2013 Catamaran Advantage Formulary Reference Guide

A list of medications that may lower your patients costs

*Formulary Disclaimer: Coverage and cost share for some drugs may be limited to specific dosage forms and/or strengths. The benefit design determines what is covered and the applicable co-payment. The medications listed on this formulary are subject to change pursuant to the formulary management activities of catamaran. The presence of a medication on this formulary list does not guarantee coverage.

Table of Contents
ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PENICILLINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CEPHALOSPORIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
FIRST GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SECOND GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . THIRD GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FOURTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 5 5 5

MACROLIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TETRACYCLINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . QUINOLONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AMINOGLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SULFONAMIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIMYCOBACTERIAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIFUNGALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIVIRALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIMALARIALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AMEBICIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTHELMINTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MISC. ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTINEOPLASTICS, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ALKYLATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIBIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTINEOPLASTIC ENZYMES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIMETABOLITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HORMONAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MITOTIC INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ENZYME INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TOPOISOMERASE I INHIBITOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTINEOPLASTICS MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CHEMOTHERAPY RESCUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CARDIOVASCULAR DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CARDIAC GLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIANGINAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BETA BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CALCIUM CHANNEL BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIARRHYTHMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ACE INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANGIOTENSIN RCPTR BLOCKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DIRECT RENIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIHYPERTENSIVES MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIHYPERTENSIVE COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DIURETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VASOPRESSORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIHYPERLIPIDEMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CARDIOVASCULAR - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DERMATOLOGICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACNE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ROSACEA AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIBIOTICS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIFUNGALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIVIRALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTI-INFLAMMATORY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIPRURITICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIPSORIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTISEBORRHEIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CORTICOSTEROIDS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IMMUNOMODULATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DERMATOLOGICALS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ENDOCRINE AND METABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CORTICOSTEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANDROGENS-ANABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ESTROGENS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PROGESTINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIDIABETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
INSULIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AMYLIN ANALOGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . INCRETIN MIMETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SULFONYLUREAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BIGUANIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MEGLITINIDE ANALOGUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DIABETIC OTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ALPHA-GLUCOSIDASE INHIBIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DPP-4 INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . INSULIN SENSITIZING AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIDIABETIC COMBINATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5 6 6 6 6 6 7 7 7 7 7 8 8 8 9 9 9 9 9 9 10 10 11 11 12 12 12 12 12 12 12 13 13 13 13 13 13 13 13

BISPHOSPHONATES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CALCITONINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PARATHYROID HORMONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . RANK LIGAND INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HORMONE RECEPTOR MDLTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FERTILITY REGULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LHRH/GNRH AGONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GROWTH HORMONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GHRH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SOMATOMEDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SOMATOSTATIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GH RECEPTOR ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . POSTERIOR PITUITARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CORTICOTROPIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PROLACTIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VASOPRESSIN ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PROGESTERONE ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . METABOLIC MODIFIERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . THYROID AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GASTROINTESTINAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LAXATIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIDIARRHEALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTACIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ULCER DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIEMETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DIGESTIVE AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GASTROINTESTINAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GENITOURINARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . URINARY ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . URINARY ANTISPASMODICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VAGINAL PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GENITOURINARY - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HEMATOLOGICAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HEMATOPOIETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTICOAGULANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HEMOSTATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HEMATOLOGICAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MOUTH/THROAT/DENTAL AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13 13 13 13 13 13 13 13 14 14 14 14 14 14 14 14 14 14 14 14 14 15 15 15 15 15 16 16 16 16 17 17 17 17 18 18 18 18

NEUROLOGY, CNS, PSYCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIANXIETY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIDEPRESSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIPSYCHOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HYPNOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ADHD, NARCOLEPSY, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTICONVULSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIPARKINSON AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NEUROLOGY, PSYCH - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NEUROMUSCULAR AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MUSCULOSKELETAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIMYASTHENIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OPHTHALMOLOGY AND OTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ARTIFICIAL TEAR/LUBRICANT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BETA-BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OPHTHALMIC STEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PROSTAGLANDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CYCLOPLEGIC MYDRIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DECONGESTANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ADRENERGIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LOCAL ANESTHETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OPHTHALMICS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OTIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OXYTOCICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PAIN MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANALGESICS - NONNARCOTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANALGESICS - OPIOID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTI-INFLAMMATORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MIGRAINE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GOUT AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LOCAL ANESTHETICS-INJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . RESPIRATORY, ALLERGY, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTIHISTAMINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NASAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . COUGH/COLD/ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19 19 19 20 20 20 21 21 21 22 22 22 22 22 23 23 23 23 23 23 23 23 23 23 24 24 24 24 24 25 26 26 26 27 27 27 27 27

ANTIASTHMATIC/COPD AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . RESPIRATORY AGENTS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TOXOIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VACCINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MULTIVITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MEDICAL DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DIABETIC SUPPLIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MISCELLANEOUS AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

29 30 30 30 31 31 31 33 33 36

Rocephin Spectracef Suprax

FOURTH GENERATION January 2013

TIER 1 cefepime

ANTI-INFECTIVES
PENICILLINS
TIER 1 amoxicillin amoxicillin/clavulanate potassium amoxicillin/clavulanate potassium er amoxicillin/potassium clavulanate ampicillin ampicillin sodium ampicillin-sulbactam dicloxacillin sodium nafcillin sodium oxacillin sodium penicillin g potassium penicillin g procaine penicillin g sodium penicillin v potassium pfizerpen-g TIER 2 Augmentin TIER 3 Augmentin Es-600 Augmentin Xr Bicillin C-r Bicillin L-a Moxatag Unasyn Unasyn Bulk Pack

MACROLIDES
TIER 1 azithromycin clarithromycin clarithromycin er e.e.s. 400 erythrocin stearate erythromycin erythromycin base erythromycin ethylsuccinate TIER 2 Dificid TIER 3 Biaxin Biaxin Xl Biaxin Xl Pac E.e.s. Granules Ery-tab Eryped 200 Eryped 400 Pce Zithromax Zithromax Tri-pak Zithromax Z-pak Zmax

TETRACYCLINES
TIER 1 avidoxy demeclocycline hcl doxycycline doxycycline hyclate doxycycline monohydrate minocycline hcl minocycline hcl er morgidox 1x100mg morgidox 2x100mg tetracycline hcl TIER 3 Adoxa Adoxa Pak 1/100 Adoxa Pak 1/150 Adoxa Pak 2/100 Alodox Convenience Kit Avidoxy Dk Doryx Dynacin Minocin Minocin Kit Monodox Nutridox Ocudox Oraxyl Solodyn Vibramycin

CEPHALOSPORIN
FIRST GENERATION
TIER 1 cefadroxil cefazolin sodium cephalexin TIER 3 Keflex

SECOND GENERATION
TIER 1 cefaclor cefaclor er cefotetan cefoxitin sodium cefprozil cefuroxime axetil cefuroxime sodium TIER 3 Ceftin Zinacef

THIRD GENERATION
TIER 1 cefdinir Cefditoren Pivoxil cefotaxime sodium cefpodoxime proxetil ceftazidime ceftriaxone sodium tazicef TIER 3 Cedax Claforan Fortaz

QUINOLONES
TIER 1 ciprofloxacin er ciprofloxacin hcl levofloxacin ofloxacin

Effective January 1, 2013 1

TIER 2 Avelox Avelox Abc Pack TIER 3 Cipro Cipro Xr Factive Levaquin Noroxin

Lamisil Onmel Sporanox Sporanox Pulsepak Terbinex Vfend

ANTIVIRALS
TIER 1 abacavir acyclovir didanosine famciclovir lamivudine lamivudine/zidovudine Nevirapine ribapak ribasphere ribatab ribavirin rimantadine hcl stavudine valacyclovir hcl zidovudine TIER 2 Aptivus Atripla Baraclude Complera Crixivan Edurant Emtriva Epivir Hbv Epzicom Fuzeon Hepsera Incivek Intelence Invirase Isentress Kaletra Lexiva Norvir Peg-intron Peg-intron Redipen Peg-intron Redipen Pak 4 Pegasys Pegasys Proclick Prezista Relenza Diskhaler Rescriptor Reyataz Selzentry Stribild Sustiva Tamiflu Trizivir Truvada Valcyte Victrelis Videx Pediatric Viracept Viramune Xr Viread TIER 3 Combivir Copegus Epivir Famvir

AMINOGLYCOSIDES
TIER 1 amikacin sulfate gentamicin sulfate kanamycin sulfate neomycin sulfate paromomycin sulfate streptomycin sulfate tobramycin sulfate TIER 2 Tobi TIER 3 Neo-fradin

SULFONAMIDES
TIER 1 sulfadiazine

ANTIMYCOBACTERIAL AGENTS
TIER 1 cycloserine ethambutol hcl isonarif isoniazid pyrazinamide rifampin TIER 2 Mycobutin seromycin TIER 3 Capastat Sulfate Myambutol Paser Priftin Rifadin Rifamate Rifater Trecator

ANTIFUNGALS
TIER 1 amphotericin b fluconazole flucytosine griseofulvin microsize griseofulvin ultramicrosize itraconazole ketoconazole nystatin terbinafine hcl voriconazole TIER 2 Noxafil TIER 3 Ancobon Bio-statin Diflucan Grifulvin V Gris-peg

Effective January 1, 2013 2

Flumadine Infergen Rebetol Retrovir Rimantalist Tyzeka Valtrex Videx Ec Viramune Virazole Zerit Ziagen Zovirax

ANTIMALARIALS
TIER 1 Atovaquone/proguanil Hcl chloroquine phosphate hydroxychloroquine sulfate mefloquine hcl Primaquine Phosphate Qualaquin quinine sulfate TIER 2 Coartem Daraprim TIER 3 Aralen Malarone Plaquenil

Zyvox TIER 3 Azactam Bactrim Bactrim Ds Cleocin Cleocin Pediatric Granules Cleocin Phosphate Coly-mycin M Flagyl Flagyl Er Invanz Ketek Lincocin Pentam 300 Primsol Septra Ds Tindamax Vancocin Hcl Xifaxan

ANTINEOPLASTICS, ETC.
ALKYLATING AGENTS
TIER 1 cyclophosphamide thiotepa TIER 2 Alkeran Ceenu Hexalen Leukeran Myleran Temodar TIER 3 Gliadel Wafer Mustargen

AMEBICIDES
TIER 2 Yodoxin

ANTHELMINTICS
TIER 1 mebendazole TIER 2 Albenza Biltricide Stromectol

ANTIBIOTICS
TIER 1 bleomycin sulfate

ANTINEOPLASTIC ENZYMES
TIER 3 Elspar Erwinaze Oncaspar

MISC. ANTI-INFECTIVES
TIER 1 aztreonam baciim bacitracin clindamycin hcl clindamycin palmitate hcl clindamycin phosphate clindamycin phosphate pharmacy bulk package colistimethate sodium dapsone e.s.p. erythromycin/sulfisoxazole metronidazole polymyxin b sulfate sulfamethoxazole/trimethoprim Sulfamethoxazole/trimethoprim Ds tinidazole Trimethoprim vancomycin vancomycin hcl TIER 2 Alinia Cayston Mepron Nebupent

ANTIMETABOLITES
TIER 1 cytarabine cytarabine aqueous floxuridine mercaptopurine methotrexate methotrexate sodium TIER 2 Oforta Tabloid Trexall Vidaza Xeloda TIER 3 Purinethol

HORMONAL AGENTS
TIER 1 anastrozole bicalutamide exemestane

Effective January 1, 2013 3

Firmagon flutamide letrozole leuprolide acetate megestrol acetate tamoxifen citrate TIER 2 Depo-provera Emcyt Lupron Depot Lysodren Vantas Xtandi Zoladex Zytiga TIER 3 Arimidex Aromasin Casodex Eligard Fareston Faslodex Femara Megace Oral Nilandron Soltamox Trelstar Depot Trelstar Depot Mixject Trelstar La Trelstar La Mixject Trelstar Mixject

Nexavar Sprycel Sutent Tarceva Tasigna Tykerb Votrient Xalkori Zelboraf TIER 3 Inlyta Iressa Stivarga Zolinza

TOPOISOMERASE I INHIBITOR
TIER 2 Hycamtin

ANTINEOPLASTICS MISC.
TIER 1 hydroxyurea tretinoin TIER 2 Actimmune Intron-a Intron-a W/diluent Matulane TIER 3 Alferon N Hydrea Sylatron Synribo Targretin Uvadex

IMMUNOMODULATORS
TIER 1 azathioprine azathioprine sodium cyclosporine cyclosporine modified gengraf hecoria mycophenolate mofetil tacrolimus TIER 2 Azasan Rapamune Revlimid Sandimmune Thalomid TIER 3 Cellcept Imuran Myfortic Neoral Prograf Zortress

CHEMOTHERAPY RESCUE
TIER 1 calcium folinate leucovorin calcium TIER 2 Mesnex

CARDIOVASCULAR DRUGS
CARDIAC GLYCOSIDES
TIER 1 Digoxin TIER 3 Lanoxin

ANTIANGINAL AGENTS
TIER 1 amyl nitrite isochron isoditrate er isosorbide dinitrate isosorbide dinitrate er isosorbide mononitrate isosorbide mononitrate er minitran nitroglycerin Nitroglycerin Lingual nitroglycerin transdermal TIER 2 Dilatrate Sr Nitro-bid Nitro-dur Nitrolingual Pumpspray Nitrostat

MITOTIC INHIBITORS
TIER 1 etoposide

ENZYME INHIBITORS
TIER 1 Vandetanib TIER 2 Afinitor Bosulif Caprelsa Gleevec Jakafi

Effective January 1, 2013 4

Ranexa TIER 3 Imdur Isordil Titradose Monoket Nitromist

BETA BLOCKERS
TIER 1 acebutolol hcl atenolol betaxolol hcl bisoprolol fumarate carvedilol labetalol hcl metoprolol succinate er metoprolol tartrate nadolol pindolol propranolol hcl propranolol hcl er sorine sotalol hcl sotalol hcl (af) timolol maleate TIER 2 Bystolic Coreg Cr TIER 3 Betapace Betapace Af Coreg Corgard Hypertenevide-12.5 Inderal La Innopran Xl Kerlone Levatol Lopressor Metoprolol Sectral Tenormin Toprol Xl Trandate Zebeta

taztia xt verapamil hcl verapamil hcl er Verapamil Hcl Sr TIER 2 Cardizem La TIER 3 Adalat Cc Calan Calan Sr Cardene Sr Cardizem Cardizem Cd Covera-hs Dilacor Xr Dynacirc Cr Hypertenipine-2.5 Isoptin Sr Nimotop Norvasc Procardia Procardia Xl Sular Tiazac Verelan Verelan Pm

ANTIARRHYTHMICS
TIER 1 amiodarone hcl disopyramide phosphate flecainide acetate mexiletine hcl procainamide hcl propafenone hcl propafenone hcl er Quinidine Gluconate quinidine gluconate cr quinidine gluconate er quinidine sulfate quinidine sulfate er TIER 2 Pacerone Tikosyn TIER 3 Cordarone Multaq Norpace Norpace Cr Rythmol Rythmol Sr Tambocor

CALCIUM CHANNEL BLOCKERS

TIER 1 afeditab cr amlodipine besylate cartia xt dilt-cd dilt-xr diltiazem cd diltiazem hcl Diltiazem Hcl Cd diltiazem hcl er diltzac felodipine er isradipine matzim la nicardipine hcl nifediac cc nifedical xl nifedipine nifedipine er nimodipine nisoldipine nisoldipine er

ACE INHIBITORS
TIER 1 benazepril hcl captopril enalapril maleate fosinopril sodium lisinopril moexipril hcl perindopril erbumine quinapril hcl ramipril trandolapril TIER 3 Accupril Aceon Altace

Effective January 1, 2013 5

Lotensin Mavik Prinivil Univasc Vasotec Zestril

ANGIOTENSIN RCPTR BLOCKER

TIER 1 eprosartan mesylate irbesartan losartan potassium TIER 2 Diovan Micardis TIER 3 Atacand Avapro Benicar Cozaar Edarbi Teveten

DIRECT RENIN INHIBITORS

TIER 2 Tekturna

ANTIHYPERTENSIVES MISC.
TIER 1 clonidine hcl doxazosin mesylate eplerenone guanabenz acetate guanfacine hcl hydralazine hcl methyldopa minoxidil phentolamine mesylate prazosin hcl Reserpine terazosin hcl TIER 2 Demser Dibenzyline TIER 3 Cardura Catapres Catapres-tts-1 Catapres-tts-2 Catapres-tts-3 Inspra Minipress Nexiclon Xr Tenex

methyldopa/hydrochlorothiazide metoprolol/hydrochlorothiazide moexipril/hydrochlorothiazide nadolol/bendroflumethiazide propranolol/hydrochlorothiazide quinapril/hydrochlorothiazide valsartan/hydrochlorothiazide TIER 2 Amturnide Azor Exforge Exforge Hct Micardis Hct Tarka Tekamlo Tekturna Hct Tribenzor Twynsta Valturna TIER 3 Accuretic Atacand Hct Avalide Benicar Hct Clorpres Corzide Diovan Hct Dutoprol Edarbyclor Hypertensolol Hyzaar Lopressor Hct Lotensin Hct Lotrel Lytensopril Lytensopril-90 Prinzide Tenoretic 100 Tenoretic 50 Teveten Hct Uniretic Vaseretic Zestoretic Ziac

DIURETICS
TIER 1 acetazolamide Acetazolamide Er acetazolamide sodium Amiloride Hcl amiloride/hydrochlorothiazide bumetanide chlorothiazide chlorthalidone furosemide hydrochlorothiazide indapamide methazolamide methyclothiazide metolazone spironolactone spironolactone/hydrochlorothiazide torsemide Triamterene/hydrochlorothiazide TIER 3 Aldactazide Aldactone Demadex

ANTIHYPERTENSIVE COMBO
TIER 1 amlodipine besylate/benazepril hcl amlodipine besylate/benazepril hydrochloride atenolol/chlorthalidone benazepril hcl/hydrochlorothiazide bisoprolol fumarate/hydrochlorothiazide candesartan cilexetil/hydrochlorothiazide captopril/hydrochlorothiazide enalapril maleate/hydrochlorothiazide fosinopril sodium/hydrochlorothiazide irbesartan/hydrochlorothiazide lisinopril/hydrochlorothiazide losartan potassium/hydrochlorothiazide

Effective January 1, 2013 6

Diamox Diuril Dyazide Dyrenium Edecrin Introl Lasix Maxzide Maxzide-25 Microzide Midamor Neptazane Thalitone Zaroxolyn

Lipitor Livalo Lofibra Lopid Mevacor Pravachol Questran Questran Light Tricor Trilipix Vascepa Zocor

CARDIOVASCULAR - MISC.
TIER 1 Amlodipine Besylate/atorvastatin Calcium papaverine hcl sildenafil citrate TIER 2 Adcirca Bidil Letairis Remodulin Tracleer Tyvaso Tyvaso Refill Tyvaso Starter Ventavis TIER 3 Caduet Revatio

VASOPRESSORS
TIER 1 ephedrine sulfate Epinephrine midodrine hcl norepinephrine bitartrate phenylephrine hcl TIER 2 Epipen Epipen 2-pak Epipen-jr Epipen-jr 2-pak TIER 3 Levophed Neo-synephrine Twinject

ANTIHYPERLIPIDEMICS
TIER 1 atorvastatin calcium cholestyramine cholestyramine light colestipol hcl colestipol hcl for oral suspension Fenofibrate fenofibrate micronized Fenofibric Acid fluvastatin gemfibrozil lovastatin Micronized Colestipol Hcl pravastatin sodium prevalite simvastatin TIER 2 Altoprev Antara Crestor Fenoglide Lipofen Lovaza Niaspan Simcor Triglide Vytorin Welchol Zetia TIER 3 Advicor Colestid Colestid Flavored Fibricor Lescol Lescol Xl

DERMATOLOGICALS
ACNE PRODUCTS
TIER 1 adapalene amnesteem avar cleanser avar-e emollient avar-e green Avita benzepro benzepro short contact benziq wash benzoyl peroxide benzoyl peroxide cleanser benzoyl peroxide cleansing benzoyl peroxide short contact benzoyl peroxide wash benzoyl peroxide wash acne treatment pack bp cleanser bp cleansing wash bp wash bp 10-1 bpo bpo creamy wash complete pack bpo 3% foaming cloths bpo 6% foaming cloths bpo 9% foaming cloths cerisa wash claravis claris clarifying wash clearplex x clenia clenia foaming wash clindacin-p clindamax clindamycin phosphate clindamycin/benzoyl peroxide

Effective January 1, 2013 7

clindareach ery erythromycin erythromycin/benzoyl peroxide lavoclen-4 acne wash kit lavoclen-4 creamy wash lavoclen-8 acne wash kit lavoclen-8 creamy wash myorisan oscion cleanser pacnex wash pr benzoyl peroxide wash prascion prascion fc prascion ra with sunscreens ra renewal medicated acne treatment maximum strength rosanil cleanser se bpo wash se bpo 3% foaming cloths se bpo 6% foaming cloths se bpo 7-5.5 wash kit se bpo 9% foaming cloths se 10-5 ss Sodium Sulfacetamide sodium sulfacetamide/sulfur sodium sulfacetamide/sulfur cleanser sodium sulfacetamide/sulfur cleanser in urea sodium sulfacetamide/sulfur cleansing cloths sodium sulfacetamide/sulfur green sodium sulfacetamide/sulfur in urea sodium sulfacetamide/sulfur wash sotret sulfacetamide sodium sulfacetamide sodium/sulfur cleanser sulfacleanse 8/4 suphera tl bpo mx cleanser Tretinoin virti-sulf zaclir cleansing zencia TIER 2 Acanya Aczone Atralin Azelex Epiduo Veltin TIER 3 Absorica Akne-mycin Avar Ls Cleanser Avar-e Ls Benzac Ac Wash Benzac W Wash Benzaclin Benzaclin With Pump Benzamycin Benzamycinpak Benzefoam Benzefoamultra Benziq Benziq Ls Clarifoam Ef Cleocin-t Clindacin Pac Clindagel Delos Desquam-x Wash Differin

Duac Evoclin Inova Inova 4/1 Acne Control Therapy Inova 8/2 Acne Control Therapy Klaron Neobenz Micro Neobenz Micro Plus Pack Neobenz Micro Sd Neobenz Micro Wash Neobenz Micro Wash Plus Pack Nuox Pacnex Hp Pacnex Lp Pacnex Mx Plexion Cleanser Plexion Cleansing Cloth Plexion Sct Retin-a Retin-a Micro Retin-a Micro Pump Rosanil Sss 10-4 Sulfoam Sumadan Kit Sumadan Wash Sumaxin Sumaxin Cp Kit Sumaxin Ts Sumaxin Wash Tretin-x Triaz Triaz Cleanser Triaz Foaming Cloths Vanoxide Hc Vanoxide-hc Zacare 4% Kit Zacare 8% Kit Ziana

ROSACEA AGENTS
TIER 1 metronidazole rosadan vitazol TIER 2 Finacea Metrogel Oracea TIER 3 Finacea Plus Metrocream Metrolotion Noritate Rosadan Kit

ANTIBIOTICS - TOPICAL
TIER 1 Centany gentamicin sulfate mupirocin TIER 3 Altabax Bactroban Centany At Cortisporin

ANTIFUNGALS - TOPICAL

Effective January 1, 2013 8

TIER 1 ciclodan ciclopirox ciclopirox nail lacquer ciclopirox olamine ciclopirox topical solution kit ciclopirox treatment clotrimazole clotrimazole/betamethasone dipropionate econazole nitrate exoderm ketoconazole ketodan nuzole nyamyc nystatin nystatin/triamcinolone nystop pedi-dri versiclear TIER 2 Exelderm Mentax TIER 3 Aloquin Ciclodan Cream Kit Ciclodan Solution Kit Cnl8 Nail Kit Ertaczo Extina Halotin Ketocon Ketodan Kit Lamisil Loprox Loprox Shampoo Lotrisone Naftin Nizoral Oxistat Pediaderm Af Complete Kit Pedipirox-4 Nail Penlac Nail Lacquer Vusion Xolegel Xolegel Corepak Xolegel Duo/head & Shoulders Xolegel Duo/xolex

TIER 3 Zonalon

ANTIPSORIATICS
TIER 1 calcipotriene Calcitriol dritho-creme hp TIER 2 Dritho-scalp Oxsoralen Ultra Soriatane Tazorac Vectical TIER 3 Amevive Calcitrene Dovonex Dovonex Scalp Sorilux Stelara Zithranol Zithranol-rr 8-mop

ANTISEBORRHEIC AGENTS
TIER 1 glycolic acid glycolic acid 70% high purity mexar wash seb-prev seb-prev wash selenium sulfide sodium sulfacetamide wash sodium sulfacetamide/urea TIER 2 Ovace Plus TIER 3 Ovace Plus Wash Ovace Wash Promiseb Promiseb Complete Selsun Shampoo Tersi Foam

CORTICOSTEROIDS - TOPICAL
TIER 1 ala cort alclometasone dipropionate alphatrex amcinonide apexicon apexicon e augmented betamethasone dipropionate betamethasone dipropionate betamethasone valerate clobetasol propionate clobetasol propionate e clobetasol propionate emollient cormax cormax scalp application cortalo desonide desoximetasone diflorasone diacetate fluocinolone acetonide fluocinolone acetonide body fluocinolone acetonide scalp fluocinonide

ANTIVIRALS - TOPICAL
TIER 2 Zovirax TIER 3 Denavir Lidovir Xerese

ANTI-INFLAMMATORY AGENTS
TIER 2 Flector Voltaren TIER 3 Napro 15% Compounding Kit Naproderm Compounding Kit Pennsaid

ANTIPRURITICS
TIER 1 Prudoxin

Effective January 1, 2013 9

fluocinonide emollient base fluocinonide-e fluticasone propionate halac halobetasol propionate halonate pac hydrocortisone hydrocortisone acetate/aloe hydrocortisone butyrate hydrocortisone in absorbase hydrocortisone valerate Lokara mometasone furoate pramcort prednicarbate scalacort synalar triamcinolone acetonide triamcinolone acetonide in absorbase trianex triderm u-cort TIER 2 Capex Cordran Tape Halog Kenalog Locoid Lipocream Taclonex TIER 3 Aclovate Ala Scalp Aqua Glycolic Hc Scalp & Body Carmol-hc Clobeta Cream Clobeta Ointment Clobex Cloderm Cloderm Pump Cordran Cordran Sp Cutivate Derma-smoothe/fs Body Oil Derma-smoothe/fs Scalp Oil Dermatop Desonate Desonil Desowen Desowen Cream/cetaphil Lotion Desowen Lotion/cetaphil Cream Desowen Ointment/cetaphil Lotion Diprolene Diprolene Af Elocon Epifoam First-hydrocortisone Halonate Lidamantle Hc Locoid Luxiq Momexin Nucort Nuzon Olux Olux-e Pandel Pediaderm Hc Pediaderm Ta Pramosone Scalacort Dk

Synalar Cream Kit Synalar Ointment Kit Synalar Ts Temovate Temovate E Texacort Topicort Ultravate Ultravate Pac Ultravate X Vanos Verdeso Westcort

IMMUNOMODULATING AGENTS
TIER 1 imiquimod TIER 2 Elidel Protopic TIER 3 Aldara Zyclara Zyclara Pump

DERMATOLOGICALS - MISC.
TIER 1 acticin aliclen aluminum acetate ammonium lactate arnica flower benzoin compound tincture benzoin tincture boric acid capsaicin cem-urea cerovel coal tar coal tar base cocaine hcl durasal ethyl chloride ethyl chloride/fine pinpoint ethyl chloride/fine stream ethyl chloride/medium jet stream ethyl chloride/medium stream ethyl chloride/mist green soap hygel hypercare laclotion lactic acid lactic acid e lactic acid w/vitamin e latrix latrix xm lidocaine lidocaine hcl lidocaine hcl jelly lidocaine/prilocaine lindane malathion permethrin podocon 25 in benzoin tincture podofilox pramox gel pyrogallic acid remeven

