Recommended Drug List

Transcription

1 Health Net Medi-Cal Recommended List The Health Net Medi-Cal Recommended List (RDL) includes drugs covered by Health Net. The drug list is updated often and may change. To get the most up-to-date information, call Member Services at TTY users may call The latest drug list can be viewed on our website at.

2 Welcome to Health Net What is the Health Net Medi-Cal Recommended List? The drug list includes drugs used to treat common diseases or health problems. A team of doctors and pharmacists meets regularly to decide which drugs should be on the drug list. The team reviews new and existing drugs and chooses drugs that work best and are safe. How do I use the Health Net Medi-Cal Recommended List? Look for your drug in the index at the end of this booklet. The index lists all of the drugs on the drug list. Both brand name drugs and generic drugs are listed in the index. Next to your drug, you will see the page number where you can find your drug. The table below tells you what the abbreviations on the List mean. Abbreviation Term What it means Age Limit Some drugs are only covered for certain ages. Carve Out These drugs are carved out by the Department of Health Care Services. This means these drugs are covered by the Medi-Cal ee-for-service program and can be billed to the State by the pharmacy. ormulary These drugs are covered on the List. N Non-formulary These drugs are not covered on the List. If your doctor feels you need a drug that is not covered, he or she can ask us to make an exception. Prior Authorization Your doctor must ask for approval from Health Net before some drugs will be covered. QL Quantity Limit Some drugs are only covered for a certain amount. Prescription and OTC These drugs are made in both prescription form and Over-the-counter (OTC) form. ST Step Therapy In some cases, you must first try certain drugs before Health Net covers another drug for your medical condition. or example, if A and B both treat your medical condition, Health Net may not cover B unless you try A first. What if my drug is not on the Health Net Medi-Cal Recommended List? If your drug is not on the drug list, call Member Services at and ask if your drug is covered. If your drug is not covered, you can ask your doctor to prescribe a similar drug that is covered. If your doctor feels you need to have the drug that is not covered, your doctor can ask us to make an exception. ii

3 Can I go to any pharmacy? Members must use pharmacies that are in the network. These pharmacies have a contract with Health Net. To find a pharmacy, call Member Services at or visit our website at. Are there any limits on my drug coverage? Some drugs have limits on coverage. If a drug has limits, it will be noted in the column on the List. How can I get an exception to the rules for drug coverage? Your doctor can ask for an exception to our rules for drug coverage. Your doctor can ask us to cover your drug even if it is not on the drug list. Your doctor can ask us to make an exception for limits on your drug. or example, if your drug has a quantity limit of 1 tablet per day, your doctor can ask us to cover more. To request an exception, your doctor can fax a prior authorization form to us at After we receive your doctor s request, we usually make our decision within one business day. If we need more information, your doctor has five business days to give us that information before we make our decision. What if I m a new member? If you are a new member in our plan, you may be taking drugs that are not on our drug list. You may also be taking a drug that is on our drug list, but the drug may have some limits. In these cases, you should talk to your doctor to see if you should change to drugs that we cover. Your doctor may request an exception so that we could cover the drug you have been taking. See the section, How do I get an exception to the rules for the drug coverage? for more information. What are over-the-counter drugs? Over-the-counter (OTC) drugs are drugs you can buy without a prescription. The Health Net Medi- Cal List covers similar OTC drugs as those listed on the State Medi-Cal List of Contract s. However, if you want Health Net to cover an OTC drug on the drug list, your doctor must write a prescription for that drug. Are brand name drugs covered? Your pharmacy benefit does not cover brand name drugs when generic drugs are available. Brand name drugs may be covered when generic drugs are not available or if your doctor says the brand name drug is medically necessary. What is a generic drug? A generic drug contains the same active ingredient and works the same way as the brand name drug. Generic drugs must be safe and effective. iii

4 Will the pharmacist give me a generic drug if one is available? Yes. Pharmacies may give you a generic drug, unless your doctor says that you must take the brand name drug. Are there any excluded or carve-out drugs? Excluded drugs The Health Net Medi-Cal List is similar to the State Medi-Cal List of Contract s and does not include certain drugs. The following types of drugs are not included on the drug list because they are excluded from coverage: dental products multivitamins erectile dysfunction drugs drugs used for cosmetic reasons Carve-out drugs Some drugs are carved out by the Department of Health Care Services. This means that these drugs are covered by the Medi-Cal ee-for-service program and can be billed to the State by the pharmacy. The following types of drugs are carved out: certain psychotherapeutic drugs HIV-related drugs treatment drugs for alcohol and heroin detoxification and dependency certain drugs to treat hemophilia What is California Children s Services? California Children s Services (CCS) is a state program for children (up to 21 years old) with certain diseases or health problems. Some drugs for CCS-covered diseases or health problems are not covered by Health Net. Only doctors approved by CCS can write prescriptions for drugs used to treat CCS-covered conditions. Pharmacies must bill CCS, and not Health Net, for these drugs. If you are at the pharmacy and you are not yet in the CCS system, call Member Services at Member Services can help you register with CCS. They may also help you get an emergency supply of your drug. Need more information? or more information about your pharmacy benefits, please review your Member Handbook or call Member Services at iv

5 Name ADHD/ANTI-NARLEPSY/ANTI- OBESITY/ANOREXIANTS - s to Treat ADHD, Sleep and Eating Disorders Amphetamines ADDERL (Use Amphetamine- Dextroamphetamine) ADDERL XR (Use Amphetamine- Dextroamphetamine) amphetaminedextroamphetamine cp mg-1.25mg-1.25mg- 1.25mg, 2.5mg-2.5mg- 2.5mg-2.5mg, 3.75mg- 3.75mg-3.75mg-3.75mg, 5mg-5mg-5mg-5mg, 6.25mg-6.25mg-6.25mg- 6.25mg, 7.5mg-7.5mg- 7.5mg-7.5mg amphetaminedextroamphetamine tabs 1.25mg-1.25mg-1.25mg- 1.25mg, 1.875mg mg-1.875mg mg, 2.5mg-2.5mg- 2.5mg-2.5mg, 3.125mg mg-3.125mg mg, 3.75mg-3.75mg- 3.75mg-3.75mg, 5mg-5mg- 5mg-5mg, 7.5mg-7.5mg- 7.5mg-7.5mg DEXEDRINE 10 MG,15 MG,5 MG (Use Dextroamphetamine Sulfate) dextroamphetamine sulfate cp24 10 mg, 15 mg, 5 mg dextroamphetamine sulfate tabs 10 mg dextroamphetamine sulfate tabs 5 mg N N N Anorexiants Non-Amphetamine ADIPEX-P (Use Phentermine HCl) N diethylpropion hcl tabs 25 mg ; ; QL(3 ea daily); Name DIETHYLPROPION HCL TABS 25 MG (Use Diethylpropion HCl) diethylpropion hcl tb24 75 mg phentermine hcl QSYMIA REGIMEX SUPRENZA Anti-Obesity Agents LI BELVIQ NTRAVE SAXENDA XENIC N Attention-Deficit/Hyperactivity Disorder (ADHD) guanfacine hcl (adhd) INTUNIV (Use Guanfacine HCl (ADHD)) STRATTERA Stimulants - Misc. METHYLPHENIDATE HCL ER 10 MG METHYLPHENIDATE HCL ER 18 MG, 27 MG, 54 MG METHYLPHENIDATE HCL ER 36 MG methylphenidate hcl tabs 10 mg, 20 mg, 5 mg methylphenidate hcl tbcr 20 mg modafinil NUVIGIL N QL(2 ea daily); ; QL(2 ea daily); ; QL(1 ea daily) 1

6 Name PROVIGIL (Use Modafinil) N RITIN (Use Methylphenidate HCl) RITIN SR (Use Methylphenidate HCl) N N ; QL(1 ea daily) AMINOGLYSIDES - s to Treat Bacterial Infections Aminoglycosides BETHKIS KITABIS K neomycin sulfate paromomycin sulfate TOBI (Use Tobramycin) N TOBI PODHER tobramycin ANGESICS - ANTI-INLAMMATORY - s to Treat Pain, Swelling, Muscle and Joint Conditions Anti-TN-alpha - Monoclonal Antibodies HUMIRA HUMIRA PEDIATRIC CROHNS DISEASE STARTER CK HUMIRA PEN HUMIRA PEN-CROHNS DISEASESTARTER HUMIRA PEN-PSORIASIS STARTER SIMPONI ARIA Antirheumatic Antimetabolites RHEUMATREX Gold Compounds RIDAURA Name Interleukin-1beta Blockers ILARIS Interleukin-6 Receptor Inhibitors ACTEMRA SOLN IV 200 MG/10ML, 400 MG/20ML, 80 MG/4ML Nonsteroidal Anti-inflammatory Agents (NSAIDs) ADVIL (Use Ibuprofen) ADVIL MIGRAINE (Use Ibuprofen) EVE CAPS (Use Naproxen Sodium) ANAPROX (Use Naproxen Sodium) ANAPROX DS (Use Naproxen Sodium) CATAM (Use Diclofenac Potassium) CELEBREX (Use Celecoxib) celecoxib CHILDRENS ADVIL (Use Ibuprofen) CHILDRENS MOTRIN CHEW 50 MG CHILDRENS MOTRIN JUNIOR STRENGTH (Use Ibuprofen) CHILDRENS MOTRIN SUSP 100 MG/5ML (Use Ibuprofen) CHILDRENS MOTRIN SUSP 40 MG/ML (Use Ibuprofen) DAYPRO (Use Oxaprozin) diclofenac potassium diclofenac sodium EC-NAPROSYN (Use Naproxen) N N N N N N N N N N N N N 2

7 Name etodolac ELDENE (Use Piroxicam) ENOPROEN CCIUM TABS 600 MG ibuprofen caps 200 mg ibuprofen chew 100 mg ibuprofen susp 100 mg/5ml ibuprofen susp 40 mg/ml, 50 mg/1.25ml ibuprofen tabs 100 mg, 200 mg, 400 mg, 600 mg, 800 mg N Name NAPROSYN TABS 250 MG, 375 MG, 500 MG (Use Naproxen) NAPROXEN naproxen naproxen sodium caps 220 mg naproxen sodium tabs 275 mg, 550 mg oxaprozin piroxicam sulindac N INDOCIN tolmetin sodium indomethacin caps or 25 mg, 50 mg indomethacin cpcr or 75 mg INANTS ADVIL (Use Ibuprofen) ketoprofen MECLOENAMATE SODIUM meloxicam susp 7.5 mg/5ml meloxicam tabs 15 mg, 7.5 mg MOBIC SUSP 7.5 MG/5ML (Use Meloxicam) MOBIC TABS 15 MG, 7.5 MG (Use Meloxicam) MOTRIN INANTS (Use Ibuprofen) MOTRIN INANTS DROPS (Use Ibuprofen) MOTRIN JUNIOR STRENGTH (Use Ibuprofen) nabumetone N N N N N N TOLMETIN SODIUM VOLTAREN-XR (Use Diclofenac Sodium) N Phosphodiesterase 4 (PDE4) Inhibitors OTEZLA Selective Costimulation Modulators ORENCIA SOLR IV 250 MG Soluble Tumor Necrosis actor Receptor Agents ENBREL ENBREL SURECLICK ANGESICS - NonNarcotic - s to Treat Pain, Muscle and Joint Conditions Analgesic Combinations butalbital-acetaminophen butalbital-acetaminophencaffeine caps 325mg- 50mg-40mg, 500mg-50mg- 40mg butalbital-acetaminophencaffeine tabs 325mg-50mg- 40mg 3

8 Name Name butalbital-aspirin-caffeine ASPIRIN LOW DOSE BUTBIT/ASPIRIN/CA EINE ESGIC 325MG-50MG- 40MG (Use Butalbital- Acetaminophen-Caffeine) IORICET TABS 325MG- 50MG-40MG (Use Butalbital-Acetaminophen- Caffeine) IORIN (Use Butalbital- Aspirin-Caffeine) Analgesics Other acetaminophen chew or 160 mg, 80 mg acetaminophen elix or 160 mg/5ml, 80 mg/2.5ml acetaminophen liqd or 160 mg/5ml acetaminophen soln or 100 mg/ml, 160 mg/5ml, 80 mg/0.8ml acetaminophen supp re 120 mg acetaminophen susp or 160 mg/5ml, 80 mg/0.8ml, 80 mg/2.5ml acetaminophen tbdp or 160 mg, 80 mg EVERL INANTS TYLENOL CHILDRENS (Use Acetaminophen) TYLENOL CHILDRENS/LAVORCRE ATOR (Use Acetaminophen) TYLENOL INANTS (Use Acetaminophen) TYLENOL JR MELTAWAYS (Use Acetaminophen) Salicylates aspirin buffered (cal carbmag carb-mag oxide) N N N N N N N ASPIRIN SUPP RE 120 MG, 200 MG aspirin supp re 300 mg, 600 mg aspirin tabs or 325 mg, 81 mg aspirin tbec or 324 mg, 325 mg, 500 mg, 81 mg BUERIN (Use Aspirin Buffered (Cal Carb-Mag Carb-Mag Oxide)) BUERIN EXTRA STRENGTH BUERIN LOW DOSE choline & mag salicylate CHOLINE MAGNESIUM TRISICYLATE DISCID (Use Salsalate) ETRIN MAXIMUM STRENGTH (Use Aspirin) ETRIN REGULAR STRENGTH (Use Aspirin) salsalate N N N N ANGESICS - OPIOID - s to Treat Pain, Muscle and Joint Conditions Opioid Agonists DEINE SULATE TABS 15 MG codeine sulfate tabs 15 mg, 30 mg, 60 mg DEMEROL TABS OR 100 MG, 50 MG (Use Meperidine HCl) DILAUDID (Use Hydromorphone HCl) DOLOPHINE (Use Methadone HCl) N N N QL(240 ea per fill retail,720 ea per 75 days retail) 4

9 Name DOLOPHINE HCL (Use Methadone HCl) EXGO 12 MG, 16 MG, 8 MG (Use Hydromorphone HCl) hydromorphone hcl liqd or 1 mg/ml HYDROMORPHONE HCL SUPP RE 3 MG hydromorphone hcl t24a or 12 mg, 16 mg, 8 mg hydromorphone hcl tabs or 2 mg, 4 mg, 8 mg KADIAN 10 MG, 100 MG, 20 MG, 30 MG, 50 MG, 60 MG, 80 MG (Use Morphine Sulfate) KADIAN 200 MG LEVORPHANOL TARTRATE MEPERIDINE HCL SOLN OR 50 MG/5ML meperidine hcl tabs or 100 mg, 50 mg methadone hcl conc or 10 mg/ml methadone hcl soln or 10 mg/5ml, 5 mg/5ml methadone hcl tabs or 10 mg methadone hcl tabs or 5 mg methadone hcl tbso or 40 mg METHADOSE 10 MG/ML (Use Methadone HCl) METHADOSE SUGAR- REE (Use Methadone HCl) N N N N N QL(120 ea per fill retail,360 ea per 75 days retail) QL(2 ea daily) QL(2 ea daily) QL(240 ea per fill retail,720 ea per 75 days retail) QL(120 ea per fill retail,360 ea per 75 days retail) Name morphine sulfate cp24 or 10 mg, 100 mg, 20 mg, 30 mg, 50 mg, 60 mg, 80 mg MORPHINE SULATE ER morphine sulfate soln or 10 mg/5ml, 100 mg/5ml, 20 mg/5ml, 20 mg/ml MORPHINE SULATE SUPP RE 10 MG, 20 MG, 30 MG, 5 MG MORPHINE SULATE TABS OR 15 MG, 30 MG morphine sulfate tbcr or 100 mg, 15 mg, 200 mg, 30 mg, 60 mg MS NTIN (Use Morphine Sulfate) NUCYNTA ER oxycodone hcl caps 5 mg OXYDONE HCL ER oxycodone hcl soln 5 mg/5ml OXYDONE HCL SOLN 5 MG/5ML (Use Oxycodone HCl) oxycodone hcl tabs 10 mg, 15 mg, 20 mg, 30 mg, 5 mg OXYNTIN N N QL(2 ea daily) QL(120 ml per fill retail,360 ml per 75 days retail) QL(90 ea per fill retail,270 ea per 75 days retail) QL(90 ea per fill retail,270 ea per 75 days retail) QL(90 ea per fill retail,270 ea per 75 days retail) QL(90 ea per fill retail,270 ea per 75 days retail) QL(1000 ml per fill retail,3000 ml per 75 days retail) QL(1000 ml per fill retail,3000 ml per 75 days retail) QL(90 ea per fill retail,270 ea per 75 days retail) 5

10 Name ROXIDONE (Use Oxycodone HCl) tramadol hcl tabs 50 mg ULTRAM (Use Tramadol HCl) Opioid Combinations acetaminophen w/ codeine soln 120mg/5ml-12mg/5ml acetaminophen w/ codeine tabs 300mg-15mg, 300mg- 60mg acetaminophen w/ codeine tabs 300mg-30mg butalbital-acetaminophencaffeine w/ codeine butalbital-aspirin-caffeine w/cod CAPIT/DEINE IORICET/DEINE (Use Butalbital-Acetaminophen- Caffeine w/ Codeine) IORIN/DEINE #3 (Use Butalbital-Aspirin- Caffeine w/cod) hydrocodoneacetaminophen caps 5mg- 500mg hydrocodoneacetaminophen tabs 10mg- 300mg, 10mg-325mg, 5mg-300mg, 5mg-325mg, 7.5mg-300mg, 7.5mg- 325mg NOR (Use Hydrocodone- Acetaminophen) N N N N N QL(90 ea per fill retail,270 ea per 75 days retail) QL(60 ea per fill retail,180 ea per 75 days retail) QL(45 ea per fill retail,135 ea per 75 days retail) QL(45 ea per fill retail,135 ea per 75 days retail) QL(45 ea per fill retail,135 ea per 75 days retail) QL(45 ea per fill retail,135 ea per 75 days retail) Name oxycodone w/ acetaminophen caps 5mg- 500mg oxycodone w/ acetaminophen tabs 10mg- 325mg, 10mg-650mg, 7.5mg-325mg, 7.5mg- 500mg oxycodone w/ acetaminophen tabs 5mg- 325mg PERCET 10MG- 325MG, 10MG-650MG, 7.5MG-325MG, 7.5MG- 500MG (Use Oxycodone w/ Acetaminophen) PERCET 5MG-325MG (Use Oxycodone w/ Acetaminophen) ROXICET TYLENOL/DEINE #3 (Use Acetaminophen w/ Codeine) TYLENOL/DEINE #4 (Use Acetaminophen w/ Codeine) XODOL (Use Hydrocodone- Acetaminophen) Opioid Partial Agonists BUNAVAIL buprenorphine hcl subl sl 2 mg, 8 mg buprenorphine hclnaloxone hcl dihydrate BUTRANS N N N N N QL(120 ea per fill retail,360 ea per 75 days retail) QL(90 ea per fill retail,270 ea per 75 days retail) QL(120 ea per fill retail,360 ea per 75 days retail) QL(90 ea per fill retail,270 ea per 75 days retail) QL(120 ea per fill retail,360 ea per 75 days retail) QL(1000 ml per fill retail,3000 ml per 75 days retail) QL(45 ea per fill retail,135 ea per 75 days retail) QL(60 ea per fill retail,180 ea per 75 days retail) QL(45 ea per fill retail,135 ea per 75 days retail) 6

11 Name SUBOXONE ZUBSOLV ANDROGENS-ANABOLIC - s to Regulate Hormones Anabolic Steroids OXANDRIN (Use Oxandrolone) oxandrolone Androgens ANDROGEL ANDROGEL PUMP ANDROXY danazol METHITEST methyltestosterone TESTIM TESTOSTERONE 1 %, 25 MG/2.5GM, 50 MG/5GM TESTOSTERONE PUMP TESTRED (Use Methyltestosterone) VOGELXO VOGELXO PUMP N N ANORECT AGENTS - Rectal s to Treat Pain, Swelling and Itching Intrarectal Steroids RTENEMA (Use Hydrocortisone (Intrarectal)) RTIOAM hydrocortisone (intrarectal) N Name ANPRAM-HC CREA 1%-1%, 1%-2.5% (Use Hydrocortisone Acetate w/ Pramoxine) ANPRAM-HC LOTN 1%- 2.5% ANPRAM-HC SINGLES (Use Hydrocortisone Acetate w/ Pramoxine) hydrocortisone acetate w/ pramoxine crea 1%-1%, 1%-2.5% lidocaine-hydrocortisone acetate (rectal) crea 3%- 0.5% lidocaine-hydrocortisone acetate (rectal) kit 3%- 0.5%, 3%-1%, 3%-2.5% PROCTOOAM HC Rectal Steroids ANUSOL-HC (Use Hydrocortisone (Rectal)) ANUSOL-HC (Use Hydrocortisone Acetate (Rectal)) hydrocortisone (rectal) hydrocortisone acetate (rectal) 25 mg Vasodilating Agents RECTIV N N N N QL(2 ea per fill retail) ANTACIDS - Ulcer and Stomach Acid s Antacid Combinations MANE alum & mag hydroxsimethicone aluminum hydroxide-mag trisil GELUSIL 200MG-25MG- 200MG (Use Alum & Mag Hydrox-Simethicone) N Rectal Combinations 7

12 Name MYLANTA DOUBLE- STRENGTH (Use Alum & Mag Hydrox-Simethicone) MYLANTA SUSP 200MG/5ML-20MG/5ML- 200MG/5ML (Use Alum & Mag Hydrox-Simethicone) Antacids - Aluminum Salts UMINUM HYDROXIDE SUSP OR Antacids - Calcium Salts calcium carbonate (antacid) 500 mg, 600 mg, 750 mg CCIUM CARBONATE TABS 648 MG MAOX (Use Calcium Carbonate (Antacid)) TUMS (Use Calcium Carbonate (Antacid)) TUMS E-X 750 (Use Calcium Carbonate (Antacid)) TUMS KIDS (Use Calcium Carbonate (Antacid)) TUMS LASTING EECTS (Use Calcium Carbonate (Antacid)) TUMS SMOOTHIES (Use Calcium Carbonate (Antacid)) N N N N N N N N ANTHELMINTICS - s to Treat Worm Infections Anthelmintics BENZA BILTRICIDE pyrantel pamoate ANTI-INECTIVE AGENTS - MISC. - s to Treat Bacterial Infections Anti-infective Agents - Misc. CAYSTON Name LAGYL (Use Metronidazole) metronidazole trimethoprim N Anti-infective Misc. - Combinations BACTRIM (Use Sulfamethoxazole- N Trimethoprim) BACTRIM DS (Use Sulfamethoxazole- N Trimethoprim) erythromycin-sulfisoxazole sulfamethoxazoletrimethoprim Antiprotozoal Agents atovaquone MEPRON (Use Atovaquone) Leprostatics DAPSONE Lincosamides CLEOCIN CAPS OR 150 MG, 300 MG, 75 MG (Use Clindamycin HCl) CLEOCIN PEDIATRIC GRANULES (Use Clindamycin Palmitate Hydrochloride) clindamycin hcl clindamycin palmitate hydrochloride N N N ANTIANGIN AGENTS - s to Treat Chest Pain Nitrates DILATRATE SR IMDUR (Use Isosorbide Mononitrate) ISORDIL TITRADOSE 40 MG N 8

13 Name ISORDIL TITRADOSE 5 MG (Use Isosorbide Dinitrate) N Name ATIVAN TABS OR 0.5 MG, 1 MG, 2 MG (Use Lorazepam) N ISOSORBIDE DINITRATE chlordiazepoxide hcl isosorbide dinitrate isosorbide mononitrate NITRO-BID NITRO-DUR 0.1 MG/HR, 0.2 MG/HR, 0.4 MG/HR, 0.6 MG/HR (Use Nitroglycerin) NITRO-DUR 0.3 MG/HR, 0.8 MG/HR nitroglycerin cpcr or 2.5 mg, 6.5 mg, 9 mg nitroglycerin pt24 td 0.1 mg/hr, 0.2 mg/hr, 0.4 mg/hr, 0.6 mg/hr NITROSTAT N ANTIANXIETY AGENTS - s to Treat Anxiety Antianxiety Agents - Misc. buspirone hcl hydroxyzine hcl soln or 10 mg/5ml hydroxyzine hcl syrp or 10 mg/5ml hydroxyzine hcl tabs or 10 mg, 25 mg, 50 mg HYDROXYZINE MOATE hydroxyzine pamoate meprobamate VISTARIL (Use Hydroxyzine Pamoate) Benzodiazepines alprazolam tabs 0.25 mg, 0.5 mg, 1 mg, 2 mg N clorazepate dipotassium DIAZEM SOLN OR 1 MG/ML diazepam tabs or 10 mg, 2 mg, 5 mg lorazepam conc or 2 mg/ml lorazepam tabs or 0.5 mg, 1 mg, 2 mg oxazepam TRANXENE T (Use Clorazepate Dipotassium) VIUM (Use Diazepam) XANAX (Use Alprazolam) N N N ANTIARRHYTHMICS - s to treat abnormal heart rhythms Antiarrhythmics Type I-A disopyramide phosphate NORCE (Use Disopyramide Phosphate) NORCE CR quinidine gluconate tbcr or 324 mg QUINIDINE SULATE quinidine sulfate QUINIDINE SULATE ER Antiarrhythmics Type I-B mexiletine hcl Antiarrhythmics Type I-C flecainide acetate N 9

14 Name propafenone hcl RYTHMOL (Use Propafenone HCl) RYTHMOL SR (Use Propafenone HCl) TAMBOR (Use lecainide Acetate) Antiarrhythmics Type III amiodarone hcl 200 mg, 400 mg RDARONE (Use Amiodarone HCl) MULTAQ TIKOSYN N N N N ANTIASTHMATIC AND BRONCHODILATOR AGENTS - s to Treat Lung Conditions Anti-Inflammatory Agents CROMOLYN SODIUM Antiasthmatic - Monoclonal Antibodies XOLAIR Asthma and Bronchodilator Agent Combinations dyphylline-guaifenesin Bronchodilators - Anticholinergics ATROVENT HA ipratropium bromide SPIRIVA HANDIHER SPIRIVA RESPIMAT TUDORZA PRESSAIR Leukotriene Modulators montelukast sodium SINGULAIR (Use Montelukast Sodium) Steroid Inhalants N QL(0.86 gm daily) QL(0.14 gm daily) QL(0.04 ea daily) Name AEROSN ARNUITY ELLIPTA ASMANEX HA ASMANEX TWISTHER 120 METERED DOSES ASMANEX TWISTHER 14 METERED DOSES ASMANEX TWISTHER 30 METERED DOSES ASMANEX TWISTHER 60 METERED DOSES ASMANEX TWISTHER 7 METERED DOSES budesonide (inhalation) 0.25 mg/2ml budesonide (inhalation) 0.5 mg/2ml LOVENT DISKUS 100 MCG/BLIST LOVENT DISKUS 250 MCG/BLIST LOVENT DISKUS 50 MCG/BLIST LOVENT HA 110 MCG/ACT, 220 MCG/ACT LOVENT HA 44 MCG/ACT PULMIRT 0.25 MG/2ML (Use Budesonide (Inhalation)) PULMIRT 0.5 MG/2ML (Use Budesonide (Inhalation)) PULMIRT 1 MG/2ML PULMIRT LEXHER 180 MCG/ACT PULMIRT LEXHER 90 MCG/ACT QVAR 40 MCG/ACT QVAR 80 MCG/ACT N N QL(0.6 gm daily) QL(0.44 gm daily) QL(1 ea per 30 days retail) QL(1 ea per 30 days retail) QL(1 ea per 30 days retail) QL(1 ea per 30 days retail) QL(1 ea per 30 days retail) QL(8 ml daily) QL(4 ml daily) QL(20 ea daily) QL(8 ea daily) QL(40 ea daily) QL(0.8 gm daily) QL(0.36 gm daily) QL(8 ml daily) QL(4 ml daily) QL(2 ml daily) QL(0.07 ea daily) QL(0.27 ea daily) QL(0.58 gm daily) QL(0.29 gm daily) 10

15 Name Sympathomimetics ACCUNEB (Use Albuterol Sulfate) ADVAIR DISKUS ADVAIR HA albuterol sulfate ANORO ELLIPTA N QL(2 ea daily) QL(0.4 gm daily) QL(2 ea daily) Name theophylline tb mg, 600 mg ANTIAGULANTS - Blood Thinners Coumarin Anticoagulants UMADIN TABS OR 1 MG, 10 MG, 2 MG, 2.5 MG, 3 MG, 4 MG, 5 MG, 6 MG, 7.5 MG warfarin sodium BREO ELLIPTA MBIVENT MBIVENT RESPIMAT DULERA EPHEDRINE HCL EPHEDRINE SULATE MAXAIR AUTOHER METAPROTERENOL SULATE SEREVENT DISKUS STRIVERDI RESPIMAT SYMBIRT terbutaline sulfate tabs or 2.5 mg, 5 mg VENTOLIN HA VOSPIRE ER (Use Albuterol Sulfate) Xanthines ELIXOPHYLLIN THEO MG, 200 MG, 300 MG theophylline tb mg, 200 mg, 300 mg, 450 mg N QL(2 ea daily) QL(0.2 gm daily) QL(0.45 gm daily) QL(2 ea daily) QL(0.14 gm daily) QL(0.34 gm daily) QL(1.2 gm daily) Direct actor Xa Inhibitors ELIQUIS XARELTO 10 MG XARELTO 15 MG, 20 MG XARELTO STARTER CK Heparins And Heparinoid-Like Agents enoxaparin sodium sc 100 mg/ml, 150 mg/ml QL(10 ml per 180 days retail) enoxaparin sodium sc 120 mg/0.8ml, 80 mg/0.8ml QL(8 ml per 180 days retail) enoxaparin sodium sc 30 mg/0.3ml QL(3 ml per 180 days retail) enoxaparin sodium sc 40 mg/0.4ml QL(4 ml per 180 days retail) enoxaparin sodium sc 60 mg/0.6ml QL(6 ml per 180 days retail) LOVENOX SC 100 MG/ML, QL(10 ml per 150 MG/ML (Use N 180 days retail) Enoxaparin Sodium) LOVENOX SC 120 QL(8 ml per MG/0.8ML, 80 MG/0.8ML N 180 days retail) (Use Enoxaparin Sodium) LOVENOX SC 30 MG/0.3ML (Use Enoxaparin Sodium) LOVENOX SC 40 MG/0.4ML (Use Enoxaparin Sodium) LOVENOX SC 60 MG/0.6ML (Use Enoxaparin Sodium) N N N QL(3 ml per 180 days retail) QL(4 ml per 180 days retail) QL(6 ml per 180 days retail) 11

16 Name Thrombin Inhibitors PRADAXA ANTINVULSANTS - s to Treat Seizures AM Glutamate Receptor Antagonists YM Anticonvulsants - Benzodiazepines clonazepam DIASTAT ACUDI (Use Diazepam (Anticonvulsant)) DIASTAT PEDIATRIC (Use Diazepam (Anticonvulsant)) diazepam (anticonvulsant) KLONOPIN (Use Clonazepam) Anticonvulsants - Misc. BANZEL carbamazepine chew 100 mg carbamazepine susp 100 mg/5ml carbamazepine tabs 200 mg gabapentin caps 100 mg, 300 mg, 400 mg gabapentin tabs 600 mg, 800 mg KEPPRA SOLN OR 100 MG/ML (Use Levetiracetam) KEPPRA TABS OR 1000 MG, 250 MG, 500 MG, 750 MG (Use Levetiracetam) LAMICT CHEW 2 MG LAMICT CHEWABLE DISPERSIBLE (Use Lamotrigine) N N N N N N QL(4 ea per 30 days retail) QL(4 ea per 30 days retail) QL(4 ea per 30 days retail) Name LAMICT TABS 100 MG, 150 MG, 200 MG, 25 MG (Use Lamotrigine) lamotrigine chew 25 mg, 5 mg lamotrigine tabs 100 mg, 150 mg, 200 mg, 25 mg levetiracetam soln or 100 mg/ml, 500 mg/5ml levetiracetam tabs or 1000 mg, 250 mg, 500 mg, 750 mg MYSOLINE (Use Primidone) NEURONTIN CAPS 100 MG, 300 MG, 400 MG (Use Gabapentin) NEURONTIN TABS 600 MG, 800 MG (Use Gabapentin) oxcarbazepine POTIGA primidone TEGRETOL TOMAX (Use Topiramate) TOMAX SPRINKLE (Use Topiramate) topiramate TRILEPT (Use Oxcarbazepine) VIMT SOLN OR 10 MG/ML VIMT TABS OR 100 MG, 150 MG, 200 MG, 50 MG ZONEGRAN (Use Zonisamide) zonisamide Carbamates N N N N N N N N 12

