Formulary
Transcription
2015 Essential Health Benefits Formulary Reference Guide List of covered drugs INTRODUCTION Catamaran utilizes a Pharmacy and Therapeutics Committee (P & T Committee), made up of practicing physicians, pharmacists, and nurses to help ensure that our formulary is medically sound and that it supports patient health. This committee reviews and evaluates medications on the formulary based on safety and efficacy to help maintain clinical integrity in all therapeutic categories. FORMULARY DESIGN Catamaran has chosen a closed formulary structure for our standard Essential Health Benefits Formulary. The formulary structure features generics, preferred and non-preferred brand-name drugs, specialty drugs, and ACA (Affordable Care Act) preventive drugs. A closed formulary limits coverage to only those products listed in these levels. Products not listed on the formulary are generally not covered. Generic drugs: Most generic drugs are listed under “GENERIC”. Drugs listed under “GENERIC” have the same active ingredient as the brand-name versions but at a lower cost. Preferred drugs: Drugs listed under “PREFERRED” include preferred brand name drugs that will generally have lower co-payments than non-preferred brand name drugs. Non-preferred drugs: Drugs listed under “NON PREFERRED” generally have higher copayments than preferred brand name drugs. Specialty drugs: Drugs listed under ‘SPECIALTY” generally have the highest co-payment and cost. Specialty drugs are prescription medications that are sometimes used to treat complex and chronic conditions. They may require special monitoring or handling. ACA preventive drugs: Drugs listed under “PREVENTIVE” may have coverage and no co-payment when health care reform requirements are met for age, gender, and/or risk factors. REASONABLE MEDICAL MANAGEMENT Catamaran’s formulary also uses medical and utilization management functions to determine whether a prescription is medically necessary. These industry recognized and accepted management functions include but are not limited to quantity limits, step therapy, and prior authorization and help Catamaran and its clients determine whether the prescribed medication was prescribed in accordance with generally accepted medical practice standards, is clinically appropriate, and confirm that the prescribed medication is not more costly than an alternative product that is as likely to produce therapeutically equivalent results. As recommended by the United States Department of Labor, Catamaran’s reasonable medical and utilization management functions apply to ACA preventive drugs. USING THIS FORMULARY REFERENCE GUIDE TO HELP CONTAIN COSTS Many health plans use the Catamaran formulary to help manage the overall cost of providing prescription drug benefits. This formulary offers a wide range of medications from which to choose. We realize that this formulary reference guide may not include every drug from every manufacturer. However, choosing a generic or preferred drug when it is appropriate can provide access to the necessary medications to stay healthy, at a cost that is more affordable. SAVING ON OUT-OF-POCKET COSTS Your health plan sets the co-payments for each formulary drug status which include generic, preferred brand-name, non-preferred brand-name, and specialty medications. Co-payments and deductibles for preventive products follow health care reform rules. Health plans often design prescription drug plans to encourage the use of generic and preferred brand-name drugs. Choosing non-preferred drugs (or specialty drugs) may mean paying higher out-of-pocket expenses (such as coinsurance, co-payments, and deductible amounts) or not receiving coverage at all. Patients may also pay less for generic drugs. PLEASE NOTE: Brand-name drugs may become non-formulary if a generic version becomes available. CONSULTING THE PRESCRIBER’S OFFICE WHEN APPROPRIATE When employers and other benefit sponsors design their prescription drug plans, they may choose to provide coverage only for certain medications, time periods, doses, quantities, or for specific conditions (e.g. they may exclude coverage for medications for unapproved, unproven, or cosmetic indications). When coverage for medications is provided based on use or quantity, Catamaran may contact your prescriber’s office for additional information to determine whether coverage is available under your plan. Patients who are unsure whether these coverage rules apply for a particular medication can consult their prescription drug benefit manual or contact a Catamaran Member Services representative to determine specific coverage requirements. KNOWING HOW THE FORMULARY INFORMATION IS ORGANIZED The following formulary reference guide is designed in the following order: generics, generic preventive, preferred brand name, non-preferred brand name, brand name preventive, specialty drugs. In addition, immediately preceding the index is a section listing ACA preventive drugs by category. *Formulary Disclaimer: Coverage for some drugs may be limited to specific dosage forms and/or strengths. The benefit design determines what is covered and the applicable co-payment. The medications listed on this formulary are subject to change pursuant to the formulary management activities of catamaran. The presence of a medication on this formulary list does not guarantee coverage. To see the most up-to-date formulary, please visit your member website. You may also call Member Services at the number listed on your ID card to request a copy be mailed to you. 35756461v.2 Table of Contents ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 PENICILLINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 CEPHALOSPORIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 FIRST GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 SECOND GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 THIRD GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 FOURTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 FIFTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 MACROLIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 TETRACYCLINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 QUINOLONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 AMINOGLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 SULFONAMIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ANTIMYCOBACTERIAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ANTIFUNGALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ANTIVIRALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ANTIMALARIALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 AMEBICIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 ANTHELMINTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 MISC. ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 ANTINEOPLASTICS, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 ALKYLATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 ANTIBIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 ANTINEOPLASTIC ENZYMES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 ANTIMETABOLITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 ANGIOGENESIS INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 ANTIBODIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 HORMONAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 MITOTIC INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 ENZYME INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 TOPOISOMERASE I INHIBITOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 RADIOPHARMACEUTICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 CELLULAR IMMUNOTHERAPY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 ANTINEOPLASTICS MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 CHEMOTHERAPY RESCUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 CHEMOTHERAPY ADJUNCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 ANTINEOPLASTIC COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 CARDIOVASCULAR DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 PHOSPHODIESTERASE INHBTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 CARDIAC GLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 ANTIANGINAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 BETA BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 CALCIUM CHANNEL BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 ANTIARRHYTHMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 ACE INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 ANGIOTENSIN RCPTR BLOCKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 DIRECT RENIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 ANTIHYPERTENSIVES MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 ANTIHYPERTENSIVE COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 DIURETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 VASOPRESSORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 ANTIHYPERLIPIDEMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 CARDIOVASCULAR - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 DERMATOLOGICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ACNE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ROSACEA AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ANTIBIOTICS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ANTIFUNGALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ANTIVIRALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ANTI-INFLAMMATORY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ANTIPRURITICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ANTIPSORIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ANTISEBORRHEIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 CORTICOSTEROIDS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 IMMUNOMODULATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 DERMATOLOGICALS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 ENDOCRINE AND METABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 CORTICOSTEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ANDROGENS-ANABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ESTROGENS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 CONTRACEPTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 PROGESTINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 ANTIDIABETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 INSULIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 AMYLIN ANALOGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 INCRETIN MIMETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 SULFONYLUREAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 BIGUANIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 MEGLITINIDE ANALOGUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 DIABETIC OTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 ALPHA-GLUCOSIDASE INHIBIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 DPP-4 INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 INSULIN SENSITIZING AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 ANTIDIABETIC COMBINATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 BISPHOSPHONATES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 CALCITONINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 PARATHYROID HORMONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 RANK LIGAND INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 CALCIUM REGULATORS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 HORMONE RECEPTOR MDLTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 LHRH/GNRH AGONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 GNRH/LHRH ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 GROWTH HORMONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 GHRH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 SOMATOMEDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SOMATOSTATIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 14 GH RECEPTOR ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 POSTERIOR PITUITARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 CORTICOTROPIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 PROLACTIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 VASOPRESSIN ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 METABOLIC MODIFIERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 THYROID AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GASTROINTESTINAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 15 LAXATIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 ANTIDIARRHEALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 ANTACIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 ULCER DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 ANTIEMETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 DIGESTIVE AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 GASTROINTESTINAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 GENITOURINARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 URINARY ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 URINARY ANTISPASMODICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 VAGINAL PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 GENITOURINARY - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 HEMATOLOGICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 HEMATOPOIETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 ANTICOAGULANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 HEMOSTATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 HEMATOLOGICAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 MOUTH/THROAT/DENTAL AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 NEUROLOGY, CNS, PSYCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 ANTIANXIETY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 ANTIDEPRESSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 ANTIPSYCHOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 HYPNOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 ADHD, NARCOLEPSY, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 ANTICONVULSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 ANTIPARKINSON AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 NEUROLOGY, PSYCH - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 NEUROMUSCULAR AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 MUSCULOSKELETAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 ANTIMYASTHENIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 OPHTHALMOLOGY AND OTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 ARTIFICIAL TEAR/LUBRICANT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 BETA-BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 OPHTHALMIC STEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 PROSTAGLANDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 CYCLOPLEGIC MYDRIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 DECONGESTANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 MIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 ADRENERGIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 LOCAL ANESTHETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 OPHTHALMICS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 OTIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 OXYTOCICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 PAIN MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 ANALGESICS - NONNARCOTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 ANALGESICS - OPIOID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 ANTI-INFLAMMATORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 MIGRAINE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 GOUT AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 LOCAL ANESTHETICS-INJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 GENERAL ANESTHETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 RESPIRATORY, ALLERGY, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 ANTIHISTAMINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 NASAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 COUGH/COLD/ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 ANTIASTHMATIC/COPD AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 RESPIRATORY AGENTS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 TOXOIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 VACCINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 MULTIVITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 MEDICAL DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 DIABETIC SUPPLIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 MEDICAL DEVICES - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 MISCELLANEOUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 ACA PREVENTIVE DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 ASPIRIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 CONTRACEPTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 FLUORIDE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 FOLIC ACID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 IMMUNIZATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 IRON . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 SMOKING CESSATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 VITAMIN D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 BOWEL PREPARATION AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 BREAST CANCER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Zinacef Zinacef IN Iso-osmotic Diluent THIRD GENERATION GENERIC cefdinir cefotaxime sodium cefpodoxime proxetil ceftazidime ceftriaxone sodium tazicef tazidime Cefditoren Pivoxil Ceftazidime Ceftazidime/Dextrose Ceftriaxone IN Iso-osmotic Dextrose Ceftriaxone/Dextrose NON PREFERRED Cedax Ceftibuten Claforan Suprax April 2015 ANTI-INFECTIVES PENICILLINS GENERIC amoxicillin amoxicillin/clavulanate potassium amoxicillin/clavulanate potassium ER ampicillin ampicillin sodium ampicillin-sulbactam dicloxacillin sodium nafcillin sodium oxacillin sodium penicillin v potassium penicillin G potassium piperacillin sodium/ tazobactam sodium piperacillin sodium/tazobactam sodium piperacillin/tazobactam Amoxicillin Ampicillin Ampicillin Sodium Ampicillin-sulbactam Nafcillin Sodium Penicillin G Potassium IN Iso-osmotic Dextrose Penicillin G Procaine Penicillin G Sodium Pfizerpen-G PREFERRED Augmentin NON PREFERRED Amoxicillin ER Bactocill IN Dextrose Bicillin C-R Bicillin L-a Moxatag Timentin CEPHALOSPORIN FIRST GENERATION GENERIC cefadroxil cefazolin sodium cephalexin Cefazolin Sodium Cefazolin Sodium/Dextrose Cephalexin SECOND GENERATION GENERIC cefaclor cefoxitin sodium cefprozil cefuroxime axetil cefuroxime sodium Cefaclor Cefaclor ER Cefotetan Cefotetan/Dextrose Cefoxitin Sodium Cefuroxime Sodium Cefuroxime/Dextrose NON PREFERRED Ceftin Mefoxin FOURTH GENERATION GENERIC cefepime Cefepime NON PREFERRED Maxipime FIFTH GENERATION NON PREFERRED Teflaro MACROLIDES GENERIC azithromycin clarithromycin clarithromycin ER erythromycin Azithromycin E.e.s. 400 Erythromycin Base Erythromycin Ethylsuccinate NON PREFERRED QL Dificid Ery-TAB Erythrocin Lactobionate PCE Zithromax TETRACYCLINES GENERIC avidoxy demeclocycline HCL doxy 100 doxycycline doxycycline hyclate doxycycline hyclate DR doxycycline monohydrate minocycline HCL minocycline HCL ER morgidox 1X100MG morgidox 2X100MG Minocin Tetracycline HCL NON PREFERRED Alodox Convenience Kit Ocudox Solodyn Effective April 1, 2015 v.1 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; ©Catamaran 2015. All Rights Reserved. May not be copied or distributed without authorization. 1 griseofulvin ultramicrosize PA itraconazole ketoconazole nystatin QL terbinafine HCL voriconazole Amphotericin B Fluconazole IN NACL PREFERRED Cancidas Lamisil Mycamine Noxafil PA Sporanox NON PREFERRED Abelcet Ambisome Amphotec Eraxis Terbinex QUINOLONES GENERIC ciprofloxacin ciprofloxacin ER ciprofloxacin HCL ciprofloxacin I.V.-IN D5W levofloxacin levofloxacin IN D5W moxifloxacin HCL ofloxacin Ciprofloxacin HCL Ofloxacin PREFERRED Avelox NON PREFERRED Factive Noroxin AMINOGLYCOSIDES GENERIC amikacin sulfate gentamicin sulfate gentamicin sulfate pediatric gentamicin sulfate/sodium chloride gentamicin sulfate/0.9% sodium chloride isotonic gentamicin neomycin sulfate paromomycin sulfate tobramycin sulfate Gentamicin Sulfate/0.9% Sodium Chloride Isotonic Gentamicin Streptomycin Sulfate Tobramycin Sulfate/Sodium Chloride SPECIALTY PA tobramycin QL Tobi Podhaler SULFONAMIDES GENERIC Sulfadiazine ANTIMYCOBACTERIAL AGENTS GENERIC ethambutol HCL isoniazid pyrazinamide rifabutin rifampin Isoniazid PREFERRED Priftin Seromycin Sirturo NON PREFERRED Capastat Sulfate Cycloserine Paser Rifamate Rifater Trecator ANTIFUNGALS GENERIC bio-statin fluconazole fluconazole IN dextrose fluconazole IN NACL flucytosine griseofulvin microsize ANTIVIRALS GENERIC abacavir QL abacavir sulfate/lamivudine/zidovudine acyclovir acyclovir sodium cidofovir didanosine QL famciclovir ganciclovir lamivudine lamivudine/zidovudine nevirapine nevirapine ER rimantadine HCL stavudine QL valacyclovir HCL zidovudine Acyclovir Sodium Foscarnet Sodium PREFERRED Aptivus QL Atripla QL Complera Crixivan Edurant Emtriva Epivir HBV Epzicom QL,PA Fuzeon Intelence Invirase Isentress Kaletra Lexiva Nevirapine Norvir Prezista QL Relenza Diskhaler Rescriptor Retrovir IV Infusion Reyataz PA Selzentry QL Stribild Sustiva QL Tamiflu PA Truvada Videx Pediatric Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 2 Viracept Viramune Viramune XR Viread Ziagen SPECIALTY QL,PA adefovir dipivoxil QL,PA entecavir moderiba ribasphere ribavirin valganciclovir QL,PA Baraclude PA Harvoni Infergen Moderiba Moderiba 1200 Dose Pack Moderiba 800 Dose Pack PA Olysio PA Peg-intron PA Peg-intron Redipen PA Peg-intron Redipen PAK 4 PA Pegasys PA Pegasys Proclick PA Pegintron Rebetol Ribasphere Ribasphere Ribapak Ribatab PA Sovaldi Tivicay QL,PA Tyzeka Valcyte PA Victrelis Virazole ANTIMALARIALS GENERIC atovaquone/proguanil HCL chloroquine phosphate hydroxychloroquine sulfate mefloquine HCL PA quinine sulfate Primaquine Phosphate PA Qualaquin PREFERRED Coartem Daraprim AMEBICIDES NON PREFERRED Yodoxin ANTHELMINTICS GENERIC ivermectin PREFERRED Albenza NON PREFERRED Biltricide MISC. ANTI-INFECTIVES GENERIC atovaquone aztreonam baciim bacitracin clindamycin palmitate HCL clindamycin phosphate clindamycin phosphate add-vantage clindamycin phosphate pharmacy bulk package clindamycin phosphate IN D5W clindamycin HCL colistimethate sodium e.s.p. imipenem/cilastatin linezolid meropenem metronidazole metronidazole IN NACL 0.79% polymyxin b sulfate sulfamethoxazole/trimethoprim sulfamethoxazole/trimethoprim DS sulfatrim pediatric tinidazole trimethoprim vancomycin HCL Bacitracin Chloramphenicol Sodium Succinate Clindamycin Phosphate Dapsone Sulfamethoxazole/Trimethoprim Vancomycin HCL Vancomycin HCL IN Dextrose PREFERRED Alinia Nebupent QL Sivextro Tygacil PA Xifaxan QL Zyvox NON PREFERRED Azactam IN Iso-osmotic Dextrose Cubicin Doribax Flagyl ER Invanz Ketek Lincocin Primsol Vibativ SPECIALTY PA Cayston ANTINEOPLASTICS, ETC ALKYLATING AGENTS GENERIC Lomustine PREFERRED Alkeran Gleostine Leukeran SPECIALTY carboplatin cisplatin cyclophosphamide ifosfamide melphalan hydrochloride oxaliplatin PA temozolomide Bicnu Busulfex Carboplatin Cisplatin Cyclophosphamide Eloxatin Gliadel Wafer Hexalen Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 3 Ifex Ifosfamide Mustargen PA Myleran Temodar Treanda PA Valchlor Zanosar ANTIBIOTICS GENERIC bleomycin sulfate SPECIALTY adriamycin daunorubicin HCL doxorubicin HCL doxorubicin HCL liposome epirubicin HCL idarubicin HCL lipodox lipodox 50 mitomycin PA mitoxantrone HCL Adriamycin Daunoxome Epirubicin HCL Valstar ANTINEOPLASTIC ENZYMES SPECIALTY Elspar PA Erwinaze Oncaspar ANTIMETABOLITES GENERIC adrucil fluorouracil methotrexate methotrexate sodium PREFERRED Trexall SPECIALTY PA azacitidine PA capecitabine cladribine cytarabine cytarabine aqueous PA decitabine floxuridine fludarabine phosphate gemcitabine HCL mercaptopurine Alimta Arranon Clolar Cytarabine Depocyt Folotyn Gemcitabine Tabloid ANGIOGENESIS INHIBITORS SPECIALTY Avastin PA Zaltrap ANTIBODIES PREFERRED Bexxar SPECIALTY PA Adcetris PA Arzerra Erbitux PA Gazyva PA Herceptin PA Kadcyla PA Perjeta PA Rituxan Vectibix PA Yervoy Zevalin Y-90 HORMONAL AGENTS GENERIC anastrozole bicalutamide exemestane flutamide letrozole megestrol acetate PREVENTIVE tamoxifen citrate PREFERRED Depo-provera Emcyt Fareston Nilandron Soltamox SPECIALTY PA leuprolide acetate QL,PA Eligard Faslodex QL,PA Firmagon QL,PA Lupron Depot Lysodren QL,PA Trelstar Depot QL,PA Trelstar Depot Mixject QL,PA Trelstar LA QL,PA Trelstar LA Mixject QL,PA Trelstar Mixject QL,PA Vantas PA Xtandi QL,PA Zoladex PA Zytiga IMMUNOMODULATORS GENERIC azathioprine cyclosporine cyclosporine modified gengraf hecoria mycophenolate mofetil mycophenolic acid DR sirolimus tacrolimus Cyclosporine Modified PREFERRED Azasan Rapamune Sandimmune NON PREFERRED Atgam Cellcept Intravenous PA Nulojix Prograf Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 4 Simulect Thymoglobulin PA Zortress SPECIALTY PA Pomalyst PA Revlimid PA Thalomid MITOTIC INHIBITORS GENERIC Docetaxel PREFERRED Teniposide SPECIALTY docetaxel etoposide paclitaxel toposar vincasar PFS vincristine sulfate vinorelbine tartrate Abraxane Docefrez Etopophos Etoposide PA Halaven Ixempra Kit PA Jevtana Marqibo Paclitaxel Vinblastine Sulfate ENZYME INHIBITORS SPECIALTY PA Afinitor PA Afinitor Disperz PA Bosulif QL,PA Caprelsa PA Cometriq PA Gilotrif PA Gleevec PA Iclusig PA Imbruvica PA Inlyta PA Istodax PA Jakafi PA Kyprolis PA Mekinist PA Nexavar PA Sprycel PA Stivarga PA Sutent PA Tafinlar PA Tarceva PA Tasigna Torisel PA Tykerb PA Velcade PA Votrient PA Xalkori PA Zelboraf PA Zolinza PA Zydelig TOPOISOMERASE I INHIBITOR SPECIALTY irinotecan topotecan HCL Camptosar Hycamtin Irinotecan Topotecan HCL RADIOPHARMACEUTICALS PREFERRED Bexxar 131 Iodine Metastron Quadramet SPECIALTY Xofigo CELLULAR IMMUNOTHERAPY PREFERRED PA Provenge ANTINEOPLASTICS MISC. GENERIC hydroxyurea PREFERRED Photofrin Uvadex SPECIALTY dacarbazine tretinoin Actimmune Alferon N Dacarbazine PA Erivedge PA Intron A PA Intron-a PA Intron-a W/Diluent Matulane Nipent Proleukin PA Sylatron PA Synribo PA Targretin Theracys Tice Bcg Trisenox CHEMOTHERAPY RESCUE GENERIC leucovorin calcium Calcium Folinate Leucovorin Calcium PREFERRED Fusilev SPECIALTY amifostine dexrazoxane mesna Mesnex Totect Voraxaze CHEMOTHERAPY ADJUNCTS SPECIALTY Elitek Kepivance ANTINEOPLASTIC COMBO SPECIALTY Ifosfamide/Mesna CARDIOVASCULAR DRUGS PHOSPHODIESTERASE INHBTR Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 5 GENERIC milrinone lactate milrinone IN dextrose CARDIAC GLYCOSIDES GENERIC digitek digox digoxin Digoxin ANTIANGINAL AGENTS GENERIC isoditrate ER isosorbide dinitrate isosorbide dinitrate ER isosorbide mononitrate isosorbide mononitrate ER minitran nitro-time nitroglycerin nitroglycerin lingual nitroglycerin transdermal nitroglycerin ER nitroglycerin IN dextrose 5% nitroglycerin IN 5% dextrose Isosorbide Dinitrate Nitroglycerin Nitroglycerin IN Dextrose 5% PREFERRED Dilatrate SR Nitro-bid Nitrostat PA Ranexa NON PREFERRED Nitro-dur Nitroglycerin Lingual Nitromist BETA BLOCKERS GENERIC acebutolol HCL atenolol betaxolol HCL bisoprolol fumarate carvedilol esmolol HCL labetalol HCL metoprolol