Horizon Blue Cross Blue Shield of New Jersey Formulary Guide: Advantage Formulary Page 1 of 116
Horizon Blue Cross Blue Shield of New Jersey Guide to Your Formulary What is a drug formulary? A drug formulary is a list of prescription drugs approved by the Food and Drug Administration (FDA) that are covered under your prescription drug benefit. How is the formulary developed? The Advantage Formulary was developed and is updated by Horizon Blue Cross Blue Shield of New Jersey s Pharmacy and Therapeutics (P&T) Committee. The P&T Committee is made up of physicians who practice in the medical community in various specialties and meet quarterly to review information on the safety, efficacy and cost of each drug considered for placement on each of Horizon BCBSNJ s formularies. In addition, the P&T Committee meets to evaluate additions, deletions or other changes to the formularies. How are the drugs classified on the formulary? Generic (G): Drugs containing the same active ingredient(s) as their corresponding brand name drugs and approved by the FDA for therapeutic equivalency to their brand name counterparts. Preferred brands (P): Drugs reviewed by Horizon BCBSNJ s P&T Committee and found to have clinical efficacy, safety or overall value over non-preferred brands. Non-Preferred brands (NP): Drugs reviewed by Horizon BCBSNJ s P&T Committee and found to not have clinical efficacy, safety or overall value over existing generics, Preferred brands or over-the-counter drugs. What is a generic drug? A generic drug has the same active ingredient and dosage form, and works in exactly the same way as its brand name counterpart. Both generic and brand name drug manufacturing facilities go through the same FDA inspection. The FDA requires generic drugs to be equal to their brand name counterparts in safety, stability, effectiveness, quality and purity. Page 2 of 116
Generic drug manufacturers don t have the substantial investment costs that the original brand name drug developer puts into the pricing of its product. Join the two-thirds of all Americans who choose generic over brand when getting their prescriptions filled. Speak to your physician or pharmacist about a possible generic substitution today. What is a Prior Authorization (PA)? Certain drugs require Prior Authorization (PA) before coverage is approved. The PA process is designed to assure that only prescription drugs that are medically necessary and appropriate are approved for coverage. PA also encourages appropriate utilization of certain prescription drugs, promotes generally accepted treatment protocols, actively monitors prescription drug use that may have serious side effects and helps keep the cost of prescription drug therapy affordable for you. What are quantity limit/gender limit/age limit? Certain prescription drugs have specific dispensing limitations for quantity, age, gender and maximum dose. To arrive at these quantity or safety limits, Horizon BCBSNJ follows recommendations by the FDA, coupled with our analysis of prescription dispensing trends and standard clinical guidelines. Page 3 of 116
Horizon BCBSNJ Advantage Formulary italics= Generic tier 1 drugs UPPERCASE BOLD= Brand name tier 2 drugs UPPERCASE = Brand name tier 3 drugs CURRENT AS OF 3/25/2012 Tier = Generic = Preferred = Non Preferred Notes PA= Prior Authorization M= Males Only F= Females Only = Quantity Limit AG= Age Restriction ADV= Requires a trial of a generic drug alternative before this Non- Preferred BRAND medication will be considered medically necessary 8-MOP ABILIFY ORAL ABILIFY DISCMELT ABSTRAL PA; ACANYA PA acarbose ACCOLATE ACCU-CHEK ACTIVE CARE ACCU-CHEK ACTIVE GLUCOSE CONT ACCU-CHEK ACTIVE TEST ACCU-CHEK ADVANTAGE DIABETES ACCU-CHEK AVIVA ACCU-CHEK AVIVA CONTROL SOLN Page 4 of 116
ACCU-CHEK AVIVA PLUS ACCU-CHEK COMFORT CURVE ACCU-CHEK COMFORT CURVE LINEAR ACCU-CHEK COMFORT CURVE TEST ACCU-CHEK COMP BLUE CONT, M-H ACCU-CHEK COMPACT GLUCOSE CONT ACCU-CHEK COMPACT PLUS CARE ACCU-CHEK COMPACT TEST ACCU-CHEK FASTCLIX ACCU-CHEK INSTANT CONTROL ACCU-CHEK MULTICLIX LANCET ACCU-CHEK NANO ACCU-CHEK SMARTVIEW STRIPS ACCU-CHEK SOFT DEV LANCETS ACCU-CHEK SOFTCLIX LANCET DEV ACCU-CHEK SOFTCLIX LANCETS ACCUNEB ACCUPRIL ACCURETIC ACCUTREND GLUCOSE Page 5 of 116
ACE AEROSOL CLOUD ENHANCER acebutolol oral ACEON acetaminophencodeine elixir acetaminophencodeine tab 300-15 mg acetaminophencodeine tab 300-30 mg, 300-60 mg acetaminophnisometh-dichloral ACETASOL HC acetazolamide oral acetazolamide sodium acetic acid otic acetic acidaluminum acetate acetylcysteine soln ACID JELLY ACIPHEX PA; ACLARO ACLARO PD ACLOVATE ACTIGALL ACTIMMUNE PA ACTIQ PA; ACTIVELLA F ACTONEL TAB 150 mg, 30 mg, 35 mg ACTONEL TAB 5 mg ACTOPLUS MET ACTOPLUS MET XR ACTOS TAB 15 mg, 30 mg, 45 mg ACULAR ACULAR LS ACURA METER KIT ACURA PLUS PA; Page 6 of 116
ACURA STARTER KIT ACURA TEST STRIPS ACUVAIL (PF) acyclovir ACZONE ADALAT CC adapalene PA ADCIRCA PA; ADDERALL TAB 10 mg ADDERALL TAB 12.5 mg, 15 mg, 20 mg, 30 mg, 5 mg, 7.5 mg ADDERALL XR 24 HR CAP 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 5 mg PA ADIPEX-P PA PA; AG PA; ADOXA PA; ADOXA PAK PA; ADRENACLICK ADRENALIN NASL ADVAIR DISKUS ADVAIR HFA ADVANCE TEST ADVANCED AM- PM ADVICOR PA ADVOCATE REDI- CODE STRIPS ADVOCATE TEST STRIPS AERO OTIC HC AEROCHAMBER AEROCHAMBER MASK AEROCHAMBER MASK LARGE AEROCHAMBER MASK SMALL AEROCHAMBER MAX - MASK LARGE Page 7 of 116
AEROCHAMBER MAX - MASK MEDIUM AEROCHAMBER MAX - MASK SMALL AEROCHAMBER MINI AEROCHAMBER MV AEROCHAMBER PLUS Z STAT AEROCHAMBER PLUS Z STAT LG MSK AEROCHAMBER PLUS Z STAT MD MSK AEROCHAMBER PLUS Z STAT SM MSK AEROCHAMBER WITH FLOWSIGNAL AEROCHAMBER Z-STAT PLUS- FLW SG AEROGEAR ACTION ASTHMA KIT AEROTRACH PLUS AFEDITAB CR AFINITOR TAB 10 mg, 2.5 mg, 5 mg, 7.5 mg AGGRENOX AGRYLIN A-HYDROCORT AIMSCO INSULIN SYRINGE AK-CON AKNE-MYCIN AK-PENTOLATE AK-POLY-BAC AKTEN (PF) ALA-CORT PA; Page 8 of 116
ALAGESIC ALAGESIC LQ ALA-HIST AC ALA-HIST DHC ALA-HIST DM ALA-HIST LQ ALA-QUIN ALA-SCALP ALAWAY ALBENZA albuterol sulfate ALCAINE alclometasone ALCORTIN A ALDACTAZIDE ALDACTONE ALDARA ALDEX AN alendronate tab 10 mg, 5 mg alendronate tab 35 mg, 40 mg, 70 mg ALFERON N alfuzosin ALICLEN ALINIA ORAL SUSP ; AG ALINIA TAB ; AG ALKERAN ORAL ALLEGRA ORAL SUSP ALLEGRA TAB 180 mg, 60 mg PA; PA; ALLEGRA ODT PA; ALLEGRA-D 12 HOUR ALLEGRA-D 24 HOUR ALLERX 10 ALLERX 30 ALLERX DF ALLERX DF 30 ALLERX PE ALLERX-D PA; PA; Page 9 of 116
