasone tab 1.5 mg taperpack..................................................................................20

dextroamphetamine sulfate cap sr 24hr 10 mg(Dexedrine)......................................................................87



dextroamphetamine sulfate oral solution 5 mg/5ml(Procentra)...................................................................... 87

dextroamphetamine sulfate tab 10 mg.......................... 87dextroamphetamine sulfate tab 5 mg............................ 87DEXTROMETHORPHAN HBR/CHLO -phenylephrine-chlorphen-dm liquid 1.75-0.75-2.75 mg/ml...................... 60

DEX-TUSS -guaifenesin-codeine liquid 300-10mg/5ml..............................................................................60

DIABETA -glyburide tab 1.25 mg...................................... 27DIABETA -glyburide tab 2.5 mg........................................ 27DIABETA -glyburide tab 5 mg........................................... 27DIALYVITE/ZINC -b-complex w/ c-zn & folic acid tab 1mg.................................................................................. 116

DIALYVITE 3000 -b-complex w/ c-biotin-e-minerals & folicacid tab 3 mg.................................................................116

DIALYVITE 5000 -b-complex w/ c-biotin-e-minerals & folicacid tab 5 mg.................................................................116

DIALYVITE SUPREME D -multiple vitamins w/ minerals &fa tab 3 mg.................................................................... 116

DIAMOX -acetazolamide cap sr 12hr 500 mg................... 53DIASTAT ACUDIAL -diazepam rectal gel delivery system10 mg.............................................................................107

DIASTAT ACUDIAL -diazepam rectal gel delivery system20 mg.............................................................................107

DIASTAT PEDIATRIC -diazepam rectal gel deliverysystem 2.5 mg............................................................... 107

DIATX ZN -b-complex w/ c-biotin-minerals & folic acid tab5 mg...............................................................................116

diazepam conc 5 mg/ml..................................................75DIAZEPAM -diazepam rectal gel delivery system 10mg.................................................................................. 107

DIAZEPAM -diazepam rectal gel delivery system 2.5mg.................................................................................. 107

DIAZEPAM -diazepam rectal gel delivery system 20mg.................................................................................. 107

DIAZEPAM -diazepam soln 1 mg/ml.................................75diazepam tab 10 mg (Valium).........................................75diazepam tab 2 mg (Valium)...........................................75diazepam tab 5 mg (Valium)...........................................75DIBENZYLINE -phenoxybenzamine hcl cap 10 mg...........47DICLEGIS -doxylamine-pyridoxine tab delayed release10-10 mg..........................................................................69

diclofenac potassium tab 50 mg (Cataflam)................101diclofenac sodium (actinic keratoses) gel 3%(Solaraze)...................................................................... 149

diclofenac sodium ophth soln 0.1%............................ 138diclofenac sodium soln 1.5% (Pennsaid).................... 149diclofenac sodium tab delayed release 25 mg............101diclofenac sodium tab delayed release 50 mg............101diclofenac sodium tab delayed release 75 mg............101diclofenac sodium tab sr 24hr 100 mg (Voltaren-xr)...................................................................................102

diclofenac w/ misoprostol tab delayed release 50-0.2mg (Arthrotec 50).........................................................102

diclofenac w/ misoprostol tab delayed release 75-0.2mg (Arthrotec 75).........................................................102

dicloxacillin sodium cap 250 mg..................................... 1dicloxacillin sodium cap 500 mg..................................... 1dicyclomine hcl cap 10 mg (Bentyl).............................. 66dicyclomine hcl oral soln 10 mg/5ml.............................67dicyclomine hcl tab 20 mg (Bentyl)............................... 67didanosine delayed release capsule 125 mg (Videxec)...................................................................................... 7

didanosine delayed release capsule 200 mg (Videxec)...................................................................................... 7



DIDRONEL -etidronate disodium tab 400 mg....................36DIFFERIN -adapalene cream 0.1%.................................149DIFFERIN -adapalene gel 0.1%...................................... 149

2015


DIFFERIN -adapalene gel 0.3%...................................... 149DIFFERIN -adapalene lotion 0.1%.................................. 149DIFICID -fidaxomicin tab 200 mg........................................ 3DIFLORASONE DIACETATE -diflorasone diacetate cream0.05%............................................................................. 149

DIFLORASONE DIACETATE -diflorasone diacetate oint0.05%............................................................................. 149

DIFLUCAN -fluconazole for susp 10 mg/ml.........................6DIFLUCAN -fluconazole for susp 40 mg/ml.........................6DIFLUCAN -fluconazole tab 100 mg................................... 6DIFLUCAN -fluconazole tab 150 mg................................... 6DIFLUCAN -fluconazole tab 200 mg................................... 6DIFLUCAN -fluconazole tab 50 mg..................................... 6diflunisal tab 500 mg.......................................................93DIGEX NF -hyoscyamine-phenyltoloxamine cap 0.0625-15mg.................................................................................... 67

DIGOXIN -digoxin oral soln 0.05 mg/ml............................ 39digoxin tab 125 mcg (0.125 mg) (Lanoxin).................... 39digoxin tab 250 mcg (0.25 mg) (Lanoxin)...................... 39DIHYDROERGOTAMINE MESYLAT -dihydroergotaminemesylate nasal spray 4 mg/ml....................................... 104

DILANTIN-125 -phenytoin susp 125 mg/5ml................... 107DILANTIN INFATABS -phenytoin chew tab 50 mg..........107DILANTIN -phenytoin sodium extended cap 100 mg.......107DILANTIN -phenytoin sodium extended cap 30 mg.........107DILATRATE SR -isosorbide dinitrate cap cr 40 mg...........39DILAUDID -hydromorphone hcl liqd 1 mg/ml.................... 95DILAUDID -hydromorphone hcl tab 2 mg..........................95DILAUDID -hydromorphone hcl tab 4 mg..........................95DILAUDID -hydromorphone hcl tab 8 mg..........................95diltiazem hcl cap sr 12hr 120 mg...................................42diltiazem hcl cap sr 12hr 60 mg.....................................42diltiazem hcl cap sr 12hr 90 mg.....................................42diltiazem hcl cap sr 24hr 120 mg...................................42diltiazem hcl cap sr 24hr 180 mg...................................42diltiazem hcl cap sr 24hr 240 mg...................................42diltiazem hcl coated beads cap sr 24hr 120 mg(Cardizem cd)................................................................. 42

diltiazem hcl coated beads cap sr 24hr 180 mg(Cardizem cd)................................................................. 42




diltiazem hcl coated beads tab sr 24hr 180 mg(Cardizem la).................................................................. 42





diltiazem hcl extended release beads cap sr 24hr 120mg (Tiazac)..................................................................... 43






diltiazem hcl tab 120 mg (Cardizem)............................. 43diltiazem hcl tab 30 mg (Cardizem)............................... 43diltiazem hcl tab 60 mg (Cardizem)............................... 43diltiazem hcl tab 90 mg...................................................43DIOVAN HCT -valsartan-hydrochlorothiazide tab 160-12.5mg.................................................................................... 47

DIOVAN HCT -valsartan-hydrochlorothiazide tab 160-25mg.................................................................................... 47

DIOVAN HCT -valsartan-hydrochlorothiazide tab 320-12.5mg.................................................................................... 47

DIOVAN HCT -valsartan-hydrochlorothiazide tab 320-25mg.................................................................................... 48

DIOVAN HCT -valsartan-hydrochlorothiazide tab 80-12.5mg.................................................................................... 47

DIOVAN -valsartan tab 160 mg.........................................47DIOVAN -valsartan tab 320 mg.........................................47DIOVAN -valsartan tab 40 mg...........................................47DIOVAN -valsartan tab 80 mg...........................................47DIPENTUM -olsalazine sodium cap 250 mg..................... 70DIPHENOXYLATE/ATROPINE -diphenoxylate w/ atropineliq 2.5-0.025 mg/5ml........................................................ 66

diphenoxylate w/ atropine tab 2.5-0.025 mg(Lomotil).......................................................................... 66

DIPHTHERIA/TETANUS TOXOID -diphtheria-tetanus toxadsorbed (dt) im inj 25-5 unit/0.5ml................................. 15

DIPROLENE AF -betamethasone dipropionate augmentedcream 0.05%..................................................................149

DIPROLENE -betamethasone dipropionate augmentedlotion 0.05%................................................................... 149

DIPROLENE -betamethasone dipropionate augmentedoint 0.05%...................................................................... 149

dipyridamole tab 25 mg (Persantine)...........................134dipyridamole tab 50 mg (Persantine)...........................134dipyridamole tab 75 mg (Persantine)...........................134DISALCID -salsalate tab 500 mg...................................... 93DISALCID -salsalate tab 750 mg...................................... 93disopyramide phosphate cap 100 mg (Norpace).......... 44disopyramide phosphate cap 150 mg (Norpace).......... 44disulfiram tab 250 mg (Antabuse)..................................90disulfiram tab 500 mg (Antabuse)..................................90DITROPAN XL -oxybutynin chloride tab sr 24hr 10 mg.....73

2015


DITROPAN XL -oxybutynin chloride tab sr 24hr 15 mg.....73DITROPAN XL -oxybutynin chloride tab sr 24hr 5 mg.......73DIURIL -chlorothiazide susp 250 mg/5ml.......................... 53divalproex sodium cap sprinkle 125 mg (Depakotesprinkles)...................................................................... 107

divalproex sodium tab delayed release 125 mg(Depakote).....................................................................107



divalproex sodium tab sr 24 hr 250 mg (Depakoteer)...................................................................................107

divalproex sodium tab sr 24 hr 500 mg (Depakoteer)...................................................................................107

DIVIGEL -estradiol td gel 0.25 mg/0.25gm (0.1%)............ 22DIVIGEL -estradiol td gel 0.5 mg/0.5gm (0.1%)................ 22DIVIGEL -estradiol td gel 1 mg/gm (0.1%)........................ 22DIVISTA -folic acid-vit b6-vit b12-omega 3-biotin-cr cap 1mg.................................................................................. 129

DOLOPHINE HCL -methadone hcl tab 5 mg.................... 95DOLOPHINE -methadone hcl tab 10 mg...........................95donepezil hydrochloride orally disintegrating tab 10mg (Aricept odt).............................................................90

donepezil hydrochloride orally disintegrating tab 5mg.................................................................................... 90

donepezil hydrochloride tab 10 mg (Aricept)................90donepezil hydrochloride tab 23 mg (Aricept)................90donepezil hydrochloride tab 5 mg (Aricept)..................90DONNATAL EXTENTABS -pb-hyoscy-atrop-scopol tab cr48.6-0.3111-0.0582-0.0195 mg........................................67

DONNATAL -pb-hyoscy-atrop-scopol elix16.2-0.1037-0.0194-0.0065 mg/5ml.................................67

DONNATAL -pb-hyoscy-atrop-scopol tab16.2-0.1037-0.0194-0.0065 mg........................................67

DORAL -quazepam tab 15 mg..........................................84DORYX -doxycycline hyclate tab delayed release 200mg...................................................................................... 4

DORYX -doxycycline hyclate tab delayed release 50mg...................................................................................... 4

dorzolamide hcl ophth soln 2% (Trusopt)...................138dorzolamide hcl-timolol maleate ophth soln 22.3-6.8mg/ml (Cosopt).............................................................138

DOVONEX -calcipotriene cream 0.005%........................ 149doxazosin mesylate tab 1 mg (Cardura)........................48doxazosin mesylate tab 2 mg (Cardura)........................48doxazosin mesylate tab 4 mg (Cardura)........................48doxazosin mesylate tab 8 mg (Cardura)........................48doxepin hcl cap 100 mg..................................................77doxepin hcl cap 10 mg................................................... 77doxepin hcl cap 150 mg..................................................77doxepin hcl cap 25 mg................................................... 77doxepin hcl cap 50 mg................................................... 77doxepin hcl conc 10 mg/ml............................................ 77DOXEPIN HCL -doxepin hcl cap 75 mg............................77

doxercalciferol cap 0.5 mcg (Hectorol)......................... 36doxercalciferol cap 1 mcg (Hectorol)............................ 36doxercalciferol cap 2.5 mcg (Hectorol)......................... 36DOXYCYCLINE -doxycycline (rosacea) cap delayedrelease 40 mg................................................................149

doxycycline hyclate cap 100 mg (Vibramycin)............... 4doxycycline hyclate cap 50 mg........................................4doxycycline hyclate tab 100 mg.......................................4doxycycline hyclate tab 20 mg.........................................4doxycycline hyclate tab delayed release 100 mg........... 4doxycycline hyclate tab delayed release 150 mg(Doryx)...............................................................................4

doxycycline hyclate tab delayed release 75 mg............. 4doxycycline monohydrate cap 100 mg (Monodox).........4doxycycline monohydrate cap 150 mg (Adoxa)............. 4doxycycline monohydrate cap 50 mg..............................4doxycycline monohydrate cap 75 mg (Monodox)...........4doxycycline monohydrate for susp 25 mg/5ml(Vibramycin)......................................................................4

doxycycline monohydrate tab 100 mg (Adoxa pak1/100)................................................................................. 4

doxycycline monohydrate tab 150 mg (Adoxa pak1/150)................................................................................. 4

doxycycline monohydrate tab 50 mg (Adoxa)................ 4doxycycline monohydrate tab 75 mg (Adoxa)................ 4DRISDOL -ergocalciferol cap 50000 unit........................ 115DRITHO-CREME HP -anthralin cream 1%......................150dronabinol cap 10 mg (Marinol)..................................... 69dronabinol cap 2.5 mg (Marinol).................................... 69dronabinol cap 5 mg (Marinol)....................................... 69drospirenone-ethinyl estradiol tab 3-0.02 mg (Yaz)......24drospirenone-ethinyl estradiol tab 3-0.03 mg (Yasmin28).................................................................................... 24

DROXIA -hydroxyurea cap 200 mg.................................129DROXIA -hydroxyurea cap 300 mg.................................129DROXIA -hydroxyurea cap 400 mg.................................129DRUG MART GLUCOSE -glucose chew tab 4 gm........... 27DRUG MART GLUCOSE -glucose-vitamin c chew tab4-0.006 gm.......................................................................27

DRYSOL -aluminum chloride soln 20%...........................150DUAC -clindamycin phosph-benzoyl peroxide (refrig) gel1.2 (1)-5%...................................................................... 150

DUAVEE -conjugated estrogens-bazedoxifene tab 0.45-20mg.................................................................................... 22

DUETACT -pioglitazone hcl-glimepiride tab 30-2 mg........ 27DUETACT -pioglitazone hcl-glimepiride tab 30-4 mg........ 28DUET DHA 400 -prenat w/fe poly-na fered-fa tab 25-1 &omega cap 400 mg........................................................116

DUET DHA BALANCED -prenat w/fe poly-na fered-fa tab25-1 & omega cap 267 mg............................................116

DUET DHA BALANCED -prenat w/fe poly-na fered-fa tab27-1 & omega cap dr 380mg.........................................116

DUET DHA -prenat w/fe poly-na fered-fa tab 25-1 &omega cap 400 mg........................................................116

DUEXIS -ibuprofen-famotidine tab 800-26.6 mg............. 102

2015


DULERA -mometasone furoate-formoterol fumarateaerosol 100-5 mcg/act..................................................... 63

DULERA -mometasone furoate-formoterol fumarateaerosol 200-5 mcg/act..................................................... 63

DULOXETINE HCL -duloxetine hcl enteric coated pelletscap 40 mg........................................................................77

duloxetine hcl enteric coated pellets cap 20 mg(Cymbalta).......................................................................77



DUOPA -carbidopa-levodopa enteral susp 4.63-20 mg/ml....................................................................................111

DURACHOL -folic acid-cholecalciferol cap 1 mg-3775unit..................................................................................129

DURAGESIC -fentanyl td patch 72hr 100 mcg/hr..............95DURAGESIC -fentanyl td patch 72hr 12 mcg/hr................95DURAGESIC -fentanyl td patch 72hr 25 mcg/hr................95DURAGESIC -fentanyl td patch 72hr 50 mcg/hr................95DURAGESIC -fentanyl td patch 72hr 75 mcg/hr................95DUREZOL -difluprednate ophth emulsion 0.05%............ 138DUTOPROL -metoprolol & hydrochlorothiazide tab sr 24hr100-12.5 mg.....................................................................48

DUTOPROL -metoprolol & hydrochlorothiazide tab sr 24hr25-12.5 mg.......................................................................48

DUTOPROL -metoprolol & hydrochlorothiazide tab sr 24hr50-12.5 mg.......................................................................48

D-VI-SOL -cholecalciferol oral liquid 400 unit/ml............. 115DYAZIDE -triamterene & hydrochlorothiazide cap 37.5-25mg.................................................................................... 53

DYMISTA -azelastine hcl-fluticasone prop nasal spray137-50 mcg/act................................................................ 59

dyphylline-guaifenesin liqd 100-100 mg/5ml.................63DYRENIUM -triamterene cap 100 mg............................... 53DYRENIUM -triamterene cap 50 mg................................. 53

E

E.E.S. 400 -erythromycin ethylsuccinate tab 400 mg.......... 3E.E.S. GRANULES -erythromycin ethylsuccinate for susp200 mg/5ml........................................................................ 3

EC-NAPROSYN -naproxen tab ec 375 mg..................... 102EC-NAPROSYN -naproxen tab ec 500 mg..................... 102econazole nitrate cream 1%......................................... 150ECOZA -econazole nitrate foam 1%............................... 150EDARBI -azilsartan medoxomil tab 40 mg........................ 48EDARBI -azilsartan medoxomil tab 80 mg........................ 48EDARBYCLOR -azilsartan medoxomil-chlorthalidone tab40-12.5 mg.......................................................................48

EDARBYCLOR -azilsartan medoxomil-chlorthalidone tab40-25 mg..........................................................................48

ED CYTE F -ferrous fumarate-folic acid-docusate sodiumtab 324-1-50 mg............................................................ 129

EDECRIN -ethacrynic acid tab 25 mg............................... 53EDLUAR -zolpidem tartrate sl tab 10 mg.......................... 84EDLUAR -zolpidem tartrate sl tab 5 mg............................ 84

EDURANT -rilpivirine hcl tab 25 mg (base equivalent)........ 7EFFER-K -potassium bicarbonate-citric acid effer tab 10meq................................................................................ 124

EFFER-K -potassium bicarbonate-citric acid effer tab 20meq................................................................................ 124

EFFEXOR XR -venlafaxine hcl cap sr 24hr 150 mg (baseequivalent)........................................................................77

EFFEXOR XR -venlafaxine hcl cap sr 24hr 37.5 mg (baseequivalent)........................................................................77

EFFEXOR XR -venlafaxine hcl cap sr 24hr 75 mg (baseequivalent)........................................................................77

EFFIENT -prasugrel hcl tab 10 mg (base equiv)............. 134EFFIENT -prasugrel hcl tab 5 mg (base equiv)............... 134EFUDEX -fluorouracil cream 5%..................................... 150EGRIFTA -tesamorelin acetate for inj 1 mg (baseequiv)................................................................................36

EGRIFTA -tesamorelin acetate for inj 2 mg (baseequiv)................................................................................36

ELDEPRYL -selegiline hcl cap 5 mg............................... 111ELENZAPATCH -lidocaine-menthol patch 4-1%............. 150ELESTAT -epinastine hcl ophth soln 0.05%....................138ELESTRIN -estradiol gel 0.06% (0.52 mg/0.87 gmmetered-dose pump)........................................................22

ELETONE -dermatological products misc - cream.......... 150ELETONE TWINPACK -dermatological products misc -cream............................................................................. 150

ELIDEL -pimecrolimus cream 1%....................................150ELIGARD -leuprolide acetate (3 month) for subcutaneousinj kit 22.5mg................................................................... 16

ELIGARD -leuprolide acetate (4 month) for subcutaneousinj kit 30 mg..................................................................... 16

ELIGARD -leuprolide acetate (6 month) for subcutaneousinj kit 45 mg..................................................................... 17

ELIGARD -leuprolide acetate for subcutaneous inj kit 7.5mg.................................................................................... 16

ELIGEN B12 -cyanocobalamin-salcaprozate sodium tab1000 mcg-100 mg..........................................................126

ELIMITE -permethrin cream 5%...................................... 150ELIPHOS -calcium acetate (phosphate binder) tab 667mg.................................................................................... 70

ELIQUIS -apixaban tab 2.5 mg....................................... 132ELIQUIS -apixaban tab 5 mg.......................................... 132ELITE-OB -prenatal vit w/ iron carbonyl-fa tab 50-1.25mg.................................................................................. 116

ELIXOPHYLLIN -theophylline elixir 80 mg/15ml................63ELLA -ulipristal acetate tab 30 mg.................................... 24ELMIRON -pentosan polysulfate sodium caps 100 mg..... 74ELOCON -mometasone furoate cream 0.1%.................. 150ELOCON -mometasone furoate oint 0.1%...................... 150ELOCON -mometasone furoate solution 0.1%(lotion)............................................................................ 150

ELOCTATE -antihemophilic factor (recomb) rfviiifc for inj1000 unit........................................................................ 134


2015



ELOCTATE -antihemophilic factor (recomb) rfviiifc for inj250 unit.......................................................................... 134




EMADINE -emedastine difumarate ophth soln 0.05%(base equiv)................................................................... 138

EMBEDA -morphine-naltrexone cap cr 100-4 mg............. 95EMBEDA -morphine-naltrexone cap cr 20-0.8 mg.............95EMBEDA -morphine-naltrexone cap cr 30-1.2 mg.............95EMBEDA -morphine-naltrexone cap cr 50-2 mg............... 95EMBEDA -morphine-naltrexone cap cr 60-2.4 mg.............95EMBEDA -morphine-naltrexone cap cr 80-3.2 mg.............95EMCYT -estramustine phosphate sodium cap 140 mg......17EMEND -aprepitant capsule 125 mg.................................69EMEND -aprepitant capsule 40 mg...................................69EMEND -aprepitant capsule 80 mg...................................69EMEND -aprepitant capsule therapy pack 80 & 125mg.................................................................................... 69

EMLA -lidocaine-prilocaine cream 2.5-2.5%....................150EMSAM -selegiline td patch 24hr 12 mg/24hr................... 77EMSAM -selegiline td patch 24hr 6 mg/24hr..................... 77EMSAM -selegiline td patch 24hr 9 mg/24hr..................... 77EMTRIVA -emtricitabine caps 200 mg................................ 7EMTRIVA -emtricitabine soln 10 mg/ml...............................7EMULSION SB -dermatological products misc -emulsion......................................................................... 150

ENABLEX -darifenacin hydrobromide tab sr 24hr 15 mg(base equiv)..................................................................... 73

ENABLEX -darifenacin hydrobromide tab sr 24hr 7.5 mg(base equiv)..................................................................... 73

enalapril maleate & hydrochlorothiazide tab 10-25 mg(Vaseretic)....................................................................... 48

enalapril maleate & hydrochlorothiazide tab 5-12.5mg.................................................................................... 48

enalapril maleate tab 10 mg (Vasotec).......................... 48enalapril maleate tab 2.5 mg (Vasotec)......................... 48enalapril maleate tab 20 mg (Vasotec).......................... 48enalapril maleate tab 5 mg (Vasotec)............................ 48ENBRACE HR -prenatal vit w/ fe gly cys-fa-omega 3 fattyacids cap........................................................................116

ENBREL -etanercept for subcutaneous inj kit 25 mg.......102ENBREL -etanercept subcutaneous soln prefilled syringe25 mg/0.5ml................................................................... 102

ENBREL -etanercept subcutaneous soln prefilled syringe50 mg/ml........................................................................ 102

ENBREL SURECLICK -etanercept subcutaneous solutionauto-injector 50 mg/ml................................................... 102

ENGERIX-B -hepatitis b vaccine (recombinant) 10mcg/0.5ml.........................................................................13

ENGERIX-B -hepatitis b vaccine (recombinant) 20 mcg/ml......................................................................................13

ENGERIX-B -hepatitis b vaccine (recombinant) susp 10mcg/0.5ml.........................................................................13

ENGERIX-B -hepatitis b vaccine (recombinant) susp 20mcg/ml..............................................................................13

ENJUVIA -estrogens, conjugated synthetic b tab 0.3mg.................................................................................... 22





enoxaparin sodium inj 100 mg/ml (Lovenox)..............132enoxaparin sodium inj 120 mg/0.8ml (Lovenox)......... 132enoxaparin sodium inj 150 mg/ml (Lovenox)..............132enoxaparin sodium inj 300 mg/3ml (Lovenox)............132enoxaparin sodium inj 30 mg/0.3ml (Lovenox)........... 132enoxaparin sodium inj 40 mg/0.4ml (Lovenox)........... 132enoxaparin sodium inj 60 mg/0.6ml (Lovenox)........... 132enoxaparin sodium inj 80 mg/0.8ml (Lovenox)........... 132entacapone tab 200 mg (Comtan)................................111entecavir tab 0.5 mg (Baraclude)..................................... 7entecavir tab 1 mg (Baraclude)........................................7ENTERAGAM -serum-derived bovine immunoglob/proteinisolate 5 gm packet....................................................... 126

ENTEREG -alvimopan cap 12 mg.....................................70ENTOCORT EC -budesonide cap sr 24hr 3 mg................20ENTRESTO -sacubitril-valsartan tab 24-26 mg.................57ENTRESTO -sacubitril-valsartan tab 49-51 mg.................57ENTRESTO -sacubitril-valsartan tab 97-103 mg...............57EPANED -enalapril maleate for oral soln 1 mg/ml.............48EPICERAM -dermatological products misc -emulsion......................................................................... 150

EPIDUO -adapalene-benzoyl peroxide gel 0.1-2.5%.......150EPIDUO FORTE -adapalene-benzoyl peroxide gel0.3-2.5%......................................................................... 150

EPIFOAM -pramoxine-hc aerosol foam 1-1%................. 150epinastine hcl ophth soln 0.05% (Elestat)...................138EPINEPHRINE -epinephrine solution auto-injector 0.15mg/0.15ml (1:1000)..........................................................53

EPINEPHRINE -epinephrine solution auto-injector 0.3mg/0.3ml (1:1000)............................................................54

EPIPEN 2-PAK -epinephrine solution auto-injector 0.3mg/0.3ml (1:1000)............................................................54

EPIPEN-JR 2-PAK -epinephrine solution auto-injector 0.15mg/0.3ml (1:2000)............................................................54

EPIVIR HBV -lamivudine oral soln 5 mg/ml (hbv)................8EPIVIR HBV -lamivudine tab 100 mg (hbv).........................8EPIVIR -lamivudine oral soln 10 mg/ml...............................7EPIVIR -lamivudine tab 150 mg.......................................... 7EPIVIR -lamivudine tab 300 mg.......................................... 7

2015


eplerenone tab 25 mg (Inspra)....................................... 48eplerenone tab 50 mg (Inspra)....................................... 48EPOGEN -epoetin alfa inj 10000 unit/ml......................... 129EPOGEN -epoetin alfa inj 20000 unit/ml......................... 129EPOGEN -epoetin alfa inj 2000 unit/ml........................... 129EPOGEN -epoetin alfa inj 3000 unit/ml........................... 129EPOGEN -epoetin alfa inj 4000 unit/ml........................... 129EPROSARTAN MESYLATE -eprosartan mesylate tab 600mg.................................................................................... 48

EPZICOM -abacavir sulfate-lamivudine tab 600-300 mg.....8EQUAGESIC -meprobamate-aspirin tab 200-325 mg....... 93EQUETRO -carbamazepine (antipsychotic) cap sr 12hr100 mg............................................................................. 81

EQUETRO -carbamazepine (antipsychotic) cap sr 12hr200 mg.............................................................................81

EQUETRO -carbamazepine (antipsychotic) cap sr 12hr300 mg............................................................................. 81

ergocalciferol cap 50000 unit (Drisdol)........................115ergoloid mesylates tab 1 mg..........................................90ERGOMAR -ergotamine tartrate sl tab 2 mg...................104ERIVEDGE -vismodegib cap 150 mg................................17ERTACZO -sertaconazole nitrate cream 2%...................150ERYGEL -erythromycin gel 2%....................................... 150ERYPED 200 -erythromycin ethylsuccinate for susp 200mg/5ml................................................................................3

ERYPED 400 -erythromycin ethylsuccinate for susp 400mg/5ml................................................................................3

ERY-TAB -erythromycin tab delayed release 250 mg......... 3ERY-TAB -erythromycin tab delayed release 333 mg......... 3ERY-TAB -erythromycin tab delayed release 500 mg......... 3ERYTHROCIN STEARATE -erythromycin stearate tab 250mg...................................................................................... 3

ERYTHROMYCIN BASE -erythromycin tab 250 mg........... 3ERYTHROMYCIN BASE -erythromycin tab 500 mg........... 3ERYTHROMYCIN ETHYLSUCCINA -erythromycinethylsuccinate tab 400 mg.................................................3

erythromycin gel 2% (Erygel).......................................150erythromycin ophth oint 5 mg/gm............................... 138erythromycin pads 2%.................................................. 150erythromycin soln 2%................................................... 150erythromycin w/ delayed release particles cap 250mg...................................................................................... 3

ESBRIET -pirfenidone cap 267 mg................................... 65ESCAVITE D -pediatric multiple vitamins w/ fl-fe chew tab0.25-6 mg.......................................................................116

ESCAVITE LQ -pediatric multiple vitamins w/ fl-fe drops0.25-6 mg/ml.................................................................. 116

ESCAVITE -pediatric multiple vitamins w/ fl-fe chew tab0.25-7.5 mg....................................................................116

escitalopram oxalate soln 5 mg/5ml (base equiv)(Lexapro)......................................................................... 77

escitalopram oxalate tab 10 mg (base equiv)(Lexapro)......................................................................... 77



ESGIC -butalbital-acetaminophen-caffeine tab 50-325-40mg.................................................................................... 93

esomeprazole magnesium cap delayed release 20 mg(base eq) (Nexium).........................................................67

esomeprazole magnesium cap delayed release 40 mg(base eq) (Nexium).........................................................67

ESSENTRA WIPES 9X9" CLEAN -isopropyl alcohol wipes70%................................................................................ 150

estazolam tab 1 mg......................................................... 84estazolam tab 2 mg......................................................... 84esterified estrogens & methyltestosterone tab0.625-1.25 mg................................................................. 22

esterified estrogens & methyltestosterone tab 1.25-2.5mg.................................................................................... 23

ESTRACE -estradiol tab 0.5 mg........................................23ESTRACE -estradiol tab 1 mg.......................................... 23ESTRACE -estradiol tab 2 mg.......................................... 23ESTRACE -estradiol vaginal cream 0.1 mg/gm.................73estradiol & norethindrone acetate tab 0.5-0.1 mg(Activella)........................................................................ 23

estradiol & norethindrone acetate tab 1-0.5 mg(Activella)........................................................................ 23

estradiol tab 0.5 mg (Estrace)........................................ 23estradiol tab 1 mg (Estrace)........................................... 23estradiol tab 2 mg (Estrace)........................................... 23estradiol td patch twice weekly 0.025 mg/24hr (Vivelle-dot)...................................................................................23

estradiol td patch twice weekly 0.0375 mg/24hr(Vivelle-dot).....................................................................23

estradiol td patch twice weekly 0.05 mg/24hr (Vivelle-dot)...................................................................................23



estradiol td patch weekly 0.025 mg/24hr (Climara).......23estradiol td patch weekly 0.0375 mg/24hr (37.5mcg/24hr) (Climara)....................................................... 23

estradiol td patch weekly 0.05 mg/24hr (Climara).........23estradiol td patch weekly 0.06 mg/24hr (Climara).........23estradiol td patch weekly 0.075 mg/24hr (Climara).......23estradiol td patch weekly 0.1 mg/24hr (Climara)...........23ESTRING -estradiol vaginal ring 2 mg (7.5 mcg/24hrs).....73ESTROGEL -estradiol gel 0.06% (0.75 mg/1.25 gmmetered-dose pump)........................................................23

ESTROPIPATE -estropipate tab 3 mg.............................. 23estropipate tab 0.75 mg.................................................. 23estropipate tab 1.5 mg.................................................... 23ESTROSTEP FE -norethindrone ac-ethinyl estrad-fe tab1-20/1-30/1-35 mg-mcg....................................................24

eszopiclone tab 1 mg (Lunesta).....................................84eszopiclone tab 2 mg (Lunesta).....................................84eszopiclone tab 3 mg (Lunesta).....................................84

2015


ethambutol hcl tab 100 mg (Myambutol).........................6ethambutol hcl tab 400 mg (Myambutol).........................6ethosuximide cap 250 mg (Zarontin)........................... 107ethosuximide soln 250 mg/5ml (Zarontin)...................107ETHYL CHLORIDE/FINE PINPO -ethyl chloride aerosolspray...............................................................................150

ETHYL CHLORIDE/FINE STREA -ethyl chloride aerosolspray...............................................................................150

ETHYL CHLORIDE/MEDIUM JET -ethyl chloride aerosolspray...............................................................................150

ETHYL CHLORIDE/MEDIUM STR -ethyl chloride aerosolspray...............................................................................150

ETHYL CHLORIDE/MIST -ethyl chloride aerosolspray...............................................................................150

ETHYL CHLORIDE -ethyl chloride aerosol spray............150ethynodiol diacetate & ethinyl estradiol tab 1 mg-35mcg.................................................................................. 24

ETIDRONATE DISODIUM -etidronate disodium tab 200mg.................................................................................... 36

ETIDRONATE DISODIUM -etidronate disodium tab 400mg.................................................................................... 36

etodolac cap 200 mg.....................................................102etodolac cap 300 mg.....................................................102etodolac tab 400 mg......................................................102etodolac tab 500 mg......................................................102etodolac tab sr 24hr 400 mg.........................................102etodolac tab sr 24hr 500 mg.........................................102etodolac tab sr 24hr 600 mg.........................................102ETOPOSIDE -etoposide cap 50 mg..................................17EURAX -crotamiton cream 10%...................................... 150EURAX -crotamiton lotion 10%....................................... 150EVAMIST -estradiol transdermal spray 1.53 mg/spray......23EVEKEO -amphetamine sulfate tab 10 mg....................... 87EVEKEO -amphetamine sulfate tab 5 mg......................... 87EVISTA -raloxifene hcl tab 60 mg..................................... 36EVOCLIN -clindamycin phosphate foam 1%................... 150EVOTAZ -atazanavir sulfate-cobicistat tab 300-150 mg(base equiv)....................................................................... 8

EVOXAC -cevimeline hcl cap 30 mg...............................142EVZIO -naloxone hcl solution auto-injector 0.4mg/0.4ml.........................................................................163

EXACTUSS -phenylephrine w/ dm-gg liqd 10-28-388mg/5ml..............................................................................60

EXALGO -hydromorphone hcl tab er 24hr deter 12 mg.....95EXALGO -hydromorphone hcl tab er 24hr deter 16 mg.....95EXALGO -hydromorphone hcl tab er 24hr deter 32 mg.....95EXALGO -hydromorphone hcl tab er 24hr deter 8 mg.......95EXELDERM -sulconazole nitrate cream 1%....................150EXELDERM -sulconazole nitrate solution 1%................. 150EXELON -rivastigmine tartrate cap 1.5 mg....................... 90EXELON -rivastigmine tartrate cap 3 mg.......................... 90EXELON -rivastigmine tartrate cap 4.5 mg....................... 90EXELON -rivastigmine tartrate cap 6 mg.......................... 90EXELON -rivastigmine td patch 24hr 13.3 mg/24hr...........90EXELON -rivastigmine td patch 24hr 4.6 mg/24hr.............90

EXELON -rivastigmine td patch 24hr 9.5 mg/24hr.............90exemestane tab 25 mg (Aromasin)................................ 17EXFORGE -amlodipine besylate-valsartan tab 10-160mg.................................................................................... 48

EXFORGE -amlodipine besylate-valsartan tab 10-320mg.................................................................................... 48



EXFORGE HCT -amlodipine-valsartan-hydrochlorothiazidetab 10-160-12.5 mg......................................................... 48

EXFORGE HCT -amlodipine-valsartan-hydrochlorothiazidetab 10-160-25 mg............................................................ 48

EXFORGE HCT -amlodipine-valsartan-hydrochlorothiazidetab 10-320-25 mg............................................................ 48

EXFORGE HCT -amlodipine-valsartan-hydrochlorothiazidetab 5-160-12.5 mg........................................................... 48

EXFORGE HCT -amlodipine-valsartan-hydrochlorothiazidetab 5-160-25 mg.............................................................. 48

EXJADE -deferasirox tab for oral susp 125 mg...............163EXJADE -deferasirox tab for oral susp 250 mg...............163EXJADE -deferasirox tab for oral susp 500 mg...............163EXODERM -sodium thiosulfate-salicylic acid lotion25-1%............................................................................. 150

EXTAVIA -interferon beta-1b for inj kit 0.3 mg.................. 90EXTINA -ketoconazole foam 2%..................................... 150EXTRA-VIRT PLUS DHA -prenatal w/o vit a w/ fe fum-doc-fa-dha cap 29-1.25-350 mg........................................... 116

F

FA-8 -folic acid cap 0.8 mg............................................. 129FABIOR -tazarotene (acne) foam 0.1%...........................150FACTIVE -gemifloxacin mesylate tab 320 mg (baseequiv)..................................................................................5

FALESSA -levomefolate glucosamine tab 1 mg (folateequivalent)......................................................................126

FALESSA -levonorgest-eth estrad tab 0.1 mg-20 mcg & fatab 1 mg kit......................................................................24

famciclovir tab 125 mg (Famvir)...................................... 8famciclovir tab 250 mg (Famvir)...................................... 8famciclovir tab 500 mg (Famvir)...................................... 8famotidine for susp 40 mg/5ml (Pepcid)....................... 67famotidine tab 40 mg (Pepcid)....................................... 67FAMVIR -famciclovir tab 125 mg.........................................8FAMVIR -famciclovir tab 250 mg.........................................8FAMVIR -famciclovir tab 500 mg.........................................8FANAPT -iloperidone tab 10 mg....................................... 81FANAPT -iloperidone tab 12 mg....................................... 81FANAPT -iloperidone tab 1 mg......................................... 81FANAPT -iloperidone tab 2 mg......................................... 81FANAPT -iloperidone tab 4 mg......................................... 81FANAPT -iloperidone tab 6 mg......................................... 81FANAPT -iloperidone tab 8 mg......................................... 81FANAPT TITRATION PACK -iloperidone tab 1 mg & 2 mg& 4 mg & 6 mg titration pak............................................ 81

2015


FARESTON -toremifene citrate tab 60 mg (baseequivalent)........................................................................17

FARXIGA -dapagliflozin propanediol tab 10 mg (baseequivalent)........................................................................28

FARYDAK -panobinostat lactate cap 10 mg (baseequivalent)........................................................................17



FAZACLO -clozapine orally disintegrating tab 100 mg...... 82FAZACLO -clozapine orally disintegrating tab 12.5 mg..... 81FAZACLO -clozapine orally disintegrating tab 150 mg...... 82FAZACLO -clozapine orally disintegrating tab 200 mg...... 82FAZACLO -clozapine orally disintegrating tab 25 mg........ 82FE 90 PLUS -fe carbonyl-fe gluconate-fa-vit b12-vit c-dsstab 90-1 mg................................................................... 129

fe fumarate-vit c-vit b12-fa cap 460 (151 fe)-60-0.01-1mg.................................................................................. 129

fe fumarate w/ b12-vit c-fa-ifc cap 110-0.015-75-0.5-240mg.................................................................................. 129

fe fum-iron polysacch complex-fa-b cmplx-c-zn-mn-cucap (Tandem plus)....................................................... 129

FEIBA -antiinhibitor coagulant complex for inj................. 134FEIBA NF -antiinhibitor coagulant complex for inj........... 134felbamate susp 600 mg/5ml (Felbatol).........................107felbamate tab 400 mg (Felbatol)...................................107felbamate tab 600 mg (Felbatol)...................................107FELBATOL -felbamate susp 600 mg/5ml........................107FELBATOL -felbamate tab 400 mg................................. 107FELBATOL -felbamate tab 600 mg................................. 107FELDENE -piroxicam cap 10 mg.................................... 102FELDENE -piroxicam cap 20 mg.................................... 102felodipine tab sr 24hr 10 mg.......................................... 43felodipine tab sr 24hr 2.5 mg......................................... 43felodipine tab sr 24hr 5 mg............................................ 43FEMARA -letrozole tab 2.5 mg......................................... 17FEMCON FE -norethindrone & ethinyl estradiol-fe chewtab 0.4 mg-35 mcg.......................................................... 24

FEMHRT LOW DOSE -norethindrone acetate-ethinylestradiol tab 0.5 mg-2.5 mcg...........................................23

FEM PH -acetic acid-oxyquinoline vaginal gel0.9-0.025%....................................................................... 73

FEMRING -estradiol acetate vaginal ring 0.05mg/24hr............................................................................ 73

FEMRING -estradiol acetate vaginal ring 0.1 mg/24hr...... 73FENOFIBRATE -fenofibrate cap 150 mg.......................... 54FENOFIBRATE -fenofibrate cap 50 mg............................ 54FENOFIBRATE -fenofibrate tab 120 mg........................... 54fenofibrate micronized cap 130 mg............................... 55fenofibrate micronized cap 134 mg (Lofibra)................ 55fenofibrate micronized cap 200 mg (Lofibra)................ 55fenofibrate micronized cap 43 mg................................. 55fenofibrate micronized cap 67 mg (Lofibra).................. 55fenofibrate tab 145 mg (Tricor)...................................... 55

fenofibrate tab 160 mg (Lofibra).................................... 55fenofibrate tab 48 mg (Tricor)........................................ 55fenofibrate tab 54 mg (Lofibra)...................................... 55FENOFIBRIC ACID -fenofibric acid tab 105 mg................ 55FENOFIBRIC ACID -fenofibric acid tab 35 mg..................55FENOGLIDE -fenofibrate tab 120 mg................................55FENOGLIDE -fenofibrate tab 40 mg................................. 55FENOPROFEN CALCIUM -fenoprofen calcium cap 400mg.................................................................................. 102

FENOPROFEN CALCIUM -fenoprofen calcium tab 600mg.................................................................................. 102

fentanyl citrate lozenge on a handle 1200 mcg(Actiq).............................................................................. 95






FENTANYL -fentanyl td patch 72hr 37.5 mcg/hr............... 95FENTANYL -fentanyl td patch 72hr 62.5 mcg/hr............... 95FENTANYL -fentanyl td patch 72hr 87.5 mcg/hr............... 95fentanyl td patch 72hr 100 mcg/hr (Duragesic).............96fentanyl td patch 72hr 12 mcg/hr (Duragesic)...............95fentanyl td patch 72hr 25 mcg/hr (Duragesic)...............95fentanyl td patch 72hr 50 mcg/hr (Duragesic)...............96fentanyl td patch 72hr 75 mcg/hr (Duragesic)...............96FENTORA -fentanyl citrate buccal tab 100 mcg (baseequiv)................................................................................96

FENTORA -fentanyl citrate buccal tab 200 mcg (baseequiv)................................................................................96




FER-IN-SOL -ferrous sulfate soln 75 mg/ml (15 mg/mlelemental fe).................................................................. 129

FERIVA 21/7 -fe asparto gly-b12-fa-c-dss-succinic acid-zntab 75-1 mg................................................................... 129

FERIVAFA -iron-c-fa-b12-biotin-copper-docusate cap110-1 mg........................................................................129

FERIVA -fe bisglycin-fe carbonyl-c-fa-b12-biotin-dss cap75-1 mg..........................................................................129

FERRALET 90 -fe carbonyl-fe gluconate-fa-vit b12-vit c-dss tab 90-1 mg.............................................................129

FERRAPLUS 90 -iron-folic acid-vit b12-vit c-docusate sodtab 90-1 mg................................................................... 129

FERRETTS CHEWABLE IRON -carbonyl iron chew tab 18mg (elemental iron)........................................................129

2015


FERREX 150 FORTE PLUS -fe asp gly-fe polysacch-succac-c-threon ac-b12-fa cap..............................................129

FERREX 28 -fe asparto gly-fe fum-b12-fa-c-succinic ac tabther pack........................................................................ 129

FERRIPROX -deferiprone tab 500 mg............................ 163FERRO-PLEX HEMATINIC -fe fum-dss-vit c-vit e-vit b12-if-fa tab 115-1 mg.......................................................... 129

FERROTRIN -iron w/ b12-vit c-fa-ifc cap36-0.015-75-0.5-240 mg................................................ 129

ferrous fumarate-fa-b complex-c-zn-mg-mn-cu tab106-1 mg....................................................................... 129

ferrous fumarate-folic acid tab 324-1 mg.................... 129ferrous sulfate elixir 220 mg/5ml (44 mg/5ml elementalfe)................................................................................... 129

FERROUS SULFATE -ferrous sulfate liquid 220 mg/5ml(44 mg/5ml elemental fe)...............................................129

FERROUS SULFATE -ferrous sulfate syrup 300 mg/5ml(60 mg/5ml elemental fe)...............................................129

ferrous sulfate soln 75 mg/ml (15 mg/ml elementalfe)................................................................................... 129

FETZIMA -levomilnacipran hcl cap sr 24hr 120 mg (baseequivalent)........................................................................78




FETZIMA TITRATION PACK -levomilnacipran hcl cap sr24hr 20 & 40 mg therapy pack........................................78

FEXMID -cyclobenzaprine hcl tab 7.5 mg....................... 114FIBRICOR -fenofibric acid tab 105 mg..............................55FIBRICOR -fenofibric acid tab 35 mg................................55FINACEA -azelaic acid gel 15%......................................150finasteride tab 5 mg (Proscar)........................................74FIORICET/CODEINE -butalbital-acetaminophen-caff w/cod cap 50-300-40-30 mg............................................... 96

FIORICET -butalbital-acetaminophen-caffeine cap50-300-40 mg...................................................................93

FIORICET -butalbital-acetaminophen-caffeine tab50-325-40 mg...................................................................93

FIORINAL/CODEINE #3 -butalbital-aspirin-caff w/ codeinecap 50-325-40-30 mg...................................................... 96

FIORINAL -butalbital-aspirin-caffeine cap 50-325-40mg.................................................................................... 93

FIRAZYR -icatibant acetate inj 30 mg/3ml (baseequivalent)......................................................................134

FIRST-HYDROCORTISONE -hydrocortisone gel 10%(cmpd kit)....................................................................... 150

FIRST-LANSOPRAZOLE -lansoprazole susp 3 mg/ml(compound kit)................................................................. 67

FIRST-OMEPRAZOLE -omeprazole susp 2 mg/ml(compound kit)................................................................. 67

FLAGYL ER -metronidazole tab sr 24hr 750 mg...............12FLAGYL -metronidazole cap 375 mg................................ 12

FLAGYL -metronidazole tab 250 mg.................................12FLAGYL -metronidazole tab 500 mg.................................12FLAREX -fluorometholone acetate ophth susp 0.1%...... 138flavoxate hcl tab 100 mg.................................................73flaxseed oil-evening primrose-bilberry cap 1000-500-40mg (Tears again hydrate)............................................126

flecainide acetate tab 100 mg.........................................44flecainide acetate tab 150 mg.........................................44flecainide acetate tab 50 mg.......................................... 44FLECTOR -diclofenac epolamine patch 1.3%................. 150FLEXIN -capsaicin-menthol topical patch 0.0375-5%......150FLOMAX -tamsulosin hcl cap 0.4 mg................................74FLONASE -fluticasone propionate nasal susp 50 mcg/act.....................................................................................59

FLO-PRED -prednisolone acetate oral susp 16.7 mg/5ml(15 mg/5ml base).............................................................20

FLORICAL -sodium fluoride w/ calcium carb cap 8.3-364mg.................................................................................. 124

FLORICAL -sodium fluoride w/ calcium carb tab 8.3-364mg.................................................................................. 124

FLORIVA -ped multiple vitamins & minerals w/ fl chew tab0.5 mg............................................................................ 116

FLORIVA -ped multiple vitamins & minerals w/ fl chew tab1 mg...............................................................................116

FLORIVA -sodium fluoride-vitamin d liqd drops 0.25 mg/ml-400 unit/ml................................................................ 124

FLOVENT DISKUS -fluticasone propionate aer pow ba100 mcg/blister.................................................................63

FLOVENT DISKUS -fluticasone propionate aer pow ba250 mcg/blister.................................................................63

FLOVENT DISKUS -fluticasone propionate aer pow ba 50mcg/blister........................................................................ 63

FLOVENT HFA -fluticasone propionate hfa inhal aer 110mcg/act (125/valve)..........................................................63

FLOVENT HFA -fluticasone propionate hfa inhal aer 220mcg/act (250/valve)..........................................................63

FLOVENT HFA -fluticasone propionate hfa inhal aero 44mcg/act (50/valve)............................................................63

FLUARIX 2011-2012 -influenza virus vaccine split pf susppref syringe 0.5 ml...........................................................13




FLUARIX QUADRIVALENT 2013 -influenza virus vac splitquadrivalent susp pref syr 0.5ml......................................13



FLUBLOK 2013-2014 -influenza virus vac recombinanthemagglutinin (ha) inj...................................................... 13

2015




FLUCELVAX 2012-2013 -influenza virus vac tiss-cultsubunit susp pref syr 0.5 ml............................................ 13




fluconazole for susp 10 mg/ml (Diflucan)....................... 6fluconazole for susp 40 mg/ml (Diflucan)....................... 6fluconazole tab 100 mg (Diflucan)................................... 6fluconazole tab 150 mg (Diflucan)................................... 6fluconazole tab 200 mg (Diflucan)................................... 6fluconazole tab 50 mg (Diflucan)..................................... 6flucytosine cap 250 mg (Ancobon)..................................6flucytosine cap 500 mg (Ancobon)..................................6fludrocortisone acetate tab 0.1 mg................................20FLULAVAL 2011-2012 -influenza virus vaccine split imsusp..................................................................................13

FLULAVAL 2012-2013 -influenza virus vaccine split imsusp..................................................................................13



FLULAVAL QUADRIVALENT 201 -influenza virus vaccinesplit quadrivalent im inj.................................................... 13

FLULAVAL QUADRIVALENT 201 -influenza virus vac splitquadrivalent susp pref syr 0.5ml......................................13

FLUMADINE -rimantadine hydrochloride tab 100 mg..........8FLUMIST QUADRIVALENT -influenza virus vaccine livequadrivalent intranasal susp............................................ 14

FLUNISOLIDE -flunisolide nasal soln 25 mcg/act(0.025%)...........................................................................59

flunisolide nasal soln 25 mcg/act (0.025%)(Flunisolide).................................................................... 59

fluocinolone acetonide (otic) oil 0.01% (Dermotic).....141fluocinolone acetonide cream 0.01%...........................150fluocinolone acetonide cream 0.025% (Synalar).........150fluocinolone acetonide oil 0.01% (body oil) (Derma-smoothe/fs bod)........................................................... 150

fluocinolone acetonide oil 0.01% (scalp oil) (Derma-smoothe/fs sca)............................................................151

fluocinolone acetonide oint 0.025% (Synalar).............151fluocinolone acetonide soln 0.01% (Synalar)..............151fluocinonide cream 0.05%............................................ 151fluocinonide cream 0.1% (Vanos)................................ 151fluocinonide emulsified base cream 0.05%.................151fluocinonide gel 0.05%..................................................151fluocinonide oint 0.05%................................................ 151fluocinonide soln 0.05%................................................151

FLUORABON -sodium fluoride soln 0.25 mg/0.6ml (from0.55 mg/0.6ml naf).........................................................124