succinate ER metoprolol tartrate nadolol pindolol propranolol HCL propranolol HCL ER sorine sotalol HCL sotalol HCL (AF) Propranolol HCL Timolol Maleate PREFERRED Bystolic Coreg CR NON PREFERRED Inderal XL Innopran XL Levatol CALCIUM CHANNEL BLOCKERS GENERIC afeditab CR amlodipine besylate cartia XT dilt-CD dilt-XR diltiazem CD diltiazem HCL diltiazem HCL CD diltiazem HCL ER diltzac felodipine ER matzim LA nicardipine HCL nifediac CC nifedical XL nifedipine nifedipine ER nimodipine nisoldipine taztia XT verapamil HCL verapamil HCL ER verapamil HCL SR Diltiazem HCL Isradipine Nisoldipine Nisoldipine ER Verapamil HCL NON PREFERRED Cardene IV Cardizem LA ANTIARRHYTHMICS GENERIC adenosine amiodarone HCL disopyramide phosphate flecainide acetate ibutilide fumarate lidocaine HCL lidocaine HCL IN D5W lidocaine HCL/dextrose mexiletine HCL pacerone propafenone HCL propafenone HCL ER quinidine gluconate CR quinidine gluconate ER quinidine sulfate Amiodarone HCL Lidocaine HCL Procainamide HCL Quinidine Gluconate Quinidine Sulfate Quinidine Sulfate ER PREFERRED Tikosyn NON PREFERRED Multaq Nexterone Norpace CR ACE INHIBITORS GENERIC benazepril HCL captopril enalapril maleate Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 6 enalaprilat fosinopril sodium lisinopril moexipril HCL perindopril erbumine quinapril HCL ramipril trandolapril Methyldopa/Hydrochlorothiazide Propranolol/Hydrochlorothiazide PREFERRED Amturnide Azor Benicar HCT Tarka Tekamlo Tekturna HCT Tribenzor NON PREFERRED PA,ST Edarbyclor PA,ST Teveten HCT ANGIOTENSIN RCPTR BLOCKER GENERIC PA,ST candesartan cilexetil eprosartan mesylate irbesartan losartan potassium telmisartan valsartan PREFERRED Benicar NON PREFERRED PA,ST Edarbi DIRECT RENIN INHIBITORS PREFERRED Tekturna ANTIHYPERTENSIVES MISC. GENERIC clonidine HCL doxazosin mesylate eplerenone fenoldopam mesylate guanfacine HCL hydralazine HCL methyldopa minoxidil prazosin HCL terazosin HCL Methyldopate HCL Phentolamine Mesylate Reserpine PREFERRED Demser Dibenzyline ANTIHYPERTENSIVE COMBO GENERIC amlodipine besylate/benazepril hydrochloride amlodipine besylate/benazepril HCL amlodipine besylate/valsartan amlodipine/valsartan/hctz atenolol/chlorthalidone benazepril HCL/hydrochlorothiazide bisoprolol fumarate/hydrochlorothiazide candesartan cilexetil/hydrochlorothiazide enalapril maleate/hydrochlorothiazide fosinopril sodium/hydrochlorothiazide irbesartan/hydrochlorothiazide lisinopril/hydrochlorothiazide losartan potassium/hydrochlorothiazide metoprolol/hydrochlorothiazide moexipril/hydrochlorothiazide nadolol/bendroflumethiazide quinapril/hydrochlorothiazide telmisartan/amlodipine telmisartan/hydrochloroth telmisartan/hydrochlorothiazide valsartan/hydrochlorothiazide Captopril/Hydrochlorothiazide DIURETICS GENERIC acetazolamide acetazolamide sodium acetazolamide ER amiloride HCL amiloride/hydrochlorothiazide bumetanide chlorothiazide chlorothiazide sodium furosemide hydrochlorothiazide indapamide mannitol methazolamide metolazone osmitrol viaflex spironolactone spironolactone/hydrochlorothiazide torsemide triamterene/hydrochlorothiazide Acetazolamide Chlorothiazide Chlorthalidone Furosemide Methyclothiazide Torsemide Triamterene/Hydrochlorothiazide NON PREFERRED Dyrenium Edecrin Sodium Edecrin VASOPRESSORS GENERIC dobutamine HCL dobutamine HCL/D5W dobutamine/dextrose 5% dopamine HCL dopamine HCL-dextrose 5% dopamine HCL/dextrose 5% dopamine/D5W ephedrine sulfate midodrine HCL norepinephrine bitartrate phenylephrine HCL Dobutamine/Dextrose 5% Dopamine HCL Epinephrine Levophed Phenylephrine HCL PREFERRED Auvi-q Epipen 2-PAK Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 7 Epipen-JR 2-PAK ANTIHYPERLIPIDEMICS GENERIC atorvastatin calcium cholestyramine cholestyramine light colestipol HCL colestipol HCL for oral suspension fenofibrate fenofibrate micronized fenofibric acid DR fluvastatin gemfibrozil lovastatin micronized colestipol HCL niacin ER omega-3-acid ethyl esters pravastatin sodium prevalite simvastatin Fenofibric Acid Niacor PREFERRED Crestor Fenofibrate Lipofen Liptruzet Simcor Vascepa Vytorin Welchol Zetia NON PREFERRED Altoprev Fenoglide Fibricor Livalo Triglide SPECIALTY QL,PA Juxtapid QL,PA Kynamro CARDIOVASCULAR - MISC. GENERIC amlodipine besylate/atorvastatin calcium cardioplegic isoxsuprine HCL papaverine HCL Isoxsuprine HCL PREFERRED QL Caverject QL Caverject Impulse QL Cialis QL Muse QL Viagra NON PREFERRED Bidil SPECIALTY epoprostenol sodium QL,PA sildenafil QL,PA sildenafil citrate QL,PA Adcirca QL,PA Adempas QL,PA Letairis QL,PA Opsumit PA Remodulin QL,PA Revatio QL,PA Tracleer QL,PA Tyvaso QL,PA Tyvaso Refill QL,PA Tyvaso Starter PA Veletri QL,PA Ventavis DERMATOLOGICALS ACNE PRODUCTS GENERIC PA adapalene amnesteem avar cleanser avar-e emollient avar-e green PA avita benzepro benzepro SHORT contact benziq wash benzoyl peroxide benzoyl peroxide wash acne treatment pack benzoyl peroxide SHORT contact bp cleansing wash bp foam bp foaming wash bp wash bp 10-1 cerisa wash claravis claris clarifying wash clearplex x clindacin etz pledgets clindacin-p clindamax clindamycin phosphate clindamycin/benzoyl peroxide ery erythromycin erythromycin/benzoyl peroxide lavoclen-4 acne wash kit lavoclen-8 acne wash kit myorisan neuac oscion cleanser pr benzoyl peroxide wash prascion prascion fc prascion ra with sunscreens rosanil cleanser se bpo wash se 10-5 ss sodium sulfacetamide sodium sulfacetamide/sulfur sodium sulfacetamide/sulfur cleanser sodium sulfacetamide/sulfur cleansing cloths sodium sulfacetamide/sulfur green sodium sulfacetamide/sulfur w/sunscreen sodium sulfacetamide/sulfur wash ss 10-2 sss 10-5 sss 10%-5% sulfacetamide sodium sulfacetamide sodium/sulfur cleanser sulfacleanse 8/4 PA tretinoin PA tretinoin microsphere PA tretinoin microsphere P.M. virti-sulf zenatane zencia Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 8 Bpo Bpo 3% Foaming Cloths Bpo 6% Foaming Cloths Bpo 9% Foaming Cloths Claravis Lavoclen-4 Creamy Wash Lavoclen-8 Creamy Wash Sodium Sulfacetamide/Sulfur Sodium Sulfacetamide/Sulfur Cleanser IN Urea Sodium Sulfacetamide/Sulfur IN Urea Zaclir Cleansing PREFERRED Acanya PA Atralin PA Differin PA Epiduo PA Ziana NON PREFERRED Absorica Azelex PA Tretin-x PA Veltin ROSACEA AGENTS GENERIC metronidazole rosadan Doxycycline PREFERRED Finacea Oracea ANTIBIOTICS - TOPICAL GENERIC mupirocin mupirocin calcium Centany Gentamicin Sulfate NON PREFERRED Altabax Cortisporin ANTIFUNGALS - TOPICAL GENERIC ciclodan ciclopirox ciclopirox nail lacquer ciclopirox olamine PA ciclopirox treatment clotrimazole clotrimazole/betamethasone dipropionate dermazene econazole nitrate exoderm hydrocortisone/iodoquinol ketoconazole ketodan nyamyc nystatin nystatin/triamcinolone nystop pedi-dri versiclear Ciclopirox Topical Solution Kit NON PREFERRED PA Cnl8 Nail Kit Ertaczo Exelderm Mentax Naftin Oxistat PA Pedipirox-4 Nail Xolegel ANTIVIRALS - TOPICAL GENERIC acyclovir PREFERRED Denavir Zovirax ANTI-INFLAMMATORY AGENTS GENERIC QL,PA diclofenac sodium PREFERRED QL Voltaren NON PREFERRED QL,PA Flector ANTIPRURITICS NON PREFERRED Prudoxin Zonalon ANTIPSORIATICS GENERIC acitretin calcipotriene calcitrene methoxsalen Calcitriol Dritho-creme HP PREFERRED QL,PA Tazorac 8-mop NON PREFERRED Vectical SPECIALTY PA Stelara ANTISEBORRHEIC AGENTS GENERIC seb-prev wash selenium sulfide sodium sulfacetamide sodium sulfacetamide wash Glycolic Acid Glycolic Acid 70% High Purity Seb-prev Selenium Sulfide Sodium Sulfacetamide/Urea NON PREFERRED Ovace Plus CORTICOSTEROIDS - TOPICAL GENERIC ala cort alclometasone dipropionate alphatrex apexicon augmented betamethasone dipropionate betamethasone dipropionate betamethasone valerate QL,PA calcipotriene/betamethasone dipropionate clobetasol propionate clobetasol propionate e clobetasol propionate emollient Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 9 clodan cormax scalp application desonide desoximetasone diflorasone diacetate fluocinolone acetonide fluocinolone acetonide body fluocinolone acetonide scalp fluocinonide fluocinonide-e fluticasone propionate halac halobetasol propionate halonate PAC hydrocortisone hydrocortisone acetate/aloe hydrocortisone acetate/pramoxine hydrocortisone butyrate hydrocortisone butyrate (lipid) hydrocortisone butyrate (lipophilic) hydrocortisone valerate hydrocortisone IN absorbase lokara mometasone furoate prednicarbate scalacort triamcinolone acetonide triderm Amcinonide Apexicon E Desoximetasone Diflorasone Diacetate Synalar Triamcinolone Acetonide Trianex U-cort PREFERRED Pramosone Pramosone E QL,PA Taclonex Tucks Anti-itch NON PREFERRED Capex Clocortolone Pivalate Clocortolone Pivalate P.M. Cloderm Cloderm P.M. Cordran Cordran Tape Dermasorb Ta Desonate Desowen Cream/Cetaphil Lotion Desowen Lotion/Cetaphil Cream Desowen Ointment/Cetaphil Lotion Halog Kenalog Locoid Pediaderm HC Pediaderm Ta Texacort Ultravate PAC Verdeso IMMUNOMODULATING AGENTS GENERIC imiquimod tacrolimus PREFERRED Elidel NON PREFERRED Zyclara Zyclara P.M. DERMATOLOGICALS - MISC. GENERIC acticin alphaquin HP ammonium lactate cerovel diclofenac sodium episone CRE finasteride fluorouracil glydo grafco silver nitrate applicator hydroquinone hydroquinone time release hygel hypercare laclotion lactic acid lactic acid e lactic acid w/vitamin e latrix lidocaine lidocaine HCL lidocaine HCL jelly lidocaine/prilocaine lidopin lindane mafenide acetate malathion melpaque HP melquin HP nuquin HP permethrin podofilox pramox gel rea LO 39 rea LO 40 remergent HQ remeven salacyn salicylic acid salicylic acid cream salicylic acid lotion salicylic acid wart remover silver sulfadiazine skin bleaching skin bleaching/sunscreen sodium hyaluronate ssd thermazene tropazone u-kera e umecta mousse urea urea hydrating urea nail urea topical urea IN zinc undecylenate/lactic acid vehicle urea 40% nail film urea-c40 x-viate Arzol Silver Nitrate App Licators Cem-urea Coal TAR CARB-o-philic 40 Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 10 CARB-o-philic/40 Salvax Silver Nitrate TL hydroquinone PREFERRED Carac Condylox Fluorouracil Oxsoralen PA Regranex Sulfamylon NON PREFERRED Avage Eurax Fluoroplex Natroba Panretin Picato Refissa Renova Renova P.M. Sklice Spinosad Synera PA Targretin Tretinoin Emollient Ulesfia Veregen SPECIALTY PA Valchlor ENDOCRINE AND METABOLIC CORTICOSTEROIDS GENERIC a-methapred baycadron betamethasone sodium phosphate/betamethasone acetate budesonide dexamethasone dexamethasone sodium phosphate fludrocortisone acetate hydrocortisone methylprednisolone methylprednisolone acetate methylprednisolone dose pack methylprednisolone sodiumsuccinate prednisolone prednisolone sodium phosphate prednisolone sodium phosphate odt prednisone A-hydrocort Cortisone Acetate Dexamethasone Dexamethasone Sodium Phosphate Prednisolone Sodium Phosphate Prednisone PREFERRED Uceris NON PREFERRED Depo-medrol Dexamethasone Intensol Dexpak 10 Day Dexpak 13 Day Dexpak 6 Day Millipred Millipred DP Orapred Odt Prednisone Intensol Rayos Solu-cortef Veripred 20 ANDROGENS-ANABOLIC GENERIC danazol QL,PA oxandrolone PA testosterone cypionate PA testosterone enanthate PA,ST Testosterone PA,ST Testosterone P.M. PREFERRED Androgel Androgel P.M. Androxy Axiron Methitest NON PREFERRED PA Anadrol-50 PA,ST Androderm PA,ST Striant Testim PA,ST Vogelxo PA,ST Vogelxo P.M. ESTROGENS GENERIC covaryx covaryx HS eemt eemt HS esterified estrogens/methltestosterone esterified estrogens/methyltestosterone esterified estrogens/methyltestosterone DS esterified estrogens/methyltestosterone HS estradiol estradiol valerate estradiol/norethindrone acetate estropipate lopreeza mimvey mimvey LO ortho-est Estropipate Jinteli PREFERRED Cenestin Combipatch Enjuvia Evamist Minivelle Premarin Premphase Prempro NON PREFERRED Alora Estrogel Menest CONTRACEPTIVES GENERIC Amethyst Necon 1/50-28 Necon 10/11-28 Zovia 1/50e PREVENTIVE altavera alyacen 1/35 Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 11 alyacen 7/7/7 QL amethia QL amethia LO apri aranelle aubra aviane azurette balziva briellyn camila QL camrese QL camrese LO caziant cesia chateal cryselle-28 cyclafem 1/35 cyclafem 7/7/7 dasetta 1/35 dasetta 7/7/7 QL daysee deblitane delyla desogestrel/ethinyl estradiol drospirenone/ethinyl estradiol elinest emoquette enpresse-28 enskyce errin estarylla falmina gianvi gildagia gildess FE 1.5/30 gildess FE 1/20 gildess 1.5/30 gildess 1/20 gildess 24 FE heather QL introvale jencycla QL jolessa jolivette junel FE 1.5/30 junel FE 1/20 junel 1.5/30 junel 1/20 kariva kelnor 1/35 kurvelo larin FE 1.5/30 larin FE 1/20 larin 1.5/30 larin 1/20 leena lessina levonest levonorgestrel QL levonorgestrel and ethinyl estradiol levonorgestrel/ethinyl estradiol levora 0.15/30-28 lomedia 24 FE loryna low-ogestrel lutera lyza marlissa QL medroxyprogesterone acetate microgestin FE microgestin FE 1.5/30 microgestin 1.5/30 microgestin 1/20 mono-linyah mononessa my way myzilra necon 0.5/35-28 necon 1/35 necon 7/7/7 next choice one dose nikki nora-be norethindrone norethindrone acetate/ethinyl estradiol norethindrone acetate/ethinyl estradiol/ferrous fumarate norgestimate/ethinyl estradiol norlyroc nortrel 0.5/35 (28) nortrel 1/35 nortrel 7/7/7 ocella orsythia philith pimtrea pirmella 1/35 pirmella 7/7/7 portia-28 previfem QL quasense reclipsen sharobel solia sprintec 28 sronyx syeda tarina FE 1/20 tilia FE tri-estarylla tri-legest FE tri-linyah tri-previfem tri-sprintec trinessa trivora-28 velivet vestura viorele vyfemla wera wymzya FE xulane zarah zenchent zenchent FE zovia 1/35e Ogestrel PREFERRED Beyaz LO Loestrin FE Minastrin 24 FE Safyral PREVENTIVE Natazia QL Nuvaring NON PREFERRED QL Depo-subq Provera 104 Ella Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 12 PREVENTIVE Implanon Mirena Nexplanon Paragard Intrauterine Copper Contraceptive T380a Skyla PROGESTINS GENERIC medroxyprogesterone acetate norethindrone acetate progesterone SPECIALTY PA Makena ANTIDIABETIC AGENTS INSULIN PREFERRED Lantus Lantus Solostar Novolin N Novolin N Relion Novolin R Novolin R Relion Novolin 70/30 Novolin 70/30 Relion Novolog Novolog Flexpen Novolog Mix 70/30 Novolog Mix 70/30 Prefilled Flexpen Novolog Penfill NON PREFERRED PA,ST Apidra PA,ST Apidra Solostar PA,ST Humalog PA,ST Humalog Kwikpen PA,ST Humalog Mix 50/50 PA,ST Humalog Mix 50/50 Kwikpen PA,ST Humalog Mix 75/25 PA,ST Humalog Mix 75/25 Kwikpen PA,ST Humulin N PA,ST Humulin N Kwikpen PA,ST Humulin N U-100 Pen PA,ST Humulin R PA,ST Humulin R U-500 (concentrated) PA,ST Humulin 70/30 PA,ST Humulin 70/30 Kwikpen PA,ST Humulin 70/30 Pen PA,ST Levemir PA,ST Levemir Flexpen PA,ST Levemir Flextouch AMYLIN ANALOGS PREFERRED PA Symlinpen 120 PA Symlinpen 60 INCRETIN MIMETIC AGENTS PREFERRED Bydureon Byetta Victoza SULFONYLUREAS GENERIC glimepiride glipizide glipizide ER glipizide XL glyburide glyburide micronized tolazamide Chlorpropamide Glyburide Tolazamide Tolbutamide NON PREFERRED Diabeta BIGUANIDES GENERIC metformin HCL metformin HCL ER PREFERRED Riomet NON PREFERRED Glumetza MEGLITINIDE ANALOGUES GENERIC nateglinide repaglinide DIABETIC OTHER PREFERRED Glucagen Glucagen Hypokit Glucagon Emergency Kit PA Invokana Proglycem NON PREFERRED Cycloset ALPHA-GLUCOSIDASE INHIBIT GENERIC acarbose NON PREFERRED Glyset DPP-4 INHIBITORS PREFERRED Januvia Onglyza NON PREFERRED Tradjenta INSULIN SENSITIZING AGENT GENERIC pioglitazone HCL NON PREFERRED Avandia ANTIDIABETIC COMBINATIONS GENERIC glipizide/metformin HCL glyburide/metformin HCL pioglitazone HCL-glimepiride pioglitazone HCL/metformin HCL PREFERRED Actoplus Met XR Janumet Janumet XR Juvisync Kombiglyze XR Prandimet NON PREFERRED Jentadueto BISPHOSPHONATES GENERIC alendronate sodium QL ibandronate sodium QL,PA,ST risedronate sodium Alendronate Sodium Etidronate Disodium PREFERRED QL Fosamax Plus D NON PREFERRED PA,ST Actonel Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 13 QL,PA,ST Atelvia QL Binosto SPECIALTY pamidronate disodium PA zoledronic acid Pamidronate Disodium PA Zoledronic Acid PA Zometa Omnitrope Saizen PA PA PA Saizen Click.easy Serostim PA Tev-tropin Zorbtive PA PA GHRH CALCITONINS SPECIALTY GENERIC QL calcitonin salmon QL calcitonin-salmon QL Fortical NON PREFERRED Miacalcin Egrifta QL,PA SOMATOMEDINS SPECIALTY PA Increlex SOMATOSTATIC AGENTS PARATHYROID HORMONE SPECIALTY QL Forteo SPECIALTY octreotide acetate RANK LIGAND INHIBITORS PA Sandostatin Lar Depot SPECIALTY QL,PA Prolia PA Xgeva PA QL,PA Signifor Somatuline Depot PA GH RECEPTOR ANTAGONISTS CALCIUM REGULATORS - MISC NON PREFERRED Ganite SPECIALTY Somavert HORMONE RECEPTOR MDLTR PA POSTERIOR PITUITARY GENERIC raloxifene hydrochloride GENERIC desmopressin acetate LHRH/GNRH AGONIST vasopressin SPECIALTY SPECIALTY chorionic gonadotropinGL,QL QL,PA Lupron Depot-PED Supprelin LA novarel QL,PA */, QL pregnyl w/diluent benzyl alcohol/NACL Synarel GL, QL Stimate GNRH/LHRH ANTAGONISTS CORTICOTROPIN SPECIALTY Cetrotide SPECIALTY QL PA H.p. Acthar Ganirelix Acetate QL PROLACTIN INHIBITORS GENERIC cabergoline GROWTH HORMONES VASOPRESSIN ANTAGONISTS SPECIALTY Genotropin SPECIALTY QL Samsca PA PA Genotropin Miniquick Humatrope METABOLIC MODIFIERS PA Humatrope Combo Pack Norditropin Cartridge Norditropin Flexpro PA PA PA Norditropin Nordiflex Pen Nutropin PA PA Nutropin AQ Nuspin 10 Nutropin AQ Nuspin 20 Nutropin AQ Nuspin 5 Nutropin AQ Pen PA PA PA PA GENERIC calcitriol doxercalciferol levocarnitine paricalcitol PREFERRED PA Sensipar NON PREFERRED Hectorol Paricalcitol Zemplar SPECIALTY sodium phenylbutyrate Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 14 PA Aldurazyme Buphenyl PA Carbaglu Cystadane PA Elaprase PA Fabrazyme PA Kuvan PA Lumizyme PA Myalept PA Myozyme PA Naglazyme Orfadin PA Ravicti PA Vimizim THYROID AGENTS GENERIC levothyroxine sodium levoxyl liothyronine sodium methimazole propylthiouracil unithroid unithroid direct Levothyroxine Sodium Nature-throid NP thyroid NP thyroid 30 NP thyroid 60 NP thyroid 90 Westhroid PREFERRED Armour Thyroid NON PREFERRED Thyrolar-1 Thyrolar-1/2 Thyrolar-1/4 Thyrolar-2 Thyrolar-3 GASTROINTESTINAL LAXATIVES GENERIC constulose lactulose pegylax polyethylene glycol 3350 Cascara Sagrada Mineral Oil Heavy PREVENTIVE gavilyte-c gavilyte-n/flavor pack gavilyte-G peg 3350/electrolytes peg-3350/electrolytes peg-3350/NACL/NA bicarbonate/KCL trilyte PREFERRED Moviprep Suclear Suprep Bowel Prep NON PREFERRED Colyte-flavor Packs Golytely Kristalose Osmoprep Prepopik ANTIDIARRHEALS GENERIC diphenoxylate/atropine lofene lonox loperamide HCL opium opium tincture Diphenoxylate/Atropine Opium Tincture (paregoric) NON PREFERRED Motofen ANTACIDS GENERIC Sodium Bicarbonate ULCER DRUGS GENERIC atropine sulfate chlordiazepoxide HCL/clidinium bromide cimetidine cimetidine HCL dicyclomine HCL ed-spaz esomeprazole sodium famotidine glycopyrrolate hyomax-SL hyoscyamine sulfate hyoscyamine sulfate odt hyoscyamine sulfate ER hyoscyamine sulfate SR hyosyne QL lansoprazole lansoprazole/amoxicillin/clarithromycin methscopolamine bromide misoprostol nizatidine nulev QL omeprazole QL omeprazole/sodium bicarbonate oscimin oscimin SR QL pantoprazole sodium QL,PA,ST rabeprazole sodium ranitidine HCL sucralfate symax fastabs symax-SL symax-SR Atropine Sulfate Belladonna & Opium Belladonna Alkaloids & Opium Dicyclomine HCL Esomeprazole Sodium Famotidine Famotidine Premixed Gastrinex NF Propantheline Bromide Scopolamine Hydrobromide PREFERRED Carafate QL Nexium Pylera NON PREFERRED QL,PA,ST Aciphex Sprinkle Atropen Cantil Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 15 Cuvposa QL,PA,ST Dexilant Donnatal Donnatal Extentabs QL,PA,ST Esomeprazole Strontium First-lansoprazole Helidac Omeclamox-PAK QL,PA,ST Prevacid Solutab QL,PA,ST Prilosec QL,PA,ST Zegerid ANTIEMETICS GENERIC QL,PA dronabinol QL granisetron HCL meclizine HCL QL ondansetron odt QL ondansetron HCL trimethobenzamide HCL univert Dimenhydrinate PREFERRED Aloxi QL Emend QL Sancuso Transderm-scop NON PREFERRED QL Anzemet QL,PA Cesamet QL Granisol QL Zuplenz DIGESTIVE AIDS PREFERRED Creon Pancrelipase Viokace NON PREFERRED PA,ST Pertzye PA,ST Ultresa PA,ST Zenpep SPECIALTY Sucraid GASTROINTESTINAL - MISC. GENERIC ana-lex anucort-HC balsalazide disodium calcium acetate colocort cromolyn sodium enulose generlac grx hicort 25 hemril-30 hydrocort ene 100MG hydrocortisone hydrocortisone acetate hydrocortisone acetate/lidocaine HCL hydrocortisone acetate/pramoxine hydrocortisone acetate/pramoxine HCL lactulose lidazone HC lidocaine HCL/hydrocortisone acetate mesalamine metoclopramide HCL pramcort procto-PAK proctosol HC proctozone-HC rectacort-HC sulfasalazine sulfazine sulfazine EC ursodiol Dexpanthenol Lidocaine HCL-hydrocortisone Acetate With Aloe PREFERRED QL Amitiza Analpram Advanced Analpram-HC Asacol HD Canasa Chenodal Cortifoam Delzicol Fosrenol Lialda QL Linzess Lotronex Pentasa Proctofoam HC Rectiv PA Relistor Renvela Sevelamer Carbonate NON PREFERRED Apriso Dipentum Giazo Phoslyra Renagel SPECIALTY PA Cimzia PA Cimzia Starter Kit PA Gattex PA Remicade GENITOURINARY URINARY ANTI-INFECTIVES GENERIC hyophen methenamine hippurate methenamine mandelate nitrofurantoin nitrofurantoin macrocrystals nitrofurantoin monohydrate nitrofurantoin monohydrate/macrocrystals phosphasal ur n-c urelle uretron d/s uribel urin d/s uro-blue uro-l uro-mp uryl ustell uta uticap utira-c utrona-c Methenamine Mandelate Urimar-t Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 16 NON PREFERRED Monurol URINARY ANTISPASMODICS GENERIC bethanechol chloride flavoxate HCL oxybutynin chloride oxybutynin chloride ER tolterodine tartrate tolterodine tartrate ER trospium chloride trospium chloride ER PREFERRED Gelnique Myrbetriq QL Oxytrol QL Oxytrol For Women Toviaz Vesicare NON PREFERRED PA,ST Enablex VAGINAL PRODUCTS GENERIC clindamycin phosphate metronidazole vaginal terconazole vandazole zazole Miconazole 3 PREFERRED Clindesse Endometrin Estrace QL Estring Vagifem NON PREFERRED Avc Cleocin Gynazole-1 PREVENTIVE Encare Options Conceptrol Vaginal Contraceptive Options Gynol II Vaginal Contraceptive Shur-seal Today Sponge Vcf Vaginal Contraceptive Film Vcf Vaginal Contraceptive Foam SPECIALTY Crinone GENITOURINARY - MISC. GENERIC acetic acid 0.25% alfuzosin HCL ER aminoacetic acid argyle sterile saline 100ML citric acid/sodium citrate curity sterile saline cytra k crystals cytra-k cytra-2 finasteride glycine hydrochloric acid neomycin/polymyxin b sulfates phenazo phenazopyridine HCL potassium citrate ER potassium citrate-citric acid crystals potassium citrate/citric acid potassium citrate/sodium citrate/citric acid sodium chloride sodium chloride 0.9% sodium citrate/citric acid tamsulosin HCL taron-crystals tricitrates virtrate-3 Cytra-3 Sorbitol Sorbitol-mannitol PREFERRED Elmiron Rapaflo Renacidin NON PREFERRED Avodart Cardura XL Oracit SPECIALTY Cystagon PA Procysbi HEMATOLOGICAL HEMATOPOIETIC AGENTS GENERIC airavite corvita 150 cyanocobalamin dexferrum fabb ferocon ferotrinsic ferrocite plus ferrogels forte folbee folcaps folic acid folic acid/vitamin b-6/vitamin b-12 folplex 2.2 foltrin hematinic plus vitamins/minerals hematinic/folic acid hematogen hematogen forte hemocyte-f hemocyte-plus iferex 150 forte infed myferon 150 forte nufol poly-iron 150 forte polysaccharide iron forte purevit dualfe plus se-tan plus tricon trigels-f forte virt-vite B-6 Folic Acid Bp Vit 3 Ed Cyte F Ferraplus 90 Folic Acid FE c plus Hematogen Fa Hydroxocobalamin Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 17 Iron Asp Gly/ Polysacch Compl/Ascorb CAL/B12/Fa/C Threon/Suc Multigen Multigen Folic Multigen Plus Tandem F TL gard RX TL icon TL-fol 500 TL-hem 150 PREVENTIVE bprotected pedia iron eq slow-release iron eql folic acid eql iron supplement therapy eql slow release iron ezfe 200 fa-8 feosol fer-iron ferate ferosul ferretts ferrex 150 ferric x-150 ferro-bob ferrocite ferrotabs ferrous drops ferrous fumarate 324 ferrous gluconate ferrous sulfate ferrousul ferus gnp folic acid gnp iron gnp slow release iron high potency iron iferex 150 iron iron slow release iron supplement iron supplement childrens kp ferrous gluconate kp ferrous sulfate kp folic acid meijer ferrous sulfate myferon 150 nu-iron 150 poly-iron 150 px folic acid px iron qc ferrous sulfate ra folic acid ra high potency iron ra iron ra slow release iron slow iron slow release iron sm folic acid sm iron sm iron slow release th folic acid th iron th slow release iron wee care yl folic acid CVS folic acid CVS iron FE gluconate FE TABS HM folic acid HM iron HM iron slow release PREFERRED Droxia Feraheme Ferrex 150 Forte Plus Ferrex 28 Nascobal Venofer NON PREFERRED Foltrate PREVENTIVE CVS Slow Release Iron Elite Iron Fa-8 Femiron Feosol Ferretts Chewable Iron Ferretts IPS Ferrimin 150 Ferro-sequels Ferrous Fumarate Ferrous Gluconate Ferrous Sulfate FE Aspartate High Potency Iron Iron Iron Chews Pediatric Iron Up Mykidz Iron 10 Novaferrum Pediatric Drops Perfect Iron Profe Proferrin ES Sm Slow Release Iron SPECIALTY sodium ferric gluconate complex/sucrose PA Aranesp Albumin Free PA Cerezyme PA Elelyso PA Epogen PA Leukine QL,PA Mozobil PA Neulasta PA Neulasta Delivery Kit PA Neumega PA Neupogen PA Nplate PA Procrit PA Promacta PA Vpriv PA Zavesca ANTICOAGULANTS GENERIC argatroban QL enoxaparin sodium QL fondaparinux sodium hep flush-10 heparin lock heparin lock flush heparin lock flush for flushing vascular access devices heparin lock flush/NACL for flushing vascular access devices heparin sodium heparin sodium dcu heparin sodium lock flush heparin sodium/sodium chloride 0.9% premix Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 18 heparin sodium/D5W heparin sodium/NACL 0.9% jantoven monoject pharma grade flush syringe/heparin lock monoject prefill advanced heparin lock flush sash kit for flushing vascular access devices warfarin sodium Acd Formula A Acd Formula B Acd-a Noclot-50 Anticoagulant Citrate Dextrose Solution A Anticoagulant Sodium Citrate Argatroban Heparin Lock Flush Heparin Sodium Heparin Sodium/D5W Heparin Sodium/NACL 0.45% Heparin Sodium/Sodium Chloride 0.9% PREFERRED QL Eliquis QL Pradaxa QL Xarelto QL Xarelto Starter Pack NON PREFERRED QL Fragmin HEMOSTATICS GENERIC aminocaproic acid tranexamic acid Aminocaproic Acid HEMATOLOGICAL - MISC. GENERIC albuked 25 albuked 5 albumin human albumin-zlb albuminar-25 albuminar-5 alburx albutein anagrelide hydrochloride buminate cilostazol clopidogrel dipyridamole flexbumin hetastarch 6%/NACL human albumin grifols kedbumin pentoxifylline ER plasbumin-25 plasbumin-5 ticlopidine HCL LMD 10% Dextrose 5% LMD 10% Sodium Chloride 0.9% Protamine Sulfate PREFERRED Aggrenox Brilinta Effient Zontivity NON PREFERRED Aggrastat Integrilin SPECIALTY Advate Alphanate/Von Willebrand Factor Complex/Human Alphanine SD Bebulin Bebulin VH Benefix Berinert Ceprotin Cinryze Corifact Eloctate Feiba Feiba NF Firazyr Helixate FS Hemofil M Humate-p Kalbitor Koate-dvi Kogenate FS Kogenate FS Bio-set Monoclate-p Mononine Novoseven Novoseven Rt Profilnine SD Recombinate Riastap Rixubis PA Soliris Thrombate Iii W/10 ML Sterile Water Thrombate Iii W/20 ML Sterile Water Tretten Wilate Xyntha Xyntha Solofuse MOUTH/THROAT/DENTAL AGENT GENERIC cavarest cavirinse cevimeline HCL chlorhexidine gluconate chlorhexidine gluconate oral rinse clinpro 5000 clotrimazole controlrx denta 5000 plus dentagel easygel fluoridex daily defense fluoridex daily defense enhanced whitening fluoridex daily defense sensitivity