17 Name felbamate ELBATOL (Use elbamate) GABA Modulators GABITRIL N Name valproate sodium syrp or 250 mg/5ml valproic acid ANTIDEPRESSANTS - s to Treat Depression Alpha-2 Receptor Antagonists (Tetracyclics) SABRIL mirtazapine tiagabine hcl Hydantoins DILANTIN DILANTIN INATABS (Use Phenytoin) DILANTIN-125 (Use Phenytoin) PHENYTEK (Use Phenytoin Sodium Extended) phenytoin phenytoin sodium extended Succinimides CELONTIN ethosuximide ZARONTIN (Use Ethosuximide) Valproic Acid DEKENE DEKOTE (Use Divalproex Sodium) DEKOTE ER (Use Divalproex Sodium) DEKOTE SPRINKLES (Use Divalproex Sodium) divalproex sodium valproate sodium soln or 250 mg/5ml N N N N N N N REMERON (Use Mirtazapine) REMERON SOLTAB (Use Mirtazapine) Antidepressants - Misc. APLENZIN bupropion hcl tabs 100 mg, 75 mg bupropion hcl tb mg, 150 mg bupropion hcl tb mg bupropion hcl tb mg, 300 mg WELLBUTRIN (Use Bupropion HCl) WELLBUTRIN SR 100 MG, 150 MG (Use Bupropion HCl) WELLBUTRIN SR 200 MG (Use Bupropion HCl) WELLBUTRIN XL (Use Bupropion HCl) N N N N N N ST Monoamine Oxidase Inhibitors (MAOIs) EMSAM MARPLAN NARDIL (Use Phenelzine Sulfate) RNATE (Use Tranylcypromine Sulfate) phenelzine sulfate tranylcypromine sulfate QL(2 ea daily) QL(2 ea daily) 13

18 Name Selective Serotonin Reuptake Inhibitors (SSRIs) CELEXA 10 MG (Use N QL(4 ea daily) Citalopram Hydrobromide) CELEXA 20 MG (Use N QL(2 ea daily) Citalopram Hydrobromide) CELEXA 40 MG (Use N Citalopram Hydrobromide) citalopram hydrobromide soln 10 mg/5ml QL(20 ml daily) citalopram hydrobromide tabs 10 mg QL(4 ea daily) citalopram hydrobromide tabs 20 mg QL(2 ea daily) citalopram hydrobromide tabs 40 mg escitalopram oxalate fluoxetine hcl caps 10 mg, 20 mg, 40 mg fluoxetine hcl soln 20 mg/5ml fluoxetine hcl tabs 10 mg, 20 mg fluvoxamine maleate LEXAPRO (Use Escitalopram Oxalate) LUVOX CR (Use luvoxamine Maleate) paroxetine hcl XIL CR (Use Paroxetine HCl) XIL SUSP 10 MG/5ML XIL TABS 10 MG, 20 MG, 30 MG, 40 MG (Use Paroxetine HCl) PROZAC (Use luoxetine HCl) sertraline hcl ZOLOT (Use Sertraline HCl) Serotonin Modulators N N N N N N Name NEAZODONE HCL nefazodone hcl trazodone hcl Serotonin-Norepinephrine Reuptake Inhibitors CYMBTA (Use N QL(2 ea daily) Duloxetine HCl) DESVENLAAXINE ER ST duloxetine hcl 20 mg, 30 mg, 60 mg EEXOR XR (Use Venlafaxine HCl) KHEDEZLA PRISTIQ venlafaxine hcl Tricyclic Agents amitriptyline hcl ANARANIL (Use Clomipramine HCl) clomipramine hcl desipramine hcl DOXEPIN HCL doxepin hcl imipramine hcl NORPRAMIN (Use Desipramine HCl) NORTRIPTYLINE HCL nortriptyline hcl MELOR (Use Nortriptyline HCl) protriptyline hcl TORANIL (Use Imipramine HCl) N N N N N QL(2 ea daily) ST ST 14

19 Name VIVACTIL (Use Protriptyline HCl) N ANTIDIABETICS - s to Regulate Blood Sugar Alpha-Glucosidase Inhibitors acarbose PRESE (Use Acarbose) Antidiabetic - Amylin Analogs SYMLINPEN 120 SYMLINPEN 60 Antidiabetic Combinations ACTOPLUS MET (Use Pioglitazone HCl-Metformin HCl) AVANDAMET AVANDARYL DUETACT (Use Pioglitazone HCl- Glimepiride) glipizide-metformin hcl GLUVANCE (Use Glyburide-Metformin) glyburide-metformin INVOKAMET JANUMET JANUMET XR JENTADUETO JUVISYNC 100MG-10MG, 100MG-20MG, 50MG- 10MG, 50MG-20MG JUVISYNC 40MG-100MG, 40MG-50MG KAZANO KOMBIGLYZE XR N N N N QL(2 ea daily) QL(2 ea daily) Name OSENI pioglitazone hcl-glimepiride pioglitazone hcl-metformin hcl Biguanides GLUPHAGE (Use Metformin HCl) GLUPHAGE XR (Use Metformin HCl) metformin hcl tabs 1000 mg, 500 mg, 850 mg metformin hcl tb mg, 750 mg Diabetic Other GLUCAGON EMERGENCY KIT KORLYM N N Dipeptidyl Peptidase-4 (DPP-4) Inhibitors JANUVIA NESINA ONGLYZA TRADJENTA Dopamine Receptor Agonists - Antidiabetic CYCLOSET Incretin Mimetic Agents (GLP-1 Receptor BYDUREON BYETTA TANZEUM TRULICITY VICTOZA Insulin Sensitizing Agents ACTOS (Use Pioglitazone HCl) N 15

20 Name AVANDIA pioglitazone hcl Insulin APIDRA APIDRA SOLOSTAR HUMOG HUMOG KWIKPEN HUMOG MIX 50/50 HUMOG MIX 50/50 KWIKPEN HUMOG MIX 75/25 HUMOG MIX 75/25 KWIKPEN HUMULIN 70/30 HUMULIN 70/30 KWIKPEN HUMULIN 70/30 PEN HUMULIN N HUMULIN N KWIKPEN HUMULIN N U-100 PEN HUMULIN R HUMULIN R U-500 (NCENTRATED) LANTUS LANTUS SOLOSTAR LEVEMIR ; QL(50 ml per 30 days retail) ; QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(20 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) Name LEVEMIR LEXPEN LEVEMIR LEXTOUCH TOUJEO SOLOSTAR Meglitinide Analogues nateglinide STARLIX (Use Nateglinide) N QL(50 ml per 30 days retail) QL(50 ml per 30 days retail) Limited to 3 boxes per month.;ql(0.5 ml daily) Sodium-Glucose Co-Transporter 2 (SGLT2) INVOKANA JARDIANCE Sulfonylureas AMARYL (Use Glimepiride) DIABETA (Use Glyburide) glimepiride glipizide GLUTROL (Use Glipizide) GLUTROL XL (Use Glipizide) glyburide glyburide micronized GLYNASE (Use Glyburide Micronized) TOLAZAMIDE tolazamide TOLBUTAMIDE N N N N N ANTIDIARRHES - s to Treat Diarrhea Antidiarrheal Agents - Misc. 16

21 Name bismuth subsalicylate PEPTO BISMOL (Use Bismuth Subsalicylate) PEPTO-BISMOL (Use Bismuth Subsalicylate) PEPTO-BISMOL INSTAOL (Use Bismuth Subsalicylate) PEPTO-BISMOL MAX STRENGTH (Use Bismuth Subsalicylate) PEPTO-BISMOL TO-GO (Use Bismuth Subsalicylate) Antiperistaltic Agents diphenoxylate w/ atropine DIPHENOXYLATE/ATROP INE LOMOTIL (Use Diphenoxylate w/ Atropine) N N N N N N ANTIDOTES - s to Treat Overdose or Toxicity Antidotes - Chelating Agents CHEMET EXJADE JADENU Opioid Antagonists EVZIO NOXONE HCL naloxone hcl naltrexone hcl REVIA (Use Naltrexone HCl) VIVITROL ANTIEMETICS - s to Treat Nausea and Vomiting Name 5-HT3 Receptor Antagonists granisetron hcl tabs or 1 mg ondansetron ondansetron hcl soln 4 mg/5ml ondansetron hcl tabs 4 mg, 8 mg ZORAN ODT (Use Ondansetron) ZORAN SOLN 4 MG/5ML (Use Ondansetron HCl) ZORAN TABS 4 MG, 8 MG (Use Ondansetron HCl) Antiemetics - Anticholinergic meclizine hcl chew 25 mg meclizine hcl tabs 12.5 mg, 25 mg TIGAN CAPS OR 300 MG (Use Trimethobenzamide HCl) trimethobenzamide hcl caps or 300 mg Antiemetics - Miscellaneous dronabinol MARINOL (Use Dronabinol) N N N N N QL(20 ea per fill retail,20 ea per 30 days retail) QL(50 ml per fill retail,50 ml per 30 days retail) QL(20 ea per fill retail,20 ea per 30 days retail) QL(20 ea per fill retail,20 ea per 30 days retail) QL(50 ml per fill retail,50 ml per 30 days retail) QL(20 ea per fill retail,20 ea per 30 days retail) ANTIUNGS - s to Treat ungal Infections Antifungals BIO-STATIN 17

22 Name GRIULVIN V (Use Griseofulvin Microsize) GRIS-PEG (Use Griseofulvin Ultramicrosize) griseofulvin microsize griseofulvin ultramicrosize LAMISIL CK 125 MG, MG LAMISIL TABS 250 MG (Use Terbinafine HCl) nystatin terbinafine hcl N N N Imidazole-Related Antifungals DILUCAN (Use N luconazole) fluconazole itraconazole ketoconazole SPORANOX CAPS 100 MG (Use Itraconazole) SPORANOX PULSEK (Use Itraconazole) VEND (Use Voriconazole) voriconazole susr or 40 mg/ml voriconazole tabs or 200 mg, 50 mg N N N QL(90 ea per retail) QL(90 ea per retail) ANTIHISTAMINES - s to Treat Allergies Antihistamines - Alkylamines CHLOR-TRIMETON (Use Chlorpheniramine Maleate) chlorpheniramine maleate syrp 2 mg/5ml chlorpheniramine maleate tabs 4 mg ED CHLORPED N Name Antihistamines - Ethanolamines ER-DRYL BENADRYL LERGY (Use Diphenhydramine HCl) BENADRYL LERGY CHILDRENS (Use Diphenhydramine HCl) BENADRYL CAPS OR 25 MG (Use Diphenhydramine HCl) BENADRYL DYE-REE LERGYLIQUID-GELS (Use Diphenhydramine HCl) BENADRYL TABS OR 25 MG (Use Diphenhydramine HCl) CLEMASTINE UMARATE SYRP 0.67 MG/5ML clemastine fumarate tabs 2.68 mg diphenhydramine hcl caps or 25 mg diphenhydramine hcl caps or 50 mg diphenhydramine hcl chew or 12.5 mg diphenhydramine hcl elix or 12.5 mg/5ml diphenhydramine hcl liqd or 12.5 mg/5ml diphenhydramine hcl syrp or 12.5 mg/5ml diphenhydramine hcl tabs or 25 mg TRIAMINIC UGH & RUNNY NOSE N N N N N Antihistamines - Non-Sedating cetirizine hcl chew 10 mg, 5 mg cetirizine hcl tabs 10 mg, 5 mg CLARITIN REDITABS 10 MG (Use Loratadine) N 18

23 Name CLARITIN REDITABS 5 MG CLARITIN SYRP 5 MG/5ML (Use Loratadine) CLARITIN TABS 10 MG (Use Loratadine) loratadine soln 5 mg/5ml loratadine syrp 5 mg/5ml loratadine tabs 10 mg loratadine tbdp 10 mg ZYRTEC LERGY TABS (Use Cetirizine HCl) ZYRTEC CHILDRENS LERGY CHEW 10 MG, 5 MG (Use Cetirizine HCl) ZYRTEC HIVES RELIE (Use Cetirizine HCl) N N N N N Antihistamines - Phenothiazines promethazine hcl soln or 6.25 mg/5ml promethazine hcl supp re 12.5 mg, 25 mg, 50 mg promethazine hcl syrp or 6.25 mg/5ml promethazine hcl tabs or 12.5 mg, 25 mg, 50 mg Antihistamines - Piperidines cyproheptadine hcl QL(10 ml daily) QL(10 ml daily) QL(10 ml daily) ANTIHYPERLIPIDEMICS - s to Treat High Cholesterol Bile Acid Sequestrants cholestyramine light powd 4 gm/dose cholestyramine powd 4 gm/dose LESTID LAVORED GRAN 5 GM (Use Colestipol HCl) LESTID GRAN 5 GM (Use Colestipol HCl) N N Name LESTID TABS 1 GM (Use Colestipol HCl) colestipol hcl gran 5 gm colestipol hcl tabs 1 gm QUESTRAN LIGHT POWD 4 GM/DOSE (Use Cholestyramine Light) QUESTRAN POWD 4 GM/DOSE (Use Cholestyramine) ibric Acid Derivatives ANTARA 130 MG, 43 MG (Use enofibrate Micronized) fenofibrate micronized 130 mg, 43 mg gemfibrozil LOPID (Use Gemfibrozil) N N N N N HMG CoA Reductase Inhibitors ADVIR atorvastatin calcium 10 mg, 20 mg, 40 mg atorvastatin calcium 80 mg fluvastatin sodium LESL (Use luvastatin Sodium) LESL XL LIPITOR 10 MG, 20 MG, 40 MG (Use Atorvastatin Calcium) LIPITOR 80 MG (Use Atorvastatin Calcium) lovastatin 10 mg, 20 mg lovastatin 40 mg MEVAR 20 MG (Use Lovastatin) N N N N QL(2 ea daily) QL(1.5 ea daily) QL(2 ea daily) QL(1.5 ea daily) 19

24 Name MEVAR 40 MG (Use Lovastatin) PRAVACHOL (Use Pravastatin Sodium) pravastatin sodium SIMR simvastatin N N ZOR (Use Simvastatin) N Nicotinic Acid Derivatives niacin (antihyperlipidemic) NIAR NIASN (Use Niacin (Antihyperlipidemic)) N QL(2 ea daily) ANTIHYPERTENSIVES - s to Treat High Blood Pressure ACE Inhibitors ACCUPRIL (Use Quinapril HCl) TACE 1.25 MG, 2.5 MG, 5 MG (Use Ramipril) TACE 10 MG (Use Ramipril) benazepril hcl captopril enalapril maleate fosinopril sodium lisinopril LOTENSIN (Use Benazepril HCl) moexipril hcl PRINIVIL (Use Lisinopril) quinapril hcl N N N N N QL(2 ea daily) Name ramipril 1.25 mg, 2.5 mg, 5 mg ramipril 10 mg UNIVASC (Use Moexipril HCl) VASOTEC (Use Enalapril Maleate) ZESTRIL (Use Lisinopril) Agents for Pheochromocytoma DEMSER DIBENZYLINE N N N Angiotensin II Receptor Antagonists ATACAND (Use N Candesartan Cilexetil) AVAPRO (Use Irbesartan) candesartan cilexetil ZAAR (Use Losartan Potassium) irbesartan losartan potassium MICARDIS (Use Telmisartan) telmisartan N N N Antiadrenergic Antihypertensives CARDURA (Use Doxazosin Mesylate) N CATAPRES (Use Clonidine HCl) N clonidine hcl tabs or 0.1 mg, 0.2 mg, 0.3 mg doxazosin mesylate guanfacine hcl methyldopa MINIPRESS (Use Prazosin HCl) N QL(2 ea daily) 20

25 Name prazosin hcl TENEX (Use Guanfacine HCl) terazosin hcl N Antihypertensive Combinations ACCURETIC (Use Quinapril- N Hydrochlorothiazide) ATACAND HCT (Use Candesartan Cilexetil- N Hydrochlorothiazide) atenolol & chlorthalidone AVIDE (Use Irbesartan- Hydrochlorothiazide) benazepril & hydrochlorothiazide bisoprolol & hydrochlorothiazide candesartan cilexetilhydrochlorothiazide CAPTOPRIL/HYDROCHL OROTHIAZIDE enalapril maleate & hydrochlorothiazide fosinopril sodium & hydrochlorothiazide HYZAAR (Use Losartan Potassium & Hydrochlorothiazide) irbesartanhydrochlorothiazide lisinopril & hydrochlorothiazide LOPRESSOR HCT (Use Metoprolol & Hydrochlorothiazide) losartan potassium & hydrochlorothiazide LOTENSIN HCT (Use Benazepril & Hydrochlorothiazide) METHYLDO/HYDROCH LOROTHIAZIDE N N N N Name telmisartan-amlodipine metoprolol & hydrochlorothiazide MICARDIS HCT (Use Telmisartan- Hydrochlorothiazide) moexiprilhydrochlorothiazide PROPRANOLOL/HYDROC HLOROTHIAZIDE quinaprilhydrochlorothiazide telmisartanhydrochlorothiazide TENORETIC 100 (Use Atenolol & Chlorthalidone) TENORETIC 50 (Use Atenolol & Chlorthalidone) TWYNSTA (Use Telmisartan-Amlodipine) UNIRETIC (Use Moexipril- Hydrochlorothiazide) VASERETIC (Use Enalapril Maleate & Hydrochlorothiazide) ZESTORETIC (Use Lisinopril & Hydrochlorothiazide) ZIAC (Use Bisoprolol & Hydrochlorothiazide) Vasodilators hydralazine hcl tabs or 10 mg, 100 mg, 25 mg, 50 mg minoxidil N N N N N N N N ANTIMARIS - s to Treat Malaria (Parasitic Infections) Antimalarial Combinations atovaquone-proguanil hcl MARONE (Use Atovaquone-Proguanil HCl) Antimalarials hydroxychloroquine sulfate N 21

26 Name PLAQUENIL (Use Hydroxychloroquine Sulfate) N ANTIMYASTHENIC/CHOLINERGIC AGENTS Antimyasthenic/Cholinergic Agents MESTINON SYRP 60 MG/5ML MESTINON TABS 60 MG (Use Pyridostigmine N Bromide) MESTINON TIMESN (Use Pyridostigmine N Bromide) PROSTIGMIN pyridostigmine bromide ANTIMYBACTERI AGENTS - s to Treat Tuberculosis (Bacterial Infections) Antimycobacterial Agents ethambutol hcl ISONIAZID SYRP OR 50 MG/5ML isoniazid tabs or 100 mg, 300 mg MYAMBUTOL (Use Ethambutol HCl) MYBUTIN (Use Rifabutin) pyrazinamide rifabutin RIADIN CAPS OR 150 MG, 300 MG (Use Rifampin) rifampin caps or 150 mg, 300 mg N N N ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES - s to Treat Cancer Alkylating Agents KERAN TABS OR 2 MG Name CYCLOPHOSPHAMIDE TABS OR 25 MG, 50 MG GLEOSTINE HEXEN LEUKERAN LOMUSTINE MYLERAN TEMODAR CAPS OR 100 MG, 140 MG, 180 MG, 20 MG, 250 MG, 5 MG (Use Temozolomide) temozolomide Antimetabolites capecitabine mercaptopurine methotrexate sodium tabs or 2.5 mg PURINETHOL (Use Mercaptopurine) PURIXAN TABLOID TREXL XELODA (Use Capecitabine) Antineoplastic - Antibodies RITUXAN N N N Antineoplastic - Cellular Immunotherapy PROVENGE Antineoplastic - Hedgehog Pathway Inhibitors ERIVEDGE Antineoplastic - Hormonal and Related Agents anastrozole 22

27 Name ARIMIDEX (Use Anastrozole) AROMASIN (Use Exemestane) bicalutamide N N Name GLEEVEC IBRANCE IMBRUVICA CASODEX (Use Bicalutamide) EMCYT exemestane ARESTON EMARA (Use Letrozole) flutamide N N JAKAI LENVIMA 10MG DAILY DOSE LENVIMA 14MG DAILY DOSE LENVIMA 20MG DAILY DOSE LENVIMA 24MG DAILY DOSE LYNRZA letrozole MEKINIST LYSODREN MEGACE OR (Use Megestrol Acetate) megestrol acetate N NEXAVAR SPRYCEL 100 MG, 140 MG, 20 MG, 50 MG, 70 MG SUTENT tamoxifen citrate ZYTIGA TAINLAR TARCEVA Antineoplastic - Immunomodulators POMYST Antineoplastic Antibiotics mitoxantrone hcl Antineoplastic Enzyme Inhibitors AINITOR 10 MG, 2.5 MG, 5 MG CAPRELSA METRIQ TASIGNA TYKERB VOTRIENT XKORI ZELBORA ZOLINZA ZYDELIG ARYDAK GILOTRI ; MO Antineoplastics Misc. HYDREA (Use Hydroxyurea) N 23

28 Name hydroxyurea MATULANE SYLATRON TARGRETIN CAPS OR 75 MG tretinoin (chemotherapy) Chemotherapy Rescue/Antidote Agents LEUVORIN CCIUM TABS OR 10 MG, 15 MG leucovorin calcium tabs or 25 mg, 5 mg Mitotic Inhibitors ETOPOSIDE ANTIRKINSON AGENTS - s to Treat Parkinson's Disease Antiparkinson Anticholinergics benztropine mesylate GENTIN (Use Benztropine Mesylate) trihexyphenidyl hcl Antiparkinson Dopaminergics AMANTADINE HCL amantadine hcl bromocriptine mesylate carbidopa-levodopa tabs 10mg-100mg, 25mg- 100mg, 25mg-250mg carbidopa-levodopa tbcr 25mg-100mg, 50mg- 200mg MIRAPEX (Use Pramipexole Dihydrochloride) RLODEL (Use Bromocriptine Mesylate) N N Name pramipexole dihydrochloride tabs mg, 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg REQUIP (Use Ropinirole Hydrochloride) REQUIP XL (Use Ropinirole Hydrochloride) ropinirole hydrochloride SINEMET (Use Carbidopa- Levodopa) SINEMET CR (Use Carbidopa-Levodopa) N N N N Antiparkinson Monoamine Oxidase Inhibitors ELDEPRYL (Use Selegiline N HCl) selegiline hcl ANTIPSYCHOTICS/ANTIMANIC AGENTS - s to Treat Mood Disorders Antimanic Agents LITHIUM lithium carbonate LITHIUM CARBONATE 150 MG,600 MG (Use Lithium Carbonate) LITHOBID (Use Lithium Carbonate) Antipsychotics - Misc. GEODON 20 MG GEODON 20 MG,40 MG,60 MG,80 MG (Use Ziprasidone HCl) LATUDA ziprasidone hcl Benzisoxazoles ANAPT ANAPT TITRATION CK 24

29 Name Name INVEGA SAPHRIS INVEGA SUSTENNA INVEGA TRINZA RISPERD (Use Risperidone) RISPERD NSTA RISPERD M-TAB (Use Risperidone) risperidone Butyrophenones HDOL (Use Haloperidol Lactate) HDOL DECANOATE 100 (Use Haloperidol Decanoate) HDOL DECANOATE 50 (Use Haloperidol Decanoate) haloperidol haloperidol decanoate haloperidol lactate Dibenzapines ADASUVE clozapine CLOZAPINE ODT CLOZARIL (Use Clozapine) AZACLO loxapine succinate LOXITANE (Use Loxapine Succinate) olanzapine SEROQUEL (Use Quetiapine umarate) SEROQUEL XR VERSACLOZ ZYPREXA (Use Olanzapine) ZYPREXA RELPREVV ZYPREXA ZYDIS (Use Olanzapine) Phenothiazines CHLORPROMAZINE HCL chlorpromazine hcl MZINE 10 MG,5 MG (Use Prochlorperazine Maleate) fluphenazine decanoate LUPHENAZINE HCL fluphenazine hcl perphenazine prochlorperazine prochlorperazine maleate thioridazine hcl trifluoperazine hcl Quinolinone Derivatives ABILIY 1 MG/ML,9.75 MG/1.3ML ABILIY 10 MG,15 MG,2 MG,20 MG,30 MG,5 MG (Use Aripiprazole) ABILIY DISCMELT N quetiapine fumarate ABILIY MAINTENA 25

30 Name Name aripiprazole lamivudine Thioxanthenes thiothixene ANTISEPTICS & DISINECTANTS - s to Prevent Bacterial Skin Infections Chlorine Antiseptics PHISOHEX ANTIVIRS - s to Treat Viral Infections Antiretrovirals abacavir sulfate abacavir sulfatelamivudine-zidovudine APTIVUS ATRIPLA MBIVIR (Use Lamivudine-Zidovudine) MPLERA CRIXIVAN didanosine EDURANT EMTRIVA EPIVIR (Use Lamivudine) EPZIM lamivudine-zidovudine LEXIVA NEVIRAPINE nevirapine NORVIR PREZBIX PREZISTA RESCRIPTOR RETROVIR (Use Zidovudine) REYATAZ SELZENTRY stavudine STRIBILD SUSTIVA TIVICAY TRIUMEQ TRIZIVIR (Use Abacavir Sulfate-Lamivudine- Zidovudine) TRUVADA N EVOTAZ TYBOST INTELENCE INVIRASE VIDEX EC (Use Didanosine) VIDEXPEDIATRIC N ISENTRESS VIRACEPT KETRA VIRAMUNE 200 MG (Use Nevirapine) 26

31 Name VIRAMUNE 50 MG/5ML Name INERGEN VIRAMUNE XR 100 MG lamivudine (hbv) VIRAMUNE XR 400 MG (Use Nevirapine) VIREAD VITEKTA ZERIT (Use Stavudine) MODERIBA MODERIBA 1200 DOSE CK MODERIBA 800 DOSE CK PEG-INTRON ZIAGEN 20 MG/ML ZIAGEN 300 MG (Use Abacavir Sulfate) zidovudine PEG-INTRON REDIPEN PEG-INTRON REDIPEN K 4 PEGASYS CMV Agents VCYTE SOLR 50 MG/ML VCYTE TABS 450 MG (Use Valganciclovir HCl) valganciclovir hcl Hepatitis Agents adefovir dipivoxil BARACLUDE SOLN 0.05 MG/ML BARACLUDE TABS 0.5 MG, 1 MG (Use Entecavir) PEGUS (Use Ribavirin (Hepatitis C)) entecavir EPIVIR HBV 100 MG (Use Lamivudine (HBV)) EPIVIR HBV 5 MG/ML HARVONI HEPSERA (Use Adefovir Dipivoxil) INCIVEK N N N N QL(21 ml daily); PEGASYS PROCLICK PEGINTRON REBETOL CAPS 200 MG (Use Ribavirin (Hepatitis C)) REBETOL SOLN 40 MG/ML RIBASPHERE RIBASPHERE RIBAK RIBATAB ribavirin (hepatitis c) SOVDI VICTRELIS Herpes Agents acyclovir famciclovir AMVIR (Use amciclovir) valacyclovir hcl N N 27

32 Name VTREX (Use Valacyclovir HCl) ZOVIRAX CAPS OR 200 MG (Use Acyclovir) ZOVIRAX SUSP OR 200 MG/5ML (Use Acyclovir) ZOVIRAX TABS OR 400 MG, 800 MG (Use Acyclovir) Influenza Agents LUMADINE (Use Rimantadine Hydrochloride) RELENZA DISKHER rimantadine hydrochloride TAMILU CAPS 30 MG, 45 MG, 75 MG TAMILU SUSR 6 MG/ML N N N N N QL(20 ea per fill retail) QL(10 ea per fill retail) QL(120 ml per fill retail) ASSORTED CLASSES - Miscellaneous s Chelating Agents CUPRIMINE DEPEN TITRATABS Enzymes XIEX Immunosuppressive Agents AZASAN azathioprine CELLCEPT (Use Mycophenolate Mofetil) cyclosporine caps or 100 mg, 25 mg CYCLOSPORINE MODIIED cyclosporine modified (for microemulsion) IMURAN (Use Azathioprine) N N Name mycophenolate mofetil mycophenolate sodium MYORTIC (Use Mycophenolate Sodium) NEOR (Use Cyclosporine Modified (or Microemulsion)) PROGRA CAPS OR 0.5 MG, 1 MG, 5 MG (Use Tacrolimus) RAMUNE SOLN 1 MG/ML RAMUNE TABS 0.5 MG, 1 MG, 2 MG (Use Sirolimus) SANDIMMUNE CAPS OR 100 MG, 25 MG (Use Cyclosporine) SANDIMMUNE SOLN OR 100 MG/ML sirolimus tacrolimus ZORTRESS N N N N N Potassium Removing Resins KAYEXATE (Use Sodium Polystyrene N Sulfonate) sodium polystyrene sulfonate SPS (Use Sodium N Polystyrene Sulfonate) Systemic Lupus Erythematosus Agents BENLYSTA BETA BLOCKERS - s to Treat High Blood Pressure Alpha-Beta Blockers carvedilol REG (Use Carvedilol) N 28

33 Name labetalol hcl tabs or 100 mg, 200 mg, 300 mg TRANDATE (Use Labetalol HCl) N Beta Blockers Cardio-Selective acebutolol hcl atenolol bisoprolol fumarate LOPRESSOR TABS OR 100 MG, 50 MG (Use Metoprolol Tartrate) metoprolol succinate metoprolol tartrate tabs or 100 mg, 25 mg, 50 mg SECTR (Use Acebutolol HCl) TENORMIN (Use Atenolol) TOPROL XL (Use Metoprolol Succinate) ZEBETA (Use Bisoprolol umarate) Beta Blockers Non-Selective BETACE (Use Sotalol HCl) BETACE A (Use Sotalol HCl (AIB/)) RGARD (Use Nadolol) HEMANGEOL INDER LA (Use Propranolol HCl) nadolol propranolol hcl cp24 or 120 mg, 160 mg, 60 mg, 80 mg PROPRANOLOL HCL SOLN OR 20 MG/5ML propranolol hcl tabs or 10 mg, 20 mg, 40 mg, 60 mg, 80 mg N N N N N N N N N Name sotalol hcl sotalol hcl (afib/afl) SOTYLIZE TIMOLOL MEATE CCIUM CHANNEL BLOCKERS - s to Treat High Blood Pressure Calcium Channel Blockers ADAT CC (Use Nifedipine) amlodipine besylate CAN (Use Verapamil HCl) CAN SR (Use Verapamil HCl) CARDIZEM (Use Diltiazem HCl) CARDIZEM CD (Use Diltiazem HCl Coated Beads) DILAR XR (Use Diltiazem HCl) diltiazem hcl coated beads cp mg, 180 mg, 240 mg, 300 mg, 360 mg diltiazem hcl cp12 or 120 mg, 60 mg, 90 mg diltiazem hcl cp24 or 120 mg, 180 mg, 240 mg diltiazem hcl extended release beads diltiazem hcl tabs or 120 mg, 30 mg, 60 mg, 90 mg felodipine ISOPTIN SR (Use Verapamil HCl) nifedipine caps 10 mg, 20 mg nifedipine tb24 30 mg, 60 mg, 90 mg nifedipine tb24 60 mg N N N N N N N QL(2 ea daily) 29

34 Name nimodipine nisoldipine 17 mg, 34 mg, 8.5 mg NISOLDIPINE ER NORVASC (Use Amlodipine Besylate) NYMIZE PROCARDIA (Use Nifedipine) PROCARDIA XL 30 MG, 90 MG (Use Nifedipine) PROCARDIA XL 60 MG (Use Nifedipine) SULAR (Use Nisoldipine) TIAZAC (Use Diltiazem HCl Extended Release Beads) verapamil hcl cp24 or 100 mg, 120 mg, 180 mg, 200 mg, 240 mg, 300 mg, 360 mg verapamil hcl tabs or 120 mg, 80 mg VERAMIL HCL TABS OR 40 MG verapamil hcl tbcr or 120 mg, 180 mg, 240 mg VERELAN (Use Verapamil HCl) VERELAN PM (Use Verapamil HCl) N N N N N N N N QL(12 ea daily,21 day(s) limit) QL(2 ea daily) CARDIOTONICS - s to Treat Heart ailure and Abnormal Heart Rhythm Cardiac Glycosides DIGOXIN SOLN OR 0.05 MG/ML digoxin tabs or mg, 0.25 mg, 125 mcg, 250 mcg LANOXIN TABS OR 125 MCG, 250 MCG Name CARDIOVASCULAR AGENTS - MISC. - s to Treat Heart and Circulation Conditions Peripheral Vasodilators ISOXSUPRINE HCL isoxsuprine hcl Prostaglandin Vasodilators REMODULIN VENTAVIS Pulmonary Hypertension - Endothelin Receptor LETAIRIS TRACLEER Pulmonary Hypertension - Phosphodiesterase ADCIRCA CEPHOSPORINS - s to Treat Bacterial Infections Cephalosporins - 1st Generation cefadroxil cephalexin caps 250 mg, 500 mg cephalexin susr 125 mg/5ml, 250 mg/5ml CEPHEXIN TABS 250 MG, 500 MG KELEX 250 MG, 500 MG (Use Cephalexin) N Cephalosporins - 2nd Generation CEACLOR cefaclor cefprozil CETIN SUSR 125 MG/5ML, 250 MG/5ML CETIN TABS 250 MG, 500 MG (Use Cefuroxime Axetil) N 30

