2021 california exclusive provider organization (epo

Kaiser Permanente 2021 California Self-Funded Formulary bull of 161

2021 CaliforniaExclusive Provider Organization (EPO) Deductible EPO (DEPO) Commercial (Self-Funded Plans) Formulary (List of Covered Drugs)

PLEASE READ THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER WHEN YOU PARTICIPATE IN A KAISER PERMANENTE EXCLUSIVE PROVIDER ORGANIZATION (EPO) OR DEDUCTIBLE EPO (DEPO) SELF-FUNDED PLAN

This prescription drug formulary was updated on 12012021 and is effective as of December 7 2021 This formulary document is subject to change and may vary depending on your health plan It does not provide information regarding specific coverage including specific exclusions copays or coinsurances That information can be found by referring to your Summary Plan Description or other Plan documents For more recent information about which drug formulary applies to your plan visit kporgformulary or for questions about your prescription benefits contact the Customer Service number on your ID card

What is the Kaiser Permanente California EPODEPO Commercial Self-Funded Formulary The California EPODEPO Commercial Self-Funded Formulary is a list of covered drugs chosen by a group of Kaiser Permanente doctors and pharmacists known as the Pharmacy and Therapeutics Committee The Committee meets regularly to evaluate and select drugs that are safe and effective for our members This Formulary meets the requirements outlined under state law regulations and guidance for commercial plans

What drugs are covered The Kaiser Permanente formulary includes medically necessary brand generic and specialty drugs listed on the California Commercial Formulary providing the prescription is filled at a Kaiser Permanente or an affiliated pharmacy and other plan rules are followed

If you are prescribed a drug on the California Commercial Formulary that drug will be provided under the terms of your drug benefit

Getting an exception to the formulary Drugs not listed on the formulary are called non-formulary drugs When a Kaiser Permanente doctor determines that a non-formulary drug is medically appropriate and necessary that drug will be provided under the terms of your prescription drug benefits If your prescription benefits are not through Kaiser Permanente you will be charged the full retail price for the drug

You may consult with your doctor if an exception to the formulary is needed You and your doctor are best able to determine your medication needs

Kaiser Permanente 2021 California Self-Funded Formulary bull Page 2 of 161

If you wish to have a non-formulary drug that your doctor determines not to be medically necessary you may file an appeal with Customer Service

Are there any restrictions on the drugs covered on the Formulary Some covered drugs may have additional requirements or limits on coverage such as Quantity Limits For certain drugs Kaiser Permanente may limit the amount of the drug dispensed to a certain daysrsquo supply For example when there is a national shortage of a drug we may limit the quantity of the drug dispensed

What is a brand-name drug Brand-name drugs are usually manufactured and sold by the drug company that originally researched and developed the drug When the patent on a brand-name drug expires other drug companies may manufacture and sell an FDA-approved generic version of the drug with the same active ingredient(s) at lower prices

What is a generic drug A generic drug is approved by the FDA as having the same active ingredient as the brand-name drug Generally generic drugs cost less than brand-name drugs

What is a specialty drug Specialty drugs are very high-cost drugs approved by the FDA that are on our formulary used to treat complex chronic conditions such as rheumatoid arthritis multiple sclerosis or cancer

What drugs are eligible to be mailed from the mail order pharmacy Most drugs can be mailed from our mail order pharmacy Some drugs (for example drugs that are extremely high cost or require special handling) may not be eligible for mailing Drugs cannot be mailed outside the United States

You can order refills through our mail-order service online at kporgrefill or by phone or mobile app There is no extra charge for mail order The appropriate cost share (according to your prescription drug benefit) will apply

Your prescription drug benefit may have a lower cost share if you use the mail order pharmacy

Please refer to your Summary Plan Description or other Plan documents for complete details of your prescription drug benefit


Kaiser Permanente California Commercial Formulary Kaiser Permanente may add or remove drugs from the California Commercial Formulary during the year These changes to the Formulary are based on new information or new drugs that become available

How do I use the formulary There are two ways to find your drug within the formulary

Medical condition The formulary begins on page 5 The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat For example drugs used to treat a heart condition are listed under the category ldquoCardiovascular Drugsrdquo If you know what your drug is used for look for the category name in the list that begins on page 5 Then look under the category name for your drug

Alphabetical listing If you are not sure what category to look under you should look for your drug in the index that begins on page 107 The index provides an alphabetical list of all the drugs included in this document Look in the index and find your drug Next to your drug you will see the page number where you can find coverage information Turn to the page listed in the index and find the name of your drug in the first column of the list

The first column of the chart lists the drug name Brand-name drugs are capitalized (eg ALBENZA) and generic drugs are listed in lower-case italics (eg amoxicillin)

All dosage forms and strengths for a particular drug listed may not be on the Formulary Some drugs have multiple dosage forms In such cases some dosages may be on the Formulary and others not Note Some of these drugs may be available only in a clinic setting and your applicable cost share may apply

The second column ldquoDrug Tierrdquo will indicate what tier number the drug is in Drugs on the California EPODEPO Commercial Self-Funded Formulary are categorized

Tier 1 ndash Preferred Generics

Tier 2 ndash Preferred Brands

Tier 3 ndash Non-Preferred (Generics and Brands)

Tier 4 ndash Specialty

Note Your plan may not include benefits for each tier designated Also some drugs are required to be provided at no cost to members Refer to your Summary Plan Description or other Plan documents for information on specific drug coverage for your plan


The third column of the chart will indicate any requirements or limits for that drug

QL = Quantity Limits -For certain drugs we may limit the amount of drug that you can receive Additionally when there is a national shortage of a drug we may limit the quantity of the drug dispensed

LD = Limited-distribution drugs can only be obtained at certain specialty pharmacies To locate a specialty pharmacy contact Customer Service

Please refer to your electronic member guidebook at kporgeguidebook for a listing of KP pharmacies available to you or contact Customer Service


Prescription Drug Name Drug Tier

Coverage RequirementsLimits

ANTI-INFECTIVE AGENTS ANTHELMINTICS ALBENZA TABS 200 MG [albendazole] 2 BILTRICIDE TABS 600 MG [praziquantel] 2 ivermectin tabs 3 mg 1 ANTI-HIV AGENTS abacavir sulfate tabs 300 mg 1 abacavir sulfate-lamivudine tabs 600-300 mg 1 abacavir-lamivudine-zidovudine tabs 300-150-300 mg 1 APTIVUS CAPS 250 MG [tipranavir] 2 BIKTARVY TABS 50-200-25 MG [bictegravir-emtricitabine-tenofovir alafenamide fumarate] 2

CIMDUO TABS 300-300 MG [lamivudine-tenofovir disoproxil fumarate] 1

COMPLERA TABS 200-25-300 MG [emtricitabine-rilpivirine-tenofovir disoproxil fumarate] 2

CRIXIVAN CAPS 200 MG [indinavir sulfate] 2 CRIXIVAN CAPS 400 MG [indinavir sulfate] 2 didanosine cap 125mg 1 DOVATO TABS 50-300 MG [dolutegravir sodium-lamivudine] 2

EDURANT TABS 25 MG [rilpivirine hcl] 2 EMTRIVA SOLN 10 MGML [emtricitabine] 2 FUZEON SOLR 90 MG [enfuvirtide] 2 QL - 30 day(s)MB INTELENCE TABS 100 MG [etravirine] 2 INTELENCE TABS 200 MG [etravirine] 2 INTELENCE TABS 25 MG [etravirine] 2 INVIRASE TABS 500 MG [saquinavir mesylate] 2 ISENTRESS CHEW 100 MG [raltegravir potassium] 2 ISENTRESS CHEW 25 MG [raltegravir potassium] 2 ISENTRESS HD TABS 600 MG [raltegravir potassium] 2 ISENTRESS TABS 400 MG [raltegravir potassium] 2 KALETRA SOLN 400-100 MG5ML [lopinavir-ritonavir] 2 KALETRA TABS 100-25 MG [lopinavir-ritonavir] 2 KALETRA TABS 200-50 MG [lopinavir-ritonavir] 2 lamivudine soln 10 mgml 1 lamivudine tabs 150 mg 1 lamivudine tabs 300 mg 1 lamivudine-zidovudine tabs 150-300 mg 1 LEXIVA TABS 700 MG [fosamprenavir calcium] 2 nevirapine er tb24 400 mg 1 nevirapine susp 50 mg5ml 1 nevirapine tabs 200 mg 1




NORVIR SOLN 80 MGML [ritonavir] 2 PREZISTA TABS 150 MG [darunavir ethanolate] 2 PREZISTA TABS 600 MG [darunavir ethanolate] 2 PREZISTA TABS 75 MG [darunavir ethanolate] 2 PREZISTA TABS 800 MG [darunavir ethanolate] 2 RESCRIPTOR TABS 200 MG [delavirdine mesylate] 2 SELZENTRY TABS 150 MG [maraviroc] 2 SELZENTRY TABS 25 MG [maraviroc] 2 SELZENTRY TABS 300 MG [maraviroc] 2 SELZENTRY TABS 75 MG [maraviroc] 2 stavudine caps 15 mg 1 stavudine caps 20 mg 1 stavudine caps 30 mg 1 stavudine caps 40 mg 1 STRIBILD TABS 150-150-200-300 MG [elvitegravir-cobicistat-emtricitabine-tenofovir df] 2

SYMFI LO TABS 400-300-300 MG [efavirenz-lamivudine-tenofovir disoproxil fumarate] 1

SYMFI TABS 600-300-300 MG [efavirenz-lamivudine-tenofovir disoproxil fumarate] 1

SYMTUZA TABS 800-150-200-10 MG [darunavir-cobicistat-emtricitabine-tenofovir alafenamide] 2

TIVICAY TABS 50 MG [dolutegravir sodium] 2 TRIUMEQ TABS 600-50-300 MG [abacavir-dolutegravir-lamivudine] 2

VIDEX SOLR 2 GM [didanosine] 2 VIDEX SOLR 4 GM [didanosine] 2 VIRACEPT TABS 250 MG [nelfinavir mesylate] 2 VIRACEPT TABS 625 MG [nelfinavir mesylate] 2 VIRAMUNE SUSP 50 MG5ML [nevirapine] 2 ZIAGEN SOLN 20 MGML [abacavir sulfate] 2 zidovudine caps 100 mg 1 zidovudine syrp 50 mg5ml 1 zidovudine tabs 300 mg 1 ANTIBACTERIALS amikacin sulfate soln 500 mg2ml 1 MB amoxicillin caps 250 mg 1 amoxicillin caps 500 mg 1 amoxicillin chew 125 mg 1 amoxicillin chew 250 mg 1 amoxicillin susr 125 mg5ml 1 amoxicillin susr 200 mg5ml 1 amoxicillin susr 250 mg5ml 1 amoxicillin susr 400 mg5ml 1




amoxicillin-pot clavulanate chew 200-285 mg 1 amoxicillin-pot clavulanate chew 400-57 mg 1 amoxicillin-pot clavulanate susr 200-285 mg5ml 1 amoxicillin-pot clavulanate susr 250-625 mg5ml 1 amoxicillin-pot clavulanate susr 400-57 mg5ml 1 amoxicillin-pot clavulanate susr 600-429 mg5ml 1 amoxicillin-pot clavulanate tabs 250-125 mg 1 amoxicillin-pot clavulanate tabs 500-125 mg 1 amoxicillin-pot clavulanate tabs 875-125 mg 1 amp-sulbacta inj 15gm 1 MB ampicillin cap 250mg 1 ampicillin caps 500 mg 1 ampicillin sodium solr 1 gm 1 MB ampicillin sodium solr 10 gm 1 MB ampicillin sodium solr 125 mg 1 MB ampicillin sodium solr 2 gm 1 MB ampicillin sodium solr 250 mg 1 MB ampicillin sodium solr 500 mg 1 MB ampicillin sus 1255ml 1 ampicillin sus 2505ml 1 ampicillin-sulbactam sodium solr 15 (1-05) gm 1 MB ampicillin-sulbactam sodium solr 15 (10-5) gm 1 MB ampicillin-sulbactam sodium solr 3 (2-1) gm 1 MB AUGMENTIN SUSR 125-3125 MG5ML [amoxicillin amp pot clavulanate] 2

AVELOX SOLN 400 MG250ML [moxifloxacin hcl in sodium chloride] 2 MB

AZACTAM IN DEXTROSE SOLN 1 GM50ML [aztreonam-dextrose] 2 MB


azithromycin solr 500 mg 1 MB azithromycin susr 100 mg5ml 1 azithromycin susr 200 mg5ml 1 azithromycin tabs 250 mg 1 azithromycin tabs 500 mg 1 azithromycin tabs 600 mg 1 aztreonam solr 1 gm 1 MB aztreonam solr 2 gm 1 MB BICILLIN L-A SUSP 1200000 UNIT2ML [penicillin g benzathine] 2 MB

BICILLIN L-A SUSP 2400000 UNIT4ML [penicillin g benzathine] 2 MB

BICILLIN L-A SUSP 600000 UNITML [penicillin g 2 MB




benzathine] CAYSTON SOLR 75 MG [aztreonam lysine] 4 QL - 30 day(s)LD cefaclor caps 250 mg 1 cefaclor caps 500 mg 1 cefadroxil caps 500 mg 1 cefazolin sodium solr 1 gm 1 MB cefazolin sodium solr 10 gm 1 MB cefazolin sodium solr 20 gm 1 MB cefazolin sodium solr 500 mg 1 MB CEFAZOLIN SODIUM-DEXTROSE SOLN 1-4 GM50ML- [cefazolin sodium-dextrose] 1 MB

CEFAZOLIN SODIUM-DEXTROSE SOLR 1-4 GM-(50ML) [cefazolin sodium-dextrose] 2 MB

cefdinir susr 125 mg5ml 1 cefdinir susr 250 mg5ml 1 cefepime hcl solr 1 gm 1 MB cefepime hcl solr 2 gm 1 MB CEFEPIME-DEXTROSE SOLR 1-5 GM-(50ML) [cefepime hcl-dextrose] 2 MB

CEFEPIME-DEXTROSE SOLR 2-5 GM-(50ML) [cefepime hcl-dextrose] 2 MB

cefixime caps 400 mg 1 cefotaxime sodium inj 10gm 1 MB cefotaxime sodium solr 1 gm 1 MB cefotaxime sodium solr 500 mg 1 MB cefotetan disodium solr 1 gm 1 MB cefotetan disodium solr 2 gm 1 MB CEFOTETAN DISODIUM-DEXTROSE SOLR 1-358 GM-(50ML) [cefotetan disodium and dextrose] 2 MB

CEFOTETAN DISODIUM-DEXTROSE SOLR 2-208 GM-(50ML) [cefotetan disodium and dextrose] 2 MB

cefoxitin sodium solr 1 gm 1 MB cefoxitin sodium solr 10 gm 1 MB cefoxitin sodium solr 2 gm 1 MB CEFOXITIN SODIUM-DEXTROSE SOLR 1-4 GM-(50ML) [cefoxitin sodium and dextrose] 2 MB

CEFOXITIN SODIUM-DEXTROSE SOLR 2-22 GM-(50ML) [cefoxitin sodium and dextrose] 2 MB

cefpodoxime proxetil susr 100 mg5ml 1 cefpodoxime proxetil susr 50 mg5ml 1 cefpodoxime proxetil tabs 100 mg 1 cefpodoxime proxetil tabs 200 mg 1 ceftazidime solr 6 gm 1 MB CEFTIN SUSR 125 MG5ML [cefuroxime axetil] 2




ceftriaxone sodium in dextrose soln 20 mgml 1 MB ceftriaxone sodium in dextrose soln 40 mgml 1 MB ceftriaxone sodium solr 1 gm 1 MB ceftriaxone sodium solr 10 gm 1 MB ceftriaxone sodium solr 2 gm 1 MB ceftriaxone sodium solr 250 mg 1 MB ceftriaxone sodium solr 500 mg 1 MB CEFTRIAXONE SODIUM-DEXTROSE SOLR 1-374 GM-(50ML) [ceftriaxone sodium and dextrose] 2 MB

CEFTRIAXONE SODIUM-DEXTROSE SOLR 2-222 GM-(50ML) [ceftriaxone sodium and dextrose] 2 MB

cefuroxime axetil tabs 250 mg 1 cefuroxime axetil tabs 500 mg 1 cefuroxime sodium solr 15 gm 1 MB cefuroxime sodium solr 75 gm 1 MB cefuroxime sodium solr 750 mg 1 MB cephalexin caps 250 mg 1 cephalexin caps 500 mg 1 cephalexin susr 125 mg5ml 1 cephalexin susr 250 mg5ml 1 cephalexin tabs 500 mg 2 chloramphenicol sod succinate solr 1 gm 2 MB CIPRO SUSR 250 MG5ML (5) [ciprofloxacin] 2 CIPRO SUSR 500 MG5ML (10) [ciprofloxacin] 2 ciprofloxacin hcl tabs 250 mg 1 ciprofloxacin hcl tabs 500 mg 1 ciprofloxacin hcl tabs 750 mg 1 ciprofloxacin in d5w soln 200 mg100ml 1 MB ciprofloxacin in d5w soln 400 mg200ml 1 MB clarithromycin susr 125 mg5ml 1 clarithromycin susr 250 mg5ml 1 clarithromycin tabs 250 mg 1 clarithromycin tabs 500 mg 1 CLEOCIN IN D5W SOLN 300 MG50ML [clindamycin phosphate in d5w] 2 MB

[Clindamycin Phosphate] CLEOCIN PHOSPHATE SOLN 300 MG2ML 1 MB


[Clindamycin Palmitate Hydrochloride] CLEOCIN SOLR 75 MG5ML 2

clindamycin hcl caps 150 mg 1 clindamycin hcl caps 300 mg 1 clindamycin palmitate hcl solr 75 mg5ml 1




clindamycin phosphate in d5w soln 600 mg50ml 1 MB clindamycin phosphate in d5w soln 900 mg50ml 1 MB clindamycin phosphate soln 300 mg2ml 1 MB CLINDAMYCIN PHOSPHATE SOLN 600 MG4ML [clindamycin phosphate] 1 MB

clindamycin phosphate soln 9000 mg60ml 1 MB CUBICIN SOLR 500 MG [daptomycin] 4 MB demeclocycline hcl tabs 150 mg 1 demeclocycline hcl tabs 300 mg 1 dicloxacillin sodium caps 250 mg 1 dicloxacillin sodium caps 500 mg 1 [Doxycycline Hyclate] DOXY 100 SOLR 100 MG 1 MB doxycycline hyclate caps 100 mg 1 doxycycline hyclate caps 50 mg 1 doxycycline hyclate tabs 100 mg 1 doxycycline hyclate tabs 20 mg 1 doxycycline monohydrate susr 25 mg5ml 1 doxycycline monohydrate tabs 100 mg 1 doxycycline monohydrate tabs 50 mg 1 ERYTHROCIN LACTOBIONATE SOLR 500 MG [erythromycin lactobionate] 2 MB

FIRVANQ SOLR 25 MGML [vancomycin hcl] 2 FIRVANQ SOLR 50 MGML [vancomycin hcl] 2 fluconazole in sodium chloride soln 100-09 mg50ml- 1 MB

FORTAZ SOLR 500 MG [ceftazidime] 2 MB gentamicin in saline soln 08-09 mgml- 1 MB gentamicin in saline soln 1-09 mgml- 1 MB gentamicin in saline soln 12-09 mgml- 1 MB gentamicin in saline soln 16-09 mgml- 1 MB gentamicin in saline soln 2-09 mgml- 2 MB gentamicin sulfate soln 10 mgml 1 MB gentamicin sulfate soln 40 mgml 1 MB INVANZ SOLR 1 GM [ertapenem sodium] 4 MB levofloxacin in d5w soln 250 mg50ml 1 MB levofloxacin in d5w soln 500 mg100ml 1 MB levofloxacin in d5w soln 750 mg150ml 1 MB levofloxacin soln 25 mgml 1 levofloxacin tabs 250 mg 1 levofloxacin tabs 500 mg 1 levofloxacin tabs 750 mg 1 linezolid soln 600 mg300ml 1 MB linezolid susr 100 mg5ml 1 meropenem solr 1 gm 1 MB




meropenem solr 500 mg 1 MB MINOCIN SOLR 100 MG [minocycline hcl] 2 MB minocycline hcl caps 100 mg 1 minocycline hcl caps 50 mg 1 minocycline hcl caps 75 mg 1 moxifloxacin hcl tabs 400 mg 1 NAFCILLIN SODIUM IN DEXTROSE SOLN 1 GM50ML [nafcillin sodium in dextrose] 2 MB

NAFCILLIN SODIUM IN DEXTROSE SOLN 2 GM100ML [nafcillin sodium in dextrose] 2 MB

nafcillin sodium solr 1 gm 1 MB nafcillin sodium solr 10 gm 1 MB nafcillin sodium solr 2 gm 1 MB neomycin sulfate tabs 500 mg 1 OXACILLIN SODIUM IN DEXTROSE SOLN 1 GM50ML [oxacillin sodium in dextrose] 2 MB

OXACILLIN SODIUM IN DEXTROSE SOLN 2 GM50ML [oxacillin sodium in dextrose] 2 MB

oxacillin sodium solr 1 gm 1 MB oxacillin sodium solr 2 gm 1 MB PENICILLIN G POT IN DEXTROSE SOLN 20000 UNITML [penicillin g pot in dextrose] 2 MB

PENICILLIN G POT IN DEXTROSE SOLN 40000 UNITML [penicillin g pot in dextrose] 2 MB


penicillin g potassium solr 20000000 unit 1 MB penicillin g potassium solr 5000000 unit 1 MB penicillin g procaine susp 600000 unitml 2 MB penicillin g sodium solr 5000000 unit 2 MB penicillin v potassium solr 125 mg5ml 1 penicillin v potassium solr 250 mg5ml 1 penicillin v potassium tabs 250 mg 1 penicillin v potassium tabs 500 mg 1 [Penicillin G Potassium] PFIZERPEN SOLR 20000000 UNIT 1 MB

piperacillin sod-tazobactam so solr 225 (2-025) gm 1 MB piperacillin sod-tazobactam so solr 3375 (3-0375) gm 1 MB

piperacillin sod-tazobactam so solr 45 (4-05) gm 1 MB piperacillin sod-tazobactam so solr 405 (36-45) gm 1 MB PRIMAXIN IV SOLR 250-250 MG [imipenem-cilastatin] 2 MB PRIMAXIN IV SOLR 500-500 MG [imipenem-cilastatin] 2 MB PRIMSOL SOLN 50 MG5ML [trimethoprim hcl] 2 streptomycin sulfate solr 1 gm 2 MB




sulfadiazine tabs 500 mg 2 sulfamethoxazole-trimethoprim soln 400-80 mg5ml 1 MB sulfamethoxazole-trimethoprim susp 200-40 mg5ml 1 sulfamethoxazole-trimethoprim tabs 400-80 mg 1 sulfamethoxazole-trimethoprim tabs 800-160 mg 1 sulfasalazine tabs 500 mg 1 sulfasalazine tbec 500 mg 1 [Cefixime] SUPRAX SUSR 100 MG5ML 2 SYNERCID SOLR 150-350 MG [quinupristin-dalfopristin] 4 MB

[Ceftazidime] TAZICEF SOLR 1 GM 1 MB [Ceftazidime] TAZICEF SOLR 2 GM 1 MB TETRACYCLINE HCL CAPS 250 MG [tetracycline hcl] 1 TETRACYCLINE HCL CAPS 500 MG [tetracycline hcl] 1 TOBI PODHALER CAPS 28 MG [tobramycin] 4 tobramycin nebu 300 mg5ml 1 tobramycin sulfate soln 10 mgml 1 MB tobramycin sulfate soln 80 mg2ml 1 MB tobramycin sulfate solr 12 gm 1 MB vancomycin hcl caps 125 mg 1 vancomycin hcl caps 250 mg 1 VANCOMYCIN HCL IN DEXTROSE SOLN 1-5 GM200ML- [vancomycin hcl-dextrose] 2 MB

VANCOMYCIN HCL IN DEXTROSE SOLN 500-5 MG100ML- [vancomycin hcl-dextrose] 2 MB

vancomycin hcl solr 1 gm 1 MB vancomycin hcl solr 10 gm 1 MB vancomycin hcl solr 5 gm 1 MB vancomycin hcl solr 500 mg 1 MB XIFAXAN TABS 550 MG [rifaximin] 2 QL - 30 day(s) ZITHROMAX PACK 1 GM [azithromycin] 2 ZOSYN SOLN 2-025 GM50ML [piperacillin sodium-tazobactam sodium in dextrose] 2 MB

ZOSYN SOLN 3-0375 GM50ML [piperacillin sodium-tazobactam sodium in dextrose] 2 MB

ZYVOX SUSR 100 MG5ML [linezolid] 4 ZYVOX TABS 600 MG [linezolid] 4 ANTIFUNGALS ABELCET SUSP 5 MGML [amphotericin b lipid] 2 MB AMBISOME SUSR 50 MG [amphotericin b liposome] 4 MB amphotericin b solr 50 mg 2 MB CANCIDAS SOLR 50 MG [caspofungin acetate] 4 MB CANCIDAS SOLR 70 MG [caspofungin acetate] 4 MB fluconazole in dextrose inj dex 200 1 MB




fluconazole in nacl inj nacl 200 1 MB fluconazole in nacl inj nacl 400 1 MB fluconazole in sodium chloride soln 200-09 mg100ml- 1 MB

fluconazole in sodium chloride soln 400-09 mg200ml- 1 MB

fluconazole susr 10 mgml 1 fluconazole susr 40 mgml 1 fluconazole tabs 100 mg 1 fluconazole tabs 150 mg 1 fluconazole tabs 200 mg 1 fluconazole tabs 50 mg 1 flucytosine caps 250 mg 1 flucytosine caps 500 mg 1 griseofulvin microsize susp 125 mg5ml 1 griseofulvin microsize tabs 500 mg 1 griseofulvin ultramicrosize tabs 125 mg 1 griseofulvin ultramicrosize tabs 250 mg 1 itraconazole caps 100 mg 1 ketoconazole tabs 200 mg 1 nystatin susp 100000 unitml 1 nystatin tabs 500000 unit 1 SPORANOX SOLN 10 MGML [itraconazole] 2 terbinafine hcl tabs 250 mg 1 VFEND IV SOLR 200 MG [voriconazole] 2 MB voriconazole tabs 200 mg 1 voriconazole tabs 50 mg 1 ANTIHEPATITIS C AGENTS HARVONI TABS 45-200 MG [ledipasvir-sofosbuvir] 4 QL - 30 day(s) HARVONI TABS 90-400 MG [ledipasvir-sofosbuvir] 4 QL - 30 day(s) PEG-INTRON REDIPEN KIT 120 RP [peginterferon alfa-2b] 4 QL - 30 day(s)

PEG-INTRON REDIPEN KIT 150 RP [peginterferon alfa-2b] 4 QL - 30 day(s)

PEGASYS PROCLICK SOAJ 135 MCG05ML [peginterferon alfa-2a] 4 QL - 30 day(s)


PEGASYS SOLN 180 MCGML [peginterferon alfa-2a] 4 QL - 30 day(s) PEGASYS SOSY 180 MCG05ML [peginterferon alfa-2a] 4 QL - 30 day(s)

PEGINTRON KIT 50 MCG05ML [peginterferon alfa-2b] 4 QL - 30 day(s)

ribavirin caps 200 mg 1




SOVALDI PACK 150 MG [sofosbuvir] 4 QL - 30 day(s) SOVALDI PACK 200 MG [sofosbuvir] 4 QL - 30 day(s) SOVALDI TABS 200 MG [sofosbuvir] 4 QL - 30 day(s) SOVALDI TABS 400 MG [sofosbuvir] 4 QL - 30 day(s) ANTIMYCOBACTERIALS CAPASTAT SULFATE SOLR 1 GM [capreomycin sulfate] 2 MB

cycloserine caps 250 mg 1 dapsone tabs 100 mg 1 dapsone tabs 25 mg 1 ethambutol hcl tabs 100 mg 1 ethambutol hcl tabs 400 mg 1 isoniazid soln 100 mgml 2 MB isoniazid syrp 50 mg5ml 2 isoniazid tabs 100 mg 1 isoniazid tabs 300 mg 1 PRETOMANID TABS 200 MG [pretomanid] 2 PRIFTIN TABS 150 MG [rifapentine] 2 pyrazinamide tabs 500 mg 1 rifabutin caps 150 mg 1 [Isoniazid amp Rifampin] RIFAMATE CAPS 150-300 MG 2 rifampin caps 150 mg 1 rifampin caps 300 mg 1 rifampin solr 600 mg 1 MB TRECATOR TABS 250 MG [ethionamide] 2 ANTIPROTOZOALS ALINIA SUSR 100 MG5ML [nitazoxanide] 2 ALINIA TABS 500 MG [nitazoxanide] 2 atovaquone susp 750 mg5ml 1 atovaquone-proguanil hcl tabs 250-100 mg 1 atovaquone-proguanil hcl tabs 625-25 mg 1 chloroquine phosphate tabs 250 mg 1 chloroquine phosphate tabs 500 mg 1 COARTEM TABS 20-120 MG [artemether-lumefantrine] 2

DARAPRIM TABS 25 MG [pyrimethamine] 2 hydroxychloroquine sulfate tabs 200 mg 1 KRINTAFEL TABS 150 MG [tafenoquine succinate] 2 mefloquine hcl tabs 250 mg 1 METRONIDAZOLE IN NACL SOLN 5-079 MGML- [metronidazole in nacl] 1 MB

METRONIDAZOLE IN NACL SOLN 500-074 MG100ML- [metronidazole in nacl] 2 MB

metronidazole tabs 250 mg 1




metronidazole tabs 500 mg 1 NEBUPENT SOLR 300 MG [pentamidine isethionate] 2 paromomycin sulfate caps 250 mg 1 PENTAM SOLR 300 MG [pentamidine isethionate] 2 MB PRIMAQUINE PHOSPHATE TABS 263 (15 Base) MG [primaquine phosphate] 2

ANTIVIRALS acyclovir caps 200 mg 1 acyclovir sodium inj 1000mg 1 MB acyclovir sodium soln 50 mgml 1 MB acyclovir susp 200 mg5ml 1 acyclovir tabs 400 mg 1 acyclovir tabs 800 mg 1 adefovir dipivoxil tabs 10 mg 1 atazanavir sulfate caps 150 mg 1 atazanavir sulfate caps 200 mg 1 atazanavir sulfate caps 300 mg 1 BARACLUDE SOLN 005 MGML [entecavir] 4 cidofovir soln 75 mgml 1 MB DAKLINZA TABS 30 MG [daclatasvir dihydrochloride] 4 DAKLINZA TABS 60 MG [daclatasvir dihydrochloride] 4 DESCOVY TABS 200-25 MG [emtricitabine-tenofovir alafenamide fumarate] 2 PREV

didanosine cpdr 200 mg 1 didanosine cpdr 250 mg 1 didanosine cpdr 400 mg 1 efavirenz caps 200 mg 1 efavirenz caps 50 mg 1 efavirenz tabs 600 mg 1 efavirenz-emtricitab-tenofovir tabs 600-200-300 mg 1 emtricitabine caps 200 mg 1 emtricitabine-tenofovir df tabs 100-150 mg 1 emtricitabine-tenofovir df tabs 133-200 mg 1 emtricitabine-tenofovir df tabs 167-250 mg 1 emtricitabine-tenofovir df tabs 200-300 mg 1 PREV entecavir tabs 05 mg 1 entecavir tabs 1 mg 1 EPCLUSA TABS 200-50 MG [sofosbuvir-velpatasvir] 4 QL - 30 day(s) EPCLUSA TABS 400-100 MG [sofosbuvir-velpatasvir] 4 QL - 30 day(s) EPIVIR HBV SOLN 5 MGML [lamivudine (hbv)] 2 EPIVIR HBV TABS 100 MG [lamivudine (hbv)] 2 EVOTAZ TABS 300-150 MG [atazanavir sulfate-cobicistat] 2

famciclovir tabs 500 mg 1




fosamprenavir calcium tabs 700 mg 1 FOSCAVIR SOLN 6000 MG250ML [foscarnet sodium] 2 MB ganciclovir sodium solr 500 mg 1 MB GENVOYA TABS 150-150-200-10 MG [elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide] 2

JULUCA TABS 50-25 MG [dolutegravir sodium-rilpivirine hcl] 2

lamivudine tabs 100 mg 1 ODEFSEY TABS 200-25-25 MG [emtricitabine-rilpivirine-tenofovir alafenamide fumarate] 2

oseltamivir phosphate caps 30 mg 1 oseltamivir phosphate caps 45 mg 1 oseltamivir phosphate caps 75 mg 1 oseltamivir phosphate susr 6 mgml 1 PREVYMIS SOLN 240 MG12ML [letermovir] 4 QL - 30 day(s)MB PREVYMIS SOLN 480 MG24ML [letermovir] 4 QL - 30 day(s)MB PREVYMIS TABS 240 MG [letermovir] 4 QL - 30 day(s) PREVYMIS TABS 480 MG [letermovir] 4 QL - 30 day(s) PREZCOBIX TABS 800-150 MG [darunavir-cobicistat] 2 RELENZA DISKHALER AEPB 5 MGBLISTER [zanamivir] 2

RETROVIR SOLN 10 MGML [zidovudine] 2 MB rimantadine hcl tabs 100 mg 1 ritonavir tabs 100 mg 1 SYNAGIS SOLN 100 MGML [palivizumab] 4 MB SYNAGIS SOLN 50 MG05ML [palivizumab] 4 MB TAMIFLU CAPS 30 MG [oseltamivir phosphate] 2 TAMIFLU CAPS 45 MG [oseltamivir phosphate] 2 TAMIFLU CAPS 75 MG [oseltamivir phosphate] 2 TAMIFLU SUSR 6 MGML [oseltamivir phosphate] 2 tenofovir disoproxil fumarate tabs 300 mg 1 TIVICAY PD TBSO 5 MG [dolutegravir sodium] 2 TIVICAY TABS 10 MG [dolutegravir sodium] 2 TIVICAY TABS 25 MG [dolutegravir sodium] 2 TRIZIVIR TABS 300-150-300 MG [abacavir sulfate-lamivudine-zidovudine] 2

valacyclovir hcl tabs 1 gm 1 valacyclovir hcl tabs 500 mg 1 VALCYTE SOLR 50 MGML [valganciclovir hcl] 4 QL - 30 day(s) valganciclovir hcl tabs 450 mg 1 VEKLURY SOLN 100 MG20ML [remdesivir] 2 VEKLURY SOLR 100 MG [remdesivir] 2 VIRAZOLE SOLR 6 GM [ribavirin] 4 voriconazole solr 200 mg 1 MB




VOSEVI TABS 400-100-100 MG [sofosbuvir-velpatasvir-voxilaprevir] 4 QL - 30 day(s)

URINARY ANTI-INFECTIVES MACRODANTIN CAPS 25 MG [nitrofurantoin macrocrystal] 2

methenamine hippurate tabs 1 gm 1 NITROFURANTOIN MACROCRYSTAL CAPS 100 MG [nitrofurantoin macrocrystal] 1

NITROFURANTOIN MACROCRYSTAL CAPS 25 MG [nitrofurantoin macrocrystal] 1


nitrofurantoin monohyd macro caps 100 mg 1 nitrofurantoin susp 25 mg5ml 1 trimethoprim tabs 100 mg 1 ANTIHISTAMINE DRUGS FIRST GENERATION ANTIHISTAMINES cyproheptadine hcl syrp 2 mg5ml 1 cyproheptadine hcl tabs 4 mg 1 diphenhydramine hcl soln 50 mgml 1 MB promethazine hcl soln 25 mgml 1 MB promethazine hcl tabs 125 mg 1 promethazine hcl tabs 25 mg 1 [Promethazine Hcl] PROMETHEGAN SUPP 125 MG 1 [Promethazine Hcl] PROMETHEGAN SUPP 25 MG 1 ANTINEOPLASTIC AGENTS ANTINEOPLASTIC AGENTS abiraterone acetate tabs 250 mg 1 QL - 30 day(s)OC ABRAXANE SUSR 100 MG [paclitaxel protein-bound particles] 4 MB

ADCETRIS SOLR 50 MG [brentuximab vedotin] 2 MB AFINITOR TABS 10 MG [everolimus] 4 QL - 30 day(s)OC ALECENSA CAPS 150 MG [alectinib hcl] 4 QL - 30 day(s)OC ALIMTA SOLR 500 MG [pemetrexed disodium] 4 MB ALKERAN TABS 2 MG [melphalan] 2 OC ALUNBRIG TABS 180 MG [brigatinib] 4 QL - 30 day(s)OC ALUNBRIG TABS 30 MG [brigatinib] 4 QL - 30 day(s)OC ALUNBRIG TABS 90 MG [brigatinib] 4 QL - 30 day(s)OC ALUNBRIG TBPK 90 amp 180 MG [brigatinib] 4 QL - 30 day(s)OC anastrozole tabs 1 mg 1 OCPREV ARRANON SOLN 5 MGML [nelarabine] 4 MB AVASTIN SOLN 100 MG4ML [bevacizumab] 4 MB AVASTIN SOLN 400 MG16ML [bevacizumab] 4 MB azacitidine susr 100 mg 1 MB




BENDEKA SOLN 100 MG4ML [bendamustine hcl] 4 QL - 30 day(s)MB bicalutamide tabs 50 mg 1 OC BICNU SOLR 100 MG [carmustine] 2 MB bleomycin sulfate solr 15 unit 1 MB bleomycin sulfate solr 30 unit 1 MB BLINCYTO SOLR 35 MCG [blinatumomab] 4 QL - 30 day(s)MB BRUKINSA CAPS 80 MG [zanubrutinib] 4 QL - 30 day(s) CABOMETYX TABS 20 MG [cabozantinib s-malate] 4 QL - 30 day(s)OC CABOMETYX TABS 40 MG [cabozantinib s-malate] 4 QL - 30 day(s)OC CABOMETYX TABS 60 MG [cabozantinib s-malate] 4 QL - 30 day(s)OC CALQUENCE CAPS 100 MG [acalabrutinib] 4 QL - 30 day(s) CAMPTOSAR SOLN 100 MG5ML [irinotecan hcl] 2 MB CAMPTOSAR SOLN 40 MG2ML [irinotecan hcl] 2 MB capecitabine tabs 150 mg 1 QL - 30 day(s)OC capecitabine tabs 500 mg 1 QL - 30 day(s)OC CAPRELSA TABS 100 MG [vandetanib] 4 QL - 30 day(s)OC CAPRELSA TABS 300 MG [vandetanib] 4 QL - 30 day(s)OC carmustine solr 100 mg 1 MB cisplatin soln 100 mg100ml 1 MB cisplatin soln 50 mg50ml 1 MB cladribine soln 10 mg10ml 1 MB COMETRIQ (100 MG DAILY DOSE) KIT 80 amp 20 MG [cabozantinib s-malate] 4 QL - 30 day(s)LDOC

COMETRIQ (140 MG DAILY DOSE) KIT 3 x 20 MG amp 80 MG [cabozantinib s-malate] 4 QL - 30 day(s)LDOC

COMETRIQ (60 MG DAILY DOSE) KIT 20 MG [cabozantinib s-malate] 4 QL - 30 day(s)LDOC

COPIKTRA CAPS 15 MG [duvelisib] 4 QL - 30 day(s)OC COPIKTRA CAPS 25 MG [duvelisib] 4 QL - 30 day(s)OC COSMEGEN SOLR 05 MG [dactinomycin] 4 MB COTELLIC TABS 20 MG [cobimetinib fumarate] 4 QL - 30 day(s)OC CYCLOPHOSPHAMIDE CAPS 25 MG [cyclophosphamide] 2 OC

CYCLOPHOSPHAMIDE CAPS 50 MG [cyclophosphamide] 1 OC

cyclophosphamide solr 1 gm 1 MB cyclophosphamide solr 2 gm 1 MB cyclophosphamide solr 500 mg 1 MB CYRAMZA SOLN 100 MG10ML [ramucirumab] 4 QL - 30 day(s)MB CYRAMZA SOLN 500 MG50ML [ramucirumab] 4 QL - 30 day(s)MB cytarabine (pf) soln 100 mgml 1 MB cytarabine (pf) soln 20 mgml 1 MB cytarabine soln 20 mgml 1 MB dacarbazine solr 100 mg 2 MB




dacarbazine solr 200 mg 1 MB DACOGEN SOLR 50 MG [decitabine] 2 MB DARZALEX SOLN 100 MG5ML [daratumumab] 4 QL - 30 day(s)MB DARZALEX SOLN 400 MG20ML [daratumumab] 4 QL - 30 day(s)MB daunorubicin hcl soln 20 mg4ml 1 MB docetaxel conc 80 mg4ml 1 MB DOXIL INJ 2 MGML [doxorubicin hcl liposomal] 2 MB doxorubicin hcl liposomal inj 2 mgml 1 MB doxorubicin hcl soln 2 mgml 1 MB doxorubicin hcl solr 10 mg 1 MB doxorubicin hcl solr 50 mg 1 MB EMCYT CAPS 140 MG [estramustine phosphate sodium] 4 QL - 30 day(s)OC

ERBITUX SOLN 100 MG50ML [cetuximab] 4 MB ERBITUX SOLN 200 MG100ML [cetuximab] 4 MB ERIVEDGE CAPS 150 MG [vismodegib] 4 QL - 30 day(s)OC erlotinib hcl tabs 100 mg 1 QL - 30 day(s)OC erlotinib hcl tabs 150 mg 1 QL - 30 day(s)OC erlotinib hcl tabs 25 mg 1 QL - 30 day(s)OC ERWINAZE SOLR 10000 UNIT [asparaginase erwinia chrysanthemi] 2 MB

etoposide caps 50 mg 2 OC everolimus tabs 25 mg 1 QL - 30 day(s)OC everolimus tabs 5 mg 1 QL - 30 day(s)OC everolimus tabs 75 mg 1 QL - 30 day(s)OC exemestane tabs 25 mg 1 OCPREV fludarabine phosphate solr 50 mg 1 MB fluorouracil soln 1 gm20ml 1 MB fluorouracil soln 25 gm50ml 1 MB fluorouracil soln 5 gm100ml 1 MB fluorouracil soln 500 mg10ml 1 MB flutamide caps 125 mg 1 OC fulvestrant soln 250 mg5ml 1 QL - 30 day(s)MB GAZYVA SOLN 1000 MG40ML [obinutuzumab] 4 QL - 30 day(s)MB gemcitabine hcl solr 200 mg 1 MB GEMZAR SOLR 1 GM [gemcitabine hcl] 4 MB GLEOSTINE CAPS 10 MG [lomustine] 2 OC GLEOSTINE CAPS 100 MG [lomustine] 2 OC GLEOSTINE CAPS 40 MG [lomustine] 2 OC GLEOSTINE CAPS 5 MG [lomustine] 2 OC HALAVEN SOLN 1 MG2ML [eribulin mesylate] 4 MB HERCEPTIN SOLR 150 MG [trastuzumab] 4 QL - 30 day(s)MB HYCAMTIN CAPS 025 MG [topotecan hcl] 4 QL - 30 day(s)OC




HYCAMTIN CAPS 1 MG [topotecan hcl] 4 QL - 30 day(s)OC hydroxyurea caps 500 mg 1 OC IBRANCE CAPS 100 MG [palbociclib] 4 QL - 30 day(s)OC IBRANCE CAPS 125 MG [palbociclib] 4 QL - 30 day(s)OC IBRANCE CAPS 75 MG [palbociclib] 4 QL - 30 day(s)OC IBRANCE TABS 100 MG [palbociclib] 4 QL - 30 day(s)OC IBRANCE TABS 125 MG [palbociclib] 4 QL - 30 day(s)OC IBRANCE TABS 75 MG [palbociclib] 2 QL - 30 day(s)OC IDAMYCIN PFS SOLN 10 MG10ML [idarubicin hcl] 2 MB IDAMYCIN PFS SOLN 20 MG20ML [idarubicin hcl] 2 MB idarubicin hcl soln 5 mg5ml 1 MB IFOSFAMIDE SOLR 1 GM [ifosfamide] 1 MB imatinib mesylate tabs 100 mg 1 OC imatinib mesylate tabs 400 mg 1 OC IMBRUVICA CAPS 140 MG [ibrutinib] 4 QL - 30 day(s)OC IMBRUVICA CAPS 70 MG [ibrutinib] 4 QL - 30 day(s)OC IMBRUVICA TABS 140 MG [ibrutinib] 4 QL - 30 day(s)OC IMBRUVICA TABS 280 MG [ibrutinib] 4 QL - 30 day(s)OC IMBRUVICA TABS 420 MG [ibrutinib] 4 QL - 30 day(s)OC IMBRUVICA TABS 560 MG [ibrutinib] 4 QL - 30 day(s)OC INTRON A SOLN 10000000 UNITML [interferon alfa-2b] 4 QL - 30 day(s)MB

INTRON A SOLN 6000000 UNITML [interferon alfa-2b] 4 QL - 30 day(s)MB

INTRON A SOLR 10000000 UNIT [interferon alfa-2b] 4 QL - 30 day(s)MB INTRON A SOLR 18000000 UNIT [interferon alfa-2b] 4 QL - 30 day(s)MB INTRON A SOLR 50000000 UNIT [interferon alfa-2b] 4 QL - 30 day(s)MB IRESSA TABS 250 MG [gefitinib] 4 QL - 30 day(s)OC irinotecan hcl soln 500 mg25ml 1 MB ISTODAX (OVERFILL) SOLR 10 MG [romidepsin] 2 MB IXEMPRA KIT SOLR 15 MG [ixabepilone] 4 QL - 30 day(s)MB IXEMPRA KIT SOLR 45 MG [ixabepilone] 2 QL - 30 day(s)MB JAKAFI TABS 10 MG [ruxolitinib phosphate] 4 QL - 30 day(s)OC JAKAFI TABS 15 MG [ruxolitinib phosphate] 4 QL - 30 day(s)OC JAKAFI TABS 20 MG [ruxolitinib phosphate] 4 QL - 30 day(s)OC JAKAFI TABS 25 MG [ruxolitinib phosphate] 4 QL - 30 day(s)OC JAKAFI TABS 5 MG [ruxolitinib phosphate] 4 QL - 30 day(s)OC JEVTANA SOLN 60 MG15ML [cabazitaxel] 4 MB KADCYLA SOLR 100 MG [ado-trastuzumab emtansine] 4 QL - 30 day(s)MB

KADCYLA SOLR 160 MG [ado-trastuzumab emtansine] 4 QL - 30 day(s)MB

KANJINTI SOLR 420 MG [trastuzumab-anns] 4 MB KEYTRUDA SOLN 100 MG4ML [pembrolizumab] 4 QL - 30 day(s)MB




KYPROLIS SOLR 10 MG [carfilzomib] 4 QL - 30 day(s)MB KYPROLIS SOLR 30 MG [carfilzomib] 4 QL - 30 day(s)MB KYPROLIS SOLR 60 MG [carfilzomib] 4 QL - 30 day(s)MB LENVIMA (10 MG DAILY DOSE) CPPK 10 MG [lenvatinib mesylate] 4 QL - 30 day(s)OC

LENVIMA (12 MG DAILY DOSE) CPPK 3 x 4 MG [lenvatinib mesylate] 2 OC

LENVIMA (14 MG DAILY DOSE) CPPK 10 amp 4 MG [lenvatinib mesylate] 4 QL - 30 day(s)OC

LENVIMA (20 MG DAILY DOSE) CPPK 2 x 10 MG [lenvatinib mesylate] 4 QL - 30 day(s)OC

LENVIMA (24 MG DAILY DOSE) CPPK 2 x 10 MG amp 4 MG [lenvatinib mesylate] 4 QL - 30 day(s)OC

letrozole tabs 25 mg 1 OC LEUKERAN TABS 2 MG [chlorambucil] 2 OC leuprolide acetate kit 1 mg02ml 1 MB LONSURF TABS 15-614 MG [trifluridine-tipiracil] 4 QL - 30 day(s)OC LONSURF TABS 20-819 MG [trifluridine-tipiracil] 4 QL - 30 day(s)OC LORBRENA TABS 100 MG [lorlatinib] 4 QL - 30 day(s)OC LORBRENA TABS 25 MG [lorlatinib] 4 QL - 30 day(s)OC LUPRON DEPOT (1-MONTH) KIT 375 MG [leuprolide acetate] 2 MB

LUPRON DEPOT (1-MONTH) KIT 75 MG [leuprolide acetate] 2 MB

LUPRON DEPOT (3-MONTH) KIT 1125 MG [leuprolide acetate (3 month)] 2 MB




LUPRON DEPOT-PED (1-MONTH) KIT 1125 MG [leuprolide acetate (cpp)] 2 MB



LUPRON DEPOT-PED (3-MONTH) KIT 1125 MG (PED) [leuprolide acetate (cpp) (3 month)] 2 MB


LYNPARZA TABS 100 MG [olaparib] 4 QL - 30 day(s)OC LYNPARZA TABS 150 MG [olaparib] 4 QL - 30 day(s)OC LYSODREN TABS 500 MG [mitotane] 2 QL - 30 day(s)OC MARQIBO SUSP 5 MG31ML [vincristine sulfate 4 QL - 30 day(s)MB




liposome] MATULANE CAPS 50 MG [procarbazine hcl] 4 QL - 30 day(s)OC megestrol acetate susp 40 mgml 1 OC megestrol acetate susp 400 mg10ml 1 OC megestrol acetate tabs 20 mg 1 OC megestrol acetate tabs 40 mg 1 OC MEKINIST TABS 05 MG [trametinib dimethyl sulfoxide] 4 QL - 30 day(s)OC

MEKINIST TABS 2 MG [trametinib dimethyl sulfoxide] 4 QL - 30 day(s)OC melphalan hcl solr 50 mg 1 MB mercaptopurine tabs 50 mg 1 OC methotrexate sodium (pf) soln 50 mg2ml 1 MB METHOTREXATE SODIUM SOLN 50 MG2ML [methotrexate sodium] 1 MB

methotrexate sodium solr 1 gm 1 MB methotrexate tabs 25 mg 1 OC mitomycin solr 20 mg 1 MB mitomycin solr 40 mg 1 MB mitomycin solr 5 mg 1 MB mitoxantrone hcl conc 25 mg125ml 1 MB MUSTARGEN SOLR 10 MG [mechlorethamine hcl] 2 MB MVASI SOLN 100 MG4ML [bevacizumab-awwb] 4 MB MYLERAN TABS 2 MG [busulfan] 4 OC NEXAVAR TABS 200 MG [sorafenib tosylate] 4 QL - 30 day(s)OC NINLARO CAPS 23 MG [ixazomib citrate] 4 QL - 30 day(s)OC NINLARO CAPS 3 MG [ixazomib citrate] 4 QL - 30 day(s)OC NINLARO CAPS 4 MG [ixazomib citrate] 4 QL - 30 day(s)OC ODOMZO CAPS 200 MG [sonidegib phosphate] 4 QL - 30 day(s)OC ONCASPAR SOLN 750 UNITML [pegaspargase] 4 MB OPDIVO SOLN 100 MG10ML [nivolumab] 4 QL - 30 day(s)MB OPDIVO SOLN 40 MG4ML [nivolumab] 4 QL - 30 day(s)MB oxaliplatin soln 100 mg20ml 1 MB oxaliplatin soln 50 mg10ml 1 MB paclitaxel conc 300 mg50ml 1 MB PADCEV SOLR 20 MG [enfortumab vedotin-ejfv] 2 PADCEV SOLR 30 MG [enfortumab vedotin-ejfv] 2 pentostatin inj 10mg 1 MB PERJETA SOLN 420 MG14ML [pertuzumab] 4 QL - 30 day(s)MB POMALYST CAPS 1 MG [pomalidomide] 4 QL - 30 day(s)OC POMALYST CAPS 2 MG [pomalidomide] 4 QL - 30 day(s)OC POMALYST CAPS 3 MG [pomalidomide] 4 QL - 30 day(s)OC POMALYST CAPS 4 MG [pomalidomide] 4 QL - 30 day(s)OC PROLEUKIN SOLR 22000000 UNIT [aldesleukin] 4 QL - 30 day(s)MB




PURIXAN SUSP 2000 MG100ML [mercaptopurine] 4 QL - 30 day(s)OC REVLIMID CAPS 10 MG [lenalidomide] 2 QL - 30 day(s)OC REVLIMID CAPS 15 MG [lenalidomide] 2 QL - 30 day(s)OC REVLIMID CAPS 25 MG [lenalidomide] 2 QL - 30 day(s)OC REVLIMID CAPS 20 MG [lenalidomide] 2 QL - 30 day(s)OC REVLIMID CAPS 25 MG [lenalidomide] 2 QL - 30 day(s)OC REVLIMID CAPS 5 MG [lenalidomide] 2 QL - 30 day(s)OC RITUXAN SOLN 100 MG10ML [rituximab] 2 MB RITUXAN SOLN 500 MG50ML [rituximab] 2 MB romidepsin solr 10 mg 4 MB ROZLYTREK CAPS 100 MG [entrectinib] 4 QL - 30 day(s)OC ROZLYTREK CAPS 200 MG [entrectinib] 4 QL - 30 day(s)OC RYDAPT CAPS 25 MG [midostaurin] 4 QL - 30 day(s)OC SARCLISA SOLN 100 MG5ML [isatuximab-irfc] 4 QL - 30 day(s) SARCLISA SOLN 500 MG25ML [isatuximab-irfc] 4 QL - 30 day(s) SPRYCEL TABS 100 MG [dasatinib] 4 QL - 30 day(s)OC SPRYCEL TABS 140 MG [dasatinib] 4 QL - 30 day(s)OC SPRYCEL TABS 20 MG [dasatinib] 4 QL - 30 day(s)OC SPRYCEL TABS 50 MG [dasatinib] 4 QL - 30 day(s)OC SPRYCEL TABS 70 MG [dasatinib] 4 QL - 30 day(s)OC SPRYCEL TABS 80 MG [dasatinib] 4 QL - 30 day(s)OC STIVARGA TABS 40 MG [regorafenib] 4 QL - 30 day(s)OC SUTENT CAPS 125 MG [sunitinib malate] 4 QL - 30 day(s)OC SUTENT CAPS 25 MG [sunitinib malate] 4 QL - 30 day(s)OC SUTENT CAPS 375 MG [sunitinib malate] 4 QL - 30 day(s)OC SUTENT CAPS 50 MG [sunitinib malate] 4 QL - 30 day(s)OC SYLVANT SOLR 100 MG [siltuximab] 4 QL - 30 day(s)MB SYLVANT SOLR 400 MG [siltuximab] 4 QL - 30 day(s)MB TABLOID TABS 40 MG [thioguanine] 2 OC TAFINLAR CAPS 50 MG [dabrafenib mesylate] 4 QL - 30 day(s)OC TAFINLAR CAPS 75 MG [dabrafenib mesylate] 4 QL - 30 day(s)OC TAGRISSO TABS 40 MG [osimertinib mesylate] 4 QL - 30 day(s)OC TAGRISSO TABS 80 MG [osimertinib mesylate] 4 QL - 30 day(s)OC tamoxifen citrate tabs 10 mg 1 OCPREV tamoxifen citrate tabs 20 mg 1 OCPREV TARGRETIN CAPS 75 MG [bexarotene] 4 OC TASIGNA CAPS 150 MG [nilotinib hcl] 4 QL - 30 day(s)OC TASIGNA CAPS 200 MG [nilotinib hcl] 4 QL - 30 day(s)OC TAXOTERE INJ 80MG2ML [docetaxel] 4 MB TECENTRIQ SOLN 1200 MG20ML [atezolizumab] 4 QL - 30 day(s)MB temozolomide caps 100 mg 1 OC temozolomide caps 140 mg 1 OC temozolomide caps 180 mg 1 OC




temozolomide caps 20 mg 1 OC temozolomide caps 250 mg 1 OC temozolomide caps 5 mg 1 OC TENIPOSIDE SOLN 10 MGML [teniposide] 2 MB thiotepa solr 15 mg 1 MB [Etoposide] TOPOSAR SOLN 100 MG5ML 1 MB topotecan hcl solr 4 mg 1 MB TORISEL SOLN 25 MGML [temsirolimus] 4 MB TREANDA SOLR 100 MG [bendamustine hcl] 4 MB tretinoin caps 10 mg 1 QL - 30 day(s)OC TRISENOX SOLN 12 MG6ML [arsenic trioxide] 4 QL - 30 day(s)MB TUKYSA TABS 150 MG [tucatinib] 4 QL - 30 day(s)OC TUKYSA TABS 50 MG [tucatinib] 4 QL - 30 day(s)OC TYKERB TABS 250 MG [lapatinib ditosylate] 4 QL - 30 day(s)OC UNITUXIN SOLN 175 MG5ML [dinutuximab] 4 QL - 30 day(s)MB VELCADE SOLR 35 MG [bortezomib] 4 MB VENCLEXTA STARTING PACK TBPK 10 amp 50 amp 100 MG [venetoclax] 4 QL - 30 day(s)OC

