Prescription Drug List - Nevada Health Co-Op

A list of medications that may lower your patients’ costs

INTRODUCTION

Catamaran utilizes a Pharmacy and Therapeutics Committee (P & T Committee), made up of

practicing physicians, pharmacists, and nurses to help ensure that our formulary is medically

sound and that it supports patient health. This committee reviews and evaluates medications

on the formulary based on safety and efficacy to help maintain clinical integrity in all

therapeutic categories.

FORMULARY DESIGN

There are numerous formulary designs that can be used by a pharmacy benefits administrator.

Catamaran has chosen a formulary structure which is open and incentive based.

Open Formulary: features uniform co-payments for medications that are preferred

and non-preferred brands, plus lower co-payments for generic drugs.

Incentive Based: features different co-payments for medications that are on or off the

formulary. In this type of formulary, the patient cost structure may be either a two-tier

or three-tier design.

USING THIS FORMULARY REFERENCE GUIDE TO HELP CONTAIN COSTS

Many benefit sponsors use the Catamaran formulary to help manage the overall cost of

providing prescription drug benefits. This formulary offers a wide range of medications from

which to choose. We realize that this formulary reference guide may not include every drug

from every manufacturer. However, choosing a preferred drug when it is appropriate can

provide access to the necessary medications to stay healthy, at a cost that is more affordable.

KNOWING HOW THE FORMULARY INFORMATION IS ORGANIZED

The following formulary reference guide is designed so that generic products are listed first in

each drug category. The preferred brand name products are listed next, and non-preferred

brand products are listed last.

PLEASE NOTE: If a generic product is listed in the “generics” section and its corresponding

brand-name product is not listed in the “preferred brand-name” section, then only the

generic product is on the formulary. If a brand name product is listed in the “preferred brand-

name” section and its corresponding generic product is not listed in the “generics” section,

then a generic version of the medication is not available.

CONSIDERING PREFERRED ALTERNATIVES

Catamaran realizes that the medications on the formulary may not always be appropriate for all

patients. However, by referring to this formulary reference guide, one can help ensure the full

advantage of the coverage provided by the prescription drug plan. Possible preferred

alternatives are listed for commonly prescribed non-preferred medications.

Pharmacies cannot substitute a preferred brand-name drug without the prescriber’s approval.

Therefore, a pharmacist may contact the prescriber to obtain authorization to dispense an

alternative preferred product when a non-preferred product is prescribed.

SAVING ON OUT-OF-POCKET COSTS

The prescription drug plan determines the cost for generic, preferred brand-name, and on-

preferred brand-name medications. Benefit providers often design prescription drug plans to

encourage the use of generic and preferred brand-name drugs. Choosing non-preferred drugs

may mean paying higher out-of-pocket expenses (such as coinsurance, co-payments, and

deductible amounts) or not receiving coverage at all. Patients may also pay less for generic

drugs, or they may be asked to pay the cost difference between brand-name drugs and their

generic alternatives, which are preferred by the plan.

CONSULTING THE PRESCRIBER’S OFFICE WHEN APPROPRIATE

When employers and other benefit sponsors design their prescription drug plans, they may

choose to provide coverage only for certain medications or for particular uses, time periods,

doses, or quantities (e.g. they may exclude coverage for medications for unapproved,

unproven, or cosmetic indications, as well as over-the-counter medications). When coverage

for medications is provided based on use or quantity, Catamaran may contact your prescriber’s

office for additional information to determine whether coverage is available under your plan.

Patients who are unsure whether these coverage rules apply for a particular medication can

consult their prescription drug benefit manual or contact a Catamaran Member Services

representative to determine specific coverage requirements.

*Formulary Disclaimer: Coverage for some drugs may be limited to specific dosage forms and/or strengths. The benefit design

determines what is covered and the applicable co-payment. The medications listed on this formulary are subject to change

pursuant to the formulary management activities of catamaran. The presence of a medication on this formulary list does not

guarantee coverage.

Table of Contents

ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

PENICILLINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

CEPHALOSPORIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FIRST GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

SECOND GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

THIRD GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FOURTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MACROLIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

TETRACYCLINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

QUINOLONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

AMINOGLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

ANTIMYCOBACTERIAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

ANTIFUNGALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

ANTIVIRALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

ANTIMALARIALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

AMEBICIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

ANTHELMINTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

MISC. ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

ANTINEOPLASTICS, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ALKYLATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTIBIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTINEOPLASTIC ENZYMES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTIMETABOLITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANGIOGENESIS INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTIBODIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

HORMONAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

MITOTIC INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ENZYME INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

TOPOISOMERASE I INHIBITOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

RADIOPHARMACEUTICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

CELLULAR IMMUNOTHERAPY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ANTINEOPLASTICS MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

CHEMOTHERAPY RESCUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

CHEMOTHERAPY ADJUNCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

CARDIOVASCULAR DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

PHOSPHODIESTERASE INHBTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

CARDIAC GLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ANTIANGINAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

BETA BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

CALCIUM CHANNEL BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ANTIARRHYTHMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ACE INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ANGIOTENSIN RCPTR BLOCKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

DIRECT RENIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ANTIHYPERTENSIVES MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

ANTIHYPERTENSIVE COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

DIURETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

VASOPRESSORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

ANTIHYPERLIPIDEMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CARDIOVASCULAR - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

DERMATOLOGICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ACNE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ROSACEA AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANTIBIOTICS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANTIFUNGALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANTIVIRALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANTI-INFLAMMATORY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANTIPRURITICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANTIPSORIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANTISEBORRHEIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

CORTICOSTEROIDS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

IMMUNOMODULATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

DERMATOLOGICALS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ENDOCRINE AND METABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

CORTICOSTEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ANDROGENS-ANABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ESTROGENS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

CONTRACEPTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

PROGESTINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

ANTIDIABETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

INSULIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

AMYLIN ANALOGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

INCRETIN MIMETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

SULFONYLUREAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

BIGUANIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

MEGLITINIDE ANALOGUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

DIABETIC OTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

ALPHA-GLUCOSIDASE INHIBIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

DPP-4 INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

INSULIN SENSITIZING AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

ANTIDIABETIC COMBINATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

BISPHOSPHONATES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

CALCITONINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

PARATHYROID HORMONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

RANK LIGAND INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

CALCIUM REGULATORS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

HORMONE RECEPTOR MDLTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

FERTILITY REGULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

LHRH/GNRH AGONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

GNRH/LHRH ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

GROWTH HORMONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

GHRH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

SOMATOMEDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

SOMATOSTATIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

GH RECEPTOR ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

POSTERIOR PITUITARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

CORTICOTROPIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

PROLACTIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

VASOPRESSIN ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

METABOLIC MODIFIERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

THYROID AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

GASTROINTESTINAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

LAXATIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTIDIARRHEALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ULCER DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTIEMETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

DIGESTIVE AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

GASTROINTESTINAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

GENITOURINARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

URINARY ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

URINARY ANTISPASMODICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

VAGINAL PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

GENITOURINARY - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

HEMATOLOGICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

HEMATOPOIETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

ANTICOAGULANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

HEMOSTATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

HEMATOLOGICAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

MOUTH/THROAT/DENTAL AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

NEUROLOGY, CNS, PSYCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

ANTIANXIETY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

ANTIDEPRESSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

ANTIPSYCHOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

HYPNOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

ADHD, NARCOLEPSY, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

ANTICONVULSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

ANTIPARKINSON AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

NEUROLOGY, PSYCH - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

NEUROMUSCULAR AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

MUSCULOSKELETAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

ANTIMYASTHENIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

OPHTHALMOLOGY AND OTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

ARTIFICIAL TEAR/LUBRICANT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

BETA-BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

OPHTHALMIC STEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

PROSTAGLANDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

CYCLOPLEGIC MYDRIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

DECONGESTANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

MIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

ADRENERGIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

LOCAL ANESTHETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

OPHTHALMICS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

OTIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

OXYTOCICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

PAIN MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

ANALGESICS - NONNARCOTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

ANALGESICS - OPIOID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

ANTI-INFLAMMATORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

MIGRAINE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

GOUT AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

LOCAL ANESTHETICS-INJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

RESPIRATORY, ALLERGY, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ANTIHISTAMINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

NASAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

COUGH/COLD/ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ANTIASTHMATIC/COPD AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

RESPIRATORY AGENTS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

TOXOIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

VACCINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

MULTIVITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

MEDICAL DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

DIABETIC SUPPLIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

MISCELLANEOUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

NON PREFERRED

Maxipime

MACROLIDES

July 2013

GENERIC

azithromycin

ANTI-INFECTIVES

clarithromycin

clarithromycin ER

PENICILLINS

PREFERRED

GENERIC

Dificid

amoxicillin

NON PREFERRED

amoxicillin/clavulanate potassium

Azithromycin

amoxicillin/clavulanate potassium ER

Ery-TAB

amoxicillin/potassium clavulanate

Erythrocin Lactobionate

ampicillin

PCE

ampicillin sodium

Zithromax

ampicillin-sulbactam

dicloxacillin sodium

TETRACYCLINES

nafcillin sodium

GENERIC

oxacillin sodium

demeclocycline HCL

penicillin v potassium

doxycycline

penicillin G potassium

doxycycline hyclate

piperacillin sodium/tazobactam sodium

doxycycline hyclate DR

piperacillin/tazobactam

doxycycline monohydrate

PREFERRED

minocycline HCL

Augmentin

minocycline HCL ER

NON PREFERRED

NON PREFERRED

Bactocill IN Dextrose

Alodox Convenience Kit

Bicillin C-R

Ocudox

Bicillin L-a

Solodyn

Moxatag

Timentin

QUINOLONES

CEPHALOSPORIN

GENERIC

ciprofloxacin

FIRST GENERATION

ciprofloxacin ER

GENERIC

ciprofloxacin HCL

cefadroxil

ciprofloxacin I.V.-IN D5W

cefazolin sodium

levofloxacin

cephalexin

levofloxacin IN D5W

NON PREFERRED

ofloxacin

Keflex

PREFERRED

SECOND GENERATION

Avelox

GENERIC

Avelox Abc Pack

cefaclor

Cipro

cefoxitin sodium

NON PREFERRED

cefprozil

Factive

cefuroxime axetil

Noroxin

cefuroxime sodium

PREFERRED

AMINOGLYCOSIDES

Ceftin

NON PREFERRED

GENERIC

Mefoxin

amikacin sulfate

Zinacef IN Iso-osmotic Dextrose

gentamicin sulfate

Zinacef IN Iso-osmotic Diluent

gentamicin sulfate/sodium chloride

THIRD GENERATION

gentamicin sulfate/0.9% sodium chloride

GENERIC

isotonic gentamicin

cefdinir

neomycin sulfate

cefotaxime sodium

paromomycin sulfate

cefpodoxime proxetil

tobramycin sulfate

ceftazidime

PREFERRED

ceftriaxone sodium

Tobi PodhalerQL

NON PREFERRED

SPECIALTY

Cedax

TobiPA

Claforan

Suprax

ANTIMYCOBACTERIAL AGENTS

FOURTH GENERATION

GENERIC

GENERIC

ethambutol HCL

cefepime

isoniazid

pyrazinamide

rifampin

Effective July 10, 2013

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 1

PREFERRED

Isentress

Cycloserine

Kaletra

Mycobutin

Lexiva

Seromycin

Nevirapine

Sirturo

Norvir

NON PREFERRED

Prezista

Capastat Sulfate

Relenza DiskhalerQL

Paser

Rescriptor

Priftin

Retrovir IV Infusion

Rifamate

Reyataz

Rifater

SelzentryPA

Trecator

StribildQL

Sustiva

ANTIFUNGALS

TamifluQL

TrizivirQL

GENERIC

TruvadaPA

fluconazole

Videx Pediatric

fluconazole IN NACL

Viracept

flucytosine

Viramune

griseofulvin microsize

Viramune XR

griseofulvin ultramicrosize

Viread

itraconazole

Ziagen

ketoconazole

SPECIALTY

nystatin

BaracludePA,QL

terbinafine HCLQL

HepseraPA,QL

voriconazole

IncivekPA

PREFERRED

InfergenPA

Lamisil

Peg-intronPA

Noxafil

Peg-intron RedipenPA

Sporanox

Peg-intron Redipen PAK 4PA

NON PREFERRED

PegasysPA

Abelcet

Pegasys ProclickPA

Ambisome

Rebetol

Amphotec

Ribapak

Cancidas

Ribatab

Eraxis

TyzekaPA,QL

Mycamine

Valcyte

Terbinex

VictrelisPA

Vfend

Virazole

ANTIVIRALS

ANTIMALARIALS

GENERIC

GENERIC

abacavir

atovaquone/proguanil HCL

acyclovir

chloroquine phosphate

acyclovir sodium

hydroxychloroquine sulfate

cidofovir

mefloquine HCL

didanosine

quinine sulfate

famciclovirQL

PREFERRED

ganciclovir

Coartem

lamivudine

Daraprim

lamivudine/zidovudine

nevirapine

AMEBICIDES

ribavirin

rimantadine HCL

PREFERRED

stavudine

Yodoxin

valacyclovir HCLQL

zidovudine

ANTHELMINTICS

PREFERRED

PREFERRED

Aptivus

Albenza

AtriplaQL

Biltricide

CompleraQL

Stromectol

Crixivan

Edurant

MISC. ANTI-INFECTIVES

Emtriva

GENERIC

Epivir

aztreonam

Epivir HBV

bacitracin

Epzicom

clindamycin palmitate HCL

FuzeonPA,QL

clindamycin phosphate

Intelence

clindamycin phosphate IN D5W

Invirase

clindamycin HCL



colistimethate sodium

SPECIALTY

erythromycin/sulfisoxazole

Daunoxome

imipenem/cilastatin

meropenem

ANTINEOPLASTIC ENZYMES

metronidazole

PREFERRED

metronidazole IN NACL 0.79%

Elspar

polymyxin b sulfate

Oncaspar

sulfamethoxazole/trimethoprim

SPECIALTY

sulfamethoxazole/trimethoprim DS

ErwinazePA

tinidazole

trimethoprim

ANTIMETABOLITES

vancomycin HCL

GENERIC

PREFERRED

cladribine

Alinia

cytarabine

Mepron

cytarabine aqueous

Nebupent

floxuridine

Xifaxan

fludarabine phosphate

Zyvox

fluorouracil

NON PREFERRED

gemcitabine HCL

Azactam IN Iso-osmotic Dextrose

mercaptopurine

Cubicin

methotrexate

Doribax

methotrexate sodium

Flagyl ER

PREFERRED

Invanz

Clolar

Ketek

Depocyt

Lincocin

Tabloid

Primsol

Trexall

Tygacil

SPECIALTY

Vibativ

Alimta

SPECIALTY

Arranon

CaystonPA

Dacogen

Folotyn

ANTINEOPLASTICS, ETC

VidazaPA

ALKYLATING AGENTS

XelodaPA

GENERIC

ANGIOGENESIS INHIBITORS

carboplatin

cisplatin

SPECIALTY

ifosfamide

Avastin

melphalan hydrochloride

ZaltrapPA

oxaliplatin

PREFERRED

ANTIBODIES

Alkeran

PREFERRED

Bicnu

Bexxar

Gliadel Wafer

Campath

Hexalen

KadcylaPA

Ifex

SPECIALTY

Ifosfamide

AdcetrisPA

Leukeran

Arzerra

Mustargen

Erbitux

Zanosar

HerceptinPA

SPECIALTY

PerjetaPA

Busulfex

RituxanPA

MyleranPA

Vectibix

TemodarPA

YervoyPA

Treanda

HORMONAL AGENTS

ANTIBIOTICS

GENERIC

GENERIC

anastrozole

bleomycin sulfate

bicalutamide

dactinomycin

exemestane

daunorubicin HCL

flutamide

doxorubicin HCL

letrozole

doxorubicin HCL liposome

leuprolide acetatePA

epirubicin HCL

megestrol acetate

idarubicin HCL

tamoxifen citrate

mitomycin

PREFERRED

mitoxantrone HCLPA

Depo-provera

PREFERRED

Emcyt

Valstar

Fareston



Lysodren

CaprelsaPA,QL

Nilandron

CometriqPA

Soltamox

GleevecPA

SPECIALTY

InlytaPA

EligardPA,QL

Istodax

Faslodex

JakafiPA

FirmagonPA,QL

KyprolisPA

Lupron DepotPA,QL

NexavarPA

Trelstar DepotPA,QL

SprycelPA

Trelstar Depot MixjectPA,QL

StivargaPA

Trelstar LAPA,QL

SutentPA

Trelstar LA MixjectPA,QL

TarcevaPA

Trelstar MixjectPA,QL

TasignaPA

VantasPA,QL

Torisel

XtandiPA,QL

TykerbPA

ZoladexPA,QL

VandetanibPA,QL

ZytigaPA

VelcadePA

VotrientPA

IMMUNOMODULATORS

XalkoriPA

ZelborafPA,QL

GENERIC

ZolinzaPA

azathioprine

cyclosporine

TOPOISOMERASE I INHIBITOR

cyclosporine modified

mycophenolate mofetil

GENERIC

tacrolimus

irinotecan

PREFERRED

topotecan HCL

Azasan

SPECIALTY

Cellcept

Hycamtin

PomalystPA,QL

Rapamune

RADIOPHARMACEUTICALS

Sandimmune

PREFERRED

NON PREFERRED

Quadramet

Atgam

Cellcept Intravenous

CELLULAR IMMUNOTHERAPY

Myfortic

PREFERRED

NulojixPA

Provenge

Prograf

Simulect

ANTINEOPLASTICS MISC.

