unitedhealthcare dual complete™ one (hmo snp) non-part d

UnitedHealthcare Dual Complete™ ONE (HMO SNP)

Non-Part D and Over the Counter Medicaid Covered Drugs

PDL CLASS PDL CATEGORY DRUG NAME

ANALGESICS ANALGESICS ACETAMINOPHEN

ANALGESICS ANALGESICS ACETAMINOPHEN-CAFFEINE-PYRILAMINE TAB

ANALGESICS ANALGESICS ACETAMINOPHEN-PAMABROM-PYRILAMINE TAB

ANALGESICS NSAIDS ASPIRIN

ANALGESICS NSAIDS ASPIRIN BUFFERED (CA CARB-MG CARB-MG OX) TAB

ANALGESICS NSAIDS ASPIRIN-ACETAMINOPHEN-CAFFEINE TAB

ANALGESICS NSAIDS ASPIRIN-AL HYDRO-MG HYDRO-CA CARB TAB

ANALGESICS NSAIDS ASPIRIN-CAFFEINE TAB

ANALGESICS NSAIDS IBUPROFEN

ANALGESICS NSAIDS MAGNESIUM SALICYLATE TETRAHYDRATE TAB

ANALGESICS NSAIDS NAPROXEN SODIUM

ANTIHISTAMINES ANTIHISTAMINE CHLORPHENIRAMINE MALEATE

ANTIHISTAMINES ANTIHISTAMINES BROMPHENIRAMINE MALEATE LIQUID

ANTIHISTAMINES ANTIHISTAMINES CHLORPHENIRAMINE

ANTIHISTAMINES ANTIHISTAMINES CLEMASTINE FUMARATE TAB

ANTIHISTAMINES ANTIHISTAMINES CYCLIZINE HCL TAB

ANTIHISTAMINES ANTIHISTAMINES DEXBROMPHENIRAMINE MALEATE TAB

ANTIHISTAMINES ANTIHISTAMINES DIPHENHYDRAMINE

ANTIHISTAMINES SECOND GENERATION ANTIHISTAMINES CETIRIZINE

ANTIHISTAMINES SECOND GENERATION ANTIHISTAMINES CETIRIZINE-PSEUDOEPHEDRINE TAB SR

ANTIHISTAMINES SECOND GENERATION ANTIHISTAMINES FEXOFENADINE

ANTIHISTAMINES SECOND GENERATION ANTIHISTAMINES LORATADINE

ANTIHISTAMINES SECOND GENERATION ANTIHISTAMINES LORATADINE & PSEUDOEPHEDRINE TAB SR

CONTRACEPTIVES CONTRACEPTIVES CONDOMS LATEX LUBRICATED

CONTRACEPTIVES CONTRACEPTIVES LEVONORGESTREL TAB

CONTRACEPTIVES CONTRACEPTIVES NONOXYNOL-9 GEL

COUGH AND COLD ALLERGY AND ANTIHISTAMINES CHLORCYCLIZINE & PSEUDOEPHEDRINE LIQUID

COUGH AND COLD ALLERGY AND ANTIHISTAMINES CHLORCYCLIZINE HCL TAB

COUGH AND COLD ALLERGY AND ANTIHISTAMINES CHLORCYCLIZINE-PHENYLEPHRINE CHEW TAB

COUGH AND COLD ALLERGY AND ANTIHISTAMINES CHLORCYCLIZINE-PHENYLEPHRINE SYRUP

COUGH AND COLD ALLERGY AND ANTIHISTAMINES CHLORCYCLIZINE-PHENYLEPHRINE TAB

COUGH AND COLD ALLERGY AND ANTIHISTAMINES CHLORPHEN TAN-PE TAN-METHSCOPOLAMINE SUSP

COUGH AND COLD ALLERGY AND ANTIHISTAMINES CHLORPHEN-PHENYLTOLOX-PE- APAP TAB SR 12HR

COUGH AND COLD ANTIHISTAMINE - ALLERGY DRUGS DIPHENHYDRAMINE HCL-PHENYLEPH HCL TANNATE CHEW TAB

COUGH AND COLD ANTIHISTAMINE - ALLERGY DRUGS DIPHENHYDRAMINE-ACETAMINOPHEN TAB

COUGH AND COLD ANTIHISTAMINE - ALLERGY DRUGS DIPHENHYDRAMINE-PHENYLEPHRINE

COUGH AND COLD ANTIHISTAMINE - ALLERGY DRUGS DIPHENHYDRAMINE-PHENYLEPHRINE-APAP

COUGH AND COLD ANTIHISTAMINE - ALLERGY DRUGS DOXYLAMINE SUCCINATE CHEW TAB

COUGH AND COLD ANTIHISTAMINE - ALLERGY DRUGS DOXYLAMINE-PHENYLEPHRINE-APAP CAP

COUGH AND COLD ANTIHISTAMINE - ALLERGY DRUGS DOXYLAMINE-PSEUDOEPHEDRINE LIQUID

COUGH AND COLD ANTIHISTAMINE - ALLERGY DRUGS PYRILAMINE-PHENYLEPHRINE TAB

COUGH AND COLD ANTIHISTAMINE - ALLERGY DRUGS THONZYLAMINE-CHLOPHEDIANOL LIQUID

COUGH AND COLD ANTIHISTAMINE - ALLERGY DRUGS THONZYLAMINE-PHENYLEPHRINE LIQUID

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS BROMPHENIRAMINE & PHENYLEPHRINE