VENCLEXTA TABS 10 MG [venetoclax] 4 QL - 30 day(s)OC VENCLEXTA TABS 100 MG [venetoclax] 4 QL - 30 day(s)OC VENCLEXTA TABS 50 MG [venetoclax] 4 QL - 30 day(s)OC vinblastine sulfate soln 1 mgml 2 MB vincristine sulfate soln 1 mgml 1 MB vinorelbine tartrate soln 10 mgml 1 MB vinorelbine tartrate soln 50 mg5ml 1 MB VOTRIENT TABS 200 MG [pazopanib hcl] 4 QL - 30 day(s)OC VYXEOS SUSR 44-100 MG [daunorubicin-cytarabine liposome] 4 QL - 30 day(s)MB

XALKORI CAPS 200 MG [crizotinib] 4 QL - 30 day(s)OC XALKORI CAPS 250 MG [crizotinib] 4 QL - 30 day(s)OC XGEVA SOLN 120 MG17ML [denosumab] 4 QL - 30 day(s) XTANDI CAPS 40 MG [enzalutamide] 4 QL - 30 day(s)OC XTANDI TABS 40 MG [enzalutamide] 4 QL - 30 day(s)OC XTANDI TABS 80 MG [enzalutamide] 4 QL - 30 day(s)OC YERVOY SOLN 200 MG40ML [ipilimumab] 4 MB YERVOY SOLN 50 MG10ML [ipilimumab] 4 MB YONDELIS SOLR 1 MG [trabectedin] 4 QL - 30 day(s)MB ZANOSAR SOLR 1 GM [streptozocin] 4 MB ZEJULA CAPS 100 MG [niraparib tosylate] 4 QL - 30 day(s)OC ZELBORAF TABS 240 MG [vemurafenib] 4 QL - 30 day(s)OC ZYDELIG TABS 100 MG [idelalisib] 4 QL - 30 day(s)OC ZYDELIG TABS 150 MG [idelalisib] 4 QL - 30 day(s)OC ZYKADIA CAPS 150 MG [ceritinib] 4 QL - 30 day(s)OC




ZYKADIA TABS 150 MG [ceritinib] 4 QL - 30 day(s)OC ZYTIGA TABS 500 MG [abiraterone acetate] 4 QL - 30 day(s)OC AUTONOMIC DRUGS ANTICHOLINERGIC AGENTS atropine sulfate inj 1mgml 1 MB ATROPINE SULFATE SOLN 04 MGML [atropine sulfate] 2 MB

ATROPINE SULFATE SOLN 8 MG20ML [atropine sulfate] 1 MB

ATROPINE SULFATE SOSY 05 MG5ML [atropine sulfate] 2 MB

ATROVENT HFA AERS 17 MCGACT [ipratropium bromide hfa] 2

BELLADONNA ALKALOIDS-OPIUM SUPP 162-30 MG [belladonna alkaloids amp opium] 2


BENTYL SOLN 10 MGML [dicyclomine hcl] 2 MB CHLORDIAZEPOXIDE-CLIDINIUM CAPS 5-25 MG [chlordiazepoxide hcl-clidinium bromide] 1

CUVPOSA SOLN 1 MG5ML [glycopyrrolate] 2 dicyclomine hcl caps 10 mg 1 dicyclomine hcl soln 10 mg5ml 1 dicyclomine hcl tabs 20 mg 1 DONNATAL ELIX 162 MG5ML [phenobarbital-hyoscyamine-atropine-scopolamine] 2

DONNATAL TABS 162 MG [phenobarbital-hyoscyamine-atropine-scopolamine] 1

glycopyrrolate soln 02 mgml 1 MB glycopyrrolate soln 04 mg2ml 1 MB glycopyrrolate soln 1 mg5ml 1 MB glycopyrrolate soln 4 mg20ml 1 MB glycopyrrolate tabs 1 mg 1 glycopyrrolate tabs 2 mg 1 HYOSCYAMINE SULFATE ER TB12 0375 MG [hyoscyamine sulfate] 1

HYOSCYAMINE SULFATE SUBL 0125 MG [hyoscyamine sulfate] 1

HYOSCYAMINE SULFATE TABS 0125 MG [hyoscyamine sulfate] 1

HYOSCYAMINE SULFATE TBDP 0125 MG [hyoscyamine sulfate] 1

HYOSYNE ELIX 0125 MG5ML [hyoscyamine sulfate] 1 HYOSYNE SOLN 0125 MGML [hyoscyamine sulfate] 1 ipratropium bromide soln 002 1




ipratropium bromide soln 003 1 LEVSIN SOLN 05 MGML [hyoscyamine sulfate] 2 MB propantheline bromide tabs 15 mg 2 SPIRIVA RESPIMAT AERS 25 MCGACT [tiotropium bromide monohydrate] 2

STIOLTO RESPIMAT AERS 25-25 MCGACT [tiotropium bromide-olodaterol hcl] 2

AUTONOMIC DRUGS MISCELLANEOUS CHANTIX CONTINUING MONTH PAK TABS 1 MG [varenicline tartrate] 2 PREV

CHANTIX STARTING MONTH PAK TABS 05 MG X 11 amp 1 MG X 42 [varenicline tartrate] 2 PREV

CHANTIX TABS 05 MG [varenicline tartrate] 2 PREV CHANTIX TABS 1 MG [varenicline tartrate] 2 PREV nicotine polacrilex lozg 4 mg 1 PREV NICORETTE GUM 2 MG [nicotine polacrilex] 2 PREV NICORETTE LOZG 2 MG [nicotine polacrilex] 2 PREV NICORETTE LOZG 4 MG [nicotine polacrilex] 2 PREV NICORETTE MINI LOZG 2 MG [nicotine polacrilex] 2 PREV nicotine polacrilex gum 2 mg 1 PREV nicotine polacrilex gum 4 mg 1 PREV nicotine polacrilex lozg 2 mg 1 PREV nicotine pt24 14 mg24hr 1 PREV nicotine pt24 21 mg24hr 1 PREV nicotine pt24 7 mg24hr 1 PREV PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS bethanechol chloride tabs 10 mg 1 bethanechol chloride tabs 25 mg 1 bethanechol chloride tabs 5 mg 1 bethanechol chloride tabs 50 mg 1 donepezil hcl tabs 10 mg 1 donepezil hcl tabs 5 mg 1 donepezil hcl tbdp 10 mg 1 donepezil hcl tbdp 5 mg 1 [Edrophonium Chloride] ENLON SOLN 10 MGML 2 MB galantamine hydrobromide er cp24 16 mg 1 galantamine hydrobromide er cp24 24 mg 1 GALANTAMINE HYDROBROMIDE ER CP24 8 MG [galantamine hydrobromide] 1

galantamine hydrobromide tabs 12 mg 1 galantamine hydrobromide tabs 4 mg 1 galantamine hydrobromide tabs 8 mg 1 GUANIDINE HCL TABS 125 MG [guanidine hcl] 2 MESTINON SOLN 60 MG5ML [pyridostigmine 2




bromide] MESTINON TBCR 180 MG [pyridostigmine bromide] 2 neostigmine methylsulfate soln 05 mgml 1 MB NEOSTIGMINE METHYLSULFATE SOLN 10 MG10ML [neostigmine methylsulfate] 2 MB

PHYSOSTIGMINE SALICYLATE SOLN 1 MGML [physostigmine salicylate] 2 MB

pilocarpine hcl tabs 5 mg 1 pyridostigmine bromide er tbcr 180 mg 1 pyridostigmine bromide tabs 60 mg 1 REGONOL SOLN 10 MG2ML [pyridostigmine bromide] 2 MB

SKELETAL MUSCLE RELAXANTS atracurium besylate soln 100 mg10ml 1 MB atracurium besylate soln 50 mg5ml 1 MB baclofen tabs 10 mg 1 baclofen tabs 20 mg 1 cisatracurium besylate (pf) soln 10 mg5ml 1 MB cisatracurium besylate (pf) soln 200 mg20ml 1 MB cisatracurium besylate soln 20 mg10ml 1 MB cyclobenzaprine hcl tabs 10 mg 1 cyclobenzaprine hcl tabs 5 mg 1 dantrolene sodium caps 100 mg 1 dantrolene sodium caps 25 mg 1 dantrolene sodium caps 50 mg 1 GABLOFEN SOLN 10000 MCG20ML [baclofen] 2 MB GABLOFEN SOLN 20000 MCG20ML [baclofen] 2 MB GABLOFEN SOLN 40000 MCG20ML [baclofen] 2 MB GABLOFEN SOSY 10000 MCG20ML [baclofen] 2 MB GABLOFEN SOSY 20000 MCG20ML [baclofen] 2 MB GABLOFEN SOSY 40000 MCG20ML [baclofen] 2 MB GABLOFEN SOSY 50 MCGML [baclofen] 2 MB methocarbamol tabs 500 mg 1 methocarbamol tabs 750 mg 1 pancuronium bromide soln 1 mgml 1 MB QUELICIN SOLN 20 MGML [succinylcholine chloride] 2 MB

rocuronium bromide soln 100 mg10ml 1 MB rocuronium bromide soln 50 mg5ml 1 MB RYANODEX SUSR 250 MG [dantrolene sodium] 2 MB tizanidine hcl tabs 2 mg 1 tizanidine hcl tabs 4 mg 1 vecuronium bromide solr 10 mg 1 MB vecuronium bromide solr 20 mg 1 MB




SYMPATHOLYTIC (ADRENERGIC BLOCKING) AGENTS dihydroergotamine mesylate soln 1 mgml 1 MB [Ergotamine Tartrate] ERGOMAR SUBL 2 MG 1 guanfacine hcl tabs 1 mg 1 guanfacine hcl tabs 2 mg 1 MIGRANAL SOLN 4 MGML [dihydroergotamine mesylate] 2

phenoxybenzamine hcl caps 10 mg 1 phentolamine mesylate solr 5 mg 1 MB SYMPATHOMIMETIC (ADRENERGIC) AGENTS albuterol sulfate hfa aers 108 (90 base) mcgact 1 albuterol sulfate nebu (25 mg3ml) 0083 1 albuterol sulfate nebu (5 mgml) 05 1 albuterol sulfate nebu 063 mg3ml 1 albuterol sulfate nebu 125 mg3ml 1 albuterol sulfate nebu 25 mg05ml 1 albuterol sulfate syrp 2 mg5ml 1 albuterol sulfate tabs 2 mg 1 albuterol sulfate tabs 4 mg 1 dobutamine hcl soln 250 mg20ml 1 MB DOBUTAMINE IN D5W SOLN 1-5 MGML- [dobutamine in d5w] 1 MB

DOBUTAMINE IN D5W SOLN 2 MGML [dobutamine in d5w] 1 MB

dopamine hcl inj 80mgml 1 MB dopamine hcl soln 160 mgml 2 MB DOPAMINE HCL SOLN 40 MGML [dopamine hcl] 1 MB dopamine hcl soln 80 mgml 1 MB DOPAMINE IN D5W SOLN 08-5 MGML- [dopamine in d5w] 1 MB

DOPAMINE IN D5W SOLN 16-5 MGML- [dopamine in d5w] 1 MB


EPHEDRINE SULFATE SOLN 50 MGML [ephedrine sulfate (pressors)] 1 MB

epinephrine hcl inj 1mgml 1 MB EPINEPHRINE PF SOLN 1 MGML [epinephrine] 2 epinephrine soaj 015 mg015ml 1 MB EPINEPHRINE SOLN 30 MG30ML [epinephrine] 1 MB EPINEPHRINE SOSY 1 MG10ML [epinephrine] 1 MB EPIPEN 2-PAK SOAJ 03 MG03ML [epinephrine (anaphylaxis)] 2

EPIPEN JR 2-PAK SOAJ 015 MG03ML [epinephrine (anaphylaxis)] 2




ipratropium-albuterol soln 05-25 (3) mg3ml 1 isoproterenol hcl soln 02 mgml 1 MB metaproterenol sulfate syrp 10 mg5ml 2 metaproterenol sulfate tabs 10 mg 2 metaproterenol sulfate tabs 20 mg 2 midodrine hcl tabs 10 mg 1 midodrine hcl tabs 25 mg 1 midodrine hcl tabs 5 mg 1 norepinephrine bitartrate soln 1 mgml 1 MB S2 (RACEPINEPHRINE) NEBU 225 [racepinephrine hcl] 2

SEREVENT DISKUS AEPB 50 MCGDOSE [salmeterol xinafoate] 2

STRIVERDI RESPIMAT AERS 25 MCGACT [olodaterol hcl] 2

terbutaline sulfate inj 1mgml 1 terbutaline sulfate soln 1 mgml 1 MB terbutaline sulfate tabs 25 mg 1 terbutaline sulfate tabs 5 mg 1 VENTOLIN HFA AERS 108 (90 Base) MCGACT [albuterol sulfate] 2

[Fluticasone-salmeterol] WIXELA INHUB AEPB 100-50 MCGDOSE 1



BLOOD DERIVATIVES BLOOD DERIVATIVES ALBUMIN HUMAN SOLN 25 [albumin human] 1 MB ALBURX SOLN 5 [albumin human] 1 MB ALBUTEIN SOLN 25 [albumin human] 1 MB BUMINATE SOLN 5 [albumin human] 2 MB PLASMANATE SOLN 5 [plasma protein fraction] 2 MB BLOOD FORMATION COAGULATION AND THROMBOSIS ANTIANEMIA DRUGS FERREX 150 CAPS 150 MG [polysaccharide iron complex] 1

INFED SOLN 50 MGML [iron dextran] 2 MB PROFERRIN ES TABS 12 MG [iron heme polypeptide] 2

PROFERRIN-FORTE TABS 12-1 MG [iron heme polypeptide-folic acid] 2

VENOFER SOLN 20 MGML [iron sucrose] 2 MB ANTIHEMORRHAGIC AGENTS




ADVATE SOLR 1000 UNIT [antihemophilic factor (rcmb) plasmaalbumin free (rahf-pfm)] 2 QL - 30 day(s)MB




ADVATE SOLR 3000 UNIT [antihemophilic factor (rcmb) plasmaalbumin free (rahf-pfm)] 2 MB



AFSTYLA KIT 1000 UNIT [antihemophilic factor (recombinant) single chain] 2 QL - 30 day(s)MB


AFSTYLA KIT 2000 UNIT [antihemophilic factor (recombinant) single chain] 2 MB





ALPHANATEVWF COMPLEXHUMAN SOLR 1000 UNIT [antihemophilic factorvon willebrand factor complex (human)]

2 MB


2 MB

ALPHANINE SD SOLR 1000 UNIT [coagulation factor ix] 2 QL - 30 day(s)MB



aminocaproic acid soln 250 mgml 1 MB BENEFIX KIT 1000 UNIT [coagulation factor ix (recombinant)] 2 MB

BENEFIX KIT 2000 UNIT [coagulation factor ix (recombinant)] 2 MB







ELOCTATE SOLR 1000 UNIT [antihemophilic factor (rcmb) fc fusion protein(bdd-rfviiifc)] 2 QL - 30 day(s)MB









ELOCTATE SOLR 750 UNIT [antihemophilic factor (rcmb) fc fusion protein(bdd-rfviiifc)] 2 MB

GELFILM FILM [gelatin adsorbable (ophth)] 2 GELFOAM SPONGE MISC 12-7 MM [gelatin absorbable] 2

GELFOAM SPONGE SIZE 100 MISC [gelatin absorbable] 2


HELIXATE FS KIT 250 UNIT [antihemophilic factor (recombinant) (rfviii)] 2 QL - 30 day(s)MB

HEMLIBRA SOLN 105 MG07ML [emicizumab-kxwh] 4 QL - 30 day(s) HEMLIBRA SOLN 150 MGML [emicizumab-kxwh] 4 QL - 30 day(s) HEMLIBRA SOLN 30 MGML [emicizumab-kxwh] 4 QL - 30 day(s) HEMLIBRA SOLN 60 MG04ML [emicizumab-kxwh] 4 QL - 30 day(s) HEMOFIL M INJ 220-400 [antihemophilic factor (human)] 2 QL - 30 day(s)MB

HEMOFIL M SOLR 1000 UNIT [antihemophilic factor (human)] 2 MB



HUMATE-P SOLR 1000-2400 UNIT [antihemophilic factorvon willebrand factor complex (human)] 2 QL - 30 day(s)MB






IDELVION SOLR 1000 UNIT [coagulation factor ix recomb albumin fusion protein (rix-fp)] 2 QL - 30 day(s)MB




KCENTRA KIT 500 UNIT [prothrombin complex concentrate human] 2 MB

KOATE SOLR 1000 UNIT [antihemophilic factor (human)] 2 MB

KOATE-DVI SOLR 250 UNIT [antihemophilic factor (human)] 2 MB


KOGENATE FS KIT 1000 UNIT [antihemophilic factor (recombinant) (rfviii)] 2 QL - 30 day(s)MB



KOVALTRY SOLR 1000 UNIT [antihemophilic factor (rcmb) plasmaalbumin free (rahf-pfm)] 2 QL - 30 day(s)MB





MONONINE SOLR 1000 UNIT [coagulation factor ix] 2 QL - 30 day(s)MB NOVOSEVEN RT SOLR 1 MG [coagulation factor viia (recombinant)] 2 MB

NOVOSEVEN RT SOLR 2 MG [coagulation factor viia (recombinant)] 2 MB



PHENOL LIQD 89 [phenol] 2 QL - 30 day(s) PRAXBIND SOLN 25 GM50ML [idarucizumab] 4 MB




PROFILNINE SOLR 1000 UNIT [factor ix complex] 2 MB PROFILNINE SOLR 1500 UNIT [factor ix complex] 2 MB PROFILNINE SOLR 500 UNIT [factor ix complex] 2 QL - 30 day(s)MB protamine sulfate soln 10 mgml 1 MB RECOMBINATE SOLR 1241-1800 UNIT [antihemophilic factor (recombinant) (rfviii)] 2 QL - 30 day(s)MB

RECOMBINATE SOLR 1801-2400 UNIT [antihemophilic factor (recombinant) (rfviii)] 2 QL - 30 day(s)MB




RECOTHROM SOLR 20000 UNIT [thrombin (recombinant)] 2


RIASTAP SOLR [fibrinogen concentrate (human)] 2 QL - 30 day(s) THROMBIN-JMI KIT 20000 UNIT [thrombin] 2 THROMBIN-JMI SOLR 20000 UNIT [thrombin] 2 THROMBIN-JMI SOLR 5000 UNIT [thrombin] 2 tranexamic acid soln 1000 mg10ml 1 MB tranexamic acid tabs 650 mg 1 WILATE KIT 1000-1000 UNIT [antihemophilic factorvon willebrand factor complex (human)] 2 MB

WILATE KIT 500-500 UNIT [antihemophilic factorvon willebrand factor complex (human)] 2 MB

XYNTHA KIT 1000 UNIT [antihemophilic factor (rcmb) moroctocog alfa(bdd-rfviiimor)] 2 QL - 30 day(s)MB

XYNTHA KIT 2000 UNIT [antihemophilic factor (rcmb) moroctocog alfa(bdd-rfviiimor)] 2 MB



XYNTHA SOLOFUSE KIT 3000 UNIT [antihemophilic factor (rcmb) moroctocog alfa(bdd-rfviiimor)] 2 QL - 30 day(s)MB

ANTITHROMBOTIC AGENTS ACD-A NOCLOT-50 SOLN 073-245-22 GM100ML [anticoagulant citrate dextrose solution a] 2

ACTIVASE SOLR 100 MG [alteplase] 2 MB ACTIVASE SOLR 50 MG [alteplase] 2 MB AGGRENOX CP12 25-200 MG [aspirin-dipyridamole] 2 anagrelide hcl caps 05 mg 1 anagrelide hcl caps 1 mg 1




ANGIOMAX SOLR 250 MG [bivalirudin trifluoroacetate] 2 MB

ARGATROBAN IN SODIUM CHLORIDE SOLN 125-09 MG125ML- [argatroban in sodium chloride] 2 MB

ARGATROBAN SOLN 250 MG25ML [argatroban] 2 MB aspirin-dipyridamole er cp12 25-200 mg 1 BRILINTA TABS 90 MG [ticagrelor] 2 CATHFLO ACTIVASE SOLR 2 MG [alteplase] 2 MB clopidogrel bisulfate tabs 75 mg 1 EFFIENT TABS 10 MG [prasugrel hcl] 2 EFFIENT TABS 5 MG [prasugrel hcl] 2 heparin sodium (porcine) lock flush soln 1 MB HEPARIN (PORCINE) IN NACL SOLN 1000-09 UT500ML- [heparin (porcine) in sodium chloride] 2 MB

HEPARIN (PORCINE) IN NACL SOLN 2000-09 UNITL- [heparin (porcine) in sodium chloride] 2 MB

HEPARIN (PORCINE) IN NACL SOLN 25000-045 UT250ML- [heparin (porcine) in sodium chloride] 2 MB

HEPARIN LOCK FLUSH SOLN 1 UNITML [heparin sodium (porcine) lock flush] 2 MB


HEPARIN SOD (PORCINE) IN D5W SOLN 100 UNITML [heparin sod (porcine) in d5w] 1 MB

HEPARIN SOD (PORCINE) IN D5W SOLN 25000-5 UT500ML- [heparin sod (porcine) in d5w] 1 MB

HEPARIN SOD (PORCINE) IN D5W SOLN 40-5 UNITML- [heparin sod (porcine) in d5w] 1 MB

HEPARIN SODIUM (PORCINE) PF SOLN 5000 UNIT05ML [heparin sodium (porcine)] 1 MB

HEPARIN SODIUM (PORCINE) SOLN 1000 UNITML [heparin sodium (porcine)] 1 MB




HEPARIN SODIUM LOCK FLUSH SOLN 100 UNITML [heparin sodium (porcine) lock flush] 1 MB

INTEGRILIN SOLN 20 MG10ML [eptifibatide] 4 MB INTEGRILIN SOLN 75 MG100ML [eptifibatide] 4 MB LOVENOX SOLN 100 MGML [enoxaparin sodium] 2 QL - 30 day(s) LOVENOX SOLN 120 MG08ML [enoxaparin sodium] 2 QL - 30 day(s) LOVENOX SOLN 150 MGML [enoxaparin sodium] 2 QL - 30 day(s) LOVENOX SOLN 30 MG03ML [enoxaparin sodium] 2 QL - 30 day(s)




LOVENOX SOLN 300 MG3ML [enoxaparin sodium] 2 QL - 30 day(s) LOVENOX SOLN 40 MG04ML [enoxaparin sodium] 2 QL - 30 day(s) LOVENOX SOLN 60 MG06ML [enoxaparin sodium] 2 QL - 30 day(s) LOVENOX SOLN 80 MG08ML [enoxaparin sodium] 2 QL - 30 day(s) PRADAXA CAPS 110 MG [dabigatran etexilate mesylate] 2

PRADAXA CAPS 150 MG [dabigatran etexilate mesylate] 2


THROMBATE III SOLR 500 UNIT [antithrombin iii (human)] 2 MB

TNKASE KIT 50 MG [tenecteplase] 2 MB warfarin sodium tabs 1 mg 1 warfarin sodium tabs 10 mg 1 warfarin sodium tabs 2 mg 1 warfarin sodium tabs 25 mg 1 warfarin sodium tabs 3 mg 1 warfarin sodium tabs 4 mg 1 warfarin sodium tabs 5 mg 1 warfarin sodium tabs 6 mg 1 warfarin sodium tabs 75 mg 1 HEMATOPOIETIC AGENTS ADAKVEO SOLN 100 MG10ML [crizanlizumab-tmca] 4 LEUKINE SOLR 250 MCG [sargramostim] 4 QL - 30 day(s)MB NEUPOGEN SOSY 300 MCG05ML [filgrastim] 4 QL - 30 day(s) NEUPOGEN SOSY 480 MCG08ML [filgrastim] 4 QL - 30 day(s) NIVESTYM SOLN 300 MCGML [filgrastim-aafi] 4 QL - 30 day(s) NIVESTYM SOLN 480 MCG16ML [filgrastim-aafi] 4 QL - 30 day(s) NIVESTYM SOSY 300 MCG05ML [filgrastim-aafi] 2 NIVESTYM SOSY 480 MCG08ML [filgrastim-aafi] 2 PROCRIT SOLN 10000 UNITML [epoetin alfa] 2 QL - 30 day(s)MB PROCRIT SOLN 2000 UNITML [epoetin alfa] 2 QL - 30 day(s)MB PROCRIT SOLN 20000 UNITML [epoetin alfa] 2 QL - 30 day(s)MB PROCRIT SOLN 3000 UNITML [epoetin alfa] 2 QL - 30 day(s)MB PROCRIT SOLN 4000 UNITML [epoetin alfa] 2 QL - 30 day(s)MB PROCRIT SOLN 40000 UNITML [epoetin alfa] 2 QL - 30 day(s)MB PROMACTA PACK 25 MG [eltrombopag olamine] 4 PROMACTA TABS 125 MG [eltrombopag olamine] 4 QL - 30 day(s) PROMACTA TABS 25 MG [eltrombopag olamine] 4 QL - 30 day(s) PROMACTA TABS 50 MG [eltrombopag olamine] 4 QL - 30 day(s) PROMACTA TABS 75 MG [eltrombopag olamine] 4 QL - 30 day(s) ZARXIO SOSY 300 MCG05ML [filgrastim-sndz] 2 QL - 30 day(s)MB ZARXIO SOSY 480 MCG08ML [filgrastim-sndz] 2 QL - 30 day(s)MB




HEMORRHEOLOGIC AGENTS pentoxifylline er tbcr 400 mg 1 CARDIOVASCULAR DRUGS ALPHA-ADRENERGIC BLOCKING AGENTS doxazosin mesylate tabs 1 mg 1 doxazosin mesylate tabs 2 mg 1 doxazosin mesylate tabs 4 mg 1 doxazosin mesylate tabs 8 mg 1 prazosin hcl caps 1 mg 1 prazosin hcl caps 2 mg 1 prazosin hcl caps 5 mg 1 tamsulosin hcl caps 04 mg 1 terazosin hcl caps 1 mg 1 terazosin hcl caps 10 mg 1 terazosin hcl caps 2 mg 1 terazosin hcl caps 5 mg 1 ANTILIPEMIC AGENTS atorvastatin calcium tabs 10 mg 1 PREV atorvastatin calcium tabs 20 mg 1 PREV atorvastatin calcium tabs 40 mg 1 PREV atorvastatin calcium tabs 80 mg 1 PREV cholestyramine light pack 4 gm 1 cholestyramine light powd 4 gmdose 1 cholestyramine pack 4 gm 1 cholestyramine powd 4 gmdose 1 colestipol hcl gran 5 gm 1 colestipol hcl pack 5 gm 1 colestipol hcl tabs 1 gm 1 ezetimibe tabs 10 mg 1 fenofibrate tabs 160 mg 1 fenofibrate tabs 54 mg 1 gemfibrozil tabs 600 mg 1 lovastatin tabs 10 mg 1 PREV lovastatin tabs 20 mg 1 PREV lovastatin tabs 40 mg 1 PREV pravastatin sodium tabs 10 mg 1 PREV pravastatin sodium tabs 20 mg 1 PREV pravastatin sodium tabs 40 mg 1 PREV pravastatin sodium tabs 80 mg 1 PREV rosuvastatin calcium tabs 10 mg 1 PREV rosuvastatin calcium tabs 20 mg 1 PREV rosuvastatin calcium tabs 40 mg 1 PREV rosuvastatin calcium tabs 5 mg 1 PREV




simvastatin tabs 10 mg 1 PREV simvastatin tabs 20 mg 1 PREV simvastatin tabs 40 mg 1 PREV simvastatin tabs 5 mg 1 PREV simvastatin tabs 80 mg 1 PREV BETA-ADRENERGIC BLOCKING AGENTS atenolol tabs 100 mg 1 atenolol tabs 25 mg 1 atenolol tabs 50 mg 1 atenolol-chlorthalidone tabs 100-25 mg 1 atenolol-chlorthalidone tabs 50-25 mg 1 bisoprolol fumarate tabs 10 mg 1 bisoprolol fumarate tabs 5 mg 1 bisoprolol-hydrochlorothiazide tabs 10-625 mg 1 bisoprolol-hydrochlorothiazide tabs 25-625 mg 1 bisoprolol-hydrochlorothiazide tabs 5-625 mg 1 BREVIBLOC IN NACL SOLN 2000 MG100ML [esmolol hcl-sodium chloride] 2 MB

BREVIBLOC IN NACL SOLN 2500 MG250ML [esmolol hcl-sodium chloride] 2 MB

carvedilol tabs 125 mg 1 carvedilol tabs 25 mg 1 carvedilol tabs 3125 mg 1 carvedilol tabs 625 mg 1 ESMOLOL HCL SOLN 100 MG10ML [esmolol hcl] 1 MB labetalol hcl soln 5 mgml 1 MB labetalol hcl tabs 100 mg 1 labetalol hcl tabs 200 mg 1 labetalol hcl tabs 300 mg 1 metoprolol succinate er tb24 100 mg 1 metoprolol succinate er tb24 200 mg 1 metoprolol succinate er tb24 25 mg 1 metoprolol succinate er tb24 50 mg 1 metoprolol tartrate soln 5 mg5ml 1 MB metoprolol tartrate tabs 100 mg 1 metoprolol tartrate tabs 25 mg 1 metoprolol tartrate tabs 50 mg 1 metoprolol-hydrochlorothiazide tabs 100-50 mg 1 nadolol tabs 20 mg 1 nadolol tabs 40 mg 1 nadolol tabs 80 mg 1 propranolol hcl er cp24 120 mg 1 propranolol hcl er cp24 160 mg 1




propranolol hcl er cp24 60 mg 1 propranolol hcl er cp24 80 mg 1 propranolol hcl soln 1 mgml 1 MB propranolol hcl soln 20 mg5ml 1 propranolol hcl tabs 10 mg 1 propranolol hcl tabs 20 mg 1 propranolol hcl tabs 40 mg 1 propranolol hcl tabs 60 mg 1 propranolol hcl tabs 80 mg 1 sotalol hcl (af) tabs 120 mg 1 sotalol hcl (af) tabs 160 mg 1 sotalol hcl (af) tabs 80 mg 1 sotalol hcl tabs 120 mg 1 sotalol hcl tabs 160 mg 1 sotalol hcl tabs 240 mg 1 sotalol hcl tabs 80 mg 1 CALCIUM-CHANNEL BLOCKING AGENTS amlodipine besylate tabs 10 mg 1 amlodipine besylate tabs 25 mg 1 amlodipine besylate tabs 5 mg 1 CARDENE IV SOLN 20-086 MG200ML- [nicardipine hcl in sodium chloride] 2 MB

CARDENE IV SOLN 20-48 MG200ML- [nicardipine hcl in dextrose] 2 MB

CARDENE IV SOLN 40-083 MG200ML- [nicardipine hcl in sodium chloride] 2 MB


[Diltiazem Hcl Coated Beads] CARTIA XT CP24 120 MG 1 [Diltiazem Hcl Coated Beads] CARTIA XT CP24 240 MG 1 [Diltiazem Hcl Coated Beads] CARTIA XT CP24 300 MG 1 CLEVIPREX EMUL 25 MG50ML [clevidipine] 2 MB CLEVIPREX EMUL 50 MG100ML [clevidipine] 2 MB diltiazem hcl er coated beads cp24 180 mg 1 diltiazem hcl er cp12 120 mg 1 diltiazem hcl er cp12 60 mg 1 diltiazem hcl er cp12 90 mg 1 diltiazem hcl er cp24 120 mg 1 diltiazem hcl er cp24 180 mg 1 diltiazem hcl er cp24 240 mg 1 diltiazem hcl soln 125 mg25ml 1 MB diltiazem hcl soln 25 mg5ml 1 MB diltiazem hcl soln 50 mg10ml 1 MB diltiazem hcl tabs 120 mg 1




diltiazem hcl tabs 30 mg 1 diltiazem hcl tabs 60 mg 1 diltiazem hcl tabs 90 mg 1 NICARDIPINE HCL SOLN 25 MGML [nicardipine hcl] 1 MB nifedipine caps 10 mg 1 nifedipine caps 20 mg 1 nifedipine er osmotic release tb24 30 mg 1 nifedipine er osmotic release tb24 60 mg 1 nifedipine er osmotic release tb24 90 mg 1 nifedipine er tb24 30 mg 1 nifedipine er tb24 60 mg 1 nimodipine caps 30 mg 1 verapamil hcl er tbcr 120 mg 1 verapamil hcl er tbcr 180 mg 1 verapamil hcl er tbcr 240 mg 1 verapamil hcl soln 25 mgml 1 MB verapamil hcl tabs 120 mg 1 verapamil hcl tabs 40 mg 1 verapamil hcl tabs 80 mg 1 CARDIAC DRUGS adenosine inj 6mg2ml 1 MB adenosine soln 12 mg4ml 1 MB adenosine soln 6 mg2ml 1 MB amiodarone hcl soln 150 mg3ml 1 MB amiodarone hcl soln 900 mg18ml 1 MB amiodarone hcl tabs 200 mg 1 DIGOXIN SOLN 005 MGML [digoxin] 2 digoxin soln 025 mgml 1 MB digoxin tabs 125 mcg 1 digoxin tabs 250 mcg 1 disopyramide phosphate caps 100 mg 1 disopyramide phosphate caps 150 mg 1 dofetilide caps 125 mcg 1 dofetilide caps 250 mcg 1 dofetilide caps 500 mcg 1 flecainide acetate tabs 100 mg 1 flecainide acetate tabs 150 mg 1 flecainide acetate tabs 50 mg 1 ibutilide fumarate soln 1 mg10ml 1 MB LANOXIN PEDIATRIC SOLN 01 MGML [digoxin] 2 MB lidocaine hcl (cardiac) pf sosy 100 mg5ml 1 MB lidocaine hcl (cardiac) sosy 50 mg5ml 2 MB LIDOCAINE IN D5W SOLN 4-5 MGML- [lidocaine in 1 MB




d5w] LIDOCAINE IN D5W SOLN 8-5 MGML- [lidocaine in d5w] 1 MB

mexiletine hcl caps 150 mg 1 mexiletine hcl caps 200 mg 1 mexiletine hcl caps 250 mg 1 milrinone lactate in dextrose soln 20-5 mg100ml- 1 MB milrinone lactate in dextrose soln 40-5 mg200ml- 1 MB milrinone lactate inj 1mgml 1 MB milrinone lactate soln 10 mg10ml 1 MB NORPACE CR CP12 100 MG [disopyramide phosphate] 2

NORPACE CR CP12 150 MG [disopyramide phosphate] 2

procainamide hcl soln 100 mgml 1 MB procainamide hcl soln 500 mgml 1 MB propafenone hcl tabs 150 mg 1 propafenone hcl tabs 225 mg 1 propafenone hcl tabs 300 mg 1 quinidine gluconate er tbcr 324 mg 1 QUINIDINE GLUCONATE SOLN 80 MGML [quinidine gluconate] 2 MB

quinidine sulfate tabs 200 mg 1 quinidine sulfate tabs 300 mg 1 HYPOTENSIVE AGENTS clonidine hcl tabs 01 mg 1 clonidine hcl tabs 02 mg 1 clonidine hcl tabs 03 mg 1 clonidine ptwk 01 mg24hr 1 clonidine ptwk 02 mg24hr 1 clonidine ptwk 03 mg24hr 1 hydralazine hcl soln 20 mgml 1 MB hydralazine hcl tabs 10 mg 1 hydralazine hcl tabs 100 mg 1 hydralazine hcl tabs 25 mg 1 hydralazine hcl tabs 50 mg 1 methyldopa tabs 250 mg 1 methyldopa tabs 500 mg 1 methyldopate hcl soln 250 mg5ml 2 MB minoxidil tabs 10 mg 1 minoxidil tabs 25 mg 1 nitroprusside sodium soln 25 mgml 1 MB PROGLYCEM SUSP 50 MGML [diazoxide] 4 reserpine tab 01mg 2




reserpine tab 025mg 2 RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITORS benazepril hcl tabs 10 mg 1 benazepril hcl tabs 20 mg 1 benazepril hcl tabs 40 mg 1 benazepril hcl tabs 5 mg 1 captopril tabs 100 mg 1 captopril tabs 125 mg 1 captopril tabs 25 mg 1 captopril tabs 50 mg 1 enalaprilat inj 125 mgml 1 MB ENTRESTO TABS 24-26 MG [sacubitril-valsartan] 2 ENTRESTO TABS 49-51 MG [sacubitril-valsartan] 2 ENTRESTO TABS 97-103 MG [sacubitril-valsartan] 2 lisinopril tabs 10 mg 1 lisinopril tabs 25 mg 1 lisinopril tabs 20 mg 1 lisinopril tabs 30 mg 1 lisinopril tabs 40 mg 1 lisinopril tabs 5 mg 1 lisinopril-hydrochlorothiazide tabs 10-125 mg 1 lisinopril-hydrochlorothiazide tabs 20-125 mg 1 lisinopril-hydrochlorothiazide tabs 20-25 mg 1 losartan potassium tabs 100 mg 1 losartan potassium tabs 25 mg 1 losartan potassium tabs 50 mg 1 losartan potassium-hctz tabs 100-125 mg 1 losartan potassium-hctz tabs 100-25 mg 1 losartan potassium-hctz tabs 50-125 mg 1 ramipril caps 10 mg 1 ramipril caps 25 mg 1 ramipril caps 5 mg 1 spironolactone tabs 100 mg 1 spironolactone tabs 25 mg 1 spironolactone tabs 50 mg 1 spironolactone-hctz tabs 25-25 mg 1 valsartan tabs 160 mg 1 valsartan tabs 320 mg 1 valsartan tabs 40 mg 1 valsartan tabs 80 mg 1 valsartan-hydrochlorothiazide tabs 160-125 mg 1 valsartan-hydrochlorothiazide tabs 160-25 mg 1 valsartan-hydrochlorothiazide tabs 320-125 mg 1




valsartan-hydrochlorothiazide tabs 320-25 mg 1 valsartan-hydrochlorothiazide tabs 80-125 mg 1 SCLEROSING AGENTS ETHAMOLIN INJ 5 [ethanolamine oleate] 2 MB [Sodium Tetradecyl Sulfate] SOTRADECOL SOLN 1 1 MB [Sodium Tetradecyl Sulfate] SOTRADECOL SOLN 3 1 MB VARITHENA FOAM 180 MG18ML [polidocanol (laureth-9)] 2 MB

VASODILATING AGENTS alprostadil soln 500 mcgml 1 MB ambrisentan tabs 10 mg 1 QL - 30 day(s)LD ambrisentan tabs 5 mg 1 QL - 30 day(s)LD CAVERJECT SOLR 20 MCG [alprostadil (vasodilator)] 2 QL - 830 day(s)MB CAVERJECT SOLR 40 MCG [alprostadil (vasodilator)] 2 QL - 830 day(s)MB dipyridamole soln 5 mgml 1 MB dipyridamole tabs 25 mg 1 dipyridamole tabs 50 mg 1 dipyridamole tabs 75 mg 1 EDEX KIT 10 MCG [alprostadil (vasodilator)] 2 QL - 830 day(s)MB EDEX KIT 20 MCG [alprostadil (vasodilator)] 2 QL - 830 day(s)MB EDEX KIT 40 MCG [alprostadil (vasodilator)] 2 QL - 830 day(s)MB isosorbide dinitrate er tbcr 40 mg 2 isosorbide dinitrate tabs 10 mg 1 isosorbide dinitrate tabs 20 mg 1 isosorbide dinitrate tabs 30 mg 1 isosorbide dinitrate tabs 5 mg 1 isosorbide mononitrate er tb24 120 mg 1 isosorbide mononitrate er tb24 30 mg 1 isosorbide mononitrate er tb24 60 mg 1 LETAIRIS TABS 10 MG [ambrisentan] 4 QL - 30 day(s)LD LETAIRIS TABS 5 MG [ambrisentan] 4 QL - 30 day(s)LD [Nitroglycerin] MINITRAN PT24 01 MGHR 1 [Nitroglycerin] MINITRAN PT24 02 MGHR 1 [Nitroglycerin] MINITRAN PT24 06 MGHR 1 [Nitroglycerin] NITRO-BID OINT 2 2 NITRO-DUR PT24 03 MGHR [nitroglycerin] 2 NITRO-DUR PT24 08 MGHR [nitroglycerin] 2 NITROGLYCERIN ER CPCR 25 MG [nitroglycerin] 1 NITROGLYCERIN ER CPCR 65 MG [nitroglycerin] 1 NITROGLYCERIN ER CPCR 9 MG [nitroglycerin] 1 NITROGLYCERIN IN D5W SOLN 100-5 MCGML- [nitroglycerin in d5w] 2 MB

NITROGLYCERIN IN D5W SOLN 200-5 MCGML- 2 MB




[nitroglycerin in d5w] NITROGLYCERIN IN D5W SOLN 400-5 MCGML- [nitroglycerin in d5w] 2 MB

nitroglycerin pt24 04 mghr 1 nitroglycerin soln 5 mgml 2 MB NITROSTAT SUBL 03 MG [nitroglycerin] 2 NITROSTAT SUBL 04 MG [nitroglycerin] 2 NITROSTAT SUBL 06 MG [nitroglycerin] 2 PAPAVERINE HCL SOLN 30 MGML [papaverine hcl] 2 MB REMODULIN SOLN 100 MG20ML [treprostinil] 4 LDMB REMODULIN SOLN 20 MG20ML [treprostinil] 4 LDMB REMODULIN SOLN 200 MG20ML [treprostinil] 4 LDMB REMODULIN SOLN 50 MG20ML [treprostinil] 4 LDMB sildenafil citrate tabs 100 mg 1 QL - 830 day(s) sildenafil citrate tabs 20 mg 1 QL - 830 day(s) sildenafil citrate tabs 50 mg 1 QL - 830 day(s) tadalafil (pah) tabs 20 mg 1 tadalafil tabs 10 mg 1 QL - 830 day(s) tadalafil tabs 25 mg 1 QL - 830 day(s) tadalafil tabs 20 mg 1 tadalafil tabs 5 mg 1 QL - 830 day(s) TRACLEER TABS 125 MG [bosentan] 4 QL - 30 day(s)LD TRACLEER TABS 625 MG [bosentan] 4 QL - 30 day(s)LD treprostinil soln 100 mg20ml 1 LDMB treprostinil soln 20 mg20ml 1 LDMB treprostinil soln 200 mg20ml 1 MB treprostinil soln 50 mg20ml 1 LDMB TYVASO SOLN 06 MGML [treprostinil] 2 QL - 30 day(s)LD VENTAVIS SOLN 10 MCGML [iloprost] 4 QL - 30 day(s)LD VENTAVIS SOLN 20 MCGML [iloprost] 4 QL - 30 day(s)LD CENTRAL NERVOUS SYSTEM AGENTS ANALGESICS AND ANTIPYRETICS acetaminophen-codeine 2 tabs 300-15 mg 1 acetaminophen-codeine 3 tabs 300-30 mg 1 acetaminophen-codeine 4 tabs 300-60 mg 1 acetaminophen-codeine soln 120-12 mg5ml 1 alfentanil hcl soln 1000 mcg2ml 1 MB buprenorphine hcl soln 03 mgml 1 MB buprenorphine hcl-naloxone hcl subl 2-05 mg 1 QL - 30 day(s) buprenorphine hcl-naloxone hcl subl 8-2 mg 1 QL - 30 day(s) butorphanol tartrate soln 1 mgml 1 MB butorphanol tartrate soln 2 mgml 1 MB CHOLINE-MAG TRISALICYLATE LIQD 500 MG5ML 1




[choline amp mag salicylate] CODEINE SULFATE TABS 15 MG [codeine sulfate] 2 CODEINE SULFATE TABS 30 MG [codeine sulfate] 1 CODEINE SULFATE TABS 60 MG [codeine sulfate] 1 DURAMORPH SOLN 05 MGML [morphine sulfate] 1 MB DURAMORPH SOLN 1 MGML [morphine sulfate] 1 MB etodolac caps 200 mg 1 etodolac caps 300 mg 1 etodolac tabs 400 mg 1 etodolac tabs 500 mg 1 fentanyl citrate (pf) soct 100 mcg2ml 1 MB FENTANYL CITRATE (PF) SOLN 100 MCG2ML [fentanyl citrate] 1 MB

FENTANYL CITRATE (PF) SOLN 500 MCG10ML [fentanyl citrate] 2 MB

fentanyl pt72 100 mcghr 1 QL - 30 day(s) fentanyl pt72 12 mcghr 1 QL - 30 day(s) fentanyl pt72 25 mcghr 1 QL - 30 day(s) fentanyl pt72 50 mcghr 1 QL - 30 day(s) fentanyl pt72 75 mcghr 1 QL - 30 day(s) hydrocodone-acetaminophen soln 75-325 mg15ml 1 hydrocodone-acetaminophen tabs 10-325 mg 1 hydrocodone-acetaminophen tabs 5-325 mg 1 hydrocodone-acetaminophen tabs 75-325 mg 1 hydromorphone hcl liqd 1 mgml 1 hydromorphone hcl pf soln 500 mg50ml 1 MB HYDROMORPHONE HCL SOLN 1 MGML [hydromorphone hcl] 1 QL - 30 day(s)MB

HYDROMORPHONE HCL SOLN 2 MGML [hydromorphone hcl] 1 MB


HYDROMORPHONE HCL SUPP 3 MG [hydromorphone hcl] 2

hydromorphone hcl tabs 2 mg 1 hydromorphone hcl tabs 4 mg 1 hydromorphone hcl tabs 8 mg 1 [Ibuprofen] IBU TABS 400 MG 1 [Ibuprofen] IBU TABS 600 MG 1 [Ibuprofen] IBU TABS 800 MG 1 ibuprofen susp 100 mg5ml 1 [Indomethacin] INDOCIN SUPP 50 MG 2 indomethacin caps 25 mg 1 indomethacin caps 50 mg 1




indomethacin er cpcr 75 mg 1 INDOMETHACIN SODIUM SOLR 1 MG [indomethacin sodium] 1 MB

INFUMORPH 200 SOLN 200 MG20ML (10 MGML) [morphine sulfate for continuous microinfusion] 2 MB


ketorolac tromethamine soln 15 mgml 1 MB ketorolac tromethamine soln 30 mgml 1 MB ketorolac tromethamine soln 60 mg2ml 1 MB [Hydrocodone-acetaminophen] LORTAB ELIX 10-300 MG15ML 1

meclofenamate sodium caps 100 mg 2 meclofenamate sodium caps 50 mg 2 mefenamic acid caps 250 mg 1 meloxicam tabs 15 mg 1 meloxicam tabs 75 mg 1 meperidine hcl soln 100 mgml 1 MB meperidine hcl soln 25 mgml 1 MB meperidine hcl soln 50 mgml 1 MB methadone hcl soln 10 mg5ml 2 METHADONE HCL SOLN 10 MGML [methadone hcl] 2 MB methadone hcl soln 5 mg5ml 2 METHADONE HCL TABS 10 MG [methadone hcl] 1 METHADONE HCL TABS 5 MG [methadone hcl] 1 morphine sulfate (concentrate) soln 100 mg5ml 1 morphine sulfate (pf) soln 05 mgml 1 MB morphine sulfate (pf) soln 1 mgml 1 MB MORPHINE SULFATE (PF) SOLN 10 MGML [morphine sulfate] 2 MB

MORPHINE SULFATE (PF) SOLN 2 MGML [morphine sulfate] 2 MB


morphine sulfate er tbcr 100 mg 1 morphine sulfate er tbcr 15 mg 1 morphine sulfate er tbcr 200 mg 1 morphine sulfate er tbcr 30 mg 1 morphine sulfate er tbcr 60 mg 1 MORPHINE SULFATE SOLN 1 MGML [morphine sulfate] 1 MB

MORPHINE SULFATE SOLN 10 MG5ML [morphine sulfate] 1

MORPHINE SULFATE SOLN 10 MGML [morphine sulfate] 2 MB












MORPHINE SULFATE SUPP 10 MG [morphine sulfate] 2



MORPHINE SULFATE SUPP 5 MG [morphine sulfate] 2 MORPHINE SULFATE TABS 15 MG [morphine sulfate] 2

MORPHINE SULFATE TABS 30 MG [morphine sulfate] 2

nabumetone tabs 500 mg 1 nabumetone tabs 750 mg 1 nalbuphine hcl soln 10 mgml 1 MB nalbuphine hcl soln 20 mgml 1 MB naproxen sodium tabs 275 mg 1 naproxen sodium tabs 550 mg 1 naproxen susp 125 mg5ml 1 naproxen tabs 250 mg 1 naproxen tabs 375 mg 1 naproxen tabs 500 mg 1 naproxen tbec 375 mg 1 NEOPROFEN SOLN 10 MGML [ibuprofen lysine] 2 MB OFIRMEV SOLN 10 MGML [acetaminophen] 2 MB oxycodone hcl soln 5 mg5ml 1 oxycodone hcl tabs 5 mg 1 oxycodone-acetaminophen tabs 10-325 mg 1 oxycodone-acetaminophen tabs 5-325 mg 1 oxycodone-acetaminophen tabs 75-325 mg 1




pentazocine-naloxone hcl tabs 50-05 mg 1 SALSALATE TABS 500 MG [salsalate] 1 SALSALATE TABS 750 MG [salsalate] 1 sufentanil citrate soln 50 mcgml 1 MB sulindac tabs 150 mg 1 sulindac tabs 200 mg 1 tramadol hcl tabs 50 mg 1 tramadol-acetaminophen tabs 375-325 mg 1 ULTIVA SOLR 1 MG [remifentanil hcl] 2 MB ULTIVA SOLR 2 MG [remifentanil hcl] 2 MB ULTIVA SOLR 5 MG [remifentanil hcl] 2 MB ANOREXIGENIC AGENTS AND RESPIRATORY AND CEREBRAL STIMULANTS amphetamine-dextroamphet er cp24 10 mg 1 amphetamine-dextroamphet er cp24 15 mg 1 amphetamine-dextroamphet er cp24 20 mg 1 amphetamine-dextroamphet er cp24 25 mg 1 amphetamine-dextroamphet er cp24 30 mg 1 amphetamine-dextroamphet er cp24 5 mg 1 amphetamine-dextroamphetamine tabs 10 mg 1 amphetamine-dextroamphetamine tabs 125 mg 1 amphetamine-dextroamphetamine tabs 15 mg 1 amphetamine-dextroamphetamine tabs 20 mg 1 amphetamine-dextroamphetamine tabs 30 mg 1 amphetamine-dextroamphetamine tabs 5 mg 1 amphetamine-dextroamphetamine tabs 75 mg 1 APTENSIO XR CP24 10 MG [methylphenidate hcl] 2 APTENSIO XR CP24 15 MG [methylphenidate hcl] 2 APTENSIO XR CP24 20 MG [methylphenidate hcl] 2 APTENSIO XR CP24 30 MG [methylphenidate hcl] 2 APTENSIO XR CP24 40 MG [methylphenidate hcl] 2 APTENSIO XR CP24 50 MG [methylphenidate hcl] 2 APTENSIO XR CP24 60 MG [methylphenidate hcl] 2 caffeine citrate soln 60 mg3ml 1 MB dexmethylphenidate hcl er cp24 10 mg 1 dexmethylphenidate hcl er cp24 15 mg 1 dexmethylphenidate hcl er cp24 20 mg 1 dexmethylphenidate hcl er cp24 25 mg 1 dexmethylphenidate hcl er cp24 30 mg 1 dexmethylphenidate hcl er cp24 35 mg 1 dexmethylphenidate hcl er cp24 40 mg 1 dexmethylphenidate hcl er cp24 5 mg 1 dexmethylphenidate hcl tabs 10 mg 1 dexmethylphenidate hcl tabs 25 mg 1




dexmethylphenidate hcl tabs 5 mg 1 dextroamphetamine sulfate er cp24 10 mg 1 dextroamphetamine sulfate er cp24 15 mg 1 dextroamphetamine sulfate er cp24 5 mg 1 dextroamphetamine sulfate tabs 10 mg 1 dextroamphetamine sulfate tabs 5 mg 1 methylphenidate hcl er (cd) cpcr 10 mg 1 methylphenidate hcl er (cd) cpcr 20 mg 1 methylphenidate hcl er (cd) cpcr 30 mg 1 methylphenidate hcl er (cd) cpcr 40 mg 1 methylphenidate hcl er (cd) cpcr 50 mg 1 methylphenidate hcl er (cd) cpcr 60 mg 1 methylphenidate hcl er tbcr 10 mg 1 methylphenidate hcl er tbcr 18 mg 1 methylphenidate hcl er tbcr 20 mg 1 methylphenidate hcl er tbcr 27 mg 1 methylphenidate hcl er tbcr 36 mg 1 methylphenidate hcl er tbcr 54 mg 1 methylphenidate hcl tabs 10 mg 1 methylphenidate hcl tabs 20 mg 1 methylphenidate hcl tabs 5 mg 1 modafinil tabs 100 mg 1 modafinil tabs 200 mg 1 VYVANSE CAPS 10 MG [lisdexamfetamine dimesylate] 2

VYVANSE CAPS 20 MG [lisdexamfetamine dimesylate] 2






ANTICONVULSANTS BANZEL SUSP 40 MGML [rufinamide] 4 BANZEL TABS 200 MG [rufinamide] 4 BANZEL TABS 400 MG [rufinamide] 4 BRIVIACT TABS 10 MG [brivaracetam] 4 BRIVIACT TABS 100 MG [brivaracetam] 4 BRIVIACT TABS 25 MG [brivaracetam] 4




BRIVIACT TABS 50 MG [brivaracetam] 4 BRIVIACT TABS 75 MG [brivaracetam] 4 carbamazepine chew 100 mg 1 carbamazepine er cp12 100 mg 1 carbamazepine er cp12 200 mg 1 carbamazepine er cp12 300 mg 1 carbamazepine er tb12 100 mg 1 carbamazepine er tb12 200 mg 1 carbamazepine er tb12 400 mg 1 carbamazepine susp 100 mg5ml 1 carbamazepine tabs 200 mg 1 CELONTIN CAPS 300 MG [methsuximide] 2 clonazepam tabs 05 mg 1 clonazepam tabs 1 mg 1 clonazepam tabs 2 mg 1 [Phenytoin Sodium Extended] DILANTIN CAPS 30 MG 2 [Phenytoin] DILANTIN INFATABS CHEW 50 MG 1 divalproex sodium csdr 125 mg 1 divalproex sodium er tb24 250 mg 1 divalproex sodium er tb24 500 mg 1 divalproex sodium tbec 125 mg 1 divalproex sodium tbec 250 mg 1 divalproex sodium tbec 500 mg 1 EQUETRO CP12 200 MG [carbamazepine (mood)] 2 ethosuximide caps 250 mg 1 ethosuximide soln 250 mg5ml 1 felbamate susp 600 mg5ml 1 felbamate tabs 400 mg 1 felbamate tabs 600 mg 1 fosphenytoin sodium soln 100 mg pe2ml 1 MB fosphenytoin sodium soln 500 mg pe10ml 1 MB gabapentin caps 100 mg 1 gabapentin caps 300 mg 1 gabapentin caps 400 mg 1 gabapentin soln 250 mg5ml 1 gabapentin tabs 600 mg 1 gabapentin tabs 800 mg 1 LAMICTAL STARTER KIT 35 x 25 MG [lamotrigine] 2 LAMICTAL STARTER KIT 42 x 25 MG amp 7 X 100 MG [lamotrigine] 2

LAMICTAL STARTER KIT 84 x 25 MG amp 14X100 MG [lamotrigine] 2

lamotrigine chew 25 mg 1




lamotrigine chew 5 mg 1 lamotrigine tabs 100 mg 1 lamotrigine tabs 150 mg 1 lamotrigine tabs 200 mg 1 lamotrigine tabs 25 mg 1 levetiracetam er tb24 500 mg 1 levetiracetam er tb24 750 mg 1 LEVETIRACETAM IN NACL SOLN 1000 MG100ML [levetiracetam in sodium chloride] 2 MB

LEVETIRACETAM IN NACL SOLN 1500 MG100ML [levetiracetam in sodium chloride] 2 MB


levetiracetam soln 100 mgml 1 levetiracetam soln 500 mg5ml 1 MB levetiracetam tabs 1000 mg 1 levetiracetam tabs 250 mg 1 levetiracetam tabs 500 mg 1 levetiracetam tabs 750 mg 1 MAGNESIUM SULFATE SOLN 20 GM500ML [magnesium sulfate] 2 MB