FLUORAC -fluorouracil-diclofenac sodium cream5-1%............................................................................... 151

FLUOR-A-DAY -sodium fluoride-xylitol chew tab 0.55 (0.25mg f)-236.79 mg............................................................ 124

FLUOR-A-DAY -sodium fluoride-xylitol chew tab 1.1 (0.5mg f)-236.79 mg............................................................ 124

FLUOR-A-DAY -sodium fluoride-xylitol chew tab 2.2 (1 mgf)-236.79 mg...................................................................124

FLUORIDEX DAILY DEFENSE S -sodium fluoride-potassium nitrate gel 1.1-5%......................................... 142

fluorometholone ophth susp 0.1% (Fml liquifilm).......138FLUOROPLEX -fluorouracil cream 1%............................151fluorouracil cream 5% (Efudex)....................................151FLUOROURACIL -fluorouracil cream 0.5%.....................151fluorouracil soln 2%...................................................... 151fluorouracil soln 5%...................................................... 151fluoxetine hcl (pmdd) cap 10 mg................................... 90fluoxetine hcl (pmdd) cap 20 mg................................... 90fluoxetine hcl cap 10 mg (Prozac)................................. 78fluoxetine hcl cap 20 mg (Prozac)................................. 78fluoxetine hcl cap 40 mg (Prozac)................................. 78fluoxetine hcl cap delayed release 90 mg (Prozacweekly)............................................................................ 78

FLUOXETINE HCL -fluoxetine hcl tab 60 mg....................78fluoxetine hcl solution 20 mg/5ml..................................78fluoxetine hcl tab 10 mg................................................. 78fluoxetine hcl tab 20 mg................................................. 78FLUPHENAZINE HCL -fluphenazine hcl elixir 2.5mg/5ml..............................................................................82

FLUPHENAZINE HCL -fluphenazine hcl oral conc 5 mg/ml......................................................................................82

fluphenazine hcl tab 10 mg............................................ 82fluphenazine hcl tab 1 mg.............................................. 82fluphenazine hcl tab 2.5 mg........................................... 82fluphenazine hcl tab 5 mg.............................................. 82FLURA-DROPS -sodium fluoride soln 0.25 mg/drop f (from0.55 mg/drop naf).......................................................... 124

FLURAZEPAM HCL -flurazepam hcl cap 15 mg............... 84FLURAZEPAM HCL -flurazepam hcl cap 30 mg............... 84flurbiprofen sodium ophth soln 0.03% (Ocufen).........138flurbiprofen tab 100 mg................................................ 102flurbiprofen tab 50 mg.................................................. 102flutamide cap 125 mg......................................................17fluticasone propionate cream 0.05% (Cutivate).......... 151fluticasone propionate lotion 0.05% (Cutivate)...........151fluticasone propionate nasal susp 50 mcg/act(Flonase)......................................................................... 59

fluticasone propionate oint 0.005% (Cutivate)............ 151fluvastatin sodium cap 20 mg (Lescol)......................... 55fluvastatin sodium cap 40 mg (Lescol)......................... 55FLUVIRIN 2011-2012 -influenza virus vaccine types a & bsurface antigen im susp...................................................14

2015


FLUVIRIN 2012-2013 -influenza virus vaccine types a & bsurface antigen im susp...................................................14




FLUVIRIN PF 2011-2012 -influenza virus vac types a & bpf susp prefilled syr 0.5 ml.............................................. 14




fluvoxamine maleate cap sr 24hr 100 mg (Luvoxcr).....................................................................................78

fluvoxamine maleate cap sr 24hr 150 mg (Luvoxcr).....................................................................................78

fluvoxamine maleate tab 100 mg................................... 78fluvoxamine maleate tab 25 mg..................................... 78fluvoxamine maleate tab 50 mg..................................... 78FLUZONE HIGH-DOSE PF 2012 -influenza virus vac splithigh-dose pf susp pref syr 0.5ml..................................... 14

FLUZONE HIGH-DOSE PF 2013 -influenza virus vac splithigh-dose pf susp pref syr 0.5ml..................................... 14



FLUZONE INTRADERMAL QUADR -influenza virus vacsplit quad intradermal pen 9 mcg/strain...........................14

FLUZONE PF 2012-2013 -influenza virus vaccine split pfsusp pref syringe 0.5 ml.................................................. 14



FLUZONE QUADRIVALENT 2013 -influenza virus vaccinesplit quadrivalent inj 0.5 ml.............................................. 14

FLUZONE QUADRIVALENT 2013 -influenza virus vacsplit quadrivalent susp pref syr 0.25 ml........................... 14

FLUZONE QUADRIVALENT 2013 -influenza virus vacsplit quadrivalent susp pref syr 0.5ml.............................. 14

FLUZONE QUADRIVALENT 2014 -influenza virus vaccinesplit quadrivalent im inj.................................................... 14




FLUZONE QUADRIVALENT 2015 -influenza virus vaccinesplit quadrivalent im inj.................................................... 14




FLUZONE SPLIT 2012-2013 -influenza virus vaccine splitim susp.............................................................................15




FML -fluorometholone ophth oint 0.1%........................... 138FML FORTE -fluorometholone ophth susp 0.25%...........138FML LIQUIFILM -fluorometholone ophth susp 0.1%....... 138FOCALGIN 90 DHA -prenat w/o a w/fecbn-fegl-dss-fa tab90 &dha cap 300mg pak............................................... 117

FOCALGIN-B -prenatal w/ calcium-vit b6-fa-ginger tab1.22 mg.......................................................................... 117

FOCALGIN CA -prenat w/o a w/fecbn-fegl-dss-fa tab &dha cap 300 mg pack....................................................117

FOCALGIN DSS -fe carbonyl-fe gluconate-fa-vit b12-vit c-dss tab 90-1 mg.............................................................129

FOCALIN -dexmethylphenidate hcl tab 10 mg.................. 87FOCALIN -dexmethylphenidate hcl tab 2.5 mg................. 87FOCALIN -dexmethylphenidate hcl tab 5 mg.................... 87FOCALIN XR -dexmethylphenidate hcl cap sr 24 hr 10mg.................................................................................... 87

FOCALIN XR -dexmethylphenidate hcl cap sr 24 hr 15mg.................................................................................... 87







FOLBECAL -prenatal w/ calcium carbonate-b6-b12-fa tab1 mg...............................................................................117

FOLBEE AR -folic acid-b12-b6-arginine-black peppertab.................................................................................. 126

FOLBIC RF -l-methylfolate w/ vit b6-vit b12 tab 1.13-25-2mg.................................................................................. 126

FOLCAL DHA -prenatal w/o vit a w/ fe fum-dss-fa-dha cap27-1.25-300 mg..............................................................117

FOLCAPS OMEGA 3 -prenatal vit w/ fe cbn-fe asp glyc-fa-omega 3 cap 27-1mg.....................................................117

2015


FOLET DHA -prenat w/fecbn-bisg-methylf-dss tab dr &dha cap pak................................................................... 117

FOLET ONE -prenat w/o a w/fecbn-bisg-methylf-dss-dhacap 38-1-225 mg............................................................117

FOLGARD OS -multiple vit w/ min & calcium-folic acid tab500-1.1 mg.....................................................................117

FOLGARD RX -folic acid-vitamin b6-vitamin b12 tab2.2-25-1 mg....................................................................129

folic acid-pyridoxine-cyanocobalamin tab 2.5-25-2mg.................................................................................. 126

folic acid tab 1 mg.........................................................129folic acid tab 400 mcg...................................................129folic acid tab 800 mcg...................................................129folic acid-vitamin b6-vitamin b12 tab 2.2-25-0.5mg.................................................................................. 130

folic acid-vitamin b6-vitamin b12 tab 2.2-25-1 mg(Folgard rx)................................................................... 130

folic acid-vitamin b6-vitamin b12 tab 2.5-25-1 mg...... 130FOLIVANE-F -fe fum-fe poly-fa-c-b3 cap62.5-62.5-1-40-3mg(125 mg fe).....................................130

FOLIVANE-OB -prenatal w/o a w/fe fum-fe poly-fa cap130-92.4-1 mg................................................................117

FOLIVANE-PLUS -fe fum-iron polysacch complex-fa-bcomplex-c-biotin cap...................................................... 130

FOLTANX -l-methylfolate w/ vit b6-vit b12 tab 3-35-2mg.................................................................................. 126

FOLTANX RF -l-methylfolate-algae-vit b12-b6 cap3-90.314-2-35 mg.......................................................... 126

FOLTX -l-methylfolate w/ vit b6-vit b12 tab 1.13-25-2mg.................................................................................. 126

fondaparinux sodium subcutaneous inj 10 mg/0.8ml(Arixtra)......................................................................... 132

fondaparinux sodium subcutaneous inj 2.5 mg/0.5ml(Arixtra)......................................................................... 132

fondaparinux sodium subcutaneous inj 5 mg/0.4ml(Arixtra)......................................................................... 132

fondaparinux sodium subcutaneous inj 7.5 mg/0.6ml(Arixtra)......................................................................... 132

FORADIL AEROLIZER -formoterol fumarate inhal cap 12mcg...................................................................................63

FORFIVO XL -bupropion hcl tab sr 24hr 450 mg.............. 78formaldehyde solution 10%..........................................163FORMA-RAY -formaldehyde solution 20%......................163FORTAMET -metformin hcl tab sr 24hr osmotic 1000mg.................................................................................... 28

FORTAMET -metformin hcl tab sr 24hr osmotic 500mg.................................................................................... 28

FORTEO -teriparatide (recombinant) inj 600mcg/2.4ml.........................................................................36

FORTESTA -testosterone td gel 10mg/act (2%)............... 21FORTICAL -calcitonin (salmon) nasal soln 200 unit/act.....................................................................................36

FOSAMAX -alendronate sodium tab 70 mg...................... 36FOSAMAX PLUS D -alendronate sodium-cholecalciferoltab 70-2800 mg-unit.........................................................36

FOSAMAX PLUS D -alendronate sodium-cholecalciferoltab 70-5600 mg-unit.........................................................36

fosinopril sodium & hydrochlorothiazide tab 10-12.5mg.................................................................................... 48

fosinopril sodium & hydrochlorothiazide tab 20-12.5mg.................................................................................... 48

fosinopril sodium tab 10 mg.......................................... 48fosinopril sodium tab 20 mg.......................................... 48fosinopril sodium tab 40 mg.......................................... 48FOSRENOL -lanthanum carbonate chew tab 1000 mg(elemental)....................................................................... 71

FOSRENOL -lanthanum carbonate chew tab 500 mg(elemental)....................................................................... 71

FOSRENOL -lanthanum carbonate chew tab 750 mg(elemental)....................................................................... 71

FOSRENOL -lanthanum carbonate oral powder pack 1000mg (elemental)................................................................. 71

FOSRENOL -lanthanum carbonate oral powder pack 750mg (elemental)................................................................. 71

FOSTEUM -genistein-zinc amino acid chelate-vitamin dcap..................................................................................126

FRAGMIN -dalteparin sodium inj 10000 unit/ml.............. 132FRAGMIN -dalteparin sodium inj 12500 unit/0.5ml..........132FRAGMIN -dalteparin sodium inj 15000 unit/0.6ml..........132FRAGMIN -dalteparin sodium inj 18000 unit/0.72ml........132FRAGMIN -dalteparin sodium inj 2500 unit/0.2ml............132FRAGMIN -dalteparin sodium inj 5000 unit/0.2ml............132FRAGMIN -dalteparin sodium inj 7500 unit/0.3ml............132FRAGMIN -dalteparin sodium inj 95000 unit/3.8ml..........132FROVA -frovatriptan succinate tab 2.5 mg (baseequivalent)......................................................................104

FULYZAQ -crofelemer tab delayed release 125 mg..........66FURADANTIN -nitrofurantoin susp 25 mg/5ml.................. 72FUROSEMIDE -furosemide oral soln 8 mg/ml.................. 53furosemide oral soln 10 mg/ml...................................... 53furosemide tab 20 mg (Lasix).........................................53furosemide tab 40 mg (Lasix).........................................53furosemide tab 80 mg (Lasix).........................................53FUSION PLUS -fe fum-iron poly cmplx-fa-b cmplx-c-biotin-probiotic cap...................................................................130

FUZEON -enfuvirtide for inj 90 mg......................................8FYCOMPA -perampanel tab 10 mg.................................107FYCOMPA -perampanel tab 12 mg.................................107FYCOMPA -perampanel tab 2 mg.................................. 107FYCOMPA -perampanel tab 4 mg.................................. 107FYCOMPA -perampanel tab 6 mg.................................. 107FYCOMPA -perampanel tab 8 mg.................................. 107

G

gabapentin cap 100 mg (Neurontin)............................ 107gabapentin cap 300 mg (Neurontin)............................ 107gabapentin cap 400 mg (Neurontin)............................ 107gabapentin oral soln 250 mg/5ml (Neurontin).............108gabapentin tab 600 mg (Neurontin)............................. 108gabapentin tab 800 mg (Neurontin)............................. 108GABITRIL -tiagabine hcl tab 12 mg.................................108

2015


GABITRIL -tiagabine hcl tab 16 mg.................................108GABITRIL -tiagabine hcl tab 2 mg.................................. 108GABITRIL -tiagabine hcl tab 4 mg.................................. 108galantamine hydrobromide cap sr 24hr 16 mg(Razadyne er)................................................................. 90

galantamine hydrobromide cap sr 24hr 24 mg(Razadyne er)................................................................. 90

galantamine hydrobromide cap sr 24hr 8 mg(Razadyne er)................................................................. 90

GALANTAMINE HYDROBROMIDE -galantaminehydrobromide oral soln 4 mg/ml...................................... 90

galantamine hydrobromide tab 12 mg (Razadyne).......90galantamine hydrobromide tab 4 mg (Razadyne).........90galantamine hydrobromide tab 8 mg (Razadyne).........90GALZIN -zinc acetate cap 25 mg (elemental zinc).......... 124GALZIN -zinc acetate cap 50 mg (elemental zinc).......... 125GARAMYCIN -gentamicin sulfate ophth soln 0.3%......... 138GASTRINEX NF -hyoscyamine-phenyltoloxamine cap0.0625-15 mg...................................................................67

GASTROCROM -cromolyn sodium oral conc 100mg/5ml..............................................................................71

gatifloxacin ophth soln 0.5% (Zymaxid)...................... 138GATTEX -teduglutide (rdna) for inj kit 5 mg...................... 71GEBAUERS PAIN EASE -pentafluoropropane-tetrafluoroethane aero spray..........................................151

GEBAUERS SPRAY AND STRETC -pentafluoropropane-tetrafluoroethane aero spray..........................................151

GELCLAIR -povidone-sodium hyaluronate-glycyrrhetinicacid gel...........................................................................142

GELFILM OP -gelatin adsorbable ophth film...................138GEL-KAM ORAL CARE RINSE -stannous fluoride conc0.63%............................................................................. 142

GEL-KAM -stannous fluoride gel 0.4%............................142GELNIQUE -oxybutynin chloride td gel 10%..................... 73GELNIQUE -oxybutynin td gel 3% (28 mg/act metered-dose pump)...................................................................... 73

GELX -oral wound care products - gel............................ 142gemfibrozil tab 600 mg (Lopid)...................................... 55GENADUR -dermatological products misc - liquid...........151GENADUR KIT -dermatological products misc topical/oral- kit................................................................................. 151

GENERESS FE -norethindrone & ethinyl estradiol-fe chewtab 0.8 mg-25 mcg.......................................................... 24

GENOTROPIN MINIQUICK -somatropin for inj 0.2 mg..... 36GENOTROPIN MINIQUICK -somatropin for inj 0.4 mg..... 36GENOTROPIN MINIQUICK -somatropin for inj 0.6 mg..... 36GENOTROPIN MINIQUICK -somatropin for inj 0.8 mg..... 36GENOTROPIN MINIQUICK -somatropin for inj 1.2 mg..... 36GENOTROPIN MINIQUICK -somatropin for inj 1.4 mg..... 36GENOTROPIN MINIQUICK -somatropin for inj 1.6 mg..... 36GENOTROPIN MINIQUICK -somatropin for inj 1.8 mg..... 36GENOTROPIN MINIQUICK -somatropin for inj 1 mg........ 36GENOTROPIN MINIQUICK -somatropin for inj 2 mg........ 36GENOTROPIN -somatropin for inj 12 mg (13.8 mgoverfill)..............................................................................36

GENOTROPIN -somatropin for subcutaneous inj 5 mg.....36GENTAMICIN SULFATE -gentamicin sulfate cream0.1%............................................................................... 151

GENTAMICIN SULFATE -gentamicin sulfate oint0.1%............................................................................... 151

gentamicin sulfate ophth oint 0.3%............................. 138gentamicin sulfate ophth soln 0.3% (Garamycin).......138GEODON -ziprasidone hcl cap 20 mg.............................. 82GEODON -ziprasidone hcl cap 40 mg.............................. 82GEODON -ziprasidone hcl cap 60 mg.............................. 82GEODON -ziprasidone hcl cap 80 mg.............................. 82GIAZO -balsalazide disodium tab 1.1 gm..........................71GILENYA -fingolimod hcl cap 0.5 mg (base equiv)........... 90GILOTRIF -afatinib dimaleate tab 20 mg (baseequivalent)........................................................................17

GILOTRIF -afatinib dimaleate tab 30 mg (baseequivalent)........................................................................17

GILOTRIF -afatinib dimaleate tab 40 mg (baseequivalent)........................................................................17

GILPHEX TR -phenylephrine-guaifenesin tab 10-388mg.................................................................................... 60

GILTUSS PED-C -phenylephrine w/ codeine-gg liquid2.5-3-50 mg/ml.................................................................60

GILTUSS -phenylephrine w/ dm-gg liqd 10-28-388mg/5ml..............................................................................60

GILTUSS TR -phenylephrine w/ dm-gg tab 10-28-388mg.................................................................................... 60

glatiramer acetate soln prefilled syringe 20 mg/ml(Copaxone)......................................................................90

GLEEVEC -imatinib mesylate tab 100 mg (baseequivalent)........................................................................17

GLEEVEC -imatinib mesylate tab 400 mg (baseequivalent)........................................................................17

GLEOSTINE -lomustine cap 100 mg.................................17GLEOSTINE -lomustine cap 10 mg.................................. 17GLEOSTINE -lomustine cap 40 mg.................................. 17glimepiride tab 1 mg (Amaryl)........................................28glimepiride tab 2 mg (Amaryl)........................................28glimepiride tab 4 mg (Amaryl)........................................28glipizide-metformin hcl tab 2.5-250 mg......................... 28glipizide-metformin hcl tab 2.5-500 mg......................... 28glipizide-metformin hcl tab 5-500 mg............................ 28glipizide tab 10 mg (Glucotrol).......................................28glipizide tab 5 mg (Glucotrol).........................................28glipizide tab sr 24hr 10 mg (Glucotrol xl)......................28glipizide tab sr 24hr 2.5 mg (Glucotrol xl).....................28glipizide tab sr 24hr 5 mg (Glucotrol xl)........................28GLUCAGEN DIAGNOSTIC -glucagon hcl (rdna) diagnosticfor inj 1 mg (base equiv)................................................163

GLUCAGEN HYPOKIT -glucagon hcl (rdna) for inj 1 mg(base equiv)..................................................................... 28

GLUCAGON EMERGENCY KIT -glucagon (rdna) for inj kit1 mg.................................................................................28

GLUCOPHAGE -metformin hcl tab 1000 mg.................... 28GLUCOPHAGE -metformin hcl tab 500 mg...................... 28

2015


GLUCOPHAGE -metformin hcl tab 850 mg...................... 28GLUCOPHAGE XR -metformin hcl tab sr 24hr 500 mg.....28GLUCOPHAGE XR -metformin hcl tab sr 24hr 750 mg.....28GLUCOSE BLOOD TEST STRIPS – VARIOUS............. 163glucose gel 40%.............................................................. 28GLUCOSE -glucose chew tab 4 gm..................................28GLUCOSE -glucose-vitamin c chew tab 4-0.006 gm.........28glucose oral liquid 15 gm/59ml...................................... 28GLUCOTROL -glipizide tab 10 mg....................................28GLUCOTROL -glipizide tab 5 mg......................................28GLUCOTROL XL -glipizide tab sr 24hr 10 mg.................. 28GLUCOTROL XL -glipizide tab sr 24hr 2.5 mg................. 28GLUCOTROL XL -glipizide tab sr 24hr 5 mg.................... 28GLUCOVANCE -glyburide-metformin tab 1.25-250 mg.....28GLUCOVANCE -glyburide-metformin tab 2.5-500 mg.......28GLUCOVANCE -glyburide-metformin tab 5-500 mg..........28GLUMETZA -metformin hcl tab sr 24hr modified release1000 mg........................................................................... 28

GLUMETZA -metformin hcl tab sr 24hr modified release500 mg.............................................................................28

GLUTARALDEHYDE -glutaral soln 25%......................... 163GLYBURIDE -glyburide tab 1.25 mg.................................28GLYBURIDE -glyburide tab 2.5 mg...................................28GLYBURIDE -glyburide tab 5 mg......................................28glyburide-metformin tab 1.25-250 mg(Glucovance)...................................................................28

glyburide-metformin tab 2.5-500 mg (Glucovance)...... 28glyburide-metformin tab 5-500 mg (Glucovance)......... 29glyburide micronized tab 1.5 mg (Glynase).................. 28glyburide micronized tab 3 mg (Glynase)..................... 28glyburide micronized tab 6 mg (Glynase)..................... 28glyburide tab 1.25 mg..................................................... 28glyburide tab 2.5 mg....................................................... 28glyburide tab 5 mg.......................................................... 28GLYCATE -glycopyrrolate tab 1.5 mg............................... 67glycopyrrolate tab 1 mg (Robinul)................................. 67glycopyrrolate tab 2 mg (Robinul forte)........................ 67GLYNASE -glyburide micronized tab 1.5 mg.................... 29GLYNASE -glyburide micronized tab 3 mg....................... 29GLYNASE -glyburide micronized tab 6 mg....................... 29GLYSET -miglitol tab 100 mg............................................29GLYSET -miglitol tab 25 mg..............................................29GLYSET -miglitol tab 50 mg..............................................29GLYXAMBI -empagliflozin-linagliptin tab 10-5 mg............. 29GLYXAMBI -empagliflozin-linagliptin tab 25-5 mg............. 29GNP GLUCOSE -glucose chew tab 4 gm......................... 29GNP GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 29

GNP QUICK DISSOLVE GLUCOS -glucose chew tab 4gm.................................................................................... 29

GNP VITAMIN D-400 -calcium carbonate-cholecalciferoltab 90 mg-400 unit........................................................ 125

GNP VITAMIN D-400 -calcium carbonate-cholecalciferoltab 90 mg-400 unit........................................................ 125

GOLYTELY -peg 3350-kcl-na bicarb-nacl-na sulfate forsoln 236 gm..................................................................... 65

GOLYTELY -peg 3350-kcl-na bicarb-nacl-na sulfatepacket 227.1 gm.............................................................. 65

GORDOFILM -salicylic & lactic acids soln16.7-16.7%..................................................................... 151

GORDONS UREA -urea ointment 40%...........................151GRALISE -gabapentin (phn) tab 300 mg...........................90GRALISE -gabapentin (phn) tab 600 mg...........................90GRALISE STARTER -gabapentin (phn) tab starter pack300 mg (9) & 600 mg (69)...............................................91

granisetron hcl tab 1 mg................................................ 69GRANIX -tbo-filgrastim soln prefilled syringe 300mcg/0.5ml.......................................................................130

GRANIX -tbo-filgrastim soln prefilled syringe 480mcg/0.8ml.......................................................................130

GRANULEX -trypsin w/ castor oil & peruvian balsamspray...............................................................................151

GRASTEK -timothy grass pollen allergen ext tab sl 2800bau................................................................................... 16

GRIFULVIN V -griseofulvin microsize tab 500 mg...............6griseofulvin microsize susp 125 mg/5ml.........................6griseofulvin microsize tab 500 mg (Grifulvin v)..............6griseofulvin ultramicrosize tab 125 mg (Gris-peg)......... 6griseofulvin ultramicrosize tab 250 mg (Gris-peg)......... 6GRIS-PEG -griseofulvin ultramicrosize tab 125 mg.............6GRIS-PEG -griseofulvin ultramicrosize tab 250 mg.............6guaifenesin-codeine liquid 200-8 mg/5ml......................60guaifenesin-codeine liquid 225-7.5 mg/5ml...................60guaifenesin-codeine soln 100-10 mg/5ml......................60guaifenesin-codeine soln 100-6.3 mg/5ml.....................60guanfacine hcl tab 1 mg (Tenex)................................... 48guanfacine hcl tab 2 mg (Tenex)................................... 48guanfacine hcl tab sr 24hr 1 mg (base equiv)(Intuniv)........................................................................... 87

guanfacine hcl tab sr 24hr 2 mg (base equiv)(Intuniv)........................................................................... 87



GUANIDINE HCL -guanidine hcl tab 125 mg.................. 114GYNAZOLE-1 -butoconazole nitrate (one dose) vaginalcream 2%.........................................................................73

H

H.P. ACTHAR -corticotropin inj gel 80 unit/ml................... 36HALAC -halobetasol prop oint 0.05% & ammonium lactatelot 12% kit...................................................................... 151

HALCION -triazolam tab 0.25 mg......................................84halobetasol propionate cream 0.05% (Ultravate)........151halobetasol propionate oint 0.05% (Ultravate)............151HALOG -halcinonide cream 0.1%................................... 151HALOG -halcinonide oint 0.1%........................................151haloperidol lactate oral conc 2 mg/ml........................... 82haloperidol tab 0.5 mg.................................................... 82

2015


haloperidol tab 10 mg..................................................... 82haloperidol tab 1 mg....................................................... 82haloperidol tab 20 mg..................................................... 82haloperidol tab 2 mg....................................................... 82haloperidol tab 5 mg....................................................... 82HALOTIN -haloprogin cream 1%.....................................151HARVONI -ledipasvir-sofosbuvir tab 90-400 mg................. 8hc-pramoxine emol cream 2.5-1% & pramoxine wipe1% kit (Analpram e)..................................................... 144

HECTOROL -doxercalciferol cap 0.5 mcg.........................36HECTOROL -doxercalciferol cap 1 mcg............................36HECTOROL -doxercalciferol cap 2.5 mcg.........................36HELIXATE FS -antihemophilic factor (recombinant) for injkit 1000 unit................................................................... 134

HELIXATE FS -antihemophilic factor (recombinant) for injkit 2000 unit................................................................... 135

HELIXATE FS -antihemophilic factor (recombinant) for injkit 250 unit..................................................................... 134

HELIXATE FS -antihemophilic factor (recombinant) for injkit 3000 unit................................................................... 135

HELIXATE FS -antihemophilic factor (recombinant) for injkit 500 unit..................................................................... 134

HEMANGEOL -propranolol hcl oral soln 4.28 mg/ml.........40HEMATOGEN FA -fe fumarate-vit c-vit b12-fa cap200-250-0.01-1 mg........................................................ 130

HEMATRON-AF -iron-docusate-b12-folic acid-c-e-cu-biotintab 150-1 mg................................................................. 130

HEMENATAL OB + DHA -prenat-fe poly cmplx-fe hemepoly-fa tab & omega 3 cap pck......................................117

HEMENATAL OB -prenat vit-fe poly cmplx-fe heme poly-fatab 28-6-1 mg................................................................ 117

HEMETAB -polysacch fe cmplx-fe heme poly-fa-b12 tab22-6-1-0.025 mg............................................................ 130

HEMOCYTE PLUS -ferrous fumarate-fa-b complex-c-zn-mg-mn-cu cap 106-1 mg............................................... 130

HEMOFIL M -antihemophilic factor (human) for inj 1000unit..................................................................................135

HEMOFIL M -antihemophilic factor (human) for inj1501-2000 unit............................................................... 135


HEMOFIL M -antihemophilic factor (human) for inj 220-400unit..................................................................................135


HEMOFIL M -antihemophilic factor (human) for inj 401-800unit..................................................................................135


HEMOFIL M -antihemophilic factor (human) for inj801-1500 unit................................................................. 135

HEPAGAM B -hepatitis b immune globulin (human) injsoln...................................................................................15

heparin sodium (porcine) inj 10000 unit/ml.................132heparin sodium (porcine) inj 1000 unit/ml...................132

heparin sodium (porcine) inj 20000 unit/ml.................132heparin sodium (porcine) inj 5000 unit/ml...................132heparin sodium (porcine) pf inj 5000 unit/0.5ml......... 132HEPARIN SODIUM -heparin sodium (porcine) inj 2000unit/ml.............................................................................132

HEPARIN SODIUM -heparin sodium (porcine) inj 2500unit/ml.............................................................................132

HEPSERA -adefovir dipivoxil tab 10 mg............................. 8HETLIOZ -tasimelteon capsule 20 mg.............................. 84HEXALEN -altretamine cap 50 mg....................................17HIPREX -methenamine hippurate tab 1 gm...................... 72HM GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 29

homatropine hbr ophth soln 5% (Isoptohomatropine)................................................................ 138

HORIZANT -gabapentin enacarbil tab cr 300 mg..............91HORIZANT -gabapentin enacarbil tab cr 600 mg..............91HPR -emollient - aerosol foam........................................ 151HPR PLUS/MB HYDROGEL -emollient foam & wounddressing gel kit...............................................................151

HPR PLUS -dermatological products misc - cream......... 151HPR PLUS -emollient - aerosol foam..............................151HPR PLUS HYDROGEL KIT -dermatological productsmisc - kit........................................................................ 151

HUMALOG -insulin lispro (human) inj 100 unit/ml............. 31HUMALOG -insulin lispro (human) soln cartridge 100 unit/ml......................................................................................31

HUMALOG KWIKPEN -insulin lispro (human) soln pen-injector 100 unit/ml...........................................................31

HUMALOG KWIKPEN -insulin lispro (human) soln pen-injector 200 unit/ml...........................................................31

HUMALOG MIX 50/50 -insulin lispro prot & lispro (human)inj 100 unit/ml (50-50)......................................................32

HUMALOG MIX 50/50 KWIKPEN -insulin lispro prot &lispro sus pen-inj 100 unit/ml (50-50).............................. 32

HUMALOG MIX 75/25 -insulin lispro prot & lispro (human)inj 100 unit/ml (75-25)......................................................32

HUMALOG MIX 75/25 KWIKPEN -insulin lispro prot &lispro sus pen-inj 100 unit/ml (75-25).............................. 32

HUMATE-P -antihemophilic factor/vwf (human) for inj1000-2400 unit............................................................... 135

HUMATE-P -antihemophilic factor/vwf (human) for inj250-600 unit................................................................... 135

HUMATE-P -antihemophilic factor/vwf (human) for inj500-1200 unit................................................................. 135

HUMATROPE COMBO PACK -somatropin for inj 5mg.................................................................................... 37

HUMATROPE -somatropin for inj 12 mg (36 unit).............37HUMATROPE -somatropin for inj 24 mg...........................37HUMATROPE -somatropin for inj 5 mg.............................36HUMATROPE -somatropin for inj 6 mg (18 unit)...............37HUMIRA -adalimumab prefilled syringe kit 10mg/0.2ml.........................................................................102

HUMIRA -adalimumab prefilled syringe kit 20mg/0.4ml.........................................................................102

2015


HUMIRA -adalimumab prefilled syringe kit 40mg/0.8ml.........................................................................102

HUMIRA PEDIATRIC CROHNS D -adalimumab prefilledsyringe kit 40 mg/0.8ml..................................................102

HUMIRA PEN -adalimumab pen-injector kit 40mg/0.8ml.........................................................................102

HUMIRA PEN-CROHNS DISEASE -adalimumab pen-injector kit 40 mg/0.8ml..................................................102

HUMIRA PEN-PSORIASIS STAR -adalimumab pen-injector kit 40 mg/0.8ml..................................................102

HUMULIN 70/30 -insulin nph isophane & regular human inj100 unit/ml (70-30)...........................................................32

HUMULIN 70/30 KWIKPEN -insulin nph & regular susppen-inj 100 unit/ml (70-30)...............................................32

HUMULIN 70/30 PEN -insulin nph & regular susp pen-inj100 unit/ml (70-30)...........................................................32

HUMULIN N -insulin nph (human) (isophane) inj 100 unit/ml......................................................................................32

HUMULIN N KWIKPEN -insulin nph (human) (isophane)susp pen-injector 100 unit/ml...........................................32

HUMULIN N U-100 PEN -insulin nph (human) (isophane)susp pen-injector 100 unit/ml...........................................32

HUMULIN R -insulin regular (human) inj 100 unit/ml.........32HUMULIN R U-500 (CONCENTR -insulin regular (human)inj 500 unit/ml.................................................................. 32

HURRISEAL -dental desensitizing product - solution...... 163hyaluronate sodium (emollient) gel 0.2% (Hylira).......151HYCAMTIN -topotecan hcl cap 0.25 mg (base equiv)....... 17HYCAMTIN -topotecan hcl cap 1 mg (base equiv)............17HYCET -hydrocodone-acetaminophen soln 7.5-325mg/15ml............................................................................96

hydralazine hcl tab 100 mg............................................ 48hydralazine hcl tab 10 mg.............................................. 48hydralazine hcl tab 25 mg.............................................. 48hydralazine hcl tab 50 mg.............................................. 48HYDREA -hydroxyurea cap 500 mg..................................17HYDRO 35 -urea in lactic acid vehicle foam 35%........... 151HYDRO 40 FOAM -urea foam 40%................................ 151hydrochlorothiazide cap 12.5 mg (Microzide)...............53hydrochlorothiazide tab 12.5 mg................................... 53hydrochlorothiazide tab 25 mg...................................... 53hydrochlorothiazide tab 50 mg...................................... 53HYDROCODONE/ACETAMINOPHEN -hydrocodone-acetaminophen soln 10-325 mg/15ml..............................96

hydrocodone-acetaminophen soln 7.5-325 mg/15ml(Hycet)............................................................................. 96

hydrocodone-acetaminophen tab 10-300 mg(Xodol)............................................................................. 96

hydrocodone-acetaminophen tab 10-325 mg(Norco).............................................................................96

hydrocodone-acetaminophen tab 2.5-325 mg...............96hydrocodone-acetaminophen tab 5-300 mg(Xodol)............................................................................. 96

hydrocodone-acetaminophen tab 5-325 mg(Norco).............................................................................96

hydrocodone-acetaminophen tab 7.5-300 mg(Xodol)............................................................................. 96

hydrocodone-acetaminophen tab 7.5-325 mg(Norco).............................................................................96

hydrocodone-ibuprofen tab 10-200 mg (Ibudone)........ 96hydrocodone-ibuprofen tab 2.5-200 mg(Reprexain)......................................................................96

hydrocodone-ibuprofen tab 5-200 mg (Reprexain).......96hydrocodone-ibuprofen tab 7.5-200 mg(Vicoprofen).................................................................... 96

hydrocodone w/ homatropine syrup 5-1.5 mg/5ml....... 60hydrocodone w/ homatropine tab 5-1.5 mg.................. 60hydrocod polst-chlorphen polst cr susp 10-8 mg/5ml(Tussionex pennkineti)..................................................60

hydrocortisone acetate suppos 25 mg (Anusol-hc).................................................................................. 144

hydrocortisone acetate suppos 30 mg(Proctocort)...................................................................144

hydrocortisone acetate w/ pramoxine rectal cream1-1% (Analpram-hc)..................................................... 144

hydrocortisone acetate w/ pramoxine rectal cream2.5-1% (Analpram-hc).................................................. 144

hydrocortisone butyrate cream 0.1% (Locoid)............151hydrocortisone butyrate hydrophilic lipo base cream0.1% (Locoid lipocream)..............................................151

hydrocortisone butyrate oint 0.1% (Locoid)................151hydrocortisone butyrate soln 0.1% (Locoid)...............151hydrocortisone cream 2.5%..........................................151hydrocortisone enema 100 mg/60ml (Cortenema)......144hydrocortisone lotion 2.5%...........................................152hydrocortisone lotion 2% (Ala scalp).......................... 152hydrocortisone oint 2.5%..............................................152hydrocortisone rectal cream 1% (Proctocort).............144hydrocortisone rectal cream 2.5% (Anusol-hc).......... 144hydrocortisone tab 10 mg (Cortef).................................20hydrocortisone tab 20 mg (Cortef).................................20hydrocortisone tab 5 mg (Cortef).................................. 20hydrocortisone valerate cream 0.2%........................... 152hydrocortisone valerate oint 0.2% (Westcort).............152hydrocortisone w/ acetic acid otic soln 1-2% (Vosolhc).................................................................................. 141

HYDROFERA BLUE 4"X4" -wound dressings - pads......152HYDROFERA BLUE FOAM DRESS -wound dressings -pads................................................................................152

HYDROFERA BLUE HEAVY DRAI -wound dressings -pads................................................................................152

HYDROFERA BLUE READY FOAM -wound dressings -pads................................................................................152

HYDROMORPHONE HCL ER -hydromorphone hcl tab er24hr deter 32 mg............................................................. 96

HYDROMORPHONE HCL -hydromorphone hcl suppos 3mg.................................................................................... 96

hydromorphone hcl liqd 1 mg/ml (Dilaudid)................. 96hydromorphone hcl tab 2 mg (Dilaudid)....................... 96hydromorphone hcl tab 4 mg (Dilaudid)....................... 96

2015


hydromorphone hcl tab 8 mg (Dilaudid)....................... 96hydromorphone hcl tab er 24hr deter 12 mg(Exalgo)........................................................................... 96

hydromorphone hcl tab er 24hr deter 16 mg(Exalgo)........................................................................... 96

hydromorphone hcl tab er 24hr deter 8 mg(Exalgo)........................................................................... 96

hydroxychloroquine sulfate tab 200 mg (Plaquenil).....11hydroxyurea cap 500 mg (Hydrea).................................17hydroxyzine hcl syrup 10 mg/5ml..................................75hydroxyzine hcl tab 10 mg............................................. 75hydroxyzine hcl tab 25 mg............................................. 75hydroxyzine hcl tab 50 mg............................................. 75hydroxyzine pamoate cap 25 mg (Vistaril)....................75hydroxyzine pamoate cap 50 mg (Vistaril)....................75HYDROXYZINE PAMOATE -hydroxyzine pamoate cap100 mg.............................................................................75

HYLASE WOUND -hyaluronate sodium gel.................... 152HYLATOPIC -emollient - aerosol foam............................152HYLATOPIC PLUS -dermatological products misc -cream............................................................................. 152

HYLATOPIC PLUS -emollient - aerosol foam................. 152HYLIRA -hyaluronate sodium (emollient) gel 0.2%..........152HYLIRA -hyaluronate sodium (emollient) lotion 0.1%......152hyoscyamine sulfate elixir 0.125 mg/5ml...................... 67hyoscyamine sulfate soln 0.125 mg/ml......................... 67hyoscyamine sulfate tab 0.125 mg (Levsin)..................67hyoscyamine sulfate tab disp 0.125 mg (Anaspaz)...... 67hyoscyamine sulfate tab sl 0.125 mg (Levsin/sl).......... 67hyoscyamine sulfate tab sr 12hr 0.375 mg (Levbid).....67HYPERHEP B S/D -hepatitis b immune globulin (human)im inj soln.........................................................................15

HYPERRAB S/D -rabies immune globulin (human) inj 150unit/ml...............................................................................15

HYPERSAL -sodium chloride soln nebu 3.5%.................. 60HYPERSAL -sodium chloride soln nebu 7%..................... 60HYPER-SAL -sodium chloride soln nebu 7%.................... 60HYPERTET S/D -tetanus immune globulin (human) inj 250unit/ml...............................................................................15

HYQVIA -immun glob inj 10 gm/100ml-hyaluron inj 800unt/5 ml kit....................................................................... 16

HYQVIA -immun glob inj 2.5 gm/25ml-hyaluron inj 200unt/1.25 ml kit.................................................................. 15

HYQVIA -immun glob inj 20 gm/200ml-hyaluron inj 1600unt/10 ml kit..................................................................... 16

HYQVIA -immun glob inj 30 gm/300ml-hyaluron inj 2400unt/15 ml kit..................................................................... 16

HYQVIA -immun glob inj 5 gm/50ml-hyaluron inj 400unt/2.5 ml kit.................................................................... 15

HYSINGLA ER -hydrocodone bitartrate tab er 24hr deter100 mg............................................................................. 97

HYSINGLA ER -hydrocodone bitartrate tab er 24hr deter120 mg.............................................................................97

HYSINGLA ER -hydrocodone bitartrate tab er 24hr deter20 mg...............................................................................96





HY-VEE GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 29

HYZAAR -losartan potassium & hydrochlorothiazide tab100-12.5 mg.....................................................................49

HYZAAR -losartan potassium & hydrochlorothiazide tab100-25 mg........................................................................49

HYZAAR -losartan potassium & hydrochlorothiazide tab50-12.5 mg.......................................................................49

I

ibandronate sodium tab 150 mg (base equivalent)(Boniva)........................................................................... 37

IBRANCE -palbociclib cap 100 mg....................................17IBRANCE -palbociclib cap 125 mg....................................17IBRANCE -palbociclib cap 75 mg......................................17IBUDONE -hydrocodone-ibuprofen tab 10-200 mg........... 97IBUPROFEN COMFORT PAC -ibuprofen tab 800 mg &liniment topical gel kit.................................................... 102

ibuprofen tab 400 mg....................................................102ibuprofen tab 600 mg....................................................102ibuprofen tab 800 mg....................................................102IC 400 -ibuprofen tab 400 mg & caffeine-vitamins capkit....................................................................................102

IC 800 -ibuprofen tab 800 mg & caffeine-vitamins capkit....................................................................................102

ICAR -carbonyl iron chew tab 15 mg (elemental iron)..... 130ICAR-C PLUS -iron-vit c-vit b12-folic acid tab100-250-0.025-1 mg...................................................... 130

ICAR PEDIATRIC -carbonyl iron susp 15 mg/1.25ml(elemental iron).............................................................. 130

ICLUSIG -ponatinib hcl tab 15 mg (base equiv)................ 17ICLUSIG -ponatinib hcl tab 45 mg (base equiv)................ 17ILEVRO -nepafenac ophth susp 0.3%.............................138IMBRUVICA -ibrutinib cap 140 mg....................................17imipramine hcl tab 10 mg (Tofranil)...............................78imipramine hcl tab 25 mg (Tofranil)...............................78imipramine hcl tab 50 mg (Tofranil)...............................78imipramine pamoate cap 100 mg (Tofranil-pm)............ 78imipramine pamoate cap 125 mg (Tofranil-pm)............ 78imipramine pamoate cap 150 mg (Tofranil-pm)............ 78imipramine pamoate cap 75 mg (Tofranil-pm).............. 78imiquimod cream 5% (Aldara)...................................... 152IMITREX STATDOSE REFILL -sumatriptan succinatesolution cartridge 4 mg/0.5ml.........................................105

IMITREX STATDOSE REFILL -sumatriptan succinatesolution cartridge 6 mg/0.5ml.........................................105

IMITREX STATDOSE SYSTEM -sumatriptan succinatesolution auto-injector 4 mg/0.5ml...................................105

2015


IMITREX STATDOSE SYSTEM -sumatriptan succinatesolution auto-injector 6 mg/0.5ml...................................105

IMITREX -sumatriptan nasal spray 20 mg/act................. 104IMITREX -sumatriptan nasal spray 5 mg/act...................104IMITREX -sumatriptan succinate inj 6 mg/0.5ml..............105IMITREX -sumatriptan succinate tab 100 mg.................. 105IMITREX -sumatriptan succinate tab 25 mg....................105IMITREX -sumatriptan succinate tab 50 mg....................105IMOGAM RABIES-HT -rabies immune globulin (human) inj150 unit/ml....................................................................... 16

IMOVAX RABIES (H.D.C.V.) -rabies virus vaccine, hdcinj......................................................................................15

IMURAN -azathioprine tab 50 mg................................... 164INATAL ADVANCE -prenatal vit w/ dss-iron carbonyl-fatab 90-1 mg................................................................... 117

INATAL GT -prenatal vit w/ dss-iron carbonyl-fa tab 90-1mg.................................................................................. 117

INATAL ULTRA -prenatal vit w/ dss-iron carbonyl-fa tab90-1 mg..........................................................................117

INCRELEX -mecasermin inj 40 mg/4ml (10 mg/ml)...........37INCRUSE ELLIPTA -umeclidinium br aero powd breath act62.5 mcg/inh (base eq)....................................................63

indapamide tab 1.25 mg..................................................53indapamide tab 2.5 mg....................................................53INDERAL LA -propranolol hcl cap sr 24hr 120 mg............ 40INDERAL LA -propranolol hcl cap sr 24hr 160 mg............ 40INDERAL LA -propranolol hcl cap sr 24hr 60 mg..............40INDERAL LA -propranolol hcl cap sr 24hr 80 mg..............40INDERAL XL -propranolol hcl sustained-release beads capsr 24hr 120 mg................................................................ 40

INDERAL XL -propranolol hcl sustained-release beads capsr 24hr 80 mg.................................................................. 40

INDOCIN -indomethacin suppos 50 mg.......................... 102INDOCIN -indomethacin susp 25 mg/5ml........................102indomethacin cap 25 mg.............................................. 102indomethacin cap 50 mg.............................................. 102indomethacin cap cr 75 mg..........................................102INFANATE BALANCE -prenatal w/o a w/fe cbn-dss-fa-dhacap 29-1-265 mg............................................................117

INFANATE PLUS -prenat w/o a w/fe fum-fe cbn-dss-fa-dha cap 27-1-260 mg.................................................... 117

INFANRIX -diph, acellular pert & tet tox inj 25 lf-58 mcg-10lf/0.5ml..............................................................................15

INFASURF -calfactant in nacl 0.9% intratracheal susp 35mg/ml................................................................................65

INLYTA -axitinib tab 1 mg................................................. 17INLYTA -axitinib tab 5 mg................................................. 17INNOPRAN XL -propranolol hcl sustained-release beadscap sr 24hr 120 mg......................................................... 40

INNOPRAN XL -propranolol hcl sustained-release beadscap sr 24hr 80 mg........................................................... 40

INOVA 4/1 ACNE CONTROL TH -benzoyl perox pad 4% &salicylic ac pad 1% & vit e 5% kit..................................152

INOVA 8/2 ACNE CONTROL TH -benzoyl perox pad 8% &salicylic ac pad 2% & vit e 5% kit..................................152

INOVA -benzoyl peroxide pad 4% & vitamin e topical 5%kit....................................................................................152

INOVA -benzoyl peroxide pad 8% & vitamin e topical 5%kit....................................................................................152

INSPRA -eplerenone tab 25 mg........................................49INSPRA -eplerenone tab 50 mg........................................49INSTA-GLUCOSE -glucose gel 77.4%..............................29INSULIN PEN NEEDLES-VARIOUS............................... 163INSULIN SYRINGES-VARIOUS......................................163INTEGRA F -fe fum-fe poly-fa-c-b3 cap62.5-62.5-1-40-3mg(125 mg fe).....................................130

INTEGRA PLUS -fe fum-iron polysacch complex-fa-bcomplex-c-biotin cap...................................................... 130

INTELENCE -etravirine tab 100 mg.................................... 8INTELENCE -etravirine tab 200 mg.................................... 8INTELENCE -etravirine tab 25 mg...................................... 8INTERARTICULAR JOINT KIT -triamcinolone inj 40 mg/ml& lidocaine 1% & ammonia inh kit...................................20

INTERMEZZO -zolpidem tartrate sl tab 1.75 mg...............84INTERMEZZO -zolpidem tartrate sl tab 3.5 mg.................85INTROL -glycerin soln 75%...............................................53INTRON A -interferon alfa-2b for inj 10000000 unit...........17INTRON A -interferon alfa-2b for inj 18000000 unit...........17INTRON A -interferon alfa-2b for inj 50000000 unit...........17INTRON A -interferon alfa-2b inj 10000000 unit/ml........... 17INTRON A -interferon alfa-2b inj 6000000 unit/ml............. 17INTRON A W/DILUENT -interferon alfa-2b for inj10000000 unit.................................................................. 17

INTRON A W/DILUENT -interferon alfa-2b for inj18000000 unit.................................................................. 17

INTRON A W/DILUENT -interferon alfa-2b for inj50000000 unit.................................................................. 17

INTUNIV -guanfacine hcl tab sr 24hr 1 mg (baseequiv)................................................................................87




INVEGA -paliperidone tab sr 24hr 1.5 mg.........................82INVEGA -paliperidone tab sr 24hr 3 mg............................82INVEGA -paliperidone tab sr 24hr 6 mg............................82INVEGA -paliperidone tab sr 24hr 9 mg............................82INVIRASE -saquinavir mesylate cap 200 mg...................... 8INVIRASE -saquinavir mesylate tab 500 mg.......................8INVOKAMET -canagliflozin-metformin hcl tab 150-1000mg.................................................................................... 29

INVOKAMET -canagliflozin-metformin hcl tab 150-500mg.................................................................................... 29



INVOKANA -canagliflozin tab 100 mg...............................29

2015


INVOKANA -canagliflozin tab 300 mg...............................29IODINE STRONG -iodine solution strong 5%(lugol's)...........................................................................125

IODINE TINCTURE -iodine tincture................................ 163IODINE TINCTURE MILD -iodine tincture.......................163IODINE TINCTURE STRONG DE -iodine tincturestrong............................................................................. 163

IODINE TINCTURE STRONG -iodine tincture strong......163iodoquinol-hc cream 1%............................................... 152iodoquinol-hydrocortisone in aloe vehicle cream1-1.9% (Vytone)............................................................ 152

IONSYS -fentanyl hcl iontophoretic td system 40 mcg/act(base equiv)..................................................................... 97

IOPIDINE -apraclonidine hcl ophth soln 0.5% (baseequivalent)......................................................................138

IOPIDINE -apraclonidine hcl ophth soln 1% (baseequivalent)......................................................................138

ipratropium-albuterol nebu soln 0.5-2.5(3) mg/3ml.......63ipratropium bromide inhal soln 0.02%.......................... 63ipratropium bromide nasal soln 0.03% (21 mcg/spray)(Atrovent)........................................................................ 59

ipratropium bromide nasal soln 0.06% (42 mcg/spray)(Atrovent)........................................................................ 59

irbesartan-hydrochlorothiazide tab 150-12.5 mg(Avalide).......................................................................... 49

irbesartan-hydrochlorothiazide tab 300-12.5 mg(Avalide).......................................................................... 49

irbesartan tab 150 mg (Avapro)..................................... 49irbesartan tab 300 mg (Avapro)..................................... 49irbesartan tab 75 mg (Avapro)....................................... 49IRENKA -duloxetine hcl enteric coated pellets cap 40mg.................................................................................... 78

IRESSA -gefitinib tab 250 mg........................................... 17IRON ASP GLY/ POLYSACCH C -fe asp gly-fe polysacch-succ ac-c-threon ac-b12-fa cap..................................... 130

IRON CHEWS PEDIATRIC -carbonyl iron chew tab 15 mg(elemental iron).............................................................. 130

iron combination cap.................................................... 130iron-docusate-b12-folic acid-c-e-cu-biotin tab 150-1 mg(Hematron-af)................................................................130

iron-folic acid-vit c-vit b6-vit b12-zinc tab 150-1.25 mg(Corvite 150)................................................................. 130

iron polysacch complex-vit b12-fa cap 150-0.025-1mg.................................................................................. 130

iron-vit c-vit b12-folic acid tab 100-250-0.025-1 mg(Icar-c plus)...................................................................130