Thymoglobulin

GENERIC

ZortressPA

dacarbazine

SPECIALTY

hydroxyurea

RevlimidPA

pentostatin

ThalomidPA

tretinoin

PREFERRED

MITOTIC INHIBITORS

Photofrin

GENERIC

Theracys

etoposide

Tice Bcg

paclitaxel

Trisenox

vincristine sulfate

Uvadex

vinorelbine tartrate

SPECIALTY

PREFERRED

Actimmune

Vumon

Alferon N

SPECIALTY

Intron-aPA

Abraxane

Intron-a W/DiluentPA

Docefrez

Matulane

Docetaxel

Ontak

Etopophos

Proleukin

HalavenPA

SylatronPA

Ixempra Kit

SynriboPA

JevtanaPA

TargretinPA

Taxotere

CHEMOTHERAPY RESCUE

ENZYME INHIBITORS

GENERIC

PREFERRED

amifostine

Afinitor Disperz

dexrazoxane

IclusigPA

leucovorin calcium

SPECIALTY

mesna

AfinitorPA

PREFERRED

BosulifPA

Fusilev



Mesnex

felodipine ER

Totect

nicardipine HCL

Voraxaze

nifedipine

nifedipine ER

CHEMOTHERAPY ADJUNCTS

nimodipine

nisoldipine

PREFERRED

nisoldipine ER

Kepivance

verapamil HCL

SPECIALTY

verapamil HCL ER

Elitek

verapamil HCL SR

PREFERRED

CARDIOVASCULAR DRUGS

Cardizem LA

PHOSPHODIESTERASE INHBTR

NON PREFERRED

GENERIC

Cardene IV

milrinone lactate

milrinone IN dextrose

ANTIARRHYTHMICS

GENERIC

CARDIAC GLYCOSIDES

adenosine

GENERIC

amiodarone HCL

digoxin

disopyramide phosphate

flecainide acetate

ANTIANGINAL AGENTS

ibutilide fumarate

GENERIC

lidocaine HCL

isosorbide dinitrate

lidocaine HCL IN D5W

isosorbide dinitrate ER

lidocaine HCL/dextrose

isosorbide mononitrate

procainamide HCL

isosorbide mononitrate ER

propafenone HCL

nitroglycerin

propafenone HCL ER

nitroglycerin transdermal

quinidine gluconate CR

nitroglycerin IN dextrose 5%

quinidine gluconate ER

nitroglycerin IN 5% dextrose

quinidine sulfate

PREFERRED

PREFERRED

Dilatrate SR

Pacerone

Nitro-bid

Tikosyn

Nitro-dur

NON PREFERRED

Nitrolingual Pumpspray

Multaq

Nitrostat

Nexterone

Ranexa

Norpace CR

NON PREFERRED

Nitroglycerin Lingual

ACE INHIBITORS

Nitromist

GENERIC

benazepril HCL

BETA BLOCKERS

captopril

GENERIC

enalapril maleate

acebutolol HCL

enalaprilat

atenolol

fosinopril sodium

betaxolol HCL

lisinopril

bisoprolol fumarate

moexipril HCL

carvedilol

perindopril erbumine

esmolol HCL

quinapril HCL

labetalol HCL

ramipril

metoprolol succinate ER

trandolapril

metoprolol tartrate

nadolol

ANGIOTENSIN RCPTR BLOCKER

propranolol HCL

GENERIC

propranolol HCL ER

eprosartan mesylate

sotalol HCL

irbesartan

PREFERRED

losartan potassium

Bystolic

PREFERRED

Coreg CR

Diovan

NON PREFERRED

Micardis

Innopran XL

NON PREFERRED

Levatol

BenicarPA,ST

EdarbiPA,ST

CALCIUM CHANNEL BLOCKERS

TevetenPA,ST

GENERIC

amlodipine besylate

DIRECT RENIN INHIBITORS

diltiazem CD

PREFERRED

diltiazem HCL

Tekturna

diltiazem HCL ER



ANTIHYPERTENSIVES MISC.

torsemide

triamterene/hydrochlorothiazide

GENERIC

NON PREFERRED

clonidine HCL

Dyrenium

doxazosin mesylate

Edecrin

eplerenone

Sodium Edecrin

fenoldopam mesylate

guanfacine HCL

VASOPRESSORS

hydralazine HCL

methyldopa

GENERIC

minoxidil

dobutamine HCL

prazosin HCL

dobutamine HCL/D5W

terazosin HCL

dobutamine/dextrose 5%

PREFERRED

dopamine HCL

Demser

dopamine HCL-dextrose 5%

Dibenzyline

dopamine HCL/dextrose 5%

dopamine/D5W

ANTIHYPERTENSIVE COMBO

ephedrine sulfate

midodrine HCL

GENERIC

norepinephrine bitartrate

amlodipine besylate/benazepril hydrochloride

phenylephrine HCL

amlodipine besylate/benazepril HCL

PREFERRED

atenolol/chlorthalidone

Epipen 2-PAK

benazepril HCL/hydrochlorothiazide

Epipen-JR 2-PAK

bisoprolol fumarate/hydrochlorothiazide

NON PREFERRED

candesartan cilexetil/hydrochlorothiazide

Auvi-q

enalapril maleate/hydrochlorothiazide

Twinject

fosinopril sodium/hydrochlorothiazide

irbesartan/hydrochlorothiazide

ANTIHYPERLIPIDEMICS

lisinopril/hydrochlorothiazide

losartan potassium/hydrochlorothiazide

GENERIC

metoprolol/hydrochlorothiazide

atorvastatin calcium

moexipril/hydrochlorothiazide

cholestyramine light

nadolol/bendroflumethiazide

colestipol HCL

quinapril/hydrochlorothiazide

colestipol HCL for oral suspension

valsartan/hydrochlorothiazide

fenofibrate

PREFERRED

fenofibrate micronized

Amturnide

fluvastatin

Azor

gemfibrozil

Exforge

lovastatin

Exforge HCT

pravastatin sodium

Micardis HCT

simvastatin

Tarka

PREFERRED

Tekamlo

Altoprev

Tekturna HCT

Crestor

Tribenzor

Lipofen

Twynsta

Lovaza

Valturna

Niaspan

NON PREFERRED

Simcor

Benicar HCTPA,ST

Vascepa

EdarbyclorPA,ST

Vytorin

Teveten HCTPA,ST

Welchol

Zetia

DIURETICS

NON PREFERRED

Fenofibric Acid

GENERIC

Fenoglide

acetazolamide

Fibricor

acetazolamide sodium

Livalo

acetazolamide ER

Triglide

amiloride HCL

Trilipix

amiloride/hydrochlorothiazide

SPECIALTY

bumetanide

JuxtapidPA,QL

chlorothiazide

chlorothiazide sodium

CARDIOVASCULAR - MISC.

furosemide

hydrochlorothiazide

GENERIC

indapamide

epoprostenol sodiumPA

mannitol

papaverine HCL

methazolamide

sildenafil citratePA,QL

metolazone

PREFERRED

spironolactone

Bidil

spironolactone/hydrochlorothiazide

CaverjectQL



Caverject ImpulseQL

ciclopirox olamine

CialisQL

clotrimazole

EdexQL

clotrimazole/betamethasone dipropionate

MuseQL

econazole nitrate

RevatioPA,QL

ketoconazole

ViagraQL

nystatin

SPECIALTY

nystatin/triamcinolone

AdcircaPA,QL

PREFERRED

LetairisPA,QL

Exelderm

RemodulinPA

Mentax

TracleerPA,QL

NON PREFERRED

TyvasoPA,QL

Cnl8 Nail Kit

Tyvaso RefillPA,QL

Ertaczo

Tyvaso StarterPA,QL

Naftin

VeletriPA

Oxistat

VentavisPA,QL

Pedipirox-4 Nail

Xolegel

DERMATOLOGICALS

ANTIVIRALS - TOPICAL

ACNE PRODUCTS

GENERIC

GENERIC

acyclovir

adapalene

PREFERRED

benzoyl peroxide

Zovirax

benzoyl peroxide SHORT contact

NON PREFERRED


Denavir

clindamycin/benzoyl peroxide

erythromycin

ANTI-INFLAMMATORY AGENTS

erythromycin/benzoyl peroxide

PREFERRED

sodium sulfacetamide

FlectorQL

sodium sulfacetamide/sulfur

Voltaren

sodium sulfacetamide/sulfur cleanser

sodium sulfacetamide/sulfur cleansing cloths

ANTIPRURITICS

sodium sulfacetamide/sulfur green

sodium sulfacetamide/sulfur wash

NON PREFERRED

sulfacetamide sodium

Prudoxin

sulfacetamide sodium/sulfur cleanser

Zonalon

tretinoin

PREFERRED

ANTIPSORIATICS

Acanya

GENERIC

Atralin

calcipotriene

Azelex

PREFERRED

Differin

Dritho-scalp

Epiduo

Oxsoralen Ultra

Veltin

Soriatane

NON PREFERRED

TazoracQL

Absorica

NON PREFERRED

Claravis

Amevive

Tretin-x

Calcitriol

Ziana

Vectical

8-mop

ROSACEA AGENTS

SPECIALTY

GENERIC

StelaraPA,QL

metronidazole

PREFERRED

ANTISEBORRHEIC AGENTS

Finacea

GENERIC

Oracea

selenium sulfide

sodium sulfacetamide wash

ANTIBIOTICS - TOPICAL

PREFERRED

GENERIC

Ovace Plus

gentamicin sulfate

mupirocin

CORTICOSTEROIDS - TOPICAL

mupirocin calcium

GENERIC

NON PREFERRED

alclometasone dipropionate

Altabax

amcinonide

Cortisporin

augmented betamethasone dipropionate

betamethasone dipropionate

ANTIFUNGALS - TOPICAL

betamethasone valerate

GENERIC

clobetasol propionate

ciclopirox

desonide

ciclopirox nail lacquer

desoximetasone



diflorasone diacetate

urea 40% nail film

fluocinolone acetonide

PREFERRED

fluocinonide

Condylox

fluticasone propionate

Eurax

halobetasol propionate

Lidoderm

hydrocortisone

Oxsoralen

hydrocortisone acetate/aloe

Ulesfia

hydrocortisone butyrate

NON PREFERRED

hydrocortisone valerate

Natroba

hydrocortisone IN absorbase

Sklice

mometasone furoate

Spinosad

prednicarbate

Synera

triamcinolone acetonide

Veregen

PREFERRED

Capex

ENDOCRINE AND METABOLIC

Clobex

CORTICOSTEROIDS

Cordran Tape

GENERIC

Halog

betamethasone sodium phosphate/betamethasone acetate

Kenalog

Locoid

budesonide

Locoid Lipocream

dexamethasone

Pramosone

dexamethasone sodium phosphate

Pramosone E

fludrocortisone acetate

TaclonexQL

hydrocortisone

Ultravate PAC

methylprednisolone

NON PREFERRED

methylprednisolone acetate

Cloderm

methylprednisolone dose pack

Cloderm P.M.

methylprednisolone sodiumsuccinate

Cordran

prednisolone

Cordran SP

prednisolone sodium phosphate

Desonate

prednisone

Desowen Cream/Cetaphil Lotion

PREFERRED

Desowen Lotion/Cetaphil Cream

Uceris

Desowen Ointment/Cetaphil Lotion

NON PREFERRED

Pediaderm HC

Depo-medrol

Pediaderm Ta

Dexamethasone Intensol

Texacort

Dexpak 10 Day

Vanos

Dexpak 13 Day

Verdeso

Dexpak 6 Day

Millipred

IMMUNOMODULATING AGENTS

Millipred DP

GENERIC

Orapred Odt

imiquimod

Prednisone Intensol

PREFERRED

Rayos

Elidel

Solu-cortef

Protopic

Veripred 20

NON PREFERRED

Zyclara

ANDROGENS-ANABOLIC

Zyclara P.M.

GENERIC

danazol

DERMATOLOGICALS - MISC.

oxandroloneQL

GENERIC

testosterone cypionate

ammonium lactate

testosterone enanthate

lactic acid

PREFERRED

lactic acid e

Androgel

lactic acid w/vitamin e

Androxy

lidocaine

NON PREFERRED

lidocaine HCL

Anadrol-50

lidocaine HCL jelly

AndrodermPA,ST

lidocaine/prilocaine

AxironPA,ST

lindane

FortestaPA,ST

malathion

StriantPA,ST

permethrin

TestimPA,ST

podofilox

salicylic acid

ESTROGENS

sodium hyaluronate

GENERIC

urea

estradiol

urea topical

estradiol valerate

urea IN zinc undecylenate/lactic acid vehicle

estradiol/norethindrone acetate



estropipate

Humulin 70/30PA,ST

PREFERRED

Humulin 70/30 PenPA,ST

Cenestin

LevemirPA,ST

Combipatch

Levemir FlexpenPA,ST

Enjuvia

AMYLIN ANALOGS

Evamist

PREFERRED

Premarin

Symlin

Premphase

NON PREFERRED

Prempro

Symlinpen 120

Vivelle-dot

Symlinpen 60

NON PREFERRED

INCRETIN MIMETIC AGENTS

Alora

PREFERRED

Estrogel

Bydureon

Menest

Byetta

NON PREFERRED

CONTRACEPTIVES

VictozaPA,ST

SULFONYLUREAS

PREFERRED

GENERIC

Beyaz

glimepiride

EllaQL

glipizide

Loestrin 24 FE

glipizide ER

LO Loestrin FE

glyburide

Safyral

glyburide micronized

PREVENTIVE

tolazamide

drospirenone/ethinyl estradiol

NON PREFERRED

levonorgestrelQL

Diabeta

levonorgestrel and ethinyl estradiolQL

Glyburide

levonorgestrel/ethinyl estradiol

BIGUANIDES

norethindrone

GENERIC

norgestimate/ethinyl estradiol

metformin HCL

norgestrel/ethinyl estradiol

metformin HCL ER

Natazia

PREFERRED

Ortho Evra

Riomet

NON PREFERRED

PROGESTINS

Glumetza

GENERIC

MEGLITINIDE ANALOGUES

medroxyprogesterone acetate

GENERIC

norethindrone acetate

nateglinide

progesterone

PREFERRED

SPECIALTY

Prandin

MakenaPA

DIABETIC OTHER

PREFERRED

ANTIDIABETIC AGENTS

Glucagon Emergency Kit

INSULIN

NON PREFERRED

PREFERRED

Glucagen

Apidra

Glucagen Hypokit

Apidra Solostar

Proglycem

Lantus

ALPHA-GLUCOSIDASE INHIBIT

Lantus Solostar

GENERIC

Novolin N

acarbose

Novolin N Relion

NON PREFERRED

Novolin R

Glyset

Novolin R Relion

DPP-4 INHIBITORS

Novolin 70/30

PREFERRED

Novolin 70/30 Relion

Januvia

Novolog

Onglyza

Novolog Flexpen

Tradjenta

Novolog Mix 70/30

INSULIN SENSITIZING AGENT

Novolog Mix 70/30 Prefilled Flexpen

GENERIC

Novolog Penfill

pioglitazone HCL

NON PREFERRED

NON PREFERRED

HumalogPA,ST

Avandia

Humalog KwikpenPA,ST

ANTIDIABETIC COMBINATIONS

Humalog Mix 50/50PA,ST

GENERIC

Humalog Mix 50/50 KwikpenPA,ST

glipizide/metformin HCL

Humalog Mix 75/25PA,ST

glyburide/metformin HCL

Humalog Mix 75/25 KwikpenPA,ST

pioglitazone HCL-glimepiride

Humulin NPA,ST

pioglitazone HCL/metformin HCL

Humulin N U-100 PenPA,ST

PREFERRED

Humulin RPA,ST

Actoplus Met XR

Humulin R U-500 (concentrated)PA,ST



Janumet

SPECIALTY

Janumet XR

CetrotideQL

Jentadueto

Juvisync

GROWTH HORMONES

Kombiglyze XR

SPECIALTY

Prandimet

GenotropinPA

Genotropin MiniquickPA

BISPHOSPHONATES

HumatropePA

GENERIC

Humatrope Combo PackPA

alendronate sodium

Norditropin CartridgePA

ibandronate sodiumQL

Norditropin FlexproPA

pamidronate disodium

Norditropin Nordiflex PenPA

zoledronic acidPA

NutropinPA

PREFERRED

Nutropin AQPA

Fosamax Plus DQL

Nutropin AQ Nuspin 10PA

NON PREFERRED


ActonelPA,ST


AtelviaPA,ST,QL

Nutropin AQ PenPA

BinostoQL

OmnitropePA

Skelid

SaizenPA

SPECIALTY

Saizen Click.easyPA

ZometaPA

SerostimPA

Tev-tropinPA

CALCITONINS

ZorbtivePA

GENERIC

GHRH

calcitonin salmonQL

calcitonin-salmonQL

SPECIALTY

NON PREFERRED

EgriftaPA,QL

Miacalcin

SOMATOMEDINS

PARATHYROID HORMONE

SPECIALTY

SPECIALTY

IncrelexPA

ForteoQL

SOMATOSTATIC AGENTS

RANK LIGAND INHIBITORS

GENERIC

SPECIALTY

octreotide acetatePA

ProliaPA,QL

PREFERRED

XgevaPA,QL

SigniforPA,QL

SPECIALTY

CALCIUM REGULATORS - MISC

Sandostatin Lar DepotPA

Somatuline DepotPA

NON PREFERRED

Ganite

GH RECEPTOR ANTAGONISTS

HORMONE RECEPTOR MDLTR

SPECIALTY

SomavertPA

PREFERRED

Evista

POSTERIOR PITUITARY

FERTILITY REGULATORS

GENERIC

desmopressin acetate

GENERIC

vasopressin

chorionic gonadotropinQL

SPECIALTY

clomiphene citrate

Stimate

SPECIALTY

BravelleQL

CORTICOTROPIN

Follistim AQQL

Gonal-fQL

SPECIALTY

Gonal-f RFFQL

Acthar HPPA

Gonal-f RFF Pen

Menopur

PROLACTIN INHIBITORS

OvidrelQL

GENERIC

RepronexQL

cabergoline

LHRH/GNRH AGONIST

VASOPRESSIN ANTAGONISTS

SPECIALTY

SPECIALTY

Lupron Depot-PEDPA,QL

Samsca

Supprelin LAPA,QL

Synarel

METABOLIC MODIFIERS

GENERIC

GNRH/LHRH ANTAGONISTS

calcitriol



levocarnitine

hyoscyamine sulfate

PREFERRED

hyoscyamine sulfate odt

Buphenyl

hyoscyamine sulfate ER

Hectorol

hyoscyamine sulfate SR

Sensipar

lansoprazoleQL

NON PREFERRED

methscopolamine bromide

Zemplar

misoprostol

SPECIALTY

nizatidine

AldurazymePA

omeprazoleQL

CarbagluPA

omeprazole/sodium bicarbonateQL

Cystadane

pantoprazole sodiumQL

ElaprasePA

ranitidine HCL

FabrazymePA

sucralfate

KuvanPA

PREFERRED

LumizymePA

Carafate

MyozymePA

NexiumQL

NaglazymePA

Pylera

Orfadin

NON PREFERRED

AciphexPA,ST,QL

THYROID AGENTS

Atropen

Cantil

GENERIC

Cuvposa

levothyroxine sodium

DexilantPA,ST,QL

liothyronine sodium

Donnatal

methimazole

Donnatal Extentabs

propylthiouracil

First-lansoprazole

NON PREFERRED

Helidac

Thyrolar-1

Omeclamox-PAK

Thyrolar-1/2

Prevacid SolutabPA,ST,QL

Thyrolar-1/4

Prevpac

Thyrolar-2

ZegeridPA,ST,QL

Thyrolar-3

ANTIEMETICS

GASTROINTESTINAL

GENERIC

LAXATIVES

dronabinolQL

GENERIC

granisetron HCLQL

lactulose

meclizine HCL

peg 3350/electrolytes

ondansetron odtQL

peg-3350/electrolytes

ondansetron HCLQL

peg-3350/NACL/NA bicarbonate/KCL

trimethobenzamide HCL

polyethylene glycol 3350

PREFERRED

PREFERRED

AnzemetQL

Colyte-flavor Packs

EmendQL

Golytely

SancusoQL

Halflytely Bowel Prep/Flavor Packs

Transderm-scop

Kristalose

NON PREFERRED

Moviprep

Aloxi

Suprep Bowel Prep

CesametQL

NON PREFERRED

GranisolQL

Osmoprep

ZuplenzQL

Prepopik

Visicol

DIGESTIVE AIDS

PREFERRED

ANTIDIARRHEALS

Creon

GENERIC

Pancrelipase

diphenoxylate/atropine

Zenpep

loperamide HCL

NON PREFERRED

opium

Pertzye

opium tincture

Ultresa

PREFERRED

Viokace

Motofen

SPECIALTY

Sucraid

ULCER DRUGS

GENERIC

GASTROINTESTINAL - MISC.