relief karigel karigel-n lidocaine viscous lidocaine HCL lidocaine HCL viscous neutragard advanced neutral sodium fluoride nystatin oralone paroex perio MED periogard phos-flur pilocarpine hydrochloride pilocarpine HCL stannous fluoride oral rinse topex topical anesthetic Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 19 QL triamcinolone acetonide triamcinolone IN orabase Aquoral Numoisyn SF SF 5000 plus NON PREFERRED Oravig Desvenlafaxine ER Doxepin HCL Fluoxetine HCL Maprotiline HCL Nefazodone HCL Nortriptyline HCL Venlafaxine HCL ER PREFERRED QL Pristiq NON PREFERRED QL Aplenzin QL,PA Emsam QL Forfivo XL Marplan Paxil QL Viibryd NEUROLOGY, CNS, PSYCH ANTIANXIETY AGENTS GENERIC alprazolam alprazolam odt alprazolam ER alprazolam XR buspirone HCL chlordiazepoxide HCL clorazepate dipotassium diazepam diazepam intensol droperidol gene-xene TAB 15MG gene-xene TAB 3.75MG gene-xene TAB 7.5MG hydroxyzine pamoate hydroxyzine HCL lorazepam meprobamate oxazepam Diazepam Hydroxyzine HCL Hydroxyzine Pamoate ANTIPSYCHOTICS GENERIC chlorpromazine HCL QL clozapine compazine compro fluphenazine decanoate fluphenazine HCL haloperidol haloperidol decanoate haloperidol lactate lithium carbonate lithium carbonate ER loxapine loxapine succinate QL olanzapine QL olanzapine odt perphenazine prochlorperazine prochlorperazine edisylate prochlorperazine maleate QL quetiapine fumarate QL risperidone QL risperidone odt QL risperidone M-TAB thioridazine HCL thiothixene trifluoperazine HCL QL ziprasidone HCL Chlorpromazine HCL QL Clozapine Odt Fluphenazine HCL Lithium Lithium Carbonate PREFERRED QL Abilify QL Abilify Discmelt Abilify Maintena QL Latuda Risperdal Consta QL Seroquel XR NON PREFERRED QL,PA,ST Fanapt QL,PA,ST Fanapt Titration Pack QL Fazaclo Geodon QL,PA,ST Invega Invega Sustenna QL,PA,ST Saphris ANTIDEPRESSANTS GENERIC amitriptyline HCL QL budeprion SR bupropion HCL QL bupropion HCL ER QL bupropion HCL SR QL bupropion HCL XL citalopram hydrobromide clomipramine HCL desipramine HCL doxepin HCL QL duloxetine HCL escitalopram oxalate QL fluoxetine DR fluoxetine HCL fluvoxamine maleate QL fluvoxamine maleate ER imipramine pamoate imipramine HCL mirtazapine mirtazapine odt nefazodone HCL nortriptyline HCL paroxetine HCL paroxetine HCL ER phenelzine sulfate protriptyline HCL sertraline HCL tranylcypromine sulfate trazodone HCL trimipramine maleate QL venlafaxine HCL QL venlafaxine HCL ER Amoxapine HYPNOTICS Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 20 GENERIC dexmedetomidine HCL estazolam QL eszopiclone flurazepam HCL midazolam HCL phenobarbital temazepam triazolam QL zaleplon QL zolpidem tartrate QL zolpidem tartrate ER Flurazepam HCL Phenobarbital Phenobarbital Sodium Quazepam PREFERRED QL Rozerem NON PREFERRED QL Intermezzo QL Silenor SPECIALTY QL,PA Hetlioz ADHD, NARCOLEPSY, ETC. GENERIC QL amphetamine/dextroamphetamine PA benzphetamine HCL caffeine citrate clonidine HCL ER QL dexedrine QL dexmethylphenidate HCL QL dexmethylphenidate HCL ER QL dextroamphetamine sulfate QL dextroamphetamine sulfate ER PA diethylpropion HCL PA diethylpropion HCL ER doxapram HCL guanfacine ER QL metadate ER QL methamphetamine HCL methylphenidate hydrochloride QL methylphenidate HCL QL methylphenidate HCL CD QL methylphenidate HCL ER QL methylphenidate HCL SR QL,PA modafinil PA phendimetrazine tartrate PA phentermine HCL QL zenzedi Caffeine/Sodium Benzoate PA Diethylpropion HCL QL Methylphenidate HCL ER PA Phendimetrazine Tartrate ER QL Procentra PREFERRED QL Daytrana QL,PA Nuvigil QL Quillivant XR QL Strattera QL Vyvanse NON PREFERRED QL Concerta QL Focalin XR Kapvay Dose Pack PA Xenical ANTICONVULSANTS GENERIC carbamazepine carbamazepine ER clonazepam clonazepam odt divalproex sodium divalproex sodium DR divalproex sodium ER epitol ethosuximide felbamate fosphenytoin sodium gabapentin lamotrigine lamotrigine odt lamotrigine ER levetiracetam levetiracetam ER oxcarbazepine phenytoin phenytoin infatabs phenytoin sodium phenytoin sodium extended primidone tiagabine hydrochloride topiragen topiramate valproate sodium valproic acid zonisamide Levetiracetam PREFERRED Banzel Celontin Diazepam Dilantin Fycompa Gabitril QL Lyrica Onfi Peganone Potiga Tegretol-XR Vimpat NON PREFERRED Diastat Pediatric Lamictal Lamictal Odt Stavzor SPECIALTY PA Sabril ANTIPARKINSON AGENTS GENERIC amantadine HCL benztropine mesylate bromocriptine mesylate carbidopa carbidopa/levodopa carbidopa/levodopa odt carbidopa/levodopa ER entacapone pramipexole dihydrochloride ropinirole ER ropinirole HCL selegiline HCL trihexyphenidyl HCL Amantadine HCL Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 21 Carbidopa/Levodopa/Entacapone PREFERRED Azilect Mirapex ER NON PREFERRED Neupro Tasmar SPECIALTY PA Apokyn NEUROLOGY, PSYCH - MISC. GENERIC acamprosate calcium DR disulfiram donepezil HCL ergoloid mesylates fluoxetine galantamine galantamine hydrobromide olanzapine/fluoxetine rivastigmine tartrate Chlordiazepoxide/Amitriptyline Galantamine Hydrobromide Perphenazine/Amitriptyline PREVENTIVE QL buproban QL bupropion HCL SR QL eq nicotine QL eq nicotine gum refill QL eq nicotine gum starter QL eq nicotine polacrilex QL eq nicotine step 3 QL eql nicotine QL eql nicotine polacrilex QL eql nicotine polacrilex refill QL eql nicotine polacrilex starter QL gnp nicotine polacrilex QL gnp nicotine polacrilex mini QL kls quit2 QL kls quit4 QL nicorelief QL nicotine QL nicotine polacrilex QL nicotine polacrilex refill QL nicotine polacrilex starter kit QL nicotine step 1 QL nicotine step 2 QL nicotine step 3 QL nicotine transdermal system QL px stop smoking aid QL qc nicotine polacrilex QL ra mini nicotine QL ra nicotine QL ra nicotine polacrilex QL ra nicotine transdermal system step 3 QL sm nicotine QL sm nicotine polacrilex QL sw nicotine polacrilex QL tgt nicotine gum QL tgt nicotine polacrilex QL tgt nicotine step one QL tgt nicotine step three QL tgt nicotine step two QL thrive QL CVS nicotine QL CVS nicotine polacrilex QL CVS nicotine polacrilex starter QL CVS nicotine transdermal system QL CVS nts step 1 QL HM nicotine polacrilex QL HM nicotine transdermal system QL HM nicotine transdermal system step 3 QL SR nicotine gum PREFERRED Exelon QL,PA Gralise QL,PA Gralise Starter Namenda Namenda Titration PAK QL Namenda XR QL Namenda XR Titration Pack Nuedexta QL Savella PREVENTIVE QL Chantix QL Chantix Continuing Month PAK QL Chantix Starting Month PAK QL Nicotine Transdermal System NON PREFERRED QL,PA Horizant Orap PREVENTIVE QL Nicotrol Inhaler QL Nicotrol Ns SPECIALTY QL,PA Ampyra QL,PA Aubagio QL,PA Avonex QL,PA Avonex Pen QL,PA Betaseron QL,PA Copaxone QL,PA Extavia QL,PA Gilenya QL,PA Rebif QL,PA Rebif Rebidose QL,PA Rebif Rebidose Titration Pack QL,PA Rebif Titration Pack QL,PA Tecfidera QL,PA Tecfidera Starter Pack QL,PA Tysabri PA Xenazine QL,PA Xyrem NEUROMUSCULAR AGENTS GENERIC atracurium besylate cisatracurium besylate pancuronium bromide QL,PA riluzole rocuronium bromide vecuronium bromide SPECIALTY PA Botox PA Dysport PA Myobloc PA Xeomin MUSCULOSKELETAL AGENTS GENERIC baclofen carisoprodol carisoprodol/aspirin carisoprodol/aspirin/codeine chlorzoxazone cyclobenzaprine HCL dantrolene sodium metaxalone Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 22 methocarbamol orphenadrine citrate orphenadrine citrate ER orphenadrine/asa/caffeine revonto tizanidine HCL Carisoprodol Dantrolene Sodium Enovarx-cyclobenzaprine HCL PREFERRED Gablofen Lioresal Intrathecal NON PREFERRED Lorzone SPECIALTY PA Euflexxa PA Hyalgan PA Monovisc PA Orthovisc PA Supartz PA Synvisc PA Synvisc One ANTIMYASTHENIC AGENTS GENERIC neostigmine methylsulfate pyridostigmine bromide Guanidine HCL Regonol PREFERRED Mestinon Mestinon Timespan Prostigmin OPHTHALMOLOGY AND OTIC ANTI-INFECTIVES GENERIC ak-poly-bac bacitracin/polymyxin b ciprofloxacin HCL erythromycin garamycin gatifloxacin gentak gentamicin sulfate ilotycin levofloxacin neo-polycin neomycin/bacitracin/polymyxin neomycin/polymyxin/bacitracin zinc neomycin/polymyxin/gramicidin ofloxacin polycin polycin b polymyxin b sulfate/trimethoprim sulfate romycin sodium sulfacetamide sulfacetamide sodium tobramycin sulfate trifluridine trimethoprim sulfate/polymyxin b sulfate Bacitracin Sulfacetamide Sodium PREFERRED Besivance Moxeza Natacyn Vigamox NON PREFERRED Azasite Ciloxan Tobrex Zirgan ARTIFICIAL TEAR/LUBRICANT NON PREFERRED Lacrisert BETA-BLOCKERS GENERIC betaxolol HCL carteolol HCL dorzolamide HCL/timolol maleate levobunolol HCL timolol maleate timolol maleate ophthalmic gel forming Istalol Levobunolol HCL Metipranolol PREFERRED Combigan NON PREFERRED Betimol Betoptic-s OPHTHALMIC STEROIDS GENERIC dexamethasone sodium phosphate fluorometholone neo-polycin HC neomycin/polymyxin/bacitracin/hydrocortisone neomycin/polymyxin/dexamethasone poly-dex prednisolone acetate sulfacetamide sodium/prednisolone sodium phosphate tobramycin/dexamethasone Neomycin/Polymyxin/Hydrocortisone Prednisolone Sodium Phosphate PREFERRED Alrex FML Lotemax Pred Mild Retisert Tobradex Tobradex ST Zylet NON PREFERRED Blephamide S.o.p. Durezol Flarex Ozurdex Vexol PROSTAGLANDINS GENERIC QL latanoprost PREFERRED QL Lumigan QL Travatan Z QL Travoprost NON PREFERRED QL Zioptan CYCLOPLEGIC MYDRIATICS GENERIC atropine sulfate Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 23 atropine-care cyclopentolate HCL homatropaire homatropine HBR mydral tropicamide Atropine Sulfate ful-GLO green GLO lissamine greenophthalmic strips ketorolac tromethamine lissamine green ocucoat viscoadherent Ak-fluor PREFERRED Bepreve QL Bromday QL Ilevro QL Nevanac Pataday Patanol QL Prolensa NON PREFERRED Acuvail Alocril Alomide Azopt Emadine Lastacaft SPECIALTY QL,PA Cystaran Eylea Jetrea Lucentis Macugen Visudyne DECONGESTANTS GENERIC altafrin neofrin phenylephrine HCL Naphazoline HCL MIOTICS GENERIC pilocarpine HCL PREFERRED Phospholine Iodide Pilopine HS NON PREFERRED Isopto Carbachol ADRENERGIC AGENTS GENERIC apraclonidine brimonidine tartrate PREFERRED Alphagan P NON PREFERRED Iopidine IMMUNOMODULATORS PREFERRED QL,PA Restasis LOCAL ANESTHETICS GENERIC altacaine parcaine proparacaine HCL tetcaine tetracaine HCL tetravisc tetravisc forte OPHTHALMICS - MISC. GENERIC ak-fluor akorn balanced salt solution altafluor azelastine HCL balanced salt balanced salt solution bio GLO bromfenac bss cromolyn sodium diclofenac sodium dorzolamide HCL epinastine HCL flucaine fluor-i-strips a.t. fluorescein-benoxinate fluorescein/proparacaine fluorets flurbiprofen sodium flurox OTIC AGENTS GENERIC acetasol HC acetic acid aero otic HC antipyrine/benzocaine aurax aurodex cortic-nd cyotic exotic-HC fluocinolone acetonide fluocinolone acetonide ear drops hydrocortisone/acetic acid neomycin/polymyxin/hydrocortisone neomycin/polymyxin/HC ofloxacin otic care oticin oto-end 10 otomax-HC pramoxine-HC Acetic Acid/Aluminum Acetate Antipyrine/Benzocaine Ciprofloxacin Myoxin Otozin PREFERRED Ciprodex NON PREFERRED Cipro HC Coly-mycin S Cortisporin-tc OXYTOCICS GENERIC methylergonovine maleate oxytocin Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 24 PAIN MANAGEMENT ANALGESICS - NONNARCOTIC GENERIC ali-flex biogesic butalbital/acetaminophen butalbital/acetaminophen/caffeine butalbital/apap/caffeine butalbital/aspirin/caffeine capacet choline magnesium trisalicylate clonidine HCL diflunisal dologesic dolorex duraxin ed-flex esgic margesic marten-TAB salsalate tencon zebutal zflex Alpain Butalbital/Aspirin/Caffeine Choline Magnesium Trisalicylate Esgic Rhinoflex-650 Tencon Zgesic PREVENTIVE adult aspirin EC low strength aspir-low aspir-81 aspirin aspirin adult low strength aspirin childrens aspirin enteric coated adult low strength aspirin low dose aspirin low strength aspirin EC aspirin EC low dose aspirin EC LO-dose aspirin 81 aspirin 81 low dose aspirtab bayer advanced aspirin regular strength bayer aspirin bayer aspirin regimen bayer aspirin EC low dose bayer chewable low dose bayer low dose childrens aspirin childrens aspirin low strength ecotrin low strength ecpirin enteric coated aspirin eq adult aspirin low strength eq aspirin eq aspirin adult low dose eq aspirin low dose eq aspirin EC eq childrens aspirin eql adult aspirin low strength eql aspirin eql aspirin low dose eql aspirin EC eql childrens aspirin gnp adult aspirin low strength gnp aspirin gnp aspirin low dose goodsense aspirin low dose kls aspirin low dose kls aspirin EC kp aspirin meijer aspirin EC miniprin low dose norwich aspirin px aspirin px enteric aspirin qc aspirin qc aspirin low dose qc childrens aspirin ra aspirin ra aspirin adult low dose ra aspirin adult low strength ra aspirin childrens ra aspirin EC ra aspirin EC adult low strength ra childrens aspirin sm aspirin sm aspirin adult low strength sm aspirin enteric coated sm aspirin low dose sm aspirin EC low strength sm childrens aspirin st joseph aspirin tgt aspirin tgt aspirin low dose tgt childrens aspirin tgt enteric-coated aspirin th aspirin th aspirin low dose th enteric aspirin CVS aspirin CVS aspirin adult low dose CVS aspirin adult low strength CVS aspirin child CVS aspirin low dose CVS aspirin low strength CVS aspirin EC CVS childrens aspirin CVS enteric aspirin EC-81 aspirin HM aspirin HM aspirin EC HM aspirin EC low dose MM aspirin SB aspirin SB aspirin EC SB childrens aspirin SB low dose asa EC PREVENTIVE Adult Aspirin Low Strength Aspirin Low Dose Medi-seltzer SPECIALTY Prialt ANALGESICS - OPIOID GENERIC acetaminophen/codeine acetaminophen/codeine #2 acetaminophen/codeine #3 acetaminophen/codeine #4 acetaminophen/codeine phosphate alfentanil Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 25 ascomp/codeine astramorph QL,PA buprenorphine HCL QL,PA buprenorphine HCL/naloxone HCL butalbital/acetaminophen/caffeine/codeine butalbital/aspirin/caffeine/codeine QL butorphanol tartrate codeine sulfate duramorph endocet endodan QL fentanyl fentanyl citrate QL,PA fentanyl citrate oral transmucosal hydrocodone bitartrate/acetaminophen hydrocodone/acetaminophen hydrocodone/ibuprofen hydrogesic hydromorphone HCL QL hydromorphone HCL ER ibudone lorcet lorcet plus lorcet HD lortab meperidine HCL meperitab methadone HCL methadone HCL intensol methadose morphine sulfate QL morphine sulfate ER nalbuphine HCL oxycodone HCL oxycodone/acetaminophen oxycodone/aspirin oxycodone/ibuprofen oxymorphone hydrochloride QL oxymorphone hydrochloride ER pentazocine/acetaminophen pentazocine/naloxone HCL reprexain roxicet stagesic sufentanil citrate QL tramadol hydrochloride/acetaminophen QL tramadol HCL QL tramadol HCL ER verdrocet vicodin vicodin ES vicodin HP xylon zamicet Acetaminophen/Caffeine/Dihydrocodeine Bitartrate Aspirin-caffeine-dihydrocodeine Codeine Sulfate CO-gesic Hydrocodone Bitartrate/Acetaminophen Hydrocodone/Acetaminophen Hydromorphone HCL Hydromorphone HCL Dosette Levorphanol Tartrate Meperidine HCL Methadone HCL Methadose Methadose Sugar-free Morphine Sulfate Morphine Sulfate Add-vantage Oxycodone HCL QL Tramadol HCL ER Trezix PREFERRED QL,PA Butrans QL,PA Lazanda QL Nucynta QL Nucynta ER QL Opana ER (crush Resistant) QL Oxycodone HCL ER QL Oxycontin QL,PA Suboxone NON PREFERRED QL,PA Abstral QL Conzip Depodur QL Embeda QL Exalgo QL,PA Fentora QL Hydromorphone HCL ER Infumorph 200 Infumorph 500 QL Kadian Oxecta QL,PA Subsys Talwin ANTI-INFLAMMATORY GENERIC QL,PA celecoxib diclofenac potassium diclofenac sodium DR diclofenac sodium ER diclofenac sodium/misoprostol etodolac etodolac ER flurbiprofen ibuprofen indomethacin indomethacin sodium indomethacin ER ketoprofen QL ketorolac tromethamine leflunomide mefenamic acid meloxicam nabumetone naproxen naproxen sodium naproxen DR oxaprozin piroxicam sulindac tolmetin sodium Fenoprofen Calcium Indomethacin Ketoprofen ER Ketorolac Tromethamine Meclofenamate Sodium Meloxicam Tolmetin Sodium PREFERRED Ridaura NON PREFERRED Nalfon Naprelan Rheumatrex QL Sprix QL Vimovo Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 26 SPECIALTY PA Actemra PA Arcalyst PA Enbrel PA Enbrel Sureclick PA Humira PA Humira Pediatric Crohns Disease Starter Pack PA Humira Pen PA Humira Pen-crohns Diseasestarter PA Humira Pen-psoriasis Starter PA Ilaris PA Kineret PA Orencia PA Simponi PA Simponi Aria PA Xeljanz MIGRAINE PRODUCTS GENERIC dihydroergotamine mesylate isometheptene mucate/caffeine/acetaminophen isometheptene/dichloralphenazone/acetaminophen migragesic ida QL naratriptan HCL nodolor QL rizatriptan benzoate QL rizatriptan benzoate odt QL sumatriptan succinate QL sumatriptan succinate refill QL zolmitriptan QL zolmitriptan odt QL Dihydroergotamine Mesylate Isometheptene/Caffeine/Acetaminophen Migralam QL Sumatriptan QL Sumatriptan Succinate PREFERRED QL Relpax NON PREFERRED QL,PA,ST Alsuma QL,PA,ST Axert Cafergot Ergomar QL,PA,ST Frova QL,PA,ST Sumavel Dosepro QL,PA,ST Treximet QL,PA,ST Zomig QL,PA,ST Zomig Nasal Spray GOUT AGENTS GENERIC allopurinol probenecid probenecid/colchicine PREFERRED Colchicine Colcrys Uloric SPECIALTY PA Krystexxa LOCAL ANESTHETICS-INJ GENERIC bupivacaine spinal bupivacaine HCL bupivacaine/epinephrine chloroprocaine HCL lidocaine HCL lidocaine/epinephrine polocaine polocaine-mpf ropivacaine ropivacaine HCL sensorcaine sensorcaine-mpf sensorcaine-mpf spinal sensorcaine-mpf/epinephrine sensorcaine/epinephrine xylocaine dental BD Pudendal/Local Block Tray 1% Lidocaine Lidocaine HCL/Dextrose Mepivacaine HCL Tetracaine HCL GENERAL ANESTHETICS GENERIC compound 347 etomidate fresenius propoven isoflurane ketamine HCL propofol sevoflurane sojourn terrell RESPIRATORY, ALLERGY, ETC ANTIHISTAMINES GENERIC arbinoxa bpm carbinoxamine maleate cetirizine HCL clemastine fumarate cyproheptadine HCL desloratadine desloratadine odt diphenhydramine HCL levocetirizine dihydrochloride pharbedryl phenadoz phenergan promethazine HCL promethazine HCL plain promethegan Brompheniramine Tannate Clemastine Fumarate Dexchlorpheniramine Maleate Respa-BR NON PREFERRED Clarinex NASAL AGENTS GENERIC QL azelastine HCL QL,PA,ST budesonide QL flunisolide QL fluticasone propionate QL ipratropium bromide QL olopatadine HCL QL triamcinolone acetonide QL Flunisolide PREFERRED QL Dymista QL Nasonex NON PREFERRED Bactroban Nasal QL,PA,ST Beconase AQ Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 27 QL,PA,ST Omnaris QL,PA,ST Qnasl PA,ST Qnasl Childrens Tyzine Tyzine Pediatric Nasal Drops QL,PA,ST Veramyst QL,PA,ST Zetonna COUGH/COLD/ALLERGY GENERIC acetylcysteine benzonatate biotuss biotuss pediatric bpm pseudo bromfed DM bromphen/pseudoephedrine HCL/dextromethorphan HBR giltuss pediatric hydrocodone bitartrate/chlorpheniramine maleate/PSE hydrocodone bitartrate/homatropine methylbromide hydrocodone polistirex/chlorpheniramine polistirex hydrocodone/homatropine hydromet nebusal nortuss-DE phenylephrine/guaifenesin promethazine VC promethazine VC/codeine promethazine-DM promethazine/codeine promethazine/dextromethorphan pulmosal sodium chloride tgq 7.5PEH/4BRM/15DM tussafed EX tussigon Albatussin NN Dextromethorphan HBR/Chlorpheniramine/Phenylephrine HCL Giltuss TR Nortuss-EX Promethazine VC Plain Promethazine VC/Codeine Rescon-JR Tgq 15DM/5PEH/2CPM Tgq 30PSE/150GFN/15DM Tgq 30PSE/3BRM/15DM Tgq 50PSE/3BRM/30DM PREFERRED Tussicaps NON PREFERRED Clarinex-d 12 HOUR Clarinex-d 24 HOUR Rezira ANTIASTHMATIC/COPD AGENTS GENERIC albuterol sulfate albuterol sulfate ER albuterol TAB 4MG aminophylline budesonide difil-G forte epinephrine HCL QL ipratropium bromide QL ipratropium bromide/albuterol sulfate QL levalbuterol QL levalbuterol HCL montelukast sodium terbutaline sulfate theochron theophylline theophylline CR theophylline ER theophylline/D5W PA zafirlukast Cromolyn Sodium Metaproterenol Sulfate Theophylline/D5W PREFERRED QL Arcapta Neohaler QL Asmanex HFA QL Asmanex Twisthaler 120 Metered Doses QL Asmanex Twisthaler 14 Metered Doses QL Asmanex Twisthaler 30 Me Tered Doses QL Asmanex Twisthaler 30 Metered Doses QL Asmanex Twisthaler 60 Metered Doses QL Asmanex Twisthaler 7 Metered Doses QL Atrovent HFA Combivent QL Combivent Respimat Daliresp QL Dulera QL Foradil Aerolizer QL Perforomist QL Proair HFA QL Pulmicort QL Pulmicort Flexhaler QL Qvar QL Serevent Diskus QL Spiriva Handihaler QL Spiriva Respimat QL Symbicort QL Tudorza Pressair NON PREFERRED QL,PA,ST Advair Diskus QL,PA,ST Advair HFA QL,PA,ST Alvesco QL,PA,ST Breo Ellipta QL Brovana Elixophyllin QL,PA,ST Flovent Diskus QL,PA,ST Flovent HFA Lufyllin QL Maxair Autohaler QL Proventil HFA Theo-24 QL Ventolin HFA QL Xopenex HFA PA Zyflo PA Zyflo CR SPECIALTY PA Xolair RESPIRATORY AGENTS - MISC SPECIALTY PA Aralast NP PA Glassia PA Kalydeco PA Prolastin-c PA Pulmozyme PA Zemaira TOXOIDS PREFERRED Tetanus Toxoid Adsorbed Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 28 PREVENTIVE Adacel Boostrix Daptacel Diphtheria/Tetanus Toxoids Adsorbed Pediatric Infanrix Kinrix Pediarix Pentacel Tenivac Tetanus/Diphtheria Toxoids-adsorbed Adult Influenza A (h1n1) Monovalent 2009 Ipol Inactivated IPV M-m-r II W/Diluent 10 Dose Medical Provider EZ Flu Shot PF 2012-2013 Medical Provider EZ Flu Shot PF 2013-2014 Medical Provider EZ Flu Shot PF 2014-2015 Medical Provider EZ Flu Shot 2013-2014 Medical Provider EZ Flu Shot 2014-2015 Menactra Menhibrix Menomune-a/C/Y/W-135 Menveo Pedvax HIB Physicians EZ Use Flu Kit 2012-2013 Pneumovax 23 Pneumovax 23/1 Dose Pneumovax 23/5 Dose Prevnar 13 Proquad Recombivax HB Rotarix Rotateq Trumenba Twinrix Vaqta Varivax Zostavax VACCINES GENERIC Bcg Vaccine PREFERRED Biothrax Imovax Rabies (h.d.c.v.) Ixiaro Rabavert Typhim VI Vivotif Berna Yf-vax PREVENTIVE Acthib Afluria PF 2012-2013 Afluria PF 2013-2014 Afluria PF 2014-2015 Afluria 2012-2013 Afluria 2013-2014 Afluria 2014-2015 Bexsero Cervarix Comvax Engerix-b Fluarix Quadrivalent 2013-2014 Fluarix Quadrivalent 2014-2015 Fluarix 2013-2014 Fluarix 2014-2015 Flublok 2013-2014 Flublok 2014-2015 Flucelvax 2013-2014 Flucelvax 2014-2015 Flulaval Quadrivalent 2013-2014 Flulaval Quadrivalent 2014-2015 Flulaval 2013-2014 Flulaval 2014-2015 Flumist Nasal Vaccine 2012-2013 Flumist Quadrivalent Fluvirin PF 2013-2014 Fluvirin PF 2014-2015 Fluvirin 2013-2014 Fluvirin 2014-2015 Fluzone High-dose PF 2013-2014 Fluzone High-dose PF 2014-2015 Fluzone Intradermal Fluzone Intradermal Quadrivalent Fluzone Pediatric PF 2013-2014 Fluzone PF 2013-2014 Fluzone PF 2014-2015 Fluzone Quadrivalent 2013-2014 Fluzone Quadrivalent 2014-2015 Fluzone Split 2013-2014 Fluzone Split 2014-2015 Gardasil Gardasil 9 Havrix Hiberix VITAMINS VITAMINS GENERIC ascorbic acid decara ergocalciferol mega-c/a plus ortho-CS 250 phytonadione thiamine HCL vitamin c 222MG vitamin d vitamin k1 Aminobenzoate Potassium Pyridoxine HCL Vitamin K1 Wheat Germ PREVENTIVE aqueous vitamin d infants bio-d-mulsion bio-d-mulsion forte bprotected pedia d-vite d 1000 d 10000 d 2000 d 400 d 5000 d-vita d-1000 d-1000 extra strength d-2000 maximum strength d-3-5 d-400 d-5000 d-5000 maximum strength delta d3 dialyvite vitamin d 5000 d2000 ultra strength d3 d3 adult d3 high potency Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 29 d3 kids d3 maximum strength d3 super strength d3 ultra strength d3-1000 d3-50 eql childrens vitamin d gummies eql vitamin d-3 eql vitamin d3 gnp vitamin d gnp vitamin d maximum strength gnp vitamin d super strength gnp vitamin d3 extra strength healthy kids vitamin d3 just d kp vitamin d maximum d3 nat-rul vitamin d optimal-d optimal-d pack opurity vitamin d pronutrients vitamin d3 ra vitamin d-3 sm vitamin d sm vitamin d3 th vitamin d3 thera-d rapid repletion thera-d sport thera-d 2000 vitamin d high potency vitamin d 400 vitamin d-1000 vitamin d-1000 maximum strength vitamin d-3 vitamin d-400 vitamin d3 vitamin d3 adult gummies vitamin d3 high potency vitamin d3 maximum strength vitamin d3 super strength CVS childrens vitamin d for bone health CVS vitamin d CVS vitamin d infants CVS vitamin d 5000 high-potency CVS vitamin d3 HM vitamin d HM vitamin d3 PA vitamin d-3 PA vitamin d-3 gummy PREFERRED Mephyton NON PREFERRED Potaba PREVENTIVE CVS Vitamin D3 Ddrops Dialyvite Vitamin D3 Max D3 D3 Dots HM Vitamin D3 Replesta Replesta Childrens Replesta Nx Sm Vitamin D3 Maximum Strength Super Daily D3 Thera-d 4000 Vitamelts Vitamin D Vitamin D Vitamin D3 Vitamin D3 400 Wellesse Vitamin D3 MULTIVITAMINS GENERIC b-complex b-complex 100 b-plex b-plex plus biocel choice-TABS corvita corvite free dialyvite folbee plus folbee plus cz infuvite infuvite adult infuvite pediatric lysiplex plus mult-vitamin/fluoride multi vitamin/fluoride multi-vit/fluoride multi-vit/iron/fluoride multi-vitamin/fluoride multi-vitamin/fluoride/iron multivitamin with fluoride multivitamin/fluoride multivitamins/fluoride mynephrocaps nephronex niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper nutrifac ZX rena-vite RX renal renalpren reno CAPS strovite plus tri-vit/fluoride tri-vitamin/fluoride triphrocaps triple-vitamin/fluoride urosex v-c forte vic-forte virt-vite plus virt-CAPS vita s forte vita-min vitacel vitamax pediatric vitamin b-complex 100 vitamins a/c/d/fluoride vol-care RX Bp Folinatal Plus B Bp Multinatal Plus Cavan-EC Sod DHA Cod Liver Oil Complete Natal DHA Completenate CO-natal Fa Elite-OB Escavite LQ Folbecal Inatal Advance Inatal GT Inatal Ultra M-vit Macnatal CN DHA Mynatal Advance Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 30 Mynatal Plus Mynatal Ultracaplet Mynatal-z Mynate 90 Plus MVC-fluoride Neurodep Obstetrix EC OB-natal One Pr Natal 400 Pr Natal 400 EC Pr Natal 430 Pr Natal 430 EC Prenaissance Plus Prenaplus Prenatabs Fa Prenatabs RX Prenatal Ad Prenatal Low Iron Prenatal Plus Prenatal Plus Iron Prenatal 19 Prenatal-u PNV-select PNV-DHA Quflora Pediatric Se-natal 19 Se-tan DHA Seton Et-EC Setonet Strovite Forte Taron-prex Tri-vit/Fluoride/Iron Triadvance Tricare Trinatal RX 1 Trinate Ultimatecare One Ultimatecare One NF Ultra TABS Vinate C Vinate Care Vinate GT Vinate IC Vinate II Vinate M Vinate One Vinate Pn Care Vinate Ultra Vitafol-OB Vp-zel PREVENTIVE sm prenatal vitamins Classic Prenatal Eql Prenatal Formula Gnp Prenatal Vitamins Mission Prenatal HP Multi Prenatal Perry Prenatal Pre-natal Formula Prenatal Prenatal And Iron Prenatal Formula Prenatal Forte Prenatal Vitamins Px Prenatal Multivitamins Ra Prenatal Sm Prenatal Vitamins NON PREFERRED AP-zel Bacmin M.v.i. Adult M.v.i. Pediatric M.v.i.