35 Name Name cefuroxime axetil LOESTRIN 24 E Cephalosporins - 3rd Generation cefdinir cefpodoxime proxetil CHEMICS Bulk Chemicals - H's HOPERIDOL NTRACEPTIVES - s to Prevent Pregnancy Combination Contraceptives - Oral BREVIN-28 (Use Norethindrone & Eth N Estradiol) CYCLESSA (Use Desogestrel-Ethinyl N Estradiol (Triphasic)) DESOGEN (Use Desogestrel & Ethinyl N Estradiol) desogestrel & ethinyl estradiol desogestrel-ethinyl estradiol (biphasic) desogestrel-ethinyl estradiol (triphasic) drospirenone-ethinyl estradiol ESTROSTEP E (Use Norethindrone Acetate- N Ethinyl Estradiol-e) ethynodiol diacet & eth estrad levonorgestrel & eth estradiol levonorgestrel-eth estradiol (triphasic) levonorgestrel-ethinyl estradiol (91-day) LOESTRIN 1.5/30-21 (Use Norethindrone Acet & Eth N Estra) LOESTRIN E 1.5/30 (Use Norethin Acet & Estrad-e) LOESTRIN E 1/20 (Use Norethin Acet & Estrad-e) LOSEASONIQUE (Use Levonorgestrel-Ethinyl Estradiol (91-Day)) MIRCETTE (Use Desogestrel-Ethinyl Estradiol (Biphasic)) MODIN (Use Norethindrone & Eth Estradiol) NEN 10/11-28 norethin acet & estrad-fe norethindrone & eth estradiol norethindrone & mestranol norethindrone acet & eth estra 30mcg-1.5mg norethindrone acetateethinyl estradiol-fe norethindrone-eth estradiol (triphasic) norgestimate-ethinyl estradiol norgestimate-ethinyl estradiol (triphasic) norgestrel & ethinyl estradiol NORINYL 1+35 (Use Norethindrone & Eth Estradiol) NORINYL 1+50 (Use Norethindrone & Mestranol) OGESTREL ORTHO TRI-CYCLEN (Use Norgestimate-Ethinyl Estradiol (Triphasic)) N N N N N N N N 31

36 Name ORTHO-CEPT (Use Desogestrel & Ethinyl Estradiol) ORTHO-CYCLEN (Use Norgestimate-Ethinyl Estradiol) ORTHO-NOVUM 1/35 (Use Norethindrone & Eth Estradiol) ORTHO-NOVUM 7/7/7 (Use Norethindrone-Eth Estradiol (Triphasic)) OVN-35 (Use Norethindrone & Eth Estradiol) SEASONIQUE (Use Levonorgestrel-Ethinyl Estradiol (91-Day)) TRI-NORINYL 28 (Use Norethindrone-Eth Estradiol (Triphasic)) YASMIN 28 (Use Drospirenone-Ethinyl Estradiol) YAZ (Use Drospirenone- Ethinyl Estradiol) ZOVIA 1/50E N N N N N N N N N Combination Contraceptives - Transdermal norelgestromin-ethinyl QL(3 ea per fill estradiol retail) ORTHO EVRA (Use QL(3 ea per fill Norelgestromin-Ethinyl N retail) Estradiol) Combination Contraceptives - Vaginal NUVARING QL(1 ea per 28 days retail) Emergency Contraceptives ELLA LEVONORGESTREL QL(1 ea per fill retail,6 ea per retail) QL(2 ea per fill retail,12 ea per retail) Name levonorgestrel (emergency oc) PLAN B ONE-STEP (Use Levonorgestrel (Emergency OC)) N QL(1 ea per fill retail,6 ea per retail); QL(1 ea per fill retail,6 ea per retail); Progestin Contraceptives - Injectable DEPO-PROVERA NTRACEPTIVE (Use Medroxyprogesterone N QL(1 ml per 90 days retail) Acetate (Contraceptive)) DEPO-SUBQ PROVERA QL(1 ml per medroxyprogesterone acetate (contraceptive) Progestin Contraceptives - Oral NOR-QD (Use Norethindrone N (Contraceptive)) norethindrone (contraceptive) ORTHO MICRONOR (Use Norethindrone N (Contraceptive)) days retail) QL(1 ml per 90 days retail) RTISTEROIDS - Steroid Hormone s to Treat Systemic Swelling Conditions Glucocorticosteroids budesonide CELESTONE RTE (Use Hydrocortisone) RTISONE ACETATE dexamethasone DEXAMETHASONE DEXAMETHASONE INTENSOL ENTORT EC (Use Budesonide) N N 32

37 Name hydrocortisone MEDROL 16 MG, 32 MG, 4 MG, 8 MG (Use Methylprednisolone) MEDROL 2 MG MEDROL DOSEK (Use Methylprednisolone) methylprednisolone MILLIPRED TABS 5 MG ORAPRED (Use Prednisolone Sodium Phosphate) prednisolone prednisolone sodium phosphate soln or 15 mg/5ml PREDNISONE prednisone N N N Name BENADRYL LERGY & LD (Use Diphenhydramine- Phenylephrine- Acetaminophen) BENADRYL LERGY & SINUSHEADACHE (Use Diphenhydramine- Phenylephrine- Acetaminophen) BENADRYL-D LERGY & SINUS (Use Diphenhydramine- Phenylephrine) brompheniramine & phenyleph elix 1mg/5ml- 1mg/5ml-2.5mg/5ml- 2.5mg/5ml, 1mg/5ml- 2.5mg/5ml brompheniramine & pseudoeph elix 1mg/5ml- 15mg/5ml brompheniramine & pseudoeph liqd 1mg/5ml- 15mg/5ml N N N PREDNISONE INTENSOL BRONPECTOL Mineralocorticoids fludrocortisone acetate UGH/LD/LERGY - s to Treat Cough, Cold and Allergy Symptoms Antitussives benzonatate 100 mg, 200 mg hydrocodone w/ homatropine TESSON PERLES (Use Benzonatate) N Cough/Cold/Allergy Combinations ADVIL LERGY & NGESTION BATUSSIN NN cetirizine-pseudoephedrine chlorpheniramine & phenylephrine tabs 4mg- 10mg chlorpheniramine & pseudoeph syrp 15mg/5ml- 1mg/5ml chlorpheniramine w/ codeine CLARITIN-D 12 HOUR (Use Loratadine & Pseudoephedrine) CLARITIN-D 24 HOUR (Use Loratadine & Pseudoephedrine) DEN-A ELIX 2MG/5ML- 5MG/5ML dexbrompheniramine & pseudoephedrine N N QL(2 ea daily) 33

38 Name DIMETAPP LD & LERGY ELIX 1MG/5ML- 2.5MG/5ML (Use Brompheniramine & Phenyleph) diphenhydraminephenylephrine liqd 12.5mg/5ml-5mg/5ml diphenhydraminephenylephrine soln 12.5mg/5ml-5mg/5ml diphenhydraminephenylephrine tabs 25mg- 10mg diphenhydraminephenylephrineacetaminophen tabs 12.5mg-12.5mg-325mg- 325mg-5mg-5mg, 12.5mg- 325mg-5mg diphenhydraminepseudoephedrine- acetaminophen DRIXOR LD/LERGY (Use Dexbrompheniramine & Pseudoephedrine) ED CHLORPED D N N Name PEDIATEX TD (Use Triprolidine & Pseudoephedrine) phenyleph-promethazine w/ cod phenylephrine w/ dm-gg liqd 30mg/5ml-200mg/5ml- 10mg/5ml phenylephrinechlorpheniramine-dm w/ apap susp 5mg/5ml- 1mg/5ml-160mg/5ml- 2.5mg/5ml, 5mg/5ml- 5mg/5ml-1mg/5ml- 1mg/5ml-160mg/5ml- 160mg/5ml-2.5mg/5ml- 2.5mg/5ml PHENYLHISTINE DH POLY-TUSSIN DHC promethazine & phenylephrine PROMETHAZINE VC PLAIN PROMETHAZINE VC/DEINE promethazine w/codeine N GILTUSS PED-C guaifenesin-codeine liqd 100mg/5ml-10mg/5ml guaifenesin-codeine soln 100mg/5ml-10mg/5ml guaifenesin-codeine syrp 100mg/5ml-10mg/5ml hydrocodone polistirexchlorpheniramine polistirex loratadine & pseudoephedrine NEOTUSS-D 60MG/10ML- 60MG/10ML-4MG/10ML- 400MG/10ML NEXAED SINUS PRESSURE +IN QL(300 ml per 28 days retail); promethazine-dm pseudoeph-cpm-dm w/apap syrp 15mg/5ml- 5mg/5ml-1mg/5ml- 160mg/5ml pseudoephedrine-ibuprofen susp 100mg/5ml-15mg/5ml RYMED SUDAED PE SEVERE LD MULTI-SYMPTOM (Use Diphenhydramine- Phenylephrine- Acetaminophen) triprolidine & pseudoephedrine liqd 0.938mg/ml-10mg/ml N 34

39 Name triprolidine & pseudoephedrine tabs 2.5mg-2.5mg-60mg-60mg, 2.5mg-60mg TUSNEL CAPS 2MG- 15MG-200MG TUSSIONEX PENNKINETIC EXTENDED RELEASE (Use Hydrocodone Polistirex- Chlorpheniramine Polistirex) TYLENOL CHILDRENS LD PLUS UGH (Use Pseudoeph-CPM-DM w/ap) TYLENOL CHILDRENS PLUS LU (Use Phenylephrine- Chlorpheniramine-DM w/ AP) TYLENOL CHILDRENS PLUS MULTI-SYMPTOM LD (Use Phenylephrine- Chlorpheniramine-DM w/ AP) ZYRTEC-D LERGY/NGESTION (Use Cetirizine- Pseudoephedrine) Misc. Respiratory Inhalants HYPERS 3.5 % sodium chloride (inhalant) aers 0.9 % sodium chloride (inhalant) nebu 0.9 %, 3 % Mucolytics acetylcysteine N N N N N QL(300 ml per 28 days retail); QL(2 ea daily) DERMATOLOGICS - s to Treat Skin Conditions Acne Products ACNE MEDICATION Name ACNE MEDICATION 10 adapalene crea 0.1 % adapalene gel 0.1 %, 0.3 % BENZAC AC WASH (Use Benzoyl Peroxide) BENZAC W WASH (Use Benzoyl Peroxide) BENZAMYCIN (Use Benzoyl Peroxide- Erythromycin) benzoyl peroxide gel 10 %, 5 % BENZOYL PEROXIDE GEL 2.5 % benzoyl peroxide liqd 10 %, 2.5 %, 4 %, 5 %, 5.25 % benzoyl peroxide liqd 7 % benzoyl peroxideerythromycin BRASIVOL CLARAVIS CLEOCIN-T (Use Clindamycin Phosphate (Topical)) CLINDAGEL 1 % CLINDAGEL 1 % (Use Clindamycin Phosphate (Topical)) clindamycin phosphate (topical) gel clindamycin phosphate (topical) lotn clindamycin phosphate (topical) soln clindamycin phosphate (topical) swab DESQUAM-X WASH (Use Benzoyl Peroxide) N N N N N N QL(45 gm per 30 days retail); QL(45 gm per 30 days retail); 35

40 Name DIERIN CREA 0.1 % (Use Adapalene) DIERIN GEL 0.1 %, 0.3 % (Use Adapalene) ERYGEL (Use Erythromycin (Acne Aid)) erythromycin (acne aid) isotretinoin 10 mg isotretinoin 20 mg isotretinoin 40 mg KLARON (Use Sulfacetamide Sodium (Acne)) NOXYL LIQD 2.5 % (Use Benzoyl Peroxide) NOXYL-4 CREAMY WASH (Use Benzoyl Peroxide) NOXYL-8 CREAMY WASH N N N N N N RETIN-A (Use Tretinoin) N RETIN-A MICRO (Use Tretinoin Microsphere) RETIN-A MICRO PUMP 0.04 %, 0.1 % (Use Tretinoin Microsphere) sulfacetamide sodium (acne) sulfacetamide sodium w/ sulfur lotn 5%-10% tretinoin tretinoin microsphere Antibiotics - Topical N N QL(45 gm per 30 days retail); QL(45 gm per 30 days retail); QL(4 ea daily) QL(5 ea daily) QL(2 ea daily) QL(45 gm per 30 days retail); QL(50 gm per 30 days retail); QL(50 gm per 30 days retail); QL(45 gm per 30 days retail); QL(50 gm per 30 days retail); Name BACIGUENT (Use Bacitracin (Topical)) bacitracin (topical) bacitracin zinc bacitracin-polymyxin b BACTROBAN (Use Mupirocin Calcium (Topical)) BACTROBAN (Use Mupirocin) RTISPORIN CREA EX 10000UNIT/GM-0.5%-0.5% RTISPORIN OINT EX 400UNIT/GM- 5000UNIT/GM-0.5%-1% GENTAMICIN SULATE CREA EX 0.1 % GENTAMICIN SULATE OINT EX 0.1 % mupirocin mupirocin calcium (topical) POLYSPORIN OINT (Use Bacitracin-Polymyxin B) Antifungals - Topical EVAZOL clotrimazole (topical) clotrimazole w/ betamethasone crea econazole nitrate EXELDERM SOLN ketoconazole (topical) crea ketoconazole (topical) sham LAMISIL AT CREA (Use Terbinafine HCl (Topical)) N N N N N 36

41 Name LAMISIL AT JOCK ITCH (Use Terbinafine HCl (Topical)) LAMISIL AT SPRAY LAMISIL SPRAY LOTRIMIN A 1 % (Use Clotrimazole (Topical)) LOTRIMIN A OR HER (Use Clotrimazole (Topical)) LOTRIMIN A JOCK ITCH (Use Clotrimazole (Topical)) LOTRISONE (Use Clotrimazole w/ Betamethasone) MICATIN (Use Miconazole Nitrate (Topical)) miconazole nitrate (topical) crea naftifine hcl NATIN CREA 1 % (Use Naftifine HCl) NATIN CREA 2 % NATIN GEL 1 %, 2 % NIZOR (Use Ketoconazole (Topical)) nystatin (topical) crea nystatin (topical) oint nystatin-triamcinolone terbinafine hcl (topical) TINACTIN CREA (Use Tolnaftate) TINACTIN JOCK ITCH CREA (Use Tolnaftate) tolnaftate crea tolnaftate liqd N N N N N N N N N N Name tolnaftate soln Antineoplastic or Premalignant Lesion Agents - CARAC EUDEX (Use luorouracil (Topical)) LUOROPLEX LUOROURACIL fluorouracil (topical) crea 5 % NRETIN PICATO Antipruritics - Topical doxepin hcl (antipruritic) PRUDOXIN ZONON (Use Doxepin HCl (Antipruritic)) Antipsoriatics calcipotriene calcitriol (topical) DOVONEX (Use Calcipotriene) DRITHO-CREME HP STELARA TAZORAC VECTIC (Use Calcitriol (Topical)) Antiseborrheic Products SEB-PREV selenium sulfide lotn 2.5 % N N N N QL(3.4 gm daily,100 gm per fill retail) QL(1 gm daily); QL(3.4 gm daily,100 gm per fill retail) 37

42 Name SELSUN SHAMPOO (Use Selenium Sulfide) Antivirals - Topical acyclovir topical ZOVIRAX OINT EX 5 % (Use Acyclovir Topical) Burn Products SILVADENE (Use Silver Sulfadiazine) silver sulfadiazine SULAMYLON CREA 85 MG/GM Corticosteroids - Topical APEXIN E betamethasone dipropionate (topical) betamethasone dipropionate augmented gel betamethasone dipropionate augmented lotn betamethasone dipropionate augmented oint betamethasone valerate crea 0.1 % betamethasone valerate lotn 0.1 % betamethasone valerate oint 0.1 % N N N QL(1 gm daily) QL(1 gm daily) Name clobetasol propionate soln CVS HDYRORTISONE ACETATE desonide crea desonide oint DESOWEN CREA (Use Desonide) DESOWEN OINT (Use Desonide) desoximetasone crea 0.05 %, 0.25 % desoximetasone gel 0.05 % desoximetasone oint 0.25 % diflorasone diacetate DILORASONE DIACETATE DIPROLENE (Use Betamethasone Dipropionate Augmented) ELON CREA (Use Mometasone uroate) ELON OINT (Use Mometasone uroate) fluocinolone acetonide crea 0.01 %, % fluocinolone acetonide oint % fluocinolone acetonide soln 0.01 % N N N N N CAPEX fluocinonide crea 0.05 % clobetasol propionate crea clobetasol propionate emollient base fluocinonide emulsified base fluocinonide gel 0.05 % clobetasol propionate foam fluocinonide oint 0.05 % clobetasol propionate gel fluocinonide soln 0.05 % clobetasol propionate oint halobetasol propionate crea 38

43 Name hydrocortisone (topical) crea 0.5 %, 2.5 % hydrocortisone (topical) crea 1 %, 1% hydrocortisone (topical) lotn 1 %, 2.5 % hydrocortisone (topical) oint 0.5 %, 2.5 % hydrocortisone (topical) oint 1 % hydrocortisone (topical) soln 1 % hydrocortisone acetate (topical) hydrocortisone valerate hydrocortisone-aloe vera KENOG (Use Triamcinolone Acetonide (Topical)) mometasone furoate crea mometasone furoate oint MONISTAT SOOTHING CARE ITCH RELIE (Use Hydrocortisone (Topical)) OLUX (Use Clobetasol Propionate) PRAMOSONE CREA 1%- 1% PRAMOSONE CREA 1%- 2.5% (Use Pramoxine-HC) PRAMOSONE LOTN 1%- 1%, 1%-2.5% PRAMOSONE OINT 1%- 1%, 1%-2.5% pramoxine-hc PSORN SYNAR (Use luocinolone Acetonide) TEMOVATE (Use Clobetasol Propionate) N N N N N N Name TEMOVATE E (Use Clobetasol Propionate Emollient Base) TOPIRT CREA 0.05 %, 0.25 % (Use Desoximetasone) TOPIRT GEL 0.05 % (Use Desoximetasone) TOPIRT OINT 0.25 % (Use Desoximetasone) TRIAMCINOLONE ACETONIDE triamcinolone acetonide (topical) TUCKS ANTI-ITCH ULTRAVATE CREA (Use Halobetasol Propionate) WESTRT (Use Hydrocortisone Valerate) Emollients LAC-HYDRIN (Use Lactic Acid (Ammonium Lactate)) LAC-HYDRIN TWELVE (Use Lactic Acid (Ammonium Lactate)) lactic acid (ammonium lactate) crea 12 % lactic acid (ammonium lactate) lotn 12 % lactic acid w/ vitamin e Enzymes - Topical SANTYL N N N N N N N N Immunomodulating Agents - Topical DARA (Use Imiquimod) imiquimod Keratolytic/Antimitotic Agents NDYLOX GEL NDYLOX SOLN (Use Podofilox) N N 39

44 Name Name podofilox HM CAMINE Local Anesthetics - Topical EMLA (Use Lidocaine- Prilocaine) ETHYL CHLORIDE/INE PINPOINT ETHYL CHLORIDE/INE STREAM ETHYL CHLORIDE/MEDIUM JET STREAM ETHYL CHLORIDE/MEDIUM STREAM ETHYL CHLORIDE/MIST lidocaine hcl gel ex 2 % lidocaine hcl soln ex 4 % lidocaine oint 5 % lidocaine-prilocaine REGENECARE HA XYLOCAINE EX 4 % (Use Lidocaine HCl) Misc. Topical aluminum chloride aluminum sulfate & calcium acetate CAMINE CAMINE PHENOLATED DOMEBORO 1347MG- 952MG (Use Aluminum Sulfate & Calcium Acetate) DRYSOL GNP CAMINE N N N MEIJER CAMINE PX CAMINE QC CAMINE RA CAMINE LOTN 6.971%-6.971% SM CAMINE SM CAMINE PHENOLATED Rosacea Agents INACEA METROCREAM (Use Metronidazole (Topical)) METROGEL (Use Metronidazole (Topical)) METROLOTION (Use Metronidazole (Topical)) metronidazole (topical) crea 0.75 % metronidazole (topical) gel 0.75 % metronidazole (topical) gel 1 % metronidazole (topical) lotn 0.75 % Scabicides & Pediculicides ELIMITE (Use Permethrin) EURAX LICE B GONE SHAM lindane malathion NIX CREME RINSE (Use Permethrin) N N N N N QL(1.67 gm daily) QL(1.5 gm daily) QL(2 gm daily) QL(2 ml daily) QL(1.5 gm daily) QL(45 gm per 30 days retail) QL(2 gm daily) QL(2 ml daily) GNP CAMINE PHENOLATED OVIDE (Use Malathion) N 40

45 Name permethrin crea ex 5 % permethrin liqd ex 1 % permethrin lotn ex 1 % PRONTO SHAM EX 0.33%-4% (Use Pyrethrins- Piperonyl Butoxide) PYRETHINS/PIPERONYL BUTOXIDE pyrethrins-piperonyl butoxide RID LIQD EX 0.33%-4% (Use Pyrethrins-Piperonyl Butoxide) Tar Products TAR N N Name REESTYLE INSULINX BLOODGLUSE TEST REESTYLE INSULINX BLOODGLUSE TEST STRIPS REESTYLE LITE TEST STRIPS REESTYLE TEST STRIPS HEMA-MBISTIX KETOCARE KETONE TEST STRIPS KETOSTIX LABSTIX QL(10 ea daily) QL(10 ea daily) QL(10 ea daily) QL(10 ea daily) ELTA TAR MULTISTIX DIAGNOSTIC PRODUCTS MULTISTIX 10 SG Diagnostic Tests ASSURE PLATINUM TEST STRIPS CHEK-STIX MBO K URINYSIS NTROL CHEK-STIX NTROL QL(10 ea daily) MULTISTIX 5 MULTISTIX 7 MULTISTIX 8 SG MULTISTIX 9 CHEMSTRIP -10 WITH SG CHEMSTRIP 10 MD CHEMSTRIP 2 GP STRIPS CHEMSTRIP 7 CHEMSTRIP 9 STRIPS CHEMSTRIP-K CLINISTIX MBISTIX DIASTIX MULTISTIX 9 SG ONETOUCH ULTRA BLUE ONETOUCH VERIO TEST STRIPS PRECISION PCX PRECISION PCX PLUS TEST STRIPS PRECISION POINT O CARE TEST STRIPS PRECISION QID TEST STRIPS PRECISION SO-TACT TEST STRIPS QL(10 ea daily) QL(10 ea daily) QL(10 ea daily) QL(10 ea daily) QL(10 ea daily) QL(10 ea daily) QL(10 ea daily) 41

46 Name PRECISION XTRA BLOOD GLUSE TEST STRIPS PRECISION XTRA STRP VI RELION KETONE RELION KETONE TEST STRIPS URISTIX URISTIX 4 QL(10 ea daily) DIGESTIVE AIDS - s to Treat Low Digestive Enzymes Digestive Enzymes CREON UNIT UNIT UNIT, 19000UNIT-6000UNIT UNIT, 38000UNIT UNIT-60000UNIT, 76000UNIT-24000UNIT UNIT pancrelipase (lipaseprotease-amylase) ZENPEP 10000UNIT- 3000UNIT-16000UNIT, UNIT-40000UNIT UNIT, 34000UNIT UNIT-55000UNIT, 51000UNIT-15000UNIT UNIT, 68000UNIT UNIT UNIT, 85000UNIT-25000UNIT UNIT ZENPEP 17000UNIT- 5000UNIT-27000UNIT (Use Pancrelipase (Lipase- Protease-Amylase)) N DIURETICS - s to Treat Heart, Circulation Conditions and Blood Pressure Carbonic Anhydrase Inhibitors ACETAZOLAMIDE acetazolamide DIAMOX (Use Acetazolamide) N Name methazolamide NEPTAZANE (Use Methazolamide) Diuretic Combinations DACTAZIDE 25MG- 25MG (Use Spironolactone & Hydrochlorothiazide) DYAZIDE (Use Triamterene & Hydrochlorothiazide) MAXZIDE (Use Triamterene & Hydrochlorothiazide) MAXZIDE-25 (Use Triamterene & Hydrochlorothiazide) spironolactone & hydrochlorothiazide triamterene & hydrochlorothiazide TRIAMTERENE/HYDROC HLOROTHIAZIDE Loop Diuretics bumetanide tabs or 0.5 mg, 1 mg, 2 mg furosemide soln or 10 mg/ml furosemide tabs or 20 mg, 40 mg, 80 mg LASIX (Use urosemide) Potassium Sparing Diuretics DACTONE (Use Spironolactone) amiloride hcl spironolactone N N N N N N N Thiazides and Thiazide-Like Diuretics CHLORTHIDONE hydrochlorothiazide indapamide 42

47 Name METHYCLOTHIAZIDE metolazone MICROZIDE (Use Hydrochlorothiazide) ZAROXOLYN (Use Metolazone) N N ENDOCRINE AND METABOLIC AGENTS - MISC. - s to Treat Bone Disease and Regulate Hormones Bone Density Regulators alendronate sodium tabs 10 mg, 5 mg alendronate sodium tabs 35 mg, 70 mg ENDRONATE SODIUM TABS 40 MG ETIDRONATE DISODIUM etidronate disodium OSAMAX (Use Alendronate Sodium) OSAMAX PLUS D Growth Hormones HUMATROPE HUMATROPE MBO CK NORDITROPIN LEXPRO NORDITROPIN NORDILEX PEN N Hormone Receptor Modulators EVISTA (Use Raloxifene N HCl) raloxifene hcl QL(4 ea per 30 days retail) QL(4 ea per 30 days retail) QL(4 ea per 30 days retail) LHRH/GnRH Agonist Analog Pituitary SYNAREL Metabolic Modifiers Name DURAZYME calcitriol caps or 0.25 mcg, 0.5 mcg calcitriol soln or 1 mcg/ml CARBAGLU CARNITOR S (Use Levocarnitine (Metabolic Modifiers)) CARNITOR SOLN OR 1 GM/10ML (Use Levocarnitine (Metabolic Modifiers)) CARNITOR TABS OR 330 MG (Use Levocarnitine (Metabolic Modifiers)) ABRAZYME KUVAN levocarnitine (metabolic modifiers) soln or 1 gm/10ml levocarnitine (metabolic modifiers) tabs or 330 mg LUMIZYME MYOZYME NAGLAZYME paricalcitol caps or 1 mcg, 2 mcg, 4 mcg ROCTROL (Use Calcitriol) SENSIR ZEMPLAR CAPS OR 1 MCG, 2 MCG, 4 MCG (Use Paricalcitol) Posterior Pituitary Hormones DDAVP SOLN NA 0.01 % (Use Desmopressin Acetate Refrigerated) N N N N N N 43

48 Name DDAVP SOLN NA 0.01 % (Use Desmopressin Acetate Spray) DDAVP TABS OR 0.1 MG, 0.2 MG (Use Desmopressin Acetate) desmopressin acetate refrigerated desmopressin acetate spray desmopressin acetate spray refrigerated desmopressin acetate tabs or 0.1 mg, 0.2 mg STIMATE N N Vasopressin Receptor Antagonists SAMSCA ESTROGENS - Hormone Replacement/Modifying s Estrogen Combinations CLIMARA PRO esterified estrogens & methyltestosterone PREMPHASE PREMPRO Estrogens CLIMARA (Use Estradiol) N ESTRACE TABS OR 0.5 MG, 1 MG, 2 MG (Use Estradiol) estradiol pttw td mg/24hr estradiol ptwk td mg/24hr, 0.05 mg/24hr, 0.06 mg/24hr, mg/24hr, 0.1 mg/24hr, 37.5 mcg/24hr estradiol tabs or 0.5 mg, 1 mg, 2 mg N QL(0.15 ea daily) QL(0.14 ea daily) QL(8 ea per 22 days retail) QL(0.14 ea daily) Name ESTROPITE estropipate MENEST MINIVELLE MG/24HR, 0.05 MG/24HR, MG/24HR, 0.1 MG/24HR PREMARIN TABS OR 0.3 MG, 0.45 MG, MG, 0.9 MG, 1.25 MG VIVELLE-DOT QL(8 ea per 22 days retail) QL(8 ea per 28 days retail) LUOROQUINOLONES - s to Treat Bacterial Infections luoroquinolones CIPRO SUSR 500 MG/5ML (Use Ciprofloxacin) CIPRO TABS 250 MG, 500 MG (Use Ciprofloxacin HCl) CIPRO XR (Use Ciprofloxacin-Ciprofloxacin HCl) ciprofloxacin CIPROLOXACIN HCL 100 MG ciprofloxacin hcl 100 mg ciprofloxacin hcl 250 mg, 500 mg, 750 mg ciprofloxacin-ciprofloxacin hcl LEVAQUIN SOLN 25 MG/ML (Use Levofloxacin) LEVAQUIN TABS 250 MG, 500 MG, 750 MG (Use Levofloxacin) levofloxacin soln or 25 mg/ml levofloxacin tabs or 250 mg, 500 mg, 750 mg ofloxacin 200 mg, 300 mg N N N N N QL(56 ea per 90 days retail) QL(14 ea per fill retail) QL(56 ea per 90 days retail) QL(14 ea per fill retail) QL(14 ea per fill retail) QL(14 ea per fill retail) 44

49 Name GASTROINTESTIN AGENTS - MISC. - Miscellaneous Gastrointestinal s Antiflatulents GAS-X EXTRA STRENGTH CHEW 125 MG (Use Simethicone) MYLANTA GAS (Use Simethicone) MYLANTA GAS RELIE MAXIMUM STRENGTH (Use Simethicone) simethicone caps 125 mg N N N Name LAZ (Use Balsalazide Disodium) DELZIL ENTYVIO mesalamine mesalamine w/ cleanser REMICADE ROWASA (Use Mesalamine w/ Cleanser) N N QL(12 ea daily) simethicone chew 125 mg SROWASA Gallstone Solubilizing Agents ACTIGL (Use Ursodiol) N sulfasalazine Intestinal Acidifiers URSO 250 (Use Ursodiol) N lactulose (encephalopathy) ursodiol caps 300 mg ursodiol tabs 250 mg Gastrointestinal Antiallergy Agents cromolyn sodium (mastocytosis) GASTROCROM (Use Cromolyn Sodium N (Mastocytosis)) Gastrointestinal Stimulants metoclopramide hcl soln or 10 mg/10ml, 5 mg/5ml metoclopramide hcl tabs or 10 mg, 5 mg REGLAN (Use Metoclopramide HCl) Inflammatory Bowel Agents AZULIDINE (Use Sulfasalazine) AZULIDINE EN-TABS (Use Sulfasalazine) balsalazide disodium N N N Phosphate Binder Agents calcium acetate (phosphate binder) caps PHOSLO (Use Calcium Acetate (Phosphate Binder)) N GENITOURINARY AGENTS - MISCELLANEOUS - Miscellaneous s to Treat Reproductive Organs and Urinary System Alkalinizers CYTRA-3 ORACIT potassium citrate (alkalinizer) 1080 mg, 540 mg SHOHLS SOLUTION MODIIED (Use Sodium Citrate & Citric Acid) sodium citrate & citric acid UROCIT-K 10 (Use Potassium Citrate (Alkalinizer)) N N 45

50 Name UROCIT-K 5 (Use Potassium Citrate (Alkalinizer)) Genitourinary Irrigants acetic acid ir 0.25 % Interstitial Cystitis Agents ELMIRON Prostatic Hypertrophy Agents finasteride LOMAX (Use Tamsulosin HCl) PROSCAR (Use inasteride) tamsulosin hcl Urinary Analgesics phenazopyridine hcl 100 mg, 200 mg PYRIDIUM (Use Phenazopyridine HCl) Urinary Stone Agents THIOLA N N N N Name HEMATOLOGIC AGENTS - MISC. - s to Treat Blood Disorders Antihemophilic Products ADVATE PHANATE/VON WILLEBRANDACTOR MPLEX/HUMAN PHANINE SD PROLIX BEBULIN BEBULIN VH BENEIX RIACT ELOCTATE EIBA EIBA N HELIXATE S GOUT AGENTS - s to Treat Gout Gout Agent Combinations colchicine w/ probenecid Gout Agents allopurinol LCHICINE TABS LCRYS KRYSTEXXA ZYLOPRIM (Use Allopurinol) Uricosurics probenecid N HEMOIL M HUMATE-P IXINITY KCENTRA KOATE-DVI KOGENATE S KOGENATE S BIO-SET MONOCLATE-P MONONINE NOVOEIGHT 46

51 Name NOVOSEVEN RT OBIZUR Name PLAVIX 75 MG (Use Clopidogrel Bisulfate) PLET (Use Cilostazol) N N PROILNINE SD ZONTIVITY REMBINATE RIASTAP RIXUBIS HEMATOPOIETIC AGENTS - s to Treat Blood Disorders Agents for Gaucher Disease CEREZYME TRETTEN VPRIV WILATE XYNTHA XYNTHA SOLOUSE Complement Inhibitors CINRYZE SOLIRIS Hematorheologic Agents pentoxifylline TRENT (Use Pentoxifylline) Platelet Aggregation Inhibitors N Agents for Sickle Cell Anemia DROXIA olic Acid/olates A-8 OLIC ACID CAPS OR 20 MG, 5 MG folic acid tabs or 1 mg folic acid tabs or 400 mcg, 800 mcg Hematopoietic Growth actors ARANESP BUMIN REE NPLATE BRILINTA PROMACTA ; cilostazol clopidogrel bisulfate 300 mg clopidogrel bisulfate 75 mg dipyridamole Hematopoietic Mixtures ferrous fumarate w/ b12-vit c-fa-ifc iron combinations iron polysaccharide complex-vit b12-folic acid EIENT NEPHRON A PERSANTINE (Use Dipyridamole) PLAVIX 300 MG (Use Clopidogrel Bisulfate) N N Iron ER-IN-SOL (Use errous Sulfate) N 47