atropine sulfate

GENERIC

cimetidine

balsalazide disodium

cimetidine HCL

calcium acetate

dicyclomine HCL

cromolyn sodium

famotidine

hydrocort ene 100MG

glycopyrrolate



hydrocortisone

PREFERRED

hydrocortisone acetate/pramoxine

Avc

lactulose

Endometrin

lidocaine HCL/hydrocortisone acetate

Estrace

mesalamine

EstringQL

metoclopramide HCL

Gynazole-1

sulfasalazine

Vagifem

ursodiol

NON PREFERRED

PREFERRED

Cleocin

AmitizaQL

SPECIALTY

Analpram-HC

Crinone

Apriso

Asacol

GENITOURINARY - MISC.

Asacol HD

GENERIC

Canasa

alfuzosin HCL ER

Cortifoam

citric acid/sodium citrate

Fosrenol

finasteride

LinzessQL

phenazopyridine HCL

Lotronex

potassium citrate/citric acid

Pentasa

tamsulosin HCL

Proctofoam HC

PREFERRED

Relistor

Elmiron

Renvela

ProcysbiPA

NON PREFERRED

Rapaflo

Dipentum

Urocit-k 15

GattexPA

NON PREFERRED

Giazo

Avodart

Phoslyra

Cardura XL

Rectiv

Oracit

Renagel

Potassium Citrate

SPECIALTY

Urocit-k 10

CimziaPA

Urocit-k 5

RemicadePA

SPECIALTY

Cystagon

GENITOURINARY

HEMATOLOGICAL

URINARY ANTI-INFECTIVES

GENERIC

HEMATOPOIETIC AGENTS

methenamine hippurate

GENERIC

nitrofurantoin

cyanocobalamin

nitrofurantoin macrocrystal

folic acid

nitrofurantoin macrocrystalline

folic acid/vitamin b-6/vitamin b-12

nitrofurantoin macrocrystals

sodium ferric gluconate complex/sucrose

NON PREFERRED

PREFERRED

Monurol

Droxia

Foltrate

URINARY ANTISPASMODICS

NON PREFERRED

GENERIC

OmontysPA

bethanechol chloride

Venofer

flavoxate HCL

SPECIALTY

oxybutynin chloride

Aranesp Albumin FreePA

oxybutynin chloride ER

CerezymePA

tolterodine tartrate

ElelysoPA

trospium chloride

EpogenPA

trospium chloride ER

LeukinePA

PREFERRED

MozobilPA,QL

Detrol LA

NeulastaPA

Enablex

NeumegaPA

Gelnique

NeupogenPA

OxytrolQL

NplatePA

Toviaz

ProcritPA

Vesicare

PromactaPA,QL

NON PREFERRED

VprivPA

Myrbetriq

ZavescaPA

PREVENTIVE

VAGINAL PRODUCTS

ferrous drops

ferrous fumarate 324

GENERIC

ferrous gluconate


ferrous gluconate iron

metronidazole vaginal

ferrous sulfate

terconazole



iron

Helixate FS

Fa-8

Hemofil M

Feosol

Humate-p

Ferrimin 150

Kalbitor

Mykidz Iron 10

Koate-dvi

Novaferrum Pediatric Drops

Kogenate FS

Profe

Kogenate FS Bio-set

Proferrin ES

Monoclate-p

Mononine

ANTICOAGULANTS

Novoseven Rt

Profilnine SD

GENERIC

Recombinate

argatroban

Riastap

enoxaparin sodiumQL

SolirisPA

fondaparinux sodiumQL

Thrombate Iii W/10 ML Sterile Water

heparin lock

Xyntha

heparin lock flush

Xyntha Solofuse

heparin lock flush for flushing vascular access devices

heparin lock flush/NACL for flushing vascular access devices

MOUTH/THROAT/DENTAL AGENT

heparin sodium

heparin sodium dcu

GENERIC

heparin sodium lock flush

cevimeline HCL

heparin sodium/sodium chloride 0.9% premix

chlorhexadine gluconate oral rinse

heparin sodium/D5W

chlorhexidine gluconate

heparin sodium/NACL 0.9%

chlorhexidine gluconate oral rinse

warfarin sodium

clotrimazole

PREFERRED

lidocaine viscous

EliquisQL

lidocaine HCL

PradaxaQL

nystatin

XareltoQL

pilocarpine hydrochloride

NON PREFERRED

pilocarpine HCL

FragminQL

stannous fluoride oral rinse

triamcinolone acetonide

HEMOSTATICS

triamcinolone IN orabase

GENERIC

NON PREFERRED

aminocaproic acid

Aphthasol

tranexamic acid

Oravig

HEMATOLOGICAL - MISC.

NEUROLOGY, CNS, PSYCH

GENERIC

ANTIANXIETY AGENTS

anagrelide hydrochloride

GENERIC

cilostazol

alprazolam

clopidogrel

alprazolam odt

dipyridamole

alprazolam ER

hetastarch 6%/NACL

buspirone HCL

pentoxifylline ER

chlordiazepoxide HCL

ticlopidine HCL

clorazepate dipotassium

PREFERRED

diazepam

Aggrenox

droperidol

Brilinta

gene-xene TAB 15MG

Effient

gene-xene TAB 3.75MG

Wilate

gene-xene TAB 7.5MG

NON PREFERRED

hydroxyzine pamoate

Aggrastat

hydroxyzine HCL

Integrilin

lorazepam

SPECIALTY

meprobamate

Advate

oxazepam

Alphanate/Von Willebrand Factor Complex/Human

Alphanine SD

ANTIDEPRESSANTS

Bebulin

GENERIC

Bebulin VH

amitriptyline HCL

Benefix

bupropion HCL

Berinert

bupropion HCL ERQL

Ceprotin

bupropion HCL SRQL

Cinryze

bupropion HCL XLQL

Corifact

citalopram hydrobromideQL

Feiba NF

clomipramine HCL

Feiba VH Immuno

desipramine HCL

Firazyr

doxepin HCL



escitalopram oxalateQL

HYPNOTICS

fluoxetine DRQL

GENERIC

fluoxetine HCLQL

estazolam

fluvoxamine maleateQL

flurazepam HCL

imipramine pamoate

phenobarbital

imipramine HCL

phenobarbital sodium

mirtazapine

temazepam

mirtazapine odt

triazolam

nortriptyline HCL

zaleplonQL

paroxetine HCLQL

zolpidem tartrateQL

paroxetine HCL ERQL

zolpidem tartrate ERQL

phenelzine sulfate

PREFERRED

protriptyline HCL

LunestaQL

sertraline HCLQL

NON PREFERRED

tranylcypromine sulfate

IntermezzoQL

trazodone HCL

RozeremQL

trimipramine maleate

SilenorQL

venlafaxine HCLQL

venlafaxine HCL ERQL

ADHD, NARCOLEPSY, ETC.

PREFERRED

GENERIC

CymbaltaQL

amphetamine/dextroamphetamineQL

PaxilQL

caffeine citrate

PristiqQL

dexmethylphenidate HCLQL

NON PREFERRED

dextroamphetamine sulfate

AplenzinQL

dextroamphetamine sulfate ERQL

EmsamQL

doxapram HCL

Forfivo XLQL

methamphetamine HCLQL

Marplan

methylphenidate hydrochloride

ViibrydQL

methylphenidate HCLQL

methylphenidate HCL CDQL

ANTIPSYCHOTICS

methylphenidate HCL ERQL

GENERIC

methylphenidate HCL SRQL

chlorpromazine HCL

modafinilQL

clozapineQL

PREFERRED

fluphenazine HCL

DaytranaQL

haloperidol

Intuniv

haloperidol decanoate

StratteraQL

haloperidol lactate

VyvanseQL

lithium carbonate

NON PREFERRED

lithium carbonate ER

Focalin XRQL

loxapine

Kapvay

loxapine succinate

Kapvay Dose Pack

olanzapineQL

NuvigilQL

olanzapine odtQL

Quillivant XRQL

perphenazine

prochlorperazine

ANTICONVULSANTS

prochlorperazine maleate

GENERIC

quetiapine fumarateQL

carbamazepine

risperidoneQL

carbamazepine ER

risperidone odtQL

clonazepam

thioridazine HCL

clonazepam odt

thiothixene

divalproex sodium

trifluoperazine HCL

divalproex sodium DR

ziprasidone HCLQL

divalproex sodium ER

PREFERRED

ethosuximide

AbilifyQL

felbamate

Abilify DiscmeltQL

fosphenytoin sodium

Abilify Maintena

gabapentin

LatudaQL

lamotrigine

Seroquel XRQL

lamotrigine ER

NON PREFERRED

levetiracetam

FanaptPA,ST,QL

levetiracetam ER

FazacloQL

oxcarbazepine

Geodon

phenytoin

InvegaPA,ST,QL

phenytoin sodium

Invega Sustenna

phenytoin sodium extended

SaphrisPA,ST,QL

primidone

tiagabine hydrochloride

topiramate



valproate sodium

NON PREFERRED

valproic acid

Campral

zonisamide

GraliseQL

PREFERRED

Gralise StarterQL

Banzel

HorizantQL

Celontin

SPECIALTY

Diastat Pediatric

AmpyraPA,QL

Diazepam

AubagioPA,QL

Dilantin

AvonexPA,QL

Gabitril

Avonex PenPA,QL

Lamictal Odt

BetaseronPA,QL

Lyrica

CopaxonePA,QL

Peganone

ExtaviaPA,QL

Potiga

GilenyaPA,QL

Tegretol-XR

RebifPA,QL

Vimpat

Rebif RebidosePA,QL

NON PREFERRED

Rebif Rebidose Titration PackPA,QL

Lamictal

Rebif Titration PackPA,QL

Stavzor

TysabriPA,QL

SPECIALTY

XenazinePA

Sabril

XyremPA,QL

ANTIPARKINSON AGENTS

NEUROMUSCULAR AGENTS

GENERIC

GENERIC

amantadine HCL

atracurium besylate

benztropine mesylate

cisatracurium besylate

bromocriptine mesylate

pancuronium bromide

carbidopa/levodopa

rocuronium bromide

carbidopa/levodopa odt

vecuronium bromide

carbidopa/levodopa CR

SPECIALTY

carbidopa/levodopa ER

BotoxPA

carbidopa/levodopa SR

DysportPA

entacapone

MyoblocPA

pramipexole dihydrochloride

XeominPA

ropinirole ER

ropinirole HCL

MUSCULOSKELETAL AGENTS

selegiline HCL

GENERIC

trihexyphenidyl HCL

baclofen

PREFERRED

carisoprodol

Azilect

carisoprodol/aspirin

Lodosyn

carisoprodol/aspirin/codeine

Mirapex ER

chlorzoxazone

NON PREFERRED

cyclobenzaprine HCL

Neupro

dantrolene sodium

Tasmar

metaxalone

SPECIALTY

methocarbamol

ApokynPA

orphenadrine citrate

orphenadrine citrate ER

NEUROLOGY, PSYCH - MISC.

orphenadrine/asa/caffeine

GENERIC

tizanidine HCL

disulfiram

NON PREFERRED

donepezil HCL

Gablofen

galantamine

Lioresal Intrathecal

galantamine hydrobromide

Lorzone

olanzapine/fluoxetine

SPECIALTY

rivastigmine tartrate

EuflexxaPA

PREFERRED

HyalganPA

Aricept

OrthoviscPA

Exelon

SupartzPA

Namenda

SynviscPA

Namenda Titration PAK

Synvisc OnePA

Namenda XRQL

Namenda XR Titration PackQL

ANTIMYASTHENIC AGENTS

Nuedexta

GENERIC

Orap

neostigmine methylsulfate

SavellaQL

pyridostigmine bromide

TecfideraPA,QL

PREFERRED

Tecfidera Starter PackPA,QL

Mestinon

Mestinon Timespan



Prostigmin

Pred Mild

NON PREFERRED

Retisert

Mytelase

Tobradex

Tobradex ST

OPHTHALMOLOGY AND OTIC

Zylet

NON PREFERRED

ANTI-INFECTIVES

Flarex

GENERIC

Vexol

bacitracin/polymyxin b

ciprofloxacin HCL

PROSTAGLANDINS

erythromycin

GENERIC

gentamicin sulfate

latanoprostQL

levofloxacin

PREFERRED

neomycin/bacitracin/polymyxin

Travatan ZQL

neomycin/polymyxin/bacitracin zinc

NON PREFERRED

neomycin/polymyxin/gramicidin

LumiganQL

ofloxacin

ZioptanQL

polymyxin b sulfate/trimethoprim sulfate

sodium sulfacetamide

CYCLOPLEGIC MYDRIATICS

sulfacetamide sodium

GENERIC

tobramycin sulfate

atropine sulfate

trifluridine

cyclopentolate HCL

trimethoprim sulfate/polymyxin b sulfate

homatropine HBR

PREFERRED

Besivance

DECONGESTANTS

Ciloxan

Moxeza

GENERIC

Natacyn

phenylephrine HCL

Tobrex

Vigamox

MIOTICS

Zymaxid

GENERIC

NON PREFERRED

pilocarpine HCL

Azasite

PREFERRED

Zirgan

Isopto Carbachol

Phospholine Iodide

ARTIFICIAL TEAR/LUBRICANT

Pilopine HS

PREFERRED

Lacrisert

ADRENERGIC AGENTS

GENERIC

BETA-BLOCKERS

apraclonidine

GENERIC

brimonidine tartrate

betaxolol HCL

PREFERRED

carteolol HCL

Alphagan P

dorzolamide HCL/timolol maleate

NON PREFERRED

levobunolol HCL

Iopidine

metipranolol

timolol maleate

IMMUNOMODULATORS

timolol maleate ophthalmic gel forming

PREFERRED

PREFERRED

RestasisQL

Betoptic-s

Combigan

LOCAL ANESTHETICS

NON PREFERRED

GENERIC

Betimol

proparacaine HCL

tetracaine HCL

OPHTHALMIC STEROIDS

GENERIC

OPHTHALMICS - MISC.

dexamethasone sodium phosphate

GENERIC

fluorometholone

azelastine HCL

neomycin/polymyxin/bacitracin/hydrocortisone

cromolyn sodium

neomycin/polymyxin/dexamethasone

diclofenac sodium

prednisolone acetate

dorzolamide HCL

sulfacetamide sodium/prednisolone sodium phosphate

epinastine HCL

tobramycin/dexamethasone

flurbiprofen sodium

PREFERRED

ketorolac tromethamine

Alrex

PREFERRED

Blephamide S.o.p.