ALLFEN CD ALLFEN CDX ALLFEN DM allopurinol ALOCRIL ALODOX ALOMIDE ALOQUIN ALORA F; ALPHAGAN P EYE DROPS 0.1 % ALPHAGAN P EYE DROPS 0.15 % ALPHAQUIN HP alprazolam ALPRAZOLAM INTENSOL ALREX ALSUMA PA; ALTABAX ALTACE ALTAFLUOR ALTAFRIN EYE DROPS 10 %, 2.5 % ALTOPREV PA aluminum acetate top ALVESCO amantadine oral AMARYL AMBIEN PA; ; AG AMBIEN CR PA; ; AG AMBIFED AMBIFED CD AMBIFED CDX AMBIFED DM AMBIFED-G CD AMBIFED-G CDX amcinonide AMERGE PA; A-METHAPRED Amethia F Page 10 of 116
AMICAR amiloride oral aminocaproic acid oral aminophylline oral amiodarone oral AMITIZA amitriptyline amlodipine ammonium lactate top AMNESTEEM PA amoxapine amoxicillin amoxicillin-pot clavulanate AMPHETAMINE SALT COMBO amiloridehydrochlorothiazide amitriptylinechlordiazepoxide amlodipineatorvastatin amlodipinebenazepril amphetaminedextroamphetamine er 24 hr cap 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 5 mg ampicillin ampicillin solution for injection 2 gram, 250 mg, 500 mg PA; AG PA; AMPYRA PA; ; AG AMRIX AMTURNIDE AMVISC AMVISC PLUS amyl nitrite ANACAINE ANADROL-50 ANAFRANIL anagrelide Page 11 of 116
ANALPRAM ADVANCED ANALPRAM E ANALPRAM-HC RECTAL CREAM ANALPRAM-HC RECTAL LOTION ANALPRAM-HC SINGLES ANAPROX PA ANAPROX DS PA ANASPAZ anastrozole ANCOBON ANDRODERM PA; M; ANDROGEL PA; M; ANDROID ANDROXY ANGELIQ F ANIMAS 2020 INSULIN PUMP ANSAID PA ANTABUSE ANTARA PA antipyrinebenzocaine ANTIVERT ANUCORT-HC ANUSOL-HC ANZEMET ORAL APEXICON APEXICON E PA APIDRA APIDRA SOLOSTAR APLENZIN APLIGRAF APOKYN apraclonidine APRI F APRISO APTIVUS AQUASOL A ARALEN Page 12 of 116
ARANELLE (28) F ARANESP (POLYSORBATE) ARAVA PA ARCALYST PA ARCAPTA NEOHALER ARESTIN ARGYLE ARICEPT PA; ARICEPT ODT PA; ARIMIDEX F ARMOUR THYROID AROMASIN ARTHROTEC 50 PA ARTHROTEC 75 PA ARTISS ASACOL ASACOL HD ASCOMP W/CODEINE ascorbic acid inj ASMALPRED PLUS ASMANEX TWISTHALER ASSURE 3 TEST ASSURE 4 STRIPS ASSURE PLATINUM STRIPS ASSURE PRO BLOOD GLUCOSE METER ASSURE PRO TEST STRIPS ASTELIN ASTEPRO ASTHMAPACK CHILDREN'S ASTHMAPACK I ASTHMAPACK II ASTHMAPACK III ASTRINGYN Page 13 of 116
ATABEX EC ATACAND ATACAND HCT ATELVIA PA atenolol atenololchlorthalidone ATIVAN ORAL ATRALIN PA; AG ATRIPLA atropine opht ATROPINE-CARE ATROVENT ATROVENT HFA AUGMENTIN ORAL SUSP 250-62.5 mg/5 ml AUGMENTIN XR AURODEX AUROGUARD AUTOJECT 2 INJECTION DEVICE AUTOPEN 1 TO 16 UNITS AUTOPEN 1 TO 21 UNITS AUTOPEN 2 TO 32 UNITS AUTOPEN 2 TO 42 UNITS AVAGE AVAILNEX AVALIDE AVANDAMET AVANDARYL AVANDIA TAB 2 mg, 4 mg, 8 mg AVAPRO AVC VAGINAL AVELOX AVELOX ABC PACK PA; Page 14 of 116
AVIANE F AVINZA AVITA PA; AG AVODART PA AVONEX AVONEX ADMINISTRATIO N PACK AXERT PA; AXID AXIRON PA; AXONA AYGESTIN AZACTAM AZASAN AZASITE azathioprine azathioprine sodium azelastine nasl azelastine opht AZELEX AZILECT azithromycin oral packet azithromycin oral susp azithromycin tab 250 mg, 500 mg, 600 mg AZOPT AZOR aztreonam AZULFIDINE AZULFIDINE EN- TABS AZURETTE F B COMPLEX 100 INJ BACIIM bacitracin im bacitracin opht bacitracinpolymyxin b opht baclofen BACMIN Page 15 of 116
bacteriostatic sodium chloride BACTRIM BACTRIM DS BACTROBAN OINTMENT BACTROBAN TOPICAL CREAM BACTROBAN NASAL balsalazide BALZIVA (28) F BANZEL TAB BARACLUDE BAYCADRON BD INSULIN PEN NEEDLE UF MINI BD INSULIN PEN NEEDLE UF ORIG BD INSULIN PEN NEEDLE UF SHORT BD INSULIN SYRINGE BD INSULIN SYRINGE HALF UNIT BD INSULIN SYRINGE MICRO- FINE BD INSULIN SYRINGE SAFETY-LOK BD INSULIN SYRINGE SLIP TIP BD INSULIN SYRINGE ULT- FINE II BD INSULIN SYRINGE ULTRA- FINE BD INTEGRA INSULIN SYRINGE BD MAGNI- GUIDE SYRINGE MAGNIFI Page 16 of 116
BD SAFETYGLIDE INSULIN SYRINGE 0.3 ml 29 x 1/2", 0.3 ml 31 x 5/16", 1 ml 29 x 1/2", 1/2 ml 30 x 5/16" BECONASE AQ PA; belladonna alkaloids-opium BELLADONNA- OPIUM benazepril benazeprilhydrochlorothiazide BENICAR BENICAR HCT BENSAL HP BENTYL BENZAC AC BENZAC AC WASH BENZAC W WASH BENZACLIN BENZACLIN PUMP BENZAMYCIN BENZAMYCINPA K BENZEFOAM BENZEFOAM ULTRA BENZIQ BENZIQ LS benzoin benzonatate benzoyl peroxide topical cleanser benzoyl peroxide topical gel 10 %, 5 % benzoyl peroxide topical pads benzphetamine PA; AG benztropine oral BEPREVE BESIVANCE Page 17 of 116
BETADINE OPHTHALMIC PREP BETAGAN betamethasone acet & sod phos betamethasone dipropionate betamethasone valerate betamethasone, augmented BETAPACE BETAPACE AF BETASERON betaxolol bethanechol chloride BETIMOL BETOPTIC S BEYAZ BIAFINE EMULSION BIAXIN BIAXIN XL BIAXIN XL PAK bicalutamide BIDIL BILTRICIDE BIOCEL BIONECT BIONIME RIGHTEST TEST STRIPS bisoprolol fumarate bisoprololhydrochlorothiazide BLEPH-10 BLEPHAMIDE BLEPHAMIDE S.O.P. BLOOD GLUCOSE TEST BONIVA ORAL PA; BONTRIL PDM PA Page 18 of 116
BP 10-1 BP-50% UREA B-PLEX B-PLEX PLUS BPO BPO CREAMY WASH PACK BRAVELLE PA; AG BREATHERITE MDI SPACER BREATHERITE RIGID SPACER& MASK BREATHERITE SPACER& MASK,ADULT BREATHERITE SPACER& MASK,CHILD BREATHERITE SPACER&MASK,I NFANT BREATHERITE SPACER&MASK,S.CHLD BREATHERITE VALVED MDI CHAMBER BREATHERITE VALVED MDI SPACER BREATHERITE WITH MASK, LARGE BREATHERITE WITH MASK, MEDIUM BREATHERITE WITH MASK, SMALL BREEZE 2 TEST STRIPS BREVICON (28) F BREVOXYL-4 COMPLETE PACK BREVOXYL-8 COMPLETE PACK BRILINTA PA; brimonidine BROMDAY Page 19 of 116
BROMDAY TWINPACK BROMFED DM bromfenac bromocriptine BRONCOMAR-1 BRONKIDS BRONTUSS SF BROVANA BROVEX BROVEX ADT BROVEX CB BROVEX CBX BROVEX PB C BROVEX PB CX BROVEX PD BROVEX PEB BROVEX PEB DM BROVEX PSB BROVEX SR BUCALSEP Budeprion SR Budeprion XL budesonide inhl budesonide oral bumetanide oral BUPAP BUPHENYL bupivacaine bupivacaine (pf) buprenorphine sl Buproban bupropion hcl buspirone BUTALBITAL COMPOUND BUTALBITAL COMPOUND W/CODEINE bupivacainedextrose-water(pf) butalbitalacetaminophen Page 20 of 116
butalbitalacetaminophen-caff butalbital-aspirincaffeine cap butalbital-aspirincaffeine tab BUTISOL butorphanol tartrate nasl BUTRANS BYDUREON BYETTA SUB-Q PEN INJECTOR 10 mcg/0.04 ml, 5 mcg/0.02 ml BYSTOLIC cabergoline CADUET CAFCIT ORAL CAFERGOT caffeine citrated oral CAFGESIC PA; CALAFOL RX CALAN CALAN SR calcipotriene topical soln calcitonin (salmon) calcitriol oral calcium acetate oral CALCIUM DISODIUM VERSENATE CALCIUM-FOLIC ACID-VITAMIN D CAMBIA PA; CAMILA F CAMPRAL Camrese F CANASA CANTIL CAPASTAT CAPEX CAPHOSOL Page 21 of 116