MAGNESIUM SULFATE SOLN 4 GM100ML [magnesium sulfate] 2 MB



magnesium sulfate soln 50 1 MB oxcarbazepine susp 300 mg5ml 1 oxcarbazepine tabs 150 mg 1 oxcarbazepine tabs 300 mg 1 oxcarbazepine tabs 600 mg 1 [Phenytoin] PHENYTOIN INFATABS CHEW 50 MG 1 phenytoin sodium extended caps 100 mg 1 phenytoin sodium soln 50 mgml 1 MB phenytoin susp 125 mg5ml 1 pregabalin caps 100 mg 1 pregabalin caps 150 mg 1 pregabalin caps 200 mg 1 pregabalin caps 225 mg 1 pregabalin caps 25 mg 1 pregabalin caps 300 mg 1 pregabalin caps 50 mg 1 pregabalin caps 75 mg 1




pregabalin soln 20 mgml 1 primidone tab 50mg 1 primidone tabs 250 mg 1 SABRIL PACK 500 MG [vigabatrin] 4 QL - 30 day(s)LD topiramate cpsp 15 mg 1 topiramate cpsp 25 mg 1 topiramate tabs 100 mg 1 topiramate tabs 200 mg 1 topiramate tabs 25 mg 1 topiramate tabs 50 mg 1 valproate sodium soln 500 mg5ml 1 MB valproic acid caps 250 mg 1 valproic acid soln 250 mg5ml 1 [Ethosuximide] ZARONTIN SOLN 250 MG5ML 1 zonisamide caps 100 mg 1 zonisamide caps 25 mg 1 zonisamide caps 50 mg 1 ANTIMANIC AGENTS lithium carbonate caps 150 mg 1 LITHIUM CARBONATE CAPS 300 MG [lithium carbonate] 1

lithium carbonate caps 600 mg 1 lithium carbonate er tbcr 300 mg 1 lithium carbonate er tbcr 450 mg 1 LITHIUM CARBONATE TABS 300 MG [lithium carbonate] 1

LITHIUM SOLN 8 MEQ5ML [lithium] 2 ANTIMIGRAINE AGENTS [Ergotamine W Caffeine] CAFERGOT TABS 1-100 MG 2 eletriptan hydrobromide tabs 20 mg 1 eletriptan hydrobromide tabs 40 mg 1 ergoloid mesylates tabs 1 mg 1 ergotamine-caffeine tabs 1-100 mg 1 ISOMETHEPTENE-DICHLORAL-APAP CAPS 65-100-325 MG [isometheptene-dichloralphenazone-acetaminophen]

1

[Ergotamine W Caffeine] MIGERGOT SUPP 2-100 MG 2 naratriptan hcl tabs 1 mg 1 naratriptan hcl tabs 25 mg 1 rizatriptan benzoate tabs 10 mg 1 rizatriptan benzoate tabs 5 mg 1 rizatriptan benzoate tbdp 10 mg 1 rizatriptan benzoate tbdp 5 mg 1 sumatriptan soln 20 mgact 1




sumatriptan succinate refill soct 6 mg05ml 1 sumatriptan succinate soaj 6 mg05ml 1 sumatriptan succinate soln 6 mg05ml 1 sumatriptan succinate sosy 6 mg05ml 1 sumatriptan succinate tabs 100 mg 1 sumatriptan succinate tabs 25 mg 1 sumatriptan succinate tabs 50 mg 1 ANTIPARKINSONIAN AGENTS amantadine hcl caps 100 mg 1 amantadine hcl soln 50 mg5ml 1 APOKYN SOCT 30 MG3ML [apomorphine hydrochloride] 4 QL - 30 day(s)

benztropine mesylate soln 1 mgml 1 MB benztropine mesylate tabs 05 mg 1 benztropine mesylate tabs 1 mg 1 benztropine mesylate tabs 2 mg 1 bromocriptine mesylate caps 5 mg 1 bromocriptine mesylate tabs 25 mg 1 cabergoline tabs 05 mg 1 carbidopa tabs 25 mg 1 carbidopa-levodopa er tbcr 25-100 mg 1 carbidopa-levodopa er tbcr 50-200 mg 1 carbidopa-levodopa tabs 10-100 mg 1 carbidopa-levodopa tabs 25-100 mg 1 carbidopa-levodopa tabs 25-250 mg 1 carbidopa-levodopa-entacapone tabs 125-50-200 mg 1 carbidopa-levodopa-entacapone tabs 1875-75-200 mg 1

carbidopa-levodopa-entacapone tabs 25-100-200 mg 2 carbidopa-levodopa-entacapone tabs 3125-125-200 mg 1

carbidopa-levodopa-entacapone tabs 375-150-200 mg 2

carbidopa-levodopa-entacapone tabs 50-200-200 mg 1 DUOPA SUSP 463-20 MGML [carbidopa-levodopa] 4 MB ENTACAPONE TABS 200 MG [entacapone] 1 KYNMOBI FILM 10 MG [apomorphine hydrochloride] 4 QL - 30 day(s) KYNMOBI FILM 15 MG [apomorphine hydrochloride] 4 QL - 30 day(s) KYNMOBI FILM 20 MG [apomorphine hydrochloride] 4 QL - 30 day(s) KYNMOBI FILM 25 MG [apomorphine hydrochloride] 4 QL - 30 day(s) KYNMOBI FILM 30 MG [apomorphine hydrochloride] 4 QL - 30 day(s) KYNMOBI TITRATION KIT KIT 1015202530 MG [apomorphine hydrochloride] 4 QL - 30 day(s)

LODOSYN TABS 25 MG [carbidopa] 2




pramipexole dihydrochloride tabs 0125 mg 1 pramipexole dihydrochloride tabs 025 mg 1 pramipexole dihydrochloride tabs 05 mg 1 pramipexole dihydrochloride tabs 075 mg 1 pramipexole dihydrochloride tabs 1 mg 1 pramipexole dihydrochloride tabs 15 mg 1 rasagiline mesylate tabs 05 mg 1 rasagiline mesylate tabs 1 mg 1 ropinirole hcl er tb24 12 mg 1 ropinirole hcl er tb24 2 mg 1 ropinirole hcl er tb24 4 mg 1 ropinirole hcl er tb24 6 mg 1 ropinirole hcl er tb24 8 mg 1 ropinirole hcl tabs 025 mg 1 ropinirole hcl tabs 05 mg 1 ropinirole hcl tabs 1 mg 1 ropinirole hcl tabs 2 mg 1 ropinirole hcl tabs 3 mg 1 ropinirole hcl tabs 4 mg 1 ropinirole hcl tabs 5 mg 1 selegiline hcl tabs 5 mg 1 trihexyphenidyl hcl soln 04 mgml 1 trihexyphenidyl hcl tabs 2 mg 1 trihexyphenidyl hcl tabs 5 mg 1 ANXIOLYTICS SEDATIVES AND HYPNOTICS alprazolam tabs 025 mg 1 QL - 30 day(s) alprazolam tabs 05 mg 1 QL - 30 day(s) alprazolam tabs 1 mg 1 QL - 30 day(s) alprazolam tabs 2 mg 1 QL - 30 day(s) buspirone hcl tabs 10 mg 1 buspirone hcl tabs 15 mg 1 buspirone hcl tabs 30 mg 1 buspirone hcl tabs 5 mg 1 buspirone hcl tabs 75 mg 1 chlordiazepoxide hcl caps 10 mg 1 chlordiazepoxide hcl caps 25 mg 1 chlordiazepoxide hcl caps 5 mg 1 clorazepate dipotassium tabs 15 mg 1 clorazepate dipotassium tabs 375 mg 1 clorazepate dipotassium tabs 75 mg 1 DIASTAT ACUDIAL GEL 10 MG [diazepam (anticonvulsant)] 2

DIASTAT ACUDIAL GEL 20 MG [diazepam 2




(anticonvulsant)] DIASTAT PEDIATRIC GEL 25 MG [diazepam (anticonvulsant)] 2

[Diazepam] DIAZEPAM INTENSOL CONC 5 MGML 1 diazepam soln 5 mg5ml 2 diazepam soln 5 mgml 1 MB diazepam tabs 10 mg 1 diazepam tabs 2 mg 1 diazepam tabs 5 mg 1 droperidol soln 25 mgml 1 MB hydroxyzine hcl soln 25 mgml 2 MB hydroxyzine hcl soln 50 mgml 1 MB hydroxyzine hcl syrp 10 mg5ml 1 hydroxyzine hcl tabs 10 mg 1 hydroxyzine hcl tabs 25 mg 1 hydroxyzine hcl tabs 50 mg 1 hydroxyzine pamoate caps 100 mg 2 hydroxyzine pamoate caps 25 mg 1 hydroxyzine pamoate caps 50 mg 1 [Lorazepam] LORAZEPAM INTENSOL CONC 2 MGML 1 QL - 30 day(s) lorazepam soln 2 mgml 1 MB lorazepam soln 4 mgml 1 MB lorazepam tabs 05 mg 1 QL - 30 day(s) lorazepam tabs 1 mg 1 lorazepam tabs 2 mg 1 QL - 30 day(s) midazolam hcl (pf) soln 10 mg2ml 1 MB midazolam hcl (pf) soln 2 mg2ml 1 MB midazolam hcl (pf) soln 5 mgml 1 MB midazolam hcl soln 10 mg2ml 1 MB midazolam hcl soln 2 mg2ml 1 MB midazolam hcl syrp 2 mgml 1 [Pentobarbital Sodium] NEMBUTAL SOLN 50 MGML 2 MB oxazepam caps 10 mg 1 QL - 30 day(s) oxazepam caps 15 mg 1 QL - 30 day(s) oxazepam caps 30 mg 1 QL - 30 day(s) PHENOBARBITAL ELIX 20 MG5ML [phenobarbital] 1 PHENOBARBITAL SODIUM SOLN 130 MGML [phenobarbital sodium] 2 MB

PHENOBARBITAL SODIUM SOLN 65 MGML [phenobarbital sodium] 2 MB

PHENOBARBITAL TABS 100 MG [phenobarbital] 1 PHENOBARBITAL TABS 15 MG [phenobarbital] 1 PHENOBARBITAL TABS 162 MG [phenobarbital] 1 PHENOBARBITAL TABS 30 MG [phenobarbital] 1




PHENOBARBITAL TABS 324 MG [phenobarbital] 1 PHENOBARBITAL TABS 60 MG [phenobarbital] 1 PHENOBARBITAL TABS 648 MG [phenobarbital] 1 PHENOBARBITAL TABS 972 MG [phenobarbital] 1 PRECEDEX SOLN 200 MCG2ML [dexmedetomidine hcl] 2 MB

SILENOR TABS 3 MG [doxepin hcl (sleep)] 2 SILENOR TABS 6 MG [doxepin hcl (sleep)] 2 temazepam caps 15 mg 1 QL - 30 day(s) temazepam caps 30 mg 1 QL - 30 day(s) zolpidem tartrate tabs 5 mg 1 QL - 30 day(s) CENTRAL NERVOUS SYSTEM AGENTS MISCELLANEOUS acamprosate calcium tbec 333 mg 1 flumazenil soln 05 mg5ml 1 MB guanfacine hcl er tb24 1 mg 1 guanfacine hcl er tb24 2 mg 1 guanfacine hcl er tb24 3 mg 1 guanfacine hcl er tb24 4 mg 1 memantine hcl tabs 10 mg 1 memantine hcl tabs 5 mg 1 NAMENDA SOL 10MG5ML [memantine hcl] 2 NAMENDA TITRATION PAK TABS 28 x 5 MG amp 21 X 10 MG [memantine hcl] 2

riluzole tabs 50 mg 1 selegiline hcl caps 5 mg 1 GENERAL ANESTHETICS BREVITAL SODIUM SOLR 500 MG [methohexital sodium] 2 MB

etomidate soln 2 mgml 1 MB FORANE SOLN [isoflurane] 2 ketamine hcl soln 10 mgml 1 MB ketamine hcl soln 100 mgml 1 MB ketamine hcl soln 50 mgml 1 MB propofol emul 1000 mg100ml 1 MB propofol emul 200 mg20ml 1 MB MULTIPLE SCLEROSIS AGENTS AVONEX KIT 30MCG [interferon beta-1a] 4 QL - 30 day(s)MB EXTAVIA KIT 03 MG [interferon beta-1b] 2 QL - 30 day(s) [Glatiramer Acetate] GLATOPA SOSY 20 MGML 1 QL - 30 day(s) OPIATE ANTAGONISTS naloxone hcl soct 04 mgml 1 MB naloxone hcl soln 04 mgml 1 MB naloxone hcl sosy 2 mg2ml 2 MB




NALTREXONE HCL POWD [naltrexone hcl (bulk)] 2 naltrexone hcl tabs 50 mg 1 NARCAN LIQD 4 MG01ML [naloxone hcl] 2 PSYCHOTHERAPEUTIC AGENTS amitriptyline hcl tabs 10 mg 1 amitriptyline hcl tabs 100 mg 1 amitriptyline hcl tabs 150 mg 1 amitriptyline hcl tabs 25 mg 1 amitriptyline hcl tabs 50 mg 1 amitriptyline hcl tabs 75 mg 1 amoxapine tabs 100 mg 2 amoxapine tabs 150 mg 2 amoxapine tabs 25 mg 2 amoxapine tabs 50 mg 2 aripiprazole tabs 10 mg 1 aripiprazole tabs 15 mg 1 aripiprazole tabs 2 mg 1 aripiprazole tabs 20 mg 1 aripiprazole tabs 30 mg 1 aripiprazole tabs 5 mg 1 ARISTADA PRSY 1064 MG39ML [aripiprazole lauroxil] 4 MB

ARISTADA PRSY 441 MG16ML [aripiprazole lauroxil] 4 MB



bupropion hcl er (sr) tb12 100 mg 1 bupropion hcl er (sr) tb12 150 mg 1 PREV bupropion hcl er (sr) tb12 200 mg 1 bupropion hcl er (xl) tb24 150 mg 1 PREV bupropion hcl er (xl) tb24 300 mg 1 bupropion hcl tabs 100 mg 1 bupropion hcl tabs 75 mg 1 chlorpromazine hcl soln 25 mgml 2 MB chlorpromazine hcl tabs 10 mg 1 chlorpromazine hcl tabs 100 mg 1 chlorpromazine hcl tabs 200 mg 1 chlorpromazine hcl tabs 25 mg 1 chlorpromazine hcl tabs 50 mg 1 citalopram hydrobromide soln 10 mg5ml 1 citalopram hydrobromide tabs 10 mg 1 citalopram hydrobromide tabs 20 mg 1




citalopram hydrobromide tabs 40 mg 1 clomipramine hcl caps 25 mg 1 clomipramine hcl caps 50 mg 1 clomipramine hcl caps 75 mg 1 clozapine tabs 100 mg 1 clozapine tabs 200 mg 1 clozapine tabs 25 mg 1 clozapine tabs 50 mg 1 [Prochlorperazine] COMPRO SUPP 25 MG 1 desipramine hcl tabs 10 mg 1 desipramine hcl tabs 100 mg 1 desipramine hcl tabs 150 mg 1 desipramine hcl tabs 25 mg 1 desipramine hcl tabs 50 mg 1 desipramine hcl tabs 75 mg 1 doxepin hcl caps 10 mg 1 doxepin hcl caps 100 mg 1 doxepin hcl caps 150 mg 1 doxepin hcl caps 25 mg 1 doxepin hcl caps 50 mg 1 doxepin hcl caps 75 mg 1 doxepin hcl conc 10 mgml 1 duloxetine hcl cpep 20 mg 1 duloxetine hcl cpep 30 mg 1 duloxetine hcl cpep 60 mg 1 escitalopram oxalate soln 5 mg5ml 1 escitalopram oxalate tabs 10 mg 1 escitalopram oxalate tabs 20 mg 1 escitalopram oxalate tabs 5 mg 1 fluoxetine hcl caps 10 mg 1 fluoxetine hcl caps 20 mg 1 fluoxetine hcl caps 40 mg 1 fluoxetine hcl soln 20 mg5ml 1 fluphenazine decanoate soln 25 mgml 1 MB fluphenazine hcl conc 5 mgml 2 fluphenazine hcl tabs 1 mg 1 fluphenazine hcl tabs 10 mg 1 fluphenazine hcl tabs 25 mg 1 fluphenazine hcl tabs 5 mg 1 fluvoxamine maleate tabs 100 mg 1 fluvoxamine maleate tabs 25 mg 1 fluvoxamine maleate tabs 50 mg 1 haloperidol decanoate soln 100 mgml 1 MB




haloperidol decanoate soln 50 mgml 1 MB haloperidol lactate conc 2 mgml 1 haloperidol lactate soln 5 mgml 1 MB haloperidol tabs 05 mg 1 haloperidol tabs 1 mg 1 haloperidol tabs 10 mg 1 haloperidol tabs 2 mg 1 haloperidol tabs 20 mg 1 haloperidol tabs 5 mg 1 imipramine hcl tabs 10 mg 1 imipramine hcl tabs 25 mg 1 imipramine hcl tabs 50 mg 1 INVEGA SUSTENNA SUSY 117 MG075ML [paliperidone palmitate] 4 MB

INVEGA SUSTENNA SUSY 156 MGML [paliperidone palmitate] 4 MB

INVEGA SUSTENNA SUSY 234 MG15ML [paliperidone palmitate] 4 MB



loxapine succinate caps 10 mg 1 loxapine succinate caps 25 mg 1 loxapine succinate caps 5 mg 1 loxapine succinate caps 50 mg 1 maprotiline hcl tabs 25 mg 2 maprotiline hcl tabs 50 mg 2 maprotiline hcl tabs 75 mg 2 mirtazapine tabs 15 mg 1 mirtazapine tabs 30 mg 1 mirtazapine tabs 45 mg 1 nefazodone hcl tabs 100 mg 2 nefazodone hcl tabs 150 mg 2 nefazodone hcl tabs 200 mg 2 nefazodone hcl tabs 250 mg 1 nefazodone hcl tabs 50 mg 1 nortriptyline hcl caps 10 mg 1 nortriptyline hcl caps 25 mg 1 nortriptyline hcl caps 50 mg 1 nortriptyline hcl caps 75 mg 1 nortriptyline hcl soln 10 mg5ml 1 olanzapine solr 10 mg 1 MB olanzapine tabs 10 mg 1




olanzapine tabs 15 mg 1 olanzapine tabs 25 mg 1 olanzapine tabs 20 mg 1 olanzapine tabs 5 mg 1 olanzapine tabs 75 mg 1 ORAP TABS 1 MG [pimozide] 2 paroxetine hcl tabs 10 mg 1 paroxetine hcl tabs 20 mg 1 paroxetine hcl tabs 30 mg 1 paroxetine hcl tabs 40 mg 1 perphenazine tabs 16 mg 1 perphenazine tabs 2 mg 1 perphenazine tabs 4 mg 1 perphenazine tabs 8 mg 1 perphenazine-amitriptyline tabs 2-10 mg 2 perphenazine-amitriptyline tabs 2-25 mg 2 perphenazine-amitriptyline tabs 4-10 mg 2 perphenazine-amitriptyline tabs 4-25 mg 2 perphenazine-amitriptyline tabs 4-50 mg 2 phenelzine sulfate tabs 15 mg 1 pimozide tabs 2 mg 1 prochlorperazine edisylate soln 10 mg2ml 1 MB prochlorperazine maleate tabs 10 mg 1 prochlorperazine maleate tabs 5 mg 1 protriptyline hcl tabs 10 mg 1 protriptyline hcl tabs 5 mg 1 quetiapine fumarate tabs 100 mg 1 quetiapine fumarate tabs 200 mg 1 quetiapine fumarate tabs 25 mg 1 quetiapine fumarate tabs 300 mg 1 quetiapine fumarate tabs 400 mg 1 quetiapine fumarate tabs 50 mg 1 RISPERDAL CONSTA SRER 125 MG [risperidone microspheres] 4 MB

RISPERDAL CONSTA SRER 25 MG [risperidone microspheres] 4 MB



RISPERIDONE SOLN 1 MGML [risperidone] 1 RISPERIDONE TABS 025 MG [risperidone] 1 risperidone tabs 05 mg 1 risperidone tabs 1 mg 1




RISPERIDONE TABS 2 MG [risperidone] 1 risperidone tabs 3 mg 1 risperidone tabs 4 mg 1 sertraline hcl tabs 100 mg 1 sertraline hcl tabs 25 mg 1 sertraline hcl tabs 50 mg 1 thioridazine hcl tabs 10 mg 1 thioridazine hcl tabs 100 mg 1 thioridazine hcl tabs 25 mg 1 thioridazine hcl tabs 50 mg 1 thiothixene caps 1 mg 1 thiothixene caps 10 mg 1 thiothixene caps 2 mg 1 thiothixene caps 5 mg 1 tranylcypromine sulfate tabs 10 mg 1 trazodone hcl tabs 100 mg 1 trazodone hcl tabs 150 mg 1 trazodone hcl tabs 50 mg 1 trifluoperazine hcl tabs 1 mg 1 trifluoperazine hcl tabs 10 mg 1 trifluoperazine hcl tabs 2 mg 1 trifluoperazine hcl tabs 5 mg 1 trimipramine maleate caps 100 mg 1 trimipramine maleate caps 25 mg 1 trimipramine maleate caps 50 mg 1 venlafaxine hcl er cp24 150 mg 1 venlafaxine hcl er cp24 375 mg 1 venlafaxine hcl er cp24 75 mg 1 venlafaxine hcl tabs 100 mg 1 venlafaxine hcl tabs 25 mg 1 venlafaxine hcl tabs 375 mg 1 venlafaxine hcl tabs 50 mg 1 venlafaxine hcl tabs 75 mg 1 ziprasidone hcl caps 20 mg 1 ziprasidone hcl caps 40 mg 1 ziprasidone hcl caps 60 mg 1 ziprasidone hcl caps 80 mg 1 CONTRACEPTIVES (FOAMS DEVICES) CONTRACEPTIVES (FOAMS DEVICES) WIDE-SEAL DIAPHRAGM 60 DPRH 2 [diaphragm wide seal] 2 PREV

WIDE-SEAL DIAPHRAGM 65 DPRH 2 [diaphragm wide seal] 2 PREV










DEVICES DEVICES AEROCHAMBER PLUS FLO-VU SMALL MISC [spaceraerosol-holding chambers] 2

AEROCHAMBER Z-STAT PLUS MISC [spaceraerosol-holding chambers] 2

AEROCHAMBER Z-STAT PLUSLARGE MISC [spaceraerosol-holding chambers] 2

AEROCHAMBER Z-STAT PLUSMEDIUM MISC [spaceraerosol-holding chambers] 2

AEROTRACH PLUS MISC [respiratory therapy supplies] 2

BD 3ML LUER-LOK SYRINGE22G X 1-14 MIS 22GX125 [syringeneedle (disp) 3 ml] 2

BD INSULIN SYRINGE MICROFINE MISC 27G X 58 1 ML [insulin syringeneedle u-100] 2

[Insulin Syringeneedle U-100] BD INSULIN SYRINGE MICROFINE MISC 28G X 12 03 ML 2

BD INSULIN SYRINGE MISC 25G X 1 1 ML [insulin syringeneedle u-100] 2


BD INSULIN SYRINGE U-500 MISC 31G X 6MM 05 ML [insulin syringeneedle u-500] 2

BD INSULIN SYRINGE UF 12UNIT MISC 31G X 516 03 ML [insulin syringeneedle u-100] 2

BD INSULIN SYRINGE UF MISC 30G X 12 03 ML [insulin syringeneedle u-100] 2




BD INSULIN SYRINGE UF MISC 31G X 516 05 ML 2




[insulin syringeneedle u-100] BD INSULIN SYRINGE UF MISC 31G X 516 1 ML [insulin syringeneedle u-100] 2

[Insulin Syringeneedle U-100] BD INSULIN SYRINGE ULTRAFINE MISC 31G X 516 05 ML 2

[Insulin Syringeneedle U-100] BD INTEGRA INSULIN SYRINGEU-1001ML29G X 12 MIS 1ML29G 2

BD INTEGRA SYRINGE MISC 25G X 58 3 ML [syringeneedle (disp) 3 ml] 2

BD LANCET DEVICE MIS DEVICE [lancet devices] 2 BD LANCET ULTRAFINE 33G MISC [lancets] 2 BD PEN NEEDLE MINI UF MISC 31G X 5 MM [insulin pen needle] 2

BD PEN NEEDLE NANO UF MISC 32G X 4 MM [insulin pen needle] 2

BD PEN NEEDLE ORIGINAL UF MISC 29G X 127MM [insulin pen needle] 2

BD PEN NEEDLE SHORT UF MISC 31G X 8 MM [insulin pen needle] 2

BD SAFETYGLIDE INSULIN SYRINGE MISC 29G X 12 03 ML [insulin syringeneedle u-100] 2

BD SAFETYGLIDE SYRINGENEEDLE MISC 27G X 58 1 ML [syringeneedle (disp) 1 ml] 2

BD VEO INSULIN SYR UF 12UNIT MISC 31G X 1564 03 ML [insulin syringeneedle u-100] 2

BD VEO INSULIN SYRINGE UF MISC 31G X 1564 03 ML [insulin syringeneedle u-100] 2



CLICKFINE PEN NEEDLES MISC 31G X 6 MM [insulin pen needle] 1

CONTOUR NEXT CONTROL SOLN NORMAL [blood glucose calibration] 2

DISPOSABLE POWER KIT [misc devices] 2 MONOJECT INSULIN SYRINGE MISC 27G X 12 1 ML [insulin syringeneedle u-100] 2

MONOJECT INSULIN SYRINGE MISC 29G X 12 03 ML [insulin syringeneedle u-100] 2


OMNITROPE PEN 5 INJ DEVICE MISC [injection device] 2

ONETOUCH DELICA LANCETS 33G MISC [lancets] 2 ONETOUCH FINEPOINT LANCETS MISC [lancets] 2 ONETOUCH SURESOFT LANCING DEV MISC 2




[lancets misc] ONETOUCH ULTRA CONTROL SOLN [blood glucose calibration] 2

ONETOUCH ULTRA MINI KIT WDEVICE [blood glucose monitoring supplies] 2

ONETOUCH ULTRASOFT LANCETS MISC [lancets] 2 ONETOUCH VERIO SOLN HIGH [blood glucose calibration] 2

PEDIATRIC SMALL MASK MISC [masks] 2 PENLET II BLOOD SAMPLER KIT [lancets misc] 2 PRODIGY CONTROL SOLUTION SOLN LOW [blood glucose calibration] 2

SURE COMFORT INSULIN SYRINGE MISC 28G X 12 05 ML [insulin syringeneedle u-100] 2










[Insulin Syringeneedle U-100] TERUMO INSULIN SYRINGEU-10005ML27G X 12 MIS 0527G 2

TRUZONE PEAK FLOW METER DEVI [peak flow meter] 2 MB

ULTRA THIN LANCETS 30G MISC [lancets] 2 ULTRA-COMFORT INSULIN SYRINGE MISC 31G X 516 03 ML [insulin syringeneedle u-100] 2

DIAGNOSTIC AGENTS DIAGNOSTIC AGENTS ACETEST TAB TABLETS [acetone (urine) test] 2 adenosine soln 3 mgml 1 MB AK-FLUOR SOLN 10 [fluorescein sodium injection] 1 MB ALBUSTIX STRP [albumin (urine) test] 2 ALTAFLUOR BENOX SOLN 025-04 [fluorescein w 1




benoxinate] BIO GLO STRP 1 MG [fluorescein sodium topical] 1 CANDIN SOLN [candida albicans skin test antigen] 2 MB CHEMSTRIP 9 STRP [multiple urine tests] 2 CHIRHOSTIM SOLR 16 MCG [secretin acetate (human)] 2 MB

[Gadoterate Meglumine] CLARISCAN SOLN 10 MMOL20ML 1




[Gadoterate Meglumine] CLARISCAN SOSY 10 MMOL20ML 1



CONRAY 43 INJ 43 [iothalamate meglumine] 2 MB CONRAY SOLN 60 [iothalamate meglumine] 2 MB CORTROSYN SOLR 025 MG [cosyntropin] 2 MB CYSTO-CONRAY II SOLN 172 [iothalamate meglumine] 2 MB

CYSTOGRAFIN SOLN 30 [diatrizoate meglumine] 2 MB CYSTOGRAFIN-DILUTE SOLN 18 [diatrizoate meglumine] 2 MB

D-XYLOSE POWD [d-xylose] 2 DIASTIX STRP [glucose urine test-(glucose oxidase)] 2

E-Z-CAT DRY PACK 2 [barium sulfate] 2 EOVIST SOLN 025 MOLL [gadoxetate disodium] 2 MB GADAVIST SOLN 1 MMOLML [gadobutrol] 2 MB GASTROGRAFIN SOLN 66-10 [diatrizoate meglumine amp sodium] 2

indigotindisulfonate sodium soln 2 MB KETO-DIASTIX STRP [urine glucose-ketones test] 2 KETOSTIX STRP [acetone (urine) test] 2 LEXISCAN SOLN 04 MG5ML [regadenoson] 2 MB LUMASON SUSR 607-25 MG [sulfur hexafluoride lipid-type a microspheres] 2 MB

MAGNEVIST SOLN 46901 MGML [gadopentetate dimeglumine] 2 MB

MD-76 R SOLN 66-10 [diatrizoate meglumine amp sodium] 2 MB




METOPIRONE CAPS 250 MG [metyrapone] 2 MULTIHANCE SOLN 529 MGML [gadobenate dimeglumine] 2 MB

OMNIPAQUE INJ 300MGML [iohexol] 2 MB OMNIPAQUE INJ 350MGML [iohexol] 2 MB OMNIPAQUE SOLN 180 MGML [iohexol] 2 MB OMNIPAQUE SOLN 240 MGML [iohexol] 2 MB OMNIPAQUE SOLN 300 MGML [iohexol] 2 MB OMNIPAQUE SOLN 350 MGML [iohexol] 2 MB ONETOUCH ULTRA STRP [glucose blood] 2 READI-CAT 2 SUSP 2 [barium sulfate] 2 READI-CAT 2 SUSP 21 [barium sulfate] 2 THYROGEN SOLR 09 MG [thyrotropin alfa] 2 MB TISSUEBLUE SOSY 0025 [brilliant blue g] 2 TUBERSOL SOLN 5 UNIT01ML [tuberculin ppd] 2 MB VOLUMEN SUSP 01 [barium sulfate] 2 ELECTROLYTIC CALORIC AND WATER BALANCE ALKALINIZING AGENTS CYTRA K CRYSTALS PACK 3300-1002 MG [potassium citrate-citric acid] 1

CYTRA-K SOLN 1100-334 MG5ML [potassium citrate-citric acid] 1

NEUT SOLN 4 [sodium bicarbonate] 2 MB POTASSIUM CITRATE ER TBCR 10 MEQ (1080 MG) [potassium citrate (alkalinizer)] 1

POTASSIUM CITRATE ER TBCR 5 MEQ (540 MG) [potassium citrate (alkalinizer)] 1

POTASSIUM CITRATE-CITRIC ACID SOLN 1100-334 MG5ML [potassium citrate-citric acid] 1

SOD CITRATE-CITRIC ACID SOLN 500-334 MG5ML [sodium citrate amp citric acid] 1

SODIUM ACETATE SOLN 2 MEQML [sodium acetate] 2 MB SODIUM BICARBONATE SOLN 42 [sodium bicarbonate] 1 MB

SODIUM BICARBONATE SOLN 75 [sodium bicarbonate] 2 MB


THAM SOLN 30 MEQ100ML [tromethamine] 2 MB TRICITRATES SOLN 550-500-334 MG5ML [pot amp sod citrates wcitric ac] 1

AMMONIA DETOXICANTS BUPHENYL TABS 500 MG [sodium phenylbutyrate] 4 QL - 30 day(s) lactulose (encephalopathy) soln 10 gm15ml 1 lactulose soln 10 gm15ml 1




LITHOSTAT TABS 250 MG [acetohydroxamic acid] 2 sodium phenylbutyrate powd 3 gmtsp 1 QL - 30 day(s) CALORIC AGENTS AMINOSYN II SOLN 10 [amino acid infusion] 2 MB AMINOSYN IIELECTROLYTES SOLN 85 [amino acid electrolyte infusion] 2 MB

CLINIMIX EDEXTROSE (27510) SOLN 275 [amino acid electrolyte w calcium infusion in d10w] 2 MB








CLINIMIXDEXTROSE (2755) SOLN 275 [amino acid infusion in d5w] 2 MB








[Amino Acid Infusion] CLINISOL SF SOLN 15 2 MB DEXTROSE SOLN 10 [dextrose] 1 MB DEXTROSE SOLN 20 [dextrose] 2 MB DEXTROSE SOLN 40 [dextrose] 2 MB DEXTROSE SOLN 5 [dextrose] 1 MB DEXTROSE SOLN 50 [dextrose] 1 MB DEXTROSE SOLN 70 [dextrose] 1 MB INTRALIPID EMUL 20 [fat emulsion plant based 2 MB




(soy)] INTRALIPID EMUL 30 [fat emulsion plant based (soy)] 2 MB

PHENEX-1 POWD [nutritional supplements] 2 PHLEXY-10 PACK [nutritional supplements] 2 PROCALAMINE SOLN 3 [amino acid electrolyte infusion] 2 MB

PROSOL SOLN 20 [amino acid infusion] 2 MB TRAVASOL SOLN 10 [amino acid infusion] 2 MB TROPHAMINE SOLN 10 [amino acid infusion] 2 MB TROPHAMINE SOLN 6 [amino acid infusion] 2 MB DIURETICS amiloride-hydrochlorothiazide tabs 5-50 mg 1 bumetanide soln 025 mgml 1 MB bumetanide tabs 05 mg 1 bumetanide tabs 1 mg 1 bumetanide tabs 2 mg 1 chlorthalidone tabs 25 mg 1 chlorthalidone tabs 50 mg 1 DYRENIUM CAPS 100 MG [triamterene] 2 DYRENIUM CAPS 50 MG [triamterene] 2 EDECRIN TABS 25 MG [ethacrynic acid] 2 ethacrynic acid tabs 25 mg 1 FUROSEMIDE SOLN 10 MGML [furosemide] 1 MB furosemide soln 10 mgml 1 MB furosemide soln 8 mgml 2 FUROSEMIDE TABS 20 MG [furosemide] 1 FUROSEMIDE TABS 40 MG [furosemide] 1 furosemide tabs 80 mg 1 hydrochlorothiazide tabs 125 mg 1 hydrochlorothiazide tabs 25 mg 1 hydrochlorothiazide tabs 50 mg 1 indapamide tabs 125 mg 1 indapamide tabs 25 mg 1 MANNITOL SOLN 25 [mannitol] 1 MB metolazone tabs 10 mg 1 metolazone tabs 25 mg 1 metolazone tabs 5 mg 1 OSMITROL SOLN 20 [mannitol] 1 MB SODIUM EDECRIN SOLR 50 MG [ethacrynate sodium] 2 MB

torsemide tabs 10 mg 1 torsemide tabs 100 mg 1 torsemide tabs 20 mg 1




torsemide tabs 5 mg 1 triamterene-hctz caps 375-25 mg 1 TRIAMTERENE-HCTZ TABS 375-25 MG [triamterene amp hydrochlorothiazide] 1

TRIAMTERENE-HCTZ TABS 75-50 MG [triamterene amp hydrochlorothiazide] 1

ION-REMOVING AGENTS [Sodium Polystyrene Sulfonate] KIONEX SUSP 15 GM60ML 1

RENVELA PACK 24 GM [sevelamer carbonate] 2 RENVELA TABS 800 MG [sevelamer carbonate] 2 sevelamer carbonate pack 24 gm 1 sevelamer carbonate tabs 800 mg 1 sodium polystyrene sulfonate powd 1 sodium polystyrene sulfonate susp 15 gm60ml 1 sodium polystyrene sulfonate susp 30 gm120ml 1 [Sodium Polystyrene Sulfonate] SPS SUSP 15 GM60ML 1

[Sodium Polystyrene Sulfonate] SPS SUSP 15 GM60ML 1

IRRIGATING SOLUTIONS ACETIC ACID SOLN 025 [acetic acid] 1 MB DIANEAL LOW CALCIUM425 DEX SOLN 483 MOSML [peritoneal dialysis solutions] 2 MB

DIANEAL PD-215 DEXTROSE SOLN 346 MOSML [peritoneal dialysis solutions] 2 MB



LACTATED RINGERS SOLN [lactated ringers (irrigation)] 2 MB

RINGERS IRRIGATION SOLN [ringers irrigation] 1 MB SODIUM CHLORIDE SOLN 09 [sodium chloride (gu irrigant)] 1 MB

STERILE WATER FOR IRRIGATION SOLN [water for irrigation sterile] 1 MB

ULTRABAGDIANEAL15 DEXTROSE SOLN 344 MOSML [peritoneal dialysis solutions] 2 MB


REPLACEMENT PREPARATIONS calcium acetate (phos binder) caps 667 mg 1 calcium acetate tabs 667 mg 1 CALCIUM CHLORIDE SOLN 10 [calcium chloride (dihydrate)] 1 MB




CALCIUM GLUCONATE SOLN 10 [calcium gluconate] 1 MB

CHROMIC CHLORIDE SOLN 40 MCG10ML [chromic chloride] 2 MB

CUPRIC CHLORIDE SOLN 04 MGML [cupric chloride] 2 MB

DEXTROSE 5ELECTROLYTE 48 SOLN [electrolyte-48 in dextrose] 2 MB

DEXTROSE IN LACTATED RINGERS SOLN 5 [dextrose in lactated ringers] 1 MB

dextrose in ringers soln 5 1 MB DEXTROSE-NACL SOLN 10-045 [dextrose w sodium chloride] 2 MB

DEXTROSE-NACL SOLN 25-045 [dextrose w sodium chloride] 1 MB






EFFER-K TBEF 25 MEQ [potassium bicarbonate] 1 hetastarch-nacl soln 6-09 1 MB HEXTEND SOLN 6 [hetastarch in lactated electrolyte] 2 MB

HYPERLYTE-CR CONC [parenteral electrolytes] 2 MB K-EFFERVESCENT TBEF 25 MEQ [potassium bicarbonate] 1

K-PHOS TABS 500 MG [potassium phosphate monobasic] 2

K-TAB TBCR 10 MEQ [potassium chloride] 2 KCL IN DEXTROSE-NACL SOLN 10-5-045 MEQL-- [potassium chloride in dextrose amp sodium chloride]

1 MB

KCL IN DEXTROSE-NACL SOLN 20-5-02 MEQL-- [potassium chloride in dextrose amp sodium chloride] 1 MB

KCL IN DEXTROSE-NACL SOLN 20-5-045 MEQL-- [potassium chloride in dextrose amp sodium chloride]

1 MB


KCL IN DEXTROSE-NACL SOLN 30-5-045 MEQL-- [potassium chloride in dextrose amp sodium 1 MB




chloride] KCL IN DEXTROSE-NACL SOLN 40-5-045 MEQL-- [potassium chloride in dextrose amp sodium chloride]

1 MB


KCL-LACTATED RINGERS-D5W SOLN 20 MEQL [potassium chloride in d5w lactated ringers] 2 MB

KLOR-CON TBCR 8 MEQ [potassium chloride] 1 LACTATED RINGERS SOLN [lactated ringers] 2 MB [Dextran 40 In D5w] LMD IN D5W SOLN 10-5 2 MB [Dextran 40 In Saline] LMD IN NACL SOLN 10-09 2 MB MTE-5 CONCENTRATE INJ CONC [trace minerals (cr-cu-mn-se-zn)] 2 MB

MAGNESIUM SULFATE IN D5W SOLN 1-5 GM100ML- [magnesium sulfate in dextrose] 2 MB

MANGANESE CHLORIDE SOLN 01 MGML [manganese chloride] 2 MB

MULTITRACE-4 CONCENTRATE SOLN 001-1-05-5 MGML [trace minerals (cr-cu-mn-zn)] 1 MB

NORMAL SALINE FLUSH SOLN 09 [sodium chloride flush] 1 MB

PHOSLYRA SOLN 667 MG5ML [calcium acetate (phosphate binder)] 2

PLASMA-LYTE A SOLN [electrolyte-a] 2 MB POTASSIUM ACETATE SOLN 2 MEQML [potassium acetate] 1 MB

potassium chloride 0075d5wnacl 0225 inj 0752 1 MB

potassium chloride crys er tbcr 10 meq 1 potassium chloride crys er tbcr 20 meq 1 potassium chloride er cpcr 10 meq 1 potassium chloride er cpcr 8 meq 1 POTASSIUM CHLORIDE IN DEXTROSE SOLN 20-5 MEQL- [potassium chloride in dextrose] 1 MB

POTASSIUM CHLORIDE IN DEXTROSE SOLN 40-5 MEQL- [potassium chloride in dextrose] 1 MB

POTASSIUM CHLORIDE IN NACL SOLN 20-045 MEQL- [potassium chloride in nacl] 1 MB



POTASSIUM CHLORIDE PACK 20 MEQ [potassium chloride] 1

potassium chloride sol 10 sf 1




POTASSIUM CHLORIDE SOLN 10 MEQ100ML [potassium chloride] 1 MB


potassium chloride soln 2 meqml 1 MB POTASSIUM CHLORIDE SOLN 20 MEQ100ML [potassium chloride] 1 MB



POTASSIUM CHLORIDE SOLN 40 MEQ15ML (20) [potassium chloride] 1

potassium phosphate inj 3mmml 1 MB POTASSIUM PHOSPHATES SOLN 45 MMOLE15ML [potassium phosphates] 1 MB

RINGERS SOLN [ringers] 1 MB SELENIUM SOLN 40 MCGML [selenious acid] 2 MB SODIUM CHLORIDE (PF) SOLN 09 [sodium chloride] 1 MB

SODIUM CHLORIDE BACTERIOSTATIC SOLN 09 [bacteriostatic sodium chloride] 1 MB

SODIUM CHLORIDE SOLN 045 [sodium chloride] 1 MB SODIUM CHLORIDE SOLN 09 [sodium chloride] 1 MB SODIUM CHLORIDE SOLN 3 [sodium chloride] 1 MB SODIUM CHLORIDE SOLN 4 MEQML [sodium chloride] 1 MB

SODIUM CHLORIDE SOLN 5 [sodium chloride] 1 MB SODIUM PHOSPHATES SOLN 45 MMOLE15ML [sodium phosphates (sodium phosphate dibasic amp monobasic)]

1 MB

TRACE ELEMENTS 4PEDIATRIC SOLN 1-100-30-500 MCGML [trace minerals (cr-cu-mn-zn)] 2 MB

ZINC CHLORIDE SOLN 1 MGML [zinc chloride] 2 MB ZINC SULFATE SOLN 1 MGML [zinc sulfate] 2 MB URICOSURIC AGENTS colchicine-probenecid tabs 05-500 mg 1 probenecid tabs 500 mg 1 ENZYMES ENZYMES ALDURAZYME SOLN 29 MG5ML [laronidase] 4 MB ARALAST NP SOLR 1000 MG [alpha1-proteinase inhibitor (human)] 4 QL - 30 day(s)MB

CEREZYME SOLR 400 UNIT [imiglucerase] 4 MB ELAPRASE SOLN 6 MG3ML [idursulfase] 4 QL - 30 day(s)MB




ELITEK SOLR 15 MG [rasburicase] 4 MB ELITEK SOLR 75 MG [rasburicase] 4 MB FABRAZYME SOLR 35 MG [agalsidase beta] 4 QL - 30 day(s)MB FABRAZYME SOLR 5 MG [agalsidase beta] 4 QL - 30 day(s)MB HYLENEX SOLN 150 UNITML [hyaluronidase human] 2 MB LUMIZYME SOLR 50 MG [alglucosidase alfa] 4 QL - 30 day(s)MB NAGLAZYME SOLN 1 MGML [galsulfase] 4 QL - 30 day(s)MB PULMOZYME SOLN 25 MG25ML [dornase alfa] 4 QL - 30 day(s) STRENSIQ SOLN 18 MG045ML [asfotase alfa] 4 QL - 30 day(s) STRENSIQ SOLN 28 MG07ML [asfotase alfa] 4 QL - 30 day(s) STRENSIQ SOLN 40 MGML [asfotase alfa] 4 QL - 30 day(s) STRENSIQ SOLN 80 MG08ML [asfotase alfa] 4 QL - 30 day(s) VIMIZIM SOLN 5 MG5ML [elosulfase alfa] 4 QL - 30 day(s)MB VORAXAZE SOLR 1000 UNIT [glucarpidase] 4 QL - 30 day(s)MB VPRIV SOLR 400 UNIT [velaglucerase alfa] 4 MB EYE EAR NOSE AND THROAT (EENT) PREPARATIONS ANTI-INFECTIVES bacitracin oint 500 unitgm 2 bacitracin-polymyxin b oint 500-10000 unitgm 1 chlorhexidine gluconate soln 012 1 ciprofloxacin hcl soln 03 1 erythromycin oint 5 mggm 1 gatifloxacin soln 05 1 [Gentamicin Sulfate (ophth)] GENTAK OINT 03 1 gentamicin sulfate soln 03 1 MITOSOL KIT 02 MG [mitomycin (ophthalmic)] 2 moxifloxacin hcl soln 05 1 NATACYN SUSP 5 [natamycin] 2 neomycin-bacitracin zn-polymyx oint 5-400-10000 1 neomycin-polymyxin-gramicidin soln 175-10000-025 1

[Neomycin-polymyxin-gramicidin] NEOSPORIN SOLN 175-10000-025 1

ofloxacin soln 03 1 polymyxin b-trimethoprim soln 10000-01 unitml- 1 sulfacetamide sodium soln 10 1 tobramycin soln 03 1 TOBREX OINT 03 [tobramycin (ophth)] 2 trifluridine soln 1 1 ZYMAXID SOLN 05 [gatifloxacin (ophth)] 2 ANTI-INFLAMMATORY AGENTS [Sulfacetamide Sod-prednisolone] BLEPHAMIDE SOP OINT 10-02 2




BLEPHAMIDE SUSP 10-02 [sulfacetamide sod-prednisolone] 2

CEQUA SOLN 009 [cyclosporine (ophth)] 2 ciprofloxacin-dexamethasone susp 03-01 1 COLY-MYCIN S SUSP 33-3-10-05 MGML [neomycin-colistin-hc-thonzonium] 2

dexamethasone sodium phosphate soln 01 1 diclofenac sodium soln 01 1 flunisolide soln 25 mcgact (0025) 1 fluorometholone susp 01 1 flurbiprofen sodium soln 003 1 fluticasone propionate susp 50 mcgact 1 FML FORTE SUSP 025 [fluorometholone (ophth)] 2 FML OINT 01 [fluorometholone (ophth)] 2 ketorolac tromethamine soln 04 1 ketorolac tromethamine soln 05 1 neomycin-polymyxin-dexameth oint 35-10000-01 1 neomycin-polymyxin-dexameth susp 35-10000-01 1 neomycin-polymyxin-hc soln 1 1 neomycin-polymyxin-hc susp 35-10000-1 1 OZURDEX IMPL 07 MG [dexamethasone (ophth)] 4 MB PRED MILD SUSP 012 [prednisolone acetate (ophth)] 2

prednisolone acetate susp 1 1 prednisolone sodium phosphate soln 1 2 RETISERT IMPL 059 MG [fluocinolone acetonide (ophth)] 4 MB

sulfacetamide-prednisolone soln 10-023 1 TOBRADEX OINT 03-01 [tobramycin-dexamethasone] 2

ANTIALLERGIC AGENTS ALOCRIL SOLN 2 [nedocromil sodium (ophth)] 2 azelastine hcl soln 01 1 cromolyn sodium soln 4 1 olopatadine hcl soln 01 1 ANTIGLAUCOMA AGENTS acetazolamide er cp12 500 mg 1 acetazolamide sodium solr 500 mg 1 MB acetazolamide tabs 125 mg 1 acetazolamide tabs 250 mg 1 betaxolol hcl soln 05 1 bimatoprost soln 003 1 brimonidine tartrate soln 02 1 dorzolamide hcl soln 2 1




dorzolamide hcl-timolol mal soln 223-68 mgml 1 latanoprost soln 0005 1 levobunolol hcl soln 05 1 methazolamide tabs 25 mg 1 methazolamide tabs 50 mg 1 MIOCHOL-E SOLR 20 MG [acetylcholine chloride] 2 MB MIOSTAT SOLN 001 [carbachol (ophth)] 2 MB PHOSPHOLINE IODIDE SOLR 0125 [echothiophate iodide] 2

pilocarpine hcl soln 1 1 pilocarpine hcl soln 2 1 pilocarpine hcl soln 4 1 timolol maleate soln 025 1 timolol maleate soln 05 1 EENT DRUGS MISCELLANEOUS ACETIC ACID SOLN 2 [acetic acid (otic)] 1 apraclonidine hcl soln 05 1 BSS PLUS SOLN [ophthalmic irrigation solution - intraocular] 2 MB

BSS SOLN [ophthalmic irrigation solution - intraocular] 2 MB

EYLEA SOLN 2 MG005ML [aflibercept] 2 MB EYLEA SOSY 2 MG005ML [aflibercept] 4 HEALON5 INJ 23MGML [sodium hyaluronate] 2 MB IOPIDINE SOLN 1 [apraclonidine hcl] 2 LACRISERT INST 5 MG [artificial tear insert] 2 LUCENTIS SOLN 03 MG005ML [ranibizumab] 4 QL - 30 day(s)MB LUCENTIS SOLN 05 MG005ML [ranibizumab] 4 QL - 30 day(s)MB LUCENTIS SOSY 03 MG005ML [ranibizumab] 4 QL - 30 day(s)MB LUCENTIS SOSY 05 MG005ML [ranibizumab] 4 QL - 30 day(s)MB MACUGEN SOLN 03 MG [pegaptanib sodium] 2 MB PHOTREXA-PHOTREXA VISCOUS KIT SOSY 0146 amp0146-20 [riboflavin5-phos sod amp riboflavin 5-phosphate sodium-dextran]

2

VISUDYNE SOLR 15 MG [verteporfin] 2 MB LOCAL ANESTHETICS AKTEN GEL 35 [lidocaine hcl (ophth)] 2 [Proparacaine Hcl] ALCAINE SOLN 05 2 C-TOPICAL SOLN 4 [cocaine hcl] 2 lidocaine viscous hcl soln 2 1 proparacaine hcl soln 05 1 TETRACAINE HCL SOLN 05 [tetracaine hcl (ophth)] 1

TETRAVISC SOLN 05 [tetracaine hcl (ophth)] 2




MYDRIATICS ATROPINE SULFATE OINT 1 [atropine sulfate (ophthalmic)] 2

ATROPINE SULFATE SOLN 1 [atropine sulfate (ophthalmic)] 1

[Cyclopentolate Hcl] CYCLOGYL SOLN 05 2 [Cyclopentolate W Phenylephrine] CYCLOMYDRIL SOLN 02-1 2

cyclopentolate hcl soln 1 1 cyclopentolate hcl soln 2 1 HOMATROPINE HBR SOLN 5 [homatropine hbr] 1 tropicamide soln 05 1 tropicamide soln 1 1 VASOCONSTRICTORS naphazoline hcl soln 2 PHENYLEPHRINE HCL SOLN 10 [phenylephrine hcl (mydriatic)] 1

PHENYLEPHRINE HCL SOLN 25 [phenylephrine hcl (mydriatic)] 1

GASTROINTESTINAL DRUGS ANTACIDS AND ADSORBENTS GELUSIL CHEW 200-200-25 MG [alum amp mag hydrox-simethicone] 2

ANTI-INFLAMMATORY AGENTS balsalazide disodium caps 750 mg 1 LIALDA TBEC 12 GM [mesalamine] 2 mesalamine enem 4 gm 1 mesalamine supp 1000 mg 1 mesalamine tbec 12 gm 1 PENTASA CPCR 250 MG [mesalamine] 2 PENTASA CPCR 500 MG [mesalamine] 2 ANTIDIARRHEA AGENTS diphenoxylate-atropine liqd 25-0025 mg5ml 2 diphenoxylate-atropine tabs 25-0025 mg 1 PAREGORIC TINC 2 MG5ML [paregoric] 2 PEPTIC RELIEF CHEW 262 MG [bismuth subsalicylate] 1

ANTIEMETICS AKYNZEO CAPS 300-05 MG [netupitant-palonosetron] 2 QL - 30 day(s)

dronabinol caps 10 mg 1 dronabinol caps 25 mg 1 dronabinol caps 5 mg 1 EMEND CAPS 125 MG [aprepitant] 2 QL - 30 day(s)




EMEND CAPS 40 MG [aprepitant] 2 QL - 30 day(s) EMEND CAPS 80 MG [aprepitant] 2 QL - 30 day(s) EMEND TRI-PACK CAPS 80 amp 125 MG [aprepitant] 2 QL - 30 day(s) fosaprepitant dimeglumine solr 150 mg 1 MB meclizine hcl tabs 25 mg 1 ondansetron hcl soln 4 mg2ml 1 MB ondansetron hcl soln 4 mg5ml 1 ondansetron hcl soln 40 mg20ml 1 MB ondansetron hcl tabs 4 mg 1 ondansetron hcl tabs 8 mg 1 ondansetron tbdp 4 mg 1 ondansetron tbdp 8 mg 1 scopolamine pt72 1 mg3days 1 TRANSDERM-SCOP PT72 1 MG3DAYS [scopolamine] 2

ANTIULCER AGENTS AND ACID SUPPRESSANTS CARAFATE SUSP 1 GM10ML [sucralfate] 2 cimetidine hcl soln 300 mg5ml 1 famotidine premixed soln 20-09 mg50ml- 2 MB famotidine soln 20 mg2ml 1 MB famotidine soln 40 mg4ml 1 MB famotidine susr 40 mg5ml 1 famotidine tabs 20 mg 1 famotidine tabs 40 mg 1 misoprostol tabs 100 mcg 1 misoprostol tabs 200 mcg 1 omeprazole cpdr 10 mg 1 omeprazole cpdr 20 mg 1 omeprazole cpdr 40 mg 1 pantoprazole sodium tbec 20 mg 1 pantoprazole sodium tbec 40 mg 1 PROTONIX SOLR 40 MG [pantoprazole sodium] 2 MB sucralfate tabs 1 gm 1 CATHARTICS AND LAXATIVES AMITIZA CAPS 24 MCG [lubiprostone] 2 AMITIZA CAPS 8 MCG [lubiprostone] 2 CASCARA SAGRADA EXTR 1 GMML [cascara sagrada] 2

[Peg 3350-kcl-sod Bicarb-sod Chloride-sod Sulfate] GAVILYTE-G SOLR 236 GM 1 PREV

GOLYTELY SOLR 236 GM [peg 3350-kcl-sod bicarb-sod chloride-sod sulfate] 1 PREV

peg 3350-kcl-na bicarb-nacl solr 420 gm 1 PREV peg 3350electrolytes solr 240 gm 1 PREV




SORBITOL SOLN 70 [sorbitol (laxative)] 2 CHOLELITHOLYTIC AGENTS URSO FORTE TABS 500 MG [ursodiol] 2 ursodiol tabs 250 mg 1 DIGESTANTS CREON CPEP 12000-38000 UNIT [pancrelipase (lipase-protease-amylase)] 2

CREON CPEP 24000-76000 UNIT [pancrelipase (lipase-protease-amylase)] 2




ZENPEP CPEP 10000-32000 UNIT [pancrelipase (lipase-protease-amylase)] 2







PROKINETIC AGENTS metoclopramide hcl soln 10 mg10ml 1 metoclopramide hcl soln 5 mgml 1 MB metoclopramide hcl tabs 10 mg 1 metoclopramide hcl tabs 5 mg 1 GOLD COMPOUNDS GOLD COMPOUNDS RIDAURA CAPS 3 MG [auranofin] 2 HEAVY METAL ANTAGONISTS HEAVY METAL ANTAGONISTS BAL IN OIL SOLN 100 MGML [dimercaprol] 2 MB CHEMET CAPS 100 MG [succimer] 4 deferasirox tabs 360 mg 1 QL - 30 day(s) deferasirox tabs 90 mg 1 QL - 30 day(s) deferoxamine mesylate solr 2 gm 1 MB deferoxamine mesylate solr 500 mg 1 MB




EXJADE TBSO 125 MG [deferasirox] 4 QL - 30 day(s) EXJADE TBSO 250 MG [deferasirox] 4 QL - 30 day(s) EXJADE TBSO 500 MG [deferasirox] 4 QL - 30 day(s) JADENU SPRINKLE PACK 180 MG [deferasirox] 4 QL - 30 day(s) JADENU SPRINKLE PACK 360 MG [deferasirox] 4 QL - 30 day(s) JADENU SPRINKLE PACK 90 MG [deferasirox] 4 QL - 30 day(s) JADENU TABS 180 MG [deferasirox] 4 QL - 30 day(s) JADENU TABS 360 MG [deferasirox] 4 QL - 30 day(s) JADENU TABS 90 MG [deferasirox] 4 QL - 30 day(s) penicillamine caps 250 mg 1 HORMONES AND SYNTHETIC SUBSTITUTES ADRENALS ASMANEX (120 METERED DOSES) AEPB 220 MCGINH [mometasone furoate (inhalation)] 2

