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Lista de medicamentos aprobados del Mercado de California de Kaiser Permanente, 2016 • Página 1 de 46

Lista de medicamentos aprobados del Mercado de California de 2016 (Lista de medicamentos cubiertos)

FAVOR DE LEER: ESTE DOCUMENTO CONTIENE INFORMACIÓN SOBRE LOS MEDICAMENTOS QUE CUBRIMOS CUANDO PARTICIPA EN UN PLAN DE SALUD CALIFICADO OFRECIDO POR KAISER PERMANENTE QUE INCLUYE EL MERCADO DE SEGUROS DE SALUD (EN CALIFORNIA, EL MERCADO SE CONOCE COMO COVERED CALIFORNIA).

Esta lista de medicamentos aprobados fue actualizada el 12/01/2016 y entra en vigencia el 1º de Diciembre de 2016. Para información más reciente u otras preguntas, llame a nuestra Central de Llamadas de Servicio a los Miembros, las 24 horas del día, los siete días de la semana (excepto los días festivos). 1-800-788-0616 en español, 1-800-464-4000 en inglés, 1-800-757-7585 en dialectos chinos, 711 Línea TTY para personas con problemas auditivos o del habla.

¿Qué es la Lista de medicamentos aprobados del Mercado de California de Kaiser Permanente?

La Lista de medicamentos aprobados del Mercado de California (California Marketplace Formulary) es una lista de los medicamentos cubiertos elegidos por un grupo de médicos y farmacéuticos de Kaiser Permanente que se conocen como el Comité de Farmacia y Terapéutica (Pharmacy and Therapeutics Committee). El Comité se reúne periódicamente para evaluar y seleccionar medicamentos que son seguros y eficaces para nuestros miembros. Esta Lista de medicamentos aprobados cumple con los requisitos delineados en las regulaciones federales de Planes de Salud Calificados (Qualified Health Plans) que se ofrecen en un mercado de seguros de salud (en California, el mercado se conoce como Covered California).

¿Qué medicamentos están cubiertos?

En general, Kaiser Permanente cubrirá medicamentos de marca y genéricos incluidos en la Lista de medicamentos aprobados del Mercado de California siempre que el medicamento sea necesario desde el punto de vista médico, se surte el medicamento recetado en una farmacia de Kaiser Permanente o una farmacia afiliada, y se siguen otras reglas de cobertura.

Si a usted le recetan un medicamento incluido que la Lista de medicamentos aprobados del Mercado de California, el medicamento se cubrirá de conformidad con los términos de su beneficio de medicamentos.


Cómo obtener una excepción a la lista de medicamentos aprobados

Los medicamentos que no figuran en la lista de medicamentos aprobados se llaman medicamentos no incluidos en la lista de medicamentos aprobados (non-formulary drugs). Si un médico de Kaiser Permanente determina que un medicamentos que no está incluido en la lista de medicamentos aprobados es apropiado y necesario desde el punto de vista médico, ese medicamento estará cubierto según los términos de sus beneficios (si tiene un beneficio de medicamentos recetados). Si no tiene un beneficio de medicamentos recetados, tendrá que pagar el precio minorista total del medicamento.

La manera más efectiva de obtener una excepción a la lista de medicamentos aprobados es enviar un correo electrónico seguro a su médico. Usted y su médico son quienes mejor pueden determinar los medicamentos que usted necesita.

También puede comunicarse con Servicio a los Miembros, llenando un formulario en línea. O llame a Servicio a los Miembros, las 24 horas del día, los 7 días de la semana.

¿Hay alguna restricción a los medicamentos cubiertos por la Lista de medicamentos aprobados?

Algunos medicamentos cubiertos pueden tener requisitos o límites de cobertura adicionales, como por ejemplo límites a la cantidad. Para determinados medicamentos, Kaiser Permanente puede limitar la cantidad del medicamento que se dispensa a un suministro de una determinada cantidad de días. Además, cuando haya escasez nacional de un medicamento, podríamos limitar la cantidad dispensada del medicamento.

¿Qué es un medicamento de marca?

Los medicamentos de marca en general son fabricados y vendidos por la compañía farmacéutica que hizo la investigación y el desarrollo original del medicamento. Cuando vence la patente del medicamento de marca, otras compañías farmacéuticas pueden fabricar y vender una versión genérica del medicamento aprobada por la FDA con el/los mismo(s) ingrediente(s) activo(s) a un precio menor.