Acuvail

Durezol

Azopt

FML

Bromday

Lotemax

Cystaran

Ozurdex

NevanacQL



Pataday

hydrocodone/acetaminophen

Patanol

hydrocodone/ibuprofen

NON PREFERRED

hydromorphone HCL

Alocril

meperidine HCL

Alomide

methadone HCL

Bepreve

morphine sulfate

Emadine

morphine sulfate ERQL

Lastacaft

nalbuphine HCL

SPECIALTY

oxycodone HCL

Jetrea

oxycodone/acetaminophen

oxycodone/aspirin

OTIC AGENTS

oxycodone/ibuprofenQL

oxymorphone hydrochlorideQL

GENERIC

oxymorphone hydrochloride ERQL

acetic acid

pentazocine/acetaminophen

antipyrine/benzocaine

pentazocine/naloxone HCL

fluocinolone acetonide

tramadol hydrochloride/acetaminophenQL

hydrocortisone/acetic acid

tramadol HCLQL

neomycin/polymyxin/hydrocortisone

tramadol HCL ERQL

neomycin/polymyxin/HC

PREFERRED

ofloxacin

AbstralQL

PREFERRED

AvinzaQL

Ciprodex

ButransQL

NON PREFERRED

FentoraQL

Cipro HC

NucyntaQL

Coly-mycin S

Nucynta ERQL

Cortisporin-tc

Opana ERQL

Opana ER (crush Resistant)QL

OXYTOCICS

OxycontinQL

Oxymorphone Hydrochloride ERQL

GENERIC

SuboxoneQL

methylergonovine maleate

NON PREFERRED

oxytocin

ConzipQL

Depodur

PAIN MANAGEMENT

ExalgoQL

ANALGESICS - NONNARCOTIC

Infumorph 200

GENERIC

Infumorph 500

butal/asa/caff

KadianQL

butalbital/acetaminophen

LazandaQL

butalbital/acetaminophen/caffeine

OnsolisQL

butalbital/asa/caffeine

Oxecta

choline magnesium trisalicylate

Rybix Odt

diflunisal

SubsysQL

salsalate

Talwin

SPECIALTY

Prialt

ANTI-INFLAMMATORY

PREVENTIVE

GENERIC

aspirin

diclofenac potassium

aspirin EC

diclofenac sodium DR

aspirin EC low dose

diclofenac sodium ER

aspirin/enteric

diclofenac sodium XR

enteric coated aspirin

diclofenac sodium/misoprostol

Halfprin

etodolac

etodolac ER

ANALGESICS - OPIOID

flurbiprofen

GENERIC

ibuprofen

acetaminophen/codeine

indomethacin

acetaminophen/codeine #2

indomethacin sodium


indomethacin ER


ketoprofen

acetaminophen/codeine phosphate

ketorolac tromethamineQL

alfentanil

leflunomide

buprenorphine HCLQL

mefenamic acid

buprenorphine HCL/naloxone HCLQL

meloxicam

butalbital/acetaminophen/caffeine/codeine

nabumetone

butalbital/aspirn/caffeine/codeine

naproxen

butorphanol tartrateQL

naproxen sodium

fentanylQL

oxaprozin

fentanyl citrate oral transmucosalQL

piroxicam

hydrocodone bitartrate/acetaminophen



sulindac

ANTIHISTAMINES

tolmetin sodium

GENERIC

PREFERRED

carbinoxamine maleate

CelebrexQL

cetirizine HCL

Ridaura

clemastine fumarate

VimovoQL

cyproheptadine HCL

NON PREFERRED

desloratadine

Nalfon

desloratadine odt

Naprelan

diphenhydramine HCL

Rheumatrex

levocetirizine dihydrochloride

SprixQL

promethazine HCL

SPECIALTY

promethazine HCL plain

ActemraPA

PREFERRED

ArcalystPA

Clarinex

EnbrelPA

Enbrel SureclickPA

NASAL AGENTS

HumiraPA,QL

GENERIC

Humira PenPA,QL

azelastine HCLQL

Humira Pen-crohns DiseasestarterPA,QL

flunisolideQL

Humira Pen-psoriasis StarterPA,QL

fluticasone propionateQL

IlarisPA

ipratropium bromideQL

KineretPA

triamcinolone acetonideQL

OrenciaPA

PREFERRED

SimponiPA,QL

AsteproQL

XeljanzPA

NasonexQL

NON PREFERRED

MIGRAINE PRODUCTS

Bactroban Nasal

GENERIC

Beconase AQPA,ST,QL

dihydroergotamine mesylate

DymistaPA,ST,QL

naratriptan HCLQL

OmnarisPA,ST,QL

rizatriptan benzoateQL

PatanaseQL

sumatriptan succinateQL

QnaslPA,ST,QL

sumatriptan succinate refillQL

Rhinocort AquaPA,ST,QL

PREFERRED

Tyzine

Cafergot

Tyzine Pediatric Nasal Drops

Ergomar

VeramystPA,ST,QL

RelpaxQL

ZetonnaPA,ST,QL

NON PREFERRED

AlsumaPA,ST,QL

COUGH/COLD/ALLERGY

AxertPA,ST,QL

GENERIC

FrovaPA,ST,QL

acetylcysteine

Sumavel DoseproPA,ST,QL

benzonatate

TreximetPA,ST,QL

dextromethorphan HBR/chlorpheniramine/phenylephrine HCL

ZomigPA,ST,QL

Zomig ZMTPA,ST,QL

dextromethorphan HBR/phenylephrine HCL/chlorpheniramine

hydrocodone bitartrate/homatropine methylbromide

GOUT AGENTS

hydrocodone polistirex and chlorpheniramine polistirex

GENERIC

hydrocodone/homatropine

allopurinol

phenylephrine/guaifenesin

allopurinol sodium

promethazine-DM

probenecid

promethazine/codeine

probenecid/colchicine

promethazine/dextromethorphan

PREFERRED

sodium chloride

Colcrys

PREFERRED

Uloric

Clarinex-d 12 HOUR

SPECIALTY

Clarinex-d 24 HOUR

KrystexxaPA

Rezira

Tussicaps

LOCAL ANESTHETICS-INJ

Zutripro

GENERIC

bupivacaine HCL

ANTIASTHMATIC/COPD AGENTS

bupivacaine/epinephrine

GENERIC

chloroprocaine HCL

albuterol sulfate

lidocaine HCL

albuterol sulfate ER

lidocaine/epinephrine

albuterol TAB 4MG

tetracaine HCL

aminophylline

budesonide

RESPIRATORY, ALLERGY, ETC

cromolyn sodium



epinephrine HCL

Decavac

ipratropium bromideQL

Infanrix

ipratropium bromide/albuterol sulfateQL

Kinrix

levalbuterolQL

Pediarix

levalbuterol HCLQL

Pentacel

metaproterenol sulfate

Tenivac

montelukast sodium

Tripedia

terbutaline sulfate

theophylline

VACCINES

theophylline CR

theophylline ER

PREFERRED

theophylline/D5W

Biothrax

zafirlukast

Fluarix Quadrivalent 2013-2014

PREFERRED

Flumist Quadrivalent

Advair DiskusQL

Fluzone Quadrivalent 2013-2014

Advair HFAQL

Imovax Rabies (h.d.c.v.)

AlvescoQL

Ixiaro

Asmanex 120 Metered DosesQL

Je-vax


Rabavert


Typhim VI


Vivotif Berna


PREVENTIVE

Atrovent HFAQL

Acthib

CombiventQL

Afluria PF 2011-2012

Combivent RespimatQL

Afluria PF 2012-2013

Daliresp

Afluria 2011-2012

DuleraQL

Afluria 2012-2013

Elixophyllin

Cervarix

Foradil AerolizerQL

Comvax

PerforomistQL

Engerix-b

Proair HFAQL

Fluarix 2011-2012

PulmicortQL

Fluarix 2012-2013

Pulmicort FlexhalerQL

Fluarix 2013-2014

QvarQL

Flucelvax 2012-2013

Serevent DiskusQL

Flulaval 2011-2012

Spiriva HandihalerQL

Flulaval 2012-2013

SymbicortQL

Flulaval 2013-2014

Tudorza PressairQL

Flumist Nasal Vaccine 2011-2012

NON PREFERRED

Flumist Nasal Vaccine 2012-2013

Arcapta NeohalerQL

Fluvirin PF 2011-2012

BrovanaQL

Fluvirin PF 2012-2013

Flovent DiskusQL

Fluvirin 2011-2012

Lufyllin

Fluvirin 2012-2013

Maxair AutohalerQL

Fluzone High-dose PF 2011-2012

Proventil HFAQL


Theo-24


Ventolin HFAQL

Fluzone Intradermal

Xopenex HFAQL

Fluzone Pediatric PF 2011-2012

Zyflo


Zyflo CR


SPECIALTY

Fluzone PF 2011-2012

XolairPA



RESPIRATORY AGENTS - MISC

Fluzone Split 2011-2012

SPECIALTY


Aralast NPPA


GlassiaPA

Gardasil

KalydecoPA

Havrix

ProlastinPA

Hiberix

Prolastin-cPA

Ipol Inactivated IPV

PulmozymePA

M-m-r II W/Diluent 10 Dose

ZemairaPA

Menactra

Menomune-a/C/Y/W-135

TOXOIDS

Menveo

Pedvax HIB

Prevnar 13

PREVENTIVE

Proquad

Adacel

Recombivax HB

Boostrix

Rotarix

Daptacel



Rotateq

Accu-chek Compact Plus Care KitQL

Twinrix

Accu-chek Compact StripsQL

Vaqta

Accu-chek Compact Test DrumQL

Varivax

Accu-chek Fastclix Lancetdevice Kit

Zostavax

Accu-chek Fastclix LancetsQL

Accu-chek Instant Glucosecontrol Solution (2 Levels)

VITAMINS

Accu-chek Multiclix Lanc Et Device Kit

Accu-chek Multiclix LancetsQL

VITAMINS

Accu-chek Nano SmartviewQL

GENERIC

Accu-chek Safe-t-pro LancetsQL

ascorbic acid

Accu-chek Safe-t-pro PluslancetsQL

ergocalciferol

Accu-chek Smartview Control

phytonadione

Accu-chek Smartview StripsQL

thiamine HCL

Accu-chek Soft Touch LancetsQL

vitamin c 222MG

Accu-chek Softclix Lancetdevice Kit

vitamin d

Accu-chek Softclix LancetsQL

vitamin k1

Accu-chek VoicemateQL

PREFERRED

Advocate LancetsQL

Mephyton

Advocate Safety LancetsQL

NON PREFERRED

Agamatrix Ultra-thin Lancets 33GQL

Potaba

Assure Haemolance Plus High Flow 18GQL

PREVENTIVE

Assure Haemolance Plus Low Flow 25GQL

d3

Assure Haemolance Plus Micro Flow 28GQL

d3 ultra strength

Assure Haemolance Plus Normal Flow 21GQL

vitamin d 400

Assure Haemolance Plus Pediatric BladeQL

vitamin d-1000

Assure Lance LancetsQL

vitamin d-3

Assure LancetsQL

vitamin d3

Aurora Healthcare LancetsQL

Dialyvite Vitamin D3 Max

Aurora Lancet Super Thin 30GQL

D3

Aurora Lancet Thin 23GQL

Replesta

AF Lancets Super ThinQL

Replesta Childrens

AT Last LancetsQL

Replesta Nx

Bayer Microlet LancetsQL

Thera-d 4000

Bullseye Safety LancetsQL

Vitamin D

BD Insulin Syringe LUER-LOK/U-100/1MLQL

Vitamin D3

BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2"QL

Vitamin D3 400

BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2"QL

BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8"QL

MULTIVITAMINS

BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2"QL

GENERIC

BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2"QL

nicotinamide w/zinc oxide/cupric oxide/folic acid

BD Insulin Syringe Microfine/U-100/0.5ML/28G X 1/2"QL

nicotinamide/zinc oxide/cupric oxide/folic acid

BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8"QL

nicotinamide/zinc/copper/fa

BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2"QL

PREFERRED

BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 5/16"

QL

Neevo DHA

NON PREFERRED

BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2"QL

Bacmin

BD Insulin Syringe Safetyglide/1ML/29G X 1/2"QL

M.v.i. Adult

BD Insulin Syringe Slip Tip/U-100/1MLQL

M.v.i. Pediatric

BD Insulin Syringe U-40/1ML/25G X 5/8"QL

M.v.i.-12 Without Vitamin K

BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16"QL

Nicazel

BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X 5/16"

QL

Nutricap

Req 49+

BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16"QL

Siderol

BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2"QL

Strovite One

BD Insulin Syringe Ultrafine/U-100/0.5ML/29G X 1/2"QL

PREVENTIVE

BD Insulin Syringe Ultrafine/U-100/1ML/29G X 1/2"QL

Right Step Prenatal

BD Insulin Syringe Ultrafine/U-100/1ML/30G X 1/2"QL

BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2"QL

MEDICAL DEVICES


DIABETIC SUPPLIES



PREFERRED

BD Insulin Syringe Ultrafine/1ML/30G X 1/2"QL

Accu-chek Active Glucose Control Solution

BD Insulin Syringe Ultrafine/1ML/31G X 5/16"QL

Accu-chek Active StripsQL

BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 1"

QL

Accu-chek Advantage Diabetes Care KitQL

Accu-chek AvivaQL

BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 5/8"

QL

Accu-chek Aviva PlusQL

Accu-chek Comfort Curve Control Solution (2 Levels)

BD Insulin Syringe/Detachable Needle/U-100/1ML/26G X 1/2"

QL

Accu-chek Comfort Curve Linearity Solution

Accu-chek Comfort Curve Test StripsQL

BD Insulin Syringe/U-100/0.5ML/30G X 1/2"QL

Accu-chek Compact Blue Control Solution (2 Levels)

BD Insulin Syringe/U-100/1ML/27G X 1/2"QL




HaemolanceQL

BD Insulin Syringe/U-100/2ML/27.5G X 5/8"QL

Haemolance Low Flow LancetsQL


Haemolance PlusQL

BD Lancet Ultrafine 30GQL

Haemolance Plus High FlowQL

BD Lancet Ultrafine 33GQL

Haemolance Plus Low FlowQL

BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X 1/2"