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS BROMPHENIRAMINE & PSEUDOEPHEDRINE

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS CHLORPHENIRAMINE & PHENYLEPHRINE

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS CHLORPHENIRAMINE & PSEUDOEPHEDRINE

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS CHLORPHENIRAMINE-PE-METHSCOPOLAMINE

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS CHLORPHEN-PE-APAP TAB & PE-APAP TAB PACK

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS CHLORPHEN-PE-METHSCOPOLAMINE TAB SR 12HR

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS CHLORPHEN-PHENYLEPHRINE W/ APAP

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS CHLORPHEN-PSE & METHSCOPOLAMINE

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS CHLORPHEN-PSE-ATROPINE-HYOS-SCOPOL TAB SR 12HR

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS DEXBROMPHENIRAMINE & PSEUDOEPHEDRINE TAB

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS DEXBROMPHENIRAMINE-PHENYLEPHRINE TAB

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS DEXCHLORPHENIRAMINE & PSEUDOEPHEDRINE TAB

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS DEXCHLORPHENIRAMINE-PHENYLEPHRINE TAB

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS DEXCHLORPHENIRAMINE-PSEUDOEPHED-APAP TAB

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS DEXCHLORPHEN-PSEUDOEPHED-METHSCOP TAB SR 12HR



COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS TRIPROLIDINE & PSEUDOEPHEDRINE