52 Name ERROUS GLUNATE 225 MG ferrous sulfate elix 220 mg/5ml ERROUS SULATE LIQD 220 MG/5ML ferrous sulfate soln 15 mg/ml ERROUS SULATE SYRP 300 MG/5ML ferrous sulfate tabs 325 mg, 65 mg ferrous sulfate tbcr 50 mg ERROUS SULATE TBEC 324 MG ferrous sulfate tbec 325 mg IRON CHEWS PEDIATRIC IRON TABS 28 MG polysaccharide iron complex 150 mg HEMOSTATICS - s to Stop Bleeding/Treat Blood Disorders Hemostatics - Systemic AMICAR SYRP 25 % AMICAR TABS 500 MG aminocaproic acid syrp or 25 % aminocaproic acid tabs or 500 mg LYSTEDA (Use Tranexamic Acid) tranexamic acid tabs or 650 mg N QL(6 ea daily,5 day(s) limit) QL(6 ea daily,5 day(s) limit) HYPNOTICS/SEDATIVES/SLEEP DISORDER AGENTS Barbiturate Hypnotics PHENOBARBIT phenobarbital Name Non-Barbiturate Hypnotics AMBIEN (Use Zolpidem Tartrate) estazolam eszopiclone 1 mg, 2 mg eszopiclone 3 mg LURAZEM HCL flurazepam hcl HCION (Use Triazolam) LUNESTA 1 MG, 2 MG (Use Eszopiclone) LUNESTA 3 MG (Use Eszopiclone) RESTORIL (Use Temazepam) temazepam triazolam zolpidem tartrate tabs 10 mg, 5 mg N N N N N LAXATIVES - Bowel Treatment s Bulk Laxatives calcium polycarbophil CITRUCEL IBER LAXATIVE (Use Methylcellulose (Laxative)) CVS NATUR IBER SUPPLEMENT EQL NATUR IBER EQUACTIN EVAC (Use Psyllium) IBERN (Use Calcium Polycarbophil) HYDROCIL INSTANT CK N N N ST; QL(1 ea daily) ST; QL(1 ea daily); ST; QL(1 ea daily) ST; QL(1 ea daily); 48

53 Name HYDROCIL INSTANT POWD (Use Psyllium) KONSYL CK 100 %, 28.3 %, 60.3 % KONSYL POWD 100 % (Use Psyllium) KONSYL POWD 60.3 %, % KONSYL-D METAMUCIL 0.52 GM,48.57 % (Use Psyllium) METAMUCIL MULTIHETH IBER % METAMUCIL ORIGIN TEXTURE % (Use Psyllium) METAMUCIL SMOOTH TEXTUREIBER SINGLES methylcellulose (laxative) powd 2 gm/10.2gm, 2 gm/19gm psyllium UNIIBER Laxative Combinations LYTE-LAVOR CKS 240GM-22.72GM-5.84GM- 2.98GM-6.72GM (Use PEG 3350-KCl-Sod Bicarb-Sod Chloride-Sod Sulfate) GOLYTELY 227.1GM- 21.5GM-5.53GM-2.82GM- 6.36GM GOLYTELY 236GM GM-5.86GM-2.97GM- 6.74GM (Use PEG KCl-Sod Bicarb-Sod Chloride-Sod Sulfate) LO-SO PREP NULYTELY/LAVOR CKS (Use PEG Potassium Chloride-Sod Bicarbonate-Sod Chloride) N N N N N N N Name peg 3350-kcl-sod bicarbsod chloride-sod sulfate peg 3350-potassium chloride-sod bicarbonatesod chloride Laxatives - Miscellaneous LEET LIQUID GLYCERIN SUPPOSITORIES lactulose MIRAX CK (Use Polyethylene Glycol 3350) MIRAX POWD (Use Polyethylene Glycol 3350) polyethylene glycol 3350 pack polyethylene glycol 3350 powd Saline Laxatives MILK O MAGNESIA NCENTRATE PHILLIPS MILK O MAGNESIA CHEWABLE PHILLIPS MILK O MAGNESIA NCENTRATED Stimulant Laxatives bisacodyl DULLAX (Use Bisacodyl) DULLAX BOWEL PREP KIT EX-LAX TABS (Use Sennosides) LEET BISADYL sennosides tabs 15 mg Surfactant Laxatives benzocaine-docusate sodium LACE (Use Docusate Sodium) N N N N N QL(28 ea per 28 days retail); QL(17.6 gm daily); QL(28 ea per 28 days retail); QL(17.6 gm daily); 49

54 Name LACE CLEAR (Use Docusate Sodium) docusate calcium docusate sodium DOCUSOL KIDS N MACROLIDES - s to Treat Bacterial Infections Azithromycin azithromycin pack or 1 gm azithromycin susr or 100 mg/5ml, 200 mg/5ml azithromycin tabs or 250 mg azithromycin tabs or 500 mg azithromycin tabs or 600 mg ZITHROMAX CK OR 1 GM (Use Azithromycin) ZITHROMAX SUSR OR 100 MG/5ML, 200 MG/5ML (Use Azithromycin) ZITHROMAX TABS OR 250 MG (Use Azithromycin) ZITHROMAX TABS OR 500 MG (Use Azithromycin) ZITHROMAX TABS OR 600 MG (Use Azithromycin) ZITHROMAX TRI-K (Use Azithromycin) ZITHROMAX Z-K (Use Azithromycin) ZMAX Clarithromycin BIAXIN SUSR 250 MG/5ML (Use Clarithromycin) N N N N N N N N QL(1 ea per 30 days retail) QL(45 ml per 30 days retail) QL(6 ea per 30 days retail) QL(3 ea per 30 days retail) QL(10 ea per 30 days retail) QL(1 ea per 30 days retail) QL(45 ml per 30 days retail) QL(6 ea per 30 days retail) QL(3 ea per 30 days retail) QL(10 ea per 30 days retail) QL(3 ea per 30 days retail) QL(6 ea per 30 days retail) QL(1 ea per 30 days retail) QL(150 ml per 30 days retail) Name BIAXIN TABS 250 MG (Use Clarithromycin) BIAXIN TABS 500 MG BIAXIN XL (Use Clarithromycin) BIAXIN XL C (Use Clarithromycin) clarithromycin susr 125 mg/5ml, 250 mg/5ml clarithromycin tabs 250 mg, 500 mg clarithromycin tb mg Erythromycins E.E.S. 400 E.E.S. GRANULES ERY-TAB ERYPED 200 ERYPED 400 ERYTHROCIN STEARATE erythromycin base ERYTHROMYCIN BASE ERYTHROMYCIN ETHYLSUCCINATE PCE MEDIC DEVICES Contraceptives AIMS LUBRICATED ATLAS LORED NDOM/SPERMICIDE ATLAS LORED LUBRICATEDNDOM ATLAS LUBRICATED NDOM N N N QL(28 ea per 30 days retail) QL(28 ea per 30 days retail) QL(14 ea per 30 days retail) QL(14 ea per 30 days retail) QL(150 ml per 30 days retail) QL(28 ea per 30 days retail) QL(14 ea per 30 days retail) 50

55 Name ATLAS LUBRICATED NDOM/SPERMICIDE CAYA CLASS ACT LUBRICATED NDOMS ELEXA NATUR EEL QL(1 ea per retail) Name KIMONO PS LUBRICATED KIMONO PS PLUS SPERMICIDE/LUBRICATE D KIMONO SENSATION LUBRICATED KIMONO SENSATION PLUS SPERMICIDE LUBRICATED ELEXA STIMULATING KIMONO SPECI ELEXA ULTRA SENSITIVE EXTRA SENSITIVE SPERMICID ANTASY LUBRICATED ANTASY LUBRICATED/SPERMICID E C EME NDOM C2 EME NDOM EMCAP HIGH SENSATION SPERMICID QL(1 ea per retail) LIESTYLES ASSORTED LORS LIESTYLES EXTRA STRENGTH LIESTYLES ORM ITTING LIESTYLES LUBRICATED LIESTYLES RIBBED LIESTYLES SKYN ORIGIN LIESTYLES SPERMICIDLYLUBRIC ATED LIESTYLES STUDDED INTENSE SENSATION KAMELEON LUBRICATED KIMONO LORS KIMONO LUBRICATED KIMONO MICRO THIN KIMONO MICRO THIN PLUS SPERMICIDE LUBRICATED KIMONO PLUS SPERMICIDE LUBRICATED KIMONO PLUS SPERMICIDE/LUBRICATE D LIESTYLES ULTRA SENSITIVE LIESTYLES ULTRA SENSITIVE/SPERMICIDE LIESTYLES VIBRA- RIBBED LIESTYLES VIBRA- RIBBED/SPERMICIDE LIESTYLES XTRA PLEASURE MAXX LUBRICATED MAXX PLUS SPERMICIDE LUBRICATED OMNILEX DIAPHRAGM ORTHO DIAPHRAGM L-LEX/65MM QL(1 ea per retail) QL(1 ea per retail) 51

56 Name ORTHO DIAPHRAGM L-LEX/70MM ORTHO DIAPHRAGM L-LEX/75MM ORTHO DIAPHRAGM L-LEX/80MM ORTHO DIAPHRAGM IL SPRING KIT 100 ORTHO DIAPHRAGM IL SPRING KIT 105 ORTHO DIAPHRAGM IL SPRING KIT 50 PREMIUM NDOMS LUBRICATED PRENTI CAVITY-RIM CERVIC CAP PRENTI ITTING SET REITY LATEX NDOMS/LUBRICATED REITY LATEX/ULTRA TEXTURED REITY LATEX/ULTRA THIN SAE-LUV NDOMS QL(1 ea per retail) QL(1 ea per retail) QL(1 ea per retail) QL(1 ea per retail) QL(1 ea per retail) QL(1 ea per retail) QL(1 ea per retail) QL(1 ea per retail) Name TROJAN REGULAR TROJAN RIBBED TROJAN RIBBED W/SPERMICID TROJAN SHARED SENSATION/LUBRICATE D TROJAN SUPRAS SPERMICID TROJAN TWISTED PLEASURE TROJAN ULTRA PLEASURE/LUBRICATED TROJAN VERY SENSITIVE LUBRICATED TROJAN VERY SENSITIVE SPERMICID LUBRICANT TROJAN VERY THIN LUBRICATED TROJAN VERY THIN SPERMICID LUBRICANT TROJAN-ENZ LUBRICANT TROJAN TROJAN ASSORTMENT CK TROJAN EXTENDED PLEASURE/LUBRICATED TROJAN EXTRA STRENGTH TROJAN-ENZ LUBRICATED TROJAN-ENZ W/SPERMICID TRUSTEX LOR NDOMS + LUBE TRUSTEX LUBRICATED TROJAN MAGNUM TROJAN MAGNUM WARM SENSATIONS TROJAN MAGNUM XL LUBRICATED TROJAN NATURAMB W/SPERMICID LUB TROJAN PLEASURE MESH/SPERMICID TROJAN PLUS TRUSTEX LUBRICATED EXTRARGE TRUSTEX LUBRICATED EXTRASTRENGTH TRUSTEX LUBRICATED/RIBBED/ST UDDED TRUSTEX LUBRICATED/SPERMICID E 52

57 Name TRUSTEX LUBRICATED/SPERMICID E EXTRA LARGE TRUSTEX LUBRICATED/SPERMICID E EXTRA STRENGTH TRUSTEX NATUR NDOMS +LUBE/LUBRICATED TRUSTEX NON- LUBRICATED TRUSTEX WITH NONOXYNOL- 9/RIBBED/STUDDED TRUSTEX/RIA LUBRICATED TRUSTEX/RIA LUBRICATED SPERMICIDE TRUSTEX/RIA LUBRICATED/SPERMICID E TRUSTEX/RIA NON- LUBRICATED ULTIMATE EELING Diabetic Supplies ACCU-CHEK ASTCLIX LANCETDEVICE KIT ACCU-CHEK MULTICLIX LANCET DEVICE KIT ACCU-CHEK SOTCLIX LANCETDEVICE ACCU-CHEK SOTCLIX LANCETDEVICE KIT ADJUSTABLE LANCING DEVICE ADVOCATE LANCING DEVICE ADVOCATE RAPID-SAE LANCING DEVICE TERNATE SITE LANCING DEVICE AQUA LANCE ADJUSTABLE LANCING DEVICE Name AUTO-LANCET AUTO-LANCET MINI AUTOLET II CLINISAE AUTOLET IMPRESSION AUTOLET IMPRESSION LANCING DEVICE AUTOLET LITE CLINISAE AUTOLET LITE STARTER CK AUTOLET MINI AUTOLET PLATORMS BAYER MICROLET 2 LANCING DEVICE BD LANCET DEVICE CARDIOM LANCING DEVICE CAREONE ADVANCED LANCINGDEVICE CLOSERCARE CVS LANCING DEVICE DROPLET LANCING DEVICE DRUG MART ADJUSTABLE LANCING DEVICE EASY MINI LANCING DEVICE EASY TOUCH LANCING DEVICE/EJECTOR ITY50 LANCING DEVICE ORA LANCING DEVICE REDS PHARMACY AUTOLET LANCING DEVICE REESTYLE NTROL SOLUTION 53

58 Name REESTYLE NTROL SOLUTION HIGH/LOW REESTYLE LASH SYSTEM REESTYLE REEDOM LITE REESTYLE INSULINX BLOODGLUSE MONITORING SYSTEM REESTYLE LITE BLOOD GLUSE MONITORING SYSTEM REESTYLE SYSTEM KIT GENTLE-LET PLATORMS 2.4MM GENTLE-LET PLATORMS 3.0MM GLOB LANCING DEVICE GLULET 2 AUTOMATIC LANCING DEVICE GLUSOURCE LANCET DEVICE GMATE LANCING DEVICE QL(1 ea per retail) QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail) QL(1 ea per retail) Name LANCET TRANSPORTER CASE LANCETS LANCING DEVICE LANCING DEVICE ADJUSTABLE LANZO LEADER ADVANCED LANCING DEVICE LIBERTY MINI LANCING DEVICE LITE TOUCH LANCING DEVICE LITE TOUCH LANCING PEN LIVE BETTER ADVANCED LANCING DEVICE MINI LANCING DEVICE MONOJECTOR END CAPS MONOJECTOR OPD END CAPS MULTI-LANCET DEVICE H-E-B INNTROL ADVANCEDLANCING DEVICE HETH CARE LANCING DEVICE HETHWISE LANCING PEN HETHY ACCENTS AUTOLET IMPRESSION LANCING DEVICE HYPOLANCE AST LANCING KIT KROGER LANCING DEVICE LANCET DEVICE ADJUSTABLE LANCET DEVICE WITH EJECTOR MULTI-LANCET DEVICE 2 NOVA SURELEX LANCING DEVICE ON CL LANCING DEVICE ON CL PLUS LANCING DEVICE ONETOUCH DELICA LANCING DEVICE ONETOUCH SURESOT LANCING DEVICE/18G ONETOUCH SURESOT LANCING DEVICE/21G ONETOUCH SURESOT LANCING DEVICE/28G ONETOUCH ULTRA 2 QL(1 ea per retail); 54

59 Name ONETOUCH ULTRA NTROL ONETOUCH ULTRA MINI ONETOUCH ULTRA SYSTEM KIT ONETOUCH ULTRASMART ONETOUCH VERIO IQ BLOOD GLUSE MONITORING SYSTEM ONETOUCH VERIO MID NTROL SOLUTION ONETOUCH VERIO SYNC BLOODGLUSE MONITORING SYSTEM PENLET II AUTOMATIC BLOODSAMPLER PENLET II REPLACEMENT CAPS PENLET II REPLACEMENT CAPS- DEEP PENLET II REPLACEMENT CAPS- REGULAR PRECISION GLUSE NTROL PRECISION GLUSE NTROLSOLUTION (TRI- LEVEL/HI/LO/NORM) PRECISION GLUSE KETONENTROL SOLUTION 1-LOW, 1- HIGH PRECISION GLUSE/KETONENT ROL SOLUTIONS 1-HI 1- LO PRECISION XTRA DEVI XX PRECISION XTRA KIT XX QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail) QL(1 ea per retail) Name PRODIGY LANCING DEVICE PSS SELECT PLATORMS PX ADVANCED LANCING DEVICE PX LANCET AUTO INJECTOR QC ADVANCED LANCING DEVICE RA LANCING DEVICE RELION LANCING DEVICE RENEW ADVANCED LANCING DEVICE RIGHTEST GD-L500 TERNATE SITE ADAPTER RIGHTEST GD500 LANCING DEVICE SELECT-LITE DEVICE/LANCETS SELECT-LITE LANCING DEVICE SHOPKO AUTOLET LANCING DEVICE SIMPLE DIAGNOSTICS LANCING DEVICE SMART DIABETES VANTAGE LANCING DEVICE SOLUS V2 LANCING DEVICE STERILANCE SURE MORT LANCING PEN SURE-PEN TGT ADVANCED LANCING DEVICE TGT LANCING DEVICE TODAYS HETH ADVANCED LANCING DEVICE 55

60 Name TRUEDRAW LANCING DEVICE ULTI-LANCE AUTO- ADJUST DEVICE ULTI-LANCE AUTOMATIC/ CLEAR TIP ULTI-LANCE MINI ADJUSTABLE DEVICE ULTILET OPERATING DEVICE ULTILET ULTI-LANCE ADJ DEVICE ULTRANCE UNISTIK 1 UNISTIK 2 UNISTIK 2 MORT UNISTIK 2 EXTRA UNISTIK 2 NEONAT UNISTIK 2 NORM UNISTIK 2 SUPER UNISTIK 3 UNISTIK 3 MORT UNISTIK 3 EXTRA UNISTIK 3 NEONAT UNISTIK 3 NORM UNISTIK CZT MORT UNISTIK CZT NORM VUE PLUS LANCING DEVICE VIDA MIA AUTOLET LANCINGDEVICE Parenteral Therapy Supplies Name CLEVER CHOICE MORT EZPEN NEEDLES 33GX4MM CLEVER CHOICE MORT EZPEN NEEDLES 33GX5MM CLEVER CHOICE MORT EZPEN NEEDLES 33GX6MM CLEVER CHOICE MORT EZPEN NEEDLES 33GX8MM EXCEL MORT POINT INSULIN PEN NEEDLES 31G X 4MM INSULIN SYRINGES AND PEN NEEDLES INSUPEN 33GX4MM Respiratory Therapy Supplies AEROCHAMBER MINI AEROSOLCHAMBER AEROCHAMBER MV AEROCHAMBER PLUS LOW VU AEROCHAMBER PLUS LOW-VU AEROCHAMBER PLUS LOW-VU/LARGE MASK AEROCHAMBER PLUS LOW-VU/MASK AEROCHAMBER PLUS LOW-VU/MEDIUM MASK AEROCHAMBER PLUS LOW-VU/SML MASK AEROCHAMBER Z-STAT PLUS VVED HOLDING CHAMBER W/LOW VU QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); 56

61 Name AEROCHAMBER Z-STAT PLUS/LOWSIGN AEROCHAMBER Z-STAT PLUS/LARGE MASK AEROCHAMBER Z-STAT PLUS/MEDIUM MASK AEROCHAMBER Z-STAT PLUS/SML MASK AEROCHAMBER/LOWSI GN AEROVENT PLUS HOLDING CHAMBER/LLAPSIBLE AIRZONE PEAK LOW METER ASSESS ULL RANGE PEAK LOW METER ASSESS LOW RANGE PEAK LOW METER ASSESS PEAK LOW METER ULL RANGE ASSESS PEAK LOW METER LOW RANGE ASTHMA CHECK METER- ZONE SYSTEM ASTHMAMENTOR E-Z SCER EASIVENT EASIVENT/MASK-LARGE EASIVENT/MASK- MEDIUM QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(1 ea per retail); Name EASIVENT/MASK-SML INSPIREASE DRUG DELIVERYSYSTEM MICROLIE DIGIT PEAK LOW METER MINI WRIGHT AS PEAK LOWMETER LOW RANGE MINI WRIGHT PEAK LOW METER OPTICHAMBER ADVANTAGE OPTICHAMBER ADVANTAGE/LARGE MASK OPTICHAMBER ADVANTAGE/MEDIUM ACE MASK OPTICHAMBER ADVANTAGE/SML ACE MASK OPTICHAMBER DIAMOND OPTICHAMBER DIAMOND/LARGEACE MASK OPTICHAMBER DIAMOND/MEDIUM ACE MASK OPTICHAMBER DIAMOND/SMLACE MASK OPTIHER OPTIHER MDI DRUG DELIVERY SYSTEM PEAK AIR PEAK LOW METERADULT/PEDIATRI C QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(1 ea per retail); QL(2 ea per retail); 57

62 Name PEAK LOW METER PERSON BEST ULL RANGE PERSON BEST LOW RANGE PIKO 1 ELECTRONIC POCKET PEAK LOW METER POCKETPEAK PEAK LOW METER LOW RANGE POCKETPEAK PEAK LOW METER/UNIVERS RANGE POCKETPEAK PEAK LOW METER/UNIVERS RANGE LPM TRUZONE PEAK LOW METER QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); QL(2 ea per retail); MIGRAINE PRODUCTS - s to Treat Migraine Headaches Migraine Combinations acetaminophenisometheptenedichloralphenazone CAERGOT MIGERGOT Migraine Products ERGOMAR Serotonin Agonists AMERGE (Use Naratriptan HCl) N QL(0.3 ea daily) Name IMITREX SOLN NA 20 MG/ACT, 5 MG/ACT (Use Sumatriptan) IMITREX SOLN SC 6 MG/0.5ML (Use Sumatriptan Succinate) IMITREX STATDOSE REILL 4 MG/0.5ML (Use Sumatriptan Succinate) IMITREX STATDOSE REILL 6 MG/0.5ML (Use Sumatriptan Succinate) IMITREX STATDOSE SYSTEM 4 MG/0.5ML (Use Sumatriptan Succinate) IMITREX STATDOSE SYSTEM 6 MG/0.5ML (Use Sumatriptan Succinate) IMITREX TABS OR 100 MG, 25 MG, 50 MG (Use Sumatriptan Succinate) naratriptan hcl sumatriptan sumatriptan succinate soaj sc 4 mg/0.5ml sumatriptan succinate soaj sc 6 mg/0.5ml sumatriptan succinate soct sc 4 mg/0.5ml sumatriptan succinate soct sc 6 mg/0.5ml SUMATRIPTAN SUCCINATE SOLN SC 4 MG/0.5ML sumatriptan succinate soln sc 6 mg/0.5ml SUMATRIPTAN SUCCINATE SOSY SC 6 MG/0.5ML sumatriptan succinate tabs or 100 mg, 25 mg, 50 mg N N N N N N N MINERS & ELECTROLYTES QL(6 ea per 30 days retail) QL(2 ml per 7 days retail) QL(0.29 ml daily,7 day(s) limit) QL(2 ml per 7 days retail) QL(0.29 ml daily,7 day(s) limit) QL(2 ml per 7 days retail) QL(9 ea per fill retail) QL(0.3 ea daily) QL(6 ea per 30 days retail) QL(0.29 ml daily,7 day(s) limit) QL(2 ml per 7 days retail) QL(0.29 ml daily,7 day(s) limit) QL(2 ml per 7 days retail) QL(0.29 ml daily,7 day(s) limit) QL(2 ml per 7 days retail) QL(2 ml per 7 days retail) QL(9 ea per fill retail) 58

63 Name Calcium CCI-CHEW Name CITRAC/VITAMIN D (Use Calcium Citrate- Vitamin D) N CCI-MIX EQL CCIUM/VITAMIN D calcium carbonate chew 1250 mg calcium carbonate tabs 1250 mg, 500 mg, 600 mg, 600mg calcium carbonatecholecalciferol caps 600mg-500unit calcium carbonatecholecalciferol chew 500mg-400unit calcium carbonatecholecalciferol tabs 500mg- 200unit, 500mg-600unit calcium carbonateergocalciferol calcium carbonate-vitamin d tabs 125unit-250mg, 125unit-500mg, 200unit- 500mg, 250mg-125unit, 400unit-600mg, 500mg- 125unit, 500mg-200unit, 500mg-500mg-200unit- 200unit, 600mg-400unit CCIUM CITRATE MATE/VITAMIN D calcium citrate tabs 200 mg, 950 mg calcium citrate-vitamin d 250mg-200unit, 315mg- 200unit CCIUM GLUNATE TABS OR 500 MG, 648 MG CCIUM LACTATE 648 MG, 750 MG calcium w/ vitamin d CCIUM/VITAMIN D CCIUM/VITAMIN D3 oyster shell RVA-C RA CCIUM HI- C/VITAMIND RA OYSTER SHELL CCIUM/VITAMIN D luoride LURA-DROPS LOZI-LUR LURIDE CHEW 0.25 MG, 0.5 MG, 1 MG (Use Sodium luoride) LURIDE SOLN 0.5 MG/ML (Use Sodium luoride) MONOC sodium fluoride chew 0.25 mg, 0.5 mg, 1 mg, 1.1 mg, 2.2 mg sodium fluoride soln mg/drop sodium fluoride soln 0.5 mg/ml SODIUM LUORIDE TABS 0.5 MG, 1 MG Iodine Products POTASSIUM IODIDE SSKI Magnesium magnesium chloride tbcr or 535 mg, 64 mg Phosphate K-PHOS N N QL(50 ml per fill retail) QL(50 ml per fill retail) 59

64 Name K-PHOS NEUTR (Use Pot Phosphate Monobasic w/ Sod Phosphate Dibasic & Monobasic) pot phosphate monobasic w/ sod phosphate dibasic & monobasic Potassium K-TAB 10 MEQ (Use Potassium Chloride) K-TAB 8 MEQ MICRO-K 10 MEQ (Use Potassium Chloride) potassium bicarb & chloride potassium bicarbonate potassium chloride cpcr or 10 meq POTASSIUM CHLORIDE ER 8 MEQ potassium chloride liqd or 10 %, 20 % potassium chloride microencapsulated crystals cr potassium chloride pack or 20 meq potassium chloride soln or 10 %, 20 % potassium chloride tbcr or 10 meq, 8 meq N N N MOUTH/THROAT/DENT AGENTS Anesthetics Topical Oral IRST-MOUTHWASH BLM lidocaine hcl (mouth-throat) 2 % Anti-infectives - Throat clotrimazole Name triamcinolone acetonide (mouth) Throat Products - Misc. pilocarpine hcl (oral) SAGEN (Use Pilocarpine HCl (Oral)) MULTIVITAMINS B-Complex w/ olic Acid b-complex w/ c & folic acid caps 1.5mg-5mg-20mg- 1.7mg-6mcg-1mg-150mcg- 10mg-100mg, 1.7mg-5mg- 6mcg-1.5mg-20mg-1mg- 150mcg-10mg-100mg NEPHROCAPS (Use B- Complex w/ C & olic Acid) Iron w/ Vitamins iron w/ vitamins tabs 2mg- 100mg-4mg-60mg-4.8mg- 3mcg-10mg-1mg-150mg, 2mg-100mg-4mg-60mg- 4.8mg-3mcg-10mg-31mg- 150mg, 400unit-30mg- 10mg-2mg-1mg-4000unit- 2mcg-1mg-0.8mg-25mg- 100mg Ped MV w/ luoride pediatric multivitamins w/fl pediatric vitamins acd w/ fluoride POLY-VI-LOR CHEW 200MCG-0.25MG-15UNIT- 400UNIT, 200MCG-0.5MG- 15UNIT-400UNIT, 200MCG-1MG-15UNIT- 400UNIT QULORA PEDIATRIC Ped MV w/ Iron N N nystatin (mouth-throat) Steroids - Mouth/Throat 60

65 Name pediatric multiple vitamins w/ iron soln 0.6mg/ml- 10mg/ml-5unit/ml-8mg/ml- 1500unit/ml-400unit/ml- 0.5mg/ml-0.4mg/ml- 35mg/ml, 1500unit/ml- 10mg/ml-5unit/ml- 400unit/ml-8mg/ml- 0.6mg/ml-0.5mg/ml- 0.4mg/ml-35mg/ml Ped Multi Vitamins w/l & E ped multivitamins w/fl & iron POLY-VI-LOR/IRON CHEW 200MCG-0.5MG- 10MG-15UNIT-400UNIT Name MPLETENATE CVS PRENAT CVS PRENAT GUMMY/DHA/OLIC ACID CVS PRENAT MULTI+DHA CVS WOMENS PRENAT+DHA ENAMIL EXPECTA EQL PRENAT ORMULA EZE ORTE TRI-VIT/LUORIDE/IRON GNP DAILY PRENAT Pediatric Multiple Vitamins pediatric multiple vitamin w/ c Pediatric Vitamins pediatric vitamins adc TRI-VI-SOL Prenatal Vitamins ATABEX EC GNP PRENAT GNP PRENAT VITAMINS GOODSENSE PRENAT VITAMINS HETHY MAMA BE WELL ROUNDED HM ONE DAILY PRENAT MBO HM PRENAT ATABEX PRENAT BRAINSTRONG PRENAT INAT ADVANCE INAT GT CNA CENTRUM SPECIIST PRENAT CLASSIC PRENAT CLINIC NUTRIENTS PRENAT ORMULA INAT ULTRA KP PRENAT MULTIVITAMINS KPN PRENAT M-VIT -NAT A MARNAT- MPLETE NAT DHA MISSION PRENAT MPLETE PRENAT MULTI PRENAT 61

66 Name Name MYNAT PNV-VP-U MYNAT ADVANCE PRE-NAT ORMULA MYNAT PLUS PRENAPLUS MYNAT ULTRACAPLET PRENATA MYNAT-Z PRENATABS A MYNATE 90 PLUS PRENATABS RX NAT-RUL PRENAT VITAMINS NAT-V RX NATVIT NIVA-PLUS NUTRICION PORVIDA O-C A O-C PRENAT OBSTETRIX EC OBTREX ONE A DAY WOMENS PRENAT/DHA ONE A DAY WOMENS PRENAT1 ONE-A-DAY WOMENS PRENAT PRENAT ORMULA PERRY PRENAT PNV ERROUS UMARATE/DOCUSATE/ OLIC ACID PNV OLIC ACID + IRON MULTIVITAMIN PNV PRENAT PLUS MULTIVITAMIN PNV TABS 29-1 PRENAT 11UNIT- 263MG-25MG-1.5MG- 27MG-4000UNIT-18MG- 1.7MG-4MCG-400UNIT- 0.8MG-2.6MG-100MG, 3.75UNIT-0.5MG-50MG- 0.5MG-25MG-15MG- 3.75MG-6.75MG-2.5MG- 5MG-0.75MG-500UNIT- 2.5MCG-0.5MG-200MCG- 25MCG-0.75MG-100UNIT, 30UNIT-4000UNIT-25MG- 1.8MG-200MG-28MG- 20MG-1.7MG-8MCG- 400UNIT-800MCG-2.6MG- 120MG, 4000UNIT- 30UNIT-200MG-25MG- 1.8MG-28MG-20MG- 1.7MG-8MCG-400UNIT- 800MCG-2.6MG-120MG, 4000UNIT-30UNIT-25MG- 1.8MG-200MG-28MG- 20MG-1.7MG-8MCG- 400UNIT-800MCG-2.6MG- 120MG PRENAT 19 PRENAT 22MG-2MG- 25MG-1.84MG-200MG- 27MG-4000UNIT-20MG- 3MG-12MCG-400UNIT- 1MG-10MG-120MG PRENAT 4000UNIT- 200MG-11UNIT-27MG- 25MG-1.84MG-18MG- 1.7MG-4MCG-400UNIT- 0.8MG-2.6MG-100MG 62

67 Name Name PRENAT AD PRENAT+DHA PRENAT AND IRON PRENAT-U PRENAT MPLETE PRENAT ORMULA PRENAT ORMULA A- REE PRENAT/OMEGA- 3/OLIC ACID/IRON PREPLUS PRETAB PRENAT ORTE PROE ORTE PRENAT LOW IRON 200MG-22UNIT-2MG- 25MG-1.84MG-27MG- 4000UNIT-20MG-3MG- 12MCG-400UNIT-1MG- 10MG-120MG, 4000UNIT- 200MG-22MG-2MG-25MG- 1.84MG-27MG-20MG- 3MG-12MCG-400UNIT- 10MG-1MG-120MG PRENAT LOW IRON 25MG-1.5MG-200MG- 27MG-4000UNIT-18MG- 1.7MG-4MCG-400UNIT- 0.8MG-11MG-2.6MG- 100MG PUREE OB PLUS PX PRENAT MULTIVITAMINS QC PRENAT RA ONE DAILY RA PRENAT RA PRENAT ORMULA/OLICACID RIGHT STEP PRENAT SE-NAT 19 PRENAT MULTI + DHA PRENAT MULTI +DHA PRENAT MULTIVITAMIN + DHA PRENAT ONE DAILY PRENAT PLUS PRENAT PLUS DHA PRENAT PLUS IRON PRENAT VITAMIN PRENAT VITAMINS PRENAT VITAMINS PLUS SIMILAC PRENAT EARLY SHIELD SM ONE DAILY PRENAT SM PRENAT VITAMINS STUART ONE STUART PRENAT TARON-BC TH PRENAT VITAMINS THERANAT MPLETE THERANAT RE NUTRITION THERANAT PLUS 63