Effective January 1, 2013 10

salacyn salicylic acid salicylic acid cream salicylic acid in ammonium lactate vehicle salicylic acid lotion salicylic acid wart remover sodium hyaluronate Spinosad sulfurated lime tl urea u-kera e umecta mousse urea urea hydrating urea in zinc undecylenate/lactic acid vehicle urea nail urea nail kit urea topical urea 40% nail film urea-c40 witch hazel x-viate xclair TIER 2 Condylox Eurax Lidoderm Ulesfia TIER 3 Aluvea Anacaine Atopiclair Aurstat Bensal Hp Drysol Eletone Elimite Emla Emulsion Sb Epiceram Gebauers Pain Ease Gebauers Spray And Stretch Genadur Gordofilm Gordons Urea Hpr Hpr Plus Hpr Plus/mb Hydrogel Hydro 35 Hydro 40 Foam Hylatopic Hylatopic Plus Hylatopic Plus/aurstat Hylira Kerafoam Kerafoam 42 Keralyt Keralyt Scalp Kerol Kerol Ad Lac-hydrin Lamb Gel Lycelle Mb Hydrogel Mimyx Natroba Neosalus Neosalus 180 Pack Nuvail

Ovide Pliaglis Pontocaine Pr Cream Pruclair Prumyx Qutenza Radigel Rinnovi Nail System Salex Salex Cream Salex Lotion salkera Salvax Salvax Duo Plus Sklice Synera Tetrix Tl-cermide Tropazone Umecta Umecta Nail Film Umecta Pd Uramaxin Uramaxin Gt Uramaxin Gt Kit Veregen Virasal Xerac Ac Xylocaine Xylocaine Jelly Zenieva

ENDOCRINE AND METABOLIC

CORTICOSTEROIDS
TIER 1 a-hydrocort a-methapred asmalpred asmalpred plus baycadron betamethasone sodium phosphate/betamethasone acetate budesonide cortisone acetate dexamethasone dexamethasone sodium phosphate fludrocortisone acetate hydrocortisone methylprednisolone methylprednisolone acetate methylprednisolone dose pack methylprednisolone sodiumsuccinate prednisolone prednisolone sodium phosphate prednisone zema-pak 10 day zema-pak 13 day zema-pak 6 day TIER 3 Aristospan Intra-articular Aristospan Intralesional Celestone Celestone-soluspan Cortef Depo-medrol Dexamethasone Intensol Dexpak 10 Day Dexpak 13 Day

Effective January 1, 2013 11

Dexpak 6 Day Entocort Ec Flo-pred Kenalog-10 Kenalog-40 Medrol Medrol Dosepak Millipred Millipred Dp Orapred Orapred Odt Pediapred Prednisone Intensol Prelone Rayos Solu-cortef Solu-medrol Veripred 20

Climara Pro Delestrogen Depo-estradiol Divigel Elestrin Estrace Estraderm Estrasorb Estrogel Femhrt Low Dose Femhrt 1/5 Femtrace Menest Menostar Minivelle Prefest Premarin

PROGESTINS ANDROGENS-ANABOLIC
TIER 1 danazol oxandrolone testosterone cypionate testosterone enanthate TIER 2 Androgel Androgel Pump Androxy Axiron Fortesta Methitest TIER 3 Anadrol-50 Androderm android Delatestryl Depo-testosterone First-testosterone First-testosterone Mc Compounding Kit Oxandrin Striant Testim Testopel testred TIER 1 medroxyprogesterone acetate norethindrone acetate progesterone TIER 2 Makena TIER 3 Aygestin Megace Es Prometrium Provera

ANTIDIABETIC AGENTS
INSULIN
TIER 2 Apidra Apidra Solostar Lantus Lantus Solostar Novolin N Novolin N Relion Novolin R Novolin R Relion Novolin 70/30 Novolin 70/30 Relion Novolog Novolog Flexpen Novolog Mix 70/30 Novolog Mix 70/30 Prefilled Flexpen Novolog Penfill TIER 3 Humalog Humalog Kwikpen Humalog Mix 50/50 Humalog Mix 50/50 Kwikpen Humalog Mix 75/25 Humalog Mix 75/25 Kwikpen Humulin R U-500 (concentrated) Levemir Levemir Flexpen

ESTROGENS
TIER 1 estradiol estradiol valerate estradiol/norethindrone acetate estropipate Jevantique jinteli mimvey ortho-est TIER 2 Cenestin Combipatch Enjuvia Evamist Premphase Prempro Vivelle-dot TIER 3 Activella Alora Angeliq Climara

AMYLIN ANALOGS
TIER 2 Symlin Symlinpen 120 Symlinpen 60

INCRETIN MIMETIC AGENTS

TIER 2 Bydureon Byetta TIER 3 Victoza

Effective January 1, 2013 12

SULFONYLUREAS
TIER 1 chlorpropamide glimepiride glipizide glipizide er Glipizide Xl glyburide glyburide micronized tolazamide tolbutamide TIER 3 Amaryl Diabeta Glucotrol Glucotrol Xl Glynase

Jentadueto Juvisync Kombiglyze Xr Prandimet TIER 3 Actoplus Met Appformin Appformin-d Avandamet Avandaryl Glucovance Metaglip

BISPHOSPHONATES
TIER 1 alendronate sodium etidronate disodium ibandronate sodium TIER 2 Actonel Atelvia Fosamax Plus D TIER 3 Binosto Boniva Didronel Fosamax Skelid

BIGUANIDES
TIER 1 metformin hcl metformin hcl er TIER 2 Riomet TIER 3 Fortamet Glucophage Glucophage Xr Glumetza

MEGLITINIDE ANALOGUES
TIER 1 nateglinide TIER 2 Prandin TIER 3 Starlix

CALCITONINS
TIER 1 Calcitonin-salmon Fortical TIER 3 Miacalcin

DIABETIC OTHER
TIER 2 Glucagon Emergency Kit TIER 3 Glucagen Glucagen Hypokit Korlym Proglycem

PARATHYROID HORMONE
TIER 2 Forteo

RANK LIGAND INHIBITORS

TIER 2 Xgeva TIER 3 Prolia

ALPHA-GLUCOSIDASE INHIBIT
TIER 1 acarbose TIER 3 Glyset Precose

HORMONE RECEPTOR MDLTR

TIER 2 Evista

DPP-4 INHIBITORS
TIER 2 Januvia Onglyza Tradjenta

FERTILITY REGULATORS
TIER 1 Chorionic Gonadotropin Novarel Pregnyl W/diluent Benzyl Alcohol/nacl

INSULIN SENSITIZING AGENT

TIER 1 Pioglitazone Hcl TIER 3 Actos Avandia

LHRH/GNRH AGONIST
TIER 2 Lupron Depot-ped Supprelin La Synarel

ANTIDIABETIC COMBINATIONS
TIER 1 glipizide/metformin hcl glyburide/metformin hcl Pioglitazone Hcl/metformin Hcl TIER 2 Actoplus Met Xr Duetact Janumet Janumet Xr

GROWTH HORMONES
TIER 2 Norditropin Cartridge Norditropin Flexpro Norditropin Nordiflex Pen Nutropin Nutropin Aq

Effective January 1, 2013 13

Nutropin Aq Nuspin 10 Nutropin Aq Nuspin 20 Nutropin Aq Nuspin 5 Nutropin Aq Pen TIER 3 Genotropin Genotropin Miniquick Humatrope Humatrope Combo Pack Omnitrope Saizen Saizen Click.easy Serostim Tev-tropin Zorbtive

TIER 2 Buphenyl Carbaglu Cystadane Hectorol Kuvan Orfadin Sensipar Zemplar TIER 3 Carnitor Carnitor Sf Rocaltrol

THYROID AGENTS
TIER 1 Levothroid levothyroxine sodium levothyroxine sodium tab 0.075mg Levoxyl liothyronine sodium methimazole nature-throid np thyroid 30 np thyroid 60 np thyroid 90 propylthiouracil Unithroid unithroid direct TIER 3 Armour Thyroid Cytomel Nature-throid Nt-2.5 Synthroid Tapazole Thyrolar-1 Thyrolar-1/2 Thyrolar-1/4 Thyrolar-2 Thyrolar-3 Tirosint Westhroid

GHRH
TIER 3 Egrifta

SOMATOMEDINS
TIER 3 Increlex

SOMATOSTATIC AGENTS
TIER 1 octreotide acetate TIER 2 Sandostatin Lar Depot Somatuline Depot TIER 3 Sandostatin

GH RECEPTOR ANTAGONISTS
TIER 2 Somavert

POSTERIOR PITUITARY
TIER 1 desmopressin acetate minirin vasopressin TIER 2 Stimate TIER 3 Ddavp Pitressin Synthetic

GASTROINTESTINAL
LAXATIVES
TIER 1 cascara sagrada cascara sagrada aromatic constulose gavilyte-c gavilyte-g gavilyte-n/flavor pack lactulose mineral oil heavy Peg 3350/electrolytes peg-3350/electrolytes peg-3350/nacl/na bicarbonate/kcl polyethylene glycol 3350 senna senna leaves senna plus trilyte TIER 2 Halflytely Bowel Prep/flavor Packs Kristalose Suprep Bowel Prep TIER 3 Colyte-flavor Packs Golytely

CORTICOTROPIN
TIER 2 Acthar Hp

PROLACTIN INHIBITORS
TIER 1 cabergoline

VASOPRESSIN ANTAGONISTS
TIER 2 Samsca

PROGESTERONE ANTAGONISTS
TIER 3 Mifeprex

METABOLIC MODIFIERS
TIER 1 calcitriol levocarnitine

Effective January 1, 2013 14

Moviprep Nulytely/flavor Packs Osmoprep Prepopik Visicol

ANTIDIARRHEALS
TIER 1 diphenoxylate/atropine lofene lonox loperamide hcl opium opium tincture paregoric TIER 2 Motofen TIER 3 Lomotil Rezyst Im Rezyst Sb Vsl#3 Ds

ANTACIDS
TIER 1 sodium bicarbonate

ULCER DRUGS
TIER 1 Atropine Sulfate belladonna & opium belladonna alkaloids belladonna alkaloids & opium cimetidine cimetidine hcl colidrops pediatric dicyclomine hcl ed-spaz famotidine gastrinex nf glycopyrrolate hyomax -dt hyomax-sl hyomax-sr hyoscyamine sulfate hyoscyamine sulfate er hyoscyamine sulfate odt hyoscyamine sulfate sr hyosyne lansoprazole Lansoprazole Odt Methscopolamine Bromide misoprostol nizatidine nulev omeprazole omeprazole/sodium bicarbonate oscimin oscimin sr Pantoprazole Sodium propantheline bromide ranitidine hcl scopolamine hydrobromide sucralfate symax fastabs symax-sl symax-sr TIER 2 Carafate

Nexium Pylera TIER 3 Aciphex Anaspaz Atropen Axid Bentyl Cantil Cuvposa Cytotec Dexilant Digex Nf First-lansoprazole First-omeprazole Gabitidine Glycopyrroate Helidac Levbid Levsin Levsin/sl Omeclamox-pak Pamine Pamine Forte Pamine Fq Pepcid Prevacid Prevacid Solutab Prevpac Prilosec Protonix Robinul Robinul Forte Sentradine Symax Duotab Zantac Zegerid

ANTIEMETICS
TIER 1 dimenhydrinate dronabinol granisetron hcl meclizine hcl ondansetron hcl ondansetron odt trimethobenzamide hcl univert TIER 2 Anzemet Emend Sancuso Transderm-scop TIER 3 Antivert Cesamet Coca Cola Syurp Granisol Marinol Tigan Zofran Zofran Odt Zuplenz

DIGESTIVE AIDS
TIER 1 Pancrelipase TIER 2 Creon

Effective January 1, 2013 15

Zenpep TIER 3 Pancreaze Pertzye Sucraid Ultresa Viokace

GASTROINTESTINAL - MISC.
TIER 1 balsalazide disodium calcium acetate colocort cromolyn sodium dexpanthenol enulose generlac Hydrocortisone hydrocortisone acetate/pramoxine lactulose lidazone hc lidocaine hcl-hydrocortisone acetate with aloe lidocaine hcl/hydrocortisone acetate mesalamine metoclopramide hcl pram-hca procto-pak proctocream hc proctosol hc proctozone-hc sulfasalazine sulfazine sulfazine ec ursodiol z-pram TIER 2 Amitiza Analpram Advanced Apriso Asacol Asacol Hd Canasa Cortifoam Fosrenol Lotronex Pentasa Proctofoam Hc Relistor Renvela TIER 3 Actigall Analpram-hc Analpram-hc Singles Anamantle Hc Anusol-hc Azulfidine Azulfidine En-tabs Chenodal Cimzia Cimzia Starter Kit Colazal Cortenema Dipentum Eliphos Entereg Gastrocrom Lialda Linzess Metozolv Odt

Phoslo Phoslyra Procort Proctocort Rectiv Reglan Renagel Rowasa Sfrowasa Urso Forte Urso 250 Zypram

GENITOURINARY
URINARY ANTI-INFECTIVES
TIER 1 hyophen Methenamine Hippurate methenamine mandelate nitrofurantoin Nitrofurantoin Macrocrystal nitrofurantoin macrocrystalline nitrofurantoin monohydrate Nitrofurantoin Monohydrate/macrocrystals phosphasal ur n-c urin d/s uryl ustell uta uticap utira-c utrona-c TIER 3 Furadantin Hiprex Macrobid Macrodantin Monurol Prosed/ds Urelle Uretron D/s Urex Uribel Urogesic-blue Uroqid #2

URINARY ANTISPASMODICS
TIER 1 bethanechol chloride flavoxate hcl oxybutynin chloride oxybutynin chloride er Tolterodine Tartrate trospium chloride trospium chloride er TIER 2 Detrol La Enablex Gelnique Oxytrol Toviaz Vesicare TIER 3 Detrol Ditropan Xl Myrbetriq Sanctura Sanctura Xr

Effective January 1, 2013 16

Urecholine

VAGINAL PRODUCTS
TIER 1 acid jelly clindamycin phosphate metronidazole vaginal miconazole 3 miconazole 3 combo pack nystatin vaginal terconazole Vandazole zazole TIER 2 Avc Crinone Estrace Estring Gynazole-1 Vagifem TIER 3 Cleocin fem ph Femring First-progesterone Vgs 100 Compounding Kit First-progesterone Vgs 200 Compounding Kit First-progesterone Vgs 25 Compounding Kit First-progesterone Vgs 400 Compounding Kit First-progesterone Vgs 50 Compounding Kit Metrogel-vaginal Premarin relagard Terazol 3 Terazol 7

Pyridium Shohls Solution Modified Thiola Urocit-k 10 Urocit-k 5 Uroxatral

HEMATOLOGICAL AGENTS
HEMATOPOIETIC AGENTS
TIER 1 airavite b-6 folic acid bp vit 3 corvita 150 cyanocobalamin Dexferrum ed cyte f fabb fe c plus ferocon ferotrin ferotrinsic ferraplus 90 ferrex 150 forte ferrex 150 forte plus ferrex 28 ferrogels forte folbee folcaps folic acid folic acid/vitamin b-6/vitamin b-12 folitab folplex 2.2 foltrin hematinic/folic acid hematogen hematogen fa hematogen forte hemocyte-f hydroxocobalamin iferex 150 forte Infed martinic mi-omega nf multigen multigen folic multigen plus myferon 150 forte nufol poly-iron 150 forte polysaccharide iron forte purevit dualfe plus se-tan plus senilezol tandem f tl gard rx tl icon tl-fol 500 tl-hem 150 tricon trigels-f forte TIER 2 Aranesp Albumin Free Droxia Foltrate Leukine Mozobil Neulasta Neumega

GENITOURINARY - MISC.
TIER 1 alfuzosin hcl er citric acid/sodium citrate cytra k crystals cytra-k cytra-2 cytra-3 finasteride phenazo phenazopyridine hcl Potassium Citrate potassium citrate/citric acid sodium citrate tamsulosin hcl taron-crystals tricitrates TIER 2 Cystagon Elmiron Rapaflo Urocit-k 15 TIER 3 Avodart Cardura Xl Citrolith Flomax Jalyn K-phos Mf K-phos No 2 Lithostat Oracit Polycitra-k Crystals Proscar

Effective January 1, 2013 17

Neupogen Nplate procrit Promacta TIER 3 Albafort Animi-3 Animi-3/vitamin D Biferarx Cardiotek-rx Cenfol Centratex Corvite Fe Corvite 150 Divista epogen Feriva Ferralet 90 Ferro-plex Hematinic Ferrotrin Fetrin Folbee Ar Folgard Rx Folivane-f Folivane-plus Folpace Rx Fumatinic Hematron-af Hemetab Icar-c Plus Integra F Integra Plus Irospan 24/6 Maxaron Forte Nascobal Nephron Fa Neurin-sl Niron Komplete Novaferrum Omontys Pre-folic Proferrin-forte Purefe Plus Tandem Plus Taron Forte Zavesca

HEMOSTATICS
TIER 1 aminocaproic acid TIER 2 Lysteda TIER 3 Amicar Artiss Astringyn Evicel Evithrom Recothrom Recothrom Spray Kit Thrombin-jmi Diluent Thrombin-jmi Epistaxis Thrombin-jmi Syringe Spray Kit Thrombin-jmi W/dil Spray Pump Actuator Thrombogen Tisseel

HEMATOLOGICAL - MISC.
TIER 1 anagrelide hydrochloride cilostazol clopidogrel dextran hm dextran 70 Dipyridamole pentoxifylline er ticlopidine hcl TIER 2 Aggrenox Brilinta Effient TIER 3 Agrylin Cathflo Activase Firazyr Kalbitor Kinlytic Persantine Plavix Pletal Trental

MOUTH/THROAT/DENTAL AGENT
TIER 1 aquoral cavirinse cevimeline hcl chlorhexadine gluconate oral rinse chlorhexidine gluconate chlorhexidine gluconate oral rinse clotrimazole dobells solution easygel lidocaine hcl lidocaine viscous neutral sodium fluoride numoisyn nystatin oralone perio med periogard pilocarpine hcl pilocarpine hydrochloride stannous fluoride oral rinse topex topical anesthetic

ANTICOAGULANTS
TIER 1 enoxaparin sodium fondaparinux sodium Heparin Sodium Heparin Sodium Dcu Heparin Sodium/nacl 0.45% Heparin Sodium/nacl 0.9% Heparin Sodium/sodium Chloride 0.9% Heparin Sodium/sodium Chloride 0.9% Premix jantoven warfarin sodium TIER 2 Pradaxa Xarelto TIER 3 Arixtra Coumadin Fragmin Iprivask Lovenox

Effective January 1, 2013 18

triamcinolone acetonide triamcinolone in orabase TIER 3 Aphthasol Caphosol Debacterol Evoxac First-bxn Mouthwash First-dukes Mouthwash First-marys Mouthwash First-mouthwash Blm Gel-kam Oral Care Rinse Gelclair Lta 360 Kit Miracle Mouthwash Mucotrol Nafrinse Daily/acidulated Nafrinse Daily/neutral Nafrinse Weekly Neutrasal Oramagicrx Oravig Peridex Prevident Salagen Salicept

NEUROLOGY, CNS, PSYCH

ANTIANXIETY AGENTS
TIER 1 alprazolam alprazolam er alprazolam odt Alprazolam Xr buspirone hcl chlordiazepoxide hcl clorazepate dipotassium diazepam droperidol hydroxyzine hcl hydroxyzine pamoate lorazepam meprobamate oxazepam TIER 3 Alprazolam Intensol Ativan Diazepam Intensol Gabavale-5 Gabazolamine Gabazolamine-0.5 Lorazepam Intensol Niravam Sentrazolam Am 0.25 Tranxene T Valium Vistaril Xanax Xanax Xr

ANTIDEPRESSANTS
TIER 1 amitriptyline hcl amoxapine budeprion sr budeprion xl bupropion hcl bupropion hcl er bupropion hcl sr

bupropion hcl xl citalopram hydrobromide clomipramine hcl desipramine hcl doxepin hcl escitalopram oxalate fluoxetine dr fluoxetine hcl fluvoxamine maleate imipramine hcl imipramine pamoate maprotiline hcl mirtazapine mirtazapine odt nefazodone hcl nortriptyline hcl paroxetine hcl paroxetine hcl er phenelzine sulfate protriptyline hcl sertraline hcl tranylcypromine sulfate trazodone hcl trimipramine maleate venlafaxine hcl venlafaxine hcl er TIER 2 Cymbalta Paxil Pristiq Viibryd TIER 3 Amitriptyline Anafranil Aplenzin Appbutamone Appbutamone-d Celexa Effexor Xr Emsam Forfivo Xl Gaboxetine Lexapro Luvox Cr Marplan Nardil Norpramin Oleptro Pamelor Parnate Paxil Cr Pexeva Prozac Prozac Weekly Remeron Remeron Soltab Sentraflox Am-10 Sentralopram Am-10 Sentravil Pm-25 Sentroxatine Surmontil Tofranil Tofranil-pm Trazamine Trazodone Vivactil Wellbutrin Wellbutrin Sr Wellbutrin Xl Zoloft

Effective January 1, 2013 19

ANTIPSYCHOTICS
TIER 1 chlorpromazine hcl clozapine Clozapine Odt compro fluphenazine decanoate fluphenazine hcl haloperidol haloperidol decanoate haloperidol lactate Lithium Carbonate lithium carbonate er Lithium Citrate loxapine loxapine succinate olanzapine olanzapine odt perphenazine prochlorperazine prochlorperazine edisylate prochlorperazine maleate quetiapine fumarate risperidone Risperidone M-tab risperidone odt thioridazine hcl thiothixene trifluoperazine hcl ziprasidone hcl TIER 2 Abilify Abilify Discmelt Latuda Seroquel Xr TIER 3 Clozaril Equetro Fanapt Fanapt Titration Pack Fazaclo Geodon Haldol Haldol Decanoate 100 Haldol Decanoate 50 Invega Invega Sustenna Lithobid Loxitane Navane Risperdal Risperdal Consta Risperdal M-tab Saphris Seroquel Zyprexa Zyprexa Relprevv Zyprexa Zydis

zaleplon zolpidem tartrate zolpidem tartrate er TIER 2 Lunesta Silenor TIER 3 Ambien Ambien Cr Amytal Sodium Butisol Sodium Doral Edluar Gabazolpidem-5 Halcion Intermezzo Luminal Nembutal Nembutal Sodium Restoril Rozerem Seconal Sentrazolpidem Pm-5 Somnote Sonata Strazepam Zolpimist

ADHD, NARCOLEPSY, ETC.

TIER 1 Amphetamine/dextroamphetamine caffeine citrate caffeine/sodium benzoate dexmethylphenidate hcl dextroamphetamine sulfate dextroamphetamine sulfate er metadate er methamphetamine hcl methylin methylin er methylphenidate hcl methylphenidate hcl cd methylphenidate hcl er Methylphenidate Hcl Sr methylphenidate hydrochloride modafinil TIER 2 Daytrana Intuniv Strattera Vyvanse TIER 3 Adderall Adderall Xr Cafcit Concerta Desoxyn Dexedrine Focalin Focalin Xr Kapvay Kapvay Dose Pack Metadate Cd Nuvigil Procentra Provigil Quillivant Xr Ritalin Ritalin La

HYPNOTICS
TIER 1 chloral hydrate estazolam flurazepam hcl phenobarbital phenobarbital sodium temazepam triazolam

Effective January 1, 2013 20

Ritalin Sr Sentramodafin Am-100

ANTICONVULSANTS
TIER 1 carbamazepine Carbamazepine Er clonazepam clonazepam odt Diazepam divalproex sodium divalproex sodium dr divalproex sodium er epitol ethosuximide Felbamate fosphenytoin sodium gabapentin lamotrigine levetiracetam levetiracetam er oxcarbazepine phenytoin phenytoin sodium phenytoin sodium extended primidone tiagabine hydrochloride topiragen topiramate valproic acid zonisamide TIER 2 Banzel Celontin diastat pediatric Dilantin Infatabs Lamictal Odt Lamictal Xr Lyrica Peganone Potiga Tegretol-xr Vimpat TIER 3 Carbatrol Depakene Depakote Depakote Er Depakote Sprinkles diastat acudial Dilantin Felbatol Gabitril Keppra Keppra Xr Klonopin Lamictal Lamictal Chewable Dispersible Lamictal Starter/not Taking Carbamazepine Lamictal Starter/taking Carbamazepine/not Taking Valproate Lamictal Starter/taking Valproate Mysoline Neurontin Onfi Phenytek Sabril Stavzor Tegretol

Therapentin-60 Therapentin-90 Topamax Topamax Sprinkle Trileptal Zarontin Zonegran

ANTIPARKINSON AGENTS
TIER 1 amantadine hcl benztropine mesylate bromocriptine mesylate carbidopa/levodopa carbidopa/levodopa cr carbidopa/levodopa er carbidopa/levodopa odt carbidopa/levodopa sr Carbidopa/levodopa/entacapone Entacapone pramipexole dihydrochloride ropinirole er ropinirole hcl selegiline hcl trihexyphenidyl hcl TIER 2 Apokyn Azilect Lodosyn Mirapex Er TIER 3 Cogentin Comtan Eldepryl Mirapex Neupro Parcopa Parlodel Requip Requip Xl Sinemet Sinemet Cr Stalevo 100 Stalevo 125 Stalevo 150 Stalevo 200 Stalevo 50 Stalevo 75 Tasmar Zelapar

NEUROLOGY, PSYCH - MISC.