CAPITAL WITH CODEINE CAPRELSA TAB 100 mg, 300 mg captopril CARAC CARAFATE CARBAGLU PA carbamazepine CARBATROL CARBATUSS CARBATUSS-12 CARBATUSS-CL CARBA-XP carbidopa-levodopa carbinoxamine maleate CARBOCAINE CARBOCAINE (PF) PA; CARDIOTEK-RX (BIOPERINE) CARDIOVID PLUS CARDIZEM CARDIZEM CD CARDIZEM LA CARDURA PA CARDURA XL PA CAREONE ULTRA THIN LANCET CARESENS N TEST STRIPS carisoprodol tab 350 mg captoprilhydrochlorothiazide carisoprodol-asacodeine carisoprodol-aspirin CARMOL HC CARNITOR ORAL CARNITOR SUGAR-FREE carteolol CARTIA XT Page 22 of 116
CARTICEL carvedilol CASODEX CATAFLAM PA CATAPRES CATAPRES-TTS- 1 CATAPRES-TTS- 2 CATAPRES-TTS- 3 CAYSTON CAZIANT F CEDAX ORAL SUSP 90 mg/5 ml CEENU cefaclor cefadroxil cefdinir cefditoren pivoxil cefepime cefotaxime cefpodoxime cefprozil CEFTIN cefuroxime axetil CELEBREX CAP 100 mg, 200 mg, 50 mg CELEBREX CAP 400 mg CELESTONE CELESTONE SOLUSPAN CELEXA TAB 10 mg, 20 mg, 40 mg CELLCEPT CAP CELLCEPT ORAL SUSP CELLCEPT TAB CELONTIN CENESTIN F CENOLATE CENTANY CENTERGY PA ADV Page 23 of 116
CENTERGY DM CENTRATEX CEPHADYN cephalexin CEREFOLIN CEREFOLIN NAC CERISA CERVIDIL CESAMET CETACAINE CETACAINE ANESTHETIC CETACAINE MEDICAL KIT E CETRAXAL CETROTIDE PA; AG CHANTIX PA; ; AG CHEMET CHENODAL PA Cheratussin AC Cheratussin DAC chloral hydrate oral chlordiazepoxide hcl chlordiazepoxideclidinium chlorhexidine gluconate mm chloroquine Tab 250 mg chloroquine tab 500 mg chlorothiazide chlorpromazine oral chlorpropamide chlorthalidone chlorzoxazone CHOICEDM CLARUS STRIPS cholesterol cholestyramine (with sugar) CHOLESTYRAMI NE LIGHT choline & magnesium salicylate Page 24 of 116
chorionic gonadotropin, human PA; AG CIALIS PA; M; AG ciclopirox ciclopirox-vite-nail lacq remo cilostazol CILOXAN cimetidine cimetidine hcl CIMZIA PA; CIMZIA POWDER FOR RECONST CIMZIA STARTER KIT CIPRO ORAL SUSP CIPRO TAB CIPRO HC CIPRO XR CIPRODEX ciprofloxacin opht PA; PA; ciprofloxacin oral citalopram CITRANATAL 90 DHA (NEW FORMULA CITRANATAL ASSURE CITRANATAL B- CALM CITRANATAL DHA (NEW FORMULA) CITRANATAL RX (NEW FORMULA) CLARAVIS PA CLARIFOAM EF CLARINEX SYRUP PA; CLARINEX TAB PA; CLARINEX TAB, RAPID DISSOLVE CLARINEX-D 12 HOUR PA; PA; Page 25 of 116
CLARINEX-D 24 HOUR CLARIS CLARIFYING WASH clarithromycin CLEANSING WASH clemastine syrup CLENIA CLEOCIN CAP 150 mg, 300 mg CLEOCIN CAP 75 mg CLEOCIN ORAL SOLUTION CLEOCIN VAGL CLEOCIN T CLEVER CHEK TEST STRIPS CLEVER CHOICE PRO BLOOD GLUCOSE MONITOR STRIPS PA; CLIMARA F; CLIMARA PRO F; CLINDAGEL CLINDAMAX clindamycin cap 150 mg, 300 mg clindamycin palmitate hcl clindamycin phosphate top clindamycin phosphate vagl clindamycin-benzoyl peroxide CLINDAREACH CLINDESSE CLINORIL PA clobetasol clobetasol-emollient CLOBEX LOTION CLOBEX SHAMPOO Page 26 of 116
CLOBEX TOPICAL SPRAY PA CLODERM PA CLOMID PA; ; AG clomiphene citrate PA; ; AG clomipramine clonazepam clonidine oral clonidine td clorazepate dipotassium CLORPRES clotrimazole mm clotrimazole top clozapine CLOZARIL CNL 8 NAIL COAGUCHEK PT COAGUCHEK XS coal tar COARTEM COCET COCET PLUS codeine sulfate codeine-guaifenesin COGENTIN CO-GESIC clotrimazolebetamethasone cod-butalbitalacetaminop-caf colchicineprobenecid COLCRYS COLESTID COLESTID FLAVORED colestipol COLOCORT COLY-MYCIN S COLYTE WITH FLAVOR PACKS COMBIGAN COMBIPATCH F; Page 27 of 116
COMBIVENT COMBIVIR COMFORT PAC- CYCLOBENZAPRI NE COMFORT PAC- IBUPROFEN COMFORT PAC- NAPROXEN COMFORT PAC- TIZANIDINE COMP-AIR ELITE COMP NEB SYSTEM COMPLERA COMPLETE NATAL DHA COMPLETENATE COMPLETE-RF PRENATAL COMPRO COMTAN CO-NATAL FA CONCEPT DHA CONCEPT OB CONCEPTION CONCERTA 24 HR TAB 18 mg, 27 mg, 36 mg, 54 mg CONDYLOX TOPICAL GEL CONDYLOX TOPICAL SOLN CONSTULOSE CONTOUR METER CONTOUR TEST STRIPS CONTROL G3 CONTROL TEST CONZIP ER COPAXONE COPD PA; ; AG COPEGUS PA; CORDARONE CORDRAN PA CORDRAN SP PA Page 28 of 116
COREG COREG CR CORFEN-DM CORGARD CORMAX CORTANE-B CORTANE-B AQUEOUS CORTEF CORTENEMA CORTIFOAM cortisone oral CORTISPORIN CORTISPORIN-TC CORVITA CORVITA 150 CORVITE CORVITE 150 CORVITE FREE CORZIDE COSOPT COTAB A COTAB AX COTABFLU COUMADIN ORAL COVARYX F COVARYX H.S. F COVERA-HS COZAAR CREON CAPSULE, DELAYED RELEASE 12,000-38,000-60,000 unit, 24,000-76,000-120,000 unit, 6,000-19,000-30,000 unit CRESTOR TAB 10 mg, 5 mg CRESTOR TAB 20 mg CRESTOR TAB 40 mg CRESYLATE PA ADV Page 29 of 116
CRINONE VAGINAL GEL 4 %, 8 % CRIXIVAN cromolyn inhl cromolyn opht CRYOSERV CRYSELLE (28) F CUPRIMINE CUROSURF CUTIVATE PA CUVPOSA cyanocobalamin (vitamin b-12) inj CYCLESSA F cyclobenzaprine er 24 hr cap cyclobenzaprine tab 10 mg, 5 mg CYCLOGYL CYCLOMYDRIL cyclopentolate cyclophosphamide oral CYCLOSET cyclosporine oral cyclosporine modified CYMBALTA CAPSULE, DELAYED RELEASE 20 mg, 30 mg, 60 mg cyproheptadine CYSTADANE CYSTAGON CYTOMEL CYTOTEC CYTRA K CRYSTALS CYTRA-2 CYTRA-3 CYTRA-K DALIRESP DALLERGY PA; Page 30 of 116
danazol oral DANTRIUM ORAL dantrolene dapsone DARAPRIM DAYPRO PA DAYTRANA PA; ; AG DDAVP NASAL SOLN DDAVP ORAL DEBACTEROL DE-CHLOR DM deferoxamine DELATESTRYL PA; M; DELESTROGEN F DELOS DEMADEX demeclocycline oral DEMEROL ORAL DEMSER DENAVIR DENTA 5000 PLUS DENTAGEL DEPADE DEPAKENE DEPAKOTE DEPAKOTE ER DEPAKOTE SPRINKLES DEPEN TITRATABS DEPLIN DEPO- ESTRADIOL DEPO-MEDROL DEPO-PROVERA IM DEPO-PROVERA IM SUSP DEPO-PROVERA IM SYRINGE DEPO-SUBQ PROVERA 104 F F; F; F Page 31 of 116
DEPO- TESTOSTERONE IM OIL 100 mg/ml, 200 mg/ml DERMA- SMOOTH/FS BODY OIL DERMA- SMOOTHE/FS SCALP OIL DERMATOP DERMAZENE DERMOTIC OIL DESFERAL desipramine oral desmopressin nasal soln desmopressin nasal spray desmopressin oral DESOGEN F DESONATE PA desonide desoximetasone PA; M; ; AG DESOXYN PA DESPEC-EXP DESPEC-PDC DESQUAM-X DETROL DETROL LA dexamethasone elixir dexamethasone oral soln dexamethasone tab 0.5 mg, 0.75 mg, 1.5 mg, 4 mg, 6 mg dexamethasone Tab 1 mg, 2 mg DEXAMETHASO NE INTENSOL dexamethasone sodium phos (PF) dexamethasone sodium phosphate DEXASOL dexchlorpheniramin e maleate Page 32 of 116
DEXEDRINE SPANSULE DEXFERRUM PA; AG DEXILANT PA; dexmethylphenidate PA; AG DEXPAK DEXPAK JR. dexpanthenol dextroamphetamine PA dextromethorphanguaifenesin DEX-TUSS DIABETA DIALYVITE DIALYVITE 3000 DIALYVITE 5000 DIALYVITE 800 WITH IRON DIAMOX SEQUELS DIASTAT DIASTAT ACUDIAL DIATX ZN diazepam oral diazepam rect DIAZEPAM INTENSOL DIBENZYLINE diclofenac potassium diclofenac sodium dicloxacillin dicyclomine didanosine DIDREX PA DIDRONEL diethylpropion PA; AG DIFFERIN PA DIFIL-G 400 diflorasone DIFLUCAN diflunisal Page 33 of 116