ASMANEX (30 METERED DOSES) AEPB 110 MCGINH [mometasone furoate (inhalation)] 2


ASMANEX HFA AERO 100 MCGACT [mometasone furoate (inhalation)] 2


betamethasone sod phos amp acet susp 6 (3-3) mgml 1 MB budesonide cpep 3 mg 1 budesonide susp 025 mg2ml 1 budesonide susp 05 mg2ml 1 cortisone acetate tabs 25 mg 1 dexamethasone elix 05 mg5ml 1 [Dexamethasone] DEXAMETHASONE INTENSOL CONC 1 MGML 2

dexamethasone sodium phosphate soln 10 mgml 1 MB dexamethasone sodium phosphate soln 20 mg5ml 1 MB dexamethasone soln 05 mg5ml 1 dexamethasone tabs 05 mg 1 dexamethasone tabs 075 mg 1 dexamethasone tabs 1 mg 2 dexamethasone tabs 15 mg 1 dexamethasone tabs 2 mg 2 dexamethasone tabs 4 mg 1 dexamethasone tabs 6 mg 1 FLOVENT HFA AERO 44 MCGACT [fluticasone propionate hfa] 2

fludrocortisone acetate tabs 01 mg 1 hydrocortisone tabs 10 mg 1




hydrocortisone tabs 20 mg 1 hydrocortisone tabs 5 mg 1 KENALOG SUSP 10 MGML [triamcinolone acetonide] 2 MB KENALOG SUSP 40 MGML [triamcinolone acetonide] 2 MB MEDROL TABS 2 MG [methylprednisolone] 2 methylprednisolone acetate susp 40 mgml 1 MB methylprednisolone acetate susp 80 mgml 1 MB methylprednisolone sodium succ solr 1000 mg 1 MB methylprednisolone sodium succ solr 125 mg 1 MB methylprednisolone sodium succ solr 40 mg 1 MB methylprednisolone tabs 16 mg 1 methylprednisolone tabs 32 mg 1 methylprednisolone tabs 4 mg 1 methylprednisolone tabs 8 mg 1 methylprednisolone tbpk 4 mg 1 [Prednisolone] MILLIPRED TABS 5 MG 1 prednisolone sodium phosphate soln 15 mg5ml 1 prednisolone sodium phosphate soln 67 (5 base) mg5ml 1

prednisolone soln 15 mg5ml 1 [Prednisone] PREDNISONE INTENSOL CONC 5 MGML 2

prednisone soln 5 mg5ml 2 prednisone tabs 1 mg 1 prednisone tabs 10 mg 1 prednisone tabs 25 mg 1 prednisone tabs 20 mg 1 prednisone tabs 5 mg 1 prednisone tabs 50 mg 1 prednisone tbpk 10 mg (21) 1 prednisone tbpk 5 mg (21) 1 PULMICORT FLEXHALER AEPB 180 MCGACT [budesonide (inhalation)] 2

SOLU-CORTEF SOLR 100 MG [hydrocortisone sod succinate] 2 MB




SOLU-MEDROL SOLR 125 MG [methylprednisolone sod succ] 2 MB





SYMBICORT AERO 160-45 MCGACT [budesonide-formoterol fumarate dihydrate] 2


ANDROGENS ANDRODERM PT24 2 MG24HR [testosterone] 2 ANDRODERM PT24 4 MG24HR [testosterone] 2 [Methyltestosterone] ANDROID CAPS 10 MG 2 danazol caps 100 mg 1 danazol caps 200 mg 1 danazol caps 50 mg 1 [Testosterone Cypionate] DEPO-TESTOSTERONE SOLN 100 MGML 2 MB

[Testosterone Cypionate] DEPO-TESTOSTERONE SOLN 200 MGML 2 MB

methyltestosterone tabs 10 mg 2 oxandrolone tabs 10 mg 1 oxandrolone tabs 25 mg 1 testosterone cypionate soln 200 mgml 1 MB testosterone enanthate soln 200 mgml 1 MB testosterone gel 125 mgact (1) 1 testosterone gel 2025 mgact (162) 1 testosterone gel 25 mg25gm (1) 1 testosterone gel 50 mg5gm (1) 1 ANTIDIABETIC AGENTS acarbose tabs 100 mg 1 acarbose tabs 25 mg 1 acarbose tabs 50 mg 1 BYDUREON BCISE AUIJ 2 MG085ML [exenatide] 2 glimepiride tabs 1 mg 1 glimepiride tabs 2 mg 1 glimepiride tabs 4 mg 1 glipizide tabs 10 mg 1 glipizide tabs 5 mg 1 glipizide tb24 10 mg 1 glipizide tb24 25 mg 1 glipizide tb24 5 mg 1 glipizide-metformin hcl tabs 25-250 mg 1 glipizide-metformin hcl tabs 25-500 mg 1 glipizide-metformin hcl tabs 5-500 mg 1 glyburide tabs 125 mg 1 glyburide tabs 25 mg 1 glyburide tabs 5 mg 1 HUMALOG MIX 5050 KWIKPEN SUPN (50-50) 100 2




UNITML [insulin lispro protamine amp lispro] HUMALOG MIX 5050 SUSP (50-50) 100 UNITML [insulin lispro protamine amp lispro] 2

HUMALOG SOLN 100 UNITML [insulin lispro] 2 HUMULIN 7030 KWIKPEN SUPN (70-30) 100 UNITML [insulin nph isophane amp reg (human)] 2

HUMULIN 7030 SUSP (70-30) 100 UNITML [insulin nph isophane amp reg (human)] 2

HUMULIN N KWIKPEN SUPN 100 UNITML [insulin nph (human) (isophane)] 2

HUMULIN N SUSP 100 UNITML [insulin nph (human) (isophane)] 2

HUMULIN R SOLN 100 UNITML [insulin regular (human)] 2

HUMULIN R U-500 (CONCENTRATED) SOLN 500 UNITML [insulin regular (human)] 2

HUMULIN R U-500 KWIKPEN SOPN 500 UNITML [insulin regular (human)] 2

JARDIANCE TABS 10 MG [empagliflozin] 2 JARDIANCE TABS 25 MG [empagliflozin] 2 LANTUS SOLN 100 UNITML [insulin glargine] 2 metformin hcl er tb24 500 mg 1 metformin hcl er tb24 750 mg 1 metformin hcl tabs 1000 mg 1 metformin hcl tabs 500 mg 1 metformin hcl tabs 850 mg 1 pioglitazone hcl tabs 15 mg 1 pioglitazone hcl tabs 30 mg 1 pioglitazone hcl tabs 45 mg 1 SYMLINPEN 120 SOPN 2700 MCG27ML [pramlintide acetate] 2

tolbutamide tabs 500 mg 2 TRADJENTA TABS 5 MG [linagliptin] 2 VICTOZA SOPN 18 MG3ML [liraglutide] 2 ANTIHYPOGLYCEMIC AGENTS BAQSIMI TWO PACK POWD 3 MGDOSE [glucagon] 2 GLUCAGEN HYPOKIT SOLR 1 MG [glucagon hcl (rdna)] 2 MB

GLUCAGEN INJ 1MG [glucagon hcl (rdna)] 2 MB glucagon emergency kit 1 mg 1 MB CONTRACEPTIVES [Norethindrone-eth Estradiol (triphasic)] ARANELLE TABS 05105-35 MG-MCG 1 PREV

[Norgestrel amp Ethinyl Estradiol] CRYSELLE-28 TABS 03-30 MG-MCG 1 PREV




drospirenone-ethinyl estradiol tabs 3-002 mg 1 PREV drospirenone-ethinyl estradiol tabs 3-003 mg 1 PREV [Levonorgestrel (emergency Oc)] ECONTRA EZ TABS 15 MG 1 PREV

ELLA TABS 30 MG [ulipristal acetate] 2 PREV [Etonogestrel-ethinyl Estradiol] ELURYNG RING 012-0015 MG24HR 1 PREV

JOLIVETTE TABS 035 MG [norethindrone (contraceptive)] 1 PREV

[Norethin Acet amp Estrad-fe] JUNEL FE 1530 TABS 15-30 MG-MCG 1 PREV


[Ethynodiol Diacet amp Eth Estrad] KELNOR 150 TABS 1-50 MG-MCG 1 PREV

[Norethindrone Acet amp Eth Estra] LOESTRIN 120 (21) TABS 1-20 MG-MCG 1 PREV

[Levonorgestrel amp Eth Estradiol] LUTERA TABS 01-20 MG-MCG 1 PREV

MIRENA (52 MG) IUD 20 MCG24HR [levonorgestrel (iud)] 2 PREVMB

[Norethindrone amp Eth Estradiol] NECON 0535 (28) TABS 05-35 MG-MCG 1 PREV

[Norethindrone-eth Estradiol (biphasic)] NECON 1011-28 TAB 1011-28 2 PREV

NEXPLANON IMPL 68 MG [etonogestrel] 2 PREVMB [Norethindrone amp Eth Estradiol] NORTREL 135 (28) TABS 1-35 MG-MCG 1 PREV

[Norethindrone-eth Estradiol (triphasic)] NORTREL 777 TABS 050751-35 MG-MCG 1 PREV

[Norgestrel amp Ethinyl Estradiol] OGESTREL TABS 05-50 MG-MCG 2 PREV

[Levonorgestrel amp Eth Estradiol] PORTIA-28 TABS 015-30 MG-MCG 1 PREV

[Desogestrel amp Ethinyl Estradiol] RECLIPSEN TABS 015-30 MG-MCG 1 PREV

[Norgestimate-ethinyl Estradiol] SPRINTEC 28 TABS 025-35 MG-MCG 1 PREV

[Norgestimate-ethinyl Estradiol (triphasic)] TRI-LO-SPRINTEC TABS 0180215025 MG-25 MCG 1 PREV

[Norgestimate-ethinyl Estradiol (triphasic)] TRI-SPRINTEC TABS 0180215025 MG-35 MCG 1 PREV

[Levonorgestrel-eth Estradiol (triphasic)] TRIVORA (28) TABS 50-3075-40 125-30 MCG 1 PREV

[Norelgestromin-ethinyl Estradiol] XULANE PTWK 150-35 MCG24HR 2 PREV

[Norelgestromin-ethinyl Estradiol] ZAFEMY PTWK 150- 1 PREV




35 MCG24HR [Ethynodiol Diacet amp Eth Estrad] ZOVIA 135E (28) TABS 1-35 MG-MCG 1 PREV

ESTROGENS AND ESTROGEN AGONISTS-ANTAGONISTS CLIMARA PTWK 0025 MG24HR [estradiol] 2 CLIMARA PTWK 00375 MG24HR [estradiol] 2 CLIMARA PTWK 005 MG24HR [estradiol] 2 CLIMARA PTWK 006 MG24HR [estradiol] 2 CLIMARA PTWK 0075 MG24HR [estradiol] 2 CLIMARA PTWK 01 MG24HR [estradiol] 2 clomiphene citrate tabs 50 mg 1 DELESTROGEN OIL 20 MGML [estradiol valerate] 2 DELESTROGEN OIL 40 MGML [estradiol valerate] 2 [Estradiol Cypionate] DEPO-ESTRADIOL OIL 5 MGML 2 MB EEMT HS TABS 0625-125 MG [esterified estrogens amp methyltestosterone] 1

EEMT TABS 125-25 MG [esterified estrogens amp methyltestosterone] 1

[Estradiol Vaginal] ESTRACE CREA 01 MGGM 2 estradiol pttw 0025 mg24hr 1 estradiol pttw 00375 mg24hr 1 estradiol pttw 005 mg24hr 1 estradiol pttw 0075 mg24hr 1 estradiol pttw 01 mg24hr 1 estradiol ptwk 005 mg24hr 1 estradiol ptwk 0075 mg24hr 1 estradiol ptwk 01 mg24hr 1 estradiol tabs 05 mg 1 estradiol tabs 1 mg 1 estradiol tabs 2 mg 1 estradiol valerate inj 10mgml 1 estradiol valerate oil 20 mgml 1 estradiol valerate oil 40 mgml 1 ESTRING RING 2 MG [estradiol vaginal] 2 PREMARIN SOLR 25 MG [estrogens conjugated] 2 raloxifene hcl tabs 60 mg 1 OCPREV VAGIFEM TABS 10 MCG [estradiol vaginal] 2 GONADOTROPINS GONAL-F RFF REDIJECT SOLN 300 UNIT05ML [follitropin alfa] 2

GONAL-F RFF REDIJECT SOLN 450 UNT075ML [follitropin alfa] 2

GONAL-F RFF REDIJECT SOLN 900 UNIT15ML [follitropin alfa] 2




GONAL-F RFF SOLR 75 UNIT [follitropin alfa] 2 GONAL-F SOLR 1050 UNIT [follitropin alfa] 2 MB GONAL-F SOLR 450 UNIT [follitropin alfa] 2 MB MENOPUR SOLR 75 UNIT [menotropins] 2 NOVAREL SOLR 10000 UNIT [chorionic gonadotropin] 1 MB

OVIDREL INJ 250 MCG05ML [choriogonadotropin alfa] 2

SYNAREL SOLN 2 MGML [nafarelin acetate] 4 PARATHYROID calcitonin (salmon) soln 200 unitact 1 FORTEO SOPN 620 MCG248ML [teriparatide (recombinant)] 4 QL - 30 day(s)MB

PITUITARY ACTHAR GEL 80 UNITML [corticotropin] 4 LDMB DDAVP RHINAL TUBE SOLN 001 [desmopressin acetate refrigerated] 2

desmopressin ace spray refrig soln 001 1 desmopressin acetate soln 4 mcgml 1 MB desmopressin acetate spray soln 001 1 desmopressin acetate tabs 01 mg 1 desmopressin acetate tabs 02 mg 1 STIMATE SOLN 15 MGML [desmopressin acetate] 4 PROGESTINS DEPO-PROVERA SUSP 400 MGML [medroxyprogesterone acetate (antineoplastic)] 2 MB

ENDOMETRIN INST 100 MG [progesterone (vaginal)] 2 hydroxyprogesterone caproate soln 125 gm5ml 1 QL - 30 day(s)MB MAKENA OIL 250 MGML [hydroxyprogesterone caproate] 2 QL - 30 day(s)MB

medroxyprogesterone acetate susp 150 mgml 1 PREVMB medroxyprogesterone acetate susy 150 mgml 1 PREVMB medroxyprogesterone acetate tabs 10 mg 1 OC medroxyprogesterone acetate tabs 25 mg 1 OC medroxyprogesterone acetate tabs 5 mg 1 OC norethindrone acetate tabs 5 mg 1 progesterone caps 100 mg 1 OC progesterone caps 200 mg 1 OC PROGESTERONE OIL 50 MGML [progesterone] 1 MB SOMATROPIN AGONISTS-ANTAGONISTS NORDITROPIN FLEXPRO SOPN 15 MG15ML [somatropin] 4 QL - 30 day(s)

OMNITROPE SOCT 10 MG15ML [somatropin] 2 QL - 30 day(s) OMNITROPE SOCT 5 MG15ML [somatropin] 2 QL - 30 day(s)




OMNITROPE SOLR 58 MG [somatropin] 2 SEROSTIM SOLR 4 MG [somatropin (non-refrigerated)] 4 QL - 30 day(s)

SEROSTIM SOLR 5 MG [somatropin (non-refrigerated)] 4 QL - 30 day(s)


THYROID AND ANTITHYROID AGENTS LEVOTHYROXINE SODIUM SOLR 200 MCG [levothyroxine sodium] 2 MB

LEVOTHYROXINE SODIUM SOLR 500 MCG [levothyroxine sodium] 2 MB

levothyroxine sodium tabs 100 mcg 1 levothyroxine sodium tabs 112 mcg 1 levothyroxine sodium tabs 125 mcg 1 levothyroxine sodium tabs 150 mcg 1 levothyroxine sodium tabs 175 mcg 1 levothyroxine sodium tabs 200 mcg 1 levothyroxine sodium tabs 25 mcg 1 levothyroxine sodium tabs 300 mcg 1 levothyroxine sodium tabs 50 mcg 1 levothyroxine sodium tabs 75 mcg 1 levothyroxine sodium tabs 88 mcg 1 LEVOXYL TABS 137 MCG [levothyroxine sodium] 1 liothyronine sodium tabs 25 mcg 1 liothyronine sodium tabs 5 mcg 1 liothyronine sodium tabs 50 mcg 1 methimazole tabs 10 mg 1 methimazole tabs 5 mg 1 propylthiouracil tabs 50 mg 1 SSKI SOLN 1 GMML [potassium iodide (expectorant)] 2

IMMUNOLOGICAL AGENTS ANTIRHEUMATIC AGENTS ENBREL SOLR 25 MG [etanercept] 4 QL - 30 day(s) ENBREL SOSY 25 MG05ML [etanercept] 4 QL - 30 day(s) ENBREL SOSY 50 MGML [etanercept] 4 QL - 30 day(s) ENBREL SURECLICK SOAJ 50 MGML [etanercept] 4 QL - 30 day(s) HUMIRA PEN PNKT 40 MG08ML [adalimumab] 4 QL - 30 day(s) HUMIRA PSKT 10 MG02ML [adalimumab] 4 QL - 30 day(s) HUMIRA PSKT 20 MG04ML [adalimumab] 4 QL - 30 day(s) HUMIRA PSKT 40 MG08ML [adalimumab] 4 QL - 30 day(s) KINERET INJ [anakinra] 4 QL - 30 day(s)LD leflunomide tabs 10 mg 1




leflunomide tabs 20 mg 1 ORENCIA CLICKJECT SOAJ 125 MGML [abatacept] 4 QL - 30 day(s) ORENCIA SOLR 250 MG [abatacept] 4 QL - 30 day(s)MB ORENCIA SOSY 125 MGML [abatacept] 4 ORENCIA SOSY 50 MG04ML [abatacept] 4 QL - 30 day(s) ORENCIA SOSY 875 MG07ML [abatacept] 4 QL - 30 day(s) OTEZLA TAB 102030 [apremilast] 4 QL - 30 day(s) OTEZLA TABS 30 MG [apremilast] 4 QL - 30 day(s) OTEZLA TBPK 10 amp 20 amp 30 MG [apremilast] 4 QL - 30 day(s) RASUVO SOAJ 10 MG02ML [methotrexate (antirheumatic)] 2

RASUVO SOAJ 125 MG025ML [methotrexate (antirheumatic)] 2








REMICADE SOLR 100 MG [infliximab] 4 MB IMMUNE SUPPRESSANTS ATGAM INJ 50 MGML [lymphocyte immune globulinanti-thymocyte globulin (equine)] 2 MB

azathioprine tabs 50 mg 1 mycophenolate mofetil caps 250 mg 1 mycophenolate mofetil susr 200 mgml 1 NEORAL SOLN 100 MGML [cyclosporine modified (for microemulsion)] 2

PROGRAF SOLN 5 MGML [tacrolimus] 2 MB RAPAMUNE SOLN 1 MGML [sirolimus] 2 SANDIMMUNE CAPS 100 MG [cyclosporine] 2 SANDIMMUNE CAPS 25 MG [cyclosporine] 2 SANDIMMUNE SOLN 100 MGML [cyclosporine] 2 SANDIMMUNE SOLN 50 MGML [cyclosporine] 2 MB sirolimus tabs 05 mg 1 sirolimus tabs 1 mg 1 sirolimus tabs 2 mg 1




tacrolimus caps 05 mg 1 tacrolimus caps 1 mg 1 tacrolimus caps 5 mg 1 LOCAL ANESTHETICS LOCAL ANESTHETICS BUPIVACAINE FISIOPHARMA SOLN 25 MGML [bupivacaine hcl] 2 MB

bupivacaine hcl (pf) soln 025 1 MB bupivacaine hcl (pf) soln 05 1 MB bupivacaine hcl (pf) soln 075 1 MB bupivacaine hcl inj 075 1 MB bupivacaine hcl soln 025 1 MB bupivacaine hcl soln 05 1 MB bupivacaine in dextrose soln 075-825 1 MB bupivacaine-epinephrine (pf) soln 025 -1200000 1 MB bupivacaine-epinephrine (pf) soln 05 -1200000 1 MB bupivacaine-epinephrine soln 025 -1200000 1 MB bupivacaine-epinephrine soln 05 -1200000 1 MB chloroprocaine hcl (pf) soln 2 1 MB chloroprocaine hcl inj 3 1 MB LIDOCAINE HCL (CARDIAC) PF SOLN 100 MG5ML [lidocaine hcl (cardiac)] 2 MB

lidocaine hcl (pf) soln 05 1 MB lidocaine hcl (pf) soln 1 1 MB lidocaine hcl (pf) soln 2 1 MB lidocaine hcl (pf) soln 4 1 MB lidocaine hcl soln 05 1 MB lidocaine hcl soln 1 1 MB lidocaine hcl soln 2 1 MB lidocaine-epinephrine soln 05 -1200000 1 MB lidocaine-epinephrine soln 1 -1100000 1 MB lidocaine-epinephrine soln 15 -1200000 1 MB lidocaine-epinephrine soln 2 -1100000 1 MB lidocaine-epinephrine soln 2 -1200000 1 MB NAROPIN SOLN 10 MGML [ropivacaine hcl] 2 MB NAROPIN SOLN 2 MGML [ropivacaine hcl] 2 MB NAROPIN SOLN 5 MGML [ropivacaine hcl] 2 MB NAROPIN SOLN 75 MGML [ropivacaine hcl] 2 MB NESACAINE SOLN 1 [chloroprocaine hcl] 2 MB NESACAINE SOLN 2 [chloroprocaine hcl] 2 MB [Mepivacaine Hcl] POLOCAINE SOLN 1 1 MB [Mepivacaine Hcl] POLOCAINE SOLN 2 1 MB [Mepivacaine Hcl] POLOCAINE-MPF SOLN 1 1 MB




[Mepivacaine Hcl] POLOCAINE-MPF SOLN 15 1 MB [Mepivacaine Hcl] POLOCAINE-MPF SOLN 2 1 MB SENSORCAINE-MPFEPINEPHRINE SOLN 075-1200000 [bupivacaine w epinephrine] 2 MB

TETRACAINE HCL SOLN 1 [tetracaine hcl] 2 MB XYLOCAINE-MPFEPINEPHRINE SOLN 1 -1200000 [lidocaine w epinephrine] 2 MB

MISCELLANEOUS THERAPEUTIC AGENTS MISCELLANEOUS THERAPEUTIC AGENTS acetylcysteine soln 10 1 acetylcysteine soln 20 1 ACETYLCYSTEINE SOLN 200 MGML [acetylcysteine (antidote)] 1 MB

ACTIMMUNE SOLN 2000000 UNIT05ML [interferon gamma-1b] 4 QL - 30 day(s)

alendronate sodium tabs 10 mg 1 alendronate sodium tabs 35 mg 1 alendronate sodium tabs 40 mg 2 alendronate sodium tabs 70 mg 1 allopurinol tabs 100 mg 1 allopurinol tabs 300 mg 1 [Disulfiram] ANTABUSE TABS 250 MG 2 AVONEX PEN AJKT 30 MCG05ML [interferon beta-1a] 4 QL - 30 day(s)MB

BOTOX COSMETIC SOLR 100 UNIT [onabotulinumtoxina (cosmetic)] 2 MB

BOTOX SOLR 100 UNIT [onabotulinumtoxina] 2 MB BOTOX SOLR 200 UNIT [onabotulinumtoxina] 2 MB BRIDION SOLN 200 MG2ML [sugammadex sodium] 2 MB CERDELGA CAPS 84 MG [eliglustat tartrate] 4 QL - 30 day(s) cinacalcet hcl tabs 30 mg 1 cinacalcet hcl tabs 60 mg 1 cinacalcet hcl tabs 90 mg 1 CINRYZE SOLR 500 UNIT [c1 esterase inhibitor (human)] 4 QL - 30 day(s)MB

colchicine tabs 06 mg 1 CYSTADANE POWD [betaine] 4 QL - 30 day(s) CYSTAGON CAPS 150 MG [cysteamine bitartrate] 2 QL - 30 day(s)LD CYSTAGON CAPS 50 MG [cysteamine bitartrate] 2 QL - 30 day(s)LD dexrazoxane hcl solr 250 mg 1 MB dexrazoxane hcl solr 500 mg 1 MB dimethyl fumarate cpdr 120 mg 1 dimethyl fumarate cpdr 240 mg 1 dimethyl fumarate starter pack misc 120 amp 240 mg 1




disulfiram tabs 250 mg 1 disulfiram tabs 500 mg 1 ELMIRON CAPS 100 MG [pentosan polysulfate sodium] 2

etidronate disodium tabs 200 mg 2 etidronate disodium tabs 400 mg 2 finasteride tabs 5 mg 1 FIRAZYR SOLN 30 MG3ML [icatibant acetate] 4 QL - 30 day(s) FLUORITAB CHEW 22 (1 F) MG [sodium fluoride] 1 PREV FLURA-DROPS SOLN 055 (025 F) MGDROP [sodium fluoride] 2 PREV

FUSILEV SOLR 50 MG [levoleucovorin calcium] 2 MB [Cyclosporine Modified (for Microemulsion)] GENGRAF CAPS 100 MG 1

[Cyclosporine Modified (for Microemulsion)] GENGRAF CAPS 25 MG 1

[Glatiramer Acetate] GLATOPA SOSY 40 MGML 1 GRASTEK SUBL 2800 BAU [timothy grass pollen allergen extract] 2

HAEGARDA SOLR 2000 UNIT [c1 esterase inhibitor (human)] 4 QL - 30 day(s)


HUMIRA PEDIATRIC CROHNS START PSKT 80 MG08ML [adalimumab] 4 QL - 30 day(s)

HUMIRA PEDIATRIC CROHNS START PSKT 80 MG08ML amp 40MG04ML [adalimumab] 4 QL - 30 day(s)

HUMIRA PEN PNKT 40 MG04ML [adalimumab] 4 QL - 30 day(s) HUMIRA PEN-CDUCHS STARTER PNKT 80 MG08ML [adalimumab] 4 QL - 30 day(s)

HUMIRA PEN-PSORUVEIT STARTER PNKT 80 MG08ML amp 40MG04ML [adalimumab] 4 QL - 30 day(s)

HUMIRA PSKT 10 MG01ML [adalimumab] 4 QL - 30 day(s) HUMIRA PSKT 20 MG02ML [adalimumab] 4 QL - 30 day(s) HUMIRA PSKT 40 MG04ML [adalimumab] 4 QL - 30 day(s) icatibant acetate soln 30 mg3ml 1 QL - 30 day(s)MB INFLECTRA SOLR 100 MG [infliximab-dyyb] 4 MB KALYDECO PACK 50 MG [ivacaftor] 4 QL - 30 day(s) KALYDECO PACK 75 MG [ivacaftor] 4 QL - 30 day(s) KALYDECO TABS 150 MG [ivacaftor] 4 QL - 30 day(s) leucovorin calcium solr 100 mg 1 MB leucovorin calcium solr 350 mg 1 MB leucovorin calcium solr 50 mg 1 MB leucovorin calcium tabs 25 mg 1 leucovorin calcium tabs 5 mg 1




levocarnitine inj 200mgml 1 MB LEVOCARNITINE SOLN 1 GM10ML [levocarnitine (metabolic modifiers)] 1

LEVOCARNITINE TABS 330 MG [levocarnitine (metabolic modifiers)] 1

LUDENT CHEW 055 (025 F) MG [sodium fluoride] 1 PREV MESNA SOLN 100 MGML [mesna] 1 MB MESNEX TABS 400 MG [mesna] 2 QL - 30 day(s) METHYLENE BLUE SOLN 1 [methylene blue (antidote)] 1 MB

mycophenolate mofetil tabs 500 mg 1 MYOBLOC SOLN 10000 UNIT2ML [rimabotulinumtoxinb] 2 MB

MYOBLOC SOLN 2500 UNIT05ML [rimabotulinumtoxinb] 2 MB

MYOBLOC SOLN 5000 UNITML [rimabotulinumtoxinb] 2 MB

octreotide acetate soln 100 mcgml 1 MB octreotide acetate soln 1000 mcgml 1 MB octreotide acetate soln 200 mcgml 1 MB octreotide acetate soln 50 mcgml 1 MB octreotide acetate soln 500 mcgml 1 MB octreotide acetate sosy 50 mcgml 1 MB pamidronate disodium soln 30 mg10ml 1 MB pamidronate disodium soln 6 mgml 2 MB pamidronate disodium soln 90 mg10ml 1 MB pamidronate disodium solr 30 mg 1 MB pamidronate disodium solr 90 mg 1 MB PREVIDENT 5000 PLUS CREA 11 [sodium fluoride (dental)] 2

PREVIDENT GEL 11 [sodium fluoride (dental)] 2 PREVIDENT SOLN 02 [sodium fluoride (dental)] 2 RIMSO-50 SOLN 50 [dimethyl sulfoxide] 2 MB SANDOSTATIN LAR DEPOT KIT 10 MG [octreotide acetate] 4 QL - 30 day(s)MB

SANDOSTATIN LAR DEPOT KIT 20 MG [octreotide acetate] 4 QL - 30 day(s)MB


SF 5000 PLUS CREA 11 [sodium fluoride (dental)] 1 sirolimus soln 1 mgml 1 SODIUM FLUORIDE CHEW 11 (05 F) MG [sodium fluoride] 1 PREV

SODIUM FLUORIDE SOLN 11 (05 F) MGML [sodium fluoride] 1 PREV




SOLIRIS SOLN 300 MG30ML [eculizumab] 4 MB sterile water for injection soln 1 MB TAKHZYRO SOLN 300 MG2ML [lanadelumab-flyo] 4 QL - 30 day(s) THALOMID CAPS 100 MG [thalidomide] 4 QL - 30 day(s) THALOMID CAPS 150 MG [thalidomide] 4 QL - 30 day(s) THALOMID CAPS 200 MG [thalidomide] 4 QL - 30 day(s) THALOMID CAPS 50 MG [thalidomide] 4 QL - 30 day(s) THIOLA TABS 100 MG [tiopronin] 2 LD TRI-CHLOR LIQD 80 [trichloroacetic acid] 2 TYSABRI CONC 300 MG15ML [natalizumab] 4 QL - 30 day(s)LDMB ULTOMIRIS SOLN 1100 MG11ML [ravulizumab-cwvz] 4 ULTOMIRIS SOLN 300 MG30ML [ravulizumab-cwvz] 4 ULTOMIRIS SOLN 300 MG3ML [ravulizumab-cwvz] 4 XELJANZ TABS 10 MG [tofacitinib citrate] 4 XELJANZ TABS 5 MG [tofacitinib citrate] 4 QL - 30 day(s) XELJANZ XR TB24 11 MG [tofacitinib citrate] 4 QL - 30 day(s) ZINECARD SOLR 250 MG [dexrazoxane hcl] 2 MB ZINECARD SOLR 500 MG [dexrazoxane hcl] 2 MB zoledronic acid conc 4 mg5ml 1 MB zoledronic acid soln 5 mg100ml 1 MB OXYTOCICS OXYTOCICS CERVIDIL INST 10 MG [dinoprostone] 2 HEMABATE SOLN 250 MCGML [carboprost tromethamine] 2 MB

methylergonovine maleate soln 02 mgml 1 MB methylergonovine maleate tabs 02 mg 1 MIFEPREX TABS 200 MG [mifepristone] 2 OXYTOCIN SOLN 10 UNITML [oxytocin] 1 MB PREPIDIL GEL 05 MG3GM [dinoprostone] 2 PROSTIN E2 SUPP 20 MG [dinoprostone] 2 PHARMACEUTICAL AIDS PHARMACEUTICAL AIDS ALOE VERA POWD [aloe vera (bulk)] 2 ALPROSTADIL POWD [alprostadil (bulk)] 2 ATROPINE SULFATE MONOHYDRATE POW MONOHYDT [atropine sulfate monohydrate] 2

BACLOFEN POWD [baclofen] 2 BACTERIOSTATIC WATER(BENZ ALC) SOLN [water for inject bacteriostatic benzyl alcohol] 2 MB

BIOTIN-D POWD [biotin (bulk)] 2 BORIC ACID POWD [boric acid (bulk)] 2 CANTHARIDIN POW [cantharidin] 2




CARBAMAZEPINE POWD [carbamazepine] 2 CHLOROFORM SOL [chloroform] 2 CHLORPROMAZINE HCL POW HCL [chlorpromazine hcl] 2

CHOLESTEROL POWD [cholesterol] 2 CLINDAMYCIN HCL POWD [clindamycin hcl (bulk)] 2 CLOBETASOL PROPIONATE POW PROPIONA [clobetasol propionate] 2

CLONIDINE HCL POWD [clonidine hcl] 2 CLOTRIMAZOLE CRYS [clotrimazole (topical)] 2 CLOTRIMAZOLE POWD [clotrimazole (topical)] 2 COAL TAR EXTRACT SOLN 20 [coal tar (crude)] 2 COLLODION FLEXIBLE LIQD [collodion flexible] 2 CYSTEAMINE HCL POWD [cysteamine hcl (bulk)] 2 DEXAMETHASONE POWD [dexamethasone (bulk)] 2 DILTIAZEM HCL POWD [diltiazem hcl (bulk)] 2 ESTRADIOL POW [estradiol] 2 GABAPENTIN POWD [gabapentin (bulk)] 2 GLYCERIN LIQD [glycerin (bulk)] 2 GLYCOPYRROLATE POWD [glycopyrrolate (bulk)] 2 HALOPERIDOL POWD [haloperidol (bulk)] 2 HYDROCORTISONE POWD [hydrocortisone (topical)] 2

HYDROPHILIC OINT [hydrophilic ointment] 2 HYDROXOCOBALAMIN POW [hydroxocobalamin (bulk)] 2

HYDROXYPROGESTERONE CAPROATE POWD [hydroxyprogesterone caproate (bulk)] 2

INDOMETHACIN POWD [indomethacin] 2 ISOSORBIDE POWD [isosorbide (bulk)] 2 KETAMINE HCL POWD [ketamine hcl (bulk)] 2 KETOPROFEN POWD [ketoprofen (bulk)] 2 L-ARGININE POWD [arginine] 2 L-CITRULLINE POWD [citrulline (bulk)] 2 L-ISOLEUCINE POWD [isoleucine] 2 L-PROLINE POWD [proline] 2 L-VALINE POWD [valine] 2 LACTIC ACID SOLN [lactic acid (bulk)] 2 LACTOSE MONOHYDRATE POWD [lactose monohydrate] 2

LACTOSE POWD [lactose] 2 LIDOCAINE HCL POWD [lidocaine hcl (bulk)] 2 METHADONE HCL POWD [methadone hcl] 2 METOCLOPRAMIDE HCL MONOHYDRATE POWD 2




[metoclopramide hcl monohydrate] METRONIDAZOLE POWD [metronidazole (bulk)] 2 MORPHINE SULFATE POWD [morphine sulfate] 2 NEOMYCIN SULFATE POWD [neomycin sulfate (topical)] 2

PAPAVERINE HCL POWD [papaverine hcl] 2 PHENOBARBITAL POWD [phenobarbital] 2 PHENTOLAMINE MESYLATE POWD [phentolamine mesylate (bulk)] 2

PLURONIC F127 GEL 20 [pluronic f127 base] 2 PODOPHYLLUM RESIN POWD [podophyllum resin] 2 POLYETHYLENE GLYCOL 400 LIQD [polyethylene glycol 400] 2

POLYETHYLENE GLYCOL 8000 POWD [polyethylene glycol 8000] 2

PROGESTERONE MICRONIZED POWD [progesterone micronized (bulk)] 2

PROGESTERONE WETTABLE POWD [progesterone (bulk)] 2

PROPYLENE GLYCOL LIQD [propylene glycol (bulk)] 2 QUINACRINE HCL POWD [quinacrine hcl] 2 SALICYLIC ACID POWD [salicylic acid (bulk)] 2 SODIUM BENZOATE POWD [sodium benzoate] 2 SORBITOL SOLN 70 [sorbitol] 2 SQUARIC ACID DIBUTYLESTER POW DIBUTYLS [squaric acid dibutylester] 2

STERILE WATER FOR INJECTION SOLN [water for injection sterile] 1 MB

SULFUR PRECIPITATED POWD [sulfur (bulk)] 2 TESTOSTERONE PROPIONATE POWD [testosterone propionate (bulk)] 2

THYMOL CRYS [thymol] 2 TRANEXAMIC ACID POWD [tranexamic acid (bulk)] 2 TRIAMCINOLONE ACETONIDE POWD [triamcinolone acetonide (topical)] 2

UREA POWD [urea (bulk)] 2 VERAPAMIL HCL POWD [verapamil hcl] 2 ZINC SULFATE GRAN [zinc sulfate] 2 ZINC SULFATE HEPTAHYDRATE POWD [zinc sulfate heptahydrate] 2

ZINC SULFATE MONOHYDRATE POWD [zinc sulfate monohydrate] 2

RESPIRATORY TRACT AGENTS ANTI-INFLAMMATORY AGENTS ADVAIR HFA AERO 115-21 MCGACT [fluticasone- 2




salmeterol] ADVAIR HFA AERO 230-21 MCGACT [fluticasone-salmeterol] 2

ADVAIR HFA AERO 45-21 MCGACT [fluticasone-salmeterol] 2

AEROSPAN AERS 80 MCGACT [flunisolide hfa] 2 ALVESCO AERS 160 MCGACT [ciclesonide] 2 ALVESCO AERS 80 MCGACT [ciclesonide] 2 COMBIVENT RESPIMAT AERS 20-100 MCGACT [ipratropium-albuterol] 2

cromolyn sodium conc 100 mg5ml 1 cromolyn sodium nebu 20 mg2ml 1 montelukast sodium chew 4 mg 1 montelukast sodium chew 5 mg 1 montelukast sodium pack 4 mg 1 montelukast sodium tabs 10 mg 1 ANTITUSSIVES benzonatate caps 100 mg 1 CHERATUSSIN AC SYRP 100-10 MG5ML [guaifenesin-codeine] 1

hydrocodone-homatropine syrp 5-15 mg5ml 1 hydrocodone-homatropine tabs 5-15 mg 1 PHENYLHISTINE DH LIQ DH [pseudoeph-chlorphen w cod] 2

promethazine-codeine soln 625-10 mg5ml 1 promethazine-dm soln 625-15 mg5ml 1 promethazine-dm syrp 625-15 mg5ml 1 phenylephrine-chlorphen-dm liqd 1 VIRTUSSIN DAC SOLN 30-10-100 MG5ML [pseudoephedrine w codeine-gg] 1

MUCOLYTIC AGENTS SODIUM CHLORIDE NEBU 09 [sodium chloride (inhalant)] 1

SODIUM CHLORIDE NEBU 10 [sodium chloride (inhalant)] 1



PULMONARY SURFACTANTS CUROSURF SUSP 120 MG15ML [poractant alfa] 2 MB CUROSURF SUSP 240 MG3ML [poractant alfa] 2 MB SURVANTA SUSP 25-09 MGML- [beractant in nacl] 2 MB RESPIRATORY AGENTS MISCELLANEOUS ARALAST NP SOLR 500 MG [alpha1-proteinase 4 QL - 30 day(s)MB




inhibitor (human)] DALIRESP TABS 500 MCG [roflumilast] 2 KALYDECO PACK 25 MG [ivacaftor] 4 QL - 30 day(s) OFEV CAPS 100 MG [nintedanib esylate] 4 OFEV CAPS 150 MG [nintedanib esylate] 4 ORKAMBI PACK 100-125 MG [lumacaftor-ivacaftor] 4 QL - 30 day(s) ORKAMBI PACK 150-188 MG [lumacaftor-ivacaftor] 4 QL - 30 day(s) ORKAMBI TABS 100-125 MG [lumacaftor-ivacaftor] 4 QL - 30 day(s) ORKAMBI TABS 200-125 MG [lumacaftor-ivacaftor] 4 SYMDEKO TBPK 100-150 amp 150 MG [tezacaftor-ivacaftor] 4 QL - 30 day(s)

SYMDEKO TBPK 50-75 amp 75 MG [tezacaftor-ivacaftor] 4 TRIKAFTA TBPK 100-50-75 amp 150 MG [elexacaftor-tezacaftor-ivacaftor] 4 QL - 30 day(s)

TRIKAFTA TBPK 50-25-375 amp 75 MG [elexacaftor-tezacaftor-ivacaftor] 4 QL - 30 day(s)

XOLAIR SOLR 150 MG [omalizumab] 4 QL - 30 day(s)LD XOLAIR SOSY 150 MGML [omalizumab] 4 QL - 30 day(s) XOLAIR SOSY 75 MG05ML [omalizumab] 4 QL - 30 day(s) VASODILATING TRACLEER TBSO 32 MG [bosentan] 4 QL - 30 day(s) SERUMS TOXOIDS AND VACCINES SERUMS ANAVIP SOLR [crotalidae immune f(ab)2 (equine)] 2 ANTIVENIN LATRODECTUS MACTANS KIT [antivenin latrodectus mactans] 2 MB

CROFAB SOLR [crotalidae polyvalent immune fab (ovine)] 2 MB

CYTOGAM INJ 50 MGML [cytomegalovirus immune globulin (human)] 2 MB

DIGIFAB SOLR 40 MG [digoxin immune fab] 2 MB FLEBOGAMMA DIF SOLN 05 GM10ML [immune globulin (human) iv] 2 MB

FLEBOGAMMA DIF SOLN 25 GM50ML [immune globulin (human) iv] 2 MB



GAMASTAN INJ [immune globulin (human) im] 2 MB GAMMAGARD SD LESS IGA SOLR 10 GM [immune globulin (human) iv] 2 MB

GAMMAGARD SD LESS IGA SOLR 5 GM [immune globulin (human) iv] 2 MB

GAMMAGARD SOLN 1 GM10ML [immune globulin 2 MB




(human) iv or subcutaneous] GAMMAGARD SOLN 30 GM300ML [immune globulin (human) iv or subcutaneous] 2 MB

GAMMAKED SOLN 1 GM10ML [immune globulin (human) iv or subcutaneous] 2 MB





GAMMAPLEX SOLN 10 GM200ML [immune globulin (human) iv] 2 MB



GAMUNEX-C SOLN 1 GM10ML [immune globulin (human) iv or subcutaneous] 2 MB





HIZENTRA SOLN 1 GM5ML [immune globulin (human) subcutaneous] 4 QL - 30 day(s)




HYPERRAB SD SOLN 300 UNIT2ML [rabies immune globulin (human)] 2 MB

HYPERRAB SOLN 300 UNITML [rabies immune globulin (human)] 2 MB

HYPERTET SD SOSY 250 UNITML [tetanus immune globulin (human)] 2 MB

HYQVIA KIT 10 GM100ML [immune globulin (human)-hyaluronidase (human recombinant)] 4 QL - 30 day(s)








IMOGAM RABIES-HT SOLN 300 UNIT2ML [rabies immune globulin (human)] 2 MB

MICRHOGAM ULTRA-FILTERED PLUS SOSY 250 UNIT [rho d immune globulin (human)] 2 MB

NABI-HB SOLN 312 UNITML [hepatitis b immune globulin (human)] 2 MB

OCTAGAM SOLN 1 GM20ML [immune globulin (human) iv] 2 MB



ODACTRA SUBL 12 SQ-HDM [dust mite mixed allergen extract] 2

PRIVIGEN SOLN 10 GM100ML [immune globulin (human) iv] 2 MB



RHOGAM ULTRA-FILTERED PLUS SOSY 1500 UNIT [rho d immune globulin (human)] 2 MB

RHOPHYLAC SOSY 1500 UNIT2ML [rho d immune globulin (human)] 2 MB

TOXOIDS ADACEL SUSP 5-2-155 LF-MCG05 [tetanus toxoid-diphtheria-acellular pertussis adsorb (tdap)] 2 MB

DIPHTHERIA-TETANUS TOXOIDS DT SUSP 25-5 LFU05ML [diphtheria-tetanus toxoids (dt)] 2 MB

INFANRIX SUSP 25-58-10 [diphtheria acellular pertussis amp tetanus toxoids] 2 MB

TDVAX SUSP 2-2 LF05ML [tetanus-diphtheria toxoids (td)] 2 MB

VACCINES ACTHIB SOLR [haemophilus b polysac conj vac] 2 MB AFLURIA SUSP [influenza virus vaccine split] 2 MB BEXSERO SUSY [meningococcal vac group b (recombant omv adjuvanted)] 2 MB

ENGERIX-B SUSP 10 MCG05ML [hepatitis b vaccine (recomb)] 2 MB

ENGERIX-B SUSP 20 MCGML [hepatitis b vaccine 2 MB




(recomb)] FLUAD SUSY 05 ML [influenza virus vaccine types a amp b surface antigen adjuvant] 2 MB

FLUZONE HIGH-DOSE SUSY 05 ML [influenza virus vaccine split high-dose preservative free] 2 MB

FLUZONE SUSP [influenza virus vaccine split] 2 MB GARDASIL 9 SUSP [human papillomavirus (hpv) 9-valent recombinant vaccine] 2 MB

GARDASIL 9 SUSY [human papillomavirus (hpv) 9-valent recombinant vaccine] 2 MB

GARDASIL INJ [human papillomavirus (hpv) quadrivalent recombinant vaccine] 2 MB

GARDASIL SUSP [human papillomavirus (hpv) quadrivalent recombinant vaccine] 2 MB

HAVRIX SUSP 1440 EL UML [hepatitis a vaccine] 2 MB HAVRIX SUSP 720 EL U05ML [hepatitis a vaccine] 2 MB HIBERIX SOLR 10 MCG [haemophilus b polysac conj vac] 2 MB

IMOVAX RABIES INJ 25 UNITML [rabies virus vaccine hdc] 2 MB

IPOL INJ [poliovirus vaccine ipv] 2 MB IXIARO SUSP [japanese encephalitis vaccine inactivated adsorbed] 2 MB

KINRIX SUSP [diph-tetanus tox ad-acell pertussis amp polio virus ipv vac] 2 MB

KINRIX SUSY 05 ML [diph-tetanus tox ad-acell pertussis amp polio virus ipv vac] 2 MB

M-M-R II SOLR [measles mumps amp rubella virus vaccines] 2 MB

MENVEO SOLR [meningococcal (acyampw-135) oligosaccharide conjugate vac] 2 MB

PEDIARIX SUSP [diph-tetanus tox-acell pert-hepatitis b recomb-polio ipv vac] 2 MB

PNEUMOVAX 23 INJ 25 MCG05ML [pneumococcal vac polyvalent] 2 MB

PREVNAR 13 SUSP [pneumococcal 13-valent conjugate vaccine] 2 MB

PROQUAD SUSR [measles-mumps-rubella-varicella virus vaccines] 2 MB

RABAVERT SUSR [rabies vaccine pcec] 2 MB RECOMBIVAX HB SUSP 10 MCGML [hepatitis b vaccine (recomb)] 2 MB

RECOMBIVAX HB SUSP 40 MCGML [hepatitis b vaccine (recomb)] 2 MB

RECOMBIVAX HB SUSP 5 MCG05ML [hepatitis b vaccine (recomb)] 2 MB

ROTARIX SUSR [rotavirus vaccine live oral] 2 MB




ROTATEQ SOLN [rotavirus vaccine live oral pentavalent] 2 MB

SHINGRIX SUSR 50 MCG05ML [zoster vaccine recombinant adjuvanted] 2 MB

TICE BCG SUSR 50 MG [bcg live intravesical] 2 MB TWINRIX SUSY 720-20 ELU-MCGML [hepatitis a (inactivated)-hepatitis b (recombinant) vaccines] 2 MB

TYPHIM VI SOLN 25 MCG05ML [typhoid vi polysaccharide vaccine] 2 MB

VAQTA SUSP 25 UNIT05ML [hepatitis a vaccine] 2 MB VAQTA SUSP 50 UNITML [hepatitis a vaccine] 2 MB VARIVAX INJ 1350 PFU05ML [varicella virus vaccine live] 2 MB

VAXCHORA SUSR [cholera vaccine live attenuated] 2 MB VIVOTIF CPDR [typhoid vaccine] 2 MB YF-VAX INJ [yellow fever vaccine] 2 MB SKIN AND MUCOUS MEMBRANE AGENTS ANTI-INFECTIVES AKTIPAK PACK 5-3 [benzoyl peroxide-erythromycin] 2

benzoyl peroxide-erythromycin gel 5-3 1 clindamycin phos-benzoyl perox gel 1-5 1 clindamycin phos-benzoyl perox gel 12-5 1 clindamycin phosphate crea 2 1 clindamycin phosphate gel 1 1 clindamycin phosphate lotn 1 1 clindamycin phosphate soln 1 1 clotrimazole troc 10 mg 1 DAKINS (14 STRENGTH) SOLN 0125 [sodium hypochlorite] 2

DAKINS (FULL STRENGTH) SOLN 05 [sodium hypochlorite] 2

erythromycin soln 2 1 gentamicin sulfate crea 01 1 gentamicin sulfate oint 01 1 GENTIAN VIOLET SOLN 1 [gentian violet] 2 HYDROCORTISONE-IODOQUINOL CREA 1-1 [iodoquinol-hc] 1

HYSEPT SOLN 025 [sodium hypochlorite] 1 ISAGEL GEL 60 [antiseptic products misc] 2 ketoconazole sham 2 1 permethrin lotn 1 1 malathion lotn 05 1 metronidazole crea 075 1 metronidazole gel 075 1




metronidazole lotn 075 1 mupirocin oint 2 1 neomycin-polymyxin b gu soln 40-200000 1 MB nystatin crea 100000 unitgm 1 [Nystatin (topical)] NYSTOP POWD 100000 UNITGM 1 permethrin crea 5 1 selenium sulfide lotn 25 1 SILVER SULFADIAZINE CREA 1 [silver sulfadiazine] 1

SULFAMYLON CREA 85 MGGM [mafenide acetate] 2 ANTI-INFLAMMATORY AGENTS alclometasone dipropionate crea 005 1 alclometasone dipropionate oint 005 1 ANUCORT-HC SUPP 25 MG [hydrocortisone acetate (rectal)] 1

betamethasone dipropionate aug crea 005 1 betamethasone dipropionate aug gel 005 1 betamethasone dipropionate aug lotn 005 1 betamethasone dipropionate aug oint 005 1 BETAMETHASONE DIPROPIONATE CREA 005 [betamethasone dipropionate (topical)] 1

BETAMETHASONE VALERATE CREA 01 [betamethasone valerate] 1

betamethasone valerate foam 012 1 BETAMETHASONE VALERATE LOTN 01 [betamethasone valerate] 1

BETAMETHASONE VALERATE OINT 01 [betamethasone valerate] 1

clobetasol propionate crea 005 1 clobetasol propionate foam 005 1 clobetasol propionate gel 005 1 clobetasol propionate lotn 005 1 clobetasol propionate oint 005 1 clobetasol propionate soln 005 1 CLOBEX LOTN 005 [clobetasol propionate] 2 CLOBEX SPRAY LIQD 005 [clobetasol propionate] 2 CORDRAN TAPE 4 MCGSQCM [flurandrenolide] 2 CORTISPORIN CREA 35-10000-05 [neomycin-polymyxin-hc] 2

CORTISPORIN OINT 1 [bacitracin-polymyxin-neomycin hc] 2

desonide oint 005 1 [Desonide] DESOWEN LOTN 005 2 desoximetasone crea 025 1




fluocinolone acetonide body oil 001 1 fluocinolone acetonide scalp oil 001 1 fluocinolone acetonide soln 001 1 fluocinonide crea 005 1 fluocinonide gel 005 1 fluocinonide oint 005 1 fluocinonide soln 005 1 fluticasone propionate crea 005 1 fluticasone propionate oint 0005 1 halobetasol propionate crea 005 1 halobetasol propionate oint 005 1 HYDROCORTISONE ACE-PRAMOXINE CREA 25-1 [pramoxine-hc] 1

hydrocortisone crea 25 1 hydrocortisone enem 100 mg60ml 1 hydrocortisone lotn 25 1 hydrocortisone oint 25 1 mometasone furoate crea 01 1 mometasone furoate oint 01 1 mometasone furoate soln 01 1 nystatin-triamcinolone crea 100000-01 unitgm- 1 nystatin-triamcinolone oint 100000-01 unitgm- 1 [Pramoxine-hc] PRAMOSONE CREA 1-1 2 [Pramoxine-hc] PRAMOSONE LOTN 1-1 2 [Pramoxine-hc] PRAMOSONE LOTN 1-25 2 PRAMOSONE OINT 1-1 [pramoxine-hc] 2 PRAMOSONE OINT 1-25 [pramoxine-hc] 2 [Hydrocortisone (rectal)] PROCTOSOL HC CREA 25 1 triamcinolone acetonide crea 0025 1 triamcinolone acetonide crea 01 1 triamcinolone acetonide crea 05 1 triamcinolone acetonide lotn 01 1 triamcinolone acetonide oint 0025 1 triamcinolone acetonide oint 01 1 triamcinolone acetonide oint 05 1 triamcinolone acetonide pste 01 1 ANTIPRURITICS AND LOCAL ANESTHETICS [Hydrocortisone Acetate W Pramoxine] ANALPRAM-HC CREA 1-1 1

[Hydrocortisone Acetate W Pramoxine] ANALPRAM-HC LOTN 25-1 2

HYDROCORT-PRAMOXINE (PERIANAL) CREA 25-1 [hydrocortisone acetate w pramoxine] 1

hydrocortisone ace-pramoxine crea 1-1 1




lidocaine hcl soln 4 1 lidocaine hcl urethralmucosal gel 2 1 lidocaine hcl urethralmucosal prsy 2 1 lidocaine oint 5 1 lidocaine-prilocaine crea 25-25 1 lidocaine-prilocaine kit 25-25 1 PHENOL LIQD [phenol] 2 [Hydrocortisone Acetate W Pramoxine] PROCTOFOAM HC FOAM 1-1 1

SARNA LOTN 05-05 [camphor amp menthol] 2 ASTRINGENTS DRYSOL SOLN 20 [aluminum chloride] 2 XERAC AC SOLN 625 [aluminum chloride in alcohol] 2

CELL STIMULANTS AND PROLIFERANTS AVITA CREA 0025 [tretinoin] 1 KEPIVANCE SOLR 625 MG [palifermin] 4 QL - 30 day(s)MB RETIN-A CREA 0025 [tretinoin] 1 RETIN-A CREA 005 [tretinoin] 2 RETIN-A CREA 01 [tretinoin] 1 RETIN-A GEL 001 [tretinoin] 1 RETIN-A GEL 0025 [tretinoin] 2 RETIN-A MICRO GEL 004 [tretinoin microsphere] 1 RETIN-A MICRO GEL 01 [tretinoin microsphere] 1 DEPIGMENTING AND PIGMENTING AGENTS methoxsalen rapid caps 10 mg 1 OXSORALEN ULTRA CAPS 10 MG [methoxsalen rapid] 2

KERATOLYTIC AGENTS KERALYT GEL 6 [salicylic acid] 2 SULFACETAMIDE SODIUM-SULFUR LIQD 10-5 [sulfacetamide sodium w sulfur] 1

SULFACETAMIDE SODIUM-SULFUR LOTN 10-5 [sulfacetamide sodium w sulfur] 2

SULFACETAMIDE SODIUM-SULFUR SUSP 10-5 [sulfacetamide sodium w sulfur] 2


KERATOPLASTIC AGENTS ELTA TAR CREA 2 [coal tar extract] 2 SKIN AND MUCOUS MEMBRANE AGENTS MISCELLANEOUS acitretin caps 10 mg 1 QL - 30 day(s) acitretin caps 25 mg 1 QL - 30 day(s) adapalene gel 01 1




adapalene gel 03 1 adapalene-benzoyl peroxide gel 01-25 1 BENZOIN COMPOUND TINC [benzoin compound] 1 BENZOIN TINC [benzoin] 2 calcipotriene crea 0005 1 calcipotriene soln 0005 1 [Isotretinoin] CLARAVIS CAPS 10 MG 1 QL - 30 day(s) [Isotretinoin] CLARAVIS CAPS 20 MG 1 QL - 30 day(s) [Isotretinoin] CLARAVIS CAPS 30 MG 1 QL - 30 day(s) [Isotretinoin] CLARAVIS CAPS 40 MG 1 QL - 30 day(s) CONDYLOX GEL 05 [podofilox] 2 COSENTYX (300 MG DOSE) SOSY 150 MGML [secukinumab] 4 QL - 30 day(s)

COSENTYX SENSOREADY (300 MG) SOAJ 150 MGML [secukinumab] 4 QL - 30 day(s)

COSENTYX SENSOREADY PEN SOAJ 150 MGML [secukinumab] 4 QL - 30 day(s)

COSENTYX SOSY 150 MGML [secukinumab] 4 QL - 30 day(s) diclofenac sodium gel 1 1 diclofenac sodium soln 15 1 DIFFERIN CREA 01 [adapalene] 2 DIFFERIN GEL 01 [adapalene] 2 DIFFERIN GEL 03 [adapalene] 2 DRITHO-CREME HP CREA 1 [anthralin] 2 EPIDUO FORTE GEL 03-25 [adapalene-benzoyl peroxide] 2