IROSPAN 24/6 -fe bisglyc-fe polys-succ acd-b cmplx-c-ca-fa tab ther pk................................................................. 130

IS 24/6 -fe bisglyc-fe polys-succ acd-b cmplx-c-ca-fa tabther pk............................................................................ 130

ISENTRESS -raltegravir potassium chew tab 100 mg(base equiv)....................................................................... 8

ISENTRESS -raltegravir potassium chew tab 25 mg (baseequiv)..................................................................................8

ISENTRESS -raltegravir potassium packet for susp 100mg (base equiv).................................................................8

ISENTRESS -raltegravir potassium tab 400 mg (baseequiv)..................................................................................8

isometheptene-caffeine-acetaminophen tab 65-20-325mg (Prodrin)................................................................. 105

ISONIAZID -isoniazid syrup 50 mg/5ml...............................6isoniazid tab 100 mg......................................................... 6isoniazid tab 300 mg......................................................... 6ISOPTIN SR -verapamil hcl tab cr 120 mg........................43ISOPTIN SR -verapamil hcl tab cr 180 mg........................43ISOPTIN SR -verapamil hcl tab cr 240 mg........................43ISOPTO ATROPINE -atropine sulfate ophth soln 1%......138ISOPTO CARBACHOL -carbachol ophth soln 1.5%....... 138ISOPTO CARBACHOL -carbachol ophth soln 3%.......... 138ISOPTO CARPINE -pilocarpine hcl ophth soln 1%......... 139ISOPTO CARPINE -pilocarpine hcl ophth soln 2%......... 139ISOPTO CARPINE -pilocarpine hcl ophth soln 4%......... 139ISOPTO HOMATROPINE -homatropine hbr ophth soln2%.................................................................................. 139

ISOPTO HOMATROPINE -homatropine hbr ophth soln5%.................................................................................. 139

ISOPTO HYOSCINE -scopolamine hbr ophth soln0.25%............................................................................. 139

ISORDIL TITRADOSE -isosorbide dinitrate tab 40 mg......39ISORDIL TITRADOSE -isosorbide dinitrate tab 5 mg........39ISOSORBIDE DINITRATE -isosorbide dinitrate tab 30mg.................................................................................... 39

isosorbide dinitrate tab 10 mg....................................... 39isosorbide dinitrate tab 20 mg....................................... 39isosorbide dinitrate tab 5 mg (Isordil titradose)........... 39isosorbide dinitrate tab cr 40 mg...................................39isosorbide mononitrate tab 10 mg.................................39isosorbide mononitrate tab 20 mg.................................39isosorbide mononitrate tab sr 24hr 120 mg (Imdur).....39isosorbide mononitrate tab sr 24hr 30 mg (Imdur).......39isosorbide mononitrate tab sr 24hr 60 mg (Imdur).......39isotretinoin cap 10 mg.................................................. 152isotretinoin cap 20 mg.................................................. 152isotretinoin cap 40 mg.................................................. 152ISOXSUPRINE HCL -isoxsuprine hcl tab 20 mg............... 57isoxsuprine hcl tab 10 mg.............................................. 57isradipine cap 2.5 mg......................................................43isradipine cap 5 mg.........................................................43ISTALOL -timolol maleate ophth soln 0.5% (once-daily)...............................................................................139

itraconazole cap 100 mg (Sporanox)...............................6ivermectin tab 3 mg (Stromectol).................................. 11IXINITY -coagulation factor ix (recombinant) for inj 1000unit..................................................................................135

IXINITY -coagulation factor ix (recombinant) for inj 1500unit..................................................................................135

IXINITY -coagulation factor ix (recombinant) for inj 500unit..................................................................................135

2015


J

JADENU -deferasirox tab 180 mg................................... 163JADENU -deferasirox tab 360 mg................................... 163JADENU -deferasirox tab 90 mg..................................... 163JAKAFI -ruxolitinib phosphate tab 10 mg (baseequivalent)........................................................................17

JAKAFI -ruxolitinib phosphate tab 15 mg (baseequivalent)........................................................................17




JALYN -dutasteride-tamsulosin hcl cap 0.5-0.4 mg...........74JANUMET -sitagliptin-metformin hcl tab 50-1000 mg........29JANUMET -sitagliptin-metformin hcl tab 50-500 mg..........29JANUMET XR -sitagliptin-metformin hcl tab sr 24hr100-1000 mg....................................................................29

JANUMET XR -sitagliptin-metformin hcl tab sr 24hr50-1000 mg......................................................................29

JANUMET XR -sitagliptin-metformin hcl tab sr 24hr 50-500mg.................................................................................... 29

JANUVIA -sitagliptin phosphate tab 100 mg (baseequiv)................................................................................29



JARDIANCE -empagliflozin tab 10 mg.............................. 29JARDIANCE -empagliflozin tab 25 mg.............................. 29JENTADUETO -linagliptin-metformin hcl tab 2.5-1000mg.................................................................................... 29

JENTADUETO -linagliptin-metformin hcl tab 2.5-500mg.................................................................................... 29

JENTADUETO -linagliptin-metformin hcl tab 2.5-850mg.................................................................................... 29

JUBLIA -efinaconazole soln 10%.................................... 152JUXTAPID -lomitapide mesylate cap 10 mg (baseequiv)................................................................................55

JUXTAPID -lomitapide mesylate cap 20 mg (baseequiv)................................................................................55





K

K2K PAIN RELIEVING PATCH -lidocaine-menthol patch4-4%............................................................................... 152

KADIAN -morphine sulfate cap sr 24hr 100 mg................ 97

KADIAN -morphine sulfate cap sr 24hr 10 mg.................. 97KADIAN -morphine sulfate cap sr 24hr 200 mg................ 97KADIAN -morphine sulfate cap sr 24hr 20 mg.................. 97KADIAN -morphine sulfate cap sr 24hr 30 mg.................. 97KADIAN -morphine sulfate cap sr 24hr 40 mg.................. 97KADIAN -morphine sulfate cap sr 24hr 50 mg.................. 97KADIAN -morphine sulfate cap sr 24hr 60 mg.................. 97KADIAN -morphine sulfate cap sr 24hr 80 mg.................. 97KALETRA -lopinavir-ritonavir soln 400-100 mg/5ml (80-20mg/ml)................................................................................ 8

KALETRA -lopinavir-ritonavir tab 100-25 mg.......................8KALETRA -lopinavir-ritonavir tab 200-50 mg.......................8KALYDECO -ivacaftor packet 50 mg.................................65KALYDECO -ivacaftor packet 75 mg.................................65KALYDECO -ivacaftor tab 150 mg.................................... 65KAPVAY -clonidine hcl tab sr 12hr 0.1 mg........................87KARBINAL ER -carbinoxamine maleate er susp 4mg/5ml..............................................................................58

KAYEXALATE -sodium polystyrene sulfonatepowder............................................................................164

KAZANO -alogliptin-metformin hcl tab 12.5-1000 mg........29KAZANO -alogliptin-metformin hcl tab 12.5-500 mg..........29KEFLEX -cephalexin cap 250 mg....................................... 2KEFLEX -cephalexin cap 500 mg....................................... 2KEFLEX -cephalexin cap 750 mg....................................... 2KENALOG -triamcinolone acetonide aerosol soln........... 152KENDALL HYDROGEL IMPREGNA -hydroactive (sterile)dressing..........................................................................152

KENDALL HYDROGEL WOUND DR -hydroactive (sterile)dressing..........................................................................152

KENDALL ZINC CALCIUM ALGI -wound dressings -misc................................................................................ 152

KENDALL ZINC CALCIUM ALGI -wound dressings -pads................................................................................152

KEPPRA -levetiracetam oral soln 100 mg/ml.................. 108KEPPRA -levetiracetam tab 1000 mg............................. 108KEPPRA -levetiracetam tab 250 mg............................... 108KEPPRA -levetiracetam tab 500 mg............................... 108KEPPRA -levetiracetam tab 750 mg............................... 108KEPPRA XR -levetiracetam tab sr 24hr 500 mg............. 108KEPPRA XR -levetiracetam tab sr 24hr 750 mg............. 108KERAFOAM 42 -urea foam 42%.....................................152KERAFOAM -urea foam 30%..........................................152KERALAC -urea cream 47%........................................... 152KERALYT -salicylic acid gel 6%......................................152KERALYT SCALP -salicylic acid shampoo 6% & salicylicacid gel 6% kit............................................................... 152

KERLONE -betaxolol hcl tab 10 mg..................................40KERLONE -betaxolol hcl tab 20 mg..................................41KERR TRIPLE DYE -triple dye swabs............................ 163KERYDIN -tavaborole soln 5%........................................152KETEK -telithromycin tab 300 mg..................................... 12KETEK -telithromycin tab 400 mg..................................... 12ketoconazole cream 2%................................................ 152ketoconazole foam 2% (Extina)....................................152

2015


ketoconazole shampoo 2% (Nizoral)........................... 152ketoconazole tab 200 mg..................................................6KETODAN KIT -ketoconazole foam 2% & cleanserkit....................................................................................152

KETONE BLOOD TEST STRIPS – VARIOUS................ 163ketoprofen cap 50 mg................................................... 102ketoprofen cap 75 mg................................................... 102KETOPROFEN ER -ketoprofen cap sr 24hr 200 mg....... 102ketorolac tromethamine ophth soln 0.4% (Acularls)................................................................................... 139

ketorolac tromethamine ophth soln 0.5% (Acular)..... 139ketorolac tromethamine tab 10 mg.............................. 102KHEDEZLA -desvenlafaxine tab sr 24hr 100 mg.............. 78KHEDEZLA -desvenlafaxine tab sr 24hr 50 mg................ 78KINERET -anakinra subcutaneous soln prefilled syringe100 mg/0.67ml............................................................... 103

KINRIX -diph-tetanus tox ad-acell pert & polio virus, ipvvac inj...............................................................................15

KITABIS PAK -tobramycin nebu soln 300 mg/5ml...............5KLARON -sulfacetamide sodium lotion 10% (acne)........ 152KLONOPIN -clonazepam tab 0.5 mg.............................. 108KLONOPIN -clonazepam tab 1 mg................................. 108KLONOPIN -clonazepam tab 2 mg................................. 108KLOR-CON/25 -potassium chloride powder packet 25meq................................................................................ 125

KLOR-CON 25 -potassium chloride powder packet 25meq................................................................................ 125

KLOR-CON M15 -potassium chloride microencapsulatedcrys cr tab 15 meq.........................................................125

KOATE-DVI -antihemophilic factor (human) for inj 1000unit..................................................................................135



KOGENATE FS -antihemophilic factor (recombinant) for injkit 1000 unit................................................................... 135


KOGENATE FS -antihemophilic factor (recombinant) for injkit 250 unit..................................................................... 135


KOGENATE FS -antihemophilic factor (recombinant) for injkit 500 unit..................................................................... 135

KOGENATE FS BIO-SET -antihemophilic factor(recombinant) for inj kit 1000 unit.................................. 135


KOGENATE FS BIO-SET -antihemophilic factor(recombinant) for inj kit 250 unit.................................... 135


KOGENATE FS BIO-SET -antihemophilic factor(recombinant) for inj kit 500 unit.................................... 135

KOMBIGLYZE XR -saxagliptin-metformin hcl tab sr 24hr2.5-1000 mg.....................................................................29

KOMBIGLYZE XR -saxagliptin-metformin hcl tab sr 24hr5-1000 mg........................................................................29

KOMBIGLYZE XR -saxagliptin-metformin hcl tab sr 24hr5-500 mg..........................................................................29

KORLYM -mifepristone tab 300 mg.................................. 29K-PHOS NEUTRAL -pot phos monobasic w/sod phos di &monobas tab 155-852-130mg........................................125

K-PHOS NO 2 -potassium & sodium acid phosphates tab305-700 mg......................................................................74

K-PHOS -potassium phosphate monobasic tab 500mg.................................................................................. 125

KRISTALOSE -lactulose oral crystal packet 10 gm...........65KRISTALOSE -lactulose oral crystal packet 20 gm...........65KROGER GLUCOSE -glucose chew tab 4 gm..................29KROGER GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 29

K-TAB -potassium chloride tab cr 10 meq.......................125K-TAB -potassium chloride tab cr 20 meq (1500 mg)......125K-TAB -potassium chloride tab cr 8 meq (600 mg)..........125KUVAN -sapropterin dihydrochloride powder packet 100mg.................................................................................... 37

KUVAN -sapropterin dihydrochloride powder packet 500mg.................................................................................... 37

KUVAN -sapropterin dihydrochloride soluble tab 100mg.................................................................................... 37

KYNAMRO -mipomersen sodium soln prefilled syringe 200mg/ml................................................................................55

L

labetalol hcl tab 100 mg (Trandate)............................... 41labetalol hcl tab 200 mg (Trandate)............................... 41labetalol hcl tab 300 mg (Trandate)............................... 41LAC-HYDRIN -lactic acid (ammonium lactate) cream12%................................................................................ 152

LAC-HYDRIN -lactic acid (ammonium lactate) lotion12%................................................................................ 152

LACRISERT -artificial tear ophth insert........................... 139lactic acid (ammonium lactate) cream 12% (Lac-hydrin)........................................................................... 152

lactic acid (ammonium lactate) lotion 10%................. 152lactic acid (ammonium lactate) lotion 12% (Lac-hydrin)........................................................................... 153

lactic acid w/ vitamin e cream 10%-3500unit/30gm...................................................................... 153

lactulose (encephalopathy) solution 10 gm/15ml......... 71lactulose solution 10 gm/15ml....................................... 65LAMICTAL CHEWABLE DISPERS -lamotrigine tabchewable dispersible 25 mg.......................................... 108

LAMICTAL CHEWABLE DISPERS -lamotrigine tabchewable dispersible 5 mg............................................ 108

LAMICTAL -lamotrigine tab 100 mg................................ 108LAMICTAL -lamotrigine tab 150 mg................................ 108LAMICTAL -lamotrigine tab 200 mg................................ 108LAMICTAL -lamotrigine tab 25 mg.................................. 108

2015


LAMICTAL ODT -lamotrigine orally disintegrating tab 100mg.................................................................................. 108




LAMICTAL ODT -lamotrigine tab disp 25 (14) & 50 mg (14)& 100 mg (7) kit.............................................................108

LAMICTAL ODT -lamotrigine tab disp 25 mg (21) & 50 mg(7) titration kit.................................................................108

LAMICTAL ODT -lamotrigine tab disp 50 mg (42) & 100mg (14) titration kit.........................................................108

LAMICTAL STARTER/NOT TAKI -lamotrigine tab 25 mg(42) & 100 mg (7) starter kit.......................................... 108

LAMICTAL STARTER/TAKING C -lamotrigine tab 25 mg(84) & 100 mg (14) starter kit........................................ 108

LAMICTAL STARTER/TAKING V -lamotrigine tab 25 mg(35) starter kit................................................................ 108

LAMICTAL XR -lamotrigine tab sr 24hr 100 mg.............. 108LAMICTAL XR -lamotrigine tab sr 24hr 200 mg.............. 108LAMICTAL XR -lamotrigine tab sr 24hr 25 (14) & 50 mg(14) & 100 mg(7) kit...................................................... 108

LAMICTAL XR -lamotrigine tab sr 24hr 250 mg.............. 108LAMICTAL XR -lamotrigine tab sr 24hr 25 mg................ 108LAMICTAL XR -lamotrigine tab sr 24hr 25 mg (21) & 50mg (7) titration kit...........................................................108

LAMICTAL XR -lamotrigine tab sr 24hr 300 mg.............. 108LAMICTAL XR -lamotrigine tab sr 24hr 50 (14) & 100mg(14) & 200 mg(7) kit..................................................108

LAMICTAL XR -lamotrigine tab sr 24hr 50 mg................ 108LAMISIL -terbinafine hcl oral granules packet 125 mg........ 7LAMISIL -terbinafine hcl oral granules packet 187.5 mg..... 7LAMISIL -terbinafine hcl tab 250 mg...................................6lamivudine oral soln 10 mg/ml (Epivir)............................8lamivudine tab 100 mg (hbv) (Epivir hbv)....................... 8lamivudine tab 150 mg (Epivir)........................................ 8lamivudine tab 300 mg (Epivir)........................................ 8lamivudine-zidovudine tab 150-300 mg (Combivir)........ 8lamotrigine orally disintegrating tab 100 mg (Lamictalodt).................................................................................108

lamotrigine orally disintegrating tab 200 mg (Lamictalodt).................................................................................109



lamotrigine tab 100 mg (Lamictal)............................... 109lamotrigine tab 150 mg (Lamictal)............................... 109lamotrigine tab 200 mg (Lamictal)............................... 109lamotrigine tab 25 mg (Lamictal)................................. 109lamotrigine tab chewable dispersible 25 mg (Lamictalchewable di)................................................................. 109

lamotrigine tab chewable dispersible 5 mg (Lamictalchewable di)................................................................. 109

lamotrigine tab sr 24hr 100 mg (Lamictal xr).............. 109lamotrigine tab sr 24hr 200 mg (Lamictal xr).............. 109lamotrigine tab sr 24hr 250 mg (Lamictal xr).............. 109lamotrigine tab sr 24hr 25 mg (Lamictal xr)................ 109lamotrigine tab sr 24hr 300 mg (Lamictal xr).............. 109lamotrigine tab sr 24hr 50 mg (Lamictal xr)................ 109LANCETS-VARIOUS....................................................... 163LANOXIN -digoxin tab 125 mcg (0.125 mg)......................39LANOXIN -digoxin tab 187.5 mcg (0.1875 mg)................. 39LANOXIN -digoxin tab 250 mcg (0.25 mg)........................39LANOXIN -digoxin tab 62.5 mcg (0.0625 mg)................... 39lansoprazole cap delayed release 15 mg(Prevacid)........................................................................ 67

lansoprazole cap delayed release 30 mg(Prevacid)........................................................................ 67

LANTUS -insulin glargine inj 100 unit/ml...........................32LANTUS SOLOSTAR -insulin glargine soln pen-injector100 unit/ml....................................................................... 32

LASIX -furosemide tab 20 mg........................................... 53LASIX -furosemide tab 40 mg........................................... 53LASIX -furosemide tab 80 mg........................................... 53LASTACAFT -alcaftadine ophth soln 0.25%....................139latanoprost ophth soln 0.005% (Xalatan).................... 139LATRIX XM -urea in zinc undecylenate-lactic acid vehicleemulsion 45%................................................................ 153

LATUDA -lurasidone hcl tab 120 mg.................................82LATUDA -lurasidone hcl tab 20 mg...................................82LATUDA -lurasidone hcl tab 40 mg...................................82LATUDA -lurasidone hcl tab 60 mg...................................82LATUDA -lurasidone hcl tab 80 mg...................................82LAVARE WOUND WASH -wound cleansers - gel...........153LAVOCLEN-4 CREAMY WASH -benzoyl peroxide liq4%.................................................................................. 153

LAVOCLEN-8 CREAMY WASH -benzoyl peroxide liq8%.................................................................................. 153

LAZANDA -fentanyl citrate nasal spray 100 mcg/act (baseequiv)................................................................................97

LAZANDA -fentanyl citrate nasal spray 400 mcg/act (baseequiv)................................................................................97

LEADER GLUCOSE -glucose chew tab 4 gm...................29LEADER GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 30

LEADER QUICK DISSOLVE GLU -glucose chew tab 4gm.................................................................................... 30

LECITHIN -lecithin granules............................................ 126leflunomide tab 10 mg (Arava)..................................... 103leflunomide tab 20 mg (Arava)..................................... 103LENVIMA 10MG DAILY DOSE -lenvatinib cap therapypack 10 mg (10 mg daily dose)....................................... 17

LENVIMA 14MG DAILY DOSE -lenvatinib cap therapypack 10 & 4 mg (14 mg daily dose)................................ 18

LENVIMA 20MG DAILY DOSE -lenvatinib cap therapypack 10 (2) mg (20 mg daily dose)..................................18

2015


LENVIMA 24MG DAILY DOSE -lenvatinib cap therapypack 10 (2) & 4 mg (24 mg daily dose)........................... 18

LESCOL -fluvastatin sodium cap 20 mg........................... 55LESCOL -fluvastatin sodium cap 40 mg........................... 55LESCOL XL -fluvastatin sodium tab sr 24 hr 80 mg.......... 55LETAIRIS -ambrisentan tab 10 mg................................... 58LETAIRIS -ambrisentan tab 5 mg..................................... 57letrozole tab 2.5 mg (Femara).........................................18LEUCOVORIN CALCIUM -leucovorin calcium tab 10mg.................................................................................... 18

LEUCOVORIN CALCIUM -leucovorin calcium tab 15mg.................................................................................... 18

leucovorin calcium tab 25 mg........................................18leucovorin calcium tab 5 mg..........................................18LEUKERAN -chlorambucil tab 2 mg..................................18LEUKINE -sargramostim lyophilized for inj 250 mcg....... 130leuprolide acetate inj kit 5 mg/ml...................................18LEVACET -aspirin-apap-salicylamide-caffeine tab500-250-150-32.5 mg...................................................... 93

levalbuterol hcl soln nebu 0.31 mg/3ml (base equiv)(Xopenex)........................................................................ 64



levalbuterol hcl soln nebu conc 1.25 mg/0.5ml (baseequiv)...............................................................................63

LEVAQUIN -levofloxacin oral soln 25 mg/ml....................... 5LEVAQUIN -levofloxacin tab 250 mg.................................. 5LEVAQUIN -levofloxacin tab 500 mg.................................. 5LEVAQUIN -levofloxacin tab 750 mg.................................. 5LEVATIO PATCH -capsaicin-menthol topical patch0.03-5%.......................................................................... 153

LEVATOL -penbutolol sulfate tab 20 mg...........................41LEVBID -hyoscyamine sulfate tab sr 12hr 0.375 mg......... 67LEVEMIR FLEXPEN -insulin detemir soln pen-injector 100unit/ml...............................................................................32

LEVEMIR FLEXTOUCH -insulin detemir soln pen-injector100 unit/ml....................................................................... 33

LEVEMIR -insulin detemir inj 100 unit/ml.......................... 32levetiracetam oral soln 100 mg/ml (Keppra)............... 109levetiracetam tab 1000 mg (Keppra)............................ 109levetiracetam tab 250 mg (Keppra).............................. 109levetiracetam tab 500 mg (Keppra).............................. 109levetiracetam tab 750 mg (Keppra).............................. 109levetiracetam tab sr 24hr 500 mg (Keppra xr).............109levetiracetam tab sr 24hr 750 mg (Keppra xr).............109LEVOBUNOLOL HCL -levobunolol hcl ophth soln0.25%............................................................................. 139

levobunolol hcl ophth soln 0.5% (Betagan)................ 139levocarnitine oral soln 1 gm/10ml (10%) (Carnitor)...... 37levocarnitine tab 330 mg (Carnitor)............................... 37levocetirizine dihydrochloride soln 2.5 mg/5ml (0.5 mg/ml) (Xyzal)....................................................................... 58

levocetirizine dihydrochloride tab 5 mg (Xyzal)............58

levofloxacin ophth soln 0.5%....................................... 139levofloxacin oral soln 25 mg/ml (Levaquin).................... 5levofloxacin tab 250 mg (Levaquin).................................5levofloxacin tab 500 mg (Levaquin).................................5levofloxacin tab 750 mg (Levaquin).................................5LEVOMEFOLATE CALCIUM/ACET -l-methylfolate-algae-b12-acetylcyst tab 6-90.314-2-600mg............................127

LEVOMEFOLATE CALCIUM/ALGA -l-methylfolate-algaecap 15-90.314 mg..........................................................127

LEVOMEFOLATE CALCIUM/ALGA -l-methylfolate-algaecap 7.5-90.314 mg.........................................................127

LEVOMEFOLATE CALCIUM/PYRI -l-methylfolate-algae-vit b12-b6 cap 3-90.314-2-35 mg.................................. 127

LEVOMEFOLATE DHA -prenat w/fe fum-l methylfolate-fa-dha cap 27-1.13-0.4 mg................................................ 117

levonorgestrel & ethinyl estradiol (91-day) tab0.15-0.03 mg................................................................... 24

levonorgestrel & ethinyl estradiol tab 0.15 mg-30mcg.................................................................................. 24

levonorgestrel & ethinyl estradiol tab 0.1 mg-20mcg.................................................................................. 24

levonorgestrel-eth estra tab0.05-30/0.075-40/0.125-30mg-mcg.................................25

levonorgestrel-ethinyl estradiol (continuous) tab 90-20mcg.................................................................................. 25

levonorgestrel tab 1.5 mg (Plan b one-step).................24levonorg-eth est tab 0.1-0.02mg(84) & eth est tab0.01mg(7) (Loseasonique).............................................24

levonorg-eth est tab 0.15-0.03mg(84) & eth est tab0.01mg(7) (Seasonique).................................................24

LEVORPHANOL TARTRATE -levorphanol tartrate tab 2mg.................................................................................... 97

levothyroxine sodium tab 100 mcg (Synthroid)............33levothyroxine sodium tab 112 mcg (Synthroid)............33levothyroxine sodium tab 125 mcg (Synthroid)............33levothyroxine sodium tab 137 mcg (Synthroid)............33levothyroxine sodium tab 150 mcg (Synthroid)............33levothyroxine sodium tab 175 mcg (Synthroid)............33levothyroxine sodium tab 200 mcg (Synthroid)............33levothyroxine sodium tab 25 mcg (Synthroid)..............33levothyroxine sodium tab 300 mcg (Synthroid)............33levothyroxine sodium tab 50 mcg (Synthroid)..............33levothyroxine sodium tab 75 mcg (Synthroid)..............33levothyroxine sodium tab 88 mcg (Synthroid)..............33LEVSIN/SL -hyoscyamine sulfate tab sl 0.125 mg............ 67LEVSIN -hyoscyamine sulfate tab 0.125 mg..................... 67LEVULAN KERASTICK -aminolevulinic acid hcl for soln20% (stick applicator).................................................... 153

LEXAPRO -escitalopram oxalate soln 5 mg/5ml (baseequiv)................................................................................78

LEXAPRO -escitalopram oxalate tab 10 mg (baseequiv)................................................................................78


2015



LEXIVA -fosamprenavir calcium susp 50 mg/ml (baseequiv)..................................................................................8

LEXIVA -fosamprenavir calcium tab 700 mg (baseequiv)..................................................................................8

LEXUSS 210 -chlorpheniramine w/ codeine liquid 2-10mg/5ml..............................................................................60

LIALDA -mesalamine tab delayed release 1.2 gm............ 71LIBRAX -chlordiazepoxide hcl-clidinium bromide cap 5-2.5mg.................................................................................... 67

LIDENZA PATCH -lidocaine-menthol patch 4-1%........... 153LIDOCAINE AND TETRACAINE -lidocaine-tetracainecream 7-7%....................................................................153

lidocaine hcl cream 3%.................................................153lidocaine hcl gel 2%...................................................... 153LIDOCAINE HCL-HYDROCORTIS -lidocaine-hydrocortisone acetate rectal gel 2.8-0.55%..................144

lidocaine hcl laryngotracheal soln 4% (Lta 360kit).................................................................................. 142

LIDOCAINE HCL -lidocaine hcl lotion 3%....................... 153lidocaine hcl soln 4% (Xylocaine)................................153lidocaine hcl viscous soln 2%......................................142lidocaine-hydrocortisone acetate rectal cream3-0.5%............................................................................ 144

lidocaine-hydrocortisone acetate rectal cream kit2-2%............................................................................... 144

lidocaine-hydrocortisone acetate rectal cream kit3-0.5%............................................................................ 144

lidocaine-hydrocortisone acetate rectal cream kit3-1%............................................................................... 144

lidocaine-hydrocortisone acetate rectal gel kit3-2.5%............................................................................ 144

lidocaine-menthol patch 4-5%...................................... 153lidocaine oint 5%........................................................... 153lidocaine patch 5% (700 mg) (Lidoderm).....................153lidocaine-prilocaine cream 2.5-2.5% (Emla)................ 153lidocaine-prilocaine kit 2.5-2.5%.................................. 153lidocaine-prilocaine kit 2.5-2.5%.................................. 153LIDOCIN -lidocaine hcl gel 3%........................................153LIDODERM -lidocaine patch 5% (700 mg)......................153LIDODEXTRAPINE -lidocaine-menthol patch 4-1%........ 153LIDOPIN -lidocaine hcl cream 3.25%.............................. 153LIDORX -lidocaine hcl gel 3%.........................................153LIDOTHOL -lidocaine-menthol patch 4.5-5%.................. 153LIDOVEX -lidocaine cream 3.75%.................................. 153LIDOVIN -lidocaine hcl cream 3.95%.............................. 153LIDOZOL -lidocaine hcl cream 3.75%............................. 153LIMBREL250 -flavocoxid-citrated zinc bisglycinate cap250-50 mg......................................................................127

LIMBREL500 -flavocoxid-citrated zinc bisglycinate cap500-50 mg......................................................................127

LIMBREL -flavocoxid cap 250 mg................................... 127LIMBREL -flavocoxid cap 500 mg................................... 127lindane lotion 1%...........................................................153

lindane shampoo 1%.....................................................153linezolid tab 600 mg (Zyvox).......................................... 12LINZESS -linaclotide cap 145 mcg....................................71LINZESS -linaclotide cap 290 mcg....................................71liothyronine sodium tab 25 mcg (Cytomel)...................33liothyronine sodium tab 50 mcg (Cytomel)...................33liothyronine sodium tab 5 mcg (Cytomel).....................33LIPITOR -atorvastatin calcium tab 10 mg (baseequivalent)........................................................................55

LIPITOR -atorvastatin calcium tab 20 mg (baseequivalent)........................................................................55



LIPOFEN -fenofibrate cap 150 mg.................................... 55LIPOFEN -fenofibrate cap 50 mg...................................... 55LIPTRUZET -ezetimibe-atorvastatin tab 10-10 mg............55LIPTRUZET -ezetimibe-atorvastatin tab 10-20 mg............55LIPTRUZET -ezetimibe-atorvastatin tab 10-40 mg............55LIPTRUZET -ezetimibe-atorvastatin tab 10-80 mg............55lisinopril & hydrochlorothiazide tab 10-12.5 mg(Zestoretic)......................................................................49

lisinopril & hydrochlorothiazide tab 20-12.5 mg(Zestoretic)......................................................................49

lisinopril & hydrochlorothiazide tab 20-25 mg(Zestoretic)......................................................................49

lisinopril tab 10 mg (Prinivil).......................................... 49lisinopril tab 2.5 mg (Zestril).......................................... 49lisinopril tab 20 mg (Prinivil).......................................... 49lisinopril tab 30 mg (Zestril)........................................... 49lisinopril tab 40 mg (Zestril)........................................... 49lisinopril tab 5 mg (Prinivil)............................................ 49LISTERINE ESSENTIAL CARE -sod monofluorophosph-eucal-men-methyl sal-thymol gel 0.76%........................ 142

LISTERINE RESTORING -sodium fluoride rinse 0.0221%(0.01% f)........................................................................ 142

LISTERINE SMART RINSE ANT -sodium fluoride rinse0.02%............................................................................. 142

LISTERINE SMART RINSE -sodium fluoride rinse0.0221% (0.01% f)......................................................... 142

LISTERINE TOOTH DEFENSE -sodium fluoride rinse0.0221% (0.01% f)......................................................... 142

LISTERINE TOTAL CARE PLUS -sodium fluoride rinse0.0221% (0.01% f)......................................................... 142

LISTERINE TOTAL CARE -sodium fluoride rinse 0.0221%(0.01% f)........................................................................ 142

LISTERINE TOTAL CARE ZERO -sodium fluoride rinse0.02%............................................................................. 142

LISTERINE WHITENING/RESTO -sodium fluoride rinse0.0221% (0.01% f)......................................................... 142

lithium carbonate cap 150 mg (Lithium carbonate)......82lithium carbonate cap 300 mg........................................82lithium carbonate cap 600 mg (Lithium carbonate)......82

2015


LITHIUM CARBONATE -lithium carbonate cap 150mg.................................................................................... 82

LITHIUM CARBONATE -lithium carbonate cap 600mg.................................................................................... 82

lithium carbonate tab 300 mg.........................................82lithium carbonate tab cr 300 mg (Lithobid)...................82lithium carbonate tab cr 450 mg.................................... 82LITHIUM -lithium oral solution 8 meq/5ml......................... 82LITHOBID -lithium carbonate tab cr 300 mg..................... 82LITHOSTAT -acetohydroxamic acid tab 250 mg............... 74LIVALO -pitavastatin calcium tab 1 mg (base equiv)......... 55LIVALO -pitavastatin calcium tab 2 mg (base equiv)......... 55LIVALO -pitavastatin calcium tab 4 mg (base equiv)......... 55L-METHYL-B6-B12 -l-methylfolate w/ vit b6-vit b12 tab3-35-2 mg.......................................................................126

L-METHYLFOLATE CA/ME-CBL/ -l-methylfolate-methylcobalamin-acetylcyst tab 6-2-600 mg..................127

L-METHYLFOLATE CA/P-5-P/M -l-methylfolate-algae-vitb12-b6 cap 3-90.314-2-35 mg....................................... 127

L-METHYLFOLATE CA/P-5-P/M -l-methylfolate w/ vit b6-vit b12 tab 3-35-2 mg.................................................... 127

L-METHYLFOLATE CALCIUM -l-methylfolate tab 15mg.................................................................................. 127

L-METHYLFOLATE CALCIUM -l-methylfolate tab 7.5mg.................................................................................. 127

L-METHYLFOLATE CA ME-CBL -l-methylfolate-algae-b12-acetylcyst tab 6-90.314-2-600mg............................127

L-METHYLFOLATE FORMULA 15 -l-methylfolate-algaecap 15-90.314 mg..........................................................127

L-METHYLFOLATE FORMULA 7. -l-methylfolate-algaecap 7.5-90.314 mg.........................................................127

L-METHYLFOLATE FORTE -l-methylfolate-algae cap15-90.314 mg.................................................................127

L-METHYLFOLATE FORTE -l-methylfolate-algae cap7.5-90.314 mg................................................................127

L-METHYLFOLATE -l-methylfolate tab 15 mg................ 127L-METHYLFOLATE -l-methylfolate tab 7.5 mg................127L-METHYLFOLATE PNV DHA -prenat w/fe fum-lmethylfolate-fa-dha cap 27-1.13-0.4 mg........................ 117

L-METHYL-MC -l-methylfolate w/ vit b12-vit b6-vit b2 tab6-1-50-5 mg................................................................... 126

L-METHYL-MC NAC -l-methylfolate-methylcobalamin-acetylcyst tab 6-2-600 mg............................................. 126

LMTHF/PYRIDOXINE HCL/CYAN -l-methylfolate w/ vit b6-vit b12 tab 1.13-25-2 mg............................................... 127

LOCOID -hydrocortisone butyrate cream 0.1%............... 153LOCOID -hydrocortisone butyrate lotion 0.1%................ 153LOCOID -hydrocortisone butyrate oint 0.1%................... 153LOCOID -hydrocortisone butyrate soln 0.1%.................. 153LOCOID LIPOCREAM -hydrocortisone butyratehydrophilic lipo base cream 0.1%..................................153

LODOSYN -carbidopa tab 25 mg....................................111LOESTRIN 1/20-21 -norethindrone ace & ethinyl estradioltab 1 mg-20 mcg............................................................. 25

LOESTRIN 1.5/30-21 -norethindrone ace & ethinylestradiol tab 1.5 mg-30 mcg............................................25

LOESTRIN FE 1/20 -norethindrone ace & ethinyl estradiol-fe tab 1 mg-20 mcg......................................................... 25

LOESTRIN FE 1.5/30 -norethindrone ace & ethinylestradiol-fe tab 1.5 mg-30 mcg........................................25

LOFIBRA -fenofibrate micronized cap 134 mg.................. 55LOFIBRA -fenofibrate micronized cap 200 mg.................. 55LOFIBRA -fenofibrate micronized cap 67 mg....................55LOFIBRA -fenofibrate tab 160 mg.....................................55LOFIBRA -fenofibrate tab 54 mg.......................................55LO LOESTRIN FE -norethin-eth estradiol-fe tab 1 mg-10mcg (24)/10 mcg (2)........................................................ 25

LOMOTIL -diphenoxylate w/ atropine tab 2.5-0.025mg.................................................................................... 66

LOMUSTINE -lomustine cap 100 mg................................ 18LOMUSTINE -lomustine cap 10 mg.................................. 18LOMUSTINE -lomustine cap 40 mg.................................. 18LONGS GLUCOSE -glucose chew tab 4 gm.................... 30LONGS GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 30

LOPID -gemfibrozil tab 600 mg.........................................55LOPRESSOR HCT -metoprolol & hydrochlorothiazide tab100-25 mg........................................................................49

LOPRESSOR HCT -metoprolol & hydrochlorothiazide tab50-25 mg..........................................................................49

LOPRESSOR -metoprolol tartrate tab 100 mg.................. 41LOPRESSOR -metoprolol tartrate tab 50 mg....................41LOPROX SHAMPOO -ciclopirox shampoo 1%............... 153lorazepam conc 2 mg/ml (Lorazepam intensol)............75LORAZEPAM INTENSOL -lorazepam conc 2 mg/ml........ 75lorazepam tab 0.5 mg (Ativan)....................................... 75lorazepam tab 1 mg (Ativan).......................................... 75lorazepam tab 2 mg (Ativan).......................................... 75LORENZA -lidocaine-menthol patch 4-1%...................... 153LORTUSS EX -pseudoephedrine w/ cod-gg liquid30-10-100 mg/5ml............................................................60

LORZONE -chlorzoxazone tab 375 mg...........................114LORZONE -chlorzoxazone tab 750 mg...........................114losartan potassium & hydrochlorothiazide tab 100-12.5mg (Hyzaar).................................................................... 49

losartan potassium & hydrochlorothiazide tab 100-25mg (Hyzaar).................................................................... 49

losartan potassium & hydrochlorothiazide tab 50-12.5mg (Hyzaar).................................................................... 49

losartan potassium tab 100 mg (Cozaar)...................... 49losartan potassium tab 25 mg (Cozaar)........................ 49losartan potassium tab 50 mg (Cozaar)........................ 49LOSEASONIQUE -levonorg-eth est tab 0.1-0.02mg(84) &eth est tab 0.01mg(7)...................................................... 25

LOTEMAX -loteprednol etabonate ophth gel 0.5%..........139LOTEMAX -loteprednol etabonate ophth oint 0.5%.........139LOTEMAX -loteprednol etabonate ophth susp 0.5%....... 139LOTENSIN -benazepril hcl tab 10 mg............................... 49LOTENSIN -benazepril hcl tab 20 mg............................... 49

2015


LOTENSIN -benazepril hcl tab 40 mg............................... 49LOTENSIN HCT -benazepril & hydrochlorothiazide tab10-12.5 mg.......................................................................49

LOTENSIN HCT -benazepril & hydrochlorothiazide tab20-12.5 mg.......................................................................49

LOTENSIN HCT -benazepril & hydrochlorothiazide tab20-25 mg..........................................................................49

LOTREL -amlodipine besylate-benazepril hcl cap 10-20mg.................................................................................... 49


LOTREL -amlodipine besylate-benazepril hcl cap 2.5-10mg.................................................................................... 49



LOTRIMIN ULTRA -butenafine hcl cream 1%................. 153LOTRISONE -clotrimazole w/ betamethasone cream1-0.05%.......................................................................... 153

LOTRONEX -alosetron hcl tab 0.5 mg (base equiv)..........71LOTRONEX -alosetron hcl tab 1 mg (base equiv).............71LOUTREX -antiseborrheic products misc - cream...........153lovastatin tab 10 mg........................................................55lovastatin tab 20 mg (Mevacor)......................................55lovastatin tab 40 mg (Mevacor)......................................56LOVAZA -omega-3-acid ethyl esters cap 1 gm................. 56LOVENOX -enoxaparin sodium inj 100 mg/ml................ 132LOVENOX -enoxaparin sodium inj 120 mg/0.8ml............132LOVENOX -enoxaparin sodium inj 150 mg/ml................ 133LOVENOX -enoxaparin sodium inj 300 mg/3ml.............. 133LOVENOX -enoxaparin sodium inj 30 mg/0.3ml............. 132LOVENOX -enoxaparin sodium inj 40 mg/0.4ml............. 132LOVENOX -enoxaparin sodium inj 60 mg/0.6ml............. 132LOVENOX -enoxaparin sodium inj 80 mg/0.8ml............. 132loxapine succinate cap 10 mg........................................82loxapine succinate cap 25 mg........................................82loxapine succinate cap 50 mg........................................82loxapine succinate cap 5 mg......................................... 82LOZI-FLUR -sodium fluoride lozenge 1 mg f (from 2.2 mgnaf)................................................................................. 125

LTA 360 KIT -lidocaine hcl laryngotracheal soln 4%....... 142LUFYLLIN -dyphylline tab 400 mg.................................... 64LUGOLS STRONG IODINE -iodine solution................... 163LUMIGAN -bimatoprost ophth soln 0.01%.......................139LUNESTA -eszopiclone tab 1 mg......................................85LUNESTA -eszopiclone tab 2 mg......................................85LUNESTA -eszopiclone tab 3 mg......................................85LURIDE -sodium fluoride chew tab 0.25 mg f (from 0.55mg naf)...........................................................................125

LURIDE -sodium fluoride chew tab 0.5 mg f (from 1.1 mgnaf)................................................................................. 125

LURIDE -sodium fluoride chew tab 1 mg f (from 2.2 mgnaf)................................................................................. 125

LURIDE -sodium fluoride soln 0.5 mg/ml f (from 1.1 mg/mlnaf)................................................................................. 125

LUXIQ -betamethasone valerate aerosol foam 0.12%.....153LUZU -luliconazole cream 1%.........................................153LYCELLE -nit remover - gel............................................ 153LYNPARZA -olaparib cap 50 mg.......................................18LYRICA -pregabalin cap 100 mg.....................................109LYRICA -pregabalin cap 150 mg.....................................109LYRICA -pregabalin cap 200 mg.....................................109LYRICA -pregabalin cap 225 mg.....................................109LYRICA -pregabalin cap 25 mg.......................................109LYRICA -pregabalin cap 300 mg.....................................109LYRICA -pregabalin cap 50 mg.......................................109LYRICA -pregabalin cap 75 mg.......................................109LYRICA -pregabalin soln 20 mg/ml................................. 109LYSODREN -mitotane tab 500 mg....................................18LYSTEDA -tranexamic acid tab 650 mg..........................133

M

MACNATAL CN DHA -prenatal w/o a w/fe cbn-dss-fa-dhacap 28-1-250 mg............................................................117

MAC PATCH -capsaicin-menthol topical patch0.0375-5%...................................................................... 153

MACROBID -nitrofurantoin monohydrate macrocrystallinecap 100 mg......................................................................72

MACRODANTIN -nitrofurantoin macrocrystalline cap 100mg.................................................................................... 72



MAGNEBIND 400 -magnesium-calcium-folic acid tab400-200-1 mg.................................................................125

MALARONE -atovaquone-proguanil hcl tab 250-100mg.................................................................................... 11

MALARONE -atovaquone-proguanil hcl tab 62.5-25mg.................................................................................... 11

malathion lotion 0.5% (Ovide)...................................... 153MAPROTILINE HCL -maprotiline hcl tab 25 mg................78MAPROTILINE HCL -maprotiline hcl tab 50 mg................78MAPROTILINE HCL -maprotiline hcl tab 75 mg................78MAR-COF BP -pseudoephedrine-bromphen-codeine liqd30-2-7.5 mg/5ml...............................................................60

MAR-COF CG EXPECTORANT -guaifenesin-codeineliquid 225-7.5 mg/5ml...................................................... 60

MARINOL -dronabinol cap 10 mg..................................... 69MARINOL -dronabinol cap 2.5 mg.................................... 69MARINOL -dronabinol cap 5 mg....................................... 69MARNATAL-F -prenatal w/o vit a w/ fe polysac cmplx-facap 60-1 mg...................................................................117

MARPLAN -isocarboxazid tab 10 mg................................78MATULANE -procarbazine hcl cap 50 mg.........................18MAVIK -trandolapril tab 1 mg............................................ 49MAVIK -trandolapril tab 2 mg............................................ 49MAVIK -trandolapril tab 4 mg............................................ 49

2015


MAXALT-MLT -rizatriptan benzoate orally disintegratingtab 10 mg.......................................................................105

MAXALT-MLT -rizatriptan benzoate orally disintegratingtab 5 mg.........................................................................105

MAXALT -rizatriptan benzoate tab 10 mg....................... 105MAXALT -rizatriptan benzoate tab 5 mg......................... 105MAXARON FORTE -fe gly-fe fum-vit c-vit b12-methylfolatetab.................................................................................. 130

MAXFE -iron-fa-vit b12-biotin-vit c-docusate-mg-zn tab160-1 mg........................................................................130

MAXIDEX -dexamethasone ophth susp 0.1%................. 139MAXITROL -neomycin-polymyxin-dexamethasone ophthoint 0.1%........................................................................ 139

MAXITROL -neomycin-polymyxin-dexamethasone ophthsusp 0.1%...................................................................... 139

MAXZIDE-25 -triamterene & hydrochlorothiazide tab37.5-25 mg.......................................................................53

MAXZIDE -triamterene & hydrochlorothiazide tab 75-50mg.................................................................................... 53

MB HYDROGEL -dermatological products misc - kit.......153MECLOFENAMATE SODIUM -meclofenamate sodiumcap 100 mg....................................................................103

MECLOFENAMATE SODIUM -meclofenamate sodiumcap 50 mg......................................................................103

MEDICAL PROVIDER EZ FLU S -influenza virus vac tiss-cult subunit pref syr kit 0.5 ml..........................................15

MEDICAL PROVIDER EZ FLU S -influenza virus vactypes a & b pf pref syringe kit 0.5 ml...............................15

MEDICINE SHOPPE GLUCOSE -glucose chew tab 4gm.................................................................................... 30

MEDI-DERM/L-RX -lidocaine-capsaicin-menthol-methylsal cream 2-0.035-5-20%...............................................154

MEDI-DERM-RX -capsaicin-menthol-methyl salicylatecream 0.035-5-20%....................................................... 154

MEDIHONEY CALCIUM ALGINAT -wound dressings -pads................................................................................154

MEDIHONEY WOUND & BURN DR -wound dressings -pads................................................................................154

MEDI-PATCH RX -lidocaine-capsaicin-menthol-methyl salpatch 0.5-0.035-5-20%...................................................154

MEDROL DOSEPAK -methylprednisolone tab 4 mg dosepack..................................................................................20

MEDROL -methylprednisolone tab 16 mg.........................20MEDROL -methylprednisolone tab 2 mg...........................20MEDROL -methylprednisolone tab 32 mg.........................20MEDROL -methylprednisolone tab 4 mg...........................20MEDROL -methylprednisolone tab 8 mg...........................20MEDROX-RX -capsaicin-menthol-methyl salicylate oint0.05-7-20%.....................................................................154

medroxyprogesterone acetate im susp 150 mg/ml(Depo-provera contrac)................................................. 25

medroxyprogesterone acetate tab 10 mg (Provera)..... 26medroxyprogesterone acetate tab 2.5 mg(Provera)..........................................................................26

medroxyprogesterone acetate tab 5 mg (Provera)....... 26

mefenamic acid cap 250 mg (Ponstel).........................103mefloquine hcl tab 250 mg............................................. 11MEGACE ES -megestrol acetate susp 625 mg/5ml.......... 26MEGACE ORAL -megestrol acetate susp 40 mg/ml......... 18megestrol acetate susp 40 mg/ml (Megace oral).......... 18megestrol acetate susp 625 mg/5ml (Megace es).........26megestrol acetate tab 20 mg..........................................18megestrol acetate tab 40 mg..........................................18MEGRIX -capsaicin-menthol disk 0.0375-5%..................154MEIJER GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 30

MEKINIST -trametinib dimethyl sulfoxide tab 0.5 mg (baseequivalent)........................................................................18

MEKINIST -trametinib dimethyl sulfoxide tab 2 mg (baseequivalent)........................................................................18

MELOXICAM COMFORT PAC -meloxicam tab 15 mg &liniment topical gel kit.................................................... 103

MELOXICAM -meloxicam susp 7.5 mg/5ml.................... 103meloxicam tab 15 mg (Mobic)...................................... 103meloxicam tab 7.5 mg (Mobic)..................................... 103memantine hcl tab 10 mg (Namenda)............................91memantine hcl tab 5 mg (28) & 10 mg (21) titration pak(Namenda titration pa)...................................................91

memantine hcl tab 5 mg (Namenda)..............................91M-END MAX D -pseudoephedrine-dexbromphen-codeineliqd 20-0.667-6 mg/5ml.................................................... 60

M-END PE -phenylephrine-bromphen w/ codeine liqd3.33-1.33-6.33 mg/5ml.....................................................60

MENEST -esterified estrogens tab 0.3 mg........................ 23MENEST -esterified estrogens tab 0.625 mg.................... 23MENEST -esterified estrogens tab 1.25 mg...................... 23MENEST -esterified estrogens tab 2.5 mg........................ 23MENOSTAR -estradiol td patch weekly 14 mcg/24hr........ 23MENTAX -butenafine hcl cream 1%................................154MENTHOCIN PATCH/LIDOCAINE -lidocaine-capsaicin-men-methyl sal patch 0.5-0.0375-5-20%....................... 154

MENTHOCIN PATCH/LIDOCAINE -lidocaine-capsaicin-menthol-methyl sal patch 0.5-0.035-5-20%................... 154

MENTHOLIX -lidocaine-menthol liquid spray 4-1%......... 154MEPERIDINE HCL/PROMETHAZI -meperidine w/promethazine cap 50-25 mg............................................97

MEPERIDINE HCL -meperidine hcl oral soln 50mg/5ml..............................................................................97

meperidine hcl tab 100 mg (Demerol)........................... 97meperidine hcl tab 50 mg (Demerol)............................. 97MEPHYTON -phytonadione tab 5 mg............................. 115meprobamate tab 200 mg............................................... 76meprobamate tab 400 mg............................................... 76MEPRON -atovaquone susp 750 mg/5ml......................... 12mercaptopurine tab 50 mg (Purinethol).........................18mesalamine enema 4 gm................................................ 71mesalamine rectal enema 4 gm & cleanser wipe kit(Rowasa)......................................................................... 71

MESNEX -mesna tab 400 mg........................................... 18

2015


MESTINON -pyridostigmine bromide syrup 60mg/5ml............................................................................114

MESTINON -pyridostigmine bromide tab 60 mg............. 114MESTINON TIMESPAN -pyridostigmine bromide tab cr180 mg........................................................................... 114

METADATE CD -methylphenidate hcl cap cr 10 mg......... 87METADATE CD -methylphenidate hcl cap cr 20 mg......... 87METADATE CD -methylphenidate hcl cap cr 30 mg......... 87METADATE CD -methylphenidate hcl cap cr 40 mg......... 87METADATE CD -methylphenidate hcl cap cr 50 mg......... 87METADATE CD -methylphenidate hcl cap cr 60 mg......... 87METAFOLBIC -l-methylfolate w/ vit b12-vit b6-vit b2 tab6-1-50-5 mg................................................................... 127

METAFOLBIC PLUS -l-methylfolate-methylcobalamin-acetylcyst tab 6-2-600 mg............................................. 127

METAFOLBIC PLUS RF -l-methylfolate-algae-b12-acetylcyst tab 6-90.314-2-600mg...................................127

METANX -l-methylfolate-algae-vit b12-b6 cap3-90.314-2-35 mg.......................................................... 127