¿Qué es un medicamento genérico?

Un medicamento genérico está aprobado por la FDA al tener el mismo ingrediente activo que el medicamento de marca. En general los medicamentos genéricos tienen menor costo que los medicamentos de marca.

¿Qué medicamentos pueden ser enviados desde la farmacia de pedido por correo?

La mayoría de los medicamentos pueden ser enviados desde nuestra farmacia de pedido por correo. Es posible que algunos medicamentos (por ejemplo, medicamentos que tienen un costo extremadamente alto o que requieren cuidados especiales) no se puedan enviar por correo. Los medicamentos no se pueden enviar fuera de los Estados Unidos.

Usted puede pedir el resurtido de medicamentos recetados a través de nuestro servicio de pedido por correo en línea en kp.org/refill (en inglés) o por teléfono o con la aplicación móvil. No hay un cargo adicional por pedir los resurtidos por correo. Se aplicará el costo compartido apropiado (según su beneficio de medicamentos recetados).

Su beneficio de medicamentos recetados puede tener un menor costo compartido si usa la farmacia de pedido por correo.

Consulte su Evidencia de Cobertura (Evidence of Coverage) o su Certificado de Seguro (Certificate of Insurance) para información detallada sobre sus beneficios de medicamentos recetados.

www.kp.org/refill


Lista de medicamentos aprobados del Mercado de California de Kaiser Permanente Kaiser Permanente puede agregar o eliminar medicamentos de la Lista de medicamentos aprobados del Mercado de California en cualquier momento del año. Estos cambios a la Lista de medicamentos aprobados están basados en información nueva o medicamentos nuevos disponibles.

La Lista de medicamentos aprobados del Mercado de California más reciente empieza en la página 4; proporciona información sobre la cobertura de algunos de los medicamentos cubiertos por Kaiser Permanente. Además puede buscar los medicamentos en forma alfabética usando el índice que empieza en la página 29.

La primera columna de la tabla indica el nombre del medicamento. Los nombres de marca aparecen en mayúscula (ej. ALBENZA) y los medicamentos genéricos aparecen en minúscula y letra cursiva (ej. amoxicillin).

El posible que no se incluyan en la Lista de medicamentos aprobados todas las formas y concentraciones de las dosis de un determinado medicamento. Algunos medicamentos están disponibles en múltiples dosis. En dichos casos, es posible que algunas dosis estén en la Lista de medicamentos aprobados y otras no. Nota: Algunos de estos medicamentos pueden estar disponibles solo en un entorno clínico.

La segunda columna “Nivel del medicamento” indicará el número de nivel en que se encuentra el medicamento. Los medicamentos en la Lista de medicamentos aprobados del Mercado de California están categorizados en tres niveles.

Nivel 1 – Nivel genérico

Nivel 2 – Nivel de marca

Nivel 4 – Nivel especializado

Nota: El nivel de clasificación de un medicamento genérico o de marca puede cambiar en cualquier momento del año. Además, determinados medicamentos de marca pueden estar cubiertos con el costo compartido que se aplica al Nivel 1 y determinados medicamentos genéricos pueden estar cubiertos con el costo compartido que se aplica al Nivel 2. El Nivel 4 es para medicamentos especializados que se cubren con un costo compartido mayor.

La tercera columna de la tabla indicará cualquier requisito o límite para ese medicamento:

QL = Límites de cantidad (Quantity Limits): Para determinados medicamentos podremos limitar la cantidad del medicamento que pueda recibir. Además, cuando haya escasez nacional de un medicamento, podremos limitar la cantidad dispensada del medicamento.