DIGEX NF digoxin oral DIHYDRO-PE DILACOR XR DILANTIN DILANTIN EXTENDED DILANTIN INFATABS DILANTIN-125 DILATRATE-SR DILAUDID DILAUDID-5 DILEX-G 200 DILEX-G 400 DILT-CD DILTIA XT diltiazem cd 24 hr cap 120 mg, 180 mg, 240 mg, 300 mg diltiazem er cap 120 mg, 180 mg, 240 mg diltiazem hcl oral DILT-XR DILTZAC ER DIOVAN DIOVAN HCT DIPENTUM dihydrocodeacetaminophen-caff diphenoxylateatropine DIPROLENE DIPROLENE AF dipyridamole oral DISKETS disopyramide disulfiram DITROPAN XL PA DIURIL divalproex DIVIGEL F DIVISTA DOLGIC PLUS Page 34 of 116
DOLOPHINE DONATUSS DC DONATUSSIN DM DONATUSSIN PEDI (REFORMULATE D) donepezil PA; DONNATAL DONNATAL EXTENTABS DORYX PA; dorzolamide dorzolamide-timolol DOVONEX doxazosin doxepin oral doxycycline hyclate cap doxycycline hyclate tab doxycycline monohydrate doxycycline monohydrate cap 100 mg, 50 mg DOXYTEX DRISDOL CAP DRITHOCREME HP DRITHO-SCALP dronabinol DROXIA DRYSOL DAB-O- MATIC DUAC DUET DHA COMPLETE DUETACT DUEXIS DULERA DUONEB DUOVISC VISCO ELASTIC DURABAC DURAGESIC Page 35 of 116
DURAXIN DUREZOL DUTOPROL DYAZIDE DYNACIN TAB 100 mg DYNACIRC CR dyphyllineguaifenesin DYRENIUM DYSPORT IM 500 unit E.E.S. 400 E.E.S. GRANULES EASIVENT HOLDING CHAMBER EASIVENT MASK LARGE EASIVENT MASK MEDIUM EASIVENT MASK SMALL EASY CHECK TEST EASY CLICK LANCING DEVICE EASY COMFORT INSULIN SYRINGE EASY COMFORT LANCETS EASY GLUCO G2 EASY PLUS EASY PLUS BLOOD GLUCOSE KIT EASY PLUS GLUCOSE SYSTEM EASY PRO PLUS TEST STRIPS EASY STEP EASY STEP BLOOD GLUCOSE METER Page 36 of 116
EASY STEP BLOOD GLUCOSE SYSTEM EASY TALK GLUCOSE TEST EASY TOUCH STRIPS EASY TOUCH INSULIN SYRINGE 0.3 ml 30 x 1/2", 0.3 ml 30 x 5/16", 0.3 ml 31 x 5/16", 1 ml 27 x 1/2", 1 ml 28 x 1/2", 1 ml 29 x 1/2", 1 ml 30 x 1/2", 1 ml 30 x 5/16", 1 ml 31 x 5/16", 1/2 ml 28 x 1/2", 1/2 ml 29 x 1/2", 1/2 ml 30 x 1/2", 1/2 ml 30 x 5/16", 1/2 ml 31 x 5/16" EASY TOUCH LANCETS EASY TRAK GLUCOSE TEST EASYGLUCO PLUS STRIPS EASYGLUCO TEST EASYMAX ECLIPSE TEST STRIPS EC-NAPROSYN PA econazole top ED A-HIST ED DM EDARBYCLOR EDECRIN EDEX M EDLUAR PA; ED-SPAZ EDURANT EEMT F EEMT HS F EFFER-K EFFEXOR XR PA EFFIENT PA; Page 37 of 116
EFUDEX EGRIFTA PA; ELDOPAQUE FORTE ELDOQUIN FORTE ELEMENT TEST STRIPS ELESTAT ELESTRIN F; ELIDEL AG ELIGARD ELIPHOS ELITE-OB ELIXOPHYLLIN ELLA ELMIRON ELOCON EMADINE EMBRACE BLOOD GLUCOSE SYSTEM STRIPS EMCYT EMEND CAP 125 mg, 80 mg EMEND CAP 40 mg EMEND CAPS IN DOSE PACK EMSAM EMTRIVA ENABLEX PA enalapril maleate enalaprilhydrochlorothiazide ENBREL PA ENBREL SURECLICK ENDACOF-C ENDACOF-DC PA ENDOCET ENDODAN ENDOMETRIN PA ENJUVIA F Page 38 of 116
enoxaparin sub-q syringe 100 mg/ml, 120 mg/0.8 ml, 150 mg/ml, 30 mg/0.3 ml, 40 mg/0.4 ml, 60 mg/0.6 ml, 80 mg/0.8 ml ENPRESSE F ENTEREG ENTOCORT EC ENULOSE ENVISION TEST STRIPS EPIDRIN EPIDUO PA EPIFLUR EPIFOAM EPIKLOR epinastine EPIPEN EPIPEN JR EPIQUIN MICRO EPITOL EPIVIR EPIVIR HBV eplerenone EPOGEN PA eprosartan EPZICOM EQUETRO ergocalciferol (vitamin d2) cap ergoloid ERGOMAR ergotamine-caffeine ERIVEDGE ERRIN F ERTACZO ERY PADS ERYPED 200 ERYPED 400 ERY-TAB ERYTHROCIN STEARATE erythromycin Page 39 of 116
erythromycin tab 500 mg erythromycin ethylsuccinate oral erythromycin with ethanol erythromycinbenzoyl peroxide escitalopram tab ESGIC ESGIC-PLUS estazolam AG ESTRACE F estradiol oral F estradiol td F; estradiol valerate F erythromycinsulfisoxazole estradiolnorethindrone acet ESTRASORB F ESTRING ESTROGEL F; F estrogensmethyltestosterone estropipate F ESTROSTEP FE-28 F ethambutol ethosuximide ethyl chloride etidronate disodium etodolac etoposide oral PA EUFLEXXA EURAX EVAMIST F; EVENCARE TEST EVISTA EVOCLIN EVOLUTION BLOOD GLUCOSE METER EVOLUTION TEST STRIPS EVOXAC F Page 40 of 116
EXACTACAIN EXALGO ER EXEFEN-IR EXEL INSULIN EXELDERM EXELON CAP 1.5 mg, 3 mg, 4.5 mg, 6 mg EXELON ORAL SOLN EXELON TRANSDERM 24 HR PATCH 4.6 mg/24 hour, 9.5 mg/24 hour exemestane EXFORGE EXFORGE HCT PA; ADV PA; ADV PA; ADV EXJADE PA; AG EXODERM EXOTIC-HC EXTAVIA EXTINA EXTRANEAL PERITONEAL DIALYSIS EZ SMART PLUS TEST EZ SMART TEST E-Z SPACER E-Z SPACER PEDSPAK FABB FACTIVE famciclovir famotidine oral famotidine tab 20 mg, 40 mg FAMVIR FANAPT FANATREX FARESTON FASLODEX FASTTAKE TEST FAZACLO Page 41 of 116
FE C PLUS felbamate FELBATOL FELDENE PA felodipine FEM PH FEMARA F FEMCON FE F FEMHRT 1/5 F FEMHRT LOW DOSE FEMRING FEMTRACE F fenofibrate fenofibrate micronized fenofibric acid FENOGLIDE PA fenoprofen fentanyl fentanyl citrate PA; FENTORA PA; F FEROCON FEROTRIN FEROTRINSIC FERRALET 90 DUAL-IRON DELIVERY FERRAPLUS 90 FERREX 150 FORTE FERREX 150 FORTE PLUS FERREX 28 FERRIPROX PA; FERROCITE PLUS FERROGELS FORTE FEXMID fexofenadine tab 180 mg, 30 mg, 60 mg fexofenadinepseudoephedrine er 12 hr tab Page 42 of 116
fexofenadinepseudoephedrine er 24 hr tab FIBRICOR PA FIFTY50 RESERVOIR FIFTY50 TEST STRIP FINACEA FINACEA PLUS finasteride FIORICET FIORICET- CODEINE FIORINAL FIORINAL- CODEINE #3 FIRAZYR PA; FIRMAGON FIRST-BXN FIRST- HYDROCORTISO NE FIRST- PROGESTERONE VGS 100 FIRST- PROGESTERONE VGS 200 FIRST- PROGESTERONE VGS 25 FIRST- PROGESTERONE VGS 400 FIRST- PROGESTERONE VGS 50 FIRST- TESTOSTERONE FIRST- TESTOSTERONE MC FLAGYL FLAGYL ER FLAREX flavoxate flecainide PA; AG PA; AG Page 43 of 116
FLECTOR PA FLEXERIL FLEXTRA PLUS FLOMAX PA FLONASE PA; FLO-PRED FLOVENT DISKUS FLOVENT HFA fluconazole flucytosine fludrocortisone FLUMADINE flunisolide fluocinolone ointment fluocinolone topical cream fluocinolone topical soln fluocinonide FLUOCINONIDE-E FLUORABON FLUOR-A-DAY FLUOR-A-DAY (WITH XYLITOL) fluocinonideemollient fluoresceinproparacaine FLUORITAB CHEWABLE fluorometholone FLUOROPLEX fluorouracil top fluoxetine cap fluoxetine cap, delayed release fluoxetine oral soln fluoxetine tab 10 mg, 20 mg fluoxetine Tab 60 mg fluphenazine hcl oral Page 44 of 116
FLURA-DROPS flurazepam AG flurbiprofen flurbiprofen sodium FLURESS FLUROX flutamide fluticasone nasl fluticasone top fluvoxamine FML FORTE FML LIQUIFILM FML S.O.P. FOCALIN PA; AG FOCALIN XR CAP 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 5 mg FOCALIN XR CAP 25 mg, 35 mg FOLBECAL FOLBEE PA; ; AG PA; FOLBEE PLUS FOLBIC FOLCAPS FOLCAPS OMEGA-3 FOLGARD OS FOLGARD RX folic acid folic acid tab 1 mg folic acid-vit b6-vit b12 tab 2.2-25-0.5 mg FOLINATAL PLUS B FOLITAB FOLIVANE-F FOLIVANE-OB FOLIVANE-PLUS FOLIVANE-PRX DHA NF FOLLISTIM AQ PA; AG FOLPACE RX Page 45 of 116