METANX -l-methylfolate w/ vit b6-vit b12 tab 3-35-2mg.................................................................................. 127

METAPROTERENOL SULFATE -metaproterenol sulfatesyrup 10 mg/5ml.............................................................. 64

METAPROTERENOL SULFATE -metaproterenol sulfatetab 10 mg.........................................................................64

METAPROTERENOL SULFATE -metaproterenol sulfatetab 20 mg.........................................................................64

METAXALONE -metaxalone tab 400 mg........................ 114metaxalone tab 800 mg (Skelaxin)...............................114metformin hcl tab 1000 mg (Glucophage).....................30metformin hcl tab 500 mg (Glucophage).......................30metformin hcl tab 850 mg (Glucophage).......................30metformin hcl tab sr 24hr 500 mg (Glucophage xr)......30metformin hcl tab sr 24hr 750 mg (Glucophage xr)......30metformin hcl tab sr 24hr osmotic 1000 mg(Fortamet)........................................................................30

metformin hcl tab sr 24hr osmotic 500 mg(Fortamet)........................................................................30

methadone hcl conc 10 mg/ml (Methadose)................. 97METHADONE HCL -methadone hcl soln 10 mg/5ml.........97METHADONE HCL -methadone hcl soln 5 mg/5ml...........97methadone hcl soln 10 mg/5ml (Methadone hcl).......... 97methadone hcl soln 5 mg/5ml (Methadone hcl)............97methadone hcl tab 10 mg (Dolophine).......................... 97methadone hcl tab 5 mg (Dolophine hcl)...................... 97methadone hcl tab for oral susp 40 mg........................ 97METHADOSE -methadone hcl conc 10 mg/ml..................97METHADOSE SUGAR-FREE -methadone hcl conc 10 mg/ml......................................................................................97

methamphetamine hcl tab 5 mg (Desoxyn)...................88methazolamide tab 25 mg (Neptazane)......................... 53methazolamide tab 50 mg (Neptazane)......................... 53methenamine hippurate tab 1 gm (Hiprex)....................72methenamine-hyoscamine-meth blue-sod phos tab81.6 mg (Urogesic-blue)................................................ 72

methenamine-hyosc-meth blue-benz acid-phenyl saltab 81.6mg (Prosed/ds)................................................. 72

methenamine-hyosc-meth blue-sod phos-phen sal cap118 mg.............................................................................72

methenamine-hyosc-meth blue-sod phos-phen sal cap120 mg.............................................................................72

methenamine-hyosc-meth blue-sod phos-phen sal tab81 mg...............................................................................72

methenamine-hyos-meth blue-sod phos-phen sal tab81.6 mg............................................................................72

METHENAMINE MANDELATE -methenamine mandelatetab 0.5 gm........................................................................72

methenamine mandelate tab 1 gm.................................72methimazole tab 10 mg (Tapazole)................................ 33methimazole tab 5 mg (Tapazole).................................. 33METHITEST -methyltestosterone oral tab 10 mg..............21methocarbamol tab 500 mg (Robaxin)........................ 114methocarbamol tab 750 mg (Robaxin-750)................. 114methotrexate sodium for inj 1 gm..................................18methotrexate sodium inj 25 mg/ml................................ 18methotrexate sodium inj pf 25 mg/ml............................18methotrexate sodium tab 2.5 mg (base equiv)..............18methoxsalen rapid cap 10 mg (Oxsoralen ultra).........154methscopolamine bromide tab 2.5 mg (Pamine).......... 67methscopolamine bromide tab 5 mg (Pamineforte)................................................................................ 67

METHYCLOTHIAZIDE -methyclothiazide tab 5 mg...........53METHYLDOPA/HYDROCHLOROTHI -methyldopa &hydrochlorothiazide tab 250-15 mg................................. 49

METHYLDOPA/HYDROCHLOROTHI -methyldopa &hydrochlorothiazide tab 250-25 mg................................. 49

methyldopa tab 250 mg.................................................. 49methyldopa tab 500 mg.................................................. 49methylergonovine maleate tab 0.2 mg.......................... 35METHYLFOL-ALGAE-B12-ACETY -l-methylfolate-algae-b12-acetylcyst tab 6-90.314-2-600mg............................127

METHYLIN -methylphenidate hcl chew tab 10 mg............ 88METHYLIN -methylphenidate hcl chew tab 2.5 mg........... 88METHYLIN -methylphenidate hcl chew tab 5 mg.............. 88METHYLIN -methylphenidate hcl soln 10 mg/5ml............. 88METHYLIN -methylphenidate hcl soln 5 mg/5ml............... 88methylphenidate hcl cap cr 10 mg (Metadate cd)......... 88methylphenidate hcl cap cr 20 mg (Metadate cd)......... 88methylphenidate hcl cap cr 30 mg (Metadate cd)......... 88methylphenidate hcl cap cr 40 mg (Metadate cd)......... 88methylphenidate hcl cap cr 50 mg (Metadate cd)......... 88methylphenidate hcl cap cr 60 mg (Metadate cd)......... 88methylphenidate hcl cap sr 24hr 20 mg (la) (Ritalinla)..................................................................................... 88

methylphenidate hcl cap sr 24hr 30 mg (la) (Ritalinla)..................................................................................... 88

methylphenidate hcl cap sr 24hr 40 mg (la) (Ritalinla)..................................................................................... 88

methylphenidate hcl chew tab 10 mg (Methylin).......... 88methylphenidate hcl chew tab 2.5 mg (Methylin)......... 88

2015


methylphenidate hcl chew tab 5 mg (Methylin)............ 88METHYLPHENIDATE HCL ER -methylphenidate hcl tabsa osm 18 mg..................................................................88

METHYLPHENIDATE HCL ER -methylphenidate hcl tabsa osm 27 mg..................................................................88



methylphenidate hcl soln 10 mg/5ml (Methylin)........... 88methylphenidate hcl soln 5 mg/5ml (Methylin)............. 88methylphenidate hcl tab 10 mg (Ritalin)........................88methylphenidate hcl tab 20 mg (Ritalin)........................88methylphenidate hcl tab 5 mg (Ritalin)..........................88methylphenidate hcl tab cr 10 mg................................. 88methylphenidate hcl tab cr 20 mg (Ritalin sr)...............88methylprednisolone tab 16 mg (Medrol)........................20methylprednisolone tab 32 mg (Medrol)........................20methylprednisolone tab 4 mg (Medrol)......................... 20methylprednisolone tab 4 mg dose pack (Medroldosepak)..........................................................................20

methylprednisolone tab 8 mg (Medrol)......................... 20METIPRANOLOL -metipranolol ophth soln 0.3%............ 139metoclopramide hcl orally disintegrating tab 5 mg(Metozolv odt).................................................................71

metoclopramide hcl soln 5 mg/5ml (10 mg/10ml)......... 71metoclopramide hcl tab 10 mg (Reglan)....................... 71metoclopramide hcl tab 5 mg (Reglan)......................... 71metolazone tab 10 mg.....................................................53metolazone tab 2.5 mg (Zaroxolyn)............................... 53metolazone tab 5 mg (Zaroxolyn).................................. 53metoprolol & hydrochlorothiazide tab 100-25 mg(Lopressor hct)...............................................................50

metoprolol & hydrochlorothiazide tab 100-50 mg........ 50metoprolol & hydrochlorothiazide tab 50-25 mg(Lopressor hct)...............................................................50

metoprolol succinate tab sr 24hr 100 mg (Toprolxl)..................................................................................... 41

metoprolol succinate tab sr 24hr 200 mg (Toprolxl)..................................................................................... 41

metoprolol succinate tab sr 24hr 25 mg (Toprol xl)......41metoprolol succinate tab sr 24hr 50 mg (Toprol xl)......41metoprolol tartrate tab 100 mg (Lopressor).................. 41metoprolol tartrate tab 25 mg.........................................41metoprolol tartrate tab 50 mg (Lopressor)....................41METOZOLV ODT -metoclopramide hcl orally disintegratingtab 5 mg...........................................................................71

METROCREAM -metronidazole cream 0.75%................ 154METROGEL -metronidazole gel 1%................................154METROGEL-VAGINAL -metronidazole vaginal gel0.75%............................................................................... 73

METROLOTION -metronidazole lotion 0.75%.................154metronidazole cap 375 mg (Flagyl)................................12metronidazole cream 0.75% (Metrocream)..................154metronidazole gel 0.75%...............................................154

metronidazole gel 1% (Metrogel)................................. 154metronidazole lotion 0.75% (Metrolotion)....................154metronidazole tab 250 mg (Flagyl).................................12metronidazole tab 500 mg (Flagyl).................................12metronidazole vaginal gel 0.75% (Metrogel-vaginal)............................................................................74

METVIXIA -methyl aminolevulinate hcl cream 16.8% (baseequiv)..............................................................................154

MEVACOR -lovastatin tab 40 mg......................................56mexiletine hcl cap 150 mg..............................................44mexiletine hcl cap 200 mg..............................................44mexiletine hcl cap 250 mg..............................................44MIACALCIN -calcitonin (salmon) inj 200 unit/ml................37MIACALCIN -calcitonin (salmon) nasal soln 200 unit/act.....................................................................................37

MICARDIS HCT -telmisartan-hydrochlorothiazide tab40-12.5 mg.......................................................................50

MICARDIS HCT -telmisartan-hydrochlorothiazide tab80-12.5 mg.......................................................................50

MICARDIS HCT -telmisartan-hydrochlorothiazide tab80-25 mg..........................................................................50

MICARDIS -telmisartan tab 20 mg.................................... 50MICARDIS -telmisartan tab 40 mg.................................... 50MICARDIS -telmisartan tab 80 mg.................................... 50MICONAZOLE 3 -miconazole nitrate vaginal suppos 200mg.................................................................................... 74

miconazole nitrate vaginal supp 200 mg & 2% cream 9gm kit.............................................................................. 74

MICRO-K -potassium chloride cap cr 10 meq................. 125MICRO-K -potassium chloride cap cr 8 meq................... 125MICROZIDE -hydrochlorothiazide cap 12.5 mg................ 53midazolam hcl syrup 2 mg/ml (base equivalent).......... 85midodrine hcl tab 10 mg.................................................54midodrine hcl tab 2.5 mg................................................54midodrine hcl tab 5 mg...................................................54MIGERGOT -ergotamine w/ caffeine suppos 2-100mg.................................................................................. 105

MIGRANAL -dihydroergotamine mesylate nasal spray 4mg/ml..............................................................................105

MIGRYL -capsaicin-menthol disk 0.0375-5%.................. 154MILLIPRED DP -prednisolone tab 5 mg dose pack...........20MILLIPRED -prednisolone sod phosphate oral soln 10mg/5ml (base equiv)........................................................ 20

MILLIPRED -prednisolone tab 5 mg..................................20MINASTRIN 24 FE -norethindrone ace-eth estradiol-fechew tab 1 mg-20 mcg (24)............................................ 25

MINERAL OIL HEAVY -mineral oil....................................65MINIPRESS -prazosin hcl cap 1 mg................................. 50MINIPRESS -prazosin hcl cap 2 mg................................. 50MINIPRESS -prazosin hcl cap 5 mg................................. 50MINIVELLE -estradiol td patch twice weekly 0.025mg/24hr............................................................................ 23

MINIVELLE -estradiol td patch twice weekly 0.0375mg/24hr............................................................................ 23

2015





MINOCIN KIT -minocycline hcl cap 100 mg w/ acne careproducts kit.........................................................................4

MINOCIN KIT -minocycline hcl cap 50 mg w/ acne careproducts kit.........................................................................4

MINOCIN -minocycline hcl cap 100 mg.............................. 4MINOCIN -minocycline hcl cap 50 mg................................ 4MINOCIN -minocycline hcl cap 75 mg................................ 4minocycline hcl cap 100 mg (Minocin)............................4minocycline hcl cap 50 mg (Minocin)..............................4minocycline hcl cap 75 mg (Minocin)..............................4minocycline hcl tab 100 mg............................................. 4minocycline hcl tab 50 mg............................................... 4minocycline hcl tab 75 mg............................................... 4minocycline hcl tab sr 24hr 135 mg................................ 4minocycline hcl tab sr 24hr 45 mg.................................. 4minocycline hcl tab sr 24hr 90 mg.................................. 4minoxidil tab 10 mg.........................................................50minoxidil tab 2.5 mg........................................................50MIRAPEX ER -pramipexole dihydrochloride tab sr 24hr0.375 mg........................................................................ 112

MIRAPEX ER -pramipexole dihydrochloride tab sr 24hr0.75 mg.......................................................................... 112

MIRAPEX ER -pramipexole dihydrochloride tab sr 24hr 1.5mg.................................................................................. 112



MIRAPEX ER -pramipexole dihydrochloride tab sr 24hr 3mg.................................................................................. 112

MIRAPEX ER -pramipexole dihydrochloride tab sr 24hr 4.5mg.................................................................................. 112

MIRAPEX -pramipexole dihydrochloride tab 0.125mg.................................................................................. 111

MIRAPEX -pramipexole dihydrochloride tab 0.25 mg......112MIRAPEX -pramipexole dihydrochloride tab 0.5 mg........112MIRAPEX -pramipexole dihydrochloride tab 0.75 mg......112MIRAPEX -pramipexole dihydrochloride tab 1.5 mg........112MIRAPEX -pramipexole dihydrochloride tab 1 mg...........112MIRCERA -methoxy polyethylene glycol-epoetin beta inj100 mcg/0.3ml............................................................... 130

MIRCERA -methoxy polyethylene glycol-epoetin beta inj200 mcg/0.3ml............................................................... 130

MIRCERA -methoxy polyethylene glycol-epoetin beta inj50 mcg/0.3ml................................................................. 130

MIRCERA -methoxy polyethylene glycol-epoetin beta inj75 mcg/0.3ml................................................................. 130

MIRCETTE -desogest-eth estrad & eth estrad tab0.15-0.02/0.01 mg(21/5)...................................................25

mirtazapine orally disintegrating tab 15 mg (Remeronsoltab)..............................................................................78



mirtazapine tab 15 mg (Remeron)..................................78mirtazapine tab 30 mg (Remeron)..................................78mirtazapine tab 45 mg (Remeron)..................................78mirtazapine tab 7.5 mg....................................................78MIRVASO -brimonidine tartrate gel 0.33% (baseequivalent)......................................................................154

misoprostol tab 100 mcg (Cytotec)................................67misoprostol tab 200 mcg (Cytotec)................................67MITIGARE -colchicine cap 0.6 mg.................................. 106MITOSOL -mitomycin for ophth soln kit 0.2 mg...............139MOBIC -meloxicam susp 7.5 mg/5ml.............................. 103MOBIC -meloxicam tab 15 mg........................................ 103MOBIC -meloxicam tab 7.5 mg....................................... 103modafinil tab 100 mg (Provigil)...................................... 88modafinil tab 200 mg (Provigil)...................................... 88MODERIBA 1200 DOSE PACK -ribavirin tab 600 mg......... 8MODERIBA 800 DOSE PACK -ribavirin tab 400 mg...........8MODERIBA -ribavirin tab 200 mg & ribavirin tab 400 mgdose pack...........................................................................8

MODERIBA -ribavirin tab 400 mg & ribavirin tab 600 mgdose pack...........................................................................8

MODICON -norethindrone & ethinyl estradiol tab 0.5mg-35 mcg....................................................................... 25

moexipril hcl tab 15 mg (Univasc)................................. 50moexipril hcl tab 7.5 mg (Univasc)................................ 50moexipril-hydrochlorothiazide tab 15-12.5 mg(Uniretic)..........................................................................50

moexipril-hydrochlorothiazide tab 15-25 mg................ 50moexipril-hydrochlorothiazide tab 7.5-12.5 mg............ 50mometasone furoate cream 0.1% (Elocon)................. 154mometasone furoate oint 0.1% (Elocon)..................... 154mometasone furoate solution 0.1% (lotion)(Elocon)......................................................................... 154

MONOCAL -sodium monofluorophosphate-calcium carbtab 22.75-625 mg...........................................................125

MONOCLATE-P -antihemophilic factor (human) for inj kit1000 unit........................................................................ 135

MONOCLATE-P -antihemophilic factor (human) for inj kit1500 unit........................................................................ 135

MONOCLATE-P -antihemophilic factor (human) for inj kit250 unit.......................................................................... 135

MONOCLATE-P -antihemophilic factor (human) for inj kit500 unit.......................................................................... 135

MONODOX -doxycycline monohydrate cap 100 mg........... 4MONODOX -doxycycline monohydrate cap 75 mg............. 4MONONINE -coagulation factor ix for inj 1000 unit......... 135MONONINE -coagulation factor ix for inj 250 unit........... 135MONONINE -coagulation factor ix for inj 500 unit........... 135

2015


montelukast sodium chew tab 4 mg (base equiv)(Singulair)........................................................................64

montelukast sodium chew tab 5 mg (base equiv)(Singulair)........................................................................64

montelukast sodium oral granules packet 4 mg (baseequiv) (Singulair)............................................................64

montelukast sodium tab 10 mg (base equiv)(Singulair)........................................................................64

MONUROL -fosfomycin tromethamine powd pack 3 gm(base equivalent)............................................................. 72

MORGIDOX 1X100MG -doxycycline hyclate cap 1 x 100mg w/ cleanser kit..............................................................4

MORGIDOX 2X100MG -doxycycline hyclate cap 2 x 100mg w/ cleanser kit..............................................................4

morphine sulfate (concentrate) oral soln 20 mg/ml......97morphine sulfate cap sr 24hr 100 mg (Kadian).............98morphine sulfate cap sr 24hr 10 mg (Kadian)...............97morphine sulfate cap sr 24hr 20 mg (Kadian)...............97morphine sulfate cap sr 24hr 30 mg (Kadian)...............97morphine sulfate cap sr 24hr 50 mg (Kadian)...............98morphine sulfate cap sr 24hr 60 mg (Kadian)...............98morphine sulfate cap sr 24hr 80 mg (Kadian)...............98MORPHINE SULFATE ER -morphine sulfate beads cap sr24hr 120 mg.................................................................... 98

MORPHINE SULFATE ER -morphine sulfate beads cap sr24hr 30 mg...................................................................... 98





MORPHINE SULFATE -morphine sulfate suppos 10mg.................................................................................... 97




MORPHINE SULFATE -morphine sulfate tab 15 mg.........97MORPHINE SULFATE -morphine sulfate tab 30 mg.........97morphine sulfate oral soln 10 mg/5ml...........................98morphine sulfate oral soln 20 mg/5ml...........................98morphine sulfate tab cr 100 mg (Ms contin)................. 98morphine sulfate tab cr 15 mg (Ms contin)................... 98morphine sulfate tab cr 200 mg (Ms contin)................. 98morphine sulfate tab cr 30 mg (Ms contin)................... 98morphine sulfate tab cr 60 mg (Ms contin)................... 98MOTOFEN -difenoxin w/ atropine tab 1-0.025 mg............ 66mouthwashes - liquid....................................................142MOVANTIK -naloxegol oxalate tab 12.5 mg (baseequivalent)........................................................................71

MOVANTIK -naloxegol oxalate tab 25 mg (baseequivalent)........................................................................71

MOVIPREP -peg 3350-kcl-nacl-na sulfate-na ascorbate-cfor soln 100 gm................................................................65

MOXATAG -amoxicillin (trihydrate) tab sr 24hr 775 mg.......1MOXEZA -moxifloxacin hcl ophth soln 0.5% (base eq) (2times daily).....................................................................139

moxifloxacin hcl tab 400 mg (base equiv) (Avelox)........5MS CONTIN -morphine sulfate tab cr 100 mg...................98MS CONTIN -morphine sulfate tab cr 15 mg.....................98MS CONTIN -morphine sulfate tab cr 200 mg...................98MS CONTIN -morphine sulfate tab cr 30 mg.....................98MS CONTIN -morphine sulfate tab cr 60 mg.....................98MS QUICK DISSOLVE GLUCOSE -glucose chew tab 4gm.................................................................................... 30

MUCOTROL -oral wound care products - wafer..............142MULTAQ -dronedarone hcl tab 400 mg (baseequivalent)........................................................................44

MULTIGEN -fe asparto gly-succ acd-c-threonic acd-b12-des stom tab.................................................................. 130

MULTIGEN FOLIC -fe asparto gly-succinic acd-vit c-threonic acd-b12-fa tab..................................................130

MULTIGEN PLUS -fe aspart gly-fe fum-succ acd-c-threonic acd-b12-fa tab..................................................130

multiple vitamins w/ minerals & fa tab 1.25 mg(Corvite).........................................................................117

mupirocin calcium cream 2% (Bactroban).................. 154mupirocin oint 2% (Bactroban).................................... 154MV FE ASPARTO GLY/FE FUM/ -fe aspart gly-fe fum-succ acd-c-threonic acd-b12-fa tab................................130

MV FE ASPARTO GLY/VIT C/V -fe asparto gly-succ acd-c-threonic acd-b12-des stom tab................................... 131

M-VIT -prenatal vit w/ fe fumarate-fa tab 27-1 mg........... 117MYALEPT -metreleptin for subcutaneous inj 11.3 mg....... 37MYAMBUTOL -ethambutol hcl tab 100 mg......................... 6MYAMBUTOL -ethambutol hcl tab 400 mg......................... 6MYCOBUTIN -rifabutin cap 150 mg.................................... 6mycophenolate mofetil cap 250 mg (Cellcept)............164mycophenolate mofetil for oral susp 200 mg/ml(Cellcept)....................................................................... 164

mycophenolate mofetil tab 500 mg (Cellcept).............164mycophenolate sodium tab dr 180 mg (mycophenolicacid equiv) (Myfortic)...................................................164

mycophenolate sodium tab dr 360 mg (mycophenolicacid equiv) (Myfortic)...................................................164

MYDRIACYL -tropicamide ophth soln 1%....................... 139MYFORTIC -mycophenolate sodium tab dr 180 mg(mycophenolic acid equiv)............................................. 164

MYFORTIC -mycophenolate sodium tab dr 360 mg(mycophenolic acid equiv)............................................. 164

MYKIDZ IRON 10 -iron susp 15 mg/1.5ml...................... 131MYKIDZ IRON FL -pediatric vitamins acd fluoride & fesusp 0.25-10 mg/2ml..................................................... 117

MYLERAN -busulfan tab 2 mg.......................................... 18

2015


MYNATAL ADVANCE -prenatal vit w/ dss-iron carbonyl-fatab 90-1 mg................................................................... 117

MYNATAL PLUS -prenatal vit w/ fe fumarate-fa tab 65-1mg.................................................................................. 117

MYNATAL -prenatal multivitamins & minerals w/ iron & facap 1 mg........................................................................117

MYNATAL ULTRACAPLET -prenatal vit w/ dss-ironcarbonyl-fa tab 90-1 mg.................................................117

MYNATAL-Z -prenatal vit w/ fe fumarate-fa tab 65-1mg.................................................................................. 117

MYNATE 90 PLUS -prenatal vit w/ dss-fe fumarate-fa tabcr 90-1 mg..................................................................... 117

MYOXIN -benzocaine-chloroxylenol-hc otic susp 15-1-10mg/ml..............................................................................141

MYRBETRIQ -mirabegron tab sr 24 hr 25 mg...................73MYRBETRIQ -mirabegron tab sr 24 hr 50 mg...................73MYSOLINE -primidone tab 250 mg.................................109MYSOLINE -primidone tab 50 mg...................................109

N

NABI-HB -hepatitis b immune globulin (human) im injsoln...................................................................................16

nabumetone tab 500 mg............................................... 103nabumetone tab 750 mg............................................... 103nadolol & bendroflumethiazide tab 40-5 mg(Corzide)..........................................................................50

nadolol & bendroflumethiazide tab 80-5 mg(Corzide)..........................................................................50

nadolol tab 20 mg (Corgard).......................................... 41nadolol tab 40 mg (Corgard).......................................... 41nadolol tab 80 mg (Corgard).......................................... 41NAFRINSE DAILY/ACIDULATED -sodium fluoride-phosphoric acid for soln 1 mg/5ml (f equiv)................... 142

NAFRINSE DAILY/NEUTRAL -sodium fluoride for solnrinse 0.05%.................................................................... 142

NAFRINSE WEEKLY -sodium fluoride for soln rinse0.2%............................................................................... 142

naftifine hcl cream 1% (Naftin).....................................154NAFTIN -naftifine hcl cream 1%......................................154NAFTIN -naftifine hcl cream 2%......................................154NAFTIN -naftifine hcl gel 1%...........................................154NAFTIN -naftifine hcl gel 2%...........................................154NALFON -fenoprofen calcium cap 400 mg......................103naltrexone hcl tab 50 mg (Revia)................................. 163NAMENDA -memantine hcl oral solution 2 mg/ml............. 91NAMENDA -memantine hcl tab 10 mg..............................91NAMENDA -memantine hcl tab 5 mg................................91NAMENDA TITRATION PAK -memantine hcl tab 5 mg(28) & 10 mg (21) titration pak........................................ 91

NAMENDA XR -memantine hcl cap sr 24hr 14 mg........... 91NAMENDA XR -memantine hcl cap sr 24hr 21 mg........... 91NAMENDA XR -memantine hcl cap sr 24hr 28 mg........... 91NAMENDA XR -memantine hcl cap sr 24hr 7 mg............. 91NAMENDA XR TITRATION PACK -memantine hcl cap sr24hr 7 mg & 14 mg & 21 mg & 28 mg pack.................... 91

NAMZARIC -memantine hcl-donepezil hcl cap sr 24hr14-10 mg..........................................................................91

NAMZARIC -memantine hcl-donepezil hcl cap sr 24hr28-10 mg..........................................................................91

NAPHAZOLINE HCL -naphazoline hcl ophth soln0.1%............................................................................... 139

NAPRELAN -naproxen sodium tab sr 24hr 375 mg (baseequiv)..............................................................................103



NAPROSYN -naproxen susp 125 mg/5ml.......................103NAPROSYN -naproxen tab 250 mg................................ 103NAPROSYN -naproxen tab 375 mg................................ 103NAPROSYN -naproxen tab 500 mg................................ 103NAPROXEN COMFORT PAC -naproxen tab 500 mg &liniment topical gel kit.................................................... 103

NAPROXEN -naproxen susp 125 mg/5ml.......................103naproxen sodium tab 275 mg (Anaprox).....................103naproxen sodium tab 550 mg (Anaprox ds)................103naproxen sodium tab sr 24hr 500 mg (base equiv)(Naprelan)......................................................................103

naproxen tab 250 mg (Naprosyn).................................103naproxen tab 375 mg (Naprosyn).................................103naproxen tab 500 mg (Naprosyn).................................103naproxen tab ec 375 mg (Ec-naprosyn)...................... 103naproxen tab ec 500 mg (Ec-naprosyn)...................... 103naratriptan hcl tab 1 mg (base equiv) (Amerge)......... 105naratriptan hcl tab 2.5 mg (base equiv) (Amerge)...... 105NARDIL -phenelzine sulfate tab 15 mg............................. 78NASCOBAL -cyanocobalamin nasal spray 500mcg/0.1ml.......................................................................131

NASONEX -mometasone furoate nasal susp 50 mcg/act.....................................................................................59

NATACHEW -prenatal vit w/ fe fum-fe bisglycin-fa chewtab 28-1 mg................................................................... 117

NATACYN -natamycin ophth susp 5%............................ 139NATALVIRT 90 DHA -prenat w/o a w/fecbn-fegl-dss-fa tab90 &dha cap 300mg pak............................................... 117

NATALVIRT CA -prenat w/o a w/fecbn-fegl-dss-fa tab &dha cap 300 mg pack....................................................117

NATALVIRT FLT -fe carbonyl-fe gluconate-fa-vit b12-vit c-dss tab 90-1 mg.............................................................131

NATALVIT -prenatal vit w/ fe fumarate-fa tab 75-1mg.................................................................................. 117

NATAL-V RX -prenatal vit w/ iron carbonyl-fa tab 29-1mg.................................................................................. 117

NATAZIA -estradiol valerate-dienogest tab 3 mg /2-2mg/2-3 mg/1 mg...............................................................25

nateglinide tab 120 mg (Starlix)..................................... 30nateglinide tab 60 mg (Starlix)....................................... 30NATELLE ONE -prenatal w/o vit a w/ fe fum-fa-omega 3cap 28-1-250 mg............................................................118

NATESTO -testosterone nasal gel 5.5 mg/act...................21

2015


NATPARA -parathyroid hormone (recombinant) for injcartridge 100 mcg............................................................37

NATPARA -parathyroid hormone (recombinant) for injcartridge 25 mcg..............................................................37



NATROBA -spinosad susp 0.9%.....................................154NATURE-THROID NT-2.5 -thyroid tab 162.5 mg (2 1/2grain)................................................................................ 34

NATURE-THROID -thyroid tab 113.75 mg........................33NATURE-THROID -thyroid tab 130 mg.............................33NATURE-THROID -thyroid tab 146.25 mg........................33NATURE-THROID -thyroid tab 16.25 mg..........................33NATURE-THROID -thyroid tab 195 mg.............................33NATURE-THROID -thyroid tab 260 mg.............................33NATURE-THROID -thyroid tab 32.5 mg............................33NATURE-THROID -thyroid tab 325 mg (5 grain)...............33NATURE-THROID -thyroid tab 48.75 mg (3/4 grain).........33NATURE-THROID -thyroid tab 65 mg...............................33NATURE-THROID -thyroid tab 81.25 mg..........................33NATURE-THROID -thyroid tab 97.5 mg............................33NEBUPENT -pentamidine isethionate for nebulization soln300 mg.............................................................................12

NEBUSAL -sodium chloride soln nebu 6%........................60NECON 1/50-28 -norethindrone & mestranol tab 1 mg-50mcg...................................................................................25

NECON 10/11-28 -norethindrone-eth estradiol tab0.5-35/1-35 mg-mcg (10/11)............................................ 25

NEEVO DHA -prenat w/o a w/fefum-methylfol-omegas cap27-1.13 mg.....................................................................118

NEFAZODONE HCL -nefazodone hcl tab 100 mg............ 79NEFAZODONE HCL -nefazodone hcl tab 150 mg............ 79NEFAZODONE HCL -nefazodone hcl tab 200 mg............ 79NEFAZODONE HCL -nefazodone hcl tab 50 mg.............. 78nefazodone hcl tab 250 mg............................................ 79NEOMYCIN/POLYMYXIN/HYDROC -neomycin-polymyxin-hc ophth susp............................................... 139

neomycin-bacitrac zn-polymyx5(3.5)mg-400unt-10000unt op oin...............................139

neomycin-polymy-gramicid op sol1.75-10000-0.025mg-unt-mg/ml (Neosporin)..............139

neomycin-polymyxin-dexamethasone ophth oint 0.1%(Maxitrol)....................................................................... 139

neomycin-polymyxin-dexamethasone ophth susp 0.1%(Maxitrol)....................................................................... 139

neomycin-polymyxin-hc otic soln 1%(Cortisporin)..................................................................141

neomycin-polymyxin-hc otic susp 3.5 mg/ml-10000unit/ml-1%..................................................................... 141

neomycin sulfate tab 500 mg........................................... 5NEORAL -cyclosporine modified cap 100 mg................. 164NEORAL -cyclosporine modified cap 25 mg................... 164NEORAL -cyclosporine modified oral soln 100 mg/ml..... 164

NEOSALUS CP -dermatological products misc -cream............................................................................. 154

NEOSALUS -dermatological products misc - cream....... 154NEOSALUS -emollient - aerosol foam............................ 154NEOSALUS -emollient - lotion.........................................154NEOSPORIN -neomycin-polymy-gramicid op sol1.75-10000-0.025mg-unt-mg/ml.....................................139

NEO-SYNALAR KIT -neomycin-fluocinolone cream0.35-0.025% & emollient cr kit.......................................154

NEO-SYNALAR -neomycin-fluocinolone cream0.35-0.025%................................................................... 154

NEOTUSS-D -pseudoephed-chlorphen w/ dm-gg liqd30-2-30-200 mg/5ml.........................................................60

NEOTUSS PLUS -phenylephrine-chlorphen-dm liquid7.5-4-30 mg/5ml...............................................................60

NEPHPLEX RX -b-complex w/ c-zn & folic acid tab 1mg.................................................................................. 118

NEPHROCAPS -b-complex w/ c & folic acid cap 1mg.................................................................................. 118

NEPHROCAPS QT -b-complex w/ c-biotin-d & folic acidtab disp 1 mg.................................................................118

NEPHRON FA -ferrous fumarate w/ fa-dss-b complex-vit ctab.................................................................................. 131

NEPHRO-VITE RX -b-complex w/ c & folic acid tab 1mg.................................................................................. 118

NEPTAZANE -methazolamide tab 25 mg......................... 53NEPTAZANE -methazolamide tab 50 mg......................... 53NESINA -alogliptin benzoate tab 12.5 mg (base equiv).....30NESINA -alogliptin benzoate tab 25 mg (base equiv)........30NESINA -alogliptin benzoate tab 6.25 mg (base equiv).....30NESTABS ABC -prenatal w/o vit a w/fe polysac-fa-ca tab& omega 3 cap.............................................................. 118

NESTABS DHA -prenat w/o a w/ fe bisglyc-fa tab 32-1 mg& omega cap pack.........................................................118

NESTABS -prenatal vit w/o vit a w/ fe bisglycinate-fa tab32-1 mg..........................................................................118

NEUAC KIT -clindamycin-benzoyl perox gel 1.2-5% &moisturizer cr kit.............................................................154

NEULASTA DELIVERY KIT -pegfilgrastim inj 6mg/0.6ml.........................................................................131

NEULASTA -pegfilgrastim inj 6 mg/0.6ml........................131NEUMEGA -oprelvekin for inj 5 mg.................................131NEUPOGEN -filgrastim inj 300 mcg/0.5ml (600 mcg/ml).................................................................................. 131

NEUPOGEN -filgrastim inj 300 mcg/ml........................... 131NEUPOGEN -filgrastim inj 480 mcg/0.8ml (600 mcg/ml).................................................................................. 131

NEUPOGEN -filgrastim inj 480 mcg/1.6ml (300 mcg/ml).................................................................................. 131

NEUPRO -rotigotine td patch 24hr 1 mg/24hr................. 112NEUPRO -rotigotine td patch 24hr 2 mg/24hr................. 112NEUPRO -rotigotine td patch 24hr 3 mg/24hr................. 112NEUPRO -rotigotine td patch 24hr 4 mg/24hr................. 112NEUPRO -rotigotine td patch 24hr 6 mg/24hr................. 112NEUPRO -rotigotine td patch 24hr 8 mg/24hr................. 112

2015


NEURIN-SL -cyanocobalamin-methylcobalamin tab sl600-600 mcg.................................................................. 131

NEURONTIN -gabapentin cap 100 mg........................... 109NEURONTIN -gabapentin cap 300 mg........................... 109NEURONTIN -gabapentin cap 400 mg........................... 109NEURONTIN -gabapentin oral soln 250 mg/5ml............. 109NEURONTIN -gabapentin tab 600 mg............................ 109NEURONTIN -gabapentin tab 800 mg............................ 109NEUTRASAL -artificial saliva - packet.............................142NEUVAXIN -capsaicin-menthol topical patch0.0375-5%...................................................................... 154

NEVANAC -nepafenac ophth susp 0.1%........................ 139NEVIRAPINE -nevirapine susp 50 mg/5ml..........................8nevirapine tab 200 mg (Viramune)...................................8nevirapine tab sr 24hr 400 mg (Viramune xr)..................8NEWGEN -prenatal vit w/o vit a w/ fe bisglycinate-fa tab32-1 mg..........................................................................118

NEXA PLUS -prenatal w/o vit a w/ fe fum-doc-fa-dha cap29-1.25-350 mg..............................................................118

NEXA SELECT -prenatal w/o vit a w/ fe fum-dss-fa-dhacap 29-1.25-325 mg.......................................................118

NEXAVAR -sorafenib tosylate tab 200 mg (baseequivalent)........................................................................18

NEXIUM -esomeprazole magnesium cap delayed release20 mg (base eq).............................................................. 67

NEXIUM -esomeprazole magnesium cap delayed release40 mg (base eq).............................................................. 67

NEXIUM -esomeprazole magnesium for delayed releasesusp pack 2.5 mg............................................................ 67

NEXIUM -esomeprazole magnesium for delayed releasesusp packet 10 mg.......................................................... 67



NEXIUM -esomeprazole magnesium for delayed releasesusp packet 5 mg............................................................ 67

niacin tab cr 1000 mg (antihyperlipidemic)(Niaspan)......................................................................... 56



NIASPAN -niacin tab cr 1000 mg (antihyperlipidemic)...... 56NIASPAN -niacin tab cr 500 mg (antihyperlipidemic)........ 56NIASPAN -niacin tab cr 750 mg (antihyperlipidemic)........ 56nicardipine hcl cap 20 mg.............................................. 43nicardipine hcl cap 30 mg.............................................. 43NICODERM CQ -nicotine td patch 24hr 14 mg/24hr......... 91NICODERM CQ -nicotine td patch 24hr 21 mg/24hr......... 91NICODERM CQ -nicotine td patch 24hr 7 mg/24hr........... 91NICOMIDE -niacinamide w/ zn-cu-methylfol-se-cr tab750-27-2-0.5 mg............................................................ 118

NICORETTE MINI -nicotine polacrilex lozenge 2 mg........ 91NICORETTE MINI -nicotine polacrilex lozenge 4 mg........ 91

NICORETTE -nicotine polacrilex gum 2 mg...................... 91NICORETTE -nicotine polacrilex gum 4 mg...................... 91NICORETTE -nicotine polacrilex lozenge 2 mg.................91NICORETTE -nicotine polacrilex lozenge 4 mg.................91NICORETTE STARTER KIT -nicotine polacrilex gum 2mg.................................................................................... 91

NICORETTE STARTER KIT -nicotine polacrilex gum 4mg.................................................................................... 91

nicotine polacrilex gum 2 mg.........................................91nicotine polacrilex gum 4 mg.........................................91nicotine polacrilex lozenge 2 mg................................... 91nicotine polacrilex lozenge 4 mg................................... 91nicotine td patch 24hr 14 mg/24hr.................................91nicotine td patch 24hr 21 mg/24hr.................................91nicotine td patch 24hr 7 mg/24hr...................................91NICOTINE TRANSDERMAL SYST -nicotine td patch 24 hrkit 21-14-7 mg/24hr..........................................................91

NICOTROL INHALER -nicotine inhaler system 10 mg (4mg delivered)................................................................... 91

NICOTROL NS -nicotine nasal spray 10 mg/ml (0.5 mg/spray)............................................................................... 91

nifedipine cap 10 mg (Procardia)...................................43nifedipine cap 20 mg.......................................................43nifedipine tab sr 24hr 30 mg (Adalat cc)....................... 43nifedipine tab sr 24hr 60 mg (Adalat cc)....................... 43nifedipine tab sr 24hr 90 mg (Adalat cc)....................... 43nifedipine tab sr 24hr osmotic 30 mg (Procardia xl).....43nifedipine tab sr 24hr osmotic 60 mg (Procardia xl).....43nifedipine tab sr 24hr osmotic 90 mg (Procardia xl).....43NILANDRON -nilutamide tab 150 mg................................18nimodipine cap 30 mg.....................................................43NIRAVAM -alprazolam orally disintegrating tab 0.25mg.................................................................................... 76

NISOLDIPINE ER -nisoldipine tab sr 24hr 25.5 mg...........43NISOLDIPINE -nisoldipine tab sr 24hr 20 mg................... 43NISOLDIPINE -nisoldipine tab sr 24hr 30 mg................... 43NISOLDIPINE -nisoldipine tab sr 24hr 40 mg................... 43nisoldipine tab sr 24hr 17 mg (Sular)............................ 43nisoldipine tab sr 24hr 34 mg (Sular)............................ 43nisoldipine tab sr 24hr 8.5 mg (Sular)........................... 43NITRO-BID -nitroglycerin oint 2%......................................39NITRO-DUR -nitroglycerin td patch 24hr 0.1 mg/hr...........39NITRO-DUR -nitroglycerin td patch 24hr 0.2 mg/hr...........39NITRO-DUR -nitroglycerin td patch 24hr 0.3 mg/hr...........39NITRO-DUR -nitroglycerin td patch 24hr 0.4 mg/hr...........39NITRO-DUR -nitroglycerin td patch 24hr 0.6 mg/hr...........39NITRO-DUR -nitroglycerin td patch 24hr 0.8 mg/hr...........39nitrofurantoin macrocrystalline cap 100 mg(Macrodantin)..................................................................72

nitrofurantoin macrocrystalline cap 50 mg(Macrodantin)..................................................................72

nitrofurantoin monohydrate macrocrystalline cap 100mg (Macrobid)................................................................ 72

nitrofurantoin susp 25 mg/5ml (Furadantin)................. 72nitroglycerin cap cr 2.5 mg............................................ 39

2015


nitroglycerin cap cr 6.5 mg............................................ 39nitroglycerin cap cr 9 mg............................................... 39NITROGLYCERIN LINGUAL -nitroglycerin lingual aerosol400 mcg/spray................................................................. 39

nitroglycerin td patch 24hr 0.1 mg/hr (Nitro-dur)..........39nitroglycerin td patch 24hr 0.2 mg/hr (Nitro-dur)..........39nitroglycerin td patch 24hr 0.4 mg/hr (Nitro-dur)..........39nitroglycerin td patch 24hr 0.6 mg/hr (Nitro-dur)..........39nitroglycerin tl soln 0.4 mg/spray (400 mcg/spray)(Nitrolingual pumpspr).................................................. 39

NITROLINGUAL PUMPSPRAY -nitroglycerin tl soln 0.4mg/spray (400 mcg/spray)............................................... 39

NITROMIST -nitroglycerin lingual aerosol 400 mcg/spray.................................................................................39

NITROSTAT -nitroglycerin sl tab 0.3 mg...........................39NITROSTAT -nitroglycerin sl tab 0.4 mg...........................40NITROSTAT -nitroglycerin sl tab 0.6 mg...........................40NIVA-PLUS -prenatal vit w/ fe fumarate-fa tab 27-1mg.................................................................................. 118

NIVATOPIC PLUS -dermatological products misc -cream............................................................................. 154

nizatidine cap 150 mg..................................................... 67nizatidine cap 300 mg (Axid)..........................................67nizatidine oral soln 15 mg/ml (Axid).............................. 67NIZORAL -ketoconazole shampoo 2%............................154NOBLE MYSTIQUE EMU-LAC -lactic acid (ammoniumlactate) cream 10%........................................................154

NORCO -hydrocodone-acetaminophen tab 10-325 mg.....98NORCO -hydrocodone-acetaminophen tab 5-325 mg.......98NORCO -hydrocodone-acetaminophen tab 7.5-325mg.................................................................................... 98

NORDITROPIN CARTRIDGE -somatropin inj 5mg/1.5ml...........................................................................37

NORDITROPIN FLEXPRO -somatropin inj 10mg/1.5ml...........................................................................37

NORDITROPIN FLEXPRO -somatropin inj 15mg/1.5ml...........................................................................37

NORDITROPIN FLEXPRO -somatropin inj 30 mg/3ml......37NORDITROPIN FLEXPRO -somatropin inj 5 mg/1.5ml.....37NORDITROPIN NORDIFLEX PEN -somatropin inj 30mg/3ml..............................................................................37

norelgestromin-ethinyl estradiol td ptwk 150-35mcg/24hr (Ortho evra)................................................... 25

norethindrone & ethinyl estradiol-fe chew tab 0.4mg-35 mcg (Femcon fe)................................................ 25

norethindrone & ethinyl estradiol-fe chew tab 0.8mg-25 mcg (Generess fe)..............................................25

norethindrone & ethinyl estradiol tab 0.4 mg-35 mcg(Ovcon-35).......................................................................25

norethindrone & ethinyl estradiol tab 0.5 mg-35 mcg(Brevicon-28).................................................................. 25

norethindrone & ethinyl estradiol tab 1 mg-35 mcg(Norinyl 1+35)................................................................. 25

norethindrone ace & ethinyl estradiol-fe tab 1.5 mg-30mcg (Loestrin fe 1.5/30)................................................ 25

norethindrone ace & ethinyl estradiol-fe tab 1 mg-20mcg (Loestrin fe 1/20)................................................... 25

norethindrone ace & ethinyl estradiol tab 1.5 mg-30mcg (Loestrin 1.5/30-21)................................................25

norethindrone ace & ethinyl estradiol tab 1 mg-20 mcg(Loestrin 1/20-21)........................................................... 25

norethindrone ace-ethinyl estradiol-fe tab 1 mg-20mcg (24) (Lomedia 24 fe).............................................. 25

norethindrone acetate-ethinyl estradiol tab 0.5 mg-2.5mcg (Femhrt low dose)................................................. 23

norethindrone acetate tab 5 mg (Aygestin)...................26norethindrone ac-ethinyl estrad-fe tab 1-20/1-30/1-35mg-mcg (Estrostep fe)...................................................25

norethindrone-eth estradiol tab 0.5-35/0.75-35/1-35 mg-mcg (Ortho-novum 7/7/7).............................................. 25

norethindrone-eth estradiol tab 0.5-35/1-35/0.5-35 mg-mcg (Tri-norinyl 28)....................................................... 25

norethindrone tab 0.35 mg (Nor-qd).............................. 25norgestimate & ethinyl estradiol tab 0.25 mg-35 mcg(Ortho-cyclen).................................................................25

norgestimate-eth estrad tab 0.18-35/0.215-35/0.25-35mg-mcg (Ortho tri-cyclen).............................................25

norgestrel & ethinyl estradiol tab 0.3 mg-30 mcg.........26NORINYL 1+35 -norethindrone & ethinyl estradiol tab 1mg-35 mcg....................................................................... 26

NORINYL 1+50 -norethindrone & mestranol tab 1 mg-50mcg...................................................................................26

NORITATE -metronidazole cream 1%.............................155NORPACE CR -disopyramide phosphate cap sr 12hr 100mg.................................................................................... 44

NORPACE CR -disopyramide phosphate cap sr 12hr 150mg.................................................................................... 44

NORPACE -disopyramide phosphate cap 100 mg............44NORPACE -disopyramide phosphate cap 150 mg............44NORPRAMIN -desipramine hcl tab 100 mg...................... 79NORPRAMIN -desipramine hcl tab 10 mg........................ 79NORPRAMIN -desipramine hcl tab 150 mg...................... 79NORPRAMIN -desipramine hcl tab 25 mg........................ 79NORPRAMIN -desipramine hcl tab 50 mg........................ 79NORPRAMIN -desipramine hcl tab 75 mg........................ 79NOR-QD -norethindrone tab 0.35 mg................................25NORTHERA -droxidopa cap 100 mg.................................54NORTHERA -droxidopa cap 200 mg.................................54NORTHERA -droxidopa cap 300 mg.................................54nortriptyline hcl cap 10 mg (Pamelor)........................... 79nortriptyline hcl cap 25 mg (Pamelor)........................... 79nortriptyline hcl cap 50 mg (Pamelor)........................... 79nortriptyline hcl cap 75 mg (Pamelor)........................... 79NORTRIPTYLINE HCL -nortriptyline hcl soln 10mg/5ml..............................................................................79

NORTUSS-EX -dextromethorphan-guaifenesin liquid20-200 mg/5ml................................................................. 60

NORVASC -amlodipine besylate tab 10 mg......................43NORVASC -amlodipine besylate tab 2.5 mg.....................43NORVASC -amlodipine besylate tab 5 mg........................43

2015


NORVIR -ritonavir cap 100 mg........................................... 8NORVIR -ritonavir oral soln 80 mg/ml.................................8NORVIR -ritonavir tab 100 mg............................................ 8NOTUSS-NX -codeine-chlorcyclizine liquid 10-9.375mg/5ml..............................................................................60

NOTUSS-NXD -codeine-pseudoephedrine-chlorcyclizineliq 10-30-9.375mg/5ml..................................................... 60

NOVACORT -hydrocortisone ace-pramoxine-aloepolysacch gel 2-1-1%.................................................... 155

NOVAFERRUM -polysacch iron complex-vit c-fa for soln100-60-1 mg/5ml............................................................131

NOVOEIGHT -antihemophilic factor (recombinant) for inj1000 unit........................................................................ 136



NOVOEIGHT -antihemophilic factor (recombinant) for inj250 unit.......................................................................... 135


NOVOEIGHT -antihemophilic factor (recombinant) for inj500 unit.......................................................................... 135

NOVOLIN 70/30 -insulin nph isophane & regular human inj100 unit/ml (70-30)...........................................................32

NOVOLIN 70/30 RELION -insulin nph isophane & regularhuman inj 100 unit/ml (70-30)..........................................32

NOVOLIN N -insulin nph (human) (isophane) inj 100 unit/ml......................................................................................32

NOVOLIN N RELION -insulin nph (human) (isophane) inj100 unit/ml....................................................................... 32

NOVOLIN R -insulin regular (human) inj 100 unit/ml......... 32NOVOLIN R RELION -insulin regular (human) inj 100 unit/ml......................................................................................32

NOVOLOG FLEXPEN -insulin aspart soln pen-injector 100unit/ml...............................................................................32

NOVOLOG -insulin aspart inj 100 unit/ml..........................32NOVOLOG MIX 70/30 -insulin aspart prot & aspart(human) inj 100 unit/ml (70-30)....................................... 32

NOVOLOG MIX 70/30 PREFILL -insulin aspart prot &aspart sus pen-inj 100 unit/ml (70-30)............................. 32

NOVOLOG PENFILL -insulin aspart inj 100 unit/ml...........32NOVOLOG PENFILL -insulin aspart soln cartridge 100unit/ml...............................................................................32

NOVOSEVEN -coagulation factor viia (recomb) for inj 2.4mg (2400 mcg)...............................................................136

NOVOSEVEN RT -coagulation factor viia (recomb) for inj 1mg (1000 mcg)...............................................................136




NOXAFIL -posaconazole susp 40 mg/ml............................ 7

NOXAFIL -posaconazole tab delayed release 100 mg........7NUCORT -hydrocortisone acetate lotion 2%................... 155NUCYNTA ER -tapentadol hcl tab sr 12hr 100 mg............98NUCYNTA ER -tapentadol hcl tab sr 12hr 150 mg............98NUCYNTA ER -tapentadol hcl tab sr 12hr 200 mg............98NUCYNTA ER -tapentadol hcl tab sr 12hr 250 mg............98NUCYNTA ER -tapentadol hcl tab sr 12hr 50 mg..............98NUCYNTA -tapentadol hcl tab 100 mg............................. 98NUCYNTA -tapentadol hcl tab 50 mg............................... 98NUCYNTA -tapentadol hcl tab 75 mg............................... 98NUEDEXTA -dextromethorphan hbr-quinidine sulfate cap20-10 mg..........................................................................91

NULYTELY/FLAVOR PACKS -peg 3350-kcl-sod bicarb-nacl for soln 420 gm........................................................66

NUMOISYN -artificial saliva - lozenge.............................142NUMOISYN -artificial saliva - solution............................. 142NUOX -benzoyl peroxide-sulfur gel 6-3%........................155NUTRESTORE -glutamine powd pack 5 gm...................126NUTRIDOX -doxycycline monohyd cap 75 mg w/ omega3-vit e cap kit..................................................................... 4

NUTRI-TAB OB + DHA -prenat w/o a w/ fe bisglyc-fa tab32-1 mg & omega cap pack.......................................... 118

NUTRI-TAB OB -prenatal vit w/o vit a w/ fe bisglycinate-fatab 32-1 mg................................................................... 118