FLUOROPLEX CREA 1 [fluorouracil (topical)] 2 fluorouracil crea 5 1 fluorouracil soln 2 1 fluorouracil soln 5 1 imiquimod crea 5 1 LEVULAN KERASTICK SOLR 20 [aminolevulinic acid hcl] 2

pimecrolimus crea 1 1 PODOCON SOLN 25 [podophyllum resin] 2 podofilox soln 05 1 SANTYL OINT 250 UNITGM [collagenase] 2 SKYRIZI PEN SOAJ 150 MGML [risankizumab-rzaa] 4 SKYRIZI SOSY 150 MGML [risankizumab-rzaa] 4 SODIUM CHLORIDE TABS 1 GM [sodium chloride] 1 STELARA SOLN 45 MG05ML [ustekinumab] 4 STELARA SOSY 45 MG05ML [ustekinumab] 4 STELARA SOSY 90 MGML [ustekinumab] 4 TACROLIMUS OINT 003 [tacrolimus (topical)] 1




TACROLIMUS OINT 01 [tacrolimus (topical)] 1 TARGRETIN GEL 1 [bexarotene (topical)] 4 tazarotene crea 01 1 TAZORAC CREA 005 [tazarotene] 2 TAZORAC GEL 005 [tazarotene] 2 TAZORAC GEL 01 [tazarotene] 2 TREMFYA SOPN 100 MGML [guselkumab] 4 TREMFYA SOSY 100 MGML [guselkumab] 4 VECTICAL OINT 3 MCGGM [calcitriol (topical)] 2 SMOOTH MUSCLE RELAXANTS GENITOURINARY SMOOTH MUSCLE RELAXANTS MYRBETRIQ SRER 8 MGML [mirabegron] 2 MYRBETRIQ TB24 25 MG [mirabegron] 2 MYRBETRIQ TB24 50 MG [mirabegron] 2 oxybutynin chloride er tb24 10 mg 1 oxybutynin chloride er tb24 15 mg 1 oxybutynin chloride er tb24 5 mg 1 oxybutynin chloride syrp 5 mg5ml 1 oxybutynin chloride tabs 5 mg 1 solifenacin succinate tabs 10 mg 1 solifenacin succinate tabs 5 mg 1 trospium chloride er cp24 60 mg 1 trospium chloride tabs 20 mg 1 RESPIRATORY SMOOTH MUSCLE RELAXANTS aminophylline soln 25 mgml 1 MB theophylline er tb12 100 mg 1 theophylline er tb12 200 mg 1 theophylline er tb12 300 mg 1 theophylline er tb12 450 mg 1 theophylline er tb24 400 mg 1 THEOPHYLLINE IN D5W SOLN 08-5 MGML- [theophylline in dextrose] 2 MB

VITAMINS MULTIVITAMIN PREPARATIONS INFUVITE ADULT INJ [multiple vitamin] 2 MB INFUVITE PEDIATRIC SOLN [pediatric multiple vitamins] 2 MB

pediatric multivitamins wfl chew 1 pediatric multivitamins wfl chew 1 MULTI-VITFLUORIDE SOLN 05 MGML [pediatric multivitamins wfl] 1

MULTI-VITFLUORIDEIRON SOLN 025-10 MGML [ped multivitamins wfl amp iron] 1

MULTI-VITIRONFLUORIDE SOLN 025-10 MGML 1




[ped multivitamins wfl amp iron] MULTIVITAMINFLUORIDE CHEW 025 MG [pediatric multivitamins wfl] 1

MULTIVITAMINFLUORIDE CHEW 05 MG [pediatric multivitamins wfl] 1


MULTIVITAMINFLUORIDE SOLN 025 MGML [pediatric multivitamins wfl] 1

MVC-FLUORIDE CHEW 025 MG [pediatric multivitamins wfl] 1



POLY-VI-SOL SOLN [pediatric multiple vitamins] 2 POLY-VI-SOLIRON SOLN 11 MGML [pediatric multiple vitamins w iron] 2

RENAL CAPS 1 MG [b-complex w c amp folic acid] 1 TRI-VI-SOL ACD SOLN 250-50-10 [pediatric vitamins adc] 2

TRI-VITFLUORIDE SOLN 05 MGML [pediatric vitamins acd w fluoride] 1

VITAMINS ACD-FLUORIDE SOLN 025 MGML [pediatric vitamins acd w fluoride] 1

VITAMIN A AQUASOL A SOLN 15 MGML [vitamin a] 2 MB VITAMIN B COMPLEX cyanocobalamin soln 1000 mcgml 1 MB folic acid soln 5 mgml 2 MB NIACIN ER CPCR 250 MG [niacin] 1 NIACIN ER CPCR 500 MG [niacin] 1 NIACIN ER TBCR 250 MG [niacin] 1 NIACIN TABS 100 MG [niacin] 1 NIACIN TABS 250 MG [niacin] 1 NIACIN TABS 50 MG [niacin] 1 NIACIN TABS 500 MG [niacin] 1 POTABA CAPS 500 MG [potassium aminobenzoate] 2 pyridoxine hcl soln 100 mgml 1 MB SLO-NIACIN TBCR 500 MG [niacin] 2 SLO-NIACIN TBCR 750 MG [niacin] 2 thiamine hcl soln 100 mgml 1 MB VITAMIN C ASCORBIC ACID SOLN 500 MGML [ascorbic acid] 1 MB VITAMIN D




calcitriol caps 025 mcg 1 calcitriol caps 05 mcg 1 ERGOCALCIFEROL SOLN 200 MCGML [ergocalciferol] 1

vitamin d (ergocalciferol) caps 125 mg (50000 ut) 1 VITAMIN K ACTIVITY MEPHYTON TABS 5 MG [phytonadione] 2 phytonadione soln 1 mg05ml 1 MB vitamin k1 soln 1 mg05ml 1 MB vitamin k1 soln 10 mgml 1 MB

Kaiser Permanente 2021 California Commercial Marketplace Formulary bull Page 107 of 161

A abacavir sulfate tabs 300 mg 5 abacavir sulfate-lamivudine tabs 600-300 mg 5 abacavir-lamivudine-zidovudine tabs 300-150-

300 mg 5 ABELCET SUSP 5 MGML [amphotericin b

lipid] 12 abiraterone acetate tabs 250 mg 17 ABRAXANE SUSR 100 MG [paclitaxel protein-

bound particles] 17 acamprosate calcium tbec 333 mg 55 acarbose tabs 100 mg 80 acarbose tabs 25 mg 80 acarbose tabs 50 mg 80 ACD-A NOCLOT-50 SOLN 073-245-22

GM100ML [anticoagulant citrate dextrose solution a] 33

acetaminophen-codeine 2 tabs 300-15 mg 43 acetaminophen-codeine 3 tabs 300-30 mg 43 acetaminophen-codeine 4 tabs 300-60 mg 43 acetaminophen-codeine soln 120-12 mg5ml

43 acetazolamide er cp12 500 mg 73 acetazolamide sodium solr 500 mg 73 acetazolamide tabs 125 mg 73 acetazolamide tabs 250 mg 73 ACETEST TAB TABLETS [acetone (urine)

test] 63 ACETIC ACID SOLN 025 [acetic acid] 68 ACETIC ACID SOLN 2 [acetic acid (otic)] 74 acetylcysteine soln 10 88 acetylcysteine soln 20 88 ACETYLCYSTEINE SOLN 200 MGML

[acetylcysteine (antidote)] 88 acitretin caps 10 mg 102 acitretin caps 25 mg 102 ACTHAR GEL 80 UNITML [corticotropin] 84 ACTHIB SOLR [haemophilus b polysac conj

vac] 97 ACTIMMUNE SOLN 2000000 UNIT05ML

[interferon gamma-1b] 88 ACTIVASE SOLR 100 MG [alteplase] 33 ACTIVASE SOLR 50 MG [alteplase] 33 acyclovir caps 200 mg 15 acyclovir sodium inj 1000mg 15 acyclovir sodium soln 50 mgml 15 acyclovir susp 200 mg5ml 15 acyclovir tabs 400 mg 15 acyclovir tabs 800 mg 15

ADACEL SUSP 5-2-155 LF-MCG05 [tetanus toxoid-diphtheria-acellular pertussis adsorb (tdap)] 97

ADAKVEO SOLN 100 MG10ML [crizanlizumab-tmca] 35

adapalene gel 01 102 adapalene gel 03 102 adapalene-benzoyl peroxide gel 01-25 102 ADCETRIS SOLR 50 MG [brentuximab

vedotin] 17 adefovir dipivoxil tabs 10 mg 15 adenosine inj 6mg2ml 39 adenosine soln 12 mg4ml 39 adenosine soln 3 mgml 64 adenosine soln 6 mg2ml 39 ADVAIR HFA AERO 115-21 MCGACT

[fluticasone-salmeterol] 93 ADVAIR HFA AERO 230-21 MCGACT


[fluticasone-salmeterol] 93 ADVATE SOLR 1000 UNIT [antihemophilic

factor (rcmb) plasmaalbumin free (rahf-pfm)] 30

ADVATE SOLR 1500 UNIT [antihemophilic factor (rcmb) plasmaalbumin free (rahf-pfm)] 30






AEROCHAMBER PLUS FLO-VU SMALL MISC [spaceraerosol-holding chambers] 61





AEROSPAN AERS 80 MCGACT [flunisolide hfa] 93


AFINITOR TABS 10 MG [everolimus] 17 AFLURIA SUSP [influenza virus vaccine split]

97 AFSTYLA KIT 1000 UNIT [antihemophilic

factor (recombinant) single chain] 30 AFSTYLA KIT 1500 UNIT [antihemophilic


factor (recombinant) single chain] 30 AFSTYLA KIT 250 UNIT [antihemophilic factor

(recombinant) single chain] 30 AFSTYLA KIT 2500 UNIT [antihemophilic



(recombinant) single chain] 30 AGGRENOX CP12 25-200 MG [aspirin-

dipyridamole] 34 AK-FLUOR SOLN 10 [fluorescein sodium

injection] 64 AKTEN GEL 35 [lidocaine hcl (ophth)] 74 AKTIPAK PACK 5-3 [benzoyl peroxide-

erythromycin] 99 AKYNZEO CAPS 300-05 MG [netupitant-

palonosetron] 75 ALBENZA 3 ALBENZA TABS 200 MG [albendazole] 5 ALBUMIN HUMAN SOLN 25 [albumin

human] 29 ALBURX SOLN 5 [albumin human] 29 ALBUSTIX STRP [albumin (urine) test] 64 ALBUTEIN SOLN 25 [albumin human] 29 albuterol sulfate hfa aers 108 (90 base)

mcgact 28 albuterol sulfate nebu (25 mg3ml) 0083 28 albuterol sulfate nebu (5 mgml) 05 28 albuterol sulfate nebu 063 mg3ml 28 albuterol sulfate nebu 125 mg3ml 28 albuterol sulfate nebu 25 mg05ml 28 albuterol sulfate syrp 2 mg5ml 28 albuterol sulfate tabs 2 mg 28 albuterol sulfate tabs 4 mg 28 alclometasone dipropionate crea 005 100 alclometasone dipropionate oint 005 100 ALDURAZYME SOLN 29 MG5ML [laronidase]

71 ALECENSA CAPS 150 MG [alectinib hcl] 17 alendronate sodium tabs 10 mg 88 alendronate sodium tabs 35 mg 88 alendronate sodium tabs 40 mg 88 alendronate sodium tabs 70 mg 88 alfentanil hcl soln 1000 mcg2ml 43 ALIMTA SOLR 500 MG [pemetrexed disodium]

17 ALINIA SUSR 100 MG5ML [nitazoxanide] 14 ALINIA TABS 500 MG [nitazoxanide] 14 ALKERAN TABS 2 MG [melphalan] 17 allopurinol tabs 100 mg 88 allopurinol tabs 300 mg 88 ALOCRIL SOLN 2 [nedocromil sodium

(ophth)] 73 ALOE VERA POWD [aloe vera (bulk)] 91 ALPHANATEVWF COMPLEXHUMAN SOLR

1000 UNIT [antihemophilic factorvon willebrand factor complex (human)] 30

ALPHANATEVWF COMPLEXHUMAN SOLR 1500 UNIT [antihemophilic factorvon willebrand factor complex (human)] 30

ALPHANINE SD SOLR 1000 UNIT [coagulation factor ix] 30



alprazolam tabs 025 mg 53 alprazolam tabs 05 mg 53 alprazolam tabs 1 mg 53 alprazolam tabs 2 mg 53 ALPROSTADIL POWD [alprostadil (bulk)] 91 alprostadil soln 500 mcgml 42 ALTAFLUOR BENOX SOLN 025-04

[fluorescein w benoxinate] 64 ALUNBRIG TABS 180 MG [brigatinib] 17 ALUNBRIG TABS 30 MG [brigatinib] 17 ALUNBRIG TABS 90 MG [brigatinib] 17 ALUNBRIG TBPK 90 amp 180 MG [brigatinib] 17 ALVESCO AERS 160 MCGACT [ciclesonide]

93 ALVESCO AERS 80 MCGACT [ciclesonide] 93 amantadine hcl caps 100 mg 52 amantadine hcl soln 50 mg5ml 52 AMBISOME SUSR 50 MG [amphotericin b

liposome] 12 ambrisentan tabs 10 mg 42 ambrisentan tabs 5 mg 42


amikacin sulfate soln 500 mg2ml 6 amiloride-hydrochlorothiazide tabs 5-50 mg

67 aminocaproic acid soln 250 mgml 30 aminophylline soln 25 mgml 104 AMINOSYN II SOLN 10 [amino acid

infusion] 65 AMINOSYN IIELECTROLYTES SOLN 85

[amino acid electrolyte infusion] 65 amiodarone hcl soln 150 mg3ml 39 amiodarone hcl soln 900 mg18ml 39 amiodarone hcl tabs 200 mg 39 AMITIZA CAPS 24 MCG [lubiprostone] 76 AMITIZA CAPS 8 MCG [lubiprostone] 76 amitriptyline hcl tabs 10 mg 56 amitriptyline hcl tabs 100 mg 56 amitriptyline hcl tabs 150 mg 56 amitriptyline hcl tabs 25 mg 56 amitriptyline hcl tabs 50 mg 56 amitriptyline hcl tabs 75 mg 56 amlodipine besylate tabs 10 mg 38 amlodipine besylate tabs 25 mg 38 amlodipine besylate tabs 5 mg 38 amoxapine tabs 100 mg 56 amoxapine tabs 150 mg 56 amoxapine tabs 25 mg 56 amoxapine tabs 50 mg 56 amoxicillin 3 amoxicillin caps 250 mg 6 amoxicillin caps 500 mg 6 amoxicillin chew 125 mg 6 amoxicillin chew 250 mg 6 amoxicillin susr 125 mg5ml 6 amoxicillin susr 200 mg5ml 6 amoxicillin susr 250 mg5ml 6 amoxicillin susr 400 mg5ml 7 amoxicillin-pot clavulanate chew 200-285 mg

7 amoxicillin-pot clavulanate chew 400-57 mg 7 amoxicillin-pot clavulanate susr 200-285

mg5ml 7 amoxicillin-pot clavulanate susr 250-625



mg5ml 7 amoxicillin-pot clavulanate tabs 250-125 mg 7 amoxicillin-pot clavulanate tabs 500-125 mg 7 amoxicillin-pot clavulanate tabs 875-125 mg 7

amphetamine-dextroamphet er cp24 10 mg 47 amphetamine-dextroamphet er cp24 15 mg 47 amphetamine-dextroamphet er cp24 20 mg 47 amphetamine-dextroamphet er cp24 25 mg 47 amphetamine-dextroamphet er cp24 30 mg 47 amphetamine-dextroamphet er cp24 5 mg 47 amphetamine-dextroamphetamine tabs 10 mg

47 amphetamine-dextroamphetamine tabs 125

mg 47 amphetamine-dextroamphetamine tabs 15 mg

47 amphetamine-dextroamphetamine tabs 20 mg




mg 47 amphotericin b solr 50 mg 12 ampicillin cap 250mg 7 ampicillin caps 500 mg 7 ampicillin sodium solr 1 gm 7 ampicillin sodium solr 10 gm 7 ampicillin sodium solr 125 mg 7 ampicillin sodium solr 2 gm 7 ampicillin sodium solr 250 mg 7 ampicillin sodium solr 500 mg 7 ampicillin sus 1255ml 7 ampicillin sus 2505ml 7 ampicillin-sulbactam sodium solr 15 (1-05)

gm 7 ampicillin-sulbactam sodium solr 15 (10-5)

gm 7 ampicillin-sulbactam sodium solr 3 (2-1) gm 7 amp-sulbacta inj 15gm 7 anagrelide hcl caps 05 mg 34 anagrelide hcl caps 1 mg 34 anastrozole tabs 1 mg 17 ANAVIP SOLR [crotalidae immune f(ab)2

(equine)] 95 ANDRODERM PT24 2 MG24HR [testosterone]

79 ANDRODERM PT24 4 MG24HR [testosterone]

79 ANGIOMAX SOLR 250 MG [bivalirudin

trifluoroacetate] 34 ANTIVENIN LATRODECTUS MACTANS KIT

[antivenin latrodectus mactans] 95


ANUCORT-HC SUPP 25 MG [hydrocortisone acetate (rectal)] 100

APOKYN SOCT 30 MG3ML [apomorphine hydrochloride] 52

apraclonidine hcl soln 05 74 APTENSIO XR CP24 10 MG [methylphenidate

hcl] 47 APTENSIO XR CP24 15 MG [methylphenidate






hcl] 47 APTIVUS CAPS 250 MG [tipranavir] 5 AQUASOL A SOLN 15 MGML [vitamin a] 105 ARALAST NP SOLR 1000 MG [alpha1-

proteinase inhibitor (human)] 71 ARALAST NP SOLR 500 MG [alpha1-

proteinase inhibitor (human)] 94 ARGATROBAN IN SODIUM CHLORIDE SOLN

125-09 MG125ML- [argatroban in sodium chloride] 34

ARGATROBAN SOLN 250 MG25ML [argatroban] 34

aripiprazole tabs 10 mg 56 aripiprazole tabs 15 mg 56 aripiprazole tabs 2 mg 56 aripiprazole tabs 20 mg 56 aripiprazole tabs 30 mg 56 aripiprazole tabs 5 mg 56 ARISTADA PRSY 1064 MG39ML [aripiprazole

lauroxil] 56 ARISTADA PRSY 441 MG16ML [aripiprazole



lauroxil] 56 ARRANON SOLN 5 MGML [nelarabine] 17 ASCORBIC ACID SOLN 500 MGML [ascorbic

acid] 105 ASMANEX (120 METERED DOSES) AEPB 220

MCGINH [mometasone furoate (inhalation)] 78





aspirin-dipyridamole er cp12 25-200 mg 34 atazanavir sulfate caps 150 mg 15 atazanavir sulfate caps 200 mg 15 atazanavir sulfate caps 300 mg 15 atenolol tabs 100 mg 37 atenolol tabs 25 mg 37 atenolol tabs 50 mg 37 atenolol-chlorthalidone tabs 100-25 mg 37 atenolol-chlorthalidone tabs 50-25 mg 37 ATGAM INJ 50 MGML [lymphocyte immune

globulinanti-thymocyte globulin (equine)] 86

atorvastatin calcium tabs 10 mg 36 atorvastatin calcium tabs 20 mg 36 atorvastatin calcium tabs 40 mg 36 atorvastatin calcium tabs 80 mg 36 atovaquone susp 750 mg5ml 14 atovaquone-proguanil hcl tabs 250-100 mg 14 atovaquone-proguanil hcl tabs 625-25 mg 14 atracurium besylate soln 100 mg10ml 27 atracurium besylate soln 50 mg5ml 27 atropine sulfate inj 1mgml 25 ATROPINE SULFATE MONOHYDRATE POW

MONOHYDT [atropine sulfate monohydrate] 91

ATROPINE SULFATE OINT 1 [atropine sulfate (ophthalmic)] 74

ATROPINE SULFATE SOLN 04 MGML [atropine sulfate] 25


ATROPINE SULFATE SOLN 8 MG20ML [atropine sulfate] 25

ATROPINE SULFATE SOSY 05 MG5ML [atropine sulfate] 25


AUGMENTIN SUSR 125-3125 MG5ML [amoxicillin amp pot clavulanate] 7

AVASTIN SOLN 100 MG4ML [bevacizumab] 18



AVELOX SOLN 400 MG250ML [moxifloxacin hcl in sodium chloride] 7

AVITA CREA 0025 [tretinoin] 102 AVONEX KIT 30MCG [interferon beta-1a] 55 AVONEX PEN AJKT 30 MCG05ML [interferon

beta-1a] 88 azacitidine susr 100 mg 18 AZACTAM IN DEXTROSE SOLN 1 GM50ML

[aztreonam-dextrose] 7 AZACTAM IN DEXTROSE SOLN 2 GM50ML

[aztreonam-dextrose] 7 azathioprine tabs 50 mg 86 azelastine hcl soln 01 73 azithromycin solr 500 mg 7 azithromycin susr 100 mg5ml 7 azithromycin susr 200 mg5ml 7 azithromycin tabs 250 mg 7 azithromycin tabs 500 mg 7 azithromycin tabs 600 mg 7 aztreonam solr 1 gm 7 aztreonam solr 2 gm 7

B bacitracin oint 500 unitgm 72 bacitracin solr 50000 unit 7 bacitracin-polymyxin b oint 500-10000

unitgm 72 BACLOFEN POWD [baclofen] 91 baclofen tabs 10 mg 27 baclofen tabs 20 mg 27 BACTERIOSTATIC WATER(BENZ ALC) SOLN

[water for inject bacteriostatic benzyl alcohol] 91

BAL IN OIL SOLN 100 MGML [dimercaprol] 77 balsalazide disodium caps 750 mg 75 BANZEL SUSP 40 MGML [rufinamide] 48 BANZEL TABS 200 MG [rufinamide] 48 BANZEL TABS 400 MG [rufinamide] 48 BAQSIMI TWO PACK POWD 3 MGDOSE

[glucagon] 81 BARACLUDE SOLN 005 MGML [entecavir] 15 BD 3ML LUER-LOK SYRINGE22G X 1-14 61 BD INSULIN SYRINGE MICROFINE MISC 27G

X 58 61 BD INSULIN SYRINGE MISC 25G X 1 61 BD INSULIN SYRINGE MISC 27G X 12 61 BD INSULIN SYRINGE UF 12UNIT MISC 31G

X 516 61

BD INSULIN SYRINGE UF MISC 30G X 12 61 BD INSULIN SYRINGE UF MISC 31G X 516 62 BD INSULIN SYRINGE U-500 MISC 31G X 6MM

05 ML [insulin syringeneedle u-500] 61 BD INTEGRA SYRINGE MISC 25G X 58 62 BD LANCET DEVICE MIS DEVICE [lancet

devices] 62 BD LANCET ULTRAFINE 33G MISC [lancets]

62 BD PEN NEEDLE MINI UF MISC 31G X 5 MM

[insulin pen needle] 62 BD PEN NEEDLE NANO UF MISC 32G X 4 MM

[insulin pen needle] 62 BD PEN NEEDLE ORIGINAL UF MISC 29G X

127MM [insulin pen needle] 62 BD PEN NEEDLE SHORT UF MISC 31G X 8

MM [insulin pen needle] 62 BD SAFETYGLIDE INSULIN SYRINGE MISC

29G X 12 62 BD SAFETYGLIDE SYRINGENEEDLE MISC

27G X 58 62 BD VEO INSULIN SYR UF 12UNIT MISC 31G

X 1564 62 BD VEO INSULIN SYRINGE UF MISC 31G X

1564 62 BELLADONNA ALKALOIDS-OPIUM SUPP 162-

30 MG [belladonna alkaloids amp opium] 25 BELLADONNA ALKALOIDS-OPIUM SUPP 162-

60 MG [belladonna alkaloids amp opium] 25 benazepril hcl tabs 10 mg 41 benazepril hcl tabs 20 mg 41 benazepril hcl tabs 40 mg 41 benazepril hcl tabs 5 mg 41 BENDEKA SOLN 100 MG4ML [bendamustine

hcl] 18 BENEFIX KIT 1000 UNIT [coagulation factor ix

(recombinant)] 30 BENEFIX KIT 2000 UNIT [coagulation factor ix




(recombinant)] 31 BENTYL SOLN 10 MGML [dicyclomine hcl] 25 BENZOIN COMPOUND TINC [benzoin

compound] 102 BENZOIN TINC [benzoin] 102 benzonatate caps 100 mg 94


benzoyl peroxide-erythromycin gel 5-3 99 benztropine mesylate soln 1 mgml 52 benztropine mesylate tabs 05 mg 52 benztropine mesylate tabs 1 mg 52 benztropine mesylate tabs 2 mg 52 betamethasone dipropionate aug crea 005

100 betamethasone dipropionate aug gel 005

100 betamethasone dipropionate aug lotn 005

100 betamethasone dipropionate aug oint 005

100 BETAMETHASONE DIPROPIONATE CREA

005 [betamethasone dipropionate (topical)] 100

betamethasone sod phos amp acet susp 6 (3-3) mgml 78


betamethasone valerate foam 012 100 BETAMETHASONE VALERATE LOTN 01

[betamethasone valerate] 100 BETAMETHASONE VALERATE OINT 01

[betamethasone valerate] 100 betaxolol hcl soln 05 73 bethanechol chloride tabs 10 mg 26 bethanechol chloride tabs 25 mg 26 bethanechol chloride tabs 5 mg 26 bethanechol chloride tabs 50 mg 26 BEXSERO SUSY [meningococcal vac group

b (recombant omv adjuvanted)] 97 bicalutamide tabs 50 mg 18 BICILLIN L-A SUSP 1200000 UNIT2ML

[penicillin g benzathine] 7 BICILLIN L-A SUSP 2400000 UNIT4ML

[penicillin g benzathine] 7 BICILLIN L-A SUSP 600000 UNITML [penicillin

g benzathine] 8 BICNU SOLR 100 MG [carmustine] 18 BIKTARVY TABS 50-200-25 MG [bictegravir-

emtricitabine-tenofovir alafenamide fumarate] 5

BILTRICIDE TABS 600 MG [praziquantel] 5 bimatoprost soln 003 73 BIO GLO STRP 1 MG [fluorescein sodium

topical] 64 BIOTIN-D POWD [biotin (bulk)] 91 bisoprolol fumarate tabs 10 mg 37 bisoprolol fumarate tabs 5 mg 37

bisoprolol-hydrochlorothiazide tabs 10-625 mg 37



bleomycin sulfate solr 15 unit 18 bleomycin sulfate solr 30 unit 18 BLEPHAMIDE SUSP 10-02 [sulfacetamide

sod-prednisolone] 72 BLINCYTO SOLR 35 MCG [blinatumomab] 18 BORIC ACID POWD [boric acid (bulk)] 91 BOTOX COSMETIC SOLR 100 UNIT

[onabotulinumtoxina (cosmetic)] 88 BOTOX SOLR 100 UNIT [onabotulinumtoxina]

88 BOTOX SOLR 200 UNIT [onabotulinumtoxina]

88 BREVIBLOC IN NACL SOLN 2000 MG100ML

[esmolol hcl-sodium chloride] 37 BREVIBLOC IN NACL SOLN 2500 MG250ML

[esmolol hcl-sodium chloride] 37 BREVITAL SODIUM SOLR 500 MG

[methohexital sodium] 55 BRIDION SOLN 200 MG2ML [sugammadex

sodium] 88 BRILINTA TABS 90 MG [ticagrelor] 34 brimonidine tartrate soln 02 73 BRIVIACT TABS 10 MG [brivaracetam] 49 BRIVIACT TABS 100 MG [brivaracetam] 49 BRIVIACT TABS 25 MG [brivaracetam] 49 BRIVIACT TABS 50 MG [brivaracetam] 49 BRIVIACT TABS 75 MG [brivaracetam] 49 bromocriptine mesylate caps 5 mg 52 bromocriptine mesylate tabs 25 mg 52 BRUKINSA CAPS 80 MG [zanubrutinib] 18 BSS PLUS SOLN [ophthalmic irrigation

solution - intraocular] 74 BSS SOLN [ophthalmic irrigation solution -

intraocular] 74 budesonide cpep 3 mg 78 budesonide susp 025 mg2ml 78 budesonide susp 05 mg2ml 78 bumetanide soln 025 mgml 67 bumetanide tabs 05 mg 67 bumetanide tabs 1 mg 67 bumetanide tabs 2 mg 67 BUMINATE SOLN 5 [albumin human] 29 BUPHENYL TABS 500 MG [sodium

phenylbutyrate] 65


BUPIVACAINE FISIOPHARMA SOLN 25 MGML [bupivacaine hcl] 86

bupivacaine hcl (pf) soln 025 87 bupivacaine hcl (pf) soln 05 87 bupivacaine hcl (pf) soln 075 87 bupivacaine hcl inj 075 87 bupivacaine hcl soln 025 87 bupivacaine hcl soln 05 87 bupivacaine in dextrose soln 075-825 87 bupivacaine-epinephrine (pf) soln 025 -1

200000 87 bupivacaine-epinephrine (pf) soln 05 -1

200000 87 bupivacaine-epinephrine soln 025 -1


200000 87 buprenorphine hcl soln 03 mgml 43 buprenorphine hcl-naloxone hcl subl 2-05

mg 43 buprenorphine hcl-naloxone hcl subl 8-2 mg

43 bupropion hcl er (sr) tb12 100 mg 56 bupropion hcl er (sr) tb12 150 mg 56 bupropion hcl er (sr) tb12 200 mg 56 bupropion hcl er (xl) tb24 150 mg 56 bupropion hcl er (xl) tb24 300 mg 56 bupropion hcl tabs 100 mg 56 bupropion hcl tabs 75 mg 56 buspirone hcl tabs 10 mg 53 buspirone hcl tabs 15 mg 53 buspirone hcl tabs 30 mg 53 buspirone hcl tabs 5 mg 53 buspirone hcl tabs 75 mg 53 butorphanol tartrate soln 1 mgml 43 butorphanol tartrate soln 2 mgml 44 BYDUREON BCISE AUIJ 2 MG085ML

[exenatide] 80

C cabergoline tabs 05 mg 52 CABOMETYX TABS 20 MG [cabozantinib s-

malate] 18 CABOMETYX TABS 40 MG [cabozantinib s-


malate] 18 caffeine citrate soln 60 mg3ml 47 calcipotriene crea 0005 102 calcipotriene soln 0005 102

calcitonin (salmon) soln 200 unitact 84 calcitriol caps 025 mcg 105 calcitriol caps 05 mcg 105 calcium acetate (phos binder) caps 667 mg 68 CALCIUM CHLORIDE SOLN 10 [calcium

chloride (dihydrate)] 68 CALCIUM GLUCONATE SOLN 10 [calcium

gluconate] 68 CALQUENCE CAPS 100 MG [acalabrutinib] 18 CAMPTOSAR SOLN 100 MG5ML [irinotecan

hcl] 18 CAMPTOSAR SOLN 40 MG2ML [irinotecan

hcl] 18 CANCIDAS SOLR 50 MG [caspofungin

acetate] 13 CANCIDAS SOLR 70 MG [caspofungin

acetate] 13 CANDIN SOLN [candida albicans skin test

antigen] 64 CANTHARIDIN POW [cantharidin] 91 CAPASTAT SULFATE SOLR 1 GM

[capreomycin sulfate] 14 capecitabine tabs 150 mg 18 capecitabine tabs 500 mg 18 CAPRELSA TABS 100 MG [vandetanib] 18 CAPRELSA TABS 300 MG [vandetanib] 18 captopril tabs 100 mg 41 captopril tabs 125 mg 41 captopril tabs 25 mg 41 captopril tabs 50 mg 41 CARAFATE SUSP 1 GM10ML [sucralfate] 76 carbamazepine chew 100 mg 49 carbamazepine er cp12 100 mg 49 carbamazepine er cp12 200 mg 49 carbamazepine er cp12 300 mg 49 carbamazepine er tb12 100 mg 49 carbamazepine er tb12 200 mg 49 carbamazepine er tb12 400 mg 49 CARBAMAZEPINE POWD [carbamazepine] 91 carbamazepine susp 100 mg5ml 49 carbamazepine tabs 200 mg 49 carbidopa tabs 25 mg 52 carbidopa-levodopa er tbcr 25-100 mg 52 carbidopa-levodopa er tbcr 50-200 mg 52 carbidopa-levodopa tabs 10-100 mg 52 carbidopa-levodopa tabs 25-100 mg 52 carbidopa-levodopa tabs 25-250 mg 52 carbidopa-levodopa-entacapone tabs 125-50-

200 mg 52 carbidopa-levodopa-entacapone tabs 1875-


75-200 mg 52 carbidopa-levodopa-entacapone tabs 25-100-


125-200 mg 52 carbidopa-levodopa-entacapone tabs 375-


200 mg 52 CARDENE IV SOLN 20-086 MG200ML-

[nicardipine hcl in sodium chloride] 38 CARDENE IV SOLN 20-48 MG200ML-

[nicardipine hcl in dextrose] 38 CARDENE IV SOLN 40-083 MG200ML-


[nicardipine hcl in dextrose] 38 carmustine solr 100 mg 18 carvedilol tabs 125 mg 37 carvedilol tabs 25 mg 37 carvedilol tabs 3125 mg 37 carvedilol tabs 625 mg 37 CASCARA SAGRADA EXTR 1 GMML [cascara

sagrada] 76 CATHFLO ACTIVASE SOLR 2 MG [alteplase]

34 CAVERJECT SOLR 20 MCG [alprostadil

(vasodilator)] 42 CAVERJECT SOLR 40 MCG [alprostadil

(vasodilator)] 42 CAYSTON SOLR 75 MG [aztreonam lysine] 8 cefaclor caps 250 mg 8 cefaclor caps 500 mg 8 cefadroxil caps 500 mg 8 cefazolin sodium solr 1 gm 8 cefazolin sodium solr 10 gm 8 cefazolin sodium solr 20 gm 8 cefazolin sodium solr 500 mg 8 CEFAZOLIN SODIUM-DEXTROSE SOLN 1-4

GM50ML- [cefazolin sodium-dextrose] 8 CEFAZOLIN SODIUM-DEXTROSE SOLR 1-4

GM-(50ML) [cefazolin sodium-dextrose] 8 cefdinir susr 125 mg5ml 8 cefdinir susr 250 mg5ml 8 cefepime hcl solr 1 gm 8 cefepime hcl solr 2 gm 8 CEFEPIME-DEXTROSE SOLR 1-5 GM-

(50ML) [cefepime hcl-dextrose] 8 CEFEPIME-DEXTROSE SOLR 2-5 GM-

(50ML) [cefepime hcl-dextrose] 8

cefixime caps 400 mg 8 cefotaxime sodium inj 10gm 8 cefotaxime sodium solr 1 gm 8 cefotaxime sodium solr 500 mg 8 cefotetan disodium solr 1 gm 8 cefotetan disodium solr 2 gm 8 CEFOTETAN DISODIUM-DEXTROSE SOLR 1-

358 GM-(50ML) [cefotetan disodium and dextrose] 8

CEFOTETAN DISODIUM-DEXTROSE SOLR 2-208 GM-(50ML) [cefotetan disodium and dextrose] 8

cefoxitin sodium solr 1 gm 8 cefoxitin sodium solr 10 gm 8 cefoxitin sodium solr 2 gm 8 CEFOXITIN SODIUM-DEXTROSE SOLR 1-4

GM-(50ML) [cefoxitin sodium and dextrose] 8

CEFOXITIN SODIUM-DEXTROSE SOLR 2-22 GM-(50ML) [cefoxitin sodium and dextrose] 8

cefpodoxime proxetil susr 100 mg5ml 8 cefpodoxime proxetil susr 50 mg5ml 8 cefpodoxime proxetil tabs 100 mg 8 cefpodoxime proxetil tabs 200 mg 8 ceftazidime solr 6 gm 8 CEFTIN SUSR 125 MG5ML [cefuroxime

axetil] 9 ceftriaxone sodium in dextrose soln 20 mgml

9 ceftriaxone sodium in dextrose soln 40 mgml

9 ceftriaxone sodium solr 1 gm 9 ceftriaxone sodium solr 10 gm 9 ceftriaxone sodium solr 2 gm 9 ceftriaxone sodium solr 250 mg 9 ceftriaxone sodium solr 500 mg 9 CEFTRIAXONE SODIUM-DEXTROSE SOLR 1-

374 GM-(50ML) [ceftriaxone sodium and dextrose] 9

CEFTRIAXONE SODIUM-DEXTROSE SOLR 2-222 GM-(50ML) [ceftriaxone sodium and dextrose] 9

cefuroxime axetil tabs 250 mg 9 cefuroxime axetil tabs 500 mg 9 cefuroxime sodium solr 15 gm 9 cefuroxime sodium solr 75 gm 9 cefuroxime sodium solr 750 mg 9 CELONTIN CAPS 300 MG [methsuximide] 49 cephalexin caps 250 mg 9


cephalexin caps 500 mg 9 cephalexin susr 125 mg5ml 9 cephalexin susr 250 mg5ml 9 cephalexin tabs 500 mg 9 CEQUA SOLN 009 [cyclosporine (ophth)]

72 CERDELGA CAPS 84 MG [eliglustat tartrate]

88 CEREZYME SOLR 400 UNIT [imiglucerase] 71 CERVIDIL INST 10 MG [dinoprostone] 91 CHANTIX CONTINUING MONTH PAK TABS 1

MG [varenicline tartrate] 26 CHANTIX STARTING MONTH PAK TABS 05

MG X 11 amp 1 MG X 42 [varenicline tartrate] 26

CHANTIX TABS 05 MG [varenicline tartrate] 26

CHANTIX TABS 1 MG [varenicline tartrate] 26 CHEMET CAPS 100 MG [succimer] 77 CHEMSTRIP 9 STRP [multiple urine tests] 64 CHERATUSSIN AC SYRP 100-10 MG5ML

[guaifenesin-codeine] 94 CHIRHOSTIM SOLR 16 MCG [secretin acetate

(human)] 64 chloramphenicol sod succinate solr 1 gm 9 chlordiazepoxide hcl caps 10 mg 53 chlordiazepoxide hcl caps 25 mg 53 chlordiazepoxide hcl caps 5 mg 53 CHLORDIAZEPOXIDE-CLIDINIUM CAPS 5-25

MG [chlordiazepoxide hcl-clidinium bromide] 25

chlorhexidine gluconate soln 012 72 CHLOROFORM SOL [chloroform] 91 chloroprocaine hcl (pf) soln 2 87 chloroprocaine hcl inj 3 87 chloroquine phosphate tabs 250 mg 14 chloroquine phosphate tabs 500 mg 14 CHLORPROMAZINE HCL POW HCL

[chlorpromazine hcl] 91 chlorpromazine hcl soln 25 mgml 56 chlorpromazine hcl tabs 10 mg 56 chlorpromazine hcl tabs 100 mg 56 chlorpromazine hcl tabs 200 mg 56 chlorpromazine hcl tabs 25 mg 56 chlorpromazine hcl tabs 50 mg 56 chlorthalidone tabs 25 mg 67 chlorthalidone tabs 50 mg 67 CHOLESTEROL POWD [cholesterol] 91 cholestyramine light pack 4 gm 36 cholestyramine light powd 4 gmdose 36

cholestyramine pack 4 gm 36 cholestyramine powd 4 gmdose 36 CHOLINE-MAG TRISALICYLATE LIQD 500

MG5ML [choline amp mag salicylate] 44 CHROMIC CHLORIDE SOLN 40 MCG10ML

[chromic chloride] 68 cidofovir soln 75 mgml 15 CIMDUO TABS 300-300 MG [lamivudine-

tenofovir disoproxil fumarate] 5 cimetidine hcl soln 300 mg5ml 76 cinacalcet hcl tabs 30 mg 88 cinacalcet hcl tabs 60 mg 88 cinacalcet hcl tabs 90 mg 88 CINRYZE SOLR 500 UNIT [c1 esterase

inhibitor (human)] 88 CIPRO SUSR 250 MG5ML (5)

[ciprofloxacin] 9 CIPRO SUSR 500 MG5ML (10)

[ciprofloxacin] 9 ciprofloxacin hcl soln 03 72 ciprofloxacin hcl tabs 250 mg 9 ciprofloxacin hcl tabs 500 mg 9 ciprofloxacin hcl tabs 750 mg 9 ciprofloxacin in d5w soln 200 mg100ml 9 ciprofloxacin in d5w soln 400 mg200ml 9 ciprofloxacin-dexamethasone susp 03-01

72 cisatracurium besylate (pf) soln 10 mg5ml 27 cisatracurium besylate (pf) soln 200 mg20ml

27 cisatracurium besylate soln 20 mg10ml 27 cisplatin soln 100 mg100ml 18 cisplatin soln 50 mg50ml 18 citalopram hydrobromide soln 10 mg5ml 57 citalopram hydrobromide tabs 10 mg 57 citalopram hydrobromide tabs 20 mg 57 citalopram hydrobromide tabs 40 mg 57 cladribine soln 10 mg10ml 18 clarithromycin susr 125 mg5ml 9 clarithromycin susr 250 mg5ml 9 clarithromycin tabs 250 mg 9 clarithromycin tabs 500 mg 9 CLEOCIN IN D5W SOLN 300 MG50ML

[clindamycin phosphate in d5w] 9 CLEOCIN IN D5W SOLN 600 MG50ML


[clindamycin phosphate in d5w] 9 CLEVIPREX EMUL 25 MG50ML [clevidipine]

38


CLEVIPREX EMUL 50 MG100ML [clevidipine] 38


CLIMARA PTWK 0025 MG24HR [estradiol] 82 CLIMARA PTWK 00375 MG24HR [estradiol]

82 CLIMARA PTWK 005 MG24HR [estradiol] 82 CLIMARA PTWK 006 MG24HR [estradiol] 82 CLIMARA PTWK 0075 MG24HR [estradiol] 83 CLIMARA PTWK 01 MG24HR [estradiol] 83 clindamycin hcl caps 150 mg 10 clindamycin hcl caps 300 mg 10 CLINDAMYCIN HCL POWD [clindamycin hcl

(bulk)] 91 clindamycin palmitate hcl solr 75 mg5ml 10 clindamycin phos-benzoyl perox gel 12-5

99 clindamycin phos-benzoyl perox gel 1-5 99 clindamycin phosphate crea 2 99 clindamycin phosphate gel 1 99 clindamycin phosphate lotn 1 99 clindamycin phosphate soln 1 99 clindamycin phosphate soln 300 mg2ml 10 CLINDAMYCIN PHOSPHATE SOLN 600

MG4ML [clindamycin phosphate] 10 clindamycin phosphate soln 9000 mg60ml 10 CLINIMIX EDEXTROSE (27510) SOLN 275

[amino acid electrolyte w calcium infusion in d10w] 65

CLINIMIX EDEXTROSE (2755) SOLN 275 [amino acid electrolyte w calcium infusion in d5w] 65






CLINIMIX EDEXTROSE (525) SOLN 5 [amino acid electrolyte w calcium infusion

in d25w] 66 CLINIMIXDEXTROSE (2755) SOLN 275

[amino acid infusion in d5w] 66 CLINIMIXDEXTROSE (42510) SOLN 425




[amino acid infusion in d5w] 66 CLINIMIXDEXTROSE (515) SOLN 5 [amino

acid infusion in d15w] 66 CLINIMIXDEXTROSE (520) SOLN 5 [amino


acid infusion in d25w] 66 clobetasol propionate crea 005 100 clobetasol propionate foam 005 100 clobetasol propionate gel 005 100 clobetasol propionate lotn 005 100 clobetasol propionate oint 005 100 CLOBETASOL PROPIONATE POW PROPIONA

[clobetasol propionate] 91 clobetasol propionate soln 005 100 CLOBEX LOTN 005 [clobetasol propionate]

100 CLOBEX SPRAY LIQD 005 [clobetasol

propionate] 100 clomiphene citrate tabs 50 mg 83 clomipramine hcl caps 25 mg 57 clomipramine hcl caps 50 mg 57 clomipramine hcl caps 75 mg 57 clonazepam tabs 05 mg 49 clonazepam tabs 1 mg 49 clonazepam tabs 2 mg 49 CLONIDINE HCL POWD [clonidine hcl] 92 clonidine hcl tabs 01 mg 40 clonidine hcl tabs 02 mg 40 clonidine hcl tabs 03 mg 40 clonidine ptwk 01 mg24hr 40 clonidine ptwk 02 mg24hr 40 clonidine ptwk 03 mg24hr 40 clopidogrel bisulfate tabs 75 mg 34 clorazepate dipotassium tabs 15 mg 53 clorazepate dipotassium tabs 375 mg 53 clorazepate dipotassium tabs 75 mg 53 CLOTRIMAZOLE CRYS [clotrimazole

(topical)] 92 CLOTRIMAZOLE POWD [clotrimazole


(topical)] 92 clotrimazole troc 10 mg 99 clozapine tabs 100 mg 57 clozapine tabs 200 mg 57 clozapine tabs 25 mg 57 clozapine tabs 50 mg 57 COAL TAR EXTRACT SOLN 20 [coal tar

(crude)] 92 COARTEM TABS 20-120 MG [artemether-

lumefantrine] 14 CODEINE SULFATE TABS 15 MG [codeine

sulfate] 44 CODEINE SULFATE TABS 30 MG [codeine


sulfate] 44 colchicine tabs 06 mg 88 colchicine-probenecid tabs 05-500 mg 71 colestipol hcl gran 5 gm 36 colestipol hcl pack 5 gm 36 colestipol hcl tabs 1 gm 36 COLLODION FLEXIBLE LIQD [collodion

flexible] 92 COLY-MYCIN S SUSP 33-3-10-05 MGML

[neomycin-colistin-hc-thonzonium] 72 COMBIVENT RESPIMAT AERS 20-100

MCGACT [ipratropium-albuterol] 94 COMETRIQ (100 MG DAILY DOSE) KIT 80 amp 20

MG [cabozantinib s-malate] 18 COMETRIQ (140 MG DAILY DOSE) KIT 3 x 20

MG amp 80 MG [cabozantinib s-malate] 18 COMETRIQ (60 MG DAILY DOSE) KIT 20 MG

[cabozantinib s-malate] 18 COMPLERA TABS 200-25-300 MG

[emtricitabine-rilpivirine-tenofovir disoproxil fumarate] 5

CONDYLOX GEL 05 [podofilox] 103 CONRAY 43 INJ 43 [iothalamate

meglumine] 64 CONRAY SOLN 60 [iothalamate

meglumine] 64 CONTOUR NEXT CONTROL SOLN NORMAL

[blood glucose calibration] 62 COPIKTRA CAPS 15 MG [duvelisib] 18 COPIKTRA CAPS 25 MG [duvelisib] 18 CORDRAN TAPE 4 MCGSQCM

[flurandrenolide] 100 cortisone acetate tabs 25 mg 78 CORTISPORIN CREA 35-10000-05

[neomycin-polymyxin-hc] 100


CORTROSYN SOLR 025 MG [cosyntropin] 64 COSENTYX (300 MG DOSE) SOSY 150 MGML

[secukinumab] 103 COSENTYX SENSOREADY (300 MG) SOAJ

150 MGML [secukinumab] 103 COSENTYX SENSOREADY PEN SOAJ 150

MGML [secukinumab] 103 COSENTYX SOSY 150 MGML [secukinumab]

103 COSMEGEN SOLR 05 MG [dactinomycin] 18 COTELLIC TABS 20 MG [cobimetinib

fumarate] 18 CREON CPEP 12000-38000 UNIT

[pancrelipase (lipase-protease-amylase)] 76 CREON CPEP 24000-76000 UNIT

[pancrelipase (lipase-protease-amylase)] 76 CREON CPEP 3000-9500 UNIT [pancrelipase

(lipase-protease-amylase)] 76 CREON CPEP 36000-114000 UNIT


(lipase-protease-amylase)] 77 CRIXIVAN CAPS 200 MG [indinavir sulfate] 5 CRIXIVAN CAPS 400 MG [indinavir sulfate] 5 CROFAB SOLR [crotalidae polyvalent

immune fab (ovine)] 95 cromolyn sodium conc 100 mg5ml 94 cromolyn sodium nebu 20 mg2ml 94 cromolyn sodium soln 4 73 C-TOPICAL SOLN 4 [cocaine hcl] 74 CUBICIN SOLR 500 MG [daptomycin] 10 CUPRIC CHLORIDE SOLN 04 MGML [cupric

chloride] 68 CUROSURF SUSP 120 MG15ML [poractant

alfa] 94 CUROSURF SUSP 240 MG3ML [poractant

alfa] 94 CUVPOSA SOLN 1 MG5ML [glycopyrrolate]25 cyanocobalamin soln 1000 mcgml 105 cyclobenzaprine hcl tabs 10 mg 27 cyclobenzaprine hcl tabs 5 mg 27 cyclopentolate hcl soln 1 74 cyclopentolate hcl soln 2 74 CYCLOPHOSPHAMIDE CAPS 25 MG

[cyclophosphamide] 18 CYCLOPHOSPHAMIDE CAPS 50 MG

[cyclophosphamide] 18 cyclophosphamide solr 1 gm 18


cyclophosphamide solr 2 gm 18 cyclophosphamide solr 500 mg 18 cycloserine caps 250 mg 14 cyproheptadine hcl syrp 2 mg5ml 17 cyproheptadine hcl tabs 4 mg 17 CYRAMZA SOLN 100 MG10ML [ramucirumab]

18 CYRAMZA SOLN 500 MG50ML [ramucirumab]

18 CYSTADANE POWD [betaine] 88 CYSTAGON CAPS 150 MG [cysteamine

bitartrate] 88 CYSTAGON CAPS 50 MG [cysteamine

bitartrate] 88 CYSTEAMINE HCL POWD [cysteamine hcl

(bulk)] 92 CYSTO-CONRAY II SOLN 172 [iothalamate

meglumine] 64 CYSTOGRAFIN SOLN 30 [diatrizoate

meglumine] 64 CYSTOGRAFIN-DILUTE SOLN 18

[diatrizoate meglumine] 64 cytarabine (pf) soln 100 mgml 18 cytarabine (pf) soln 20 mgml 19 cytarabine soln 20 mgml 19 CYTOGAM INJ 50 MGML [cytomegalovirus

immune globulin (human)] 95 CYTRA K CRYSTALS PACK 3300-1002 MG

[potassium citrate-citric acid] 65 CYTRA-K SOLN 1100-334 MG5ML [potassium

citrate-citric acid] 65

D dacarbazine solr 100 mg 19 dacarbazine solr 200 mg 19 DACOGEN SOLR 50 MG [decitabine] 19 DAKINS (14 STRENGTH) SOLN 0125

[sodium hypochlorite] 99 DAKINS (FULL STRENGTH) SOLN 05

[sodium hypochlorite] 99 DAKLINZA TABS 30 MG [daclatasvir

dihydrochloride] 15 DAKLINZA TABS 60 MG [daclatasvir

dihydrochloride] 15 DALIRESP TABS 500 MCG [roflumilast] 94 danazol caps 100 mg 79 danazol caps 200 mg 80 danazol caps 50 mg 80 dantrolene sodium caps 100 mg 27 dantrolene sodium caps 25 mg 27

dantrolene sodium caps 50 mg 27 dapsone tabs 100 mg 14 dapsone tabs 25 mg 14 DARAPRIM TABS 25 MG [pyrimethamine] 14 DARZALEX SOLN 100 MG5ML

[daratumumab] 19 DARZALEX SOLN 400 MG20ML

[daratumumab] 19 daunorubicin hcl soln 20 mg4ml 19 DDAVP RHINAL TUBE SOLN 001

[desmopressin acetate refrigerated] 84 deferasirox tabs 360 mg 77 deferasirox tabs 90 mg 77 deferoxamine mesylate solr 2 gm 77 deferoxamine mesylate solr 500 mg 77 DELESTROGEN OIL 20 MGML [estradiol

valerate] 83 DELESTROGEN OIL 40 MGML [estradiol

valerate] 83 demeclocycline hcl tabs 150 mg 10 demeclocycline hcl tabs 300 mg 10 DEPO-PROVERA SUSP 400 MGML

[medroxyprogesterone acetate (antineoplastic)] 84

DESCOVY TABS 200-25 MG [emtricitabine-tenofovir alafenamide fumarate] 15

desipramine hcl tabs 10 mg 57 desipramine hcl tabs 100 mg 57 desipramine hcl tabs 150 mg 57 desipramine hcl tabs 25 mg 57 desipramine hcl tabs 50 mg 57 desipramine hcl tabs 75 mg 57 desmopressin ace spray refrig soln 001 84 desmopressin acetate soln 4 mcgml 84 desmopressin acetate spray soln 001 84 desmopressin acetate tabs 01 mg 84 desmopressin acetate tabs 02 mg 84 desonide oint 005 100 desoximetasone crea 025 100 dexamethasone elix 05 mg5ml 78 DEXAMETHASONE POWD [dexamethasone

(bulk)] 92 dexamethasone sodium phosphate soln 01

72 dexamethasone sodium phosphate soln 10

mgml 78 dexamethasone sodium phosphate soln 20

mg5ml 78 dexamethasone soln 05 mg5ml 78 dexamethasone tabs 05 mg 78


dexamethasone tabs 075 mg 78 dexamethasone tabs 1 mg 78 dexamethasone tabs 15 mg 78 dexamethasone tabs 2 mg 78 dexamethasone tabs 4 mg 78 dexamethasone tabs 6 mg 78 dexmethylphenidate hcl er cp24 10 mg 47 dexmethylphenidate hcl er cp24 15 mg 47 dexmethylphenidate hcl er cp24 20 mg 47 dexmethylphenidate hcl er cp24 25 mg 47 dexmethylphenidate hcl er cp24 30 mg 47 dexmethylphenidate hcl er cp24 35 mg 47 dexmethylphenidate hcl er cp24 40 mg 47 dexmethylphenidate hcl er cp24 5 mg 48 dexmethylphenidate hcl tabs 10 mg 48 dexmethylphenidate hcl tabs 25 mg 48 dexmethylphenidate hcl tabs 5 mg 48 dexrazoxane hcl solr 250 mg 88 dexrazoxane hcl solr 500 mg 88 dextroamphetamine sulfate er cp24 10 mg 48 dextroamphetamine sulfate er cp24 15 mg 48 dextroamphetamine sulfate er cp24 5 mg 48 dextroamphetamine sulfate tabs 10 mg 48 dextroamphetamine sulfate tabs 5 mg 48 DEXTROSE 5ELECTROLYTE 48 SOLN

[electrolyte-48 in dextrose] 68 DEXTROSE IN LACTATED RINGERS SOLN 5

[dextrose in lactated ringers] 68 dextrose in ringers soln 5 68 DEXTROSE SOLN 10 [dextrose] 66 DEXTROSE SOLN 20 [dextrose] 66 DEXTROSE SOLN 40 [dextrose] 66 DEXTROSE SOLN 5 [dextrose] 66 DEXTROSE SOLN 50 [dextrose] 66 DEXTROSE SOLN 70 [dextrose] 66 DEXTROSE-NACL SOLN 10-045 [dextrose

w sodium chloride] 69 DEXTROSE-NACL SOLN 25-045 [dextrose

w sodium chloride] 69 DEXTROSE-NACL SOLN 5-02 [dextrose w

sodium chloride] 69 DEXTROSE-NACL SOLN 5-0225 [dextrose




sodium chloride] 69 DIANEAL LOW CALCIUM425 DEX SOLN

483 MOSML [peritoneal dialysis solutions] 68

DIANEAL PD-215 DEXTROSE SOLN 346 MOSML [peritoneal dialysis solutions] 68



DIASTAT ACUDIAL GEL 10 MG [diazepam (anticonvulsant)] 54


DIASTAT PEDIATRIC GEL 25 MG [diazepam (anticonvulsant)] 54

DIASTIX STRP [glucose urine test-(glucose oxidase)] 64

diazepam soln 5 mg5ml 54 diazepam soln 5 mgml 54 diazepam tabs 10 mg 54 diazepam tabs 2 mg 54 diazepam tabs 5 mg 54 diclofenac sodium gel 1 103 diclofenac sodium soln 01 72 diclofenac sodium soln 15 103 dicloxacillin sodium caps 250 mg 10 dicloxacillin sodium caps 500 mg 10 dicyclomine hcl caps 10 mg 25 dicyclomine hcl soln 10 mg5ml 25 dicyclomine hcl tabs 20 mg 25 didanosine cap 125mg 5 didanosine cpdr 200 mg 15 didanosine cpdr 250 mg 15 didanosine cpdr 400 mg 15 DIFFERIN CREA 01 [adapalene] 103 DIFFERIN GEL 01 [adapalene] 103 DIFFERIN GEL 03 [adapalene] 103 DIGIFAB SOLR 40 MG [digoxin immune fab]95 DIGOXIN SOLN 005 MGML [digoxin] 39 digoxin soln 025 mgml 39 digoxin tabs 125 mcg 39 digoxin tabs 250 mcg 39 dihydroergotamine mesylate soln 1 mgml 28 diltiazem hcl er coated beads cp24 180 mg 38 diltiazem hcl er cp12 120 mg 38 diltiazem hcl er cp12 60 mg 38 diltiazem hcl er cp12 90 mg 38 diltiazem hcl er cp24 120 mg 38 diltiazem hcl er cp24 180 mg 38 diltiazem hcl er cp24 240 mg 38 DILTIAZEM HCL POWD [diltiazem hcl (bulk)]