FOLPLEX 2.2 FOLTRATE FOLTX FORA D10 STRIPS FORA D15C FORA D15G FORA D15Z FORA D20 STRIPS FORA G20 STRIPS FORA G30A STRIPS FORA G71A STRIPS FORA G90 STRIPS FORA V10 STRIPS FORA V12 GLUCOSE FORA V20 STRIPS FORA V22 STRIPS FORA V30A STRIPS FORADIL AEROLIZER FORMADON TOPICAL SOLN FORTAMET 24 HR TAB CTRL REL 1,000 mg, 500 mg FORTAVIT FORTEO PA PA; FORTESTA PA; M; FORTICAL FOSAMAX TAB PA; FOSAMAX PLUS D fosinopril fosinoprilhydrochlorothiazide FOSRENOL FOSTEUM FOVEX FRAGMIN SUB-Q PA; Page 46 of 116
FRAGMIN SUB-Q SYRINGE 10,000 unit/ml, 12,500 unit/0.5 ml, 15,000 unit/0.6 ml, 18,000 unit/0.72 ml, 2,500 unit/0.2 ml, 5,000 unit/0.2 ml, 7,500 unit/0.3 ml FREESTYLE CONTROL FREESTYLE FLASH SYSTEM FREESTYLE FREEDOM FREESTYLE FREEDOM LITE FREESTYLE LANCETS FREESTYLE LITE METER FREESTYLE LITE STRIPS FREESTYLE NAVIGATOR GLUC SENS FREESTYLE SIDEKICK II FREESTYLE SYSTEM KIT FREESTYLE TEST FRESHKOTE FROVA PA; FURADANTIN furosemide oral soln 10 mg/ml furosemide Oral Soln 40 mg/5 ml furosemide tab FUZEON SUB-Q KIT G-4 TEST gabapentin GABITRIL galantamine PA GALZIN ganirelix PA; AG GASTRINEX NF Page 47 of 116
GASTROCROM GASTROMARK GAVILYTE-C GAVILYTE-G GAVILYTE-N GELFILM OPHT GELNIQUE PA gemfibrozil oral GENERESS FE GENERLAC GENGRAF GENOTROPIN PA; AG GENOTROPIN MINIQUICK GENTAK EYE OINTMENT gentamicin eye drops gentamicin top GENTEX 30 GEODON IM GEODON ORAL PA; AG GESTICARE DHA Gianvi GILDESS FE F GILENYA PA; GLEEVEC TAB 100 mg, 400 mg glimepiride glipizide glipizide-metformin GLUCAGEN GLUCAGEN DIAGNOSTIC KIT GLUCAGEN HYPOKIT GLUCAGON EMERGENCY GLUCOCARD 01 METER GLUCOCARD 01 SENSOR GLUCOCARD 01- MINI PA; Page 48 of 116
GLUCOCARD EXPRESSION STRIPS GLUCOCARD VITAL SENSOR GLUCOCARD X- METER GLUCOCARD X- SENSOR GLUCOCOM AUTOLINK GLUCOCOM BLOOD GLUCOSE GLUCOCOM GLUCOSE GLUCOCOM LANCETS GLUCOLAB STRIPS GLUCOLET 2 AUTOMATIC LANCING GLUCOPHAGE TAB 1,000 mg GLUCOPHAGE TAB 500 mg, 850 mg GLUCOPHAGE XR GLUCOTROL GLUCOTROL XL GLUCOVANCE GLUMETZA GLUTATHIONE-L glyburide glyburide micronized glyburide-metformin glycine ir GLYCINE UROLOGIC GLYCOLAX glycopyrrolate GLYNASE GLYSET GM100 STRIPS GOLYTELY Page 49 of 116
GONAL-F PA; AG GONAL-F RFF PA; AG GONAL-F RFF PEN GORDOFILM GORDONS UREA GRALISE GRALISE 30-DAY STARTER PACK granisetron oral GRANULEX GRIFULVIN V griseofulvin microsize GRIS-PEG guaifenesin tab guanfacine guanidine GUARDIAN REAL-TIME GLU MONITOR GUARDIAN RT CHARGER PA; AG GUARDIAN RT MONITOR SYSTEM GUARDIAN RT STARTER KIT GUARDIAN RT TEST PLUG DEVICE HALCION HALFLYTELY- BISACODYL W- FLAV PK halobetasol propionate HALOG HALONATE HALONATE PAC haloperidol haloperidol lactate oral HEATHER F HECTOROL ORAL HELIDAC Page 50 of 116
HEMABATE HEMATINIC PLUS VIT/MINERALS HEMATINIC/FOLI C ACID HEMATOGEN HEMATOGEN FA HEMATOGEN FORTE HEMATRON HEMATRON-AF HEMAX HEMOCYTE-F HEMOCYTE-PLUS HEMRIL-30 HEPSERA HEXALEN HIPREX HIST-PSE HOMATROPAIRE HORIZANT HUMALOG HUMALOG KWIKPEN HUMALOG MIX 50-50 HUMALOG MIX 50-50 KWIKPEN HUMALOG MIX 75-25 HUMALOG MIX 75-25 KWIKPEN HUMAPEN LUXURA HD HUMAPEN MEMOIR HUMATROPE PA; AG HUMIRA PA HUMIRA CROHN'S DIS START PCK PA HUMIRA PEN PA HUMIRA PSORIASIS STARTER PACK HUMULIN 70/30 PA Page 51 of 116
HUMULIN 70/30 PEN HUMULIN N HUMULIN N PEN HUMULIN R HUMULIN R U- 500 "CONCENTRATE D" HYALGAN HYCAMTIN ORAL HYCET hydralazine oral HYDREA HYDRO 35 HYDRO 40 hydrochlorothiazide cap hydrochlorothiazide Tab 12.5 mg hydrochlorothiazide tab 25 mg, 50 mg PA hydrocodoneacetaminophen Oral Soln 10-325 mg/15 ml(15 ml), 2.5-167 mg/5 ml, 5-163 mg/7.5ml(7.5ml), 5-334 mg/10 ml, 7.5-500 mg/15 ml(15 ml) hydrocodoneacetaminophen oral soln 7.5-500 mg/15 ml hydrocodoneacetaminophen tab hydrocodonehomatropine syrup hydrocodoneibuprofen hydrocortisone hydrocortisone ointment 1 %, 2.5 % hydrocortisone acetaloe vera hydrocortisone acetate rect Page 52 of 116
hydrocortisone butyrate hydrocortisone valerate hydrocortisoneacetic acid hydrocortisone-min oil-wht pet hydrocortisonepramox-e-pram#1 hydrocortisonepramoxine rect hydrogen peroxide soln 35 % HYDROMET hydromorphone oral hydromorphone rect hydroquinone hydroquinone microspheres hydroquinone with sunscreen hydroxocobalamin im hydroxychloroquine oral hydroxyurea hydroxyzine hcl hydroxyzine pamoate HYLATOPIC HYOMAX HYOMAX-DT HYOMAX-FT HYOMAX-SL HYOMAX-SR hyoscyamine sulfate HYOSYNE HYPERCARE HYPER-SAL NEB SOLUTION 7 % HYZAAR IBUDONE ibuprofen tab 400 mg, 600 mg, 800 mg Page 53 of 116
ibuprofenoxycodone IC400 IC800 ICAR-C PLUS ICAR-C PLUS SR IFEREX 150 FORTE ILARIS (PF) IMDUR imipramine hcl imipramine pamoate imiquimod IMITREX NASL PA; IMITREX ORAL PA; IMITREX SUBQ PA; IMITREX STATDOSE KIT REFILL IMITREX STATDOSE PEN IMPLANON F PA PA IMURAN INATAL ADVANCE INATAL GT INATAL ULTRA INCIVEK PA; INCRELEX PA; AG indapamide INDERAL LA INDOCIN ORAL PA INDOCIN RECT indomethacin INFASURF INFED INFERGEN SUB-Q 15 mcg/0.5 ml, 9 mcg/0.3 ml INFINITY TEST STRIPS INLYTA TAB 1 mg, 5 mg INNOPRAN XL PA PA; Page 54 of 116
INNOVO INOVA INOVA 4-1 INOVA 8-2 INS SYRINGE/NEEDL E 0.5CC/27G INSPRA insulin needles (disposable) INSULIN PEN NEEDLE INSULIN SYRINGE INSULIN SYRINGE MICROFINE insulin syringe needleless INSULIN SYRINGE ULTRAFINE insulin syringeneedle U-100 insulin syringes (disposable) INTEGRA F INTEGRA PLUS INTELENCE INTERMEZZO INTRON A PA INTUNIV ER PA; ; AG INVEGA INVIRASE iodoquinol-hc IODOSORB IONAMIN-30 PA IOPHEN C-NR IOPHEN DM-NR IOPHEN-NR IOPIDINE EYE DROPPERETTE IOPIDINE EYE DROPS ipratropium bromide Page 55 of 116
ipratropiumalbuterol IPRIVASK ISENTRESS ISOCHRON ISONARIF isoniazid oral ISOPTO ATROPINE ISOPTO CARBACHOL ISOPTO CARPINE ISOPTO HOMATROPINE ISOPTO HYOSCINE ISORDIL ISORDIL TITRADOSE isosorbide dinitrate isosorbide mononitrate isoxsuprine isradipine ISTALOL itraconazole JAKAFI PA; JALYN PA JANTOVEN JANUMET JANUMET XR 24 HR TAB 100-1000 mg, 50-1,000 mg, 50-500 mg JANUVIA TAB 100 mg, 25 mg, 50 mg JAY-PHYL J-COF DHC JENTADUETO TAB 2.5-1,000 mg, 2.5-500 mg, 2.5-850 mg J-MAX DHC JOLESSA F PA; ; AG JOLIVETTE F Page 56 of 116