Nombre del medicamento

Nivel del

medicamento

Requisitos/ Límites

ANTI-INFECTIVE AGENTS ANTHELMINTICS ALBENZA 2 BILTRICIDE 2 ivermectin 1 PREZCOBIX 2 ANTI-HIV AGENTS abacavir sulfate 1, 2 abacavir sulfate-lamivudine-zidovudine 1 APTIVUS 2 ATRIPLA 2 COMPLERA 2 CRIXIVAN 2 didanosine 1, 2 EDURANT 2 EMTRIVA 2 EPZICOM 2 FUZEON 2 QL INTELENCE 2 INVIRASE 2 ISENTRESS 2 KALETRA 2 lamivudine 1 lamivudine-zidovudine 1 LEXIVA 2 nevirapine 1, 2 NORVIR 2 PREZISTA 2 RESCRIPTOR 2 REYATAZ 2 SELZENTRY 2 stavudine 1 STRIBILD 2 SUSTIVA 2 TIVICAY 2 TRIUMEQ 2 TRUVADA 2 VIRACEPT 2 VIREAD 2 zidovudine 1, 2 ANTIBACTERIALS amikacin sulfate 1 amoxicillin 1, 2 amoxicillin & pot clavulanate 1, 2 ampicillin 1, 2 ampicillin & sulbactam sodium 1, 2 ampicillin sodium 1, 2


Nivel del

medicamento


AVELOX 2 AZACTAM IN DEXTROSE 2 azithromycin 1, 2 aztreonam 1 bacitracin 1 BACTOCILL IN DEXTROSE 2 BICILLIN L-A 2 CAYSTON 4 LD cefaclor 1 cefadroxil 1 cefazolin sodium 1, 2 CEFAZOLIN SODIUM-DEXTROSE 2 cefdinir 1 cefepime hcl 1 CEFEPIME-DEXTROSE 2 cefotaxime sodium 1 cefotetan disodium 1 CEFOTETAN DISODIUM-DEXTROSE

2

cefoxitin sodium 1 CEFOXITIN SODIUM-DEXTROSE 2 cefpodoxime proxetil 1 ceftazidime 1, 2 ceftriaxone sodium 1 CEFTRIAXONE SODIUM IN DEXTROSE

1

CEFTRIAXONE SODIUM-DEXTROSE 2 cefuroxime axetil 1, 2 cefuroxime sodium 1, 2 CEFUROXIME SODIUM-DEXTROSE 2 cephalexin 1, 2 CHLORAMPHENICOL SOD SUCCINATE 2 ciprofloxacin 1, 2 ciprofloxacin hcl 1 ciprofloxacin in d5w 1 clarithromycin 1 CLEOCIN IN D5W 2 clindamycin hcl 1 clindamycin palmitate hydrochloride 1, 2



Nivel del

medicamento


clindamycin phosphate 1 CUBICIN 4 demeclocycline hcl 1 dicloxacillin sodium 1 doxycycline (monohydrate) 1 doxycycline hyclate 1 ERYTHROCIN LACTOBIONATE 2 FLUCONAZOLE IN SODIUM CHLORIDE 1 FORTAZ IN D5W 2 gentamicin in saline 1, 2 gentamicin sulfate 1 INVANZ 4 levofloxacin 1 levofloxacin in d5w 1 linezolid 1, 4 meropenem 1 minocycline hcl 1, 2 moxifloxacin hcl 1 nafcillin sodium 1, 2 NAFCILLIN SODIUM IN DEXTROSE 2 neomycin sulfate 1 oxacillin sodium 1 PENICILLIN G POT IN DEXTROSE 2 penicillin g potassium 1 PENICILLIN G PROCAINE 2 PENICILLIN G SODIUM 2 penicillin v potassium 1 piperacillin sodium-tazobactam sodium 1 PRIMAXIN IV 2 PRIMSOL 2 STREPTOMYCIN SULFATE 2 SULFADIAZINE 2 sulfamethoxazole-trimethoprim 1, 2 sulfasalazine 1 SUPRAX 2 SYNERCID 4 TETRACYCLINE HCL 2 tobramycin 1, 4 tobramycin sulfate 1 vancomycin hcl 1


Nivel del

medicamento


VANCOMYCIN HCL IN DEXTROSE 2 XIFAXAN 2 QL ZINACEF IN STERILE WATER 2 ZOSYN 2 ANTIFUNGALS ABELCET 2 AMBISOME 4 AMPHOTERICIN B 2 CANCIDAS 4 fluconazole 1 fluconazole in dextrose 1 fluconazole in nacl 1 flucytosine 1 griseofulvin microsize 1, 2 griseofulvin ultramicrosize 1 itraconazole 1, 2 ketoconazole 1 nystatin 1 nystatin (mouth-throat) 1 terbinafine hcl 1 voriconazole 1, 2 ANTIHEPATITIS C AGENTS HARVONI 4 QL INFERGEN 4 QL PEG-INTRON REDIPEN 4 QL