QL

Haemolance Plus Max FlowQL

Haemolance Plus Pediatric FlowQL

BD Microtainer LancetsQL

Hy-vee LancetsQL

BD Pen Needle/Mini/Ultrafine/31G X 3/16"QL

LancetsQL

BD Pen Needle/Nano/Ultra Fine/32G X 4MMQL

Lancets Bullseye SafetyQL

BD Pen Needle/SHORT/Ultrafine/31G X 5/16"QL

Lancets Safety Seal 21GQL

BD Pen Needle/Ultrafine/29G X 12.7MMQL


BD Pen Needle/Ultrafine/29GX1/2" 12.7MMQL


BD Pen Needles SHORT/Ultrafine/31G X 5/16"QL


Careone Lancet ThinQL

Lancets ThinQL

Careone Lancet Ultra ThinQL

Lancets Twist TopQL

Cleanlet Lancets 28GQL

Lancets Ultra FineQL

Clever Chek Lancets UltrathinQL

Lancets Ultra ThinQL

Clever Chek Lancets Ultrathin 30GQL

Lancets 26G Twist TopQL

Coaguchek LancetsQL

Lancets 28GQL

Comfort LancetsQL

Lancets 30GQL

Diastar Easy Test II Lancets 30GQL


Diastar Easy Test Lancets30GQL


Droplet Lancets Ultra Thin 30GQL

Lifescan Unistik II LancetsQL

Drug Mart Unilet Lancets Super Thin 30GQL

Lifescan Unistik 2 Deep PenetrationQL

Drug Mart Unilet Lancets Ultra Thin 28GQL

Live Better Lancet Super Thin 30GQL

E-z Ject LancetsQL

Live Better Lancet Ultra Thin 28GQL

E-z Ject Lancets ColorQL

Medisense Thin LancetsQL

E-z Ject Lancets Super ThinQL

Medlance Plus Extra Lancets 21GQL

E-z Ject Lancets Super Thin 30GQL

Medlance Plus LancetsQL

E-z Ject Lancets Thin 26GQL

Medlance Plus Lancets Lite 25GQL

E-z Ject Lancets 21GQL

Medlance Plus Lite Lancets 25GQL

E-ZJECT Lancets Micro-thin 33GQL

Medlance Plus Special Lancets 0.8MMQL

Easy Touch Lancets 28G/TwistQL

Medlance Plus Superlite 30GQL


Medlance Plus Superlite 30G/Comfort MaxQL


Medlance Plus Universal Lancets 21GQL


Medlance Plus/Lite 25GQL

Easy Touch Safety Lancets21G/Pressure ActivatedQL

Medlance/ExtraQL


Medlance/LiteQL

Easy Touch Safety Lancets26G/Button ActivatedQL

Medlance/UniversalQL


Meijer Super Thin LancetsQL

Easy Touch Safety Lancets28G/Button ActivatedQL

Microlet LancetsQL


Microtainer Safety Flow Lancet/Sterile/Single-useQL

Easy Twist & CAP LancetsQL

Monolet LancetsQL

Easytest II LancetsQL

Monolet Opd LancetsQL

Easytest LancetsQL

Monolettor Safety LancetsQL

EZ Smart Blood Glucose LancetsQL

Myglucohealth Mgh Softlance Lancets 30GQL

EZ-lets Lancets 21GQL

Netgroup LancetsQL


Nova Safety Lancets 23GQL

EZ-lets Lancets 26G Super-softQL

Nova Safety Lancets 28GQL

EZ-lets Lancets 28G Ultra-softQL

Nova Sureflex LancetsQL


Novofine Autocover 30GX8MMQL

Fasttake Test StripsQL

Novofine 30GX8MMQL

Fifty50 Safety Seal Lancets 30GQL

Novofine 32GX6MMQL

Fifty50 Safety Seal Lancets 32GQL

Novotwist 30GX8MMQL

Fine 30QL

Novotwist 32GX5MMQL

Fingerstix LancetsQL

On Call LancetsQL

Fora LancetsQL

On Call Plus LancetsQL

Freestyle LancetsQL

Onetouch Basic SystemQL

Freestyle Unistick II LancetsQL

Onetouch Basic/Profile Test StripsQL

Gentle-let GP LancetsQL

Onetouch Club Lancets Fine PointQL

Gentle-let Lancets General Purpose Style/Fine PointQL

Onetouch Combo PackQL

Gentle-let Lancets General Purpose Style/Medium PointQL

Onetouch Delica LancetsQL

Gentle-let Lancets Safety Style/Fine PointQL

Onetouch Delica Lancets Fine 30GQL

Gentle-let Lancets Safety Style/Medium PointQL

Onetouch Delica Lancing Device

Glucocom Lancets 28GQL

Onetouch Finepoint LancetsQL


Onetouch LancetsQL


Onetouch Ping Meter Remote

Glucosource LancetsQL

Onetouch Profile SystemQL

H&h Thinlet Lancets 26GQL

Onetouch Suresoft Lancing Device/Dual Site

H&h Thinlet Super Thin Lancets 30GQL



Onetouch Suresoft Lancing Device/Gentle

Solus V2 Twist Lancets 30GQL

Onetouch Suresoft Lancing Device/Regular

Sterilance TLQL

Onetouch Ultra BlueQL

Sure-lance Flat LancetsQL

Onetouch Ultra Control

Sure-lance Lancets 26GQL

Onetouch Ultra MiniQL

Sure-lance Thin Lancets 28GQL

Onetouch Ultra System KitQL

Sure-lance Ultra Thin LancetsQL

Onetouch Ultra 2QL

Sure-touch Lancets UniversalQL

Onetouch Ultralink System (hex)QL

Surelite LancetsQL

Onetouch Ultralink System (DEC)QL

Surestep Pro Test StripsQL

Onetouch UltrasmartQL

Surestep Test StripsQL

Onetouch Ultrasoft LancetsQL

Techlite AST LancetsQL

Onetouch Verio Control Solution High

Techlite LancetsQL

Onetouch Verio IQ Blood Glucose Monitoring SystemQL

Techlite Lancets 30GQL

Onetouch Verio IQ Test StripsQL

Thinlets GP LancetsQL

Onetouch Verio Mid Control Solution

Thinlets LancetQL

Onetouch Verio Test StripsQL

Trueplus Lancets 26GQL

Pen Needles 29G X 12MMQL


Pen Needles 29GX1/2"QL

Trueplus Lancets 28G Super ThinQL



Pen Needles 31G X 1/4" SHORTQL

Trueplus Lancets 30G Ultra ThinQL

Pen Needles 31G X 3/16"QL


Pen Needles 31G X 6MMQL

Trueplus Lancets 33G Micro ThinQL


Trueplus Safety Lancets 28GQL

Perfect Lancets 30GQL

Ulticare Thin Lancets 30GQL

Perfect Pressure Activated Safety Lancets 28GQL

Ultilet Basic Lancets 30GQL

Pharmacy Counter LancetsQL

Ultilet Classic LancetsQL

Precision Thin LancetsQL

Ultilet LancetsQL

Precision Thins GP LancetQL

Ultilet Lancets 33GQL

Precision Ultra LancetQL

Ultilet Safety Lancets 23GQL

Prodigy Pressure Activated Safety LancetsQL

Ultra-thin II Auto LancetQL

Prodigy Safety LancetsQL

Ultra-thin II Lancets 28GQL

Prodigy Twist Top LancetsQL

Ultra-thin II Lancets 30GQL

Pss Select GP LancetsQL

Ultra-thin II Lancets/28G X 1/8"QL

Pss Select Safety LancetsQL

Ultra-thin II Lancets/30G X 1/8"QL

Px Lancets Ultra ThinQL

Ultra-thin II Safety Autolancets 26GQL

Qc Lancets Super ThinQL

Unilet Comfortouch LancetQL

Qc Lancets Ultra ThinQL

Unilet ExceliteQL

Relion LancetsQL

Unilet Excelite IIQL

Relion Lancets Standard 21GQL

Unilet G.p. LancetQL

Relion Lancets Thin 26GQL

Unilet G.p. Superlite LancetQL

Relion Lancets Ultra-thin30GQL

Unilet GP 28 Ultra ThinQL

Relion Thin LancetsQL

Unilet LancetQL

Relion Ultra Thin LancetsQL

Unilet Superlite LancetQL

Relion Ultra Thin Lancets30GQL

Universal 1 Lancets Thin 26GQL

Relion Ultra Thin Plus Lancets 32GQL

Universal 1 Lancets Ultra Thin 30GQL

Relion Ultra Thin Plus Lancets 33GQL

Valumark Lancet Super Thin 30GQL

Renew Advanced Lancing Cartridge RefillsQL

Valumark Lancet Ultra Thin 28GQL

Rightest Gl300 LancetsQL

Vida Mia Unilet Lancets Super Thin 30GQL

Safe-t-lance Low Flow 25GQL

Vida Mia Unilet Lancets Ultra Thin 28GQL

Safe-t-lance Normal Flow 21GQL

Vitalet Pro LancetsQL

Safe-t-lance Plus Safety Lancet High FlowQL

Vitalet Pro Plus LancetsQL

Safe-t-lance Plus Safety Lancet Low FlowQL

W&f Lancets Colored 21GQL

Safe-t-lance Plus Safety Lancet Normal FlowQL

W&f Lancets 26GQL

Safety Lancet 2MMQL

Walgreens LancetsQL

Safety Lancet 21G/Pressure ActivatedQL

Walgreens Thin LancetsQL

Safety Lancet 28G/Pressure ActivatedQL

Walgreens Ultra Thin LancetsQL

Safety LancetsQL

1ST Choice Lancets Super ThinQL

Safety Lancets 21GQL

1ST Choice Lancets ThinQL

Safety Lancets 28GQL

1ST Choice Lancets Ultra ThinQL

Safety Let LancetsQL

Safety Seal Lancets 28GQL

MISCELLANEOUS

Safety Seal Lancets 30GQL

Single-letQL

PREFERRED

Smart Diabetes Vantage Universal Lancets 30GQL

Chemet

Smart Sense Color Lancets Universal 33GQL

SPECIALTY

Smart Sense Standard Lancets Universal 21GQL

ExjadePA

Smart Sense Super Thin Lancets Universal 30GQL

FerriproxPA

Smart Sense Thin Lancets Universal 26GQL

Smartest Lancets 28GQL

Solus V2 Pressure Activated Safety Lancets 28GQL



Index

A

Adacel, 19

amlodipine besylate, 5

adapalene, 7

amlodipine besylate/benazepril HCL, 6

abacavir, 2

Adcetris, 3

amlodipine besylate/benazepril hydrochloride, 6

Abelcet, 2

Adcirca, 7

Abilify, 14

adenosine, 5

ammonium lactate, 8

Abilify Discmelt, 14

Advair Diskus, 19

amoxicillin, 1

Abilify Maintena, 14

Advair HFA, 19

amoxicillin/clavulanate potassium, 1

Abraxane, 4

Advate, 13

amoxicillin/clavulanate potassium ER, 1

Absorica, 7

Advocate Lancets, 20

amoxicillin/potassium clavulanate, 1

Abstral, 17

Advocate Safety Lancets, 20

amphetamine/dextroamphetamine, 14

Acanya, 7

AF Lancets Super Thin, 20

Amphotec, 2

acarbose, 9

Afinitor, 4

ampicillin, 1

Accu-chek Active Glucose Control Solution, 20

Afinitor Disperz, 4

ampicillin sodium, 1

Afluria 2011-2012, 19

ampicillin-sulbactam, 1

Accu-chek Active Strips, 20

Afluria 2012-2013, 19

Ampyra, 15

Accu-chek Advantage Diabetes Care Kit, 20

Afluria PF 2011-2012, 19

Amturnide, 6

Afluria PF 2012-2013, 19

Anadrol-50, 8

Accu-chek Aviva, 20

Agamatrix Ultra-thin Lancets 33G, 20

anagrelide hydrochloride, 13

Accu-chek Aviva Plus, 20

Aggrastat, 13

Analpram-HC, 12

Accu-chek Comfort Curve Control Solution (2 Levels), 20

Aggrenox, 13

anastrozole, 3

Albenza, 2

Androderm, 8

Accu-chek Comfort Curve Linearity Solution, 20

albuterol sulfate, 18

Androgel, 8

albuterol sulfate ER, 18

Androxy, 8

Accu-chek Comfort Curve Test Strips, 20

albuterol TAB 4MG, 18

antipyrine/benzocaine, 17

Accu-chek Compact Blue Control Solution (2 Levels), 20

alclometasone dipropionate, 7

Anzemet, 11

Aldurazyme, 11

Aphthasol, 13

Accu-chek Compact Plus Care Kit, 20

alendronate sodium, 10

Apidra, 9

Accu-chek Compact Strips, 20

alfentanil, 17

Apidra Solostar, 9

Accu-chek Compact Test Drum, 20

Alferon N, 4

Aplenzin, 14

Accu-chek Fastclix Lancetdevice Kit, 20

alfuzosin HCL ER, 12

Apokyn, 15

Accu-chek Fastclix Lancets, 20

Alimta, 3

apraclonidine, 16

Accu-chek Instant Glucosecontrol Solution (2 Levels), 20

Alinia, 3

Apriso, 12

Alkeran, 3

Aptivus, 2

Accu-chek Multiclix Lanc Et Device Kit, 20

allopurinol, 18

Aralast NP, 19

allopurinol sodium, 18

Aranesp Albumin Free, 12

Accu-chek Multiclix Lancets, 20

Alocril, 17

Arcalyst, 18

Accu-chek Nano Smartview, 20

Alodox Convenience Kit, 1

Arcapta Neohaler, 19

Accu-chek Safe-t-pro Lancets, 20

Alomide, 17

argatroban, 13

Accu-chek Safe-t-pro Pluslancets, 20

Alora, 9

Aricept, 15

Accu-chek Smartview Control, 20

Aloxi, 11

Arranon, 3

Accu-chek Smartview Strips, 20

Alphagan P, 16

Arzerra, 3

Accu-chek Soft Touch Lancets, 20

Alphanate/Von Willebrand Factor Complex/Human, 13

Asacol, 12

Accu-chek Softclix Lancetdevice Kit, 20

Asacol HD, 12

Accu-chek Softclix Lancets, 20

Alphanine SD, 13

ascorbic acid, 20

Accu-chek Voicemate, 20

alprazolam, 13

Asmanex 120 Metered Doses, 19

acebutolol HCL, 5

alprazolam ER, 13


acetaminophen/codeine, 17

alprazolam odt, 13


acetaminophen/codeine #2, 17

Alrex, 16



Alsuma, 18



Altabax, 7

aspirin, 17

acetaminophen/codeine phosphate, 17

Altoprev, 6

aspirin EC, 17

acetazolamide, 6

Alvesco, 19

aspirin EC low dose, 17

acetazolamide ER, 6

amantadine HCL, 15

aspirin/enteric, 17

acetazolamide sodium, 6

Ambisome, 2

Assure Haemolance Plus High Flow 18G, 20

acetic acid, 17

amcinonide, 7

acetylcysteine, 18

Amevive, 7

Assure Haemolance Plus Low Flow 25G, 20

Aciphex, 11

amifostine, 4

Actemra, 18

amikacin sulfate, 1

Assure Haemolance Plus Micro Flow 28G, 20

Acthar HP, 10

amiloride HCL, 6

Acthib, 19

amiloride/hydrochlorothiazide, 6

Assure Haemolance Plus Normal Flow 21G, 20

Actimmune, 4

aminocaproic acid, 13

Actonel, 10

aminophylline, 18

Assure Haemolance Plus Pediatric Blade, 20

Actoplus Met XR, 9

amiodarone HCL, 5

Acuvail, 16

Amitiza, 12

Assure Lance Lancets, 20

acyclovir, 2, 7

amitriptyline HCL, 13

Assure Lancets, 20

acyclovir sodium, 2

Astepro, 18

BD Insulin Syringe Microfine/U-100/0.5ML/28G X 1/2", 20

5/16", 21

AT Last Lancets, 20

BD Pen Needle/Ultrafine/29G X 12.7MM, 21

Atelvia, 10

BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8", 20

atenolol, 5

BD Pen Needle/Ultrafine/29GX1/2" 12.7MM, 21

atenolol/chlorthalidone, 6

BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2", 20

Atgam, 4

BD Pen Needles SHORT/Ultrafine/31G X 5/16", 21

atorvastatin calcium, 6

BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2", 20

atovaquone/proguanil HCL, 2

Bebulin, 13

atracurium besylate, 15

BD Insulin Syringe Safetyglide/1ML/29G X 1/2", 20

Bebulin VH, 13

Atralin, 7

Beconase AQ, 18

Atripla, 2

BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 5/16", 20

benazepril HCL, 5

Atropen, 11

benazepril HCL/hydrochlorothiazide, 6

atropine sulfate, 11, 16

BD Insulin Syringe Slip Tip/U-100/1ML, 20

Benefix, 13

Atrovent HFA, 19

Benicar, 5

Aubagio, 15

BD Insulin Syringe U-40/1ML/25G X 5/8", 20

Benicar HCT, 6

augmented betamethasone dipropionate, 7

benzonatate, 18

BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16", 20

benzoyl peroxide, 7

Augmentin, 1

benzoyl peroxide SHORT contact, 7

Aurora Healthcare Lancets, 20

BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X 5/16", 20

benztropine mesylate, 15

Aurora Lancet Super Thin 30G, 20

Bepreve, 17

Aurora Lancet Thin 23G, 20

BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16", 20

Berinert, 13

Auvi-q, 6

Besivance, 16

Avandia, 9

BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2", 20

betamethasone dipropionate, 7

Avastin, 3

betamethasone sodium phosphate/betamethasone acetate, 8

Avc, 12


Avelox, 1

betamethasone valerate, 7

Avelox Abc Pack, 1


Betaseron, 15

Avinza, 17

betaxolol HCL, 5, 16

Avodart, 12


bethanechol chloride, 12

Avonex, 15

Betimol, 16

Avonex Pen, 15

BD Insulin Syringe Ultrafine/1ML/30G X 1/2", 20

Betoptic-s, 16

Axert, 18

Bexxar, 3

Axiron, 8

BD Insulin Syringe Ultrafine/1ML/31G X 5/16", 20

Beyaz, 9

Azactam IN Iso-osmotic Dextrose, 3

bicalutamide, 3

Azasan, 4

BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2", 20

Bicillin C-R, 1

Azasite, 16

Bicillin L-a, 1

azathioprine, 4

BD Insulin Syringe Ultrafine/U-100/0.5ML/29G X 1/2", 20

Bicnu, 3

azelastine HCL, 16, 18

Bidil, 6

Azelex, 7

BD Insulin Syringe Ultrafine/U-100/1ML/29G X 1/2", 20

Biltricide, 2

Azilect, 15

Binosto, 10

azithromycin, 1

BD Insulin Syringe Ultrafine/U-100/1ML/30G X 1/2", 20

Biothrax, 19

Azithromycin, 1

bisoprolol fumarate, 5

Azopt, 16

BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 1", 20

bisoprolol fumarate/hydrochlorothiazide, 6