NUTRIVIT -b-complex w/ lysine-min-fe & fa liqd 800-15-1mg/15ml..........................................................................118

NUTROPIN AQ NUSPIN 10 -somatropin inj 10mg/2ml..............................................................................37

NUTROPIN AQ NUSPIN 20 -somatropin inj 20mg/2ml..............................................................................37

NUTROPIN AQ NUSPIN 5 -somatropin inj 5 mg/2ml........ 37NUTROPIN AQ PEN -somatropin inj 10 mg/2ml............... 37NUTROPIN AQ PEN -somatropin inj 20 mg/2ml............... 37NUVAIL -dermatological products misc - solution............155NUVARING -etonogestrel-ethinyl estradiol va ring0.120-0.015 mg/24hr........................................................26

NUVESSA -metronidazole vaginal gel 1.3%..................... 74NUVIGIL -armodafinil tab 150 mg..................................... 88NUVIGIL -armodafinil tab 200 mg..................................... 88NUVIGIL -armodafinil tab 250 mg..................................... 88NUVIGIL -armodafinil tab 50 mg....................................... 88NUZON -hydrocortisone acetate-aloe vera gel 2%..........155NYMALIZE -nimodipine oral soln 60 mg/20ml...................43nystatin cream 100000 unit/gm.................................... 155nystatin oint 100000 unit/gm........................................ 155nystatin oral powder......................................................... 7nystatin susp 100000 unit/ml........................................142nystatin tab 500000 unit....................................................7nystatin topical powder................................................ 155nystatin-triamcinolone cream 100000-0.1 unit/gm-%.................................................................................... 155

nystatin-triamcinolone oint 100000-0.1 unit/gm-%..... 155

O

OB COMPLETE/DHA -prenat w/ iron cbn-fe asp glyc-fa-omega cap 30-10-1-200 mg.......................................... 118

2015


OB COMPLETE ONE -prenatal w/o a w/fecbn-fe asp glyc-fa-fish cap 50-1-476 mg.................................................118

OB COMPLETE PETITE -prenat w/o a w/fecbn-feaspglyc-fa-omega cap 35-5-1-200 mg........................................ 118

OB COMPLETE PREMIER -prenatal vit w/ fe cbn-fe aspglyc-fa tab 30-20-1 mg...................................................118

OB COMPLETE -prenatal vit w/ iron carbonyl-fa tab50-1.25 mg.....................................................................118

OB-NATAL ONE -prenatal vit w/ fe cbn-fe asp glyc-fa-omega 3 cap 27-1mg.....................................................118

OBREDON -hydrocodone-guaifenesin soln 2.5-200mg/5ml..............................................................................60

OBSTETRIX DHA -prenat w/fecbn-fa-dss tab 29-1 mg &omega 3 cap 387 mg pak..............................................118

OBSTETRIX EC -prenatal vit w/ dss-iron carbonyl-fa tab29-1 mg..........................................................................118

O-CAL FA -prenatal vit w/ fe fumarate-fa tab 27-1 mg.....118O-CAL PRENATAL -prenatal vit w/ fe fumarate-fa tab 15-1mg.................................................................................. 118

octreotide acetate inj 1000 mcg/ml (1 mg/ml)(Sandostatin).................................................................. 37

octreotide acetate inj 100 mcg/ml (0.1 mg/ml)(Sandostatin).................................................................. 37




OCUFEN -flurbiprofen sodium ophth soln 0.03%............ 139OCUFLOX -ofloxacin ophth soln 0.3%............................ 139OCUVEL -multiple vitamins w/ minerals & fa cap 0.5mg.................................................................................. 118

OFEV -nintedanib esylate cap 100 mg (baseequivalent)........................................................................65

OFEV -nintedanib esylate cap 150 mg (baseequivalent)........................................................................65

OFLOXACIN -ofloxacin tab 400 mg.................................... 5ofloxacin ophth soln 0.3% (Ocuflox)........................... 139ofloxacin otic soln 0.3%................................................141OGESTREL -norgestrel & ethinyl estradiol tab 0.5 mg-50mcg...................................................................................26

olanzapine-fluoxetine hcl cap 12-25 mg (Symbyax)..... 92olanzapine-fluoxetine hcl cap 12-50 mg (Symbyax)..... 92olanzapine-fluoxetine hcl cap 3-25 mg (Symbyax)....... 91olanzapine-fluoxetine hcl cap 6-25 mg (Symbyax)....... 91olanzapine-fluoxetine hcl cap 6-50 mg (Symbyax)....... 91olanzapine orally disintegrating tab 10 mg (Zyprexazydis)............................................................................... 82

olanzapine orally disintegrating tab 15 mg (Zyprexazydis)............................................................................... 82



olanzapine tab 10 mg (Zyprexa).....................................82olanzapine tab 15 mg (Zyprexa).....................................82olanzapine tab 2.5 mg (Zyprexa)....................................82olanzapine tab 20 mg (Zyprexa).....................................82olanzapine tab 5 mg (Zyprexa).......................................82olanzapine tab 7.5 mg (Zyprexa)....................................82OLEPTRO -trazodone hcl tab sr 24hr 150 mg.................. 79OLEPTRO -trazodone hcl tab sr 24hr 300 mg.................. 79olopatadine hcl nasal soln 0.6% (Patanase)................. 59OLUX -clobetasol propionate foam 0.05%...................... 155OLUX-E -clobetasol propionate emulsion foam0.05%............................................................................. 155

OLYSIO -simeprevir sodium cap 150 mg (baseequivalent)..........................................................................8

OMECLAMOX-PAK -amoxicillin cap-clarithro tab w/omepraz cap dr therapy pack..........................................68

omega-3-acid ethyl esters cap 1 gm (Lovaza).............. 56OMEPRAZOLE + SYRSPEND SF -omeprazole susp 2mg/ml (compound kit)...................................................... 68

omeprazole cap delayed release 10 mg (Prilosec)....... 68omeprazole cap delayed release 20 mg (Prilosec)....... 68omeprazole cap delayed release 40 mg (Prilosec)....... 68omeprazole-sodium bicarbonate cap 20-1100 mg(Zegerid).......................................................................... 68

omeprazole-sodium bicarbonate cap 40-1100 mg(Zegerid).......................................................................... 68

OMNARIS -ciclesonide nasal susp 50 mcg/act................. 59OMNI GEL -stannous fluoride gel 0.4%.......................... 142OMNIPRED -prednisolone acetate ophth susp 1%......... 139OMNITROPE -somatropin for inj 5.8 mg...........................37OMNITROPE -somatropin inj 10 mg/1.5ml........................37OMNITROPE -somatropin inj 5 mg/1.5ml......................... 37ondansetron hcl oral soln 4 mg/5ml (Zofran)................69ondansetron hcl tab 24 mg............................................ 69ondansetron hcl tab 4 mg (Zofran)................................ 69ondansetron hcl tab 8 mg (Zofran)................................ 69ondansetron orally disintegrating tab 4 mg (Zofranodt)...................................................................................69

ondansetron orally disintegrating tab 8 mg (Zofranodt)...................................................................................69

ONEXTON -clindamycin phosphate-benzoyl peroxide gel1.2-3.75%....................................................................... 155

ONFI -clobazam suspension 2.5 mg/ml.......................... 109ONFI -clobazam tab 10 mg............................................. 109ONFI -clobazam tab 20 mg............................................. 109ONGLYZA -saxagliptin hcl tab 2.5 mg (base equiv).......... 30ONGLYZA -saxagliptin hcl tab 5 mg (base equiv)............. 30ONMEL -itraconazole tab 200 mg.......................................7OPANA ER (CRUSH RESISTANT -oxymorphone hcl taber 12hr deter 10 mg.........................................................98

OPANA ER (CRUSH RESISTANT -oxymorphone hcl taber 12hr deter 15 mg.........................................................98


2015




OPANA ER (CRUSH RESISTANT -oxymorphone hcl taber 12hr deter 5 mg...........................................................98

OPANA ER (CRUSH RESISTANT -oxymorphone hcl taber 12hr deter 7.5 mg........................................................98

OPANA -oxymorphone hcl tab 10 mg............................... 98OPANA -oxymorphone hcl tab 5 mg................................. 98opium tincture 1% (10 mg/ml) (morphine equiv)...........66OPSUMIT -macitentan tab 10 mg..................................... 58OPTASE -trypsin w/ castor oil & peruvian balsam gel..... 155ORACEA -doxycycline (rosacea) cap delayed release 40mg.................................................................................. 155

ORACIT -sodium citrate & citric acid soln 490-640mg/5ml..............................................................................74

ORAFATE -sucralfate-malate paste 10%........................ 143ORALAIR ADULT SAMPLE KIT -grass mixed pollen exttab sl 300 ir (index of reactivity)...................................... 16

ORALAIR ADULT STARTER PAC -grass mixed pollen exttab sl 300 ir (index of reactivity)...................................... 16

ORALAIR CHILDREN/ADOLESCE -grass mixed pollen exttab sl 100 ir (index of reactivity)...................................... 16

ORALAIR CHILDREN/ADOLESCE -grass mixed pollentab sl therpak 100 (3) ir & 300 (6) ir................................ 16

ORALAIR -grass mixed pollen ext tab sl 300 ir (index ofreactivity).......................................................................... 16

ORAMAGICRX -oral wound care products - for susprinse................................................................................143

ORAP -pimozide tab 1 mg................................................ 92ORAP -pimozide tab 2 mg................................................ 92ORAPRED ODT -prednisolone sod phos orally disintegrtab 10 mg (base eq)........................................................ 20

ORAPRED ODT -prednisolone sod phos orally disintegrtab 15 mg (base eq)........................................................ 20

ORAPRED ODT -prednisolone sod phos orally disintegrtab 30 mg (base eq)........................................................ 20

ORAVIG -miconazole buccal tab 50 mg (mouth-throat)............................................................................. 143

ORBIVAN -butalbital-acetaminophen-caffeine cap50-300-40 mg...................................................................93

ORBIVAN CF -butalbital-acetaminophen tab 50-300mg.................................................................................... 93

ORENCIA -abatacept subcutaneous soln prefilled syringe125 mg/ml...................................................................... 103

ORENITRAM -treprostinil diolamine tab cr 0.125 mg (baseequiv)................................................................................58


ORENITRAM -treprostinil diolamine tab cr 1 mg (baseequiv)................................................................................58


ORFADIN -nitisinone cap 10 mg.......................................37

ORFADIN -nitisinone cap 2 mg.........................................37ORFADIN -nitisinone cap 5 mg.........................................37ORKAMBI -lumacaftor-ivacaftor tab 200-125 mg.............. 65orphenadrine citrate tab sr 12hr 100 mg..................... 114orphenadrine w/ aspirin & caffeine tab 25-385-30mg.................................................................................. 114

ORTHO-CEPT -desogestrel & ethinyl estradiol tab 0.15mg-30 mcg....................................................................... 26

ORTHO-CYCLEN -norgestimate & ethinyl estradiol tab0.25 mg-35 mcg...............................................................26

ORTHO EVRA -norelgestromin-ethinyl estradiol td ptwk150-35 mcg/24hr..............................................................26

ORTHO MICRONOR -norethindrone tab 0.35 mg.............26ORTHO-NOVUM 1/35 -norethindrone & ethinyl estradioltab 1 mg-35 mcg............................................................. 26

ORTHO-NOVUM 7/7/7 -norethindrone-eth estradiol tab0.5-35/0.75-35/1-35 mg-mcg............................................26

ORTHO TRI-CYCLEN LO -norgestimate-eth estrad tab0.18-25/0.215-25/0.25-25 mg-mcg...................................26

ORTHO TRI-CYCLEN -norgestimate-eth estrad tab0.18-35/0.215-35/0.25-35 mg-mcg...................................26

OSENI -alogliptin-pioglitazone tab 12.5-15 mg..................30OSENI -alogliptin-pioglitazone tab 12.5-30 mg..................30OSENI -alogliptin-pioglitazone tab 12.5-45 mg..................30OSENI -alogliptin-pioglitazone tab 25-15 mg.....................30OSENI -alogliptin-pioglitazone tab 25-30 mg.....................30OSENI -alogliptin-pioglitazone tab 25-45 mg.....................30OSMOPREP -sod phos mono-sod phos di tabs1.102-0.398 gm(1.5gm na phos)..................................... 66

OSPHENA -ospemifene tab 60 mg................................... 37OTEZLA -apremilast tab 30 mg.......................................103OTEZLA -apremilast tab starter therapy pack 10 mg & 20mg & 30 mg...................................................................103

OTICIN HC NR -pramoxine-hc-chloroxylenol otic soln10-10-1 mg/ml................................................................141

OTOZIN -antipyrine-benzocaine-glycerin-zinc ace otic liqd5.4-1-2-1%......................................................................141

OTREXUP -methotrexate soln pf auto-injector 10mg/0.4ml.........................................................................103




OVACE PLUS -sulfacetamide sodium cream 10%..........155OVACE PLUS -sulfacetamide sodium foam 9.8%...........155OVACE PLUS -sulfacetamide sodium lotion 9.8%.......... 155OVACE PLUS -sulfacetamide sodium shampoo 10%..... 155OVACE PLUS WASH -sulfacetamide sodium cleansing gel10%................................................................................ 155

OVACE PLUS WASH -sulfacetamide sodium liquid10%................................................................................ 155

OVACE WASH -sulfacetamide sodium liquid 10%.......... 155

2015


OVCON-35 -norethindrone & ethinyl estradiol tab 0.4mg-35 mcg....................................................................... 26

OVIDE -malathion lotion 0.5%.........................................155OXANDRIN -oxandrolone tab 10 mg.................................21OXANDRIN -oxandrolone tab 2.5 mg................................21oxandrolone tab 10 mg (Oxandrin)................................21oxandrolone tab 2.5 mg (Oxandrin)...............................21oxaprozin tab 600 mg (Daypro)....................................103oxazepam cap 10 mg...................................................... 76oxazepam cap 15 mg...................................................... 76oxazepam cap 30 mg...................................................... 76oxcarbazepine susp 300 mg/5ml (60 mg/ml)(Trileptal)....................................................................... 109

oxcarbazepine tab 150 mg (Trileptal).......................... 109oxcarbazepine tab 300 mg (Trileptal).......................... 109oxcarbazepine tab 600 mg (Trileptal).......................... 109OXISTAT -oxiconazole nitrate cream 1%........................155OXISTAT -oxiconazole nitrate lotion 1%......................... 155OXSORALEN -methoxsalen lotion 1%............................155OXSORALEN ULTRA -methoxsalen rapid cap 10 mg.....155OXTELLAR XR -oxcarbazepine tab sr 24hr 150 mg....... 109OXTELLAR XR -oxcarbazepine tab sr 24hr 300 mg....... 109OXTELLAR XR -oxcarbazepine tab sr 24hr 600 mg....... 109oxybutynin chloride syrup 5 mg/5ml............................. 73oxybutynin chloride tab 5 mg........................................ 73oxybutynin chloride tab sr 24hr 10 mg (Ditropanxl)..................................................................................... 73

oxybutynin chloride tab sr 24hr 15 mg (Ditropanxl)..................................................................................... 73

oxybutynin chloride tab sr 24hr 5 mg (Ditropan xl)......73oxycodone-aspirin tab 4.8355-325 mg (Percodan)....... 99oxycodone hcl cap 5 mg................................................ 99oxycodone hcl conc 100 mg/5ml (20 mg/ml)(Oxycodone hcl).............................................................99

OXYCODONE HCL ER -oxycodone hcl tab er 12hr deter10 mg...............................................................................99




OXYCODONE HCL -oxycodone hcl conc 100 mg/5ml (20mg/ml).............................................................................. 99

OXYCODONE HCL -oxycodone hcl soln 5 mg/5ml...........99oxycodone hcl soln 5 mg/5ml (Oxycodone hcl)............99oxycodone hcl tab 10 mg............................................... 99oxycodone hcl tab 15 mg (Roxicodone)........................99oxycodone hcl tab 20 mg............................................... 99oxycodone hcl tab 30 mg (Roxicodone)........................99oxycodone hcl tab 5 mg (Roxicodone)..........................99oxycodone-ibuprofen tab 5-400 mg...............................99oxycodone w/ acetaminophen tab 10-325 mg(Percocet)........................................................................99

oxycodone w/ acetaminophen tab 2.5-325 mg(Percocet)........................................................................99

oxycodone w/ acetaminophen tab 5-325 mg(Percocet)........................................................................99

oxycodone w/ acetaminophen tab 7.5-325 mg(Percocet)........................................................................99

OXYCONTIN -oxycodone hcl tab er 12hr deter 10 mg......99OXYCONTIN -oxycodone hcl tab er 12hr deter 15 mg......99OXYCONTIN -oxycodone hcl tab er 12hr deter 20 mg......99OXYCONTIN -oxycodone hcl tab er 12hr deter 30 mg......99OXYCONTIN -oxycodone hcl tab er 12hr deter 40 mg......99OXYCONTIN -oxycodone hcl tab er 12hr deter 60 mg......99OXYCONTIN -oxycodone hcl tab er 12hr deter 80 mg......99oxymorphone hcl tab 10 mg (Opana)............................ 99oxymorphone hcl tab 5 mg (Opana).............................. 99oxymorphone hcl tab sr 12hr 10 mg............................. 99oxymorphone hcl tab sr 12hr 15 mg............................. 99oxymorphone hcl tab sr 12hr 20 mg............................. 99oxymorphone hcl tab sr 12hr 30 mg............................. 99oxymorphone hcl tab sr 12hr 40 mg............................. 99oxymorphone hcl tab sr 12hr 5 mg............................... 99oxymorphone hcl tab sr 12hr 7.5 mg.............................99OXYTROL -oxybutynin td patch twice weekly 3.9mg/24hr............................................................................ 73

P

PAIN RELIEF PATCH -capsaicin-menthol topical patch0.0375-5%...................................................................... 155

PAIN RELIEF PATCH -lidocaine-menthol patch5-1%............................................................................... 155

PAIRE OB -prenat w/ fe poly cmplx-fe asp-fe gly-fa tab &dha cap pak................................................................... 118

PAMELOR -nortriptyline hcl cap 10 mg.............................79PAMELOR -nortriptyline hcl cap 25 mg.............................79PAMELOR -nortriptyline hcl cap 50 mg.............................79PAMELOR -nortriptyline hcl cap 75 mg.............................79PAMINE FORTE -methscopolamine bromide tab 5 mg.....68PAMINE FQ -methscopolamine tab 5 mg & misc intestinalflora reg cap.....................................................................68

PAMINE -methscopolamine bromide tab 2.5 mg...............68PANATUSS DXP -phenylephrine-dexbromphen-dm-ggliquid 5-1-15-100 mg/5ml................................................. 61

PANCREAZE -pancrelipase (lip-prot-amyl) dr cap10500-25000-43750 unit..................................................69



PANCREAZE -pancrelipase (lip-prot-amyl) dr cap4200-10000-17500 unit....................................................69

PANCRELIPASE -pancrelipase (lip-prot-amyl) dr cap5000-17000-27000 unit....................................................70

PANDEL -hydrocortisone probutate cream 0.1%............ 155PANRETIN -alitretinoin gel 0.1%.....................................155pantoprazole sodium ec tab 20 mg (base equiv)(Protonix)........................................................................ 68

2015


pantoprazole sodium ec tab 40 mg (base equiv)(Protonix)........................................................................ 68

PARAFON FORTE DSC -chlorzoxazone tab 500 mg......114paricalcitol cap 1 mcg (Zemplar)................................... 37paricalcitol cap 2 mcg (Zemplar)................................... 37paricalcitol cap 4 mcg (Zemplar)................................... 38PARLODEL -bromocriptine mesylate cap 5 mg.............. 112PARNATE -tranylcypromine sulfate tab 10 mg..................79paromomycin sulfate cap 250 mg....................................5paroxetine hcl tab 10 mg (Paxil).................................... 79paroxetine hcl tab 20 mg (Paxil).................................... 79paroxetine hcl tab 30 mg (Paxil).................................... 79paroxetine hcl tab 40 mg (Paxil).................................... 79paroxetine hcl tab sr 24hr 12.5 mg (Paxil cr)................ 79paroxetine hcl tab sr 24hr 25 mg (Paxil cr)................... 79paroxetine hcl tab sr 24hr 37.5 mg (Paxil cr)................ 79PASER -aminosalicylic acid cr granules packet 4 gm......... 6PATADAY -olopatadine hcl ophth soln 0.2%...................139PATANASE -olopatadine hcl nasal soln 0.6%...................59PATANOL -olopatadine hcl ophth soln 0.1%...................140PAXIL CR -paroxetine hcl tab sr 24hr 12.5 mg................. 79PAXIL CR -paroxetine hcl tab sr 24hr 25 mg.................... 79PAXIL CR -paroxetine hcl tab sr 24hr 37.5 mg................. 79PAXIL -paroxetine hcl oral susp 10 mg/5ml (baseequiv)................................................................................79

PAXIL -paroxetine hcl tab 10 mg...................................... 79PAXIL -paroxetine hcl tab 20 mg...................................... 79PAXIL -paroxetine hcl tab 30 mg...................................... 79PAXIL -paroxetine hcl tab 40 mg...................................... 79PAZEO -olopatadine hcl ophth soln 0.7% (baseequivalent)......................................................................140

PCE -erythromycin w/ enteric coated particles tab 333mg...................................................................................... 3

PCE -erythromycin w/ enteric coated particles tab 500mg...................................................................................... 3

PCP 100 -mag cit-bisacodyl-petrolat-peg-metoclopramide-electrol kit.........................................................................66

PEDIADERM AF COMPLETE KIT -nystatin cream 100000unit/gm & diaper rash cream kit.....................................155

PEDIADERM HC -hydrocortisone lot 2% & emollientcream kit........................................................................ 155

PEDIADERM TA -triamcinolone cream 0.1% & emollientcream kit........................................................................ 155

PEDIAPRED -prednisolone sod phosph oral soln 6.7mg/5ml (5 mg/5ml base)..................................................20

PEDIARIX -diph-tetanus tox-acell pert-hepatitis b-polio ipvvac inj...............................................................................15

PEDIATEX TDM -pseudoephed-triprolidine-dm susp10-0.938-4 mg/ml.............................................................61

pediatric multiple vitamins w/ fl-fe drops 0.25-10 mg/ml................................................................................... 118

pediatric multiple vitamins w/ fluoride chew tab 0.25mg.................................................................................. 118

pediatric multiple vitamins w/ fluoride chew tab 0.5mg.................................................................................. 118

pediatric multiple vitamins w/ fluoride chew tab 1mg.................................................................................. 118

pediatric multiple vitamins w/ fluoride soln 0.25 mg/ml................................................................................... 118

pediatric multiple vitamins w/ fluoride soln 0.5 mg/ml................................................................................... 118

pediatric vitamins acd w/ fluoride soln 0.25 mg/ml................................................................................... 118

pediatric vitamins acd w/ fluoride soln 0.5 mg/ml...... 118peg 3350-kcl-na bicarb-nacl-na sulfate for soln 236 gm(Golytely).........................................................................66

peg 3350-kcl-na bicarb-nacl-na sulfate for soln 240 gm(Colyte-flavor packs)......................................................66

peg 3350-kcl-sod bicarb-nacl for soln 420 gm(Nulytely/flavor pack).....................................................66

PEGANONE -ethotoin tab 250 mg.................................. 109PEGASYS -peginterferon alfa-2a inj 180 mcg/0.5ml........... 9PEGASYS -peginterferon alfa-2a inj 180 mcg/ml................ 9PEGASYS PROCLICK -peginterferon alfa-2a inj 135mcg/0.5ml...........................................................................9

PEGASYS PROCLICK -peginterferon alfa-2a inj 180mcg/0.5ml...........................................................................9

PEGINTRON -peginterferon alfa-2b for inj kit 120mcg/0.5ml...........................................................................9

PEG-INTRON -peginterferon alfa-2b for inj kit 120mcg/0.5ml...........................................................................8







PEG-INTRON REDIPEN PAK 4 -peginterferon alfa-2b forinj kit 120 mcg/0.5ml..........................................................9

PEG-INTRON REDIPEN PAK 4 -peginterferon alfa-2b forinj kit 150 mcg/0.5ml..........................................................9

PEG-INTRON REDIPEN PAK 4 -peginterferon alfa-2b forinj kit 50 mcg/0.5ml............................................................9

PEG-INTRON REDIPEN PAK 4 -peginterferon alfa-2b forinj kit 80 mcg/0.5ml............................................................9

PEG-INTRON REDIPEN -peginterferon alfa-2b for inj kit120 mcg/0.5ml................................................................... 9

PEG-INTRON REDIPEN -peginterferon alfa-2b for inj kit150 mcg/0.5ml................................................................... 9

PEG-INTRON REDIPEN -peginterferon alfa-2b for inj kit50 mcg/0.5ml..................................................................... 9

PEG-INTRON REDIPEN -peginterferon alfa-2b for inj kit80 mcg/0.5ml..................................................................... 9

penicillin v potassium for soln 125 mg/5ml.................... 1

2015


penicillin v potassium for soln 250 mg/5ml.................... 1penicillin v potassium tab 250 mg...................................1penicillin v potassium tab 500 mg...................................1PENLAC NAIL LACQUER -ciclopirox solution 8%.......... 155PENNSAID -diclofenac sodium soln 2%......................... 155PENTACEL -diph-ac per-tet tox ad-poliov-haemoph b polyvac for im susp................................................................ 15

PENTASA -mesalamine cap cr 250 mg............................ 71PENTASA -mesalamine cap cr 500 mg............................ 71pentazocine w/ naloxone tab 50-0.5 mg........................ 99PENTETATE CALCIUM TRISODI -pentetate calciumtrisodium iv or inhalation soln 200 mg/ml.......................163

PENTETATE ZINC TRISODIUM -pentetate zinc trisodiumiv or inhalation soln 200 mg/ml......................................163

pentoxifylline tab cr 400 mg.........................................136PEPCID -famotidine for susp 40 mg/5ml...........................68PEPCID -famotidine tab 40 mg......................................... 68PERCOCET -oxycodone w/ acetaminophen tab 10-325mg.................................................................................... 99

PERCOCET -oxycodone w/ acetaminophen tab 2.5-325mg.................................................................................... 99

PERCOCET -oxycodone w/ acetaminophen tab 5-325mg.................................................................................... 99

PERCOCET -oxycodone w/ acetaminophen tab 7.5-325mg.................................................................................... 99

PERCODAN -oxycodone-aspirin tab 4.8355-325 mg........ 99PERFOROMIST -formoterol fumarate soln nebu 20mcg/2ml............................................................................64

PERIDEX -chlorhexidine gluconate soln 0.12%.............. 143perindopril erbumine tab 2 mg.......................................50perindopril erbumine tab 4 mg (Aceon)........................ 50perindopril erbumine tab 8 mg (Aceon)........................ 50PERMAVAN EXTERNAL PATCH -lidocaine-dm-trolaminesalicylate patch 4-4-10%................................................155

permethrin cream 5% (Elimite).....................................155PERPHENAZINE/AMITRIPTYLIN -perphenazine-amitriptyline tab 2-10 mg................................................. 92

PERPHENAZINE/AMITRIPTYLIN -perphenazine-amitriptyline tab 2-25 mg................................................. 92




perphenazine tab 16 mg................................................. 83perphenazine tab 2 mg................................................... 82perphenazine tab 4 mg................................................... 82perphenazine tab 8 mg................................................... 82PERSANTINE -dipyridamole tab 25 mg.......................... 136PERSANTINE -dipyridamole tab 50 mg.......................... 136PERSANTINE -dipyridamole tab 75 mg.......................... 136PERTZYE -pancrelipase (lip-prot-amyl) dr cap16000-57500-60500 unit..................................................70

PERTZYE -pancrelipase (lip-prot-amyl) dr cap8000-28750-30250 unit....................................................70

PEXEVA -paroxetine mesylate tab 10 mg (base equiv).....79PEXEVA -paroxetine mesylate tab 20 mg (base equiv).....79PEXEVA -paroxetine mesylate tab 30 mg (base equiv).....79PEXEVA -paroxetine mesylate tab 40 mg (base equiv).....79PHARMACIST CHOICE TSX PAT -methyl salicylate-lidocaine-menthol patch 2-4-1%.................................... 155

phenazopyridine hcl tab 100 mg (Pyridium)................. 74phenazopyridine hcl tab 200 mg (Pyridium)................. 74phenelzine sulfate tab 15 mg (Nardil)............................79phenobarbital elixir 20 mg/5ml.......................................85PHENOBARBITAL -phenobarbital tab 100 mg..................85PHENOBARBITAL -phenobarbital tab 15 mg....................85PHENOBARBITAL -phenobarbital tab 30 mg....................85PHENOBARBITAL -phenobarbital tab 60 mg....................85phenobarbital tab 16.2 mg..............................................85phenobarbital tab 32.4 mg..............................................85phenobarbital tab 64.8 mg..............................................85phenobarbital tab 97.2 mg..............................................85phenylephrine-brompheniramine-dm liquid 7.5-4-15mg/5ml.............................................................................61

phenylephrine-guaifenesin liqd 7.5-100 mg/5ml (1.5-20mg/ml)..............................................................................61

phenylephrine hcl ophth soln 10%.............................. 140phenylephrine hcl ophth soln 2.5%............................. 140phenylephrine-promethazine w/ codeine syrup5-6.25-10 mg/5ml............................................................ 61

phenylephrine w/ dm-gg liqd 10-30-200 mg/5ml........... 61phenylephrine w/ dm-gg liqd 2.5-7.5-88 mg/ml............. 61PHENYLHISTINE DH -pseudoephedrine-chlorphen w/codeine liq 30-2-10 mg/5ml............................................. 61

PHENYTEK -phenytoin sodium extended cap 200mg.................................................................................. 109

PHENYTEK -phenytoin sodium extended cap 300mg.................................................................................. 109

phenytoin chew tab 50 mg (Dilantin infatabs)............ 109phenytoin sodium extended cap 100 mg(Dilantin)........................................................................109

phenytoin susp 125 mg/5ml (Dilantin).........................109PHOS-FLUR ORTHO DEFENSE -sodium fluoride rinse0.044%........................................................................... 143

PHOS FLUR -sodium fluoride rinse 0.044%....................143PHOSLO -calcium acetate (phosphate binder) cap 667 mg(169 mg ca)..................................................................... 71

PHOSLYRA -calcium acetate (phosphate binder) oral soln667 mg/5ml...................................................................... 71

PHOSPHOLINE IODIDE -echothiophate iodide ophth forsoln 0.125%................................................................... 140

PHYSICIANS EZ USE JOINT T -triamcinolone inj 40 mg/ml & lidocaine 1% & ammonia inh kit.............................. 20

phytonadione inj 1 mg/0.5ml (2 mg/ml)....................... 115PICATO -ingenol mebutate gel 0.015%.......................... 155PICATO -ingenol mebutate gel 0.05%............................ 155

2015


PICO SINGLE USE NEGATIVE -wound dressings -kit....................................................................................155

pilocarpine hcl ophth soln 1% (Isopto carpine).......... 140pilocarpine hcl ophth soln 2% (Isopto carpine).......... 140pilocarpine hcl ophth soln 4% (Isopto carpine).......... 140pilocarpine hcl tab 5 mg (Salagen).............................. 143pilocarpine hcl tab 7.5 mg (Salagen)........................... 143pindolol tab 10 mg.......................................................... 41pindolol tab 5 mg............................................................ 41PINNACAINE OTIC -benzocaine otic soln 20%.............. 141pioglitazone hcl-glimepiride tab 30-2 mg (Duetact)......30pioglitazone hcl-glimepiride tab 30-4 mg (Duetact)......30pioglitazone hcl-metformin hcl tab 15-500 mg(Actoplus met)................................................................30

pioglitazone hcl-metformin hcl tab 15-850 mg(Actoplus met)................................................................30

pioglitazone hcl tab 15 mg (base equiv) (Actos)...........30pioglitazone hcl tab 30 mg (base equiv) (Actos)...........30pioglitazone hcl tab 45 mg (base equiv) (Actos)...........30piroxicam cap 10 mg (Feldene)....................................103piroxicam cap 20 mg (Feldene)....................................103PKU EASY MICROTABS -nutritional supplement tabsdelayed release..............................................................127

PLAN B ONE-STEP -levonorgestrel tab 1.5 mg................26PLAQUENIL -hydroxychloroquine sulfate tab 200 mg.......11PLAVIX -clopidogrel bisulfate tab 300 mg (baseequiv)..............................................................................136

PLAVIX -clopidogrel bisulfate tab 75 mg (base equiv).....136PLEGRIDY -peginterferon beta-1a soln pen-injector 125mcg/0.5ml.........................................................................92

PLEGRIDY -peginterferon beta-1a soln prefilled syringe125 mcg/0.5ml................................................................. 92

PLEGRIDY STARTER PACK -peginterferon beta-1a solnpen-inj 63 & 94 mcg/0.5ml pack...................................... 92

PLEGRIDY STARTER PACK -peginterferon beta-1a solnpref syr 63 & 94 mcg/0.5ml pack.....................................92

PLETAL -cilostazol tab 100 mg.......................................136PLETAL -cilostazol tab 50 mg.........................................136PLEXION CLEANSER -sulfacetamide sodium w/ sulfurcleanser 9.8-4.8%.......................................................... 156

PLEXION CLEANSING CLOTHS -sulfacetamide sodiumw/ sulfur cleansing cloth 9.8-4.8%................................. 156

PLEXION -sulfacetamide sodium w/ sulfur cream9.8-4.8%......................................................................... 156

PLEXION -sulfacetamide sodium w/ sulfur lotion9.8-4.8%......................................................................... 155

PLIAGLIS -lidocaine-tetracaine cream 7-7%................... 156PNEUMOVAX 23/1 DOSE -pneumococcal vaccinepolyvalent inj 25 mcg/0.5ml............................................. 15

PNEUMOVAX 23/5 DOSE -pneumococcal vaccinepolyvalent inj 25 mcg/0.5ml............................................. 15

PNEUMOVAX 23 -pneumococcal vaccine polyvalent inj 25mcg/0.5ml.........................................................................15

PNV-DHA+DOCUSATE -prenatal w/o vit a w/ fe fum-dss-fa-dha cap 27-1.25-300 mg........................................... 119

PNV-DHA -prenat w/o a w/fefum-methfol-fa-dha cap27-0.6-0.4-300 mg......................................................... 119

PNV FERROUS FUMARATE/DOCU -prenatal vit w/ dss-fefumarate-fa tab 29-1 mg................................................ 119

PNV-FIRST -prenatal mv w/ fe polysac cmplx-fa-dha cap29-1-200 mg...................................................................119

PNV FOLIC ACID + IRON MUL -prenatal vit w/ fefumarate-fa tab 27-1 mg................................................ 119

PNV-OB/DHA -prenatal mv w/fe fum-fa tab 65-1 mg & dhacap 250 mg pack........................................................... 119

PNV OB+DHA -prenat w/o a w/fecbn-fegl-dss-fa tab & dhacap 250 mg pack........................................................... 119

PNV-OMEGA -prenat w/o a w/ fe fumerate-methylfolate-fa-omega 3 cap..................................................................119

PNV PRENATAL PLUS MULTIVI -prenatal vit w/ fefumarate-fa tab 27-1 mg................................................ 119

PNV-SELECT -prenatal vit w/ fe fum-methylfolate-fa tab27-0.6-0.4 mg.................................................................119

PNV TABS 29-1 -prenatal vit w/ iron carbonyl-fa tab 29-1mg.................................................................................. 119

PNV-TOTAL -prenat w/ fe cbn-fe bisglyc-fa-fish oil cap35-5-1.2 mg....................................................................119

PNV-VP-U -prenatal w/o a vit w/ fe fumarate-fa cap106.5-1 mg.....................................................................119

PODIAPN -l-methylfolate-b12-b6-alpha lipoic ac cap5-2-35-300 mg............................................................... 127

PODOCON 25 IN BENZOIN TIN -podophyllum resin soln25%................................................................................ 156

podofilox soln 0.5% (Condylox)................................... 156polyethylene glycol 3350 oral packet............................ 66polyethylene glycol 3350 oral powder...........................66polymyxin b-trimethoprim ophth soln 10000 unit/ml-0.1% (Polytrim)........................................................140

POLYTRIM -polymyxin b-trimethoprim ophth soln 10000unit/ml-0.1%................................................................... 140

POLY-TUSSIN AC -phenylephrine-bromphen w/ codeineliquid 10-4-10 mg/5ml...................................................... 61

POLY-TUSSIN -codeine-chlorcyclizine liquid 10-9.375mg/5ml..............................................................................61

POLY-TUSSIN D -codeine-pseudoephedrine-chlorcyclizine liq 10-30-9.375mg/5ml...............................61

POLY-VI-FLOR/IRON -ped multiple vitamin w/ fl-febiphasic susp 0.25-7 mg/ml...........................................119

POLY-VI-FLOR/IRON -ped multiple vit w/ fl-fe biphasicchew tab 0.5-10 mg.......................................................119

POLY-VI-FLOR FS -pediatric multiple vitamins w/ fluorideoral strip 1 mg................................................................119

POLY-VI-FLOR FS -pediatric multiple vit w/ fluoride oralstrip 0.25 mg..................................................................119

POLY-VI-FLOR FS -pediatric multiple vit w/ fluoride oralstrip 0.5 mg....................................................................119

POLY-VI-FLOR -ped multiple vit w/ fluoride biphasic chewtab 0.25 mg....................................................................119

POLY-VI-FLOR -ped multiple vit w/ fluoride biphasic chewtab 0.5 mg......................................................................119

2015


POLY-VI-FLOR -ped multiple vit w/ fluoride biphasic chewtab 1 mg.........................................................................119

POLY-VI-FLOR -ped multiple vit w/ fluoride biphasic susp0.25 mg/ml..................................................................... 119

POMALYST -pomalidomide cap 1 mg...............................18POMALYST -pomalidomide cap 2 mg...............................18POMALYST -pomalidomide cap 3 mg...............................18POMALYST -pomalidomide cap 4 mg...............................18PONSTEL -mefenamic acid cap 250 mg.........................103pot & sod citrates w/ cit ac soln 550-500-334mg/5ml.............................................................................74

POTABA -potassium aminobenzoate cap 500 mg.......... 115POTABA -potassium aminobenzoate tab 500 mg........... 115potassium bicarbonate effer tab 25 meq.....................125potassium chloride cap cr 10 meq (Micro-k)...............125potassium chloride cap cr 8 meq (Micro-k).................125POTASSIUM CHLORIDE ER -potassium chloride tab cr20 meq (1500 mg)......................................................... 125

POTASSIUM CHLORIDE ER -potassium chloride tab cr 8meq (600 mg)................................................................ 125

potassium chloride microencapsulated crys cr tab 10meq................................................................................ 125

potassium chloride microencapsulated crys cr tab 20meq................................................................................ 125

potassium chloride oral liq 10% (20 meq/15ml).......... 125potassium chloride oral liq 20% (40 meq/15ml).......... 125potassium chloride powder packet 20 meq................ 125potassium chloride tab cr 10 meq (K-tab)...................125potassium chloride tab cr 8 meq (600 mg)..................125potassium citrate & citric acid powder pack 3300-1002mg.................................................................................... 74

potassium citrate & citric acid soln 1100-334mg/5ml.............................................................................74

potassium citrate tab cr 10 meq (1080 mg) (Urocit-k10).................................................................................... 74

potassium citrate tab cr 15 meq (1620 mg) (Urocit-k15).................................................................................... 74

potassium citrate tab cr 5 meq (540 mg) (Urocit-k5)...................................................................................... 74

pot bicarbonate & chloride effer tab 25 meq...............125POTIGA -ezogabine tab 200 mg..................................... 110POTIGA -ezogabine tab 300 mg..................................... 110POTIGA -ezogabine tab 400 mg..................................... 110POTIGA -ezogabine tab 50 mg.......................................109pot phos monobasic w/sod phos di & monobas tab155-852-130mg (K-phos neutral)................................ 125

PRADAXA -dabigatran etexilate mesylate cap 150 mg(etexilate base eq)......................................................... 133

PRADAXA -dabigatran etexilate mesylate cap 75 mg(etexilate base eq)......................................................... 133

PRALUENT -alirocumab subcutaneous soln pen-injector150 mg/ml........................................................................ 56

PRALUENT -alirocumab subcutaneous soln pen-injector75 mg/ml.......................................................................... 56

PRALUENT -alirocumab subcutaneous soln prefilledsyringe 150 mg/ml........................................................... 56

PRALUENT -alirocumab subcutaneous soln prefilledsyringe 75 mg/ml............................................................. 56

pramipexole dihydrochloride tab 0.125 mg(Mirapex)....................................................................... 112





pramipexole dihydrochloride tab 1 mg (Mirapex).......112pramipexole dihydrochloride tab sr 24hr 0.375 mg(Mirapex er)...................................................................112

pramipexole dihydrochloride tab sr 24hr 0.75 mg(Mirapex er)...................................................................112

pramipexole dihydrochloride tab sr 24hr 1.5 mg(Mirapex er)...................................................................112

pramipexole dihydrochloride tab sr 24hr 3 mg(Mirapex er)...................................................................112

PRAMOSONE E -pramoxine-hc emollient base cream1-2.5%............................................................................ 156

PRAMOSONE -pramoxine-hc cream 1-1%..................... 156PRAMOSONE -pramoxine-hc cream 1-2.5%.................. 156PRAMOSONE -pramoxine-hc lotion 1-1%...................... 156PRAMOSONE -pramoxine-hc lotion 1-2.5%................... 156PRAMOSONE -pramoxine-hc oint 1-1%......................... 156PRAMOSONE -pramoxine-hc oint 1-2.5%...................... 156PRAMOTIC -pramoxine-chloroxylenol otic liquid1-0.1%............................................................................ 142

pramoxine-chloroxylenol otic liquid 1-0.1%(Pramotic)......................................................................142

pramoxine-hc-chloroxylenol otic soln 10-10-1 mg/ml(Cortane-b-otic)............................................................ 142

pramoxine-hc cream 1-2.5% (Pramosone).................. 156pramoxine hcl gel 1%....................................................156PRANDIMET -repaglinide-metformin hcl tab 1-500 mg..... 30PRANDIMET -repaglinide-metformin hcl tab 2-500 mg..... 30PRANDIN -repaglinide tab 0.5 mg.................................... 30PRANDIN -repaglinide tab 1 mg....................................... 30PRANDIN -repaglinide tab 2 mg....................................... 30PRASCION RA WITH SUNSCREE -sulfacetamidesodium-sulfur-sunscreen cream 10-5%......................... 156

PRASTERA -prasterone cap 200 mg & ibuprofen tab 400mg kit............................................................................. 103

PRAVACHOL -pravastatin sodium tab 20 mg................... 56PRAVACHOL -pravastatin sodium tab 40 mg................... 56PRAVACHOL -pravastatin sodium tab 80 mg................... 56pravastatin sodium tab 10 mg........................................56pravastatin sodium tab 20 mg (Pravachol)................... 56pravastatin sodium tab 40 mg (Pravachol)................... 56pravastatin sodium tab 80 mg (Pravachol)................... 56

2015


prazosin hcl cap 1 mg (Minipress).................................50prazosin hcl cap 2 mg (Minipress).................................50prazosin hcl cap 5 mg (Minipress).................................50PR CREAM -dermatological products misc - kit.............. 156PRECOSE -acarbose tab 100 mg.....................................30PRECOSE -acarbose tab 25 mg.......................................30PRECOSE -acarbose tab 50 mg.......................................30PRED FORTE -prednisolone acetate ophth susp 1%......140PRED-G -gentamicin-prednisolone ace ophth susp0.3-1%............................................................................ 140

PRED-G S.O.P. -gentamicin-prednisolone ace ophth oint0.3-0.6%......................................................................... 140

PRED MILD -prednisolone acetate ophth susp0.12%............................................................................. 140

prednicarbate cream 0.1% (Dermatop)........................ 156prednicarbate oint 0.1% (Dermatop)............................ 156prednisolone acetate ophth susp 1% (Pred forte)...... 140PREDNISOLONE SODIUM PHOSP -prednisolone sodiumphosphate ophth soln 1%.............................................. 140

PREDNISOLONE SODIUM PHOSP -prednisolone sodiumphosphate oral soln 25 mg/5ml (base eq)....................... 21

prednisolone sod phos orally disintegr tab 10 mg(base eq) (Orapred odt).................................................20



prednisolone sod phosphate oral soln 15 mg/5ml(base equiv).................................................................... 20

prednisolone sod phosph oral soln 6.7 mg/5ml (5mg/5ml base) (Pediapred)............................................. 20

prednisolone syrup 15 mg/5ml (usp solutionequivalent) (Prelone)......................................................21

PREDNISONE INTENSOL -prednisone conc 5 mg/ml......21PREDNISONE -prednisone oral soln 5 mg/5ml.................21PREDNISONE -prednisone tab 10 mg dose pack.............21PREDNISONE -prednisone tab 50 mg..............................21PREDNISONE -prednisone tab 5 mg dose pack...............21prednisone tab 10 mg..................................................... 21prednisone tab 1 mg....................................................... 21prednisone tab 2.5 mg.................................................... 21prednisone tab 20 mg..................................................... 21prednisone tab 5 mg....................................................... 21PREFERAOB +DHA -prenat-fe poly cmplx 28mg-fe hemepoly-fa tab&dha cap pack.............................................. 119

PREFERA OB + DHA -prenat-fe poly cmplx-fe heme poly-fa tab & omega 3 cap pck............................................. 119

PREFERAOB ONE -prenat-fe poly cmplx-fe heme poly-fa-dha cap 22-6-1-200 mg................................................. 119

PREFERA OB -prenat vit-fe poly cmplx-fe heme poly-fatab 28-6-1 mg................................................................ 119

PREFERRED PLUS GLUCOSE -glucose chew tab 4gm.................................................................................... 30

PREFERRED PLUS GLUCOSE -glucose-vitamin c chewtab 4-0.006 gm................................................................ 31

PREFEST -estradiol tab 1 mg(15)/estrad-norgestimate tab1-0.09mg(15)....................................................................23

PREFOL-DHA -prenatal w/o vit a w/ fe fum-dss-fa-dha cap26-1.2-300 mg................................................................119

PRE-FOLIC -folic acid-vitamin c tab 1-100 mg................131PREMARIN -estrogens, conjugated tab 0.3 mg................ 23PREMARIN -estrogens, conjugated tab 0.45 mg.............. 23PREMARIN -estrogens, conjugated tab 0.625 mg............ 23PREMARIN -estrogens, conjugated tab 0.9 mg................ 23PREMARIN -estrogens, conjugated tab 1.25 mg.............. 24PREMARIN -estrogens, conjugated vaginal cream 0.625mg/gm.............................................................................. 74

PREMIUM SCAR PATCH -allantoin-lidocaine-petrolatumpatch 2-4-30%................................................................156

PREMPHASE -conj est 0.625(14)/conj est-medroxypro actab 0.625-5mg(14)........................................................... 24

PREMPRO -conjugated estrogen-medroxyprogest acetatetab 0.3-1.5 mg................................................................. 24

PREMPRO -conjugated estrogen-medroxyprogest acetatetab 0.45-1.5 mg............................................................... 24

PREMPRO -conjugated estrogen-medroxyprogest acetatetab 0.625-2.5 mg..............................................................24

PREMPRO -conjugated estrogen-medroxyprogest acetatetab 0.625-5 mg................................................................ 24

PRENA1/QUATREFOLIC -prenat w/o a w/fefum-methfol-fa-dha cap 30-0.6-0.4-200 mg....................................... 121

PRENA1 CHEW -prenat w/ b2-b6-b12-d3-folic acid chewtab 1.4 mg......................................................................120

PRENA1 PEARL -prenat w/oa w/fefum-na fered-fa-dhacap cr 30-1.4-200 mg.................................................... 121

PRENA1 PLUS/QUATREFOLIC -prenat w/o a w/ fechelate-l methylfol-fa tab & dha cap pk......................... 121

PRENAISSANCE 90 DHA -prenat w/o a w/fecbn-fegl-dss-fa tab 90 &dha cap 300mg pak..................................... 120

PRENAISSANCE BALANCE -prenatal w/o vit a w/ fe cbn-dss-fa-dha cap 30-1-260 mg..........................................119

PRENAISSANCE DHA -prenat w/o a w/fecbn-fegl-dss-fatab & dha cap 250 mg pack.......................................... 120

PRENAISSANCE HARMONY DHA -prenat w/fe poly-nafered-fa tab 27-1 & omega cap dr 380mg......................120

PRENAISSANCE NEXT-B -prenatal w/ calcium-vit b6-fa-ginger tab 1.22 mg........................................................ 120

PRENAISSANCE NEXT -prenatal w/ calcium-vit b6-fa-ginger tab 1.2 mg.......................................................... 120

PRENAISSANCE PLUS -prenatal w/o a w/fe cbn-dss-fa-dha cap 28-1-250 mg.................................................... 120

PRENAISSANCE -prenatal w/o vit a w/ fe fum-dss-fa-dhacap 29-1.25-325 mg.......................................................119

PRENAISSANCE PROMISE -prenat w/o a w/fecbn-fegl-dss-fa tab & dha cap 300 mg pack................................120

PRENAPLUS -prenatal vit w/ fe fumarate-fa tab 27-1mg.................................................................................. 120

PRENATABS FA -prenatal vit w/ fe fumarate-fa tab 29-1mg.................................................................................. 120

2015


PRENATABS RX -prenatal vit w/ iron carbonyl-fa tab 29-1mg.................................................................................. 120

PRENATAL 19 -prenatal vit w/ dss-fe fumarate-fa tab 29-1mg.................................................................................. 120

PRENATAL 19 -prenatal vit w/ fe fumarate-fa chew tab29-1 mg..........................................................................120

PRENATAL AD -prenatal vit w/ dss-iron carbonyl-fa tab90-1 mg..........................................................................120

PRENATAL LOW IRON -prenatal vit w/ fe fumarate-fa tab27-1 mg..........................................................................120

PRENATAL PLUS IRON -prenatal vit w/ iron carbonyl-fatab 29-1 mg................................................................... 120

PRENATAL PLUS -prenatal vit w/ fe fumarate-fa tab 27-1mg.................................................................................. 120

PRENATAL -prenatal vit w/ fe fumarate-fa tab 27-1mg.................................................................................. 120

PRENATAL-U -prenatal w/o a vit w/ fe fumarate-fa cap106.5-1 mg.....................................................................120

PRENATAL VITAMINS PLUS -prenatal vit w/ fe fumarate-fa tab 27-1 mg............................................................... 120

PRENATA -prenatal w/o a vit w/ fe fum-fa tab chew 29-1mg.................................................................................. 120

PRENATE AM -prenatal w/ calcium-vit b6-vit b12-fa-gingertab 1 mg.........................................................................120

PRENATE DHA -prenat w/o a w/feaspg-methfol-fa-dhacap 18-0.6-0.4-300 mg.................................................. 120

PRENATE DHA -prenat w/o a w/fefum-methfol-fa-dha cap28-0.6-0.4-300 mg......................................................... 120

PRENATE ELITE -prenatal vit w/ fe fum-methylfolate-fatab 26-0.6-0.4 mg.......................................................... 120

PRENATE ELITE -prenatal w/ fe asp gly-l methylfol-fa tab20-0.6-0.4 mg.................................................................120

PRENATE ENHANCE -prenat w/o a w/fefum-methfol-fa-dha cap 28-0.6-0.4-400 mg........................................... 120

PRENATE ESSENTIAL -prenat w/o a w/feaspg-methfol-fa-dha cap 18-0.6-0.4-300 mg........................................... 120