-12 Without Vitamin K Neevo DHA Nicadan Nicazel Nicazel Forte Nutricap Prefera OB Prefera OB + DHA Preferaob One Req 49+ Siderol Strovite One Tri-zel Vinate DHA RF PREVENTIVE Atabex Prenatal Brainstrong Prenatal Centrum Specialist Prenatal CVS Prenatal CVS Prenatal Gummy/DHA/Folic Acid CVS Prenatal Multi+dha Enfamil Expecta Gnp Daily Prenatal Gnp Prenatal Goodsense Prenatal Vitamins Healthy Mama Be Well Rounded HM One Daily Prenatal Combo HM Prenatal Kp Prenatal Multivitamins Mission Prenatal Nat-rul Prenatal Vitamins One A Day Womens Prenatal/DHA One-a-day Womens Prenatal Prenatal Complete Prenatal Multi +dha Prenatal Multivitamin + DHA Prenatal One Daily Prenatal Plus DHA Prenatal/Omega-3/Folic Acid/Iron PA Prenatal Formula Qc Prenatal Ra One Daily Ra Prenatal Formula/Folicacid Right Step Prenatal Similac Prenatal Early Shield Sm One Daily Prenatal Stuart One Stuart Prenatal Stuart Prenatal + DHA Th Prenatal Vitamins Your Life Multi Prenatal MEDICAL DEVICES DIABETIC SUPPLIES PREFERRED QL Accu-chek Fastclix Lancets QL Accu-chek Multiclix Lancets QL Accu-chek Safe-t-pro Lancets QL Accu-chek Safe-t-pro Pluslancets QL Accu-chek Soft Touch Lancets QL Accu-chek Softclix Lancets QL Acti-lance Lancets 28G QL Acti-lance Lite Safety Lancets 28G QL Acti-lance Special Safety Lancets 17G QL Acti-lance Special Safetylancets 17G QL Acti-lance Universal Safety Lancets 23G QL Advocate Lancets Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 31 QL Advocate Safety Lancets QL Agamatrix Ultra-thin Lancets 33G Amigo Insulin P.M. Animas Vibe Insulin P.M. Animas Vibe Insulin P.M./Black Animas Vibe Insulin P.M./Blue Animas Vibe Insulin P.M./Limelight Green Animas Vibe Insulin P.M./Pink Glow QL Assure Comfort Lancets Ultra Thin 28G QL Assure Comfort Lancets Ultra Thin 30G QL Assure Haemolance Plus High Flow 18G QL Assure Haemolance Plus Low Flow 25G QL Assure Haemolance Plus Micro Flow 28G QL Assure Haemolance Plus Normal Flow 21G QL Assure Haemolance Plus Pediatric Blade QL Assure Lance Lancets QL Assure Lancets QL Aurora Lancet Super Thin 30G QL Aurora Lancet Thin 23G QL AF Lancets Super Thin QL AT Last Lancets QL Bayer Microlet Lancets QL Bullseye Mini Safety Lancets QL Bullseye Safety Lancets QL BD Insulin Syringe LUER-LOK/U-100/1ML QL BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2" QL BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2" QL BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8" QL BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2" QL BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2" QL BD Insulin Syringe Microfine/U-100/0.5ML/28G X 1/2" QL BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8" QL BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2" BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X QL 5/16" QL BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2" QL BD Insulin Syringe Safetyglide/1ML/29G X 1/2" QL BD Insulin Syringe Slip Tip/U-100/1ML QL BD Insulin Syringe U-40/1ML/25G X 5/8" QL BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16" BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X QL 5/16" QL BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16" QL BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2" QL BD Insulin Syringe Ultrafine/U-100/0.5ML/29G X 1/2" QL BD Insulin Syringe Ultrafine/U-100/1ML/29G X 1/2" QL BD Insulin Syringe Ultrafine/U-100/1ML/30G X 1/2" QL BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2" QL BD Insulin Syringe Ultrafine/0.3ML/31G X 5/16" QL BD Insulin Syringe Ultrafine/0.5ML/30G X 1/2" QL BD Insulin Syringe Ultrafine/0.5ML/31G X 5/16" QL BD Insulin Syringe Ultrafine/1ML/30G X 1/2" QL BD Insulin Syringe Ultrafine/1ML/31G X 5/16" BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X QL 1" BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X QL 5/8" BD Insulin Syringe/Detachable Needle/U-100/1ML/26G X QL 1/2" QL BD Insulin Syringe/U-100/0.5ML/30G X 1/2" QL BD Insulin Syringe/U-100/1ML/27G X 1/2" QL BD Insulin Syringe/U-100/1ML/28G X 1/2" QL BD Insulin Syringe/U-100/2ML/27.5G X 5/8" QL BD Insulin Syringe/U-100/2ML/29G X 1/2" QL BD Lancet Ultrafine 30G QL BD Lancet Ultrafine 33G BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X QL 1/2" QL BD Microtainer Lancets QL BD Pen Needle/Mini/Ultrafine/31G X 3/16" QL BD Pen Needle/Nano/Ultra Fine/32G X 4MM QL BD Pen Needle/SHORT/Ultrafine/31G X 5/16" QL BD Pen Needle/Ultrafine/29G X 12.7MM QL BD Pen Needle/Ultrafine/29GX1/2" 12.7MM QL BD Pen Needles SHORT/Ultrafine/31G X 5/16" QL Careone Lancet Thin QL Careone Lancet Ultra Thin Cartridge IR 1000 3ML Cartridge IR 1200 Cartridge P.M. QL Cleanlet Lancets 28G QL Clever Chek Lancets Ultrathin QL Clever Chek Lancets Ultrathin 30G QL Coaguchek Lancets QL Comfort Assured Lancets Micro Thin 33G QL Comfort Assured Lancets Super Thin 28G Comfort Infusion Set 23"/17MM Comfort Infusion Set 31"/17MM Comfort Infusion Set 43"/17MM QL Comfort Lancets Comfort SHORT Infusion Set 23"/13MM Comfort SHORT Infusion Set 31"/13MM Comfort SHORT Infusion Set 43"/13MM Contact Detach Infusion Set 23" 6MM/29G Contact Detach Infusion Set 23" 8MM/29G Contact Detach Infusion Set 43" 6MM/29G Contact Detach Infusion Set 43" 8MM/29G QL CVS Lancets Micro Thin 33G QL CVS Lancets Original QL CVS Lancets Thin 26G QL CVS Lancets Ultra Thin 30G QL CVS Lancets 21G QL CVS Ultra Thin Lancets QL Diastar Easy Test II Lancets 30G QL Diastar Easy Test Lancets30G QL Droplet Lancets Ultra Thin 30G QL Drug Mart Lancets Thin QL Drug Mart Lancets Ultra Thin QL Drug Mart On-the-go Lancets Gentle 30G QL Drug Mart Unilet Lancets Super Thin 30G QL Drug Mart Unilet Lancets Ultra Thin 28G QL Duane Reade Lancet Alternate Site 26G QL Duane Reade Lancet Super Thin 30G QL Duane Reade Lancet Ultra Thin 28G QL E-z Ject Lancets QL E-z Ject Lancets Color QL E-z Ject Lancets Super Thin QL E-z Ject Lancets Super Thin 30G QL E-z Ject Lancets Thin 26G QL E-z Ject Lancets 21G QL E-ZJECT Lancets Micro-thin 33G QL Easy Comfort Lancets QL Easy Comfort Lancets 30G/Pull Top QL Easy Comfort Lancets 30G/Thin Top QL Easy Touch Lancets 21G/Pressure Activated QL Easy Touch Lancets 23G/Pressure Activated QL Easy Touch Lancets 26G/Pressure Activated QL Easy Touch Lancets 28G/Pressure Activated QL Easy Touch Lancets 28G/Twist QL Easy Touch Lancets 30G/Pressure Activated QL Easy Touch Lancets 30G/Twist QL Easy Touch Lancets 32G/Pressure Activated QL Easy Touch Lancets 32G/Twist QL Easy Touch Lancets 33G/Twist QL Easy Touch Safety Lancets21G/Pressure Activated QL Easy Touch Safety Lancets23G/Pressure Activated QL Easy Touch Safety Lancets26G/Button Activated QL Easy Touch Safety Lancets26G/Pressure Activated QL Easy Touch Safety Lancets28G/Button Activated QL Easy Touch Safety Lancets28G/Pressure Activated QL Easy Twist & CAP Lancets QL Easytest II Lancets Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 32 QL Easytest Lancets QL Embrace Lancets Ultra Thin 30G QL Eql Color Lancets Micro Thin 33G QL Eql Color Lancets 21G QL Eql Super Thin Lancets 30G QL Eql Thin Lancets 26G QL EZ Smart Blood Glucose Lancets QL EZ-lets Lancets 21G QL EZ-lets Lancets 23G QL EZ-lets Lancets 26G Super-soft QL EZ-lets Lancets 28G Ultra-soft QL EZ-lets Lancets 30G QL Fasttake Compact Monitoring System QL Fasttake Test Strips QL Fifty50 Safety Seal Lancets 30G QL Fifty50 Safety Seal Lancets 32G QL Fine 30 QL Fingerstix Lancets QL Fora Lancets QL Freds Pharmacy Unilet Lancets Super Thin 30G QL Freds Pharmacy Unilet Lancets Ultra Thin 28G QL Freestyle Lancets QL Freestyle Unistick II Lancets QL Gentle-let GP Lancets QL Gentle-let Lancets General Purpose Style/Fine Point QL Gentle-let Lancets General Purpose Style/Medium Point QL Gentle-let Lancets Safety Style/Fine Point QL Gentle-let Lancets Safety Style/Medium Point QL Global Inject Ease Lancets 28G QL Global Inject Ease Lancets 30G QL Glucocom Lancets 28G QL Glucocom Lancets 30G QL Glucocom Lancets 33G Glucopro Syringe Reservoir/3ML/Needle/22G X 3/8" Glucose Control Normal Glucose Control Solution QL Glucosource Lancets QL Gmate Lancets 30G QL Gnp Lancets QL Gnp Lancets Micro Thin 33G QL Gnp Lancets Super Thin 30G QL Gnp Lancets Thin QL Gnp Lancets Thin 26G QL Gnp Lancets 21G QL Gnp Micro Thin Lancets 33G QL Gnp Super Thin Lancets/30G QL H&h Thinlet Lancets 26G QL H&h Thinlet Super Thin Lancets 30G QL H-e-b Incontrol Lancets Super Thin 30G QL H-e-b Incontrol Lancets Ultra Thin 28G QL Haemolance QL Haemolance Low Flow Lancets QL Haemolance Plus QL Haemolance Plus High Flow QL Haemolance Plus Low Flow QL Haemolance Plus Max Flow QL Haemolance Plus Pediatric Flow QL Healthwise Lancets 30G QL Healthy Accents Unilet Lancets Super Thin 30G QL Hy-vee Lancets QL Hy-vee Thin Lancets QL HM Lancets Micro Thin 33G QL HM Lancets Ultra Thin 30G Inset Infusion Set 23" 6MM Inset Infusion Set 23" 9MM Inset Infusion Set 43" 6MM Inset Infusion Set 43" 9MM Inset 30 Infusion Set 23" Inset 30 Infusion Set 43" Insulin P.M. IR2020 Black Insulin P.M. IR2020 Blue Insulin P.M. IR2020 Green Insulin P.M. IR2020 Red Insulin P.M. IR2020 Silver QL Kinney Lancets QL Kinney Thin Lancets QL Kroger Lancets QL Kroger Lancets Micro Thin33G QL Kroger Lancets Super Thin QL Kroger Lancets Thin QL Kroger Lancets Thin 26G QL Kroger Lancets Ultrathin 30G QL Kroger Lancets 21G QL Lancets QL Lancets Bullseye Safety QL Lancets Micro Thin 33G QL Lancets Safety Seal 21G QL Lancets Safety Seal 26G QL Lancets Safety Seal 28G QL Lancets Safety Seal 30G QL Lancets Super Thin 28G QL Lancets Thin QL Lancets Twist Top QL Lancets Ultra Fine QL Lancets Ultra Thin QL Lancets Ultra Thin 30G QL Lancets 26G Twist Top QL Lancets 28G QL Lancets 30G QL Lancets 30G Twist Top QL Lancets 31G Twist Top QL Leader Lancets Colored QL Leader Super Thin Lancet QL Leader Thin Lancets QL Liberty Blood Glucose Meter Liberty Glucose Control Mid Liberty Glucose Control Normal QL Liberty Test Strips QL Lifescan Unistik II Lancets QL Lifescan Unistik 2 Deep Penetration QL Lite Touch Lancets QL Litetouch Lancets Micro Thin 33G QL Live Better Lancet Super Thin 30G QL Live Better Lancet Ultra Thin 28G QL Longs Lancets Standard QL Longs Lancets Thin QL Longs Lancets Ultra Thin QL Medichoice Pre-set Safety Lancet Dual Use QL Medichoice Pre-set Safety Lancet Low Flow QL Medichoice Pre-set Safety Lancet Medium Flow QL Medichoice Pre-set Safety Lancet Moderate Flow QL Medichoice Safety Lancet Extra QL Medichoice Safety Lancet Normal QL Medicine Shoppe Lancets QL Medicine Shoppe Lancets Thin QL Medisense Thin Lancets QL Medlance Plus Extra Lancets 21G QL Medlance Plus Lancets QL Medlance Plus Lancets Lite 25G QL Medlance Plus Lite Lancets 25G QL Medlance Plus Special Lancets 0.8MM QL Medlance Plus Superlite 30G QL Medlance Plus Superlite 30G/Comfort Max QL Medlance Plus Universal Lancets 21G QL Medlance Plus/Lite 25G QL Medlance/Extra QL Medlance/Lite QL Medlance/Universal QL Meijer Color Lancets Universal 33G QL Meijer Lancets Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 33 QL Meijer Lancets Thin QL Meijer Lancets Universal 33G QL Meijer Super Thin Lancets QL Microlet Lancets QL Microtainer Safety Flow Lancet/Sterile/Single-use QL Monolet Lancets QL Monolet Opd Lancets QL Monolettor Safety Lancets QL Myglucohealth Mgh Softlance Lancets 30G QL Netgroup Lancets QL Nova Safety Lancets 23G QL Nova Safety Lancets 28G QL Nova Sureflex Lancets QL Novofine Autocover 30GX8MM QL Novofine 30GX8MM QL Novofine 32GX6MM QL Novotwist 30GX8MM QL Novotwist 32GX5MM QL On Call Lancets QL On Call Plus Lancets QL Onetouch Basic System QL Onetouch Basic/Profile Test Strips QL Onetouch Club Lancets Fine Point QL Onetouch Combo Pack QL Onetouch Delica Lancets Extra Fine 33G QL Onetouch Delica Lancets Fine 30G QL Onetouch Finepoint Lancets QL Onetouch Lancets Onetouch Ping Insulin P.M. Onetouch Ping Meter Remote QL Onetouch Profile System QL Onetouch Ultra Blue Onetouch Ultra Control QL Onetouch Ultra Mini QL Onetouch Ultra System Kit QL Onetouch Ultra 2 QL Onetouch Ultralink System (hex) QL Onetouch Ultralink System (DEC) QL Onetouch Ultrasmart QL Onetouch Ultrasoft Lancets QL Onetouch Verio Onetouch Verio Control Solution High QL Onetouch Verio IQ Blood Glucose Monitoring System Onetouch Verio Mid Control Solution QL Onetouch Verio Sync Bloodglucose Monitoring System QL Onetouch Verio Test Strips QL Pen Needles 29G X 12MM QL Pen Needles 29GX1/2" QL Pen Needles 30GX5/16" QL Pen Needles 31G X 1/4" SHORT QL Pen Needles 31G X 3/16" QL Pen Needles 31G X 6MM QL Pen Needles 31GX5/16" QL Perfect Lancets 30G QL Perfect Pressure Activated Safety Lancets 28G QL Pharmacist Choice Ultra Thin Lancets QL Pharmacist Choice Ultra Thin Lancets 28G QL Pharmacist Choice Ultra Thin Lancets 30G QL Pharmacist Choice Ultra Thin Lancets 31G QL Pharmacist Choice Ultra Thin Lancets 33G QL Pharmacy Counter Lancets QL Precision Thin Lancets QL Precision Thins GP Lancet QL Precision Ultra Lancet QL Preferred Plus Lancets Colored 21G QL Preferred Plus Lancets Super Thin 30G QL Preferred Plus Lancets Thin 26G QL Prodigy Pressure Activated Safety Lancets QL Prodigy Twist Top Lancets QL Pss Select GP Lancets QL Pss Select Safety Lancets QL Px Lancets QL Px Lancets Ultra Thin QL Qc Lancets QL Qc Lancets Super Thin QL Qc Lancets Thin QL Qc Lancets Ultra Thin QL Ra E-ZJECT Color Lancets Micro-thin 33G QL Ra E-ZJECT Lancets Thin 26G QL Ra E-ZJECT Lancets Thin 28G QL Ra E-ZJECT Lancets Ultra Thin 30G QL Ra E-ZJECT Lancets 28G QL Reality Lancets QL Reality Trigger Lancets QL Relion Lancets QL Relion Lancets Micro-thin33G QL Relion Lancets Standard 21G QL Relion Lancets Thin 26G QL Relion Lancets Ultra-thin30G QL Relion Thin Lancets QL Relion Ultra Thin Lancets QL Relion Ultra Thin Lancets30G QL Relion Ultra Thin Plus Lancets 32G QL Relion Ultra Thin Plus Lancets 33G QL Renew Advanced Lancing Cartridge Refills QL Rexall Lancets Ultra Thin QL Rightest Gl300 Lancets QL Safe-t-lance Low Flow 25G QL Safe-t-lance Normal Flow 21G QL Safe-t-lance Plus Safety Lancet High Flow QL Safe-t-lance Plus Safety Lancet Low Flow QL Safe-t-lance Plus Safety Lancet Normal Flow QL Safety Lancet 2MM QL Safety Lancet 21G/Pressure Activated QL Safety Lancet 28G/Pressure Activated QL Safety Lancets QL Safety Lancets 21G QL Safety Lancets 28G QL Safety Let Lancets QL Safety Seal Lancets 28G QL Safety Seal Lancets 30G QL Sapscare Twist Top Lancets 30G QL Shopko On-the-go Comfort Lancets 30G QL Shopko Unilet Lancets Super Thin 30G QL Shopko Unilet Lancets Ultra Thin 28G QL Single-let QL Sm Lancets 21G QL Sm Micro Thin Lancets 33G QL Sm Super Thin Lancets QL Sm Super Thin Lancets 30G QL Sm Thin Lancets 26G QL Smart Diabetes Vantage Universal Lancets 30G QL Smart Sense Color Lancets Universal 33G QL Smart Sense Standard Lancets Universal 21G QL Smart Sense Super Thin Lancets Universal 30G QL Smart Sense Thin Lancets Universal 26G QL Smartest Lancets 28G QL Solus V2 Pressure Activated Safety Lancets 28G QL Solus V2 Twist Lancets 30G QL Sterilance TL QL Super Thin Lancets QL Sure Comfort Lancets 28G QL Sure Comfort Lancets 30G QL Sure-lance Flat Lancets QL Sure-lance Lancets 26G QL Sure-lance Thin Lancets 28G QL Sure-lance Ultra Thin Lancets QL Sure-touch Lancets Universal QL Surelite Lancets Surestep Glucose Control Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 34 Surestep Glucose Control Solution Surestep Pro High Glucosecontrol Surestep Pro Low Glucose Control Surestep Pro Normal Glucose Control QL Surestep Pro Test Strips QL Surestep Test Strips QL SB Lancets Thin QL SB Lancets Ultra Thin QL Techlite AST Lancets QL Techlite Lancets QL Techlite Lancets 30G QL Tgt Lancet Alternate Site QL Tgt Lancet Micro Thin 33G QL Tgt Lancet Super Thin 30G QL Tgt Lancet Thin 23G QL Tgt Lancet Thin 26G QL Tgt Lancet Ultra Thin 28G QL Tgt Lancet Ultra Thin 30G QL Thinlets GP Lancets QL Thinlets Lancet QL Todays Health Super Thin Lancets 30G QL Todays Health Ultra Thin Lancets 28G QL Travel Lancets 30G QL Trueplus Lancets 26G QL Trueplus Lancets 28G QL Trueplus Lancets 28G Super Thin QL Trueplus Lancets 30G QL Trueplus Lancets 30G Ultra Thin QL Trueplus Lancets 33G QL Trueplus Lancets 33G Micro Thin QL Trueplus Safety Lancets 28G QL Ulticare Thin Lancets 30G QL Ultilet Basic Lancets 30G QL Ultilet Classic Lancets QL Ultilet Lancets QL Ultilet Lancets 33G QL Ultilet Safety Lancets 23G QL Ultra Thin Lancets 28G QL Ultra Thin Lancets 30G QL Ultra-thin II Auto Lancet QL Ultra-thin II Lancets 28G QL Ultra-thin II Lancets 30G QL Ultra-thin II Safety Autolancets 26G QL Unilet Comfortouch Lancet QL Unilet Excelite QL Unilet Excelite II QL Unilet G.p. Lancet QL Unilet G.p. Superlite Lancet QL Unilet GP 28 Ultra Thin QL Unilet Lancet QL Unilet Superlite Lancet QL Unistik 3 Gentle QL Universal 1 Lancets Thin 26G QL Universal 1 Lancets Ultra Thin 30G V-go 20 V-go 30 V-go 40 QL Value Plus Lancets Standard 21G QL Value Plus Lancets Super Thin 30G QL Value Plus Lancets Thin 26G QL Valumark Lancet Super Thin 30G QL Valumark Lancet Ultra Thin 28G QL Vida Mia Unilet Lancets Super Thin 30G QL Vida Mia Unilet Lancets Ultra Thin 28G QL Vitalet Pro Lancets QL Vitalet Pro Plus Lancets QL W&f Lancets Colored 21G QL W&f Lancets 26G QL Walgreens Advanced Travellancets 28G QL Walgreens Comfort Assuredlancets Micro Thin/33G QL Walgreens Comfort Assuredlancets Super Thin/28G QL Walgreens Lancets QL Walgreens Thin Lancets QL Walgreens Ultra Thin Lancets QL 1ST Choice Lancets Super Thin QL 1ST Choice Lancets Thin QL 1ST Choice Lancets Ultra Thin QL 1ST Tier Unilet Comfortouch Lancets 28G QL 1ST Tier Unilet Comfortouch Lancets 30G NON PREFERRED Accu-chek Active Glucose Control Solution QL Accu-chek Active Strips QL Accu-chek Aviva QL Accu-chek Aviva Plus Accu-chek Combo Accu-chek Comfort Curve Control Solution (2 Levels) Accu-chek Comfort Curve Linearity Solution QL Accu-chek Comfort Curve Test Strips Accu-chek Compact Blue Control Solution (2 Levels) QL Accu-chek Compact Plus QL Accu-chek Compact Plus Care Kit Accu-chek Compact Plus Clear Control Solution (2 Levels) QL Accu-chek Compact Test Drum Accu-chek Fastclix Lancetdevice Kit Accu-chek Instant Glucosecontrol Solution (2 Levels) Accu-chek Multiclix Lanc Et Device Kit QL Accu-chek Nano Smartview Accu-chek Rapid-d Infusion Set/24"/10MM Accu-chek Rapid-d Infusion Set/24"/6MM Accu-chek Rapid-d Infusion Set/24"/8MM Accu-chek Rapid-d Infusion Set/31"/10MM Accu-chek Rapid-d Infusion Set/31"/6MM Accu-chek Rapid-d Infusion Set/31"/8MM Accu-chek Rapid-d Infusion Set/43"/10MM Accu-chek Rapid-d Infusion Set/43"/6MM Accu-chek Rapid-d Infusion Set/43"/8MM Accu-chek Smartview Control QL Accu-chek Smartview Strips Accu-chek Softclix Lancetdevice Kit Accu-chek Spirit Adapter Kit Accu-chek Spirit Battery Kit Accu-chek Spirit Insulin P.M. Kit Accu-chek Tender II Infusion Set/24"/13MM Accu-chek Tender II Infusion Set/24"/17MM Accu-chek Tender II Infusion Set/31"/13MM Accu-chek Tender II Infusion Set/31"/17MM Accu-chek Tender II Infusion Set/43"/17MM QL Accu-chek Voicemate Liberty Mini Lancing Device Onetouch Delica Lancing Device Onetouch Suresoft Lancing Device/18G Onetouch Suresoft Lancing Device/21G Onetouch Suresoft Lancing Device/28G QL Prodigy Autocode Blood Glucose Monitoring System QL Prodigy Autocode Blood Glucose Monitoring/Talking QL Prodigy NO Coding Blood Glucose Test Strips QL Prodigy Pocket Blood Glucose Meter Kit QL Prodigy Voice Blood Glucose Meter Kit MEDICAL DEVICES - MISC PREFERRED QL Aerochamber Mini Aerosol Chamber QL Aerochamber MV QL Aerochamber Plus Flow VU QL Aerochamber Plus Flow-VU QL Aerochamber Plus Flow-VU/Large Mask QL Aerochamber Plus Flow-VU/Mask QL Aerochamber Plus Flow-VU/Medium Mask QL Aerochamber Plus Flow-VU/Small Mask Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 35 Aerochamber Z-stat Plus Valved Holding Chamber W/Flow QL VU QL Aerochamber Z-stat Plus/Flowsignal QL Aerochamber Z-stat Plus/Large Mask QL Aerochamber Z-stat Plus/Medium Mask QL Aerochamber Z-stat Plus/Small Mask QL Aerochamber/Flowsignal Alcoh-glove Contoured Wipe Alcoh-wipe 12" X 12" Alcohol Pads Alcohol Prep Pads Alcohol Swabs Alcohol Wipes QL Arial Chamber QL Breatherite QL Breatherite Collapsible Adult Spacer W/Mask QL Breatherite Collapsible Child Spacer W/Mask QL Breatherite Collapsible Infant Spacer W/Mask QL Breatherite Collapsible Small Child Spacer W/Mask QL Breatherite Collapsible Spacer W/ Neonate Mask QL Breatherite Rigid Spacer W/Mask QL Breatherite W/Large Mask QL Breatherite W/Medium Mask QL Breatherite W/Small Mask BD Swabs Single Use BD Swabs Single Use Butterfly Curity Alcohol Preps/Medium 2 Ply Curity Alcohol Swabs CVS Alcohol Prep Swabs CVS Alcohol Swabs Detachable Face Mask QL E-z Spacer QL E-z Spacer The Body Guards Pack QL Easivent QL Easivent/Mask-large QL Easivent/Mask-medium QL Easivent/Mask-small Easy Touch Alcohol Prep Pads/Medium Fifty50 Alcohol Prep Pads Global Alcohol Prep Ease Pads Gnp Alcohol Swabs Healthwise Alcohol Prep Pads QL Inspirachamber/Anti-static Valved/Mouthpiece QL Inspirachamber/Soothermask/Inspiramask/Medium QL Inspirachamber/Soothermask/Inspiramask/Small Inspirease Bags QL Inspirease Drug Delivery System Inspirease Mouthpiece Inspirease Reservoir Bags QL Liteaire Mask Vortex/Baby Whirl Duckling Mask Vortex/Child/Frog Mask Vortex/Spinner The Duck Mask Vortex/Toddler/Lady Bug Meijer Alcohol Swabs Extra-thick QL Microchamber QL Microspacer QL Nessi Spacer/Large Mask QL Nessi Spacer/Mouthpiece QL Nessi Spacer/Small/MED Mask QL Optichamber Advantage QL Optichamber Diamond QL Optichamber Diamond/Largeface Mask QL Optichamber Diamond/Medium Face Mask QL Optichamber Diamond/Smallface Mask Optichamber Valved Holding Chamber Optichamber/Mask QL Optihaler QL Optihaler MDI Drug Delivery System Panda Mask Large Panda Mask Medium Panda Mask Small Pediatric Panda Mask Pharmacist Choice Alcoholprep Pads QL Pocket Chamber QL Pocket Spacer Qc Alcohol Swabs Ra Alcohol Swabs Reality Swabs Relion Alcohol Swabs QL Riteflo Saps Care Alcohol Prep Pads Shopko Alcohol Swabs Sm Alcohol Prep Pads Sure Comfort Alcohol Prep Pads Sure-prep Alcohol Prep Pads SB Alcohol Prep Pads Tgt Alcohol Swabs Ultilet Alcohol Swab Ultilet Alcohol Swabs QL Valved Holding Chamber QL Vortex Valved Holding Chamber QL Watchhaler Webcol Alcohol Prep Large 1 Ply Webcol Alcohol Prep Large 2 Ply Webcol Alcohol Prep Medium 2 Ply MISCELLANEOUS GENERIC acetylcysteine adenosine alprostadil amino acids aminosyn II 8.5%/electrolytes aminosyn 8.5%/electrolytes aminosyn-hf argyle sterile water 100ML calcium chloride calcium gluconate chloromag chromium chloride clinisol SF 15% cosyntropin cysteine HCL deferoxamine mesylate dehydrated alcohol delflex-lm/1.5% dextrose delflex-LC/1.5% dextrose dextrose 10% dextrose 10% flex container dextrose 2.5%/sodium chloride 0.45% dextrose 2.5%/NACL 0.45% dextrose 30% dextrose 30% partial fill dextrose 5% dextrose 5% viaflex dextrose 5%/lactated ringers dextrose 5%/potassium chloride 0.15% dextrose 5%/ringers dextrose 5%/sodium chloride 0.2% dextrose 5%/sodium chloride 0.33% dextrose 5%/sodium chloride 0.45% dextrose 5%/sodium chloride 0.9% dextrose 5%/NACL 0.2% dextrose 5%/NACL 0.33% dextrose 5%/NACL 0.45% dextrose 5%/NACL 0.9% dextrose 50% dextrose 70% Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 36 dipyridamole effer-k effervescent pot chloride effervescent potassium effervescent potassium/chloride flumazenil folastin folbic fomepizole formadon formaldehyde hepatamine hepatasol indigo carmine indocyanine green intralipid isolyte-m/dextrose 5% isosulfan blue k-effervescent k-prime k-sol k-vescent kendall sodium chloride flush kionex klor-CON klor-CON m10 klor-CON m20 klor-CON 10 klor-CON 8 klor-CON/EF l-cysteine HCL lactated ringers lactated ringers dextrose 5% viaflex lactated ringers irrigation lactated ringers viaflex lanolin liposyn iii magnesium chloride magnesium sulfate methylene blue monoject pharma grade flush syringe monoject sodium chloride flush morrhuate sodium multitrace-4 concentrate multitrace-5 concentrate n-acetyl-l-cysteine naloxone HCL naltrexone HCL normal saline flush normal saline flush for flushing vascular access devices normal saline i.v. flush normosol-m IN D5W nutrilipid nutrilyte nutrilyte II phospha 250 neutral physiolyte physiosol irrigation potassium acetate potassium bicarbonate potassium chloride potassium chloride CR potassium chloride ER potassium chloride SR potassium chloride 0.15% /NACL 0.45% viaflex potassium chloride 0.15% w/NACL 0.9% viaflex potassium chloride 0.15% D5W/NACL 0.33% potassium chloride 0.15% D5W/NACL 0.45% potassium chloride 0.15% D5W/NACL 0.45% viaflex potassium chloride 0.15% NACL 0.9% potassium chloride 0.15%/D5W potassium chloride 0.22% D5W/NACL 0.45% potassium chloride 0.224%/D5W/NACL 0.45% potassium chloride 0.224%D5W/NACL 0.45% viaflex potassium chloride 0.3%/D5W potassium chloride 0.3%/NACL 0.9%/viaflex potassium phosphate potassium phosphates premasol ringers injection ringers irrigation saline flush saline flush zr/sterile field scleromate sodium morrhuate sodium acetate sodium bicarbonate sodium bicarbonate partial fill sodium chloride sodium chloride bacteriostatic sodium chloride flush sodium chloride pab sodium chloride 0.45% sodium chloride 0.45% viaflex sodium phosphate sodium polystyrene sulfonate sodium thiosulfate sterile diluent for epoprostenol sodium sterile water for injection sterile water irrigation sterile water irrigation plastic bottle sterile water irrigation w/hanger swabflush saline flush tis-u-sol tpn electrolytes virt-phos 250 neutral virt-vite forte vp-precip zinc sulfate Ammonium Molybdate Antivenin Latrodectus Mactans Antivenin Micrurus Fulvius BD posiflush Calcium-folic Acid Plus D Chromium Chloride Clinimix E 4.25%/Dextrose 25% Clinimix 4.25%/Dextrose 10% Clinimix 4.25%/Dextrose 20% Clinimix 4.25%/Dextrose 25% Copper Sulfate Copper Trace Metal Cysteine HCL Delflex-lm/2.5% Dextrose Delflex-lm/4.25% Dextrose Delflex-sm/1.5% Dextrose Delflex-sm/2.5% Dextrose Dextrose 10%/NACL 0.2% Dextrose 10%/NACL 0.225% Dextrose 10%/NACL 0.45% Dextrose 20% Dextrose 25% Dextrose 40% Dextrose 5% /Electrolyte #48 Viaflex Dextrose 5%/NACL 0.225% Dextrose 5%/NACL 0.3% Freamine Iii Hyperlyte-CR Imogam Rabies-ht KCL 0.075%/D5W/NACL 0.45% KCL 0.15%/D5W/ NACL 0.3% KCL 0.15%/D5W/Lr Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 37 KCL 0.15%/D5W/NACL 0.2% KCL 0.15%/D5W/NACL 0.225% KCL 0.15%/D5W/NACL 0.45% KCL 0.15%/D5W/NACL 0.9% KCL 0.3%/D5W/Lr IV Lac Ring KCL 0.3%/D5W/NACL 0.45% KCL 0.3%/D5W/NACL 0.9% L-methyl-b6-b12 L-methylfolate L-methylfolate Calcium L-methylfolate CA/P-5-P.M.