Azor, 6

aztreonam, 2

BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 5/8", 20

bleomycin sulfate, 3

B

Blephamide S.o.p., 16

BD Insulin Syringe/Detachable Needle/U-100/1ML/26G X 1/2", 20

Boostrix, 19

bacitracin, 2

Bosulif, 4

bacitracin/polymyxin b, 16

BD Insulin Syringe/U-100/0.5ML/30G X 1/2", 20

Botox, 15

baclofen, 15

Bravelle, 10

Bacmin, 20

BD Insulin Syringe/U-100/1ML/27G X 1/2", 20

Brilinta, 13

Bactocill IN Dextrose, 1

brimonidine tartrate, 16

Bactroban Nasal, 18


Bromday, 16

balsalazide disodium, 11

bromocriptine mesylate, 15

Banzel, 15

BD Insulin Syringe/U-100/2ML/27.5G X 5/8", 21

Brovana, 19

Baraclude, 2

budesonide, 8, 18

Bayer Microlet Lancets, 20


Bullseye Safety Lancets, 20

BD Insulin Syringe LUER-LOK/U-100/1ML, 20

bumetanide, 6

BD Lancet Ultrafine 30G, 21

Buphenyl, 11

BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2", 20

BD Lancet Ultrafine 33G, 21

bupivacaine HCL, 18

BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X 1/2", 21

bupivacaine/epinephrine, 18

BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2", 20

buprenorphine HCL, 17

BD Microtainer Lancets, 21

buprenorphine HCL/naloxone HCL, 17

BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8", 20

BD Pen Needle/Mini/Ultrafine/31G X 3/16", 21

bupropion HCL, 13

bupropion HCL ER, 13

BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2", 20

BD Pen Needle/Nano/Ultra Fine/32G X 4MM, 21

bupropion HCL SR, 13

bupropion HCL XL, 13

BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2", 20

BD Pen Needle/SHORT/Ultrafine/31G X

buspirone HCL, 13

Busulfex, 3

ceftazidime, 1

clindamycin palmitate HCL, 2

butal/asa/caff, 17

Ceftin, 1

clindamycin phosphate, 2, 7, 12

butalbital/acetaminophen, 17

ceftriaxone sodium, 1

clindamycin phosphate IN D5W, 2

butalbital/acetaminophen/caffeine, 17

cefuroxime axetil, 1

clindamycin/benzoyl peroxide, 7

butalbital/acetaminophen/caffeine/codeine, 17

cefuroxime sodium, 1

clobetasol propionate, 7

Celebrex, 18

Clobex, 8

butalbital/asa/caffeine, 17

Cellcept, 4

Cloderm, 8

butalbital/aspirn/caffeine/codeine, 17

Cellcept Intravenous, 4

Cloderm P.M., 8

butorphanol tartrate, 17

Celontin, 15

Clolar, 3

Butrans, 17

Cenestin, 9

clomiphene citrate, 10

Bydureon, 9

cephalexin, 1

clomipramine HCL, 13

Byetta, 9

Ceprotin, 13

clonazepam, 14

Bystolic, 5

Cerezyme, 12

clonazepam odt, 14

C

Cervarix, 19

clonidine HCL, 6

Cesamet, 11

clopidogrel, 13

cabergoline, 10

cetirizine HCL, 18

clorazepate dipotassium, 13

Cafergot, 18

Cetrotide, 10

clotrimazole, 7, 13

caffeine citrate, 14

cevimeline HCL, 13

clotrimazole/betamethasone dipropionate, 7

calcipotriene, 7

Chemet, 22

calcitonin salmon, 10

chlordiazepoxide HCL, 13

clozapine, 14

calcitonin-salmon, 10

chlorhexadine gluconate oral rinse, 13

Cnl8 Nail Kit, 7

Calcitriol, 7

chlorhexidine gluconate, 13

Coaguchek Lancets, 21

calcitriol, 10

chlorhexidine gluconate oral rinse, 13

Coartem, 2

calcium acetate, 11

chloroprocaine HCL, 18

Colcrys, 18

Campath, 3

chloroquine phosphate, 2

colestipol HCL, 6

Campral, 15

chlorothiazide, 6

colestipol HCL for oral suspension, 6

Canasa, 12

chlorothiazide sodium, 6

colistimethate sodium, 3

Cancidas, 2

chlorpromazine HCL, 14

Coly-mycin S, 17

candesartan cilexetil/hydrochlorothiazide, 6

chlorzoxazone, 15

Colyte-flavor Packs, 11

cholestyramine light, 6

Combigan, 16

Cantil, 11

choline magnesium trisalicylate, 17

Combipatch, 9

Capastat Sulfate, 2

chorionic gonadotropin, 10

Combivent, 19

Capex, 8

Cialis, 7

Combivent Respimat, 19

Caprelsa, 4

ciclopirox, 7

Cometriq, 4

captopril, 5

ciclopirox nail lacquer, 7

Comfort Lancets, 21

Carafate, 11

ciclopirox olamine, 7

Complera, 2

Carbaglu, 11

cidofovir, 2

Comvax, 19

carbamazepine, 14

cilostazol, 13

Condylox, 8

carbamazepine ER, 14

Ciloxan, 16

Conzip, 17

carbidopa/levodopa, 15

cimetidine, 11

Copaxone, 15

carbidopa/levodopa CR, 15

cimetidine HCL, 11

Cordran, 8

carbidopa/levodopa ER, 15

Cimzia, 12

Cordran SP, 8

carbidopa/levodopa odt, 15

Cinryze, 13

Cordran Tape, 8

carbidopa/levodopa SR, 15

Cipro, 1

Coreg CR, 5

carbinoxamine maleate, 18

Cipro HC, 17

Corifact, 13

carboplatin, 3

Ciprodex, 17

Cortifoam, 12

Cardene IV, 5

ciprofloxacin, 1

Cortisporin, 7

Cardizem LA, 5

ciprofloxacin ER, 1

Cortisporin-tc, 17

Cardura XL, 12

ciprofloxacin HCL, 1, 16

Creon, 11

Careone Lancet Thin, 21

ciprofloxacin I.V.-IN D5W, 1

Crestor, 6

Careone Lancet Ultra Thin, 21

cisatracurium besylate, 15

Crinone, 12

carisoprodol, 15

cisplatin, 3

Crixivan, 2

carisoprodol/aspirin, 15

citalopram hydrobromide, 13

cromolyn sodium, 11, 16, 18

carisoprodol/aspirin/codeine, 15

citric acid/sodium citrate, 12

Cubicin, 3

carteolol HCL, 16

cladribine, 3

Cuvposa, 11

carvedilol, 5

Claforan, 1

cyanocobalamin, 12

Caverject, 6

Claravis, 7

cyclobenzaprine HCL, 15

Caverject Impulse, 7

Clarinex, 18

cyclopentolate HCL, 16

Cayston, 3

Clarinex-d 12 HOUR, 18

Cycloserine, 2

Cedax, 1

Clarinex-d 24 HOUR, 18

cyclosporine, 4

cefaclor, 1

clarithromycin, 1

cyclosporine modified, 4

cefadroxil, 1

clarithromycin ER, 1

Cymbalta, 14

cefazolin sodium, 1

Cleanlet Lancets 28G, 21

cyproheptadine HCL, 18

cefdinir, 1

clemastine fumarate, 18

Cystadane, 11

cefepime, 1

Cleocin, 12

Cystagon, 12

cefotaxime sodium, 1

Clever Chek Lancets Ultrathin, 21

Cystaran, 16

cefoxitin sodium, 1

Clever Chek Lancets Ultrathin 30G, 21

cytarabine, 3

cefpodoxime proxetil, 1

clindamycin HCL, 2

cytarabine aqueous, 3

cefprozil, 1

D

Differin, 7

Easy Touch Lancets 28G/Twist, 21

Dificid, 1


d3, 20

diflorasone diacetate, 8


D3, 20

diflunisal, 17


d3 ultra strength, 20

digoxin, 5

Easy Touch Safety Lancets21G/Pressure Activated, 21

dacarbazine, 4

dihydroergotamine mesylate, 18

Dacogen, 3

Dilantin, 15


dactinomycin, 3

Dilatrate SR, 5

Daliresp, 19

diltiazem CD, 5

Easy Touch Safety Lancets26G/Button Activated, 21

danazol, 8

diltiazem HCL, 5

dantrolene sodium, 15

diltiazem HCL ER, 5


Daptacel, 19

Diovan, 5

Daraprim, 2

Dipentum, 12

Easy Touch Safety Lancets28G/Button Activated, 21

daunorubicin HCL, 3

diphenhydramine HCL, 18

Daunoxome, 3

diphenoxylate/atropine, 11


Daytrana, 14

dipyridamole, 13

Decavac, 19

disopyramide phosphate, 5

Easy Twist & CAP Lancets, 21

demeclocycline HCL, 1

disulfiram, 15

Easytest II Lancets, 21

Demser, 6

divalproex sodium, 14

Easytest Lancets, 21

Denavir, 7

divalproex sodium DR, 14

econazole nitrate, 7

Depo-medrol, 8

divalproex sodium ER, 14

Edarbi, 5

Depo-provera, 3

dobutamine HCL, 6

Edarbyclor, 6

Depocyt, 3

dobutamine HCL/D5W, 6

Edecrin, 6

Depodur, 17

dobutamine/dextrose 5%, 6

Edex, 7

desipramine HCL, 13

Docefrez, 4

Edurant, 2

desloratadine, 18

Docetaxel, 4

Effient, 13

desloratadine odt, 18

donepezil HCL, 15

Egrifta, 10

desmopressin acetate, 10

Donnatal, 11

Elaprase, 11

Desonate, 8

Donnatal Extentabs, 11

Elelyso, 12

desonide, 7

dopamine HCL, 6

Elidel, 8

Desowen Cream/Cetaphil Lotion, 8

dopamine HCL-dextrose 5%, 6

Eligard, 4

Desowen Lotion/Cetaphil Cream, 8

dopamine HCL/dextrose 5%, 6

Eliquis, 13

Desowen Ointment/Cetaphil Lotion, 8

dopamine/D5W, 6

Elitek, 5

desoximetasone, 7

Doribax, 3

Elixophyllin, 19

Detrol LA, 12

dorzolamide HCL, 16

Ella, 9

dexamethasone, 8

dorzolamide HCL/timolol maleate, 16

Elmiron, 12

Dexamethasone Intensol, 8

doxapram HCL, 14

Elspar, 3

dexamethasone sodium phosphate, 8, 16

doxazosin mesylate, 6

Emadine, 17

doxepin HCL, 13

Emcyt, 3

Dexilant, 11

doxorubicin HCL, 3

Emend, 11

dexmethylphenidate HCL, 14

doxorubicin HCL liposome, 3

Emsam, 14

Dexpak 10 Day, 8

doxycycline, 1

Emtriva, 2

Dexpak 13 Day, 8

doxycycline hyclate, 1

Enablex, 12

Dexpak 6 Day, 8

doxycycline hyclate DR, 1

enalapril maleate, 5

dexrazoxane, 4

doxycycline monohydrate, 1

enalapril maleate/hydrochlorothiazide, 6

dextroamphetamine sulfate, 14

Dritho-scalp, 7

enalaprilat, 5

dextroamphetamine sulfate ER, 14

dronabinol, 11

Enbrel, 18

dextromethorphan HBR/chlorpheniramine/phenylephrine HCL, 18

droperidol, 13

Enbrel Sureclick, 18

Droplet Lancets Ultra Thin 30G, 21

Endometrin, 12

drospirenone/ethinyl estradiol, 9

Engerix-b, 19

dextromethorphan HBR/phenylephrine HCL/chlorpheniramine, 18

Droxia, 12

Enjuvia, 9

Drug Mart Unilet Lancets Super Thin 30G, 21

enoxaparin sodium, 13

Diabeta, 9

entacapone, 15

Dialyvite Vitamin D3 Max, 20

Drug Mart Unilet Lancets Ultra Thin 28G, 21

enteric coated aspirin, 17

Diastar Easy Test II Lancets 30G, 21

ephedrine sulfate, 6

Diastar Easy Test Lancets30G, 21

Dulera, 19

Epiduo, 7

Diastat Pediatric, 15

Durezol, 16

epinastine HCL, 16

diazepam, 13

Dymista, 18

epinephrine HCL, 19

Diazepam, 15

Dyrenium, 6

Epipen 2-PAK, 6

Dibenzyline, 6

Dysport, 15

Epipen-JR 2-PAK, 6

diclofenac potassium, 17

E

epirubicin HCL, 3

diclofenac sodium, 16

Epivir, 2

E-z Ject Lancets, 21

diclofenac sodium DR, 17

Epivir HBV, 2

E-z Ject Lancets 21G, 21

diclofenac sodium ER, 17

eplerenone, 6

E-z Ject Lancets Color, 21

diclofenac sodium XR, 17

Epogen, 12

E-z Ject Lancets Super Thin, 21

diclofenac sodium/misoprostol, 17

epoprostenol sodium, 6

E-z Ject Lancets Super Thin 30G, 21

dicloxacillin sodium, 1

eprosartan mesylate, 5

E-z Ject Lancets Thin 26G, 21

dicyclomine HCL, 11

Epzicom, 2

E-ZJECT Lancets Micro-thin 33G, 21

didanosine, 2

Eraxis, 2

Feosol, 13

Fluzone PF 2012-2013, 19

Erbitux, 3

Ferrimin 150, 13

Fluzone PF 2013-2014, 19

ergocalciferol, 20

Ferriprox, 22

Fluzone Quadrivalent 2013-2014, 19

Ergomar, 18

ferrous drops, 12

Fluzone Split 2011-2012, 19

Ertaczo, 7

ferrous fumarate 324, 12


Erwinaze, 3

ferrous gluconate, 12


Ery-TAB, 1

ferrous gluconate iron, 12

FML, 16

Erythrocin Lactobionate, 1

ferrous sulfate, 12

Focalin XR, 14

erythromycin, 7, 16

Fibricor, 6

folic acid, 12

erythromycin/benzoyl peroxide, 7

Fifty50 Safety Seal Lancets 30G, 21

folic acid/vitamin b-6/vitamin b-12, 12

erythromycin/sulfisoxazole, 3

Fifty50 Safety Seal Lancets 32G, 21

Follistim AQ, 10

escitalopram oxalate, 14

Finacea, 7

Folotyn, 3

esmolol HCL, 5

finasteride, 12

Foltrate, 12

estazolam, 14

Fine 30, 21

fondaparinux sodium, 13

Estrace, 12

Fingerstix Lancets, 21

Fora Lancets, 21

estradiol, 8

Firazyr, 13

Foradil Aerolizer, 19

estradiol valerate, 8

Firmagon, 4

Forfivo XL, 14

estradiol/norethindrone acetate, 8

First-lansoprazole, 11

Forteo, 10

Estring, 12

Flagyl ER, 3

Fortesta, 8

Estrogel, 9

Flarex, 16

Fosamax Plus D, 10

estropipate, 9

flavoxate HCL, 12

fosinopril sodium, 5

ethambutol HCL, 1

flecainide acetate, 5

fosinopril sodium/hydrochlorothiazide, 6

ethosuximide, 14

Flector, 7

fosphenytoin sodium, 14

etodolac, 17

Flovent Diskus, 19

Fosrenol, 12

etodolac ER, 17

floxuridine, 3

Fragmin, 13

Etopophos, 4

Fluarix 2011-2012, 19

Freestyle Lancets, 21

etoposide, 4

Fluarix 2012-2013, 19

Freestyle Unistick II Lancets, 21

Euflexxa, 15

Fluarix 2013-2014, 19

Frova, 18

Eurax, 8

Fluarix Quadrivalent 2013-2014, 19

furosemide, 6

Evamist, 9

Flucelvax 2012-2013, 19

Fusilev, 4

Evista, 10

fluconazole, 2

Fuzeon, 2

Exalgo, 17

fluconazole IN NACL, 2

G

Exelderm, 7

flucytosine, 2

gabapentin, 14

Exelon, 15

fludarabine phosphate, 3

Gabitril, 15

exemestane, 3

fludrocortisone acetate, 8

Gablofen, 15

Exforge, 6

Flulaval 2011-2012, 19

galantamine, 15

Exforge HCT, 6

Flulaval 2012-2013, 19

galantamine hydrobromide, 15

Exjade, 22

Flulaval 2013-2014, 19

ganciclovir, 2

Extavia, 15

Flumist Nasal Vaccine 2011-2012, 19

Ganite, 10

EZ Smart Blood Glucose Lancets, 21

Flumist Nasal Vaccine 2012-2013, 19

Gardasil, 19

EZ-lets Lancets 21G, 21

Flumist Quadrivalent, 19

Gattex, 12


flunisolide, 18

Gelnique, 12

EZ-lets Lancets 26G Super-soft, 21

fluocinolone acetonide, 8, 17

gemcitabine HCL, 3

EZ-lets Lancets 28G Ultra-soft, 21

fluocinonide, 8

gemfibrozil, 6


fluorometholone, 16

gene-xene TAB 15MG, 13

F

fluorouracil, 3

gene-xene TAB 3.75MG, 13

fluoxetine DR, 14

Fa-8, 13

gene-xene TAB 7.5MG, 13

fluoxetine HCL, 14

Fabrazyme, 11

Genotropin, 10

fluphenazine HCL, 14

Factive, 1

Genotropin Miniquick, 10

flurazepam HCL, 14

famciclovir, 2

gentamicin sulfate, 1, 7, 16

flurbiprofen, 17

famotidine, 11

gentamicin sulfate/0.9% sodium chloride, 1

flurbiprofen sodium, 16

Fanapt, 14

flutamide, 3

Fareston, 3

gentamicin sulfate/sodium chloride, 1

fluticasone propionate, 8, 18

Faslodex, 4

Gentle-let GP Lancets, 21

fluvastatin, 6

Fasttake Test Strips, 21

Gentle-let Lancets General Purpose Style/Fine Point, 21

Fluvirin 2011-2012, 19

Fazaclo, 14

Fluvirin 2012-2013, 19

Feiba NF, 13

Gentle-let Lancets General Purpose Style/Medium Point, 21

Fluvirin PF 2011-2012, 19

Feiba VH Immuno, 13

Fluvirin PF 2012-2013, 19

felbamate, 14

Gentle-let Lancets Safety Style/Fine Point, 21

fluvoxamine maleate, 14

felodipine ER, 5

Fluzone High-dose PF 2011-2012, 19

fenofibrate, 6

Gentle-let Lancets Safety Style/Medium Point, 21


fenofibrate micronized, 6


Fenofibric Acid, 6

Geodon, 14

Fluzone Intradermal, 19

Fenoglide, 6

Giazo, 12

Fluzone Pediatric PF 2011-2012, 19

fenoldopam mesylate, 6

Gilenya, 15


fentanyl, 17

Glassia, 19


fentanyl citrate oral transmucosal, 17

Gleevec, 4

Fluzone PF 2011-2012, 19

Fentora, 17

Gliadel Wafer, 3

glimepiride, 9

hetastarch 6%/NACL, 13

imiquimod, 8

glipizide, 9

Hexalen, 3

Imovax Rabies (h.d.c.v.), 19

glipizide ER, 9

Hiberix, 19

Incivek, 2

glipizide/metformin HCL, 9

homatropine HBR, 16

Increlex, 10

Glucagen, 9

Horizant, 15

indapamide, 6

Glucagen Hypokit, 9

Humalog, 9

indomethacin, 17

Glucagon Emergency Kit, 9

Humalog Kwikpen, 9

indomethacin ER, 17

Glucocom Lancets 28G, 21

Humalog Mix 50/50, 9

indomethacin sodium, 17


Humalog Mix 50/50 Kwikpen, 9