J-TAN D PD J-TAN PD JUNEL 1.5/30 (21) F JUNEL 1/20 (21) F JUNEL FE 1.5/30 (28) JUNEL FE 1/20 (28) F JUVISYNC KADIAN KALETRA KALEXATE KALYDECO PA; kanamycin KAPVAY PA; KARIVA F KAYEXALATE K- EFFERVESCENT KEFLEX KELNOR 1/35 (28) F KENALOG KEPPRA ORAL F KEPPRA XR KERAFOAM KERALYT RX KERALYT SCALP COMPLETE KERLONE KEROL KEROL AD KETEK AG ketoconazole ketoprofen ketorolac opht ketorolac oral KEYNOTE KINERET KIONEX KLARON KLONOPIN KLOR-CON KLOR-CON 10 KLOR-CON 8 Page 57 of 116
KLOR-CON M10 KLOR-CON M15 KLOR-CON M20 KLOR-CON/EF KOMBIGLYZE XR 24 HR TAB 2.5-1,000 mg, 5-1,000 mg, 5-500 mg K-PHOS MF K-PHOS NO 2 K-PHOS ORIGINAL K-PHOS- NEUTRAL KRISTALOSE K-TAB KUVAN PA l norgest&e estradiol-e estrad labetalol oral LAC-HYDRIN LACLOTION lactic acid LACTIC ACID E LACTOCAL-F lactulose oral soln 10 gram/15 ml LAMICTAL LAMICTAL ODT LAMICTAL ODT STARTER (BLUE) LAMICTAL ODT STARTER (GREEN) LAMICTAL ODT STARTER (ORANGE) LAMICTAL STARTER (BLUE) KIT LAMICTAL STARTER (GREEN) KIT LAMICTAL STARTER (ORANGE) KIT LAMICTAL XR Page 58 of 116
LAMICTAL XR STARTER (BLUE) LAMICTAL XR STARTER (GREEN) LAMICTAL XR STARTER (ORANGE) LAMISIL ORAL GRANULES IN PACKET LAMISIL TAB LAMISIL TOP lamivudine lamivudinezidovudine lamotrigine LANCETS,ULTRA THIN LANOXIN ORAL lansoprazole cap, delayed release 15 mg lansoprazole cap, delayed release 30 mg LANTUS LANTUS SOLOSTAR LASIX LASTACAFT latanoprost LATRIX LATRIX XM LATUDA TAB 40 mg, 80 mg LAVOCLEN-4 LAVOCLEN-4 (NEW CLEANSER) LAVOCLEN-8 LAVOCLEN-8 (NEW CLEANSER) LAZANDA PA; lecithin oral granules LEENA 28 F Page 59 of 116
leflunomide LESCOL PA LESCOL XL PA LESSINA F LETAIRIS PA; letrozole F leucovorin calcium oral LEUKERAN LEUKINE PA leuprolide LEVACET levalbuterol hcl LEVAQUIN LEVATOL LEVBID LEVEMIR LEVEMIR FLEXPEN levetiracetam er 24 hr tab levetiracetam oral soln 100 mg/ml levetiracetam Oral Soln 500 mg/5 ml (5 ml) levetiracetam tab LEVITRA M; AG levobunolol levocarnitine tab levocarnitine (with sugar) levocetirizine oral soln levocetirizine tab levofloxacin opht levofloxacin oral LEVORA-28 F levorphanol tartrate LEVOTHROID levothyroxine oral LEVOXYL LEVSIN Page 60 of 116
LEVSIN/SL LEVULAN LEXAPRO LEXIVA LEXUSS 210 LIALDA LIBERTY BLOOD GLUCOSE METER LIBERTY BLOOD GLUCOSE MONITOR LIBERTY TEST LIBRAX (WITH CLIDINIUM) LIDAMANTLE HC lidocaine hcl mm lidocaine hcl ointment lidocainehydrocortisone rectal kit 3-1 % (7 g) LIDOCAINE VISCOUS lidocainehydrocortisone-aloe vera rectal kit 3-2.5 % (7 gram) lidocaine-prilocaine LIDOCORT LIDODERM LIFESCAN FINEPOINT LANCETS LIMBREL LIMBREL250 LIMBREL500 LINCOCIN lindane liothyronine oral Lipitor LIPOCHOL PLUS LIPOFEN PA lisinopril lisinoprilhydrochlorothiazide Page 61 of 116
LITE TOUCH INSULIN PEN NEEDLES LITE TOUCH INSULIN SYRINGE LITE TOUCH LANCETS LITE TOUCH LANCING DEVICE LITEAIRE MDI CHAMBER lithium carbonate Cap 150 mg, 600 mg lithium carbonate cap 300 mg lithium carbonate er tab lithium carbonate tab lithium citrate LITHOBID LITHOSTAT LIVALO PA LO LOESTRIN FE F LOCOID LOCOID LIPOCREAM LODOSYN LOESTRIN 1.5/30 (21) LOESTRIN 1/20 (21) LOESTRIN 24 FE F LOESTRIN FE 1.5/30 (28) LOESTRIN FE 1/20 (28) LOFIBRA PA LOHIST - D LOHIST-DM LOKARA LOMOTIL LO-OVRAL (28) F loperamide cap LOPID PA F F F F Page 62 of 116
LOPRESSOR ORAL LOPRESSOR HCT LOPROX lorazepam oral LORAZEPAM INTENSOL LORCET 10/650 LORCET PLUS LORTAB LORTAB ELIXIR LORTUSS EX Loryna LORZONE losartan losartanhydrochlorothiazide LOSEASONIQUE F LOTEMAX LOTENSIN LOTENSIN HCT LOTREL LOTRISONE LOTRONEX PA; ; AG lovastatin LOVAZA PA; ; AG LOVENOX SUB-Q LOVENOX SUB-Q SYRINGE 100 mg/ml, 120 mg/0.8 ml, 150 mg/ml, 30 mg/0.3 ml, 40 mg/0.4 ml, 60 mg/0.6 ml, 80 mg/0.8 ml LOW-OGESTREL (28) loxapine succinate LOXITANE LOZI-FLUR LTA PRE- ATTACHED LUDENT FLUORIDE LUFYLLIN LUGOLS F Page 63 of 116
LUMIGAN PA; LUNESTA PA; ; AG LUPRON DEPOT IM SYRINGE KIT 3.75 mg, 7.5 mg LUPRON DEPOT (3 MONTH) LUPRON DEPOT (4 MONTH) LUPRON DEPOT (6 MONTH) LUPRON DEPOT- PED LUPRON DEPOT- PED (3 MONTH) LUSAIR LUSTRA LUSTRA-AF LUSTRA-ULTRA LUTERA (28) F LUVERIS PA; ; AG LUVOX CR LUXIQ PA LYBREL F LYRICA LYSIPLEX PLUS TAB LYSODREN LYSTEDA MACROBID MACRODANTIN MACUTEK MAGELLAN INSULIN SAFETY SYRNG MAGNACET MAGNEBIND 400 MALARONE malathion maprotiline MAR-COF BP MAR-COF CG MARGESIC MARINOL MARNATAL-F Page 64 of 116
MARPLAN MARTEN-TAB MARTINIC MATERNITY MAVIK MAXAIR AUTOHALER MAXALT MAXALT-MLT MAXIDEX MAXIDONE MAXIFED CD MAXIFED CDX MAXIFED-G CD MAXIFED-G CDX MAXIFLU CD MAXIFLU CDX MAXIMA MAXINATE MAXIPHEN MAXIPHEN CD MAXIPHEN CDX MAXIPHEN DM MAXITROL MAXZIDE MAXZIDE-25MG M-CLEAR M-CLEAR WC meclofenamate oral MEDI-JECTOR VISION MEDROL MEDROL (PAK) medroxyprogesteron e im medroxyprogesteron e tab 10 mg medroxyprogesteron e tab 2.5 mg, 5 mg mefenamic acid mefloquine MEGACE ES MEGACE ORAL F; Page 65 of 116
megestrol meloxicam MELPAQUE HP MELQUIN 3 MELQUIN HP M-END PE M-END WC MENEST F MENOPUR PA; ; AG MENOSTAR F; MENTAX meperidine oral MEPERITAB MEPHYTON meprobamate MEPRON mercaptopurine mesalamine rect mesalaminecleansing wipes MESNEX ORAL MESTINON MESTINON TIMESPAN METADATE CD CAP 10 mg, 20 mg, 30 mg METADATE CD CAP 40 mg, 50 mg, 60 mg PA; ; AG PA; AG METADATE ER PA; ; AG METANX metaproterenol oral metaxalone metformin er 24 hr tab metformin er 24 hr tab ctrl rel metformin tab 1,000 mg metformin tab 500 mg, 850 mg methadone oral concentrate Page 66 of 116
methadone Oral Soln methadone soluble tab methadone tab METHADONE INTENSOL METHADOSE methamphetamine PA methazolamide oral methenamine hippurate methenamine mandelate METHERGINE ORAL methimazole METHITEST methocarbamol methotrexate sodium oral methscopolamine oral methyclothiazide methyldopa methyldopahydrochlorothiazide METHYLIN PA; AG methylphenidate er 24 hr tab 18 mg, 27 mg, 36 mg, 54 mg methylphenidate er multiphase cap 50-50 methylphenidate er tab 10 mg, 20 mg methylphenidate oral soln PA; ; AG PA; ; AG PA; ; AG PA; AG methylphenidate tab PA; AG methylprednisolone metipranolol metoclopramide injection metoclopramide oral metoclopramide Syringe metolazone Page 67 of 116
metoprolol succinate metoprolol tartrate tab 100 mg, 50 mg metoprolol tartrate Tab 25 mg metoprololhydrochlorothiazide METOZOLV ODT METROCREAM METROGEL METROGEL VAGINAL METROLOTION metronidazole METVIXIA MEVACOR PA mexiletine MIACALCIN MICARDIS MICARDIS HCT MICONAZOLE-3 VAGINAL SUPPOSITORY MICRO BLOOD GLUCOSE STRIPS MICRODOT BLOOD GLUCOSE MONITORING SYSTEM STRIPS MICROGESTIN 1.5/30 (21) MICROGESTIN 1/20 (21) MICROGESTIN FE 1.5/30 (28) MICROGESTIN FE 1/20 (28) MICROZIDE midazolam oral midodrine MIFEPREX MIGERGOT MIGRANAL MILLIPRED MILLIPRED DP MIMVEY F F F F F Page 68 of 116