92 diltiazem hcl soln 125 mg25ml 38 diltiazem hcl soln 25 mg5ml 39 diltiazem hcl soln 50 mg10ml 39 diltiazem hcl tabs 120 mg 39 diltiazem hcl tabs 30 mg 39 diltiazem hcl tabs 60 mg 39 diltiazem hcl tabs 90 mg 39 dimethyl fumarate cpdr 120 mg 88 dimethyl fumarate cpdr 240 mg 88 dimethyl fumarate starter pack misc 120 amp

240 mg 88 diphenhydramine hcl soln 50 mgml 17 diphenoxylate-atropine liqd 25-0025 mg5ml

75 diphenoxylate-atropine tabs 25-0025 mg 75 DIPHTHERIA-TETANUS TOXOIDS DT SUSP

25-5 LFU05ML [diphtheria-tetanus toxoids (dt)] 97

dipyridamole soln 5 mgml 42 dipyridamole tabs 25 mg 42 dipyridamole tabs 50 mg 42 dipyridamole tabs 75 mg 42 disopyramide phosphate caps 100 mg 39 disopyramide phosphate caps 150 mg 39 DISPOSABLE POWER KIT [misc devices] 62 disulfiram tabs 250 mg 88 disulfiram tabs 500 mg 88 divalproex sodium csdr 125 mg 49 divalproex sodium er tb24 250 mg 49 divalproex sodium er tb24 500 mg 49 divalproex sodium tbec 125 mg 49 divalproex sodium tbec 250 mg 49 divalproex sodium tbec 500 mg 49 dobutamine hcl soln 250 mg20ml 28 DOBUTAMINE IN D5W SOLN 1-5 MGML-

[dobutamine in d5w] 28 DOBUTAMINE IN D5W SOLN 2 MGML

[dobutamine in d5w] 28 docetaxel conc 80 mg4ml 19 dofetilide caps 125 mcg 39 dofetilide caps 250 mcg 39 dofetilide caps 500 mcg 39 donepezil hcl tabs 10 mg 26 donepezil hcl tabs 5 mg 26 donepezil hcl tbdp 10 mg 26 donepezil hcl tbdp 5 mg 26 DONNATAL ELIX 162 MG5ML [phenobarbital-

hyoscyamine-atropine-scopolamine] 25 DONNATAL TABS 162 MG [phenobarbital-

hyoscyamine-atropine-scopolamine] 25 dopamine hcl inj 80mgml 28 dopamine hcl soln 160 mgml 28 DOPAMINE HCL SOLN 40 MGML [dopamine

hcl] 28 dopamine hcl soln 80 mgml 28 DOPAMINE IN D5W SOLN 08-5 MGML-

[dopamine in d5w] 28 DOPAMINE IN D5W SOLN 16-5 MGML-


[dopamine in d5w] 28 dorzolamide hcl soln 2 73 dorzolamide hcl-timolol mal soln 223-68

mgml 73 DOVATO TABS 50-300 MG [dolutegravir

sodium-lamivudine] 5 doxazosin mesylate tabs 1 mg 36 doxazosin mesylate tabs 2 mg 36 doxazosin mesylate tabs 4 mg 36 doxazosin mesylate tabs 8 mg 36 doxepin hcl caps 10 mg 57 doxepin hcl caps 100 mg 57 doxepin hcl caps 150 mg 57 doxepin hcl caps 25 mg 57 doxepin hcl caps 50 mg 57 doxepin hcl caps 75 mg 57 doxepin hcl conc 10 mgml 57 DOXIL INJ 2 MGML [doxorubicin hcl

liposomal] 19 doxorubicin hcl liposomal inj 2 mgml 19 doxorubicin hcl soln 2 mgml 19 doxorubicin hcl solr 10 mg 19 doxorubicin hcl solr 50 mg 19 doxycycline hyclate caps 100 mg 10 doxycycline hyclate caps 50 mg 10 doxycycline hyclate tabs 100 mg 10 doxycycline hyclate tabs 20 mg 10 doxycycline monohydrate susr 25 mg5ml 10 doxycycline monohydrate tabs 100 mg 10 doxycycline monohydrate tabs 50 mg 10 DRITHO-CREME HP CREA 1 [anthralin] 103 dronabinol caps 10 mg 75 dronabinol caps 25 mg 75 dronabinol caps 5 mg 75 droperidol soln 25 mgml 54 drospirenone-ethinyl estradiol tabs 3-002 mg

81 drospirenone-ethinyl estradiol tabs 3-003 mg

81


DRYSOL SOLN 20 [aluminum chloride] 102 duloxetine hcl cpep 20 mg 57 duloxetine hcl cpep 30 mg 57 duloxetine hcl cpep 60 mg 57 DUOPA SUSP 463-20 MGML [carbidopa-

levodopa] 52 DURAMORPH SOLN 05 MGML [morphine

sulfate] 44 DURAMORPH SOLN 1 MGML [morphine

sulfate] 44 D-XYLOSE POWD [d-xylose] 64 DYRENIUM CAPS 100 MG [triamterene] 67 DYRENIUM CAPS 50 MG [triamterene] 67

E EDECRIN TABS 25 MG [ethacrynic acid] 67 EDEX KIT 10 MCG [alprostadil (vasodilator)]

42 EDEX KIT 20 MCG [alprostadil (vasodilator)]


42 EDURANT TABS 25 MG [rilpivirine hcl] 5 EEMT HS TABS 0625-125 MG [esterified

estrogens amp methyltestosterone] 83 EEMT TABS 125-25 MG [esterified estrogens

amp methyltestosterone] 83 efavirenz caps 200 mg 15 efavirenz caps 50 mg 15 efavirenz tabs 600 mg 15 efavirenz-emtricitab-tenofovir tabs 600-200-

300 mg 15 EFFER-K TBEF 25 MEQ [potassium

bicarbonate] 69 EFFIENT TABS 10 MG [prasugrel hcl] 34 EFFIENT TABS 5 MG [prasugrel hcl] 34 ELAPRASE SOLN 6 MG3ML [idursulfase] 71 eletriptan hydrobromide tabs 20 mg 51 eletriptan hydrobromide tabs 40 mg 51 ELITEK SOLR 15 MG [rasburicase] 71 ELITEK SOLR 75 MG [rasburicase] 71 ELLA TABS 30 MG [ulipristal acetate] 81 ELMIRON CAPS 100 MG [pentosan

polysulfate sodium] 88 ELOCTATE SOLR 1000 UNIT [antihemophilic

factor (rcmb) fc fusion protein(bdd-rfviiifc)] 31

ELOCTATE SOLR 1500 UNIT [antihemophilic factor (rcmb) fc fusion protein(bdd-rfviiifc)] 31









ELTA TAR CREA 2 [coal tar extract] 102 EMCYT CAPS 140 MG [estramustine

phosphate sodium] 19 EMEND CAPS 125 MG [aprepitant] 75 EMEND CAPS 40 MG [aprepitant] 75 EMEND CAPS 80 MG [aprepitant] 75 EMEND TRI-PACK CAPS 80 amp 125 MG

[aprepitant] 75 emtricitabine caps 200 mg 15 emtricitabine-tenofovir df tabs 100-150 mg 15 emtricitabine-tenofovir df tabs 133-200 mg 15 emtricitabine-tenofovir df tabs 167-250 mg 15 emtricitabine-tenofovir df tabs 200-300 mg 15 EMTRIVA SOLN 10 MGML [emtricitabine] 5 enalaprilat inj 125 mgml 41 ENBREL SOLR 25 MG [etanercept] 85 ENBREL SOSY 25 MG05ML [etanercept] 85 ENBREL SOSY 50 MGML [etanercept] 85 ENBREL SURECLICK SOAJ 50 MGML

[etanercept] 85 ENDOMETRIN INST 100 MG [progesterone

(vaginal)] 84 ENGERIX-B SUSP 10 MCG05ML [hepatitis b

vaccine (recomb)] 97 ENGERIX-B SUSP 20 MCGML [hepatitis b

vaccine (recomb)] 97


ENTACAPONE TABS 200 MG [entacapone] 52 entecavir tabs 05 mg 15 entecavir tabs 1 mg 15 ENTRESTO TABS 24-26 MG [sacubitril-

valsartan] 41 ENTRESTO TABS 49-51 MG [sacubitril-


valsartan] 41 EOVIST SOLN 025 MOLL [gadoxetate

disodium] 64 EPCLUSA TABS 200-50 MG [sofosbuvir-

velpatasvir] 15 EPCLUSA TABS 400-100 MG [sofosbuvir-

velpatasvir] 15 EPHEDRINE SULFATE SOLN 50 MGML

[ephedrine sulfate (pressors)] 28 EPIDUO FORTE GEL 03-25 [adapalene-

benzoyl peroxide] 103 epinephrine hcl inj 1mgml 28 EPINEPHRINE PF SOLN 1 MGML

[epinephrine] 28 epinephrine soaj 015 mg015ml 28 EPINEPHRINE SOLN 30 MG30ML

[epinephrine] 28 EPINEPHRINE SOSY 1 MG10ML

[epinephrine] 28 EPIPEN 2-PAK SOAJ 03 MG03ML

[epinephrine (anaphylaxis)] 28 EPIPEN JR 2-PAK SOAJ 015 MG03ML

[epinephrine (anaphylaxis)] 29 EPIVIR HBV SOLN 5 MGML [lamivudine

(hbv)] 15 EPIVIR HBV TABS 100 MG [lamivudine (hbv)]

15 EQUETRO CP12 200 MG [carbamazepine

(mood)] 49 ERBITUX SOLN 100 MG50ML [cetuximab] 19 ERBITUX SOLN 200 MG100ML [cetuximab] 19 ERGOCALCIFEROL SOLN 200 MCGML

[ergocalciferol] 105 ergoloid mesylates tabs 1 mg 51 ergotamine-caffeine tabs 1-100 mg 51 ERIVEDGE CAPS 150 MG [vismodegib] 19 erlotinib hcl tabs 100 mg 19 erlotinib hcl tabs 150 mg 19 erlotinib hcl tabs 25 mg 19 ERWINAZE SOLR 10000 UNIT [asparaginase

erwinia chrysanthemi] 19 ERYTHROCIN LACTOBIONATE SOLR 500 MG

[erythromycin lactobionate] 10 erythromycin oint 5 mggm 72 erythromycin soln 2 99 escitalopram oxalate soln 5 mg5ml 57 escitalopram oxalate tabs 10 mg 57 escitalopram oxalate tabs 20 mg 57 escitalopram oxalate tabs 5 mg 57 ESMOLOL HCL SOLN 100 MG10ML [esmolol

hcl] 37 ESTRADIOL POW [estradiol] 92 estradiol pttw 0025 mg24hr 83 estradiol pttw 00375 mg24hr 83 estradiol pttw 005 mg24hr 83 estradiol pttw 0075 mg24hr 83 estradiol pttw 01 mg24hr 83 estradiol ptwk 005 mg24hr 83 estradiol ptwk 0075 mg24hr 83 estradiol ptwk 01 mg24hr 83 estradiol tabs 05 mg 83 estradiol tabs 1 mg 83 estradiol tabs 2 mg 83 estradiol valerate inj 10mgml 83 estradiol valerate oil 20 mgml 83 estradiol valerate oil 40 mgml 83 ESTRING RING 2 MG [estradiol vaginal] 83 ethacrynic acid tabs 25 mg 67 ethambutol hcl tabs 100 mg 14 ethambutol hcl tabs 400 mg 14 ETHAMOLIN INJ 5 [ethanolamine oleate]

42 ethosuximide caps 250 mg 49 ethosuximide soln 250 mg5ml 49 etidronate disodium tabs 200 mg 88 etidronate disodium tabs 400 mg 88 etodolac caps 200 mg 44 etodolac caps 300 mg 44 etodolac tabs 400 mg 44 etodolac tabs 500 mg 44 etomidate soln 2 mgml 55 etoposide caps 50 mg 19 everolimus tabs 25 mg 19 everolimus tabs 5 mg 19 everolimus tabs 75 mg 19 EVOTAZ TABS 300-150 MG [atazanavir

sulfate-cobicistat] 16 exemestane tabs 25 mg 19 EXJADE TBSO 125 MG [deferasirox] 77 EXJADE TBSO 250 MG [deferasirox] 77 EXJADE TBSO 500 MG [deferasirox] 77 EXTAVIA KIT 03 MG [interferon beta-1b] 55


EYLEA SOLN 2 MG005ML [aflibercept] 74 EYLEA SOSY 2 MG005ML [aflibercept] 74 E-Z-CAT DRY PACK 2 [barium sulfate] 64 ezetimibe tabs 10 mg 36

F FABRAZYME SOLR 35 MG [agalsidase beta]

71 FABRAZYME SOLR 5 MG [agalsidase beta] 71 famciclovir tabs 500 mg 16 famotidine premixed soln 20-09 mg50ml-

76 famotidine soln 20 mg2ml 76 famotidine soln 40 mg4ml 76 famotidine susr 40 mg5ml 76 famotidine tabs 20 mg 76 famotidine tabs 40 mg 76 felbamate susp 600 mg5ml 49 felbamate tabs 400 mg 49 felbamate tabs 600 mg 49 fenofibrate tabs 160 mg 36 fenofibrate tabs 54 mg 36 fentanyl citrate (pf) soct 100 mcg2ml 44 FENTANYL CITRATE (PF) SOLN 100 MCG2ML

[fentanyl citrate] 44 FENTANYL CITRATE (PF) SOLN 500

MCG10ML [fentanyl citrate] 44 fentanyl pt72 100 mcghr 44 fentanyl pt72 12 mcghr 44 fentanyl pt72 25 mcghr 44 fentanyl pt72 50 mcghr 44 fentanyl pt72 75 mcghr 44 FERREX 150 CAPS 150 MG [polysaccharide

iron complex] 29 finasteride tabs 5 mg 88 FIRAZYR SOLN 30 MG3ML [icatibant acetate]

89 FIRVANQ SOLR 25 MGML [vancomycin hcl]


10 FLEBOGAMMA DIF SOLN 05 GM10ML

[immune globulin (human) iv] 95 FLEBOGAMMA DIF SOLN 25 GM50ML



[immune globulin (human) iv] 95 flecainide acetate tabs 100 mg 39

flecainide acetate tabs 150 mg 39 flecainide acetate tabs 50 mg 39 FLOVENT HFA AERO 44 MCGACT

[fluticasone propionate hfa] 78 FLUAD SUSY 05 ML [influenza virus vaccine

types a amp b surface antigen adjuvant] 97 fluconazole in dextrose inj dex 200 13 fluconazole in nacl inj nacl 200 13 fluconazole in nacl inj nacl 400 13 fluconazole in sodium chloride soln 100-09

mg50ml- 10 fluconazole in sodium chloride soln 200-09


mg200ml- 13 fluconazole susr 10 mgml 13 fluconazole susr 40 mgml 13 fluconazole tabs 100 mg 13 fluconazole tabs 150 mg 13 fluconazole tabs 200 mg 13 fluconazole tabs 50 mg 13 flucytosine caps 250 mg 13 flucytosine caps 500 mg 13 fludarabine phosphate solr 50 mg 19 fludrocortisone acetate tabs 01 mg 78 flumazenil soln 05 mg5ml 55 flunisolide soln 25 mcgact (0025) 72 fluocinolone acetonide body oil 001 100 fluocinolone acetonide scalp oil 001 100 fluocinolone acetonide soln 001 100 fluocinonide crea 005 100 fluocinonide gel 005 100 fluocinonide oint 005 100 fluocinonide soln 005 100 FLUORITAB CHEW 22 (1 F) MG [sodium

fluoride] 89 fluorometholone susp 01 72 FLUOROPLEX CREA 1 [fluorouracil

(topical)] 103 fluorouracil crea 5 103 fluorouracil soln 1 gm20ml 19 fluorouracil soln 2 103 fluorouracil soln 25 gm50ml 19 fluorouracil soln 5 103 fluorouracil soln 5 gm100ml 19 fluorouracil soln 500 mg10ml 19 fluoxetine hcl caps 10 mg 57 fluoxetine hcl caps 20 mg 57 fluoxetine hcl caps 40 mg 57 fluoxetine hcl soln 20 mg5ml 57


fluphenazine decanoate soln 25 mgml 57 fluphenazine hcl conc 5 mgml 57 fluphenazine hcl tabs 1 mg 57 fluphenazine hcl tabs 10 mg 57 fluphenazine hcl tabs 25 mg 57 fluphenazine hcl tabs 5 mg 57 FLURA-DROPS SOLN 055 (025 F) MGDROP

[sodium fluoride] 89 flurbiprofen sodium soln 003 73 flutamide caps 125 mg 19 fluticasone propionate crea 005 101 fluticasone propionate oint 0005 101 fluticasone propionate susp 50 mcgact 73 fluvoxamine maleate tabs 100 mg 57 fluvoxamine maleate tabs 25 mg 58 fluvoxamine maleate tabs 50 mg 58 FLUZONE HIGH-DOSE SUSY 05 ML

[influenza virus vaccine split high-dose preservative free] 97

FLUZONE SUSP [influenza virus vaccine split] 97

FML FORTE SUSP 025 [fluorometholone (ophth)] 73

FML OINT 01 [fluorometholone (ophth)] 73 folic acid soln 5 mgml 105 FORANE SOLN [isoflurane] 55 FORTAZ SOLR 500 MG [ceftazidime] 10 FORTEO SOPN 620 MCG248ML [teriparatide

(recombinant)] 84 fosamprenavir calcium tabs 700 mg 16 fosaprepitant dimeglumine solr 150 mg 75 FOSCAVIR SOLN 6000 MG250ML [foscarnet

sodium] 16 fosphenytoin sodium soln 100 mg pe2ml 49 fosphenytoin sodium soln 500 mg pe10ml 49 fulvestrant soln 250 mg5ml 19 furosemide soln 10 mgml 67 furosemide soln 8 mgml 67 FUROSEMIDE TABS 20 MG [furosemide] 67 FUROSEMIDE TABS 40 MG [furosemide] 67 furosemide tabs 80 mg 67 FUSILEV SOLR 50 MG [levoleucovorin

calcium] 89 FUZEON SOLR 90 MG [enfuvirtide] 5

G gabapentin caps 100 mg 49 gabapentin caps 300 mg 49 gabapentin caps 400 mg 49 GABAPENTIN POWD [gabapentin (bulk)] 92

gabapentin soln 250 mg5ml 49 gabapentin tabs 600 mg 49 gabapentin tabs 800 mg 49 GABLOFEN SOLN 10000 MCG20ML

[baclofen] 27 GABLOFEN SOLN 20000 MCG20ML


[baclofen] 27 GABLOFEN SOSY 10000 MCG20ML



[baclofen] 27 GABLOFEN SOSY 50 MCGML [baclofen] 27 GADAVIST SOLN 1 MMOLML [gadobutrol] 64 galantamine hydrobromide er cp24 16 mg 26 galantamine hydrobromide er cp24 24 mg 26 GALANTAMINE HYDROBROMIDE ER CP24 8

MG [galantamine hydrobromide] 26 galantamine hydrobromide tabs 12 mg 26 galantamine hydrobromide tabs 4 mg 26 galantamine hydrobromide tabs 8 mg 26 GAMASTAN INJ [immune globulin (human)

im] 95 GAMMAGARD SD LESS IGA SOLR 10 GM

[immune globulin (human) iv] 95 GAMMAGARD SD LESS IGA SOLR 5 GM

[immune globulin (human) iv] 95 GAMMAGARD SOLN 1 GM10ML [immune

globulin (human) iv or subcutaneous] 95 GAMMAGARD SOLN 30 GM300ML [immune

globulin (human) iv or subcutaneous] 95 GAMMAKED SOLN 1 GM10ML [immune





globulin (human) iv or subcutaneous] 96 GAMMAPLEX SOLN 10 GM200ML [immune

globulin (human) iv] 96 GAMMAPLEX SOLN 20 GM400ML [immune


globulin (human) iv] 96


GAMUNEX-C SOLN 1 GM10ML [immune globulin (human) iv or subcutaneous] 96





ganciclovir sodium solr 500 mg 16 GARDASIL 9 SUSP [human papillomavirus

(hpv) 9-valent recombinant vaccine] 97 GARDASIL 9 SUSY [human papillomavirus

(hpv) 9-valent recombinant vaccine] 98 GARDASIL INJ [human papillomavirus

(hpv) quadrivalent recombinant vaccine] 98 GARDASIL SUSP [human papillomavirus

(hpv) quadrivalent recombinant vaccine] 98 GASTROGRAFIN SOLN 66-10 [diatrizoate

meglumine amp sodium] 64 gatifloxacin soln 05 72 GAZYVA SOLN 1000 MG40ML

[obinutuzumab] 19 GELFILM FILM [gelatin adsorbable (ophth)] 31 GELFOAM SPONGE MISC 12-7 MM [gelatin

absorbable] 31 GELFOAM SPONGE SIZE 100 MISC [gelatin


absorbable] 31 GELUSIL CHEW 200-200-25 MG [alum amp mag

hydrox-simethicone] 75 gemcitabine hcl solr 200 mg 19 gemfibrozil tabs 600 mg 36 GEMZAR SOLR 1 GM [gemcitabine hcl] 19 gentamicin in saline soln 08-09 mgml- 10 gentamicin in saline soln 12-09 mgml- 10 gentamicin in saline soln 16-09 mgml- 10 gentamicin in saline soln 1-09 mgml- 10 gentamicin in saline soln 2-09 mgml- 10 gentamicin sulfate crea 01 99 gentamicin sulfate oint 01 99 gentamicin sulfate soln 03 72 gentamicin sulfate soln 10 mgml 10 gentamicin sulfate soln 40 mgml 10 GENTIAN VIOLET SOLN 1 [gentian violet]99 GENVOYA TABS 150-150-200-10 MG

[elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide] 16

GLEOSTINE CAPS 10 MG [lomustine] 19 GLEOSTINE CAPS 100 MG [lomustine] 19 GLEOSTINE CAPS 40 MG [lomustine] 19 GLEOSTINE CAPS 5 MG [lomustine] 19 glimepiride tabs 1 mg 80 glimepiride tabs 2 mg 80 glimepiride tabs 4 mg 80 glipizide tabs 10 mg 80 glipizide tabs 5 mg 80 glipizide tb24 10 mg 80 glipizide tb24 25 mg 80 glipizide tb24 5 mg 80 glipizide-metformin hcl tabs 25-250 mg 80 glipizide-metformin hcl tabs 25-500 mg 80 glipizide-metformin hcl tabs 5-500 mg 80 GLUCAGEN HYPOKIT SOLR 1 MG [glucagon

hcl (rdna)] 81 GLUCAGEN INJ 1MG [glucagon hcl (rdna)]

81 glucagon emergency kit 1 mg 81 glyburide tabs 125 mg 80 glyburide tabs 25 mg 80 glyburide tabs 5 mg 80 GLYCERIN LIQD [glycerin (bulk)] 92 GLYCOPYRROLATE POWD [glycopyrrolate

(bulk)] 92 glycopyrrolate soln 02 mgml 25 glycopyrrolate soln 04 mg2ml 25 glycopyrrolate soln 1 mg5ml 25 glycopyrrolate soln 4 mg20ml 25 glycopyrrolate tabs 1 mg 25 glycopyrrolate tabs 2 mg 25 GOLYTELY SOLR 236 GM [peg 3350-kcl-sod

bicarb-sod chloride-sod sulfate] 76 GONAL-F RFF REDIJECT SOLN 300

UNIT05ML [follitropin alfa] 83 GONAL-F RFF REDIJECT SOLN 450

UNT075ML [follitropin alfa] 83 GONAL-F RFF REDIJECT SOLN 900

UNIT15ML [follitropin alfa] 83 GONAL-F RFF SOLR 75 UNIT [follitropin alfa]

83 GONAL-F SOLR 1050 UNIT [follitropin alfa] 83 GONAL-F SOLR 450 UNIT [follitropin alfa] 83 GRASTEK SUBL 2800 BAU [timothy grass

pollen allergen extract] 89 griseofulvin microsize susp 125 mg5ml 13 griseofulvin microsize tabs 500 mg 13 griseofulvin ultramicrosize tabs 125 mg 13 griseofulvin ultramicrosize tabs 250 mg 13


guanfacine hcl er tb24 1 mg 55 guanfacine hcl er tb24 2 mg 55 guanfacine hcl er tb24 3 mg 55 guanfacine hcl er tb24 4 mg 55 guanfacine hcl tabs 1 mg 28 guanfacine hcl tabs 2 mg 28 GUANIDINE HCL TABS 125 MG [guanidine

hcl] 27

H HAEGARDA SOLR 2000 UNIT [c1 esterase

inhibitor (human)] 89 HAEGARDA SOLR 3000 UNIT [c1 esterase

inhibitor (human)] 89 HALAVEN SOLN 1 MG2ML [eribulin mesylate]

20 halobetasol propionate crea 005 101 halobetasol propionate oint 005 101 haloperidol decanoate soln 100 mgml 58 haloperidol decanoate soln 50 mgml 58 haloperidol lactate conc 2 mgml 58 haloperidol lactate soln 5 mgml 58 HALOPERIDOL POWD [haloperidol (bulk)] 92 haloperidol tabs 05 mg 58 haloperidol tabs 1 mg 58 haloperidol tabs 10 mg 58 haloperidol tabs 2 mg 58 haloperidol tabs 20 mg 58 haloperidol tabs 5 mg 58 HARVONI TABS 45-200 MG [ledipasvir-

sofosbuvir] 13 HARVONI TABS 90-400 MG [ledipasvir-

sofosbuvir] 13 HAVRIX SUSP 1440 EL UML [hepatitis a

vaccine] 98 HAVRIX SUSP 720 EL U05ML [hepatitis a

vaccine] 98 HEALON5 INJ 23MGML [sodium

hyaluronate] 74 HELIXATE FS KIT 250 UNIT [antihemophilic

factor (recombinant) (rfviii)] 31 HEMABATE SOLN 250 MCGML [carboprost

tromethamine] 91 HEMLIBRA SOLN 105 MG07ML [emicizumab-

kxwh] 31 HEMLIBRA SOLN 150 MGML [emicizumab-


kxwh] 31 HEMLIBRA SOLN 60 MG04ML [emicizumab-

kxwh] 31 HEMOFIL M INJ 220-400 [antihemophilic

factor (human)] 31 HEMOFIL M SOLR 1000 UNIT [antihemophilic



factor (human)] 31 HEPARIN (PORCINE) IN NACL SOLN 1000-09

UT500ML- [heparin (porcine) in sodium chloride] 34

HEPARIN (PORCINE) IN NACL SOLN 2000-09 UNITL- [heparin (porcine) in sodium chloride] 34

HEPARIN (PORCINE) IN NACL SOLN 25000-045 UT250ML- [heparin (porcine) in sodium chloride] 34

HEPARIN LOCK FLUSH SOLN 1 UNITML [heparin sodium (porcine) lock flush] 34


HEPARIN SOD (PORCINE) IN D5W SOLN 100 UNITML [heparin sod (porcine) in d5w] 34

HEPARIN SOD (PORCINE) IN D5W SOLN 25000-5 UT500ML- [heparin sod (porcine) in d5w] 34

HEPARIN SOD (PORCINE) IN D5W SOLN 40-5 UNITML- [heparin sod (porcine) in d5w] 34

heparin sodium (porcine) lock flush soln 34 HEPARIN SODIUM (PORCINE) PF SOLN 5000

UNIT05ML [heparin sodium (porcine)] 34 HEPARIN SODIUM (PORCINE) SOLN 1000

UNITML [heparin sodium (porcine)] 34 HEPARIN SODIUM (PORCINE) SOLN 10000



UNITML [heparin sodium (porcine)] 34 HEPARIN SODIUM LOCK FLUSH SOLN 100

UNITML [heparin sodium (porcine) lock flush] 34

HERCEPTIN SOLR 150 MG [trastuzumab] 20 hetastarch-nacl soln 6-09 69 HEXTEND SOLN 6 [hetastarch in lactated

electrolyte] 69 HIBERIX SOLR 10 MCG [haemophilus b

polysac conj vac] 98


HIZENTRA SOLN 1 GM5ML [immune globulin (human) subcutaneous] 96




HOMATROPINE HBR SOLN 5 [homatropine hbr] 75

HUMALOG MIX 5050 KWIKPEN SUPN (50-50) 100 UNITML [insulin lispro protamine amp lispro] 80

HUMALOG MIX 5050 SUSP (50-50) 100 UNITML [insulin lispro protamine amp lispro] 80

HUMALOG SOLN 100 UNITML [insulin lispro] 80

HUMATE-P SOLR 1000-2400 UNIT [antihemophilic factorvon willebrand factor complex (human)] 32



HUMIRA PEDIATRIC CROHNS START PSKT 80 MG08ML amp 40MG04ML [adalimumab] 89

HUMIRA PEDIATRIC CROHNS START PSKT 80 MG08ML [adalimumab] 89

HUMIRA PEN PNKT 40 MG04ML [adalimumab] 89


HUMIRA PEN-CDUCHS STARTER PNKT 80 MG08ML [adalimumab] 89

HUMIRA PEN-PSORUVEIT STARTER PNKT 80 MG08ML amp 40MG04ML [adalimumab] 89

HUMIRA PSKT 10 MG01ML [adalimumab] 89 HUMIRA PSKT 10 MG02ML [adalimumab] 85 HUMIRA PSKT 20 MG02ML [adalimumab] 89 HUMIRA PSKT 20 MG04ML [adalimumab] 85 HUMIRA PSKT 40 MG04ML [adalimumab] 89 HUMIRA PSKT 40 MG08ML [adalimumab] 85 HUMULIN 7030 KWIKPEN SUPN (70-30) 100

UNITML [insulin nph isophane amp reg (human)] 80







HYCAMTIN CAPS 025 MG [topotecan hcl] 20 HYCAMTIN CAPS 1 MG [topotecan hcl] 20 hydralazine hcl soln 20 mgml 40 hydralazine hcl tabs 10 mg 40 hydralazine hcl tabs 100 mg 40 hydralazine hcl tabs 25 mg 40 hydralazine hcl tabs 50 mg 40 hydrochlorothiazide tabs 125 mg 67 hydrochlorothiazide tabs 25 mg 67 hydrochlorothiazide tabs 50 mg 67 hydrocodone-acetaminophen soln 75-325

mg15ml 44 hydrocodone-acetaminophen tabs 10-325 mg

44 hydrocodone-acetaminophen tabs 5-325 mg


44 hydrocodone-homatropine syrp 5-15 mg5ml

94 hydrocodone-homatropine tabs 5-15 mg 94 hydrocortisone ace-pramoxine crea 1-1 101 HYDROCORTISONE ACE-PRAMOXINE CREA

25-1 [pramoxine-hc] 101 hydrocortisone crea 25 101 hydrocortisone enem 100 mg60ml 101 hydrocortisone lotn 25 101 hydrocortisone oint 25 101 HYDROCORTISONE POWD [hydrocortisone

(topical)] 92 hydrocortisone tabs 10 mg 78 hydrocortisone tabs 20 mg 78 hydrocortisone tabs 5 mg 78 HYDROCORTISONE-IODOQUINOL CREA 1-1

[iodoquinol-hc] 99 HYDROCORT-PRAMOXINE (PERIANAL) CREA

25-1 [hydrocortisone acetate w pramoxine] 101


hydromorphone hcl liqd 1 mgml 44 hydromorphone hcl pf soln 500 mg50ml 44 HYDROMORPHONE HCL SOLN 1 MGML

[hydromorphone hcl] 44 HYDROMORPHONE HCL SOLN 2 MGML


[hydromorphone hcl] 44 HYDROMORPHONE HCL SUPP 3 MG

[hydromorphone hcl] 44 hydromorphone hcl tabs 2 mg 44 hydromorphone hcl tabs 4 mg 44 hydromorphone hcl tabs 8 mg 44 HYDROPHILIC OINT [hydrophilic ointment] 92 HYDROXOCOBALAMIN POW

[hydroxocobalamin (bulk)] 92 hydroxychloroquine sulfate tabs 200 mg 14 HYDROXYPROGESTERONE CAPROATE

POWD [hydroxyprogesterone caproate (bulk)] 92

hydroxyprogesterone caproate soln 125 gm5ml 84

hydroxyurea caps 500 mg 20 hydroxyzine hcl soln 25 mgml 54 hydroxyzine hcl soln 50 mgml 54 hydroxyzine hcl syrp 10 mg5ml 54 hydroxyzine hcl tabs 10 mg 54 hydroxyzine hcl tabs 25 mg 54 hydroxyzine hcl tabs 50 mg 54 hydroxyzine pamoate caps 100 mg 54 hydroxyzine pamoate caps 25 mg 54 hydroxyzine pamoate caps 50 mg 54 HYLENEX SOLN 150 UNITML [hyaluronidase

human] 71 HYOSCYAMINE SULFATE ER TB12 0375 MG

[hyoscyamine sulfate] 25 HYOSCYAMINE SULFATE SUBL 0125 MG

[hyoscyamine sulfate] 25 HYOSCYAMINE SULFATE TABS 0125 MG

[hyoscyamine sulfate] 25 HYOSCYAMINE SULFATE TBDP 0125 MG

[hyoscyamine sulfate] 25 HYOSYNE ELIX 0125 MG5ML [hyoscyamine

sulfate] 25 HYOSYNE SOLN 0125 MGML [hyoscyamine

sulfate] 26 HYPERLYTE-CR CONC [parenteral

electrolytes] 69 HYPERRAB SD SOLN 300 UNIT2ML [rabies

immune globulin (human)] 96

HYPERRAB SOLN 300 UNITML [rabies immune globulin (human)] 96

HYPERTET SD SOSY 250 UNITML [tetanus immune globulin (human)] 96

HYQVIA KIT 10 GM100ML [immune globulin (human)-hyaluronidase (human recombinant)] 96





HYSEPT SOLN 025 [sodium hypochlorite] 99

I IBRANCE CAPS 100 MG [palbociclib] 20 IBRANCE CAPS 125 MG [palbociclib] 20 IBRANCE CAPS 75 MG [palbociclib] 20 IBRANCE TABS 100 MG [palbociclib] 20 IBRANCE TABS 125 MG [palbociclib] 20 IBRANCE TABS 75 MG [palbociclib] 20 ibuprofen susp 100 mg5ml 44 ibutilide fumarate soln 1 mg10ml 39 icatibant acetate soln 30 mg3ml 89 IDAMYCIN PFS SOLN 10 MG10ML [idarubicin

hcl] 20 IDAMYCIN PFS SOLN 20 MG20ML [idarubicin

hcl] 20 idarubicin hcl soln 5 mg5ml 20 IDELVION SOLR 1000 UNIT [coagulation

factor ix recomb albumin fusion protein (rix-fp)] 32

IDELVION SOLR 2000 UNIT [coagulation factor ix recomb albumin fusion protein (rix-fp)] 32



IFOSFAMIDE SOLR 1 GM [ifosfamide] 20 imatinib mesylate tabs 100 mg 20 imatinib mesylate tabs 400 mg 20


IMBRUVICA CAPS 140 MG [ibrutinib] 20 IMBRUVICA CAPS 70 MG [ibrutinib] 20 IMBRUVICA TABS 140 MG [ibrutinib] 20 IMBRUVICA TABS 280 MG [ibrutinib] 20 IMBRUVICA TABS 420 MG [ibrutinib] 20 IMBRUVICA TABS 560 MG [ibrutinib] 20 imipramine hcl tabs 10 mg 58 imipramine hcl tabs 25 mg 58 imipramine hcl tabs 50 mg 58 imiquimod crea 5 103 IMOGAM RABIES-HT SOLN 300 UNIT2ML

[rabies immune globulin (human)] 96 IMOVAX RABIES INJ 25 UNITML [rabies virus

vaccine hdc] 98 indapamide tabs 125 mg 67 indapamide tabs 25 mg 67 indigotindisulfonate sodium soln 64 indomethacin caps 25 mg 45 indomethacin caps 50 mg 45 indomethacin er cpcr 75 mg 45 INDOMETHACIN POWD [indomethacin] 92 INDOMETHACIN SODIUM SOLR 1 MG

[indomethacin sodium] 45 INFANRIX SUSP 25-58-10 [diphtheria

acellular pertussis amp tetanus toxoids] 97 INFED SOLN 50 MGML [iron dextran] 29 INFLECTRA SOLR 100 MG [infliximab-dyyb]89 INFUMORPH 200 SOLN 200 MG20ML (10

MGML) [morphine sulfate for continuous microinfusion] 45

INFUMORPH 500 SOLN 500 MG20ML (25 MGML) [morphine sulfate for continuous microinfusion] 45

INFUVITE ADULT INJ [multiple vitamin] 104 INFUVITE PEDIATRIC SOLN [pediatric

multiple vitamins] 104 INTEGRILIN SOLN 20 MG10ML [eptifibatide]

34 INTEGRILIN SOLN 75 MG100ML [eptifibatide]

34 INTELENCE TABS 100 MG [etravirine] 5 INTELENCE TABS 200 MG [etravirine] 5 INTELENCE TABS 25 MG [etravirine] 5 INTRALIPID EMUL 20 [fat emulsion plant

based (soy)] 66 INTRALIPID EMUL 30 [fat emulsion plant

based (soy)] 66 INTRON A SOLN 10000000 UNITML

[interferon alfa-2b] 20 INTRON A SOLN 6000000 UNITML [interferon

alfa-2b] 20 INTRON A SOLR 10000000 UNIT [interferon



alfa-2b] 20 INVANZ SOLR 1 GM [ertapenem sodium] 10 INVEGA SUSTENNA SUSY 117 MG075ML

[paliperidone palmitate] 58 INVEGA SUSTENNA SUSY 156 MGML

[paliperidone palmitate] 58 INVEGA SUSTENNA SUSY 234 MG15ML



[paliperidone palmitate] 58 INVIRASE TABS 500 MG [saquinavir

mesylate] 5 IOPIDINE SOLN 1 [apraclonidine hcl] 74 IPOL INJ [poliovirus vaccine ipv] 98 ipratropium bromide soln 002 26 ipratropium bromide soln 003 26 ipratropium-albuterol soln 05-25 (3) mg3ml

29 IRESSA TABS 250 MG [gefitinib] 20 irinotecan hcl soln 500 mg25ml 20 ISAGEL GEL 60 [antiseptic products misc]

99 ISENTRESS CHEW 100 MG [raltegravir

potassium] 5 ISENTRESS CHEW 25 MG [raltegravir

potassium] 5 ISENTRESS HD TABS 600 MG [raltegravir

potassium] 5 ISENTRESS TABS 400 MG [raltegravir

potassium] 5 ISOMETHEPTENE-DICHLORAL-APAP CAPS

65-100-325 MG [isometheptene-dichloralphenazone-acetaminophen] 51

isoniazid soln 100 mgml 14 isoniazid syrp 50 mg5ml 14 isoniazid tabs 100 mg 14 isoniazid tabs 300 mg 14 isoproterenol hcl soln 02 mgml 29 isosorbide dinitrate er tbcr 40 mg 42 isosorbide dinitrate tabs 10 mg 42 isosorbide dinitrate tabs 20 mg 42 isosorbide dinitrate tabs 30 mg 42


isosorbide dinitrate tabs 5 mg 42 isosorbide mononitrate er tb24 120 mg 42 isosorbide mononitrate er tb24 30 mg 42 isosorbide mononitrate er tb24 60 mg 42 ISOSORBIDE POWD [isosorbide (bulk)] 92 ISTODAX (OVERFILL) SOLR 10 MG

[romidepsin] 20 itraconazole caps 100 mg 13 ivermectin tabs 3 mg 5 IXEMPRA KIT SOLR 15 MG [ixabepilone] 20 IXEMPRA KIT SOLR 45 MG [ixabepilone] 20 IXIARO SUSP [japanese encephalitis vaccine

inactivated adsorbed] 98

J JADENU SPRINKLE PACK 180 MG

[deferasirox] 77 JADENU SPRINKLE PACK 360 MG


[deferasirox] 77 JADENU TABS 180 MG [deferasirox] 77 JADENU TABS 360 MG [deferasirox] 77 JADENU TABS 90 MG [deferasirox] 77 JAKAFI TABS 10 MG [ruxolitinib phosphate]20 JAKAFI TABS 15 MG [ruxolitinib phosphate]20 JAKAFI TABS 20 MG [ruxolitinib phosphate]20 JAKAFI TABS 25 MG [ruxolitinib phosphate]20 JAKAFI TABS 5 MG [ruxolitinib phosphate] 20 JARDIANCE TABS 10 MG [empagliflozin] 81 JARDIANCE TABS 25 MG [empagliflozin] 81 JEVTANA SOLN 60 MG15ML [cabazitaxel] 20 JOLIVETTE TABS 035 MG [norethindrone

(contraceptive)] 81 JULUCA TABS 50-25 MG [dolutegravir

sodium-rilpivirine hcl] 16

K KADCYLA SOLR 100 MG [ado-trastuzumab

emtansine] 20 KADCYLA SOLR 160 MG [ado-trastuzumab

emtansine] 20 KALETRA SOLN 400-100 MG5ML [lopinavir-

ritonavir] 5 KALETRA TABS 100-25 MG [lopinavir-


ritonavir] 5 KALYDECO PACK 25 MG [ivacaftor] 94

KALYDECO PACK 50 MG [ivacaftor] 89 KALYDECO PACK 75 MG [ivacaftor] 89 KALYDECO TABS 150 MG [ivacaftor] 89 KANJINTI SOLR 420 MG [trastuzumab-anns]

21 KCENTRA KIT 500 UNIT [prothrombin

complex concentrate human] 32 KCL IN DEXTROSE-NACL SOLN 10-5-045

MEQL-- [potassium chloride in dextrose amp sodium chloride] 69

KCL IN DEXTROSE-NACL SOLN 20-5-02 MEQL-- [potassium chloride in dextrose amp sodium chloride] 69






KCL-LACTATED RINGERS-D5W SOLN 20 MEQL [potassium chloride in d5w lactated ringers] 69

K-EFFERVESCENT TBEF 25 MEQ [potassium bicarbonate] 69

KENALOG SUSP 10 MGML [triamcinolone acetonide] 78


KEPIVANCE SOLR 625 MG [palifermin] 102 KERALYT GEL 6 [salicylic acid] 102 KETAMINE HCL POWD [ketamine hcl (bulk)]

92 ketamine hcl soln 10 mgml 55 ketamine hcl soln 100 mgml 55 ketamine hcl soln 50 mgml 55 ketoconazole sham 2 99 ketoconazole tabs 200 mg 13 KETO-DIASTIX STRP [urine glucose-ketones

test] 64 KETOPROFEN POWD [ketoprofen (bulk)] 92 ketorolac tromethamine soln 04 73


ketorolac tromethamine soln 05 73 ketorolac tromethamine soln 15 mgml 45 ketorolac tromethamine soln 30 mgml 45 ketorolac tromethamine soln 60 mg2ml 45 KETOSTIX STRP [acetone (urine) test] 64 KEYTRUDA SOLN 100 MG4ML

[pembrolizumab] 21 KINERET INJ [anakinra] 85 KINRIX SUSP [diph-tetanus tox ad-acell

pertussis amp polio virus ipv vac] 98 KINRIX SUSY 05 ML [diph-tetanus tox ad-

acell pertussis amp polio virus ipv vac] 98 KLOR-CON TBCR 8 MEQ [potassium chloride]

69 KOATE SOLR 1000 UNIT [antihemophilic

factor (human)] 32 KOATE-DVI SOLR 250 UNIT [antihemophilic


factor (human)] 32 KOGENATE FS KIT 1000 UNIT [antihemophilic

factor (recombinant) (rfviii)] 32 KOGENATE FS KIT 2000 UNIT [antihemophilic


factor (recombinant) (rfviii)] 32 KOVALTRY SOLR 1000 UNIT [antihemophilic


KOVALTRY SOLR 2000 UNIT [antihemophilic factor (rcmb) plasmaalbumin free (rahf-pfm)] 32





KRINTAFEL TABS 150 MG [tafenoquine succinate] 14

K-TAB TBCR 10 MEQ [potassium chloride] 69 KYNMOBI FILM 10 MG [apomorphine

hydrochloride] 52 KYNMOBI FILM 15 MG [apomorphine

hydrochloride] 52

KYNMOBI FILM 20 MG [apomorphine hydrochloride] 52



KYNMOBI TITRATION KIT KIT 1015202530 MG [apomorphine hydrochloride] 53

KYPROLIS SOLR 10 MG [carfilzomib] 21 KYPROLIS SOLR 30 MG [carfilzomib] 21 KYPROLIS SOLR 60 MG [carfilzomib] 21

L labetalol hcl soln 5 mgml 37 labetalol hcl tabs 100 mg 37 labetalol hcl tabs 200 mg 37 labetalol hcl tabs 300 mg 37 LACRISERT INST 5 MG [artificial tear insert]

74 LACTATED RINGERS SOLN [lactated ringers

(irrigation)] 68 LACTATED RINGERS SOLN [lactated

ringers] 70 LACTIC ACID SOLN [lactic acid (bulk)] 92 LACTOSE MONOHYDRATE POWD [lactose

monohydrate] 92 LACTOSE POWD [lactose] 92 lactulose (encephalopathy) soln 10 gm15ml

65 lactulose soln 10 gm15ml 65 LAMICTAL STARTER KIT 35 x 25 MG

[lamotrigine] 49 LAMICTAL STARTER KIT 42 x 25 MG amp 7 X 100

MG [lamotrigine] 49 LAMICTAL STARTER KIT 84 x 25 MG amp 14X100

MG [lamotrigine] 50 lamivudine soln 10 mgml 5 lamivudine tabs 100 mg 16 lamivudine tabs 150 mg 5 lamivudine tabs 300 mg 5 lamivudine-zidovudine tabs 150-300 mg 5 lamotrigine chew 25 mg 50 lamotrigine chew 5 mg 50 lamotrigine tabs 100 mg 50 lamotrigine tabs 150 mg 50 lamotrigine tabs 200 mg 50 lamotrigine tabs 25 mg 50 LANOXIN PEDIATRIC SOLN 01 MGML

[digoxin] 39 LANTUS SOLN 100 UNITML [insulin glargine]


81 L-ARGININE POWD [arginine] 92 latanoprost soln 0005 73 L-CITRULLINE POWD [citrulline (bulk)] 92 leflunomide tabs 10 mg 85 leflunomide tabs 20 mg 85 LENVIMA (10 MG DAILY DOSE) CPPK 10 MG

[lenvatinib mesylate] 21 LENVIMA (12 MG DAILY DOSE) CPPK 3 x 4

MG [lenvatinib mesylate] 21 LENVIMA (14 MG DAILY DOSE) CPPK 10 amp 4

MG [lenvatinib mesylate] 21 LENVIMA (20 MG DAILY DOSE) CPPK 2 x 10


MG amp 4 MG [lenvatinib mesylate] 21 LETAIRIS TABS 10 MG [ambrisentan] 42 LETAIRIS TABS 5 MG [ambrisentan] 42 letrozole tabs 25 mg 21 leucovorin calcium solr 100 mg 89 leucovorin calcium solr 350 mg 89 leucovorin calcium solr 50 mg 89 leucovorin calcium tabs 25 mg 89 leucovorin calcium tabs 5 mg 89 LEUKERAN TABS 2 MG [chlorambucil] 21 LEUKINE SOLR 250 MCG [sargramostim] 35 leuprolide acetate kit 1 mg02ml 21 levetiracetam er tb24 500 mg 50 levetiracetam er tb24 750 mg 50 LEVETIRACETAM IN NACL SOLN 1000

MG100ML [levetiracetam in sodium chloride] 50

LEVETIRACETAM IN NACL SOLN 1500 MG100ML [levetiracetam in sodium chloride] 50


levetiracetam soln 100 mgml 50 levetiracetam soln 500 mg5ml 50 levetiracetam tabs 1000 mg 50 levetiracetam tabs 250 mg 50 levetiracetam tabs 500 mg 50 levetiracetam tabs 750 mg 50 levobunolol hcl soln 05 73 levocarnitine inj 200mgml 89 LEVOCARNITINE SOLN 1 GM10ML

[levocarnitine (metabolic modifiers)] 89 LEVOCARNITINE TABS 330 MG [levocarnitine

(metabolic modifiers)] 89

levofloxacin in d5w soln 250 mg50ml 10 levofloxacin in d5w soln 500 mg100ml 10 levofloxacin in d5w soln 750 mg150ml 10 levofloxacin soln 25 mgml 10 levofloxacin tabs 250 mg 10 levofloxacin tabs 500 mg 10 levofloxacin tabs 750 mg 10 LEVOTHYROXINE SODIUM SOLR 200 MCG

[levothyroxine sodium] 85 LEVOTHYROXINE SODIUM SOLR 500 MCG

[levothyroxine sodium] 85 levothyroxine sodium tabs 100 mcg 85 levothyroxine sodium tabs 112 mcg 85 levothyroxine sodium tabs 125 mcg 85 levothyroxine sodium tabs 150 mcg 85 levothyroxine sodium tabs 175 mcg 85 levothyroxine sodium tabs 200 mcg 85 levothyroxine sodium tabs 25 mcg 85 levothyroxine sodium tabs 300 mcg 85 levothyroxine sodium tabs 50 mcg 85 levothyroxine sodium tabs 75 mcg 85 levothyroxine sodium tabs 88 mcg 85 LEVOXYL TABS 137 MCG [levothyroxine

sodium] 85 LEVSIN SOLN 05 MGML [hyoscyamine

sulfate] 26 LEVULAN KERASTICK SOLR 20

[aminolevulinic acid hcl] 103 LEXISCAN SOLN 04 MG5ML [regadenoson]

64 LEXIVA TABS 700 MG [fosamprenavir

calcium] 5 LIALDA TBEC 12 GM [mesalamine] 75 LIDOCAINE HCL (CARDIAC) PF SOLN 100

MG5ML [lidocaine hcl (cardiac)] 87 lidocaine hcl (cardiac) pf sosy 100 mg5ml 40 lidocaine hcl (cardiac) sosy 50 mg5ml 40 lidocaine hcl (pf) soln 05 87 lidocaine hcl (pf) soln 1 87 lidocaine hcl (pf) soln 2 87 lidocaine hcl (pf) soln 4 87 LIDOCAINE HCL POWD [lidocaine hcl (bulk)]

92 lidocaine hcl soln 05 87 lidocaine hcl soln 1 87 lidocaine hcl soln 2 87 lidocaine hcl soln 4 101 lidocaine hcl urethralmucosal gel 2 101 lidocaine hcl urethralmucosal prsy 2 101 LIDOCAINE IN D5W SOLN 4-5 MGML-


[lidocaine in d5w] 40 LIDOCAINE IN D5W SOLN 8-5 MGML-

[lidocaine in d5w] 40 lidocaine oint 5 101 lidocaine viscous hcl soln 2 74 lidocaine-epinephrine soln 05 -1

200000 87 lidocaine-epinephrine soln 1 -1



100000 87 200000 87

lidocaine-prilocaine crea 25-25 101 lidocaine-prilocaine kit 25-25 101 linezolid soln 600 mg300ml 11 linezolid susr 100 mg5ml 11 liothyronine sodium tabs 25 mcg 85 liothyronine sodium tabs 5 mcg 85 liothyronine sodium tabs 50 mcg 85 lisinopril tabs 10 mg 41 lisinopril tabs 25 mg 41 lisinopril tabs 20 mg 41 lisinopril tabs 30 mg 41 lisinopril tabs 40 mg 41 lisinopril tabs 5 mg 41 lisinopril-hydrochlorothiazide tabs 10-125

mg 41 lisinopril-hydrochlorothiazide tabs 20-125

mg 41 lisinopril-hydrochlorothiazide tabs 20-25 mg

41 L-ISOLEUCINE POWD [isoleucine] 92 lithium carbonate caps 150 mg 51 LITHIUM CARBONATE CAPS 300 MG [lithium

carbonate] 51 lithium carbonate caps 600 mg 51 lithium carbonate er tbcr 300 mg 51 lithium carbonate er tbcr 450 mg 51 LITHIUM CARBONATE TABS 300 MG [lithium

carbonate] 51 LITHIUM SOLN 8 MEQ5ML [lithium] 51 LITHOSTAT TABS 250 MG [acetohydroxamic

acid] 65 LODOSYN TABS 25 MG [carbidopa] 53 LONSURF TABS 15-614 MG [trifluridine-

tipiracil] 21 LONSURF TABS 20-819 MG [trifluridine-

tipiracil] 21

lorazepam soln 2 mgml 54 lorazepam soln 4 mgml 54 lorazepam tabs 05 mg 54 lorazepam tabs 1 mg 54 lorazepam tabs 2 mg 54 LORBRENA TABS 100 MG [lorlatinib] 21 LORBRENA TABS 25 MG [lorlatinib] 21 losartan potassium tabs 100 mg 41 losartan potassium tabs 25 mg 41 losartan potassium tabs 50 mg 41 losartan potassium-hctz tabs 100-125 mg 41 losartan potassium-hctz tabs 100-25 mg 41 losartan potassium-hctz tabs 50-125 mg 41 lovastatin tabs 10 mg 36 lovastatin tabs 20 mg 36 lovastatin tabs 40 mg 36 LOVENOX SOLN 100 MGML [enoxaparin

sodium] 34 LOVENOX SOLN 120 MG08ML [enoxaparin

sodium] 35 LOVENOX SOLN 150 MGML [enoxaparin






sodium] 35 loxapine succinate caps 10 mg 58 loxapine succinate caps 25 mg 58 loxapine succinate caps 5 mg 58 loxapine succinate caps 50 mg 58 L-PROLINE POWD [proline] 92 LUCENTIS SOLN 03 MG005ML

[ranibizumab] 74 LUCENTIS SOLN 05 MG005ML

[ranibizumab] 74 LUCENTIS SOSY 03 MG005ML


[ranibizumab] 74 LUDENT CHEW 055 (025 F) MG [sodium

fluoride] 89 LUMASON SUSR 607-25 MG [sulfur

hexafluoride lipid-type a microspheres] 64 LUMIZYME SOLR 50 MG [alglucosidase alfa]


71 LUPRON DEPOT (1-MONTH) KIT 375 MG

[leuprolide acetate] 21 LUPRON DEPOT (1-MONTH) KIT 75 MG


[leuprolide acetate (3 month)] 21 LUPRON DEPOT (3-MONTH) KIT 225 MG



[leuprolide acetate (6 month)] 21 LUPRON DEPOT-PED (1-MONTH) KIT 1125

MG [leuprolide acetate (cpp)] 21 LUPRON DEPOT-PED (1-MONTH) KIT 15 MG

[leuprolide acetate (cpp)] 21 LUPRON DEPOT-PED (1-MONTH) KIT 75 MG

[leuprolide acetate (cpp)] 21 LUPRON DEPOT-PED (3-MONTH) KIT 1125

MG (PED) [leuprolide acetate (cpp) (3 month)] 21

LUPRON DEPOT-PED (3-MONTH) KIT 30 MG (PED) [leuprolide acetate (cpp) (3 month)] 21

L-VALINE POWD [valine] 92 LYNPARZA TABS 100 MG [olaparib] 21 LYNPARZA TABS 150 MG [olaparib] 22 LYSODREN TABS 500 MG [mitotane] 22

M MTE-5 CONCENTRATE INJ CONC [trace

minerals (cr-cu-mn-se-zn)] 70 MACRODANTIN CAPS 25 MG [nitrofurantoin

macrocrystal] 17 MACUGEN SOLN 03 MG [pegaptanib sodium]

74 MAGNESIUM SULFATE IN D5W SOLN 1-5

GM100ML- [magnesium sulfate in dextrose] 70

MAGNESIUM SULFATE SOLN 20 GM500ML [magnesium sulfate] 50




magnesium sulfate soln 50 50 MAGNEVIST SOLN 46901 MGML

[gadopentetate dimeglumine] 64 MAKENA OIL 250 MGML

[hydroxyprogesterone caproate] 84 malathion lotn 05 99 MANGANESE CHLORIDE SOLN 01 MGML