TIER 1 chlordiazepoxide/amitriptyline disulfiram donepezil hcl ergoloid mesylates fluoxetine galantamine galantamine hydrobromide olanzapine/fluoxetine perphenazine/amitriptyline rivastigmine tartrate TIER 2 Ampyra Avonex Avonex Pen Copaxone Namenda

Effective January 1, 2013 21

Namenda Titration Pak Nuedexta Orap Rebif Rebif Titration Pack Savella Xenazine Xyrem TIER 3 Antabuse Aricept Aricept Odt Aubagio Betaseron Campral Exelon Extavia Gilenya Gralise Gralise Starter Horizant Razadyne Razadyne Er Sarafem Savella Titration Pack Symbyax

Skelaxin Soma Therabenzaprine-60 Therabenzaprine-90 Therabenzaprine-90-5 Tizanidine Comfort Pac Zanaflex

ANTIMYASTHENIC AGENTS
TIER 1 Guanidine Hcl neostigmine methylsulfate pyridostigmine bromide TIER 2 Mestinon Timespan Prostigmin TIER 3 Enlon Mestinon Mytelase Regonol

OPHTHALMOLOGY AND OTIC

ANTI-INFECTIVES
TIER 1 ak-poly-bac bacitracin bacitracin/polymyxin b ciprofloxacin hcl erythromycin garamycin gentak gentamicin sulfate ilotycin levofloxacin neo-polycin neomycin/bacitracin/polymyxin neomycin/polymyxin/bacitracin zinc neomycin/polymyxin/gramicidin ofloxacin polycin b Polymyxin B Sulfate/trimethoprim Sulfate romycin sodium sulfacetamide sulfacetamide sodium tobramycin sulfate tobrasol Trifluridine trimethoprim sulfate/polymyxin b sulfate TIER 2 Besivance Ciloxan Moxeza Natacyn Vigamox Zymaxid TIER 3 Azasite Betadine Ophthalmic Prep Bleph-10 Iquix Mitosol Neosporin Ocuflox Polytrim Quixin Tobrex Viroptic Zirgan

NEUROMUSCULAR AGENTS
TIER 2 Rilutek TIER 3 Anectine Botox Dysport Myobloc Quelicin Quelicin 1000 Xeomin

MUSCULOSKELETAL AGENTS
TIER 1 baclofen carisoprodol carisoprodol/aspirin carisoprodol/aspirin/codeine chlorzoxazone cyclobenzaprine hcl cyclobenzaprine hcl er dantrolene sodium ed baclofen Metaxalone methocarbamol orphenadrine citrate orphenadrine citrate er orphenadrine compound ds orphenadrine/asa/caffeine tizanidine hcl TIER 3 Amrix Cyclobenzaprine Comfort Pac Dantrium Fexmid Flexeril Lorzone Norflex Parafon Forte Dsc Prazolamine Robaxin Robaxin-750

Effective January 1, 2013 22

ARTIFICIAL TEAR/LUBRICANT
TIER 2 Lacrisert

TIER 3 Lumigan Xalatan Zioptan

BETA-BLOCKERS
TIER 1 betaxolol hcl carteolol hcl dorzolamide hcl/timolol maleate levobunolol hcl Metipranolol timolol maleate Timolol Maleate Ophthalmic Gel Forming TIER 2 Betoptic-s Combigan TIER 3 Betagan Betimol Cosopt Cosopt Pf Istalol Optipranolol Timoptic Timoptic Ocudose Timoptic-xe

CYCLOPLEGIC MYDRIATICS
TIER 1 ak-pentolate atropine sulfate atropine-care cyclopentolate hcl cylate homatropaire homatropine hbr mydral tropicamide TIER 3 Cyclogyl Cyclomydril Isopto Atropine Isopto Homatropine Isopto Hyoscine Mydriacyl

DECONGESTANTS
TIER 1 ak-con altafrin neofrin phenylephrine hcl TIER 3 Mydfrin

OPHTHALMIC STEROIDS
TIER 1 dexamethasone sodium phosphate fluor-op Fluorometholone neomycin/polymyxin/bacitracin/hydrocortisone neomycin/polymyxin/dexamethasone neomycin/polymyxin/hydrocortisone poly-dex Prednisolone Acetate prednisolone sodium phosphate sulfacetamide sodium/prednisolone sodium phosphate tobramycin/dexamethasone TIER 2 Alrex Blephamide S.o.p. Durezol Fml Lotemax Pred Mild Tobradex St Zylet TIER 3 Blephamide Flarex Fml Forte Fml Liquifilm Maxidex Maxitrol Omnipred Poly-pred Pred Forte Pred-g Pred-g S.o.p. Tobradex Vexol

MIOTICS
TIER 1 pilocarpine hcl TIER 2 Isopto Carbachol Phospholine Iodide Pilopine Hs TIER 3 Isopto Carpine

ADRENERGIC AGENTS
TIER 1 apraclonidine brimonidine tartrate TIER 3 Alphagan P Iopidine

IMMUNOMODULATORS
TIER 2 Restasis

LOCAL ANESTHETICS
TIER 1 altacaine parcaine proparacaine hcl tetcaine tetracaine hcl tetravisc tetravisc forte TIER 3 Akten Alcaine

PROSTAGLANDINS
TIER 1 latanoprost TIER 2 Travatan Z

Effective January 1, 2013 23

OPHTHALMICS - MISC.
TIER 1 akorn balanced salt solution azelastine hcl balanced salt solution bromfenac cromolyn sodium diclofenac sodium dorzolamide hcl epinastine hcl flurbiprofen sodium ketorolac tromethamine TIER 2 Acuvail Azopt Bromday Nevanac Pataday Patanol TIER 3 Acular Acular Ls Alamast Alocril Alomide Bepreve Elestat Emadine Ilevro Lastacaft Ocufen Optivar Trusopt Voltaren

Vosol Vosol Hc Zinotic Zinotic Es

OXYTOCICS
TIER 1 methylergonovine maleate Oxytocin TIER 3 Cervidil Hemabate Methergine Pitocin Prepidil Prostin E2

PAIN MANAGEMENT
ANALGESICS - NONNARCOTIC
TIER 1 ali-flex alpain anabar anolor 300 biogesic bp poly-650 bupap butal/asa/caff butalbital compound butalbital/acetaminophen butalbital/acetaminophen/caffeine Butalbital/asa/caffeine butalbital/aspirin/caffeine cafgesic forte capacet cephadyn choline magnesium trisalicylate diflunisal dologesic dolorex duraxin ed-flex frenadol margesic marten-tab mst 600 novagesic promacet repan rhinoflex rhinoflex-650 salsalate tencon zebutal zflex zgesic TIER 3 Acuflex Alagesic Lq Bioregesic Dolgic Plus Durabac Durabac Forte Equagesic Esgic Esgic-plus Fioricet Fiorinal

OTIC AGENTS
TIER 1 acetasol hc acetic acid acetic acid/aluminum acetate antipyrine/benzocaine aurax aurodex Ciprofloxacin fluocinolone acetonide hydrocortisone/acetic acid myoxin neomycin/polymyxin/hc neomycin/polymyxin/hydrocortisone ofloxacin otic care oticin otozin TIER 2 Ciprodex TIER 3 Auralgan cetraxal Cipro Hc Coly-mycin S Cortisporin Cortisporin-tc Cresylate Dermotic Neotic Pinnacaine Otic Pramotic Treagan Otic Trioxin

Effective January 1, 2013 24

Flextra Flextra Ds Flextra-650 Lagesic Levacet Orbivan Orbivan Cf Phrenilin Forte Relagesic Sedapap Staflex

ANALGESICS - OPIOID
TIER 1 acetaminophen/caffeine/dihydrocodeine bitartrate acetaminophen/codeine acetaminophen/codeine #2 acetaminophen/codeine #3 acetaminophen/codeine #4 acetaminophen/codeine phosphate alfentanil ascomp/codeine astramorph buprenorphine hcl butalbital/acetaminophen/caffeine/codeine butalbital/aspirn/caffeine/codeine butorphanol tartrate co-gesic codeine phosphate Codeine Sulfate Duramorph endocet Endodan fentanyl fentanyl citrate oral transmucosal hydrocodone bitartrate/acetaminophen hydrocodone/acetaminophen hydrocodone/ibuprofen hydrogesic hydromorphone hcl hydromorphone hcl dosette ibudone levorphanol tartrate meperidine hcl meperitab methadone hcl Methadose Methadose Sugar-free Morphine Sulfate Morphine Sulfate Er nalbuphine hcl oxycodone hcl oxycodone/acetaminophen oxycodone/aspirin oxycodone/ibuprofen oxymorphone hydrochloride oxymorphone hydrochloride er pentazocine/acetaminophen pentazocine/naloxone hcl stagesic tramadol hcl Tramadol Hcl Er Tramadol Hydrochloride/acetaminophen trezix vicodin hp TIER 2 Abstral Avinza Butrans

Fentora Nucynta Nucynta Er Opana Er Opana Er (crush Resistant) Oxycontin Suboxone TIER 3 Actiq Alfenta Buprenex Capital/codeine Cocet Cocet Plus Conzip Demerol Dilaudid Dilaudid-hp Dilaudid-5 Dolophine Dolophine Hcl Duragesic Exalgo Fioricet/codeine Fiorinal/codeine #3 Hycet hydrocodone-acetaminophen tab 7.5-750 mg Hydromorphone Infumorph 200 Infumorph 500 Kadian Lazanda Liquicet Lorcet Plus Lorcet 10/650 Lortab Magnacet Maxidone Methadone Hcl Intensol Morphine morphine sulfate powder Morphine/saline Ms Contin Ms/hydrogel Norco Onsolis Opana Oramorph Sr Oxecta oxycodone Percocet Percodan Primlev Reprexain Roxicet Roxicodone Rybix Odt Ryzolt Subsys Subutex Synalgos-dc Talwin Theracodeine-300 Theracodophen-low-90 Theracodophen-325 Theracodophen-650 Theracodophen-750 Theratramadol-60 Theratramadol-90 Tylenol/codeine #3

Effective January 1, 2013 25

Tylenol/codeine #4 Tylox Ultracet Ultram Ultram Er Vicodin Vicodin Es Vicoprofen Xodol Xolox Zamicet Zolvit Zydone

ANTI-INFLAMMATORY
TIER 1 diclofenac potassium diclofenac sodium dr diclofenac sodium er Diclofenac Sodium Xr diclofenac sodium/misoprostol etodolac etodolac er fenoprofen calcium flurbiprofen ibuprofen indomethacin indomethacin er ketoprofen ketoprofen er ketorolac tromethamine leflunomide meclofenamate sodium mefenamic acid Meloxicam nabumetone naproxen naproxen dr naproxen sodium oxaprozin piroxicam sulindac tolmetin sodium TIER 2 Arcalyst Celebrex Enbrel Enbrel Sureclick Humira Humira Pen Humira Pen-crohns Diseasestarter Humira Pen-psoriasis Starter Ridaura Vimovo TIER 3 Anaprox Anaprox Ds Arava Arthrotec 50 Arthrotec 75 Cataflam Clinoril Daypro Duexis Ec-naprosyn Feldene Ibuprofen Comfort Pac Ic 400 Ic 800

Ilaris Indocin Kineret Meloxicam Comfort Pac Mobic Myochrysine Nalfon Naprelan Naprosyn Naproxen Comfort Pac Orencia Ponstel Rheumatrex Simponi Sprix Therafeldamine Theraprofen-60 Theraprofen-800 Theraprofen-90 Theraproxen Theraproxen-500 Theraproxen-60 Theraproxen-90 Trepadiclofen-25 Trepoxen-250 Trepoxicam-7.5 Voltaren-xr Wound Gel Xeljanz Zipsor

MIGRAINE PRODUCTS
TIER 1 dihydroergotamine mesylate naratriptan hcl Sumatriptan sumatriptan succinate Sumatriptan Succinate Refill TIER 2 Cafergot Ergomar Maxalt Maxalt-mlt Relpax Treximet TIER 3 Alsuma Amerge Axert Cambia D.h.e. 45 Frova Imitrex Imitrex Statdose Refill Imitrex Statdose System Migergot Migral Migranal Sumavel Dosepro Zomig Zomig Zmt

GOUT AGENTS
TIER 1 Allopurinol probenecid probenecid/colchicine TIER 2 Colcrys

Effective January 1, 2013 26

Uloric TIER 3 Zyloprim

LOCAL ANESTHETICS-INJ
TIER 1 bd pudendal/local block tray 1% lidocaine bupivacaine hcl Bupivacaine/epinephrine chloroprocaine hcl lidocaine hcl lidocaine/epinephrine mepivacaine hcl polocaine polocaine-mpf sensorcaine sensorcaine-mpf sensorcaine/epinephrine tetracaine hcl TIER 3 Argyle Pneumothorax Procedure Tray/8fr Carbocaine Duocaine Durasafe Spinal/epidural Tray/1% Xylocaine/19gx36"close Cath Durasafe Spinal/epidural Tray/1% Xylocaine/19gx36"open Cath Durasafe Spinal/epidural Tray/1% Xylocaine/20gx36"close Cath Durasafe Spinal/epidural Tray/1% Xylocaine/20gx36"open Cath Exparel Lets Kit Marcaine Marcaine W/o Epi Marcaine/epinephrine Monoject Basic Biopsy Tray Without Biopsy Needle 20gx 11/2" Monoject Bone Marrow Aspiration Tray/iliac Needle 16g Monoject Bone Marrow Aspiration Tray/rosenthal Needle 16gx2" Monoject Bone Marrow Biopsy Tray/biop Aspir Needle 11gx4" Monoject Bone Marrow Biopsy Tray/biop Aspir Needle 8gx4" Monoject Bone Marrow Biopsy Tray/biop Aspir/iliac Aspir Ndle Naropin Nesacaine Nesacaine-mpf Pontocaine Pontocaine Niphanoid Sensorcaine-mpf/epinephrine Xylocaine Xylocaine-mpf Xylocaine-mpf/epinephrine Xylocaine/epinephrine

dexchlorpheniramine maleate dexchlorpheniramine maleate cr diphenhydramine hcl dytuss fexofenadine hcl levocetirizine dihydrochloride lohist-12 phenadoz promethazine hcl promethazine hcl plain promethegan respa-br respivent df respivent df 30 TIER 2 Clarinex Reditabs TIER 3 Aerohist Ahist Ala-hist Allerx Df Allerx Df 30 Clarinex Doxytex Ed Chlorped Ed-chlor-tan Lodrane 24 Palgic Phenergan Phenergan Fortis Ryneze Vazol Xyzal

NASAL AGENTS
TIER 1 azelastine hcl flunisolide fluticasone propionate ipratropium bromide triamcinolone acetonide TIER 2 Astepro Nasonex Qnasl TIER 3 Adrenalin Astelin Atrovent Bactroban Nasal Beconase Aq Dymista Flonase Lusonal Nasacort Aq Omnaris Patanase Rhinocort Aqua Tyzine Tyzine Pediatric Nasal Drops Veramyst Zetonna

RESPIRATORY, ALLERGY, ETC

ANTIHISTAMINES
TIER 1 arbinoxa bpm bromax brompheniramine tannate bromspiro carbinoxamine maleate cetirizine hcl clemastine fumarate cyproheptadine hcl desloratadine

COUGH/COLD/ALLERGY
TIER 1 acetylcysteine airacof albatussin nn alenaze-d

Effective January 1, 2013 27

alenaze-d nr balacall dm benzonatate bidhist-d biotuss biotuss pediatric bpm pseudo bromatan plus bromfed dm centergy centergy dm ceron-dm chlor-mes d chlor-mes jr coldec dm dacex-dm de-chlor dm de-chlor dr dehistine despec-exp dex-tuss dextromethorphan hbr/chlorpheniramine/phenylephrine hcl dextromethorphan hbr/phenylephrine hcl/chlorpheniramine dihydro-cp dihydro-pe dm-pe-chlor ed-a-hist dm entre-b exefen-ir expectuss g/p gani-tuss dm nr gani-tuss nr ganidin-nr genexa la gentex lq gfn 1200/dm 60 gfn 550/pse 60 guaifenesin/phenylephrinehcl hdc dm hydrocodone bitartrate/homatropine methylbromide hydrocodone polistirex and chlorpheniramine polistirex hydrocodone/homatropine hydromet indamix dm kgs-pe lohist-12d myci-gc myhist-pd mytussin ac nasohist neutrahist nohist nohist dmx nortuss-de nortuss-ex p chlor dm pe-guai phenylephrine/guaifenesin promethazine vc promethazine vc plain promethazine vc/codeine promethazine-dm promethazine/codeine promethazine/dextromethorphan protid pulmari-gp r-tanna r-tanna pediatric relacon-dm nr

relasin dm relcof pse relera resperal-dm respivent-d rinate pediatric robafen ac romilar ac ru-hist forte ru-tuss simuc-gp sodium chloride sudahist sudatex-dm sutan-dm tannihist-12 rf tgq 15dm/5peh/2cpm tgq 30pse/150gfn/15dm tgq 30pse/3brm/15dm tgq 50pse/3brm/30dm tgq 7.5peh/4brm/15dm tl-dex dm tl-hist cd tl-hist cm trexbrom tussafed ex tussigon v-cof v-hist vazotab z-dex z-dex 12d z-tuss dm zotex-pe zotex-12d TIER 2 Clarinex-d 12 Hour Clarinex-d 24 Hour Rezira Tussicaps Zutripro TIER 3 Aerokid Ala-hist D Alahist Ac Alahist Dhc Allerscript Allerx Dose Pack Allerx Pe Allerx-d Allfen Cd Allfen Cdx Ambifed Cd Ambifed Cdx Ambifed-g Cd Ambifed-g Cdx Atuss Ds C-tan D Plus Carba-xp Carbaphen 12 Carbaphen 12 Ped Carbatuss Carbatuss-cl Carbatuss-12 Cenhist Cgu Wc Corzall Corzall Plus Corzall-pe Cotab A

Effective January 1, 2013 28

Cotab Ax Cotabflu Cpb Wc Dallergy Dallergy Dm Dallergy Jr Dallergy Pe Dallergy Pse Dallergy-jr Decon-a Deltuss Dmx Despec-pdc Donatuss Dc Donatuss Xp Donatussin Dm Drymax Duraflu Ed Chlorped D Ed Dm Exactuss Exall Exall-d Gentex 30 Gilphex Tr Giltuss Giltuss Ped-c Giltuss Pediatric Giltuss Tr Hydroc/apap hydrocodone 10mg Hyper-sal Hypersal J-cof Dhc J-max Dhc J-tan D J-tan D Sr Lodrane 12d Lodrane 24d Maxifed Cd Maxifed Cdx Maxifed-g Cd Maxifed-g Cdx Maxiflu Cd Maxiflu Cdx Maxiphen Cd Maxiphen Cdx Nariz Nasohist Dm Nasotuss Nebusal Neo Dm Neotuss Plus Norel Sr Notuss-ac Panatuss Dxp Pediatex Td Pediatex Tdm Phena-plus Phena-s Phenflu Cd Phenflu Cdx Poly Hist Dhc Poly Hist Nc Poly Hist Pd Poly-tussin Dhc Poly-tussin Ex Pro-clear Prohist Cd Prohist Cf Prohist Lq

Relhist Rescon Rescon-jr Rescon-mx Respa-a.r. Ru-tuss Dm Semprex-d Seradex Stahist Suttar-sf Suttar-2 Tekral Tessalon Tessalon Perles Trispec Dmx Trispec Dmx Pediatric Trispec Pse Trispec Pse Pediatric Trituss Tusnel Ped-c Tussionex Pennkinetic Extended Release Tusso-c Tusso-dmr Tusso-zmr Vazobid Vazotan Z-cof I Zonatuss Zotex Zotex -gp Zotex Pe Zotex Pediatric Zotex-c Zotex-d Zotex-dm Zotex-ex Zotex-g

ANTIASTHMATIC/COPD AGENTS
TIER 1 albuterol sulfate albuterol sulfate er aminophylline budesonide copd cromolyn sodium dg 200 difil-g forte difil-g 400 dy-g dyflex-g dylix dyphylline gg dyphylline-gg epinephrine hcl ipratropium bromide ipratropium bromide/albuterol sulfate jay-phyl levalbuterol Levalbuterol Hcl metaproterenol sulfate montelukast sodium terbutaline sulfate theochron theophylline theophylline cr theophylline er Zafirlukast

Effective January 1, 2013 29

TIER 2 Advair Diskus Advair Hfa Alvesco Asmanex 120 Metered Doses Asmanex 14 Metered Doses Asmanex 30 Metered Doses Asmanex 60 Metered Doses Asmanex 7 Metered Doses Atrovent Hfa Combivent Combivent Respimat Daliresp Dulera Elixophyllin Foradil Aerolizer Perforomist Proair Hfa Pulmicort Flexhaler Qvar Serevent Diskus Spiriva Handihaler Symbicort Tudorza Pressair TIER 3 Accolate Accuneb Adrenalin Arcapta Neohaler Broncomar-1 Brondil Brovana Dilex-g 200 Dilex-g 400 Duoneb Ed-bron G Flovent Diskus Flovent Hfa Isuprel Lufyllin Maxair Autohaler Proventil Hfa Pulmicort Pulmophylline Senophylline Singulair Theo-24 Ventolin Hfa Vospire Er Xolair Xopenex Xopenex Concentrate Xopenex Hfa Zyflo Zyflo Cr

diphtheria/tetanus toxoid pediatric diphtheria/tetanus toxoids adsorbed pediatric tetanus toxoid adsorbed tetanus/diphtheria toxoids-adsorbed adult TIER 2 Adacel Boostrix Daptacel Infanrix Kinrix Pediarix Pentacel Tenivac Trihibit Tripedia

VACCINES
TIER 1 influenza a (h1n1) monovalent 2009 influenza a (h1n1) monovalent 2009 pf pneumovax 23/1 dose pneumovax 23/5 dose yf-vax TIER 2 Acthib Afluria Pf 2010-2011 Afluria Pf 2011-2012 Afluria Pf 2012-2013 Afluria 2009-2010 Afluria 2011-2012 Afluria 2012-2013 Agriflu 2010-2011 Biothrax Cervarix Comvax Engerix-b Fluarix 2010-2011 Fluarix 2011-2012 Fluarix 2012-2013 Flucelvax 2012-2013 Flulaval 2010-2011 Flulaval 2011-2012 Flulaval 2012-2013 Flumist Nasal Vaccine 2010-2011 Flumist Nasal Vaccine 2011-2012 Flumist Nasal Vaccine 2012-2013 Fluvirin Pf 2011-2012 Fluvirin Pf 2012-2013 Fluvirin 2010-2011 Fluvirin 2011-2012 Fluvirin 2012-2013 Fluzone High-dose Pf 2010-2011 Fluzone High-dose Pf 2011-2012 Fluzone High-dose Pf 2012-2013 Fluzone Pediatric Pf 2010-2011 Fluzone Pediatric Pf 2011-2012 Fluzone Pediatric Pf 2012-2013 Fluzone Pf 2010-2011 Fluzone Pf 2011-2012 Fluzone Pf 2012-2013 Fluzone Split 2010-2011 Fluzone Split 2011-2012 Fluzone Split 2012-2013 Gardasil Havrix Hiberix Imovax Rabies (h.d.c.v.) Influenza Vaccine For Safeway Dependants

RESPIRATORY AGENTS - MISC

TIER 2 Kalydeco Pulmozyme TIER 3 Curosurf Infasurf Survanta Intratracheal

TOXOIDS
TIER 1 decavac

Effective January 1, 2013 30

Ipol Inactivated Ipv Ixiaro Je-vax M-m-r Ii W/diluent 10 Dose Menactra Menhibrix Menomune-a/c/y/w-135 Menveo Pedvax Hib Prevnar 13 Proquad Rabavert Recombivax Hb Rotarix Rotateq Twinrix Typhim Vi Vaqta Varivax Vivotif Berna Zostavax

VITAMINS
VITAMINS
TIER 1 ascor l nc ascor l 500 ascorbic acid cenolate Ergocalciferol mega-c/a plus niacin niacor ortho-cs 250 phytonadione pyridoxine hcl thiamine hcl vitamin c 222mg vitamin d vitamin k1 wheat germ TIER 2 Mephyton TIER 3 Aquasol A Parenteral Decara Drisdol

MULTIVITAMINS
TIER 1 b-complex b-complex 100 b-plex b-plex plus biocel bp folinatal plus b bp multinatal plus cavan one omega cavan prenatal/ec calcium cavan-ec sod dha co-natal fa cod liver oil complete natal dha completenate corvita corvite free dialyvite elite ob with dha elite-ob

ferrocite plus folbecal folbee plus folbee plus cz gentex ade hematinic plus vitamins/minerals hemocyte-plus inatal advance inatal gt inatal ultra lysiplex plus m-vit macnatal cn dha mult-vitamin/fluoride multi vitamin/fluoride multi-vit/fluoride multi-vit/iron/fluoride multi-vitamin/fluoride multi-vitamin/fluoride/iron multivitamin with fluoride multivitamin/fluoride multivitamins/fluoride mvc-fluoride mynatal advance mynatal plus mynatal ultracaplet mynatal-z mynate 90 plus mynephrocaps nephronex neurodep nicotinamide w/zinc oxide/cupric oxide/folic acid nicotinamide/zinc oxide/cupric oxide/folic acid nicotinamide/zinc/copper/fa nutricap nutrifac zx ob-natal one obstetrix ec pnv-dha pnv-select poly-vitamin/fluoride poly-vitamin/iron/fluoride polyvitamin/fluoride pr natal 400 pr natal 400 ec pr natal 430 pr natal 430 ec prenafirst prenaissance plus prenaplus prenatabs fa prenatabs obn prenatabs rx prenatal ad prenatal low iron prenatal plus/iron prenatal 19 prenatal-u rena-vite rx renal renalpren reno caps se-care se-care conceive se-natal one se-natal 19 se-natal 90 se-plete dha se-tan dha seton et-ec

Effective January 1, 2013 31

setonet siderol strovite plus taron ec calcium taron-ec cal taron-prex therobec tl nicotinamide tri rx tri-vit/fluoride tri-vit/fluoride/iron tri-vitamin/fluoride tri-vitamin/iron/fluoride triadvance tricare trimesis rx trinatal rx 1 trinate triphrocaps triple-vitamin/fluoride trust natal dha ultimatecare one ultimatecare one nf ultra tabs urosex v-c forte vic-forte vinate az vinate c vinate care vinate gt vinate ic vinate ii vinate m vinate one vinate pn care vinate ultra vita s forte vita-min vitacel vitafol-ob vitamin b-complex 100 vitamin forte vitamins a/c/d/fluoride vitaspire vol-care rx vp-zel TIER 2 Neevo Neevo Dha Prefera Ob Prefera Ob + Dha Preferaob One TIER 3 Adrenal C Formula Advanced Am/pm Albafort Ap-zel Atabex Ec Atabex Prenatal B-nexa Bacmin Bal-care Dha Bal-care Dha Essential Caromega Cavan-alpha Kit Cavan-folate Dha Cavan-folate Ob Citranatal Assure Citranatal B-calm

Citranatal Dha Citranatal Harmony Citranatal Rx Citranatal 90 Dha Complete-rf Prenatal Concept Dha Concept Ob Corenate-dha Corvite Crnatal Dialyvite Supreme D Dialyvite 3000 Dialyvite 5000 Dialyvite/zinc Diatx Zn Duet Dha Duet Dha Balanced Duet Dha Ec Elite-ob 400 Escavite Folcal Dha Folcaps Omega 3 Folgard Os Folivane-ec Calcium Dha Nf Folivane-ob Folivane-prx Dha Nf Fortavit Gesticare Dha Hemenatal Ob Hemenatal Ob + Dha Hemocyte Plus L-methylfolate Pnv Dha Lactocal-f Levomefolate Dha Levomefolate Pnv Marnatal-f Marnatal-f Plus Duo Pack Maxinate Multichew Mykidz Iron Fl Mynatal Nata Komplete Natachew Natafort Natalvit Natelle One Natelle-ez Nephplex Rx Nephro-vite Rx Nephrocaps Nephrocaps Qt Nestabs Nestabs Dha Nexa Plus Nexa Select Nicazel Nicomide Nutri-tab Ob Nutri-tab Ob + Dha Nutrivit O-cal Fa O-cal Prenatal Ob Complete Ob Complete One Ob Complete Petite Ob Complete Premier Ob Complete With Dha Ob Complete 400 Ob Complete/dha Obstetrix Dha

Effective January 1, 2013 32

Paire Ob Pnv Ob+dha Pnv-dha+docusate Pnv-omega Pnv-total Poly-vi-flor Poly-vi-flor/iron Prenaissance Prenaissance Balance Prenaissance Harmony Dha Prenaissance Next Prenata Prenatal Mv & Min/fe-fa-dha Prenatal Plus Prenatal Plus Iron Prenatal Vitamins Plus Prenate Dha Prenate Elite Prenate Essential Prenate Mini Prena1 Chew/quatrefolic Prena1 Plus/quatrefolic Prena1/quatrefolic Prenexa Preque 10 Promar Protect Cardio Protect Plus Protect Plus Nr Protectbone Protectiron Protectnatal Purefe Ob Plus Reaphirm Relnate Dha Renatabs Renatabs With Iron Renax Renax 5.5 Req 49+ Select-ob Select-ob+dha Senetonic Strovite Strovite Advance Strovite Forte Strovite One Supervite Supervite Ec Support Support-500 Synagex Synatek Tandem Dha Tandem Ob Taron-bc Taron-c Dha Taron-duo Ec Tl G-fol Os Tl-assure One Tl-assure+dha Tl-fluorivite Tl-select Tl-select Dha Tri-vi-flor Tri-vi-floro Tri-zel Tricare Dha 301 Tricare Prenatal Dha One Trinatal Gt

Trinatal Ultra Triveen-duo Dha Triveen-one Triveen-prx Rnf Triveen-ten Triveen-u Udamin Udamin Sp Ultimate Ob Dha Ultimatecare Advantage Ultimatecare Combo V-natal V-natal Dha Vemavite-prx 2 Vena-bal Dha Venatal Complete Dha Venatal-fa Vinacal Vinate Az Extra Vinate Calcium Vinate Dha Virt-bal Dha Virt-bal Dha Plus Virt-pn Virt-pn Dha Virt-select Vita-pren Vitafol Vitafol-ob+dha Vitafol-one Vitafol-plus Vitafol-pn Vitaject Vital-d Rx Vitamax Pediatric Vitamedmd One Rx/quatrefolic Vitamedmd Plus Rx/quatre Folic Vitamedmd Redichew Rx/quatrefolic Vitaroca Plus Viva Ct Prenatal Viva Dha Vol-nate Vol-plus Vol-tab Rx Vp-ch-pnv Vp-era Ob Plus Vp-ggr-b6 Prenatal Vp-pnv-dha Zatean-ch Zatean-pn Zatean-pn Dha Zatean-pn Plus Zingiber