MINIPRESS PA MINITRAN MINOCIN MISC MINOCIN ORAL minocycline oral minoxidil oral MIRALAX ORAL POWDER MIRAPEX MIRAPEX ER MIRCETTE F mirtazapine misoprostol MOBAN MOBIC PA MODICON (28) F moexipril moexiprilhydrochlorothiazide mometasone MOMEXIN MONODOX MONOJECT INSULIN SAFETY SYRING MONOJECT INSULIN SYRINGE MONOJECT ULTRA COMFORT INSULIN MONOKET MONONESSA (28) F MONUROL MORGIDOX PA; ; AG MORGIDOX 1X100 MORGIDOX 2X100 morphine er cap, pellets PA; ; AG PA; ; AG Page 69 of 116 morphine er tab morphine Oral Soln 10 mg/5 ml morphine oral soln 20 mg/5 ml
morphine rect morphine tab morphine concentrate MOTOFEN MOVIPREP MOXATAG MOXEZA MOZOBIL MS CONTIN MST 600 MUCOTROL MULTAQ PA MULTI VIT- FLUORIDE-IRON MULTICHEW MULTIGEN MULTIGEN FOLIC MULTIGEN PLUS MULTI-VITAMIN WITH FLUORIDE mupirocin MURI-LUBE MUSE M MVC-FLUORIDE M-VIT MYAMBUTOL MYCOBUTIN mycophenolate mofetil MYDFRIN MYDRIACYL MYFERON 150 FORTE MYFORTIC MYGLUCOHEALT H STRIPS MYHIST-DM MYLERAN MYNATAL MYNATAL ADVANCE MYNATAL PLUS MYNATAL-Z Page 70 of 116
MYNATE 90 PLUS MYSOLINE MYTELASE nabumetone nadolol nadololbendroflumethiazide NAFRINSE NAFTIN TOPICAL CREAM 1 % NALFON PA naloxone naltrexone oral NAMENDA PA NAMENDA TITRATION PAK NAPRELAN CR PA NAPROSYN PA naproxen naproxen sodium tab 275 mg, 550 mg naratriptan PA; NARDIL NAROPIN NASACORT AQ PA; NASCOBAL NASOHIST NASOHIST DM NASONEX NATACYN NATALVIT NATAZIA F nateglinide NATELLE ONE NATROBA NATURE-THROID TAB 130 mg, 16.25 mg, 162.5 mg, 195 mg, 260 mg, 32.5 mg, 325 mg, 48.75 mg, 65 mg, 97.5 mg NEBUPENT NECON 0.5/35 (28) F NECON 1/35 (28) F Page 71 of 116
NECON 1/50 (28) F NECON 10/11 (28) F NECON 7/7/7 (28) F nefazodone NEO AC NEO DM NEOBENZ MICRO CREAM PLUS PACK NEO-FRADIN NEOFRIN neomycin neomycin-polymyxin b gu neomycinbacitracin-poly-hc neomycinbacitracinpolymyxin neomycinpolymyxin-dexameth neomycinpolymyxingramicidin neomycinpolymyxin-hc NEORAL NEOSPORIN OPHT NEOSPORIN GU IRRIGANT NEOTUSS-D NEPHPLEX RX NEPHROCAPS NEPHRON FA NEPHRONEX CAP NEPHRO-VITE RX NEPTAZANE NESACAINE NESACAINE-MPF NEULASTA PA NEUMEGA PA NEUPOGEN PA NEURIN-SL NEURONTIN NEUTRAHIST Page 72 of 116
NEUTRAHIST PDX NEUTRASAL NEVANAC NEXAVAR PA; NEXICLON XR 24 HR TAB NEXICLON XR ORAL 24 HR SUSP PA; ; AG PA; ; AG NEXIUM PA; NEXIUM PACKET PA NEXT CHOICE F NIACOR NIASPAN EXTENDED- RELEASE nicardipine oral NICAZEL NICOTROL NICOTROL NS NIFEDIAC CC NIFEDICAL XL nifedipine nifedipine er tab 30 mg, 60 mg NILANDRON nimodipine NIMOTOP NIRAVAM nisoldipine NITRO-BID NITRO-DUR nitrofurantoin macrocrystal nitrofurantoin monohyd/m-cryst nitroglycerin oral nitroglycerin td NITROLINGUAL NITROMIST NITROSTAT NITRO-TIME nizatidine NIZORAL Page 73 of 116
NORA-BE F NORCO NORDETTE-28 F NORDITROPIN FLEXPRO NORDITROPIN NORDIFLEX norethindrone acetate norgestrel-ethinyl estradiol NORINYL 1+35 (28) NORINYL 1+50 (28) NORITATE NOROXIN NORPACE NORPACE CR NORPRAMIN NOR-QD F NORTREL 0.5/35 (28) PA; AG PA; AG F F F F NORTREL 1/35 (21) NORTREL 1/35 (28) NORTREL 7/7/7 (28) nortriptyline NORVASC NORVIR CAP NORVIR ORAL SOLN NORVIR TAB NOVA MAX BLOOD GLUCOSE METER NOVA MAX GLUCOSE TEST NOVA SUREFLEX LANCETS NOVACORT NOVAREL PA; AG NOVOLIN 70/30 NOVOLIN N F F F Page 74 of 116
NOVOLIN R NOVOLOG NOVOLOG FLEXPEN NOVOLOG MIX 70-30 NOVOLOG MIX 70-30 FLEXPEN NOVOLOG PENFILL NOVOPEN 3 NOVOPEN 3 PENMATE NOVOPEN JR NOXAFIL NPLATE NUCORT NUCYNTA ; AG NUCYNTA ER ; AG NUEDEXTA PA; NULEV NULYTELY WITH FLAVOR PACKS NUMOISYN NUOX NUQUIN HP NUTRESTORE NUTRICAP NUTROPIN PA; AG NUTROPIN AQ PA; AG NUTROPIN AQ NUSPIN PA; AG NUVARING F; NUVIGIL TAB 150 mg, 250 mg, 50 mg NYAMYC nystatin oral powder 150 million unit nystatin Oral Powder 50 million unit, 500 million unit nystatin oral susp nystatin tab nystatin top nystatin vagl PA; ; AG Page 75 of 116
nystatintriamcinolone NYSTOP OB COMPLETE TAB OB-NATAL ONE OBSTETRIX DHA OBSTETRIX EC OBTREX OBTREX DHA O-CAL FA O-CAL PRENATAL OCELLA F octreotide acetate injection OCUDOX OCUFEN OCUFLOX ofloxacin OGEN 2.5 F OGESTREL (28) F olanzapine oral OLEPTRO ER 24 HR TAB 150 mg, 300 mg OLUX PA OLUX-E PA omeprazole cap, delayed release omeprazole-sodium bicarbonate OMNARIS PA; OMNIPRED OMNITROPE PA; AG ondansetron ondansetron hcl oral ONE TOUCH BASIC SYSTEM ONE TOUCH DELICA LANC DEVICE ONE TOUCH DELICA LANCETS Page 76 of 116
ONE TOUCH NORMAL CONTROL ONE TOUCH SURESOFT LANCING DEV ONE TOUCH TEST ONE TOUCH ULTRA 2 ONE TOUCH ULTRA CONTROL ONE TOUCH ULTRA SMART ONE TOUCH ULTRA SYSTEM KIT ONE TOUCH ULTRA TEST ONE TOUCH ULTRALINK ONE TOUCH ULTRAMINI ONE TOUCH ULTRASOFT LANCETS ONE TOUCH VERIO ONE TOUCH VERIO HIGH CONTROL ONE TOUCH VERIO IQ ONE TOUCH VERIO MID CONTROL ONFI ONGLYZA TAB 2.5 mg, 5 mg PA; ; AG ONSOLIS PA; OPANA ORAL OPANA ER OPTASE OPTICHAMBER ADVANTAGE OPTICHAMBER ADVANTAGE-LG MASK Page 77 of 116
OPTICHAMBER ADVANTAGE- MED MASK OPTICHAMBER ADVANTAGE- SML MSK OPTICHAMBER LARGE FACE MASK OPTICHAMBER MEDIUM FACE MASK OPTICHAMBER SMALL FACE MASK OPTIPRANOLOL OPTIUM EZ OPTIUM TEST OPTIVAR ORACEA PA; ORACIT ORALONE ORAP ORAPRED ORAPRED ODT ORASEP ORBIVAN ORENCIA SUBQ PA; ORFADIN PA ORGAN-I NR orphenadrine citrate oral ORPHENADRINE COMPOUND ORPHENADRINE COMPOUND-DS ORSINI INSULIN SYRINGE Orsythia ORTHO EVRA F; ORTHO MICRONOR ORTHO TRI- CYCLEN (28) ORTHO TRI- CYCLEN LO ORTHO-CEPT (28) F F F F Page 78 of 116
ORTHO-CYCLEN (28) ORTHO-NOVUM 1/35 (28) ORTHO-NOVUM 7/7/7 (28) OSMOPREP OTICIN OTICIN HC (BAK FREE) OTO-END 10 OTOMAX-HC OVCON-35 (28) F OVCON-50 (28) F OVIDE OVIDREL PA; AG OXANDRIN oxandrolone oxaprozin oxazepam oxcarbazepine OXECTA F F F OXISTAT OXSORALEN OXSORALEN ULTRA oxybutynin chloride oral oxycodone cap oxycodone oral concentrate oxycodone oral soln oxycodone tab 10 mg oxycodone tab 15 mg, 20 mg, 30 mg, 5 mg oxycodoneacetaminophen OXYCONTIN oxymorphone OXYTROL PA; PACERONE PACNEX PACNEX MX Page 79 of 116
PAIN EASE PALGIC ORAL LIQUID PAMELOR PAMINE PAMINE FORTE PAMINE FQ PANCREAZE PANCRELIPASE 5000 PANDEL PA PANRETIN pantoprazole papaverine oral PARAFON FORTE DSC PARCAINE PARCOPA PAREMYD PARLODEL PARNATE paromomycin paroxetine hcl PASER PATADAY PATANASE PATANOL PAXIL PAXIL CR PCE PEDIADERM HC PEDIAPRED PEDIATEX TD pediatric multivitamin-fl PEDI-DRI PEDIPIROX-4 peg 3350- electrolytes PEG-3350 WITH FLAVOR PACKS PEGANONE PEGASYS PA Page 80 of 116