-CBL Lecithin Lmthf/Pyridoxine HCL/Cyanocobalamin Lozi-flur Magnesium Sulfate Magnesium Sulfate IN D5W Multitrace-4 Multitrace-4 Neonatal Multitrace-5 MD-gastroview Naloxone HCL Normosol -r Normosol-r IN D5W Potassium Acetate Potassium Chloride Potassium Chloride ER Potassium Chloride 0.15% /NACL 0.45% Viaflex Potassium Chloride 0.15%/NACL 0.9% Potassium Chloride 0.3%/ NACL 0.9% Saccharin Sodium Selenium Sodium Chloride Sodium Fluoride Sodium Lactate Sodium Saccharin Dihydrate Tryptophan Vp-gstn Zinc Sulfate Zinc Trace Metal PREVENTIVE fluor-a-day fluoride fluoritab flura-drops karidium ludent nafrinse nafrinse drops sodium fluoride PREFERRED Chemet Chemstrip-k Cuprimine Fluor-a-day Hyperrab S/D K-phos NON PREFERRED Botox Cosmetic Cerefolin Cyanocobalamin/Levomefolate Calcium/Pyridoxine HCL Depen Titratabs Effer-k Fluorabon Flura-drops Folbic RF Foltx Galzin Isolyte-s Klor-CON M15 L-methyl-mc Magnebind 400 Metafolbic Phisohex Plasma-lyte A Plasma-lyte-148 Vayacog Vayarin Vayarol Vita-respa SPECIALTY PA Adagen PA Benlysta PA Bivigam PA Carimune Nanofiltered PA Cytogam PA Exjade PA Ferriprox PA Flebogamma Dif PA Gamastan S/D PA Gammagard Liquid PA Gammagard S/D PA Gammagard S/D Iga Less Than 1mcg/ML PA Gammaked PA Gammaplex PA Gamunex-c Hepagam B PA Hizentra Hyperhep B S/D Hyperrho S/D Hyperrho S/D Mini-dose Micrhogam Ultra-filtered Plus Nabi-HB PA Octagam PA Privigen Rhogam Ultra-filtered Plus Rhophylac PA Synagis Syprine QL,PA Thyrogen Vivitrol Winrho SDF PA Xiaflex ACA PREVENTIVE DRUGS ASPIRIN PREVENTIVE adult aspirin EC low strength aspir-low aspir-81 aspirin aspirin adult low strength aspirin childrens aspirin enteric coated adult low strength aspirin low dose aspirin low strength aspirin EC aspirin EC low dose aspirin EC LO-dose aspirin 81 aspirin 81 low dose aspirtab bayer advanced aspirin regular strength bayer aspirin bayer aspirin regimen bayer aspirin EC low dose bayer chewable low dose bayer low dose childrens aspirin Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 38 childrens aspirin low strength ecotrin low strength ecpirin enteric coated aspirin eq adult aspirin low strength eq aspirin eq aspirin adult low dose eq aspirin low dose eq aspirin EC eq childrens aspirin eql adult aspirin low strength eql aspirin eql aspirin low dose eql aspirin EC eql childrens aspirin gnp adult aspirin low strength gnp aspirin gnp aspirin low dose goodsense aspirin low dose kls aspirin low dose kls aspirin EC kp aspirin meijer aspirin EC miniprin low dose norwich aspirin px aspirin px enteric aspirin qc aspirin qc aspirin low dose qc childrens aspirin ra aspirin ra aspirin adult low dose ra aspirin adult low strength ra aspirin childrens ra aspirin EC ra aspirin EC adult low strength ra childrens aspirin sm aspirin sm aspirin adult low strength sm aspirin enteric coated sm aspirin low dose sm aspirin EC low strength sm childrens aspirin st joseph aspirin tgt aspirin tgt aspirin low dose tgt childrens aspirin tgt enteric-coated aspirin th aspirin th aspirin low dose th enteric aspirin CVS aspirin CVS aspirin adult low dose CVS aspirin adult low strength CVS aspirin child CVS aspirin low dose CVS aspirin low strength CVS aspirin EC CVS childrens aspirin CVS enteric aspirin EC-81 aspirin HM aspirin HM aspirin EC HM aspirin EC low dose MM aspirin SB aspirin SB aspirin EC SB childrens aspirin SB low dose asa EC PREVENTIVE Adult Aspirin Low Strength Aspirin Low Dose Medi-seltzer CONTRACEPTIVES GENERIC Amethyst Necon 1/50-28 Necon 10/11-28 Zovia 1/50e PREVENTIVE altavera alyacen 1/35 alyacen 7/7/7 QL amethia QL amethia LO apri aranelle aubra aviane azurette balziva briellyn camila QL camrese QL camrese LO caziant cesia chateal cryselle-28 cyclafem 1/35 cyclafem 7/7/7 dasetta 1/35 dasetta 7/7/7 QL daysee deblitane delyla desogestrel/ethinyl estradiol drospirenone/ethinyl estradiol elinest emoquette enpresse-28 enskyce errin estarylla falmina gianvi gildagia gildess FE 1.5/30 gildess FE 1/20 gildess 1.5/30 gildess 1/20 gildess 24 FE heather QL introvale jencycla QL jolessa jolivette junel FE 1.5/30 junel FE 1/20 junel 1.5/30 junel 1/20 kariva kelnor 1/35 kurvelo larin FE 1.5/30 larin FE 1/20 larin 1.5/30 Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 39 larin 1/20 leena lessina levonest levonorgestrel QL levonorgestrel and ethinyl estradiol levonorgestrel/ethinyl estradiol levora 0.15/30-28 lomedia 24 FE loryna low-ogestrel lutera lyza marlissa QL medroxyprogesterone acetate microgestin FE microgestin FE 1.5/30 microgestin 1.5/30 microgestin 1/20 mono-linyah mononessa my way myzilra necon 0.5/35-28 necon 1/35 necon 7/7/7 next choice one dose nikki nora-be norethindrone norethindrone acetate/ethinyl estradiol norethindrone acetate/ethinyl estradiol/ferrous fumarate norgestimate/ethinyl estradiol norlyroc nortrel 0.5/35 (28) nortrel 1/35 nortrel 7/7/7 ocella orsythia philith pimtrea pirmella 1/35 pirmella 7/7/7 portia-28 previfem QL quasense reclipsen sharobel solia sprintec 28 sronyx syeda tarina FE 1/20 tilia FE tri-estarylla tri-legest FE tri-linyah tri-previfem tri-sprintec trinessa trivora-28 velivet vestura viorele vyfemla wera wymzya FE xulane zarah zenchent zenchent FE zovia 1/35e Ogestrel PREFERRED Beyaz LO Loestrin FE Minastrin 24 FE Safyral PREVENTIVE Natazia QL Nuvaring NON PREFERRED QL Depo-subq Provera 104 PREVENTIVE Encare Fc Female Condom Fc2 Female Condom Femcap Omniflex Diaphragm Options Conceptrol Vaginal Contraceptive Options Gynol II Vaginal Contraceptive Ortho Diaphragm All-flex/65MM Ortho Diaphragm All-flex/70MM Ortho Diaphragm All-flex/75MM Ortho Diaphragm All-flex/80MM Ortho Diaphragm Coil Spring Kit 100 Ortho Diaphragm Coil Spring Kit 105 Ortho Diaphragm Coil Spring Kit 50 Ortho Diaphragm Flat Spring Kit 55 Ortho Diaphragm Flat Spring Kit 60 Ortho Diaphragm Flat Spring Kit 65 Ortho Diaphragm Flat Spring Kit 70 Ortho Diaphragm Flat Spring Kit 75 Ortho Diaphragm Flat Spring Kit 80 Ortho Diaphragm Flat Spring Kit 85 Ortho Diaphragm Flat Spring Kit 90 Ortho Diaphragm Flat Spring Kit 95 Prentif Cavity-rim Cervical CAP Prentif Fitting Set Shur-seal Vcf Vaginal Contraceptive Film Vcf Vaginal Contraceptive Foam Wide-seal Silicone Diaphragm Kit 60 Wide-seal Silicone Diaphragm Kit 65 Wide-seal Silicone Diaphragm Kit 70 Wide-seal Silicone Diaphragm Kit 75 Wide-seal Silicone Diaphragm Kit 80 Wide-seal Silicone Diaphragm Kit 85 Wide-seal Silicone Diaphragm Kit 90 Wide-seal Silicone Diaphragm Kit 95 PREVENTIVE Implanon Mirena Nexplanon Skyla FLUORIDE GENERIC Lozi-flur Sodium Fluoride PREVENTIVE fluor-a-day fluoride fluoritab flura-drops karidium ludent nafrinse nafrinse drops Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 40 sodium fluoride PREFERRED Fluor-a-day NON PREFERRED Fluorabon Flura-drops FOLIC ACID GENERIC M-vit Prenaplus Prenatal Low Iron Prenatal Plus Tricare PREVENTIVE eql folic acid fa-8 folic acid gnp folic acid kp folic acid px folic acid ra folic acid sm folic acid sm prenatal vitamins th folic acid yl folic acid Classic Prenatal CVS folic acid Eql Prenatal Formula Gnp Prenatal Vitamins HM folic acid Mission Prenatal HP Multi Prenatal Perry Prenatal Pre-natal Formula Prenatal Prenatal And Iron Prenatal Formula Prenatal Forte Prenatal Vitamins Px Prenatal Multivitamins Ra Prenatal Sm Prenatal Vitamins PREVENTIVE Atabex Prenatal CVS Prenatal Fa-8 Gnp Daily Prenatal Gnp Prenatal Goodsense Prenatal Vitamins HM One Daily Prenatal Combo HM Prenatal Kp Prenatal Multivitamins Mission Prenatal Nat-rul Prenatal Vitamins One-a-day Womens Prenatal Prenatal Complete Prenatal Multi +dha Prenatal One Daily PA Prenatal Formula Qc Prenatal Ra One Daily Ra Prenatal Formula/Folicacid Right Step Prenatal Sm One Daily Prenatal Stuart Prenatal Stuart Prenatal + DHA Th Prenatal Vitamins IMMUNIZATIONS PREVENTIVE Acthib Adacel Afluria PF 2012-2013 Afluria PF 2013-2014 Afluria PF 2014-2015 Afluria 2012-2013 Afluria 2013-2014 Afluria 2014-2015 Bexsero Boostrix Cervarix Comvax Daptacel Diphtheria/Tetanus Toxoids Adsorbed Pediatric Engerix-b Fluarix Quadrivalent 2013-2014 Fluarix Quadrivalent 2014-2015 Fluarix 2013-2014 Fluarix 2014-2015 Flublok 2013-2014 Flublok 2014-2015 Flucelvax 2013-2014 Flucelvax 2014-2015 Flulaval Quadrivalent 2013-2014 Flulaval Quadrivalent 2014-2015 Flulaval 2013-2014 Flulaval 2014-2015 Flumist Nasal Vaccine 2012-2013 Flumist Quadrivalent Fluvirin PF 2013-2014 Fluvirin PF 2014-2015 Fluvirin 2013-2014 Fluvirin 2014-2015 Fluzone High-dose PF 2013-2014 Fluzone High-dose PF 2014-2015 Fluzone Intradermal Fluzone Intradermal Quadrivalent Fluzone Pediatric PF 2013-2014 Fluzone PF 2013-2014 Fluzone PF 2014-2015 Fluzone Quadrivalent 2013-2014 Fluzone Quadrivalent 2014-2015 Fluzone Split 2013-2014 Fluzone Split 2014-2015 Gardasil Gardasil 9 Havrix Hiberix Infanrix Influenza A (h1n1) Monovalent 2009 Ipol Inactivated IPV Kinrix M-m-r II W/Diluent 10 Dose Medical Provider EZ Flu Shot PF 2012-2013 Medical Provider EZ Flu Shot PF 2013-2014 Medical Provider EZ Flu Shot PF 2014-2015 Medical Provider EZ Flu Shot 2013-2014 Medical Provider EZ Flu Shot 2014-2015 Menactra Menomune-a/C/Y/W-135 Menveo Pediarix Pedvax HIB Pentacel Physicians EZ Use Flu Kit 2012-2013 Pneumovax 23 Pneumovax 23/1 Dose Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 41 Pneumovax 23/5 Dose Prevnar 13 Proquad Recombivax HB Rotarix Rotateq Tenivac Tetanus/Diphtheria Toxoids-adsorbed Adult Trumenba Twinrix Vaqta Varivax Zostavax IRON PREVENTIVE bprotected pedia iron eq slow-release iron eql iron supplement therapy eql slow release iron ezfe 200 feosol fer-iron ferate ferosul ferretts ferrex 150 ferric x-150 ferro-bob ferrocite ferrotabs ferrous drops ferrous fumarate 324 ferrous gluconate ferrous sulfate ferrousul ferus gnp iron gnp slow release iron high potency iron iferex 150 iron iron slow release iron supplement iron supplement childrens kp ferrous gluconate kp ferrous sulfate meijer ferrous sulfate myferon 150 nu-iron 150 poly-iron 150 px iron qc ferrous sulfate ra high potency iron ra iron ra slow release iron slow iron slow release iron sm iron sm iron slow release th iron th slow release iron wee care CVS iron FE gluconate FE TABS HM iron HM iron slow release PREVENTIVE CVS Slow Release Iron Elite Iron Femiron Feosol Ferretts IPS Ferrimin 150 Ferro-sequels Ferrous Fumarate Ferrous Gluconate Ferrous Sulfate FE Aspartate High Potency Iron Iron Iron Chews Pediatric Iron Up Mykidz Iron 10 Novaferrum Pediatric Drops Perfect Iron Profe Proferrin ES Sm Slow Release Iron SMOKING CESSATION PREVENTIVE QL buproban QL bupropion HCL SR QL eq nicotine QL eq nicotine gum refill QL eq nicotine gum starter QL eq nicotine polacrilex QL eq nicotine step 3 QL eql nicotine QL eql nicotine polacrilex QL eql nicotine polacrilex refill QL eql nicotine polacrilex starter QL gnp nicotine polacrilex QL gnp nicotine polacrilex mini QL kls quit2 QL kls quit4 QL nicorelief QL nicotine QL nicotine polacrilex QL nicotine polacrilex refill QL nicotine polacrilex starter kit QL nicotine step 1 QL nicotine step 2 QL nicotine step 3 QL nicotine transdermal system QL px stop smoking aid QL qc nicotine polacrilex QL ra mini nicotine QL ra nicotine QL ra nicotine polacrilex QL ra nicotine transdermal system step 3 QL sm nicotine QL sm nicotine polacrilex QL sw nicotine polacrilex QL tgt nicotine gum QL tgt nicotine polacrilex QL tgt nicotine step one QL tgt nicotine step three QL tgt nicotine step two QL thrive QL CVS nicotine QL CVS nicotine polacrilex QL CVS nicotine polacrilex starter QL CVS nicotine transdermal system QL CVS nts step 1 Effective April 1, 2015 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; 42 QL HM nicotine polacrilex QL HM nicotine transdermal system QL HM nicotine transdermal system step 3 QL SR nicotine gum PREVENTIVE QL Chantix QL Chantix Continuing Month PAK QL Chantix Starting Month PAK QL Nicotine Transdermal System PREVENTIVE QL Nicotrol Inhaler QL Nicotrol Ns VITAMIN D GENERIC decara PREVENTIVE aqueous vitamin d infants bio-d-mulsion bio-d-mulsion forte bprotected pedia d-vite d 1000 d 10000 d 2000 d 400 d 5000 d-vita d-1000 d-1000 extra strength d-2000 maximum strength d-3-5 d-400 d-5000 d-5000 maximum strength delta d3 dialyvite vitamin d 5000 d2000 ultra strength d3 d3 adult d3 high potency d3 kids d3 maximum strength d3 super strength d3 ultra strength d3-1000 d3-50 eql childrens vitamin d gummies eql vitamin d-3 eql vitamin d3 gnp vitamin d gnp vitamin d maximum strength gnp vitamin d super strength gnp vitamin d3 extra strength healthy kids vitamin d3 just d kp vitamin d maximum d3 nat-rul vitamin d optimal-d optimal-d pack opurity vitamin d pronutrients vitamin d3 ra vitamin d-3 sm vitamin d sm vitamin d3 th vitamin d3 thera-d rapid repletion thera-d sport thera-d 2000 vitamin d vitamin d high potency vitamin d 400 vitamin d-1000 vitamin d-1000 maximum strength vitamin d-3 vitamin d-400 vitamin d3 vitamin d3 adult gummies vitamin d3 high potency vitamin d3 maximum strength vitamin d3 super strength CVS childrens vitamin d for bone health CVS vitamin d CVS vitamin d infants CVS vitamin d 5000 high-potency CVS vitamin d3 HM vitamin d HM vitamin d3 PA vitamin d-3 PA vitamin d-3 gummy PREVENTIVE CVS Vitamin D3 Ddrops Dialyvite Vitamin D3 Max D3 D3 Dots HM Vitamin D3 Replesta Replesta Childrens Replesta Nx Sm Vitamin D3 Maximum Strength Super Daily D3 Thera-d 4000 Vitamelts Vitamin D Vitamin D Vitamin D3 Vitamin D3 400 Wellesse Vitamin D3 BOWEL PREPARATION AGENTS PREVENTIVE gavilyte-c gavilyte-n/flavor pack gavilyte-G peg 3350/electrolytes peg-3350/electrolytes peg-3350/NACL/NA bicarbonate/KCL trilyte NON PREFERRED Colyte-flavor Packs Golytely BREAST CANCER PREVENTIVE tamoxifen citrate Effective April 1, 2015 v.1 PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; ©Catamaran 2015. All Rights Reserved. May not be copied or distributed without authorization. 43 Index A A-hydrocort, 11 a-methapred, 11 abacavir, 2 abacavir sulfate/lamivudine/zidovudine, 2 Abelcet, 2 Abilify, 20 Abilify Discmelt, 20 Abilify Maintena, 20 Abraxane, 5 Absorica, 9 Abstral, 26 acamprosate calcium DR, 22 Acanya, 9 acarbose, 13 Accu-chek Active Glucose Control Solution, 35 Accu-chek Active Strips, 35 Accu-chek Aviva, 35 Accu-chek Aviva Plus, 35 Accu-chek Combo, 35 Accu-chek Comfort Curve Control Solution (2 Levels), 35 Accu-chek Comfort Curve Linearity Solution, 35 Accu-chek Comfort Curve Test Strips, 35 Accu-chek Compact Blue Control Solution (2 Levels), 35 Accu-chek Compact Plus, 35 Accu-chek Compact Plus Care Kit, 35 Accu-chek Compact Plus Clear Control Solution (2 Levels), 35 Accu-chek Compact Test Drum, 35 Accu-chek Fastclix Lancetdevice Kit, 35 Accu-chek Fastclix Lancets, 31 Accu-chek Instant Glucosecontrol Solution (2 Levels), 35 Accu-chek Multiclix Lanc Et Device Kit, 35 Accu-chek Multiclix Lancets, 31 Accu-chek Nano Smartview, 35 Accu-chek Rapid-d Infusion Set/24"/10MM, 35 Accu-chek Rapid-d Infusion Set/24"/6MM, 35 Accu-chek Rapid-d Infusion Set/24"/8MM, 35 Accu-chek Rapid-d Infusion Set/31"/10MM, 35 Accu-chek Rapid-d Infusion Set/31"/6MM, 35 Accu-chek Rapid-d Infusion Set/31"/8MM, 35 Accu-chek Rapid-d Infusion Set/43"/10MM, 35 Accu-chek Rapid-d Infusion Set/43"/6MM, 35 Accu-chek Rapid-d Infusion Set/43"/8MM, 35 Accu-chek Safe-t-pro Lancets, 31 Accu-chek Safe-t-pro Pluslancets, 31 Accu-chek Smartview Control, 35 Accu-chek Smartview Strips, 35 Accu-chek Soft Touch Lancets, 31 Accu-chek Softclix Lancetdevice Kit, 35 Accu-chek Softclix Lancets, 31 Accu-chek Spirit Adapter Kit, 35 Accu-chek Spirit Battery Kit, 35 Accu-chek Spirit Insulin P.M. Kit, 35 Accu-chek Tender II Infusion Set/24"/13MM, 35 Accu-chek Tender II Infusion Set/24"/17MM, 35 Accu-chek Tender II Infusion Set/31"/13MM, 35 Accu-chek Tender II Infusion Set/31"/17MM, 35 Accu-chek Tender II Infusion Set/43"/17MM, 35 Accu-chek Voicemate, 35 Acd Formula A, 19 Acd Formula B, 19 Acd-a Noclot-50, 19 acebutolol HCL, 6 Acetaminophen/Caffeine/Dihydrocodeine Bitartrate, 26 acetaminophen/codeine, 25 acetaminophen/codeine #2, 25 acetaminophen/codeine #3, 25 acetaminophen/codeine #4, 25 acetaminophen/codeine phosphate, 25 acetasol HC, 24 acetazolamide, 7 Acetazolamide, 7 acetazolamide ER, 7 acetazolamide sodium, 7 acetic acid, 24 acetic acid 0.25%, 17 Acetic Acid/Aluminum Acetate, 24 acetylcysteine, 28, 36 Aciphex Sprinkle, 15 acitretin, 9 Actemra, 27 Acthib, 29, 41 Acti-lance Lancets 28G, 31 Acti-lance Lite Safety Lancets 28G, 31 Acti-lance Special Safety Lancets 17G, 31 Acti-lance Special Safetylancets 17G, 31 Acti-lance Universal Safety Lancets 23G, 31 acticin, 10 Actimmune, 5 Actonel, 13 Actoplus Met XR, 13 Acuvail, 24 acyclovir, 2, 9 acyclovir sodium, 2 Acyclovir Sodium, 2 Adacel, 29, 41 Adagen, 38 adapalene, 8 Adcetris, 4 Adcirca, 8 adefovir dipivoxil, 3 Adempas, 8 adenosine, 6, 36 adriamycin, 4 Adriamycin, 4 adrucil, 4 adult aspirin EC low strength, 25, 38 Adult Aspirin Low Strength, 25, 39 Advair Diskus, 28 Advair HFA, 28 Advate, 19 Advocate Lancets, 31 Advocate Safety Lancets, 32 aero otic HC, 24 Aerochamber Mini Aerosol Chamber, 35 Aerochamber MV, 35 Aerochamber Plus Flow VU, 35 Aerochamber Plus Flow-VU, 35 Aerochamber Plus Flow-VU/Large Mask, 35 Aerochamber Plus Flow-VU/Mask, 35 Aerochamber Plus Flow-VU/Medium Mask, 35 Aerochamber Plus Flow-VU/Small Mask, 35 Aerochamber Z-stat Plus Valved Holding Chamber W/Flow VU, 36 Aerochamber Z-stat Plus/Flowsignal, 36 Aerochamber Z-stat Plus/Large Mask, 36 Aerochamber Z-stat Plus/Medium Mask, 36 Aerochamber Z-stat Plus/Small Mask, 36 Aerochamber/Flowsignal, 36 AF Lancets Super Thin, 32 afeditab CR, 6 Afinitor, 5 Afinitor Disperz, 5 Afluria 2012-2013, 29, 41 Afluria 2013-2014, 29, 41 Afluria 2014-2015, 29, 41 Afluria PF 2012-2013, 29, 41 Afluria PF 2013-2014, 29, 41 Afluria PF 2014-2015, 29, 41 Agamatrix Ultra-thin Lancets 33G, 32 Aggrastat, 19 Aggrenox, 19 airavite, 17 ak-fluor, 24 Ak-fluor, 24 ak-poly-bac, 23 akorn balanced salt solution, 24 ala cort, 9 Albatussin NN, 28 Albenza, 3 albuked 25, 19 albuked 5, 19 albumin human, 19 albumin-zlb, 19 albuminar-25, 19 albuminar-5, 19 alburx, 19 albutein, 19 albuterol sulfate, 28 albuterol sulfate ER, 28 albuterol TAB 4MG, 28 alclometasone dipropionate, 9 Alcoh-glove Contoured Wipe, 36 Alcoh-wipe 12" X 12", 36 Alcohol Pads, 36 Alcohol Prep Pads, 36 Alcohol Swabs, 36 Alcohol Wipes, 36 Aldurazyme, 15 alendronate sodium, 13 Alendronate Sodium, 13 alfentanil, 25 Alferon N, 5 alfuzosin HCL ER, 17 ali-flex, 25 Alimta, 4 Alinia, 3 Alkeran, 3 allopurinol, 27 Alocril, 24 Alodox Convenience Kit, 1 Alomide, 24 Alora, 11 Aloxi, 16 Alpain, 25 Alphagan P, 24 Alphanate/Von Willebrand Factor Complex/Human, 19 Alphanine SD, 19 alphaquin HP, 10 alphatrex, 9 alprazolam, 20 alprazolam ER, 20 alprazolam odt, 20 alprazolam XR, 20 alprostadil, 36 Alrex, 23 Alsuma, 27 Altabax, 9 altacaine, 24 altafluor, 24 altafrin, 24 altavera, 11, 39 Altoprev, 8 Alvesco, 28 alyacen 1/35, 11, 39 alyacen 7/7/7, 12, 39 amantadine HCL, 21 Amantadine HCL, 21 Ambisome, 2 Amcinonide, 10 amethia, 12, 39 amethia LO, 12, 39 Amethyst, 11, 39 amifostine, 5 Amigo Insulin P.M., 32 amikacin sulfate, 2 amiloride HCL, 7 amiloride/hydrochlorothiazide, 7 amino acids, 36 aminoacetic acid, 17 Aminobenzoate Potassium, 29 aminocaproic acid, 19 Aminocaproic Acid, 19 aminophylline, 28 aminosyn 8.5%/electrolytes, 36 aminosyn II 8.5%/electrolytes, 36 aminosyn-hf, 36 amiodarone HCL, 6 Amiodarone HCL, 6 Amitiza, 16 amitriptyline HCL, 20 amlodipine besylate, 6 amlodipine besylate/atorvastatin calcium, 8 amlodipine besylate/benazepril HCL, 7 amlodipine besylate/benazepril hydrochloride, 7 amlodipine besylate/valsartan, 7 amlodipine/valsartan/hctz, 7 ammonium lactate, 10 Ammonium Molybdate, 37 amnesteem, 8 Amoxapine, 20 amoxicillin, 1 Amoxicillin, 1 Amoxicillin ER, 1 amoxicillin/clavulanate potassium, 1 amoxicillin/clavulanate potassium ER, 1 amphetamine/dextroamphetamine, 21 Amphotec, 2 Amphotericin B, 2 ampicillin, 1 Ampicillin, 1 ampicillin sodium, 1 Ampicillin Sodium, 1 ampicillin-sulbactam, 1 Ampicillin-sulbactam, 1 Ampyra, 22 Amturnide, 7 ana-lex, 16 Anadrol-50, 11 anagrelide hydrochloride, 19 Analpram Advanced, 16 Analpram-HC, 16 anastrozole, 4 Androderm, 11 Androgel, 11 Androgel P.M., 11 Androxy, 11 Animas Vibe Insulin P.M., 32 Animas Vibe Insulin P.M./Black, 32 Animas Vibe Insulin P.M./Blue, 32 Animas Vibe Insulin P.M./Limelight Green, 32 Animas Vibe Insulin P.M./Pink Glow, 32 Anticoagulant Citrate Dextrose Solution A, 19 Anticoagulant Sodium Citrate, 19 antipyrine/benzocaine, 24 Antipyrine/Benzocaine, 24 Antivenin Latrodectus Mactans, 37 Antivenin Micrurus Fulvius, 37 anucort-HC, 16 Anzemet, 16 AP-zel, 31 apexicon, 9 Apexicon E, 10 Apidra, 13 Apidra Solostar, 13 Aplenzin, 20 Apokyn, 22 apraclonidine, 24 apri, 12, 39 Apriso, 16 Aptivus, 2 aqueous vitamin d infants, 29, 43 Aquoral, 20 Aralast NP, 28 aranelle, 12, 39 Aranesp Albumin Free, 18 arbinoxa, 27 Arcalyst, 27 Arcapta Neohaler, 28 argatroban, 18 Argatroban, 19 argyle sterile saline 100ML, 17 argyle sterile water 100ML, 36 Arial Chamber, 36 Armour Thyroid, 15 Arranon, 4 Arzerra, 4 Arzol Silver Nitrate App Licators, 10 Asacol HD, 16 ascomp/codeine, 26 ascorbic acid, 29 Asmanex HFA, 28 Asmanex Twisthaler 120 Metered Doses, 28 Asmanex Twisthaler 14 Metered Doses, 28 Asmanex Twisthaler 30 Me Tered Doses, 28 Asmanex Twisthaler 30 Metered Doses, 28 Asmanex Twisthaler 60 Metered Doses, 28 Asmanex Twisthaler 7 Metered Doses, 28 aspir-81, 25, 38 aspir-low, 25, 38 aspirin, 25, 38 aspirin 81, 25, 38 aspirin 81 low dose, 25, 38 aspirin adult low strength, 25, 38 aspirin childrens, 25, 38 aspirin EC, 25, 38 aspirin EC LO-dose, 25, 38 aspirin EC low dose, 25, 38 aspirin enteric coated adult low strength, 25, 38 aspirin low dose, 25, 38 Aspirin Low Dose, 25, 39 aspirin low strength, 25, 38 Aspirin-caffeine-dihydrocodeine, 26 aspirtab, 25, 38 Assure Comfort Lancets Ultra Thin 28G, 32 Assure Comfort Lancets Ultra Thin 30G, 32 Assure Haemolance Plus High Flow 18G, 32 Assure Haemolance Plus Low Flow 25G, 32 Assure Haemolance Plus Micro Flow 28G, 32 Assure Haemolance Plus Normal Flow 21G, 32 Assure Haemolance Plus Pediatric Blade, 32 Assure Lance Lancets, 32 Assure Lancets, 32 astramorph, 26 AT Last Lancets, 32 Atabex Prenatal, 31, 41 Atelvia, 14 atenolol, 6 atenolol/chlorthalidone, 7 Atgam, 4 atorvastatin calcium, 8 atovaquone, 3 atovaquone/proguanil HCL, 3 atracurium besylate, 22 Atralin, 9 Atripla, 2 Atropen, 15 atropine sulfate, 15, 23 Atropine Sulfate, 15, 24 atropine-care, 24 Atrovent HFA, 28 Aubagio, 22 aubra, 12, 39 augmented betamethasone dipropionate, 9 Augmentin, 1 aurax, 24 aurodex, 24 Aurora Lancet Super Thin 30G, 32 Aurora Lancet Thin 23G, 32 Auvi-q, 7 Avage, 11 Avandia, 13 avar cleanser, 8 avar-e emollient, 8 avar-e green, 8 Avastin, 4 Avc, 17 Avelox, 2 aviane, 12, 39 avidoxy, 1 avita, 8 Avodart, 17 Avonex, 22 Avonex Pen, 22 Axert, 27 Axiron, 11 azacitidine, 4 Azactam IN Iso-osmotic Dextrose, 3 Azasan, 4 Azasite, 23 azathioprine, 4 azelastine HCL, 24, 27 Azelex, 9 Azilect, 22 azithromycin, 1 Azithromycin, 1 Azopt, 24 Azor, 7 aztreonam, 3 azurette, 12, 39 B B-6 Folic Acid, 17 b-complex, 30 b-complex 100, 30 b-plex, 30 b-plex plus, 30 baciim, 3 bacitracin, 3 Bacitracin, 3, 23 bacitracin/polymyxin b, 23 baclofen, 22 Bacmin, 31 Bactocill IN Dextrose, 1 Bactroban Nasal, 27 balanced salt, 24 balanced salt solution, 24 balsalazide disodium, 16 balziva, 12, 39 Banzel, 21 Baraclude, 3 baycadron, 11 bayer advanced aspirin regular strength, 25, 38 bayer aspirin, 25, 38 bayer aspirin EC low dose, 25, 38 bayer aspirin regimen, 25, 38 bayer chewable low dose, 25, 38 bayer low dose, 25, 38 Bayer Microlet Lancets, 32 Bcg Vaccine, 29 BD Insulin Syringe LUER-LOK/U100/1ML, 32 BD Insulin Syringe Microfine IV/U100/0.3ML/28G X 1/2", 32 BD Insulin Syringe Microfine IV/U100/0.5ML/28G X 1/2", 32 BD Insulin Syringe Microfine IV/U100/1ML/27G X 5/8", 32 BD Insulin Syringe Microfine IV/U100/1ML/28G X 1/2", 32 BD Insulin Syringe Microfine/U100/0.3ML/28G X 1/2", 32 BD Insulin Syringe Microfine/U100/0.5ML/28G X 1/2", 32 BD Insulin Syringe Microfine/U100/1ML/27G X 5/8", 32 BD Insulin Syringe Microfine/U100/1ML/28G X 1/2", 32 BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2", 32 BD Insulin Syringe Safetyglide/1ML/29G X 1/2", 32 BD Insulin Syringe Safetyglide/U100/0.3ML/31G X 5/16", 32 BD Insulin Syringe Slip Tip/U-100/1ML, 32 BD Insulin Syringe U-40/1ML/25G X 5/8", 32 BD Insulin Syringe Ultrafine Halfunit/0.3ML/31G X 5/16", 32 BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X 5/16", 32 BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16", 32 BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2", 32 BD Insulin Syringe Ultrafine/0.3ML/31G X 5/16", 32 BD Insulin Syringe Ultrafine/0.5ML/30G X 1/2", 32 BD Insulin Syringe Ultrafine/0.5ML/31G X 5/16", 32 BD Insulin Syringe Ultrafine/1ML/30G X 1/2", 32 BD Insulin Syringe Ultrafine/1ML/31G X 5/16", 32 BD Insulin Syringe Ultrafine/U100/0.3ML/29G X 1/2", 32 BD Insulin Syringe Ultrafine/U100/0.5ML/29G X 1/2", 32 BD Insulin Syringe Ultrafine/U100/1ML/29G X 1/2", 32 BD Insulin Syringe Ultrafine/U100/1ML/30G X 1/2", 32 BD Insulin Syringe/Detachable Needle/U100/1ML/25G X 1", 32 BD Insulin Syringe/Detachable Needle/U- 100/1ML/25G X 5/8", 32 BD Insulin Syringe/Detachable Needle/U100/1ML/26G X 1/2", 32 BD Insulin Syringe/U-100/0.5ML/30G X 1/2", 32 BD Insulin Syringe/U-100/1ML/27G X 1/2", 32 BD Insulin Syringe/U-100/1ML/28G X 1/2", 32 BD Insulin Syringe/U-100/2ML/27.5G X 5/8", 32 BD Insulin Syringe/U-100/2ML/29G X 1/2", 32 BD Lancet Ultrafine 30G, 32 BD Lancet Ultrafine 33G, 32 BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X 1/2", 32 BD Microtainer Lancets, 32 BD Pen Needle/Mini/Ultrafine/31G X 3/16", 32 BD Pen Needle/Nano/Ultra Fine/32G X 4MM, 32 BD Pen Needle/SHORT/Ultrafine/31G X 5/16", 32 BD Pen Needle/Ultrafine/29G X 12.7MM, 32 BD Pen Needle/Ultrafine/29GX1/2" 12.7MM, 32 BD Pen Needles SHORT/Ultrafine/31G X 5/16", 32 BD posiflush, 37 BD Pudendal/Local Block Tray 1% Lidocaine, 27 BD Swabs Single Use, 36 BD Swabs Single Use Butterfly, 36 Bebulin, 19 Bebulin VH, 19 Beconase AQ, 27 Belladonna & Opium, 15 Belladonna Alkaloids & Opium, 15 benazepril HCL, 6 benazepril HCL/hydrochlorothiazide, 7 Benefix, 19 Benicar, 7 Benicar HCT, 7 Benlysta, 38 benzepro, 8 benzepro SHORT contact, 8 benziq wash, 8 benzonatate, 28 benzoyl peroxide, 8 benzoyl peroxide SHORT contact, 8 benzoyl peroxide wash acne treatment pack, 8 benzphetamine HCL, 21 benztropine mesylate, 21 Bepreve, 24 Berinert, 19 Besivance, 23 betamethasone dipropionate, 9 betamethasone sodium phosphate/betamethasone acetate, 11 betamethasone valerate, 9 Betaseron, 22 betaxolol HCL, 6, 23 bethanechol chloride, 17 Betimol, 23 Betoptic-s, 23 Bexsero, 29, 41 Bexxar, 4 Bexxar 131 Iodine, 5 Beyaz, 12, 40 bicalutamide, 4 Bicillin C-R, 1 Bicillin L-a, 1 Bicnu, 3 Bidil, 8 Biltricide, 3 Binosto, 14 bio GLO, 24 bio-d-mulsion, 29, 43 bio-d-mulsion forte, 29, 43 bio-statin, 2 biocel, 30 biogesic, 25 Biothrax, 29 biotuss, 28 biotuss pediatric, 28 bisoprolol fumarate, 6 bisoprolol fumarate/hydrochlorothiazide, 7 Bivigam, 38 bleomycin sulfate, 4 Blephamide S.o.p., 23 Boostrix, 29, 41 Bosulif, 5 Botox, 22 Botox Cosmetic, 38 bp 10-1, 8 bp cleansing wash, 8 bp foam, 8 bp foaming wash, 8 Bp Folinatal Plus B, 30 Bp Multinatal Plus, 30 Bp Vit 3, 17 bp wash, 8 bpm, 27 bpm pseudo, 28 Bpo, 9 Bpo 3% Foaming Cloths, 9 Bpo 6% Foaming Cloths, 9 Bpo 9% Foaming Cloths, 9 bprotected pedia d-vite, 29, 43 bprotected pedia iron, 18, 42 Brainstrong Prenatal, 31 Breatherite, 36 Breatherite Collapsible Adult Spacer W/Mask, 36 Breatherite Collapsible Child Spacer W/Mask, 36 Breatherite Collapsible Infant Spacer W/Mask, 36 Breatherite Collapsible Small Child Spacer W/Mask, 36 Breatherite Collapsible Spacer W/ Neonate Mask, 36 Breatherite Rigid Spacer W/Mask, 36 Breatherite W/Large Mask, 36 Breatherite W/Medium Mask, 36 Breatherite W/Small Mask, 36 Breo Ellipta, 28 briellyn, 12, 39 Brilinta, 19 brimonidine tartrate, 24 Bromday, 24 bromfed DM, 28 bromfenac, 24 bromocriptine mesylate, 21 bromphen/pseudoephedrine HCL/dextromethorphan HBR, 28 Brompheniramine Tannate, 27 Brovana, 28 bss, 24 budeprion SR, 20 budesonide, 11, 27, 28 Bullseye Mini Safety Lancets, 32 Bullseye Safety Lancets, 32 bumetanide, 7 buminate, 19 Buphenyl, 15 bupivacaine HCL, 27 bupivacaine spinal, 27 bupivacaine/epinephrine, 27 buprenorphine HCL, 26 buprenorphine HCL/naloxone HCL, 26 buproban, 22, 42 bupropion HCL, 20 bupropion HCL ER, 20 bupropion HCL SR, 20, 22, 42 bupropion HCL XL, 20 buspirone HCL, 20 Busulfex, 3 butalbital/acetaminophen, 25 butalbital/acetaminophen/caffeine, 25 butalbital/acetaminophen/caffeine/codein e, 26 butalbital/apap/caffeine, 25 butalbital/aspirin/caffeine, 25 Butalbital/Aspirin/Caffeine, 25 butalbital/aspirin/caffeine/codeine, 26 butorphanol tartrate, 26 Butrans, 26 Bydureon, 13 Byetta, 13 Bystolic, 6 C cabergoline, 14 Cafergot, 27 caffeine citrate, 21 Caffeine/Sodium Benzoate, 21 calcipotriene, 9 calcipotriene/betamethasone dipropionate, 9 calcitonin salmon, 14 calcitonin-salmon, 14 calcitrene, 9 Calcitriol, 9 calcitriol, 14 calcium acetate, 16 calcium chloride, 36 Calcium Folinate, 5 calcium gluconate, 36 Calcium-folic Acid Plus D, 37 camila, 12, 39 Camptosar, 5 camrese, 12, 39 camrese LO, 12, 39 Canasa, 16 Cancidas, 2 candesartan cilexetil, 7 candesartan cilexetil/hydrochlorothiazide, 7 Cantil, 15 capacet, 25 Capastat Sulfate, 2 capecitabine, 4 Capex, 10 Caprelsa, 5 captopril, 6 Captopril/Hydrochlorothiazide, 7 Carac, 11 Carafate, 15 CARB-o-philic 40, 10 CARB-o-philic/40, 11 Carbaglu, 15 carbamazepine, 21 carbamazepine ER, 21 carbidopa, 21 carbidopa/levodopa, 21 carbidopa/levodopa ER, 21 carbidopa/levodopa odt, 21 Carbidopa/Levodopa/Entacapone, 22 carbinoxamine maleate, 27 carboplatin, 3 Carboplatin, 3 Cardene IV, 6 cardioplegic, 8 Cardizem LA, 6 Cardura XL, 17 Careone Lancet Thin, 32 Careone Lancet Ultra Thin, 32 Carimune Nanofiltered, 38 carisoprodol, 22 Carisoprodol, 23 carisoprodol/aspirin, 22 carisoprodol/aspirin/codeine, 22 carteolol HCL, 23 cartia XT, 6 Cartridge IR 1000 3ML, 32 Cartridge IR 1200, 32 Cartridge P.M., 32 carvedilol, 6 Cascara Sagrada, 15 Cavan-EC Sod DHA, 30 cavarest, 19 Caverject, 8 Caverject Impulse, 8 cavirinse, 19 Cayston, 3 caziant, 12, 39 Cedax, 1 cefaclor, 1 Cefaclor, 1 Cefaclor ER, 1 cefadroxil, 1 cefazolin sodium, 1 Cefazolin Sodium, 1 Cefazolin Sodium/Dextrose, 1 cefdinir, 1 Cefditoren Pivoxil, 1 cefepime, 1 Cefepime, 1 cefotaxime sodium, 1 Cefotetan, 1 Cefotetan/Dextrose, 1 cefoxitin sodium, 1 Cefoxitin Sodium, 1 cefpodoxime proxetil, 1 cefprozil, 1 ceftazidime, 1 Ceftazidime, 1 Ceftazidime/Dextrose, 1 Ceftibuten, 1 Ceftin, 1 Ceftriaxone IN Iso-osmotic Dextrose, 1 ceftriaxone sodium, 1 Ceftriaxone/Dextrose, 1 cefuroxime axetil, 1 cefuroxime sodium, 1 Cefuroxime Sodium, 1 Cefuroxime/Dextrose, 1 celecoxib, 26 Cellcept Intravenous, 4 Celontin, 21 Cem-urea, 10 Cenestin, 11 Centany, 9 Centrum Specialist Prenatal, 31 cephalexin, 1 Cephalexin, 1 Ceprotin, 19 Cerefolin, 38 Cerezyme, 18 cerisa wash, 8 cerovel, 10 Cervarix, 29, 41 Cesamet, 16 cesia, 12, 39 cetirizine HCL, 27 Cetrotide, 14 cevimeline HCL, 19 Chantix, 22, 43 Chantix Continuing Month PAK, 22, 43 Chantix Starting Month PAK, 22, 43 chateal, 12, 39 Chemet, 38 Chemstrip-k, 38 Chenodal, 16 childrens aspirin, 25, 38 childrens aspirin low strength, 25, 39 Chloramphenicol Sodium Succinate, 3 chlordiazepoxide HCL, 20 chlordiazepoxide HCL/clidinium bromide, 15 Chlordiazepoxide/Amitriptyline, 22 chlorhexidine gluconate, 19 chlorhexidine gluconate oral rinse, 19 chloromag, 36 chloroprocaine HCL, 27 chloroquine phosphate, 3 chlorothiazide, 7 Chlorothiazide, 7 chlorothiazide sodium, 7 chlorpromazine HCL, 20 Chlorpromazine HCL, 20 Chlorpropamide, 13 Chlorthalidone, 7 chlorzoxazone, 22 choice-TABS, 30 cholestyramine, 8 cholestyramine light, 8 choline magnesium trisalicylate, 25 Choline Magnesium Trisalicylate, 25 chorionic gonadotropin, 14 chromium chloride, 36 Chromium Chloride, 37 Cialis, 8 ciclodan, 9 ciclopirox, 9 ciclopirox nail lacquer, 9 ciclopirox olamine, 9 Ciclopirox Topical Solution Kit, 9 ciclopirox treatment, 9 cidofovir, 2 cilostazol, 19 Ciloxan, 23 cimetidine, 15 cimetidine HCL, 15 Cimzia, 16 Cimzia Starter Kit, 16 Cinryze, 19 Cipro HC, 24 Ciprodex, 24 ciprofloxacin, 2 Ciprofloxacin, 24 ciprofloxacin ER, 2 ciprofloxacin HCL, 2, 23 Ciprofloxacin HCL, 2 ciprofloxacin I.V.