MEDICAL DEVICES
DIABETIC SUPPLIES
TIER 2 Accu-chek Active Strips Accu-chek Advantage Diabetes Care Kit Accu-chek Aviva Accu-chek Aviva Plus Accu-chek Comfort Curve Test Strips Accu-chek Compact Plus Care Kit Accu-chek Compact Strips Accu-chek Compact Test Drum Accu-chek Fastclix Lancets Accu-chek Multiclix Lancets Accu-chek Nano Smartview Accu-chek Safe-t-pro Lancets

Effective January 1, 2013 33

Accu-chek Safe-t-pro Pluslancets Accu-chek Smartview Strips Accu-chek Soft Touch Lancets Accu-chek Softclix Lancets Acti-lance Lancets 28g Acti-lance Lite Safety Lancets 28g Acti-lance Special Safety Lancets 17g Acti-lance Special Safetylancets 17g Acti-lance Universal Safety Lancets 23g Advocate Lancets Advocate Safety Lancets Af Lancets Super Thin Agamatrix Ultra-thin Lancets 33g Assure Haemolance Plus High Flow 18g Assure Haemolance Plus Low Flow 25g Assure Haemolance Plus Micro Flow 28g Assure Haemolance Plus Normal Flow 21g Assure Haemolance Plus Pediatric Blade Assure Lance Lancets Assure Lancets At Last Lancets Aurora Healthcare Lancets Aurora Lancet Super Thin 30g Aurora Lancet Thin 23g Bayer Microlet Lancets Bd Insulin Syringe Luer-lok/u-100/1ml Bd Insulin Syringe Microfine Iv/u-100/0.3ml/28g X 1/2" Bd Insulin Syringe Microfine Iv/u-100/0.5ml/28g X 1/2" Bd Insulin Syringe Microfine Iv/u-100/1ml/27g X 5/8" Bd Insulin Syringe Microfine Iv/u-100/1ml/28g X 1/2" Bd Insulin Syringe Microfine/u-100/0.3ml/28g X 1/2" Bd Insulin Syringe Microfine/u-100/0.5ml/28g X 1/2" Bd Insulin Syringe Microfine/u-100/1ml/27g X 5/8" Bd Insulin Syringe Microfine/u-100/1ml/28g X 1/2" Bd Insulin Syringe Safetyglide/u-100/0.3ml/31g X 5/16" Bd Insulin Syringe Safetyglide/0.5ml/29g X 1/2" Bd Insulin Syringe Safetyglide/1ml/29g X 1/2" Bd Insulin Syringe Slip Tip/u-100/1ml Bd Insulin Syringe U-40/1ml/25g X 5/8" Bd Insulin Syringe Ultrafine Half-unit/0.3ml/31g X 5/16" Bd Insulin Syringe Ultrafine Ii/short/0.5ml/31g X 5/16" Bd Insulin Syringe Ultrafine Ii/short/1ml/31g X 5/16" Bd Insulin Syringe Ultrafine/u-100/0.3ml/29g X 1/2" Bd Insulin Syringe Ultrafine/u-100/0.5ml/29g X 1/2" Bd Insulin Syringe Ultrafine/u-100/1ml/29g X 1/2" Bd Insulin Syringe Ultrafine/u-100/1ml/30g X 1/2" Bd Insulin Syringe Ultrafine/0.3ml/30g X 1/2" Bd Insulin Syringe Ultrafine/0.3ml/31g X 5/16" Bd Insulin Syringe Ultrafine/0.5ml/30g X 1/2" Bd Insulin Syringe Ultrafine/0.5ml/31g X 5/16" Bd Insulin Syringe Ultrafine/1ml/30g X 1/2" Bd Insulin Syringe Ultrafine/1ml/31g X 5/16" Bd Insulin Syringe/detachable Needle/u-100/1ml/25g X 1" Bd Insulin Syringe/detachable Needle/u-100/1ml/25g X 5/8" Bd Insulin Syringe/detachable Needle/u-100/1ml/26g X 1/2" Bd Insulin Syringe/u-100/0.5ml/30g X 1/2" Bd Insulin Syringe/u-100/1ml/27g X 1/2" Bd Insulin Syringe/u-100/1ml/28g X 1/2" Bd Insulin Syringe/u-100/2ml/27.5g X 5/8" Bd Insulin Syringe/u-100/2ml/29g X 1/2" Bd Lancet Ultrafine 30g Bd Lancet Ultrafine 33g Bd Microtainer Lancets Bullseye Mini Safety Lancets Bullseye Safety Lancets Careone Lancet Thin Careone Lancet Ultra Thin Cleanlet Lancets 28g Clever Chek Lancets Ultrathin

Clever Chek Lancets Ultrathin 30g Coaguchek Lancets Comfort Assured Lancets Micro Thin 33g Comfort Assured Lancets Super Thin 28g Comfort Lancets Cvs Lancets Micro Thin 33g Cvs Lancets Original Cvs Lancets Thin Cvs Lancets Thin 26g Cvs Lancets Ultra Thin 30g Cvs Lancets 21g Cvs Ultra Thin Lancets Diastar Easy Test Ii Lancets 30g Diastar Easy Test Lancets30g Droplet Lancets Ultra Thin 30g Drug Mart Lancets Thin Drug Mart Lancets Ultra Thin Drug Mart Unilet Lancets Super Thin 30g Drug Mart Unilet Lancets Ultra Thin 28g Duane Reade Lancet Alternate Site 26g Duane Reade Lancet Super Thin 30g Duane Reade Lancet Ultra Thin 28g E-z Ject Lancets E-z Ject Lancets Color E-z Ject Lancets Super Thin E-z Ject Lancets Super Thin 30g E-z Ject Lancets Thin 26g E-z Ject Lancets 21g E-zject Lancets Micro-thin 33g Easy Comfort Lancets Easy Touch Lancets Easytest Ii Lancets Easytest Lancets Eql Color Lancets 21g Eql Super Thin Lancets 30g Eql Thin Lancets 26g Ez Smart Blood Glucose Lancets Ez-lets Lancets 21g Ez-lets Lancets 23g Ez-lets Lancets 26g Super-soft Ez-lets Lancets 28g Ultra-soft Ez-lets Lancets 30g Fasttake Test Strips Fifty50 Safety Seal Lancets 30g Fifty50 Safety Seal Lancets 32g Fine 30 Fingerstix Lancets Fora Lancets Freestyle Lancets Freestyle Unistick Ii Lancets Gentle-let Gp Lancets Gentle-let Lancets General Purpose Style/fine Point Gentle-let Lancets General Purpose Style/medium Point Gentle-let Lancets Safety Style/fine Point Gentle-let Lancets Safety Style/medium Point Global Inject Ease Lancets 28g Global Inject Ease Lancets 30g Glucocom Lancets 28g Glucocom Lancets 30g Glucocom Lancets 33g Glucosource Lancets Gnp Lancets Gnp Lancets Micro Thin 33g Gnp Lancets Super Thin 30g Gnp Lancets Thin Gnp Lancets Thin 26g Gnp Lancets 21g Gnp Micro Thin Lancets 33g Gnp Super Thin Lancets/30g H&h Thinlet Lancets 26g

Effective January 1, 2013 34

H&h Thinlet Super Thin Lancets 30g H-e-b Incontrol Lancets Super Thin 30g H-e-b Incontrol Lancets Ultra Thin 28g Haemolance Haemolance Low Flow Lancets Haemolance Plus Haemolance Plus High Flow Haemolance Plus Low Flow Haemolance Plus Max Flow Haemolance Plus Pediatric Flow Healthwise Lancets 30g Healthy Accents Unilet Lancets Super Thin 30g Hm Lancets Micro Thin 33g Hm Lancets Ultra Thin 30g Hy-vee Lancets Hy-vee Thin Lancets Keep Fit Lancets 28g/twist Keep Fit Lancets 30g/twist Keep Fit Lancets 32g/twist Keep Fit Lancets 33g/twist Keep Fit Safety Lancets 21g/pressure Activated Keep Fit Safety Lancets 23g/pressure Activated Keep Fit Safety Lancets 26g/button Activated Keep Fit Safety Lancets 26g/pressure Activated Keep Fit Safety Lancets 28g/button Activated Keep Fit Safety Lancets 28g/pressure Activated Kinney Lancets Kinney Thin Lancets Kroger Lancets Kroger Lancets Micro Thin33g Kroger Lancets Super Thin Kroger Lancets Thin Kroger Lancets Thin 26g Kroger Lancets Ultrathin 30g Kroger Lancets 21g Lady Lite Lancets Lancets Thin Lancets Ultra Thin Lancets Ultra Thin 30g Leader Lancets Colored Leader Super Thin Lancet Leader Thin Lancets Lifescan Unistik Ii Lancets Lifescan Unistik 2 Deep Penetration Lite Touch Lancets Live Better Lancet Super Thin 30g Live Better Lancet Ultra Thin 28g Longs Lancets Standard Longs Lancets Thin Longs Lancets Ultra Thin Major Comfort Lancets Medi-lance Lancets Medichoice Pre-set Safety Lancet Dual Use Medichoice Pre-set Safety Lancet Low Flow Medichoice Pre-set Safety Lancet Medium Flow Medichoice Pre-set Safety Lancet Moderate Flow Medichoice Safety Lancet Extra Medichoice Safety Lancet Normal Medicine Shoppe Lancets Medicine Shoppe Lancets Thin Medisense Thin Lancets Medlance Plus Lancets Medlance Plus Lancets Lite 25g Medlance Plus Superlite 30g Medlance Plus Universal Lancets 21g Medlance Plus/lite 25g Medlance/extra Medlance/lite Medlance/universal Meijer Color Lancets Universal 33g

Meijer Lancets Meijer Lancets Thin Meijer Lancets Universal 33g Meijer Super Thin Lancets Microlet Lancets Microtainer Safety Flow Lancet/sterile/single-use Monolet Lancets Monolet Opd Lancets Monolettor Safety Lancets Myglucohealth Mgh Softlance Lancets 30g Netgroup Lancets Nova Safety Lancets 23g Nova Safety Lancets 28g Nova Sureflex Lancets Novofine Autocover 30gx8mm Novofine 30gx8mm Novofine 32gx6mm Novotwist 30gx8mm Novotwist 32gx5mm On Call Lancets On Call Plus Lancets Onetouch Basic System Onetouch Basic/profile Test Strips Onetouch Basic/profile/one Touch Ii Test Strips Onetouch Club Lancets Fine Point Onetouch Combo Pack Onetouch Delica Lancets Onetouch Delica Lancets Fine 30g Onetouch Finepoint Lancets Onetouch Lancets Onetouch Profile System Onetouch Ultra Blue Onetouch Ultra Mini Onetouch Ultra System Kit Onetouch Ultra Test Strips Onetouch Ultra 2 Onetouch Ultrasoft Lancets Onetouch Verio Control Solution High Onetouch Verio Iq Blood Glucose Monitoring System Onetouch Verio Iq Test Strips Onetouch Verio Mid Control Solution Onetouch Verio Test Strips Perfect Lancets 30g Perfect Pressure Activated Safety Lancets 28g Pharmacist Choice Ultra Thin Lancets Pharmacist Choice Ultra Thin Lancets 28g Pharmacist Choice Ultra Thin Lancets 30g Pharmacist Choice Ultra Thin Lancets 31g Pharmacy Counter Lancets Precision Thin Lancets Precision Thins Gp Lancet Precision Ultra Lancet Preferred Plus Lancets Colored 21g Preferred Plus Lancets Super Thin 30g Preferred Plus Lancets Thin 26g Prodigy Pressure Activated Safety Lancets Prodigy Safety Lancets Prodigy Twist Top Lancets Pss Select Gp Lancets Pss Select Safety Lancets Px Lancets Px Lancets Ultra Thin Qc Lancets Super Thin Qc Lancets Ultra Thin Ra E-zject Color Lancets Micro-thin 33g Ra E-zject Lancets Thin 26g Ra E-zject Lancets Thin 28g Ra E-zject Lancets Ultra Thin 30g Ra E-zject Lancets 28g Reality Lancets

Effective January 1, 2013 35

Reality Trigger Lancets Relion Lancets Relion Lancets Standard 21g Relion Lancets Thin 26g Relion Lancets Ultra-thin30g Relion Thin Lancets Relion Ultra Thin Lancets Relion Ultra Thin Lancets30g Relion Ultra Thin Plus Lancets 32g Relion Ultra Thin Plus Lancets 33g Renew Advanced Lancing Cartridge Refills Rightest Gl300 Lancets Safe-t-lance Low Flow 25g Safe-t-lance Normal Flow 21g Safe-t-lance Plus Safety Lancet High Flow Safe-t-lance Plus Safety Lancet Low Flow Safe-t-lance Plus Safety Lancet Normal Flow Safety Lancet 2mm Safety Lancets Safety Lancets 21g Safety Let Lancets Safety Seal Lancets 28g Safety Seal Lancets 30g Sb Lancets Thin Sb Lancets Ultra Thin Single-let Sm Lancets 21g Sm Micro Thin Lancets 33g Sm Super Thin Lancets 30g Sm Thin Lancets 26g Smart Diabetes Vantage Universal Lancets 30g Smart Sense Color Lancets Universal 33g Smart Sense Standard Lancets Universal 21g Smart Sense Super Thin Lancets Universal 30g Smart Sense Thin Lancets Universal 26g Smartest Lancets 28g Solo V2 Twist Lancets Sterilance Tl Sure Comfort Lancets 28g Sure Comfort Lancets 30g Sure-lance Flat Lancets Sure-lance Lancets 26g Sure-lance Thin Lancets 28g Sure-lance Ultra Thin Lancets Sure-touch Lancets Universal Surelite Lancets Surestep Pro Test Strips Surestep Test Strips Techlite Ast Lancets Techlite Lancets Tgt Lancet Alternate Site Tgt Lancet Super Thin 30g Tgt Lancet Thin 23g Tgt Lancet Ultra Thin 28g Thinlets Gp Lancets Thinlets Lancet Todays Health Super Thin Lancets 30g Todays Health Ultra Thin Lancets 28g Trueplus Lancets 28g Trueplus Lancets 28g Super Thin Trueplus Lancets 30g Trueplus Lancets 30g Ultra Thin Trueplus Lancets 33g Trueplus Lancets 33g Micro Thin Trueplus Safety Lancets 28g Ulticare Thin Lancets 30g Ultilet Basic Lancets 30g Ultilet Classic Lancets Ultilet Lancets Ultilet Safety Lancets 23g

Ultra Thin Lancets 28g Ultra Thin Lancets 30g Ultra-thin Ii Auto Lancet Ultra-thin Ii Lancets 28g Ultra-thin Ii Lancets 30g Ultra-thin Ii Lancets/28g X 1/8" Ultra-thin Ii Lancets/30g X 1/8" Ultra-thin Ii Safety Autolancets 26g Unilet Comfortouch Lancet Unilet Excelite Unilet Excelite Ii Unilet G.p. Lancet Unilet G.p. Superlite Lancet Unilet Gp 28 Ultra Thin Unilet Lancet Unilet Superlite Lancet Universal 1 Lancets Thin 26g Universal 1 Lancets Ultra Thin 30g Value Plus Lancets Standard 21g Value Plus Lancets Super Thin 30g Value Plus Lancets Thin 26g Valumark Lancet Super Thin 30g Valumark Lancet Ultra Thin 28g Vida Mia Unilet Lancets Super Thin 30g Vida Mia Unilet Lancets Ultra Thin 28g Vitalet Pro Lancets Vitalet Pro Plus Lancets W&f Lancets Colored 21g W&f Lancets 26g Walgreens Advanced Travellancets 28g Walgreens Comfort Assuredlancets Micro Thin/33g Walgreens Comfort Assuredlancets Super Thin/28g Walgreens Lancets Walgreens Thin Lancets Walgreens Ultra Thin Lancets 1st Choice Lancets Super Thin 1st Choice Lancets Thin 1st Choice Lancets Ultra Thin 1st Tier Unilet Comfortouch Lancets 28g 1st Tier Unilet Comfortouch Lancets 30g

MISCELLANEOUS AGENTS
TIER 1 pentetate calcium trisodium pentetate zinc trisodium TIER 2 Chemet Exjade TIER 3 Ferriprox

Effective January 1, 2013 36

Index
A
a-hydrocort, 11 a-methapred, 11 abacavir, 2 Abilify, 20 Abilify Discmelt, 20 Absorica, 8 Abstral, 25 Acanya, 8 acarbose, 13 Accolate, 30 Accu-chek Active Strips, 33 Accu-chek Advantage Diabetes Care Kit, 33 Accu-chek Aviva, 33 Accu-chek Aviva Plus, 33 Accu-chek Comfort Curve Test Strips, 33 Accu-chek Compact Plus Care Kit, 33 Accu-chek Compact Strips, 33 Accu-chek Compact Test Drum, 33 Accu-chek Fastclix Lancets, 33 Accu-chek Multiclix Lancets, 33 Accu-chek Nano Smartview, 33 Accu-chek Safe-t-pro Lancets, 33 Accu-chek Safe-t-pro Pluslancets, 34 Accu-chek Smartview Strips, 34 Accu-chek Soft Touch Lancets, 34 Accu-chek Softclix Lancets, 34 Accuneb, 30 Accupril, 5 Accuretic, 6 acebutolol hcl, 5 Aceon, 5 acetaminophen/caffeine/dihydrocodeine bitartrate, 25 acetaminophen/codeine, 25 acetaminophen/codeine #2, 25 acetaminophen/codeine #3, 25 acetaminophen/codeine #4, 25 acetaminophen/codeine phosphate, 25 acetasol hc, 24 acetazolamide, 6 Acetazolamide Er, 6 acetazolamide sodium, 6 acetic acid, 24 acetic acid/aluminum acetate, 24 acetylcysteine, 27 acid jelly, 17 Aciphex, 15 Aclovate, 10 Acthar Hp, 14 Acthib, 30 Acti-lance Lancets 28g, 34 Acti-lance Lite Safety Lancets 28g, 34 Acti-lance Special Safety Lancets 17g, 34 Acti-lance Special Safetylancets 17g, 34 Acti-lance Universal Safety Lancets 23g, 34 acticin, 10 Actigall, 16 Actimmune, 4 Actiq, 25 Activella, 12 Actonel, 13 Actoplus Met, 13 Actoplus Met Xr, 13 Actos, 13 Acuflex, 24 Acular, 24 Acular Ls, 24 Acuvail, 24 acyclovir, 2 Aczone, 8 Adacel, 30 Adalat Cc, 5 adapalene, 7 Adcirca, 7 Adderall, 20 Adderall Xr, 20 Adoxa, 1 Adoxa Pak 1/100, 1 Adoxa Pak 1/150, 1 Adoxa Pak 2/100, 1 Adrenal C Formula, 32 Adrenalin, 27, 30 Advair Diskus, 30 Advair Hfa, 30 Advanced Am/pm, 32 Advicor, 7 Advocate Lancets, 34 Advocate Safety Lancets, 34 Aerohist, 27 Aerokid, 28 Af Lancets Super Thin, 34 afeditab cr, 5 Afinitor, 4 Afluria 2009-2010, 30 Afluria 2011-2012, 30 Afluria 2012-2013, 30 Afluria Pf 2010-2011, 30 Afluria Pf 2011-2012, 30 Afluria Pf 2012-2013, 30 Agamatrix Ultra-thin Lancets 33g, 34 Aggrenox, 18 Agriflu 2010-2011, 30 Agrylin, 18 Ahist, 27 airacof, 27 airavite, 17 ak-con, 23 ak-pentolate, 23 ak-poly-bac, 22 Akne-mycin, 8 akorn balanced salt solution, 24 Akten, 23 ala cort, 9 Ala Scalp, 10 Ala-hist, 27 Ala-hist D, 28 Alagesic Lq, 24 Alahist Ac, 28 Alahist Dhc, 28 Alamast, 24 Albafort, 18, 32 albatussin nn, 27 Albenza, 3 albuterol sulfate, 29 albuterol sulfate er, 29 Alcaine, 23 alclometasone dipropionate, 9 Aldactazide, 6 Aldactone, 6 Aldara, 10 alenaze-d, 27 alenaze-d nr, 28 alendronate sodium, 13 Alfenta, 25 alfentanil, 25 Alferon N, 4 alfuzosin hcl er, 17 ali-flex, 24 aliclen, 10 Alinia, 3 Alkeran, 3 Allerscript, 28 Allerx Df, 27 Allerx Df 30, 27 Allerx Dose Pack, 28 Allerx Pe, 28 Allerx-d, 28 Allfen Cd, 28 Allfen Cdx, 28 Allopurinol, 26 Alocril, 24 Alodox Convenience Kit, 1 Alomide, 24 Aloquin, 9 Alora, 12 alpain, 24 Alphagan P, 23 alphatrex, 9 alprazolam, 19 alprazolam er, 19 Alprazolam Intensol, 19 alprazolam odt, 19 Alprazolam Xr, 19 Alrex, 23 Alsuma, 26 Altabax, 8 altacaine, 23 Altace, 5 altafrin, 23 Altoprev, 7 aluminum acetate, 10 Aluvea, 11 Alvesco, 30 amantadine hcl, 21 Amaryl, 13 Ambien, 20 Ambien Cr, 20 Ambifed Cd, 28 Ambifed Cdx, 28 Ambifed-g Cd, 28 Ambifed-g Cdx, 28 amcinonide, 9 Amerge, 26 Amevive, 9 Amicar, 18 amikacin sulfate, 2 Amiloride Hcl, 6 amiloride/hydrochlorothiazide, 6 aminocaproic acid, 18 aminophylline, 29 amiodarone hcl, 5

Amitiza, 16 Amitriptyline, 19 amitriptyline hcl, 19 amlodipine besylate, 5 Amlodipine Besylate/atorvastatin Calcium, 7 amlodipine besylate/benazepril hcl, 6 amlodipine besylate/benazepril hydrochloride, 6 ammonium lactate, 10 amnesteem, 7 amoxapine, 19 amoxicillin, 1 amoxicillin/clavulanate potassium, 1 amoxicillin/clavulanate potassium er, 1 amoxicillin/potassium clavulanate, 1 Amphetamine/dextroamphetamine, 20 amphotericin b, 2 ampicillin, 1 ampicillin sodium, 1 ampicillin-sulbactam, 1 Ampyra, 21 Amrix, 22 Amturnide, 6 amyl nitrite, 4 Amytal Sodium, 20 anabar, 24 Anacaine, 11 Anadrol-50, 12 Anafranil, 19 anagrelide hydrochloride, 18 Analpram Advanced, 16 Analpram-hc, 16 Analpram-hc Singles, 16 Anamantle Hc, 16 Anaprox, 26 Anaprox Ds, 26 Anaspaz, 15 anastrozole, 3 Ancobon, 2 Androderm, 12 Androgel, 12 Androgel Pump, 12 android, 12 Androxy, 12 Anectine, 22 Angeliq, 12 Animi-3, 18 Animi-3/vitamin D, 18 anolor 300, 24 Antabuse, 22 Antara, 7 antipyrine/benzocaine, 24 Antivert, 15 Anusol-hc, 16 Anzemet, 15 Ap-zel, 32 apexicon, 9 apexicon e, 9 Aphthasol, 19 Apidra, 12 Apidra Solostar, 12 Aplenzin, 19 Apokyn, 21 Appbutamone, 19 Appbutamone-d, 19 Appformin, 13 Appformin-d, 13

apraclonidine, 23 Apriso, 16 Aptivus, 2 Aqua Glycolic Hc Scalp & Body, 10 Aquasol A Parenteral, 31 aquoral, 18 Aralen, 3 Aranesp Albumin Free, 17 Arava, 26 arbinoxa, 27 Arcalyst, 26 Arcapta Neohaler, 30 Argyle Pneumothorax Procedure Tray/8fr, 27 Aricept, 22 Aricept Odt, 22 Arimidex, 4 Aristospan Intra-articular, 11 Aristospan Intralesional, 11 Arixtra, 18 Armour Thyroid, 14 arnica flower, 10 Aromasin, 4 Arthrotec 50, 26 Arthrotec 75, 26 Artiss, 18 Asacol, 16 Asacol Hd, 16 ascomp/codeine, 25 ascor l 500, 31 ascor l nc, 31 ascorbic acid, 31 asmalpred, 11 asmalpred plus, 11 Asmanex 120 Metered Doses, 30 Asmanex 14 Metered Doses, 30 Asmanex 30 Metered Doses, 30 Asmanex 60 Metered Doses, 30 Asmanex 7 Metered Doses, 30 Assure Haemolance Plus High Flow 18g, 34 Assure Haemolance Plus Low Flow 25g, 34 Assure Haemolance Plus Micro Flow 28g, 34 Assure Haemolance Plus Normal Flow 21g, 34 Assure Haemolance Plus Pediatric Blade, 34 Assure Lance Lancets, 34 Assure Lancets, 34 Astelin, 27 Astepro, 27 astramorph, 25 Astringyn, 18 At Last Lancets, 34 Atabex Ec, 32 Atabex Prenatal, 32 Atacand, 6 Atacand Hct, 6 Atelvia, 13 atenolol, 5 atenolol/chlorthalidone, 6 Ativan, 19 Atopiclair, 11 atorvastatin calcium, 7 Atovaquone/proguanil Hcl, 3 Atralin, 8

Atripla, 2 Atropen, 15 Atropine Sulfate, 15 atropine sulfate, 23 atropine-care, 23 Atrovent, 27 Atrovent Hfa, 30 Atuss Ds, 28 Aubagio, 22 augmented betamethasone dipropionate, 9 Augmentin, 1 Augmentin Es-600, 1 Augmentin Xr, 1 Auralgan, 24 aurax, 24 aurodex, 24 Aurora Healthcare Lancets, 34 Aurora Lancet Super Thin 30g, 34 Aurora Lancet Thin 23g, 34 Aurstat, 11 Avalide, 6 Avandamet, 13 Avandaryl, 13 Avandia, 13 Avapro, 6 avar cleanser, 7 Avar Ls Cleanser, 8 avar-e emollient, 7 avar-e green, 7 Avar-e Ls, 8 Avc, 17 Avelox, 2 Avelox Abc Pack, 2 avidoxy, 1 Avidoxy Dk, 1 Avinza, 25 Avita, 7 Avodart, 17 Avonex, 21 Avonex Pen, 21 Axert, 26 Axid, 15 Axiron, 12 Aygestin, 12 Azactam, 3 Azasan, 4 Azasite, 22 azathioprine, 4 azathioprine sodium, 4 azelastine hcl, 24, 27 Azelex, 8 Azilect, 21 azithromycin, 1 Azopt, 24 Azor, 6 aztreonam, 3 Azulfidine, 16 Azulfidine En-tabs, 16