68 Name THRIVITE 19 Name VOL-PLUS TL OLATE VOL-TAB RX TRIADVANCE TRICARE TRINAT GT TRINAT RX 1 TRINAT ULTRA WEGMANS MPLETE PRENAT+DHA YOUR LIE MULTI PRENAT MUSCULOSKELET THERAPY AGENTS - s to Treat Spasms Central Muscle Relaxants baclofen TRINATE carisoprodol 350 mg ULTRA TABS cyclobenzaprine hcl VENAT-A VINATE AZ EXTRA VINATE CCIUM VINATE GT VINATE IC VINATE II VINATE M VINATE ONE VINATE ULTRA VIRT NATE VIRT-ADVANCE VIRT-VITE GT VITA-PREN VITAOL-OB VITAOL-PN VOL-NATE EXMID (Use Cyclobenzaprine HCl) methocarbamol tabs or 500 mg, 750 mg ROBAXIN TABS OR 500 MG (Use Methocarbamol) ROBAXIN-750 (Use Methocarbamol) SOMA 350 MG (Use Carisoprodol) Direct Muscle Relaxants DANTRIUM 25 MG, 50 MG (Use Dantrolene Sodium) DANTROLENE SODIUM CAPS OR 100 MG dantrolene sodium caps or 25 mg, 50 mg N N N N N NAS AGENTS - SYSTEMIC AND TOPIC - s to treat the Nose or Sinus Nasal Agents - Misc. OCEAN NAS SPRAY (Use Saline) saline soln na 0.65 %, 0.65%, 0.65%-0.002% Nasal Antiallergy ASTEPRO (Use Azelastine HCl) N N QL(60 ml per 30 days retail) 64

69 Name azelastine hcl 0.1 % azelastine hcl 0.15 % Nasal Anticholinergics ATROVENT (Use Ipratropium Bromide (Nasal)) ipratropium bromide (nasal) Nasal Steroids LONASE (Use luticasone Propionate (Nasal)) LONASE LERGY RELIE LUNISOLIDE flunisolide (nasal) fluticasone propionate (nasal) N N Sympathomimetic Decongestants NAS DENGESTANT pseudoephedrine hcl liqd 15 mg/5ml pseudoephedrine hcl tabs 30 mg, 60 mg SUDAED (Use Pseudoephedrine HCl) SUDAED CHILDRENS (Use Pseudoephedrine HCl) SUDAED NGESTION (Use Pseudoephedrine HCl) SUDAED NAS DENGESTANT MAXIMUM STRENGTH (Use Pseudoephedrine HCl) N N N N QL(2 ml daily) QL(60 ml per 30 days retail) QL(32 ml per fill retail,32 ml per 30 days retail); QL(32 ml per fill retail,32 ml per 30 days retail); QL(50 ml per 30 days retail) QL(1.67 ml daily) QL(32 ml per fill retail,32 ml per 30 days retail); Name SUDAED PE CHILDRENS NAS DENGESTANT NEUROMUSCULAR AGENTS - s to Relax/Paralyze Muscles Neuromuscular Blocking Agent - Neurotoxins BOTOX DYSPORT MYOBLOC XEOMIN NUTRIENTS Misc. Nutritional Substances ATABEX DHA docosahexaenoic acid 200 mg EXPECTA LIPIL (Use Docosahexaenoic Acid) N OPHTHMIC AGENTS - s to Treat the Eye Artificial Tears and Lubricants NUTRATEAR polyvinyl alcohol Beta-blockers - Ophthalmic BETAGAN (Use Levobunolol HCl) betaxolol hcl (ophth) BETOPTIC-S SOPT (Use Dorzolamide HCl-Timolol Maleate) dorzolamide hcl-timolol maleate ISTOL LEVOBUNOLOL HCL N N 65

70 Name Name levobunolol hcl PHOSPHOLINE IODIDE METIPRANOLOL pilocarpine hcl timolol maleate (ophth) TIMOPTIC (Use Timolol Maleate (Ophth)) TIMOPTIC OCUDOSE TIMOPTIC-XE (Use Timolol Maleate (Ophth)) Cycloplegic Mydriatics atropine sulfate (ophthalmic) ATROPINE SULATE OINT OP 1 % CYCLOGYL 0.5 % CYCLOGYL 1 %, 2 % (Use Cyclopentolate HCl) CYCLOMYDRIL cyclopentolate hcl homatropine hbr ISOPTO ATROPINE (Use Atropine Sulfate (Ophthalmic)) ISOPTO HOMATROPINE 2 % ISOPTO HOMATROPINE 5 % (Use Homatropine HBr) ISOPTO HYOSCINE MYDRIACYL (Use Tropicamide) tropicamide Miotics ISOPTO CARBACHOL ISOPTO CARPINE (Use Pilocarpine HCl) N N N N N N N Ophthalmic - Angiogenesis Inhibitors LUCENTIS Ophthalmic Adrenergic Agents PHAGAN P 0.1 % PHAGAN P 0.15 % (Use Brimonidine Tartrate) apraclonidine hcl brimonidine tartrate IOPIDINE 0.5 % (Use Apraclonidine HCl) IOPIDINE 1 % Ophthalmic Anti-infectives BACITRACIN OINT OP 500 UNIT/GM bacitracin-polymyxin b (ophth) BLEPH-10 (Use Sulfacetamide Sodium (Ophth)) CILOXAN OINT CILOXAN SOLN (Use Ciprofloxacin HCl (Ophth)) ciprofloxacin hcl (ophth) erythromycin (ophth) GARAMYCIN 0.3 % (Use Gentamicin Sulfate (Ophth)) gatifloxacin (ophth) gentamicin sulfate (ophth) NATACYN neomycin-bacitracin znpolymyxin N N N N N 66

71 Name neomycin-polymyxingramicidin NEOSPORIN (Use Neomycin-Polymyxin- Gramicidin) OCULOX (Use Ofloxacin (Ophth)) ofloxacin (ophth) polymyxin b-trimethoprim POLYTRIM (Use Polymyxin B-Trimethoprim) sulfacetamide sodium (ophth) SULACETAMIDE SODIUM OINT OP N N N Name CAINE (Use Proparacaine HCl) proparacaine hcl tetracaine hcl (ophth) Ophthalmic Steroids bacitracin-poly-neomycinhc BLEPHAMIDE BLEPHAMIDE S.O.P. dexamethasone sodium phosphate (ophth) fluorometholone (ophth) N tobramycin (ophth) ML TOBREX OINT ML ORTE TOBREX SOLN (Use Tobramycin (Ophth)) N ML LIQUIILM (Use luorometholone (Ophth)) N trifluridine MAXIDEX VIROPTIC (Use Trifluridine) ZYMAXID (Use Gatifloxacin (Ophth)) Ophthalmic Decongestants MYDRIN (Use Phenylephrine HCl (Ophth)) NAPHAZOLINE HCL naphazoline w/ pheniramine 0.025%-0.3% NAPHN-A (Use Naphazoline w/ Pheniramine) phenylephrine hcl (ophth) 2.5 % N N N N Ophthalmic Immunomodulators RESTASIS Ophthalmic Local Anesthetics MAXITROL (Use Neomycin-Polymy- Dexameth) neomycin-polymydexameth NEOMYCIN/POLYMYXIN/ HYDRORTISONE OMNIPRED (Use Prednisolone Acetate (Ophth)) PRED ORTE (Use Prednisolone Acetate (Ophth)) PRED MILD PRED-G PRED-G S.O.P. prednisolone acetate (ophth) N N N 67

72 Name PREDNISOLONE SODIUM PHOSPHATE SOLN OP 1 % sulfacetamide sodprednisolone TOBRADEX SUSP (Use Tobramycin- Dexamethasone) tobramycindexamethasone Ophthalmics - Misc. ACULAR (Use Ketorolac Tromethamine (Ophth)) ACULAR LS (Use Ketorolac Tromethamine (Ophth)) azelastine hcl (ophth) BROMDAY bromfenac sodium (ophth) CYSTARAN dorzolamide hcl ENUCLENE flurbiprofen sodium ketorolac tromethamine (ophth) ketotifen fumarate (ophth) MURO 128 OINT 5 % (Use Sodium Chloride Hypertonic) N N N N QL(2.15 ml daily) Name sodium chloride hypertonic TRUSOPT (Use Dorzolamide HCl) ZADITOR (Use Ketotifen umarate (Ophth)) Prostaglandins - Ophthalmic BIMATOPROST latanoprost LUMIGAN XATAN (Use Latanoprost) N N N OTIC AGENTS - s to Treat the Ear Otic Agents - Miscellaneous acetic acid (otic) ACETIC ACID/UMINUM ACETATE carbamide peroxide (otic) CRESYLATE DEBROX (Use Carbamide Peroxide (Otic)) Otic Analgesics PINNACAINE OTIC Otic Anti-infectives CIPROLOXACIN ofloxacin (otic) N QL(0.09 ml daily) QL(0.09 ml daily) QL(0.09 ml daily) QL(0.09 ml daily) MURO 128 SOLN 2 % MURO 128 SOLN 5 % (Use Sodium Chloride Hypertonic) OCUEN (Use lurbiprofen Sodium) OPTIVAR (Use Azelastine HCl (Ophth)) N N N Otic Combinations antipyrine-benzocaine 1.4%-5.4%, 14mg/ml- 54mg/ml RTANE-B AQUEOUS RTANE-B-OTIC (Use Pramoxine-HC- Chloroxylenol) N 68

73 Name RTISPORIN SOLN OT 10000UNIT/ML-3.5MG/ML- 1% (Use Neomycin- Polymyxin-HC (Otic)) neomycin-polymyxin-hc (otic) OTICIN HC NR (Use Pramoxine-HC- Chloroxylenol) pramoxine-hc-chloroxylenol pramoxine-hc-chloroxylenol aqueous N N OXYTOCICS - s to Prevent/Control Uterine Bleeding Oxytocics methylergonovine maleate tabs or 0.2 mg SSIVE IMMUNIZING AGENTS - Antibody s to Treat Low Immune System Monoclonal Antibodies SYNAGIS PENICILLINS - s to Treat Bacterial Infections Aminopenicillins amoxicillin caps 250 mg, 500 mg AMOXICILLIN CHEW 125 MG, 250 MG amoxicillin susr 125 mg/5ml, 200 mg/5ml, 250 mg/5ml, 400 mg/5ml amoxicillin tabs 500 mg AMPICILLIN ampicillin Natural Penicillins penicillin v potassium Penicillin Combinations amoxicillin & pot clavulanate Name AUGMENTIN ES-600 (Use Amoxicillin & Pot Clavulanate) AUGMENTIN SUSR 125MG/5ML-31.25MG/5ML AUGMENTIN SUSR 250MG/5ML-62.5MG/5ML (Use Amoxicillin & Pot Clavulanate) AUGMENTIN TABS 500MG-125MG, 875MG- 125MG (Use Amoxicillin & Pot Clavulanate) AUGMENTIN XR (Use Amoxicillin & Pot Clavulanate) N N N N Penicillinase-Resistant Penicillins dicloxacillin sodium PROGESTINS - Hormone Replacement/Modifying s Progestins AYGESTIN (Use Norethindrone Acetate) MAKENA medroxyprogesterone acetate norethindrone acetate PROVERA (Use Medroxyprogesterone Acetate) N N PSYCHOTHERAPEUTIC AND NEUROLOGIC AGENTS - MISC. - s to Treat Mental and Emotional Conditions Agents for Chemical Dependency acamprosate calcium ANTABUSE (Use Disulfiram) CAMPR (Use Acamprosate Calcium) disulfiram Antidementia Agents N 69

74 Name ARICEPT (Use Donepezil Hydrochloride) ARICEPT ODT (Use Donepezil Hydrochloride) donepezil hydrochloride EXELON CAPS OR 1.5 MG, 3 MG, 4.5 MG, 6 MG (Use Rivastigmine Tartrate) EXELON PT24 TD 13.3 MG/24HR, 4.6 MG/24HR, 9.5 MG/24HR EXELON SOLN OR 2 MG/ML GANTAMINE HYDROBROMIDE galantamine hydrobromide NAMENDA TABS 10 MG, 5 MG NAMENDA XR NAMENDA XR TITRATION CK RAZADYNE ER (Use Galantamine Hydrobromide) RAZADYNE TABS 12 MG, 4 MG, 8 MG (Use Galantamine Hydrobromide) rivastigmine tartrate N N N N N Combination Psychotherapeutics CHLORDIAZEPOXIDE/AMI TRIPTYLINE olanzapine-fluoxetine hcl PERPHENAZINE/AMITRIP TYLINE SYMBYAX (Use Olanzapine-luoxetine HCl) Movement Disorder Therapy XENAZINE Name Multiple Sclerosis Agents AMPYRA AVONEX AVONEX PEN BETASERON XONE 20 MG/ML (Use Glatiramer Acetate) XONE 40 MG/ML EXTAVIA glatiramer acetate LEMTRADA PLEGRIDY PLEGRIDY STARTER CK REBI REBI REBIDOSE REBI REBIDOSE TITRATIONCK REBI TITRATION CK TYSABRI N Premenstrual Dysphoric Disorder (PMDD) Agents fluoxetine hcl (pmdd) 10 QL(30 ea per mg fill retail) fluoxetine hcl (pmdd) 20 QL(60 ea per mg 30 days retail) Pseudobulbar Affect (PBA) Agents NUEDEXTA Psychotherapeutic and Neurological Agents - ergoloid mesylates ORAP Smoking Deterrents 70

75 Name bupropion hcl (smoking deterrent) CHANTIX CHANTIX NTINUING MONTHK CHANTIX STARTING MONTH K NIDERM CQ (Use Nicotine) NIRETTE (Use Nicotine Polacrilex) NIRETTE MINI (Use Nicotine Polacrilex) NIRETTE STARTER KIT (Use Nicotine Polacrilex) nicotine nicotine polacrilex NITINE TRANSDERM SYSTEM NITROL INHER NITROL NS ZYBAN (Use Bupropion HCl (Smoking Deterrent)) N N N N N QL(180 ea per retail) QL(180 ea per retail) QL(180 ea per retail) RESPIRATORY AGENTS - MISC. - s to Treat Lung Conditions Alpha-Proteinase Inhibitor (Human) ARAST NP GLASSIA PROLASTIN-C ZEMAIRA Cystic ibrosis Agents KYDE PULMOZYME Name SULONAMIDES - s to Treat Bacterial Infections Sulfonamides SULADIAZINE TETRACYCLINES - s to Treat Bacterial Infections Tetracyclines doxycycline (monohydrate) susr 25 mg/5ml doxycycline hyclate caps or 100 mg, 50 mg doxycycline hyclate tabs or 100 mg MINOCIN (Use Minocycline HCl) minocycline hcl caps 100 mg, 50 mg, 75 mg TETRACYCLINE HCL VIBRAMYCIN CAPS 100 MG (Use Doxycycline Hyclate) VIBRAMYCIN SUSR 25 MG/5ML (Use Doxycycline (Monohydrate)) VIBRAMYCIN SYRP 50 MG/5ML N N N THYROID AGENTS - s to Regulate Thyroid Hormones Antithyroid Agents methimazole propylthiouracil TAZOLE (Use Methimazole) Thyroid Hormones ARMOUR THYROID CYTOMEL 25 MCG, 50 MCG (Use Liothyronine Sodium) CYTOMEL 5 MCG N N 71

76 Name levothyroxine sodium liothyronine sodium tabs or 25 mcg, 5 mcg, 50 mcg NATURE-THROID 130 MG, MG, 195 MG, 32.5 MG, 65 MG NATURE-THROID NT-2.5 SYNTHROID thyroid THYROLAR-1 THYROLAR-1/2 THYROLAR-1/4 THYROLAR-2 THYROLAR-3 WESTHROID 130 MG, MG, MG, 195 MG, 32.5 MG, 65 MG WESTHROID-P 130 MG, MG, 32.5 MG, 65 MG WP THYROID 130 MG, MG, 32.5 MG, 65 MG ULCER DRUGS - s to Treat Bowel, Intestine and Stomach Conditions Antispasmodics ANASZ (Use Hyoscyamine Sulfate) belladonna alkaloidsphenobarbital BENTYL CAPS OR 10 MG (Use Dicyclomine HCl) BENTYL TABS OR 20 MG (Use Dicyclomine HCl) chlordiazepoxide hclclidinium bromide CUVPOSA N N N Name dicyclomine hcl DICYCLOMINE HCL DONNAT ELIX MG/5ML MG/5ML MG/5ML- 16.2MG/5ML glycopyrrolate tabs or 1 mg, 2 mg hyoscyamine sulfate LEVBID (Use Hyoscyamine Sulfate) LEVSIN TABS OR MG (Use Hyoscyamine Sulfate) LEVSIN/SL (Use Hyoscyamine Sulfate) LIBRAX (Use Chlordiazepoxide HCl- Clidinium Bromide) PRONTHELINE BROMIDE ROBINUL ORTE (Use Glycopyrrolate) ROBINUL TABS OR 1 MG (Use Glycopyrrolate) SYMAX DUOTAB H-2 Antagonists cimetidine 200 mg cimetidine 300 mg, 400 mg cimetidine 800 mg cimetidine hcl famotidine tabs 10 mg, 40 mg famotidine tabs 20 mg PEPCID AC CHEW PEPCID AC EZ CHEWS MAXIMUM STRENGTH N N N N N N QL(4 ea daily) QL(2 ea daily) 72

77 Name PEPCID AC MAXIMUM STRENGTH (Use amotidine) PEPCID AC TABS (Use amotidine) PEPCID TABS 20 MG (Use amotidine) PEPCID TABS 40 MG (Use amotidine) ranitidine hcl caps or 150 mg, 300 mg ranitidine hcl syrp or 15 mg/ml, 150 mg/10ml, 75 mg/5ml ranitidine hcl tabs or 150 mg ranitidine hcl tabs or 300 mg ranitidine hcl tabs or 75 mg TAGAMET HB (Use Cimetidine) ZANTAC 150 MAXIMUM STRENGTH (Use Ranitidine HCl) ZANTAC 75 (Use Ranitidine HCl) ZANTAC SYRP OR 15 MG/ML (Use Ranitidine HCl) ZANTAC TABS OR 150 MG (Use Ranitidine HCl) ZANTAC TABS OR 300 MG (Use Ranitidine HCl) Misc. Anti-Ulcer CARAATE SUSP 1 GM/10ML CARAATE TABS 1 GM (Use Sucralfate) sucralfate Proton Pump Inhibitors CVS OMEPRAZOLE N N N N N N N N N N N QL(2 ea daily) QL(2 ea daily) QL(2 ea daily) Name EQL OMEPRAZOLE IRST-LANSOPRAZOLE IRST-OMEPRAZOLE GNP OMEPRAZOLE HM OMEPRAZOLE KLS OMEPRAZOLE lansoprazole 15 mg lansoprazole 30 mg omeprazole OMEPRAZOLE OMEPRAZOLE + SYRSPEND SKA pantoprazole sodium tbec or 20 mg, 40 mg PREVACID 15 MG (Use Lansoprazole) PREVACID 24HR (Use Lansoprazole) PREVACID 30 MG (Use Lansoprazole) PREVACID SOLUTAB PRILOSEC CPDR 10 MG, 20 MG, 40 MG (Use Omeprazole) PRILOSEC OTC PROTONIX TBEC OR 20 MG, 40 MG (Use Pantoprazole Sodium) PX OMEPRAZOLE RA OMEPRAZOLE SB OMEPRAZOLE N N N N N ; ; ; ST; QL(1 ea daily); EQ OMEPRAZOLE SM OMEPRAZOLE 73

78 Name SW OMEPRAZOLE TGT OMEPRAZOLE Ulcer s - Prostaglandins CYTOTEC (Use Misoprostol) misoprostol Ulcer Therapy Combinations amoxicillin-clarithromycin w/ lansoprazole HELIDAC PREVC (Use Amoxicillin-Clarithromycin w/ Lansoprazole) N N QL(112 ea per fill retail) QL(224 ea per fill retail) QL(112 ea per fill retail) URINARY ANTI-INECTIVES - s to Treat Bladder/Kidney Infections Urinary Anti-infective Combinations methenamine-hyoscmethylene blue-sod phosphenyl sal tabs 40.8mg- 0.12mg-36.2mg-81.6mg- 10.8mg, 40.8mg-36.2mg- 0.12mg-81.6mg-10.8mg Urinary Anti-infectives URADANTIN (Use Nitrofurantoin) MACROBID (Use Nitrofurantoin Monohyd Macro) MACRODANTIN 100 MG, 50 MG (Use Nitrofurantoin Macrocrystal) MACRODANTIN 25 MG N N N Name Urinary Antispasmodic - Antimuscarinics DETROL (Use Tolterodine N Tartrate) DETROL LA (Use N Tolterodine Tartrate) DITRON XL (Use N Oxybutynin Chloride) oxybutynin chloride SANCTURA (Use Trospium Chloride) SANCTURA XR (Use Trospium Chloride) tolterodine tartrate cp24 2 mg, 4 mg tolterodine tartrate tabs 1 mg, 2 mg trospium chloride N N Urinary Antispasmodics - Cholinergic Agonists bethanechol chloride URECHOLINE (Use Bethanechol Chloride) N VAGIN PRODUCTS - s to Treat Vaginal Infections and Low Hormones Spermicides ENCARE OPTIONS NCEPTROL VAGIN NTRACEPTIVE OPTIONS GYNOL II VAGINNTRACEPTIV E SHUR-SE nitrofurantoin nitrofurantoin macrocrystal nitrofurantoin monohyd macro URINARY ANTISSMODICS - s to Treat Miscellaneous Bladder Spasms TODAY SPONGE VC VAGIN NTRACEPTIVE ILM VC VAGIN NTRACEPTIVE OAM Vaginal Anti-infectives AVC 74

79 Name CLEOCIN CREA VA 2 % (Use Clindamycin Phosphate Vaginal) clindamycin phosphate vaginal CLINDESSE clotrimazole vaginal 1 % N Name AUVI-Q EPINEPHRINE EPIPEN 2-K EPIPEN-JR 2-K QL(2 ea per fill retail) QL(2 ea per fill retail) QL(2 ea per fill retail) QL(2 ea per fill retail) GYNE-LOTRIMIN (Use Clotrimazole Vaginal) METROGEL-VAGIN (Use Metronidazole Vaginal) metronidazole vaginal miconazole nitrate vaginal crea 2 %, 4 % miconazole nitrate vaginal kit miconazole nitrate vaginal supp 100 mg MONISTAT 3 (Use Miconazole Nitrate Vaginal) MONISTAT 3 MBINATION CK (Use Miconazole Nitrate Vaginal) MONISTAT 7 SIMPLY CURE (Use Miconazole Nitrate Vaginal) tioconazole vaginal VAGISTAT-1 (Use Tioconazole Vaginal) Vaginal Estrogens ESTRACE CREA VA 0.1 MG/GM PREMARIN CREA VA MG/GM N N N N N N VASOPRESSORS - s to Treat Heart and Circulation Conditions Anaphylaxis Therapy Agents ADRENACLICK QL(2 ea per fill retail) VITAMINS Oil Soluble Vitamins BABY DDROPS (Use Cholecalciferol) cholecalciferol caps 1000 unit, 2000 unit, 5000 unit cholecalciferol liqd 400 unt/0.03ml cholecalciferol tabs 1000 unit, 2000 unit, 400 unit, 5000 unit DRISDOL CAPS UNIT (Use Ergocalciferol) ergocalciferol caps unit MEPHYTON phytonadione tabs or 100 mcg VITAMIN A TABS 10000UNIT-1000UNIT Water Soluble Vitamins niacin cpcr 250 mg niacin tabs 100 mg, 50 mg, 500 mg niacin tbcr 500 mg POTABA pyridoxine hcl tabs or 100 mg, 25 mg, 50 mg SLO-NIACIN 500 MG (Use Niacin) N N N 75

80 Index abacavir sulfate 26 abacavir sulfate-lamivudinezidovudine 26 ABILIY 25 ABILIY DISCMELT 25 ABILIY MAINTENA 25 acamprosate calcium 69 acarbose 15 ACCU-CHEK ASTCLIX LANCETDEVICE KIT ACCU-CHEK MULTICLIX 53 LANCET DEVICE KIT ACCU-CHEK SOTCLIX 53 LANCETDEVICE ACCU-CHEK SOTCLIX 53 LANCETDEVICE KIT 53 ACCUNEB 11 ACCUPRIL 20 ACCURETIC 21 acebutolol hcl 29 acetaminophen 100 mg/ml, 160 mg/5ml, 80 mg/0.8ml 4 acetaminophen 120 mg 4 acetaminophen 160 mg, 80 mg 4 acetaminophen 160 mg/5ml 4 acetaminophen 160 mg/5ml, 80 mg/0.8ml, 80 mg/2.5ml 4 acetaminophen 160 mg/5ml, 80 mg/2.5ml acetaminophen w/ codeine 4 120mg/5ml-12mg/5ml acetaminophen w/ codeine 6 300mg-15mg, 300mg-60mg acetaminophen w/ codeine 6 300mg-30mg 6 acetaminophen-isometheptenedichloralphenazone 58 ACETAZOLAMIDE 42 acetazolamide 42 acetic acid (otic) 68 acetic acid 0.25 % 46 ACETIC ACID/UMINUM ACETATE 68 acetylcysteine 35 ACNE MEDICATION 35 ACNE MEDICATION ACTEMRA 200 MG/10ML, 400 MG/20ML, 80 MG/4ML 2 ACTIGL 45 ACTOPLUS MET 15 ACTOS 15 ACULAR 68 ACULAR LS 68 acyclovir 27 acyclovir topical 38 ADAT CC 29 adapalene 0.1 % 35 adapalene 0.1 %, 0.3 % 35 ADASUVE 25 ADCIRCA 30 ADDERL 1 ADDERL XR 1 adefovir dipivoxil 27 ADIPEX-P 1 ADJUSTABLE LANCING DEVICE 53 ADRENACLICK 75 ADVAIR DISKUS 11 ADVAIR HA 11 ADVATE 46 ADVIR 19 ADVIL 2 ADVIL LERGY & NGESTION 33 ADVIL MIGRAINE 2 ADVOCATE LANCING DEVICE 53 ADVOCATE RAPID-SAE LANCING DEVICE AEROCHAMBER MINI 53 AEROSOLCHAMBER 56 AEROCHAMBER MV 56 AEROCHAMBER PLUS LOW VU AEROCHAMBER PLUS 56 LOW-VU AEROCHAMBER PLUS 56 LOW-VU/LARGE MASK 56 AEROCHAMBER PLUS LOW-VU/MASK AEROCHAMBER PLUS 56 LOW-VU/MEDIUM MASK56 AEROCHAMBER PLUS LOW-VU/SML MASK 56 AEROCHAMBER Z-STAT PLUS VVED HOLDING CHAMBER W/LOW VU 56 AEROCHAMBER Z-STAT PLUS/LOWSIGN 57 AEROCHAMBER Z-STAT PLUS/LARGE MASK 57 AEROCHAMBER Z-STAT PLUS/MEDIUM MASK 57 AEROCHAMBER Z-STAT PLUS/SML MASK 57 AEROCHAMBER/LOWSIGN 57 AEROSN 10 AEROVENT PLUS HOLDING CHAMBER/LLAPSIBLE 57 AINITOR 10 MG, 2.5 MG, 5 MG 23 AIMS LUBRICATED 50 AIRZONE PEAK LOW METER 57 BATUSSIN NN 33 BENZA 8 albuterol sulfate 11 CAINE 67 DACTAZIDE 25MG- 25MG 42 DACTONE 42 DARA 39 DURAZYME 43 alendronate sodium 10 mg, 5 mg 43 alendronate sodium 35 mg, 70 mg 43 ENDRONATE SODIUM 40 MG 43 ER-DRYL 18 EVAZOL 36 EVE 2 KERAN 2 MG 22 LI 1 allopurinol 46 MANE 7 PHAGAN P 0.1 % 66 PHAGAN P 0.15 % 66 PHANATE/VON WILLEBRANDACTOR MPLEX/HUMAN 46 PHANINE SD 46 alprazolam 0.25 mg, 0.5 mg, 1 mg, 2 mg 9 PROLIX 46 TACE 1.25 MG, 2.5 MG, 5 MG 20 TACE 10 MG 20 TERNATE SITE LANCING DEVICE alum & mag hydroxsimethicone 53 7 aluminum chloride 40 UMINUM HYDROXIDE 8 aluminum hydroxide-mag trisil 7 Index 1

81 aluminum sulfate & calcium acetate 40 AMANTADINE HCL 24 amantadine hcl 24 AMARYL 16 AMBIEN 48 AMERGE 58 AMICAR 25 % 48 AMICAR 500 MG 48 amiloride hcl 42 aminocaproic acid 25 % 48 aminocaproic acid 500 mg 48 amiodarone hcl 200 mg, 400 mg 10 amitriptyline hcl 14 amlodipine besylate 29 amoxicillin & pot clavulanate 69 AMOXICILLIN 125 MG, 250 MG 69 amoxicillin 125 mg/5ml, 200 mg/5ml, 250 mg/5ml, 400 mg/5ml 69 amoxicillin 250 mg, 500 mg 69 amoxicillin 500 mg 69 amoxicillin-clarithromycin w/ lansoprazole 74 amphetaminedextroamphetamine 1.25mg- 1.25mg-1.25mg-1.25mg, 1.875mg-1.875mg-1.875mg mg, 2.5mg-2.5mg-2.5mg- 2.5mg, 3.125mg-3.125mg mg-3.125mg, 3.75mg- 3.75mg-3.75mg-3.75mg, 5mg- 5mg-5mg-5mg, 7.5mg-7.5mg- 7.5mg-7.5mg 1 amphetaminedextroamphetamine 1.25mg- 1.25mg-1.25mg-1.25mg, 2.5mg- 2.5mg-2.5mg-2.5mg, 3.75mg- 3.75mg-3.75mg-3.75mg, 5mg- 5mg-5mg-5mg, 6.25mg-6.25mg- 6.25mg-6.25mg, 7.5mg-7.5mg- 7.5mg-7.5mg 1 AMPICILLIN 69 ampicillin 69 AMPYRA 70 ANARANIL 14 ANPRAM-HC 1%-1%, 1%- 2.5% 7 ANPRAM-HC 1%-2.5% 7 ANPRAM-HC SINGLES 7 ANAPROX 2 ANAPROX DS 2 ANASZ 72 anastrozole 22 ANDROGEL 7 ANDROGEL PUMP 7 ANDROXY 7 ANORO ELLIPTA 11 ANTABUSE 69 ANTARA 130 MG, 43 MG 19 antipyrine-benzocaine 1.4%- 5.4%, 14mg/ml-54mg/ml 68 ANUSOL-HC 7 APEXIN E 38 APIDRA 16 APIDRA SOLOSTAR 16 APLENZIN 13 apraclonidine hcl 66 APTIVUS 26 AQUA LANCE ADJUSTABLE LANCING DEVICE 53 ARAST NP 71 ARANESP BUMIN REE 47 ARICEPT 70 ARICEPT ODT 70 ARIMIDEX 23 aripiprazole 26 ARMOUR THYROID 71 ARNUITY ELLIPTA 10 AROMASIN 23 ASMANEX HA 10 ASMANEX TWISTHER 120 METERED DOSES 10 ASMANEX TWISTHER 14 METERED DOSES 10 ASMANEX TWISTHER 30 METERED DOSES 10 ASMANEX TWISTHER 60 METERED DOSES 10 ASMANEX TWISTHER 7 METERED DOSES 10 ASPIRIN 120 MG, 200 MG 4 aspirin 300 mg, 600 mg 4 aspirin 324 mg, 325 mg, 500 mg, 81 mg 4 aspirin 325 mg, 81 mg 4 aspirin buffered (cal carb-mag carb-mag oxide) 4 ASPIRIN LOW DOSE 4 ASSESS ULL RANGE PEAK LOW METER 57 ASSESS LOW RANGE PEAK LOW METER 57 ASSESS PEAK LOW METER ULL RANGE 57 ASSESS PEAK LOW METER LOW RANGE ASSURE PLATINUM TEST 57 STRIPS 41 ASTEPRO 64 ASTHMA CHECK METER-ZONE SYSTEM 57 ASTHMAMENTOR 57 ATABEX DHA 65 ATABEX EC 61 ATABEX PRENAT 61 ATACAND 20 ATACAND HCT 21 atenolol 29 atenolol & chlorthalidone 21 ATIVAN 0.5 MG, 1 MG, 2 MG 9 ATLAS LORED NDOM/SPERMICIDE ATLAS LORED 50 LUBRICATEDNDOM ATLAS LUBRICATED 50 NDOM ATLAS LUBRICATED 50 NDOM/SPERMICIDE 51 atorvastatin calcium 10 mg, 20 mg, 40 mg 19 atorvastatin calcium 80 mg 19 atovaquone 8 atovaquone-proguanil hcl 21 ATRIPLA 26 atropine sulfate (ophthalmic) 66 ATROPINE SULATE 1 % 66 ATROVENT 65 ATROVENT HA 10 AUGMENTIN 125MG/5ML MG/5ML AUGMENTIN 250MG/5ML MG/5ML 69 AUGMENTIN 500MG-125MG, 875MG-125MG 69 AUGMENTIN ES AUGMENTIN XR 69 AUTO-LANCET 53 AUTO-LANCET MINI 53 AUTOLET II CLINISAE 53 AUTOLET IMPRESSION 53 AUTOLET IMPRESSION LANCING DEVICE 53 Index 2