[manganese chloride] 70 MANNITOL SOLN 25 [mannitol] 67 maprotiline hcl tabs 25 mg 58 maprotiline hcl tabs 50 mg 58 maprotiline hcl tabs 75 mg 58 MARQIBO SUSP 5 MG31ML [vincristine

sulfate liposome] 22 MATULANE CAPS 50 MG [procarbazine hcl] 22 MD-76 R SOLN 66-10 [diatrizoate

meglumine amp sodium] 64 meclizine hcl tabs 25 mg 75 meclofenamate sodium caps 100 mg 45 meclofenamate sodium caps 50 mg 45 MEDROL TABS 2 MG [methylprednisolone] 78 medroxyprogesterone acetate susp 150

mgml 84 medroxyprogesterone acetate susy 150

mgml 84 medroxyprogesterone acetate tabs 10 mg 84 medroxyprogesterone acetate tabs 25 mg 84 medroxyprogesterone acetate tabs 5 mg 84 mefenamic acid caps 250 mg 45 mefloquine hcl tabs 250 mg 14 megestrol acetate susp 40 mgml 22 megestrol acetate susp 400 mg10ml 22 megestrol acetate tabs 20 mg 22 megestrol acetate tabs 40 mg 22 MEKINIST TABS 05 MG [trametinib dimethyl

sulfoxide] 22 MEKINIST TABS 2 MG [trametinib dimethyl

sulfoxide] 22 meloxicam tabs 15 mg 45 meloxicam tabs 75 mg 45 melphalan hcl solr 50 mg 22 memantine hcl tabs 10 mg 55 memantine hcl tabs 5 mg 55 MENOPUR SOLR 75 UNIT [menotropins] 83 MENVEO SOLR [meningococcal (acyampw-

135) oligosaccharide conjugate vac] 98 meperidine hcl soln 100 mgml 45 meperidine hcl soln 25 mgml 45 meperidine hcl soln 50 mgml 45 MEPHYTON TABS 5 MG [phytonadione] 106 mercaptopurine tabs 50 mg 22 meropenem solr 1 gm 11


meropenem solr 500 mg 11 mesalamine enem 4 gm 75 mesalamine supp 1000 mg 75 mesalamine tbec 12 gm 75 MESNA SOLN 100 MGML [mesna] 89 MESNEX TABS 400 MG [mesna] 90 MESTINON SOLN 60 MG5ML [pyridostigmine

bromide] 27 MESTINON TBCR 180 MG [pyridostigmine

bromide] 27 metaproterenol sulfate syrp 10 mg5ml 29 metaproterenol sulfate tabs 10 mg 29 metaproterenol sulfate tabs 20 mg 29 metformin hcl er tb24 500 mg 81 metformin hcl er tb24 750 mg 81 metformin hcl tabs 1000 mg 81 metformin hcl tabs 500 mg 81 metformin hcl tabs 850 mg 81 METHADONE HCL POWD [methadone hcl] 92 methadone hcl soln 10 mg5ml 45 METHADONE HCL SOLN 10 MGML

[methadone hcl] 45 methadone hcl soln 5 mg5ml 45 METHADONE HCL TABS 10 MG [methadone

hcl] 45 METHADONE HCL TABS 5 MG [methadone

hcl] 45 methazolamide tabs 25 mg 73 methazolamide tabs 50 mg 73 methenamine hippurate tabs 1 gm 17 methimazole tabs 10 mg 85 methimazole tabs 5 mg 85 methocarbamol tabs 500 mg 27 methocarbamol tabs 750 mg 27 methotrexate sodium (pf) soln 50 mg2ml 22 METHOTREXATE SODIUM SOLN 50 MG2ML

[methotrexate sodium] 22 methotrexate sodium solr 1 gm 22 methotrexate tabs 25 mg 22 methoxsalen rapid caps 10 mg 102 methyldopa tabs 250 mg 40 methyldopa tabs 500 mg 40 methyldopate hcl soln 250 mg5ml 40 METHYLENE BLUE SOLN 1 [methylene

blue (antidote)] 90 methylergonovine maleate soln 02 mgml 91 methylergonovine maleate tabs 02 mg 91 methylphenidate hcl er (cd) cpcr 10 mg 48 methylphenidate hcl er (cd) cpcr 20 mg 48 methylphenidate hcl er (cd) cpcr 30 mg 48

methylphenidate hcl er (cd) cpcr 40 mg 48 methylphenidate hcl er (cd) cpcr 50 mg 48 methylphenidate hcl er (cd) cpcr 60 mg 48 methylphenidate hcl er tbcr 10 mg 48 methylphenidate hcl er tbcr 18 mg 48 methylphenidate hcl er tbcr 20 mg 48 methylphenidate hcl er tbcr 27 mg 48 methylphenidate hcl er tbcr 36 mg 48 methylphenidate hcl er tbcr 54 mg 48 methylphenidate hcl tabs 10 mg 48 methylphenidate hcl tabs 20 mg 48 methylphenidate hcl tabs 5 mg 48 methylprednisolone acetate susp 40 mgml 78 methylprednisolone acetate susp 80 mgml 78 methylprednisolone sodium succ solr 1000

mg 78 methylprednisolone sodium succ solr 125 mg

78 methylprednisolone sodium succ solr 40 mg

79 methylprednisolone tabs 16 mg 79 methylprednisolone tabs 32 mg 79 methylprednisolone tabs 4 mg 79 methylprednisolone tabs 8 mg 79 methylprednisolone tbpk 4 mg 79 methyltestosterone tabs 10 mg 80 METOCLOPRAMIDE HCL MONOHYDRATE

POWD [metoclopramide hcl monohydrate] 92

metoclopramide hcl soln 10 mg10ml 77 metoclopramide hcl soln 5 mgml 77 metoclopramide hcl tabs 10 mg 77 metoclopramide hcl tabs 5 mg 77 metolazone tabs 10 mg 67 metolazone tabs 25 mg 67 metolazone tabs 5 mg 67 METOPIRONE CAPS 250 MG [metyrapone] 64 metoprolol succinate er tb24 100 mg 37 metoprolol succinate er tb24 200 mg 37 metoprolol succinate er tb24 25 mg 37 metoprolol succinate er tb24 50 mg 37 metoprolol tartrate soln 5 mg5ml 37 metoprolol tartrate tabs 100 mg 37 metoprolol tartrate tabs 25 mg 37 metoprolol tartrate tabs 50 mg 37 metoprolol-hydrochlorothiazide tabs 100-50

mg 37 metronidazole crea 075 99 metronidazole gel 075 99 METRONIDAZOLE IN NACL SOLN 5-079


MGML- [metronidazole in nacl] 14 METRONIDAZOLE IN NACL SOLN 500-074

MG100ML- [metronidazole in nacl] 15 metronidazole lotn 075 99 METRONIDAZOLE POWD [metronidazole

(bulk)] 92 metronidazole tabs 250 mg 15 metronidazole tabs 500 mg 15 mexiletine hcl caps 150 mg 40 mexiletine hcl caps 200 mg 40 mexiletine hcl caps 250 mg 40 MICRHOGAM ULTRA-FILTERED PLUS SOSY

250 UNIT [rho d immune globulin (human)] 97

midazolam hcl (pf) soln 10 mg2ml 54 midazolam hcl (pf) soln 2 mg2ml 54 midazolam hcl (pf) soln 5 mgml 54 midazolam hcl soln 10 mg2ml 54 midazolam hcl soln 2 mg2ml 54 midazolam hcl syrp 2 mgml 54 midodrine hcl tabs 10 mg 29 midodrine hcl tabs 25 mg 29 midodrine hcl tabs 5 mg 29 MIFEPREX TABS 200 MG [mifepristone] 91 MIGRANAL SOLN 4 MGML

[dihydroergotamine mesylate] 28 milrinone lactate in dextrose soln 20-5

mg100ml- 40 milrinone lactate in dextrose soln 40-5

mg200ml- 40 milrinone lactate inj 1mgml 40 milrinone lactate soln 10 mg10ml 40 MINOCIN SOLR 100 MG [minocycline hcl] 11 minocycline hcl caps 100 mg 11 minocycline hcl caps 50 mg 11 minocycline hcl caps 75 mg 11 minoxidil tabs 10 mg 40 minoxidil tabs 25 mg 40 MIOCHOL-E SOLR 20 MG [acetylcholine

chloride] 73 MIOSTAT SOLN 001 [carbachol (ophth)] 73 MIRENA (52 MG) IUD 20 MCG24HR

[levonorgestrel (iud)] 82 mirtazapine tabs 15 mg 58 mirtazapine tabs 30 mg 58 mirtazapine tabs 45 mg 58 misoprostol tabs 100 mcg 76 misoprostol tabs 200 mcg 76 mitomycin solr 20 mg 22 mitomycin solr 40 mg 22

mitomycin solr 5 mg 22 MITOSOL KIT 02 MG [mitomycin

(ophthalmic)] 72 mitoxantrone hcl conc 25 mg125ml 22 M-M-R II SOLR [measles mumps amp rubella

virus vaccines] 98 modafinil tabs 100 mg 48 modafinil tabs 200 mg 48 mometasone furoate crea 01 101 mometasone furoate oint 01 101 mometasone furoate soln 01 101 MONOJECT INSULIN SYRINGE MISC 27G X

12 62 MONOJECT INSULIN SYRINGE MISC 29G X

12 62 MONONINE SOLR 1000 UNIT [coagulation

factor ix] 32 montelukast sodium chew 4 mg 94 montelukast sodium chew 5 mg 94 montelukast sodium pack 4 mg 94 montelukast sodium tabs 10 mg 94 morphine sulfate (concentrate) soln 100

mg5ml 45 morphine sulfate (pf) soln 05 mgml 45 morphine sulfate (pf) soln 1 mgml 45 MORPHINE SULFATE (PF) SOLN 10 MGML

[morphine sulfate] 45 MORPHINE SULFATE (PF) SOLN 2 MGML


[morphine sulfate] 45 morphine sulfate er tbcr 100 mg 45 morphine sulfate er tbcr 15 mg 45 morphine sulfate er tbcr 200 mg 45 morphine sulfate er tbcr 30 mg 45 morphine sulfate er tbcr 60 mg 45 MORPHINE SULFATE POWD [morphine

sulfate] 92 MORPHINE SULFATE SOLN 1 MGML

[morphine sulfate] 45 MORPHINE SULFATE SOLN 10 MG5ML

[morphine sulfate] 45 MORPHINE SULFATE SOLN 10 MGML




[morphine sulfate] 46


MORPHINE SULFATE SOLN 25 MGML [morphine sulfate] 46











moxifloxacin hcl soln 05 72 moxifloxacin hcl tabs 400 mg 11 MULTIHANCE SOLN 529 MGML [gadobenate

dimeglumine] 64 MULTITRACE-4 CONCENTRATE SOLN 001-1-

05-5 MGML [trace minerals (cr-cu-mn-zn)] 70

MULTI-VITFLUORIDE SOLN 05 MGML [pediatric multivitamins wfl] 104


MULTI-VITIRONFLUORIDE SOLN 025-10 MGML [ped multivitamins wfl amp iron] 104





mupirocin oint 2 99 MUSTARGEN SOLR 10 MG [mechlorethamine

hcl] 22 MVASI SOLN 100 MG4ML [bevacizumab-

awwb] 22 MVC-FLUORIDE CHEW 025 MG [pediatric

multivitamins wfl] 105



mycophenolate mofetil caps 250 mg 86 mycophenolate mofetil susr 200 mgml 86 mycophenolate mofetil tabs 500 mg 90 MYLERAN TABS 2 MG [busulfan] 22 MYOBLOC SOLN 10000 UNIT2ML

[rimabotulinumtoxinb] 90 MYOBLOC SOLN 2500 UNIT05ML

[rimabotulinumtoxinb] 90 MYOBLOC SOLN 5000 UNITML

[rimabotulinumtoxinb] 90 MYRBETRIQ TB24 25 MG [mirabegron] 104 MYRBETRIQ TB24 50 MG [mirabegron] 104

N NABI-HB SOLN 312 UNITML [hepatitis b

immune globulin (human)] 97 nabumetone tabs 500 mg 46 nabumetone tabs 750 mg 46 nadolol tabs 20 mg 37 nadolol tabs 40 mg 37 nadolol tabs 80 mg 38 NAFCILLIN SODIUM IN DEXTROSE SOLN 1

GM50ML [nafcillin sodium in dextrose] 11 NAFCILLIN SODIUM IN DEXTROSE SOLN 2

GM100ML [nafcillin sodium in dextrose] 11 nafcillin sodium solr 1 gm 11 nafcillin sodium solr 10 gm 11 nafcillin sodium solr 2 gm 11 NAGLAZYME SOLN 1 MGML [galsulfase] 71 nalbuphine hcl soln 10 mgml 46 nalbuphine hcl soln 20 mgml 46 naloxone hcl soct 04 mgml 56 naloxone hcl soln 04 mgml 56 naloxone hcl sosy 2 mg2ml 56 NALTREXONE HCL POWD [naltrexone hcl

(bulk)] 56 naltrexone hcl tabs 50 mg 56 NAMENDA SOL 10MG5ML [memantine hcl] 55 NAMENDA TITRATION PAK TABS 28 x 5 MG amp

21 X 10 MG [memantine hcl] 55 naphazoline hcl soln 75 naproxen sodium tabs 275 mg 46 naproxen sodium tabs 550 mg 46 naproxen susp 125 mg5ml 46 naproxen tabs 250 mg 46 naproxen tabs 375 mg 46


naproxen tabs 500 mg 46 naproxen tbec 375 mg 46 naratriptan hcl tabs 1 mg 51 naratriptan hcl tabs 25 mg 51 NARCAN LIQD 4 MG01ML [naloxone hcl] 56 NAROPIN SOLN 10 MGML [ropivacaine hcl]

87 NAROPIN SOLN 2 MGML [ropivacaine hcl] 87 NAROPIN SOLN 5 MGML [ropivacaine hcl] 87 NAROPIN SOLN 75 MGML [ropivacaine hcl]

87 NATACYN SUSP 5 [natamycin] 72 NEBUPENT SOLR 300 MG [pentamidine

isethionate] 15 nefazodone hcl tabs 100 mg 58 nefazodone hcl tabs 150 mg 58 nefazodone hcl tabs 200 mg 58 nefazodone hcl tabs 250 mg 58 nefazodone hcl tabs 50 mg 58 NEOMYCIN SULFATE POWD [neomycin

sulfate (topical)] 92 neomycin sulfate tabs 500 mg 11 neomycin-bacitracin zn-polymyx oint 5-400-

10000 72 neomycin-polymyxin b gu soln 40-200000 99 neomycin-polymyxin-dexameth oint 35-

10000-01 73 neomycin-polymyxin-dexameth susp 35-

10000-01 73 neomycin-polymyxin-gramicidin soln 175-

10000-025 72 neomycin-polymyxin-hc soln 1 73 neomycin-polymyxin-hc susp 35-10000-1 73 NEOPROFEN SOLN 10 MGML [ibuprofen

lysine] 46 NEORAL SOLN 100 MGML [cyclosporine

modified (for microemulsion)] 86 neostigmine methylsulfate soln 05 mgml 27 NEOSTIGMINE METHYLSULFATE SOLN 10

MG10ML [neostigmine methylsulfate] 27 NESACAINE SOLN 1 [chloroprocaine hcl]87 NESACAINE SOLN 2 [chloroprocaine hcl]87 NEUPOGEN SOSY 300 MCG05ML

[filgrastim] 35 NEUPOGEN SOSY 480 MCG08ML

[filgrastim] 35 NEUT SOLN 4 [sodium bicarbonate] 65 nevirapine er tb24 400 mg 5 nevirapine susp 50 mg5ml 5 nevirapine tabs 200 mg 5

NEXAVAR TABS 200 MG [sorafenib tosylate] 22

NEXPLANON IMPL 68 MG [etonogestrel] 82 NIACIN ER CPCR 250 MG [niacin] 105 NIACIN ER CPCR 500 MG [niacin] 105 NIACIN ER TBCR 250 MG [niacin] 105 NIACIN TABS 100 MG [niacin] 105 NIACIN TABS 250 MG [niacin] 105 NIACIN TABS 50 MG [niacin] 105 NIACIN TABS 500 MG [niacin] 105 NICARDIPINE HCL SOLN 25 MGML

[nicardipine hcl] 39 NICORETTE GUM 2 MG [nicotine polacrilex]

26 NICORETTE LOZG 2 MG [nicotine polacrilex]


26 NICORETTE MINI LOZG 2 MG [nicotine

polacrilex] 26 nicotine polacrilex gum 2 mg 26 nicotine polacrilex gum 4 mg 26 nicotine polacrilex lozg 2 mg 26 nicotine polacrilex lozg 4 mg 26 nicotine pt24 14 mg24hr 26 nicotine pt24 21 mg24hr 26 nicotine pt24 7 mg24hr 26 nifedipine caps 10 mg 39 nifedipine caps 20 mg 39 nifedipine er osmotic release tb24 30 mg 39 nifedipine er osmotic release tb24 60 mg 39 nifedipine er osmotic release tb24 90 mg 39 nifedipine er tb24 30 mg 39 nifedipine er tb24 60 mg 39 nimodipine caps 30 mg 39 NINLARO CAPS 23 MG [ixazomib citrate] 22 NINLARO CAPS 3 MG [ixazomib citrate] 22 NINLARO CAPS 4 MG [ixazomib citrate] 22 NITRO-DUR PT24 03 MGHR [nitroglycerin] 42 NITRO-DUR PT24 08 MGHR [nitroglycerin] 42 NITROFURANTOIN MACROCRYSTAL CAPS

100 MG [nitrofurantoin macrocrystal] 17 NITROFURANTOIN MACROCRYSTAL CAPS


50 MG [nitrofurantoin macrocrystal] 17 nitrofurantoin monohyd macro caps 100 mg

17 nitrofurantoin susp 25 mg5ml 17 NITROGLYCERIN ER CPCR 25 MG


[nitroglycerin] 42 NITROGLYCERIN ER CPCR 65 MG


[nitroglycerin] 42 NITROGLYCERIN IN D5W SOLN 100-5

MCGML- [nitroglycerin in d5w] 43 NITROGLYCERIN IN D5W SOLN 200-5


MCGML- [nitroglycerin in d5w] 43 nitroglycerin pt24 04 mghr 43 nitroglycerin soln 5 mgml 43 nitroprusside sodium soln 25 mgml 41 NITROSTAT SUBL 03 MG [nitroglycerin] 43 NITROSTAT SUBL 04 MG [nitroglycerin] 43 NITROSTAT SUBL 06 MG [nitroglycerin] 43 NIVESTYM SOLN 300 MCGML [filgrastim-

aafi] 35 NIVESTYM SOLN 480 MCG16ML [filgrastim-

aafi] 35 NIVESTYM SOSY 300 MCG05ML [filgrastim-


aafi] 35 NORDITROPIN FLEXPRO SOPN 15 MG15ML

[somatropin] 84 norepinephrine bitartrate soln 1 mgml 29 norethindrone acetate tabs 5 mg 84 NORMAL SALINE FLUSH SOLN 09 [sodium

chloride flush] 70 NORPACE CR CP12 100 MG [disopyramide

phosphate] 40 NORPACE CR CP12 150 MG [disopyramide

phosphate] 40 nortriptyline hcl caps 10 mg 58 nortriptyline hcl caps 25 mg 58 nortriptyline hcl caps 50 mg 58 nortriptyline hcl caps 75 mg 58 nortriptyline hcl soln 10 mg5ml 59 NORVIR SOLN 80 MGML [ritonavir] 6 NOVAREL SOLR 10000 UNIT [chorionic

gonadotropin] 83 NOVOSEVEN RT SOLR 1 MG [coagulation

factor viia (recombinant)] 32 NOVOSEVEN RT SOLR 2 MG [coagulation



factor viia (recombinant)] 32 nystatin crea 100000 unitgm 99 nystatin susp 100000 unitml 13 nystatin tabs 500000 unit 13 nystatin-triamcinolone crea 100000-01

unitgm- 101 nystatin-triamcinolone oint 100000-01

unitgm- 101

O OCTAGAM SOLN 1 GM20ML [immune

globulin (human) iv] 97 OCTAGAM SOLN 25 GM50ML [immune


globulin (human) iv] 97 octreotide acetate soln 100 mcgml 90 octreotide acetate soln 1000 mcgml 90 octreotide acetate soln 200 mcgml 90 octreotide acetate soln 50 mcgml 90 octreotide acetate soln 500 mcgml 90 octreotide acetate sosy 50 mcgml 90 ODACTRA SUBL 12 SQ-HDM [dust mite mixed

allergen extract] 97 ODEFSEY TABS 200-25-25 MG [emtricitabine-

rilpivirine-tenofovir alafenamide fumarate] 16

ODOMZO CAPS 200 MG [sonidegib phosphate] 22

OFEV CAPS 100 MG [nintedanib esylate] 94 OFEV CAPS 150 MG [nintedanib esylate] 94 OFIRMEV SOLN 10 MGML [acetaminophen]

46 ofloxacin soln 03 72 olanzapine solr 10 mg 59 olanzapine tabs 10 mg 59 olanzapine tabs 15 mg 59 olanzapine tabs 25 mg 59 olanzapine tabs 20 mg 59 olanzapine tabs 5 mg 59 olanzapine tabs 75 mg 59 olopatadine hcl soln 01 73 omeprazole cpdr 10 mg 76 omeprazole cpdr 20 mg 76 omeprazole cpdr 40 mg 76 OMNIPAQUE INJ 300MGML [iohexol] 64 OMNIPAQUE INJ 350MGML [iohexol] 64 OMNIPAQUE SOLN 180 MGML [iohexol] 64 OMNIPAQUE SOLN 240 MGML [iohexol] 64 OMNIPAQUE SOLN 300 MGML [iohexol] 64


OMNIPAQUE SOLN 350 MGML [iohexol] 64 OMNITROPE PEN 5 INJ DEVICE MISC

[injection device] 62 OMNITROPE SOCT 10 MG15ML

[somatropin] 84 OMNITROPE SOCT 5 MG15ML [somatropin]

84 OMNITROPE SOLR 58 MG [somatropin] 84 ONCASPAR SOLN 750 UNITML

[pegaspargase] 22 ondansetron hcl soln 4 mg2ml 75 ondansetron hcl soln 4 mg5ml 75 ondansetron hcl soln 40 mg20ml 75 ondansetron hcl tabs 4 mg 75 ondansetron hcl tabs 8 mg 75 ondansetron tbdp 4 mg 76 ondansetron tbdp 8 mg 76 ONETOUCH DELICA LANCETS 33G MISC

[lancets] 63 ONETOUCH FINEPOINT LANCETS MISC

[lancets] 63 ONETOUCH SURESOFT LANCING DEV MISC

[lancets misc] 63 ONETOUCH ULTRA CONTROL SOLN [blood

glucose calibration] 63 ONETOUCH ULTRA MINI KIT WDEVICE

[blood glucose monitoring supplies] 63 ONETOUCH ULTRA STRP [glucose blood] 65 ONETOUCH ULTRASOFT LANCETS MISC

[lancets] 63 ONETOUCH VERIO SOLN HIGH [blood

glucose calibration] 63 OPANA SOLN 1 MGML [oxymorphone hcl] 46 OPDIVO SOLN 100 MG10ML [nivolumab] 22 OPDIVO SOLN 40 MG4ML [nivolumab] 22 ORAP TABS 1 MG [pimozide] 59 ORAP TABS 2 MG [pimozide] 59 ORENCIA CLICKJECT SOAJ 125 MGML

[abatacept] 85 ORENCIA SOLR 250 MG [abatacept] 85 ORENCIA SOSY 125 MGML [abatacept] 85 ORENCIA SOSY 50 MG04ML [abatacept] 85 ORENCIA SOSY 875 MG07ML [abatacept] 85 ORKAMBI PACK 100-125 MG [lumacaftor-

ivacaftor] 94 ORKAMBI PACK 150-188 MG [lumacaftor-

ivacaftor] 94 ORKAMBI TABS 100-125 MG [lumacaftor-


ivacaftor] 95 oseltamivir phosphate caps 30 mg 16 oseltamivir phosphate caps 45 mg 16 oseltamivir phosphate caps 75 mg 16 oseltamivir phosphate susr 6 mgml 16 OSMITROL SOLN 20 [mannitol] 67 OTEZLA TAB 102030 [apremilast] 85 OTEZLA TABS 30 MG [apremilast] 86 OTEZLA TBPK 10 amp 20 amp 30 MG [apremilast]86 OVIDREL INJ 250 MCG05ML

[choriogonadotropin alfa] 83 OXACILLIN SODIUM IN DEXTROSE SOLN 1

GM50ML [oxacillin sodium in dextrose] 11 OXACILLIN SODIUM IN DEXTROSE SOLN 2

GM50ML [oxacillin sodium in dextrose] 11 oxacillin sodium solr 1 gm 11 oxacillin sodium solr 2 gm 11 oxaliplatin soln 100 mg20ml 22 oxaliplatin soln 50 mg10ml 22 oxandrolone tabs 10 mg 80 oxandrolone tabs 25 mg 80 oxazepam caps 10 mg 54 oxazepam caps 15 mg 54 oxazepam caps 30 mg 54 oxcarbazepine susp 300 mg5ml 50 oxcarbazepine tabs 150 mg 50 oxcarbazepine tabs 300 mg 50 oxcarbazepine tabs 600 mg 50 OXSORALEN ULTRA CAPS 10 MG

[methoxsalen rapid] 102 oxybutynin chloride er tb24 10 mg 104 oxybutynin chloride er tb24 15 mg 104 oxybutynin chloride er tb24 5 mg 104 oxybutynin chloride syrp 5 mg5ml 104 oxybutynin chloride tabs 5 mg 104 oxycodone hcl soln 5 mg5ml 46 oxycodone hcl tabs 5 mg 46 oxycodone-acetaminophen tabs 10-325 mg 47 oxycodone-acetaminophen tabs 5-325 mg 47 oxycodone-acetaminophen tabs 75-325 mg

47 OXYTOCIN SOLN 10 UNITML [oxytocin] 91 OZURDEX IMPL 07 MG [dexamethasone

(ophth)] 73

P paclitaxel conc 300 mg50ml 22 PADCEV SOLR 20 MG [enfortumab vedotin-

ejfv] 22 PADCEV SOLR 30 MG [enfortumab vedotin-


ejfv] 22 pamidronate disodium soln 30 mg10ml 90 pamidronate disodium soln 6 mgml 90 pamidronate disodium soln 90 mg10ml 90 pamidronate disodium solr 30 mg 90 pamidronate disodium solr 90 mg 90 pancuronium bromide soln 1 mgml 27 pantoprazole sodium tbec 20 mg 76 pantoprazole sodium tbec 40 mg 76 PAPAVERINE HCL POWD [papaverine hcl] 92 PAPAVERINE HCL SOLN 30 MGML

[papaverine hcl] 43 PAREGORIC TINC 2 MG5ML [paregoric] 75 paromomycin sulfate caps 250 mg 15 paroxetine hcl tabs 10 mg 59 paroxetine hcl tabs 20 mg 59 paroxetine hcl tabs 30 mg 59 paroxetine hcl tabs 40 mg 59 PEDIARIX SUSP [diph-tetanus tox-acell pert-

hepatitis b recomb-polio ipv vac] 98 pediatric multivitamins wfl chew 104 PEDIATRIC SMALL MASK MISC [masks] 63 peg 3350electrolytes solr 240 gm 76 peg 3350-kcl-na bicarb-nacl solr 420 gm 76 PEGASYS PROCLICK SOAJ 135 MCG05ML

[peginterferon alfa-2a] 13 PEGASYS PROCLICK SOAJ 180 MCG05ML

[peginterferon alfa-2a] 13 PEGASYS SOLN 180 MCGML [peginterferon

alfa-2a] 13 PEGASYS SOSY 180 MCG05ML

[peginterferon alfa-2a] 13 PEGINTRON KIT 50 MCG05ML

[peginterferon alfa-2b] 14 PEG-INTRON REDIPEN KIT 120 RP


[peginterferon alfa-2b] 13 penicillamine caps 250 mg 78 PENICILLIN G POT IN DEXTROSE SOLN

20000 UNITML [penicillin g pot in dextrose] 11

PENICILLIN G POT IN DEXTROSE SOLN 40000 UNITML [penicillin g pot in dextrose] 11


penicillin g potassium solr 20000000 unit 11 penicillin g potassium solr 5000000 unit 11

penicillin g procaine susp 600000 unitml 11 penicillin g sodium solr 5000000 unit 11 penicillin v potassium solr 125 mg5ml 11 penicillin v potassium solr 250 mg5ml 11 penicillin v potassium tabs 250 mg 11 penicillin v potassium tabs 500 mg 11 PENLET II BLOOD SAMPLER KIT [lancets

misc] 63 PENTAM SOLR 300 MG [pentamidine

isethionate] 15 PENTASA CPCR 250 MG [mesalamine] 75 PENTASA CPCR 500 MG [mesalamine] 75 pentazocine-naloxone hcl tabs 50-05 mg 47 pentostatin inj 10mg 22 pentoxifylline er tbcr 400 mg 36 PEPTIC RELIEF CHEW 262 MG [bismuth

subsalicylate] 75 PERJETA SOLN 420 MG14ML [pertuzumab]

22 permethrin crea 5 99 permethrin lotn 1 99 perphenazine tabs 16 mg 59 perphenazine tabs 2 mg 59 perphenazine tabs 4 mg 59 perphenazine tabs 8 mg 59 perphenazine-amitriptyline tabs 2-10 mg 59 perphenazine-amitriptyline tabs 2-25 mg 59 perphenazine-amitriptyline tabs 4-10 mg 59 perphenazine-amitriptyline tabs 4-25 mg 59 perphenazine-amitriptyline tabs 4-50 mg 59 phenelzine sulfate tabs 15 mg 59 PHENEX-1 POWD [nutritional supplements]

66 PHENOBARBITAL ELIX 20 MG5ML

[phenobarbital] 54 PHENOBARBITAL POWD [phenobarbital] 92 PHENOBARBITAL SODIUM SOLN 130 MGML

[phenobarbital sodium] 54 PHENOBARBITAL SODIUM SOLN 65 MGML

[phenobarbital sodium] 54 PHENOBARBITAL TABS 100 MG

[phenobarbital] 54 PHENOBARBITAL TABS 15 MG




[phenobarbital] 55


PHENOBARBITAL TABS 60 MG [phenobarbital] 55



PHENOL LIQD [phenol] 101 PHENOL LIQD 89 [phenol] 33 phenoxybenzamine hcl caps 10 mg 28 PHENTOLAMINE MESYLATE POWD

[phentolamine mesylate (bulk)] 92 phentolamine mesylate solr 5 mg 28 PHENYLEPHRINE HCL SOLN 10

[phenylephrine hcl (mydriatic)] 75 PHENYLEPHRINE HCL SOLN 25

[phenylephrine hcl (mydriatic)] 75 phenylephrine-chlorphen-dm liqd 94 PHENYLHISTINE DH LIQ DH [pseudoeph-

chlorphen w cod] 94 phenytoin sodium extended caps 100 mg 50 phenytoin sodium soln 50 mgml 50 phenytoin susp 125 mg5ml 50 PHLEXY-10 PACK [nutritional supplements]

66 PHOSLYRA SOLN 667 MG5ML [calcium

acetate (phosphate binder)] 70 PHOSPHOLINE IODIDE SOLR 0125

[echothiophate iodide] 73 PHOTREXA-PHOTREXA VISCOUS KIT SOSY

0146 amp0146-20 [riboflavin5-phos sod amp riboflavin 5-phosphate sodium-dextran] 74

PHYSOSTIGMINE SALICYLATE SOLN 1 MGML [physostigmine salicylate] 27

phytonadione soln 1 mg05ml 106 pilocarpine hcl soln 1 73 pilocarpine hcl soln 2 74 pilocarpine hcl soln 4 74 pilocarpine hcl tabs 5 mg 27 pimecrolimus crea 1 103 pimozide tabs 2 mg 59 pioglitazone hcl tabs 15 mg 81 pioglitazone hcl tabs 30 mg 81 pioglitazone hcl tabs 45 mg 81 piperacillin sod-tazobactam so solr 225 (2-

025) gm 11 piperacillin sod-tazobactam so solr 3375 (3-

0375) gm 11 piperacillin sod-tazobactam so solr 45 (4-05)

gm 11 piperacillin sod-tazobactam so solr 405 (36-

45) gm 11 PLASMA-LYTE A SOLN [electrolyte-a] 70 PLASMANATE SOLN 5 [plasma protein

fraction] 29 PLURONIC F127 GEL 20 [pluronic f127

base] 93 PNEUMOVAX 23 INJ 25 MCG05ML

[pneumococcal vac polyvalent] 98 PODOCON SOLN 25 [podophyllum resin]

103 podofilox soln 05 103 PODOPHYLLUM RESIN POWD [podophyllum

resin] 93 POLYETHYLENE GLYCOL 400 LIQD

[polyethylene glycol 400] 93 POLYETHYLENE GLYCOL 8000 POWD

[polyethylene glycol 8000] 93 polymyxin b-trimethoprim soln 10000-01

unitml- 72 POLY-VI-SOL SOLN [pediatric multiple

vitamins] 105 POLY-VI-SOLIRON SOLN 11 MGML [pediatric

multiple vitamins w iron] 105 POMALYST CAPS 1 MG [pomalidomide] 22 POMALYST CAPS 2 MG [pomalidomide] 22 POMALYST CAPS 3 MG [pomalidomide] 22 POMALYST CAPS 4 MG [pomalidomide] 23 POTABA CAPS 500 MG [potassium

aminobenzoate] 105 POTASSIUM ACETATE SOLN 2 MEQML

[potassium acetate] 70 potassium chloride 0075d5wnacl 0225

inj 0752 70 potassium chloride crys er tbcr 10 meq 70 potassium chloride crys er tbcr 20 meq 70 potassium chloride er cpcr 10 meq 70 potassium chloride er cpcr 8 meq 70 POTASSIUM CHLORIDE IN DEXTROSE SOLN

20-5 MEQL- [potassium chloride in dextrose] 70

POTASSIUM CHLORIDE IN DEXTROSE SOLN 40-5 MEQL- [potassium chloride in dextrose] 70

POTASSIUM CHLORIDE IN NACL SOLN 20-045 MEQL- [potassium chloride in nacl] 70





potassium chloride sol 10 sf 70 POTASSIUM CHLORIDE SOLN 10 MEQ100ML

[potassium chloride] 70 POTASSIUM CHLORIDE SOLN 10 MEQ50ML

[potassium chloride] 70 potassium chloride soln 2 meqml 70 POTASSIUM CHLORIDE SOLN 20 MEQ100ML




(20) [potassium chloride] 71 POTASSIUM CITRATE ER TBCR 10 MEQ

(1080 MG) [potassium citrate (alkalinizer)] 65



potassium phosphate inj 3mmml 71 POTASSIUM PHOSPHATES SOLN 45

MMOLE15ML [potassium phosphates] 71 PRADAXA CAPS 110 MG [dabigatran etexilate

mesylate] 35 PRADAXA CAPS 150 MG [dabigatran etexilate


mesylate] 35 pramipexole dihydrochloride tabs 0125 mg 53 pramipexole dihydrochloride tabs 025 mg 53 pramipexole dihydrochloride tabs 05 mg 53 pramipexole dihydrochloride tabs 075 mg 53 pramipexole dihydrochloride tabs 1 mg 53 pramipexole dihydrochloride tabs 15 mg 53 PRAMOSONE OINT 1-1 [pramoxine-hc] 101 PRAMOSONE OINT 1-25 [pramoxine-hc]

101 pravastatin sodium tabs 10 mg 36 pravastatin sodium tabs 20 mg 36 pravastatin sodium tabs 40 mg 36 pravastatin sodium tabs 80 mg 36 PRAXBIND SOLN 25 GM50ML

[idarucizumab] 33 prazosin hcl caps 1 mg 36 prazosin hcl caps 2 mg 36

prazosin hcl caps 5 mg 36 PRECEDEX SOLN 200 MCG2ML

[dexmedetomidine hcl] 55 PRED MILD SUSP 012 [prednisolone

acetate (ophth)] 73 prednisolone acetate susp 1 73 prednisolone sodium phosphate soln 1 73 prednisolone sodium phosphate soln 15

mg5ml 79 prednisolone sodium phosphate soln 67 (5

base) mg5ml 79 prednisolone soln 15 mg5ml 79 prednisone soln 5 mg5ml 79 prednisone tabs 1 mg 79 prednisone tabs 10 mg 79 prednisone tabs 25 mg 79 prednisone tabs 20 mg 79 prednisone tabs 5 mg 79 prednisone tabs 50 mg 79 prednisone tbpk 10 mg (21) 79 prednisone tbpk 5 mg (21) 79 pregabalin caps 100 mg 50 pregabalin caps 150 mg 50 pregabalin caps 200 mg 50 pregabalin caps 225 mg 50 pregabalin caps 25 mg 50 pregabalin caps 300 mg 51 pregabalin caps 50 mg 51 pregabalin caps 75 mg 51 pregabalin soln 20 mgml 51 PREMARIN SOLR 25 MG [estrogens

conjugated] 83 PREPIDIL GEL 05 MG3GM [dinoprostone] 91 PRETOMANID TABS 200 MG [pretomanid] 14 PREVIDENT 5000 PLUS CREA 11 [sodium

fluoride (dental)] 90 PREVIDENT GEL 11 [sodium fluoride

(dental)] 90 PREVIDENT SOLN 02 [sodium fluoride

(dental)] 90 PREVNAR 13 SUSP [pneumococcal 13-valent

conjugate vaccine] 98 PREVYMIS SOLN 240 MG12ML [letermovir] 16 PREVYMIS SOLN 480 MG24ML [letermovir] 16 PREVYMIS TABS 240 MG [letermovir] 16 PREVYMIS TABS 480 MG [letermovir] 16 PREZCOBIX TABS 800-150 MG [darunavir-

cobicistat] 16 PREZISTA TABS 150 MG [darunavir

ethanolate] 6


PREZISTA TABS 600 MG [darunavir ethanolate] 6



PRIFTIN TABS 150 MG [rifapentine] 14 PRIMAQUINE PHOSPHATE TABS 263 (15

Base) MG [primaquine phosphate] 15 PRIMAXIN IV SOLR 250-250 MG [imipenem-

cilastatin] 11 PRIMAXIN IV SOLR 500-500 MG [imipenem-

cilastatin] 12 primidone tab 50mg 51 primidone tabs 250 mg 51 PRIMSOL SOLN 50 MG5ML [trimethoprim

hcl] 12 PRIVIGEN SOLN 10 GM100ML [immune

globulin (human) iv] 97 PRIVIGEN SOLN 20 GM200ML [immune


globulin (human) iv] 97 probenecid tabs 500 mg 71 procainamide hcl soln 100 mgml 40 procainamide hcl soln 500 mgml 40 PROCALAMINE SOLN 3 [amino acid

electrolyte infusion] 66 prochlorperazine edisylate soln 10 mg2ml 59 prochlorperazine maleate tabs 10 mg 59 prochlorperazine maleate tabs 5 mg 59 PROCRIT SOLN 10000 UNITML [epoetin alfa]

35 PROCRIT SOLN 2000 UNITML [epoetin alfa]





35 PRODIGY CONTROL SOLUTION SOLN LOW

[blood glucose calibration] 63 PROFERRIN ES TABS 12 MG [iron heme

polypeptide] 29 PROFERRIN-FORTE TABS 12-1 MG [iron

heme polypeptide-folic acid] 29 PROFILNINE SOLR 1000 UNIT [factor ix

complex] 33 PROFILNINE SOLR 1500 UNIT [factor ix


complex] 33 progesterone caps 100 mg 84 progesterone caps 200 mg 84 PROGESTERONE MICRONIZED POWD

[progesterone micronized (bulk)] 93 PROGESTERONE OIL 50 MGML

[progesterone] 84 PROGESTERONE WETTABLE POWD

[progesterone (bulk)] 93 PROGLYCEM SUSP 50 MGML [diazoxide] 41 PROGRAF SOLN 5 MGML [tacrolimus] 86 PROLEUKIN SOLR 22000000 UNIT

[aldesleukin] 23 PROMACTA PACK 25 MG [eltrombopag

olamine] 35 PROMACTA TABS 125 MG [eltrombopag




olamine] 36 promethazine hcl soln 25 mgml 17 promethazine hcl tabs 125 mg 17 promethazine hcl tabs 25 mg 17 promethazine-codeine soln 625-10 mg5ml 94 promethazine-dm soln 625-15 mg5ml 94 promethazine-dm syrp 625-15 mg5ml 94 propafenone hcl tabs 150 mg 40 propafenone hcl tabs 225 mg 40 propafenone hcl tabs 300 mg 40 propantheline bromide tabs 15 mg 26 proparacaine hcl soln 05 74 propofol emul 1000 mg100ml 55 propofol emul 200 mg20ml 55 propranolol hcl er cp24 120 mg 38 propranolol hcl er cp24 160 mg 38 propranolol hcl er cp24 60 mg 38 propranolol hcl er cp24 80 mg 38 propranolol hcl soln 1 mgml 38 propranolol hcl soln 20 mg5ml 38 propranolol hcl tabs 10 mg 38 propranolol hcl tabs 20 mg 38 propranolol hcl tabs 40 mg 38 propranolol hcl tabs 60 mg 38


propranolol hcl tabs 80 mg 38 PROPYLENE GLYCOL LIQD [propylene

glycol (bulk)] 93 propylthiouracil tabs 50 mg 85 PROQUAD SUSR [measles-mumps-rubella-

varicella virus vaccines] 98 PROSOL SOLN 20 [amino acid infusion] 66 PROSTIN E2 SUPP 20 MG [dinoprostone] 91 protamine sulfate soln 10 mgml 33 PROTONIX SOLR 40 MG [pantoprazole

sodium] 76 protriptyline hcl tabs 10 mg 59 protriptyline hcl tabs 5 mg 59 PULMICORT FLEXHALER AEPB 180 MCGACT

[budesonide (inhalation)] 79 PULMOZYME SOLN 25 MG25ML [dornase

alfa] 71 PURIXAN SUSP 2000 MG100ML

[mercaptopurine] 23 pyrazinamide tabs 500 mg 14 pyridostigmine bromide er tbcr 180 mg 27 pyridostigmine bromide tabs 60 mg 27 pyridoxine hcl soln 100 mgml 105

Q QUELICIN SOLN 20 MGML [succinylcholine

chloride] 27 quetiapine fumarate tabs 100 mg 59 quetiapine fumarate tabs 200 mg 59 quetiapine fumarate tabs 25 mg 59 quetiapine fumarate tabs 300 mg 59 quetiapine fumarate tabs 400 mg 59 quetiapine fumarate tabs 50 mg 59 QUINACRINE HCL POWD [quinacrine hcl] 93 quinidine gluconate er tbcr 324 mg 40 QUINIDINE GLUCONATE SOLN 80 MGML

[quinidine gluconate] 40 quinidine sulfate tabs 200 mg 40 quinidine sulfate tabs 300 mg 40

R RABAVERT SUSR [rabies vaccine pcec] 98 raloxifene hcl tabs 60 mg 83 ramipril caps 10 mg 41 ramipril caps 25 mg 41 ramipril caps 5 mg 41 RAPAMUNE SOLN 1 MGML [sirolimus] 86 rasagiline mesylate tabs 05 mg 53 rasagiline mesylate tabs 1 mg 53










READI-CAT 2 SUSP 2 [barium sulfate] 65 READI-CAT 2 SUSP 21 [barium sulfate] 65 RECOMBINATE SOLR 1241-1800 UNIT

[antihemophilic factor (recombinant) (rfviii)] 33

RECOMBINATE SOLR 1801-2400 UNIT [antihemophilic factor (recombinant) (rfviii)] 33




RECOMBIVAX HB SUSP 10 MCGML [hepatitis b vaccine (recomb)] 98


RECOMBIVAX HB SUSP 5 MCG05ML [hepatitis b vaccine (recomb)] 98



REGONOL SOLN 10 MG2ML [pyridostigmine bromide] 27

RELENZA DISKHALER AEPB 5 MGBLISTER [zanamivir] 16

REMICADE SOLR 100 MG [infliximab] 86


REMODULIN SOLN 100 MG20ML [treprostinil] 43




RENAL CAPS 1 MG [b-complex w c amp folic acid] 105

RENVELA PACK 24 GM [sevelamer carbonate] 67

RENVELA TABS 800 MG [sevelamer carbonate] 68

RESCRIPTOR TABS 100 MG [delavirdine mesylate] 6


reserpine tab 01mg 41 reserpine tab 025mg 41 RETIN-A CREA 0025 [tretinoin] 102 RETIN-A CREA 005 [tretinoin] 102 RETIN-A CREA 01 [tretinoin] 102 RETIN-A GEL 001 [tretinoin] 102 RETIN-A GEL 0025 [tretinoin] 102 RETIN-A MICRO GEL 004 [tretinoin

microsphere] 102 RETIN-A MICRO GEL 01 [tretinoin

microsphere] 102 RETISERT IMPL 059 MG [fluocinolone

acetonide (ophth)] 73 RETROVIR SOLN 10 MGML [zidovudine] 16 REVLIMID CAPS 10 MG [lenalidomide] 23 REVLIMID CAPS 15 MG [lenalidomide] 23 REVLIMID CAPS 25 MG [lenalidomide] 23 REVLIMID CAPS 20 MG [lenalidomide] 23 REVLIMID CAPS 25 MG [lenalidomide] 23 REVLIMID CAPS 5 MG [lenalidomide] 23 RHOGAM ULTRA-FILTERED PLUS SOSY 1500

UNIT [rho d immune globulin (human)] 97 RHOPHYLAC SOSY 1500 UNIT2ML [rho d

immune globulin (human)] 97 RIASTAP SOLR [fibrinogen concentrate

(human)] 33 ribavirin caps 200 mg 14 RIDAURA CAPS 3 MG [auranofin] 77 rifabutin caps 150 mg 14 rifampin caps 150 mg 14 rifampin caps 300 mg 14 rifampin solr 600 mg 14

riluzole tabs 50 mg 55 rimantadine hcl tabs 100 mg 16 RIMSO-50 SOLN 50 [dimethyl sulfoxide] 90 RINGERS IRRIGATION SOLN [ringers

irrigation] 68 RINGERS SOLN [ringers] 71 RISPERDAL CONSTA SRER 125 MG

[risperidone microspheres] 59 RISPERDAL CONSTA SRER 25 MG



[risperidone microspheres] 59 RISPERIDONE SOLN 1 MGML [risperidone]60 RISPERIDONE TABS 025 MG [risperidone] 60 RISPERIDONE TABS 05 MG [risperidone] 60 risperidone tabs 1 mg 60 RISPERIDONE TABS 2 MG [risperidone] 60 risperidone tabs 3 mg 60 risperidone tabs 4 mg 60 ritonavir tabs 100 mg 16 RITUXAN SOLN 100 MG10ML [rituximab] 23 RITUXAN SOLN 500 MG50ML [rituximab] 23 rizatriptan benzoate tabs 10 mg 51 rizatriptan benzoate tabs 5 mg 51 rizatriptan benzoate tbdp 10 mg 52 rizatriptan benzoate tbdp 5 mg 52 rocuronium bromide soln 100 mg10ml 27 rocuronium bromide soln 50 mg5ml 27 romidepsin solr 10 mg 23 ropinirole hcl er tb24 12 mg 53 ropinirole hcl er tb24 2 mg 53 ropinirole hcl er tb24 4 mg 53 ropinirole hcl er tb24 6 mg 53 ropinirole hcl er tb24 8 mg 53 ropinirole hcl tabs 025 mg 53 ropinirole hcl tabs 05 mg 53 ropinirole hcl tabs 1 mg 53 ropinirole hcl tabs 2 mg 53 ropinirole hcl tabs 3 mg 53 ropinirole hcl tabs 4 mg 53 ropinirole hcl tabs 5 mg 53 rosuvastatin calcium tabs 10 mg 36 rosuvastatin calcium tabs 20 mg 37 rosuvastatin calcium tabs 40 mg 37 rosuvastatin calcium tabs 5 mg 37 ROTARIX SUSR [rotavirus vaccine live oral]

98 ROTATEQ SOLN [rotavirus vaccine live oral


pentavalent] 98 ROZLYTREK CAPS 100 MG [entrectinib] 23 ROZLYTREK CAPS 200 MG [entrectinib] 23 RYANODEX SUSR 250 MG [dantrolene

sodium] 27 RYDAPT CAPS 25 MG [midostaurin] 23

S S2 (RACEPINEPHRINE) NEBU 225

[racepinephrine hcl] 29 SABRIL PACK 500 MG [vigabatrin] 51 SALICYLIC ACID POWD [salicylic acid (bulk)]

93 SALSALATE TABS 500 MG [salsalate] 47 SALSALATE TABS 750 MG [salsalate] 47 SANDIMMUNE CAPS 100 MG [cyclosporine]

86 SANDIMMUNE CAPS 25 MG [cyclosporine] 86 SANDIMMUNE SOLN 100 MGML

[cyclosporine] 86 SANDIMMUNE SOLN 50 MGML

[cyclosporine] 86 SANDOSTATIN LAR DEPOT KIT 10 MG

[octreotide acetate] 90 SANDOSTATIN LAR DEPOT KIT 20 MG


[octreotide acetate] 90 SANTYL OINT 250 UNITGM [collagenase] 103 SARCLISA SOLN 100 MG5ML [isatuximab-

irfc] 23 SARCLISA SOLN 500 MG25ML [isatuximab-

irfc] 23 SARNA LOTN 05-05 [camphor amp menthol]

102 scopolamine pt72 1 mg3days 76 selegiline hcl caps 5 mg 55 selegiline hcl tabs 5 mg 53 SELENIUM SOLN 40 MCGML [selenious acid]

71 selenium sulfide lotn 25 99 SELZENTRY TABS 150 MG [maraviroc] 6 SELZENTRY TABS 25 MG [maraviroc] 6 SELZENTRY TABS 300 MG [maraviroc] 6 SELZENTRY TABS 75 MG [maraviroc] 6 SENSORCAINE-MPFEPINEPHRINE SOLN

075-1 200000 [bupivacaine w epinephrine] 87


SEROSTIM SOLR 4 MG [somatropin (non-refrigerated)] 84



sertraline hcl tabs 100 mg 60 sertraline hcl tabs 25 mg 60 sertraline hcl tabs 50 mg 60 sevelamer carbonate pack 24 gm 68 sevelamer carbonate tabs 800 mg 68 SF 5000 PLUS CREA 11 [sodium fluoride

(dental)] 90 SHINGRIX SUSR 50 MCG05ML [zoster

vaccine recombinant adjuvanted] 98 sildenafil citrate tabs 100 mg 43 sildenafil citrate tabs 20 mg 43 SILENOR TABS 3 MG [doxepin hcl (sleep)] 55 SILENOR TABS 6 MG [doxepin hcl (sleep)] 55 SILVER SULFADIAZINE CREA 1 [silver

sulfadiazine] 100 simvastatin tabs 10 mg 37 simvastatin tabs 20 mg 37 simvastatin tabs 40 mg 37 simvastatin tabs 5 mg 37 simvastatin tabs 80 mg 37 sirolimus soln 1 mgml 90 sirolimus tabs 05 mg 86 sirolimus tabs 1 mg 86 sirolimus tabs 2 mg 86 SKYRIZI (150 MG DOSE) PSKT 75 MG083ML

[risankizumab-rzaa] 103 SKYRIZI PEN SOAJ 150 MGML

[risankizumab-rzaa] 103 SKYRIZI SOSY 150 MGML [risankizumab-

rzaa] 103 SLO-NIACIN TBCR 500 MG [niacin] 105 SLO-NIACIN TBCR 750 MG [niacin] 105 SOD CITRATE-CITRIC ACID SOLN 500-334

MG5ML [sodium citrate amp citric acid] 65 SODIUM ACETATE SOLN 2 MEQML [sodium

acetate] 65 SODIUM BENZOATE POWD [sodium

benzoate] 93 SODIUM BICARBONATE SOLN 42 [sodium

bicarbonate] 65 SODIUM BICARBONATE SOLN 75 [sodium


bicarbonate] 65


SODIUM CHLORIDE (PF) SOLN 09 [sodium chloride] 71

SODIUM CHLORIDE BACTERIOSTATIC SOLN 09 [bacteriostatic sodium chloride] 71





SODIUM CHLORIDE SOLN 045 [sodium chloride] 71

SODIUM CHLORIDE SOLN 09 [sodium chloride (gu irrigant)] 68



SODIUM CHLORIDE SOLN 4 MEQML [sodium chloride] 71


SODIUM CHLORIDE TABS 1 GM [sodium chloride] 103

SODIUM EDECRIN SOLR 50 MG [ethacrynate sodium] 67

SODIUM FLUORIDE CHEW 11 (05 F) MG [sodium fluoride] 90

SODIUM FLUORIDE SOLN 11 (05 F) MGML [sodium fluoride] 90

sodium phenylbutyrate powd 3 gmtsp 65 SODIUM PHOSPHATES SOLN 45

MMOLE15ML [sodium phosphates (sodium phosphate dibasic amp monobasic)] 71

sodium polystyrene sulfonate powd 68 sodium polystyrene sulfonate susp 15

gm60ml 68 sodium polystyrene sulfonate susp 30

gm120ml 68 solifenacin succinate tabs 10 mg 104 solifenacin succinate tabs 5 mg 104 SOLIRIS SOLN 300 MG30ML [eculizumab] 90 SOLU-CORTEF SOLR 100 MG

[hydrocortisone sod succinate] 79 SOLU-CORTEF SOLR 1000 MG


[hydrocortisone sod succinate] 79

SOLU-CORTEF SOLR 500 MG [hydrocortisone sod succinate] 79

SOLU-MEDROL SOLR 125 MG [methylprednisolone sod succ] 79


SORBITOL SOLN 70 [sorbitol (laxative)] 76 SORBITOL SOLN 70 [sorbitol] 93 sotalol hcl (af) tabs 120 mg 38 sotalol hcl (af) tabs 160 mg 38 sotalol hcl (af) tabs 80 mg 38 sotalol hcl tabs 120 mg 38 sotalol hcl tabs 160 mg 38 sotalol hcl tabs 240 mg 38 sotalol hcl tabs 80 mg 38 SOVALDI PACK 150 MG [sofosbuvir] 14 SOVALDI PACK 200 MG [sofosbuvir] 14 SOVALDI TABS 200 MG [sofosbuvir] 14 SOVALDI TABS 400 MG [sofosbuvir] 14 SPIRIVA RESPIMAT AERS 25 MCGACT

[tiotropium bromide monohydrate] 26 spironolactone tabs 100 mg 41 spironolactone tabs 25 mg 41 spironolactone tabs 50 mg 41 spironolactone-hctz tabs 25-25 mg 41 SPORANOX SOLN 10 MGML [itraconazole] 13 SPRYCEL TABS 100 MG [dasatinib] 23 SPRYCEL TABS 140 MG [dasatinib] 23 SPRYCEL TABS 20 MG [dasatinib] 23 SPRYCEL TABS 50 MG [dasatinib] 23 SPRYCEL TABS 70 MG [dasatinib] 23 SPRYCEL TABS 80 MG [dasatinib] 23 SQUARIC ACID DIBUTYLESTER POW

DIBUTYLS [squaric acid dibutylester] 93 SSKI SOLN 1 GMML [potassium iodide

(expectorant)] 85 stavudine caps 15 mg 6 stavudine caps 20 mg 6 stavudine caps 30 mg 6 stavudine caps 40 mg 6 STELARA SOLN 45 MG05ML [ustekinumab]

103 STELARA SOSY 45 MG05ML [ustekinumab]

103 STELARA SOSY 90 MGML [ustekinumab] 103 sterile water for injection soln 90 STERILE WATER FOR INJECTION SOLN

[water for injection sterile] 93 STERILE WATER FOR IRRIGATION SOLN

[water for irrigation sterile] 68


STIMATE SOLN 15 MGML [desmopressin acetate] 84


STIVARGA TABS 40 MG [regorafenib] 23 STRENSIQ SOLN 18 MG045ML [asfotase

alfa] 71 STRENSIQ SOLN 28 MG07ML [asfotase alfa]

72 STRENSIQ SOLN 40 MGML [asfotase alfa] 72 STRENSIQ SOLN 80 MG08ML [asfotase alfa]

72 streptomycin sulfate solr 1 gm 12 STRIBILD TABS 150-150-200-300 MG

[elvitegravir-cobicistat-emtricitabine-tenofovir df] 6


sucralfate tabs 1 gm 76 sufentanil citrate soln 50 mcgml 47 sulfacetamide sodium soln 10 72 SULFACETAMIDE SODIUM-SULFUR LIQD 10-

5 [sulfacetamide sodium w sulfur] 102 SULFACETAMIDE SODIUM-SULFUR LOTN 10-

5 [sulfacetamide sodium w sulfur] 102 SULFACETAMIDE SODIUM-SULFUR SUSP 10-

5 [sulfacetamide sodium w sulfur] 102 SULFACETAMIDE SODIUM-SULFUR SUSP 8-4

[sulfacetamide sodium w sulfur] 102 sulfacetamide-prednisolone soln 10-023 73 sulfadiazine tabs 500 mg 12 sulfamethoxazole-trimethoprim soln 400-80

mg5ml 12 sulfamethoxazole-trimethoprim susp 200-40

mg5ml 12 sulfamethoxazole-trimethoprim tabs 400-80

mg 12 sulfamethoxazole-trimethoprim tabs 800-160

mg 12 SULFAMYLON CREA 85 MGGM [mafenide

acetate] 100 sulfasalazine tabs 500 mg 12 sulfasalazine tbec 500 mg 12 SULFUR PRECIPITATED POWD [sulfur