B
b-6 folic acid, 17 b-complex, 31 b-complex 100, 31 B-nexa, 32 b-plex, 31 b-plex plus, 31 baciim, 3 bacitracin, 3, 22

bacitracin/polymyxin b, 22 baclofen, 22 Bacmin, 32 Bactrim, 3 Bactrim Ds, 3 Bactroban, 8 Bactroban Nasal, 27 Bal-care Dha, 32 Bal-care Dha Essential, 32 balacall dm, 28 balanced salt solution, 24 balsalazide disodium, 16 Banzel, 21 Baraclude, 2 baycadron, 11 Bayer Microlet Lancets, 34 Bd Insulin Syringe Luer-lok/u-100/1ml, 34 Bd Insulin Syringe Microfine Iv/u100/0.3ml/28g X 1/2", 34 Bd Insulin Syringe Microfine Iv/u100/0.5ml/28g X 1/2", 34 Bd Insulin Syringe Microfine Iv/u100/1ml/27g X 5/8", 34 Bd Insulin Syringe Microfine Iv/u100/1ml/28g X 1/2", 34 Bd Insulin Syringe Microfine/u100/0.3ml/28g X 1/2", 34 Bd Insulin Syringe Microfine/u100/0.5ml/28g X 1/2", 34 Bd Insulin Syringe Microfine/u100/1ml/27g X 5/8", 34 Bd Insulin Syringe Microfine/u100/1ml/28g X 1/2", 34 Bd Insulin Syringe Safetyglide/0.5ml/29g X 1/2", 34 Bd Insulin Syringe Safetyglide/1ml/29g X 1/2", 34 Bd Insulin Syringe Safetyglide/u100/0.3ml/31g X 5/16", 34 Bd Insulin Syringe Slip Tip/u-100/1ml, 34 Bd Insulin Syringe U-40/1ml/25g X 5/8", 34 Bd Insulin Syringe Ultrafine Halfunit/0.3ml/31g X 5/16", 34 Bd Insulin Syringe Ultrafine Ii/short/0.5ml/31g X 5/16", 34 Bd Insulin Syringe Ultrafine Ii/short/1ml/31g X 5/16", 34 Bd Insulin Syringe Ultrafine/0.3ml/30g X 1/2", 34 Bd Insulin Syringe Ultrafine/0.3ml/31g X 5/16", 34 Bd Insulin Syringe Ultrafine/0.5ml/30g X 1/2", 34 Bd Insulin Syringe Ultrafine/0.5ml/31g X 5/16", 34 Bd Insulin Syringe Ultrafine/1ml/30g X 1/2", 34 Bd Insulin Syringe Ultrafine/1ml/31g X 5/16", 34 Bd Insulin Syringe Ultrafine/u100/0.3ml/29g X 1/2", 34 Bd Insulin Syringe Ultrafine/u100/0.5ml/29g X 1/2", 34 Bd Insulin Syringe Ultrafine/u100/1ml/29g X 1/2", 34 Bd Insulin Syringe Ultrafine/u-

100/1ml/30g X 1/2", 34 Bd Insulin Syringe/detachable Needle/u100/1ml/25g X 1", 34 Bd Insulin Syringe/detachable Needle/u100/1ml/25g X 5/8", 34 Bd Insulin Syringe/detachable Needle/u100/1ml/26g X 1/2", 34 Bd Insulin Syringe/u-100/0.5ml/30g X 1/2", 34 Bd Insulin Syringe/u-100/1ml/27g X 1/2", 34 Bd Insulin Syringe/u-100/1ml/28g X 1/2", 34 Bd Insulin Syringe/u-100/2ml/27.5g X 5/8", 34 Bd Insulin Syringe/u-100/2ml/29g X 1/2", 34 Bd Lancet Ultrafine 30g, 34 Bd Lancet Ultrafine 33g, 34 Bd Microtainer Lancets, 34 bd pudendal/local block tray 1% lidocaine, 27 Beconase Aq, 27 belladonna & opium, 15 belladonna alkaloids, 15 belladonna alkaloids & opium, 15 benazepril hcl, 5 benazepril hcl/hydrochlorothiazide, 6 Benicar, 6 Benicar Hct, 6 Bensal Hp, 11 Bentyl, 15 Benzac Ac Wash, 8 Benzac W Wash, 8 Benzaclin, 8 Benzaclin With Pump, 8 Benzamycin, 8 Benzamycinpak, 8 Benzefoam, 8 Benzefoamultra, 8 benzepro, 7 benzepro short contact, 7 Benziq, 8 Benziq Ls, 8 benziq wash, 7 benzoin compound tincture, 10 benzoin tincture, 10 benzonatate, 28 benzoyl peroxide, 7 benzoyl peroxide cleanser, 7 benzoyl peroxide cleansing, 7 benzoyl peroxide short contact, 7 benzoyl peroxide wash, 7 benzoyl peroxide wash acne treatment pack, 7 benztropine mesylate, 21 Bepreve, 24 Besivance, 22 Betadine Ophthalmic Prep, 22 Betagan, 23 betamethasone dipropionate, 9 betamethasone sodium phosphate/betamethasone acetate, 11 betamethasone valerate, 9 Betapace, 5 Betapace Af, 5 Betaseron, 22 betaxolol hcl, 5, 23

bethanechol chloride, 16 Betimol, 23 Betoptic-s, 23 Biaxin, 1 Biaxin Xl, 1 Biaxin Xl Pac, 1 bicalutamide, 3 Bicillin C-r, 1 Bicillin L-a, 1 bidhist-d, 28 Bidil, 7 Biferarx, 18 Biltricide, 3 Binosto, 13 Bio-statin, 2 biocel, 31 biogesic, 24 Bioregesic, 24 Biothrax, 30 biotuss, 28 biotuss pediatric, 28 bisoprolol fumarate, 5 bisoprolol fumarate/hydrochlorothiazide, 6 bleomycin sulfate, 3 Bleph-10, 22 Blephamide, 23 Blephamide S.o.p., 23 Boniva, 13 Boostrix, 30 boric acid, 10 Bosulif, 4 Botox, 22 bp 10-1, 7 bp cleanser, 7 bp cleansing wash, 7 bp folinatal plus b, 31 bp multinatal plus, 31 bp poly-650, 24 bp vit 3, 17 bp wash, 7 bpm, 27 bpm pseudo, 28 bpo, 7 bpo 3% foaming cloths, 7 bpo 6% foaming cloths, 7 bpo 9% foaming cloths, 7 bpo creamy wash complete pack, 7 Brilinta, 18 brimonidine tartrate, 23 bromatan plus, 28 bromax, 27 Bromday, 24 bromfed dm, 28 bromfenac, 24 bromocriptine mesylate, 21 brompheniramine tannate, 27 bromspiro, 27 Broncomar-1, 30 Brondil, 30 Brovana, 30 budeprion sr, 19 budeprion xl, 19 budesonide, 11, 29 Bullseye Mini Safety Lancets, 34 Bullseye Safety Lancets, 34 bumetanide, 6 bupap, 24

Buphenyl, 14 bupivacaine hcl, 27 Bupivacaine/epinephrine, 27 Buprenex, 25 buprenorphine hcl, 25 bupropion hcl, 19 bupropion hcl er, 19 bupropion hcl sr, 19 bupropion hcl xl, 19 buspirone hcl, 19 butal/asa/caff, 24 butalbital compound, 24 butalbital/acetaminophen, 24 butalbital/acetaminophen/caffeine, 24 butalbital/acetaminophen/caffeine/codein e, 25 Butalbital/asa/caffeine, 24 butalbital/aspirin/caffeine, 24 butalbital/aspirn/caffeine/codeine, 25 Butisol Sodium, 20 butorphanol tartrate, 25 Butrans, 25 Bydureon, 12 Byetta, 12 Bystolic, 5

C
C-tan D Plus, 28 cabergoline, 14 Caduet, 7 Cafcit, 20 Cafergot, 26 caffeine citrate, 20 caffeine/sodium benzoate, 20 cafgesic forte, 24 Calan, 5 Calan Sr, 5 calcipotriene, 9 Calcitonin-salmon, 13 Calcitrene, 9 Calcitriol, 9 calcitriol, 14 calcium acetate, 16 calcium folinate, 4 Cambia, 26 Campral, 22 Canasa, 16 candesartan cilexetil/hydrochlorothiazide, 6 Cantil, 15 capacet, 24 Capastat Sulfate, 2 Capex, 10 Caphosol, 19 Capital/codeine, 25 Caprelsa, 4 capsaicin, 10 captopril, 5 captopril/hydrochlorothiazide, 6 Carafate, 15 Carba-xp, 28 Carbaglu, 14 carbamazepine, 21 Carbamazepine Er, 21 Carbaphen 12, 28 Carbaphen 12 Ped, 28 Carbatrol, 21 Carbatuss, 28 Carbatuss-12, 28

Carbatuss-cl, 28 carbidopa/levodopa, 21 carbidopa/levodopa cr, 21 carbidopa/levodopa er, 21 carbidopa/levodopa odt, 21 carbidopa/levodopa sr, 21 Carbidopa/levodopa/entacapone, 21 carbinoxamine maleate, 27 Carbocaine, 27 Cardene Sr, 5 Cardiotek-rx, 18 Cardizem, 5 Cardizem Cd, 5 Cardizem La, 5 Cardura, 6 Cardura Xl, 17 Careone Lancet Thin, 34 Careone Lancet Ultra Thin, 34 carisoprodol, 22 carisoprodol/aspirin, 22 carisoprodol/aspirin/codeine, 22 Carmol-hc, 10 Carnitor, 14 Carnitor Sf, 14 Caromega, 32 carteolol hcl, 23 cartia xt, 5 carvedilol, 5 cascara sagrada, 14 cascara sagrada aromatic, 14 Casodex, 4 Cataflam, 26 Catapres, 6 Catapres-tts-1, 6 Catapres-tts-2, 6 Catapres-tts-3, 6 Cathflo Activase, 18 cavan one omega, 31 cavan prenatal/ec calcium, 31 Cavan-alpha Kit, 32 cavan-ec sod dha, 31 Cavan-folate Dha, 32 Cavan-folate Ob, 32 cavirinse, 18 Cayston, 3 Cedax, 1 Ceenu, 3 cefaclor, 1 cefaclor er, 1 cefadroxil, 1 cefazolin sodium, 1 cefdinir, 1 Cefditoren Pivoxil, 1 cefepime, 1 cefotaxime sodium, 1 cefotetan, 1 cefoxitin sodium, 1 cefpodoxime proxetil, 1 cefprozil, 1 ceftazidime, 1 Ceftin, 1 ceftriaxone sodium, 1 cefuroxime axetil, 1 cefuroxime sodium, 1 Celebrex, 26 Celestone, 11 Celestone-soluspan, 11 Celexa, 19

Cellcept, 4 Celontin, 21 cem-urea, 10 Cenestin, 12 Cenfol, 18 Cenhist, 28 cenolate, 31 Centany, 8 Centany At, 8 centergy, 28 centergy dm, 28 Centratex, 18 cephadyn, 24 cephalexin, 1 cerisa wash, 7 ceron-dm, 28 cerovel, 10 Cervarix, 30 Cervidil, 24 Cesamet, 15 cetirizine hcl, 27 cetraxal, 24 cevimeline hcl, 18 Cgu Wc, 28 Chemet, 36 Chenodal, 16 chlor-mes d, 28 chlor-mes jr, 28 chloral hydrate, 20 chlordiazepoxide hcl, 19 chlordiazepoxide/amitriptyline, 21 chlorhexadine gluconate oral rinse, 18 chlorhexidine gluconate, 18 chlorhexidine gluconate oral rinse, 18 chloroprocaine hcl, 27 chloroquine phosphate, 3 chlorothiazide, 6 chlorpromazine hcl, 20 chlorpropamide, 13 chlorthalidone, 6 chlorzoxazone, 22 cholestyramine, 7 cholestyramine light, 7 choline magnesium trisalicylate, 24 Chorionic Gonadotropin, 13 ciclodan, 9 Ciclodan Cream Kit, 9 Ciclodan Solution Kit, 9 ciclopirox, 9 ciclopirox nail lacquer, 9 ciclopirox olamine, 9 ciclopirox topical solution kit, 9 ciclopirox treatment, 9 cilostazol, 18 Ciloxan, 22 cimetidine, 15 cimetidine hcl, 15 Cimzia, 16 Cimzia Starter Kit, 16 Cipro, 2 Cipro Hc, 24 Cipro Xr, 2 Ciprodex, 24 Ciprofloxacin, 24 ciprofloxacin er, 1 ciprofloxacin hcl, 1, 22 citalopram hydrobromide, 19 Citranatal 90 Dha, 32

Citranatal Assure, 32 Citranatal B-calm, 32 Citranatal Dha, 32 Citranatal Harmony, 32 Citranatal Rx, 32 citric acid/sodium citrate, 17 Citrolith, 17 Claforan, 1 claravis, 7 Clarifoam Ef, 8 Clarinex, 27 Clarinex Reditabs, 27 Clarinex-d 12 Hour, 28 Clarinex-d 24 Hour, 28 claris clarifying wash, 7 clarithromycin, 1 clarithromycin er, 1 Cleanlet Lancets 28g, 34 clearplex x, 7 clemastine fumarate, 27 clenia, 7 clenia foaming wash, 7 Cleocin, 3, 17 Cleocin Pediatric Granules, 3 Cleocin Phosphate, 3 Cleocin-t, 8 Clever Chek Lancets Ultrathin, 34 Clever Chek Lancets Ultrathin 30g, 34 Climara, 12 Climara Pro, 12 Clindacin Pac, 8 clindacin-p, 7 Clindagel, 8 clindamax, 7 clindamycin hcl, 3 clindamycin palmitate hcl, 3 clindamycin phosphate, 3, 7, 17 clindamycin phosphate pharmacy bulk package, 3 clindamycin/benzoyl peroxide, 7 clindareach, 8 Clinoril, 26 Clobeta Cream, 10 Clobeta Ointment, 10 clobetasol propionate, 9 clobetasol propionate e, 9 clobetasol propionate emollient, 9 Clobex, 10 Cloderm, 10 Cloderm Pump, 10 clomipramine hcl, 19 clonazepam, 21 clonazepam odt, 21 clonidine hcl, 6 clopidogrel, 18 clorazepate dipotassium, 19 Clorpres, 6 clotrimazole, 9, 18 clotrimazole/betamethasone dipropionate, 9 clozapine, 20 Clozapine Odt, 20 Clozaril, 20 Cnl8 Nail Kit, 9 co-gesic, 25 co-natal fa, 31 Coaguchek Lancets, 34 coal tar, 10

coal tar base, 10 Coartem, 3 Coca Cola Syurp, 15 cocaine hcl, 10 Cocet, 25 Cocet Plus, 25 cod liver oil, 31 codeine phosphate, 25 Codeine Sulfate, 25 Cogentin, 21 Colazal, 16 Colcrys, 26 coldec dm, 28 Colestid, 7 Colestid Flavored, 7 colestipol hcl, 7 colestipol hcl for oral suspension, 7 colidrops pediatric, 15 colistimethate sodium, 3 colocort, 16 Coly-mycin M, 3 Coly-mycin S, 24 Colyte-flavor Packs, 14 Combigan, 23 Combipatch, 12 Combivent, 30 Combivent Respimat, 30 Combivir, 2 Comfort Assured Lancets Micro Thin 33g, 34 Comfort Assured Lancets Super Thin 28g, 34 Comfort Lancets, 34 Complera, 2 complete natal dha, 31 Complete-rf Prenatal, 32 completenate, 31 compro, 20 Comtan, 21 Comvax, 30 Concept Dha, 32 Concept Ob, 32 Concerta, 20 Condylox, 11 constulose, 14 Conzip, 25 Copaxone, 21 copd, 29 Copegus, 2 Cordarone, 5 Cordran, 10 Cordran Sp, 10 Cordran Tape, 10 Coreg, 5 Coreg Cr, 5 Corenate-dha, 32 Corgard, 5 cormax, 9 cormax scalp application, 9 cortalo, 9 Cortef, 11 Cortenema, 16 Cortifoam, 16 cortisone acetate, 11 Cortisporin, 8, 24 Cortisporin-tc, 24 corvita, 31 corvita 150, 17

Corvite, 32 Corvite 150, 18 Corvite Fe, 18 corvite free, 31 Corzall, 28 Corzall Plus, 28 Corzall-pe, 28 Corzide, 6 Cosopt, 23 Cosopt Pf, 23 Cotab A, 28 Cotab Ax, 29 Cotabflu, 29 Coumadin, 18 Covera-hs, 5 Cozaar, 6 Cpb Wc, 29 Creon, 15 Crestor, 7 Cresylate, 24 Crinone, 17 Crixivan, 2 Crnatal, 32 cromolyn sodium, 16, 24, 29 Curosurf, 30 Cutivate, 10 Cuvposa, 15 Cvs Lancets 21g, 34 Cvs Lancets Micro Thin 33g, 34 Cvs Lancets Original, 34 Cvs Lancets Thin, 34 Cvs Lancets Thin 26g, 34 Cvs Lancets Ultra Thin 30g, 34 Cvs Ultra Thin Lancets, 34 cyanocobalamin, 17 Cyclobenzaprine Comfort Pac, 22 cyclobenzaprine hcl, 22 cyclobenzaprine hcl er, 22 Cyclogyl, 23 Cyclomydril, 23 cyclopentolate hcl, 23 cyclophosphamide, 3 cycloserine, 2 cyclosporine, 4 cyclosporine modified, 4 cylate, 23 Cymbalta, 19 cyproheptadine hcl, 27 Cystadane, 14 Cystagon, 17 cytarabine, 3 cytarabine aqueous, 3 Cytomel, 14 Cytotec, 15 cytra k crystals, 17 cytra-2, 17 cytra-3, 17 cytra-k, 17

D
D.h.e. 45, 26 dacex-dm, 28 Daliresp, 30 Dallergy, 29 Dallergy Dm, 29 Dallergy Jr, 29 Dallergy Pe, 29 Dallergy Pse, 29 Dallergy-jr, 29

danazol, 12 Dantrium, 22 dantrolene sodium, 22 dapsone, 3 Daptacel, 30 Daraprim, 3 Daypro, 26 Daytrana, 20 Ddavp, 14 de-chlor dm, 28 de-chlor dr, 28 Debacterol, 19 Decara, 31 decavac, 30 Decon-a, 29 dehistine, 28 Delatestryl, 12 Delestrogen, 12 Delos, 8 Deltuss Dmx, 29 Demadex, 6 demeclocycline hcl, 1 Demerol, 25 Demser, 6 Denavir, 9 Depakene, 21 Depakote, 21 Depakote Er, 21 Depakote Sprinkles, 21 Depo-estradiol, 12 Depo-medrol, 11 Depo-provera, 4 Depo-testosterone, 12 Derma-smoothe/fs Body Oil, 10 Derma-smoothe/fs Scalp Oil, 10 Dermatop, 10 Dermotic, 24 desipramine hcl, 19 desloratadine, 27 desmopressin acetate, 14 Desonate, 10 desonide, 9 Desonil, 10 Desowen, 10 Desowen Cream/cetaphil Lotion, 10 Desowen Lotion/cetaphil Cream, 10 Desowen Ointment/cetaphil Lotion, 10 desoximetasone, 9 Desoxyn, 20 despec-exp, 28 Despec-pdc, 29 Desquam-x Wash, 8 Detrol, 16 Detrol La, 16 dex-tuss, 28 dexamethasone, 11 Dexamethasone Intensol, 11 dexamethasone sodium phosphate, 11, 23 dexchlorpheniramine maleate, 27 dexchlorpheniramine maleate cr, 27 Dexedrine, 20 Dexferrum, 17 Dexilant, 15 dexmethylphenidate hcl, 20 Dexpak 10 Day, 11 Dexpak 13 Day, 11 Dexpak 6 Day, 12

dexpanthenol, 16 dextran 70, 18 dextran hm, 18 dextroamphetamine sulfate, 20 dextroamphetamine sulfate er, 20 dextromethorphan hbr/chlorpheniramine/phenylephrine hcl, 28 dextromethorphan hbr/phenylephrine hcl/chlorpheniramine, 28 dg 200, 29 Diabeta, 13 dialyvite, 31 Dialyvite 3000, 32 Dialyvite 5000, 32 Dialyvite Supreme D, 32 Dialyvite/zinc, 32 Diamox, 7 Diastar Easy Test Ii Lancets 30g, 34 Diastar Easy Test Lancets30g, 34 diastat acudial, 21 diastat pediatric, 21 Diatx Zn, 32 diazepam, 19 Diazepam, 21 Diazepam Intensol, 19 Dibenzyline, 6 diclofenac potassium, 26 diclofenac sodium, 24 diclofenac sodium dr, 26 diclofenac sodium er, 26 Diclofenac Sodium Xr, 26 diclofenac sodium/misoprostol, 26 dicloxacillin sodium, 1 dicyclomine hcl, 15 didanosine, 2 Didronel, 13 Differin, 8 Dificid, 1 difil-g 400, 29 difil-g forte, 29 diflorasone diacetate, 9 Diflucan, 2 diflunisal, 24 Digex Nf, 15 Digoxin, 4 dihydro-cp, 28 dihydro-pe, 28 dihydroergotamine mesylate, 26 Dilacor Xr, 5 Dilantin, 21 Dilantin Infatabs, 21 Dilatrate Sr, 4 Dilaudid, 25 Dilaudid-5, 25 Dilaudid-hp, 25 Dilex-g 200, 30 Dilex-g 400, 30 dilt-cd, 5 dilt-xr, 5 diltiazem cd, 5 diltiazem hcl, 5 Diltiazem Hcl Cd, 5 diltiazem hcl er, 5 diltzac, 5 dimenhydrinate, 15 Diovan, 6 Diovan Hct, 6

Dipentum, 16 diphenhydramine hcl, 27 diphenoxylate/atropine, 15 diphtheria/tetanus toxoid pediatric, 30 diphtheria/tetanus toxoids adsorbed pediatric, 30 Diprolene, 10 Diprolene Af, 10 Dipyridamole, 18 disopyramide phosphate, 5 disulfiram, 21 Ditropan Xl, 16 Diuril, 7 divalproex sodium, 21 divalproex sodium dr, 21 divalproex sodium er, 21 Divigel, 12 Divista, 18 dm-pe-chlor, 28 dobells solution, 18 Dolgic Plus, 24 dologesic, 24 Dolophine, 25 Dolophine Hcl, 25 dolorex, 24 Donatuss Dc, 29 Donatuss Xp, 29 Donatussin Dm, 29 donepezil hcl, 21 Doral, 20 Doryx, 1 dorzolamide hcl, 24 dorzolamide hcl/timolol maleate, 23 Dovonex, 9 Dovonex Scalp, 9 doxazosin mesylate, 6 doxepin hcl, 19 doxycycline, 1 doxycycline hyclate, 1 doxycycline monohydrate, 1 Doxytex, 27 Drisdol, 31 dritho-creme hp, 9 Dritho-scalp, 9 dronabinol, 15 droperidol, 19 Droplet Lancets Ultra Thin 30g, 34 Droxia, 17 Drug Mart Lancets Thin, 34 Drug Mart Lancets Ultra Thin, 34 Drug Mart Unilet Lancets Super Thin 30g, 34 Drug Mart Unilet Lancets Ultra Thin 28g, 34 Drymax, 29 Drysol, 11 Duac, 8 Duane Reade Lancet Alternate Site 26g, 34 Duane Reade Lancet Super Thin 30g, 34 Duane Reade Lancet Ultra Thin 28g, 34 Duet Dha, 32 Duet Dha Balanced, 32 Duet Dha Ec, 32 Duetact, 13 Duexis, 26 Dulera, 30 Duocaine, 27

Duoneb, 30 Durabac, 24 Durabac Forte, 24 Duraflu, 29 Duragesic, 25 Duramorph, 25 Durasafe Spinal/epidural Tray/1% Xylocaine/19gx36"close Cath, 27 Durasafe Spinal/epidural Tray/1% Xylocaine/19gx36"open Cath, 27 Durasafe Spinal/epidural Tray/1% Xylocaine/20gx36"close Cath, 27 Durasafe Spinal/epidural Tray/1% Xylocaine/20gx36"open Cath, 27 durasal, 10 duraxin, 24 Durezol, 23 Dutoprol, 6 dy-g, 29 Dyazide, 7 dyflex-g, 29 dylix, 29 Dymista, 27 Dynacin, 1 Dynacirc Cr, 5 dyphylline gg, 29 dyphylline-gg, 29 Dyrenium, 7 Dysport, 22 dytuss, 27

E
E-z Ject Lancets, 34 E-z Ject Lancets 21g, 34 E-z Ject Lancets Color, 34 E-z Ject Lancets Super Thin, 34 E-z Ject Lancets Super Thin 30g, 34 E-z Ject Lancets Thin 26g, 34 E-zject Lancets Micro-thin 33g, 34 e.e.s. 400, 1 E.e.s. Granules, 1 e.s.p., 3 Easy Comfort Lancets, 34 Easy Touch Lancets, 34 easygel, 18 Easytest Ii Lancets, 34 Easytest Lancets, 34 Ec-naprosyn, 26 econazole nitrate, 9 ed baclofen, 22 Ed Chlorped, 27 Ed Chlorped D, 29 ed cyte f, 17 Ed Dm, 29 ed-a-hist dm, 28 Ed-bron G, 30 Ed-chlor-tan, 27 ed-flex, 24 ed-spaz, 15 Edarbi, 6 Edarbyclor, 6 Edecrin, 7 Edluar, 20 Edurant, 2 Effexor Xr, 19 Effient, 18 Egrifta, 14 Eldepryl, 21 Elestat, 24

Elestrin, 12 Eletone, 11 Elidel, 10 Eligard, 4 Elimite, 11 Eliphos, 16 elite ob with dha, 31 elite-ob, 31 Elite-ob 400, 32 Elixophyllin, 30 Elmiron, 17 Elocon, 10 Elspar, 3 Emadine, 24 Emcyt, 4 Emend, 15 Emla, 11 Emsam, 19 Emtriva, 2 Emulsion Sb, 11 Enablex, 16 enalapril maleate, 5 enalapril maleate/hydrochlorothiazide, 6 Enbrel, 26 Enbrel Sureclick, 26 endocet, 25 Endodan, 25 Engerix-b, 30 Enjuvia, 12 Enlon, 22 enoxaparin sodium, 18 Entacapone, 21 Entereg, 16 Entocort Ec, 12 entre-b, 28 enulose, 16 ephedrine sulfate, 7 Epiceram, 11 Epiduo, 8 Epifoam, 10 epinastine hcl, 24 Epinephrine, 7 epinephrine hcl, 29 Epipen, 7 Epipen 2-pak, 7 Epipen-jr, 7 Epipen-jr 2-pak, 7 epitol, 21 Epivir, 2 Epivir Hbv, 2 eplerenone, 6 epogen, 18 eprosartan mesylate, 6 Epzicom, 2 Eql Color Lancets 21g, 34 Eql Super Thin Lancets 30g, 34 Eql Thin Lancets 26g, 34 Equagesic, 24 Equetro, 20 Ergocalciferol, 31 ergoloid mesylates, 21 Ergomar, 26 Ertaczo, 9 Erwinaze, 3 ery, 8 Ery-tab, 1 Eryped 200, 1 Eryped 400, 1

erythrocin stearate, 1 erythromycin, 1, 8, 22 erythromycin base, 1 erythromycin ethylsuccinate, 1 erythromycin/benzoyl peroxide, 8 erythromycin/sulfisoxazole, 3 Escavite, 32 escitalopram oxalate, 19 Esgic, 24 Esgic-plus, 24 estazolam, 20 Estrace, 12, 17 Estraderm, 12 estradiol, 12 estradiol valerate, 12 estradiol/norethindrone acetate, 12 Estrasorb, 12 Estring, 17 Estrogel, 12 estropipate, 12 ethambutol hcl, 2 ethosuximide, 21 ethyl chloride, 10 ethyl chloride/fine pinpoint, 10 ethyl chloride/fine stream, 10 ethyl chloride/medium jet stream, 10 ethyl chloride/medium stream, 10 ethyl chloride/mist, 10 etidronate disodium, 13 etodolac, 26 etodolac er, 26 etoposide, 4 Eurax, 11 Evamist, 12 Evicel, 18 Evista, 13 Evithrom, 18 Evoclin, 8 Evoxac, 19 Exactuss, 29 Exalgo, 25 Exall, 29 Exall-d, 29 exefen-ir, 28 Exelderm, 9 Exelon, 22 exemestane, 3 Exforge, 6 Exforge Hct, 6 Exjade, 36 exoderm, 9 Exparel, 27 expectuss, 28 Extavia, 22 Extina, 9 Ez Smart Blood Glucose Lancets, 34 Ez-lets Lancets 21g, 34 Ez-lets Lancets 23g, 34 Ez-lets Lancets 26g Super-soft, 34 Ez-lets Lancets 28g Ultra-soft, 34 Ez-lets Lancets 30g, 34