PEGASYS CONVENIENCE PACK PEGASYS PROCLICK PA PA PEGINTRON PA PEGINTRON REDIPEN PE-HIST DM penicillin g potassium penicillin g procaine penicillin g sodium penicillin v potassium PENLAC PA PENNSAID PENTAM PENTASA pentoxifylline PEPCID PERCOCET PERCODAN PERFOROMIST PERIDEX perindopril erbumine PERIOGARD permethrin topical cream perphenazine pentazocineacetaminophen pentazocinenaloxone perphenazineamitriptyline PERSANTINE PEXEVA PFIZERPEN-G PHARMACIST CHOICE PHENADOZ PHENA-PLUS PHENA-S Page 81 of 116
PHENA-S 12 phenazopyridine PHENAZOPYRIDI NE PLUS phendimetrazine tartrate PHENERGAN AG PHENFLU CD PHENFLU CDX phenobarbital elixir phenobarbital Tab 100 mg, 16.2 mg phenobarbital tab 15 mg, 30 mg, 32.4 mg, 60 mg, 64.8 mg, 97.2 mg phenol Liquid PA; AG phentermine PA; AG phenobarb-hyoscyatropine-scop phenylephpromethazine-cod phenylephrine eye drops 2.5 % PHENYLHISTINE DH PHENYTEK phenytoin Oral Susp 100 mg/4 ml phenytoin oral susp 125 mg/5 ml phenytoin sodium extended PHISOHEX PHOS-FLUR DENTAL GEL PHOSLO PHOSLYRA PHOSPHA 250 NEUTRAL PHOSPHOLINE IODIDE PHRENILIN FORTE PHYSIOLYTE PHYSIOSOL IRRIGATION pilocarpine hcl Page 82 of 116
PILOPINE HS pindolol piroxicam PITRESSIN PLAN B ONE- STEP PLAQUENIL PLAVIX PLEGISOL PLETAL PLEXION PLEXION CLEANSING CLOTHS PLEXION SCT PNV-DHA PNV-DHA + DOCUSATE PNV-DHA PLUS PNV-Select Tab 27-1 mg PNV-TOTAL F POCKET CHAMBER POCKETCHEM EZ STRIPS PODOCON podofilox POLOCAINE POLOCAINE (PF) POLY HIST DHC POLY HIST NC POLY IRON PN POLY IRON PN FORTE polyethylene glycol 3350 oral POLYGESIC POLY-IRON 150 FORTE polymyxin B sulfate polyoxyl 40 stearate POLYSACCHARID E IRON FORTE polysorbate 40 Page 83 of 116
polysorbate 60 polysorbate 80 POLYTRIM POLY-TUSSIN AC POLY-TUSSIN DHC POLY-TUSSIN EX PONSTEL PA PONTOCAINE PONTOCAINE TOPICAL SOLN PORTIA F POTABA potassium bicarb & chloride potassium bicarbcitric acid potassium chloride oral potassium citrate potassium citratecitric acid potassium hydroxide Top PR NATAL 400 PR NATAL 400 EC PR NATAL 430 PR NATAL 430 EC PR OTIC SOLUTION PRADAXA PA; pramipexole tab 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 1.5 mg PRAMOSONE PRAMOSONE E PRANDIMET PRANDIN PRASCION PRASCION FC PRASCION RA PRAVACHOL PA pravastatin prazosin Page 84 of 116
PRECISION PCX PLUS TEST PRECISION PCX TEST PRECISION POINT OF CARE TEST PRECISION Q-I-D TEST PRECISION XTRA TEST PRECOSE PRED FORTE PRED MILD PRED-G PRED-G S.O.P. prednicarbate prednisolone prednisolone acetate prednisolone sodium phosphate prednisone Oral Soln prednisone tab prednisone tabs in a dose pack PREDNISONE INTENSOL PREFERA-OB ONE PREFEST F PREGNYL PA; AG PRELONE PREMARIN ORAL PREMARIN VAGL PREMPHASE F PREMPRO F PRENAFIRST PrenaPlus Prenatabs FA Tab 29-1 mg Prenatabs Rx Tab 29-1 mg PRENATAL 19 Prenatal AD Tab 90-1-50 mg F Page 85 of 116
PRENATAL LOW IRON PRENATAL-U PRENATE PLUS PRENEXA PREPIDIL PRESTIGE SMART SYSTEM TEST PREVACID CAPSULE, DELAYED RELEASE 30 mg PREVACID SOLUTAB RAPID DISSOLVE 30 mg PREVALITE PREVIDENT PREVIDENT 5000 BOOSTER PREVIDENT 5000 DRY MOUTH PREVIDENT 5000 PLUS PA; PA PREVIDENT 5000 SENSITIVE PREVIFEM F PREVPAC PREZISTA PRIFTIN PRILOSEC CAPSULE, DELAYED RELEASE 10 mg, 40 mg PRILOSEC ORAL SUSP primaquine primidone PRIMLEV PRIMSOL PRINIVIL PRINZIDE PA; PA PRISTIQ PA PROAIR HFA PROBARIMIN QT probenecid Page 86 of 116
PROCARDIA PROCARDIA XL PROCENTRA PA; prochlorperazine prochlorperazine maleate oral PRO-CLEAR AC PRO-CLEAR CAPS PROCRIT PA PROCTOCORT PROCTOCREAM- HC PROCTOFOAM HC PROCTO-PAK PROCTOSOL HC PROCTOZONE-HC PRODIGY AUTOCODE METER PRODIGY AUTOCODE PRO PRODIGY AUTOCODE TEST STRIPS PRODIGY INSULIN SYRINGE PRODIGY LANCETS PRODIGY LANCING DEVICE PRODIGY NO CODING PRODIGY VOICE GLUCOSE METER PRODIGY VOICE PRO PRODRIN PROFERRIN- FORTE progesterone PROGESTERONE IN OIL progesterone micronized PROGLYCEM Page 87 of 116
PROGRAF ORAL PROLIA PROMACET PROMACTA TAB 12.5 mg, 25 mg, 50 mg, 75 mg PROMAR promethazine AG PROMETHAZINE VC PROMETHAZINE VC-CODEINE promethazine-dm PROMETHEGAN PROMETRIUM propafenone tab propantheline proparacaine PROPECIA propranolol er 24 hr cap extended release PA; propranolol Oral Soln propranolol tab promethazinecodeine propranololhydrochlorothiazid propylthiouracil PRO-RED AC PROSCAR PA PROSED/DS (ATROPINE FREE) PROSTIGMIN PROSTIN E2 PROTECT CARDIO PROTECT PLUS PROTECT PLUS NR PROTID PROTONIX ORAL PA; PROTOPIC AG protriptyline PROVENTIL HFA Page 88 of 116
PROVERA PROVIGIL PA; ; AG PROZAC PROZAC WEEKLY PRUDOXIN PRUTECT PULMICORT NEB SUSPENSION 0.25 mg/2 ml, 0.5 mg/2 ml PULMICORT NEB SUSPENSION 1 mg/2 ml PULMICORT FLEXHALER PULMOZYME PURINETHOL PYLERA pyrazinamide pyridostigmine bromide PYRIL D PYRIL DM PYROGALLIC ACID Q-CARE RX Q2 Q-CARE RX Q4 QUALAQUIN QUASENSE F QUESTRAN QUESTRAN LIGHT QUICKTEK TEST quinapril quinaprilhydrochlorothiazide quinidine gluconate oral quinidine sulfate QUINTET BLOOD GLUCOSE METER QUINZYME QUTENZA QVAR Page 89 of 116
ramipril RANEXA ranitidine tab 150 mg, 300 mg RAPAFLO PA RAPAMUNE RAZADYNE PA; ADV RAZADYNE ER PA; ADV REBETOL CAP PA; REBETOL ORAL SOLN REBIF REBIF TITRATION PACK RECLIPSEN (28) F RECTIV REFISSA PA REFUAH PLUS REFUAH PLUS GLUCOSE MONITOR REGLAN PA; REGRANEX PA; RELAGARD RELAMINE RELCOF C RELENZA DISKHALER RELION ULTIMA RELION ULTRA THIN PLUS LANCETS RELISTOR SUB- Q RELISTOR SUB- Q KIT ; AG RELPAX PA; REMERON REMERON SOLTAB REMEVEN RENACIDIN RENAGEL RENAL CAPS RENA-VITE RX Page 90 of 116
RENAX RENO CAPS RENOVA RENVELA REPAN REPREXAIN REPRONEX PA; ; AG REQ49+ REQUIP REQUIP XL RESCRIPTOR DISPERSIBLE TAB RESCRIPTOR TAB RESECTISOL reserpine RESPA-AR RESPAIRE-30 RESTASIS RESTORIL RETIN-A PA; AG RETIN-A MICRO PA; AG RETIN-A MICRO PUMP RETROVIR ORAL PA; AG REVATIO ORAL PA; REVIA REVLIMID CAP 10 mg, 15 mg, 25 mg, 5 mg REYATAZ REZIRA PA REZYST IM RHEUMATREX RHINOCORT AQUA RHINOFLEX RHINOFLEX-650 RIBAPAK DOSE PACK PA; PA; PA RIBASPHERE CAP PA; RIBASPHERE TAB 200 mg, 400 mg, 600 mg PA; Page 91 of 116
RIBATAB DOSE PACK PA ribavirin PA; RIDAURA RIFADIN ORAL RIFAMATE rifampin oral RIFATER RIGHTEST GS550 TEST STRIPS RILUTEK rimantadine RIMSO-50 RIOMET RISPERDAL RISPERDAL M- TAB risperidone RISPERIDONE M- TAB RITALIN PA; AG RITALIN LA PA; ; AG RITALIN SR PA; ; AG rivastigmine PA ROBAXIN ORAL ROBAXIN-750 ROBINUL ROBINUL FORTE ROCALTROL ropinirole ROSANIL TOPICAL KIT ROWASA ROXICET ORAL SOLN ROXICET TAB ROXICODONE TAB 15 mg, 30 mg ROZEREM PA; ; AG RU-HIST FORTE RU-TUSS DM RYBIX ODT RYDEX RYTHMOL Page 92 of 116