-IN D5W, 2 cisatracurium besylate, 22 cisplatin, 3 Cisplatin, 3 citalopram hydrobromide, 20 citric acid/sodium citrate, 17 cladribine, 4 Claforan, 1 claravis, 8 Claravis, 9 Clarinex, 27 Clarinex-d 12 HOUR, 28 Clarinex-d 24 HOUR, 28 claris clarifying wash, 8 clarithromycin, 1 clarithromycin ER, 1 Classic Prenatal, 31, 41 Cleanlet Lancets 28G, 32 clearplex x, 8 clemastine fumarate, 27 Clemastine Fumarate, 27 Cleocin, 17 Clever Chek Lancets Ultrathin, 32 Clever Chek Lancets Ultrathin 30G, 32 clindacin etz pledgets, 8 clindacin-p, 8 clindamax, 8 clindamycin HCL, 3 clindamycin palmitate HCL, 3 clindamycin phosphate, 3, 8, 17 Clindamycin Phosphate, 3 clindamycin phosphate add-vantage, 3 clindamycin phosphate IN D5W, 3 clindamycin phosphate pharmacy bulk package, 3 clindamycin/benzoyl peroxide, 8 Clindesse, 17 Clinimix 4.25%/Dextrose 10%, 37 Clinimix 4.25%/Dextrose 20%, 37 Clinimix 4.25%/Dextrose 25%, 37 Clinimix E 4.25%/Dextrose 25%, 37 clinisol SF 15%, 36 clinpro 5000, 19 clobetasol propionate, 9 clobetasol propionate e, 9 clobetasol propionate emollient, 9 Clocortolone Pivalate, 10 Clocortolone Pivalate P.M., 10 clodan, 10 Cloderm, 10 Cloderm P.M., 10 Clolar, 4 clomipramine HCL, 20 clonazepam, 21 clonazepam odt, 21 clonidine HCL, 7, 25 clonidine HCL ER, 21 clopidogrel, 19 clorazepate dipotassium, 20 clotrimazole, 9, 19 clotrimazole/betamethasone dipropionate, 9 clozapine, 20 Clozapine Odt, 20 Cnl8 Nail Kit, 9 CO-gesic, 26 CO-natal Fa, 30 Coaguchek Lancets, 32 Coal TAR, 10 Coartem, 3 Cod Liver Oil, 30 codeine sulfate, 26 Codeine Sulfate, 26 Colchicine, 27 Colcrys, 27 colestipol HCL, 8 colestipol HCL for oral suspension, 8 colistimethate sodium, 3 colocort, 16 Coly-mycin S, 24 Colyte-flavor Packs, 15, 43 Combigan, 23 Combipatch, 11 Combivent, 28 Combivent Respimat, 28 Cometriq, 5 Comfort Assured Lancets Micro Thin 33G, 32 Comfort Assured Lancets Super Thin 28G, 32 Comfort Infusion Set 23"/17MM, 32 Comfort Infusion Set 31"/17MM, 32 Comfort Infusion Set 43"/17MM, 32 Comfort Lancets, 32 Comfort SHORT Infusion Set 23"/13MM, 32 Comfort SHORT Infusion Set 31"/13MM, 32 Comfort SHORT Infusion Set 43"/13MM, 32 compazine, 20 Complera, 2 Complete Natal DHA, 30 Completenate, 30 compound 347, 27 compro, 20 Comvax, 29, 41 Concerta, 21 Condylox, 11 constulose, 15 Contact Detach Infusion Set 23" 6MM/29G, 32 Contact Detach Infusion Set 23" 8MM/29G, 32 Contact Detach Infusion Set 43" 6MM/29G, 32 Contact Detach Infusion Set 43" 8MM/29G, 32 controlrx, 19 Conzip, 26 Copaxone, 22 Copper Sulfate, 37 Copper Trace Metal, 37 Cordran, 10 Cordran Tape, 10 Coreg CR, 6 Corifact, 19 cormax scalp application, 10 cortic-nd, 24 Cortifoam, 16 Cortisone Acetate, 11 Cortisporin, 9 Cortisporin-tc, 24 corvita, 30 corvita 150, 17 corvite free, 30 cosyntropin, 36 covaryx, 11 covaryx HS, 11 Creon, 16 Crestor, 8 Crinone, 17 Crixivan, 2 cromolyn sodium, 16, 24 Cromolyn Sodium, 28 cryselle-28, 12, 39 Cubicin, 3 Cuprimine, 38 Curity Alcohol Preps/Medium 2 Ply, 36 Curity Alcohol Swabs, 36 curity sterile saline, 17 Cuvposa, 16 CVS Alcohol Prep Swabs, 36 CVS Alcohol Swabs, 36 CVS aspirin, 25, 39 CVS aspirin adult low dose, 25, 39 CVS aspirin adult low strength, 25, 39 CVS aspirin child, 25, 39 CVS aspirin EC, 25, 39 CVS aspirin low dose, 25, 39 CVS aspirin low strength, 25, 39 CVS childrens aspirin, 25, 39 CVS childrens vitamin d for bone health, 30, 43 CVS enteric aspirin, 25, 39 CVS folic acid, 18, 41 CVS iron, 18, 42 CVS Lancets 21G, 32 CVS Lancets Micro Thin 33G, 32 CVS Lancets Original, 32 CVS Lancets Thin 26G, 32 CVS Lancets Ultra Thin 30G, 32 CVS nicotine, 22, 42 CVS nicotine polacrilex, 22, 42 CVS nicotine polacrilex starter, 22, 42 CVS nicotine transdermal system, 22, 42 CVS nts step 1, 22, 42 CVS Prenatal, 31, 41 CVS Prenatal Gummy/DHA/Folic Acid, 31 CVS Prenatal Multi+dha, 31 CVS Slow Release Iron, 18, 42 CVS Ultra Thin Lancets, 32 CVS vitamin d, 30, 43 CVS vitamin d 5000 high-potency, 30, 43 CVS vitamin d infants, 30, 43 CVS vitamin d3, 30, 43 CVS Vitamin D3, 30, 43 cyanocobalamin, 17 Cyanocobalamin/Levomefolate Calcium/Pyridoxine HCL, 38 cyclafem 1/35, 12, 39 cyclafem 7/7/7, 12, 39 cyclobenzaprine HCL, 22 cyclopentolate HCL, 24 cyclophosphamide, 3 Cyclophosphamide, 3 Cycloserine, 2 Cycloset, 13 cyclosporine, 4 cyclosporine modified, 4 Cyclosporine Modified, 4 cyotic, 24 cyproheptadine HCL, 27 Cystadane, 15 Cystagon, 17 Cystaran, 24 cysteine HCL, 36 Cysteine HCL, 37 cytarabine, 4 Cytarabine, 4 cytarabine aqueous, 4 Cytogam, 38 cytra k crystals, 17 cytra-2, 17 Cytra-3, 17 cytra-k, 17 D d 1000, 29, 43 d 10000, 29, 43 d 2000, 29, 43 d 400, 29, 43 d 5000, 29, 43 d-1000, 29, 43 d-1000 extra strength, 29, 43 d-2000 maximum strength, 29, 43 d-3-5, 29, 43 d-400, 29, 43 d-5000, 29, 43 d-5000 maximum strength, 29, 43 d-vita, 29, 43 d2000 ultra strength, 29, 43 d3, 29, 43 D3, 30, 43 d3 adult, 29, 43 D3 Dots, 30, 43 d3 high potency, 29, 43 d3 kids, 30, 43 d3 maximum strength, 30, 43 d3 super strength, 30, 43 d3 ultra strength, 30, 43 d3-1000, 30, 43 d3-50, 30, 43 dacarbazine, 5 Dacarbazine, 5 Daliresp, 28 danazol, 11 dantrolene sodium, 22 Dantrolene Sodium, 23 Dapsone, 3 Daptacel, 29, 41 Daraprim, 3 dasetta 1/35, 12, 39 dasetta 7/7/7, 12, 39 daunorubicin HCL, 4 Daunoxome, 4 daysee, 12, 39 Daytrana, 21 Ddrops, 30, 43 deblitane, 12, 39 decara, 29, 43 decitabine, 4 deferoxamine mesylate, 36 dehydrated alcohol, 36 delflex-LC/1.5% dextrose, 36 delflex-lm/1.5% dextrose, 36 Delflex-lm/2.5% Dextrose, 37 Delflex-lm/4.25% Dextrose, 37 Delflex-sm/1.5% Dextrose, 37 Delflex-sm/2.5% Dextrose, 37 delta d3, 29, 43 delyla, 12, 39 Delzicol, 16 demeclocycline HCL, 1 Demser, 7 Denavir, 9 denta 5000 plus, 19 dentagel, 19 Depen Titratabs, 38 Depo-medrol, 11 Depo-provera, 4 Depo-subq Provera 104, 12, 40 Depocyt, 4 Depodur, 26 Dermasorb Ta, 10 dermazene, 9 desipramine HCL, 20 desloratadine, 27 desloratadine odt, 27 desmopressin acetate, 14 desogestrel/ethinyl estradiol, 12, 39 Desonate, 10 desonide, 10 Desowen Cream/Cetaphil Lotion, 10 Desowen Lotion/Cetaphil Cream, 10 Desowen Ointment/Cetaphil Lotion, 10 desoximetasone, 10 Desoximetasone, 10 Desvenlafaxine ER, 20 Detachable Face Mask, 36 dexamethasone, 11 Dexamethasone, 11 Dexamethasone Intensol, 11 dexamethasone sodium phosphate, 11, 23 Dexamethasone Sodium Phosphate, 11 Dexchlorpheniramine Maleate, 27 dexedrine, 21 dexferrum, 17 Dexilant, 16 dexmedetomidine HCL, 21 dexmethylphenidate HCL, 21 dexmethylphenidate HCL ER, 21 Dexpak 10 Day, 11 Dexpak 13 Day, 11 Dexpak 6 Day, 11 Dexpanthenol, 16 dexrazoxane, 5 dextroamphetamine sulfate, 21 dextroamphetamine sulfate ER, 21 Dextromethorphan HBR/Chlorpheniramine/Phenylephrine HCL, 28 dextrose 10%, 36 dextrose 10% flex container, 36 Dextrose 10%/NACL 0.2%, 37 Dextrose 10%/NACL 0.225%, 37 Dextrose 10%/NACL 0.45%, 37 dextrose 2.5%/NACL 0.45%, 36 dextrose 2.5%/sodium chloride 0.45%, 36 Dextrose 20%, 37 Dextrose 25%, 37 dextrose 30%, 36 dextrose 30% partial fill, 36 Dextrose 40%, 37 dextrose 5%, 36 Dextrose 5% /Electrolyte #48 Viaflex, 37 dextrose 5% viaflex, 36 dextrose 5%/lactated ringers, 36 dextrose 5%/NACL 0.2%, 36 Dextrose 5%/NACL 0.225%, 37 Dextrose 5%/NACL 0.3%, 37 dextrose 5%/NACL 0.33%, 36 dextrose 5%/NACL 0.45%, 36 dextrose 5%/NACL 0.9%, 36 dextrose 5%/potassium chloride 0.15%, 36 dextrose 5%/ringers, 36 dextrose 5%/sodium chloride 0.2%, 36 dextrose 5%/sodium chloride 0.33%, 36 dextrose 5%/sodium chloride 0.45%, 36 dextrose 5%/sodium chloride 0.9%, 36 dextrose 50%, 36 dextrose 70%, 36 Diabeta, 13 dialyvite, 30 dialyvite vitamin d 5000, 29, 43 Dialyvite Vitamin D3 Max, 30, 43 Diastar Easy Test II Lancets 30G, 32 Diastar Easy Test Lancets30G, 32 Diastat Pediatric, 21 diazepam, 20 Diazepam, 20, 21 diazepam intensol, 20 Dibenzyline, 7 diclofenac potassium, 26 diclofenac sodium, 9, 10, 24 diclofenac sodium DR, 26 diclofenac sodium ER, 26 diclofenac sodium/misoprostol, 26 dicloxacillin sodium, 1 dicyclomine HCL, 15 Dicyclomine HCL, 15 didanosine, 2 diethylpropion HCL, 21 Diethylpropion HCL, 21 diethylpropion HCL ER, 21 Differin, 9 Dificid, 1 difil-G forte, 28 diflorasone diacetate, 10 Diflorasone Diacetate, 10 diflunisal, 25 digitek, 6 digox, 6 digoxin, 6 Digoxin, 6 dihydroergotamine mesylate, 27 Dihydroergotamine Mesylate, 27 Dilantin, 21 Dilatrate SR, 6 dilt-CD, 6 dilt-XR, 6 diltiazem CD, 6 diltiazem HCL, 6 Diltiazem HCL, 6 diltiazem HCL CD, 6 diltiazem HCL ER, 6 diltzac, 6 Dimenhydrinate, 16 Dipentum, 16 diphenhydramine HCL, 27 diphenoxylate/atropine, 15 Diphenoxylate/Atropine, 15 Diphtheria/Tetanus Toxoids Adsorbed Pediatric, 29, 41 dipyridamole, 19, 37 disopyramide phosphate, 6 disulfiram, 22 divalproex sodium, 21 divalproex sodium DR, 21 divalproex sodium ER, 21 dobutamine HCL, 7 dobutamine HCL/D5W, 7 dobutamine/dextrose 5%, 7 Dobutamine/Dextrose 5%, 7 Docefrez, 5 Docetaxel, 5 docetaxel, 5 dologesic, 25 dolorex, 25 donepezil HCL, 22 Donnatal, 16 Donnatal Extentabs, 16 dopamine HCL, 7 Dopamine HCL, 7 dopamine HCL-dextrose 5%, 7 dopamine HCL/dextrose 5%, 7 dopamine/D5W, 7 Doribax, 3 dorzolamide HCL, 24 dorzolamide HCL/timolol maleate, 23 doxapram HCL, 21 doxazosin mesylate, 7 doxepin HCL, 20 Doxepin HCL, 20 doxercalciferol, 14 doxorubicin HCL, 4 doxorubicin HCL liposome, 4 doxy 100, 1 doxycycline, 1 Doxycycline, 9 doxycycline hyclate, 1 doxycycline hyclate DR, 1 doxycycline monohydrate, 1 Dritho-creme HP, 9 dronabinol, 16 droperidol, 20 Droplet Lancets Ultra Thin 30G, 32 drospirenone/ethinyl estradiol, 12, 39 Droxia, 18 Drug Mart Lancets Thin, 32 Drug Mart Lancets Ultra Thin, 32 Drug Mart On-the-go Lancets Gentle 30G, 32 Drug Mart Unilet Lancets Super Thin 30G, 32 Drug Mart Unilet Lancets Ultra Thin 28G, 32 Duane Reade Lancet Alternate Site 26G, 32 Duane Reade Lancet Super Thin 30G, 32 Duane Reade Lancet Ultra Thin 28G, 32 Dulera, 28 duloxetine HCL, 20 duramorph, 26 duraxin, 25 Durezol, 23 Dymista, 27 Dyrenium, 7 Dysport, 22 E E-z Ject Lancets, 32 E-z Ject Lancets 21G, 32 E-z Ject Lancets Color, 32 E-z Ject Lancets Super Thin, 32 E-z Ject Lancets Super Thin 30G, 32 E-z Ject Lancets Thin 26G, 32 E-z Spacer, 36 E-z Spacer The Body Guards Pack, 36 E-ZJECT Lancets Micro-thin 33G, 32 E.e.s. 400, 1 e.s.p., 3 Easivent, 36 Easivent/Mask-large, 36 Easivent/Mask-medium, 36 Easivent/Mask-small, 36 Easy Comfort Lancets, 32 Easy Comfort Lancets 30G/Pull Top, 32 Easy Comfort Lancets 30G/Thin Top, 32 Easy Touch Alcohol Prep Pads/Medium, 36 Easy Touch Lancets 21G/Pressure Activated, 32 Easy Touch Lancets 23G/Pressure Activated, 32 Easy Touch Lancets 26G/Pressure Activated, 32 Easy Touch Lancets 28G/Pressure Activated, 32 Easy Touch Lancets 28G/Twist, 32 Easy Touch Lancets 30G/Pressure Activated, 32 Easy Touch Lancets 30G/Twist, 32 Easy Touch Lancets 32G/Pressure Activated, 32 Easy Touch Lancets 32G/Twist, 32 Easy Touch Lancets 33G/Twist, 32 Easy Touch Safety Lancets21G/Pressure Activated, 32 Easy Touch Safety Lancets23G/Pressure Activated, 32 Easy Touch Safety Lancets26G/Button Activated, 32 Easy Touch Safety Lancets26G/Pressure Activated, 32 Easy Touch Safety Lancets28G/Button Activated, 32 Easy Touch Safety Lancets28G/Pressure Activated, 32 Easy Twist & CAP Lancets, 32 easygel, 19 Easytest II Lancets, 32 Easytest Lancets, 33 EC-81 aspirin, 25, 39 econazole nitrate, 9 ecotrin low strength, 25, 39 ecpirin, 25, 39 Ed Cyte F, 17 ed-flex, 25 ed-spaz, 15 Edarbi, 7 Edarbyclor, 7 Edecrin, 7 Edurant, 2 eemt, 11 eemt HS, 11 effer-k, 37 Effer-k, 38 effervescent pot chloride, 37 effervescent potassium, 37 effervescent potassium/chloride, 37 Effient, 19 Egrifta, 14 Elaprase, 15 Elelyso, 18 Elidel, 10 Eligard, 4 elinest, 12, 39 Eliquis, 19 Elite Iron, 18, 42 Elite-OB, 30 Elitek, 5 Elixophyllin, 28 Ella, 12 Elmiron, 17 Eloctate, 19 Eloxatin, 3 Elspar, 4 Emadine, 24 Embeda, 26 Embrace Lancets Ultra Thin 30G, 33 Emcyt, 4 Emend, 16 emoquette, 12, 39 Emsam, 20 Emtriva, 2 Enablex, 17 enalapril maleate, 6 enalapril maleate/hydrochlorothiazide, 7 enalaprilat, 7 Enbrel, 27 Enbrel Sureclick, 27 Encare, 17, 40 endocet, 26 endodan, 26 Endometrin, 17 Enfamil Expecta, 31 Engerix-b, 29, 41 Enjuvia, 11 Enovarx-cyclobenzaprine HCL, 23 enoxaparin sodium, 18 enpresse-28, 12, 39 enskyce, 12, 39 entacapone, 21 entecavir, 3 enteric coated aspirin, 25, 39 enulose, 16 ephedrine sulfate, 7 Epiduo, 9 epinastine HCL, 24 Epinephrine, 7 epinephrine HCL, 28 Epipen 2-PAK, 7 Epipen-JR 2-PAK, 8 epirubicin HCL, 4 Epirubicin HCL, 4 episone CRE, 10 epitol, 21 Epivir HBV, 2 eplerenone, 7 Epogen, 18 epoprostenol sodium, 8 eprosartan mesylate, 7 Epzicom, 2 eq adult aspirin low strength, 25, 39 eq aspirin, 25, 39 eq aspirin adult low dose, 25, 39 eq aspirin EC, 25, 39 eq aspirin low dose, 25, 39 eq childrens aspirin, 25, 39 eq nicotine, 22, 42 eq nicotine gum refill, 22, 42 eq nicotine gum starter, 22, 42 eq nicotine polacrilex, 22, 42 eq nicotine step 3, 22, 42 eq slow-release iron, 18, 42 eql adult aspirin low strength, 25, 39 eql aspirin, 25, 39 eql aspirin EC, 25, 39 eql aspirin low dose, 25, 39 eql childrens aspirin, 25, 39 eql childrens vitamin d gummies, 30, 43 Eql Color Lancets 21G, 33 Eql Color Lancets Micro Thin 33G, 33 eql folic acid, 18, 41 eql iron supplement therapy, 18, 42 eql nicotine, 22, 42 eql nicotine polacrilex, 22, 42 eql nicotine polacrilex refill, 22, 42 eql nicotine polacrilex starter, 22, 42 Eql Prenatal Formula, 31, 41 eql slow release iron, 18, 42 Eql Super Thin Lancets 30G, 33 Eql Thin Lancets 26G, 33 eql vitamin d-3, 30, 43 eql vitamin d3, 30, 43 Eraxis, 2 Erbitux, 4 ergocalciferol, 29 ergoloid mesylates, 22 Ergomar, 27 Erivedge, 5 errin, 12, 39 Ertaczo, 9 Erwinaze, 4 ery, 8 Ery-TAB, 1 Erythrocin Lactobionate, 1 erythromycin, 1, 8, 23 Erythromycin Base, 1 Erythromycin Ethylsuccinate, 1 erythromycin/benzoyl peroxide, 8 Escavite LQ, 30 escitalopram oxalate, 20 esgic, 25 Esgic, 25 esmolol HCL, 6 esomeprazole sodium, 15 Esomeprazole Sodium, 15 Esomeprazole Strontium, 16 estarylla, 12, 39 estazolam, 21 esterified estrogens/methltestosterone, 11 esterified estrogens/methyltestosterone, 11 esterified estrogens/methyltestosterone DS, 11 esterified estrogens/methyltestosterone HS, 11 Estrace, 17 estradiol, 11 estradiol valerate, 11 estradiol/norethindrone acetate, 11 Estring, 17 Estrogel, 11 estropipate, 11 Estropipate, 11 eszopiclone, 21 ethambutol HCL, 2 ethosuximide, 21 Etidronate Disodium, 13 etodolac, 26 etodolac ER, 26 etomidate, 27 Etopophos, 5 etoposide, 5 Etoposide, 5 Euflexxa, 23 Eurax, 11 Evamist, 11 Exalgo, 26 Exelderm, 9 Exelon, 22 exemestane, 4 Exjade, 38 exoderm, 9 exotic-HC, 24 Extavia, 22 Eylea, 24 EZ Smart Blood Glucose Lancets, 33 EZ-lets Lancets 21G, 33 EZ-lets Lancets 23G, 33 EZ-lets Lancets 26G Super-soft, 33 EZ-lets Lancets 28G Ultra-soft, 33 EZ-lets Lancets 30G, 33 ezfe 200, 18, 42 F fa-8, 18, 41 Fa-8, 18, 41 fabb, 17 Fabrazyme, 15 Factive, 2 falmina, 12, 39 famciclovir, 2 famotidine, 15 Famotidine, 15 Famotidine Premixed, 15 Fanapt, 20 Fanapt Titration Pack, 20 Fareston, 4 Faslodex, 4 Fasttake Compact Monitoring System, 33 Fasttake Test Strips, 33 Fazaclo, 20 Fc Female Condom, 40 Fc2 Female Condom, 40 FE Aspartate, 18, 42 FE c plus, 17 FE gluconate, 18, 42 FE TABS, 18, 42 Feiba, 19 Feiba NF, 19 felbamate, 21 felodipine ER, 6 Femcap, 40 Femiron, 18, 42 fenofibrate, 8 Fenofibrate, 8 fenofibrate micronized, 8 Fenofibric Acid, 8 fenofibric acid DR, 8 Fenoglide, 8 fenoldopam mesylate, 7 Fenoprofen Calcium, 26 fentanyl, 26 fentanyl citrate, 26 fentanyl citrate oral transmucosal, 26 Fentora, 26 feosol, 18, 42 Feosol, 18, 42 fer-iron, 18, 42 Feraheme, 18 ferate, 18, 42 ferocon, 17 ferosul, 18, 42 ferotrinsic, 17 Ferraplus 90, 17 ferretts, 18, 42 Ferretts Chewable Iron, 18 Ferretts IPS, 18, 42 ferrex 150, 18, 42 Ferrex 150 Forte Plus, 18 Ferrex 28, 18 ferric x-150, 18, 42 Ferrimin 150, 18, 42 Ferriprox, 38 ferro-bob, 18, 42 Ferro-sequels, 18, 42 ferrocite, 18, 42 ferrocite plus, 17 ferrogels forte, 17 ferrotabs, 18, 42 ferrous drops, 18, 42 Ferrous Fumarate, 18, 42 ferrous fumarate 324, 18, 42 ferrous gluconate, 18, 42 Ferrous Gluconate, 18, 42 ferrous sulfate, 18, 42 Ferrous Sulfate, 18, 42 ferrousul, 18, 42 ferus, 18, 42 Fibricor, 8 Fifty50 Alcohol Prep Pads, 36 Fifty50 Safety Seal Lancets 30G, 33 Fifty50 Safety Seal Lancets 32G, 33 Finacea, 9 finasteride, 10, 17 Fine 30, 33 Fingerstix Lancets, 33 Firazyr, 19 Firmagon, 4 First-lansoprazole, 16 Flagyl ER, 3 Flarex, 23 flavoxate HCL, 17 Flebogamma Dif, 38 flecainide acetate, 6 Flector, 9 flexbumin, 19 Flovent Diskus, 28 Flovent HFA, 28 floxuridine, 4 Fluarix 2013-2014, 29, 41 Fluarix 2014-2015, 29, 41 Fluarix Quadrivalent 2013-2014, 29, 41 Fluarix Quadrivalent 2014-2015, 29, 41 Flublok 2013-2014, 29, 41 Flublok 2014-2015, 29, 41 flucaine, 24 Flucelvax 2013-2014, 29, 41 Flucelvax 2014-2015, 29, 41 fluconazole, 2 fluconazole IN dextrose, 2 fluconazole IN NACL, 2 Fluconazole IN NACL, 2 flucytosine, 2 fludarabine phosphate, 4 fludrocortisone acetate, 11 Flulaval 2013-2014, 29, 41 Flulaval 2014-2015, 29, 41 Flulaval Quadrivalent 2013-2014, 29, 41 Flulaval Quadrivalent 2014-2015, 29, 41 flumazenil, 37 Flumist Nasal Vaccine 2012-2013, 29, 41 Flumist Quadrivalent, 29, 41 flunisolide, 27 Flunisolide, 27 fluocinolone acetonide, 10, 24 fluocinolone acetonide body, 10 fluocinolone acetonide ear drops, 24 fluocinolone acetonide scalp, 10 fluocinonide, 10 fluocinonide-e, 10 fluor-a-day, 38, 40 Fluor-a-day, 38, 41 fluor-i-strips a.t., 24 Fluorabon, 38, 41 fluorescein-benoxinate, 24 fluorescein/proparacaine, 24 fluorets, 24 fluoride, 38, 40 fluoridex daily defense, 19 fluoridex daily defense enhanced whitening, 19 fluoridex daily defense sensitivity relief, 19 fluoritab, 38, 40 fluorometholone, 23 Fluoroplex, 11 fluorouracil, 4, 10 Fluorouracil, 11 fluoxetine, 22 fluoxetine DR, 20 fluoxetine HCL, 20 Fluoxetine HCL, 20 fluphenazine decanoate, 20 fluphenazine HCL, 20 Fluphenazine HCL, 20 flura-drops, 38, 40 Flura-drops, 38, 41 flurazepam HCL, 21 Flurazepam HCL, 21 flurbiprofen, 26 flurbiprofen sodium, 24 flurox, 24 flutamide, 4 fluticasone propionate, 10, 27 fluvastatin, 8 Fluvirin 2013-2014, 29, 41 Fluvirin 2014-2015, 29, 41 Fluvirin PF 2013-2014, 29, 41 Fluvirin PF 2014-2015, 29, 41 fluvoxamine maleate, 20 fluvoxamine maleate ER, 20 Fluzone High-dose PF 2013-2014, 29, 41 Fluzone High-dose PF 2014-2015, 29, 41 Fluzone Intradermal, 29, 41 Fluzone Intradermal Quadrivalent, 29, 41 Fluzone Pediatric PF 2013-2014, 29, 41 Fluzone PF 2013-2014, 29, 41 Fluzone PF 2014-2015, 29, 41 Fluzone Quadrivalent 2013-2014, 29, 41 Fluzone Quadrivalent 2014-2015, 29, 41 Fluzone Split 2013-2014, 29, 41 Fluzone Split 2014-2015, 29, 41 FML, 23 Focalin XR, 21 folastin, 37 Folbecal, 30 folbee, 17 folbee plus, 30 folbee plus cz, 30 folbic, 37 Folbic RF, 38 folcaps, 17 folic acid, 17, 41 Folic Acid, 17 folic acid/vitamin b-6/vitamin b-12, 17 Folotyn, 4 folplex 2.2, 17 Foltrate, 18 foltrin, 17 Foltx, 38 fomepizole, 37 fondaparinux sodium, 18 Fora Lancets, 33 Foradil Aerolizer, 28 Forfivo XL, 20 formadon, 37 formaldehyde, 37 Forteo, 14 Fortical, 14 Fosamax Plus D, 13 Foscarnet Sodium, 2 fosinopril sodium, 7 fosinopril sodium/hydrochlorothiazide, 7 fosphenytoin sodium, 21 Fosrenol, 16 Fragmin, 19 Freamine Iii, 37 Freds Pharmacy Unilet Lancets Super Thin 30G, 33 Freds Pharmacy Unilet Lancets Ultra Thin 28G, 33 Freestyle Lancets, 33 Freestyle Unistick II Lancets, 33 fresenius propoven, 27 Frova, 27 ful-GLO, 24 furosemide, 7 Furosemide, 7 Fusilev, 5 Fuzeon, 2 Fycompa, 21 G gabapentin, 21 Gabitril, 21 Gablofen, 23 galantamine, 22 galantamine hydrobromide, 22 Galantamine Hydrobromide, 22 Galzin, 38 Gamastan S/D, 38 Gammagard Liquid, 38 Gammagard S/D, 38 Gammagard S/D Iga Less Than 1mcg/ML, 38 Gammaked, 38 Gammaplex, 38 Gamunex-c, 38 ganciclovir, 2 Ganirelix Acetate, 14 Ganite, 14 garamycin, 23 Gardasil, 29, 41 Gardasil 9, 29, 41 Gastrinex NF, 15 gatifloxacin, 23 Gattex, 16 gavilyte-c, 15, 43 gavilyte-G, 15, 43 gavilyte-n/flavor pack, 15, 43 Gazyva, 4 Gelnique, 17 Gemcitabine, 4 gemcitabine HCL, 4 gemfibrozil, 8 gene-xene TAB 15MG, 20 gene-xene TAB 3.75MG, 20 gene-xene TAB 7.5MG, 20 generlac, 16 gengraf, 4 Genotropin, 14 Genotropin Miniquick, 14 gentak, 23 gentamicin sulfate, 2, 23 Gentamicin Sulfate, 9 gentamicin sulfate pediatric, 2 gentamicin sulfate/0.9% sodium chloride, 2 Gentamicin Sulfate/0.9% Sodium Chloride, 2 gentamicin sulfate/sodium chloride, 2 Gentle-let GP Lancets, 33 Gentle-let Lancets General Purpose Style/Fine Point, 33 Gentle-let Lancets General Purpose Style/Medium Point, 33 Gentle-let Lancets Safety Style/Fine Point, 33 Gentle-let Lancets Safety Style/Medium Point, 33 Geodon, 20 gianvi, 12, 39 Giazo, 16 gildagia, 12, 39 gildess 1.5/30, 12, 39 gildess 1/20, 12, 39 gildess 24 FE, 12, 39 gildess FE 1.5/30, 12, 39 gildess FE 1/20, 12, 39 Gilenya, 22 Gilotrif, 5 giltuss pediatric, 28 Giltuss TR, 28 Glassia, 28 Gleevec, 5 Gleostine, 3 Gliadel Wafer, 3 glimepiride, 13 glipizide, 13 glipizide ER, 13 glipizide XL, 13 glipizide/metformin HCL, 13 Global Alcohol Prep Ease Pads, 36 Global Inject Ease Lancets 28G, 33 Global Inject Ease Lancets 30G, 33 Glucagen, 13 Glucagen Hypokit, 13 Glucagon Emergency Kit, 13 Glucocom Lancets 28G, 33 Glucocom Lancets 30G, 33 Glucocom Lancets 33G, 33 Glucopro Syringe Reservoir/3ML/Needle/22G X 3/8", 33 Glucose Control Normal, 33 Glucose Control Solution, 33 Glucosource Lancets, 33 Glumetza, 13 glyburide, 13 Glyburide, 13 glyburide micronized, 13 glyburide/metformin HCL, 13 glycine, 17 Glycolic Acid, 9 Glycolic Acid 70% High Purity, 9 glycopyrrolate, 15 glydo, 10 Glyset, 13 Gmate Lancets 30G, 33 gnp adult aspirin low strength, 25, 39 Gnp Alcohol Swabs, 36 gnp aspirin, 25, 39 gnp aspirin low dose, 25, 39 Gnp Daily Prenatal, 31, 41 gnp folic acid, 18, 41 gnp iron, 18, 42 Gnp Lancets, 33 Gnp Lancets 21G, 33 Gnp Lancets Micro Thin 33G, 33 Gnp Lancets Super Thin 30G, 33 Gnp Lancets Thin, 33 Gnp Lancets Thin 26G, 33 Gnp Micro Thin Lancets 33G, 33 gnp nicotine polacrilex, 22, 42 gnp nicotine polacrilex mini, 22, 42 Gnp Prenatal, 31, 41 Gnp Prenatal Vitamins, 31, 41 gnp slow release iron, 18, 42 Gnp Super Thin Lancets/30G, 33 gnp vitamin d, 30, 43 gnp vitamin d maximum strength, 30, 43 gnp vitamin d super strength, 30, 43 gnp vitamin d3 extra strength, 30, 43 Golytely, 15, 43 goodsense aspirin low dose, 25, 39 Goodsense Prenatal Vitamins, 31, 41 grafco silver nitrate applicator, 10 Gralise, 22 Gralise Starter, 22 granisetron HCL, 16 Granisol, 16 green GLO lissamine greenophthalmic strips, 24 griseofulvin microsize, 2 griseofulvin ultramicrosize, 2 grx hicort 25, 16 guanfacine ER, 21 guanfacine HCL, 7 Guanidine HCL, 23 Gynazole-1, 17 H H&h Thinlet Lancets 26G, 33 H&h Thinlet Super Thin Lancets 30G, 33 H-e-b Incontrol Lancets Super Thin 30G, 33 H-e-b Incontrol Lancets Ultra Thin 28G, 33 H.p. Acthar, 14 Haemolance, 33 Haemolance Low Flow Lancets, 33 Haemolance Plus, 33 Haemolance Plus High Flow, 33 Haemolance Plus Low Flow, 33 Haemolance Plus Max Flow, 33 Haemolance Plus Pediatric Flow, 33 halac, 10 Halaven, 5 halobetasol propionate, 10 Halog, 10 halonate PAC, 10 haloperidol, 20 haloperidol decanoate, 20 haloperidol lactate, 20 Harvoni, 3 Havrix, 29, 41 Healthwise Alcohol Prep Pads, 36 Healthwise Lancets 30G, 33 Healthy Accents Unilet Lancets Super Thin 30G, 33 healthy kids vitamin d3, 30, 43 Healthy Mama Be Well Rounded, 31 heather, 12, 39 hecoria, 4 Hectorol, 14 Helidac, 16 Helixate FS, 19 hematinic plus vitamins/minerals, 17 hematinic/folic acid, 17 hematogen, 17 Hematogen Fa, 17 hematogen forte, 17 hemocyte-f, 17 hemocyte-plus, 17 Hemofil M, 19 hemril-30, 16 hep flush-10, 18 Hepagam B, 38 heparin lock, 18 heparin lock flush, 18 Heparin Lock Flush, 19 heparin lock flush for flushing vascular access devices, 18 heparin lock flush/NACL for flushing vascular access devices, 18 heparin sodium, 18 Heparin Sodium, 19 heparin sodium dcu, 18 heparin sodium lock flush, 18 heparin sodium/D5W, 19 Heparin Sodium/D5W, 19 Heparin Sodium/NACL 0.45%, 19 heparin sodium/NACL 0.9%, 19 Heparin Sodium/Sodium Chloride 0.9%, 19 heparin sodium/sodium chloride 0.9% premix, 18 hepatamine, 37 hepatasol, 37 Herceptin, 4 hetastarch 6%/NACL, 19 Hetlioz, 21 Hexalen, 3 Hiberix, 29, 41 high potency iron, 18, 42 High Potency Iron, 18, 42 Hizentra, 38 HM aspirin, 25, 39 HM aspirin EC, 25, 39 HM aspirin EC low dose, 25, 39 HM folic acid, 18, 41 HM iron, 18, 42 HM iron slow release, 18, 42 HM Lancets Micro Thin 33G, 33 HM Lancets Ultra Thin 30G, 33 HM nicotine polacrilex, 22, 43 HM nicotine transdermal system, 22, 43 HM nicotine transdermal system step 3, 22, 43 HM One Daily Prenatal Combo, 31, 41 HM Prenatal, 31, 41 HM vitamin d, 30, 43 HM vitamin d3, 