F
fabb, 17 Factive, 2 famciclovir, 2 famotidine, 15 Famvir, 2 Fanapt, 20

Fanapt Titration Pack, 20 Fareston, 4 Faslodex, 4 Fasttake Test Strips, 34 Fazaclo, 20 fe c plus, 17 Felbamate, 21 Felbatol, 21 Feldene, 26 felodipine er, 5 fem ph, 17 Femara, 4 Femhrt 1/5, 12 Femhrt Low Dose, 12 Femring, 17 Femtrace, 12 Fenofibrate, 7 fenofibrate micronized, 7 Fenofibric Acid, 7 Fenoglide, 7 fenoprofen calcium, 26 fentanyl, 25 fentanyl citrate oral transmucosal, 25 Fentora, 25 Feriva, 18 ferocon, 17 ferotrin, 17 ferotrinsic, 17 Ferralet 90, 18 ferraplus 90, 17 ferrex 150 forte, 17 ferrex 150 forte plus, 17 ferrex 28, 17 Ferriprox, 36 Ferro-plex Hematinic, 18 ferrocite plus, 31 ferrogels forte, 17 Ferrotrin, 18 Fetrin, 18 Fexmid, 22 fexofenadine hcl, 27 Fibricor, 7 Fifty50 Safety Seal Lancets 30g, 34 Fifty50 Safety Seal Lancets 32g, 34 Finacea, 8 Finacea Plus, 8 finasteride, 17 Fine 30, 34 Fingerstix Lancets, 34 Fioricet, 24 Fioricet/codeine, 25 Fiorinal, 24 Fiorinal/codeine #3, 25 Firazyr, 18 Firmagon, 4 First-bxn Mouthwash, 19 First-dukes Mouthwash, 19 First-hydrocortisone, 10 First-lansoprazole, 15 First-marys Mouthwash, 19 First-mouthwash Blm, 19 First-omeprazole, 15 First-progesterone Vgs 100 Compounding Kit, 17 First-progesterone Vgs 200 Compounding Kit, 17 First-progesterone Vgs 25 Compounding Kit, 17

First-progesterone Vgs 400 Compounding Kit, 17 First-progesterone Vgs 50 Compounding Kit, 17 First-testosterone, 12 First-testosterone Mc Compounding Kit, 12 Flagyl, 3 Flagyl Er, 3 Flarex, 23 flavoxate hcl, 16 flecainide acetate, 5 Flector, 9 Flexeril, 22 Flextra, 25 Flextra Ds, 25 Flextra-650, 25 Flo-pred, 12 Flomax, 17 Flonase, 27 Flovent Diskus, 30 Flovent Hfa, 30 floxuridine, 3 Fluarix 2010-2011, 30 Fluarix 2011-2012, 30 Fluarix 2012-2013, 30 Flucelvax 2012-2013, 30 fluconazole, 2 flucytosine, 2 fludrocortisone acetate, 11 Flulaval 2010-2011, 30 Flulaval 2011-2012, 30 Flulaval 2012-2013, 30 Flumadine, 3 Flumist Nasal Vaccine 2010-2011, 30 Flumist Nasal Vaccine 2011-2012, 30 Flumist Nasal Vaccine 2012-2013, 30 flunisolide, 27 fluocinolone acetonide, 9, 24 fluocinolone acetonide body, 9 fluocinolone acetonide scalp, 9 fluocinonide, 9 fluocinonide emollient base, 10 fluocinonide-e, 10 fluor-op, 23 Fluorometholone, 23 fluoxetine, 21 fluoxetine dr, 19 fluoxetine hcl, 19 fluphenazine decanoate, 20 fluphenazine hcl, 20 flurazepam hcl, 20 flurbiprofen, 26 flurbiprofen sodium, 24 flutamide, 4 fluticasone propionate, 10, 27 fluvastatin, 7 Fluvirin 2010-2011, 30 Fluvirin 2011-2012, 30 Fluvirin 2012-2013, 30 Fluvirin Pf 2011-2012, 30 Fluvirin Pf 2012-2013, 30 fluvoxamine maleate, 19 Fluzone High-dose Pf 2010-2011, 30 Fluzone High-dose Pf 2011-2012, 30 Fluzone High-dose Pf 2012-2013, 30 Fluzone Pediatric Pf 2010-2011, 30 Fluzone Pediatric Pf 2011-2012, 30

Fluzone Pediatric Pf 2012-2013, 30 Fluzone Pf 2010-2011, 30 Fluzone Pf 2011-2012, 30 Fluzone Pf 2012-2013, 30 Fluzone Split 2010-2011, 30 Fluzone Split 2011-2012, 30 Fluzone Split 2012-2013, 30 Fml, 23 Fml Forte, 23 Fml Liquifilm, 23 Focalin, 20 Focalin Xr, 20 folbecal, 31 folbee, 17 Folbee Ar, 18 folbee plus, 31 folbee plus cz, 31 Folcal Dha, 32 folcaps, 17 Folcaps Omega 3, 32 Folgard Os, 32 Folgard Rx, 18 folic acid, 17 folic acid/vitamin b-6/vitamin b-12, 17 folitab, 17 Folivane-ec Calcium Dha Nf, 32 Folivane-f, 18 Folivane-ob, 32 Folivane-plus, 18 Folivane-prx Dha Nf, 32 Folpace Rx, 18 folplex 2.2, 17 Foltrate, 17 foltrin, 17 fondaparinux sodium, 18 Fora Lancets, 34 Foradil Aerolizer, 30 Forfivo Xl, 19 Fortamet, 13 Fortavit, 32 Fortaz, 1 Forteo, 13 Fortesta, 12 Fortical, 13 Fosamax, 13 Fosamax Plus D, 13 fosinopril sodium, 5 fosinopril sodium/hydrochlorothiazide, 6 fosphenytoin sodium, 21 Fosrenol, 16 Fragmin, 18 Freestyle Lancets, 34 Freestyle Unistick Ii Lancets, 34 frenadol, 24 Frova, 26 Fumatinic, 18 Furadantin, 16 furosemide, 6 Fuzeon, 2

G
g/p, 28 gabapentin, 21 Gabavale-5, 19 Gabazolamine, 19 Gabazolamine-0.5, 19 Gabazolpidem-5, 20 Gabitidine, 15 Gabitril, 21

Gaboxetine, 19 galantamine, 21 galantamine hydrobromide, 21 gani-tuss dm nr, 28 gani-tuss nr, 28 ganidin-nr, 28 garamycin, 22 Gardasil, 30 gastrinex nf, 15 Gastrocrom, 16 gavilyte-c, 14 gavilyte-g, 14 gavilyte-n/flavor pack, 14 Gebauers Pain Ease, 11 Gebauers Spray And Stretch, 11 Gel-kam Oral Care Rinse, 19 Gelclair, 19 Gelnique, 16 gemfibrozil, 7 Genadur, 11 generlac, 16 genexa la, 28 gengraf, 4 Genotropin, 14 Genotropin Miniquick, 14 gentak, 22 gentamicin sulfate, 2, 8, 22 Gentex 30, 29 gentex ade, 31 gentex lq, 28 Gentle-let Gp Lancets, 34 Gentle-let Lancets General Purpose Style/fine Point, 34 Gentle-let Lancets General Purpose Style/medium Point, 34 Gentle-let Lancets Safety Style/fine Point, 34 Gentle-let Lancets Safety Style/medium Point, 34 Geodon, 20 Gesticare Dha, 32 gfn 1200/dm 60, 28 gfn 550/pse 60, 28 Gilenya, 22 Gilphex Tr, 29 Giltuss, 29 Giltuss Ped-c, 29 Giltuss Pediatric, 29 Giltuss Tr, 29 Gleevec, 4 Gliadel Wafer, 3 glimepiride, 13 glipizide, 13 glipizide er, 13 Glipizide Xl, 13 glipizide/metformin hcl, 13 Global Inject Ease Lancets 28g, 34 Global Inject Ease Lancets 30g, 34 Glucagen, 13 Glucagen Hypokit, 13 Glucagon Emergency Kit, 13 Glucocom Lancets 28g, 34 Glucocom Lancets 30g, 34 Glucocom Lancets 33g, 34 Glucophage, 13 Glucophage Xr, 13 Glucosource Lancets, 34 Glucotrol, 13

Glucotrol Xl, 13 Glucovance, 13 Glumetza, 13 glyburide, 13 glyburide micronized, 13 glyburide/metformin hcl, 13 glycolic acid, 9 glycolic acid 70% high purity, 9 Glycopyrroate, 15 glycopyrrolate, 15 Glynase, 13 Glyset, 13 Gnp Lancets, 34 Gnp Lancets 21g, 34 Gnp Lancets Micro Thin 33g, 34 Gnp Lancets Super Thin 30g, 34 Gnp Lancets Thin, 34 Gnp Lancets Thin 26g, 34 Gnp Micro Thin Lancets 33g, 34 Gnp Super Thin Lancets/30g, 34 Golytely, 14 Gordofilm, 11 Gordons Urea, 11 Gralise, 22 Gralise Starter, 22 granisetron hcl, 15 Granisol, 15 green soap, 10 Grifulvin V, 2 Gris-peg, 2 griseofulvin microsize, 2 griseofulvin ultramicrosize, 2 guaifenesin/phenylephrinehcl, 28 guanabenz acetate, 6 guanfacine hcl, 6 Guanidine Hcl, 22 Gynazole-1, 17

H
H&h Thinlet Lancets 26g, 34 H&h Thinlet Super Thin Lancets 30g, 35 H-e-b Incontrol Lancets Super Thin 30g, 35 H-e-b Incontrol Lancets Ultra Thin 28g, 35 Haemolance, 35 Haemolance Low Flow Lancets, 35 Haemolance Plus, 35 Haemolance Plus High Flow, 35 Haemolance Plus Low Flow, 35 Haemolance Plus Max Flow, 35 Haemolance Plus Pediatric Flow, 35 halac, 10 Halcion, 20 Haldol, 20 Haldol Decanoate 100, 20 Haldol Decanoate 50, 20 Halflytely Bowel Prep/flavor Packs, 14 halobetasol propionate, 10 Halog, 10 Halonate, 10 halonate pac, 10 haloperidol, 20 haloperidol decanoate, 20 haloperidol lactate, 20 Halotin, 9 Havrix, 30 hdc dm, 28 Healthwise Lancets 30g, 35

Healthy Accents Unilet Lancets Super Thin 30g, 35 hecoria, 4 Hectorol, 14 Helidac, 15 Hemabate, 24 hematinic plus vitamins/minerals, 31 hematinic/folic acid, 17 hematogen, 17 hematogen fa, 17 hematogen forte, 17 Hematron-af, 18 Hemenatal Ob, 32 Hemenatal Ob + Dha, 32 Hemetab, 18 Hemocyte Plus, 32 hemocyte-f, 17 hemocyte-plus, 31 Heparin Sodium, 18 Heparin Sodium Dcu, 18 Heparin Sodium/nacl 0.45%, 18 Heparin Sodium/nacl 0.9%, 18 Heparin Sodium/sodium Chloride 0.9%, 18 Heparin Sodium/sodium Chloride 0.9% Premix, 18 Hepsera, 2 Hexalen, 3 Hiberix, 30 Hiprex, 16 Hm Lancets Micro Thin 33g, 35 Hm Lancets Ultra Thin 30g, 35 homatropaire, 23 homatropine hbr, 23 Horizant, 22 Hpr, 11 Hpr Plus, 11 Hpr Plus/mb Hydrogel, 11 Humalog, 12 Humalog Kwikpen, 12 Humalog Mix 50/50, 12 Humalog Mix 50/50 Kwikpen, 12 Humalog Mix 75/25, 12 Humalog Mix 75/25 Kwikpen, 12 Humatrope, 14 Humatrope Combo Pack, 14 Humira, 26 Humira Pen, 26 Humira Pen-crohns Diseasestarter, 26 Humira Pen-psoriasis Starter, 26 Humulin R U-500 (concentrated), 12 Hy-vee Lancets, 35 Hy-vee Thin Lancets, 35 Hycamtin, 4 Hycet, 25 hydralazine hcl, 6 Hydrea, 4 Hydro 35, 11 Hydro 40 Foam, 11 Hydroc/apap, 29 hydrochlorothiazide, 6 hydrocodone 10mg, 29 hydrocodone bitartrate/acetaminophen, 25 hydrocodone bitartrate/homatropine methylbromide, 28 hydrocodone polistirex and chlorpheniramine polistirex, 28

hydrocodone-acetaminophen tab 7.5-750 mg, 25 hydrocodone/acetaminophen, 25 hydrocodone/homatropine, 28 hydrocodone/ibuprofen, 25 hydrocortisone, 10, 11 Hydrocortisone, 16 hydrocortisone acetate/aloe, 10 hydrocortisone acetate/pramoxine, 16 hydrocortisone butyrate, 10 hydrocortisone in absorbase, 10 hydrocortisone valerate, 10 hydrocortisone/acetic acid, 24 hydrogesic, 25 hydromet, 28 Hydromorphone, 25 hydromorphone hcl, 25 hydromorphone hcl dosette, 25 hydroxocobalamin, 17 hydroxychloroquine sulfate, 3 hydroxyurea, 4 hydroxyzine hcl, 19 hydroxyzine pamoate, 19 hygel, 10 Hylatopic, 11 Hylatopic Plus, 11 Hylatopic Plus/aurstat, 11 Hylira, 11 hyomax -dt, 15 hyomax-sl, 15 hyomax-sr, 15 hyophen, 16 hyoscyamine sulfate, 15 hyoscyamine sulfate er, 15 hyoscyamine sulfate odt, 15 hyoscyamine sulfate sr, 15 hyosyne, 15 Hyper-sal, 29 hypercare, 10 Hypersal, 29 Hypertenevide-12.5, 5 Hypertenipine-2.5, 5 Hypertensolol, 6 Hyzaar, 6

I
ibandronate sodium, 13 ibudone, 25 ibuprofen, 26 Ibuprofen Comfort Pac, 26 Ic 400, 26 Ic 800, 26 Icar-c Plus, 18 iferex 150 forte, 17 Ilaris, 26 Ilevro, 24 ilotycin, 22 Imdur, 5 imipramine hcl, 19 imipramine pamoate, 19 imiquimod, 10 Imitrex, 26 Imitrex Statdose Refill, 26 Imitrex Statdose System, 26 Imovax Rabies (h.d.c.v.), 30 Imuran, 4 inatal advance, 31 inatal gt, 31 inatal ultra, 31

Incivek, 2 Increlex, 14 indamix dm, 28 indapamide, 6 Inderal La, 5 Indocin, 26 indomethacin, 26 indomethacin er, 26 Infanrix, 30 Infasurf, 30 Infed, 17 Infergen, 3 influenza a (h1n1) monovalent 2009, 30 influenza a (h1n1) monovalent 2009 pf, 30 Influenza Vaccine For Safeway Dependants, 30 Infumorph 200, 25 Infumorph 500, 25 Inlyta, 4 Innopran Xl, 5 Inova, 8 Inova 4/1 Acne Control Therapy, 8 Inova 8/2 Acne Control Therapy, 8 Inspra, 6 Integra F, 18 Integra Plus, 18 Intelence, 2 Intermezzo, 20 Introl, 7 Intron-a, 4 Intron-a W/diluent, 4 Intuniv, 20 Invanz, 3 Invega, 20 Invega Sustenna, 20 Invirase, 2 Iopidine, 23 Ipol Inactivated Ipv, 31 ipratropium bromide, 27, 29 ipratropium bromide/albuterol sulfate, 29 Iprivask, 18 Iquix, 22 irbesartan, 6 irbesartan/hydrochlorothiazide, 6 Iressa, 4 Irospan 24/6, 18 Isentress, 2 isochron, 4 isoditrate er, 4 isonarif, 2 isoniazid, 2 Isoptin Sr, 5 Isopto Atropine, 23 Isopto Carbachol, 23 Isopto Carpine, 23 Isopto Homatropine, 23 Isopto Hyoscine, 23 Isordil Titradose, 5 isosorbide dinitrate, 4 isosorbide dinitrate er, 4 isosorbide mononitrate, 4 isosorbide mononitrate er, 4 isradipine, 5 Istalol, 23 Isuprel, 30 itraconazole, 2 Ixiaro, 31

J
J-cof Dhc, 29 J-max Dhc, 29 J-tan D, 29 J-tan D Sr, 29 Jakafi, 4 Jalyn, 17 jantoven, 18 Janumet, 13 Janumet Xr, 13 Januvia, 13 jay-phyl, 29 Je-vax, 31 Jentadueto, 13 Jevantique, 12 jinteli, 12 Juvisync, 13

K
K-phos Mf, 17 K-phos No 2, 17 Kadian, 25 Kalbitor, 18 Kaletra, 2 Kalydeco, 30 kanamycin sulfate, 2 Kapvay, 20 Kapvay Dose Pack, 20 Keep Fit Lancets 28g/twist, 35 Keep Fit Lancets 30g/twist, 35 Keep Fit Lancets 32g/twist, 35 Keep Fit Lancets 33g/twist, 35 Keep Fit Safety Lancets 21g/pressure Activated, 35 Keep Fit Safety Lancets 23g/pressure Activated, 35 Keep Fit Safety Lancets 26g/button Activated, 35 Keep Fit Safety Lancets 26g/pressure Activated, 35 Keep Fit Safety Lancets 28g/button Activated, 35 Keep Fit Safety Lancets 28g/pressure Activated, 35 Keflex, 1 Kenalog, 10 Kenalog-10, 12 Kenalog-40, 12 Keppra, 21 Keppra Xr, 21 Kerafoam, 11 Kerafoam 42, 11 Keralyt, 11 Keralyt Scalp, 11 Kerlone, 5 Kerol, 11 Kerol Ad, 11 Ketek, 3 Ketocon, 9 ketoconazole, 2, 9 ketodan, 9 Ketodan Kit, 9 ketoprofen, 26 ketoprofen er, 26 ketorolac tromethamine, 24, 26 kgs-pe, 28 Kineret, 26 Kinlytic, 18

Kinney Lancets, 35 Kinney Thin Lancets, 35 Kinrix, 30 Klaron, 8 Klonopin, 21 Kombiglyze Xr, 13 Korlym, 13 Kristalose, 14 Kroger Lancets, 35 Kroger Lancets 21g, 35 Kroger Lancets Micro Thin33g, 35 Kroger Lancets Super Thin, 35 Kroger Lancets Thin, 35 Kroger Lancets Thin 26g, 35 Kroger Lancets Ultrathin 30g, 35 Kuvan, 14

L
L-methylfolate Pnv Dha, 32 labetalol hcl, 5 Lac-hydrin, 11 laclotion, 10 Lacrisert, 23 lactic acid, 10 lactic acid e, 10 lactic acid w/vitamin e, 10 Lactocal-f, 32 lactulose, 14, 16 Lady Lite Lancets, 35 Lagesic, 25 Lamb Gel, 11 Lamictal, 21 Lamictal Chewable Dispersible, 21 Lamictal Odt, 21 Lamictal Starter/not Taking Carbamazepine, 21 Lamictal Starter/taking Carbamazepine/not Taking Valproate, 21 Lamictal Starter/taking Valproate, 21 Lamictal Xr, 21 Lamisil, 2, 9 lamivudine, 2 lamivudine/zidovudine, 2 lamotrigine, 21 Lancets Thin, 35 Lancets Ultra Thin, 35 Lancets Ultra Thin 30g, 35 Lanoxin, 4 lansoprazole, 15 Lansoprazole Odt, 15 Lantus, 12 Lantus Solostar, 12 Lasix, 7 Lastacaft, 24 latanoprost, 23 latrix, 10 latrix xm, 10 Latuda, 20 lavoclen-4 acne wash kit, 8 lavoclen-4 creamy wash, 8 lavoclen-8 acne wash kit, 8 lavoclen-8 creamy wash, 8 Lazanda, 25 Leader Lancets Colored, 35 Leader Super Thin Lancet, 35 Leader Thin Lancets, 35 leflunomide, 26 Lescol, 7 Lescol Xl, 7

Letairis, 7 letrozole, 4 Lets Kit, 27 leucovorin calcium, 4 Leukeran, 3 Leukine, 17 leuprolide acetate, 4 Levacet, 25 levalbuterol, 29 Levalbuterol Hcl, 29 Levaquin, 2 Levatol, 5 Levbid, 15 Levemir, 12 Levemir Flexpen, 12 levetiracetam, 21 levetiracetam er, 21 levobunolol hcl, 23 levocarnitine, 14 levocetirizine dihydrochloride, 27 levofloxacin, 1, 22 Levomefolate Dha, 32 Levomefolate Pnv, 32 Levophed, 7 levorphanol tartrate, 25 Levothroid, 14 levothyroxine sodium, 14 levothyroxine sodium tab 0.075mg, 14 Levoxyl, 14 Levsin, 15 Levsin/sl, 15 Lexapro, 19 Lexiva, 2 Lialda, 16 Lidamantle Hc, 10 lidazone hc, 16 lidocaine, 10 lidocaine hcl, 10, 18, 27 lidocaine hcl jelly, 10 lidocaine hcl-hydrocortisone acetate with aloe, 16 lidocaine hcl/hydrocortisone acetate, 16 lidocaine viscous, 18 lidocaine/epinephrine, 27 lidocaine/prilocaine, 10 Lidoderm, 11 Lidovir, 9 Lifescan Unistik 2 Deep Penetration, 35 Lifescan Unistik Ii Lancets, 35 Lincocin, 3 lindane, 10 Linzess, 16 liothyronine sodium, 14 Lipitor, 7 Lipofen, 7 Liquicet, 25 lisinopril, 5 lisinopril/hydrochlorothiazide, 6 Lite Touch Lancets, 35 Lithium Carbonate, 20 lithium carbonate er, 20 Lithium Citrate, 20 Lithobid, 20 Lithostat, 17 Livalo, 7 Live Better Lancet Super Thin 30g, 35 Live Better Lancet Ultra Thin 28g, 35 Locoid, 10

Locoid Lipocream, 10 Lodosyn, 21 Lodrane 12d, 29 Lodrane 24, 27 Lodrane 24d, 29 lofene, 15 Lofibra, 7 lohist-12, 27 lohist-12d, 28 Lokara, 10 Lomotil, 15 Longs Lancets Standard, 35 Longs Lancets Thin, 35 Longs Lancets Ultra Thin, 35 lonox, 15 loperamide hcl, 15 Lopid, 7 Lopressor, 5 Lopressor Hct, 6 Loprox, 9 Loprox Shampoo, 9 lorazepam, 19 Lorazepam Intensol, 19 Lorcet 10/650, 25 Lorcet Plus, 25 Lortab, 25 Lorzone, 22 losartan potassium, 6 losartan potassium/hydrochlorothiazide, 6 Lotemax, 23 Lotensin, 6 Lotensin Hct, 6 Lotrel, 6 Lotrisone, 9 Lotronex, 16 lovastatin, 7 Lovaza, 7 Lovenox, 18 loxapine, 20 loxapine succinate, 20 Loxitane, 20 Lta 360 Kit, 19 Lufyllin, 30 Lumigan, 23 Luminal, 20 Lunesta, 20 Lupron Depot, 4 Lupron Depot-ped, 13 Lusonal, 27 Luvox Cr, 19 Luxiq, 10 Lycelle, 11 Lyrica, 21 lysiplex plus, 31 Lysodren, 4 Lysteda, 18 Lytensopril, 6 Lytensopril-90, 6

M
M-m-r Ii W/diluent 10 Dose, 31 m-vit, 31 macnatal cn dha, 31 Macrobid, 16 Macrodantin, 16 Magnacet, 25 Major Comfort Lancets, 35 Makena, 12

Malarone, 3 malathion, 10 maprotiline hcl, 19 Marcaine, 27 Marcaine W/o Epi, 27 Marcaine/epinephrine, 27 margesic, 24 Marinol, 15 Marnatal-f, 32 Marnatal-f Plus Duo Pack, 32 Marplan, 19 marten-tab, 24 martinic, 17 Matulane, 4 matzim la, 5 Mavik, 6 Maxair Autohaler, 30 Maxalt, 26 Maxalt-mlt, 26 Maxaron Forte, 18 Maxidex, 23 Maxidone, 25 Maxifed Cd, 29 Maxifed Cdx, 29 Maxifed-g Cd, 29 Maxifed-g Cdx, 29 Maxiflu Cd, 29 Maxiflu Cdx, 29 Maxinate, 32 Maxiphen Cd, 29 Maxiphen Cdx, 29 Maxitrol, 23 Maxzide, 7 Maxzide-25, 7 Mb Hydrogel, 11 mebendazole, 3 meclizine hcl, 15 meclofenamate sodium, 26 Medi-lance Lancets, 35 Medichoice Pre-set Safety Lancet Dual Use, 35 Medichoice Pre-set Safety Lancet Low Flow, 35 Medichoice Pre-set Safety Lancet Medium Flow, 35 Medichoice Pre-set Safety Lancet Moderate Flow, 35 Medichoice Safety Lancet Extra, 35 Medichoice Safety Lancet Normal, 35 Medicine Shoppe Lancets, 35 Medicine Shoppe Lancets Thin, 35 Medisense Thin Lancets, 35 Medlance Plus Lancets, 35 Medlance Plus Lancets Lite 25g, 35 Medlance Plus Superlite 30g, 35 Medlance Plus Universal Lancets 21g, 35 Medlance Plus/lite 25g, 35 Medlance/extra, 35 Medlance/lite, 35 Medlance/universal, 35 Medrol, 12 Medrol Dosepak, 12 medroxyprogesterone acetate, 12 mefenamic acid, 26 mefloquine hcl, 3 mega-c/a plus, 31 Megace Es, 12

Megace Oral, 4 megestrol acetate, 4 Meijer Color Lancets Universal 33g, 35 Meijer Lancets, 35 Meijer Lancets Thin, 35 Meijer Lancets Universal 33g, 35 Meijer Super Thin Lancets, 35 Meloxicam, 26 Meloxicam Comfort Pac, 26 Menactra, 31 Menest, 12 Menhibrix, 31 Menomune-a/c/y/w-135, 31 Menostar, 12 Mentax, 9 Menveo, 31 meperidine hcl, 25 meperitab, 25 Mephyton, 31 mepivacaine hcl, 27 meprobamate, 19 Mepron, 3 mercaptopurine, 3 mesalamine, 16 Mesnex, 4 Mestinon, 22 Mestinon Timespan, 22 Metadate Cd, 20 metadate er, 20 Metaglip, 13 metaproterenol sulfate, 29 Metaxalone, 22 metformin hcl, 13 metformin hcl er, 13 methadone hcl, 25 Methadone Hcl Intensol, 25 Methadose, 25 Methadose Sugar-free, 25 methamphetamine hcl, 20 methazolamide, 6 Methenamine Hippurate, 16 methenamine mandelate, 16 Methergine, 24 methimazole, 14 Methitest, 12 methocarbamol, 22 methotrexate, 3 methotrexate sodium, 3 Methscopolamine Bromide, 15 methyclothiazide, 6 methyldopa, 6 methyldopa/hydrochlorothiazide, 6 methylergonovine maleate, 24 methylin, 20 methylin er, 20 methylphenidate hcl, 20 methylphenidate hcl cd, 20 methylphenidate hcl er, 20 Methylphenidate Hcl Sr, 20 methylphenidate hydrochloride, 20 methylprednisolone, 11 methylprednisolone acetate, 11 methylprednisolone dose pack, 11 methylprednisolone sodiumsuccinate, 11 Metipranolol, 23 metoclopramide hcl, 16 metolazone, 6 Metoprolol, 5

metoprolol succinate er, 5 metoprolol tartrate, 5 metoprolol/hydrochlorothiazide, 6 Metozolv Odt, 16 Metrocream, 8 Metrogel, 8 Metrogel-vaginal, 17 Metrolotion, 8 metronidazole, 3, 8 metronidazole vaginal, 17 Mevacor, 7 mexar wash, 9 mexiletine hcl, 5 mi-omega nf, 17 Miacalcin, 13 Micardis, 6 Micardis Hct, 6 miconazole 3, 17 miconazole 3 combo pack, 17 Microlet Lancets, 35 Micronized Colestipol Hcl, 7 Microtainer Safety Flow Lancet/sterile/single-use, 35 Microzide, 7 Midamor, 7 midodrine hcl, 7 Mifeprex, 14 Migergot, 26 Migral, 26 Migranal, 26 Millipred, 12 Millipred Dp, 12 mimvey, 12 Mimyx, 11 mineral oil heavy, 14 Minipress, 6 minirin, 14 minitran, 4 Minivelle, 12 Minocin, 1 Minocin Kit, 1 minocycline hcl, 1 minocycline hcl er, 1 minoxidil, 6 Miracle Mouthwash, 19 Mirapex, 21 Mirapex Er, 21 mirtazapine, 19 mirtazapine odt, 19 misoprostol, 15 Mitosol, 22 Mobic, 26 modafinil, 20 moexipril hcl, 5 moexipril/hydrochlorothiazide, 6 mometasone furoate, 10 Momexin, 10 Monodox, 1 Monoject Basic Biopsy Tray Without Biopsy Needle 20gx 1-1/2", 27 Monoject Bone Marrow Aspiration Tray/iliac Needle 16g, 27 Monoject Bone Marrow Aspiration Tray/rosenthal Needle 16gx2", 27 Monoject Bone Marrow Biopsy Tray/biop Aspir Needle 11gx4", 27 Monoject Bone Marrow Biopsy Tray/biop Aspir Needle 8gx4", 27