82 AUTOLET LITE CLINISAE 53 AUTOLET LITE STARTER CK 53 AUTOLET MINI 53 AUTOLET PLATORMS 53 AUVI-Q 75 AVIDE 21 AVANDAMET 15 AVANDARYL 15 AVANDIA 16 AVAPRO 20 AVC 74 AVONEX 70 AVONEX PEN 70 AYGESTIN 69 AZASAN 28 azathioprine 28 azelastine hcl (ophth) 68 azelastine hcl 0.1 % 65 azelastine hcl 0.15 % 65 azithromycin 1 gm 50 azithromycin 100 mg/5ml, 200 mg/5ml 50 azithromycin 250 mg 50 azithromycin 500 mg 50 azithromycin 600 mg 50 AZULIDINE 45 AZULIDINE EN-TABS 45 b-complex w/ c & folic acid 1.5mg-5mg-20mg-1.7mg-6mcg- 1mg-150mcg-10mg-100mg, 1.7mg-5mg-6mcg-1.5mg-20mg- 1mg-150mcg-10mg-100mg 60 BABY DDROPS 75 BACIGUENT 36 bacitracin (topical) 36 BACITRACIN 500 UNIT/GM 66 bacitracin zinc 36 bacitracin-poly-neomycin-hc 67 bacitracin-polymyxin b 36 bacitracin-polymyxin b (ophth) 66 baclofen 64 BACTRIM 8 BACTRIM DS 8 BACTROBAN 36 balsalazide disodium 45 BANZEL 12 BARACLUDE 0.05 MG/ML 27 BARACLUDE 0.5 MG, 1 MG BAYER MICROLET 2 27 LANCING DEVICE 53 BD LANCET DEVICE 53 BEBULIN 46 BEBULIN VH 46 belladonna alkaloidsphenobarbital 72 BELVIQ 1 BENADRYL 25 MG 18 BENADRYL LERGY 18 BENADRYL LERGY & LD BENADRYL LERGY & 33 SINUSHEADACHE BENADRYL LERGY 33 CHILDRENS BENADRYL DYE-REE 18 LERGYLIQUID-GELS 18 BENADRYL-D LERGY & SINUS benazepril & 33 hydrochlorothiazide 21 benazepril hcl 20 BENEIX 46 BENLYSTA 28 BENTYL 10 MG 72 BENTYL 20 MG 72 BENZAC AC WASH 35 BENZAC W WASH 35 BENZAMYCIN 35 benzocaine-docusate sodium benzonatate 100 mg, mg 33 benzoyl peroxide 10 %, 2.5 %, 4 %, 5 %, 5.25 % benzoyl peroxide 10 %, 5 35 % 35 BENZOYL PEROXIDE 2.5 % 35 benzoyl peroxide 7 % 35 benzoyl peroxideerythromycin 35 benztropine mesylate 24 BETAGAN 65 betamethasone dipropionate (topical) 38 betamethasone dipropionate augmented 38 betamethasone valerate 0.1 % 38 BETACE 29 BETACE A 29 BETASERON 70 betaxolol hcl (ophth) 65 bethanechol chloride 74 BETHKIS 2 BETOPTIC-S 65 BIAXIN 250 MG 50 BIAXIN 250 MG/5ML 50 BIAXIN 500 MG 50 BIAXIN XL 50 BIAXIN XL C 50 bicalutamide 23 BILTRICIDE 8 BIMATOPROST 68 BIO-STATIN 17 bisacodyl 49 bismuth subsalicylate 17 bisoprolol & hydrochlorothiazide 21 bisoprolol fumarate 29 BLEPH BLEPHAMIDE 67 BLEPHAMIDE S.O.P. 67 BOTOX 65 BRAINSTRONG PRENAT61 BRASIVOL 35 BREO ELLIPTA 11 BREVIN BRILINTA 47 brimonidine tartrate 66 BROMDAY 68 bromfenac sodium (ophth) 68 bromocriptine mesylate 24 brompheniramine & phenyleph 1mg/5ml-1mg/5ml-2.5mg/5ml- 2.5mg/5ml, 1mg/5ml- 2.5mg/5ml 33 brompheniramine & pseudoeph 1mg/5ml-15mg/5ml 33 BRONPECTOL 33 budesonide 32 budesonide (inhalation) 0.25 mg/2ml budesonide (inhalation) mg/2ml 10 BUERIN 4 BUERIN EXTRA STRENGTH 4 Index 3

83 BUERIN LOW DOSE 4 bumetanide 0.5 mg, 1 mg, 2 mg 42 BUNAVAIL 6 buprenorphine hcl 2 mg, 8 mg 6 buprenorphine hcl-naloxone hcl dihydrate bupropion hcl (smoking 6 deterrent) bupropion hcl 100 mg, mg bupropion hcl 100 mg, mg bupropion hcl 150 mg, mg 13 bupropion hcl 200 mg 13 buspirone hcl 9 butalbital-acetaminophen 3 butalbital-acetaminophencaffeine 325mg-50mg-40mg butalbital-acetaminophencaffeine 3 325mg-50mg-40mg, 500mg-50mg-40mg butalbital-acetaminophencaffeine 3 w/ codeine 6 butalbital-aspirin-caffeine 4 butalbital-aspirin-caffeine w/cod 6 BUTBIT/ASPIRIN/CAEIN E 4 BUTRANS 6 BYDUREON 15 BYETTA 15 CAERGOT 58 CAMINE 40 CAMINE PHENOLATED 40 CAN 29 CAN SR 29 CCI-CHEW 59 CCI-MIX 59 calcipotriene 37 calcitriol (topical) 37 calcitriol 0.25 mcg, 0.5 mcg 43 calcitriol 1 mcg/ml 43 calcium acetate (phosphate binder) 45 calcium carbonate (antacid) 500 mg, 600 mg, 750 mg 8 calcium carbonate 1250 mg 59 calcium carbonate 1250 mg, 500 mg, 600 mg, 600mg 59 CCIUM CARBONATE 648 MG 8 calcium carbonatecholecalciferol 500mg-200unit, 500mg-600unit 59 calcium carbonatecholecalciferol 500mg- 400unit 59 calcium carbonatecholecalciferol 600mg- 500unit 59 calcium carbonateergocalciferol 59 calcium carbonate-vitamin d 125unit-250mg, 125unit- 500mg, 200unit-500mg, 250mg-125unit, 400unit- 600mg, 500mg-125unit, 500mg-200unit, 500mg-500mg- 200unit-200unit, 600mg- 400unit 59 calcium citrate 200 mg, 950 mg 59 CCIUM CITRATE MATE/VITAMIN D 59 calcium citrate-vitamin d 250mg-200unit, 315mg- 200unit 59 CCIUM GLUNATE 500 MG, 648 MG 59 CCIUM LACTATE 648 MG, 750 MG 59 calcium polycarbophil 48 calcium w/ vitamin d 59 CCIUM/VITAMIN D 59 CCIUM/VITAMIN D3 59 CNA 61 CAMPR 69 candesartan cilexetil 20 candesartan cilexetilhydrochlorothiazide 21 capecitabine 22 CAPEX 38 CAPIT/DEINE 6 CAPRELSA 23 captopril 20 CAPTOPRIL/HYDROCHLORO THIAZIDE 21 CARAC 37 CARAATE 1 GM 73 CARAATE 1 GM/10ML 73 CARBAGLU 43 carbamazepine 100 mg 12 carbamazepine 100 mg/5ml 12 carbamazepine 200 mg 12 carbamide peroxide (otic) 68 carbidopa-levodopa 10mg- 100mg, 25mg-100mg, 25mg- 250mg carbidopa-levodopa 25mg mg, 50mg-200mg CARDIOM LANCING 24 DEVICE 53 CARDIZEM 29 CARDIZEM CD 29 CARDURA 20 CAREONE ADVANCED LANCINGDEVICE 53 carisoprodol 350 mg 64 CARNITOR 1 GM/10ML 43 CARNITOR 330 MG 43 CARNITOR S 43 carvedilol 28 CASODEX 23 CATAM 2 CATAPRES 20 CAYA 51 CAYSTON 8 CEACLOR 30 cefaclor 30 cefadroxil 30 cefdinir 31 cefpodoxime proxetil 31 cefprozil 30 CETIN 125 MG/5ML, 250 MG/5ML 30 CETIN 250 MG, 500 MG 30 cefuroxime axetil 31 CELEBREX 2 celecoxib 2 CELESTONE 32 CELEXA 10 MG 14 CELEXA 20 MG 14 CELEXA 40 MG 14 CELLCEPT 28 CELONTIN 13 CENTRUM SPECIIST PRENAT 61 cephalexin 125 mg/5ml, 250 mg/5ml 30 cephalexin 250 mg, 500 mg 30 CEPHEXIN 250 MG, 500 MG 30 CEREZYME 47 cetirizine hcl 10 mg, 5 mg 18 Index 4

84 cetirizine-pseudoephedrine 33 CHANTIX 71 CHANTIX NTINUING MONTHK 71 CHANTIX STARTING MONTH K CHEK-STIX MBO K 71 URINYSIS NTROL 41 CHEK-STIX NTROL 41 CHEMET 17 CHEMSTRIP -10 WITH SG 41 CHEMSTRIP 10 MD 41 CHEMSTRIP 2 GP STRIPS 41 CHEMSTRIP 7 41 CHEMSTRIP 9 STRIPS 41 CHEMSTRIP-K 41 CHILDRENS ADVIL 2 CHILDRENS MOTRIN 100 MG/5ML CHILDRENS MOTRIN 40 2 MG/ML 2 CHILDRENS MOTRIN 50 MG 2 CHILDRENS MOTRIN JUNIOR STRENGTH 2 CHLOR-TRIMETON 18 chlordiazepoxide hcl 9 chlordiazepoxide hcl-clidinium bromide 72 CHLORDIAZEPOXIDE/AMITRIP TYLINE chlorpheniramine & 70 phenylephrine 4mg-10mg 33 chlorpheniramine & pseudoeph 15mg/5ml-1mg/5ml chlorpheniramine maleate 2 33 mg/5ml chlorpheniramine maleate 4 18 mg 18 chlorpheniramine w/ codeine 33 CHLORPROMAZINE HCL 25 chlorpromazine hcl 25 CHLORTHIDONE 42 cholecalciferol 1000 unit, 2000 unit, 400 unit, 5000 unit 75 cholecalciferol 1000 unit, 2000 unit, 5000 unit cholecalciferol unt/0.03ml 75 cholestyramine 4 gm/dose 19 cholestyramine light 4 gm/dose 19 choline & mag salicylate 4 CHOLINE MAGNESIUM TRISICYLATE 4 cilostazol 47 CILOXAN 66 cimetidine 200 mg 72 cimetidine 300 mg, 400 mg72 cimetidine 800 mg 72 cimetidine hcl 72 CINRYZE 47 CIPRO 250 MG, 500 MG 44 CIPRO 500 MG/5ML 44 CIPRO XR 44 ciprofloxacin 44 CIPROLOXACIN 68 ciprofloxacin hcl (ophth) 66 CIPROLOXACIN HCL 100 MG 44 ciprofloxacin hcl 100 mg 44 ciprofloxacin hcl 250 mg, 500 mg, 750 mg ciprofloxacin-ciprofloxacin 44 hcl 44 citalopram hydrobromide 10 mg 14 citalopram hydrobromide 10 mg/5ml 14 citalopram hydrobromide 20 mg 14 citalopram hydrobromide 40 mg 14 CITRAC/VITAMIN D 59 CITRUCEL IBER LAXATIVE 48 CLARAVIS 35 clarithromycin 125 mg/5ml, 250 mg/5ml 50 clarithromycin 250 mg, 500 mg 50 clarithromycin 500 mg 50 CLARITIN 10 MG 19 CLARITIN 5 MG/5ML 19 CLARITIN REDITABS 10 MG CLARITIN REDITABS 5 18 MG 19 CLARITIN-D 12 HOUR 33 CLARITIN-D 24 HOUR 33 CLASS ACT LUBRICATED 51 CLASSIC PRENAT 61 CLEMASTINE UMARATE 0.67 MG/5ML clemastine fumarate mg 18 CLEOCIN 150 MG, 300 MG, 75 MG 8 CLEOCIN 2 % 75 CLEOCIN PEDIATRIC GRANULES 8 CLEOCIN-T 35 CLEVER CHOICE MORT EZPEN NEEDLES 33GX4MM 56 CLEVER CHOICE MORT EZPEN NEEDLES 33GX5MM 56 CLEVER CHOICE MORT EZPEN NEEDLES 33GX6MM 56 CLEVER CHOICE MORT EZPEN NEEDLES 33GX8MM 56 CLIMARA 44 CLIMARA PRO 44 CLINDAGEL 35 clindamycin hcl 8 clindamycin palmitate hydrochloride clindamycin phosphate 8 (topical) clindamycin phosphate 35 vaginal 75 CLINDESSE 75 CLINIC NUTRIENTS PRENAT ORMULA 61 CLINISTIX 41 clobetasol propionate 38 clobetasol propionate emollient base 38 clomipramine hcl 14 clonazepam 12 clonidine hcl 0.1 mg, 0.2 mg, 0.3 mg 20 clopidogrel bisulfate 300 mg 47 clopidogrel bisulfate 75 mg 47 clorazepate dipotassium 9 CLOSERCARE 53 clotrimazole 60 clotrimazole (topical) 36 clotrimazole vaginal 1 % 75 clotrimazole w/ betamethasone 36 clozapine 25 CLOZAPINE ODT 25 CLOZARIL 25 -NAT A 61 TAR 41 Index 5

85 DEINE SULATE 15 MG 4 codeine sulfate 15 mg, 30 mg, 60 mg 4 GENTIN 24 LACE 49 LACE CLEAR 50 LAZ 45 LCHICINE 46 colchicine w/ probenecid 46 LCRYS 46 LESTID 1 GM 19 LESTID 5 GM 19 LESTID LAVORED 5 GM 19 colestipol hcl 1 gm 19 colestipol hcl 5 gm 19 LYTE-LAVOR CKS 240GM-22.72GM-5.84GM- 2.98GM-6.72GM 49 MBISTIX 41 MBIVENT 11 MBIVENT RESPIMAT 11 MBIVIR 26 METRIQ 23 MZINE 25 MPLERA 26 MPLETE NAT DHA 61 MPLETE PRENAT 61 MPLETENATE 61 NDOMS 51 NDYLOX 39 NTRAVE 1 XONE 20 MG/ML 70 XONE 40 MG/ML 70 PEGUS 27 RDARONE 10 REG 28 RGARD 29 RIACT 46 RTANE-B AQUEOUS 68 RTANE-B-OTIC 68 RTE 32 RTENEMA 7 RTIOAM 7 RTISONE ACETATE 32 RTISPORIN 10000UNIT/GM- 0.5%-0.5% 36 RTISPORIN 10000UNIT/ML-3.5MG/ML-1% 69 RTISPORIN 400UNIT/GM- 5000UNIT/GM-0.5%-1% 36 SOPT 65 UMADIN 1 MG, 10 MG, 2 MG, 2.5 MG, 3 MG, 4 MG, 5 MG, 6 MG, 7.5 MG 11 ZAAR 20 CREON UNIT UNIT UNIT, 19000UNIT-6000UNIT UNIT, 38000UNIT UNIT-60000UNIT, 76000UNIT-24000UNIT UNIT 42 CRESYLATE 68 CRIXIVAN 26 CROMOLYN SODIUM 10 cromolyn sodium (mastocytosis) 45 CUPRIMINE 28 CUVPOSA 72 CVS HDYRORTISONE ACETATE 38 CVS LANCING DEVICE 53 CVS NATUR IBER SUPPLEMENT 48 CVS OMEPRAZOLE 73 CVS PRENAT 61 CVS PRENAT GUMMY/DHA/OLIC ACID CVS PRENAT 61 MULTI+DHA CVS WOMENS 61 PRENAT+DHA 61 CYCLESSA 31 cyclobenzaprine hcl 64 CYCLOGYL 0.5 % 66 CYCLOGYL 1 %, 2 % 66 CYCLOMYDRIL 66 cyclopentolate hcl 66 CYCLOPHOSPHAMIDE 25 MG, 50 MG 22 CYCLOSET 15 cyclosporine 100 mg, 25 mg CYCLOSPORINE 28 MODIIED cyclosporine modified (for 28 microemulsion) 28 CYMBTA 14 cyproheptadine hcl 19 CYSTARAN 68 CYTOMEL 25 MCG, 50 MCG 71 CYTOMEL 5 MCG 71 CYTOTEC 74 CYTRA-3 45 danazol 7 DANTRIUM 25 MG, 50 MG 64 DANTROLENE SODIUM 100 MG 64 dantrolene sodium 25 mg, 50 mg 64 DAPSONE 8 DAYPRO 2 DDAVP 0.01 % 43 DDAVP 0.1 MG, 0.2 MG 44 DEBROX 68 DEN-A 2MG/5ML- 5MG/5ML 33 DELZIL 45 DEMEROL 100 MG, 50 MG 4 DEMSER 20 DEKENE 13 DEKOTE 13 DEKOTE ER 13 DEKOTE SPRINKLES 13 DEPEN TITRATABS 28 DEPO-PROVERA NTRACEPTIVE DEPO-SUBQ PROVERA desipramine hcl 14 desmopressin acetate 0.1 mg, 0.2 mg desmopressin acetate 44 refrigerated 44 desmopressin acetate spray 44 desmopressin acetate spray refrigerated 44 DESOGEN 31 desogestrel & ethinyl estradiol 31 desogestrel-ethinyl estradiol (biphasic) 31 desogestrel-ethinyl estradiol (triphasic) 31 desonide 38 DESOWEN 38 desoximetasone 0.05 % 38 desoximetasone 0.05 %, 0.25 % 38 Index 6

86 desoximetasone 0.25 % 38 DESQUAM-X WASH 35 DESVENLAAXINE ER 14 DETROL 74 DETROL LA 74 dexamethasone 32 DEXAMETHASONE 32 DEXAMETHASONE INTENSOL dexamethasone sodium 32 phosphate (ophth) dexbrompheniramine & 67 pseudoephedrine 33 DEXEDRINE 1 dextroamphetamine sulfate 10 mg 1 dextroamphetamine sulfate 10 mg, 15 mg, 5 mg 1 dextroamphetamine sulfate 5 mg 1 DIABETA 16 DIAMOX 42 DIASTAT ACUDI 12 DIASTAT PEDIATRIC 12 DIASTIX 41 diazepam (anticonvulsant) 12 DIAZEM 1 MG/ML 9 diazepam 10 mg, 2 mg, 5 mg 9 DIBENZYLINE 20 diclofenac potassium 2 diclofenac sodium 2 dicloxacillin sodium 69 dicyclomine hcl 72 DICYCLOMINE HCL 72 didanosine 26 diethylpropion hcl 25 mg 1 DIETHYLPROPION HCL 25 MG 1 diethylpropion hcl 75 mg 1 DIERIN 0.1 % 36 DIERIN 0.1 %, 0.3 % 36 diflorasone diacetate 38 DILORASONE DIACETATE 38 DILUCAN 18 DIGOXIN 0.05 MG/ML 30 digoxin mg, 0.25 mg, 125 mcg, 250 mcg 30 DILAR XR 29 DILANTIN 13 DILANTIN INATABS 13 DILANTIN DILATRATE SR 8 DILAUDID 4 diltiazem hcl 120 mg, 180 mg, 240 mg 29 diltiazem hcl 120 mg, 30 mg, 60 mg, 90 mg 29 diltiazem hcl 120 mg, 60 mg, 90 mg 29 diltiazem hcl coated beads 120 mg, 180 mg, 240 mg, 300 mg, 360 mg 29 diltiazem hcl extended release beads 29 DIMETAPP LD & LERGY 1MG/5ML-2.5MG/5ML 34 diphenhydramine hcl 12.5 mg 18 diphenhydramine hcl 12.5 mg/5ml 18 diphenhydramine hcl 25 mg 18 diphenhydramine hcl 50 mg 18 diphenhydraminephenylephrine 12.5mg/5ml- 5mg/5ml 34 diphenhydraminephenylephrine 25mg-10mg 34 diphenhydraminephenylephrine-acetaminophen 12.5mg-12.5mg-325mg-325mg- 5mg-5mg, 12.5mg-325mg- 5mg 34 diphenhydraminepseudoephedrineacetaminophen 34 diphenoxylate w/ atropine 17 DIPHENOXYLATE/ATROPINE 17 DIPROLENE 38 dipyridamole 47 DISCID 4 disopyramide phosphate 9 disulfiram 69 DITRON XL 74 divalproex sodium 13 docosahexaenoic acid 200 mg 65 docusate calcium 50 docusate sodium 50 DOCUSOL KIDS 50 DOLOPHINE 4 DOLOPHINE HCL 5 DOMEBORO 1347MG- 952MG 40 donepezil hydrochloride 70 DONNAT MG/5ML MG/5ML MG/5ML- 16.2MG/5ML 72 dorzolamide hcl 68 dorzolamide hcl-timolol maleate 65 DOVONEX 37 doxazosin mesylate 20 DOXEPIN HCL 14 doxepin hcl 14 doxepin hcl (antipruritic) 37 doxycycline (monohydrate) 25 mg/5ml 71 doxycycline hyclate 100 mg 71 doxycycline hyclate 100 mg, 50 mg 71 DRISDOL UNIT 75 DRITHO-CREME HP 37 DRIXOR LD/LERGY 34 dronabinol 17 DROPLET LANCING DEVICE drospirenone-ethinyl 53 estradiol 31 DROXIA 47 DRUG MART ADJUSTABLE LANCING DEVICE 53 DRYSOL 40 DUETACT 15 DULLAX 49 DULLAX BOWEL PREP KIT 49 DULERA 11 duloxetine hcl 20 mg, 30 mg, 60 mg 14 DYAZIDE 42 dyphylline-guaifenesin 10 DYSPORT 65 E-Z SCER 57 E.E.S E.E.S. GRANULES 50 EASIVENT 57 EASIVENT/MASK-LARGE 57 EASIVENT/MASK-MEDIUM 57 EASIVENT/MASK-SML 57 EASY MINI LANCING DEVICE 53 Index 7

87 EASY TOUCH LANCING DEVICE/EJECTOR 53 EC-NAPROSYN 2 econazole nitrate 36 ETRIN MAXIMUM STRENGTH ETRIN REGULAR 4 STRENGTH 4 ED CHLORPED 18 ED CHLORPED D 34 EDURANT 26 EEXOR XR 14 EIENT 47 EUDEX 37 ELDEPRYL 24 ELEXA NATUR EEL 51 ELEXA STIMULATING 51 ELEXA ULTRA SENSITIVE 51 ELIMITE 40 ELIQUIS 11 ELIXOPHYLLIN 11 ELLA 32 ELMIRON 46 ELON 38 ELOCTATE 46 ELTA TAR 41 EMCYT 23 EMLA 40 EMSAM 13 EMTRIVA 26 enalapril maleate 20 enalapril maleate & hydrochlorothiazide 21 ENBREL 3 ENBREL SURECLICK 3 ENCARE 74 ENAMIL EXPECTA 61 enoxaparin sodium 100 mg/ml, 150 mg/ml enoxaparin sodium mg/0.8ml, 80 mg/0.8ml enoxaparin sodium mg/0.3ml enoxaparin sodium mg/0.4ml enoxaparin sodium mg/0.6ml 11 entecavir 27 ENTORT EC 32 ENTYVIO 45 ENUCLENE 68 EPHEDRINE HCL 11 EPHEDRINE SULATE 11 EPINEPHRINE 75 EPIPEN 2-K 75 EPIPEN-JR 2-K 75 EPIVIR 26 EPIVIR HBV 27 EPZIM 26 EQ OMEPRAZOLE 73 EQL CCIUM/VITAMIN D 59 EQL NATUR IBER 48 EQL OMEPRAZOLE 73 EQL PRENAT ORMULA 61 EQUACTIN 48 ergocalciferol unit 75 ergoloid mesylates 70 ERGOMAR 58 ERIVEDGE 22 ERY-TAB 50 ERYGEL 36 ERYPED ERYPED ERYTHROCIN STEARATE 50 erythromycin (acne aid) 36 erythromycin (ophth) 66 erythromycin base 50 ERYTHROMYCIN BASE 50 ERYTHROMYCIN ETHYLSUCCINATE 50 erythromycin-sulfisoxazole 8 escitalopram oxalate 14 ESGIC 4 estazolam 48 esterified estrogens & methyltestosterone 44 ESTRACE 0.1 MG/GM 75 ESTRACE 0.5 MG, 1 MG, 2 MG 44 estradiol mg/24hr, 0.05 mg/24hr, 0.06 mg/24hr, mg/24hr, 0.1 mg/24hr, 37.5 mcg/24hr 44 estradiol mg/24hr 44 estradiol 0.5 mg, 1 mg, 2 mg 44 ESTROPITE 44 estropipate 44 ESTROSTEP E 31 eszopiclone 1 mg, 2 mg 48 eszopiclone 3 mg 48 ethambutol hcl 22 ethosuximide 13 ETHYL CHLORIDE/INE PINPOINT ETHYL CHLORIDE/INE 40 STREAM 40 ETHYL CHLORIDE/MEDIUM JET STREAM 40 ETHYL CHLORIDE/MEDIUM STREAM 40 ETHYL CHLORIDE/MIST 40 ethynodiol diacet & eth estrad 31 ETIDRONATE DISODIUM 43 etidronate disodium 43 etodolac 3 ETOPOSIDE 24 EURAX 40 EVAC 48 EVISTA 43 EVOTAZ 26 EVZIO 17 EX-LAX 49 EXGO 12 MG, 16 MG, 8 MG EXCEL MORT POINT 5 INSULIN PEN NEEDLES 31G X 4MM 56 EXELDERM 36 EXELON 1.5 MG, 3 MG, 4.5 MG, 6 MG 70 EXELON 13.3 MG/24HR, 4.6 MG/24HR, 9.5 MG/24HR 70 EXELON 2 MG/ML 70 exemestane 23 EXJADE 17 EXPECTA LIPIL 65 EXTAVIA 70 EXTRA SENSITIVE SPERMICID 51 EZE ORTE 61 A-8 47 ABRAZYME 43 famciclovir 27 famotidine 10 mg, 40 mg 72 famotidine 20 mg 72 AMVIR 27 Index 8

88 ANAPT 24 ANAPT TITRATION CK 24 ANTASY LUBRICATED 51 ANTASY LUBRICATED/SPERMICIDE 51 ARESTON 23 ARYDAK 23 AZACLO 25 C EME NDOM 51 C2 EME NDOM 51 EIBA 46 EIBA N 46 felbamate 13 ELBATOL 13 ELDENE 3 felodipine 29 EMARA 23 EMCAP 51 fenofibrate micronized 130 mg, 43 mg 19 ENOPROEN CCIUM 600 MG 3 ER-IN-SOL 47 ferrous fumarate w/ b12-vit c-faifc 47 ERROUS GLUNATE 225 MG 48 ferrous sulfate 15 mg/ml 48 ferrous sulfate 220 mg/5ml 48 ERROUS SULATE 220 MG/5ML ERROUS SULATE MG/5ML ERROUS SULATE MG 48 ferrous sulfate 325 mg 48 ferrous sulfate 325 mg, 65 mg 48 ferrous sulfate 50 mg 48 EVERL INANTS 4 EXMID 64 IBERN 48 ITY50 LANCING DEVICE 53 INACEA 40 finasteride 46 IORICET 325MG-50MG- 40MG 4 IORICET/DEINE 6 IORIN 4 IORIN/DEINE #3 6 IRST-LANSOPRAZOLE 73 IRST-MOUTHWASH BLM 60 IRST-OMEPRAZOLE 73 LAGYL 8 flecainide acetate 9 LEET BISADYL 49 LEET LIQUID GLYCERIN SUPPOSITORIES 49 LOMAX 46 LONASE 65 LONASE LERGY RELIE LOVENT DISKUS MCG/BLIST LOVENT DISKUS MCG/BLIST LOVENT DISKUS MCG/BLIST 10 LOVENT HA 110 MCG/ACT, 220 MCG/ACT LOVENT HA MCG/ACT 10 fluconazole 18 fludrocortisone acetate 33 LUMADINE 28 LUNISOLIDE 65 flunisolide (nasal) 65 fluocinolone acetonide 0.01 % 38 fluocinolone acetonide 0.01 %, % 38 fluocinolone acetonide % 38 fluocinonide 0.05 % 38 fluocinonide emulsified base 38 fluorometholone (ophth) 67 LUOROPLEX 37 LUOROURACIL 37 fluorouracil (topical) 5 % 37 fluoxetine hcl (pmdd) 10 mg fluoxetine hcl (pmdd) mg fluoxetine hcl 10 mg, mg 14 fluoxetine hcl 10 mg, 20 mg, 40 mg 14 fluoxetine hcl 20 mg/5ml 14 fluphenazine decanoate 25 LUPHENAZINE HCL 25 fluphenazine hcl 25 LURA-DROPS 59 LURAZEM HCL 48 flurazepam hcl 48 flurbiprofen sodium 68 flutamide 23 fluticasone propionate (nasal) 65 fluvastatin sodium 19 fluvoxamine maleate 14 ML 67 ML ORTE 67 ML LIQUIILM 67 folic acid 1 mg 47 OLIC ACID 20 MG, 5 MG 47 folic acid 400 mcg, 800 mcg 47 ORA LANCING DEVICE 53 OSAMAX 43 OSAMAX PLUS D 43 fosinopril sodium 20 fosinopril sodium & hydrochlorothiazide 21 REDS PHARMACY AUTOLET LANCING DEVICE REESTYLE NTROL 53 SOLUTION REESTYLE NTROL 53 SOLUTION HIGH/LOW REESTYLE LASH 54 SYSTEM REESTYLE REEDOM 54 LITE REESTYLE INSULINX 54 BLOODGLUSE MONITORING SYSTEM REESTYLE INSULINX 54 BLOODGLUSE TEST REESTYLE INSULINX 41 BLOODGLUSE TEST STRIPS REESTYLE LITE BLOOD 41 GLUSE MONITORING SYSTEM REESTYLE LITE TEST 54 STRIPS 41 REESTYLE SYSTEM KIT 54 REESTYLE TEST STRIPS 41 URADANTIN 74 furosemide 10 mg/ml 42 furosemide 20 mg, 40 mg, 80 mg 42 YM 12 gabapentin 100 mg, 300 mg, 400 mg 12 Index 9

89 gabapentin 600 mg, 800 mg 12 GABITRIL 13 GANTAMINE HYDROBROMIDE 70 galantamine hydrobromide 70 GARAMYCIN 66 GAS-X EXTRA STRENGTH 125 MG 45 GASTROCROM 45 gatifloxacin (ophth) 66 GELUSIL 200MG-25MG- 200MG 7 gemfibrozil 19 gentamicin sulfate (ophth) 66 GENTAMICIN SULATE 0.1 % 36 GENTLE-LET PLATORMS 2.4MM 54 GENTLE-LET PLATORMS 3.0MM 54 GEODON 24 GILOTRI 23 GILTUSS PED-C 34 GLASSIA 71 glatiramer acetate 70 GLEEVEC 23 GLEOSTINE 22 glimepiride 16 glipizide 16 glipizide-metformin hcl 15 GLOB LANCING DEVICE 54 GLUCAGON EMERGENCY KIT 15 GLULET 2 AUTOMATIC LANCING DEVICE 54 GLUPHAGE 15 GLUPHAGE XR 15 GLUSOURCE LANCET DEVICE 54 GLUTROL 16 GLUTROL XL 16 GLUVANCE 15 glyburide 16 glyburide micronized 16 glyburide-metformin 15 glycopyrrolate 1 mg, 2 mg 72 GLYNASE 16 GMATE LANCING DEVICE 54 GNP CAMINE 40 GNP CAMINE PHENOLATED 40 GNP DAILY PRENAT 61 GNP OMEPRAZOLE 73 GNP PRENAT 61 GNP PRENAT VITAMINS 61 GOLYTELY 227.1GM-21.5GM- 5.53GM-2.82GM-6.36GM 49 GOLYTELY 236GM-22.74GM- 5.86GM-2.97GM-6.74GM 49 GOODSENSE PRENAT VITAMINS 61 granisetron hcl 1 mg 17 GRIULVIN V 18 GRIS-PEG 18 griseofulvin microsize 18 griseofulvin ultramicrosize 18 guaifenesin-codeine 100mg/5ml-10mg/5ml 34 guanfacine hcl 20 guanfacine hcl (adhd) 1 GYNE-LOTRIMIN 75 H-E-B INNTROL ADVANCEDLANCING DEVICE 54 HCION 48 HDOL 25 HDOL DECANOATE HDOL DECANOATE halobetasol propionate 38 haloperidol 25 HOPERIDOL 31 haloperidol decanoate 25 haloperidol lactate 25 HARVONI 27 HETH CARE LANCING DEVICE HETHWISE LANCING 54 PEN HETHY ACCENTS 54 AUTOLET IMPRESSION LANCING DEVICE 54 HETHY MAMA BE WELL ROUNDED 61 HELIDAC 74 HELIXATE S 46 HEMA-MBISTIX 41 HEMANGEOL 29 HEMOIL M 46 HEPSERA 27 HEXEN 22 HIGH SENSATION SPERMICID 51 HM CAMINE 40 HM OMEPRAZOLE 73 HM ONE DAILY PRENAT MBO 61 HM PRENAT 61 homatropine hbr 66 HUMOG 16 HUMOG KWIKPEN 16 HUMOG MIX 50/50 16 HUMOG MIX 50/50 KWIKPEN 16 HUMOG MIX 75/25 16 HUMOG MIX 75/25 KWIKPEN 16 HUMATE-P 46 HUMATROPE 43 HUMATROPE MBO CK 43 HUMIRA 2 HUMIRA PEDIATRIC CROHNS DISEASE STARTER CK 2 HUMIRA PEN 2 HUMIRA PEN-CROHNS DISEASESTARTER HUMIRA PEN-PSORIASIS 2 STARTER 2 HUMULIN 70/30 16 HUMULIN 70/30 KWIKPEN 16 HUMULIN 70/30 PEN 16 HUMULIN N 16 HUMULIN N KWIKPEN 16 HUMULIN N U-100 PEN 16 HUMULIN R 16 HUMULIN R U-500 (NCENTRATED) 16 hydralazine hcl 10 mg, 100 mg, 25 mg, 50 mg 21 HYDREA 23 hydrochlorothiazide 42 HYDROCIL INSTANT 48 hydrocodone polistirexchlorpheniramine polistirex hydrocodone w/ 34 homatropine 33 hydrocodone-acetaminophen 10mg-300mg, 10mg-325mg, 5mg-300mg, 5mg-325mg, 7.5mg- 300mg, 7.5mg-325mg 6 hydrocodone-acetaminophen 5mg-500mg 6 Index 10