30, 43 HM Vitamin D3, 30, 43 homatropaire, 24 homatropine HBR, 24 Horizant, 22 Humalog, 13 Humalog Kwikpen, 13 Humalog Mix 50/50, 13 Humalog Mix 50/50 Kwikpen, 13 Humalog Mix 75/25, 13 Humalog Mix 75/25 Kwikpen, 13 human albumin grifols, 19 Humate-p, 19 Humatrope, 14 Humatrope Combo Pack, 14 Humira, 27 Humira Pediatric Crohns Disease Starter Pack, 27 Humira Pen, 27 Humira Pen-crohns Diseasestarter, 27 Humira Pen-psoriasis Starter, 27 Humulin 70/30, 13 Humulin 70/30 Kwikpen, 13 Humulin 70/30 Pen, 13 Humulin N, 13 Humulin N Kwikpen, 13 Humulin N U-100 Pen, 13 Humulin R, 13 Humulin R U-500 (concentrated), 13 Hy-vee Lancets, 33 Hy-vee Thin Lancets, 33 Hyalgan, 23 Hycamtin, 5 hydralazine HCL, 7 hydrochloric acid, 17 hydrochlorothiazide, 7 hydrocodone bitartrate/acetaminophen, 26 Hydrocodone Bitartrate/Acetaminophen, 26 hydrocodone bitartrate/chlorpheniramine maleate/PSE, 28 hydrocodone bitartrate/homatropine methylbromide, 28 hydrocodone polistirex/chlorpheniramine polistirex, 28 hydrocodone/acetaminophen, 26 Hydrocodone/Acetaminophen, 26 hydrocodone/homatropine, 28 hydrocodone/ibuprofen, 26 hydrocort ene 100MG, 16 hydrocortisone, 10, 11, 16 hydrocortisone acetate, 16 hydrocortisone acetate/aloe, 10 hydrocortisone acetate/lidocaine HCL, 16 hydrocortisone acetate/pramoxine, 10, 16 hydrocortisone acetate/pramoxine HCL, 16 hydrocortisone butyrate, 10 hydrocortisone butyrate (lipid), 10 hydrocortisone butyrate (lipophilic), 10 hydrocortisone IN absorbase, 10 hydrocortisone valerate, 10 hydrocortisone/acetic acid, 24 hydrocortisone/iodoquinol, 9 hydrogesic, 26 hydromet, 28 hydromorphone HCL, 26 Hydromorphone HCL, 26 Hydromorphone HCL Dosette, 26 hydromorphone HCL ER, 26 Hydromorphone HCL ER, 26 hydroquinone, 10 hydroquinone time release, 10 Hydroxocobalamin, 17 hydroxychloroquine sulfate, 3 hydroxyurea, 5 hydroxyzine HCL, 20 Hydroxyzine HCL, 20 hydroxyzine pamoate, 20 Hydroxyzine Pamoate, 20 hygel, 10 hyomax-SL, 15 hyophen, 16 hyoscyamine sulfate, 15 hyoscyamine sulfate ER, 15 hyoscyamine sulfate odt, 15 hyoscyamine sulfate SR, 15 hyosyne, 15 hypercare, 10 Hyperhep B S/D, 38 Hyperlyte-CR, 37 Hyperrab S/D, 38 Hyperrho S/D, 38 Hyperrho S/D Mini-dose, 38 I ibandronate sodium, 13 ibudone, 26 ibuprofen, 26 ibutilide fumarate, 6 Iclusig, 5 idarubicin HCL, 4 iferex 150, 18, 42 iferex 150 forte, 17 Ifex, 4 ifosfamide, 3 Ifosfamide, 4 Ifosfamide/Mesna, 5 Ilaris, 27 Ilevro, 24 ilotycin, 23 Imbruvica, 5 imipenem/cilastatin, 3 imipramine HCL, 20 imipramine pamoate, 20 imiquimod, 10 Imogam Rabies-ht, 37 Imovax Rabies (h.d.c.v.), 29 Implanon, 13, 40 Inatal Advance, 30 Inatal GT, 30 Inatal Ultra, 30 Increlex, 14 indapamide, 7 Inderal XL, 6 indigo carmine, 37 indocyanine green, 37 indomethacin, 26 Indomethacin, 26 indomethacin ER, 26 indomethacin sodium, 26 Infanrix, 29, 41 infed, 17 Infergen, 3 Influenza A (h1n1) Monovalent 2009, 29, 41 Infumorph 200, 26 Infumorph 500, 26 infuvite, 30 infuvite adult, 30 infuvite pediatric, 30 Inlyta, 5 Innopran XL, 6 Inset 30 Infusion Set 23", 33 Inset 30 Infusion Set 43", 33 Inset Infusion Set 23" 6MM, 33 Inset Infusion Set 23" 9MM, 33 Inset Infusion Set 43" 6MM, 33 Inset Infusion Set 43" 9MM, 33 Inspirachamber/Anti-static Valved/Mouthpiece, 36 Inspirachamber/Soothermask/Inspiramas k/Medium, 36 Inspirachamber/Soothermask/Inspiramas k/Small, 36 Inspirease Bags, 36 Inspirease Drug Delivery System, 36 Inspirease Mouthpiece, 36 Inspirease Reservoir Bags, 36 Insulin P.M. IR2020 Black, 33 Insulin P.M. IR2020 Blue, 33 Insulin P.M. IR2020 Green, 33 Insulin P.M. IR2020 Red, 33 Insulin P.M. IR2020 Silver, 33 Integrilin, 19 Intelence, 2 Intermezzo, 21 intralipid, 37 Intron A, 5 Intron-a, 5 Intron-a W/Diluent, 5 introvale, 12, 39 Invanz, 3 Invega, 20 Invega Sustenna, 20 Invirase, 2 Invokana, 13 Iopidine, 24 Ipol Inactivated IPV, 29, 41 ipratropium bromide, 27, 28 ipratropium bromide/albuterol sulfate, 28 irbesartan, 7 irbesartan/hydrochlorothiazide, 7 irinotecan, 5 Irinotecan, 5 iron, 18, 42 Iron, 18, 42 Iron Asp Gly/ Polysacch Compl/Ascorb CAL/B12/Fa/C Threon/Suc, 18 Iron Chews Pediatric, 18, 42 iron slow release, 18, 42 iron supplement, 18, 42 iron supplement childrens, 18, 42 Iron Up, 18, 42 Isentress, 2 isoditrate ER, 6 isoflurane, 27 isolyte-m/dextrose 5%, 37 Isolyte-s, 38 isometheptene mucate/caffeine/acetaminophen, 27 Isometheptene/Caffeine/Acetaminophen, 27 isometheptene/dichloralphenazone/aceta minophen, 27 isoniazid, 2 Isoniazid, 2 Isopto Carbachol, 24 isosorbide dinitrate, 6 Isosorbide Dinitrate, 6 isosorbide dinitrate ER, 6 isosorbide mononitrate, 6 isosorbide mononitrate ER, 6 isosulfan blue, 37 isotonic gentamicin, 2 Isotonic Gentamicin, 2 isoxsuprine HCL, 8 Isoxsuprine HCL, 8 Isradipine, 6 Istalol, 23 Istodax, 5 itraconazole, 2 ivermectin, 3 Ixempra Kit, 5 Ixiaro, 29 J Jakafi, 5 jantoven, 19 Janumet, 13 Janumet XR, 13 Januvia, 13 jencycla, 12, 39 Jentadueto, 13 Jetrea, 24 Jevtana, 5 Jinteli, 11 jolessa, 12, 39 jolivette, 12, 39 junel 1.5/30, 12, 39 junel 1/20, 12, 39 junel FE 1.5/30, 12, 39 junel FE 1/20, 12, 39 just d, 30, 43 Juvisync, 13 Juxtapid, 8 K k-effervescent, 37 K-phos, 38 k-prime, 37 k-sol, 37 k-vescent, 37 Kadcyla, 4 Kadian, 26 Kalbitor, 19 Kaletra, 2 Kalydeco, 28 Kapvay Dose Pack, 21 karidium, 38, 40 karigel, 19 karigel-n, 19 kariva, 12, 39 KCL 0.075%/D5W/NACL 0.45%, 37 KCL 0.15%/D5W/ NACL 0.3%, 37 KCL 0.15%/D5W/Lr, 37 KCL 0.15%/D5W/NACL 0.2%, 38 KCL 0.15%/D5W/NACL 0.225%, 38 KCL 0.15%/D5W/NACL 0.45%, 38 KCL 0.15%/D5W/NACL 0.9%, 38 KCL 0.3%/D5W/Lr IV Lac Ring, 38 KCL 0.3%/D5W/NACL 0.45%, 38 KCL 0.3%/D5W/NACL 0.9%, 38 kedbumin, 19 kelnor 1/35, 12, 39 Kenalog, 10 kendall sodium chloride flush, 37 Kepivance, 5 ketamine HCL, 27 Ketek, 3 ketoconazole, 2, 9 ketodan, 9 ketoprofen, 26 Ketoprofen ER, 26 ketorolac tromethamine, 24, 26 Ketorolac Tromethamine, 26 Kineret, 27 Kinney Lancets, 33 Kinney Thin Lancets, 33 Kinrix, 29, 41 kionex, 37 klor-CON, 37 klor-CON 10, 37 klor-CON 8, 37 klor-CON m10, 37 Klor-CON M15, 38 klor-CON m20, 37 klor-CON/EF, 37 kls aspirin EC, 25, 39 kls aspirin low dose, 25, 39 kls quit2, 22, 42 kls quit4, 22, 42 Koate-dvi, 19 Kogenate FS, 19 Kogenate FS Bio-set, 19 Kombiglyze XR, 13 kp aspirin, 25, 39 kp ferrous gluconate, 18, 42 kp ferrous sulfate, 18, 42 kp folic acid, 18, 41 Kp Prenatal Multivitamins, 31, 41 kp vitamin d, 30, 43 Kristalose, 15 Kroger Lancets, 33 Kroger Lancets 21G, 33 Kroger Lancets Micro Thin33G, 33 Kroger Lancets Super Thin, 33 Kroger Lancets Thin, 33 Kroger Lancets Thin 26G, 33 Kroger Lancets Ultrathin 30G, 33 Krystexxa, 27 kurvelo, 12, 39 Kuvan, 15 Kynamro, 8 Kyprolis, 5 L l-cysteine HCL, 37 L-methyl-b6-b12, 38 L-methyl-mc, 38 L-methylfolate, 38 L-methylfolate CA/P-5-P.M.-CBL, 38 L-methylfolate Calcium, 38 labetalol HCL, 6 laclotion, 10 Lacrisert, 23 lactated ringers, 37 lactated ringers dextrose 5% viaflex, 37 lactated ringers irrigation, 37 lactated ringers viaflex, 37 lactic acid, 10 lactic acid e, 10 lactic acid w/vitamin e, 10 lactulose, 15, 16 Lamictal, 21 Lamictal Odt, 21 Lamisil, 2 lamivudine, 2 lamivudine/zidovudine, 2 lamotrigine, 21 lamotrigine ER, 21 lamotrigine odt, 21 Lancets, 33 Lancets 26G Twist Top, 33 Lancets 28G, 33 Lancets 30G, 33 Lancets 30G Twist Top, 33 Lancets 31G Twist Top, 33 Lancets Bullseye Safety, 33 Lancets Micro Thin 33G, 33 Lancets Safety Seal 21G, 33 Lancets Safety Seal 26G, 33 Lancets Safety Seal 28G, 33 Lancets Safety Seal 30G, 33 Lancets Super Thin 28G, 33 Lancets Thin, 33 Lancets Twist Top, 33 Lancets Ultra Fine, 33 Lancets Ultra Thin, 33 Lancets Ultra Thin 30G, 33 lanolin, 37 lansoprazole, 15 lansoprazole/amoxicillin/clarithromycin, 15 Lantus, 13 Lantus Solostar, 13 larin 1.5/30, 12, 39 larin 1/20, 12, 40 larin FE 1.5/30, 12, 39 larin FE 1/20, 12, 39 Lastacaft, 24 latanoprost, 23 latrix, 10 Latuda, 20 lavoclen-4 acne wash kit, 8 Lavoclen-4 Creamy Wash, 9 lavoclen-8 acne wash kit, 8 Lavoclen-8 Creamy Wash, 9 Lazanda, 26 Leader Lancets Colored, 33 Leader Super Thin Lancet, 33 Leader Thin Lancets, 33 Lecithin, 38 leena, 12, 40 leflunomide, 26 lessina, 12, 40 Letairis, 8 letrozole, 4 leucovorin calcium, 5 Leucovorin Calcium, 5 Leukeran, 3 Leukine, 18 leuprolide acetate, 4 levalbuterol, 28 levalbuterol HCL, 28 Levatol, 6 Levemir, 13 Levemir Flexpen, 13 Levemir Flextouch, 13 levetiracetam, 21 Levetiracetam, 21 levetiracetam ER, 21 levobunolol HCL, 23 Levobunolol HCL, 23 levocarnitine, 14 levocetirizine dihydrochloride, 27 levofloxacin, 2, 23 levofloxacin IN D5W, 2 levonest, 12, 40 levonorgestrel, 12, 40 levonorgestrel and ethinyl estradiol, 12, 40 levonorgestrel/ethinyl estradiol, 12, 40 Levophed, 7 levora 0.15/30-28, 12, 40 Levorphanol Tartrate, 26 levothyroxine sodium, 15 Levothyroxine Sodium, 15 levoxyl, 15 Lexiva, 2 Lialda, 16 Liberty Blood Glucose Meter, 33 Liberty Glucose Control Mid, 33 Liberty Glucose Control Normal, 33 Liberty Mini Lancing Device, 35 Liberty Test Strips, 33 lidazone HC, 16 lidocaine, 10 lidocaine HCL, 6, 10, 19, 27 Lidocaine HCL, 6 lidocaine HCL IN D5W, 6 lidocaine HCL jelly, 10 lidocaine HCL viscous, 19 Lidocaine HCL-hydrocortisone Acetate With Aloe, 16 lidocaine HCL/dextrose, 6 Lidocaine HCL/Dextrose, 27 lidocaine HCL/hydrocortisone acetate, 16 lidocaine viscous, 19 lidocaine/epinephrine, 27 lidocaine/prilocaine, 10 lidopin, 10 Lifescan Unistik 2 Deep Penetration, 33 Lifescan Unistik II Lancets, 33 Lincocin, 3 lindane, 10 linezolid, 3 Linzess, 16 Lioresal Intrathecal, 23 liothyronine sodium, 15 lipodox, 4 lipodox 50, 4 Lipofen, 8 liposyn iii, 37 Liptruzet, 8 lisinopril, 7 lisinopril/hydrochlorothiazide, 7 lissamine green, 24 Lite Touch Lancets, 33 Liteaire, 36 Litetouch Lancets Micro Thin 33G, 33 Lithium, 20 lithium carbonate, 20 Lithium Carbonate, 20 lithium carbonate ER, 20 Livalo, 8 Live Better Lancet Super Thin 30G, 33 Live Better Lancet Ultra Thin 28G, 33 LMD 10% Dextrose 5%, 19 LMD 10% Sodium Chloride 0.9%, 19 Lmthf/Pyridoxine HCL/Cyanocobalamin, 38 LO Loestrin FE, 12, 40 Locoid, 10 lofene, 15 lokara, 10 lomedia 24 FE, 12, 40 Lomustine, 3 Longs Lancets Standard, 33 Longs Lancets Thin, 33 Longs Lancets Ultra Thin, 33 lonox, 15 loperamide HCL, 15 lopreeza, 11 lorazepam, 20 lorcet, 26 lorcet HD, 26 lorcet plus, 26 lortab, 26 loryna, 12, 40 Lorzone, 23 losartan potassium, 7 losartan potassium/hydrochlorothiazide, 7 Lotemax, 23 Lotronex, 16 lovastatin, 8 low-ogestrel, 12, 40 loxapine, 20 loxapine succinate, 20 Lozi-flur, 38, 40 Lucentis, 24 ludent, 38, 40 Lufyllin, 28 Lumigan, 23 Lumizyme, 15 Lupron Depot, 4 Lupron Depot-PED, 14 lutera, 12, 40 Lyrica, 21 lysiplex plus, 30 Lysodren, 4 lyza, 12, 40 M M-m-r II W/Diluent 10 Dose, 29, 41 M-vit, 30, 41 M.v.i. Adult, 31 M.v.i. Pediatric, 31 M.v.i.-12 Without Vitamin K, 31 Macnatal CN DHA, 30 Macugen, 24 mafenide acetate, 10 Magnebind 400, 38 magnesium chloride, 37 magnesium sulfate, 37 Magnesium Sulfate, 38 Magnesium Sulfate IN D5W, 38 Makena, 13 malathion, 10 mannitol, 7 Maprotiline HCL, 20 margesic, 25 marlissa, 12, 40 Marplan, 20 Marqibo, 5 marten-TAB, 25 Mask Vortex/Baby Whirl Duckling, 36 Mask Vortex/Child/Frog, 36 Mask Vortex/Spinner The Duck, 36 Mask Vortex/Toddler/Lady Bug, 36 Matulane, 5 matzim LA, 6 Maxair Autohaler, 28 maximum d3, 30, 43 Maxipime, 1 MD-gastroview, 38 meclizine HCL, 16 Meclofenamate Sodium, 26 Medi-seltzer, 25, 39 Medical Provider EZ Flu Shot 2013-2014, 29, 41 Medical Provider EZ Flu Shot 2014-2015, 29, 41 Medical Provider EZ Flu Shot PF 20122013, 29, 41 Medical Provider EZ Flu Shot PF 20132014, 29, 41 Medical Provider EZ Flu Shot PF 20142015, 29, 41 Medichoice Pre-set Safety Lancet Dual Use, 33 Medichoice Pre-set Safety Lancet Low Flow, 33 Medichoice Pre-set Safety Lancet Medium Flow, 33 Medichoice Pre-set Safety Lancet Moderate Flow, 33 Medichoice Safety Lancet Extra, 33 Medichoice Safety Lancet Normal, 33 Medicine Shoppe Lancets, 33 Medicine Shoppe Lancets Thin, 33 Medisense Thin Lancets, 33 Medlance Plus Extra Lancets 21G, 33 Medlance Plus Lancets, 33 Medlance Plus Lancets Lite 25G, 33 Medlance Plus Lite Lancets 25G, 33 Medlance Plus Special Lancets 0.8MM, 33 Medlance Plus Superlite 30G, 33 Medlance Plus Superlite 30G/Comfort Max, 33 Medlance Plus Universal Lancets 21G, 33 Medlance Plus/Lite 25G, 33 Medlance/Extra, 33 Medlance/Lite, 33 Medlance/Universal, 33 medroxyprogesterone acetate, 12, 13, 40 mefenamic acid, 26 mefloquine HCL, 3 Mefoxin, 1 mega-c/a plus, 29 megestrol acetate, 4 Meijer Alcohol Swabs Extra-thick, 36 meijer aspirin EC, 25, 39 Meijer Color Lancets Universal 33G, 33 meijer ferrous sulfate, 18, 42 Meijer Lancets, 33 Meijer Lancets Thin, 34 Meijer Lancets Universal 33G, 34 Meijer Super Thin Lancets, 34 Mekinist, 5 meloxicam, 26 Meloxicam, 26 melpaque HP, 10 melphalan hydrochloride, 3 melquin HP, 10 Menactra, 29, 41 Menest, 11 Menhibrix, 29 Menomune-a/C/Y/W-135, 29, 41 Mentax, 9 Menveo, 29, 41 meperidine HCL, 26 Meperidine HCL, 26 meperitab, 26 Mephyton, 30 Mepivacaine HCL, 27 meprobamate, 20 mercaptopurine, 4 meropenem, 3 mesalamine, 16 mesna, 5 Mesnex, 5 Mestinon, 23 Mestinon Timespan, 23 metadate ER, 21 Metafolbic, 38 Metaproterenol Sulfate, 28 Metastron, 5 metaxalone, 22 metformin HCL, 13 metformin HCL ER, 13 methadone HCL, 26 Methadone HCL, 26 methadone HCL intensol, 26 methadose, 26 Methadose, 26 Methadose Sugar-free, 26 methamphetamine HCL, 21 methazolamide, 7 methenamine hippurate, 16 methenamine mandelate, 16 Methenamine Mandelate, 16 methimazole, 15 Methitest, 11 methocarbamol, 23 methotrexate, 4 methotrexate sodium, 4 methoxsalen, 9 methscopolamine bromide, 15 Methyclothiazide, 7 methyldopa, 7 Methyldopa/Hydrochlorothiazide, 7 Methyldopate HCL, 7 methylene blue, 37 methylergonovine maleate, 24 methylphenidate HCL, 21 methylphenidate HCL CD, 21 methylphenidate HCL ER, 21 Methylphenidate HCL ER, 21 methylphenidate HCL SR, 21 methylphenidate hydrochloride, 21 methylprednisolone, 11 methylprednisolone acetate, 11 methylprednisolone dose pack, 11 methylprednisolone sodiumsuccinate, 11 Metipranolol, 23 metoclopramide HCL, 16 metolazone, 7 metoprolol succinate ER, 6 metoprolol tartrate, 6 metoprolol/hydrochlorothiazide, 7 metronidazole, 3, 9 metronidazole IN NACL 0.79%, 3 metronidazole vaginal, 17 mexiletine HCL, 6 Miacalcin, 14 Miconazole 3, 17 Micrhogam Ultra-filtered Plus, 38 Microchamber, 36 microgestin 1.5/30, 12, 40 microgestin 1/20, 12, 40 microgestin FE, 12, 40 microgestin FE 1.5/30, 12, 40 Microlet Lancets, 34 micronized colestipol HCL, 8 Microspacer, 36 Microtainer Safety Flow Lancet/Sterile/Single-use, 34 midazolam HCL, 21 midodrine HCL, 7 migragesic ida, 27 Migralam, 27 Millipred, 11 Millipred DP, 11 milrinone IN dextrose, 6 milrinone lactate, 6 mimvey, 11 mimvey LO, 11 Minastrin 24 FE, 12, 40 Mineral Oil Heavy, 15 miniprin low dose, 25, 39 minitran, 6 Minivelle, 11 Minocin, 1 minocycline HCL, 1 minocycline HCL ER, 1 minoxidil, 7 Mirapex ER, 22 Mirena, 13, 40 mirtazapine, 20 mirtazapine odt, 20 misoprostol, 15 Mission Prenatal, 31, 41 Mission Prenatal HP, 31, 41 mitomycin, 4 mitoxantrone HCL, 4 MM aspirin, 25, 39 modafinil, 21 moderiba, 3 Moderiba, 3 Moderiba 1200 Dose Pack, 3 Moderiba 800 Dose Pack, 3 moexipril HCL, 7 moexipril/hydrochlorothiazide, 7 mometasone furoate, 10 mono-linyah, 12, 40 Monoclate-p, 19 monoject pharma grade flush syringe, 37 monoject pharma grade flush syringe/heparin lock, 19 monoject prefill advanced heparin lock flush, 19 monoject sodium chloride flush, 37 Monolet Lancets, 34 Monolet Opd Lancets, 34 Monolettor Safety Lancets, 34 mononessa, 12, 40 Mononine, 19 Monovisc, 23 montelukast sodium, 28 Monurol, 17 morgidox 1X100MG, 1 morgidox 2X100MG, 1 morphine sulfate, 26 Morphine Sulfate, 26 Morphine Sulfate Add-vantage, 26 morphine sulfate ER, 26 morrhuate sodium, 37 Motofen, 15 Moviprep, 15 Moxatag, 1 Moxeza, 23 moxifloxacin HCL, 2 Mozobil, 18 mult-vitamin/fluoride, 30 Multaq, 6 Multi Prenatal, 31, 41 multi vitamin/fluoride, 30 multi-vit/fluoride, 30 multi-vit/iron/fluoride, 30 multi-vitamin/fluoride, 30 multi-vitamin/fluoride/iron, 30 Multigen, 18 Multigen Folic, 18 Multigen Plus, 18 Multitrace-4, 38 multitrace-4 concentrate, 37 Multitrace-4 Neonatal, 38 Multitrace-5, 38 multitrace-5 concentrate, 37 multivitamin with fluoride, 30 multivitamin/fluoride, 30 multivitamins/fluoride, 30 mupirocin, 9 mupirocin calcium, 9 Muse, 8 Mustargen, 4 MVC-fluoride, 31 my way, 12, 40 Myalept, 15 Mycamine, 2 mycophenolate mofetil, 4 mycophenolic acid DR, 4 mydral, 24 myferon 150, 18, 42 myferon 150 forte, 17 Myglucohealth Mgh Softlance Lancets 30G, 34 Mykidz Iron 10, 18, 42 Myleran, 4 Mynatal Advance, 30 Mynatal Plus, 31 Mynatal Ultracaplet, 31 Mynatal-z, 31 Mynate 90 Plus, 31 mynephrocaps, 30 Myobloc, 22 myorisan, 8 Myoxin, 24 Myozyme, 15 Myrbetriq, 17 myzilra, 12, 40 N n-acetyl-l-cysteine, 37 Nabi-HB, 38 nabumetone, 26 nadolol, 6 nadolol/bendroflumethiazide, 7 nafcillin sodium, 1 Nafcillin Sodium, 1 nafrinse, 38, 40 nafrinse drops, 38, 40 Naftin, 9 Naglazyme, 15 nalbuphine HCL, 26 Nalfon, 26 naloxone HCL, 37 Naloxone HCL, 38 naltrexone HCL, 37 Namenda, 22 Namenda Titration PAK, 22 Namenda XR, 22 Namenda XR Titration Pack, 22 Naphazoline HCL, 24 Naprelan, 26 naproxen, 26 naproxen DR, 26 naproxen sodium, 26 naratriptan HCL, 27 Nascobal, 18 Nasonex, 27 Nat-rul Prenatal Vitamins, 31, 41 nat-rul vitamin d, 30, 43 Natacyn, 23 Natazia, 12, 40 nateglinide, 13 Natroba, 11 Nature-throid, 15 Nebupent, 3 nebusal, 28 necon 0.5/35-28, 12, 40 necon 1/35, 12, 40 Necon 1/50-28, 11, 39 Necon 10/11-28, 11, 39 necon 7/7/7, 12, 40 Neevo DHA, 31 nefazodone HCL, 20 Nefazodone HCL, 20 neo-polycin, 23 neo-polycin HC, 23 neofrin, 24 neomycin sulfate, 2 neomycin/bacitracin/polymyxin, 23 neomycin/polymyxin b sulfates, 17 neomycin/polymyxin/bacitracin zinc, 23 neomycin/polymyxin/bacitracin/hydrocorti sone, 23 neomycin/polymyxin/dexamethasone, 23 neomycin/polymyxin/gramicidin, 23 neomycin/polymyxin/HC, 24 Neomycin/Polymyxin/Hydrocortisone, 23 neomycin/polymyxin/hydrocortisone, 24 neostigmine methylsulfate, 23 nephronex, 30 Nessi Spacer/Large Mask, 36 Nessi Spacer/Mouthpiece, 36 Nessi Spacer/Small/MED Mask, 36 Netgroup Lancets, 34 neuac, 8 Neulasta, 18 Neulasta Delivery Kit, 18 Neumega, 18 Neupogen, 18 Neupro, 22 Neurodep, 31 neutragard advanced, 19 neutral sodium fluoride, 19 Nevanac, 24 nevirapine, 2 Nevirapine, 2 nevirapine ER, 2 Nexavar, 5 Nexium, 15 Nexplanon, 13, 40 next choice one dose, 12, 40 Nexterone, 6 niacin ER, 8 niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper, 30 Niacor, 8 Nicadan, 31 nicardipine HCL, 6 Nicazel, 31 Nicazel Forte, 31 nicorelief, 22, 42 nicotine, 22, 42 nicotine polacrilex, 22, 42 nicotine polacrilex refill, 22, 42 nicotine polacrilex starter kit, 22, 42 nicotine step 1, 22, 42 nicotine step 2, 22, 42 nicotine step 3, 22, 42 nicotine transdermal system, 22, 42 Nicotine Transdermal System, 22, 43 Nicotrol Inhaler, 22, 43 Nicotrol Ns, 22, 43 nifediac CC, 6 nifedical XL, 6 nifedipine, 6 nifedipine ER, 6 nikki, 12, 40 Nilandron, 4 nimodipine, 6 Nipent, 5 nisoldipine, 6 Nisoldipine, 6 Nisoldipine ER, 6 Nitro-bid, 6 Nitro-dur, 6 nitro-time, 6 nitrofurantoin, 16 nitrofurantoin macrocrystals, 16 nitrofurantoin monohydrate, 16 nitrofurantoin monohydrate/macrocrystals, 16 nitroglycerin, 6 Nitroglycerin, 6 nitroglycerin ER, 6 nitroglycerin IN 5% dextrose, 6 nitroglycerin IN dextrose 5%, 6 Nitroglycerin IN Dextrose 5%, 6 nitroglycerin lingual, 6 Nitroglycerin Lingual, 6 nitroglycerin transdermal, 6 Nitromist, 6 Nitrostat, 6 nizatidine, 15 nodolor, 27 nora-be, 12, 40 Norditropin Cartridge, 14 Norditropin Flexpro, 14 Norditropin Nordiflex Pen, 14 norepinephrine bitartrate, 7 norethindrone, 12, 40 norethindrone acetate, 13 norethindrone acetate/ethinyl estradiol, 12, 40 norethindrone acetate/ethinyl estradiol/ferrous fumarate, 12, 40 norgestimate/ethinyl estradiol, 12, 40 norlyroc, 12, 40 normal saline flush, 37 normal saline flush for flushing vascular access devices, 37 normal saline i.v. flush, 37 Normosol -r, 38 normosol-m IN D5W, 37 Normosol-r IN D5W, 38 Noroxin, 2 Norpace CR, 6 nortrel 0.5/35 (28), 12, 40 nortrel 1/35, 12, 40 nortrel 7/7/7, 12, 40 nortriptyline HCL, 20 Nortriptyline HCL, 20 nortuss-DE, 28 Nortuss-EX, 28 Norvir, 2 norwich aspirin, 25, 39 Nova Safety Lancets 23G, 34 Nova Safety Lancets 28G, 34 Nova Sureflex Lancets, 34 Novaferrum Pediatric Drops, 18, 42 novarel, 14 Novofine 30GX8MM, 34 Novofine 32GX6MM, 34 Novofine Autocover 30GX8MM, 34 Novolin 70/30, 13 Novolin 70/30 Relion, 13 Novolin N, 13 Novolin N Relion, 13 Novolin R, 13 Novolin R Relion, 13 Novolog, 13 Novolog Flexpen, 13 Novolog Mix 70/30, 13 Novolog Mix 70/30 Prefilled Flexpen, 13 Novolog Penfill, 13 Novoseven, 19 Novoseven Rt, 19 Novotwist 30GX8MM, 34 Novotwist 32GX5MM, 34 Noxafil, 2 NP thyroid, 15 NP thyroid 30, 15 NP thyroid 60, 15 NP thyroid 90, 15 Nplate, 18 nu-iron 150, 18, 42 Nucynta, 26 Nucynta ER, 26 Nuedexta, 22 nufol, 17 nulev, 15 Nulojix, 4 Numoisyn, 20 nuquin HP, 10 Nutricap, 31 nutrifac ZX, 30 nutrilipid, 37 nutrilyte, 37 nutrilyte II, 37 Nutropin, 14 Nutropin AQ Nuspin 10, 14 Nutropin AQ Nuspin 20, 14 Nutropin AQ Nuspin 5, 14 Nutropin AQ Pen, 14 Nuvaring, 12, 40 Nuvigil, 21 nyamyc, 9 nystatin, 2, 9, 19 nystatin/triamcinolone, 9 nystop, 9 O OB-natal One, 31 Obstetrix EC, 31 ocella, 12, 40 Octagam, 38 octreotide acetate, 14 ocucoat viscoadherent, 24 Ocudox, 1 ofloxacin, 2, 23, 24 Ofloxacin, 2 Ogestrel, 12, 40 olanzapine, 20 olanzapine odt, 20 olanzapine/fluoxetine, 22 olopatadine HCL, 27 Olysio, 3 Omeclamox-PAK, 16 omega-3-acid ethyl esters, 8 omeprazole, 15 omeprazole/sodium bicarbonate, 15 Omnaris, 28 Omniflex Diaphragm, 40 Omnitrope, 14 On Call Lancets, 34 On Call Plus Lancets, 34 Oncaspar, 4 ondansetron HCL, 16 ondansetron odt, 16 One A Day Womens Prenatal/DHA, 31 One-a-day Womens Prenatal, 31, 41 Onetouch Basic System, 34 Onetouch Basic/Profile Test Strips, 34 Onetouch Club Lancets Fine Point, 34 Onetouch Combo Pack, 34 Onetouch Delica Lancets Extra Fine 33G, 34 Onetouch Delica Lancets Fine 30G, 34 Onetouch Delica Lancing Device, 35 Onetouch Finepoint Lancets, 34 Onetouch Lancets, 34 Onetouch Ping Insulin P.M., 34 Onetouch Ping Meter Remote, 34 Onetouch Profile System, 34 Onetouch Suresoft Lancing Device/18G, 35 Onetouch Suresoft Lancing Device/21G, 35 Onetouch Suresoft Lancing Device/28G, 35 Onetouch Ultra 2, 34 Onetouch Ultra Blue, 34 Onetouch Ultra Control, 34 Onetouch Ultra Mini, 34 Onetouch Ultra System Kit, 34 Onetouch Ultralink System (DEC), 34 Onetouch Ultralink System (hex), 34 Onetouch Ultrasmart, 34 Onetouch Ultrasoft Lancets, 34 Onetouch Verio, 34 Onetouch Verio Control Solution High, 34 Onetouch Verio IQ Blood Glucose Monitoring System, 34 Onetouch Verio Mid Control Solution, 34 Onetouch Verio Sync Bloodglucose Monitoring System, 34 Onetouch Verio Test Strips, 34 Onfi, 21 Onglyza, 13 Opana ER (crush Resistant), 26 opium, 15 opium tincture, 15 Opium Tincture (paregoric), 15 Opsumit, 8 Optichamber Advantage, 36 Optichamber Diamond, 36 Optichamber Diamond/Largeface Mask, 36 Optichamber Diamond/Medium Face Mask, 36 Optichamber Diamond/Smallface Mask, 36 Optichamber Valved Holding Chamber, 36 Optichamber/Mask, 36 Optihaler, 36 Optihaler MDI Drug Delivery System, 36 optimal-d, 30, 43 optimal-d pack, 30, 43 Options Conceptrol Vaginal Contraceptive, 17, 40 Options Gynol II Vaginal Contraceptive, 17, 40 opurity vitamin d, 30, 43 Oracea, 9 Oracit, 17 oralone, 19 Orap, 22 Orapred Odt, 11 Oravig, 20 Orencia, 27 Orfadin, 15 orphenadrine citrate, 23 orphenadrine citrate ER, 23 orphenadrine/asa/caffeine, 23 orsythia, 12, 40 Ortho Diaphragm All-flex/65MM, 40 Ortho Diaphragm All-flex/70MM, 40 Ortho Diaphragm All-flex/75MM, 40 Ortho Diaphragm All-flex/80MM, 40 Ortho Diaphragm Coil Spring Kit 100, 40 Ortho Diaphragm Coil Spring Kit 105, 40 Ortho Diaphragm Coil Spring Kit 50, 40 Ortho Diaphragm Flat Spring Kit 55, 40 Ortho Diaphragm Flat Spring Kit 60, 40 Ortho Diaphragm Flat Spring Kit 65, 40 Ortho Diaphragm Flat Spring Kit 70, 40 Ortho Diaphragm Flat Spring Kit 75, 40 Ortho Diaphragm Flat Spring Kit 80, 40 Ortho Diaphragm Flat Spring Kit 85, 40 Ortho Diaphragm Flat Spring Kit 90, 40 Ortho Diaphragm Flat Spring Kit 95, 40 ortho-CS 250, 29 ortho-est, 11 Orthovisc, 23 oscimin, 15 oscimin SR, 15 oscion cleanser, 8 osmitrol viaflex, 7 Osmoprep, 15 otic care, 24 oticin, 24 oto-end 10, 24 otomax-HC, 24 Otozin, 24 Ovace Plus, 9 oxacillin sodium, 1 oxaliplatin, 3 oxandrolone, 11 oxaprozin, 26 oxazepam, 20 oxcarbazepine, 21 Oxecta, 26 Oxistat, 9 Oxsoralen, 11 oxybutynin chloride, 17 oxybutynin chloride ER, 17 oxycodone HCL, 26 Oxycodone HCL, 26 Oxycodone HCL ER, 26 oxycodone/acetaminophen, 26 oxycodone/aspirin, 26 oxycodone/ibuprofen, 26 Oxycontin, 26 oxymorphone hydrochloride, 26 oxymorphone hydrochloride ER, 26 oxytocin, 24 Oxytrol, 17 Oxytrol For Women, 17 Ozurdex, 23 P PA Prenatal Formula, 31, 41 PA vitamin d-3, 30, 43 PA vitamin d-3 gummy, 30, 43 pacerone, 6 paclitaxel, 5 Paclitaxel, 5 pamidronate disodium, 14 Pamidronate Disodium, 14 Pancrelipase, 16 pancuronium bromide, 22 Panda Mask Large, 36 Panda Mask Medium, 36 Panda Mask Small, 36 Panretin, 11 pantoprazole sodium, 15 papaverine HCL, 8 Paragard Intrauterine Copper Contraceptive T380a, 13 parcaine, 24 paricalcitol, 14 Paricalcitol, 14 paroex, 19 paromomycin sulfate, 2 paroxetine HCL, 20 paroxetine HCL ER, 20 Paser, 2 Pataday, 24 Patanol, 24 Paxil, 20 PCE, 1 pedi-dri, 9 Pediaderm HC, 10 Pediaderm Ta, 10 Pediarix, 29, 41 Pediatric Panda Mask, 36 Pedipirox-4 Nail, 9 Pedvax HIB, 29, 41 peg 3350/electrolytes, 15, 43 peg-3350/electrolytes, 15, 43 peg-3350/NACL/NA bicarbonate/KCL, 15, 43 Peg-intron, 3 Peg-intron Redipen, 3 Peg-intron Redipen PAK 4, 3 Peganone, 21 Pegasys, 3 Pegasys Proclick, 3 Pegintron, 3 pegylax, 15 Pen Needles 29G X 12MM, 34 Pen Needles 29GX1/2", 34 Pen Needles 30GX5/16", 34 Pen Needles 31G X 1/4" SHORT, 34 Pen Needles 31G X 3/16", 34 Pen Needles 31G X 6MM, 34 Pen Needles 31GX5/16", 34 penicillin G potassium, 1 Penicillin G Potassium IN Iso-osmotic Dextrose, 1 Penicillin G Procaine, 1 Penicillin G Sodium, 1 penicillin v potassium, 1 Pentacel, 29, 41 Pentasa, 16 pentazocine/acetaminophen, 26 pentazocine/naloxone HCL, 26 pentoxifylline ER, 19 Perfect Iron, 18, 42 Perfect Lancets 30G, 34 Perfect Pressure Activated Safety Lancets 28G, 34 Perforomist, 28 perindopril erbumine, 7 perio MED, 19 periogard, 19 Perjeta, 4 permethrin, 10 perphenazine, 20 Perphenazine/Amitriptyline, 22 Perry Prenatal, 31, 41 Pertzye, 16 Pfizerpen-G, 1 pharbedryl, 27 Pharmacist Choice Alcoholprep Pads, 36 Pharmacist Choice Ultra Thin Lancets, 34 Pharmacist Choice Ultra Thin Lancets 28G, 34 Pharmacist Choice Ultra Thin Lancets 30G, 34 Pharmacist Choice Ultra Thin Lancets 31G, 34 Pharmacist Choice Ultra Thin Lancets 33G, 34 Pharmacy Counter Lancets, 34 phenadoz, 27 phenazo, 17 phenazopyridine HCL, 17 phendimetrazine tartrate, 21 Phendimetrazine Tartrate ER, 21 phenelzine sulfate, 20 phenergan, 27 phenobarbital, 21 Phenobarbital, 21 Phenobarbital Sodium, 21 phentermine HCL, 21 Phentolamine Mesylate, 7 phenylephrine HCL, 7, 24 Phenylephrine HCL, 7 phenylephrine/guaifenesin, 28 phenytoin, 21 phenytoin infatabs, 21 phenytoin sodium, 21 phenytoin sodium extended, 21 philith, 12, 40 Phisohex, 38 phos-flur, 19 Phoslyra, 16 phospha 250 neutral, 37 phosphasal, 16 Phospholine Iodide, 24 Photofrin, 5 Physicians EZ Use Flu Kit 2012-2013, 29, 41 physiolyte, 37 physiosol irrigation, 37 phytonadione, 29 Picato, 11 pilocarpine HCL, 19, 24 pilocarpine hydrochloride, 19 Pilopine HS, 24 pimtrea, 12, 40 pindolol, 6 