PRENATE ESSENTIAL -prenat w/o a w/feasp-methylf-fa-omeg cap 29-0.6-0.4-340 mg........................................ 120

PRENATE MINI -prenat w/oa w/fecb-feasp-meth-fa-dhacap 18-0.6-0.4-350 mg.................................................. 120

PRENATE PIXIE -prenat w/o a w/feaspg-methfol-fa-dhacap 10-0.6-0.4-200 mg.................................................. 120

PRENATE -prenat mv & min w/ l-methylfolate-fa chew tab0.6-0.4 mg......................................................................120

PRENATE RESTORE -prenat w/o a w/fefum-methfol-fa-dha cap 27-0.6-0.4-400 mg........................................... 120

PRENATE STAR -prenatal vit w/ fe asparto glycinate-fatab 20-1 mg................................................................... 120

PRENEXA -prenatal w/o vit a w/ fe fum-dss-fa-dha cap27-1.25-300 mg..............................................................121

PREPIDIL -dinoprostone cervical gel 0.5 mg/3gm.............35PREPLUS -prenatal vit w/ fe fumarate-fa tab 27-1mg.................................................................................. 121

PREPOPIK -sod picosulfate-mg oxide-citric acid pack 10mg-3.5 gm-12 gm............................................................ 66

PREQUE 10 -prenatal mv w/fe carbonyl-dss-fa-dha tab15-25-0.5-50 mg............................................................ 121

PRESERA -emollient - aerosol foam...............................156PRESTALIA -perindopril arginine-amlodipine besylate tab14-10 mg..........................................................................50

PRESTALIA -perindopril arginine-amlodipine besylate tab3.5-2.5 mg........................................................................50

PRESTALIA -perindopril arginine-amlodipine besylate tab7-5 mg..............................................................................50

PRETAB -prenatal vit w/ fe fumarate-fa tab 29-1 mg.......121PREVACID -lansoprazole cap delayed release 15 mg......68PREVACID -lansoprazole cap delayed release 30 mg......68PREVACID SOLUTAB -lansoprazole tab delayed releaseorally disintegrating 15 mg...............................................68

PREVACID SOLUTAB -lansoprazole tab delayed releaseorally disintegrating 30 mg...............................................68

PREVIDENT 5000 BOOSTER PL -sodium fluoride paste1.1%............................................................................... 143

PREVIDENT 5000 BOOSTER -sodium fluoride paste1.1%............................................................................... 143

PREVIDENT 5000 DRY MOUTH -sodium fluoride gel1.1% (0.5% f).................................................................143

PREVIDENT 5000 ENAMEL PRO -sodium fluoride-potassium nitrate paste 1.1-5%..................................... 143

PREVIDENT 5000 PLUS -sodium fluoride cream1.1%............................................................................... 143

PREVIDENT 5000 SENSITIVE -sodium fluoride-potassiumnitrate paste 1.1-5%.......................................................143

PREVIDENT FLUORIDE -sodium fluoride gel 1.1% (0.5%f)..................................................................................... 143

PREVIDENT -sodium fluoride rinse 0.2%........................143PREVNAR 13 -pneumococcal 13-valent conjugate vaccineinj......................................................................................15

PREVPAC -amoxicillin cap-clarithro tab-lansopraz cap drtherapy pack.................................................................... 68

PREZCOBIX -darunavir-cobicistat tab 800-150 mg.............9PREZISTA -darunavir ethanolate susp 100 mg/ml (baseequiv)..................................................................................9

PREZISTA -darunavir ethanolate tab 150 mg (baseequiv)..................................................................................9




PRIFTIN -rifapentine tab 150 mg........................................ 6PRILOSEC -omeprazole cap delayed release 10 mg........68PRILOSEC -omeprazole cap delayed release 20 mg........68PRILOSEC -omeprazole cap delayed release 40 mg........68PRILOSEC -omeprazole magnesium for delayed releasesusp packet 10 mg.......................................................... 68

PRILOSEC -omeprazole magnesium for delayed releasesusp packet 2.5 mg......................................................... 68

2015


PRIMAQUINE PHOSPHATE -primaquine phosphate tab26.3 mg (15 mg base)..................................................... 11

primidone tab 250 mg (Mysoline).................................110primidone tab 50 mg (Mysoline).................................. 110PRIMLEV -oxycodone w/ acetaminophen tab 10-300mg.................................................................................. 100

PRIMLEV -oxycodone w/ acetaminophen tab 5-300mg.................................................................................... 99

PRIMLEV -oxycodone w/ acetaminophen tab 7.5-300mg.................................................................................. 100

PRIMSOL -trimethoprim hcl oral soln 50 mg/5ml (baseequiv)................................................................................12

PRINIVIL -lisinopril tab 10 mg........................................... 50PRINIVIL -lisinopril tab 20 mg........................................... 50PRINIVIL -lisinopril tab 5 mg............................................. 50PRINZIDE -lisinopril & hydrochlorothiazide tab 10-12.5mg.................................................................................... 50

PRISTIQ -desvenlafaxine succinate tab sr 24hr 100 mg(base equiv)..................................................................... 79



PR NATAL 400 EC -prenat-fe bis-fe prot succ-fa-ca tab &omega cap dr 400 pk.................................................... 119

PR NATAL 400 -prenat-fe bis-fe prot succ-fa-ca tab &omega 3 cap 400 pk......................................................119

PR NATAL 430 EC -prenat-fe bis-fe prot succ-fa-ca tab &omega cap dr 430 pk.................................................... 119

PR NATAL 430 -prenat-fe bis-fe prot succ-fa-ca tab &omega 3 cap 430 pk......................................................119

PROAIR HFA -albuterol sulfate inhal aero 108 mcg/act(90mcg base equiv)......................................................... 64

PROAIR RESPICLICK -albuterol sulfate aer pow ba 108mcg/act (90 mcg base equiv).......................................... 64

probenecid tab 500 mg................................................. 106PROCARDIA -nifedipine cap 10 mg..................................43PROCARDIA XL -nifedipine tab sr 24hr osmotic 30mg.................................................................................... 43

PROCARDIA XL -nifedipine tab sr 24hr osmotic 60mg.................................................................................... 43

PROCARDIA XL -nifedipine tab sr 24hr osmotic 90mg.................................................................................... 43

PROCENTRA -dextroamphetamine sulfate oral solution 5mg/5ml..............................................................................88

prochlorperazine maleate tab 10 mg (base equivalent)(Compazine)....................................................................83

prochlorperazine maleate tab 5 mg (base equivalent)(Compazine)....................................................................83

prochlorperazine suppos 25 mg.................................... 83PRO-CLEAR AC -codeine-pyrilamine syrup 9-8.33mg/5ml..............................................................................61

PROCORT -hydrocortisone acetate w/ pramoxine rectalcream 1.85-1.15%..........................................................144

PROCRIT -epoetin alfa inj 10000 unit/ml........................ 131

PROCRIT -epoetin alfa inj 20000 unit/ml........................ 131PROCRIT -epoetin alfa inj 2000 unit/ml.......................... 131PROCRIT -epoetin alfa inj 3000 unit/ml.......................... 131PROCRIT -epoetin alfa inj 40000 unit/ml........................ 131PROCRIT -epoetin alfa inj 4000 unit/ml.......................... 131PROCTOCORT -hydrocortisone acetate suppos 30mg.................................................................................. 144

PROCTOCORT -hydrocortisone rectal cream 1%...........144PROCTOFOAM HC -hydrocortisone acetate w/ pramoxinerectal foam 1-1%............................................................144

PROCYSBI -cysteamine bitartrate cap delayed release 25mg (base equiv)...............................................................74

PROCYSBI -cysteamine bitartrate cap delayed release 75mg (base equiv)...............................................................74

PRODRIN -isometheptene-caffeine-acetaminophen tab65-20-325 mg.................................................................105

PROFERRIN-FORTE -iron heme polypeptide-folic acid tab12-1 mg (fe equiv)......................................................... 131

PROFILNINE -factor ix complex for inj 1000 unit............ 136PROFILNINE -factor ix complex for inj 1500 unit............ 136PROFILNINE -factor ix complex for inj 500 unit.............. 136PROFILNINE SD -factor ix complex for inj 1000 unit.......136PROFILNINE SD -factor ix complex for inj 1500 unit.......136PROFILNINE SD -factor ix complex for inj 500 unit.........136progesterone im in oil 50 mg/ml.................................... 26progesterone micronized cap 100 mg(Prometrium)...................................................................26

progesterone micronized cap 200 mg(Prometrium)...................................................................26

PROGLYCEM -diazoxide susp 50 mg/ml..........................31PROGRAF -tacrolimus cap 0.5 mg................................. 164PROGRAF -tacrolimus cap 1 mg.................................... 164PROGRAF -tacrolimus cap 5 mg.................................... 164PROLENSA -bromfenac sodium ophth soln 0.07% (baseequivalent)......................................................................140

PROLIDA -lidocaine-menthol patch 4-1%....................... 156PROMACTA -eltrombopag olamine tab 12.5 mg (baseequiv)..............................................................................131

PROMACTA -eltrombopag olamine tab 25 mg (baseequiv)..............................................................................131



promethazine-dm syrup 6.25-15 mg/5ml....................... 61promethazine hcl suppos 12.5 mg.................................58promethazine hcl suppos 25 mg....................................58promethazine hcl suppos 50 mg....................................58promethazine hcl syrup 6.25 mg/5ml.............................58promethazine hcl tab 12.5 mg........................................58promethazine hcl tab 25 mg...........................................58promethazine hcl tab 50 mg...........................................58PROMETHAZINE VC PLAIN -promethazine &phenylephrine syrup 6.25-5 mg/5ml.................................61

promethazine w/ codeine syrup 6.25-10 mg/5ml...........61

2015


PROMETRIUM -progesterone micronized cap 100 mg.....26PROMETRIUM -progesterone micronized cap 200 mg.....26PROMISEB -antiseborrheic products misc - cream.........156PROMISEB COMPLETE -antiseborrheic products misc -kit....................................................................................156

propafenone hcl cap sr 12hr 225 mg (Rythmol sr)....... 44propafenone hcl cap sr 12hr 325 mg (Rythmol sr)....... 44propafenone hcl cap sr 12hr 425 mg (Rythmol sr)....... 45propafenone hcl tab 150 mg (Rythmol)......................... 45propafenone hcl tab 225 mg (Rythmol)......................... 45propafenone hcl tab 300 mg.......................................... 45PROPANTHELINE BROMIDE -propantheline bromide tab15 mg...............................................................................68

proparacaine hcl ophth soln 0.5% (Alcaine)............... 140PROPRANOLOL/HYDROCHLOROTH -propranolol &hydrochlorothiazide tab 40-25 mg................................... 50

PROPRANOLOL/HYDROCHLOROTH -propranolol &hydrochlorothiazide tab 80-25 mg................................... 50

propranolol hcl cap sr 24hr 120 mg (Inderal la)............41propranolol hcl cap sr 24hr 160 mg (Inderal la)............41propranolol hcl cap sr 24hr 60 mg (Inderal la)..............41propranolol hcl cap sr 24hr 80 mg (Inderal la)..............41PROPRANOLOL HCL -propranolol hcl oral soln 20mg/5ml..............................................................................41

PROPRANOLOL HCL -propranolol hcl oral soln 40mg/5ml..............................................................................41

propranolol hcl tab 10 mg.............................................. 41propranolol hcl tab 20 mg.............................................. 41propranolol hcl tab 40 mg.............................................. 41propranolol hcl tab 60 mg.............................................. 41propranolol hcl tab 80 mg.............................................. 41propylthiouracil tab 50 mg............................................. 34PRO-RED AC -phenylephrine-dexchlorphenir-codeinesyrup 5-1-9 mg/5ml..........................................................61

PROSCAR -finasteride tab 5 mg.......................................74PROSED/DS -methenamine-hyosc-meth blue-benz acid-phenyl sal tab 81.6mg..................................................... 72

PROSTIN E2 -dinoprostone vaginal suppos 20 mg...........35PROTECTIRON -iron polysacch-fa-b complex-vit c-e &minerals tab 60-1 mg.....................................................131

PROTHELIAL -sucralfate-malate paste 10%...................143PROTONIX -pantoprazole sodium ec tab 20 mg (baseequiv)................................................................................68

PROTONIX -pantoprazole sodium ec tab 40 mg (baseequiv)................................................................................68

PROTONIX -pantoprazole sodium for delayed releasesusp packet 40 mg.......................................................... 68

PROTOPIC -tacrolimus oint 0.03%................................. 156PROTOPIC -tacrolimus oint 0.1%................................... 156protriptyline hcl tab 10 mg (Vivactil)............................. 79protriptyline hcl tab 5 mg (Vivactil)............................... 79PROVENTIL HFA -albuterol sulfate inhal aero 108 mcg/act(90mcg base equiv)......................................................... 64

PROVENZA -lidocaine-menthol patch 4-1%................... 156PROVERA -medroxyprogesterone acetate tab 10 mg...... 26

PROVERA -medroxyprogesterone acetate tab 2.5 mg......26PROVERA -medroxyprogesterone acetate tab 5 mg........ 26PROVIDA DHA -prenat w/o a w/fe fum-fe poly-fa-dha cap16-16-1.25-110 mg........................................................ 121

PROVIDA OB -prenatal w/o a w/fe fum-fe poly-fa cap20-20-1.25 mg................................................................121

PROVIGIL -modafinil tab 100 mg......................................88PROVIGIL -modafinil tab 200 mg......................................88PROZAC -fluoxetine hcl cap 10 mg.................................. 79PROZAC -fluoxetine hcl cap 20 mg.................................. 79PROZAC -fluoxetine hcl cap 40 mg.................................. 79PROZAC WEEKLY -fluoxetine hcl cap delayed release 90mg.................................................................................... 80

PROZENA -lidocaine patch 4%.......................................156PRUCLAIR -dermatological products misc - cream.........156PRUDOXIN -doxepin hcl cream 5%................................156PRUMYX -dermatological products misc - cream............156pseudoeph-chlorphen w/ hydrocodone soln 60-4-5mg/5ml (Zutripro)........................................................... 61

pseudoephed-bromphen-dm syrup 30-2-10 mg/5ml.....61pseudoephedrine-bromphen-codeine liq 10-1.33-6.33mg/5ml.............................................................................61

pseudoephedrine w/ cod-gg soln 30-10-100mg/5ml.............................................................................61

pseudoephedrine w/ cod-gg syrup 30-10-100 mg/5ml(Suttar-sf)........................................................................ 61

PSORCON -diflorasone diacetate cream 0.05%............. 156PULMICORT -budesonide inhalation susp 0.25mg/2ml..............................................................................64

PULMICORT -budesonide inhalation susp 0.5 mg/2ml..... 64PULMICORT -budesonide inhalation susp 1 mg/2ml........ 64PULMICORT FLEXHALER -budesonide inhal aero powd180 mcg/act (breath activated)........................................ 64

PULMICORT FLEXHALER -budesonide inhal aero powd90 mcg/act (breath activated).......................................... 64

PULMOZYME -dornase alfa inhal soln 1 mg/ml................ 65PUREFE OB PLUS -prenatal w/o a w/fe fum-fe poly-fa cap162.115.2-1 mg..............................................................121

PUREFE PLUS -ferrous fumarate-fa-b complex-c-zn-mg-mn-cu cap 106-1 mg......................................................131

PURIXAN -mercaptopurine susp 2000 mg/100ml (20 mg/ml).................................................................................... 18

PX GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 31

PYLERA -bismuth subcit-metronidazole-tetracycline cap140-125-125 mg...............................................................68

pyrazinamide tab 500 mg..................................................6PYRIDIUM -phenazopyridine hcl tab 100 mg....................74PYRIDIUM -phenazopyridine hcl tab 200 mg....................74pyridostigmine bromide tab 60 mg (Mestinon)........... 115pyridostigmine bromide tab cr 180 mg (Mestinontimespan)...................................................................... 114

PYROGALLIC ACID -pyrogallol-chlorobutanol oint25-2%............................................................................. 156

2015


Q

QNASL -beclomethasone dipropionate nasal aerosol 80mcg/act.............................................................................59

QNASL CHILDRENS -beclomethasone dipropionate nasalaerosol 40 mcg/act.......................................................... 59

QROXIN -capsaicin-menthol topical patch0.0375-5%...................................................................... 156

Q-TABS -levomefolate glucosamine tab 1 mg (folateequivalent)......................................................................127

QUADRACEL -diph-tetanus tox ad-acell pert & polio virus,ipv vac inj.........................................................................15

QUALAQUIN -quinine sulfate cap 324 mg........................ 11QUARTETTE -levonor-eth est tab 0.15-0.02/0.025/0.03mg &eth est 0.01 mg....................................................... 26

QUAZEPAM -quazepam tab 15 mg.................................. 85QUDEXY XR -topiramate cap er 24hr sprinkle 100mg.................................................................................. 110

QUDEXY XR -topiramate cap er 24hr sprinkle 150mg.................................................................................. 110

QUDEXY XR -topiramate cap er 24hr sprinkle 200mg.................................................................................. 110

QUDEXY XR -topiramate cap er 24hr sprinkle 25 mg..... 110QUDEXY XR -topiramate cap er 24hr sprinkle 50 mg..... 110QUESTRAN -cholestyramine powder 4 gm/dose..............56QUESTRAN -cholestyramine powder packets 4 gm......... 56QUESTRAN LIGHT -cholestyramine light powder 4 gm/dose..................................................................................56

quetiapine fumarate tab 100 mg (Seroquel).................. 83quetiapine fumarate tab 200 mg (Seroquel).................. 83quetiapine fumarate tab 25 mg (Seroquel)....................83quetiapine fumarate tab 300 mg (Seroquel).................. 83quetiapine fumarate tab 400 mg (Seroquel).................. 83quetiapine fumarate tab 50 mg (Seroquel)....................83QUFLORA PEDIATRIC -pediatric multiple vitamins w/fluoride chew tab 0.25 mg............................................. 121

QUFLORA PEDIATRIC -pediatric multiple vitamins w/fluoride chew tab 0.5 mg............................................... 121

QUFLORA PEDIATRIC -pediatric multiple vitamins w/fluoride chew tab 1 mg.................................................. 121

QUFLORA PEDIATRIC -pediatric multiple vitamins w/fluoride soln 0.25 mg/ml................................................ 121

QUFLORA PEDIATRIC -pediatric multiple vitamins w/fluoride soln 0.5 mg/ml.................................................. 121

QUILLIVANT XR -methylphenidate hcl for er susp 25mg/5ml (5 mg/ml).............................................................88

quinapril hcl tab 10 mg (Accupril)................................. 50quinapril hcl tab 20 mg (Accupril)................................. 50quinapril hcl tab 40 mg (Accupril)................................. 50quinapril hcl tab 5 mg (Accupril)................................... 50quinapril-hydrochlorothiazide tab 10-12.5 mg(Accuretic).......................................................................50

quinapril-hydrochlorothiazide tab 20-12.5 mg(Accuretic).......................................................................50

quinapril-hydrochlorothiazide tab 20-25 mg(Accuretic).......................................................................50

quinidine gluconate tab cr 324 mg................................ 45QUINIDINE SULFATE ER -quinidine sulfate tab cr 300mg.................................................................................... 45

QUINIDINE SULFATE -quinidine sulfate tab 200 mg........ 45quinidine sulfate tab 300 mg..........................................45quinine sulfate cap 324 mg (Qualaquin)........................11QUINZYME -coenzyme q10 tab disp 90 mg................... 163QUTENZA -capsaicin patch 8% & cleansing gel kit.........156QVAR -beclomethasone dipropionate inhal aero soln 40mcg/act.............................................................................64

QVAR -beclomethasone dipropionate inhal aero soln 80mcg/act.............................................................................64

R

RABAVERT -rabies vaccine, pcec for inj...........................15rabeprazole sodium ec tab 20 mg (Aciphex).................68RADIOGARDASE -prussian blue insoluble cap 0.5gm.................................................................................. 163

RA GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 31

RAGWITEK -short ragweed pollen allergen extract tab sl12 amb a 1-u................................................................... 16

raloxifene hcl tab 60 mg (Evista)................................... 38ramipril cap 1.25 mg (Altace)......................................... 50ramipril cap 10 mg (Altace)............................................ 50ramipril cap 2.5 mg (Altace)........................................... 50ramipril cap 5 mg (Altace).............................................. 50RANEXA -ranolazine tab sr 12hr 1000 mg........................40RANEXA -ranolazine tab sr 12hr 500 mg..........................40ranitidine hcl cap 150 mg............................................... 68ranitidine hcl cap 300 mg............................................... 68ranitidine hcl syrup 15 mg/ml (75 mg/5ml)....................68ranitidine hcl tab 300 mg (Zantac)................................. 68RAPAFLO -silodosin cap 4 mg......................................... 74RAPAFLO -silodosin cap 8 mg......................................... 74RAPAMUNE -sirolimus oral soln 1 mg/ml....................... 164RAPAMUNE -sirolimus tab 0.5 mg..................................164RAPAMUNE -sirolimus tab 1 mg.....................................164RAPAMUNE -sirolimus tab 2 mg.....................................164RASUVO -methotrexate soln pf auto-injector 10mg/0.2ml.........................................................................103

RASUVO -methotrexate soln pf auto-injector 12.5mg/0.25ml.......................................................................103

RASUVO -methotrexate soln pf auto-injector 15mg/0.3ml.........................................................................104






2015




RAVICTI -glycerol phenylbutyrate liquid 1.1 gm/ml........... 38RAYOS -prednisone tab delayed release 1 mg.................21RAYOS -prednisone tab delayed release 2 mg.................21RAYOS -prednisone tab delayed release 5 mg.................21RAZADYNE ER -galantamine hydrobromide cap sr 24hr16 mg...............................................................................92

RAZADYNE ER -galantamine hydrobromide cap sr 24hr24 mg...............................................................................92

RAZADYNE ER -galantamine hydrobromide cap sr 24hr 8mg.................................................................................... 92

RAZADYNE -galantamine hydrobromide oral soln 4 mg/ml......................................................................................92

RAZADYNE -galantamine hydrobromide tab 12 mg..........92RAZADYNE -galantamine hydrobromide tab 4 mg............92RAZADYNE -galantamine hydrobromide tab 8 mg............92REACH KIDS -sodium fluoride paste 0.15%................... 143REBETOL -ribavirin cap 200 mg.........................................9REBETOL -ribavirin soln 40 mg/ml..................................... 9REBIF -interferon beta-1a inj 22 mcg/0.5ml (12mu/ml) (44mcg/ml).............................................................................92

REBIF -interferon beta-1a inj 44 mcg/0.5ml (24mu/ml) (88mcg/ml).............................................................................92

REBIF REBIDOSE -interferon beta-1a inj 22 mcg/0.5ml(12mu/ml) (44 mcg/ml).....................................................92

REBIF REBIDOSE -interferon beta-1a inj 44 mcg/0.5ml(24mu/ml) (88 mcg/ml).....................................................92

REBIF REBIDOSE TITRATION -interferon beta-1a inj 6 x8.8 mcg/0.2ml & 6 x 22 mcg/0.5ml.................................. 92

REBIF TITRATION PACK -interferon beta-1a inj 6 x 8.8mcg/0.2ml & 6 x 22 mcg/0.5ml........................................ 92

RECIPHEXAMINE -lidocaine-menthol patch 4-1%..........156RECOMBINATE -antihemophilic factor (recombinant) forinj 1241-1800 unit.......................................................... 136

RECOMBINATE -antihemophilic factor (recombinant) forinj 1801-2400 unit.......................................................... 136

RECOMBINATE -antihemophilic factor (recombinant) forinj 220-400 unit.............................................................. 136

RECOMBINATE -antihemophilic factor (recombinant) forinj 401-800 unit.............................................................. 136

RECOMBINATE -antihemophilic factor (recombinant) forinj 801-1240 unit............................................................ 136

RECOMBIVAX HB -hepatitis b vaccine (recombinant) susp10 mcg/ml........................................................................ 15

RECOMBIVAX HB -hepatitis b vaccine (recombinant) susp40 mcg/ml........................................................................ 15

RECOMBIVAX HB -hepatitis b vaccine (recombinant) susp5 mcg/0.5ml..................................................................... 15

RECTIV -nitroglycerin oint 0.4%......................................144REGENECARE -lidocaine hcl-collagen-aloe vera gel2%.................................................................................. 156

REGLAN -metoclopramide hcl tab 10 mg......................... 71

REGLAN -metoclopramide hcl tab 5 mg........................... 71REGRANEX -becaplermin gel 0.01%..............................156RELAGARD -acetic acid-oxyquinoline vaginal gel0.9-0.025%....................................................................... 74

RELEEVIA -capsaicin-menthol topical patch0.0375-5%...................................................................... 156

RELEEVIA MC -capsaicin-menthol topical patch0.0375-5%...................................................................... 156

RELEEVIA ML -lidocaine-menthol patch 4-1%................156RELENZA DISKHALER -zanamivir aero powder breathactivated 5 mg/blister.........................................................9

RELHIST -bromphen tan-phenyleph tan chew tab 6-15mg.................................................................................... 61

RELION GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 31

RELION R -insulin regular (human) inj 100 unit/ml............32RELISTOR -methylnaltrexone bromide inj 12 mg/0.6ml (20mg/ml).............................................................................. 71

RELISTOR -methylnaltrexone bromide inj 8 mg/0.4ml (20mg/ml).............................................................................. 71

RELNATE DHA -prenatal vit w/ fe fum-fa-omega 3 cap28-1-200 mg...................................................................121

RELPAX -eletriptan hydrobromide tab 20 mg (baseequivalent)......................................................................105

RELPAX -eletriptan hydrobromide tab 40 mg (baseequivalent)......................................................................105

RELYYT -capsaicin-menthol topical patch 0.025-5%...... 156REMATEX -capsaicin-menthol-methyl salicylate cream0.035-6-30%...................................................................156

REMAXAZON EXTERNAL PATCH -lidocaine-capsaicin-chondroitin-glucos patch 4-0.0285-3-5%....................... 157

REMBRANDT CANKER SORE -sodium fluoride paste0.243%........................................................................... 143

REMBRANDT DEEPLY WHITE+PE -sodiummonofluorophosphate paste 0.884%............................. 143

REMBRANDT INTENSE STAIN -sodium fluoride paste0.243%........................................................................... 143

REMBRANDT WHITENING -sodium fluoride rinse0.02%............................................................................. 143

REMERON -mirtazapine tab 15 mg.................................. 80REMERON -mirtazapine tab 30 mg.................................. 80REMERON -mirtazapine tab 45 mg.................................. 80REMERON SOLTAB -mirtazapine orally disintegrating tab15 mg...............................................................................80

REMERON SOLTAB -mirtazapine orally disintegrating tab30 mg...............................................................................80

REMERON SOLTAB -mirtazapine orally disintegrating tab45 mg...............................................................................80

RENAGEL -sevelamer hcl tab 400 mg..............................71RENAGEL -sevelamer hcl tab 800 mg..............................71RENATABS -b-complex w/ c-biotin-vit e & folic acid tab 1mg.................................................................................. 121

RENATABS WITH IRON -b complex-c-biotin-e-fa tab 1mg& fe cbn tab 100 mg pack............................................. 121

2015


RENOVO -capsaicin-menthol topical patch0.0375-5%...................................................................... 157

RENOVO LIDO 5 -lidocaine-capsaicin cream5-0.05%.......................................................................... 157

RENUU NL -allantoin-petrolatum patch 2-30%................157RENUU PATCH -allantoin-lidocaine-petrolatum patch2-5-30%..........................................................................157

RENVELA -sevelamer carbonate packet 0.8 gm...............71RENVELA -sevelamer carbonate packet 2.4 gm...............71RENVELA -sevelamer carbonate tab 800 mg................... 71repaglinide tab 0.5 mg (Prandin)....................................31repaglinide tab 1 mg (Prandin).......................................31repaglinide tab 2 mg (Prandin).......................................31REPREXAIN -hydrocodone-ibuprofen tab 2.5-200mg.................................................................................. 100

REPREXAIN -hydrocodone-ibuprofen tab 5-200 mg.......100REQUIP -ropinirole hydrochloride tab 0.25 mg............... 112REQUIP -ropinirole hydrochloride tab 0.5 mg................. 112REQUIP -ropinirole hydrochloride tab 1 mg.................... 112REQUIP -ropinirole hydrochloride tab 2 mg.................... 112REQUIP -ropinirole hydrochloride tab 3 mg.................... 112REQUIP -ropinirole hydrochloride tab 4 mg.................... 112REQUIP -ropinirole hydrochloride tab 5 mg.................... 112REQUIP XL -ropinirole hydrochloride tab sr 24hr 12 mg(base equivalent)........................................................... 113

REQUIP XL -ropinirole hydrochloride tab sr 24hr 2 mg(base equivalent)........................................................... 112




RESCON-MX -dexchlorpheniramine-phenylephrine tab sr12hr 6-40 mg................................................................... 61

RESCRIPTOR -delavirdine mesylate tab 100 mg............... 9RESCRIPTOR -delavirdine mesylate tab 200 mg............... 9RESCULA -unoprostone isopropyl ophth soln 0.15%......140RESERPINE -reserpine tab 0.1 mg.................................. 50RESERPINE -reserpine tab 0.25 mg.................................50RESPA-BR -brompheniramine maleate tab sr 12hr 11mg.................................................................................... 58

RESPIRATORY THERAPY SUPPLIES – VARIOUS.......163RESTASIS -cyclosporine (ophth) emulsion 0.05%.......... 140RESTORA RX -lactobacillus casei-folic acid cap 60-1.25mg.................................................................................... 66

RESTORE SILVER DRESSING 2 -wound dressings -pads................................................................................157



RESTORIL -temazepam cap 15 mg..................................85RESTORIL -temazepam cap 22.5 mg...............................85RESTORIL -temazepam cap 30 mg..................................85

RESTORIL -temazepam cap 7.5 mg.................................85RETIN-A MICRO PUMP -tretinoin microsphere gel0.04%............................................................................. 157

RETIN-A MICRO PUMP -tretinoin microsphere gel0.08%............................................................................. 157

RETIN-A MICRO PUMP -tretinoin microsphere gel0.1%............................................................................... 157

RETIN-A MICRO -tretinoin microsphere gel 0.04%.........157RETIN-A MICRO -tretinoin microsphere gel 0.1%...........157RETIN-A -tretinoin cream 0.025%................................... 157RETIN-A -tretinoin cream 0.05%..................................... 157RETIN-A -tretinoin cream 0.1%.......................................157RETIN-A -tretinoin gel 0.01%.......................................... 157RETIN-A -tretinoin gel 0.025%........................................ 157RETROVIR -zidovudine cap 100 mg...................................9RETROVIR -zidovudine syrup 10 mg/ml............................. 9REVATIO -sildenafil citrate for suspension 10 mg/ml........ 58REVATIO -sildenafil citrate tab 20 mg...............................58REVESTA -folic acid-cholecalciferol cap 1 mg-5750unit..................................................................................131

REVIA -naltrexone hcl tab 50 mg....................................163REVLIMID -lenalidomide cap 10 mg............................... 164REVLIMID -lenalidomide cap 15 mg............................... 164REVLIMID -lenalidomide cap 20 mg............................... 164REVLIMID -lenalidomide cap 25 mg............................... 164REVLIMID -lenalidomide cap 5 mg................................. 164REVLIMID -lenalidomide caps 2.5 mg.............................164REXAPHENAC -diclofenac sodium cream 1%................157REXULTI -brexpiprazole tab 0.25 mg................................83REXULTI -brexpiprazole tab 0.5 mg................................. 83REXULTI -brexpiprazole tab 1 mg.................................... 83REXULTI -brexpiprazole tab 2 mg.................................... 83REXULTI -brexpiprazole tab 3 mg.................................... 83REXULTI -brexpiprazole tab 4 mg.................................... 83REYATAZ -atazanavir sulfate cap 150 mg (base equiv)......9REYATAZ -atazanavir sulfate cap 200 mg (base equiv)......9REYATAZ -atazanavir sulfate cap 300 mg (base equiv)......9REYATAZ -atazanavir sulfate oral powder packet 50 mg(base equiv)....................................................................... 9

REZIRA -pseudoephedrine w/ hydrocodone soln 60-5mg/5ml..............................................................................61

RHEUMATREX -methotrexate sodium tab 2.5 mg(antirheumatic)............................................................... 104

RHINOCORT AQUA -budesonide nasal susp 32 mcg/act.....................................................................................59

RIAX -benzoyl peroxide foam 5.5%................................ 157RIAX -benzoyl peroxide foam 9.5%................................ 157RIBASPHERE RIBAPAK -ribavirin tab 200 mg & ribavirintab 400 mg dose pack.......................................................9

RIBASPHERE RIBAPAK -ribavirin tab 400 mg................... 9RIBASPHERE RIBAPAK -ribavirin tab 400 mg & ribavirintab 600 mg dose pack.....................................................10

RIBASPHERE RIBAPAK -ribavirin tab 600 mg................... 9RIBASPHERE -ribavirin tab 400 mg................................... 9RIBASPHERE -ribavirin tab 600 mg................................... 9

2015


RIBATAB -ribavirin tab 400 mg......................................... 10RIBATAB -ribavirin tab 400 mg & ribavirin tab 600 mgdose pack.........................................................................10

RIBATAB -ribavirin tab 600 mg......................................... 10ribavirin cap 200 mg (Rebetol).......................................10ribavirin tab 200 mg (Copegus)......................................10RIDAURA -auranofin cap 3 mg....................................... 104rifabutin cap 150 mg (Mycobutin).................................... 6RIFADIN -rifampin cap 150 mg........................................... 6RIFADIN -rifampin cap 300 mg........................................... 6RIFAMATE -isoniazid & rifampin cap 150-300 mg.............. 6rifampin cap 150 mg (Rifadin)..........................................6rifampin cap 300 mg (Rifadin)..........................................6RIFATER -isoniazid-rifampin w/ pyrazinamide tab50-120-300 mg...................................................................6

RILUTEK -riluzole tab 50 mg.......................................... 113riluzole tab 50 mg (Rilutek).......................................... 113rimantadine hydrochloride tab 100 mg (Flumadine).....10RIOMET -metformin hcl oral soln 500 mg/5ml.................. 31risedronate sodium tab 150 mg (Actonel).....................38risedronate sodium tab 30 mg (Actonel).......................38risedronate sodium tab 35 mg (Actonel).......................38risedronate sodium tab 5 mg (Actonel).........................38risedronate sodium tab delayed release 35 mg(Atelvia)........................................................................... 38

RISPERDAL M-TAB -risperidone orally disintegrating tab0.5 mg..............................................................................83

RISPERDAL M-TAB -risperidone orally disintegrating tab 1mg.................................................................................... 83




RISPERDAL -risperidone soln 1 mg/ml.............................83RISPERDAL -risperidone tab 0.25 mg.............................. 83RISPERDAL -risperidone tab 0.5 mg................................ 83RISPERDAL -risperidone tab 1 mg................................... 83RISPERDAL -risperidone tab 2 mg................................... 83RISPERDAL -risperidone tab 3 mg................................... 83RISPERDAL -risperidone tab 4 mg................................... 83risperidone orally disintegrating tab 0.25 mg............... 83risperidone orally disintegrating tab 0.5 mg (Risperdalm-tab).............................................................................. 83

risperidone orally disintegrating tab 1 mg (Risperdalm-tab).............................................................................. 83




risperidone soln 1 mg/ml (Risperdal)............................ 83risperidone tab 0.25 mg (Risperdal).............................. 83

risperidone tab 0.5 mg (Risperdal)................................ 83risperidone tab 1 mg (Risperdal)................................... 83risperidone tab 2 mg (Risperdal)................................... 83risperidone tab 3 mg (Risperdal)................................... 83risperidone tab 4 mg (Risperdal)................................... 83RITALIN LA -methylphenidate hcl cap sr 24hr 10 mg(la).................................................................................... 89

RITALIN LA -methylphenidate hcl cap sr 24hr 20 mg(la).................................................................................... 89




RITALIN -methylphenidate hcl tab 10 mg..........................88RITALIN -methylphenidate hcl tab 20 mg..........................88RITALIN -methylphenidate hcl tab 5 mg........................... 88rivastigmine tartrate cap 1.5 mg (Exelon)..................... 92rivastigmine tartrate cap 3 mg (Exelon)........................ 92rivastigmine tartrate cap 4.5 mg (Exelon)..................... 92rivastigmine tartrate cap 6 mg (Exelon)........................ 92RIXUBIS -coagulation factor ix (recombinant) for inj 1000unit..................................................................................136

RIXUBIS -coagulation factor ix (recombinant) for inj 2000unit..................................................................................136




rizatriptan benzoate orally disintegrating tab 10 mg(Maxalt-mlt)................................................................... 105

rizatriptan benzoate orally disintegrating tab 5 mg(Maxalt-mlt)................................................................... 105

rizatriptan benzoate tab 10 mg (Maxalt)...................... 105rizatriptan benzoate tab 5 mg (Maxalt)........................ 105R-NATAL OB -prenatal w/o a w/fe cbn-fa-dha cap20-1-320 mg...................................................................121

ROBAXIN-750 -methocarbamol tab 750 mg................... 114ROBAXIN -methocarbamol tab 500 mg.......................... 114ROBINUL FORTE -glycopyrrolate tab 2 mg......................68ROBINUL -glycopyrrolate tab 1 mg...................................68ROCALTROL -calcitriol cap 0.25 mcg...............................38ROCALTROL -calcitriol cap 0.5 mcg.................................38ROCALTROL -calcitriol oral soln 1 mcg/ml....................... 38ropinirole hydrochloride tab 0.25 mg (Requip)........... 113ropinirole hydrochloride tab 0.5 mg (Requip).............113ropinirole hydrochloride tab 1 mg (Requip)................113ropinirole hydrochloride tab 2 mg (Requip)................113ropinirole hydrochloride tab 3 mg (Requip)................113ropinirole hydrochloride tab 4 mg (Requip)................113ropinirole hydrochloride tab 5 mg (Requip)................113

2015


ropinirole hydrochloride tab sr 24hr 12 mg (baseequivalent) (Requip xl)................................................ 113





ROSADAN KIT -metronidazole cream 0.75% w/ cleanserkit....................................................................................157

ROSADAN KIT -metronidazole gel 0.75% w/ cleanserkit....................................................................................157

ROSANIL -sulfacetamide sod-sulfur emul 10-5% & skincleanser kit.....................................................................157

ROSULA -sulfacetamide sodium w/ sulfur wash10-4.5%.......................................................................... 157

ROWASA -mesalamine rectal enema 4 gm & cleanserwipe kit.............................................................................71

ROXICET -oxycodone w/ acetaminophen soln 5-325mg/5ml............................................................................100

ROXICODONE -oxycodone hcl tab 15 mg......................100ROXICODONE -oxycodone hcl tab 30 mg......................100ROXICODONE -oxycodone hcl tab 5 mg........................100ROZEREM -ramelteon tab 8 mg....................................... 85RTD WOUND CARE DRESSING -wound dressings -pads................................................................................157

RYDEX -pseudoephedrine-bromphen-codeine liq10-1.33-6.33 mg/5ml........................................................61

RYTARY -carbidopa & levodopa cap cr 23.75-95 mg......113RYTARY -carbidopa & levodopa cap cr 36.25-145mg.................................................................................. 113

RYTARY -carbidopa & levodopa cap cr 48.75-195mg.................................................................................. 113

RYTARY -carbidopa & levodopa cap cr 61.25-245mg.................................................................................. 113

RYTHMOL -propafenone hcl tab 150 mg..........................45RYTHMOL -propafenone hcl tab 225 mg..........................45RYTHMOL SR -propafenone hcl cap sr 12hr 225 mg....... 45RYTHMOL SR -propafenone hcl cap sr 12hr 325 mg....... 45RYTHMOL SR -propafenone hcl cap sr 12hr 425 mg....... 45

S

SABRIL -vigabatrin powd pack 500 mg...........................110SABRIL -vigabatrin tab 500 mg.......................................110SAFYRAL -drospirenone-ethinyl estrad-levomefolate tab3-0.03-0.451 mg...............................................................26

SAIZEN CLICK.EASY -somatropin (non-refrigerated) forinj 8.8 mg......................................................................... 38

SAIZEN -somatropin (non-refrigerated) for inj 5 mg.......... 38SAIZEN -somatropin (non-refrigerated) for inj 8.8 mg....... 38SALAGEN -pilocarpine hcl tab 5 mg............................... 143SALAGEN -pilocarpine hcl tab 7.5 mg............................ 143SALEX CREAM -salicylic acid cream 6% & cleanser liqdkit....................................................................................157

SALEX LOTION -salicylic acid lotion 6% & cleanser liqdkit....................................................................................157

SALEX -salicylic acid shampoo 6%.................................157SALICEPT -oral wound care products - for susprinse................................................................................143

salicylic acid cream 6%................................................ 157salicylic acid cream 6% & cleanser liqd kit (Salexcream)............................................................................157

salicylic acid film forming liquid 27.5% (Virasal)........ 157salicylic acid film-forming soln 28.5% (Ultrasal-er)...................................................................................157

salicylic acid foam 6% (Salvax)....................................157salicylic acid gel 6% (Keralyt)...................................... 157SALICYLIC ACID IN AMMONIU -salicylic acid inammonium lactate vehicle foam 6%.............................. 157

salicylic acid lotion 6%................................................. 157salicylic acid lotion 6% & cleanser liqd kit (Salexlotion)............................................................................ 157

SALICYLIC ACID -salicylic acid soln 26%.......................157salicylic acid shampoo 6% (Salex).............................. 157SALKERA -salicylic acid in ammonium lactate vehiclefoam 6%.........................................................................157

salsalate tab 500 mg....................................................... 93salsalate tab 750 mg....................................................... 93SALVAX DUO PLUS -salicylic acid foam 6% & urea inlactic acid foam 35% kit.................................................157

SALVAX -salicylic acid foam 6%..................................... 157SAMSCA -tolvaptan tab 15 mg......................................... 38SAMSCA -tolvaptan tab 30 mg......................................... 38SANARE SCAR THERAPY -cream base........................163SANCUSO -granisetron td patch 3.1 mg/24hr (contains34.3 mg)...........................................................................69

SANDIMMUNE -cyclosporine cap 100 mg...................... 164SANDIMMUNE -cyclosporine cap 25 mg........................ 164SANDIMMUNE -cyclosporine oral soln 100 mg/ml..........164SANDOSTATIN -octreotide acetate inj 1000 mcg/ml (1 mg/ml).................................................................................... 38

SANDOSTATIN -octreotide acetate inj 100 mcg/ml (0.1mg/ml).............................................................................. 38




SANTYL -collagenase oint 250 unit/gm...........................157SAPHRIS -asenapine maleate sl tab 10 mg (baseequiv)................................................................................83

SAPHRIS -asenapine maleate sl tab 2.5 mg (baseequiv)................................................................................83

SAPHRIS -asenapine maleate sl tab 5 mg (baseequiv)................................................................................83

SARAFEM -fluoxetine hcl (pmdd) tab 10 mg.....................92SARAFEM -fluoxetine hcl (pmdd) tab 20 mg.....................92

2015


SAVAYSA -edoxaban tosylate tab 15 mg (baseequivalent)......................................................................133



SAVELLA -milnacipran hcl tab 100 mg............................. 92SAVELLA -milnacipran hcl tab 12.5 mg............................ 92SAVELLA -milnacipran hcl tab 25 mg............................... 92SAVELLA -milnacipran hcl tab 50 mg............................... 92SAVELLA TITRATION PACK -milnacipran hcl tab 12.5 mg(5) & 25 mg (8) & 50 mg (42) pak................................... 92

SCALACORT DK -hc lot 2% & sal acid-sulfur shampoo2-2% & shampoo kit...................................................... 158

SCAR PATCH -allantoin-lidocaine-petrolatum patch2-4-30%..........................................................................158

SCAR PATCH -allantoin-lidocaine-petrolatum patch2-5-30%..........................................................................158

scar treatment products - gel.......................................158SEASONIQUE -levonorg-eth est tab 0.15-0.03mg(84) &eth est tab 0.01mg(7)...................................................... 26

SECONAL -secobarbital sodium cap 100 mg....................85SECTRAL -acebutolol hcl cap 200 mg..............................41SECTRAL -acebutolol hcl cap 400 mg..............................41SELECT-OB+DHA -prenatal mv w/fe poly-fa chw 29-1 mg& dha cap 250 mg pak.................................................. 121

SELECT-OB -prenatal vit w/ fe polysac cmplx-fa chew tab29-1 mg..........................................................................121

SELECT-OB -prenat w/ fepolycmplx-methylfol-fa chew tab29-0.6-0.4 mg.................................................................121

selegiline hcl cap 5 mg (Eldepryl)................................113selegiline hcl tab 5 mg..................................................113selenium sulfide lotion 2.5%........................................ 158SELRX -selenium sulfide-pyrithione zinc in urea shampoo2.3%............................................................................... 158

SELZENTRY -maraviroc tab 150 mg................................ 10SELZENTRY -maraviroc tab 300 mg................................ 10SEMPREX-D -acrivastine & pseudoephedrine cap 8-60mg.................................................................................... 61

SE-NATAL 19 -prenatal vit w/ dss-fe fumarate-fa tab 29-1mg.................................................................................. 121

SE-NATAL 19 -prenatal vit w/ fe fumarate-fa chew tab29-1 mg..........................................................................121

SENNA LEAVES -senna leaves........................................66SENSIPAR -cinacalcet hcl tab 30 mg (base equiv)........... 38SENSIPAR -cinacalcet hcl tab 60 mg (base equiv)........... 38SENSIPAR -cinacalcet hcl tab 90 mg (base equiv)........... 38SEREVENT DISKUS -salmeterol xinafoate aer pow ba 50mcg/dose (base equiv).................................................... 64

SEROMYCIN -cycloserine cap 250 mg...............................6SEROQUEL -quetiapine fumarate tab 100 mg..................83SEROQUEL -quetiapine fumarate tab 200 mg..................83SEROQUEL -quetiapine fumarate tab 25 mg....................83SEROQUEL -quetiapine fumarate tab 300 mg..................83SEROQUEL -quetiapine fumarate tab 400 mg..................84

SEROQUEL -quetiapine fumarate tab 50 mg....................83SEROQUEL XR -quetiapine fumarate tab sr 24hr 150mg.................................................................................... 84

SEROQUEL XR -quetiapine fumarate tab sr 24hr 200mg.................................................................................... 84




SEROSTIM -somatropin (non-refrigerated) forsubcutaneous inj 4 mg.....................................................38



sertraline hcl oral conc 20 mg/ml (Zoloft)..................... 80sertraline hcl tab 100 mg (Zoloft)...................................80sertraline hcl tab 25 mg (Zoloft).....................................80sertraline hcl tab 50 mg (Zoloft).....................................80SE-TAN DHA -prenatal w/fe fum-fe poly -fa-omega 3 cap15-15-1 mg.....................................................................121

SETON ET-EC -prenat-fe bis-fe prot succ-fa-ca tab &omega cap dr 430 pk.................................................... 121

SETONET -prenat-fe bis-fe prot succ-fa-ca tab & omega 3cap 430 pk..................................................................... 121

SEVELAMER CARBONATE -sevelamer carbonate tab800 mg............................................................................. 71

SFROWASA -mesalamine sulfite-free (sf) enema 4gm/60ml............................................................................71

SHOHLS SOLUTION MODIFIED -sodium citrate & citricacid soln 500-334 mg/5ml............................................... 74

SIGNIFOR -pasireotide diaspartate inj 0.3 mg/ml (baseequiv)................................................................................38



sildenafil citrate tab 20 mg (Revatio).............................58SILENOR -doxepin hcl (sleep) tab 3 mg (base equiv)....... 85SILENOR -doxepin hcl (sleep) tab 6 mg (base equiv)....... 85SILMANIX PAIN RELIEIVING -capsaicin-menthol-histamine cream 0.0375-3-0.035%................................ 158

SILVADENE -silver sulfadiazine cream 1%.....................158SILVERA PAIN RELIEF -capsaicin-lidocaine-mentholpatch 0.0375-1-5%.........................................................158

silver nitrate-potassium nitrate applicator 75-25%(Arzol silver nitrate)..................................................... 158

SILVER NITRATE -silver nitrate oint 10%.......................158SILVER NITRATE -silver nitrate soln 0.5%..................... 158SILVER NITRATE -silver nitrate soln 10%...................... 158SILVER NITRATE -silver nitrate soln 25%...................... 158SILVER NITRATE -silver nitrate soln 50%...................... 158

2015


SILVERSEAL HYDROGEL DRESS -silver - pad2"x3"............................................................................... 158

SILVERSEAL HYDROGEL DRESS -silver - pad4"x5"............................................................................... 158

silver sulfadiazine cream 1% (Silvadene)....................158SILVRSTAT WOUND DRESSING -silver - gel................158SIMBRINZA -brinzolamide-brimonidine tartrate ophth susp1-0.2%............................................................................ 140

SIMCOR -niacin-simvastatin tab sr 24hr 1000-20 mg....... 56SIMCOR -niacin-simvastatin tab sr 24hr 1000-40 mg....... 56SIMCOR -niacin-simvastatin tab sr 24hr 500-20 mg......... 56SIMCOR -niacin-simvastatin tab sr 24hr 500-40 mg......... 56SIMCOR -niacin-simvastatin tab sr 24hr 750-20 mg......... 56SIMPONI -golimumab subcutaneous soln auto-injector 100mg/ml..............................................................................104

SIMPONI -golimumab subcutaneous soln auto-injector 50mg/0.5ml.........................................................................104

SIMPONI -golimumab subcutaneous soln prefilled syringe100 mg/ml...................................................................... 104

SIMPONI -golimumab subcutaneous soln prefilled syringe50 mg/0.5ml................................................................... 104

simvastatin tab 10 mg (Zocor)....................................... 56simvastatin tab 20 mg (Zocor)....................................... 56simvastatin tab 40 mg (Zocor)....................................... 56simvastatin tab 5 mg (Zocor)......................................... 56simvastatin tab 80 mg (Zocor)....................................... 56SINELEE -capsaicin-menthol topical patch0.0375-5%...................................................................... 158

SINELEE -capsaicin-menthol topical patch 0.05-5%....... 158SINEMET -carbidopa & levodopa tab 10-100 mg............113SINEMET -carbidopa & levodopa tab 25-100 mg............113SINEMET -carbidopa & levodopa tab 25-250 mg............113SINEMET CR -carbidopa & levodopa tab cr 25-100mg.................................................................................. 113

SINEMET CR -carbidopa & levodopa tab cr 50-200mg.................................................................................. 113

SINGULAIR -montelukast sodium chew tab 4 mg (baseequiv)................................................................................64

SINGULAIR -montelukast sodium chew tab 5 mg (baseequiv)................................................................................64

SINGULAIR -montelukast sodium oral granules packet 4mg (base equiv)...............................................................64

SINGULAIR -montelukast sodium tab 10 mg (baseequiv)................................................................................64

sirolimus tab 0.5 mg (Rapamune)................................164sirolimus tab 1 mg (Rapamune)...................................165sirolimus tab 2 mg (Rapamune)...................................165SIRTURO -bedaquiline fumarate tab 100 mg (baseequiv)..................................................................................6

SITAVIG -acyclovir buccal tab 50 mg................................10SIVEXTRO -tedizolid phosphate tab 200 mg.................... 12SKELAXIN -metaxalone tab 800 mg............................... 114SKLICE -ivermectin lotion 0.5%...................................... 158SMART SENSE GLUCOSE -glucose-vitamin c chew tab4-0.006 gm.......................................................................31