90 hydrocortisone 33 hydrocortisone (intrarectal) 7 hydrocortisone (rectal) 7 hydrocortisone (topical) 0.5 %, 2.5 % 39 hydrocortisone (topical) 1 % 39 hydrocortisone (topical) 1 %, 1% 39 hydrocortisone (topical) 1 %, 2.5 % 39 hydrocortisone acetate (rectal) 25 mg hydrocortisone acetate 7 (topical) hydrocortisone acetate w/ 39 pramoxine 1%-1%, 1%-2.5% 7 hydrocortisone valerate 39 hydrocortisone-aloe vera 39 hydromorphone hcl 1 mg/ml 5 hydromorphone hcl 12 mg, 16 mg, 8 mg 5 hydromorphone hcl 2 mg, 4 mg, 8 mg HYDROMORPHONE HCL 3 5 MG 5 hydroxychloroquine sulfate 21 hydroxyurea 24 hydroxyzine hcl 10 mg, 25 mg, 50 mg 9 hydroxyzine hcl 10 mg/5ml 9 HYDROXYZINE MOATE 9 hydroxyzine pamoate 9 hyoscyamine sulfate 72 HYPERS 3.5 % 35 HYPOLANCE AST LANCING KIT 54 HYZAAR 21 IBRANCE 23 ibuprofen 100 mg 3 ibuprofen 100 mg, 200 mg, 400 mg, 600 mg, 800 mg 3 ibuprofen 100 mg/5ml 3 ibuprofen 200 mg 3 ibuprofen 40 mg/ml, 50 mg/1.25ml 3 ILARIS 2 IMBRUVICA 23 IMDUR 8 imipramine hcl 14 imiquimod 39 IMITREX 100 MG, 25 MG, 50 MG 58 IMITREX 20 MG/ACT, 5 MG/ACT 58 IMITREX 6 MG/0.5ML 58 IMITREX STATDOSE REILL 4 MG/0.5ML 58 IMITREX STATDOSE REILL 6 MG/0.5ML 58 IMITREX STATDOSE SYSTEM 4 MG/0.5ML 58 IMITREX STATDOSE SYSTEM 6 MG/0.5ML 58 IMURAN 28 INAT ADVANCE 61 INAT GT 61 INAT ULTRA 61 INCIVEK 27 indapamide 42 INDER LA 29 INDOCIN 3 indomethacin 25 mg, 50 mg 3 indomethacin 75 mg 3 INANTS ADVIL 3 INERGEN 27 INSPIREASE DRUG DELIVERYSYSTEM 57 INSULIN SYRINGES AND PEN NEEDLES 56 INSUPEN 33GX4MM 56 INTELENCE 26 INTENSE SENSATION 51 INTUNIV 1 INVEGA 25 INVEGA SUSTENNA 25 INVEGA TRINZA 25 INVIRASE 26 INVOKAMET 15 INVOKANA 16 IOPIDINE 0.5 % 66 IOPIDINE 1 % 66 ipratropium bromide 10 ipratropium bromide (nasal) 65 irbesartan 20 irbesartan-hydrochlorothiazide 21 IRON 28 MG 48 IRON CHEWS PEDIATRIC 48 iron combinations 47 iron polysaccharide complex-vit b12-folic acid 47 iron w/ vitamins 2mg-100mg- 4mg-60mg-4.8mg-3mcg-10mg- 1mg-150mg, 2mg-100mg-4mg- 60mg-4.8mg-3mcg-10mg-31mg- 150mg, 400unit-30mg-10mg- 2mg-1mg-4000unit-2mcg-1mg- 0.8mg-25mg-100mg 60 ISENTRESS 26 isoniazid 100 mg, 300 mg 22 ISONIAZID 50 MG/5ML 22 ISOPTIN SR 29 ISOPTO ATROPINE 66 ISOPTO CARBACHOL 66 ISOPTO CARPINE 66 ISOPTO HOMATROPINE 2 % ISOPTO HOMATROPINE 5 66 % 66 ISOPTO HYOSCINE 66 ISORDIL TITRADOSE 40 MG 8 ISORDIL TITRADOSE 5 MG 9 ISOSORBIDE DINITRATE 9 isosorbide dinitrate 9 isosorbide mononitrate 9 isotretinoin 10 mg 36 isotretinoin 20 mg 36 isotretinoin 40 mg 36 ISOXSUPRINE HCL 30 isoxsuprine hcl 30 ISTOL 65 itraconazole 18 IXINITY 46 JADENU 17 JAKAI 23 JANUMET 15 JANUMET XR 15 JANUVIA 15 JARDIANCE 16 JENTADUETO 15 JUVISYNC 100MG-10MG, 100MG-20MG, 50MG-10MG, 50MG-20MG JUVISYNC 40MG-100MG, 15 40MG-50MG 15 K-PHOS 59 K-PHOS NEUTR 60 K-TAB 10 MEQ 60 K-TAB 8 MEQ 60 Index 11

91 KADIAN 10 MG, 100 MG, 20 MG, 30 MG, 50 MG, 60 MG, 80 MG 5 KADIAN 200 MG 5 KETRA 26 KYDE 71 KAMELEON LUBRICATED 51 KAYEXATE 28 KAZANO 15 KCENTRA 46 KELEX 250 MG, 500 MG 30 KENOG 39 KEPPRA 100 MG/ML 12 KEPPRA 1000 MG, 250 MG, 500 MG, 750 MG 12 KETOCARE 41 ketoconazole 18 ketoconazole (topical) 36 KETONE TEST STRIPS 41 ketoprofen 3 ketorolac tromethamine (ophth) 68 KETOSTIX 41 ketotifen fumarate (ophth) 68 KHEDEZLA 14 KIMONO LORS 51 KIMONO LUBRICATED 51 KIMONO MICRO THIN 51 KIMONO MICRO THIN PLUS SPERMICIDE LUBRICATED51 KIMONO PLUS SPERMICIDE LUBRICATED KIMONO PLUS 51 SPERMICIDE/LUBRICATED 51 KIMONO PS LUBRICATED 51 KIMONO PS PLUS SPERMICIDE/LUBRICATED 51 KIMONO SENSATION LUBRICATED 51 KIMONO SENSATION PLUS SPERMICIDE LUBRICATED51 KIMONO SPECI 51 KITABIS K 2 KLARON 36 KLONOPIN 12 KLS OMEPRAZOLE 73 KOATE-DVI 46 KOGENATE S 46 KOGENATE S BIO-SET 46 KOMBIGLYZE XR 15 KONSYL 100 % 49 KONSYL 100 %, 28.3 %, 60.3 % 49 KONSYL 60.3 %, % 49 KONSYL-D 49 KORLYM 15 KP PRENAT MULTIVITAMINS 61 KPN PRENAT 61 KROGER LANCING DEVICE 54 KRYSTEXXA 46 KUVAN 43 labetalol hcl 100 mg, 200 mg, 300 mg 29 LABSTIX 41 LAC-HYDRIN 39 LAC-HYDRIN TWELVE 39 lactic acid (ammonium lactate) 12 % 39 lactic acid w/ vitamin e 39 lactulose 49 lactulose (encephalopathy) 45 LAMICT 100 MG, 150 MG, 200 MG, 25 MG 12 LAMICT 2 MG 12 LAMICT CHEWABLE DISPERSIBLE LAMISIL 125 MG, MG 18 LAMISIL 250 MG 18 LAMISIL AT 36 LAMISIL AT JOCK ITCH 37 LAMISIL AT SPRAY 37 LAMISIL SPRAY 37 lamivudine 26 lamivudine (hbv) 27 lamivudine-zidovudine 26 lamotrigine 100 mg, 150 mg, 200 mg, 25 mg 12 lamotrigine 25 mg, 5 mg 12 LANCET DEVICE ADJUSTABLE LANCET DEVICE WITH 54 EJECTOR 54 LANCET TRANSPORTER CASE 54 LANCETS 54 LANCING DEVICE 54 LANCING DEVICE ADJUSTABLE 54 LANOXIN 125 MCG, 250 MCG 30 lansoprazole 15 mg 73 lansoprazole 30 mg 73 LANTUS 16 LANTUS SOLOSTAR 16 LANZO 54 LASIX 42 latanoprost 68 LATUDA 24 LEADER ADVANCED LANCING DEVICE 54 LEMTRADA 70 LENVIMA 10MG DAILY DOSE LENVIMA 14MG DAILY 23 DOSE LENVIMA 20MG DAILY 23 DOSE LENVIMA 24MG DAILY 23 DOSE 23 LESL 19 LESL XL 19 LETAIRIS 30 letrozole 23 LEUVORIN CCIUM 10 MG, 15 MG 24 leucovorin calcium 25 mg, 5 mg 24 LEUKERAN 22 LEVAQUIN 25 MG/ML 44 LEVAQUIN 250 MG, 500 MG, 750 MG 44 LEVBID 72 LEVEMIR 16 LEVEMIR LEXPEN 16 LEVEMIR LEXTOUCH 16 levetiracetam 100 mg/ml, 500 mg/5ml 12 levetiracetam 1000 mg, 250 mg, 500 mg, 750 mg 12 LEVOBUNOLOL HCL 65 levobunolol hcl 66 levocarnitine (metabolic modifiers) 1 gm/10ml levocarnitine (metabolic 43 modifiers) 330 mg 43 levofloxacin 25 mg/ml 44 levofloxacin 250 mg, 500 mg, 750 mg 44 LEVONORGESTREL 32 levonorgestrel & eth estradiol 31 Index 12

92 levonorgestrel (emergency oc) levonorgestrel-eth estradiol 32 (triphasic) 31 levonorgestrel-ethinyl estradiol (91-day) 31 LEVORPHANOL TARTRATE 5 levothyroxine sodium 72 LEVSIN MG 72 LEVSIN/SL 72 LEXAPRO 14 LEXIVA 26 LIBERTY MINI LANCING DEVICE 54 LIBRAX 72 LICE B GONE 40 lidocaine 5 % 40 lidocaine hcl (mouth-throat) 2 % 60 lidocaine hcl 2 % 40 lidocaine hcl 4 % 40 lidocaine-hydrocortisone acetate (rectal) 3%-0.5% 7 lidocaine-hydrocortisone acetate (rectal) 3%-0.5%, 3%-1%, 3%- 2.5% 7 lidocaine-prilocaine 40 LIESTYLES ASSORTED LORS LIESTYLES EXTRA 51 STRENGTH LIESTYLES ORM 51 ITTING 51 LIESTYLES LUBRICATED 51 LIESTYLES RIBBED 51 LIESTYLES SKYN ORIGIN LIESTYLES 51 SPERMICIDLYLUBRICATED 51 LIESTYLES STUDDED 51 LIESTYLES ULTRA SENSITIVE LIESTYLES ULTRA 51 SENSITIVE/SPERMICIDE LIESTYLES VIBRA- 51 RIBBED LIESTYLES VIBRA- 51 RIBBED/SPERMICIDE LIESTYLES XTRA 51 PLEASURE 51 lindane 40 liothyronine sodium 25 mcg, 5 mcg, 50 mcg 72 LIPITOR 10 MG, 20 MG, 40 MG 19 LIPITOR 80 MG 19 lisinopril 20 lisinopril & hydrochlorothiazide LITE TOUCH LANCING 21 DEVICE LITE TOUCH LANCING 54 PEN 54 LITHIUM 24 lithium carbonate 24 LITHIUM CARBONATE 24 LITHOBID 24 LIVE BETTER ADVANCED LANCING DEVICE 54 LO-SO PREP 49 LOESTRIN 1.5/ LOESTRIN 24 E 31 LOESTRIN E 1.5/30 31 LOESTRIN E 1/20 31 LOMOTIL 17 LOMUSTINE 22 LOPID 19 LOPRESSOR 100 MG, 50 MG 29 LOPRESSOR HCT 21 loratadine & pseudoephedrine 34 loratadine 10 mg 19 loratadine 5 mg/5ml 19 lorazepam 0.5 mg, 1 mg, 2 mg 9 lorazepam 2 mg/ml 9 losartan potassium 20 losartan potassium & hydrochlorothiazide 21 LOSEASONIQUE 31 LOTENSIN 20 LOTENSIN HCT 21 LOTRIMIN A 37 LOTRIMIN A OR HER 37 LOTRIMIN A JOCK ITCH 37 LOTRISONE 37 lovastatin 10 mg, 20 mg 19 lovastatin 40 mg 19 LOVENOX 100 MG/ML, 150 MG/ML 11 LOVENOX 120 MG/0.8ML, 80 MG/0.8ML 11 LOVENOX 30 MG/0.3ML 11 LOVENOX 40 MG/0.4ML 11 LOVENOX 60 MG/0.6ML 11 loxapine succinate 25 LOXITANE 25 LOZI-LUR 59 LUCENTIS 66 LUMIGAN 68 LUMIZYME 43 LUNESTA 1 MG, 2 MG 48 LUNESTA 3 MG 48 LURIDE 0.25 MG, 0.5 MG, 1 MG 59 LURIDE 0.5 MG/ML 59 LUVOX CR 14 LYNRZA 23 LYSODREN 23 LYSTEDA 48 M-VIT 61 MAOX 8 MACROBID 74 MACRODANTIN 100 MG, 50 MG 74 MACRODANTIN 25 MG 74 magnesium chloride 535 mg, 64 mg 59 MAKENA 69 MARONE 21 malathion 40 MARINOL 17 MARNAT- 61 MARPLAN 13 MATULANE 24 MAXAIR AUTOHER 11 MAXIDEX 67 MAXITROL 67 MAXX LUBRICATED 51 MAXX PLUS SPERMICIDE LUBRICATED 51 MAXZIDE 42 MAXZIDE meclizine hcl 12.5 mg, 25 mg 17 meclizine hcl 25 mg 17 MECLOENAMATE SODIUM 3 MEDROL 16 MG, 32 MG, 4 MG, 8 MG 33 MEDROL 2 MG 33 MEDROL DOSEK 33 Index 13

93 medroxyprogesterone acetate 69 medroxyprogesterone acetate (contraceptive) 32 MEGACE OR 23 megestrol acetate 23 MEIJER CAMINE 40 MEKINIST 23 meloxicam 15 mg, 7.5 mg 3 meloxicam 7.5 mg/5ml 3 MENEST 44 meperidine hcl 100 mg, 50 mg5 MEPERIDINE HCL 50 MG/5ML 5 MEPHYTON 75 meprobamate 9 MEPRON 8 mercaptopurine 22 mesalamine 45 mesalamine w/ cleanser 45 MESTINON 60 MG 22 MESTINON 60 MG/5ML 22 MESTINON TIMESN 22 METAMUCIL 49 METAMUCIL MULTIHETH IBER % METAMUCIL ORIGIN 49 TEXTURE METAMUCIL SMOOTH 49 TEXTUREIBER SINGLES 49 METAPROTERENOL SULATE 11 metformin hcl 1000 mg, 500 mg, 850 mg metformin hcl 500 mg, mg 15 methadone hcl 10 mg 5 methadone hcl 10 mg/5ml, 5 mg/5ml 5 methadone hcl 10 mg/ml 5 methadone hcl 40 mg 5 methadone hcl 5 mg 5 METHADOSE 5 METHADOSE SUGAR-REE 5 methazolamide 42 methenamine-hyosc-methylene blue-sod phos-phenyl sal 40.8mg-0.12mg-36.2mg-81.6mg- 10.8mg, 40.8mg-36.2mg-0.12mg- 81.6mg-10.8mg 74 methimazole 71 METHITEST 7 methocarbamol 500 mg, 750 mg methotrexate sodium mg 22 METHYCLOTHIAZIDE 43 methylcellulose (laxative) 2 gm/10.2gm, 2 gm/19gm 49 methyldopa 20 METHYLDO/HYDROCHLO ROTHIAZIDE 21 methylergonovine maleate 0.2 mg 69 methylphenidate hcl 10 mg, 20 mg, 5 mg 1 methylphenidate hcl 20 mg 1 METHYLPHENIDATE HCL ER 10 MG 1 METHYLPHENIDATE HCL ER 18 MG, 27 MG, 54 MG 1 METHYLPHENIDATE HCL ER 36 MG 1 methylprednisolone 33 methyltestosterone 7 METIPRANOLOL 66 metoclopramide hcl 10 mg, 5 mg metoclopramide hcl mg/10ml, 5 mg/5ml 45 metolazone 43 metoprolol & hydrochlorothiazide 21 metoprolol succinate 29 metoprolol tartrate 100 mg, 25 mg, 50 mg 29 METROCREAM 40 METROGEL 40 METROGEL-VAGIN 75 METROLOTION 40 metronidazole 8 metronidazole (topical) 0.75 % metronidazole (topical) 1 40 % 40 metronidazole vaginal 75 MEVAR 20 MG 19 MEVAR 40 MG 20 mexiletine hcl 9 MICARDIS 20 MICARDIS HCT 21 MICATIN 37 miconazole nitrate (topical) 37 miconazole nitrate vaginal 75 miconazole nitrate vaginal 100 mg 75 miconazole nitrate vaginal 2 %, 4 % 75 MICRO-K 10 MEQ 60 MICROLIE DIGIT PEAK LOW METER 57 MICROZIDE 43 MIGERGOT 58 MILK O MAGNESIA NCENTRATE 49 MILLIPRED 5 MG 33 MINI LANCING DEVICE 54 MINI WRIGHT AS PEAK LOWMETER LOW RANGE 57 MINI WRIGHT PEAK LOW METER 57 MINIPRESS 20 MINIVELLE MG/24HR, 0.05 MG/24HR, MG/24HR, 0.1 MG/24HR 44 MINOCIN 71 minocycline hcl 100 mg, 50 mg, 75 mg 71 minoxidil 21 MIRAX 49 MIRAPEX 24 MIRCETTE 31 mirtazapine 13 misoprostol 74 MISSION PRENAT 61 mitoxantrone hcl 23 MOBIC 15 MG, 7.5 MG 3 MOBIC 7.5 MG/5ML 3 modafinil 1 MODERIBA 27 MODERIBA 1200 DOSE CK MODERIBA 800 DOSE 27 CK 27 MODIN 31 moexipril hcl 20 moexipril-hydrochlorothiazide 21 mometasone furoate 39 MONISTAT 3 75 MONISTAT 3 MBINATION CK MONISTAT 7 SIMPLY 75 CURE 75 MONISTAT SOOTHING CARE ITCH RELIE 39 Index 14

94 MONOC 59 MONOCLATE-P 46 MONOJECTOR END CAPS 54 MONOJECTOR OPD END CAPS 54 MONONINE 46 montelukast sodium 10 morphine sulfate 10 mg, 100 mg, 20 mg, 30 mg, 50 mg, 60 mg, 80 mg 5 MORPHINE SULATE 10 MG, 20 MG, 30 MG, 5 MG 5 morphine sulfate 10 mg/5ml, 100 mg/5ml, 20 mg/5ml, 20 mg/ml 5 morphine sulfate 100 mg, 15 mg, 200 mg, 30 mg, 60 mg 5 MORPHINE SULATE 15 MG, 30 MG 5 MORPHINE SULATE ER 5 MOTRIN INANTS 3 MOTRIN INANTS DROPS 3 MOTRIN JUNIOR STRENGTH 3 MS NTIN 5 MULTAQ 10 MULTI PRENAT 61 MULTI-LANCET DEVICE 54 MULTI-LANCET DEVICE 2 54 MULTISTIX 41 MULTISTIX 10 SG 41 MULTISTIX 5 41 MULTISTIX 7 41 MULTISTIX 8 SG 41 MULTISTIX 9 41 MULTISTIX 9 SG 41 mupirocin 36 mupirocin calcium (topical) 36 MURO % 68 MURO % 68 MYAMBUTOL 22 MYBUTIN 22 mycophenolate mofetil 28 mycophenolate sodium 28 MYDRIN 67 MYDRIACYL 66 MYORTIC 28 MYLANTA 200MG/5ML- 20MG/5ML-200MG/5ML MYLANTA DOUBLE- 8 STRENGTH 8 MYLANTA GAS 45 MYLANTA GAS RELIE MAXIMUM STRENGTH 45 MYLERAN 22 MYNAT 62 MYNAT ADVANCE 62 MYNAT PLUS 62 MYNAT ULTRACAPLET 62 MYNAT-Z 62 MYNATE 90 PLUS 62 MYOBLOC 65 MYOZYME 43 MYSOLINE 12 nabumetone 3 nadolol 29 naftifine hcl 37 NATIN 1 % 37 NATIN 1 %, 2 % 37 NATIN 2 % 37 NAGLAZYME 43 NOXONE HCL 17 naloxone hcl 17 naltrexone hcl 17 NAMENDA 10 MG, 5 MG 70 NAMENDA XR 70 NAMENDA XR TITRATION CK 70 NAPHAZOLINE HCL 67 naphazoline w/ pheniramine 0.025%-0.3% 67 NAPHN-A 67 NAPROSYN 250 MG, 375 MG, 500 MG 3 NAPROXEN 3 naproxen 3 naproxen sodium 220 mg 3 naproxen sodium 275 mg, 550 mg 3 naratriptan hcl 58 NARDIL 13 NAS DENGESTANT 65 NAT-RUL PRENAT VITAMINS 62 NATACYN 66 NAT-V RX 62 NATVIT 62 nateglinide 16 NATURE-THROID 130 MG, MG, 195 MG, 32.5 MG, 65 MG 72 NATURE-THROID NT NEN 10/ NEAZODONE HCL 14 nefazodone hcl 14 neomycin sulfate 2 neomycin-bacitracin znpolymyxin 66 neomycin-polymy-dexameth 67 neomycin-polymyxin-gramicidin 67 neomycin-polymyxin-hc (otic) 69 NEOMYCIN/POLYMYXIN/HYDR ORTISONE 67 NEOR 28 NEOSPORIN 67 NEOTUSS-D 60MG/10ML- 60MG/10ML-4MG/10ML- 400MG/10ML 34 NEPHROCAPS 60 NEPHRON A 47 NEPTAZANE 42 NESINA 15 NEURONTIN 100 MG, 300 MG, 400 MG NEURONTIN 600 MG, MG 12 NEVIRAPINE 26 nevirapine 26 NEXAED SINUS PRESSURE +IN 34 NEXAVAR 23 niacin (antihyperlipidemic) 20 niacin 100 mg, 50 mg, 500 mg 75 niacin 250 mg 75 niacin 500 mg 75 NIAR 20 NIASN 20 NIDERM CQ 71 NIRETTE 71 NIRETTE MINI 71 NIRETTE STARTER KIT 71 nicotine 71 nicotine polacrilex 71 NITINE TRANSDERM SYSTEM 71 NITROL INHER 71 Index 15

95 NITROL NS 71 nifedipine 10 mg, 20 mg 29 nifedipine 30 mg, 60 mg, 90 mg 29 nifedipine 60 mg 29 nimodipine 30 nisoldipine 17 mg, 34 mg, 8.5 mg 30 NISOLDIPINE ER 30 NITRO-BID 9 NITRO-DUR 0.1 MG/HR, 0.2 MG/HR, 0.4 MG/HR, 0.6 MG/HR NITRO-DUR 0.3 MG/HR, MG/HR 9 nitrofurantoin 74 nitrofurantoin macrocrystal 74 nitrofurantoin monohyd macro 74 nitroglycerin 0.1 mg/hr, 0.2 mg/hr, 0.4 mg/hr, 0.6 mg/hr 9 nitroglycerin 2.5 mg, 6.5 mg, 9 mg 9 NITROSTAT 9 NIVA-PLUS 62 NIX CREME RINSE 40 NIZOR 37 NOR-QD 32 NOR 6 NORDITROPIN LEXPRO 43 NORDITROPIN NORDILEX PEN norelgestromin-ethinyl 43 estradiol 32 norethin acet & estrad-fe 31 norethindrone & eth estradiol31 norethindrone & mestranol 31 norethindrone (contraceptive) 32 norethindrone acet & eth estra 30mcg-1.5mg 31 norethindrone acetate 69 norethindrone acetate-ethinyl estradiol-fe norethindrone-eth estradiol 31 (triphasic) norgestimate-ethinyl 31 estradiol 31 norgestimate-ethinyl estradiol (triphasic) 31 norgestrel & ethinyl estradiol 31 NORINYL NORINYL NORCE 9 NORCE CR 9 NORPRAMIN 14 NORTRIPTYLINE HCL 14 nortriptyline hcl 14 NORVASC 30 NORVIR 26 NOVA SURELEX LANCING DEVICE 54 NOVOEIGHT 46 NOVOSEVEN RT 47 NPLATE 47 NUCYNTA ER 5 NUEDEXTA 70 NULYTELY/LAVOR CKS 49 NUTRATEAR 65 NUTRICION PORVIDA 62 NUVARING 32 NUVIGIL 1 NYMIZE 30 nystatin 18 nystatin (mouth-throat) 60 nystatin (topical) 37 nystatin-triamcinolone 37 O-C A 62 O-C PRENAT 62 OBIZUR 47 OBSTETRIX EC 62 OBTREX 62 OCEAN NAS SPRAY 64 OCUEN 68 OCULOX 67 ofloxacin (ophth) 67 ofloxacin (otic) 68 ofloxacin 200 mg, 300 mg 44 OGESTREL 31 olanzapine 25 olanzapine-fluoxetine hcl 70 OLUX 39 omeprazole 73 OMEPRAZOLE 73 OMEPRAZOLE + SYRSPEND SKA 73 OMNILEX DIAPHRAGM 51 OMNIPRED 67 ON CL LANCING DEVICE 54 ON CL PLUS LANCING DEVICE 54 ondansetron 17 ondansetron hcl 4 mg, 8 mg 17 ondansetron hcl 4 mg/5ml 17 ONE A DAY WOMENS PRENAT/DHA 62 ONE A DAY WOMENS PRENAT1 62 ONE-A-DAY WOMENS PRENAT 62 ONETOUCH DELICA LANCING DEVICE 54 ONETOUCH SURESOT LANCING DEVICE/18G 54 ONETOUCH SURESOT LANCING DEVICE/21G 54 ONETOUCH SURESOT LANCING DEVICE/28G 54 ONETOUCH ULTRA 2 54 ONETOUCH ULTRA BLUE 41 ONETOUCH ULTRA NTROL 55 ONETOUCH ULTRA MINI 55 ONETOUCH ULTRA SYSTEM KIT 55 ONETOUCH ULTRASMART 55 ONETOUCH VERIO IQ BLOOD GLUSE MONITORING SYSTEM 55 ONETOUCH VERIO MID NTROL SOLUTION 55 ONETOUCH VERIO SYNC BLOODGLUSE MONITORING SYSTEM 55 ONETOUCH VERIO TEST STRIPS 41 ONGLYZA 15 OPTICHAMBER ADVANTAGE 57 OPTICHAMBER ADVANTAGE/LARGE MASK 57 OPTICHAMBER ADVANTAGE/MEDIUM ACE MASK 57 OPTICHAMBER ADVANTAGE/SML ACE MASK 57 OPTICHAMBER DIAMOND 57 OPTICHAMBER DIAMOND/LARGEACE MASK 57 OPTICHAMBER DIAMOND/MEDIUM ACE MASK 57 Index 16

96 OPTICHAMBER DIAMOND/SMLACE MASK 57 OPTIHER 57 OPTIHER MDI DRUG DELIVERY SYSTEM OPTIONS NCEPTROL 57 VAGIN NTRACEPTIVE OPTIONS GYNOL II 74 VAGINNTRACEPTIVE 74 OPTIVAR 68 ORACIT 45 ORAP 70 ORAPRED 33 ORENCIA 250 MG 3 ORTHO DIAPHRAGM L- LEX/65MM ORTHO DIAPHRAGM L- 51 LEX/70MM ORTHO DIAPHRAGM L- 52 LEX/75MM ORTHO DIAPHRAGM L- 52 LEX/80MM 52 ORTHO DIAPHRAGM IL SPRING KIT ORTHO DIAPHRAGM IL SPRING KIT ORTHO DIAPHRAGM IL SPRING KIT ORTHO EVRA 32 ORTHO MICRONOR 32 ORTHO TRI-CYCLEN 31 ORTHO-CEPT 32 ORTHO-CYCLEN 32 ORTHO-NOVUM 1/35 32 ORTHO-NOVUM 7/7/7 32 OSENI 15 OTEZLA 3 OTICIN HC NR 69 OVN OVIDE 40 OXANDRIN 7 oxandrolone 7 oxaprozin 3 oxazepam 9 oxcarbazepine 12 oxybutynin chloride 74 oxycodone hcl 10 mg, 15 mg, 20 mg, 30 mg, 5 mg 5 oxycodone hcl 5 mg 5 oxycodone hcl 5 mg/5ml 5 OXYDONE HCL 5 MG/5ML 5 OXYDONE HCL ER 5 oxycodone w/ acetaminophen 10mg-325mg, 10mg-650mg, 7.5mg-325mg, 7.5mg- 500mg 6 oxycodone w/ acetaminophen 5mg-325mg 6 oxycodone w/ acetaminophen 5mg-500mg 6 OXYNTIN 5 oyster shell 59 PRENAT ORMULA62 MELOR 14 pancrelipase (lipase-proteaseamylase) 42 NOXYL 2.5 % 36 NOXYL-4 CREAMY WASH 36 NOXYL-8 CREAMY WASH 36 NRETIN 37 pantoprazole sodium 20 mg, 40 mg 73 paricalcitol 1 mcg, 2 mcg, 4 mcg 43 RLODEL 24 RNATE 13 paromomycin sulfate 2 paroxetine hcl 14 RVA-C 59 XIL 10 MG, 20 MG, 30 MG, 40 MG 14 XIL 10 MG/5ML 14 XIL CR 14 PCE 50 PEAK AIR PEAK LOW METERADULT/PEDIATRIC 57 PEAK LOW METER 58 ped multivitamins w/fl & iron 61 PEDIATEX TD 34 pediatric multiple vitamin w/ c 61 pediatric multiple vitamins w/ iron 0.6mg/ml-10mg/ml-5unit/ml- 8mg/ml-1500unit/ml-400unit/ml- 0.5mg/ml-0.4mg/ml-35mg/ml, 1500unit/ml-10mg/ml-5unit/ml- 400unit/ml-8mg/ml-0.6mg/ml- 0.5mg/ml-0.4mg/ml-35mg/ml 61 pediatric multivitamins w/fl 60 pediatric vitamins acd w/ fluoride 60 pediatric vitamins adc 61 peg 3350-kcl-sod bicarb-sod chloride-sod sulfate 49 peg 3350-potassium chloride-sod bicarbonate-sod chloride 49 PEG-INTRON 27 PEG-INTRON REDIPEN 27 PEG-INTRON REDIPEN K 4 27 PEGASYS 27 PEGASYS PROCLICK 27 PEGINTRON 27 penicillin v potassium 69 PENLET II AUTOMATIC BLOODSAMPLER 55 PENLET II REPLACEMENT CAPS 55 PENLET II REPLACEMENT CAPS-DEEP 55 PENLET II REPLACEMENT CAPS-REGULAR 55 pentoxifylline 47 PEPCID 20 MG 73 PEPCID 40 MG 73 PEPCID AC 72 PEPCID AC EZ CHEWS MAXIMUM STRENGTH 72 PEPCID AC MAXIMUM STRENGTH 73 PEPTO BISMOL 17 PEPTO-BISMOL 17 PEPTO-BISMOL INSTAOL 17 PEPTO-BISMOL MAX STRENGTH 17 PEPTO-BISMOL TO-GO 17 PERCET 10MG-325MG, 10MG-650MG, 7.5MG-325MG, 7.5MG-500MG 6 PERCET 5MG-325MG 6 permethrin 1 % 41 permethrin 5 % 41 perphenazine 25 Index 17