Monoject Bone Marrow Biopsy Tray/biop Aspir/iliac Aspir Ndle, 27 Monoket, 5 Monolet Lancets, 35 Monolet Opd Lancets, 35 Monolettor Safety Lancets, 35 montelukast sodium, 29 Monurol, 16 morgidox 1x100mg, 1 morgidox 2x100mg, 1 Morphine, 25 Morphine Sulfate, 25 Morphine Sulfate Er, 25 morphine sulfate powder, 25 Morphine/saline, 25 Motofen, 15 Moviprep, 15 Moxatag, 1 Moxeza, 22 Mozobil, 17 Ms Contin, 25 Ms/hydrogel, 25 mst 600, 24 Mucotrol, 19 mult-vitamin/fluoride, 31 Multaq, 5 multi vitamin/fluoride, 31 multi-vit/fluoride, 31 multi-vit/iron/fluoride, 31 multi-vitamin/fluoride, 31 multi-vitamin/fluoride/iron, 31 Multichew, 32 multigen, 17 multigen folic, 17 multigen plus, 17 multivitamin with fluoride, 31 multivitamin/fluoride, 31 multivitamins/fluoride, 31 mupirocin, 8 Mustargen, 3 mvc-fluoride, 31 Myambutol, 2 myci-gc, 28 Mycobutin, 2 mycophenolate mofetil, 4 Mydfrin, 23 mydral, 23 Mydriacyl, 23 myferon 150 forte, 17 Myfortic, 4 Myglucohealth Mgh Softlance Lancets 30g, 35 myhist-pd, 28 Mykidz Iron Fl, 32 Myleran, 3 Mynatal, 32 mynatal advance, 31 mynatal plus, 31 mynatal ultracaplet, 31 mynatal-z, 31 mynate 90 plus, 31 mynephrocaps, 31 Myobloc, 22 Myochrysine, 26 myorisan, 8 myoxin, 24 Myrbetriq, 16 Mysoline, 21

Mytelase, 22 mytussin ac, 28

N
nabumetone, 26 nadolol, 5 nadolol/bendroflumethiazide, 6 nafcillin sodium, 1 Nafrinse Daily/acidulated, 19 Nafrinse Daily/neutral, 19 Nafrinse Weekly, 19 Naftin, 9 nalbuphine hcl, 25 Nalfon, 26 Namenda, 21 Namenda Titration Pak, 22 Naprelan, 26 Napro 15% Compounding Kit, 9 Naproderm Compounding Kit, 9 Naprosyn, 26 naproxen, 26 Naproxen Comfort Pac, 26 naproxen dr, 26 naproxen sodium, 26 naratriptan hcl, 26 Nardil, 19 Nariz, 29 Naropin, 27 Nasacort Aq, 27 Nascobal, 18 nasohist, 28 Nasohist Dm, 29 Nasonex, 27 Nasotuss, 29 Nata Komplete, 32 Natachew, 32 Natacyn, 22 Natafort, 32 Natalvit, 32 nateglinide, 13 Natelle One, 32 Natelle-ez, 32 Natroba, 11 nature-throid, 14 Nature-throid Nt-2.5, 14 Navane, 20 Nebupent, 3 Nebusal, 29 Neevo, 32 Neevo Dha, 32 nefazodone hcl, 19 Nembutal, 20 Nembutal Sodium, 20 Neo Dm, 29 Neo-fradin, 2 neo-polycin, 22 Neo-synephrine, 7 Neobenz Micro, 8 Neobenz Micro Plus Pack, 8 Neobenz Micro Sd, 8 Neobenz Micro Wash, 8 Neobenz Micro Wash Plus Pack, 8 neofrin, 23 neomycin sulfate, 2 neomycin/bacitracin/polymyxin, 22 neomycin/polymyxin/bacitracin zinc, 22 neomycin/polymyxin/bacitracin/hydrocorti sone, 23 neomycin/polymyxin/dexamethasone, 23

neomycin/polymyxin/gramicidin, 22 neomycin/polymyxin/hc, 24 neomycin/polymyxin/hydrocortisone, 23, 24 Neoral, 4 Neosalus, 11 Neosalus 180 Pack, 11 Neosporin, 22 neostigmine methylsulfate, 22 Neotic, 24 Neotuss Plus, 29 Nephplex Rx, 32 Nephro-vite Rx, 32 Nephrocaps, 32 Nephrocaps Qt, 32 Nephron Fa, 18 nephronex, 31 Neptazane, 7 Nesacaine, 27 Nesacaine-mpf, 27 Nestabs, 32 Nestabs Dha, 32 Netgroup Lancets, 35 Neulasta, 17 Neumega, 17 Neupogen, 18 Neupro, 21 Neurin-sl, 18 neurodep, 31 Neurontin, 21 neutrahist, 28 neutral sodium fluoride, 18 Neutrasal, 19 Nevanac, 24 Nevirapine, 2 Nexa Plus, 32 Nexa Select, 32 Nexavar, 4 Nexiclon Xr, 6 Nexium, 15 niacin, 31 niacor, 31 Niaspan, 7 nicardipine hcl, 5 Nicazel, 32 Nicomide, 32 nicotinamide w/zinc oxide/cupric oxide/folic acid, 31 nicotinamide/zinc oxide/cupric oxide/folic acid, 31 nicotinamide/zinc/copper/fa, 31 nifediac cc, 5 nifedical xl, 5 nifedipine, 5 nifedipine er, 5 Nilandron, 4 nimodipine, 5 Nimotop, 5 Niravam, 19 Niron Komplete, 18 nisoldipine, 5 nisoldipine er, 5 Nitro-bid, 4 Nitro-dur, 4 nitrofurantoin, 16 Nitrofurantoin Macrocrystal, 16 nitrofurantoin macrocrystalline, 16 nitrofurantoin monohydrate, 16

Nitrofurantoin Monohydrate/macrocrystals, 16 nitroglycerin, 4 Nitroglycerin Lingual, 4 nitroglycerin transdermal, 4 Nitrolingual Pumpspray, 4 Nitromist, 5 Nitrostat, 4 nizatidine, 15 Nizoral, 9 nohist, 28 nohist dmx, 28 Norco, 25 Norditropin Cartridge, 13 Norditropin Flexpro, 13 Norditropin Nordiflex Pen, 13 Norel Sr, 29 norepinephrine bitartrate, 7 norethindrone acetate, 12 Norflex, 22 Noritate, 8 Noroxin, 2 Norpace, 5 Norpace Cr, 5 Norpramin, 19 nortriptyline hcl, 19 nortuss-de, 28 nortuss-ex, 28 Norvasc, 5 Norvir, 2 Notuss-ac, 29 Nova Safety Lancets 23g, 35 Nova Safety Lancets 28g, 35 Nova Sureflex Lancets, 35 Novaferrum, 18 novagesic, 24 Novarel, 13 Novofine 30gx8mm, 35 Novofine 32gx6mm, 35 Novofine Autocover 30gx8mm, 35 Novolin 70/30, 12 Novolin 70/30 Relion, 12 Novolin N, 12 Novolin N Relion, 12 Novolin R, 12 Novolin R Relion, 12 Novolog, 12 Novolog Flexpen, 12 Novolog Mix 70/30, 12 Novolog Mix 70/30 Prefilled Flexpen, 12 Novolog Penfill, 12 Novotwist 30gx8mm, 35 Novotwist 32gx5mm, 35 Noxafil, 2 np thyroid 30, 14 np thyroid 60, 14 np thyroid 90, 14 Nplate, 18 Nucort, 10 Nucynta, 25 Nucynta Er, 25 Nuedexta, 22 nufol, 17 nulev, 15 Nulytely/flavor Packs, 15 numoisyn, 18 Nuox, 8 Nutri-tab Ob, 32

Nutri-tab Ob + Dha, 32 nutricap, 31 Nutridox, 1 nutrifac zx, 31 Nutrivit, 32 Nutropin, 13 Nutropin Aq, 13 Nutropin Aq Nuspin 10, 14 Nutropin Aq Nuspin 20, 14 Nutropin Aq Nuspin 5, 14 Nutropin Aq Pen, 14 Nuvail, 11 Nuvigil, 20 nuzole, 9 Nuzon, 10 nyamyc, 9 nystatin, 2, 9, 18 nystatin vaginal, 17 nystatin/triamcinolone, 9 nystop, 9

O
O-cal Fa, 32 O-cal Prenatal, 32 Ob Complete, 32 Ob Complete 400, 32 Ob Complete One, 32 Ob Complete Petite, 32 Ob Complete Premier, 32 Ob Complete With Dha, 32 Ob Complete/dha, 32 ob-natal one, 31 Obstetrix Dha, 32 obstetrix ec, 31 octreotide acetate, 14 Ocudox, 1 Ocufen, 24 Ocuflox, 22 ofloxacin, 1, 22, 24 Oforta, 3 olanzapine, 20 olanzapine odt, 20 olanzapine/fluoxetine, 21 Oleptro, 19 Olux, 10 Olux-e, 10 Omeclamox-pak, 15 omeprazole, 15 omeprazole/sodium bicarbonate, 15 Omnaris, 27 Omnipred, 23 Omnitrope, 14 Omontys, 18 On Call Lancets, 35 On Call Plus Lancets, 35 Oncaspar, 3 ondansetron hcl, 15 ondansetron odt, 15 Onetouch Basic System, 35 Onetouch Basic/profile Test Strips, 35 Onetouch Basic/profile/one Touch Ii Test Strips, 35 Onetouch Club Lancets Fine Point, 35 Onetouch Combo Pack, 35 Onetouch Delica Lancets, 35 Onetouch Delica Lancets Fine 30g, 35 Onetouch Finepoint Lancets, 35 Onetouch Lancets, 35 Onetouch Profile System, 35

Onetouch Ultra 2, 35 Onetouch Ultra Blue, 35 Onetouch Ultra Mini, 35 Onetouch Ultra System Kit, 35 Onetouch Ultra Test Strips, 35 Onetouch Ultrasoft Lancets, 35 Onetouch Verio Control Solution High, 35 Onetouch Verio Iq Blood Glucose Monitoring System, 35 Onetouch Verio Iq Test Strips, 35 Onetouch Verio Mid Control Solution, 35 Onetouch Verio Test Strips, 35 Onfi, 21 Onglyza, 13 Onmel, 2 Onsolis, 25 Opana, 25 Opana Er, 25 Opana Er (crush Resistant), 25 opium, 15 opium tincture, 15 Optipranolol, 23 Optivar, 24 Oracea, 8 Oracit, 17 oralone, 18 Oramagicrx, 19 Oramorph Sr, 25 Orap, 22 Orapred, 12 Orapred Odt, 12 Oravig, 19 Oraxyl, 1 Orbivan, 25 Orbivan Cf, 25 Orencia, 26 Orfadin, 14 orphenadrine citrate, 22 orphenadrine citrate er, 22 orphenadrine compound ds, 22 orphenadrine/asa/caffeine, 22 ortho-cs 250, 31 ortho-est, 12 oscimin, 15 oscimin sr, 15 oscion cleanser, 8 Osmoprep, 15 otic care, 24 oticin, 24 otozin, 24 Ovace Plus, 9 Ovace Plus Wash, 9 Ovace Wash, 9 Ovide, 11 oxacillin sodium, 1 Oxandrin, 12 oxandrolone, 12 oxaprozin, 26 oxazepam, 19 oxcarbazepine, 21 Oxecta, 25 Oxistat, 9 Oxsoralen Ultra, 9 oxybutynin chloride, 16 oxybutynin chloride er, 16 oxycodone, 25 oxycodone hcl, 25

oxycodone/acetaminophen, 25 oxycodone/aspirin, 25 oxycodone/ibuprofen, 25 Oxycontin, 25 oxymorphone hydrochloride, 25 oxymorphone hydrochloride er, 25 Oxytocin, 24 Oxytrol, 16

P
p chlor dm, 28 Pacerone, 5 Pacnex Hp, 8 Pacnex Lp, 8 Pacnex Mx, 8 pacnex wash, 8 Paire Ob, 33 Palgic, 27 Pamelor, 19 Pamine, 15 Pamine Forte, 15 Pamine Fq, 15 Panatuss Dxp, 29 Pancreaze, 16 Pancrelipase, 15 Pandel, 10 Pantoprazole Sodium, 15 papaverine hcl, 7 Parafon Forte Dsc, 22 parcaine, 23 Parcopa, 21 paregoric, 15 Parlodel, 21 Parnate, 19 paromomycin sulfate, 2 paroxetine hcl, 19 paroxetine hcl er, 19 Paser, 2 Pataday, 24 Patanase, 27 Patanol, 24 Paxil, 19 Paxil Cr, 19 Pce, 1 pe-guai, 28 pedi-dri, 9 Pediaderm Af Complete Kit, 9 Pediaderm Hc, 10 Pediaderm Ta, 10 Pediapred, 12 Pediarix, 30 Pediatex Td, 29 Pediatex Tdm, 29 Pedipirox-4 Nail, 9 Pedvax Hib, 31 Peg 3350/electrolytes, 14 peg-3350/electrolytes, 14 peg-3350/nacl/na bicarbonate/kcl, 14 Peg-intron, 2 Peg-intron Redipen, 2 Peg-intron Redipen Pak 4, 2 Peganone, 21 Pegasys, 2 Pegasys Proclick, 2 penicillin g potassium, 1 penicillin g procaine, 1 penicillin g sodium, 1 penicillin v potassium, 1 Penlac Nail Lacquer, 9

Pennsaid, 9 Pentacel, 30 Pentam 300, 3 Pentasa, 16 pentazocine/acetaminophen, 25 pentazocine/naloxone hcl, 25 pentetate calcium trisodium, 36 pentetate zinc trisodium, 36 pentoxifylline er, 18 Pepcid, 15 Percocet, 25 Percodan, 25 Perfect Lancets 30g, 35 Perfect Pressure Activated Safety Lancets 28g, 35 Perforomist, 30 Peridex, 19 perindopril erbumine, 5 perio med, 18 periogard, 18 permethrin, 10 perphenazine, 20 perphenazine/amitriptyline, 21 Persantine, 18 Pertzye, 16 Pexeva, 19 pfizerpen-g, 1 Pharmacist Choice Ultra Thin Lancets, 35 Pharmacist Choice Ultra Thin Lancets 28g, 35 Pharmacist Choice Ultra Thin Lancets 30g, 35 Pharmacist Choice Ultra Thin Lancets 31g, 35 Pharmacy Counter Lancets, 35 Phena-plus, 29 Phena-s, 29 phenadoz, 27 phenazo, 17 phenazopyridine hcl, 17 phenelzine sulfate, 19 Phenergan, 27 Phenergan Fortis, 27 Phenflu Cd, 29 Phenflu Cdx, 29 phenobarbital, 20 phenobarbital sodium, 20 phentolamine mesylate, 6 phenylephrine hcl, 7, 23 phenylephrine/guaifenesin, 28 Phenytek, 21 phenytoin, 21 phenytoin sodium, 21 phenytoin sodium extended, 21 Phoslo, 16 Phoslyra, 16 phosphasal, 16 Phospholine Iodide, 23 Phrenilin Forte, 25 phytonadione, 31 pilocarpine hcl, 18, 23 pilocarpine hydrochloride, 18 Pilopine Hs, 23 pindolol, 5 Pinnacaine Otic, 24 Pioglitazone Hcl, 13 Pioglitazone Hcl/metformin Hcl, 13

piroxicam, 26 Pitocin, 24 Pitressin Synthetic, 14 Plaquenil, 3 Plavix, 18 Pletal, 18 Plexion Cleanser, 8 Plexion Cleansing Cloth, 8 Plexion Sct, 8 Pliaglis, 11 pneumovax 23/1 dose, 30 pneumovax 23/5 dose, 30 Pnv Ob+dha, 33 pnv-dha, 31 Pnv-dha+docusate, 33 Pnv-omega, 33 pnv-select, 31 Pnv-total, 33 podocon 25 in benzoin tincture, 10 podofilox, 10 polocaine, 27 polocaine-mpf, 27 Poly Hist Dhc, 29 Poly Hist Nc, 29 Poly Hist Pd, 29 poly-dex, 23 poly-iron 150 forte, 17 Poly-pred, 23 Poly-tussin Dhc, 29 Poly-tussin Ex, 29 Poly-vi-flor, 33 Poly-vi-flor/iron, 33 poly-vitamin/fluoride, 31 poly-vitamin/iron/fluoride, 31 polycin b, 22 Polycitra-k Crystals, 17 polyethylene glycol 3350, 14 polymyxin b sulfate, 3 Polymyxin B Sulfate/trimethoprim Sulfate, 22 polysaccharide iron forte, 17 Polytrim, 22 polyvitamin/fluoride, 31 Ponstel, 26 Pontocaine, 11, 27 Pontocaine Niphanoid, 27 Potassium Citrate, 17 potassium citrate/citric acid, 17 Potiga, 21 pr benzoyl peroxide wash, 8 Pr Cream, 11 pr natal 400, 31 pr natal 400 ec, 31 pr natal 430, 31 pr natal 430 ec, 31 Pradaxa, 18 pram-hca, 16 pramcort, 10 pramipexole dihydrochloride, 21 Pramosone, 10 Pramotic, 24 pramox gel, 10 Prandimet, 13 Prandin, 13 prascion, 8 prascion fc, 8 prascion ra with sunscreens, 8 Pravachol, 7

pravastatin sodium, 7 Prazolamine, 22 prazosin hcl, 6 Pre-folic, 18 Precision Thin Lancets, 35 Precision Thins Gp Lancet, 35 Precision Ultra Lancet, 35 Precose, 13 Pred Forte, 23 Pred Mild, 23 Pred-g, 23 Pred-g S.o.p., 23 prednicarbate, 10 prednisolone, 11 Prednisolone Acetate, 23 prednisolone sodium phosphate, 11, 23 prednisone, 11 Prednisone Intensol, 12 Prefera Ob, 32 Prefera Ob + Dha, 32 Preferaob One, 32 Preferred Plus Lancets Colored 21g, 35 Preferred Plus Lancets Super Thin 30g, 35 Preferred Plus Lancets Thin 26g, 35 Prefest, 12 Pregnyl W/diluent Benzyl Alcohol/nacl, 13 Prelone, 12 Premarin, 12, 17 Premphase, 12 Prempro, 12 Prena1 Chew/quatrefolic, 33 Prena1 Plus/quatrefolic, 33 Prena1/quatrefolic, 33 prenafirst, 31 Prenaissance, 33 Prenaissance Balance, 33 Prenaissance Harmony Dha, 33 Prenaissance Next, 33 prenaissance plus, 31 prenaplus, 31 Prenata, 33 prenatabs fa, 31 prenatabs obn, 31 prenatabs rx, 31 prenatal 19, 31 prenatal ad, 31 prenatal low iron, 31 Prenatal Mv & Min/fe-fa-dha, 33 Prenatal Plus, 33 Prenatal Plus Iron, 33 prenatal plus/iron, 31 Prenatal Vitamins Plus, 33 prenatal-u, 31 Prenate Dha, 33 Prenate Elite, 33 Prenate Essential, 33 Prenate Mini, 33 Prenexa, 33 Prepidil, 24 Prepopik, 15 Preque 10, 33 Prevacid, 15 Prevacid Solutab, 15 prevalite, 7 Prevident, 19 Prevnar 13, 31

Prevpac, 15 Prezista, 2 Priftin, 2 Prilosec, 15 Primaquine Phosphate, 3 primidone, 21 Primlev, 25 Primsol, 3 Prinivil, 6 Prinzide, 6 Pristiq, 19 Pro-clear, 29 Proair Hfa, 30 probenecid, 26 probenecid/colchicine, 26 procainamide hcl, 5 Procardia, 5 Procardia Xl, 5 Procentra, 20 prochlorperazine, 20 prochlorperazine edisylate, 20 prochlorperazine maleate, 20 Procort, 16 procrit, 18 procto-pak, 16 Proctocort, 16 proctocream hc, 16 Proctofoam Hc, 16 proctosol hc, 16 proctozone-hc, 16 Prodigy Pressure Activated Safety Lancets, 35 Prodigy Safety Lancets, 35 Prodigy Twist Top Lancets, 35 Proferrin-forte, 18 progesterone, 12 Proglycem, 13 Prograf, 4 Prohist Cd, 29 Prohist Cf, 29 Prohist Lq, 29 Prolia, 13 promacet, 24 Promacta, 18 Promar, 33 promethazine hcl, 27 promethazine hcl plain, 27 promethazine vc, 28 promethazine vc plain, 28 promethazine vc/codeine, 28 promethazine-dm, 28 promethazine/codeine, 28 promethazine/dextromethorphan, 28 promethegan, 27 Prometrium, 12 Promiseb, 9 Promiseb Complete, 9 propafenone hcl, 5 propafenone hcl er, 5 propantheline bromide, 15 proparacaine hcl, 23 propranolol hcl, 5 propranolol hcl er, 5 propranolol/hydrochlorothiazide, 6 propylthiouracil, 14 Proquad, 31 Proscar, 17 Prosed/ds, 16

Prostigmin, 22 Prostin E2, 24 Protect Cardio, 33 Protect Plus, 33 Protect Plus Nr, 33 Protectbone, 33 Protectiron, 33 Protectnatal, 33 protid, 28 Protonix, 15 Protopic, 10 protriptyline hcl, 19 Proventil Hfa, 30 Provera, 12 Provigil, 20 Prozac, 19 Prozac Weekly, 19 Pruclair, 11 Prudoxin, 9 Prumyx, 11 Pss Select Gp Lancets, 35 Pss Select Safety Lancets, 35 pulmari-gp, 28 Pulmicort, 30 Pulmicort Flexhaler, 30 Pulmophylline, 30 Pulmozyme, 30 Purefe Ob Plus, 33 Purefe Plus, 18 purevit dualfe plus, 17 Purinethol, 3 Px Lancets, 35 Px Lancets Ultra Thin, 35 Pylera, 15 pyrazinamide, 2 Pyridium, 17 pyridostigmine bromide, 22 pyridoxine hcl, 31 pyrogallic acid, 10

Q
Qc Lancets Super Thin, 35 Qc Lancets Ultra Thin, 35 Qnasl, 27 Qualaquin, 3 Quelicin, 22 Quelicin 1000, 22 Questran, 7 Questran Light, 7 quetiapine fumarate, 20 Quillivant Xr, 20 quinapril hcl, 5 quinapril/hydrochlorothiazide, 6 Quinidine Gluconate, 5 quinidine gluconate cr, 5 quinidine gluconate er, 5 quinidine sulfate, 5 quinidine sulfate er, 5 quinine sulfate, 3 Quixin, 22 Qutenza, 11 Qvar, 30

R
r-tanna, 28 r-tanna pediatric, 28 Ra E-zject Color Lancets Micro-thin 33g, 35 Ra E-zject Lancets 28g, 35

Ra E-zject Lancets Thin 26g, 35 Ra E-zject Lancets Thin 28g, 35 Ra E-zject Lancets Ultra Thin 30g, 35 ra renewal medicated acne treatment maximum strength, 8 Rabavert, 31 Radigel, 11 ramipril, 5 Ranexa, 5 ranitidine hcl, 15 Rapaflo, 17 Rapamune, 4 Rayos, 12 Razadyne, 22 Razadyne Er, 22 Reality Lancets, 35 Reality Trigger Lancets, 36 Reaphirm, 33 Rebetol, 3 Rebif, 22 Rebif Titration Pack, 22 Recombivax Hb, 31 Recothrom, 18 Recothrom Spray Kit, 18 Rectiv, 16 Reglan, 16 Regonol, 22 relacon-dm nr, 28 relagard, 17 Relagesic, 25 relasin dm, 28 relcof pse, 28 Relenza Diskhaler, 2 relera, 28 Relhist, 29 Relion Lancets, 36 Relion Lancets Standard 21g, 36 Relion Lancets Thin 26g, 36 Relion Lancets Ultra-thin30g, 36 Relion Thin Lancets, 36 Relion Ultra Thin Lancets, 36 Relion Ultra Thin Lancets30g, 36 Relion Ultra Thin Plus Lancets 32g, 36 Relion Ultra Thin Plus Lancets 33g, 36 Relistor, 16 Relnate Dha, 33 Relpax, 26 Remeron, 19 Remeron Soltab, 19 remeven, 10 Remodulin, 7 rena-vite rx, 31 Renagel, 16 renal, 31 renalpren, 31 Renatabs, 33 Renatabs With Iron, 33 Renax, 33 Renax 5.5, 33 Renew Advanced Lancing Cartridge Refills, 36 reno caps, 31 Renvela, 16 repan, 24 Reprexain, 25 Req 49+, 33 Requip, 21 Requip Xl, 21

Rescon, 29 Rescon-jr, 29 Rescon-mx, 29 Rescriptor, 2 Reserpine, 6 Respa-a.r., 29 respa-br, 27 resperal-dm, 28 respivent df, 27 respivent df 30, 27 respivent-d, 28 Restasis, 23 Restoril, 20 Retin-a, 8 Retin-a Micro, 8 Retin-a Micro Pump, 8 Retrovir, 3 Revatio, 7 Revlimid, 4 Reyataz, 2 Rezira, 28 Rezyst Im, 15 Rezyst Sb, 15 Rheumatrex, 26 Rhinocort Aqua, 27 rhinoflex, 24 rhinoflex-650, 24 ribapak, 2 ribasphere, 2 ribatab, 2 ribavirin, 2 Ridaura, 26 Rifadin, 2 Rifamate, 2 rifampin, 2 Rifater, 2 Rightest Gl300 Lancets, 36 Rilutek, 22 rimantadine hcl, 2 Rimantalist, 3 rinate pediatric, 28 Rinnovi Nail System, 11 Riomet, 13 Risperdal, 20 Risperdal Consta, 20 Risperdal M-tab, 20 risperidone, 20 Risperidone M-tab, 20 risperidone odt, 20 Ritalin, 20 Ritalin La, 20 Ritalin Sr, 21 rivastigmine tartrate, 21 robafen ac, 28 Robaxin, 22 Robaxin-750, 22 Robinul, 15 Robinul Forte, 15 Rocaltrol, 14 Rocephin, 1 romilar ac, 28 romycin, 22 ropinirole er, 21 ropinirole hcl, 21 rosadan, 8 Rosadan Kit, 8 Rosanil, 8 rosanil cleanser, 8

Rotarix, 31 Rotateq, 31 Rowasa, 16 Roxicet, 25 Roxicodone, 25 Rozerem, 20 ru-hist forte, 28 ru-tuss, 28 Ru-tuss Dm, 29 Rybix Odt, 25 Ryneze, 27 Rythmol, 5 Rythmol Sr, 5 Ryzolt, 25