(bulk)] 93 sulindac tabs 150 mg 47 sulindac tabs 200 mg 47 sumatriptan soln 20 mgact 52 sumatriptan succinate refill soct 6 mg05ml

52

sumatriptan succinate soaj 6 mg05ml 52 sumatriptan succinate soln 6 mg05ml 52 sumatriptan succinate sosy 6 mg05ml 52 sumatriptan succinate tabs 100 mg 52 sumatriptan succinate tabs 25 mg 52 sumatriptan succinate tabs 50 mg 52 SURE COMFORT INSULIN SYRINGE MISC

28G X 12 63 SURE COMFORT INSULIN SYRINGE MISC




31G X 516 63 SURVANTA SUSP 25-09 MGML- [beractant

in nacl] 94 SUTENT CAPS 125 MG [sunitinib malate] 23 SUTENT CAPS 25 MG [sunitinib malate] 23 SUTENT CAPS 375 MG [sunitinib malate] 23 SUTENT CAPS 50 MG [sunitinib malate] 23 SYLVANT SOLR 100 MG [siltuximab] 23 SYLVANT SOLR 400 MG [siltuximab] 23 SYMBICORT AERO 160-45 MCGACT

[budesonide-formoterol fumarate dihydrate] 79


SYMDEKO TBPK 100-150 amp 150 MG [tezacaftor-ivacaftor] 95




SYMLINPEN 120 SOPN 2700 MCG27ML [pramlintide acetate] 81


SYNAGIS SOLN 100 MGML [palivizumab] 16 SYNAGIS SOLN 50 MG05ML [palivizumab] 16 SYNAREL SOLN 2 MGML [nafarelin acetate]

84 SYNERCID SOLR 150-350 MG [quinupristin-

dalfopristin] 12


T TABLOID TABS 40 MG [thioguanine] 23 tacrolimus caps 05 mg 86 tacrolimus caps 1 mg 86 tacrolimus caps 5 mg 86 TACROLIMUS OINT 003 [tacrolimus

(topical)] 103 TACROLIMUS OINT 01 [tacrolimus

(topical)] 103 tadalafil (pah) tabs 20 mg 43 tadalafil tabs 10 mg 43 tadalafil tabs 25 mg 43 tadalafil tabs 20 mg 43 tadalafil tabs 5 mg 43 TAFINLAR CAPS 50 MG [dabrafenib mesylate]

23 TAFINLAR CAPS 75 MG [dabrafenib mesylate]

23 TAGRISSO TABS 40 MG [osimertinib

mesylate] 23 TAGRISSO TABS 80 MG [osimertinib

mesylate] 23 TAKHZYRO SOLN 300 MG2ML [lanadelumab-

flyo] 90 TAMIFLU CAPS 30 MG [oseltamivir

phosphate] 16 TAMIFLU CAPS 45 MG [oseltamivir


phosphate] 16 TAMIFLU SUSR 6 MGML [oseltamivir

phosphate] 16 tamoxifen citrate tabs 10 mg 23 tamoxifen citrate tabs 20 mg 23 tamsulosin hcl caps 04 mg 36 TARGRETIN CAPS 75 MG [bexarotene] 23 TARGRETIN GEL 1 [bexarotene (topical)]

103 TASIGNA CAPS 150 MG [nilotinib hcl] 23 TASIGNA CAPS 200 MG [nilotinib hcl] 23 TAXOTERE INJ 80MG2ML [docetaxel] 23 tazarotene crea 01 103 TAZORAC CREA 005 [tazarotene] 103 TAZORAC GEL 005 [tazarotene] 103 TAZORAC GEL 01 [tazarotene] 104 TDVAX SUSP 2-2 LF05ML [tetanus-

diphtheria toxoids (td)] 97 TECENTRIQ SOLN 1200 MG20ML

[atezolizumab] 23 temazepam caps 15 mg 55

temazepam caps 30 mg 55 temozolomide caps 100 mg 23 temozolomide caps 140 mg 24 temozolomide caps 180 mg 24 temozolomide caps 20 mg 24 temozolomide caps 250 mg 24 temozolomide caps 5 mg 24 TENIPOSIDE SOLN 10 MGML [teniposide] 24 tenofovir disoproxil fumarate tabs 300 mg 16 terazosin hcl caps 1 mg 36 terazosin hcl caps 10 mg 36 terazosin hcl caps 2 mg 36 terazosin hcl caps 5 mg 36 terbinafine hcl tabs 250 mg 13 terbutaline sulfate inj 1mgml 29 terbutaline sulfate soln 1 mgml 29 terbutaline sulfate tabs 25 mg 29 terbutaline sulfate tabs 5 mg 29 testosterone cypionate soln 200 mgml 80 testosterone enanthate soln 200 mgml 80 testosterone gel 125 mgact (1) 80 testosterone gel 2025 mgact (162) 80 testosterone gel 25 mg25gm (1) 80 testosterone gel 50 mg5gm (1) 80 TESTOSTERONE PROPIONATE POWD

[testosterone propionate (bulk)] 93 TETRACAINE HCL SOLN 05 [tetracaine hcl

(ophth)] 74 TETRACAINE HCL SOLN 1 [tetracaine hcl]

87 TETRACYCLINE HCL CAPS 250 MG

[tetracycline hcl] 12 TETRACYCLINE HCL CAPS 500 MG

[tetracycline hcl] 12 TETRAVISC SOLN 05 [tetracaine hcl

(ophth)] 74 THALOMID CAPS 100 MG [thalidomide] 90 THALOMID CAPS 150 MG [thalidomide] 90 THALOMID CAPS 200 MG [thalidomide] 90 THALOMID CAPS 50 MG [thalidomide] 90 THAM SOLN 30 MEQ100ML [tromethamine]65 theophylline er tb12 100 mg 104 theophylline er tb12 200 mg 104 theophylline er tb12 300 mg 104 theophylline er tb12 450 mg 104 theophylline er tb24 400 mg 104 THEOPHYLLINE IN D5W SOLN 08-5 MGML-

[theophylline in dextrose] 104 thiamine hcl soln 100 mgml 105 THIOLA TABS 100 MG [tiopronin] 91


thioridazine hcl tabs 10 mg 60 thioridazine hcl tabs 100 mg 60 thioridazine hcl tabs 25 mg 60 thioridazine hcl tabs 50 mg 60 thiotepa solr 15 mg 24 thiothixene caps 1 mg 60 thiothixene caps 10 mg 60 thiothixene caps 2 mg 60 thiothixene caps 5 mg 60 THROMBATE III SOLR 500 UNIT [antithrombin

iii (human)] 35 THROMBIN-JMI KIT 20000 UNIT [thrombin] 33 THROMBIN-JMI SOLR 20000 UNIT [thrombin]

33 THROMBIN-JMI SOLR 5000 UNIT [thrombin]33 THYMOL CRYS [thymol] 93 THYROGEN SOLR 09 MG [thyrotropin alfa] 65 TICE BCG SUSR 50 MG [bcg live intravesical]

98 timolol maleate soln 025 74 timolol maleate soln 05 74 TISSUEBLUE SOSY 0025 [brilliant blue g]

65 TIVICAY PD TBSO 5 MG [dolutegravir

sodium] 16 TIVICAY TABS 10 MG [dolutegravir sodium] 16 TIVICAY TABS 25 MG [dolutegravir sodium] 16 TIVICAY TABS 50 MG [dolutegravir sodium] 6 tizanidine hcl tabs 2 mg 27 tizanidine hcl tabs 4 mg 27 TNKASE KIT 50 MG [tenecteplase] 35 TOBI PODHALER CAPS 28 MG [tobramycin]

12 TOBRADEX OINT 03-01 [tobramycin-

dexamethasone] 73 tobramycin nebu 300 mg5ml 12 tobramycin soln 03 72 tobramycin sulfate soln 10 mgml 12 tobramycin sulfate soln 80 mg2ml 12 tobramycin sulfate solr 12 gm 12 TOBREX OINT 03 [tobramycin (ophth)] 72 tolbutamide tabs 500 mg 81 topiramate cpsp 15 mg 51 topiramate cpsp 25 mg 51 topiramate tabs 100 mg 51 topiramate tabs 200 mg 51 topiramate tabs 25 mg 51 topiramate tabs 50 mg 51 topotecan hcl solr 4 mg 24 TORISEL SOLN 25 MGML [temsirolimus] 24

torsemide tabs 10 mg 67 torsemide tabs 100 mg 67 torsemide tabs 20 mg 67 torsemide tabs 5 mg 67 TRACE ELEMENTS 4PEDIATRIC SOLN 1-100-

30-500 MCGML [trace minerals (cr-cu-mn-zn)] 71

TRACLEER TABS 125 MG [bosentan] 43 TRACLEER TABS 625 MG [bosentan] 43 TRACLEER TBSO 32 MG [bosentan] 95 TRADJENTA TABS 5 MG [linagliptin] 81 tramadol hcl tabs 50 mg 47 tramadol-acetaminophen tabs 375-325 mg 47 TRANEXAMIC ACID POWD [tranexamic acid

(bulk)] 93 tranexamic acid soln 1000 mg10ml 33 tranexamic acid tabs 650 mg 33 TRANSDERM-SCOP (15 MG) PT72 1

MG3DAYS [scopolamine] 76 tranylcypromine sulfate tabs 10 mg 60 TRAVASOL SOLN 10 [amino acid infusion]

66 trazodone hcl tabs 100 mg 60 trazodone hcl tabs 150 mg 60 trazodone hcl tabs 50 mg 60 TREANDA SOLR 100 MG [bendamustine hcl]

24 TRECATOR TABS 250 MG [ethionamide] 14 TREMFYA SOPN 100 MGML [guselkumab]

104 TREMFYA SOSY 100 MGML [guselkumab]104 treprostinil soln 100 mg20ml 43 treprostinil soln 20 mg20ml 43 treprostinil soln 200 mg20ml 43 treprostinil soln 50 mg20ml 43 tretinoin caps 10 mg 24 triamcinolone acetonide crea 0025 101 triamcinolone acetonide crea 01 101 triamcinolone acetonide crea 05 101 triamcinolone acetonide lotn 01 101 triamcinolone acetonide oint 0025 101 triamcinolone acetonide oint 01 101 triamcinolone acetonide oint 05 101 TRIAMCINOLONE ACETONIDE POWD

[triamcinolone acetonide (topical)] 93 triamcinolone acetonide pste 01 101 triamterene-hctz caps 375-25 mg 67 TRIAMTERENE-HCTZ TABS 375-25 MG

[triamterene amp hydrochlorothiazide] 67 TRIAMTERENE-HCTZ TABS 75-50 MG


[triamterene amp hydrochlorothiazide] 67 TRI-CHLOR LIQD 80 [trichloroacetic acid]

91 TRICITRATES SOLN 550-500-334 MG5ML [pot

amp sod citrates wcitric ac] 65 trifluoperazine hcl tabs 1 mg 60 trifluoperazine hcl tabs 10 mg 60 trifluoperazine hcl tabs 2 mg 60 trifluoperazine hcl tabs 5 mg 60 trifluridine soln 1 72 trihexyphenidyl hcl soln 04 mgml 53 trihexyphenidyl hcl tabs 2 mg 53 trihexyphenidyl hcl tabs 5 mg 53 TRIKAFTA TBPK 100-50-75 amp 150 MG

[elexacaftor-tezacaftor-ivacaftor] 95 TRIKAFTA TBPK 50-25-375 amp 75 MG

[elexacaftor-tezacaftor-ivacaftor] 95 trimethoprim tabs 100 mg 17 trimipramine maleate caps 100 mg 60 trimipramine maleate caps 25 mg 60 trimipramine maleate caps 50 mg 60 TRISENOX SOLN 12 MG6ML [arsenic

trioxide] 24 TRIUMEQ TABS 600-50-300 MG [abacavir-

dolutegravir-lamivudine] 6 TRI-VI-SOL ACD SOLN 250-50-10 [pediatric

vitamins adc] 105 TRI-VITFLUORIDE SOLN 05 MGML

[pediatric vitamins acd w fluoride] 105 TRIZIVIR TABS 300-150-300 MG [abacavir

sulfate-lamivudine-zidovudine] 16 TROPHAMINE SOLN 10 [amino acid

infusion] 67 TROPHAMINE SOLN 6 [amino acid

infusion] 67 tropicamide soln 05 75 tropicamide soln 1 75 trospium chloride er cp24 60 mg 104 trospium chloride tabs 20 mg 104 TRUZONE PEAK FLOW METER DEVI [peak

flow meter] 63 TUBERSOL SOLN 5 UNIT01ML [tuberculin

ppd] 65 TUKYSA TABS 150 MG [tucatinib] 24 TUKYSA TABS 50 MG [tucatinib] 24 TWINRIX SUSY 720-20 ELU-MCGML

[hepatitis a (inactivated)-hepatitis b (recombinant) vaccines] 98

TYKERB TABS 250 MG [lapatinib ditosylate] 24

TYPHIM VI SOLN 25 MCG05ML [typhoid vi polysaccharide vaccine] 98

TYSABRI CONC 300 MG15ML [natalizumab] 91

TYVASO SOLN 06 MGML [treprostinil] 43

U ULTIVA SOLR 1 MG [remifentanil hcl] 47 ULTIVA SOLR 2 MG [remifentanil hcl] 47 ULTIVA SOLR 5 MG [remifentanil hcl] 47 ULTOMIRIS SOLN 1100 MG11ML

[ravulizumab-cwvz] 91 ULTOMIRIS SOLN 300 MG30ML

[ravulizumab-cwvz] 91 ULTOMIRIS SOLN 300 MG3ML [ravulizumab-

cwvz] 91 ULTRA THIN LANCETS 30G MISC [lancets] 63 ULTRABAGDIANEAL15 DEXTROSE SOLN


ULTRABAGDIANEAL25 DEXTROSE SOLN 395 MOSML [peritoneal dialysis solutions] 68

ULTRA-COMFORT INSULIN SYRINGE MISC 31G X 516 63

UNITUXIN SOLN 175 MG5ML [dinutuximab] 24

UREA POWD [urea (bulk)] 93 URSO FORTE TABS 500 MG [ursodiol] 76 ursodiol tabs 250 mg 76

V VAGIFEM TABS 10 MCG [estradiol vaginal] 83 valacyclovir hcl tabs 1 gm 16 valacyclovir hcl tabs 500 mg 16 VALCYTE SOLR 50 MGML [valganciclovir

hcl] 16 valganciclovir hcl tabs 450 mg 16 valproate sodium soln 500 mg5ml 51 valproic acid caps 250 mg 51 valproic acid soln 250 mg5ml 51 valsartan tabs 160 mg 41 valsartan tabs 320 mg 41 valsartan tabs 40 mg 41 valsartan tabs 80 mg 41 valsartan-hydrochlorothiazide tabs 160-125

mg 42 valsartan-hydrochlorothiazide tabs 160-25 mg

42


valsartan-hydrochlorothiazide tabs 320-125 mg 42



vancomycin hcl caps 125 mg 12 vancomycin hcl caps 250 mg 12 VANCOMYCIN HCL IN DEXTROSE SOLN 1-5

GM200ML- [vancomycin hcl-dextrose] 12 VANCOMYCIN HCL IN DEXTROSE SOLN 500-

5 MG100ML- [vancomycin hcl-dextrose] 12

vancomycin hcl solr 1 gm 12 vancomycin hcl solr 10 gm 12 vancomycin hcl solr 5 gm 12 vancomycin hcl solr 500 mg 12 VAQTA SUSP 25 UNIT05ML [hepatitis a

vaccine] 99 VAQTA SUSP 50 UNITML [hepatitis a

vaccine] 99 VARITHENA FOAM 180 MG18ML [polidocanol

(laureth-9)] 42 VARIVAX INJ 1350 PFU05ML [varicella virus

vaccine live] 99 VAXCHORA SUSR [cholera vaccine live

attenuated] 99 VECTICAL OINT 3 MCGGM [calcitriol

(topical)] 104 vecuronium bromide solr 10 mg 28 vecuronium bromide solr 20 mg 28 VEKLURY SOLN 100 MG20ML [remdesivir] 16 VEKLURY SOLR 100 MG [remdesivir] 17 VELCADE SOLR 35 MG [bortezomib] 24 VENCLEXTA STARTING PACK TBPK 10 amp 50

amp 100 MG [venetoclax] 24 VENCLEXTA TABS 10 MG [venetoclax] 24 VENCLEXTA TABS 100 MG [venetoclax] 24 VENCLEXTA TABS 50 MG [venetoclax] 24 venlafaxine hcl er cp24 150 mg 60 venlafaxine hcl er cp24 375 mg 60 venlafaxine hcl er cp24 75 mg 60 venlafaxine hcl tabs 100 mg 60 venlafaxine hcl tabs 25 mg 60 venlafaxine hcl tabs 375 mg 60 venlafaxine hcl tabs 50 mg 60 venlafaxine hcl tabs 75 mg 60 VENOFER SOLN 20 MGML [iron sucrose] 30 VENTAVIS SOLN 10 MCGML [iloprost] 43 VENTAVIS SOLN 20 MCGML [iloprost] 43

VENTOLIN HFA AERS 108 (90 Base) MCGACT [albuterol sulfate] 29

verapamil hcl er tbcr 120 mg 39 verapamil hcl er tbcr 180 mg 39 verapamil hcl er tbcr 240 mg 39 VERAPAMIL HCL POWD [verapamil hcl] 93 verapamil hcl soln 25 mgml 39 verapamil hcl tabs 120 mg 39 verapamil hcl tabs 40 mg 39 verapamil hcl tabs 80 mg 39 VFEND IV SOLR 200 MG [voriconazole] 13 VICTOZA SOPN 18 MG3ML [liraglutide] 81 VIDEX SOLR 2 GM [didanosine] 6 VIDEX SOLR 4 GM [didanosine] 6 VIMIZIM SOLN 5 MG5ML [elosulfase alfa] 72 vinblastine sulfate soln 1 mgml 24 vincristine sulfate soln 1 mgml 24 vinorelbine tartrate soln 10 mgml 24 vinorelbine tartrate soln 50 mg5ml 24 VIRACEPT TABS 250 MG [nelfinavir mesylate]

6 VIRACEPT TABS 625 MG [nelfinavir mesylate]

6 VIRAMUNE SUSP 50 MG5ML [nevirapine] 6 VIRAZOLE SOLR 6 GM [ribavirin] 17 VIRTUSSIN DAC SOLN 30-10-100 MG5ML

[pseudoephedrine w codeine-gg] 94 VISUDYNE SOLR 15 MG [verteporfin] 74 vitamin d (ergocalciferol) caps 125 mg

(50000 ut) 105 vitamin k1 soln 1 mg05ml 106 vitamin k1 soln 10 mgml 106 VITAMINS ACD-FLUORIDE SOLN 025 MGML

[pediatric vitamins acd w fluoride] 105 VIVOTIF CPDR [typhoid vaccine] 99 VOLUMEN SUSP 01 [barium sulfate] 65 VORAXAZE SOLR 1000 UNIT [glucarpidase]72 voriconazole solr 200 mg 17 voriconazole tabs 200 mg 13 voriconazole tabs 50 mg 13 VOSEVI TABS 400-100-100 MG [sofosbuvir-

velpatasvir-voxilaprevir] 17 VOTRIENT TABS 200 MG [pazopanib hcl] 24 VPRIV SOLR 400 UNIT [velaglucerase alfa] 72 VYVANSE CAPS 10 MG [lisdexamfetamine

dimesylate] 48 VYVANSE CAPS 20 MG [lisdexamfetamine


dimesylate] 48






VYXEOS SUSR 44-100 MG [daunorubicin-cytarabine liposome] 24

W warfarin sodium tabs 1 mg 35 warfarin sodium tabs 10 mg 35 warfarin sodium tabs 2 mg 35 warfarin sodium tabs 25 mg 35 warfarin sodium tabs 3 mg 35 warfarin sodium tabs 4 mg 35 warfarin sodium tabs 5 mg 35 warfarin sodium tabs 6 mg 35 warfarin sodium tabs 75 mg 35 WIDE-SEAL DIAPHRAGM 60 DPRH 2

[diaphragm wide seal] 61 WIDE-SEAL DIAPHRAGM 65 DPRH 2







[diaphragm wide seal] 61 WILATE KIT 1000-1000 UNIT [antihemophilic

factorvon willebrand factor complex (human)] 33

WILATE KIT 500-500 UNIT [antihemophilic factorvon willebrand factor complex (human)] 33

X XALKORI CAPS 200 MG [crizotinib] 24 XALKORI CAPS 250 MG [crizotinib] 24 XELJANZ TABS 10 MG [tofacitinib citrate] 91 XELJANZ TABS 5 MG [tofacitinib citrate] 91

XELJANZ XR TB24 11 MG [tofacitinib citrate] 91

XERAC AC SOLN 625 [aluminum chloride in alcohol] 102

XGEVA SOLN 120 MG17ML [denosumab] 24 XIFAXAN TABS 550 MG [rifaximin] 12 XOLAIR SOLR 150 MG [omalizumab] 95 XOLAIR SOSY 150 MGML [omalizumab] 95 XOLAIR SOSY 75 MG05ML [omalizumab] 95 XTANDI CAPS 40 MG [enzalutamide] 24 XTANDI TABS 40 MG [enzalutamide] 24 XTANDI TABS 80 MG [enzalutamide] 24 XYLOCAINE-MPFEPINEPHRINE SOLN 1 -1

200000 [lidocaine w epinephrine] 87 XYNTHA KIT 1000 UNIT [antihemophilic factor

(rcmb) moroctocog alfa(bdd-rfviiimor)] 33 XYNTHA KIT 2000 UNIT [antihemophilic factor



(rcmb) moroctocog alfa(bdd-rfviiimor)] 33 XYNTHA SOLOFUSE KIT 3000 UNIT

[antihemophilic factor (rcmb) moroctocog alfa(bdd-rfviiimor)] 33

Y YERVOY SOLN 200 MG40ML [ipilimumab] 24 YERVOY SOLN 50 MG10ML [ipilimumab] 24 YF-VAX INJ [yellow fever vaccine] 99 YONDELIS SOLR 1 MG [trabectedin] 24

Z ZANOSAR SOLR 1 GM [streptozocin] 24 ZARXIO SOSY 300 MCG05ML [filgrastim-

sndz] 36 ZARXIO SOSY 480 MCG08ML [filgrastim-

sndz] 36 ZEJULA CAPS 100 MG [niraparib tosylate] 24 ZELBORAF TABS 240 MG [vemurafenib] 24 ZENPEP CPEP 10000-32000 UNIT

[pancrelipase (lipase-protease-amylase)] 77 ZENPEP CPEP 15000-47000 UNIT







[pancrelipase (lipase-protease-amylase)] 77 ZIAGEN SOLN 20 MGML [abacavir sulfate] 6 zidovudine caps 100 mg 6 zidovudine syrp 50 mg5ml 6 zidovudine tabs 300 mg 6 ZINC CHLORIDE SOLN 1 MGML [zinc

chloride] 71 ZINC SULFATE GRAN [zinc sulfate] 93 ZINC SULFATE HEPTAHYDRATE POWD [zinc

sulfate heptahydrate] 93 ZINC SULFATE MONOHYDRATE POWD [zinc

sulfate monohydrate] 93 ZINC SULFATE SOLN 1 MGML [zinc sulfate]

71 ZINECARD SOLR 250 MG [dexrazoxane hcl]91 ZINECARD SOLR 500 MG [dexrazoxane hcl]91 ziprasidone hcl caps 20 mg 60 ziprasidone hcl caps 40 mg 60

ziprasidone hcl caps 60 mg 60 ziprasidone hcl caps 80 mg 60 ZITHROMAX PACK 1 GM [azithromycin] 12 zoledronic acid conc 4 mg5ml 91 zoledronic acid soln 5 mg100ml 91 zolpidem tartrate tabs 5 mg 55 zonisamide caps 100 mg 51 zonisamide caps 25 mg 51 zonisamide caps 50 mg 51 ZOSYN SOLN 2-025 GM50ML [piperacillin

sodium-tazobactam sodium in dextrose] 12 ZOSYN SOLN 3-0375 GM50ML [piperacillin

sodium-tazobactam sodium in dextrose] 12 ZYDELIG TABS 100 MG [idelalisib] 24 ZYDELIG TABS 150 MG [idelalisib] 25 ZYKADIA CAPS 150 MG [ceritinib] 25 ZYKADIA TABS 150 MG [ceritinib] 25 ZYMAXID SOLN 05 [gatifloxacin (ophth)] 72 ZYTIGA TABS 500 MG [abiraterone acetate] 25 ZYVOX SUSR 100 MG5ML [linezolid] 12 ZYVOX TABS 600 MG [linezolid] 12


Language Assistance Services English Language assistance is available at no cost to you 24 hours a day 7 days a week You can request interpreter services materials translated into your language or in alternative formats Just call us at 1-800-464-4000 24 hours a day 7 days a week (closed holidays) TTY users call 711

Arabic یة أو ترجمة وثائق للغتك أو لصیغ أخرى الفور لترجمة مجانا على مدار الساعة كافة أیام الأسبوع بإمكانك طلب خدمة ا متوفرة لك الفوریة ة جم تر ل ات ا خدمتصال یرجي الا صي لن تف ا ا دمة الھ خ لمستخدمي العطلات) لأسبوع (مغلق أیام على مدار الساعة كافة أیام ا 4000-464-800-1 على الرقم ال بنا ص ى الات ما علیك سو

) 711الرقم ( لى ع

Armenian Ձեզ կարող է անվճար օգնություն տրամադրվել լեզվի հարցում` օրը 24 ժամ շաբաթը 7 օր Դուք կարող եք պահանջել բանավոր թարգմանչի ծառայություններ Ձեր լեզվով թարգմանված կամ այլընտրանքային ձևաչափով պատրաստված նյութեր Պարզապես զանգահարեք մեզ` 1-800-464-4000 հեռախոսահամարով` օրը 24 ժամ` շաբաթը 7 օր (տոն օրերին փակ է) TTY-ից օգտվողները պետք է զանգահարեն 711

Chinese 您每週 7天每天 24小時均可獲得免費語言協助您可以申請口譯服務要求將資料翻譯成您所用語言

或轉換為其他格式我們每週 7天每天 24小時均歡迎您打電話 1-800-757-7585 前來聯絡（節假日休息）聽障及語障專線 (TTY) 使用者請撥 711

Farsi جمھر ت مترجم شفاھیخدمات شما می توانید برای است در اختیار شما ھذ ھزین بدون اخ روز ھفتھ 7ساعت شبانروز و 24در زبانی خدمات روز ھفتھ 7انروز و ساعت شب 24در فیست کاو یا بھ صورتھای دیگر درخواست کنیدا شمن بھ زباجزوات ندبگیر تماس 711با شماره TTYتماس بگیرید کاربران 4000-464-800-1بھ شماره ) با ماای تعطیل زھرونای ث (بھ است

Hindi िबना िकसी लागत क दभािषया सवाए िदन क 24 घट साह क सातो िदन उपल ह आप एक दभािषय की सवाओ क िलए िबना िकसी लागत क सामिगरयो को अपनी भाषा म अनवाद करवान क िलए या वकक परापो क िलए अनरोध कर सकत ह बस कवल हम 1-800-464-4000 पर िदन क 24 घट साह क सातो िदन (छियो वाल िदन बद रहता ह) कॉल कर TTY उपयोगकता 711 पर कॉल कर

Hmong Muajkwc pab txhais lus pub dawb rau koj 24 teev ib hnub twg 7 hnub ib lim tiam twg Koj thov tau cov kev pab txhais lus muab cov ntaub ntawv txhais ua koj hom lus los yog ua lwm homTsuas hu rau 1-800-464-4000 24 teev ib hnub twg 7 hnub ib lim tiam twg (cov hnub caiv kaw) Cov neeg siv TTY hu 711

Japanese 当院では言語支援を無料で年中無休終日ご利用いただけます通訳サービス日本語に翻訳さ

れた資料あるいは資料を別の書式でも依頼できますお気軽に 1-800-464-4000 までお電話ください（祭日を

除き年中無休）TTYユーザーは 711にお電話ください

Khmer ជនយ គនឥតអសៃថដលអកេឡើយ 24 េងមយៃថ 7 ៃថមយទតយ អកចេស ើសេសអកបកែរប សរៈែដលនបកែរបេែខរ ឬទរងផសងេទៀត រនែតទរសពមកេយើង មេលខ 1-800-464-4000 ន 24 េងមយៃថ 7 ៃថមយទតយ (បទៃថបណយ) អកេរបើ TTY េេលខ 711

Korean 요일 및 시간에 관계없이 언어 지원 서비스를 무료로 이용하실 수 있습니다 귀하는 통역 서비스 귀하의 언어로 번역된 자료 또는 대체 형식의 자료를 요청할 수 있습니다 요일 및 시간에 관계없이 1-800-464-4000번으로 전화하십시오 (공휴일 휴무) TTY 사용자 번호 711


Laotian ການຊວຍເຫອດານພາສາມ ໃຫໂດຍບ ເສຽຄາແກທານ ຕະຫອດ 24 ຊວໂມງ 7 ວນຕອາທດ ທານສາມາດຮອງຂຮບບ ລ ການນາຍພາສາ ໃຫແປເອກະສານເປນພາສາຂອງທານ ຫ ໃນຮບແບບອ ນ ພຽງແຕໂທຣຫາພວກເຮ າທ 1-800-464-4000 ຕະຫອດ 24 ຊວໂມງ 7 ວນຕອາທດ (ປ ດວນພກຕາງໆ) ຜໃຊສາຍ TTY ໂທຣ 711

Navajo Saad bee aacutekaacutersquoarsquoayeed naacutehoacuteloacute trsquoaacuteaacute jiikrsquoeacute naadiin doo bibąąrsquo diacuteiacutersquo aheacuteeacutersquoiikeed tsostsrsquoid yiskąąjiacute damoo naacuteaacutedleehjiacute Atah halnersquoeacute aacutekaacutersquoadoolwołiacutegiacuteiacute joacutekiacute trsquoaacuteadoo lersquoeacute trsquoaacuteaacute hoacutehazaadjiacute hadilyąąrsquogo eacuteiacute doodaiirsquo naacuteaacutenaacute laacute ałrsquoąą aacutedaatrsquoehiacutegiacuteiacute bee haacutedadilyaarsquogo Kojiacute hodiilnih 1-800-464-4000 naadiin doo bibąąrsquo diacuteiacutersquo aheacuteeacutersquoiikeed tsostsrsquoid yiskąąjiacute damoo naacutersquoaacutedleehjiacute (Dahodiyin biniiyeacute ersquoersquoaahgo eacuteiacute darsquodeelkaal) TTY chodeeyooliacuteniacutegiacuteiacute kojiacute hodiilnih 711

Punjabi ਿਬਨਾ ਿਕਸੀ ਲਾਗਤ ਦ ਿਦਨ ਦ 24 ਘਟ ਹਫਤ ਦ 7 ਿਦਨ ਦਭਾਸ਼ੀਆ ਸਵਾਵਾ ਤਹਾਡ ਲਈ ਉਪਲਬਧ ਹ ਤਸੀ ਇਕ ਦਭਾਸ਼ੀਏ ਦੀ ਮਦਦ ਲਈ ਸਮਗਰੀਆ ਨ ਆਪਣੀ ਭਾਸ਼ਾ ਿਵਚ ਅਨਵਾਦ ਕਰਵਾਉਣ ਲਈ ਜਾ ਿਕਸ ਵਖ ਫਾਰਮਟ ਿਵਚ ਪਾਪਤ ਕਰਨ ਲਈ ਬਨਤੀ ਕਰ ਸਕਦ ਹ ਬਸ ਿਸਰਫ਼ ਸਾਨ 1-800-464-4000 ਤ ਿਦਨ ਦ 24 ਘਟ ਹਫ਼ਤ ਦ 7 ਿਦਨ (ਛਟੀਆ ਵਾਲ ਿਦਨ ਬਦ ਰਿਹਦਾ ਹ) ਫ਼ਨ ਕਰ TTY ਦਾ ਉਪਯਗ ਕਰਨ ਵਾਲ 711 lsquoਤ ਫ਼ਨ ਕਰਨ

Russian Мы бесплатно обеспечиваем Вас услугами перевода 24 часа в сутки 7 дней в неделю Вы можете воспользоваться помощью устного переводчика запросить перевод материалов на свой язык или запросить их в одном из альтернативных форматов Просто позвоните нам по телефону 1-800-464-4000 который доступен 24 часа в сутки 7 дней в неделю (кроме праздничных дней) Пользователи линии TTY могут звонить по номеру 711

Spanish Contamos con asistencia de idiomas sin costo alguno para usted 24 horas al diacutea 7 diacuteas a la semana Puede solicitar los servicios de un inteacuterprete que los materiales se traduzcan a su idioma o en formatos alternativos Solo llame al 1-800-788-0616 24 horas al diacutea 7 diacuteas a la semana (cerrado los diacuteas festivos) Los usuarios de TTY deben llamar al 711

Tagalog May magagamit na tulong sa wika nang wala kang babayaran 24 na oras bawat araw 7 araw bawat linggo Maaari kang humingi ng mga serbisyo ng tagasalin sa wika mga babasahin na isinalin sa iyong wika o sa mga alternatibong format Tawagan lamang kami sa 1-800-464-4000 24 na oras bawat araw 7 araw bawat linggo (sarado sa mga pista opisyal) Ang mga gumagamit ng TTY ay maaaring tumawag sa 711

Thai เรามบรการลามฟรสาหรบคณตลอด 24 ชวโมง ทกวนตลอดชวโมงทาการของเราคณสามารถขอใหลามชวยตอบคาถามของคณทเกยวกบความคมครองการดแลสขภาพของเราและคณยงสามารถขอใหมการแปลเอกสารเปนภาษาทคณใชไดโดยไมมการคดคาบรการเพยงโทรหาเราทหมายเลข 1-800-464-4000 ตลอด 24 ชวโมงทกวน (ปดใหบรการในวนหยดราชการ) ผใช TTY โปรดโทรไปท 711

Vietnamese Dịch vụ thocircng dịch được cung cấp miễn phiacute cho quyacute vị 24 giờ mỗi ngagravey 7 ngagravey trong tuần Quyacute vị coacute thể yecircu cầu dịch vụ thocircng dịch tagravei liệu phiecircn dịch ra ngocircn ngữ của quyacute vị hoặc tagravei liệu bằng nhiều higravenh thức khaacutec Quyacute vị chỉ cần gọi cho chuacuteng tocirci tại số 1-800-464-4000 24 giờ mỗi ngagravey 7 ngagravey trong tuần (trừ caacutec ngagravey lễ) Người dugraveng TTY xin gọi 711


Nondiscrimination Notice

Kaiser Permanente does not discriminate on the basis of age race ethnicity color national origin cultural background ancestry religion sex gender identity gender expression sexual orientation marital status physical or mental disability source of payment genetic information citizenship primary language or immigration status

Language assistance services are available from our Member Services Contact Center 24 hours a day seven days a week (except closed holidays) Interpreter services including sign language are available at no cost to you during all hours of operation Auxiliary aids and services for individuals with disabilities are available at no cost to you during all hours of operation We can also provide you your family and friends with any special assistance needed to access our facilities and services You may request materials translated in your language and may also request these materials in large text or in other formats to accommodate your needs at no cost to you For more information call 1-800-464-4000 (TTY users call 711)

A grievance is any expression of dissatisfaction expressed by you or your authorized representative through the grievance process For example if you believe that we have discriminated against you you can file a grievance Please refer to your Evidence of Coverage or Certificate of Insurance or speak with a Member Services representative for the dispute-resolution options that apply to you This is especially important if you are a Medicare Medi-Cal MRMIP Medi-Cal Access FEHBP or CalPERS member because you have different dispute-resolution options available

You may submit a grievance in the following ways bull By completing a Complaint or Benefit ClaimRequest form at a Member Services office located at a

Plan Facility (please refer to Your Guidebook or the facility directory on our website at kporg for addresses)

bull By mailing your written grievance to a Member Services office at a Plan Facility (please refer to Your Guidebook or the facility directory on our website at kporg for addresses)

bull By calling our Member Service Contact Center toll free at 1-800-464-4000 (TTY users call 711)

bull By completing the grievance form on our website at kporg

Please call our Member Service Contact Center if you need help submitting a grievance

The Kaiser Permanente Civil Rights Coordinator will be notified of all grievances related to discrimination on the basis of race color national origin sex age or disability You may also contact the Kaiser Permanente Civil Rights Coordinator directly at One Kaiser Plaza 12th Floor Suite 1223 Oakland CA 94612

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal available at ocrportalhhsgovocrportallobbyjsf or by mail or phone at US Department of Health and Human Services 200 Independence Avenue SW Room 509F HHH Building Washington DC 20201 1ndash800ndash368ndash1019 800ndash537ndash7697 (TDD) Complaint forms are available at hhsgovocrofficefileindexhtml


Aviso de no discriminacioacuten

Kaiser Permanente no discrimina a ninguna persona por su edad raza etnia color paiacutes de origen antecedentes culturales ascendencia religioacuten sexo identidad de geacutenero expresioacuten de geacutenero orientacioacuten sexual estado civil discapacidad fiacutesica o mental fuente de pago informacioacuten geneacutetica ciudadaniacutea lengua materna o estado migratorio

La Central de Llamadas de Servicio a los Miembros brinda servicios de asistencia con el idioma las 24 horasdel diacutea los siete diacuteas de la semana (excepto los diacuteas festivos) Se ofrecen servicios de interpretacioacuten sin costo alguno para usted durante el horario de atencioacuten incluido el lenguaje de sentildeas Se ofrecen aparatos y servicios auxiliares para personas con discapacidades sin costo alguno durante el horario de atencioacuten Tambieacuten podemos ofrecerle a usted a sus familiares y amigos cualquier ayuda especial que necesiten para acceder a nuestros centros de atencioacuten y servicios Puede solicitar los materiales traducidos a su idioma y tambieacuten los puede solicitar con letra grande o en otros formatos que se adapten a sus necesidades sin costo para usted Para obtener maacutes informacioacuten llame al 1-800-788-0616 (los usuarios de la liacutenea TTY deben llamar al 711)

Una queja es una expresioacuten de inconformidad que manifiesta usted o su representante autorizado a traveacutes del proceso de quejas Por ejemplo si usted cree que ha sufrido discriminacioacuten de nuestra parte puede presentar una queja Consulte su Evidencia de Cobertura (Evidence of Coverage) o Certificado de Seguro (Certificate of Insurance) o comuniacutequese con un representante de Servicio a los Miembros para conocer las opciones de resolucioacuten de disputas que le corresponden Esto tiene especial importancia si es miembro de Medicare Medi-Cal el Programa de Seguro Meacutedico para Riesgos Mayores (Major Risk Medical Insurance Program MRMIP) Medi-Cal Access el Programa de Beneficios Meacutedicos para los Empleados Federales (Federal Employees Health Benefits Program FEHBP) o CalPERS ya que dispone de otras opciones para resolver disputas

Puede presentar una queja de las siguientes maneras

bull Completando un formulario de queja o de reclamacioacutensolicitud de beneficios en una oficina de Servicio a los Miembros ubicada en un centro del plan (consulte las direcciones en Su Guiacutea o en el directorio de centros de atencioacuten en nuestro sitio web en kporgespanol)

bull Enviando por correo su queja por escrito a una oficina de Servicio a los Miembros en un centro del plan (consulte las direcciones en Su Guiacutea o en el directorio de centros de atencioacuten en nuestro sitio web en kporgespanol)

bull Llamando a la liacutenea telefoacutenica gratuita de la Central de Llamadas de Servicio a los Miembros al 1-800-788-0616 (los usuarios de la liacutenea TTY deben llamar al 711)

bull Completando el formulario de queja en nuestro sitio web en kporgespanol

Llame a nuestra Central de Llamadas de Servicio a los Miembros si necesita ayuda para presentar una queja

Se le informaraacute al coordinador de derechos civiles de Kaiser Permanente (Civil Rights Coordinator) de todas las quejas relacionadas con la discriminacioacuten por motivos de raza color paiacutes de origen geacutenero edad o discapacidad Tambieacuten puede comunicarse directamente con el coordinador de derechos civiles de Kaiser Permanente en One Kaiser Plaza 12th Floor Suite 1223 Oakland CA 94612

Tambieacuten puede presentar una queja formal de derechos civiles de forma electroacutenica ante la Oficina de Derechos Civiles (Office for Civil Rights) en el Departamento de Salud y Servicios Humanos de los Estados Unidos (US Department of Health and Human Services) mediante el portal de quejas formales de la Oficina de Derechos Civiles (Office for Civil Rights Complaint Portal) en ocrportalhhsgovocrportallobbyjfs (en ingleacutes) o por correo postal o por teleacutefono a US Department of Health and Human Services 200 Independence Avenue SW Room 509F HHH Building Washington DC 20201 1-800-368-1019 1-800-537-7697 (liacutenea TDD) Los formularios de queja formal estaacuten disponibles en hhsgovocrofficefileindexhtml (en ingleacutes)


無歧視公告

Kaiser Permanente禁止以年齡人種族裔膚色原國籍文化背景血統宗教性別性別認

同性別表達性取向婚姻狀況生理或心理殘障付款來源遺傳資訊公民身份主要語言或

移民身份為由而歧視任何人

會員服務聯絡中心每週七天每天24小時提供語言協助服務（節假日除外）本機構在全部營業時間內

免費為您提供口譯包括手語服務以及殘障人士輔助器材和服務我們還可為您和您的親友提供使

用本機構設施與服務所需要的任何特別協助您還可免費索取翻譯成您的語言的資料以及符合您需

求的大號字體或其他格式的版本若需更多資訊請致電 1-800-757-7585（TTY專線使用者請撥

711）

申訴指任何您或您的授權代表透過申訴程序來表達不滿的做法例如如果您認為自己受到歧視即可提出申

訴若需瞭解適用於自己的爭議解決選項請參閱《承保範圍說明書》(Evidence of Coverage) 或《保險證明

書》(Certificate of Insurance)或咨詢會員服務代表如果您是 MedicareMedi-Cal高風險醫療保險計劃 (Major Risk Medical Insurance Program MRMIP)Medi-Cal Access聯邦僱員健康保險計劃 (Federal Employees Health Benefits Program FEHBP) 或 CalPERS 會員採取上述行動尤其重要因為您可能有不同

的爭議解決選項

您可透過以下方式提出申訴

bull 在健康保險計劃服務設施的會員服務處填寫《投訴或福利索賠申請表》（地址見《健康服務指南》

(Your Guidebook) 或我們網站kporg上的服務設施名錄）

bull 將書面申訴信郵寄到健康保險計劃服務設施的會員服務處（地址見《健康服務指南》或我們網站

kporg上的服務設施名錄）

bull 致電我們的會員服務聯絡中心免費電話號碼是1-800-757-7585（TTY專線請撥711）

bull 在我們的網站上填寫申訴表網址是kporg

如果您在提交申訴時需要協助請致電我們的會員服務聯絡中心

涉及人種膚色原國籍性別年齡或殘障歧視的一切申訴都將通知Kaiser Permanente的民權事務協

調員您也可與Kaiser Permanente的民權事務協調員直接聯絡地址 One Kaiser Plaza 12th Floor Suite 1223 Oakland CA 94612

您還可以電子方式透過民權辦公室的投訴入口網站向美國健康與公共服務部民權辦公室提出民權投訴網址是

ocrportalhhsgovocrportallobbyjsf或者按照如下資訊採用郵寄或電話方式聯絡US Department of Health and Human Services 200 Independence Avenue SW Room 509F HHH Building Washington DC 20201 1-800-368-1019 1-800-537-7697（TDD）投訴表可從網站

hhsgovocrofficefileindexhtml下載


California Member Services 24 hours a day seven days a week (closed holidays) 1-800-464-4000 English 1- 800-788-0616 Spanish 1-800-757-7585 Chinese dialects 711 TTY for the hearingspeech impaired

Please recycle MOM 60379021 092015


What is the Kaiser Permanente California EPODEPO Commercial Self-Funded Formulary

What drugs are covered

Getting an exception to the formulary

Are there any restrictions on the drugs covered on the Formulary

What is a brand-name drug

What is a generic drug

What is a specialty drug

What drugs are eligible to be mailed from the mail order pharmacy

Kaiser Permanente California Commercial Formulary

ANTI-INFECTIVE AGENTS

ANTHELMINTICS

ANTI-HIV AGENTS

ANTIBACTERIALS

ANTIFUNGALS

ANTIHEPATITIS C AGENTS

ANTIMYCOBACTERIALS

ANTIPROTOZOALS

ANTIVIRALS

URINARY ANTI-INFECTIVES

ANTIHISTAMINE DRUGS

FIRST GENERATION ANTIHISTAMINES

ANTINEOPLASTIC AGENTS


AUTONOMIC DRUGS

ANTICHOLINERGIC AGENTS

AUTONOMIC DRUGS MISCELLANEOUS

PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS

SKELETAL MUSCLE RELAXANTS

SYMPATHOLYTIC (ADRENERGIC BLOCKING) AGENTS

SYMPATHOMIMETIC (ADRENERGIC) AGENTS

BLOOD DERIVATIVES

BLOOD DERIVATIVES

BLOOD FORMATION COAGULATION AND THROMBOSIS

ANTIANEMIA DRUGS

ANTIHEMORRHAGIC AGENTS

ANTITHROMBOTIC AGENTS

HEMATOPOIETIC AGENTS

HEMORRHEOLOGIC AGENTS

CARDIOVASCULAR DRUGS

ALPHA-ADRENERGIC BLOCKING AGENTS

ANTILIPEMIC AGENTS

BETA-ADRENERGIC BLOCKING AGENTS

CALCIUM-CHANNEL BLOCKING AGENTS

CARDIAC DRUGS

HYPOTENSIVE AGENTS

RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITORS

SCLEROSING AGENTS

VASODILATING AGENTS

CENTRAL NERVOUS SYSTEM AGENTS

ANALGESICS AND ANTIPYRETICS

ANOREXIGENIC AGENTS AND RESPIRATORY AND CEREBRAL STIMULANTS

ANTICONVULSANTS

ANTIMANIC AGENTS

ANTIMIGRAINE AGENTS

ANTIPARKINSONIAN AGENTS

ANXIOLYTICS SEDATIVES AND HYPNOTICS

CENTRAL NERVOUS SYSTEM AGENTS MISCELLANEOUS

GENERAL ANESTHETICS

MULTIPLE SCLEROSIS AGENTS

OPIATE ANTAGONISTS

PSYCHOTHERAPEUTIC AGENTS

CONTRACEPTIVES (FOAMS DEVICES)


DEVICES

DEVICES

DIAGNOSTIC AGENTS

DIAGNOSTIC AGENTS

ELECTROLYTIC CALORIC AND WATER BALANCE

ALKALINIZING AGENTS

AMMONIA DETOXICANTS

CALORIC AGENTS

DIURETICS

ION-REMOVING AGENTS

IRRIGATING SOLUTIONS

REPLACEMENT PREPARATIONS

URICOSURIC AGENTS

ENZYMES

ENZYMES

EYE EAR NOSE AND THROAT (EENT) PREPARATIONS

ANTI-INFECTIVES

ANTI-INFLAMMATORY AGENTS

ANTIALLERGIC AGENTS

ANTIGLAUCOMA AGENTS

EENT DRUGS MISCELLANEOUS

LOCAL ANESTHETICS

MYDRIATICS

VASOCONSTRICTORS

GASTROINTESTINAL DRUGS

ANTACIDS AND ADSORBENTS


ANTIDIARRHEA AGENTS

ANTIEMETICS

ANTIULCER AGENTS AND ACID SUPPRESSANTS

CATHARTICS AND LAXATIVES

CHOLELITHOLYTIC AGENTS

DIGESTANTS

PROKINETIC AGENTS

GOLD COMPOUNDS

GOLD COMPOUNDS

HEAVY METAL ANTAGONISTS


HORMONES AND SYNTHETIC SUBSTITUTES

ADRENALS

ANDROGENS

ANTIDIABETIC AGENTS

ANTIHYPOGLYCEMIC AGENTS

CONTRACEPTIVES

ESTROGENS AND ESTROGEN AGONISTS-ANTAGONISTS

GONADOTROPINS

PARATHYROID

PITUITARY

PROGESTINS

SOMATROPIN AGONISTS-ANTAGONISTS

THYROID AND ANTITHYROID AGENTS

IMMUNOLOGICAL AGENTS

ANTIRHEUMATIC AGENTS

IMMUNE SUPPRESSANTS

LOCAL ANESTHETICS

LOCAL ANESTHETICS

MISCELLANEOUS THERAPEUTIC AGENTS


OXYTOCICS

PHARMACEUTICAL AIDS

PHARMACEUTICAL AIDS

RESPIRATORY TRACT AGENTS


ANTITUSSIVES

MUCOLYTIC AGENTS

PULMONARY SURFACTANTS

RESPIRATORY AGENTS MISCELLANEOUS

VASODILATING

SERUMS TOXOIDS AND VACCINES

SERUMS

TOXOIDS

VACCINES

SKIN AND MUCOUS MEMBRANE AGENTS

ANTI-INFECTIVES


ANTIPRURITICS AND LOCAL ANESTHETICS

ASTRINGENTS

CELL STIMULANTS AND PROLIFERANTS

DEPIGMENTING AND PIGMENTING AGENTS

KERATOLYTIC AGENTS

KERATOPLASTIC AGENTS

SKIN AND MUCOUS MEMBRANE AGENTS MISCELLANEOUS

SMOOTH MUSCLE RELAXANTS

GENITOURINARY SMOOTH MUSCLE RELAXANTS

RESPIRATORY SMOOTH MUSCLE RELAXANTS

VITAMINS

MULTIVITAMIN PREPARATIONS

VITAMIN A

VITAMIN B COMPLEX

VITAMIN C

VITAMIN D

VITAMIN K ACTIVITY

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

Y

Z

X


If you wish to have a non-formulary drug that your doctor determines not to be medically necessary you may file an appeal with Customer Service

Are there any restrictions on the drugs covered on the Formulary Some covered drugs may have additional requirements or limits on coverage such as Quantity Limits For certain drugs Kaiser Permanente may limit the amount of the drug dispensed to a certain daysrsquo supply For example when there is a national shortage of a drug we may limit the quantity of the drug dispensed

What is a brand-name drug Brand-name drugs are usually manufactured and sold by the drug company that originally researched and developed the drug When the patent on a brand-name drug expires other drug companies may manufacture and sell an FDA-approved generic version of the drug with the same active ingredient(s) at lower prices

What is a generic drug A generic drug is approved by the FDA as having the same active ingredient as the brand-name drug Generally generic drugs cost less than brand-name drugs

What is a specialty drug Specialty drugs are very high-cost drugs approved by the FDA that are on our formulary used to treat complex chronic conditions such as rheumatoid arthritis multiple sclerosis or cancer

What drugs are eligible to be mailed from the mail order pharmacy Most drugs can be mailed from our mail order pharmacy Some drugs (for example drugs that are extremely high cost or require special handling) may not be eligible for mailing Drugs cannot be mailed outside the United States

You can order refills through our mail-order service online at kporgrefill or by phone or mobile app There is no extra charge for mail order The appropriate cost share (according to your prescription drug benefit) will apply

Your prescription drug benefit may have a lower cost share if you use the mail order pharmacy

Please refer to your Summary Plan Description or other Plan documents for complete details of your prescription drug benefit
























































































































































































































































































2 MB


2 MB



































































































































































































































1









































































































































































































































1 MB



1 MB







1 MB
































1 MB


























2













































































































































































































































































































































































































































































































































































X 516 61























































phenylbutyrate] 65










[exenatide] 80







































































38









































































































































81













































































































































hcl] 27




































































































































































































hydrochloride] 52













































100000 87 200000 87









tipiracil] 21



















































































































































































unitgm- 101

































(ophth)] 73































[phenobarbital] 55




































































ethanolate] 6































































































































bicarbonate] 65

























































52


















dalfopristin] 12












































































42


























dimesylate] 48


































































































無歧視公告








711）
































ANTHELMINTICS

ANTI-HIV AGENTS

ANTIBACTERIALS

ANTIFUNGALS


ANTIMYCOBACTERIALS

ANTIPROTOZOALS

ANTIVIRALS


ANTIHISTAMINE DRUGS




AUTONOMIC DRUGS







BLOOD DERIVATIVES

BLOOD DERIVATIVES


ANTIANEMIA DRUGS







ANTILIPEMIC AGENTS



CARDIAC DRUGS

HYPOTENSIVE AGENTS


SCLEROSING AGENTS

VASODILATING AGENTS




ANTICONVULSANTS

ANTIMANIC AGENTS

ANTIMIGRAINE AGENTS




GENERAL ANESTHETICS


OPIATE ANTAGONISTS




DEVICES

DEVICES

DIAGNOSTIC AGENTS

DIAGNOSTIC AGENTS


ALKALINIZING AGENTS

AMMONIA DETOXICANTS

CALORIC AGENTS

DIURETICS

ION-REMOVING AGENTS



URICOSURIC AGENTS

ENZYMES

ENZYMES


ANTI-INFECTIVES


ANTIALLERGIC AGENTS

ANTIGLAUCOMA AGENTS


LOCAL ANESTHETICS

MYDRIATICS

VASOCONSTRICTORS




ANTIDIARRHEA AGENTS

ANTIEMETICS




DIGESTANTS

PROKINETIC AGENTS

GOLD COMPOUNDS

GOLD COMPOUNDS




ADRENALS

ANDROGENS

ANTIDIABETIC AGENTS


CONTRACEPTIVES


GONADOTROPINS

PARATHYROID

PITUITARY

PROGESTINS





IMMUNE SUPPRESSANTS

LOCAL ANESTHETICS

LOCAL ANESTHETICS



OXYTOCICS

PHARMACEUTICAL AIDS

PHARMACEUTICAL AIDS



ANTITUSSIVES

MUCOLYTIC AGENTS



VASODILATING


SERUMS

TOXOIDS

VACCINES


ANTI-INFECTIVES



ASTRINGENTS



KERATOLYTIC AGENTS






VITAMINS


VITAMIN A

VITAMIN B COMPLEX

VITAMIN C

VITAMIN D

VITAMIN K ACTIVITY

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

Y

Z

X
























































































































































































































































































2 MB


2 MB



































































































































































































































1









































































































































































































































1 MB



1 MB







1 MB
































1 MB


























2













































































































































































































































































































































































































































































































































































X 516 61























































phenylbutyrate] 65










[exenatide] 80







































































38









































































































































81













































































































































hcl] 27




































































































































































































hydrochloride] 52













































100000 87 200000 87









tipiracil] 21



















































































































































































unitgm- 101

































(ophth)] 73































[phenobarbital] 55




































































ethanolate] 6































































































































bicarbonate] 65

























































52


















dalfopristin] 12












































































42


























dimesylate] 48


































































































無歧視公告








711）
































ANTHELMINTICS

ANTI-HIV AGENTS

ANTIBACTERIALS

ANTIFUNGALS


ANTIMYCOBACTERIALS

ANTIPROTOZOALS

ANTIVIRALS


ANTIHISTAMINE DRUGS




AUTONOMIC DRUGS







BLOOD DERIVATIVES

BLOOD DERIVATIVES


ANTIANEMIA DRUGS







ANTILIPEMIC AGENTS



CARDIAC DRUGS

HYPOTENSIVE AGENTS


SCLEROSING AGENTS

VASODILATING AGENTS




ANTICONVULSANTS

ANTIMANIC AGENTS

ANTIMIGRAINE AGENTS




GENERAL ANESTHETICS


OPIATE ANTAGONISTS




DEVICES

DEVICES

DIAGNOSTIC AGENTS

DIAGNOSTIC AGENTS


ALKALINIZING AGENTS

AMMONIA DETOXICANTS

CALORIC AGENTS

DIURETICS

ION-REMOVING AGENTS



URICOSURIC AGENTS

ENZYMES

ENZYMES


ANTI-INFECTIVES


ANTIALLERGIC AGENTS

ANTIGLAUCOMA AGENTS


LOCAL ANESTHETICS

MYDRIATICS

VASOCONSTRICTORS




ANTIDIARRHEA AGENTS

ANTIEMETICS




DIGESTANTS

PROKINETIC AGENTS

GOLD COMPOUNDS

GOLD COMPOUNDS




ADRENALS

ANDROGENS

ANTIDIABETIC AGENTS


CONTRACEPTIVES


GONADOTROPINS

PARATHYROID

PITUITARY

PROGESTINS





IMMUNE SUPPRESSANTS

LOCAL ANESTHETICS

LOCAL ANESTHETICS



OXYTOCICS

PHARMACEUTICAL AIDS

PHARMACEUTICAL AIDS



ANTITUSSIVES

MUCOLYTIC AGENTS



VASODILATING


SERUMS

TOXOIDS

VACCINES


ANTI-INFECTIVES



ASTRINGENTS



KERATOLYTIC AGENTS






VITAMINS


VITAMIN A

VITAMIN B COMPLEX

VITAMIN C

VITAMIN D

VITAMIN K ACTIVITY

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

Y

Z

X

2021 california exclusive provider organization (epo

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