Infanrix, 19


Humalog Mix 75/25, 9

Infergen, 2

Glucosource Lancets, 21

Humalog Mix 75/25 Kwikpen, 9

Infumorph 200, 17

Glumetza, 9

Humate-p, 13

Infumorph 500, 17

glyburide, 9

Humatrope, 10

Inlyta, 4

Glyburide, 9

Humatrope Combo Pack, 10

Innopran XL, 5

glyburide micronized, 9

Humira, 18

Integrilin, 13

glyburide/metformin HCL, 9

Humira Pen, 18

Intelence, 2

glycopyrrolate, 11

Humira Pen-crohns Diseasestarter, 18

Intermezzo, 14

Glyset, 9

Humira Pen-psoriasis Starter, 18

Intron-a, 4

Golytely, 11

Humulin 70/30, 9

Intron-a W/Diluent, 4

Gonal-f, 10

Humulin 70/30 Pen, 9

Intuniv, 14

Gonal-f RFF, 10

Humulin N, 9

Invanz, 3

Gonal-f RFF Pen, 10

Humulin N U-100 Pen, 9

Invega, 14

Gralise, 15

Humulin R, 9

Invega Sustenna, 14

Gralise Starter, 15

Humulin R U-500 (concentrated), 9

Invirase, 2

granisetron HCL, 11

Hy-vee Lancets, 21

Iopidine, 16

Granisol, 11

Hyalgan, 15

Ipol Inactivated IPV, 19

griseofulvin microsize, 2

Hycamtin, 4

ipratropium bromide, 18, 19

griseofulvin ultramicrosize, 2

hydralazine HCL, 6

ipratropium bromide/albuterol sulfate, 19

guanfacine HCL, 6

hydrochlorothiazide, 6

irbesartan, 5

Gynazole-1, 12

hydrocodone bitartrate/acetaminophen, 17

irbesartan/hydrochlorothiazide, 6

H

irinotecan, 4

hydrocodone bitartrate/homatropine methylbromide, 18

iron, 13

H&h Thinlet Lancets 26G, 21

Isentress, 2

H&h Thinlet Super Thin Lancets 30G, 21

hydrocodone polistirex and chlorpheniramine polistirex, 18

isoniazid, 1

Haemolance, 21

Isopto Carbachol, 16

Haemolance Low Flow Lancets, 21

hydrocodone/acetaminophen, 17

isosorbide dinitrate, 5

Haemolance Plus, 21

hydrocodone/homatropine, 18

isosorbide dinitrate ER, 5

Haemolance Plus High Flow, 21

hydrocodone/ibuprofen, 17

isosorbide mononitrate, 5

Haemolance Plus Low Flow, 21

hydrocort ene 100MG, 11

isosorbide mononitrate ER, 5

Haemolance Plus Max Flow, 21

hydrocortisone, 8(2), 12

isotonic gentamicin, 1

Haemolance Plus Pediatric Flow, 21

hydrocortisone acetate/aloe, 8

Istodax, 4

Halaven, 4

hydrocortisone acetate/pramoxine, 12

itraconazole, 2

Halflytely Bowel Prep/Flavor Packs, 11

hydrocortisone butyrate, 8

Ixempra Kit, 4

Halfprin, 17

hydrocortisone IN absorbase, 8

Ixiaro, 19

halobetasol propionate, 8

hydrocortisone valerate, 8

J

Halog, 8

hydrocortisone/acetic acid, 17

haloperidol, 14

Jakafi, 4

hydromorphone HCL, 17

haloperidol decanoate, 14

Janumet, 10

hydroxychloroquine sulfate, 2

haloperidol lactate, 14

Janumet XR, 10

hydroxyurea, 4

Havrix, 19

Januvia, 9

hydroxyzine HCL, 13

Hectorol, 11

Je-vax, 19

hydroxyzine pamoate, 13

Helidac, 11

Jentadueto, 10

hyoscyamine sulfate, 11

Helixate FS, 13

Jetrea, 17

hyoscyamine sulfate ER, 11

Hemofil M, 13

Jevtana, 4

hyoscyamine sulfate odt, 11

heparin lock, 13

Juvisync, 10

hyoscyamine sulfate SR, 11

heparin lock flush, 13

Juxtapid, 6

I

heparin lock flush for flushing vascular access devices, 13

K

ibandronate sodium, 10

Kadcyla, 3

heparin lock flush/NACL for flushing vascular access devices, 13

ibuprofen, 17

Kadian, 17

ibutilide fumarate, 5

Kalbitor, 13

heparin sodium, 13

Iclusig, 4

Kaletra, 2

heparin sodium dcu, 13

idarubicin HCL, 3

Kalydeco, 19

heparin sodium lock flush, 13

Ifex, 3

Kapvay, 14

heparin sodium/D5W, 13

ifosfamide, 3

Kapvay Dose Pack, 14

heparin sodium/NACL 0.9%, 13

Ifosfamide, 3

Keflex, 1

heparin sodium/sodium chloride 0.9% premix, 13

Ilaris, 18

Kenalog, 8

imipenem/cilastatin, 3

Kepivance, 5

Hepsera, 2

imipramine HCL, 14

Ketek, 3

Herceptin, 3

imipramine pamoate, 14

ketoconazole, 2, 7

levonorgestrel, 9

Medisense Thin Lancets, 21

ketoprofen, 17

levonorgestrel and ethinyl estradiol, 9

Medlance Plus Extra Lancets 21G, 21

ketorolac tromethamine, 16, 17

levonorgestrel/ethinyl estradiol, 9

Medlance Plus Lancets, 21

Kineret, 18

levothyroxine sodium, 11

Medlance Plus Lancets Lite 25G, 21

Kinrix, 19

Lexiva, 2

Medlance Plus Lite Lancets 25G, 21

Koate-dvi, 13

lidocaine, 8

Medlance Plus Special Lancets 0.8MM, 21

Kogenate FS, 13

lidocaine HCL, 5, 8, 13, 18

Kogenate FS Bio-set, 13

lidocaine HCL IN D5W, 5

Medlance Plus Superlite 30G, 21

Kombiglyze XR, 10

lidocaine HCL jelly, 8

Medlance Plus Superlite 30G/Comfort Max, 21

Kristalose, 11

lidocaine HCL/dextrose, 5

Krystexxa, 18

lidocaine HCL/hydrocortisone acetate, 12

Medlance Plus Universal Lancets 21G, 21

Kuvan, 11

lidocaine viscous, 13

Kyprolis, 4

lidocaine/epinephrine, 18

Medlance Plus/Lite 25G, 21

L

lidocaine/prilocaine, 8

Medlance/Extra, 21

Lidoderm, 8

Medlance/Lite, 21

labetalol HCL, 5

Lifescan Unistik 2 Deep Penetration, 21

Medlance/Universal, 21

Lacrisert, 16

Lifescan Unistik II Lancets, 21

medroxyprogesterone acetate, 9

lactic acid, 8

Lincocin, 3

mefenamic acid, 17

lactic acid e, 8

lindane, 8

mefloquine HCL, 2

lactic acid w/vitamin e, 8

Linzess, 12

Mefoxin, 1

lactulose, 11, 12

Lioresal Intrathecal, 15

megestrol acetate, 3

Lamictal, 15

liothyronine sodium, 11

Meijer Super Thin Lancets, 21

Lamictal Odt, 15

Lipofen, 6

meloxicam, 17

Lamisil, 2

lisinopril, 5

melphalan hydrochloride, 3

lamivudine, 2

lisinopril/hydrochlorothiazide, 6

Menactra, 19

lamivudine/zidovudine, 2

lithium carbonate, 14

Menest, 9

lamotrigine, 14

lithium carbonate ER, 14

Menomune-a/C/Y/W-135, 19

lamotrigine ER, 14

Livalo, 6

Menopur, 10

Lancets, 21

Live Better Lancet Super Thin 30G, 21

Mentax, 7

Lancets 26G Twist Top, 21

Live Better Lancet Ultra Thin 28G, 21

Menveo, 19

Lancets 28G, 21

LO Loestrin FE, 9

meperidine HCL, 17

Lancets 30G, 21

Locoid, 8

Mephyton, 20


Locoid Lipocream, 8

meprobamate, 13


Lodosyn, 15

Mepron, 3

Lancets Bullseye Safety, 21

Loestrin 24 FE, 9

mercaptopurine, 3

Lancets Safety Seal 21G, 21

loperamide HCL, 11

meropenem, 3


lorazepam, 13

mesalamine, 12


Lorzone, 15

mesna, 4


losartan potassium, 5

Mesnex, 5

Lancets Thin, 21

losartan potassium/hydrochlorothiazide, 6

Mestinon, 15

Lancets Twist Top, 21

Mestinon Timespan, 15

Lancets Ultra Fine, 21

Lotemax, 16

metaproterenol sulfate, 19

Lancets Ultra Thin, 21

Lotronex, 12

metaxalone, 15

lansoprazole, 11

lovastatin, 6

metformin HCL, 9

Lantus, 9

Lovaza, 6

metformin HCL ER, 9

Lantus Solostar, 9

loxapine, 14

methadone HCL, 17

Lastacaft, 17

loxapine succinate, 14

methamphetamine HCL, 14

latanoprost, 16

Lufyllin, 19

methazolamide, 6

Latuda, 14

Lumigan, 16

methenamine hippurate, 12

Lazanda, 17

Lumizyme, 11

methimazole, 11

leflunomide, 17

Lunesta, 14

methocarbamol, 15

Letairis, 7

Lupron Depot, 4

methotrexate, 3

letrozole, 3

Lupron Depot-PED, 10

methotrexate sodium, 3

leucovorin calcium, 4

Lyrica, 15

methscopolamine bromide, 11

Leukeran, 3

Lysodren, 4

methyldopa, 6

Leukine, 12

M

methylergonovine maleate, 17

leuprolide acetate, 3

methylphenidate HCL, 14

levalbuterol, 19

M-m-r II W/Diluent 10 Dose, 19

methylphenidate HCL CD, 14

levalbuterol HCL, 19

M.v.i. Adult, 20

methylphenidate HCL ER, 14

Levatol, 5

M.v.i. Pediatric, 20

methylphenidate HCL SR, 14

Levemir, 9

M.v.i.-12 Without Vitamin K, 20

methylphenidate hydrochloride, 14

Levemir Flexpen, 9

Makena, 9

methylprednisolone, 8

levetiracetam, 14

malathion, 8

methylprednisolone acetate, 8

levetiracetam ER, 14

mannitol, 6

methylprednisolone dose pack, 8

levobunolol HCL, 16

Marplan, 14

methylprednisolone sodiumsuccinate, 8

levocarnitine, 11

Matulane, 4

metipranolol, 16

levocetirizine dihydrochloride, 18

Maxair Autohaler, 19

metoclopramide HCL, 12

levofloxacin, 1, 16

Maxipime, 1

metolazone, 6

levofloxacin IN D5W, 1

meclizine HCL, 11

metoprolol succinate ER, 5

nalbuphine HCL, 17

Norditropin Flexpro, 10

metoprolol tartrate, 5

Nalfon, 18

Norditropin Nordiflex Pen, 10

metoprolol/hydrochlorothiazide, 6

Namenda, 15

norepinephrine bitartrate, 6

metronidazole, 3, 7

Namenda Titration PAK, 15

norethindrone, 9

metronidazole IN NACL 0.79%, 3

Namenda XR, 15

norethindrone acetate, 9

metronidazole vaginal, 12

Namenda XR Titration Pack, 15

norgestimate/ethinyl estradiol, 9

Miacalcin, 10

Naprelan, 18

norgestrel/ethinyl estradiol, 9

Micardis, 5

naproxen, 17

Noroxin, 1

Micardis HCT, 6

naproxen sodium, 17

Norpace CR, 5

Microlet Lancets, 21

naratriptan HCL, 18

nortriptyline HCL, 14

Microtainer Safety Flow Lancet/Sterile/Single-use, 21

Nasonex, 18

Norvir, 2

Natacyn, 16

Nova Safety Lancets 23G, 21

midodrine HCL, 6

Natazia, 9

Nova Safety Lancets 28G, 21

Millipred, 8

nateglinide, 9

Nova Sureflex Lancets, 21

Millipred DP, 8

Natroba, 8

Novaferrum Pediatric Drops, 13

milrinone IN dextrose, 5

Nebupent, 3

Novofine 30GX8MM, 21

milrinone lactate, 5

Neevo DHA, 20

Novofine 32GX6MM, 21

minocycline HCL, 1

neomycin sulfate, 1

Novofine Autocover 30GX8MM, 21

minocycline HCL ER, 1

neomycin/bacitracin/polymyxin, 16

Novolin 70/30, 9

minoxidil, 6

neomycin/polymyxin/bacitracin zinc, 16

Novolin 70/30 Relion, 9

Mirapex ER, 15

neomycin/polymyxin/bacitracin/hydrocortisone, 16

Novolin N, 9

mirtazapine, 14

Novolin N Relion, 9

mirtazapine odt, 14

neomycin/polymyxin/dexamethasone, 16

Novolin R, 9

misoprostol, 11

neomycin/polymyxin/gramicidin, 16

Novolin R Relion, 9

mitomycin, 3

neomycin/polymyxin/HC, 17

Novolog, 9

mitoxantrone HCL, 3

neomycin/polymyxin/hydrocortisone, 17

Novolog Flexpen, 9

modafinil, 14

neostigmine methylsulfate, 15

Novolog Mix 70/30, 9

moexipril HCL, 5

Netgroup Lancets, 21

Novolog Mix 70/30 Prefilled Flexpen, 9

moexipril/hydrochlorothiazide, 6

Neulasta, 12

Novolog Penfill, 9

mometasone furoate, 8

Neumega, 12

Novoseven Rt, 13

Monoclate-p, 13

Neupogen, 12

Novotwist 30GX8MM, 21

Monolet Lancets, 21

Neupro, 15

Novotwist 32GX5MM, 21

Monolet Opd Lancets, 21

Nevanac, 16

Noxafil, 2

Monolettor Safety Lancets, 21

nevirapine, 2

Nplate, 12

Mononine, 13

Nevirapine, 2

Nucynta, 17

montelukast sodium, 19

Nexavar, 4

Nucynta ER, 17

Monurol, 12

Nexium, 11

Nuedexta, 15

morphine sulfate, 17

Nexterone, 5

Nulojix, 4

morphine sulfate ER, 17

Niaspan, 6

Nutricap, 20

Motofen, 11

nicardipine HCL, 5

Nutropin, 10

Moviprep, 11

Nicazel, 20

Nutropin AQ, 10

Moxatag, 1

nicotinamide w/zinc oxide/cupric oxide/folic acid, 20

Nutropin AQ Nuspin 10, 10

Moxeza, 16


Mozobil, 12

nicotinamide/zinc oxide/cupric oxide/folic acid, 20


Multaq, 5

Nutropin AQ Pen, 10

mupirocin, 7

nicotinamide/zinc/copper/fa, 20

Nuvigil, 14

mupirocin calcium, 7

nifedipine, 5

nystatin, 2, 7, 13

Muse, 7

nifedipine ER, 5

nystatin/triamcinolone, 7

Mustargen, 3

Nilandron, 4

O

Mycamine, 2

nimodipine, 5

octreotide acetate, 10

Mycobutin, 2

nisoldipine, 5

Ocudox, 1

mycophenolate mofetil, 4

nisoldipine ER, 5

ofloxacin, 1, 16, 17

Myfortic, 4

Nitro-bid, 5

olanzapine, 14

Myglucohealth Mgh Softlance Lancets 30G, 21

Nitro-dur, 5

olanzapine odt, 14

nitrofurantoin, 12

olanzapine/fluoxetine, 15

Mykidz Iron 10, 13

nitrofurantoin macrocrystal, 12

Omeclamox-PAK, 11

Myleran, 3

nitrofurantoin macrocrystalline, 12

omeprazole, 11

Myobloc, 15

nitrofurantoin macrocrystals, 12

omeprazole/sodium bicarbonate, 11

Myozyme, 11

nitroglycerin, 5

Omnaris, 18

Myrbetriq, 12

nitroglycerin IN 5% dextrose, 5

Omnitrope, 10

Mytelase, 16

nitroglycerin IN dextrose 5%, 5

Omontys, 12

N

Nitroglycerin Lingual, 5

On Call Lancets, 21

nitroglycerin transdermal, 5

nabumetone, 17

On Call Plus Lancets, 21

Nitrolingual Pumpspray, 5

nadolol, 5

Oncaspar, 3

Nitromist, 5

nadolol/bendroflumethiazide, 6

ondansetron HCL, 11

Nitrostat, 5

nafcillin sodium, 1

ondansetron odt, 11

nizatidine, 11

Naftin, 7

Onetouch Basic System, 21

Norditropin Cartridge, 10

Naglazyme, 11

Onetouch Basic/Profile Test Strips, 21

Onetouch Club Lancets Fine Point, 21

oxycodone/ibuprofen, 17

phenylephrine HCL, 6, 16

Onetouch Combo Pack, 21

Oxycontin, 17

phenylephrine/guaifenesin, 18

Onetouch Delica Lancets, 21

oxymorphone hydrochloride, 17

phenytoin, 14

Onetouch Delica Lancets Fine 30G, 21

oxymorphone hydrochloride ER, 17

phenytoin sodium, 14

Onetouch Delica Lancing Device, 21

Oxymorphone Hydrochloride ER, 17

phenytoin sodium extended, 14

Onetouch Finepoint Lancets, 21

oxytocin, 17

Phoslyra, 12

Onetouch Lancets, 21

Oxytrol, 12

Phospholine Iodide, 16

Onetouch Ping Meter Remote, 21

Ozurdex, 16

Photofrin, 4

Onetouch Profile System, 21

P

phytonadione, 20

Onetouch Suresoft Lancing Device/Dual Site, 21

pilocarpine HCL, 13, 16

Pacerone, 5

pilocarpine hydrochloride, 13

paclitaxel, 4

Onetouch Suresoft Lancing Device/Gentle, 22

Pilopine HS, 16

pamidronate disodium, 10

pioglitazone HCL, 9

Pancrelipase, 11

Onetouch Suresoft Lancing Device/Regular, 22

pioglitazone HCL-glimepiride, 9

pancuronium bromide, 15

pioglitazone HCL/metformin HCL, 9

pantoprazole sodium, 11

Onetouch Ultra 2, 22

piperacillin sodium/tazobactam sodium, 1

papaverine HCL, 6

Onetouch Ultra Blue, 22

piperacillin/tazobactam, 1

paromomycin sulfate, 1

Onetouch Ultra Control, 22

piroxicam, 17

paroxetine HCL, 14

Onetouch Ultra Mini, 22

podofilox, 8

paroxetine HCL ER, 14

Onetouch Ultra System Kit, 22

polyethylene glycol 3350, 11

Paser, 2

Onetouch Ultralink System (DEC), 22

polymyxin b sulfate, 3

Pataday, 17

Onetouch Ultralink System (hex), 22

polymyxin b sulfate/trimethoprim sulfate, 16

Patanase, 18

Onetouch Ultrasmart, 22

Patanol, 17

Onetouch Ultrasoft Lancets, 22

Pomalyst, 4

Paxil, 14

Onetouch Verio Control Solution High, 22

Potaba, 20

PCE, 1

Potassium Citrate, 12

Pediaderm HC, 8

Onetouch Verio IQ Blood Glucose Monitoring System, 22

potassium citrate/citric acid, 12

Pediaderm Ta, 8

Potiga, 15

Pediarix, 19

Onetouch Verio IQ Test Strips, 22

Pradaxa, 13

Pedipirox-4 Nail, 7

Onetouch Verio Mid Control Solution, 22

pramipexole dihydrochloride, 15

Pedvax HIB, 19

Onetouch Verio Test Strips, 22

Pramosone, 8