SM GLUCOSE -glucose chew tab 4 gm........................... 31SM GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 31

sodium chloride soln nebu 0.9%................................... 61sodium chloride soln nebu 10%.................................... 61sodium chloride soln nebu 3%...................................... 61sodium chloride soln nebu 7% (Hyper-sal)...................61sodium citrate & citric acid soln 500-334 mg/5ml(Shohls solution modi)..................................................75

sodium fluoride chew tab 0.25 mg f (from 0.55 mg naf)(Luride).......................................................................... 126

sodium fluoride chew tab 0.5 mg f (from 1.1 mg naf)(Luride).......................................................................... 126

sodium fluoride chew tab 1 mg f (from 2.2 mg naf)(Luride).......................................................................... 126

sodium fluoride cream 1.1% (Prevident 5000plus)...............................................................................143

sodium fluoride gel 1.1% (0.5% f) (Previdentfluoride)......................................................................... 143

sodium fluoride paste 1.1% (Prevident 5000boost)............................................................................ 143

sodium fluoride-potassium nitrate paste 1.1-5%(Prevident 5000 sensi).................................................143

sodium fluoride rinse 0.0221% (0.01% f)..................... 143sodium fluoride rinse 0.05%.........................................143sodium fluoride rinse 0.2% (Prevident)....................... 143SODIUM FLUORIDE -sodium fluoride tab 0.5 mg f (from1.1 mg naf).................................................................... 126

SODIUM FLUORIDE -sodium fluoride tab 1 mg f (from 2.2mg naf)...........................................................................126

sodium fluoride soln 0.125 mg/drop f (0.275 mg/dropnaf).................................................................................126

sodium fluoride soln 0.5 mg/ml f (from 1.1 mg/ml naf)(Luride).......................................................................... 126

sodium phenylbutyrate oral powder 3 gm/teaspoonful(Buphenyl).......................................................................38

sodium polystyrene sulfonate oral susp 15 gm/60ml(Sps).............................................................................. 165

sodium polystyrene sulfonate powder(Kayexalate).................................................................. 165

sodium polystyrene sulfonate rectal susp 30gm/120ml.......................................................................165

SODIUM SULFACETAMIDE/SULF -sulfacetamidesodium-sulfur in urea emulsion 10-5%.......................... 158

SODIUM SULFACETAMIDE/SULF -sulfacetamidesodium-sulfur in urea gel 10-5%....................................158

SODIUM SULFACETAMIDE/SULF -sulfacetamide sodiumw/ sulfur susp 10-5%..................................................... 158

SODIUM SULFACETAMIDE WASH -sulfacetamidesodium in bakuchiol vehicle wash 10%......................... 158

SOLAICE -capsaicin-menthol topical patch 0.05-5%.......158SOLARAZE -diclofenac sodium (actinic keratoses) gel3%.................................................................................. 158

SOLODYN -minocycline hcl tab sr 24hr 105 mg................. 4SOLODYN -minocycline hcl tab sr 24hr 115 mg................. 5

2015


SOLODYN -minocycline hcl tab sr 24hr 55 mg................... 4SOLODYN -minocycline hcl tab sr 24hr 65 mg................... 4SOLODYN -minocycline hcl tab sr 24hr 80 mg................... 4SOLTAMOX -tamoxifen citrate oral soln 10 mg/5ml (baseequivalent)........................................................................18

SOMA -carisoprodol tab 250 mg..................................... 114SOMA -carisoprodol tab 350 mg..................................... 114SOMAVERT -pegvisomant for inj 10 mg (as protein)........ 38SOMAVERT -pegvisomant for inj 15 mg (as protein)........ 38SOMAVERT -pegvisomant for inj 20 mg (as protein)........ 38SOMAVERT -pegvisomant for inj 25 mg (as protein)........ 38SOMAVERT -pegvisomant for inj 30 mg (as protein)........ 38SONATA -zaleplon cap 10 mg.......................................... 85SONATA -zaleplon cap 5 mg............................................ 85SOOLANTRA -ivermectin cream 1%...............................158SOOTHEE -lidocaine-capsaicin-men-methyl sal patch0.5-0.0375-5-20%...........................................................158

SORIATANE -acitretin cap 10 mg................................... 158SORIATANE -acitretin cap 17.5 mg................................ 158SORIATANE -acitretin cap 25 mg................................... 158SORILUX -calcipotriene foam 0.005%............................ 158sotalol hcl (afib/afl) tab 120 mg (Betapace af)...............41sotalol hcl (afib/afl) tab 160 mg (Betapace af)...............41sotalol hcl (afib/afl) tab 80 mg (Betapace af)................ 41sotalol hcl tab 120 mg (Betapace)................................. 41sotalol hcl tab 160 mg (Betapace)................................. 41sotalol hcl tab 240 mg.................................................... 41sotalol hcl tab 80 mg (Betapace)................................... 41SOTYLIZE -sotalol hcl oral solution 5 mg/ml.....................41SOVALDI -sofosbuvir tab 400 mg..................................... 10SPACERS – VARIOUS................................................... 163SPATONE PUR-ABSORB IRON -ferrous sulfate liquid 5mg/20ml (elemental iron)............................................... 131

SPECTRACEF -cefditoren pivoxil tab 200 mg (baseequivalent)..........................................................................2

SPECTRACEF -cefditoren pivoxil tab 400 mg (baseequivalent)..........................................................................2

SPINOSAD -spinosad susp 0.9%....................................158SPIRIVA HANDIHALER -tiotropium bromide monohydrateinhal cap 18 mcg (base equiv)........................................ 64

SPIRIVA RESPIMAT -tiotropium bromide monohydrateinhal aerosol 2.5 mcg/act.................................................64

spironolactone & hydrochlorothiazide tab 25-25 mg(Aldactazide)................................................................... 53

spironolactone tab 100 mg (Aldactone)........................ 53spironolactone tab 25 mg (Aldactone).......................... 53spironolactone tab 50 mg (Aldactone).......................... 53SPORANOX -itraconazole cap 100 mg...............................7SPORANOX -itraconazole oral soln 10 mg/ml.................... 7SPORANOX PULSEPAK -itraconazole cap 100 mg........... 7SPRIX -ketorolac tromethamine nasal spray 15.75 mg/spray...............................................................................104

SPRYCEL -dasatinib tab 100 mg...................................... 18SPRYCEL -dasatinib tab 140 mg...................................... 18SPRYCEL -dasatinib tab 20 mg........................................18

SPRYCEL -dasatinib tab 50 mg........................................18SPRYCEL -dasatinib tab 70 mg........................................18SPRYCEL -dasatinib tab 80 mg........................................18SPS -sodium polystyrene sulfonate oral susp 15gm/60ml..........................................................................165

SSKI -potassium iodide soln 1 gm/ml..............................126STALEVO 100 -carbidopa-levodopa-entacapone tabs25-100-200 mg...............................................................113

STALEVO 125 -carbidopa-levodopa-entacapone tabs31.25-125-200 mg..........................................................113

STALEVO 150 -carbidopa-levodopa-entacapone tabs37.5-150-200 mg............................................................113

STALEVO 200 -carbidopa-levodopa-entacapone tabs50-200-200 mg...............................................................113

STALEVO 50 -carbidopa-levodopa-entacapone tabs12.5-50-200 mg..............................................................113

STALEVO 75 -carbidopa-levodopa-entacapone tabs18.75-75-200 mg............................................................113

stannous fluoride conc 0.63% (Gel-kam oral careri)....................................................................................143

stannous fluoride gel 0.4%...........................................143STANNOUS FLUORIDE RINSE -stannous fluoride liq0.1%............................................................................... 143

STARLIX -nateglinide tab 120 mg.....................................31STARLIX -nateglinide tab 60 mg.......................................31STATUSS GREEN -codeine-pseudoephedrine-chlorcyclizine liq 9-30-12.5 mg/5ml..................................61

stavudine cap 15 mg (Zerit)............................................10stavudine cap 20 mg (Zerit)............................................10stavudine cap 30 mg (Zerit)............................................10stavudine cap 40 mg (Zerit)............................................10stavudine for oral soln 1 mg/ml (Zerit).......................... 10STAVZOR -valproic acid cap delayed release 125mg.................................................................................. 110

STAVZOR -valproic acid cap delayed release 250mg.................................................................................. 110

STAVZOR -valproic acid cap delayed release 500mg.................................................................................. 110

STELARA -ustekinumab soln prefilled syringe 45mg/0.5ml.........................................................................158

STELARA -ustekinumab soln prefilled syringe 90 mg/ml....................................................................................158

STIMATE -desmopressin acetate nasal soln 1.5 mg/ml......................................................................................38

STIOLTO RESPIMAT -tiotropium br-olodaterol inhal aerosoln 2.5-2.5 mcg/act........................................................ 64

STIVARGA -regorafenib tab 40 mg...................................18STRATTERA -atomoxetine hcl cap 100 mg (baseequiv)................................................................................89

STRATTERA -atomoxetine hcl cap 10 mg (baseequiv)................................................................................89



2015





STRIANT -testosterone buccal mucoadhesive system 30mg.................................................................................... 21

STRIBILD -elvitegrav-cobicis-emtricitab-tenofov tab150-150-200-300 mg....................................................... 10

STRIVERDI RESPIMAT -olodaterol hcl inhal aerosol soln2.5 mcg/act (base equiv)................................................. 64

STROMECTOL -ivermectin tab 3 mg................................11STROVITE FORTE -multiple vitamins w/ minerals & fasyrup 1 mg/15ml............................................................ 121

SUBOXONE -buprenorphine hcl-naloxone hcl sl film 12-3mg (base equiv).............................................................100

SUBOXONE -buprenorphine hcl-naloxone hcl sl film 2-0.5mg (base equiv).............................................................100



SUBSYS -fentanyl sublingual spray 100 mcg..................100SUBSYS -fentanyl sublingual spray 1200 mcg (600 mcg x2).................................................................................... 100

SUBSYS -fentanyl sublingual spray 1600 mcg (800 mcg x2).................................................................................... 100

SUBSYS -fentanyl sublingual spray 200 mcg..................100SUBSYS -fentanyl sublingual spray 400 mcg..................100SUBSYS -fentanyl sublingual spray 600 mcg..................100SUBSYS -fentanyl sublingual spray 800 mcg..................100SUCRAID -sacrosidase soln 8500 unit/ml.........................70sucralfate tab 1 gm (Carafate)........................................68SULAR -nisoldipine tab sr 24hr 17 mg..............................43SULAR -nisoldipine tab sr 24hr 34 mg..............................43SULAR -nisoldipine tab sr 24hr 8.5 mg.............................43sulfacetamide sodium cleansing gel 10% (Ovace pluswash)............................................................................. 158

sulfacetamide sodium liquid 10% (Ovace wash)........ 159sulfacetamide sodium lotion 10% (acne) (Klaron)......159sulfacetamide sodium ophth soln 10% (Bleph-10)..... 140sulfacetamide sodium-prednisolone ophth soln10-0.23(0.25)%...............................................................140

sulfacetamide sodium shampoo 10% (Ovaceplus)...............................................................................159

SULFACETAMIDE SODIUM -sulfacetamide sodium ophthoint 10%......................................................................... 140

sulfacetamide sodium w/ sulfur cleanser 10-2% (Avarls cleanser)................................................................... 159

sulfacetamide sodium w/ sulfur cleanser 9.8-4.8%(Plexion cleanser)........................................................ 159

sulfacetamide sodium w/ sulfur cleansing cloth10-5%............................................................................. 159

sulfacetamide sodium w/ sulfur cleansing pad 10-4%(Sumaxin)...................................................................... 159

sulfacetamide sodium w/ sulfur cream 10-2% (Avar-els)................................................................................... 159

sulfacetamide sodium w/ sulfur cream 10-5%............ 159sulfacetamide sodium w/ sulfur cream 9.8-4.8%(Plexion)........................................................................ 159

sulfacetamide sodium w/ sulfur emulsion 10-1%....... 159sulfacetamide sodium w/ sulfur emulsion 10-5%....... 159sulfacetamide sodium w/ sulfur foam 10-5% (Clarifoamef)................................................................................... 159

sulfacetamide sodium w/ sulfur lotion 10-5%............. 159sulfacetamide sodium w/ sulfur lotion 9.8-4.8%(Plexion)........................................................................ 159

sulfacetamide sodium w/ sulfur susp 8-4% (Sumaxints)................................................................................... 159

sulfacetamide sodium w/ sulfur wash 9-4.5%(Sumadan wash).......................................................... 159

sulfacetamide sodium w/ sulfur wash 9-4% (Sumaxinwash)............................................................................. 159

sulfacetamide sod-sulfur wash 9-4.5% & skin cleanserkit (Sumadan kit)..........................................................158

sulfacetamide sod-sulfur wash 9-4.5% & sunscreen kit(Sumadan xlt)............................................................... 158

SULFADIAZINE -sulfadiazine tab 500 mg...........................6sulfamethoxazole-trimethoprim susp 200-40mg/5ml.............................................................................12

sulfamethoxazole-trimethoprim tab 400-80 mg(Bactrim)..........................................................................12

sulfamethoxazole-trimethoprim tab 800-160 mg(Bactrim ds).................................................................... 12

SULFAMYLON -mafenide acetate cream 85 mg/gm.......159SULFAMYLON -mafenide acetate packet for topical soln5% (50 gm).................................................................... 159

sulfasalazine tab 500 mg (Azulfidine)............................71sulfasalazine tab delayed release 500 mg (Azulfidineen-tabs)........................................................................... 71

SULFOAM -sulfur shampoo 2%...................................... 159SULFURATED LIME -sulfurated lime solution................ 159sulindac tab 150 mg......................................................104sulindac tab 200 mg......................................................104SUMADAN KIT -sulfacetamide sod-sulfur wash 9-4.5% &skin cleanser kit............................................................. 159

SUMADAN WASH -sulfacetamide sodium w/ sulfur wash9-4.5%............................................................................ 159

SUMADAN XLT -sulfacetamide sod-sulfur wash 9-4.5% &sunscreen kit..................................................................159

sumatriptan succinate inj 6 mg/0.5ml (Imitrex)...........105sumatriptan succinate solution auto-injector 4mg/0.5ml (Imitrex statdose sys)................................. 105

sumatriptan succinate solution auto-injector 6mg/0.5ml (Imitrex statdose sys)................................. 105

sumatriptan succinate solution cartridge 4 mg/0.5ml(Imitrex statdose ref)................................................... 105

2015


sumatriptan succinate solution cartridge 6 mg/0.5ml(Imitrex statdose ref)................................................... 105

SUMATRIPTAN SUCCINATE -sumatriptan succinate inj 4mg/0.5ml.........................................................................105

SUMATRIPTAN SUCCINATE -sumatriptan succinatesolution prefilled syringe 6 mg/0.5ml............................. 105

sumatriptan succinate tab 100 mg (Imitrex)................106sumatriptan succinate tab 25 mg (Imitrex)..................105sumatriptan succinate tab 50 mg (Imitrex)..................105SUMATRIPTAN -sumatriptan nasal spray 20 mg/act...... 105SUMATRIPTAN -sumatriptan nasal spray 5 mg/act........ 105SUMAVEL DOSEPRO -sumatriptan succinate solution jet-injector 4 mg/0.5ml........................................................ 106

SUMAVEL DOSEPRO -sumatriptan succinate solution jet-injector 6 mg/0.5ml........................................................ 106

SUMAXIN CP KIT -sulfacetamide sod-sulfur pad 10-4% &skin cleanser kit............................................................. 159

SUMAXIN -sulfacetamide sodium w/ sulfur cleansing pad10-4%............................................................................. 159

SUMAXIN TS -sulfacetamide sodium w/ sulfur susp8-4%............................................................................... 159

SUMAXIN WASH -sulfacetamide sodium w/ sulfur wash9-4%............................................................................... 159

SUPER DAILY D3 -cholecalciferol drops 1000 unit/0.03ml(per drop)....................................................................... 115

SUPERVITE -b-complex w/ lysine-zn & folic acidliquid............................................................................... 121

SUPERVITE EC -multiple vitamins w/ minerals & fa tab dr1 mg...............................................................................121

SUPRAX -cefixime cap 400 mg.......................................... 2SUPRAX -cefixime chew tab 100 mg..................................2SUPRAX -cefixime chew tab 200 mg..................................2SUPRAX -cefixime for susp 100 mg/5ml.............................2SUPRAX -cefixime for susp 200 mg/5ml.............................2SUPRAX -cefixime for susp 500 mg/5ml.............................2SUPREP BOWEL PREP -sodium sulfate-potassiumsulfate-magnesium sulfate oral soln................................ 66

SURFAXIN -lucinactant intratracheal susp 30 mg/ml........ 65SURMONTIL -trimipramine maleate cap 100 mg.............. 80SURMONTIL -trimipramine maleate cap 25 mg................ 80SURMONTIL -trimipramine maleate cap 50 mg................ 80SURVANTA INTRATRACHEAL -beractant in nacl 0.9%intratracheal susp 25 mg/ml............................................ 65

SUSTIVA -efavirenz cap 200 mg...................................... 10SUSTIVA -efavirenz cap 50 mg........................................ 10SUSTIVA -efavirenz tab 600 mg....................................... 10SUTENT -sunitinib malate cap 12.5 mg (baseequivalent)........................................................................18

SUTENT -sunitinib malate cap 25 mg (baseequivalent)........................................................................18

SUTENT -sunitinib malate cap 37.5 mg (baseequivalent)........................................................................18

SUTENT -sunitinib malate cap 50 mg (baseequivalent)........................................................................18

SUTTAR-2 -pseudoephedrine w/ cod-gg syrup 30-10-100mg/5ml..............................................................................61

SUTTAR-SF -pseudoephedrine w/ cod-gg syrup30-10-100 mg/5ml............................................................61

SYLATRON -peginterferon alfa-2b for inj kit 200 mcg....... 18SYLATRON -peginterferon alfa-2b for inj kit 300 mcg....... 18SYLATRON -peginterferon alfa-2b for inj kit 600 mcg....... 18SYMAX DUOTAB -hyoscyamine sulfate tab cr 0.375 mg(0.125 mg ir/0.25 mg cr)..................................................68

SYMBICORT -budesonide-formoterol fumarate dihydaerosol 160-4.5 mcg/act.................................................. 64

SYMBICORT -budesonide-formoterol fumarate dihydaerosol 80-4.5 mcg/act.................................................... 64

SYMBYAX -olanzapine-fluoxetine hcl cap 12-25 mg.........93SYMBYAX -olanzapine-fluoxetine hcl cap 12-50 mg.........93SYMBYAX -olanzapine-fluoxetine hcl cap 3-25 mg...........93SYMBYAX -olanzapine-fluoxetine hcl cap 6-25 mg...........93SYMBYAX -olanzapine-fluoxetine hcl cap 6-50 mg...........93SYMLINPEN 120 -pramlintide acetate pen-inj 2700mcg/2.7ml (1000 mcg/ml)................................................ 31

SYMLINPEN 60 -pramlintide acetate pen-inj 1500mcg/1.5ml (1000 mcg/ml)................................................ 31

SYNAGEX -multiple vitamins w/ minerals & fa cap 1.25mg.................................................................................. 121

SYNALAR CREAM KIT -fluocinolone cream 0.025%-emollient cream kit.........................................................159

SYNALAR -fluocinolone acetonide cream 0.025%.......... 159SYNALAR -fluocinolone acetonide oint 0.025%.............. 159SYNALAR -fluocinolone acetonide soln 0.01%............... 159SYNALAR OINTMENT KIT -fluocinolone oint 0.025%-emollient cream kit.........................................................159

SYNALAR TS -fluocinolone acetonide soln 0.01% &cleanser kit.....................................................................159

SYNALGOS-DC -aspirin-caffeine-dihydrocodeine cap356.4-30-16 mg..............................................................100

SYNAREL -nafarelin acetate nasal soln 2 mg/ml.............. 38SYNATEK -multiple vitamins w/ minerals & fa cap 1.25mg.................................................................................. 121

SYNERA -lidocaine-tetracaine topical patch 70-70mg.................................................................................. 159

SYNTHROID -levothyroxine sodium tab 100 mcg.............34SYNTHROID -levothyroxine sodium tab 112 mcg.............34SYNTHROID -levothyroxine sodium tab 125 mcg.............34SYNTHROID -levothyroxine sodium tab 137 mcg.............34SYNTHROID -levothyroxine sodium tab 150 mcg.............34SYNTHROID -levothyroxine sodium tab 175 mcg.............34SYNTHROID -levothyroxine sodium tab 200 mcg.............34SYNTHROID -levothyroxine sodium tab 25 mcg...............34SYNTHROID -levothyroxine sodium tab 300 mcg.............34SYNTHROID -levothyroxine sodium tab 50 mcg...............34SYNTHROID -levothyroxine sodium tab 75 mcg...............34SYNTHROID -levothyroxine sodium tab 88 mcg...............34SYNVEXIA -lidocaine-menthol patch 4-1%..................... 159SYNVEXIA TC -lidocaine-menthol cream 4-1%.............. 159SYPRINE -trientine hcl cap 250 mg................................ 165

2015


T

TABLOID -thioguanine tab 40 mg..................................... 19TACLONEX -calcipotriene-betamethasone dipropionateoint 0.005-0.064%..........................................................160

TACLONEX -calcipotriene-betamethasone dipropionatesusp 0.005-0.064%........................................................ 159

tacrolimus cap 0.5 mg (Prograf).................................. 165tacrolimus cap 1 mg (Prograf)..................................... 165tacrolimus cap 5 mg (Prograf)..................................... 165tacrolimus oint 0.03% (Protopic)..................................160tacrolimus oint 0.1% (Protopic)....................................160TAFINLAR -dabrafenib mesylate cap 50 mg (baseequivalent)........................................................................19

TAFINLAR -dabrafenib mesylate cap 75 mg (baseequivalent)........................................................................19

TAMIFLU -oseltamivir phosphate cap 30 mg (baseequiv)................................................................................10



TAMIFLU -oseltamivir phosphate for susp 6 mg/ml (baseequiv)................................................................................10

tamoxifen citrate tab 10 mg (base equivalent)..............19tamoxifen citrate tab 20 mg (base equivalent)..............19tamsulosin hcl cap 0.4 mg (Flomax)..............................75TANDEM F -ferrous fum-iron polysacch-fa cap162-115.2-1 mg (106 mg fe)..........................................131

TANDEM PLUS -fe fum-iron polysacch complex-fa-bcmplx-c-zn-mn-cu cap....................................................131

TANZEUM -albiglutide for soln pen-injector 30 mg............31TANZEUM -albiglutide for soln pen-injector 50 mg............31TAPAZOLE -methimazole tab 10 mg................................ 34TAPAZOLE -methimazole tab 5 mg.................................. 34TARCEVA -erlotinib hcl tab 100 mg (base equivalent)...... 19TARCEVA -erlotinib hcl tab 150 mg (base equivalent)...... 19TARCEVA -erlotinib hcl tab 25 mg (base equivalent)........ 19TARGADOX -doxycycline hyclate tab 50 mg...................... 5TARGRETIN -bexarotene cap 75 mg................................19TARGRETIN -bexarotene gel 1%....................................160TARKA -trandolapril-verapamil hcl tab cr 1-240 mg.......... 50TARKA -trandolapril-verapamil hcl tab cr 2-180 mg.......... 51TARKA -trandolapril-verapamil hcl tab cr 2-240 mg.......... 51TARKA -trandolapril-verapamil hcl tab cr 4-240 mg.......... 51TARON-BC -prenat w/o a w/ fe cbnyl-fa tab 20-1 mg & vitb6 tab pak......................................................................121

TARON-C DHA -prenatal w/fe fum-fe poly -fa-omega 3 cap53.5-38-1 mg..................................................................121

TARON-DUO EC -prenat-fe bis-fe prot succ-fa-ca tab &omega cap dr 400 pk.................................................... 122

TARON FORTE -fe bisglycinate-fe polysacch-vit c-vit b12-fa cap............................................................................. 131

TARON-PREX -prenatal w/o vit a w/ fe fum-dss-fa-dha cap30-1.2-265 mg................................................................122

TASIGNA -nilotinib hcl cap 150 mg (base equivalent).......19

TASIGNA -nilotinib hcl cap 200 mg (base equivalent).......19TASMAR -tolcapone tab 100 mg.....................................113TAZORAC -tazarotene cream 0.05%.............................. 160TAZORAC -tazarotene cream 0.1%................................ 160TAZORAC -tazarotene gel 0.05%................................... 160TAZORAC -tazarotene gel 0.1%..................................... 160TEARS AGAIN HYDRATE -flaxseed oil-evening primrose-bilberry cap 1000-500-40 mg.........................................127

TECFIDERA -dimethyl fumarate capsule delayed release120 mg.............................................................................93

TECFIDERA -dimethyl fumarate capsule delayed release240 mg.............................................................................93

TECFIDERA STARTER PACK -dimethyl fumarate capsuledr starter pack 120 mg & 240 mg....................................93

TECHNIVIE -ombitasvir-paritaprevir-ritonavir tab12.5-75-50 mg..................................................................10

TEGADERM AG MESH DRESSING -wound dressings -pads................................................................................160

TEGRETOL -carbamazepine susp 100 mg/5ml.............. 110TEGRETOL -carbamazepine tab 200 mg........................110TEGRETOL-XR -carbamazepine tab sr 12hr 100 mg......110TEGRETOL-XR -carbamazepine tab sr 12hr 200 mg......110TEGRETOL-XR -carbamazepine tab sr 12hr 400 mg......110TEKTURNA -aliskiren fumarate tab 150 mg (baseequivalent)........................................................................51

TEKTURNA -aliskiren fumarate tab 300 mg (baseequivalent)........................................................................51

TEKTURNA HCT -aliskiren-hydrochlorothiazide tab150-12.5 mg.....................................................................51

TEKTURNA HCT -aliskiren-hydrochlorothiazide tab 150-25mg.................................................................................... 51

TEKTURNA HCT -aliskiren-hydrochlorothiazide tab300-12.5 mg.....................................................................51

TEKTURNA HCT -aliskiren-hydrochlorothiazide tab 300-25mg.................................................................................... 51

telmisartan-amlodipine tab 40-10 mg (Twynsta)...........51telmisartan-amlodipine tab 40-5 mg (Twynsta).............51telmisartan-amlodipine tab 80-10 mg (Twynsta)...........51telmisartan-amlodipine tab 80-5 mg (Twynsta).............51telmisartan-hydrochlorothiazide tab 40-12.5 mg(Micardis hct)..................................................................51

telmisartan-hydrochlorothiazide tab 80-12.5 mg(Micardis hct)..................................................................51

telmisartan-hydrochlorothiazide tab 80-25 mg(Micardis hct)..................................................................51

telmisartan tab 20 mg (Micardis)................................... 51telmisartan tab 40 mg (Micardis)................................... 51telmisartan tab 80 mg (Micardis)................................... 51temazepam cap 15 mg (Restoril)................................... 85temazepam cap 22.5 mg (Restoril).................................85temazepam cap 30 mg (Restoril)................................... 85temazepam cap 7.5 mg (Restoril).................................. 85TEMODAR -temozolomide cap 100 mg............................ 19TEMODAR -temozolomide cap 140 mg............................ 19TEMODAR -temozolomide cap 180 mg............................ 19

2015


TEMODAR -temozolomide cap 20 mg.............................. 19TEMODAR -temozolomide cap 250 mg............................ 19TEMODAR -temozolomide cap 5 mg................................ 19TEMOVATE -clobetasol propionate cream 0.05%...........160TEMOVATE -clobetasol propionate gel 0.05%................160TEMOVATE -clobetasol propionate oint 0.05%...............160TEMOVATE -clobetasol propionate soln 0.05%..............160TEMOVATE E -clobetasol propionate emollient basecream 0.05%..................................................................160

temozolomide cap 100 mg (Temodar)........................... 19temozolomide cap 140 mg (Temodar)........................... 19temozolomide cap 180 mg (Temodar)........................... 19temozolomide cap 20 mg (Temodar)............................. 19temozolomide cap 250 mg (Temodar)........................... 19temozolomide cap 5 mg (Temodar)............................... 19TENEX -guanfacine hcl tab 1 mg......................................51TENEX -guanfacine hcl tab 2 mg......................................51TENIVAC -tetanus-diphtheria toxoids (td) inj 5-2 lfu.......... 15TENORETIC 100 -atenolol & chlorthalidone tab 100-25mg.................................................................................... 51

TENORETIC 50 -atenolol & chlorthalidone tab 50-25mg.................................................................................... 51

TENORMIN -atenolol tab 100 mg..................................... 41TENORMIN -atenolol tab 25 mg....................................... 41TENORMIN -atenolol tab 50 mg....................................... 41TERAZOL 3 -terconazole vaginal cream 0.8%..................74TERAZOL 7 -terconazole vaginal cream 0.4%..................74terazosin hcl cap 10 mg..................................................51terazosin hcl cap 1 mg................................................... 51terazosin hcl cap 2 mg................................................... 51terazosin hcl cap 5 mg................................................... 51terbinafine hcl tab 250 mg (Lamisil)................................ 7terbutaline sulfate tab 2.5 mg.........................................64terbutaline sulfate tab 5 mg........................................... 64terconazole vaginal cream 0.4% (Terazol 7)..................74terconazole vaginal cream 0.8% (Terazol 3)..................74terconazole vaginal suppos 80 mg................................74TERSI FOAM -selenium sulfide foam 2.25%...................160TESSALON PERLES -benzonatate cap 100 mg...............61TESTIM -testosterone td gel 50 mg/5gm (1%).................. 21testosterone cypionate im inj in oil 100 mg/ml (Depo-testosterone)...................................................................22

testosterone cypionate im inj in oil 200 mg/ml (Depo-testosterone)...................................................................22

testosterone enanthate im inj in oil 200 mg/ml.............22TESTOSTERONE PUMP -testosterone td gel 12.5 mg/act(1%)..................................................................................22

TESTOSTERONE -testosterone cypionate im inj in oil 250mg/ml................................................................................22

TESTOSTERONE -testosterone td gel 10mg/act (2%)......22TESTOSTERONE -testosterone td gel 25 mg/2.5gm(1%)..................................................................................21

TESTOSTERONE -testosterone td gel 50 mg/5gm(1%)..................................................................................22

TESTRED -methyltestosterone cap 10 mg........................22

TETANUS/DIPHTHERIA TOXOID -tetanus-diphtheriatoxoids (td) inj 2-2 lf/0.5ml............................................... 15

tetracaine hcl ophth soln 0.5%.....................................140TETRACYCLINE HCL -tetracycline hcl cap 250 mg............5TETRACYCLINE HCL -tetracycline hcl cap 500 mg............5TETRAMEX -tetracaine-menthol-camphor liqd spray2-1-3%............................................................................160

TETRIX -dermatological products misc - kit.................... 160TEVETEN -eprosartan mesylate tab 600 mg.................... 51TEVETEN HCT -eprosartan mesylate-hydrochlorothiazidetab 600-25 mg................................................................. 51

TEV-TROPIN -somatropin for subcutaneous inj 5 mg....... 38TEXACORT -hydrocortisone soln 2.5%...........................160TEXAVITE LQ -pediatric multivitamins w/fl-fe-zn drops0.25-7-3 mg/ml...............................................................122

TGQ 15DM/5PEH/2CPM -phenylephrine-chlorphen-dmsyrup 5-2-15 mg/5ml........................................................61

TGQ 30PSE/150GFN/15DM -pseudoephedrine w/ dm-ggsyrup 30-15-150 mg/5ml..................................................62

TGQ 30PSE/3BRM/15DM -pseudoephed-bromphen-dmsyrup 30-3-15 mg/5ml......................................................62

TGQ 50PSE/3BRM/30DM -pseudoephed-bromphen-dmsyrup 50-3-30 mg/5ml......................................................62

TGT GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 31

THALOMID -thalidomide cap 100 mg..............................165THALOMID -thalidomide cap 150 mg..............................165THALOMID -thalidomide cap 200 mg..............................165THALOMID -thalidomide cap 50 mg................................165THEO-24 -theophylline cap sr 24hr 100 mg......................64THEO-24 -theophylline cap sr 24hr 200 mg......................65THEO-24 -theophylline cap sr 24hr 300 mg......................65THEO-24 -theophylline cap sr 24hr 400 mg......................65theophylline soln 80 mg/15ml........................................ 65theophylline tab sr 12hr 100 mg.................................... 65theophylline tab sr 12hr 200 mg.................................... 65theophylline tab sr 12hr 300 mg.................................... 65theophylline tab sr 12hr 450 mg.................................... 65theophylline tab sr 24hr 400 mg.................................... 65theophylline tab sr 24hr 600 mg.................................... 65THERA-FLUR-N -sodium fluoride gel 1.1% (0.5% f)....... 143THIOLA -tiopronin tab 100 mg.......................................... 75thioridazine hcl tab 100 mg............................................ 84thioridazine hcl tab 10 mg.............................................. 84thioridazine hcl tab 25 mg.............................................. 84thioridazine hcl tab 50 mg.............................................. 84thiothixene cap 10 mg.....................................................84thiothixene cap 1 mg...................................................... 84thiothixene cap 2 mg...................................................... 84thiothixene cap 5 mg...................................................... 84THRIVITE 19 -prenatal vit w/ dss-fe fumarate-fa tab 29-1mg.................................................................................. 122

thyroid tab 30 mg (1/2 grain) (Armour thyroid)............. 34thyroid tab 60 mg (1 grain) (Armour thyroid)................34thyroid tab 90 mg (1 1/2 grain) (Armour thyroid).......... 34

2015


THYROLAR-1/2 -liotrix (t3-t4) tab 30 mg (6.25-25mcg)................................................................................. 34

THYROLAR-1/4 -liotrix (t3-t4) tab 15 mg (3.1-12.5mcg)................................................................................. 34

THYROLAR-1 -liotrix (t3-t4) tab 60 mg (12.5-50 mcg).......34THYROLAR-2 -liotrix (t3-t4) tab 120 mg (25-100 mcg)......34THYROLAR-3 -liotrix (t3-t4) tab 180 mg (37.5-150mcg)................................................................................. 34

tiagabine hcl tab 2 mg (Gabitril).................................. 110tiagabine hcl tab 4 mg (Gabitril).................................. 110TIAZAC -diltiazem hcl extended release beads cap sr 24hr120 mg............................................................................. 43

TIAZAC -diltiazem hcl extended release beads cap sr 24hr180 mg.............................................................................44




TIAZAC -diltiazem hcl extended release beads cap sr 24hr420 mg............................................................................. 44

ticlopidine hcl tab 250 mg............................................ 136TIGAN -trimethobenzamide hcl cap 300 mg..................... 69TIKOSYN -dofetilide cap 125 mcg (0.125 mg).................. 45TIKOSYN -dofetilide cap 250 mcg (0.25 mg).................... 45TIKOSYN -dofetilide cap 500 mcg (0.5 mg)...................... 45timolol maleate ophth gel forming soln 0.25%(Timoptic-xe).................................................................140

timolol maleate ophth gel forming soln 0.5% (Timoptic-xe).................................................................................. 140

timolol maleate ophth soln 0.25% (Timoptic)..............140timolol maleate ophth soln 0.5% (Timoptic)................140TIMOLOL MALEATE -timolol maleate tab 10 mg..............41TIMOLOL MALEATE -timolol maleate tab 20 mg..............41TIMOLOL MALEATE -timolol maleate tab 5 mg................41TIMOPTIC OCUDOSE -timolol maleate preservative freeophth soln 0.25%...........................................................140

TIMOPTIC OCUDOSE -timolol maleate preservative freeophth soln 0.5%.............................................................140

TIMOPTIC -timolol maleate ophth soln 0.25%................ 140TIMOPTIC -timolol maleate ophth soln 0.5%.................. 140TIMOPTIC-XE -timolol maleate ophth gel forming soln0.25%............................................................................. 140

TIMOPTIC-XE -timolol maleate ophth gel forming soln0.5%............................................................................... 140

TINDAMAX -tinidazole tab 250 mg................................... 12TINDAMAX -tinidazole tab 500 mg................................... 12tinidazole tab 250 mg (Tindamax)..................................12tinidazole tab 500 mg (Tindamax)..................................12TIROSINT -levothyroxine sodium cap 100 mcg................ 34TIROSINT -levothyroxine sodium cap 112 mcg................ 34TIROSINT -levothyroxine sodium cap 125 mcg................ 34TIROSINT -levothyroxine sodium cap 137 mcg................ 34TIROSINT -levothyroxine sodium cap 13 mcg.................. 34

TIROSINT -levothyroxine sodium cap 150 mcg................ 34TIROSINT -levothyroxine sodium cap 25 mcg.................. 34TIROSINT -levothyroxine sodium cap 50 mcg.................. 34TIROSINT -levothyroxine sodium cap 75 mcg.................. 34TIROSINT -levothyroxine sodium cap 88 mcg.................. 34TIVICAY -dolutegravir sodium tab 50 mg (base equiv)......10TIVORBEX -indomethacin cap 20 mg............................. 104TIVORBEX -indomethacin cap 40 mg............................. 104TIZANIDINE COMFORT PAC -tizanidine tab 4 mg &liniment topical gel pack................................................ 114

tizanidine hcl cap 2 mg (base equivalent)(Zanaflex)...................................................................... 114



tizanidine hcl tab 2 mg (base equivalent)....................114tizanidine hcl tab 4 mg (base equivalent)(Zanaflex)...................................................................... 114

TL-CARE DHA -prenatal w/fe fumarate-fa-dss-fish oil cap27-1-500 mg...................................................................122

TL-CERMIDE -dermatological products misc -emulsion......................................................................... 160

TL-FLUORIVITE -pediatric multiple vitamins w/ fl-fe chewtab 0.25-7.5 mg..............................................................122

TL FOLATE -prenatal vit w/ fe fum-methylfolate-fa tab27-0.5-0.5 mg.................................................................122

TL G-FOL OS -multiple vit w/ min & calcium-folic acid tab500-1.1 mg.....................................................................122

TL-SELECT DHA -prenatal w/o vit a w/ fe fum-doc-fa-dhacap 29-1.25-350 mg.......................................................122

TL-SELECT -prenatal w/o vit a w/ fe fum-dss-fa-dha cap29-1.25-325 mg..............................................................122

TL TRISEB -antiseborrheic products misc - cream..........160TOBI PODHALER -tobramycin inhal cap 28 mg................. 5TOBI -tobramycin nebu soln 300 mg/5ml............................5TOBRADEX ST -tobramycin-dexamethasone ophth susp0.3-0.05%....................................................................... 140

TOBRADEX -tobramycin-dexamethasone ophth oint0.3-0.1%......................................................................... 140

TOBRADEX -tobramycin-dexamethasone ophth susp0.3-0.1%......................................................................... 140

tobramycin-dexamethasone ophth susp 0.3-0.1%(Tobradex).....................................................................140

tobramycin nebu soln 300 mg/5ml (Tobi)........................5tobramycin ophth soln 0.3% (Tobrex)......................... 140TOBREX -tobramycin ophth oint 0.3%............................ 141TOBREX -tobramycin ophth soln 0.3%........................... 140TOFRANIL -imipramine hcl tab 10 mg.............................. 80TOFRANIL -imipramine hcl tab 25 mg.............................. 80TOFRANIL -imipramine hcl tab 50 mg.............................. 80TOFRANIL-PM -imipramine pamoate cap 100 mg............80TOFRANIL-PM -imipramine pamoate cap 125 mg............80TOFRANIL-PM -imipramine pamoate cap 150 mg............80TOFRANIL-PM -imipramine pamoate cap 75 mg..............80

2015


tolazamide tab 250 mg....................................................31TOLAZAMIDE -tolazamide tab 500 mg............................. 31TOLBUTAMIDE -tolbutamide tab 500 mg......................... 31tolcapone tab 100 mg (Tasmar)................................... 113tolmetin sodium cap 400 mg........................................104TOLMETIN SODIUM -tolmetin sodium tab 200 mg......... 104TOLMETIN SODIUM -tolmetin sodium tab 600 mg......... 104tolterodine tartrate cap sr 24hr 2 mg (Detrol la)........... 73tolterodine tartrate cap sr 24hr 4 mg (Detrol la)........... 73tolterodine tartrate tab 1 mg (Detrol).............................73tolterodine tartrate tab 2 mg (Detrol).............................73TOPAMAX SPRINKLE -topiramate sprinkle cap 15mg.................................................................................. 110

TOPAMAX SPRINKLE -topiramate sprinkle cap 25mg.................................................................................. 110

TOPAMAX -topiramate tab 100 mg.................................110TOPAMAX -topiramate tab 200 mg.................................110TOPAMAX -topiramate tab 25 mg...................................110TOPAMAX -topiramate tab 50 mg...................................110TOPICORT -desoximetasone cream 0.05%....................160TOPICORT -desoximetasone cream 0.25%....................160TOPICORT -desoximetasone gel 0.05%.........................160TOPICORT -desoximetasone oint 0.05%........................160TOPICORT -desoximetasone oint 0.25%........................160TOPICORT -desoximetasone spray 0.25%.....................160TOPIRAMATE ER -topiramate cap er 24hr sprinkle 100mg.................................................................................. 110

TOPIRAMATE ER -topiramate cap er 24hr sprinkle 150mg.................................................................................. 110




topiramate sprinkle cap 15 mg (Topamaxsprinkle)........................................................................ 110

topiramate sprinkle cap 25 mg (Topamaxsprinkle)........................................................................ 110

topiramate tab 100 mg (Topamax)............................... 110topiramate tab 200 mg (Topamax)............................... 110topiramate tab 25 mg (Topamax)................................. 110topiramate tab 50 mg (Topamax)................................. 110TOPROL XL -metoprolol succinate tab sr 24hr 100 mg.....41TOPROL XL -metoprolol succinate tab sr 24hr 200 mg.....41TOPROL XL -metoprolol succinate tab sr 24hr 25 mg...... 41TOPROL XL -metoprolol succinate tab sr 24hr 50 mg...... 41torsemide tab 100 mg (Demadex).................................. 53torsemide tab 10 mg (Demadex).................................... 53torsemide tab 20 mg (Demadex).................................... 53torsemide tab 5 mg (Demadex)...................................... 53TOUJEO SOLOSTAR -insulin glargine soln pen-injector300 unit/ml....................................................................... 33

TOVIAZ -fesoterodine fumarate tab sr 24hr 4 mg............. 73TOVIAZ -fesoterodine fumarate tab sr 24hr 8 mg............. 73

TRACLEER -bosentan tab 125 mg................................... 58TRACLEER -bosentan tab 62.5 mg.................................. 58TRADJENTA -linagliptin tab 5 mg..................................... 31tramadol-acetaminophen tab 37.5-325 mg(Ultracet)........................................................................100

TRAMADOL HCL ER -tramadol hcl cap sr 24hr biphasicrelease 100 mg..............................................................100




tramadol hcl tab 50 mg (Ultram).................................. 100tramadol hcl tab sr 24hr 100 mg (Ultram er)............... 100tramadol hcl tab sr 24hr 200 mg (Ultram er)............... 100tramadol hcl tab sr 24hr 300 mg (Ultram er)............... 100tramadol hcl tab sr 24hr biphasic release 100 mg......100tramadol hcl tab sr 24hr biphasic release 200 mg......100tramadol hcl tab sr 24hr biphasic release 300 mg......100TRANDATE -labetalol hcl tab 100 mg...............................41TRANDATE -labetalol hcl tab 200 mg...............................41TRANDATE -labetalol hcl tab 300 mg...............................42trandolapril tab 1 mg (Mavik)......................................... 51trandolapril tab 2 mg (Mavik)......................................... 51trandolapril tab 4 mg (Mavik)......................................... 51trandolapril-verapamil hcl tab cr 1-240 mg (Tarka).......51trandolapril-verapamil hcl tab cr 2-180 mg (Tarka).......51trandolapril-verapamil hcl tab cr 2-240 mg (Tarka).......51trandolapril-verapamil hcl tab cr 4-240 mg (Tarka).......51tranexamic acid tab 650 mg (Lysteda).........................133TRANSDERM-SCOP -scopolamine td patch 72hr 1mg/3days..........................................................................69

TRANXENE T -clorazepate dipotassium tab 15 mg.......... 76TRANXENE T -clorazepate dipotassium tab 3.75 mg....... 76TRANXENE T -clorazepate dipotassium tab 7.5 mg......... 76tranylcypromine sulfate tab 10 mg (Parnate)................80TRAVATAN Z -travoprost ophth soln 0.004%(benzalkonium free) (bak free).......................................141

TRAVOPROST -travoprost ophth soln 0.004%............... 141trazodone hcl tab 100 mg............................................... 80trazodone hcl tab 150 mg............................................... 80trazodone hcl tab 300 mg............................................... 80trazodone hcl tab 50 mg.................................................80TREAGAN OTIC -antipyrine-benzocaine-polycosanol oticsol 5.4-1.4-0.0097%.......................................................142

TRECATOR -ethionamide tab 250 mg................................6tretinoin cap 10 mg......................................................... 19tretinoin cream 0.025% (Retin-a)..................................160tretinoin cream 0.05% (Retin-a)....................................160tretinoin cream 0.1% (Retin-a)......................................160tretinoin gel 0.01% (Retin-a)......................................... 160tretinoin gel 0.025% (Retin-a)....................................... 160tretinoin microsphere gel 0.04% (Retin-a micro)........ 160tretinoin microsphere gel 0.1% (Retin-a micro).......... 160

2015


TRETIN-X -tretinoin cream 0.025% w/ cleanser &moisturizer kit.................................................................160

TRETIN-X -tretinoin cream 0.05% w/ cleanser &moisturizer kit.................................................................160

TRETIN-X -tretinoin cream 0.075%.................................160TRETIN-X -tretinoin cream 0.1% w/ cleanser & moisturizerkit....................................................................................160

TRETTEN -coagulation factor xiii a-subunit for inj2000-3125 unit............................................................... 136

TREXALL -methotrexate sodium tab 10 mg (baseequiv)................................................................................19



TREXALL -methotrexate sodium tab 7.5 mg (baseequiv)................................................................................19

TREXIMET -sumatriptan-naproxen sodium tab 85-500mg.................................................................................. 106

TREZIX -acetaminophen-caffeine-dihydrocodeine cap320.5-30-16 mg..............................................................100

TRIADVANCE -prenatal vit w/ dss-iron carbonyl-fa tab90-1 mg..........................................................................122

triamcinolone acetonide aerosol soln (Kenalog)........160triamcinolone acetonide cream 0.025%.......................160triamcinolone acetonide cream 0.1%...........................160triamcinolone acetonide cream 0.5%...........................160triamcinolone acetonide dental paste 0.1%................ 143triamcinolone acetonide lotion 0.025%....................... 160triamcinolone acetonide lotion 0.1%........................... 160triamcinolone acetonide nasal aerosol suspension 55mcg/act (Nasacort aq)................................................... 59

triamcinolone acetonide oint 0.025%...........................160triamcinolone acetonide oint 0.1%...............................160TRIAMCINOLONE ACETONIDE -triamcinolone acetonideoint 0.5%........................................................................ 160

TRIAMTERENE/HYDROCHLOROTH -triamterene &hydrochlorothiazide cap 50-25 mg...................................53

triamterene & hydrochlorothiazide cap 37.5-25 mg(Dyazide)......................................................................... 53

triamterene & hydrochlorothiazide tab 37.5-25 mg(Maxzide-25)....................................................................53

triamterene & hydrochlorothiazide tab 75-50 mg(Maxzide)......................................................................... 53

TRIANEX -triamcinolone acetonide oint 0.05%............... 160triazolam tab 0.125 mg....................................................85triazolam tab 0.25 mg (Halcion)..................................... 85TRIBENZOR -olmesartan-amlodipine-hydrochlorothiazidetab 20-5-12.5 mg............................................................. 51

TRIBENZOR -olmesartan-amlodipine-hydrochlorothiazidetab 40-10-12.5 mg........................................................... 51

TRIBENZOR -olmesartan-amlodipine-hydrochlorothiazidetab 40-10-25 mg.............................................................. 51

TRIBENZOR -olmesartan-amlodipine-hydrochlorothiazidetab 40-5-12.5 mg............................................................. 51

TRIBENZOR -olmesartan-amlodipine-hydrochlorothiazidetab 40-5-25 mg................................................................ 51

TRICARE PRENATAL COMPLEAT -prenat w/o a fefum-fatab 27-1 mg & fish oil chew cap pak............................. 122

TRICARE PRENATAL DHA ONE -prenatal w/fe fumarate-fa-dss-fish oil cap 27-1-500 mg..................................... 122

TRICARE -prenatal vit w/ fe fumarate-fa tab 27-1 mg..... 122TRI-CHLOR -trichloroacetic acid liqd 80%...................... 160TRICODE AR -pseudoephedrine-chlorphen w/ codeine liq30-2-8 mg/5ml..................................................................62

TRICODE GF -pseudoephedrine w/ cod-gg liquid 30-8-200mg/5ml..............................................................................62

TRICOR -fenofibrate tab 145 mg...................................... 56TRICOR -fenofibrate tab 48 mg........................................ 56trifluoperazine hcl tab 10 mg......................................... 84trifluoperazine hcl tab 1 mg........................................... 84trifluoperazine hcl tab 2 mg........................................... 84trifluoperazine hcl tab 5 mg........................................... 84trifluridine ophth soln 1% (Viroptic)............................ 141TRIGLIDE -fenofibrate tab 160 mg....................................56trihexyphenidyl hcl elixir 0.4 mg/ml.............................113trihexyphenidyl hcl tab 2 mg........................................113trihexyphenidyl hcl tab 5 mg........................................113TRILEPTAL -oxcarbazepine susp 300 mg/5ml (60 mg/ml).................................................................................. 110

TRILEPTAL -oxcarbazepine tab 150 mg.........................110TRILEPTAL -oxcarbazepine tab 300 mg.........................110TRILEPTAL -oxcarbazepine tab 600 mg.........................110TRILIPIX -choline fenofibrate cap dr 135 mg (fenofibricacid equiv)........................................................................56

TRILIPIX -choline fenofibrate cap dr 45 mg (fenofibric acidequiv)................................................................................56

trimethobenzamide hcl cap 300 mg (Tigan).................. 69trimethoprim tab 100 mg................................................ 12TRINATAL GT -prenatal vit w/ dss-iron carbonyl-fa tab90-1 mg..........................................................................122

TRINATAL RX 1 -prenatal vit w/ fe fumarate-fa tab 60-1mg.................................................................................. 122

TRINATAL ULTRA -prenatal vit w/ dss-iron carbonyl-fa tab90-1 mg..........................................................................122

TRINATE -prenatal vit w/ fe fumarate-fa tab 28-1 mg......122TRI-NORINYL 28 -norethindrone-eth estradiol tab0.5-35/1-35/0.5-35 mg-mcg..............................................26

TRIPLE DYE -triple dye solution..................................... 163TRISTART DHA -prenat w/o a w/fecbn-methylf-fa-dha cap31-0.6-0.4-200 mg......................................................... 122

TRI-TABS DHA -prenat w/o a w/ fe bisglyc-fa tab 32-1 mg& omega cap pack.........................................................122

TRIUMEQ -abacavir-dolutegravir-lamivudine tab600-50-300 mg.................................................................10

TRIVEEN-DUO DHA -prenat-fe bis-fe prot succ-fa-ca tab& omega 3 cap 400 pk.................................................. 122

TRIVEEN-PRX RNF -prenatal w/o vit a w/ fe fum-dss-fa-dha cap 26-1.2-300 mg................................................. 122