COUGH AND COLD ANTIHISTAMINE AND DECONGESTANTS TRIPROLIDINE HCL LIQUID

COUGH AND COLD ANTITUSSIVES ACETAMINOPHEN W/ DM LIQUID

COUGH AND COLD ANTITUSSIVES BENZONATATE CAP

COUGH AND COLD ANTITUSSIVES CARBET CIT-CARBET TAN-PE HCL-PE TAN SUS

COUGH AND COLD ANTITUSSIVES CARBETAPENTANE CIT-PSEUDOEPH HCL TANNATE SUSP

COUGH AND COLD ANTITUSSIVES CHLOPHEDIANOL-CHLORCYCLIZINE

COUGH AND COLD ANTITUSSIVES CHLOPHEDIANOL-GUAIFENESIN LIQUID

COUGH AND COLD ANTITUSSIVES CHLOPHEDIANOL-PSEUDOEPHEDRINE LIQD

COUGH AND COLD ANTITUSSIVES CHLOPHEDIANOL-PYRILAMINE LIQUID

COUGH AND COLD ANTITUSSIVES CHLOPHEDIANOL-TRIPROLIDINE LIQUID

COUGH AND COLD ANTITUSSIVES CHLORPHEN TANNATE-CARBETAPENTANE TANNATE TAB

COUGH AND COLD ANTITUSSIVES CHLORPHENIRAMINE W/ CODEINE

COUGH AND COLD ANTITUSSIVES CHLORPHENIRAMINE-DM

COUGH AND COLD ANTITUSSIVES CODEINE-CHLORPHENIRAMINE-ACETAMINOPHEN TAB

COUGH AND COLD ANTITUSSIVES CODEINE-PHENYLEPHRINE-CHLORCYCLIZINE LIQD

COUGH AND COLD ANTITUSSIVES CODEINE-PYRILAMINE SYRUP

COUGH AND COLD ANTITUSSIVES DEXTROMETHORPHAN HBR LIQUID

COUGH AND COLD ANTITUSSIVES DEXTROMETHORPHAN POLISTIREX LIQUID CR

COUGH AND COLD ANTITUSSIVES DEXTROMETHORPHAN-APAP-CHLORPHENIRAMINE

COUGH AND COLD ANTITUSSIVES DEXTROMETHORPHAN-DOXYLAMINE-APAP

COUGH AND COLD ANTITUSSIVES DEXTROMETHORPHAN-GUAIFENESIN

COUGH AND COLD ANTITUSSIVES DEXTROMETHORPHAN-PHENYLEPHRINE-APAP

COUGH AND COLD ANTITUSSIVES DIHYDROCODEINE-GUAIFENESIN LIQUID

COUGH AND COLD ANTITUSSIVES DOXYLAMINE-DM LIQUID

COUGH AND COLD ANTITUSSIVES GUAIFENESIN-CODEINE

COUGH AND COLD ANTITUSSIVES HYDROCOD POLST-CHLORPHEN POLST

COUGH AND COLD ANTITUSSIVES HYDROCODONE W/ HOMATROPINE

COUGH AND COLD ANTITUSSIVES HYDROCODONE-CHLORPHENIRAMINE SOLN

COUGH AND COLD ANTITUSSIVES PHENYLEPH HCL-PYRIL MAL-DM HBR TANNATE CHEW TAB

COUGH AND COLD ANTITUSSIVES PHENYLEPH TAN-PYRILAMINE TAN-DM TAN SUSP

COUGH AND COLD ANTITUSSIVES PHENYLEPH-CHLORPHEN-DM W/APAP

COUGH AND COLD ANTITUSSIVES PHENYLEPH-DEXCHLORPHEN-PYRIL-DM SYRUP

COUGH AND COLD ANTITUSSIVES PHENYLEPH-EPHED-CPM W/ CARBETAPENTANE TAB

COUGH AND COLD ANTITUSSIVES PHENYLEPH-PYRILAMINE-CHLOPHEDIANOL LIQD

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE TAN-CARBETAPENTANE TAN SUSP

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE W/ ACETAMINOPHEN

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE W/ CODEINE

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE W/ DM

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-BROMPHEN W/ CODEINE

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-BROMPHEN-CARBETAPENTANE SUSP

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-BROMPHEN-DIHYDROCODEINE LIQD

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-BROMPHENIRAMINE-DM

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-CHLOPHEDIANOL-GG

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-CHLORPHEN W/ CODEINE SYRUP

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-CHLORPHEN-DIHYDROCODEINE

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-CHLORPHEN-DM

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-CODEINE-GUAIFENESIN-APAP

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-DEXBROMPHEN-CHLOPHEDIANOL LIQD

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-DEXCHLORPHENIR-CODEINE LIQUID

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-DIHYDROCODEINE

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-DM SYRUP

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-DM-GG W/ APAP

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-DOXYLAMINE-DM-APAP LIQUID

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-PROMETHAZINE W/ CODEINE SYRUP

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-PYRILAMINE W/ CODEINE SYRUP

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-PYRILAMINE-DIHYDROCOD LIQUID

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-PYRILAMINE-DM

COUGH AND COLD ANTITUSSIVES PHENYLEPHRINE-THONZYLAMINE-DM LIQUID

COUGH AND COLD ANTITUSSIVES PHENYLEPH-THONZYLAMINE-CHLOPHEDIANOL LIQUID

COUGH AND COLD ANTITUSSIVES PHENYLEPH-TRIPROLIDINE-CHLOPHEDIANOL LIQUID



COUGH AND COLD ANTITUSSIVES PROMETHAZINE W/ CODEINE SYRUP

COUGH AND COLD ANTITUSSIVES PROMETHAZINE-DM SYRUP

COUGH AND COLD ANTITUSSIVES PSE-CHLORCYCLIZINE-CHLOPHEDIANOL LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPH-CHLORPHEN W/ HYDROCODONE

COUGH AND COLD ANTITUSSIVES PSEUDOEPH-CHLORPHEN-DM W/ APAP

COUGH AND COLD ANTITUSSIVES PSEUDOEPH-DOXYLAMINE-DM W/APAP LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPHED TAN-DEXCHLORPHEN TAN-DM TAN SUSP

COUGH AND COLD ANTITUSSIVES PSEUDOEPHED-BROMPHEN-DIHYDROCODEINE LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPHED-BROMPHEN-DM

COUGH AND COLD ANTITUSSIVES PSEUDOEPHED-CHLORPHEN-DIHYDROCODEINE SYRUP

COUGH AND COLD ANTITUSSIVES PSEUDOEPHED-CHLORPHEN-DM

COUGH AND COLD ANTITUSSIVES PSEUDOEPHED-CODEINE-GUAIFENESIN-APAP

COUGH AND COLD ANTITUSSIVES PSEUDOEPHED-DEXBROMPHENIRAMINE-DM LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPHED-DEXCHLORPHEN-CHLOPHEDIANOL LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPHED-DOXYLAMINE-DM LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE TAN-CARBETAPENTANE TAN CHEW TAB

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE W/ APAP-DM

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE W/ CODEINE

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE W/ DM

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE W/ HYDROCODONE SOLN

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE-BROMPHEN-CODEINE LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE-CHLOPHEDIANOL

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE-CHLORCYCLIZINE-CHLOPHEDIANOL TAB

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE-CHLORPHEN W/ CODEINE LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE-DEXBROMPHEN-CODEINE LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE-DM-GG W/ APAP LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE-PYRILAMINE-CODEINE SYRUP