PEGASYS 4 QL ribavirin (hepatitis c) 1 SOVALDI 4 QL ANTIMYCOBACTERIALS CAPASTAT SULFATE 2 CYCLOSERINE 2 dapsone 1 ethambutol hcl 1 isoniazid 1, 2 PRIFTIN 2 pyrazinamide 1 rifabutin 1 RIFAMATE 2 rifampin 1 TRECATOR 2 ANTIPROTOZOALS ALINIA 2 atovaquone 1 atovaquone-proguanil hcl 1 chloroquine phosphate 1



Nivel del

medicamento


COARTEM 2 DARAPRIM 2 hydroxychloroquine sulfate 1 mefloquine hcl 1 metronidazole 1 metronidazole in nacl 1, 2 NEBUPENT 2 paromomycin sulfate 1 PRIMAQUINE PHOSPHATE 2 YODOXIN 2 ANTIVIRALS acyclovir 1 acyclovir sodium 1 adefovir dipivoxil 1 cidofovir 1 DAKLINZA 4 DESCOVY 2 entecavir 1, 4 EPCLUSA 4 QL famciclovir 1 FOSCAVIR 2 ganciclovir sodium 1 GENVOYA 2 lamivudine (hbv) 1, 2 ODEFSEY 2 RELENZA DISKHALER 2 rimantadine hydrochloride 1 SYNAGIS 4 TAMIFLU 2 TIVICAY 2 TRUVADA 2 valacyclovir hcl 1 valganciclovir hcl 1, 4 QL VIRAZOLE 4 voriconazole 1 URINARY ANTI-INFECTIVES methenamine hippurate 1 nitrofurantoin 1 nitrofurantoin macrocrystal 1, 2 nitrofurantoin monohyd macro 1 trimethoprim 1 ANTIHISTAMINE DRUGS FIRST GENERATION ANTIHISTAMINES


Nivel del

medicamento


chlorpheniramine & phenylephrine 1 cyproheptadine hcl 1 diphenhydramine hcl 1 promethazine hcl 1 ANTINEOPLASTIC AGENTS ANTINEOPLASTIC AGENTS ABRAXANE 4 ADCETRIS 2 AFINITOR 4 QL ALECENSA 4 QL ALIMTA 4 ALKERAN 2 anastrozole 1 ARRANON 4 AVASTIN 4 azacitidine 1 BENDEKA 2, 4 bicalutamide 1 BICNU 2 bleomycin sulfate 1 BLINCYTO 4 CAMPTOSAR 1, 2 capecitabine 1 QL CAPRELSA 4 QL, LD cisplatin 1 cladribine 1 COMETRIQ (100 MG DAILY DOSE) 4 QL, LD

COSMEGEN 4 COTELLIC 4 QL cyclophosphamide 1, 2 CYRAMZA 4 cytarabine 1, 2 dacarbazine 1, 2 DACOGEN 4 daunorubicin hcl 1 DAUNOXOME 2 DEPOCYT 2 DOCETAXEL 1, 2,

4 doxorubicin hcl 1 doxorubicin hcl liposomal 1, 2 EMCYT 4 QL ERBITUX 4 ERIVEDGE 4 QL ERWINAZE 2 etoposide 1, 2 exemestane 1



Nivel del

medicamento


FASLODEX 4 QL fludarabine phosphate 1 fluorouracil 1 flutamide 1 GAZYVA 4 gemcitabine hcl 1, 4 GLEEVEC 2 QL GLEOSTINE 2 HALAVEN 4 HERCEPTIN 4 HEXALEN 4 hydroxyurea 1 IBRANCE 4 QL idarubicin hcl 1, 2 ifosfamide 1 IFOSFAMIDE-MESNA 2 IMBRUVICA 4 QL INTRON A 4 QL IRESSA 2 QL ISTODAX 4 IXEMPRA KIT 4 JAKAFI 4 QL JEVTANA 4 KADCYLA 4 KEYTRUDA 4 KYPROLIS 4 QL LENVIMA 10 MG DAILY DOSE 4 QL

letrozole 1 LEUKERAN 2 leuprolide acetate 1, 2 LONSURF 4 QL LUPRON DEPOT 2 LUPRON DEPOT-PED 2 LYNPARZA 4 QL, LD LYSODREN 2 QL MARQIBO 4 MATULANE 4 QL megestrol acetate 1 MEKINIST 4 QL melphalan hcl 1 mercaptopurine 1, 4 QL methotrexate sodium 1 mitomycin 1 mitoxantrone hcl 1 MUSTARGEN 2 MYLERAN 4 NEXAVAR 4 QL NINLARO 4 QL ONCASPAR 4