97 PERPHENAZINE/AMITRIPTYLIN E 70 PERRY PRENAT 62 PERSANTINE 47 PERSON BEST ULL RANGE PERSON BEST LOW 58 RANGE 58 phenazopyridine hcl 100 mg, 200 mg 46 phenelzine sulfate 13 PHENOBARBIT 48 phenobarbital 48 phentermine hcl 1 phenyleph-promethazine w/ cod 34 phenylephrine hcl (ophth) 2.5 % phenylephrine w/ dm-gg 67 30mg/5ml-200mg/5ml-10mg/5ml 34 phenylephrine-chlorpheniraminedm w/ apap 5mg/5ml-1mg/5ml- 160mg/5ml-2.5mg/5ml, 5mg/5ml- 5mg/5ml-1mg/5ml-1mg/5ml- 160mg/5ml-160mg/5ml- 2.5mg/5ml-2.5mg/5ml 34 PHENYLHISTINE DH 34 PHENYTEK 13 phenytoin 13 phenytoin sodium extended 13 PHILLIPS MILK O MAGNESIA CHEWABLE 49 PHILLIPS MILK O MAGNESIA NCENTRATED 49 PHISOHEX 26 PHOSLO 45 PHOSPHOLINE IODIDE 66 phytonadione 100 mcg 75 PICATO 37 PIKO 1 ELECTRONIC 58 pilocarpine hcl 66 pilocarpine hcl (oral) 60 PINNACAINE OTIC 68 pioglitazone hcl 16 pioglitazone hcl-glimepiride 15 pioglitazone hcl-metformin hcl 15 piroxicam 3 PLAN B ONE-STEP 32 PLAQUENIL 22 PLAVIX 300 MG 47 PLAVIX 75 MG 47 PLEGRIDY 70 PLEGRIDY STARTER CK 70 PLET 47 PNV ERROUS UMARATE/DOCUSATE/OLI C ACID 62 PNV OLIC ACID + IRON MULTIVITAMIN 62 PNV PRENAT PLUS MULTIVITAMIN 62 PNV TABS PNV-VP-U 62 POCKET PEAK LOW METER 58 POCKETPEAK PEAK LOW METER LOW RANGE 58 POCKETPEAK PEAK LOW METER/UNIVERS RANGE 58 POCKETPEAK PEAK LOW METER/UNIVERS RANGE LPM 58 podofilox 40 POLY-TUSSIN DHC 34 POLY-VI-LOR 200MCG- 0.25MG-15UNIT-400UNIT, 200MCG-0.5MG-15UNIT- 400UNIT, 200MCG-1MG- 15UNIT-400UNIT 60 POLY-VI-LOR/IRON 200MCG-0.5MG-10MG- 15UNIT-400UNIT 61 polyethylene glycol polymyxin b-trimethoprim 67 polysaccharide iron complex 150 mg 48 POLYSPORIN 36 POLYTRIM 67 polyvinyl alcohol 65 POMYST 23 pot phosphate monobasic w/ sod phosphate dibasic & monobasic 60 POTABA 75 potassium bicarb & chloride 60 potassium bicarbonate 60 potassium chloride 10 %, 20 % 60 potassium chloride 10 meq 60 potassium chloride 10 meq, 8 meq 60 potassium chloride 20 meq 60 POTASSIUM CHLORIDE ER 8 MEQ potassium chloride 60 microencapsulated crystals cr 60 potassium citrate (alkalinizer) 1080 mg, 540 mg 45 POTASSIUM IODIDE 59 POTIGA 12 PRADAXA 12 pramipexole dihydrochloride mg, 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg 24 PRAMOSONE 1%-1% 39 PRAMOSONE 1%-1%, 1%- 2.5% 39 PRAMOSONE 1%-2.5% 39 pramoxine-hc 39 pramoxine-hc-chloroxylenol 69 pramoxine-hc-chloroxylenol aqueous 69 PRAVACHOL 20 pravastatin sodium 20 prazosin hcl 21 PRE-NAT ORMULA 62 PRECISION GLUSE NTROL PRECISION GLUSE 55 NTROLSOLUTION (TRI- LEVEL/HI/LO/NORM) PRECISION GLUSE 55 KETONENTROL SOLUTION 1-LOW, 1-HIGH PRECISION 55 GLUSE/KETONENTROL SOLUTIONS 1-HI 1-LO 55 PRECISION PCX 41 PRECISION PCX PLUS TEST STRIPS 41 PRECISION POINT O CARE TEST STRIPS PRECISION QID TEST 41 STRIPS 41 PRECISION SO-TACT TEST STRIPS 41 PRECISION XTRA 42 PRECISION XTRA BLOOD GLUSE TEST STRIPS 42 PRESE 15 PRED ORTE 67 PRED MILD 67 PRED-G 67 PRED-G S.O.P. 67 Index 18

98 prednisolone 33 prednisolone acetate (ophth) 67 PREDNISOLONE SODIUM PHOSPHATE 1 % 68 prednisolone sodium phosphate 15 mg/5ml 33 PREDNISONE 33 prednisone 33 PREDNISONE INTENSOL 33 PREMARIN 0.3 MG, 0.45 MG, MG, 0.9 MG, 1.25 MG 44 PREMARIN MG/GM 75 PREMIUM NDOMS LUBRICATED 52 PREMPHASE 44 PREMPRO 44 PRENAPLUS 62 PRENATA 62 PRENATABS A 62 PRENATABS RX 62 PRENAT 11UNIT-263MG- 25MG-1.5MG-27MG-4000UNIT- 18MG-1.7MG-4MCG-400UNIT- 0.8MG-2.6MG-100MG, 3.75UNIT-0.5MG-50MG-0.5MG- 25MG-15MG-3.75MG-6.75MG- 2.5MG-5MG-0.75MG-500UNIT- 2.5MCG-0.5MG-200MCG- 25MCG-0.75MG-100UNIT, 30UNIT-4000UNIT-25MG- 1.8MG-200MG-28MG-20MG- 1.7MG-8MCG-400UNIT- 800MCG-2.6MG-120MG, 4000UNIT-30UNIT-200MG- 25MG-1.8MG-28MG-20MG- 1.7MG-8MCG-400UNIT- 800MCG-2.6MG-120MG, 4000UNIT-30UNIT-25MG- 1.8MG-200MG-28MG-20MG- 1.7MG-8MCG-400UNIT- 800MCG-2.6MG-120MG 62 PRENAT PRENAT 22MG-2MG-25MG- 1.84MG-200MG-27MG- 4000UNIT-20MG-3MG-12MCG- 400UNIT-1MG-10MG-120MG 62 PRENAT 4000UNIT-200MG- 11UNIT-27MG-25MG-1.84MG- 18MG-1.7MG-4MCG-400UNIT- 0.8MG-2.6MG-100MG 62 PRENAT AD 63 PRENAT AND IRON 63 PRENAT MPLETE 63 PRENAT ORMULA 63 PRENAT ORMULA A- REE 63 PRENAT ORTE 63 PRENAT LOW IRON 200MG-22UNIT-2MG-25MG- 1.84MG-27MG-4000UNIT- 20MG-3MG-12MCG-400UNIT- 1MG-10MG-120MG, 4000UNIT-200MG-22MG-2MG- 25MG-1.84MG-27MG-20MG- 3MG-12MCG-400UNIT-10MG- 1MG-120MG 63 PRENAT LOW IRON 25MG- 1.5MG-200MG-27MG- 4000UNIT-18MG-1.7MG- 4MCG-400UNIT-0.8MG-11MG- 2.6MG-100MG 63 PRENAT MULTI + DHA 63 PRENAT MULTI +DHA 63 PRENAT MULTIVITAMIN + DHA 63 PRENAT ONE DAILY 63 PRENAT PLUS 63 PRENAT PLUS DHA 63 PRENAT PLUS IRON 63 PRENAT VITAMIN 63 PRENAT VITAMINS 63 PRENAT VITAMINS PLUS 63 PRENAT+DHA 63 PRENAT-U 63 PRENAT/OMEGA-3/OLIC ACID/IRON PRENTI CAVITY-RIM 63 CERVIC CAP 52 PRENTI ITTING SET 52 PREPLUS 63 PRETAB 63 PREVACID 15 MG 73 PREVACID 24HR 73 PREVACID 30 MG 73 PREVACID SOLUTAB 73 PREVC 74 PREZBIX 26 PREZISTA 26 PRILOSEC 10 MG, 20 MG, 40 MG 73 PRILOSEC OTC 73 primidone 12 PRINIVIL 20 PRISTIQ 14 probenecid 46 PROCARDIA 30 PROCARDIA XL 30 MG, 90 MG 30 PROCARDIA XL 60 MG 30 prochlorperazine 25 prochlorperazine maleate 25 PROCTOOAM HC 7 PRODIGY LANCING DEVICE 55 PROE ORTE 63 PROILNINE SD 47 PROGRA 0.5 MG, 1 MG, 5 MG 28 PROLASTIN-C 71 PROMACTA 47 promethazine & phenylephrine 34 promethazine hcl 12.5 mg, 25 mg, 50 mg promethazine hcl mg/5ml 19 PROMETHAZINE VC PLAIN 34 PROMETHAZINE VC/DEINE 34 promethazine w/codeine 34 promethazine-dm 34 PRONTO 0.33%-4% 41 propafenone hcl 10 PRONTHELINE BROMIDE 72 proparacaine hcl 67 propranolol hcl 10 mg, 20 mg, 40 mg, 60 mg, 80 mg 29 propranolol hcl 120 mg, 160 mg, 60 mg, 80 mg PROPRANOLOL HCL MG/5ML 29 PROPRANOLOL/HYDROCHLOR OTHIAZIDE 21 propylthiouracil 71 PROSCAR 46 PROSTIGMIN 22 PROTONIX 20 MG, 40 MG 73 protriptyline hcl 14 PROVENGE 22 PROVERA 69 PROVIGIL 2 PROZAC 14 PRUDOXIN 37 Index 19

99 pseudoeph-cpm-dm w/apap 15mg/5ml-5mg/5ml-1mg/5ml- 160mg/5ml pseudoephedrine hcl mg/5ml 65 pseudoephedrine hcl 30 mg, 60 mg pseudoephedrine-ibuprofen mg/5ml-15mg/5ml 34 PSORN 39 PSS SELECT PLATORMS 55 psyllium 49 PULMIRT 0.25 MG/2ML 10 PULMIRT 0.5 MG/2ML 10 PULMIRT 1 MG/2ML 10 PULMIRT LEXHER 180 MCG/ACT 10 PULMIRT LEXHER 90 MCG/ACT 10 PULMOZYME 71 PUREE OB PLUS 63 PURINETHOL 22 PURIXAN 22 PX ADVANCED LANCING DEVICE 55 PX CAMINE 40 PX LANCET AUTO INJECTOR 55 PX OMEPRAZOLE 73 PX PRENAT MULTIVITAMINS 63 pyrantel pamoate 8 pyrazinamide 22 PYRETHINS/PIPERONYL BUTOXIDE 41 pyrethrins-piperonyl butoxide41 PYRIDIUM 46 pyridostigmine bromide 22 pyridoxine hcl 100 mg, 25 mg, 50 mg QC ADVANCED LANCING 75 DEVICE 55 QC CAMINE 40 QC PRENAT 63 QSYMIA 1 QUESTRAN 4 GM/DOSE 19 QUESTRAN LIGHT 4 GM/DOSE 19 quetiapine fumarate 25 QULORA PEDIATRIC 60 quinapril hcl 20 quinapril-hydrochlorothiazide 21 quinidine gluconate 324 mg 9 QUINIDINE SULATE 9 quinidine sulfate 9 QUINIDINE SULATE ER 9 QVAR 40 MCG/ACT 10 QVAR 80 MCG/ACT 10 RA CAMINE 6.971% % RA CCIUM HI- 40 C/VITAMIND 59 RA LANCING DEVICE 55 RA OMEPRAZOLE 73 RA ONE DAILY 63 RA OYSTER SHELL CCIUM/VITAMIN D 59 RA PRENAT 63 RA PRENAT ORMULA/OLICACID 63 raloxifene hcl 43 ramipril 1.25 mg, 2.5 mg, 5 mg 20 ramipril 10 mg 20 ranitidine hcl 15 mg/ml, 150 mg/10ml, 75 mg/5ml 73 ranitidine hcl 150 mg 73 ranitidine hcl 150 mg, 300 mg 73 ranitidine hcl 300 mg 73 ranitidine hcl 75 mg 73 RAMUNE 0.5 MG, 1 MG, 2 MG 28 RAMUNE 1 MG/ML 28 RAZADYNE 12 MG, 4 MG, 8 MG 70 RAZADYNE ER 70 REITY LATEX NDOMS/LUBRICATED 52 REITY LATEX/ULTRA TEXTURED REITY LATEX/ULTRA 52 THIN 52 REBETOL 200 MG 27 REBETOL 40 MG/ML 27 REBI 70 REBI REBIDOSE 70 REBI REBIDOSE TITRATIONCK 70 REBI TITRATION CK 70 REMBINATE 47 RECTIV 7 REGENECARE HA 40 REGIMEX 1 REGLAN 45 RELENZA DISKHER 28 RELION KETONE 42 RELION KETONE TEST STRIPS 42 RELION LANCING DEVICE 55 REMERON 13 REMERON SOLTAB 13 REMICADE 45 REMODULIN 30 RENEW ADVANCED LANCING DEVICE 55 REQUIP 24 REQUIP XL 24 RESCRIPTOR 26 RESTASIS 67 RESTORIL 48 RETIN-A 36 RETIN-A MICRO 36 RETIN-A MICRO PUMP 0.04 %, 0.1 % 36 RETROVIR 26 REVIA 17 REYATAZ 26 RHEUMATREX 2 RIASTAP 47 RIBASPHERE 27 RIBASPHERE RIBAK 27 RIBATAB 27 ribavirin (hepatitis c) 27 RID 0.33%-4% 41 RIDAURA 2 rifabutin 22 RIADIN 150 MG, 300 MG 22 rifampin 150 mg, 300 mg 22 RIGHT STEP PRENAT 63 RIGHTEST GD-L500 TERNATE SITE ADAPTER 55 RIGHTEST GD500 LANCING DEVICE 55 rimantadine hydrochloride 28 RISPERD 25 RISPERD NSTA 25 RISPERD M-TAB 25 risperidone 25 Index 20

100 RITIN 2 RITIN SR 2 RITUXAN 22 rivastigmine tartrate 70 RIXUBIS 47 ROBAXIN 500 MG 64 ROBAXIN ROBINUL 1 MG 72 ROBINUL ORTE 72 ROCTROL 43 ropinirole hydrochloride 24 ROWASA 45 ROXICET 6 ROXIDONE 6 RYMED 34 RYTHMOL 10 RYTHMOL SR 10 SABRIL 13 SAE-LUV NDOMS 52 SAGEN 60 saline 0.65 %, 0.65%, 0.65% % 64 salsalate 4 SAMSCA 44 SANCTURA 74 SANCTURA XR 74 SANDIMMUNE 100 MG, 25 MG 28 SANDIMMUNE 100 MG/ML 28 SANTYL 39 SAPHRIS 25 SAXENDA 1 SB OMEPRAZOLE 73 SE-NAT SEASONIQUE 32 SEB-PREV 37 SECTR 29 SELECT-LITE DEVICE/LANCETS SELECT-LITE LANCING 55 DEVICE 55 selegiline hcl 24 selenium sulfide 2.5 % 37 SELSUN SHAMPOO 38 SELZENTRY 26 sennosides 15 mg 49 SENSIR 43 SEREVENT DISKUS 11 SEROQUEL 25 SEROQUEL XR 25 sertraline hcl 14 SROWASA 45 SHOHLS SOLUTION MODIIED 45 SHOPKO AUTOLET LANCING DEVICE 55 SHUR-SE 74 SILVADENE 38 silver sulfadiazine 38 SIMR 20 simethicone 125 mg 45 SIMILAC PRENAT EARLY SHIELD SIMPLE DIAGNOSTICS 63 LANCING DEVICE 55 SIMPONI ARIA 2 simvastatin 20 SINEMET 24 SINEMET CR 24 SINGULAIR 10 sirolimus 28 SLO-NIACIN 500 MG 75 SM CAMINE 40 SM CAMINE PHENOLATED 40 SM OMEPRAZOLE 73 SM ONE DAILY PRENAT 63 SM PRENAT VITAMINS63 SMART DIABETES VANTAGE LANCING DEVICE 55 sodium chloride (inhalant) 0.9 % 35 sodium chloride (inhalant) 0.9 %, 3 % 35 sodium chloride hypertonic 68 sodium citrate & citric acid 45 sodium fluoride mg/drop 59 sodium fluoride 0.25 mg, 0.5 mg, 1 mg, 1.1 mg, 2.2 mg 59 SODIUM LUORIDE 0.5 MG, 1 MG 59 sodium fluoride 0.5 mg/ml 59 sodium polystyrene sulfonate 28 SOLIRIS 47 SOLUS V2 LANCING DEVICE 55 SOMA 350 MG 64 sotalol hcl 29 sotalol hcl (afib/afl) 29 SOTYLIZE 29 SOVDI 27 SPIRIVA HANDIHER 10 SPIRIVA RESPIMAT 10 spironolactone 42 spironolactone & hydrochlorothiazide 42 SPORANOX 100 MG 18 SPORANOX PULSEK 18 SPRYCEL 100 MG, 140 MG, 20 MG, 50 MG, 70 MG 23 SPS 28 SSKI 59 STARLIX 16 stavudine 26 STELARA 37 STERILANCE 55 STIMATE 44 STRATTERA 1 STRIBILD 26 STRIVERDI RESPIMAT 11 STUART ONE 63 STUART PRENAT 63 SUBOXONE 7 sucralfate 73 SUDAED 65 SUDAED CHILDRENS 65 SUDAED NGESTION 65 SUDAED NAS DENGESTANT MAXIMUM STRENGTH 65 SUDAED PE CHILDRENS NAS DENGESTANT 65 SUDAED PE SEVERE LD MULTI-SYMPTOM 34 SULAR 30 sulfacetamide sodprednisolone 68 SULACETAMIDE SODIUM 67 sulfacetamide sodium (acne) 36 sulfacetamide sodium (ophth) 67 sulfacetamide sodium w/ sulfur 5%-10% 36 SULADIAZINE 71 sulfamethoxazoletrimethoprim 8 SULAMYLON 85 MG/GM 38 Index 21

101 sulfasalazine 45 sulindac 3 sumatriptan 58 sumatriptan succinate 100 mg, 25 mg, 50 mg sumatriptan succinate 4 58 mg/0.5ml 58 SUMATRIPTAN SUCCINATE 4 MG/0.5ML sumatriptan succinate 6 58 mg/0.5ml 58 SUMATRIPTAN SUCCINATE 6 MG/0.5ML 58 SUPRENZA 1 SURE MORT LANCING PEN 55 SURE-PEN 55 SUSTIVA 26 SUTENT 23 SW OMEPRAZOLE 74 SYLATRON 24 SYMAX DUOTAB 72 SYMBIRT 11 SYMBYAX 70 SYMLINPEN SYMLINPEN SYNAGIS 69 SYNAR 39 SYNAREL 43 SYNTHROID 72 TABLOID 22 tacrolimus 28 TAINLAR 23 TAGAMET HB 73 TAMBOR 10 TAMILU 30 MG, 45 MG, 75 MG 28 TAMILU 6 MG/ML 28 tamoxifen citrate 23 tamsulosin hcl 46 TANZEUM 15 TAZOLE 71 TARCEVA 23 TARGRETIN 75 MG 24 TARON-BC 63 TASIGNA 23 TAZORAC 37 TEGRETOL 12 telmisartan 20 telmisartan-amlodipine 21 telmisartan-hydrochlorothiazide 21 temazepam 48 TEMODAR 100 MG, 140 MG, 180 MG, 20 MG, 250 MG, 5 MG 22 TEMOVATE 39 TEMOVATE E 39 temozolomide 22 TENEX 21 TENORETIC TENORETIC TENORMIN 29 terazosin hcl 21 terbinafine hcl 18 terbinafine hcl (topical) 37 terbutaline sulfate 2.5 mg, 5 mg 11 TESSON PERLES 33 TESTIM 7 TESTOSTERONE 1 %, 25 MG/2.5GM, 50 MG/5GM 7 TESTOSTERONE PUMP 7 TESTRED 7 tetracaine hcl (ophth) 67 TETRACYCLINE HCL 71 TGT ADVANCED LANCING DEVICE 55 TGT LANCING DEVICE 55 TGT OMEPRAZOLE 74 TH PRENAT VITAMINS 63 THEO MG, 200 MG, 300 MG 11 theophylline 100 mg, 200 mg, 300 mg, 450 mg 11 theophylline 400 mg, 600 mg 11 THERANAT MPLETE THERANAT RE 63 NUTRITION 63 THERANAT PLUS 63 THIOLA 46 thioridazine hcl 25 thiothixene 26 THRIVITE thyroid 72 THYROLAR-1 72 THYROLAR-1/2 72 THYROLAR-1/4 72 THYROLAR-2 72 THYROLAR-3 72 tiagabine hcl 13 TIAZAC 30 TIGAN 300 MG 17 TIKOSYN 10 TIMOLOL MEATE 29 timolol maleate (ophth) 66 TIMOPTIC 66 TIMOPTIC OCUDOSE 66 TIMOPTIC-XE 66 TINACTIN 37 TINACTIN JOCK ITCH 37 tioconazole vaginal 75 TIVICAY 26 TL OLATE 64 TOBI 2 TOBI PODHER 2 TOBRADEX 68 tobramycin 2 tobramycin (ophth) 67 tobramycin-dexamethasone 68 TOBREX 67 TODAY SPONGE 74 TODAYS HETH ADVANCED LANCING DEVICE 55 TORANIL 14 TOLAZAMIDE 16 tolazamide 16 TOLBUTAMIDE 16 tolmetin sodium 3 TOLMETIN SODIUM 3 tolnaftate 37 tolterodine tartrate 1 mg, 2 mg tolterodine tartrate 2 mg, 4 74 mg 74 TOMAX 12 TOMAX SPRINKLE 12 TOPIRT 0.05 % 39 TOPIRT 0.05 %, 0.25 % 39 TOPIRT 0.25 % 39 topiramate 12 TOPROL XL 29 TOUJEO SOLOSTAR 16 TRACLEER 30 TRADJENTA 15 Index 22

102 tramadol hcl 50 mg 6 TRANDATE 29 tranexamic acid 650 mg 48 TRANXENE T 9 tranylcypromine sulfate 13 trazodone hcl 14 TRENT 47 tretinoin 36 tretinoin (chemotherapy) 24 tretinoin microsphere 36 TRETTEN 47 TREXL 22 TRI-NORINYL TRI-VI-SOL 61 TRI-VIT/LUORIDE/IRON 61 TRIADVANCE 64 TRIAMCINOLONE ACETONIDE triamcinolone acetonide 39 (mouth) triamcinolone acetonide 60 (topical) 39 TRIAMINIC UGH & RUNNY NOSE triamterene & 18 hydrochlorothiazide 42 TRIAMTERENE/HYDROCHLOR OTHIAZIDE 42 triazolam 48 TRICARE 64 trifluoperazine hcl 25 trifluridine 67 trihexyphenidyl hcl 24 TRILEPT 12 trimethobenzamide hcl 300 mg 17 trimethoprim 8 TRINAT GT 64 TRINAT RX 1 64 TRINAT ULTRA 64 TRINATE 64 triprolidine & pseudoephedrine 0.938mg/ml-10mg/ml 34 triprolidine & pseudoephedrine 2.5mg-2.5mg-60mg-60mg, 2.5mg-60mg 35 TRIUMEQ 26 TRIZIVIR 26 TROJAN 52 TROJAN ASSORTMENT CK 52 TROJAN EXTENDED PLEASURE/LUBRICATED 52 TROJAN EXTRA STRENGTH 52 TROJAN MAGNUM 52 TROJAN MAGNUM WARM SENSATIONS 52 TROJAN MAGNUM XL LUBRICATED 52 TROJAN NATURAMB W/SPERMICID LUB 52 TROJAN PLEASURE MESH/SPERMICID 52 TROJAN PLUS 52 TROJAN REGULAR 52 TROJAN RIBBED 52 TROJAN RIBBED W/SPERMICID 52 TROJAN SHARED SENSATION/LUBRICATED 52 TROJAN SUPRAS SPERMICID 52 TROJAN TWISTED PLEASURE 52 TROJAN ULTRA PLEASURE/LUBRICATED 52 TROJAN VERY SENSITIVE LUBRICATED 52 TROJAN VERY SENSITIVE SPERMICID LUBRICANT 52 TROJAN VERY THIN LUBRICATED 52 TROJAN VERY THIN SPERMICID LUBRICANT 52 TROJAN-ENZ LUBRICANT 52 TROJAN-ENZ LUBRICATED 52 TROJAN-ENZ W/SPERMICID 52 tropicamide 66 trospium chloride 74 TRUEDRAW LANCING DEVICE 56 TRULICITY 15 TRUSOPT 68 TRUSTEX LOR NDOMS + LUBE 52 TRUSTEX LUBRICATED 52 TRUSTEX LUBRICATED EXTRARGE 52 TRUSTEX LUBRICATED EXTRASTRENGTH 52 TRUSTEX LUBRICATED/RIBBED/STUDDE D 52 TRUSTEX LUBRICATED/SPERMICIDE 52 TRUSTEX LUBRICATED/SPERMICIDE EXTRA LARGE 53 TRUSTEX LUBRICATED/SPERMICIDE EXTRA STRENGTH 53 TRUSTEX NATUR NDOMS +LUBE/LUBRICATED 53 TRUSTEX NON- LUBRICATED 53 TRUSTEX WITH NONOXYNOL- 9/RIBBED/STUDDED 53 TRUSTEX/RIA LUBRICATED 53 TRUSTEX/RIA LUBRICATED SPERMICIDE 53 TRUSTEX/RIA LUBRICATED/SPERMICIDE 53 TRUSTEX/RIA NON- LUBRICATED 53 TRUVADA 26 TRUZONE PEAK LOW METER 58 TUCKS ANTI-ITCH 39 TUDORZA PRESSAIR 10 TUMS 8 TUMS E-X TUMS KIDS 8 TUMS LASTING EECTS 8 TUMS SMOOTHIES 8 TUSNEL 2MG-15MG- 200MG 35 TUSSIONEX PENNKINETIC EXTENDED RELEASE 35 TWYNSTA 21 TYBOST 26 TYKERB 23 TYLENOL CHILDRENS 4 TYLENOL CHILDRENS LD PLUS UGH 35 TYLENOL CHILDRENS PLUS LU 35 TYLENOL CHILDRENS PLUS MULTI-SYMPTOM LD 35 Index 23

103 TYLENOL CHILDRENS/LAVORCREATOR 4 TYLENOL INANTS 4 TYLENOL JR MELTAWAYS 4 TYLENOL/DEINE #3 6 TYLENOL/DEINE #4 6 TYSABRI 70 ULTI-LANCE AUTO-ADJUST DEVICE ULTI-LANCE AUTOMATIC/ 56 CLEAR TIP 56 ULTI-LANCE MINI ADJUSTABLE DEVICE ULTILET OPERATING 56 DEVICE ULTILET ULTI-LANCE ADJ 56 DEVICE 56 ULTIMATE EELING 53 ULTRA TABS 64 ULTRANCE 56 ULTRAM 6 ULTRAVATE 39 UNIIBER 49 UNIRETIC 21 UNISTIK 1 56 UNISTIK 2 56 UNISTIK 2 MORT 56 UNISTIK 2 EXTRA 56 UNISTIK 2 NEONAT 56 UNISTIK 2 NORM 56 UNISTIK 2 SUPER 56 UNISTIK 3 56 UNISTIK 3 MORT 56 UNISTIK 3 EXTRA 56 UNISTIK 3 NEONAT 56 UNISTIK 3 NORM 56 UNISTIK CZT MORT 56 UNISTIK CZT NORM 56 UNIVASC 20 URECHOLINE 74 URISTIX 42 URISTIX 4 42 UROCIT-K UROCIT-K 5 46 URSO ursodiol 250 mg 45 ursodiol 300 mg 45 VAGISTAT-1 75 valacyclovir hcl 27 VCYTE 450 MG 27 VCYTE 50 MG/ML 27 valganciclovir hcl 27 VIUM 9 valproate sodium 250 mg/5ml 13 valproic acid 13 VTREX 28 VUE PLUS LANCING DEVICE 56 VASERETIC 21 VASOTEC 20 VC VAGIN NTRACEPTIVE ILM VC VAGIN 74 NTRACEPTIVE OAM 74 VECTIC 37 VENAT-A 64 venlafaxine hcl 14 VENTAVIS 30 VENTOLIN HA 11 verapamil hcl 100 mg, 120 mg, 180 mg, 200 mg, 240 mg, 300 mg, 360 mg 30 verapamil hcl 120 mg, 180 mg, 240 mg verapamil hcl 120 mg, mg 30 VERAMIL HCL 40 MG 30 VERELAN 30 VERELAN PM 30 VERSACLOZ 25 VEND 18 VIBRAMYCIN 100 MG 71 VIBRAMYCIN 25 MG/5ML 71 VIBRAMYCIN 50 MG/5ML 71 VICTOZA 15 VICTRELIS 27 VIDA MIA AUTOLET LANCINGDEVICE 56 VIDEX EC 26 VIDEXPEDIATRIC 26 VIMT 10 MG/ML 12 VIMT 100 MG, 150 MG, 200 MG, 50 MG 12 VINATE AZ EXTRA 64 VINATE CCIUM 64 VINATE GT 64 VINATE IC 64 VINATE II 64 VINATE M 64 VINATE ONE 64 VINATE ULTRA 64 VIRACEPT 26 VIRAMUNE 26 VIRAMUNE XR 27 VIREAD 27 VIROPTIC 67 VIRT NATE 64 VIRT-ADVANCE 64 VIRT-VITE GT 64 VISTARIL 9 VITA-PREN 64 VITAOL-OB 64 VITAOL-PN 64 VITAMIN A 10000UNIT- 1000UNIT 75 VITEKTA 27 VIVACTIL 15 VIVELLE-DOT 44 VIVITROL 17 VOGELXO 7 VOGELXO PUMP 7 VOL-NATE 64 VOL-PLUS 64 VOL-TAB RX 64 VOLTAREN-XR 3 voriconazole 200 mg, 50 mg 18 voriconazole 40 mg/ml 18 VOSPIRE ER 11 VOTRIENT 23 VPRIV 47 warfarin sodium 11 WEGMANS MPLETE PRENAT+DHA 64 WELLBUTRIN 13 WELLBUTRIN SR 100 MG, 150 MG 13 WELLBUTRIN SR 200 MG 13 WELLBUTRIN XL 13 WESTRT 39 WESTHROID 130 MG, MG, MG, 195 MG, 32.5 MG, 65 MG 72 WESTHROID-P 130 MG, MG, 32.5 MG, 65 MG 72 WILATE 47 Index 24

104 WP THYROID 130 MG, MG, 32.5 MG, 65 MG 72 XATAN 68 XKORI 23 XANAX 9 XARELTO 10 MG 11 XARELTO 15 MG, 20 MG 11 XARELTO STARTER CK 11 XELODA 22 XENAZINE 70 XENIC 1 XEOMIN 65 XIEX 28 XODOL 6 XOLAIR 10 XYLOCAINE 4 % 40 XYNTHA 47 XYNTHA SOLOUSE 47 YASMIN YAZ 32 YOUR LIE MULTI PRENAT 64 ZADITOR 68 ZANTAC 15 MG/ML 73 ZANTAC 150 MAXIMUM STRENGTH 73 ZANTAC 150 MG 73 ZANTAC 300 MG 73 ZANTAC ZARONTIN 13 ZAROXOLYN 43 ZEBETA 29 ZELBORA 23 ZEMAIRA 71 ZEMPLAR 1 MCG, 2 MCG, 4 MCG 43 ZENPEP 10000UNIT-3000UNIT UNIT, UNIT UNIT UNIT, 34000UNIT-10000UNIT UNIT, 51000UNIT UNIT-82000UNIT, 68000UNIT-20000UNIT UNIT, 85000UNIT UNIT UNIT 42 ZENPEP 17000UNIT-5000UNIT UNIT 42 ZERIT 27 ZESTORETIC 21 ZESTRIL 20 ZIAC 21 ZIAGEN 27 zidovudine 27 ziprasidone hcl 24 ZITHROMAX 1 GM 50 ZITHROMAX 100 MG/5ML, 200 MG/5ML 50 ZITHROMAX 250 MG 50 ZITHROMAX 500 MG 50 ZITHROMAX 600 MG 50 ZITHROMAX TRI-K 50 ZITHROMAX Z-K 50 ZMAX 50 ZOR 20 ZORAN 4 MG, 8 MG 17 ZORAN 4 MG/5ML 17 ZORAN ODT 17 ZOLINZA 23 ZOLOT 14 zolpidem tartrate 10 mg, 5 mg 48 ZONON 37 ZONEGRAN 12 zonisamide 12 ZONTIVITY 47 ZORTRESS 28 ZOVIA 1/50E 32 ZOVIRAX 200 MG 28 ZOVIRAX 200 MG/5ML 28 ZOVIRAX 400 MG, 800 MG 28 ZOVIRAX 5 % 38 ZUBSOLV 7 ZYBAN 71 ZYDELIG 23 ZYLOPRIM 46 ZYMAXID 67 ZYPREXA 25 ZYPREXA RELPREVV 25 ZYPREXA ZYDIS 25 ZYRTEC LERGY 19 ZYRTEC CHILDRENS LERGY 10 MG, 5 MG 19 ZYRTEC HIVES RELIE 19 ZYRTEC-D LERGY/NGESTION 35 ZYTIGA 23 Index 25