pioglitazone HCL, 13 pioglitazone HCL-glimepiride, 13 pioglitazone HCL/metformin HCL, 13 piperacillin sodium/ tazobactam sodium, 1 piperacillin sodium/tazobactam sodium, 1 piperacillin/tazobactam, 1 pirmella 1/35, 12, 40 pirmella 7/7/7, 12, 40 piroxicam, 26 plasbumin-25, 19 plasbumin-5, 19 Plasma-lyte A, 38 Plasma-lyte-148, 38 Pneumovax 23, 29, 41 Pneumovax 23/1 Dose, 29, 41 Pneumovax 23/5 Dose, 29, 42 PNV-DHA, 31 PNV-select, 31 Pocket Chamber, 36 Pocket Spacer, 36 podofilox, 10 polocaine, 27 polocaine-mpf, 27 poly-dex, 23 poly-iron 150, 18, 42 poly-iron 150 forte, 17 polycin, 23 polycin b, 23 polyethylene glycol 3350, 15 polymyxin b sulfate, 3 polymyxin b sulfate/trimethoprim sulfate, 23 polysaccharide iron forte, 17 Pomalyst, 5 portia-28, 12, 40 Potaba, 30 potassium acetate, 37 Potassium Acetate, 38 potassium bicarbonate, 37 potassium chloride, 37 Potassium Chloride, 38 potassium chloride 0.15% /NACL 0.45% viaflex, 37 Potassium Chloride 0.15% /NACL 0.45% Viaflex, 38 potassium chloride 0.15% D5W/NACL 0.33%, 37 potassium chloride 0.15% D5W/NACL 0.45%, 37 potassium chloride 0.15% D5W/NACL 0.45% viaflex, 37 potassium chloride 0.15% NACL 0.9%, 37 potassium chloride 0.15% w/NACL 0.9% viaflex, 37 potassium chloride 0.15%/D5W, 37 Potassium Chloride 0.15%/NACL 0.9%, 38 potassium chloride 0.22% D5W/NACL 0.45%, 37 potassium chloride 0.224%/D5W/NACL 0.45%, 37 potassium chloride 0.224%D5W/NACL 0.45% viaflex, 37 Potassium Chloride 0.3%/ NACL 0.9%, 38 potassium chloride 0.3%/D5W, 37 potassium chloride 0.3%/NACL 0.9%/viaflex, 37 potassium chloride CR, 37 potassium chloride ER, 37 Potassium Chloride ER, 38 potassium chloride SR, 37 potassium citrate ER, 17 potassium citrate-citric acid crystals, 17 potassium citrate/citric acid, 17 potassium citrate/sodium citrate/citric acid, 17 potassium phosphate, 37 potassium phosphates, 37 Potiga, 21 pr benzoyl peroxide wash, 8 Pr Natal 400, 31 Pr Natal 400 EC, 31 Pr Natal 430, 31 Pr Natal 430 EC, 31 Pradaxa, 19 pramcort, 16 pramipexole dihydrochloride, 21 Pramosone, 10 Pramosone E, 10 pramox gel, 10 pramoxine-HC, 24 Prandimet, 13 prascion, 8 prascion fc, 8 prascion ra with sunscreens, 8 pravastatin sodium, 8 prazosin HCL, 7 Pre-natal Formula, 31, 41 Precision Thin Lancets, 34 Precision Thins GP Lancet, 34 Precision Ultra Lancet, 34 Pred Mild, 23 prednicarbate, 10 prednisolone, 11 prednisolone acetate, 23 prednisolone sodium phosphate, 11 Prednisolone Sodium Phosphate, 11, 23 prednisolone sodium phosphate odt, 11 prednisone, 11 Prednisone, 11 Prednisone Intensol, 11 Prefera OB, 31 Prefera OB + DHA, 31 Preferaob One, 31 Preferred Plus Lancets Colored 21G, 34 Preferred Plus Lancets Super Thin 30G, 34 Preferred Plus Lancets Thin 26G, 34 pregnyl w/diluent benzyl alcohol/NACL, 14 Premarin, 11 premasol, 37 Premphase, 11 Prempro, 11 Prenaissance Plus, 31 Prenaplus, 31, 41 Prenatabs Fa, 31 Prenatabs RX, 31 Prenatal, 31, 41 Prenatal 19, 31 Prenatal Ad, 31 Prenatal And Iron, 31, 41 Prenatal Complete, 31, 41 Prenatal Formula, 31, 41 Prenatal Forte, 31, 41 Prenatal Low Iron, 31, 41 Prenatal Multi +dha, 31, 41 Prenatal Multivitamin + DHA, 31 Prenatal One Daily, 31, 41 Prenatal Plus, 31, 41 Prenatal Plus DHA, 31 Prenatal Plus Iron, 31 Prenatal Vitamins, 31, 41 Prenatal-u, 31 Prenatal/Omega-3/Folic Acid/Iron, 31 Prentif Cavity-rim Cervical CAP, 40 Prentif Fitting Set, 40 Prepopik, 15 Prevacid Solutab, 16 prevalite, 8 previfem, 12, 40 Prevnar 13, 29, 42 Prezista, 2 Prialt, 25 Priftin, 2 Prilosec, 16 Primaquine Phosphate, 3 primidone, 21 Primsol, 3 Pristiq, 20 Privigen, 38 Proair HFA, 28 probenecid, 27 probenecid/colchicine, 27 Procainamide HCL, 6 Procentra, 21 prochlorperazine, 20 prochlorperazine edisylate, 20 prochlorperazine maleate, 20 Procrit, 18 procto-PAK, 16 Proctofoam HC, 16 proctosol HC, 16 proctozone-HC, 16 Procysbi, 17 Prodigy Autocode Blood Glucose Monitoring System, 35 Prodigy Autocode Blood Glucose Monitoring/Talking, 35 Prodigy NO Coding Blood Glucose Test Strips, 35 Prodigy Pocket Blood Glucose Meter Kit, 35 Prodigy Pressure Activated Safety Lancets, 34 Prodigy Twist Top Lancets, 34 Prodigy Voice Blood Glucose Meter Kit, 35 Profe, 18, 42 Proferrin ES, 18, 42 Profilnine SD, 19 progesterone, 13 Proglycem, 13 Prograf, 4 Prolastin-c, 28 Prolensa, 24 Proleukin, 5 Prolia, 14 Promacta, 18 promethazine HCL, 27 promethazine HCL plain, 27 promethazine VC, 28 Promethazine VC Plain, 28 promethazine VC/codeine, 28 Promethazine VC/Codeine, 28 promethazine-DM, 28 promethazine/codeine, 28 promethazine/dextromethorphan, 28 promethegan, 27 pronutrients vitamin d3, 30, 43 propafenone HCL, 6 propafenone HCL ER, 6 Propantheline Bromide, 15 proparacaine HCL, 24 propofol, 27 propranolol HCL, 6 Propranolol HCL, 6 propranolol HCL ER, 6 Propranolol/Hydrochlorothiazide, 7 propylthiouracil, 15 Proquad, 29, 42 Prostigmin, 23 Protamine Sulfate, 19 protriptyline HCL, 20 Provenge, 5 Proventil HFA, 28 Prudoxin, 9 Pss Select GP Lancets, 34 Pss Select Safety Lancets, 34 Pulmicort, 28 Pulmicort Flexhaler, 28 pulmosal, 28 Pulmozyme, 28 purevit dualfe plus, 17 px aspirin, 25, 39 px enteric aspirin, 25, 39 px folic acid, 18, 41 px iron, 18, 42 Px Lancets, 34 Px Lancets Ultra Thin, 34 Px Prenatal Multivitamins, 31, 41 px stop smoking aid, 22, 42 Pylera, 15 pyrazinamide, 2 pyridostigmine bromide, 23 Pyridoxine HCL, 29 Q Qc Alcohol Swabs, 36 qc aspirin, 25, 39 qc aspirin low dose, 25, 39 qc childrens aspirin, 25, 39 qc ferrous sulfate, 18, 42 Qc Lancets, 34 Qc Lancets Super Thin, 34 Qc Lancets Thin, 34 Qc Lancets Ultra Thin, 34 qc nicotine polacrilex, 22, 42 Qc Prenatal, 31, 41 Qnasl, 28 Qnasl Childrens, 28 Quadramet, 5 Qualaquin, 3 quasense, 12, 40 Quazepam, 21 quetiapine fumarate, 20 Quflora Pediatric, 31 Quillivant XR, 21 quinapril HCL, 7 quinapril/hydrochlorothiazide, 7 Quinidine Gluconate, 6 quinidine gluconate CR, 6 quinidine gluconate ER, 6 quinidine sulfate, 6 Quinidine Sulfate, 6 Quinidine Sulfate ER, 6 quinine sulfate, 3 Qvar, 28 R Ra Alcohol Swabs, 36 ra aspirin, 25, 39 ra aspirin adult low dose, 25, 39 ra aspirin adult low strength, 25, 39 ra aspirin childrens, 25, 39 ra aspirin EC, 25, 39 ra aspirin EC adult low strength, 25, 39 ra childrens aspirin, 25, 39 Ra E-ZJECT Color Lancets Micro-thin 33G, 34 Ra E-ZJECT Lancets 28G, 34 Ra E-ZJECT Lancets Thin 26G, 34 Ra E-ZJECT Lancets Thin 28G, 34 Ra E-ZJECT Lancets Ultra Thin 30G, 34 ra folic acid, 18, 41 ra high potency iron, 18, 42 ra iron, 18, 42 ra mini nicotine, 22, 42 ra nicotine, 22, 42 ra nicotine polacrilex, 22, 42 ra nicotine transdermal system step 3, 22, 42 Ra One Daily, 31, 41 Ra Prenatal, 31, 41 Ra Prenatal Formula/Folicacid, 31, 41 ra slow release iron, 18, 42 ra vitamin d-3, 30, 43 Rabavert, 29 rabeprazole sodium, 15 raloxifene hydrochloride, 14 ramipril, 7 Ranexa, 6 ranitidine HCL, 15 Rapaflo, 17 Rapamune, 4 Ravicti, 15 Rayos, 11 rea LO 39, 10 rea LO 40, 10 Reality Lancets, 34 Reality Swabs, 36 Reality Trigger Lancets, 34 Rebetol, 3 Rebif, 22 Rebif Rebidose, 22 Rebif Rebidose Titration Pack, 22 Rebif Titration Pack, 22 reclipsen, 12, 40 Recombinate, 19 Recombivax HB, 29, 42 rectacort-HC, 16 Rectiv, 16 Refissa, 11 Regonol, 23 Regranex, 11 Relenza Diskhaler, 2 Relion Alcohol Swabs, 36 Relion Lancets, 34 Relion Lancets Micro-thin33G, 34 Relion Lancets Standard 21G, 34 Relion Lancets Thin 26G, 34 Relion Lancets Ultra-thin30G, 34 Relion Thin Lancets, 34 Relion Ultra Thin Lancets, 34 Relion Ultra Thin Lancets30G, 34 Relion Ultra Thin Plus Lancets 32G, 34 Relion Ultra Thin Plus Lancets 33G, 34 Relistor, 16 Relpax, 27 remergent HQ, 10 remeven, 10 Remicade, 16 Remodulin, 8 rena-vite RX, 30 Renacidin, 17 Renagel, 16 renal, 30 renalpren, 30 Renew Advanced Lancing Cartridge Refills, 34 reno CAPS, 30 Renova, 11 Renova P.M., 11 Renvela, 16 repaglinide, 13 Replesta, 30, 43 Replesta Childrens, 30, 43 Replesta Nx, 30, 43 reprexain, 26 14 Req 49+, 31 Rescon-JR, 28 Rescriptor, 2 Reserpine, 7 Respa-BR, 27 Restasis, 24 Retisert, 23 Retrovir IV Infusion, 2 Revatio, 8 Revlimid, 5 revonto, 23 Rexall Lancets Ultra Thin, 34 Reyataz, 2 Rezira, 28 Rheumatrex, 26 Rhinoflex-650, 25 Rhogam Ultra-filtered Plus, 38 Rhophylac, 38 Riastap, 19 ribasphere, 3 Ribasphere, 3 Ribasphere Ribapak, 3 Ribatab, 3 ribavirin, 3 Ridaura, 26 rifabutin, 2 Rifamate, 2 rifampin, 2 Rifater, 2 Right Step Prenatal, 31, 41 Rightest Gl300 Lancets, 34 riluzole, 22 rimantadine HCL, 2 ringers injection, 37 ringers irrigation, 37 Riomet, 13 risedronate sodium, 13 Risperdal Consta, 20 risperidone, 20 risperidone M-TAB, 20 risperidone odt, 20 Riteflo, 36 Rituxan, 4 rivastigmine tartrate, 22 Rixubis, 19 rizatriptan benzoate, 27 rizatriptan benzoate odt, 27 rocuronium bromide, 22 romycin, 23 ropinirole ER, 21 ropinirole HCL, 21 ropivacaine, 27 ropivacaine HCL, 27 rosadan, 9 rosanil cleanser, 8 Rotarix, 29, 42 Rotateq, 29, 42 roxicet, 26 Rozerem, 21 S Sabril, 21 Saccharin Sodium, 38 Safe-t-lance Low Flow 25G, 34 Safe-t-lance Normal Flow 21G, 34 Safe-t-lance Plus Safety Lancet High Flow, 34 Safe-t-lance Plus Safety Lancet Low Flow, 34 Safe-t-lance Plus Safety Lancet Normal Flow, 34 Safety Lancet 21G/Pressure Activated, 34 Safety Lancet 28G/Pressure Activated, 34 Safety Lancet 2MM, 34 Safety Lancets, 34 Safety Lancets 21G, 34 Safety Lancets 28G, 34 Safety Let Lancets, 34 Safety Seal Lancets 28G, 34 Safety Seal Lancets 30G, 34 Safyral, 12, 40 Saizen, 14 Saizen Click.easy, 14 salacyn, 10 salicylic acid, 10 salicylic acid cream, 10 salicylic acid lotion, 10 salicylic acid wart remover, 10 saline flush, 37 saline flush zr/sterile field, 37 salsalate, 25 Salvax, 11 Samsca, 14 Sancuso, 16 Sandimmune, 4 Sandostatin Lar Depot, 14 Saphris, 20 Saps Care Alcohol Prep Pads, 36 Sapscare Twist Top Lancets 30G, 34 sash kit for flushing vascular access devices, 19 Savella, 22 SB Alcohol Prep Pads, 36 SB aspirin, 25, 39 SB aspirin EC, 25, 39 SB childrens aspirin, 25, 39 SB Lancets Thin, 35 SB Lancets Ultra Thin, 35 SB low dose asa EC, 25, 39 scalacort, 10 scleromate sodium morrhuate, 37 Scopolamine Hydrobromide, 15 se 10-5 ss, 8 se bpo wash, 8 Se-natal 19, 31 Se-tan DHA, 31 se-tan plus, 17 Seb-prev, 9 seb-prev wash, 9 selegiline HCL, 21 Selenium, 38 selenium sulfide, 9 Selenium Sulfide, 9 Selzentry, 2 Sensipar, 14 sensorcaine, 27 sensorcaine-mpf, 27 sensorcaine-mpf spinal, 27 sensorcaine-mpf/epinephrine, 27 sensorcaine/epinephrine, 27 Serevent Diskus, 28 Seromycin, 2 Seroquel XR, 20 Serostim, 14 sertraline HCL, 20 Seton Et-EC, 31 Setonet, 31 Sevelamer Carbonate, 16 sevoflurane, 27 SF, 20 SF 5000 plus, 20 sharobel, 12, 40 Shopko Alcohol Swabs, 36 Shopko On-the-go Comfort Lancets 30G, 34 Shopko Unilet Lancets Super Thin 30G, 34 Shopko Unilet Lancets Ultra Thin 28G, 34 Shur-seal, 17, 40 Siderol, 31 Signifor, 14 sildenafil, 8 sildenafil citrate, 8 Silenor, 21 Silver Nitrate, 11 silver sulfadiazine, 10 Simcor, 8 Similac Prenatal Early Shield, 31 Simponi, 27 Simponi Aria, 27 Simulect, 5 simvastatin, 8 Single-let, 34 sirolimus, 4 Sirturo, 2 Sivextro, 3 skin bleaching, 10 skin bleaching/sunscreen, 10 Sklice, 11 Skyla, 13, 40 slow iron, 18, 42 slow release iron, 18, 42 Sm Alcohol Prep Pads, 36 sm aspirin, 25, 39 sm aspirin adult low strength, 25, 39 sm aspirin EC low strength, 25, 39 sm aspirin enteric coated, 25, 39 sm aspirin low dose, 25, 39 sm childrens aspirin, 25, 39 sm folic acid, 18, 41 sm iron, 18, 42 sm iron slow release, 18, 42 Sm Lancets 21G, 34 Sm Micro Thin Lancets 33G, 34 sm nicotine, 22, 42 sm nicotine polacrilex, 22, 42 Sm One Daily Prenatal, 31, 41 sm prenatal vitamins, 31, 41 Sm Prenatal Vitamins, 31, 41 Sm Slow Release Iron, 18, 42 Sm Super Thin Lancets, 34 Sm Super Thin Lancets 30G, 34 Sm Thin Lancets 26G, 34 sm vitamin d, 30, 43 sm vitamin d3, 30, 43 Sm Vitamin D3 Maximum Strength, 30, 43 Smart Diabetes Vantage Universal Lancets 30G, 34 Smart Sense Color Lancets Universal 33G, 34 Smart Sense Standard Lancets Universal 21G, 34 Smart Sense Super Thin Lancets Universal 30G, 34 Smart Sense Thin Lancets Universal 26G, 34 Smartest Lancets 28G, 34 sodium acetate, 37 Sodium Bicarbonate, 15 sodium bicarbonate, 37 sodium bicarbonate partial fill, 37 sodium chloride, 17, 28, 37 Sodium Chloride, 38 sodium chloride 0.45%, 37 sodium chloride 0.45% viaflex, 37 sodium chloride 0.9%, 17 sodium chloride bacteriostatic, 37 sodium chloride flush, 37 sodium chloride pab, 37 sodium citrate/citric acid, 17 Sodium Edecrin, 7 sodium ferric gluconate complex/sucrose, 18 Sodium Fluoride, 38, 40 sodium fluoride, 38, 41 sodium hyaluronate, 10 Sodium Lactate, 38 sodium phenylbutyrate, 14 sodium phosphate, 37 sodium polystyrene sulfonate, 37 Sodium Saccharin Dihydrate, 38 sodium sulfacetamide, 8, 9, 23 sodium sulfacetamide wash, 9 sodium sulfacetamide/sulfur, 8 Sodium Sulfacetamide/Sulfur, 9 sodium sulfacetamide/sulfur cleanser, 8 Sodium Sulfacetamide/Sulfur Cleanser IN Urea, 9 sodium sulfacetamide/sulfur cleansing cloths, 8 sodium sulfacetamide/sulfur green, 8 Sodium Sulfacetamide/Sulfur IN Urea, 9 sodium sulfacetamide/sulfur w/sunscreen, 8 sodium sulfacetamide/sulfur wash, 8 Sodium Sulfacetamide/Urea, 9 sodium thiosulfate, 37 sojourn, 27 solia, 12, 40 Soliris, 19 Solodyn, 1 Soltamox, 4 Solu-cortef, 11 Solus V2 Pressure Activated Safety Lancets 28G, 34 Solus V2 Twist Lancets 30G, 34 Somatuline Depot, 14 Somavert, 14 Sorbitol, 17 Sorbitol-mannitol, 17 sorine, 6 sotalol HCL, 6 sotalol HCL (AF), 6 Sovaldi, 3 Spinosad, 11 Spiriva Handihaler, 28 Spiriva Respimat, 28 spironolactone, 7 spironolactone/hydrochlorothiazide, 7 Sporanox, 2 sprintec 28, 12, 40 Sprix, 26 Sprycel, 5 SR nicotine gum, 22, 43 sronyx, 12, 40 ss 10-2, 8 ssd, 10 sss 10%-5%, 8 sss 10-5, 8 st joseph aspirin, 25, 39 stagesic, 26 stannous fluoride oral rinse, 19 stavudine, 2 Stavzor, 21 Stelara, 9 Sterilance TL, 34 sterile diluent for epoprostenol sodium, 37 sterile water for injection, 37 sterile water irrigation, 37 sterile water irrigation plastic bottle, 37 sterile water irrigation w/hanger, 37 Stimate, 14 Stivarga, 5 Strattera, 21 Streptomycin Sulfate, 2 Striant, 11 Stribild, 2 Strovite Forte, 31 Strovite One, 31 strovite plus, 30 Stuart One, 31 Stuart Prenatal, 31, 41 Stuart Prenatal + DHA, 31, 41 Suboxone, 26 Subsys, 26 Suclear, 15 Sucraid, 16 sucralfate, 15 sufentanil citrate, 26 sulfacetamide sodium, 8, 23 Sulfacetamide Sodium, 23 sulfacetamide sodium/prednisolone sodium phosphate, 23 sulfacetamide sodium/sulfur cleanser, 8 sulfacleanse 8/4, 8 Sulfadiazine, 2 sulfamethoxazole/trimethoprim, 3 Sulfamethoxazole/Trimethoprim, 3 sulfamethoxazole/trimethoprim DS, 3 Sulfamylon, 11 sulfasalazine, 16 sulfatrim pediatric, 3 sulfazine, 16 sulfazine EC, 16 sulindac, 26 Sumatriptan, 27 sumatriptan succinate, 27 Sumatriptan Succinate, 27 sumatriptan succinate refill, 27 Sumavel Dosepro, 27 Supartz, 23 Super Daily D3, 30, 43 Super Thin Lancets, 34 Supprelin LA, 14 Suprax, 1 Suprep Bowel Prep, 15 Sure Comfort Alcohol Prep Pads, 36 Sure Comfort Lancets 28G, 34 Sure Comfort Lancets 30G, 34 Sure-lance Flat Lancets, 34 Sure-lance Lancets 26G, 34 Sure-lance Thin Lancets 28G, 34 Sure-lance Ultra Thin Lancets, 34 Sure-prep Alcohol Prep Pads, 36 Sure-touch Lancets Universal, 34 Surelite Lancets, 34 Surestep Glucose Control, 34 Surestep Glucose Control Solution, 35 Surestep Pro High Glucosecontrol, 35 Surestep Pro Low Glucose Control, 35 Surestep Pro Normal Glucose Control, 35 Surestep Pro Test Strips, 35 Surestep Test Strips, 35 Sustiva, 2 Sutent, 5 sw nicotine polacrilex, 22, 42 swabflush saline flush, 37 syeda, 12, 40 Sylatron, 5 symax fastabs, 15 symax-SL, 15 symax-SR, 15 Symbicort, 28 Symlinpen 120, 13 Symlinpen 60, 13 Synagis, 38 Synalar, 10 Synarel, 14 Synera, 11 Synribo, 5 Synvisc, 23 Synvisc One, 23 Syprine, 38 T Tabloid, 4 Taclonex, 10 tacrolimus, 4, 10 Tafinlar, 5 Talwin, 26 Tamiflu, 2 tamoxifen citrate, 4, 43 tamsulosin HCL, 17 Tandem F, 18 Tarceva, 5 Targretin, 5, 11 tarina FE 1/20, 12, 40 Tarka, 7 taron-crystals, 17 Taron-prex, 31 Tasigna, 5 Tasmar, 22 tazicef, 1 tazidime, 1 Tazorac, 9 taztia XT, 6 Tecfidera, 22 Tecfidera Starter Pack, 22 Techlite AST Lancets, 35 Techlite Lancets, 35 Techlite Lancets 30G, 35 Teflaro, 1 Tegretol-XR, 21 Tekamlo, 7 Tekturna, 7 Tekturna HCT, 7 telmisartan, 7 telmisartan/amlodipine, 7 telmisartan/hydrochloroth, 7 telmisartan/hydrochlorothiazide, 7 temazepam, 21 Temodar, 4 temozolomide, 3 tencon, 25 Tencon, 25 Teniposide, 5 Tenivac, 29, 42 terazosin HCL, 7 terbinafine HCL, 2 Terbinex, 2 terbutaline sulfate, 28 terconazole, 17 terrell, 27 Testim, 11 Testosterone, 11 testosterone cypionate, 11 testosterone enanthate, 11 Testosterone P.M., 11 Tetanus Toxoid Adsorbed, 28 Tetanus/Diphtheria Toxoids-adsorbed Adult, 29, 42 tetcaine, 24 tetracaine HCL, 24 Tetracaine HCL, 27 Tetracycline HCL, 1 tetravisc, 24 tetravisc forte, 24 Tev-tropin, 14 Teveten HCT, 7 Texacort, 10 Tgq 15DM/5PEH/2CPM, 28 Tgq 30PSE/150GFN/15DM, 28 Tgq 30PSE/3BRM/15DM, 28 Tgq 50PSE/3BRM/30DM, 28 tgq 7.5PEH/4BRM/15DM, 28 Tgt Alcohol Swabs, 36 tgt aspirin, 25, 39 tgt aspirin low dose, 25, 39 tgt childrens aspirin, 25, 39 tgt enteric-coated aspirin, 25, 39 Tgt Lancet Alternate Site, 35 Tgt Lancet Micro Thin 33G, 35 Tgt Lancet Super Thin 30G, 35 Tgt Lancet Thin 23G, 35 Tgt Lancet Thin 26G, 35 Tgt Lancet Ultra Thin 28G, 35 Tgt Lancet Ultra Thin 30G, 35 tgt nicotine gum, 22, 42 tgt nicotine polacrilex, 22, 42 tgt nicotine step one, 22, 42 tgt nicotine step three, 22, 42 tgt nicotine step two, 22, 42 th aspirin, 25, 39 th aspirin low dose, 25, 39 th enteric aspirin, 25, 39 th folic acid, 18, 41 th iron, 18, 42 Th Prenatal Vitamins, 31, 41 th slow release iron, 18, 42 th vitamin d3, 30, 43 Thalomid, 5 Theo-24, 28 theochron, 28 theophylline, 28 theophylline CR, 28 theophylline ER, 28 theophylline/D5W, 28 Theophylline/D5W, 28 thera-d 2000, 30, 43 Thera-d 4000, 30, 43 thera-d rapid repletion, 30, 43 thera-d sport, 30, 43 Theracys, 5 thermazene, 10 thiamine HCL, 29 Thinlets GP Lancets, 35 Thinlets Lancet, 35 thioridazine HCL, 20 thiothixene, 20 thrive, 22, 42 Thrombate Iii W/10 ML Sterile Water, 19 Thrombate Iii W/20 ML Sterile Water, 19 Thymoglobulin, 5 Thyrogen, 38 Thyrolar-1, 15 Thyrolar-1/2, 15 Thyrolar-1/4, 15 Thyrolar-2, 15 Thyrolar-3, 15 tiagabine hydrochloride, 21 Tice Bcg, 5 ticlopidine HCL, 19 Tikosyn, 6 tilia FE, 12, 40 Timentin, 1 Timolol Maleate, 6 timolol maleate, 23 timolol maleate ophthalmic gel forming, 23 tinidazole, 3 tis-u-sol, 37 Tivicay, 3 tizanidine HCL, 23 TL gard RX, 18 TL hydroquinone, 11 TL icon, 18 TL-fol 500, 18 TL-hem 150, 18 Tobi Podhaler, 2 Tobradex, 23 Tobradex ST, 23 tobramycin, 2 tobramycin sulfate, 2, 23 Tobramycin Sulfate/Sodium Chloride, 2 tobramycin/dexamethasone, 23 Tobrex, 23 Today Sponge, 17 Todays Health Super Thin Lancets 30G, 35 Todays Health Ultra Thin Lancets 28G, 35 tolazamide, 13 Tolazamide, 13 Tolbutamide, 13 tolmetin sodium, 26 Tolmetin Sodium, 26 tolterodine tartrate, 17 tolterodine tartrate ER, 17 topex topical anesthetic, 19 topiragen, 21 topiramate, 21 toposar, 5 topotecan HCL, 5 Topotecan HCL, 5 Torisel, 5 torsemide, 7 Torsemide, 7 Totect, 5 Toviaz, 17 tpn electrolytes, 37 Tracleer, 8 Tradjenta, 13 tramadol HCL, 26 tramadol HCL ER, 26 Tramadol HCL ER, 26 tramadol hydrochloride/acetaminophen, 26 trandolapril, 7 tranexamic acid, 19 Transderm-scop, 16 tranylcypromine sulfate, 20 Travatan Z, 23 Travel Lancets 30G, 35 Travoprost, 23 trazodone HCL, 20 Treanda, 4 Trecator, 2 Trelstar Depot, 4 Trelstar Depot Mixject, 4 Trelstar LA, 4 Trelstar LA Mixject, 4 Trelstar Mixject, 4 Tretin-x, 9 tretinoin, 5, 8 Tretinoin Emollient, 11 tretinoin microsphere, 8 tretinoin microsphere P.M., 8 Tretten, 19 Trexall, 4 Treximet, 27 Trezix, 26 tri-estarylla, 12, 40 tri-legest FE, 12, 40 tri-linyah, 12, 40 tri-previfem, 12, 40 tri-sprintec, 12, 40 tri-vit/fluoride, 30 Tri-vit/Fluoride/Iron, 31 tri-vitamin/fluoride, 30 Tri-zel, 31 Triadvance, 31 triamcinolone acetonide, 10, 20, 27 Triamcinolone Acetonide, 10 triamcinolone IN orabase, 20 triamterene/hydrochlorothiazide, 7 Triamterene/Hydrochlorothiazide, 7 Trianex, 10 triazolam, 21 Tribenzor, 7 Tricare, 31, 41 tricitrates, 17 tricon, 17 triderm, 10 trifluoperazine HCL, 20 trifluridine, 23 trigels-f forte, 17 Triglide, 8 trihexyphenidyl HCL, 21 trilyte, 15, 43 trimethobenzamide HCL, 16 trimethoprim, 3 trimethoprim sulfate/polymyxin b sulfate, 23 trimipramine maleate, 20 Trinatal RX 1, 31 Trinate, 31 trinessa, 12, 40 triphrocaps, 30 triple-vitamin/fluoride, 30 Trisenox, 5 trivora-28, 12, 40 tropazone, 10 tropicamide, 24 trospium chloride, 17 trospium chloride ER, 17 Trueplus Lancets 26G, 35 Trueplus Lancets 28G, 35 Trueplus Lancets 28G Super Thin, 35 Trueplus Lancets 30G, 35 Trueplus Lancets 30G Ultra Thin, 35 Trueplus Lancets 33G, 35 Trueplus Lancets 33G Micro Thin, 35 Trueplus Safety Lancets 28G, 35 Trumenba, 29, 42 Truvada, 2 Tryptophan, 38 Tucks Anti-itch, 10 Tudorza Pressair, 28 tussafed EX, 28 Tussicaps, 28 tussigon, 28 Twinrix, 29, 42 Tygacil, 3 Tykerb, 5 Typhim VI, 29 Tysabri, 22 Tyvaso, 8 Tyvaso Refill, 8 Tyvaso Starter, 8 Tyzeka, 3 Tyzine, 28 Tyzine Pediatric Nasal Drops, 28 U U-cort, 10 u-kera e, 10 Uceris, 11 Ulesfia, 11 Uloric, 27 Ulticare Thin Lancets 30G, 35 Ultilet Alcohol Swab, 36 Ultilet Alcohol Swabs, 36 Ultilet Basic Lancets 30G, 35 Ultilet Classic Lancets, 35 Ultilet Lancets, 35 Ultilet Lancets 33G, 35 Ultilet Safety Lancets 23G, 35 Ultimatecare One, 31 Ultimatecare One NF, 31 Ultra TABS, 31 Ultra Thin Lancets 28G, 35 Ultra Thin Lancets 30G, 35 Ultra-thin II Auto Lancet, 35 Ultra-thin II Lancets 28G, 35 Ultra-thin II Lancets 30G, 35 Ultra-thin II Safety Autolancets 26G, 35 Ultravate PAC, 10 Ultresa, 16 umecta mousse, 10 Unilet Comfortouch Lancet, 35 Unilet Excelite, 35 Unilet Excelite II, 35 Unilet G.p. Lancet, 35 Unilet G.p. Superlite Lancet, 35 Unilet GP 28 Ultra Thin, 35 Unilet Lancet, 35 Unilet Superlite Lancet, 35 Unistik 3 Gentle, 35 unithroid, 15 unithroid direct, 15 Universal 1 Lancets Thin 26G, 35 Universal 1 Lancets Ultra Thin 30G, 35 univert, 16 ur n-c, 16 urea, 10 urea 40% nail film, 10 urea hydrating, 10 urea IN zinc undecylenate/lactic acid vehicle, 10 urea nail, 10 urea topical, 10 urea-c40, 10 urelle, 16 uretron d/s, 16 uribel, 16 Urimar-t, 16 urin d/s, 16 uro-blue, 16 uro-l, 16 uro-mp, 16 urosex, 30 ursodiol, 16 uryl, 16 ustell, 16 uta, 16 uticap, 16 utira-c, 16 utrona-c, 16 Uvadex, 5 V v-c forte, 30 V-go 20, 35 V-go 30, 35 V-go 40, 35 Vagifem, 17 valacyclovir HCL, 2 Valchlor, 4, 11 Valcyte, 3 valganciclovir, 3 valproate sodium, 21 valproic acid, 21 valsartan, 7 valsartan/hydrochlorothiazide, 7 Valstar, 4 Value Plus Lancets Standard 21G, 35 Value Plus Lancets Super Thin 30G, 35 Value Plus Lancets Thin 26G, 35 Valumark Lancet Super Thin 30G, 35 Valumark Lancet Ultra Thin 28G, 35 Valved Holding Chamber, 36 vancomycin HCL, 3 Vancomycin HCL, 3 Vancomycin HCL IN Dextrose, 3 vandazole, 17 Vantas, 4 Vaqta, 29, 42 Varivax, 29, 42 Vascepa, 8 vasopressin, 14 Vayacog, 38 Vayarin, 38 Vayarol, 38 Vcf Vaginal Contraceptive Film, 17, 40 Vcf Vaginal Contraceptive Foam, 17, 40 Vectibix, 4 Vectical, 9 vecuronium bromide, 22 Velcade, 5 Veletri, 8 velivet, 12, 40 Veltin, 9 venlafaxine HCL, 20 venlafaxine HCL ER, 20 Venlafaxine HCL ER, 20 Venofer, 18 Ventavis, 8 Ventolin HFA, 28 Veramyst, 28 verapamil HCL, 6 Verapamil HCL, 6 verapamil HCL ER, 6 verapamil HCL SR, 6 Verdeso, 10 verdrocet, 26 Veregen, 11 Veripred 20, 11 versiclear, 9 Vesicare, 17 vestura, 12, 40 Vexol, 23 Viagra, 8 Vibativ, 3 vic-forte, 30 vicodin, 26 vicodin ES, 26 vicodin HP, 26 Victoza, 13 Victrelis, 3 Vida Mia Unilet Lancets Super Thin 30G, 35 Vida Mia Unilet Lancets Ultra Thin 28G, 35 Videx Pediatric, 2 Vigamox, 23 Viibryd, 20 Vimizim, 15 Vimovo, 26 Vimpat, 21 Vinate C, 31 Vinate Care, 31 Vinate DHA RF, 31 Vinate GT, 31 Vinate IC, 31 Vinate II, 31 Vinate M, 31 Vinate One, 31 Vinate Pn Care, 31 Vinate Ultra, 31 Vinblastine Sulfate, 5 vincasar PFS, 5 vincristine sulfate, 5 vinorelbine tartrate, 5 Viokace, 16 viorele, 12, 40 Viracept, 3 Viramune, 3 Viramune XR, 3 Virazole, 3 Viread, 3 virt-CAPS, 30 virt-phos 250 neutral, 37 virt-vite, 17 virt-vite forte, 37 virt-vite plus, 30 virti-sulf, 8 virtrate-3, 17 Visudyne, 24 vita s forte, 30 vita-min, 30 Vita-respa, 38 vitacel, 30 Vitafol-OB, 31 Vitalet Pro Lancets, 35 Vitalet Pro Plus Lancets, 35 vitamax pediatric, 30 Vitamelts Vitamin D, 30, 43 vitamin b-complex 100, 30 vitamin c 222MG, 29 vitamin d, 29, 43 Vitamin D, 30, 43 vitamin d 400, 30, 43 vitamin d high potency, 30, 43 vitamin d-1000, 30, 43 vitamin d-1000 maximum strength, 30, 43 vitamin d-3, 30, 43 vitamin d-400, 30, 43 vitamin d3, 30, 43 Vitamin D3, 30, 43 Vitamin D3 400, 30, 43 vitamin d3 adult gummies, 30, 43 vitamin d3 high potency, 30, 43 vitamin d3 maximum strength, 30, 43 vitamin d3 super strength, 30, 43 vitamin k1, 29 Vitamin K1, 29 vitamins a/c/d/fluoride, 30 Vivitrol, 38 Vivotif Berna, 29 Vogelxo, 11 Vogelxo P.M., 11 vol-care RX, 30 Voltaren, 9 Voraxaze, 5 voriconazole, 2 Vortex Valved Holding Chamber, 36 Votrient, 5 Vp-gstn, 38 vp-precip, 37 Vp-zel, 31 Vpriv, 18 vyfemla, 12, 40 Vytorin, 8 Vyvanse, 21 W W&f Lancets 26G, 35 W&f Lancets Colored 21G, 35 Walgreens Advanced Travellancets 28G, 35 Walgreens Comfort Assuredlancets Micro Thin/33G, 35 Walgreens Comfort Assuredlancets Super Thin/28G, 35 Walgreens Lancets, 35 Walgreens Thin Lancets, 35 Walgreens Ultra Thin Lancets, 35 warfarin sodium, 19 Watchhaler, 36 Webcol Alcohol Prep Large 1 Ply, 36 Webcol Alcohol Prep Large 2 Ply, 36 Webcol Alcohol Prep Medium 2 Ply, 36 wee care, 18, 42 Welchol, 8 Wellesse Vitamin D3, 30, 43 wera, 12, 40 Westhroid, 15 Wheat Germ, 29 Wide-seal Silicone Diaphragm Kit 60, 40 Wide-seal Silicone Diaphragm Kit 65, 40 Wide-seal Silicone Diaphragm Kit 70, Wide-seal Silicone Diaphragm Kit 75, Wide-seal Silicone Diaphragm Kit 80, Wide-seal Silicone Diaphragm Kit 85, Wide-seal Silicone Diaphragm Kit 90, Wide-seal Silicone Diaphragm Kit 95, Wilate, 19 Winrho SDF, 38 wymzya FE, 12, 40 X x-viate, 10 Xalkori, 5 Xarelto, 19 Xarelto Starter Pack, 19 Xeljanz, 27 Xenazine, 22 Xenical, 21 Xeomin, 22 Xgeva, 14 Xiaflex, 38 Xifaxan, 3 Xofigo, 5 Xolair, 28 Xolegel, 9 Xopenex HFA, 28 Xtandi, 4 xulane, 12, 40 xylocaine dental, 27 xylon, 26 Xyntha, 19 Xyntha Solofuse, 19 Xyrem, 22 Y Yervoy, 4 Yf-vax, 29 yl folic acid, 18, 41 Yodoxin, 3 Your Life Multi Prenatal, 31 Z Zaclir Cleansing, 9 zafirlukast, 28 zaleplon, 21 Zaltrap, 4 zamicet, 26 Zanosar, 4 zarah, 12, 40 Zavesca, 18 zazole, 17 zebutal, 25 Zegerid, 16 Zelboraf, 5 Zemaira, 28 Zemplar, 14 zenatane, 8 zenchent, 12, 40 zenchent FE, 12, 40 zencia, 8 Zenpep, 16 zenzedi, 21 Zetia, 8 Zetonna, 28 Zevalin Y-90, 4 zflex, 25 Zgesic, 25 Ziagen, 3 Ziana, 9 zidovudine, 2 40 40 40 40 40 40 Zinacef, 1 Zinacef IN Iso-osmotic Diluent, 1 zinc sulfate, 37 Zinc Sulfate, 38 Zinc Trace Metal, 38 Zioptan, 23 ziprasidone HCL, 20 Zirgan, 23 Zithromax, 1 Zoladex, 4 zoledronic acid, 14 Zoledronic Acid, 14 Zolinza, 5 zolmitriptan, 27 zolmitriptan odt, 27 zolpidem tartrate, 21 zolpidem tartrate ER, 21 Zometa, 14 Zomig, 27 Zomig Nasal Spray, 27 Zonalon, 9 zonisamide, 21 Zontivity, 19 Zorbtive, 14 Zortress, 5 Zostavax, 29, 42 zovia 1/35e, 12, 40 Zovia 1/50e, 11, 39 Zovirax, 9 Zuplenz, 16 Zyclara, 10 Zyclara P.M., 10 Zydelig, 5 Zyflo, 28 Zyflo CR, 28 Zylet, 23 Zytiga, 4 Zyvox, 3 1 1ST Choice Lancets Super Thin, 35 1ST Choice Lancets Thin, 35 1ST Choice Lancets Ultra Thin, 35 1ST Tier Unilet Comfortouch Lancets 28G, 35 1ST Tier Unilet Comfortouch Lancets 30G, 35 8 8-mop, 9
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