COUGH AND COLD ANTITUSSIVES PSEUDOEPHEDRINE-TRIPROLIDINE W/ COD LIQUID

COUGH AND COLD ANTITUSSIVES PSEUDOEPHED-TRIPROLIDINE-DM SUSP

COUGH AND COLD BRONCHODILATOR EPHEDRINE SULFATE CAP

COUGH AND COLD BRONCHODILATOR RACEPINEPHRINE HCL SOLN NEBULIZER

COUGH AND COLD DECONGESTANTS PHENYLEPHRINE HCL TAB

COUGH AND COLD DECONGESTANTS PSEUDOEPHEDRINE HCL

COUGH AND COLD DECONGESTANTS PSEUDOEPHEDRINE W/ ACETAMINOPHEN TAB

COUGH AND COLD DECONGESTANTS PSEUDOEPHEDRINE-IBUPROFEN

COUGH AND COLD DECONGESTANTS PSEUDOEPHEDRINE-METHSCOPOLAMINE TAB SR

COUGH AND COLD EXPECTORANTS GUAIFENESIN

COUGH AND COLD EXPECTORANTS GUAIFENESIN TAB SR

COUGH AND COLD EXPECTORANTS PHENYLEPHRINE TANNATE-GUAIFENESIN SUSP

COUGH AND COLD EXPECTORANTS PHENYLEPHRINE-APAP

COUGH AND COLD EXPECTORANTS PHENYLEPHRINE-GUAIFENESIN

COUGH AND COLD EXPECTORANTS PHENYLEPHRINE-GUAIFENESIN TAB SR

COUGH AND COLD EXPECTORANTS PSEUDOEPHEDRINE-ACETAMINOPHEN-GUAIFENESIN TAB

COUGH AND COLD EXPECTORANTS PSEUDOEPHEDRINE-GUAIFENESIN CAP

COUGH AND COLD EXPECTORANTS PSEUDOEPHEDRINE-GUAIFENESIN TAB SR

COUGH AND COLD LOCAL ANESTHETICS THROAT LOZENGES - LOZENGES

COUGH AND COLD MISCELLANEOUS PHENYLEPHRINE IN HARD FAT RECTAL SUPPOS

COUGH AND COLD MISCELLANEOUS PHENYLEPH-SHARK LIVER OIL-COCOA BUTTER SUPPOS

DRUGS TO REGULATE BLOOD SUGAR

DRUGS TO REGULATE BLOOD SUGAR GLUCOSE CHEW TAB


DRUGS TO REGULATE BLOOD SUGAR GLUCOSE GEL


DRUGS TO REGULATE BLOOD SUGAR GLUCOSE-VITAMIN C CHEW TAB

EAR DRUGS EAR DRUGS CARBAMIDE PEROXIDE 6.5% OTIC SOLN

EYE DROPS EYE ALLERGIES KETOTIFEN FUMARATE OPHTH SOLN

EYE DROPS EYE ALLERGIES TETRAHYDROZOLINE HCL OPHTH SOLN 0.05%

EYE DROPS EYE ALLERGIES TETRAHYDROZOLINE W/ ZINC SULFATE OPHTH SOLN

EYE DROPS MISCELLANEOUS ARTIFICIAL TEAR OPHTHALMIC

EYE DROPS MISCELLANEOUS CARBOXYMETHYLCELLULOSE SODIUM OPHTH SOLN

EYE DROPS MISCELLANEOUS CARBOXYMETHYLCELLULOSE-HYPROMELLOSE GEL

EYE DROPS MISCELLANEOUS GLYCERIN-POLYSORBATE 80 OPHTH SOLN



EYE DROPS MISCELLANEOUS HYPROMELLOSE OPHTH

EYE DROPS MISCELLANEOUS OPHTHALMIC IRRIGATION SOLUTION

EYE DROPS MISCELLANEOUS POLYETHYLENE GLYCOL-POLYVINYL ALCOHOL OPHTH SOLN

EYE DROPS MISCELLANEOUS POLYETHYLENE GLYCOL-PROPYLENE GLYCOL OPHTH GEL

EYE DROPS MISCELLANEOUS POLYVINYL ALCOHOL OPHTH SOLN

EYE DROPS MISCELLANEOUS POLYVINYL ALCOHOL-POVIDONE OPHTH SOLN

EYE DROPS MISCELLANEOUS PROPYLENE GLYCOL OPHTH SOLN

EYE DROPS MISCELLANEOUS SODIUM CHLORIDE HYPERTONIC OPHTH

GASTROINTESTINAL PRODUCTS ANTACIDS ALUM & MAG HYDROXIDE-SIMETHICONE

GASTROINTESTINAL PRODUCTS ANTACIDS ALUMINUM & MAGNESIUM HYDROXIDES SUSP

GASTROINTESTINAL PRODUCTS ANTACIDS ALUMINUM HYDROXIDE GEL SUSP

GASTROINTESTINAL PRODUCTS ANTACIDS ALUMINUM HYDROXIDE-MAGNESIUM CARBONATE

GASTROINTESTINAL PRODUCTS ANTACIDS ALUMINUM HYDROXIDE-MAGNESIUM TRISILICATE CHEW TAB

GASTROINTESTINAL PRODUCTS ANTACIDS CALCIUM CARBONATE (ANTACID)