S
Sabril, 21 Safe-t-lance Low Flow 25g, 36 Safe-t-lance Normal Flow 21g, 36 Safe-t-lance Plus Safety Lancet High Flow, 36 Safe-t-lance Plus Safety Lancet Low Flow, 36 Safe-t-lance Plus Safety Lancet Normal Flow, 36 Safety Lancet 2mm, 36 Safety Lancets, 36 Safety Lancets 21g, 36 Safety Let Lancets, 36 Safety Seal Lancets 28g, 36 Safety Seal Lancets 30g, 36 Saizen, 14 Saizen Click.easy, 14 salacyn, 11 Salagen, 19 Salex, 11 Salex Cream, 11 Salex Lotion, 11 Salicept, 19 salicylic acid, 11 salicylic acid cream, 11 salicylic acid in ammonium lactate vehicle, 11 salicylic acid lotion, 11 salicylic acid wart remover, 11 salkera, 11 salsalate, 24 Salvax, 11 Salvax Duo Plus, 11 Samsca, 14 Sanctura, 16 Sanctura Xr, 16 Sancuso, 15 Sandimmune, 4 Sandostatin, 14 Sandostatin Lar Depot, 14 Saphris, 20 Sarafem, 22 Savella, 22 Savella Titration Pack, 22 Sb Lancets Thin, 36 Sb Lancets Ultra Thin, 36 scalacort, 10 Scalacort Dk, 10 scopolamine hydrobromide, 15 se 10-5 ss, 8 se bpo 3% foaming cloths, 8 se bpo 6% foaming cloths, 8 se bpo 7-5.5 wash kit, 8

se bpo 9% foaming cloths, 8 se bpo wash, 8 se-care, 31 se-care conceive, 31 se-natal 19, 31 se-natal 90, 31 se-natal one, 31 se-plete dha, 31 se-tan dha, 31 se-tan plus, 17 seb-prev, 9 seb-prev wash, 9 Seconal, 20 Sectral, 5 Sedapap, 25 Select-ob, 33 Select-ob+dha, 33 selegiline hcl, 21 selenium sulfide, 9 Selsun Shampoo, 9 Selzentry, 2 Semprex-d, 29 Senetonic, 33 senilezol, 17 senna, 14 senna leaves, 14 senna plus, 14 Senophylline, 30 Sensipar, 14 sensorcaine, 27 sensorcaine-mpf, 27 Sensorcaine-mpf/epinephrine, 27 sensorcaine/epinephrine, 27 Sentradine, 15 Sentraflox Am-10, 19 Sentralopram Am-10, 19 Sentramodafin Am-100, 21 Sentravil Pm-25, 19 Sentrazolam Am 0.25, 19 Sentrazolpidem Pm-5, 20 Sentroxatine, 19 Septra Ds, 3 Seradex, 29 Serevent Diskus, 30 seromycin, 2 Seroquel, 20 Seroquel Xr, 20 Serostim, 14 sertraline hcl, 19 seton et-ec, 31 setonet, 32 Sfrowasa, 16 Shohls Solution Modified, 17 siderol, 32 sildenafil citrate, 7 Silenor, 20 Simcor, 7 Simponi, 26 simuc-gp, 28 simvastatin, 7 Sinemet, 21 Sinemet Cr, 21 Single-let, 36 Singulair, 30 Skelaxin, 22 Skelid, 13 Sklice, 11 Sm Lancets 21g, 36

Sm Micro Thin Lancets 33g, 36 Sm Super Thin Lancets 30g, 36 Sm Thin Lancets 26g, 36 Smart Diabetes Vantage Universal Lancets 30g, 36 Smart Sense Color Lancets Universal 33g, 36 Smart Sense Standard Lancets Universal 21g, 36 Smart Sense Super Thin Lancets Universal 30g, 36 Smart Sense Thin Lancets Universal 26g, 36 Smartest Lancets 28g, 36 sodium bicarbonate, 15 sodium chloride, 28 sodium citrate, 17 sodium hyaluronate, 11 Sodium Sulfacetamide, 8 sodium sulfacetamide, 22 sodium sulfacetamide wash, 9 sodium sulfacetamide/sulfur, 8 sodium sulfacetamide/sulfur cleanser, 8 sodium sulfacetamide/sulfur cleanser in urea, 8 sodium sulfacetamide/sulfur cleansing cloths, 8 sodium sulfacetamide/sulfur green, 8 sodium sulfacetamide/sulfur in urea, 8 sodium sulfacetamide/sulfur wash, 8 sodium sulfacetamide/urea, 9 Solo V2 Twist Lancets, 36 Solodyn, 1 Soltamox, 4 Solu-cortef, 12 Solu-medrol, 12 Soma, 22 Somatuline Depot, 14 Somavert, 14 Somnote, 20 Sonata, 20 Soriatane, 9 Sorilux, 9 sorine, 5 sotalol hcl, 5 sotalol hcl (af), 5 sotret, 8 Spectracef, 1 Spinosad, 11 Spiriva Handihaler, 30 spironolactone, 6 spironolactone/hydrochlorothiazide, 6 Sporanox, 2 Sporanox Pulsepak, 2 Sprix, 26 Sprycel, 4 Sss 10-4, 8 Staflex, 25 stagesic, 25 Stahist, 29 Stalevo 100, 21 Stalevo 125, 21 Stalevo 150, 21 Stalevo 200, 21 Stalevo 50, 21 Stalevo 75, 21 stannous fluoride oral rinse, 18 Starlix, 13

stavudine, 2 Stavzor, 21 Stelara, 9 Sterilance Tl, 36 Stimate, 14 Stivarga, 4 Strattera, 20 Strazepam, 20 streptomycin sulfate, 2 Striant, 12 Stribild, 2 Stromectol, 3 Strovite, 33 Strovite Advance, 33 Strovite Forte, 33 Strovite One, 33 strovite plus, 32 Suboxone, 25 Subsys, 25 Subutex, 25 Sucraid, 16 sucralfate, 15 sudahist, 28 sudatex-dm, 28 Sular, 5 sulfacetamide sodium, 8, 22 sulfacetamide sodium/prednisolone sodium phosphate, 23 sulfacetamide sodium/sulfur cleanser, 8 sulfacleanse 8/4, 8 sulfadiazine, 2 sulfamethoxazole/trimethoprim, 3 Sulfamethoxazole/trimethoprim Ds, 3 sulfasalazine, 16 sulfazine, 16 sulfazine ec, 16 Sulfoam, 8 sulfurated lime, 11 sulindac, 26 Sumadan Kit, 8 Sumadan Wash, 8 Sumatriptan, 26 sumatriptan succinate, 26 Sumatriptan Succinate Refill, 26 Sumavel Dosepro, 26 Sumaxin, 8 Sumaxin Cp Kit, 8 Sumaxin Ts, 8 Sumaxin Wash, 8 Supervite, 33 Supervite Ec, 33 suphera, 8 Support, 33 Support-500, 33 Supprelin La, 13 Suprax, 1 Suprep Bowel Prep, 14 Sure Comfort Lancets 28g, 36 Sure Comfort Lancets 30g, 36 Sure-lance Flat Lancets, 36 Sure-lance Lancets 26g, 36 Sure-lance Thin Lancets 28g, 36 Sure-lance Ultra Thin Lancets, 36 Sure-touch Lancets Universal, 36 Surelite Lancets, 36 Surestep Pro Test Strips, 36 Surestep Test Strips, 36 Surmontil, 19

Survanta Intratracheal, 30 Sustiva, 2 sutan-dm, 28 Sutent, 4 Suttar-2, 29 Suttar-sf, 29 Sylatron, 4 Symax Duotab, 15 symax fastabs, 15 symax-sl, 15 symax-sr, 15 Symbicort, 30 Symbyax, 22 Symlin, 12 Symlinpen 120, 12 Symlinpen 60, 12 Synagex, 33 synalar, 10 Synalar Cream Kit, 10 Synalar Ointment Kit, 10 Synalar Ts, 10 Synalgos-dc, 25 Synarel, 13 Synatek, 33 Synera, 11 Synribo, 4 Synthroid, 14

T
Tabloid, 3 Taclonex, 10 tacrolimus, 4 Talwin, 25 Tambocor, 5 Tamiflu, 2 tamoxifen citrate, 4 tamsulosin hcl, 17 Tandem Dha, 33 tandem f, 17 Tandem Ob, 33 Tandem Plus, 18 tannihist-12 rf, 28 Tapazole, 14 Tarceva, 4 Targretin, 4 Tarka, 6 taron ec calcium, 32 Taron Forte, 18 Taron-bc, 33 Taron-c Dha, 33 taron-crystals, 17 Taron-duo Ec, 33 taron-ec cal, 32 taron-prex, 32 Tasigna, 4 Tasmar, 21 tazicef, 1 Tazorac, 9 taztia xt, 5 Techlite Ast Lancets, 36 Techlite Lancets, 36 Tegretol, 21 Tegretol-xr, 21 Tekamlo, 6 Tekral, 29 Tekturna, 6 Tekturna Hct, 6 temazepam, 20 Temodar, 3

Temovate, 10 Temovate E, 10 tencon, 24 Tenex, 6 Tenivac, 30 Tenoretic 100, 6 Tenoretic 50, 6 Tenormin, 5 Terazol 3, 17 Terazol 7, 17 terazosin hcl, 6 terbinafine hcl, 2 Terbinex, 2 terbutaline sulfate, 29 terconazole, 17 Tersi Foam, 9 Tessalon, 29 Tessalon Perles, 29 Testim, 12 Testopel, 12 testosterone cypionate, 12 testosterone enanthate, 12 testred, 12 tetanus toxoid adsorbed, 30 tetanus/diphtheria toxoids-adsorbed adult, 30 tetcaine, 23 tetracaine hcl, 23, 27 tetracycline hcl, 1 tetravisc, 23 tetravisc forte, 23 Tetrix, 11 Tev-tropin, 14 Teveten, 6 Teveten Hct, 6 Texacort, 10 tgq 15dm/5peh/2cpm, 28 tgq 30pse/150gfn/15dm, 28 tgq 30pse/3brm/15dm, 28 tgq 50pse/3brm/30dm, 28 tgq 7.5peh/4brm/15dm, 28 Tgt Lancet Alternate Site, 36 Tgt Lancet Super Thin 30g, 36 Tgt Lancet Thin 23g, 36 Tgt Lancet Ultra Thin 28g, 36 Thalitone, 7 Thalomid, 4 Theo-24, 30 theochron, 29 theophylline, 29 theophylline cr, 29 theophylline er, 29 Therabenzaprine-60, 22 Therabenzaprine-90, 22 Therabenzaprine-90-5, 22 Theracodeine-300, 25 Theracodophen-325, 25 Theracodophen-650, 25 Theracodophen-750, 25 Theracodophen-low-90, 25 Therafeldamine, 26 Therapentin-60, 21 Therapentin-90, 21 Theraprofen-60, 26 Theraprofen-800, 26 Theraprofen-90, 26 Theraproxen, 26 Theraproxen-500, 26

Theraproxen-60, 26 Theraproxen-90, 26 Theratramadol-60, 25 Theratramadol-90, 25 therobec, 32 thiamine hcl, 31 Thinlets Gp Lancets, 36 Thinlets Lancet, 36 Thiola, 17 thioridazine hcl, 20 thiotepa, 3 thiothixene, 20 Thrombin-jmi Diluent, 18 Thrombin-jmi Epistaxis, 18 Thrombin-jmi Syringe Spray Kit, 18 Thrombin-jmi W/dil Spray Pump Actuator, 18 Thrombogen, 18 Thyrolar-1, 14 Thyrolar-1/2, 14 Thyrolar-1/4, 14 Thyrolar-2, 14 Thyrolar-3, 14 tiagabine hydrochloride, 21 Tiazac, 5 ticlopidine hcl, 18 Tigan, 15 Tikosyn, 5 timolol maleate, 5, 23 Timolol Maleate Ophthalmic Gel Forming, 23 Timoptic, 23 Timoptic Ocudose, 23 Timoptic-xe, 23 Tindamax, 3 tinidazole, 3 Tirosint, 14 Tisseel, 18 Tizanidine Comfort Pac, 22 tizanidine hcl, 22 tl bpo mx cleanser, 8 Tl G-fol Os, 33 tl gard rx, 17 tl icon, 17 tl nicotinamide, 32 tl urea, 11 Tl-assure One, 33 Tl-assure+dha, 33 Tl-cermide, 11 tl-dex dm, 28 Tl-fluorivite, 33 tl-fol 500, 17 tl-hem 150, 17 tl-hist cd, 28 tl-hist cm, 28 Tl-select, 33 Tl-select Dha, 33 Tobi, 2 Tobradex, 23 Tobradex St, 23 tobramycin sulfate, 2, 22 tobramycin/dexamethasone, 23 tobrasol, 22 Tobrex, 22 Todays Health Super Thin Lancets 30g, 36 Todays Health Ultra Thin Lancets 28g, 36

Tofranil, 19 Tofranil-pm, 19 tolazamide, 13 tolbutamide, 13 tolmetin sodium, 26 Tolterodine Tartrate, 16 Topamax, 21 Topamax Sprinkle, 21 topex topical anesthetic, 18 Topicort, 10 topiragen, 21 topiramate, 21 Toprol Xl, 5 torsemide, 6 Toviaz, 16 Tracleer, 7 Tradjenta, 13 tramadol hcl, 25 Tramadol Hcl Er, 25 Tramadol Hydrochloride/acetaminophen, 25 Trandate, 5 trandolapril, 5 Transderm-scop, 15 Tranxene T, 19 tranylcypromine sulfate, 19 Travatan Z, 23 Trazamine, 19 Trazodone, 19 trazodone hcl, 19 Treagan Otic, 24 Trecator, 2 Trelstar Depot, 4 Trelstar Depot Mixject, 4 Trelstar La, 4 Trelstar La Mixject, 4 Trelstar Mixject, 4 Trental, 18 Trepadiclofen-25, 26 Trepoxen-250, 26 Trepoxicam-7.5, 26 Tretin-x, 8 tretinoin, 4 Tretinoin, 8 Trexall, 3 trexbrom, 28 Treximet, 26 trezix, 25 tri rx, 32 Tri-vi-flor, 33 Tri-vi-floro, 33 tri-vit/fluoride, 32 tri-vit/fluoride/iron, 32 tri-vitamin/fluoride, 32 tri-vitamin/iron/fluoride, 32 Tri-zel, 33 triadvance, 32 triamcinolone acetonide, 10, 19, 27 triamcinolone acetonide in absorbase, 10 triamcinolone in orabase, 19 Triamterene/hydrochlorothiazide, 6 trianex, 10 Triaz, 8 Triaz Cleanser, 8 Triaz Foaming Cloths, 8 triazolam, 20 Tribenzor, 6 tricare, 32

Tricare Dha 301, 33 Tricare Prenatal Dha One, 33 tricitrates, 17 tricon, 17 Tricor, 7 triderm, 10 trifluoperazine hcl, 20 Trifluridine, 22 trigels-f forte, 17 Triglide, 7 trihexyphenidyl hcl, 21 Trihibit, 30 Trileptal, 21 Trilipix, 7 trilyte, 14 trimesis rx, 32 trimethobenzamide hcl, 15 Trimethoprim, 3 trimethoprim sulfate/polymyxin b sulfate, 22 trimipramine maleate, 19 Trinatal Gt, 33 trinatal rx 1, 32 Trinatal Ultra, 33 trinate, 32 Trioxin, 24 Tripedia, 30 triphrocaps, 32 triple-vitamin/fluoride, 32 Trispec Dmx, 29 Trispec Dmx Pediatric, 29 Trispec Pse, 29 Trispec Pse Pediatric, 29 Trituss, 29 Triveen-duo Dha, 33 Triveen-one, 33 Triveen-prx Rnf, 33 Triveen-ten, 33 Triveen-u, 33 Trizivir, 2 Tropazone, 11 tropicamide, 23 trospium chloride, 16 trospium chloride er, 16 Trueplus Lancets 28g, 36 Trueplus Lancets 28g Super Thin, 36 Trueplus Lancets 30g, 36 Trueplus Lancets 30g Ultra Thin, 36 Trueplus Lancets 33g, 36 Trueplus Lancets 33g Micro Thin, 36 Trueplus Safety Lancets 28g, 36 Trusopt, 24 trust natal dha, 32 Truvada, 2 Tudorza Pressair, 30 Tusnel Ped-c, 29 tussafed ex, 28 Tussicaps, 28 tussigon, 28 Tussionex Pennkinetic Extended Release, 29 Tusso-c, 29 Tusso-dmr, 29 Tusso-zmr, 29 Twinject, 7 Twinrix, 31 Twynsta, 6 Tykerb, 4

Tylenol/codeine #3, 25 Tylenol/codeine #4, 26 Tylox, 26 Typhim Vi, 31 Tyvaso, 7 Tyvaso Refill, 7 Tyvaso Starter, 7 Tyzeka, 3 Tyzine, 27 Tyzine Pediatric Nasal Drops, 27

U
u-cort, 10 u-kera e, 11 Udamin, 33 Udamin Sp, 33 Ulesfia, 11 Uloric, 27 Ulticare Thin Lancets 30g, 36 Ultilet Basic Lancets 30g, 36 Ultilet Classic Lancets, 36 Ultilet Lancets, 36 Ultilet Safety Lancets 23g, 36 Ultimate Ob Dha, 33 Ultimatecare Advantage, 33 Ultimatecare Combo, 33 ultimatecare one, 32 ultimatecare one nf, 32 ultra tabs, 32 Ultra Thin Lancets 28g, 36 Ultra Thin Lancets 30g, 36 Ultra-thin Ii Auto Lancet, 36 Ultra-thin Ii Lancets 28g, 36 Ultra-thin Ii Lancets 30g, 36 Ultra-thin Ii Lancets/28g X 1/8", 36 Ultra-thin Ii Lancets/30g X 1/8", 36 Ultra-thin Ii Safety Autolancets 26g, 36 Ultracet, 26 Ultram, 26 Ultram Er, 26 Ultravate, 10 Ultravate Pac, 10 Ultravate X, 10 Ultresa, 16 Umecta, 11 umecta mousse, 11 Umecta Nail Film, 11 Umecta Pd, 11 Unasyn, 1 Unasyn Bulk Pack, 1 Unilet Comfortouch Lancet, 36 Unilet Excelite, 36 Unilet Excelite Ii, 36 Unilet G.p. Lancet, 36 Unilet G.p. Superlite Lancet, 36 Unilet Gp 28 Ultra Thin, 36 Unilet Lancet, 36 Unilet Superlite Lancet, 36 Uniretic, 6 Unithroid, 14 unithroid direct, 14 Univasc, 6 Universal 1 Lancets Thin 26g, 36 Universal 1 Lancets Ultra Thin 30g, 36 univert, 15 ur n-c, 16 Uramaxin, 11 Uramaxin Gt, 11 Uramaxin Gt Kit, 11

urea, 11 urea 40% nail film, 11 urea hydrating, 11 urea in zinc undecylenate/lactic acid vehicle, 11 urea nail, 11 urea nail kit, 11 urea topical, 11 urea-c40, 11 Urecholine, 17 Urelle, 16 Uretron D/s, 16 Urex, 16 Uribel, 16 urin d/s, 16 Urocit-k 10, 17 Urocit-k 15, 17 Urocit-k 5, 17 Urogesic-blue, 16 Uroqid #2, 16 urosex, 32 Uroxatral, 17 Urso 250, 16 Urso Forte, 16 ursodiol, 16 uryl, 16 ustell, 16 uta, 16 uticap, 16 utira-c, 16 utrona-c, 16 Uvadex, 4

V
v-c forte, 32 v-cof, 28 v-hist, 28 V-natal, 33 V-natal Dha, 33 Vagifem, 17 valacyclovir hcl, 2 Valcyte, 2 Valium, 19 valproic acid, 21 valsartan/hydrochlorothiazide, 6 Valtrex, 3 Valturna, 6 Value Plus Lancets Standard 21g, 36 Value Plus Lancets Super Thin 30g, 36 Value Plus Lancets Thin 26g, 36 Valumark Lancet Super Thin 30g, 36 Valumark Lancet Ultra Thin 28g, 36 Vancocin Hcl, 3 vancomycin, 3 vancomycin hcl, 3 Vandazole, 17 Vandetanib, 4 Vanos, 10 Vanoxide Hc, 8 Vanoxide-hc, 8 Vantas, 4 Vaqta, 31 Varivax, 31 Vascepa, 7 Vaseretic, 6 vasopressin, 14 Vasotec, 6 Vazobid, 29 Vazol, 27

vazotab, 28 Vazotan, 29 Vectical, 9 Veltin, 8 Vemavite-prx 2, 33 Vena-bal Dha, 33 Venatal Complete Dha, 33 Venatal-fa, 33 venlafaxine hcl, 19 venlafaxine hcl er, 19 Ventavis, 7 Ventolin Hfa, 30 Veramyst, 27 verapamil hcl, 5 verapamil hcl er, 5 Verapamil Hcl Sr, 5 Verdeso, 10 Veregen, 11 Verelan, 5 Verelan Pm, 5 Veripred 20, 12 versiclear, 9 Vesicare, 16 Vexol, 23 Vfend, 2 Vibramycin, 1 vic-forte, 32 Vicodin, 26 Vicodin Es, 26 vicodin hp, 25 Vicoprofen, 26 Victoza, 12 Victrelis, 2 Vida Mia Unilet Lancets Super Thin 30g, 36 Vida Mia Unilet Lancets Ultra Thin 28g, 36 Vidaza, 3 Videx Pediatric, 2 Videx Ec, 3 Vigamox, 22 Viibryd, 19 Vimovo, 26 Vimpat, 21 Vinacal, 33 vinate az, 32 Vinate Az Extra, 33 vinate c, 32 Vinate Calcium, 33 vinate care, 32 Vinate Dha, 33 vinate gt, 32 vinate ic, 32 vinate ii, 32 vinate m, 32 vinate one, 32 vinate pn care, 32 vinate ultra, 32 Viokace, 16 Viracept, 2 Viramune, 3 Viramune Xr, 2 Virasal, 11 Virazole, 3 Viread, 2 Viroptic, 22 Virt-bal Dha, 33 Virt-bal Dha Plus, 33

Virt-pn, 33 Virt-pn Dha, 33 Virt-select, 33 virti-sulf, 8 Visicol, 15 Vistaril, 19 vita s forte, 32 vita-min, 32 Vita-pren, 33 vitacel, 32 Vitafol, 33 vitafol-ob, 32 Vitafol-ob+dha, 33 Vitafol-one, 33 Vitafol-plus, 33 Vitafol-pn, 33 Vitaject, 33 Vital-d Rx, 33 Vitalet Pro Lancets, 36 Vitalet Pro Plus Lancets, 36 Vitamax Pediatric, 33 Vitamedmd One Rx/quatrefolic, 33 Vitamedmd Plus Rx/quatre Folic, 33 Vitamedmd Redichew Rx/quatrefolic, 33 vitamin b-complex 100, 32 vitamin c 222mg, 31 vitamin d, 31 vitamin forte, 32 vitamin k1, 31 vitamins a/c/d/fluoride, 32 Vitaroca Plus, 33 vitaspire, 32 vitazol, 8 Viva Ct Prenatal, 33 Viva Dha, 33 Vivactil, 19 Vivelle-dot, 12 Vivotif Berna, 31 vol-care rx, 32 Vol-nate, 33 Vol-plus, 33 Vol-tab Rx, 33 Voltaren, 9, 24 Voltaren-xr, 26 voriconazole, 2 Vosol, 24 Vosol Hc, 24 Vospire Er, 30 Votrient, 4 Vp-ch-pnv, 33 Vp-era Ob Plus, 33 Vp-ggr-b6 Prenatal, 33 Vp-pnv-dha, 33 vp-zel, 32 Vsl#3 Ds, 15 Vusion, 9 Vytorin, 7 Vyvanse, 20

W
W&f Lancets 26g, 36 W&f Lancets Colored 21g, 36 Walgreens Advanced Travellancets 28g, 36 Walgreens Comfort Assuredlancets Micro Thin/33g, 36 Walgreens Comfort Assuredlancets Super Thin/28g, 36 Walgreens Lancets, 36

Walgreens Thin Lancets, 36 Walgreens Ultra Thin Lancets, 36 warfarin sodium, 18 Welchol, 7 Wellbutrin, 19 Wellbutrin Sr, 19 Wellbutrin Xl, 19 Westcort, 10 Westhroid, 14 wheat germ, 31 witch hazel, 11 Wound Gel, 26

X
x-viate, 11 Xalatan, 23 Xalkori, 4 Xanax, 19 Xanax Xr, 19 Xarelto, 18 xclair, 11 Xeljanz, 26 Xeloda, 3 Xenazine, 22 Xeomin, 22 Xerac Ac, 11 Xerese, 9 Xgeva, 13 Xifaxan, 3 Xodol, 26 Xolair, 30 Xolegel, 9 Xolegel Corepak, 9 Xolegel Duo/head & Shoulders, 9 Xolegel Duo/xolex, 9 Xolox, 26 Xopenex, 30 Xopenex Concentrate, 30 Xopenex Hfa, 30 Xtandi, 4 Xylocaine, 11, 27 Xylocaine Jelly, 11 Xylocaine-mpf, 27 Xylocaine-mpf/epinephrine, 27 Xylocaine/epinephrine, 27 Xyrem, 22 Xyzal, 27

Y
yf-vax, 30 Yodoxin, 3

Z
Z-cof I, 29 z-dex, 28 z-dex 12d, 28 z-pram, 16 z-tuss dm, 28 Zacare 4% Kit, 8 Zacare 8% Kit, 8 zaclir cleansing, 8 Zafirlukast, 29 zaleplon, 20 Zamicet, 26 Zanaflex, 22 Zantac, 15 Zarontin, 21 Zaroxolyn, 7 Zatean-ch, 33 Zatean-pn, 33

Zatean-pn Dha, 33 Zatean-pn Plus, 33 Zavesca, 18 zazole, 17 Zebeta, 5 zebutal, 24 Zegerid, 15 Zelapar, 21 Zelboraf, 4 zema-pak 10 day, 11 zema-pak 13 day, 11 zema-pak 6 day, 11 Zemplar, 14 zencia, 8 Zenieva, 11 Zenpep, 16 Zerit, 3 Zestoretic, 6 Zestril, 6 Zetia, 7 Zetonna, 27 zflex, 24 zgesic, 24 Ziac, 6 Ziagen, 3 Ziana, 8 zidovudine, 2 Zinacef, 1 Zingiber, 33 Zinotic, 24 Zinotic Es, 24 Zioptan, 23 ziprasidone hcl, 20 Zipsor, 26 Zirgan, 22 Zithranol, 9 Zithranol-rr, 9 Zithromax, 1 Zithromax Tri-pak, 1 Zithromax Z-pak, 1 Zmax, 1 Zocor, 7 Zofran, 15 Zofran Odt, 15 Zoladex, 4 Zolinza, 4 Zoloft, 19 zolpidem tartrate, 20 zolpidem tartrate er, 20 Zolpimist, 20 Zolvit, 26 Zomig, 26 Zomig Zmt, 26 Zonalon, 9 Zonatuss, 29 Zonegran, 21 zonisamide, 21 Zorbtive, 14 Zortress, 4 Zostavax, 31 Zotex, 29 Zotex -gp, 29 Zotex Pe, 29 Zotex Pediatric, 29 zotex-12d, 28 Zotex-c, 29 Zotex-d, 29 Zotex-dm, 29

Zotex-ex, 29 Zotex-g, 29 zotex-pe, 28 Zovirax, 3, 9 Zuplenz, 15 Zutripro, 28 Zyclara, 10 Zyclara Pump, 10 Zydone, 26 Zyflo, 30 Zyflo Cr, 30 Zylet, 23 Zyloprim, 27 Zymaxid, 22 Zypram, 16 Zyprexa, 20 Zyprexa Relprevv, 20 Zyprexa Zydis, 20 Zytiga, 4 Zyvox, 3

1
1st Choice Lancets Super Thin, 36 1st Choice Lancets Thin, 36 1st Choice Lancets Ultra Thin, 36 1st Tier Unilet Comfortouch Lancets 28g, 36 1st Tier Unilet Comfortouch Lancets 30g, 36

8
8-mop, 9