2015


TRI-VI-FLORO -ped vit acd & l-methylfol w/ fl biphasicsusp 0.25 mg/ml............................................................ 122

TRI-VI-FLORO -ped vit acd & l-methylfol w/ fl biphasicsusp 0.5 mg/ml.............................................................. 122

TRI-VI-FLOR -ped vit acd & l-methylfol w/ fl biphasic susp0.25 mg/ml..................................................................... 122

TRI-VI-FLOR -ped vit acd & l-methylfol w/ fl biphasic susp0.5 mg/ml....................................................................... 122

TRI-VIT/FLUORIDE/IRON -pediatric vitamins acd fluoride& fe drops 0.25-10 mg/ml.............................................. 122

TRIZIVIR -abacavir sulfate-lamivudine-zidovudine tab300-150-300 mg...............................................................10

TROKENDI XR -topiramate cap sr 24hr 100 mg............. 110TROKENDI XR -topiramate cap sr 24hr 200 mg............. 110TROKENDI XR -topiramate cap sr 24hr 25 mg...............110TROKENDI XR -topiramate cap sr 24hr 50 mg...............110TROPAZONE -emollient - lotion......................................161tropicamide ophth soln 0.5%........................................141tropicamide ophth soln 1% (Mydriacyl).......................141trospium chloride cap sr 24hr 60 mg............................ 73trospium chloride tab 20 mg.......................................... 73TRULICITY -dulaglutide soln pen-injector 0.75mg/0.5ml...........................................................................31

TRULICITY -dulaglutide soln pen-injector 1.5mg/0.5ml...........................................................................31

TRUSOPT -dorzolamide hcl ophth soln 2%.................... 141TRUVADA -emtricitabine-tenofovir disoproxil fumarate tab200-300 mg......................................................................10

trypsin w/ castor oil & peruvian balsam spray(Granulex)..................................................................... 161

TUDORZA PRESSAIR -aclidinium bromide aerosol powdbreath activated 400 mcg/act...........................................65

TUSNEL -brompheniramine w/ dm-gg cap 2-15-200mg.................................................................................... 62

TUSSICAPS -hydrocod polst-chlorphen polst cap sr 12hr10-8 mg............................................................................62

TUSSICAPS -hydrocod polst-chlorphen polst cap sr 12hr5-4 mg..............................................................................62

TUSSIONEX PENNKINETIC EXT -hydrocod polst-chlorphen polst cr susp 10-8 mg/5ml...............................62

TUZISTRA XR -codeine polist-chlorphen polist er susp14.7-2.8 mg/5ml............................................................... 62

TWYNSTA -telmisartan-amlodipine tab 40-10 mg.............51TWYNSTA -telmisartan-amlodipine tab 40-5 mg...............51TWYNSTA -telmisartan-amlodipine tab 80-10 mg.............52TWYNSTA -telmisartan-amlodipine tab 80-5 mg...............51TYBOST -cobicistat tab 150 mg........................................10TYKERB -lapatinib ditosylate tab 250 mg (base equiv)..... 19TYLENOL/CODEINE #3 -acetaminophen w/ codeine tab300-30 mg......................................................................100

TYLENOL/CODEINE #4 -acetaminophen w/ codeine tab300-60 mg......................................................................100

TYLENOL/CODEINE -acetaminophen w/ codeine tab300-15 mg......................................................................100

TYVASO REFILL -treprostinil inhalation solution 0.6 mg/ml......................................................................................58

TYVASO STARTER -treprostinil inhalation solution 0.6mg/ml................................................................................58

TYVASO -treprostinil inhalation solution 0.6 mg/ml........... 58TYZEKA -telbivudine tab 600 mg...................................... 10TYZINE PEDIATRIC NASAL DR -tetrahydrozoline hclnasal soln 0.05%............................................................. 59

TYZINE -tetrahydrozoline hcl nasal soln 0.1%.................. 59

U

UCERIS -budesonide rectal foam 2 mg/act.....................144UCERIS -budesonide tab sr 24hr 9 mg.............................21UDAMIN SP -multiple vitamins w/ minerals & fa tab 1mg.................................................................................. 122

ULESFIA -benzyl alcohol lotion 5%.................................161ULORIC -febuxostat tab 40 mg.......................................106ULORIC -febuxostat tab 80 mg.......................................106ULTILET GLUCOSE -glucose chew tab 4 gm...................31ULTIMATECARE ONE NF -prenatal w/fe cbnyl-fe aspglyc-fa-dss-omega cap 20-7-1 mg................................. 122

ULTIMATECARE ONE -prenatal vit w/ fe cbn-fe asp glyc-fa-omega 3 cap 27-1mg................................................ 122

ULTIMATE OB DHA -prenat w/ fe poly cmplx-fe asp-fe gly-fa tab & dha cap pak..................................................... 122

ULTRACET -tramadol-acetaminophen tab 37.5-325mg.................................................................................. 100

ULTRAM ER -tramadol hcl tab sr 24hr 100 mg...............101ULTRAM ER -tramadol hcl tab sr 24hr 200 mg...............101ULTRAM ER -tramadol hcl tab sr 24hr 300 mg...............101ULTRAM -tramadol hcl tab 50 mg...................................100ULTRASAL-ER -salicylic acid film-forming soln28.5%............................................................................. 161

ULTRA TABS -prenatal vit w/ dss-iron carbonyl-fa tab 90-1mg.................................................................................. 122

ULTRAVATE -halobetasol propionate cream 0.05%....... 161ULTRAVATE -halobetasol propionate oint 0.05%........... 161ULTRAVATE X -halobetasol prop cream 0.05% & lacticacid cream 10% kit........................................................ 161

ULTRAVATE X -halobetasol prop oint 0.05% & lactic acidcream 10% kit................................................................161

ULTRESA -pancrelipase (lip-prot-amyl) dr cap13800-27600-27600 unit..................................................70



UMECTA NAIL FILM -urea suspension 40%...................161UMECTA PD -urea-hyaluronate sodium emulsion40-0.3%.......................................................................... 161

UMECTA PD -urea-hyaluronate sodium susp40-0.3%.......................................................................... 161

UMECTA -urea emulsion 40%........................................ 161UMECTA -urea suspension 40%.....................................161UP & UP GLUCOSE -glucose-vitamin c chew tab 4-0.006gm.................................................................................... 31

2015


URAMAXIN GT KIT -urea gel 45% & emollient creamkit....................................................................................161

URAMAXIN GT -urea gel 45%........................................161URAMAXIN -urea cream 45%.........................................161URAMAXIN -urea gel 45%.............................................. 161URAMAXIN -urea in ammonium lactate vehicle foam20%................................................................................ 161

URAMAXIN -urea lotion 45%.......................................... 161urea cream 39% (Aluvea)..............................................161urea cream 40%............................................................. 161urea cream 45% (Uramaxin)......................................... 161urea cream 47% (Keralac).............................................161urea cream 50%............................................................. 161urea foam 40% (Hydro 40 foam).................................. 161urea gel 40%.................................................................. 161urea gel 45% (Uramaxin)...............................................161urea in lactic acid-salicylic acid vehicle susp 50%.....161urea in lactic acid vehicle foam 35% (Hydro 35).........161urea in zinc undecylenate-lactic acid vehicle emulsion50%................................................................................ 161

urea lotion 40%..............................................................161urea lotion 45% (Uramaxin).......................................... 161UREA NAIL KIT -urea susp 40% & hyaluronate sodium gel0.2% kit.......................................................................... 161

UREA NAIL -urea in zinc undecylenate-lactic acid vehiclestick 50%........................................................................161

urea suspension 40% (Umecta)................................... 161URECHOLINE -bethanechol chloride tab 10 mg...............73URECHOLINE -bethanechol chloride tab 25 mg...............73URECHOLINE -bethanechol chloride tab 50 mg...............73URECHOLINE -bethanechol chloride tab 5 mg.................73URETRON D/S -methenamine-hyosc-meth blue-sod phos-phen sal tab 120 mg........................................................72

UREVAZ -urea cream 44%............................................. 161UREX -methenamine hippurate tab 1 gm..........................72URIMAR-T -methenamine-hyosc-meth blue-sod phos-phen sal tab 120 mg........................................................72

URINE TEST STRIPS – VARIOUS.................................163UROCIT-K 10 -potassium citrate tab cr 10 meq (1080mg)................................................................................... 75

UROCIT-K 15 -potassium citrate tab cr 15 meq (1620mg)................................................................................... 75

UROCIT-K 5 -potassium citrate tab cr 5 meq (540 mg).....75UROGESIC-BLUE -methenamine-hyoscamine-meth blue-sod phos tab 81.6 mg......................................................72

UROQID #2 -methenamine mandelate-sod phosphatemonobasic tab 500-500 mg............................................. 72

UROXATRAL -alfuzosin hcl tab sr 24hr 10 mg................. 75URSO 250 -ursodiol tab 250 mg.......................................71ursodiol cap 300 mg (Actigall)....................................... 71ursodiol tab 250 mg (Urso 250)......................................71ursodiol tab 500 mg (Urso forte)....................................72URSO FORTE -ursodiol tab 500 mg.................................71UTA -methenamine-hyoscamine-meth blue-sod phos cap120 mg............................................................................. 72

UTOPIC -urea cream 41%.............................................. 161

V

VAGIFEM -estradiol vaginal tab 10 mcg........................... 74valacyclovir hcl tab 1 gm (Valtrex)................................ 10valacyclovir hcl tab 500 mg (Valtrex)............................ 10VALCHLOR -mechlorethamine hcl gel 0.016% (baseequivalent)......................................................................161

VALCYTE -valganciclovir hcl for soln 50 mg/ml (baseequiv)................................................................................10

VALCYTE -valganciclovir hcl tab 450 mg (baseequivalent)........................................................................10

valganciclovir hcl tab 450 mg (base equivalent)(Valcyte).......................................................................... 10

VALIUM -diazepam tab 10 mg.......................................... 76VALIUM -diazepam tab 2 mg............................................ 76VALIUM -diazepam tab 5 mg............................................ 76valproate sodium syrup 250 mg/5ml (base equiv)(Depakene).................................................................... 111

valproic acid cap 250 mg (Depakene)..........................111valsartan-hydrochlorothiazide tab 160-12.5 mg (Diovanhct)...................................................................................52

valsartan-hydrochlorothiazide tab 160-25 mg (Diovanhct)...................................................................................52

valsartan-hydrochlorothiazide tab 320-12.5 mg (Diovanhct)...................................................................................52

valsartan-hydrochlorothiazide tab 320-25 mg (Diovanhct)...................................................................................52

valsartan-hydrochlorothiazide tab 80-12.5 mg (Diovanhct)...................................................................................52

valsartan tab 160 mg (Diovan)....................................... 52valsartan tab 320 mg (Diovan)....................................... 52valsartan tab 40 mg (Diovan)......................................... 52valsartan tab 80 mg (Diovan)......................................... 52VALTREX -valacyclovir hcl tab 1 gm.................................10VALTREX -valacyclovir hcl tab 500 mg.............................10VALUE PLUS GLUCOSE -glucose chew tab 4 gm........... 31VALUE PLUS GLUCOSE -glucose-vitamin c chew tab4-0.006 gm.......................................................................31

VANACOF CD -phenylephrine-dexchlorphenir-codeineliquid 5-1-10 mg/5ml........................................................ 62

VANATOL LQ -butalbital-acetaminophen-caffeine soln50-325-40 mg/15ml..........................................................93

VANCOCIN HCL -vancomycin hcl cap 125 mg.................12VANCOCIN HCL -vancomycin hcl cap 250 mg.................12vancomycin hcl cap 125 mg (Vancocin hcl)..................12vancomycin hcl cap 250 mg (Vancocin hcl)..................12VANOS -fluocinonide cream 0.1%.................................. 161VANOXIDE-HC -benzoyl peroxide-hc lotion 5-0.5%........161VARIZIG -varicella-zoster immune glob (human) for im inj125 unit............................................................................ 16

VASCEPA -icosapent ethyl cap 1 gm............................... 56VASCUDERM STASIS KIT -wound dressings - kit..........161VASERETIC -enalapril maleate & hydrochlorothiazide tab10-25 mg..........................................................................52

VASOTEC -enalapril maleate tab 10 mg...........................52

2015


VASOTEC -enalapril maleate tab 2.5 mg..........................52VASOTEC -enalapril maleate tab 20 mg...........................52VASOTEC -enalapril maleate tab 5 mg.............................52VAYACOG -phosphatidylserine-dha-epa cap 100-19.5-6.5mg.................................................................................. 127

VAYARIN -phosphatidylserine-dha-epa cap 75-21.5-8.5mg.................................................................................. 127

VAYAROL -phytosterol esters-dha-epa cap630-232.5-92.5 mg.........................................................127

VECAMYL -mecamylamine hcl tab 2.5 mg....................... 52VECTICAL -calcitriol oint 3 mcg/gm................................ 161VELMA PAIN RELIEF -methyl salicylate-lidocaine-mentholpatch 16-4-2%................................................................161

VELPHORO -sucroferric oxyhydroxide chew tab 500mg.................................................................................... 72

VELTIN -clindamycin phosphate-tretinoin gel1.2-0.025%..................................................................... 161

VEMAVITE-PRX 2 -prenatal w/o vit a w/ fe fum-dss-fa-dhacap 27-1.25-300 mg.......................................................123

VENA-BAL DHA -prenat w/fe poly-na fered-fa tab 27-1 &omega cap dr 430mg.....................................................123

VENATAL-FA -prenatal vit w/ fe fumarate-fa tab 29-1mg.................................................................................. 123

VENELEX -balsam peru-castor oil oint............................161venlafaxine hcl cap sr 24hr 150 mg (base equivalent)(Effexor xr)......................................................................80

venlafaxine hcl cap sr 24hr 37.5 mg (base equivalent)(Effexor xr)......................................................................80

venlafaxine hcl cap sr 24hr 75 mg (base equivalent)(Effexor xr)......................................................................80

VENLAFAXINE HCL ER -venlafaxine hcl tab sr 24hr 150mg (base equivalent)....................................................... 80


VENLAFAXINE HCL ER -venlafaxine hcl tab sr 24hr 37.5mg (base equivalent)....................................................... 80


venlafaxine hcl tab 100 mg.............................................80venlafaxine hcl tab 25 mg...............................................80venlafaxine hcl tab 37.5 mg............................................80venlafaxine hcl tab 50 mg...............................................80venlafaxine hcl tab 75 mg...............................................80venlafaxine hcl tab sr 24hr 150 mg (base equivalent)(Venlafaxine hcl er)........................................................80

venlafaxine hcl tab sr 24hr 37.5 mg (base equivalent)(Venlafaxine hcl er)........................................................80

venlafaxine hcl tab sr 24hr 75 mg (base equivalent)(Venlafaxine hcl er)........................................................80

VENTAVIS -iloprost inhalation solution 10 mcg/ml............58VENTAVIS -iloprost inhalation solution 20 mcg/ml............58VENTOLIN HFA -albuterol sulfate inhal aero 108 mcg/act(90mcg base equiv)......................................................... 65

VERAMYST -fluticasone furoate nasal susp 27.5 mcg/spray.................................................................................59

verapamil hcl cap sr 24hr 100 mg (Verelan pm)........... 44verapamil hcl cap sr 24hr 120 mg (Verelan)..................44verapamil hcl cap sr 24hr 180 mg (Verelan)..................44verapamil hcl cap sr 24hr 200 mg (Verelan pm)........... 44verapamil hcl cap sr 24hr 240 mg (Verelan)..................44verapamil hcl cap sr 24hr 300 mg (Verelan pm)........... 44verapamil hcl cap sr 24hr 360 mg (Verelan)..................44verapamil hcl tab 120 mg (Calan).................................. 44verapamil hcl tab 80 mg (Calan).................................... 44verapamil hcl tab cr 120 mg (Calan sr)..........................44verapamil hcl tab cr 180 mg (Calan sr)..........................44verapamil hcl tab cr 240 mg (Calan sr)..........................44VERAPAMIL HCL -verapamil hcl tab 40 mg..................... 44VERDESO -desonide foam 0.05%.................................. 161VEREGEN -sinecatechins oint 15%................................ 161VERELAN PM -verapamil hcl cap sr 24hr 100 mg............ 44VERELAN PM -verapamil hcl cap sr 24hr 200 mg............ 44VERELAN PM -verapamil hcl cap sr 24hr 300 mg............ 44VERELAN -verapamil hcl cap sr 24hr 120 mg.................. 44VERELAN -verapamil hcl cap sr 24hr 180 mg.................. 44VERELAN -verapamil hcl cap sr 24hr 240 mg.................. 44VERELAN -verapamil hcl cap sr 24hr 360 mg.................. 44VERIPRED 20 -prednisolone sod phosphate oral soln 20mg/5ml (base equiv)........................................................ 21

VERSACLOZ -clozapine susp 50 mg/ml........................... 84VESICARE -solifenacin succinate tab 10 mg.................... 73VESICARE -solifenacin succinate tab 5 mg...................... 73VEXA -allantoin-lidocaine-petrolatum patch 2-4-30%......161VEXOL -rimexolone ophth susp 1%................................141VFEND -voriconazole for susp 40 mg/ml............................ 7VFEND -voriconazole tab 200 mg.......................................7VFEND -voriconazole tab 50 mg.........................................7VIBRAMYCIN -doxycycline calcium syrup 50 mg/5ml......... 5VIBRAMYCIN -doxycycline hyclate cap 100 mg................. 5VIBRAMYCIN -doxycycline monohydrate for susp 25mg/5ml................................................................................5

VICOPROFEN -hydrocodone-ibuprofen tab 7.5-200mg.................................................................................. 101

VICTOZA -liraglutide soln pen-injector 18 mg/3ml (6 mg/ml).................................................................................... 31

VICTRELIS -boceprevir cap 200 mg................................. 10VIDEX -didanosine for soln 2 gm...................................... 10VIDEX -didanosine for soln 4 gm...................................... 10VIDEX EC -didanosine delayed release capsule 125mg.................................................................................... 10

VIDEX EC -didanosine delayed release capsule 200mg.................................................................................... 10



VIEKIRA PAK -ombitas-paritapre-riton & dasab tab pak12.5-75-50 & 250 mg.......................................................10

VIGAMOX -moxifloxacin hcl ophth soln 0.5% (baseequiv)..............................................................................141

2015


VIIBRYD -vilazodone hcl tab 10 mg..................................80VIIBRYD -vilazodone hcl tab 20 mg..................................80VIIBRYD -vilazodone hcl tab 40 mg..................................80VIIBRYD -vilazodone hcl tab starter kit 10 (7) & 20 (7) & 40(16) mg.............................................................................80

VIMOVO -naproxen-esomeprazole magnesium tab dr375-20 mg......................................................................104

VIMOVO -naproxen-esomeprazole magnesium tab dr500-20 mg......................................................................104

VIMPAT -lacosamide oral solution 10 mg/ml...................111VIMPAT -lacosamide tab 100 mg....................................111VIMPAT -lacosamide tab 150 mg....................................111VIMPAT -lacosamide tab 200 mg....................................111VIMPAT -lacosamide tab 50 mg......................................111VINACAL B -prenat w/o a w/fecbn-feglu-fa tab 20-1 mg &vit b6 tab pak.................................................................123

VINACAL -prenatal w/o a w/ fe carbonyl-fe gluc-dss-fa tab27-1mg........................................................................... 123

VINATE AZ EXTRA -prenatal vit w/ fe bisglycinate chelate-fa tab 29-1 mg............................................................... 123

VINATE CALCIUM -prenatal vit w/ iron carbonyl-fe gluc-fatab 27-1 mg................................................................... 123

VINATE CARE -prenatal w/o a vit w/ fe fum-fa tab chew40-1 mg..........................................................................123

VINATE C -prenatal w/o a vit w/ fe fumarate-fa tab 30-1mg.................................................................................. 123

VINATE DHA RF -prenat w/o a w/fefum-methylfol-omegascap 27-1.13 mg..............................................................123

VINATE GT -prenatal vit w/ dss-iron carbonyl-fa tab 90-1mg.................................................................................. 123

VINATE IC -prenatal w/o a w/fe fum-fe poly-fa cap162.115.2-1 mg..............................................................123

VINATE II -prenatal vit w/ fe bisglycinate chelate-fa tab29-1 mg..........................................................................123

VINATE M -prenatal vit w/ sel-fe fumarate-fa tab 27-1mg.................................................................................. 123

VINATE ONE -prenatal vit w/ fe fumarate-fa tab 60-1mg.................................................................................. 123

VINATE ULTRA -prenatal vit w/ dss-iron carbonyl-fa tab90-1 mg..........................................................................123

VIOKACE -pancrelipase (lip-prot-amyl) tab10440-39150-39150 unit..................................................70

VIOKACE -pancrelipase (lip-prot-amyl) tab20880-78300-78300 unit..................................................70

VIRACEPT -nelfinavir mesylate tab 250 mg......................10VIRACEPT -nelfinavir mesylate tab 625 mg......................10VIRAMUNE -nevirapine susp 50 mg/5ml.......................... 11VIRAMUNE -nevirapine tab 200 mg..................................10VIRAMUNE XR -nevirapine tab sr 24hr 100 mg................11VIRAMUNE XR -nevirapine tab sr 24hr 400 mg................11VIRASAL -salicylic acid film forming liquid 27.5%........... 161VIRAZOLE -ribavirin for inhal soln 6 gm........................... 11VIREAD -tenofovir disoproxil fumarate oral powder 40 mg/gm.................................................................................... 11

VIREAD -tenofovir disoproxil fumarate tab 150 mg........... 11

VIREAD -tenofovir disoproxil fumarate tab 200 mg........... 11VIREAD -tenofovir disoproxil fumarate tab 250 mg........... 11VIREAD -tenofovir disoproxil fumarate tab 300 mg........... 11VIROPTIC -trifluridine ophth soln 1%.............................. 141VIRT-ADVANCE -prenatal vit w/ dss-iron carbonyl-fa tab90-1 mg..........................................................................123

VIRT-BAL DHA PLUS -prenat w/fe poly-na fered-fa tab27-1 & omega cap dr 380mg.........................................123

VIRT-CARE ONE -prenatal vit w/ fe cbn-fe asp glyc-fa-omega 3 cap 27-1mg.....................................................123

VIRT-C DHA -prenatal w/fe fum-fe poly -fa-omega 3 cap53.5-38-1 mg..................................................................123

VIRT NATE -prenatal vit w/ fe fumarate-fa tab 28-1mg.................................................................................. 123

VIRT-PN DHA -prenat w/o a w/fefum-methfol-fa-dha cap27-0.6-0.4-300 mg......................................................... 123

VIRT-PN PLUS -prenat w/o a w/ fe fumerate-methylfolate-fa-omega 3 cap..............................................................123

VIRT-PN -prenatal vit w/ fe fum-methylfolate-fa tab27-0.6-0.4 mg.................................................................123

VIRTPREX -prenatal w/o vit a w/ fe fum-dss-fa-dha cap26-1.2-300 mg................................................................123

VIRT-SELECT -prenatal w/o vit a w/ fe fum-dss-fa-dha cap29-1.25-325 mg..............................................................123

VIRT-VITE GT -prenatal vit w/ dss-iron carbonyl-fa tab90-1 mg..........................................................................123

VISTARIL -hydroxyzine pamoate cap 25 mg.................... 76VISTARIL -hydroxyzine pamoate cap 50 mg.................... 76VITACIRC-B -l-methylfolate w/ vit b6-vit b12 tab 3-35-2mg.................................................................................. 127

VITAFOL-NANO -prenatal w/o a w/ fefum-l methylfol-fa tab18-0.6-0.4 mg.................................................................123

VITAFOL-OB+DHA -prenatal mv w/fe fum-fa tab 65-1 mg& dha cap 250 mg pack................................................ 123

VITAFOL-OB -prenatal vit w/ fe fumarate-fa tab 65-1mg.................................................................................. 123

VITAFOL-ONE -prenatal mv w/ fe polysac cmplx-fa-dhacap 29-1-200 mg............................................................123

VITAFOL-PN -prenatal vit w/ fe fumarate-fa tab 65-1mg.................................................................................. 123

VITAFOL ULTRA -prenat w/fe poly-methylfol-fa-dha cap29-0.6-0.4-200 mg......................................................... 123

VITAL-D RX -b-complex w/ c-biotin-d-zinc & folic acid tab1 mg...............................................................................124

VITAMEDMD ONE RX/QUATREFO -prenat w/o a w/fefum-methfol-fa-dha cap 30-0.6-0.4-200 mg................ 124

VITAMEDMD PLUS RX/QUATRE -prenat w/o a w/ fechelate-l methylfol-fa tab & dha cap pk......................... 124

VITAMEDMD REDICHEW RX -prenat w/ b2-b6-b12-d3-folic acid chew tab 1.4 mg.............................................124

VITAMIN D2 -ergocalciferol tab 400 unit......................... 115VITAMIN D3 -cholecalciferol spray 1000 unit/spray........ 115VITAMIN D -cholecalciferol cap 400 unit.........................115VITAMIN K1 -phytonadione inj 10 mg/ml........................ 115

2015


VITAPEARL -prenat w/oa w/fefum-na fered-fa-dha cap cr30-1.4-200 mg................................................................124

VITA-PREN -prenatal vit w/ docusate-iron-fa tab 65-1mg.................................................................................. 123

VITA-RESPA -folic acid-pyridoxine-cyanocobalamin tab2.2-25-1.3 mg.................................................................127

VITEKTA -elvitegravir tab 150 mg.....................................11VITEKTA -elvitegravir tab 85 mg.......................................11VITUZ -hydrocodone-chlorpheniramine soln 5-4mg/5ml..............................................................................62

VIVA DHA -prenatal vit w/ fe fum-fa-omega 3 cap 28-1-200mg.................................................................................. 124

VIVELLE-DOT -estradiol td patch twice weekly 0.025mg/24hr............................................................................ 24





VIVOTIF BERNA -typhoid vaccine cap delayedrelease..............................................................................15

V-NATAL DHA -prenat w/o a w/ fe bisglyc-fa tab 32-1 mg& omega cap pack.........................................................123

V-NATAL -prenatal vit w/o vit a w/ fe bisglycinate-fa tab32-1 mg..........................................................................122

VOGELXO PUMP -testosterone td gel 12.5 mg/act(1%)..................................................................................22

VOGELXO -testosterone td gel 50 mg/5gm (1%)..............22VOL-NATE -prenatal vit w/ fe fumarate-fa tab 28-1mg.................................................................................. 124

VOL-PLUS -prenatal vit w/ fe fumarate-fa tab 27-1mg.................................................................................. 124

VOL-TAB RX -prenatal vit w/ iron carbonyl-fa tab 29-1mg.................................................................................. 124

VOLTAREN -diclofenac sodium gel 1%.......................... 161voriconazole for susp 40 mg/ml (Vfend)......................... 7voriconazole tab 200 mg (Vfend)..................................... 7voriconazole tab 50 mg (Vfend)....................................... 7VOSPIRE ER -albuterol sulfate tab sr 12hr 4 mg..............65VOSPIRE ER -albuterol sulfate tab sr 12hr 8 mg..............65VOTRIENT -pazopanib hcl tab 200 mg (base equiv).........19VP-CH PLUS -prenatal w/o a w/fe cbn-dss-fa-dha cap29-1-265 mg...................................................................124

VP-CH-PNV -prenatal w/o vit a w/ fe cbn-dss-fa-dha cap30-1-260 mg...................................................................124

VP CH ULTRA -prenat w/o a w/fe fum-fe cbn-dss-fa-dhacap 27-1-260 mg............................................................124

VP-GGR-B6 PRENATAL -prenatal w/ calcium-vit b6-fa-ginger tab 1.2 mg.......................................................... 124

VP-GSTN -genistein-zinc amino acid chelate-vitamin dcap..................................................................................128

VP-HEME OB + DHA -prenat-fe poly cmplx-fe heme poly-fa tab & omega 3 cap pck............................................. 124

VP-HEME OB -prenat vit-fe poly cmplx-fe heme poly-fa tab28-6-1 mg.......................................................................124

VP-HEME ONE -prenat-fe poly cmplx-fe heme poly-fa-dhacap 22-6-1-200 mg........................................................ 124

VP-PNV-DHA -prenatal vit w/ fe fum-fa-omega 3 cap28-1-215.8 mg................................................................124

VUSION -miconazole-zinc oxide-white petrolatum oint0.25-15-81.35%..............................................................161

VYTONE -iodoquinol-hydrocortisone in aloe vehicle cream1-1.9%............................................................................ 162

VYTORIN -ezetimibe-simvastatin tab 10-10 mg................56VYTORIN -ezetimibe-simvastatin tab 10-20 mg................56VYTORIN -ezetimibe-simvastatin tab 10-40 mg................56VYTORIN -ezetimibe-simvastatin tab 10-80 mg................56VYVANSE -lisdexamfetamine dimesylate cap 10 mg........89VYVANSE -lisdexamfetamine dimesylate cap 20 mg........89VYVANSE -lisdexamfetamine dimesylate cap 30 mg........89VYVANSE -lisdexamfetamine dimesylate cap 40 mg........89VYVANSE -lisdexamfetamine dimesylate cap 50 mg........89VYVANSE -lisdexamfetamine dimesylate cap 60 mg........89VYVANSE -lisdexamfetamine dimesylate cap 70 mg........89

W

WALGREENS GLUCOSE -glucose chew tab 4 gm.......... 31WALGREENS GLUCOSE -glucose-vitamin c chew tab4-0.006 gm.......................................................................31

warfarin sodium tab 10 mg (Coumadin)...................... 133warfarin sodium tab 1 mg (Coumadin)........................ 133warfarin sodium tab 2.5 mg (Coumadin)..................... 133warfarin sodium tab 2 mg (Coumadin)........................ 133warfarin sodium tab 3 mg (Coumadin)........................ 133warfarin sodium tab 4 mg (Coumadin)........................ 133warfarin sodium tab 5 mg (Coumadin)........................ 133warfarin sodium tab 6 mg (Coumadin)........................ 133warfarin sodium tab 7.5 mg (Coumadin)..................... 133WELCHOL -colesevelam hcl packet for susp 3.75 gm...... 57WELCHOL -colesevelam hcl tab 625 mg..........................56WELLBUTRIN -bupropion hcl tab 100 mg.........................81WELLBUTRIN -bupropion hcl tab 75 mg...........................80WELLBUTRIN SR -bupropion hcl tab sr 12hr 100 mg.......81WELLBUTRIN SR -bupropion hcl tab sr 12hr 150 mg.......81WELLBUTRIN SR -bupropion hcl tab sr 12hr 200 mg.......81WELLBUTRIN XL -bupropion hcl tab sr 24hr 150 mg....... 81WELLBUTRIN XL -bupropion hcl tab sr 24hr 300 mg....... 81WELLESSE VITAMIN D3 -cholecalciferol oral liquid 1000unit/10ml.........................................................................115

WESTCORT -hydrocortisone valerate oint 0.2%.............162WESTHROID-P -thyroid tab 130 mg.................................35WESTHROID-P -thyroid tab 16.25 mg.............................. 35WESTHROID-P -thyroid tab 32.5 mg................................35WESTHROID-P -thyroid tab 48.75 mg (3/4 grain).............35WESTHROID-P -thyroid tab 65 mg...................................35WESTHROID-P -thyroid tab 97.5 mg................................35WESTHROID -thyroid tab 113.75 mg................................34

2015


WESTHROID -thyroid tab 130 mg.................................... 34WESTHROID -thyroid tab 146.25 mg................................35WESTHROID -thyroid tab 16.25 mg................................. 34WESTHROID -thyroid tab 162.5 mg (2 1/2 grain)............. 34WESTHROID -thyroid tab 195 mg.................................... 34WESTHROID -thyroid tab 260 mg.................................... 34WESTHROID -thyroid tab 32.5 mg................................... 34WESTHROID -thyroid tab 325 mg (5 grain)...................... 35WESTHROID -thyroid tab 48.75 mg (3/4 grain)................ 34WESTHROID -thyroid tab 65 mg...................................... 34WESTHROID -thyroid tab 81.25 mg................................. 34WESTHROID -thyroid tab 97.5 mg................................... 34WILATE -antihemophilic factor/vwf (human) for inj1000-1000 unit............................................................... 136

WILATE -antihemophilic factor/vwf (human) for inj 500-500unit..................................................................................136

WITCH HAZEL -witch hazel (hamamelis virginiana) liqd(hamamelis water)......................................................... 162

wound dressings - cream............................................. 162WP THYROID -thyroid tab 113.75 mg.............................. 35WP THYROID -thyroid tab 130 mg................................... 35WP THYROID -thyroid tab 16.25 mg................................ 35WP THYROID -thyroid tab 32.5 mg.................................. 35WP THYROID -thyroid tab 48.75 mg (3/4 grain)............... 35WP THYROID -thyroid tab 65 mg..................................... 35WP THYROID -thyroid tab 81.25 mg................................ 35WP THYROID -thyroid tab 97.5 mg.................................. 35

X

XALATAN -latanoprost ophth soln 0.005%......................141XALKORI -crizotinib cap 200 mg.......................................19XALKORI -crizotinib cap 250 mg.......................................19XANAX -alprazolam tab 0.25 mg...................................... 76XANAX -alprazolam tab 0.5 mg........................................ 76XANAX -alprazolam tab 1 mg........................................... 76XANAX -alprazolam tab 2 mg........................................... 76XANAX XR -alprazolam tab sr 24hr 0.5 mg...................... 76XANAX XR -alprazolam tab sr 24hr 1 mg......................... 76XANAX XR -alprazolam tab sr 24hr 2 mg......................... 76XANAX XR -alprazolam tab sr 24hr 3 mg......................... 76XARELTO -rivaroxaban tab 10 mg..................................133XARELTO -rivaroxaban tab 15 mg..................................133XARELTO -rivaroxaban tab 20 mg..................................133XARELTO STARTER PACK -rivaroxaban tab startertherapy pack 15 mg & 20 mg........................................ 133

XARTEMIS XR -oxycodone w/ acetaminophen tab cr7.5-325 mg.....................................................................101

XCLAIR -dermatological products misc - cream..............162XELJANZ -tofacitinib citrate tab 5 mg (baseequivalent)......................................................................104

XELODA -capecitabine tab 150 mg.................................. 19XELODA -capecitabine tab 500 mg.................................. 19XENADERM -trypsin w/ castor oil & peruvian balsamoint..................................................................................162

XENAZINE -tetrabenazine tab 12.5 mg.............................93XENAZINE -tetrabenazine tab 25 mg................................93

XERAC AC -aluminum chloride in alcohol solution6.25%............................................................................. 162

XERESE -acyclovir-hydrocortisone cream 5-1%............. 162XEROFORM NON-OCCLUSIVE OI -bismuthtribromophenate-petrolatum dressing - misc..................162

XEROFORM NON-OCCLUSIVE OI -bismuthtribromophenate-petrolatum dressing pads................... 162

XEROFORM OCCLUSIVE PETROL -bismuthtribromophenate-petrolatum dressing - misc..................162

XEROFORM OCCLUSIVE PETROL -bismuthtribromophenate-petrolatum dressing pads................... 162

XEROFORM PETROLATUM DRESS -bismuthtribromophenate-petrolatum dressing - misc..................162

XEROFORM PETROLATUM DRESS -bismuthtribromophenate-petrolatum dressing pads................... 162

XIFAXAN -rifaximin tab 200 mg........................................ 12XIFAXAN -rifaximin tab 550 mg........................................ 12XIGDUO XR -dapagliflozin-metformin hcl tab sr 24hr10-1000 mg......................................................................31

XIGDUO XR -dapagliflozin-metformin hcl tab sr 24hr10-500 mg........................................................................31

XIGDUO XR -dapagliflozin-metformin hcl tab sr 24hr5-1000 mg........................................................................31

XIGDUO XR -dapagliflozin-metformin hcl tab sr 24hr 5-500mg.................................................................................... 31

XODOL -hydrocodone-acetaminophen tab 10-300mg.................................................................................. 101

XODOL -hydrocodone-acetaminophen tab 5-300 mg......101XODOL -hydrocodone-acetaminophen tab 7.5-300mg.................................................................................. 101

XOLEGEL COREPAK -ketoconazole gel 2% &hydrocortisone gel 1% kit.............................................. 162

XOLEGEL DUO/HEAD & SHOULD -ketoconazole gel 2%& pyrithione zinc shampoo 1% kit..................................162

XOLEGEL DUO/XOLEX -ketoconazole gel 2% &pyrithione zinc shampoo 1% kit..................................... 162

XOLEGEL -ketoconazole gel 2%.................................... 162XOPENEX HFA -levalbuterol tartrate inhal aerosol 45 mcg/act (base equiv)............................................................... 65

XTANDI -enzalutamide cap 40 mg....................................19XYLOCAINE -lidocaine hcl soln 4%................................ 162XYNTHA -antihemophilic factor recombinant paf for inj kit1000 unit........................................................................ 136

XYNTHA -antihemophilic factor recombinant paf for inj kit2000 unit........................................................................ 136

XYNTHA -antihemophilic factor recombinant paf for inj kit250 unit.......................................................................... 136

XYNTHA -antihemophilic factor recombinant paf for inj kit500 unit.......................................................................... 136

XYNTHA SOLOFUSE -antihemophilic factor recombinantpaf for inj kit 1000 unit...................................................137


XYNTHA SOLOFUSE -antihemophilic factor recombinantpaf for inj kit 250 unit.....................................................136

2015



XYNTHA SOLOFUSE -antihemophilic factor recombinantpaf for inj kit 500 unit.....................................................137

XYPHEX -capsaicin-menthol disk 0.0375-5%................. 162XYREM -sodium oxybate oral solution 500 mg/ml............ 93XYZAL -levocetirizine dihydrochloride soln 2.5 mg/5ml (0.5mg/ml).............................................................................. 58

XYZAL -levocetirizine dihydrochloride tab 5 mg................ 58

Y

YASMIN 28 -drospirenone-ethinyl estradiol tab 3-0.03mg.................................................................................... 26

YAZ -drospirenone-ethinyl estradiol tab 3-0.02 mg........... 26YODOXIN -iodoquinol tab 210 mg.................................... 11YODOXIN -iodoquinol tab 650 mg.................................... 11

Z

ZACARE 4% KIT -benzoyl peroxide lotion 4% &hyaluronate sodium gel 0.2% kit....................................162

ZACARE 8% KIT -benzoyl peroxide lotion 8% &hyaluronate sodium gel 0.2% kit....................................162

ZACLIR CLEANSING -benzoyl peroxide lotion 8%......... 162zafirlukast tab 10 mg (Accolate).................................... 65zafirlukast tab 20 mg (Accolate).................................... 65zaleplon cap 10 mg (Sonata)..........................................85zaleplon cap 5 mg (Sonata)............................................85ZAMICET -hydrocodone-acetaminophen soln 10-325mg/15ml..........................................................................101

ZANAFLEX -tizanidine hcl cap 2 mg (baseequivalent)......................................................................114



ZANAFLEX -tizanidine hcl tab 4 mg (baseequivalent)......................................................................114

ZANTAC -ranitidine hcl tab 300 mg.................................. 68ZARONTIN -ethosuximide cap 250 mg........................... 111ZARONTIN -ethosuximide soln 250 mg/5ml....................111ZATEAN-CH -prenatal w/o a w/fe cbn-dss-fa-dha cap27-1-250 mg...................................................................124

ZATEAN-PN DHA -prenat w/o a w/fefum-methfol-fa-dhacap 27-0.6-0.4-300 mg.................................................. 124

ZATEAN-PN PLUS -prenat w/o a w/ fe fumerate-methylfolate-fa-omega 3 cap......................................... 124

ZATEAN-PN -prenatal vit w/ fe fum-methylfolate-fa tab27-0.6-0.4 mg.................................................................124

ZAVESCA -miglustat cap 100 mg................................... 131ZEBETA -bisoprolol fumarate tab 10 mg...........................42ZEBETA -bisoprolol fumarate tab 5 mg.............................42ZEGERID -omeprazole-sodium bicarbonate cap 20-1100mg.................................................................................... 68

ZEGERID -omeprazole-sodium bicarbonate cap 40-1100mg.................................................................................... 69

ZEGERID -omeprazole-sodium bicarbonate powd pack forsusp 20-1680 mg.............................................................69

ZEGERID -omeprazole-sodium bicarbonate powd pack forsusp 40-1680 mg.............................................................69

ZELAPAR -selegiline hcl orally disintegrating tab 1.25mg.................................................................................. 113

ZELBORAF -vemurafenib tab 240 mg...............................19ZEMPLAR -paricalcitol cap 1 mcg.....................................38ZEMPLAR -paricalcitol cap 2 mcg.....................................38ZENATANE -isotretinoin cap 30 mg................................162ZENPEP -pancrelipase (lip-prot-amyl) dr cap10000-34000-55000 unit..................................................70

ZENPEP -pancrelipase (lip-prot-amyl) dr cap15000-51000-82000 unit..................................................70

ZENPEP -pancrelipase (lip-prot-amyl) dr cap20000-68000-109000 unit................................................70

ZENPEP -pancrelipase (lip-prot-amyl) dr cap25000-85000-136000 unit................................................70

ZENPEP -pancrelipase (lip-prot-amyl) dr cap3000-10000-16000 unit....................................................70

ZENPEP -pancrelipase (lip-prot-amyl) dr cap40000-136000-218000 unit..............................................70

ZENPEP -pancrelipase (lip-prot-amyl) dr cap5000-17000-27000 unit....................................................70

ZENZEDI -dextroamphetamine sulfate tab 15 mg.............89ZENZEDI -dextroamphetamine sulfate tab 2.5 mg............89ZENZEDI -dextroamphetamine sulfate tab 20 mg.............89ZENZEDI -dextroamphetamine sulfate tab 30 mg.............89ZENZEDI -dextroamphetamine sulfate tab 7.5 mg............89ZERIT -stavudine cap 15 mg............................................ 11ZERIT -stavudine cap 20 mg............................................ 11ZERIT -stavudine cap 30 mg............................................ 11ZERIT -stavudine cap 40 mg............................................ 11ZERIT -stavudine for oral soln 1 mg/ml.............................11ZERUVIA -lidocaine-menthol patch 4-1%........................162ZESTORETIC -lisinopril & hydrochlorothiazide tab 10-12.5mg.................................................................................... 52

ZESTORETIC -lisinopril & hydrochlorothiazide tab 20-12.5mg.................................................................................... 52

ZESTORETIC -lisinopril & hydrochlorothiazide tab 20-25mg.................................................................................... 52

ZESTRIL -lisinopril tab 10 mg........................................... 52ZESTRIL -lisinopril tab 2.5 mg.......................................... 52ZESTRIL -lisinopril tab 20 mg........................................... 52ZESTRIL -lisinopril tab 30 mg........................................... 52ZESTRIL -lisinopril tab 40 mg........................................... 52ZESTRIL -lisinopril tab 5 mg............................................. 52ZETIA -ezetimibe tab 10 mg............................................. 57ZETONNA -ciclesonide nasal aerosol soln 37 mcg/act (50mcg/valve)........................................................................ 59

ZIAC -bisoprolol & hydrochlorothiazide tab 10-6.25 mg.....52ZIAC -bisoprolol & hydrochlorothiazide tab 2.5-6.25mg.................................................................................... 52

ZIAC -bisoprolol & hydrochlorothiazide tab 5-6.25 mg...... 52ZIAGEN -abacavir sulfate soln 20 mg/ml (base equiv)...... 11

2015


ZIAGEN -abacavir sulfate tab 300 mg (base equiv).......... 11ZIANA -clindamycin phosphate-tretinoin gel1.2-0.025%..................................................................... 162

zidovudine cap 100 mg (Retrovir)..................................11zidovudine syrup 10 mg/ml (Retrovir)........................... 11zidovudine tab 300 mg....................................................11ZINGIBER -prenatal w/ calcium-vit b6-fa-ginger tab 1.2mg.................................................................................. 124

ZIOPTAN -tafluprost ophth soln 0.0015%....................... 141ziprasidone hcl cap 20 mg (Geodon).............................84ziprasidone hcl cap 40 mg (Geodon).............................84ziprasidone hcl cap 60 mg (Geodon).............................84ziprasidone hcl cap 80 mg (Geodon).............................84ZIPSOR -diclofenac potassium cap 25 mg......................104ZIRGAN -ganciclovir ophth gel 0.15%.............................141ZITHRANOL -anthralin shampoo 1%.............................. 162ZITHRANOL-RR -anthralin cream 1.2%..........................162ZITHROMAX -azithromycin for susp 100 mg/5ml................3ZITHROMAX -azithromycin for susp 200 mg/5ml................3ZITHROMAX -azithromycin powd pack for susp 1 gm........ 3ZITHROMAX -azithromycin tab 250 mg.............................. 3ZITHROMAX -azithromycin tab 500 mg.............................. 3ZITHROMAX -azithromycin tab 600 mg.............................. 3ZITHROMAX TRI-PAK -azithromycin tab 500 mg............... 3ZITHROMAX Z-PAK -azithromycin tab 250 mg...................3ZMAX -azithromycin extended release for oral susp 2gm...................................................................................... 3

ZOCOR -simvastatin tab 10 mg........................................ 57ZOCOR -simvastatin tab 20 mg........................................ 57ZOCOR -simvastatin tab 40 mg........................................ 57ZOCOR -simvastatin tab 5 mg.......................................... 57ZOCOR -simvastatin tab 80 mg........................................ 57ZOFRAN ODT -ondansetron orally disintegrating tab 4mg.................................................................................... 69

ZOFRAN ODT -ondansetron orally disintegrating tab 8mg.................................................................................... 69

ZOFRAN -ondansetron hcl oral soln 4 mg/5ml..................69ZOFRAN -ondansetron hcl tab 4 mg.................................69ZOFRAN -ondansetron hcl tab 8 mg.................................69ZOHYDRO ER -hydrocodone bitartrate cap sr 12hr abuse-deterrent 10 mg............................................................. 101

ZOHYDRO ER -hydrocodone bitartrate cap sr 12hr abuse-deterrent 15 mg............................................................. 101





ZOLINZA -vorinostat cap 100 mg......................................19zolmitriptan orally disintegrating tab 2.5 mg (Zomigzmt)................................................................................ 106

zolmitriptan orally disintegrating tab 5 mg (Zomigzmt)................................................................................ 106

zolmitriptan tab 2.5 mg (Zomig)................................... 106zolmitriptan tab 5 mg (Zomig)...................................... 106ZOLOFT -sertraline hcl oral conc 20 mg/ml...................... 81ZOLOFT -sertraline hcl tab 100 mg.................................. 81ZOLOFT -sertraline hcl tab 25 mg.................................... 81ZOLOFT -sertraline hcl tab 50 mg.................................... 81zolpidem tartrate tab 10 mg (Ambien)........................... 85zolpidem tartrate tab 5 mg (Ambien)............................. 85zolpidem tartrate tab cr 12.5 mg (Ambien cr)................85zolpidem tartrate tab cr 6.25 mg (Ambien cr)................85ZOLPIMIST -zolpidem tartrate oral spray 5 mg/act........... 85ZOMACTON -somatropin for inj 10 mg............................. 39ZOMACTON -somatropin for subcutaneous inj 5 mg........ 39ZOMIG NASAL SPRAY -zolmitriptan nasal spray 5 mg/spray unit....................................................................... 106

ZOMIG ZMT -zolmitriptan orally disintegrating tab 2.5mg.................................................................................. 106

ZOMIG ZMT -zolmitriptan orally disintegrating tab 5mg.................................................................................. 106

ZOMIG -zolmitriptan nasal spray 2.5 mg/spray unit.........106ZOMIG -zolmitriptan nasal spray 5 mg/spray unit............106ZOMIG -zolmitriptan tab 2.5 mg...................................... 106ZOMIG -zolmitriptan tab 5 mg.........................................106ZONALON -doxepin hcl cream 5%................................. 162ZONATUSS -benzonatate cap 150 mg............................. 62ZONEGRAN -zonisamide cap 100 mg............................ 111ZONEGRAN -zonisamide cap 25 mg.............................. 111zonisamide cap 100 mg (Zonegran).............................111zonisamide cap 25 mg (Zonegran)...............................111zonisamide cap 50 mg.................................................. 111ZONTIVITY -vorapaxar sulfate tab 2.08 mg (baseequivalent)......................................................................137

ZORBTIVE -somatropin (non-refrigerated) forsubcutaneous inj 8.8 mg..................................................39

ZORTRESS -everolimus tab 0.25 mg............................. 165ZORTRESS -everolimus tab 0.5 mg............................... 165ZORTRESS -everolimus tab 0.75 mg............................. 165ZORVOLEX -diclofenac cap 18 mg.................................104ZORVOLEX -diclofenac cap 35 mg.................................104ZOSTAVAX -zoster vaccine live for inj 19400unit/0.65ml........................................................................15

ZOVIA 1/50E -ethynodiol diacetate & ethinyl estradiol tab 1mg-50 mcg....................................................................... 26

ZOVIRAX -acyclovir cap 200 mg.......................................11ZOVIRAX -acyclovir cream 5%....................................... 162ZOVIRAX -acyclovir oint 5%........................................... 162ZOVIRAX -acyclovir susp 200 mg/5ml.............................. 11ZOVIRAX -acyclovir tab 400 mg....................................... 11ZOVIRAX -acyclovir tab 800 mg....................................... 11Z-TUSS AC -chlorpheniramine w/ codeine liquid 2-9mg/5ml..............................................................................62

ZUBSOLV -buprenorphine hcl-naloxone hcl sl tab 1.4-0.36mg (base eq)................................................................. 101

2015




ZUPLENZ -ondansetron oral soluble film 4 mg................. 69ZUPLENZ -ondansetron oral soluble film 8 mg................. 69ZUTRIPRO -pseudoeph-chlorphen w/ hydrocodone soln60-4-5 mg/5ml..................................................................62

ZYBAN -bupropion hcl (smoking deterrent) tab sr 12hr 150mg.................................................................................... 93

ZYCLARA -imiquimod cream 3.75%............................... 162ZYCLARA PUMP -imiquimod cream 2.5%...................... 162ZYCLARA PUMP -imiquimod cream 3.75%.................... 162ZYDELIG -idelalisib tab 100 mg........................................19ZYDELIG -idelalisib tab 150 mg........................................19ZYFLO CR -zileuton tab sr 12hr 600 mg...........................65ZYFLO -zileuton tab 600 mg............................................. 65ZYKADIA -ceritinib cap 150 mg.........................................19ZYLET -loteprednol etabonate-tobramycin ophth susp0.5-0.3%......................................................................... 141

ZYLOPRIM -allopurinol tab 100 mg.................................106ZYLOPRIM -allopurinol tab 300 mg.................................106ZYMAXID -gatifloxacin ophth soln 0.5%..........................141ZYPREXA -olanzapine tab 10 mg..................................... 84ZYPREXA -olanzapine tab 15 mg..................................... 84ZYPREXA -olanzapine tab 2.5 mg.................................... 84ZYPREXA -olanzapine tab 20 mg..................................... 84ZYPREXA -olanzapine tab 5 mg.......................................84ZYPREXA -olanzapine tab 7.5 mg.................................... 84ZYPREXA ZYDIS -olanzapine orally disintegrating tab 10mg.................................................................................... 84

ZYPREXA ZYDIS -olanzapine orally disintegrating tab 15mg.................................................................................... 84



ZYTAZE -zinc citrate-phytase cap 25-500 mg.................128ZYTIGA -abiraterone acetate tab 250 mg......................... 19ZYVOX -linezolid for susp 100 mg/5ml............................. 12ZYVOX -linezolid tab 600 mg............................................12

rx drug list - bcbstx

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