GASTROINTESTINAL PRODUCTS ANTACIDS CALCIUM CARBONATE-MAG HYDROXIDE

GASTROINTESTINAL PRODUCTS ANTACIDS CHARCOAL ACTIVATED-SORBITOL LIQ

GASTROINTESTINAL PRODUCTS ANTACIDS MAGNESIUM OXIDE TAB

GASTROINTESTINAL PRODUCTS ANTACIDS SODIUM BICARBONATE TAB

GASTROINTESTINAL PRODUCTS ANTIDIARRHEALS BISMUTH SUBSALICYLATE

GASTROINTESTINAL PRODUCTS ANTIDIARRHEALS LACTOBACILLUS RHAMNOSUS (GG) CAP

GASTROINTESTINAL PRODUCTS ANTIDIARRHEALS LACTOBACILLUS TAB

GASTROINTESTINAL PRODUCTS ANTIDIARRHEALS LOPERAMIDE

GASTROINTESTINAL PRODUCTS ANTIDIARRHEALS LOPERAMIDE-SIMETHICONE TAB

GASTROINTESTINAL PRODUCTS ANTIDIARRHEALS PROBIOTIC PRODUCT - CAP

GASTROINTESTINAL PRODUCTS ANTIDIARRHEALS SACCHAROMYCES BOULARDII PACKET

GASTROINTESTINAL PRODUCTS ANTIEMETICS DIMENHYDRINATE TAB

GASTROINTESTINAL PRODUCTS ANTIEMETICS FRUCTOSE-DEXTROSE-PHOSPHORIC ACID ORAL SOLN

GASTROINTESTINAL PRODUCTS ANTIEMETICS IPECAC SYRUP

GASTROINTESTINAL PRODUCTS ANTIEMETICS MECLIZINE

GASTROINTESTINAL PRODUCTS ANTI-GAS SIMETHICONE

GASTROINTESTINAL PRODUCTS H2-ANTAGONISTS CIMETIDINE TAB 200 MG

GASTROINTESTINAL PRODUCTS H2-ANTAGONISTS FAMOTIDINE TAB

GASTROINTESTINAL PRODUCTS H2-ANTAGONISTS FAMOTIDINE-CA CARBONATE-MAG HYDROXIDE CHEW TAB

GASTROINTESTINAL PRODUCTS H2-ANTAGONISTS RANITIDINE HCL TAB

GASTROINTESTINAL PRODUCTS LAXATIVES ALOE LIQUID

GASTROINTESTINAL PRODUCTS LAXATIVES BENZOCAINE-DOCUSATE SODIUM RECTAL ENEMA

GASTROINTESTINAL PRODUCTS LAXATIVES BISACODYL

GASTROINTESTINAL PRODUCTS LAXATIVES CALCIUM POLYCARBOPHIL TAB

GASTROINTESTINAL PRODUCTS LAXATIVES CASTOR OIL

GASTROINTESTINAL PRODUCTS LAXATIVES DOCUSATE CALCIUM CAP

GASTROINTESTINAL PRODUCTS LAXATIVES DOCUSATE SODIUM

GASTROINTESTINAL PRODUCTS LAXATIVES GLYCERIN

GASTROINTESTINAL PRODUCTS LAXATIVES MAGNESIUM CITRATE SOLN

GASTROINTESTINAL PRODUCTS LAXATIVES MAGNESIUM HYDROXIDE SUSP

GASTROINTESTINAL PRODUCTS LAXATIVES MAGNESIUM SULFATE ORAL GRANULES

GASTROINTESTINAL PRODUCTS LAXATIVES METHYLCELLULOSE POWDER

GASTROINTESTINAL PRODUCTS LAXATIVES METHYLCELLULOSE TAB

GASTROINTESTINAL PRODUCTS LAXATIVES MINERAL OIL

GASTROINTESTINAL PRODUCTS LAXATIVES POLYETHYLENE GLYCOL 3350 ORAL

GASTROINTESTINAL PRODUCTS LAXATIVES PSYLLIUM

GASTROINTESTINAL PRODUCTS LAXATIVES SENNA TAB

GASTROINTESTINAL PRODUCTS LAXATIVES SENNOSIDES

GASTROINTESTINAL PRODUCTS LAXATIVES SENNOSIDES-DOCUSATE SODIUM TAB

GASTROINTESTINAL PRODUCTS LAXATIVES SENNOSIDES-PSYLLIUM CAP

GASTROINTESTINAL PRODUCTS LAXATIVES SODIUM PHOSPHATES

GASTROINTESTINAL PRODUCTS MISCELLANEOUS LACTASE CAP 250 MG

GASTROINTESTINAL PRODUCTS PROTON-PUMP INHIBITORS LANSOPRAZOLE CAP DELAYED RELEASE 15 MG

GASTROINTESTINAL PRODUCTS PROTON-PUMP INHIBITORS OMEPRAZOLE 20 MG