peg 3350/electrolytes, 11

Onglyza, 9

Pramosone E, 8

peg-3350/electrolytes, 11

Onsolis, 17

Prandimet, 10

peg-3350/NACL/NA bicarbonate/KCL, 11

Ontak, 4

Prandin, 9

Peg-intron, 2

Opana ER, 17

pravastatin sodium, 6

Peg-intron Redipen, 2

Opana ER (crush Resistant), 17

prazosin HCL, 6

Peg-intron Redipen PAK 4, 2

opium, 11

Precision Thin Lancets, 22

Peganone, 15

opium tincture, 11

Precision Thins GP Lancet, 22

Pegasys, 2

Oracea, 7

Precision Ultra Lancet, 22

Pegasys Proclick, 2

Oracit, 12

Pred Mild, 16

Pen Needles 29G X 12MM, 22

Orap, 15

prednicarbate, 8

Pen Needles 29GX1/2", 22

Orapred Odt, 8

prednisolone, 8


Oravig, 13

prednisolone acetate, 16

Pen Needles 31G X 1/4" SHORT, 22

Orencia, 18

prednisolone sodium phosphate, 8

Pen Needles 31G X 3/16", 22

Orfadin, 11

prednisone, 8

Pen Needles 31G X 6MM, 22

orphenadrine citrate, 15

Prednisone Intensol, 8


orphenadrine citrate ER, 15

Premarin, 9

penicillin G potassium, 1

orphenadrine/asa/caffeine, 15

Premphase, 9

penicillin v potassium, 1

Ortho Evra, 9

Prempro, 9

Pentacel, 19

Orthovisc, 15

Prepopik, 11

Pentasa, 12

Osmoprep, 11

Prevacid Solutab, 11

pentazocine/acetaminophen, 17

Ovace Plus, 7

Prevnar 13, 19

pentazocine/naloxone HCL, 17

Ovidrel, 10

Prevpac, 11

pentostatin, 4

oxacillin sodium, 1

Prezista, 2

pentoxifylline ER, 13

oxaliplatin, 3

Prialt, 17

Perfect Lancets 30G, 22

oxandrolone, 8

Priftin, 2

Perfect Pressure Activated Safety Lancets 28G, 22

oxaprozin, 17

primidone, 14

oxazepam, 13

Primsol, 3

Perforomist, 19

oxcarbazepine, 14

Pristiq, 14

perindopril erbumine, 5

Oxecta, 17

Proair HFA, 19

Perjeta, 3

Oxistat, 7

probenecid, 18

permethrin, 8

Oxsoralen, 8

probenecid/colchicine, 18

perphenazine, 14

Oxsoralen Ultra, 7

procainamide HCL, 5

Pertzye, 11

oxybutynin chloride, 12

prochlorperazine, 14

Pharmacy Counter Lancets, 22

oxybutynin chloride ER, 12

prochlorperazine maleate, 14

phenazopyridine HCL, 12

oxycodone HCL, 17

Procrit, 12

phenelzine sulfate, 14

oxycodone/acetaminophen, 17

Proctofoam HC, 12

phenobarbital, 14

oxycodone/aspirin, 17

Procysbi, 12

phenobarbital sodium, 14

Prodigy Pressure Activated Safety Lancets, 22

Rebif Rebidose Titration Pack, 15

Safe-t-lance Plus Safety Lancet Low Flow, 22

Rebif Titration Pack, 15

Prodigy Safety Lancets, 22

Recombinate, 13

Safe-t-lance Plus Safety Lancet Normal Flow, 22

Prodigy Twist Top Lancets, 22

Recombivax HB, 19

Profe, 13

Rectiv, 12

Safety Lancet 21G/Pressure Activated, 22

Proferrin ES, 13

Relenza Diskhaler, 2

Profilnine SD, 13

Relion Lancets, 22

Safety Lancet 28G/Pressure Activated, 22

progesterone, 9

Relion Lancets Standard 21G, 22

Proglycem, 9

Relion Lancets Thin 26G, 22

Safety Lancet 2MM, 22

Prograf, 4

Relion Lancets Ultra-thin30G, 22

Safety Lancets, 22

Prolastin, 19

Relion Thin Lancets, 22

Safety Lancets 21G, 22

Prolastin-c, 19

Relion Ultra Thin Lancets, 22

Safety Lancets 28G, 22

Proleukin, 4

Relion Ultra Thin Lancets30G, 22

Safety Let Lancets, 22

Prolia, 10

Relion Ultra Thin Plus Lancets 32G, 22

Safety Seal Lancets 28G, 22

Promacta, 12

Relion Ultra Thin Plus Lancets 33G, 22

Safety Seal Lancets 30G, 22

promethazine HCL, 18

Relistor, 12

Safyral, 9

promethazine HCL plain, 18

Relpax, 18

Saizen, 10

promethazine-DM, 18

Remicade, 12

Saizen Click.easy, 10

promethazine/codeine, 18

Remodulin, 7

salicylic acid, 8

promethazine/dextromethorphan, 18

Renagel, 12

salsalate, 17

propafenone HCL, 5

Renew Advanced Lancing Cartridge Refills, 22

Samsca, 10

propafenone HCL ER, 5

Sancuso, 11

proparacaine HCL, 16

Renvela, 12

Sandimmune, 4

propranolol HCL, 5

Replesta, 20

Sandostatin Lar Depot, 10

propranolol HCL ER, 5

Replesta Childrens, 20

Saphris, 14

propylthiouracil, 11

Replesta Nx, 20

Savella, 15

Proquad, 19

Repronex, 10

selegiline HCL, 15

Prostigmin, 16

Req 49+, 20

selenium sulfide, 7

Protopic, 8

Rescriptor, 2

Selzentry, 2

protriptyline HCL, 14

Restasis, 16

Sensipar, 11

Provenge, 4

Retisert, 16

Serevent Diskus, 19

Proventil HFA, 19

Retrovir IV Infusion, 2

Seromycin, 2

Prudoxin, 7

Revatio, 7

Seroquel XR, 14

Pss Select GP Lancets, 22

Revlimid, 4

Serostim, 10

Pss Select Safety Lancets, 22

Reyataz, 2

sertraline HCL, 14

Pulmicort, 19

Rezira, 18

Siderol, 20

Pulmicort Flexhaler, 19

Rheumatrex, 18

Signifor, 10

Pulmozyme, 19

Rhinocort Aqua, 18

sildenafil citrate, 6

Px Lancets Ultra Thin, 22

Riastap, 13

Silenor, 14

Pylera, 11

Ribapak, 2

Simcor, 6

pyrazinamide, 1

Ribatab, 2

Simponi, 18

pyridostigmine bromide, 15

ribavirin, 2

Simulect, 4

Q

Ridaura, 18

simvastatin, 6

Rifamate, 2

Single-let, 22

Qc Lancets Super Thin, 22

rifampin, 1

Sirturo, 2

Qc Lancets Ultra Thin, 22

Rifater, 2

Skelid, 10

Qnasl, 18

Right Step Prenatal, 20

Sklice, 8

Quadramet, 4

Rightest Gl300 Lancets, 22

Smart Diabetes Vantage Universal Lancets 30G, 22

quetiapine fumarate, 14

rimantadine HCL, 2

Quillivant XR, 14

Riomet, 9

Smart Sense Color Lancets Universal 33G, 22

quinapril HCL, 5

risperidone, 14

quinapril/hydrochlorothiazide, 6

risperidone odt, 14

Smart Sense Standard Lancets Universal 21G, 22

quinidine gluconate CR, 5

Rituxan, 3

quinidine gluconate ER, 5

rivastigmine tartrate, 15

Smart Sense Super Thin Lancets Universal 30G, 22

quinidine sulfate, 5

rizatriptan benzoate, 18

quinine sulfate, 2

rocuronium bromide, 15

Smart Sense Thin Lancets Universal 26G, 22

Qvar, 19

ropinirole ER, 15

R

ropinirole HCL, 15

Smartest Lancets 28G, 22

Rotarix, 19

sodium chloride, 18

Rabavert, 19

Rotateq, 20

Sodium Edecrin, 6

ramipril, 5

Rozerem, 14

sodium ferric gluconate complex/sucrose, 12

Ranexa, 5

Rybix Odt, 17

ranitidine HCL, 11

S

sodium hyaluronate, 8

Rapaflo, 12

sodium sulfacetamide, 7, 16

Rapamune, 4

Sabril, 15

sodium sulfacetamide wash, 7

Rayos, 8

Safe-t-lance Low Flow 25G, 22

sodium sulfacetamide/sulfur, 7

Rebetol, 2

Safe-t-lance Normal Flow 21G, 22

sodium sulfacetamide/sulfur cleanser, 7

Rebif, 15

Safe-t-lance Plus Safety Lancet High Flow, 22

sodium sulfacetamide/sulfur cleansing

Rebif Rebidose, 15

cloths, 7

Synera, 8

Timentin, 1

sodium sulfacetamide/sulfur green, 7

Synribo, 4

timolol maleate, 16

sodium sulfacetamide/sulfur wash, 7

Synvisc, 15

timolol maleate ophthalmic gel forming, 16

Soliris, 13

Synvisc One, 15

Solodyn, 1

T

tinidazole, 3

Soltamox, 4

tizanidine HCL, 15

Tabloid, 3

Solu-cortef, 8

Tobi, 1

Taclonex, 8

Solus V2 Pressure Activated Safety Lancets 28G, 22

Tobi Podhaler, 1

tacrolimus, 4

Tobradex, 16

Talwin, 17

Solus V2 Twist Lancets 30G, 22

Tobradex ST, 16

Tamiflu, 2

Somatuline Depot, 10

tobramycin sulfate, 1, 16

tamoxifen citrate, 3

Somavert, 10

tobramycin/dexamethasone, 16

tamsulosin HCL, 12

Soriatane, 7

Tobrex, 16

Tarceva, 4

sotalol HCL, 5

tolazamide, 9

Targretin, 4

Spinosad, 8

tolmetin sodium, 18

Tarka, 6

Spiriva Handihaler, 19

tolterodine tartrate, 12

Tasigna, 4

spironolactone, 6

topiramate, 14

Tasmar, 15

spironolactone/hydrochlorothiazide, 6

topotecan HCL, 4

Taxotere, 4

Sporanox, 2

Torisel, 4

Tazorac, 7

Sprix, 18

torsemide, 6

Tecfidera, 15

Sprycel, 4

Totect, 5

Tecfidera Starter Pack, 15

stannous fluoride oral rinse, 13

Toviaz, 12

Techlite AST Lancets, 22

stavudine, 2

Tracleer, 7

Techlite Lancets, 22

Stavzor, 15

Tradjenta, 9

Techlite Lancets 30G, 22

Stelara, 7

tramadol HCL, 17

Tegretol-XR, 15

Sterilance TL, 22

tramadol HCL ER, 17

Tekamlo, 6

Stimate, 10

tramadol hydrochloride/acetaminophen, 17

Tekturna, 5

Stivarga, 4

Tekturna HCT, 6

Strattera, 14

trandolapril, 5

temazepam, 14

Striant, 8

tranexamic acid, 13

Temodar, 3

Stribild, 2

Transderm-scop, 11

Tenivac, 19

Stromectol, 2

tranylcypromine sulfate, 14

terazosin HCL, 6

Strovite One, 20

Travatan Z, 16

terbinafine HCL, 2

Suboxone, 17

trazodone HCL, 14

Terbinex, 2

Subsys, 17

Treanda, 3

terbutaline sulfate, 19

Sucraid, 11

Trecator, 2

terconazole, 12

sucralfate, 11

Trelstar Depot, 4

Testim, 8

sulfacetamide sodium, 7, 16

Trelstar Depot Mixject, 4

testosterone cypionate, 8

sulfacetamide sodium/prednisolone sodium phosphate, 16

Trelstar LA, 4

testosterone enanthate, 8

Trelstar LA Mixject, 4

tetracaine HCL, 16, 18

sulfacetamide sodium/sulfur cleanser, 7

Trelstar Mixject, 4

Tev-tropin, 10

sulfamethoxazole/trimethoprim, 3

Tretin-x, 7

Teveten, 5

sulfamethoxazole/trimethoprim DS, 3

tretinoin, 4, 7

Teveten HCT, 6

sulfasalazine, 12

Trexall, 3

Texacort, 8

sulindac, 18

Treximet, 18

Thalomid, 4

sumatriptan succinate, 18

triamcinolone acetonide, 8, 13, 18

Theo-24, 19

sumatriptan succinate refill, 18

triamcinolone IN orabase, 13

theophylline, 19

Sumavel Dosepro, 18

triamterene/hydrochlorothiazide, 6

theophylline CR, 19

Supartz, 15

triazolam, 14

theophylline ER, 19

Supprelin LA, 10

Tribenzor, 6

theophylline/D5W, 19

Suprax, 1

trifluoperazine HCL, 14

Thera-d 4000, 20

Suprep Bowel Prep, 11

trifluridine, 16

Theracys, 4

Sure-lance Flat Lancets, 22

Triglide, 6

thiamine HCL, 20

Sure-lance Lancets 26G, 22

trihexyphenidyl HCL, 15

Thinlets GP Lancets, 22

Sure-lance Thin Lancets 28G, 22

Trilipix, 6

Thinlets Lancet, 22

Sure-lance Ultra Thin Lancets, 22

trimethobenzamide HCL, 11

thioridazine HCL, 14

Sure-touch Lancets Universal, 22

trimethoprim, 3

thiothixene, 14

Surelite Lancets, 22

trimethoprim sulfate/polymyxin b sulfate, 16

Thrombate Iii W/10 ML Sterile Water, 13

Surestep Pro Test Strips, 22

Thymoglobulin, 4

Surestep Test Strips, 22

trimipramine maleate, 14

Thyrolar-1, 11

Sustiva, 2

Tripedia, 19

Thyrolar-1/2, 11

Sutent, 4

Trisenox, 4

Thyrolar-1/4, 11

Sylatron, 4

Trizivir, 2

Thyrolar-2, 11

Symbicort, 19

trospium chloride, 12

Thyrolar-3, 11

Symlin, 9

trospium chloride ER, 12

tiagabine hydrochloride, 14

Symlinpen 120, 9

Trueplus Lancets 26G, 22

Tice Bcg, 4

Symlinpen 60, 9


ticlopidine HCL, 13

Synarel, 10

Trueplus Lancets 28G Super Thin, 22

Tikosyn, 5


Valturna, 6

Vivotif Berna, 19

Trueplus Lancets 30G Ultra Thin, 22

Valumark Lancet Super Thin 30G, 22

Voltaren, 7


Valumark Lancet Ultra Thin 28G, 22

Voraxaze, 5

Trueplus Lancets 33G Micro Thin, 22

vancomycin HCL, 3

voriconazole, 2

Trueplus Safety Lancets 28G, 22

Vandetanib, 4

Votrient, 4

Truvada, 2

Vanos, 8

Vpriv, 12

Tudorza Pressair, 19

Vantas, 4

Vumon, 4

Tussicaps, 18

Vaqta, 20

Vytorin, 6

Twinject, 6

Varivax, 20

Vyvanse, 14

Twinrix, 20

Vascepa, 6

W

Twynsta, 6

vasopressin, 10

W&f Lancets 26G, 22

Tygacil, 3

Vectibix, 3

W&f Lancets Colored 21G, 22

Tykerb, 4

Vectical, 7

Walgreens Lancets, 22

Typhim VI, 19

vecuronium bromide, 15

Walgreens Thin Lancets, 22

Tysabri, 15

Velcade, 4

Walgreens Ultra Thin Lancets, 22

Tyvaso, 7

Veletri, 7

warfarin sodium, 13

Tyvaso Refill, 7

Veltin, 7

Welchol, 6

Tyvaso Starter, 7

venlafaxine HCL, 14

Wilate, 13

Tyzeka, 2

venlafaxine HCL ER, 14

X

Tyzine, 18

Venofer, 12

Tyzine Pediatric Nasal Drops, 18

Ventavis, 7

Xalkori, 4

U

Ventolin HFA, 19

Xarelto, 13

Veramyst, 18

Xeljanz, 18

Uceris, 8

verapamil HCL, 5

Xeloda, 3

Ulesfia, 8

verapamil HCL ER, 5

Xenazine, 15

Uloric, 18

verapamil HCL SR, 5

Xeomin, 15

Ulticare Thin Lancets 30G, 22

Verdeso, 8

Xgeva, 10

Ultilet Basic Lancets 30G, 22

Veregen, 8

Xifaxan, 3

Ultilet Classic Lancets, 22

Veripred 20, 8

Xolair, 19

Ultilet Lancets, 22

Vesicare, 12

Xolegel, 7

Ultilet Lancets 33G, 22

Vexol, 16

Xopenex HFA, 19

Ultilet Safety Lancets 23G, 22

Vfend, 2

Xtandi, 4

Ultra-thin II Auto Lancet, 22

Viagra, 7

Xyntha, 13

Ultra-thin II Lancets 28G, 22

Vibativ, 3

Xyntha Solofuse, 13

Ultra-thin II Lancets 30G, 22

Victoza, 9

Xyrem, 15

Ultra-thin II Lancets/28G X 1/8", 22

Victrelis, 2

Y

Ultra-thin II Lancets/30G X 1/8", 22

Vida Mia Unilet Lancets Super Thin 30G, 22

Ultra-thin II Safety Autolancets 26G, 22

Yervoy, 3

Ultravate PAC, 8

Yodoxin, 2

Vida Mia Unilet Lancets Ultra Thin 28G, 22

Ultresa, 11

Z

Unilet Comfortouch Lancet, 22

Vidaza, 3

zafirlukast, 19

Unilet Excelite, 22

Videx Pediatric, 2

zaleplon, 14

Unilet Excelite II, 22

Vigamox, 16

Zaltrap, 3

Unilet G.p. Lancet, 22

Viibryd, 14

Zanosar, 3

Unilet G.p. Superlite Lancet, 22

Vimovo, 18

Zavesca, 12

Unilet GP 28 Ultra Thin, 22

Vimpat, 15

Zegerid, 11

Unilet Lancet, 22

vincristine sulfate, 4

Zelboraf, 4

Unilet Superlite Lancet, 22

vinorelbine tartrate, 4

Zemaira, 19

Universal 1 Lancets Thin 26G, 22

Viokace, 11

Zemplar, 11

Universal 1 Lancets Ultra Thin 30G, 22

Viracept, 2

Zenpep, 11

urea, 8

Viramune, 2

Zetia, 6

urea 40% nail film, 8

Viramune XR, 2

Zetonna, 18

urea IN zinc undecylenate/lactic acid vehicle, 8

Virazole, 2

Ziagen, 2

Viread, 2

Ziana, 7

urea topical, 8

Visicol, 11

zidovudine, 2

Urocit-k 10, 12

Vitalet Pro Lancets, 22

Zinacef IN Iso-osmotic Dextrose, 1

Urocit-k 15, 12

Vitalet Pro Plus Lancets, 22

Zinacef IN Iso-osmotic Diluent, 1

Urocit-k 5, 12

vitamin c 222MG, 20

Zioptan, 16

ursodiol, 12

vitamin d, 20

ziprasidone HCL, 14

Uvadex, 4

Vitamin D, 20

Zirgan, 16

V

vitamin d 400, 20

Zithromax, 1

vitamin d-1000, 20

Vagifem, 12

Zoladex, 4

vitamin d-3, 20

valacyclovir HCL, 2

zoledronic acid, 10

vitamin d3, 20

Valcyte, 2

Zolinza, 4

Vitamin D3, 20

valproate sodium, 15

zolpidem tartrate, 14

Vitamin D3 400, 20

valproic acid, 15

zolpidem tartrate ER, 14

vitamin k1, 20

valsartan/hydrochlorothiazide, 6

Zometa, 10

Vivelle-dot, 9

Valstar, 3

Zomig, 18

Zomig ZMT, 18

Zonalon, 7

zonisamide, 15

Zorbtive, 10

Zortress, 4

Zostavax, 20

Zovirax, 7

Zuplenz, 11

Zutripro, 18

Zyclara, 8

Zyclara P.M., 8

Zyflo, 19

Zyflo CR, 19

Zylet, 16

Zymaxid, 16

Zytiga, 4

Zyvox, 3

1

1ST Choice Lancets Super Thin, 22

1ST Choice Lancets Thin, 22

1ST Choice Lancets Ultra Thin, 22

8

8-mop, 7

Documents

Prescription Drug List - Nevada Health Co-Op