GASTROINTESTINAL PRODUCTS PROTON-PUMP INHIBITORS OMEPRAZOLE-SODIUM BICARBONATE CAP

INHALATION SOLUTIONS INHALATION SOLUTIONS SODIUM CHLORIDE SOLN NEBU 0.9%



IRON PREPARATIONS IRON PREPARATIONS CARBONYL IRON SUSP

IRON PREPARATIONS IRON PREPARATIONS FE FUM-FE POLYSAC-C-B3 CAP

IRON PREPARATIONS IRON PREPARATIONS FERROUS FUMARATE TAB

IRON PREPARATIONS IRON PREPARATIONS FERROUS FUM-IRON POLYSACCH CAP

IRON PREPARATIONS IRON PREPARATIONS FERROUS GLUCONATE TAB

IRON PREPARATIONS IRON PREPARATIONS FERROUS SULFATE

IRON PREPARATIONS IRON PREPARATIONS FERUMOXYTOL INJ

IRON PREPARATIONS IRON PREPARATIONS IRON DEXTRAN INJ

IRON PREPARATIONS IRON PREPARATIONS IRON SUCROSE INJ

IRON PREPARATIONS IRON PREPARATIONS IRON-VIT C-VIT B12-FOLIC ACID CAP CR

IRON PREPARATIONS IRON PREPARATIONS POLYSACCH FE COMPLEX-CHOLECALCIFEROL LIQ

IRON PREPARATIONS IRON PREPARATIONS POLYSACCHARIDE FE COMPLEX-FE HEME POLYPEPTIDE TAB

IRON PREPARATIONS IRON PREPARATIONS POLYSACCHARIDE IRON COMPLEX

MISCELLANEOUS AGENTS MISCELLANEOUS CAMPHOR-EUCALYPTUS-MENTHOL-TURP OIL-WHITE PET -OINT

MISCELLANEOUS AGENTS MISCELLANEOUS COENZYME Q10 CAP

MISCELLANEOUS AGENTS MISCELLANEOUS COENZYME Q10-LEVOCARNITINE CAP

MISCELLANEOUS AGENTS MISCELLANEOUS OMEGA-3 FATTY ACIDS CAP

MISCELLANEOUS AGENTS MISCELLANEOUS PROPYLENE GLYCOL

MISCELLANEOUS AGENTS MISCELLANEOUS SODIUM FLUORIDE RINSE

MISCELLANEOUS AGENTS MISCELLANEOUS UBIQUINOL LIPOSOMAL LIQUID

MISCELLANEOUS AGENTS PHARMACEUTICAL AIDS AQUABASE

MISCELLANEOUS AGENTS PHARMACEUTICAL AIDS HYPROMELLOSE (BULK) POWDER

MISCELLANEOUS AGENTS PHARMACEUTICAL AIDS ORAL VEHICLES

MISCELLANEOUS AGENTS PHARMACEUTICAL AIDS POLYETHYLENE GLYCOL OINTMENT

MISCELLANEOUS AGENTS PHARMACEUTICAL AIDS VEHICLE S

MISCELLANEOUS AGENTS PHARMACEUTICAL AIDS WATER FOR INJECT, BACTERIOSTATIC BENZYL ALCOHOL

MISCELLANEOUS AGENTS PHARMACEUTICAL AIDS WATER FOR INJECTION

NASAL PRODUCTS MISCELLANEOUS NASAL MOISTURIZER COMBINATION - GEL

NASAL PRODUCTS MISCELLANEOUS SALINE NASAL

NASAL PRODUCTS NASAL DECONGESTANT OXYMETAZOLINE HCL NASAL SOLN

NASAL PRODUCTS NASAL DECONGESTANT PHENYLEPHRINE HCL NASAL SOLN

NASAL SPRAYS ANTIALLERGIC AGENTS CROMOLYN SODIUM NASAL AEROSOL SOLN

PROGESTINS PROGESTINS MEGESTROL ACETATE

SCABICIDES AND PEDICULICIDES SCABICIDES AND PEDICULICIDES PERMETHRIN

SCABICIDES AND PEDICULICIDES SCABICIDES AND PEDICULICIDES PYRETH-PIPERONYL BUTOX SHAM-PERMETH AERO-NIT REMOVER GEL KIT

SCABICIDES AND PEDICULICIDES SCABICIDES AND PEDICULICIDES PYRETHRINS-PIPERONYL BUTOXIDE

SEDATIVE/HYPNOTICS SEDATIVE/HYPNOTICS DIPHENHYDRAMINE HCL (SLEEP) TAB

SEDATIVE/HYPNOTICS SEDATIVE/HYPNOTICS DIPHENHYDRAMINE-ACETAMINOPHEN TAB (SLEEP)

SEDATIVE/HYPNOTICS SEDATIVE/HYPNOTICS DOXYLAMINE SUCCINATE (SLEEP) TAB

SEDATIVE/HYPNOTICS SEDATIVE/HYPNOTICS MELATONIN TAB

SMOKING CESSATION SMOKING CESSATION NICOTINE POLACRILEX GUM

SMOKING CESSATION SMOKING CESSATION NICOTINE POLACRILEX LOZENGE

SMOKING CESSATION SMOKING CESSATION NICOTINE TD PATCH 24HR

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CALCIUM CARBONATE-CHOLECALCIFEROL

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CALCIUM CARBONATE-ERGOCALCIFEROL TAB

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CALCIUM CARBONATE-VITAMIN D

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CALCIUM CARB-VIT D W/ MINERALS CHEW TAB

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CALCIUM CITRATE TAB

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CALCIUM CITRATE-VITAMIN D TAB

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CALCIUM GLUBIONATE SYRUP

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CALCIUM GLUCONATE TAB

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CALCIUM LACTATE TAB

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CALCIUM-CHOLECALCIFEROL TAB

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CHROMIUM CHLORIDE INJ 4 MCG/ML

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS CUPRIC CHLORIDE INJ 0.4 MG/ML

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS MAGNESIUM CHLORIDE TAB CR

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS MAGNESIUM CHLORIDE-CALCIUM TAB DR

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS MAGNESIUM CL-CA CARBONATE TAB DR

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS MAGNESIUM GLUCONATE TAB



THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS MAGNESIUM OXIDE TAB

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS MAGNESIUM TAB

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS MANGANESE CHLORIDE INJ 0.1 MG/ML

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS ORAL ELECTROLYTE SOLUTION

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS ORAL ELECTROLYTE TAB

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS OYSTER SHELL CALCIUM TAB 500 MG

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS ZINC CHLORIDE INJ 1 MG/ML

THERAPEUTIC NUTRIENTS THERAPEUTIC NUTRIENTS ZINC SULFATE CAP

TOPICAL AGENTS ACNE BENZOYL PEROXIDE

TOPICAL AGENTS ASTRINGENTS ALUMINUM SULFATE & CALCIUM ACETATE POWD PACK

TOPICAL AGENTS ASTRINGENTS CALAMINE LOTION

TOPICAL AGENTS ASTRINGENTS WITCH HAZEL LIQUID

TOPICAL AGENTS ASTRINGENTS ZINC OXIDE OINT

TOPICAL AGENTS KERATOLYTIC AGENTS SALICYLIC ACID

TOPICAL AGENTS KERATOLYTIC AGENTS UREA

TOPICAL AGENTS LOCAL ANESTHETICS CAMPHOR & MENTHOL LOTION

TOPICAL AGENTS LOCAL ANESTHETICS DIBUCAINE OINT

TOPICAL AGENTS LOCAL ANESTHETICS DIPHENHYDRAMINE HCL SOLN

TOPICAL AGENTS LOCAL ANESTHETICS DIPHENHYDRAMINE-ZINC ACETATE CREAM

TOPICAL AGENTS LOCAL ANESTHETICS LIDOCAINE CREAM

TOPICAL AGENTS LOCAL ANESTHETICS PRAMOXINE HCL RECTAL FOAM

TOPICAL AGENTS LOCAL ANESTHETICS PRAMOXINE-BENZYL ALCOHOL GEL

TOPICAL AGENTS LOCAL ANESTHETICS PRAMOXINE-CALAMINE LOTION

TOPICAL AGENTS LOCAL ANESTHETICS PRAMOX-PE-GLYCERIN-PETROLATUM RECTAL CREAM

TOPICAL AGENTS MISCELLANEOUS SKIN PRODUCTS CHLORHEXIDINE GLUCONATE LIQUID

TOPICAL AGENTS MISCELLANEOUS SKIN PRODUCTS HYDROGEN PEROXIDE SOLN

TOPICAL AGENTS MISCELLANEOUS SKIN PRODUCTS ISOPROPYL ALCOHOL

TOPICAL AGENTS MISCELLANEOUS SKIN PRODUCTS POVIDONE-IODINE

TOPICAL AGENTS PHARMACEUTICAL AIDS EMOLLIENT

TOPICAL AGENTS PHARMACEUTICAL AIDS HYDROPHILIC OINTMENT

TOPICAL AGENTS PHARMACEUTICAL AIDS LANOLIN

TOPICAL AGENTS SKIN PROTECTANT COLLOIDAL OATMEAL PACKET

TOPICAL AGENTS SKIN PROTECTANT DIAPER RASH PRODUCTS - OINTMENT

TOPICAL AGENTS SKIN PROTECTANT DIMETHICONE

TOPICAL AGENTS SKIN PROTECTANT EMOLLIENT - LOTION

TOPICAL AGENTS SKIN PROTECTANT RECTAL PROTECTANT-EMOLLIENT OINTMENT

TOPICAL AGENTS SKIN PROTECTANT SKIN PROTECTANTS MISC

TOPICAL AGENTS SKIN PROTECTANT VITAMINS A & D OINTMENT

TOPICAL AGENTS SKIN PROTECTANT WHITE PETROLATUM GEL

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS ALOE VERA

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS ALUMINUM HYDROXIDE OINT

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS AMMONIUM LACTATE

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS CAPSAICIN CREAM

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS CAPSAICIN-MENTHOL-METHYL SALICYLATE CREAM

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS CAPSICUM OLEORESIN CREAM

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS DERMATOLOGICAL PRODUCTS MISC - LIQUID

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS DOCOSANOL CREAM

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS HYDROQUINONE CREAM

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS LINIMENTS & RUBS

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS LIVE YEAST CELL & SHARK LIVER OIL W/ EMOLLIENTS OINT

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS MENTHOL-METHYL SALICYLATE CREAM

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS MINERAL OIL-HYDROPHILIC PETROLATUM OINTMENT

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS PETROLATUM-ZINC OXIDE OINT

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS PHENYLEPHRINE-SHARK LIVER OIL-MO-PET OINT

TOPICAL AGENTS TOPICAL AGENTS - MISCELLANEOUS TROLAMINE SALICYLATE CREAM

TOPICAL AGENTS TOPICAL ANTIBIOTICS BACITRACIN OINT

TOPICAL AGENTS TOPICAL ANTIBIOTICS BACITRACIN ZINC OINT

TOPICAL AGENTS TOPICAL ANTIBIOTICS BACITRACIN-POLYMYXIN B OINT

TOPICAL AGENTS TOPICAL ANTIBIOTICS NEOMYCIN-BACITRACIN-POLYMYXIN OINT

TOPICAL AGENTS TOPICAL ANTIBIOTICS NEOMYCIN-BACITRACIN-POLYMYXIN-PRAMOXINE OINT

TOPICAL AGENTS TOPICAL ANTIFUNGALS BUTENAFINE



TOPICAL AGENTS TOPICAL ANTIFUNGALS CLOTRIMAZOLE

TOPICAL AGENTS TOPICAL ANTIFUNGALS MICONAZOLE NITRATE

TOPICAL AGENTS TOPICAL ANTIFUNGALS TERBINAFINE

TOPICAL AGENTS TOPICAL ANTIFUNGALS TOLNAFTATE

TOPICAL AGENTS TOPICAL STEROIDS HYDROCORTISONE

TOPICAL AGENTS TOPICAL STEROIDS HYDROCORTISONE ACETATE CREAM

TOPICAL AGENTS TOPICAL STEROIDS HYDROCORTISONE-ALOE VERA

TOPICAL AGENTS VAGINAL ANTIFUNGALS CLOTRIMAZOLE VAGINAL CREAM

TOPICAL AGENTS VAGINAL ANTIFUNGALS MICONAZOLE NITRATE VAGINAL

TOPICAL AGENTS VAGINAL ANTIFUNGALS TIOCONAZOLE VAGINAL OINT

URINARY ANALGESICS URINARY ANALGESICS PHENAZOPYRIDINE HCL TAB

VITAMINS CHOLESTEROL CONTROL NIACIN

VITAMINS MULTIVITAMIN PREPARATIONS MULTIPLE VITAMINS

VITAMINS MULTIVITAMIN PREPARATIONS MULTIPLE VITAMINS W/ IRON

VITAMINS MULTIVITAMIN PREPARATIONS MULTIPLE VITAMINS W/ MINERALS

VITAMINS MULTIVITAMIN PREPARATIONS PEDIATRIC MULTIPLE VITAMIN W/ MINERALS

VITAMINS MULTIVITAMIN PREPARATIONS PEDIATRIC MULTIPLE VITAMIN W/ IRON

VITAMINS PRENATAL VITAMINS PRENATAL VITAMINS

VITAMINS VITAMINS ASCORBIC ACID

VITAMINS VITAMINS B-COMPLEX VITAMINS

VITAMINS VITAMINS CHOLECALCIFEROL

VITAMINS VITAMINS CYANOCOBALAMIN

VITAMINS VITAMINS ERGOCALCIFEROL

VITAMINS VITAMINS FOLIC ACID

VITAMINS VITAMINS HYDROXOCOBALAMIN INJ

VITAMINS VITAMINS NIACINAMIDE TAB

VITAMINS VITAMINS PHYTONADIONE

VITAMINS VITAMINS PYRIDOXINE

VITAMINS VITAMINS THIAMINE

VITAMINS VITAMINS TOCOPHEROLS-TOCOTRIENOLS LIQUID

VITAMINS VITAMINS VITAMIN A

VITAMINS VITAMINS VITAMIN E

IR_141230_111005

unitedhealthcare dual complete™ one (hmo snp) non-part d

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