Nivel del

medicamento


OPDIVO 4 oxaliplatin 1 paclitaxel 1 pentostatin 1 PERJETA 4 POMALYST 4 QL PROLEUKIN 4 REVLIMID 2 QL RITUXAN 2 SPRYCEL 4 QL STIVARGA 4 QL SUTENT 4 QL SYLVANT 4 TABLOID 2 TAFINLAR 4 QL TAGRISSO 4 QL tamoxifen citrate 1 TARCEVA 4 QL TARGRETIN 4 QL TASIGNA 4 QL TECENTRIQ 4 QL temozolomide 1 TENIPOSIDE 2 THIOTEPA 2 topotecan hcl 1, 4 QL TORISEL 4 tretinoin (chemotherapy) 1 QL

TRISENOX 4 TYKERB 4 QL UNITUXIN 4 VELCADE 4 VINBLASTINE SULFATE 2 vincristine sulfate 1 vinorelbine tartrate 1 VOTRIENT 4 QL XALKORI 4 QL XTANDI 4 QL YERVOY 4 ZANOSAR 4 ZELBORAF 4 QL ZYDELIG 4 QL ZYKADIA 4 QL ZYTIGA 4 QL AUTONOMIC DRUGS ANTICHOLINERGIC AGENTS atropine sulfate 1 ATROVENT HFA 2 BELLADONNA 2



Nivel del

medicamento


ALKALOIDS-OPIUM chlordiazepoxide hcl-clidinium bromide 1 dicyclomine hcl 1, 2 DONNATAL 2 glycopyrrolate 1, 2 hyoscyamine sulfate 1, 2 ipratropium bromide 1 ipratropium bromide (nasal) 1 PROPANTHELINE BROMIDE 2 SCOPOLAMINE HBR 2 SPIRIVA RESPIMAT 2 STIOLTO RESPIMAT 2 AUTONOMIC DRUGS, MISCELLANEOUS CHANTIX 2 nicotine 1 nicotine polacrilex 1, 2 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS bethanechol chloride 1 donepezil hydrochloride 1 ENLON 2 galantamine hydrobromide 1 GUANIDINE HCL 2 neostigmine methylsulfate 1 PHYSOSTIGMINE SALICYLATE 2 pilocarpine hcl (oral) 1 PROSTIGMIN 2 pyridostigmine bromide 1, 2 SKELETAL MUSCLE RELAXANTS atracurium besylate 1 baclofen 1, 2 cisatracurium besylate 1 cyclobenzaprine hcl 1 dantrolene sodium 1, 2 methocarbamol 1 pancuronium bromide 1 QUELICIN 2 rocuronium bromide 1 tizanidine hcl 1 vecuronium bromide 1 SYMPATHOLYTIC (ADRENERGIC BLOCKING) AGENTS dihydroergotamine 1, 2


Nivel del

medicamento


mesylate ERGOMAR 2 guanfacine hcl 1 phenoxybenzamine hcl 1 PHENTOLAMINE MESYLATE 2 SYMPATHOMIMETIC (ADRENERGIC) AGENTS ADVAIR DISKUS 2 albuterol sulfate 1, 2 COMBIVENT 2 dobutamine hcl 1 dobutamine in d5w 1 dopamine hcl 1, 2 dopamine in d5w 1 ephedrine sulfate (pressors) 1 EPINEPHRINE 2 epinephrine hcl 1 isoproterenol hcl 1, 2 METAPROTERENOL SULFATE 2 midodrine hcl 1 norepinephrine bitartrate 1 phenylephrine hcl (pressors) 1 SEREVENT DISKUS 2 STRIVERDI RESPIMAT 2 terbutaline sulfate 1 BLOOD DERIVATIVES BLOOD DERIVATIVES albumin, human 1 PLASMANATE 2 BLOOD FORMATION, COAGULATION, AND THROMBOSIS ANTIANEMIA DRUGS INFED 2 polysaccharide iron complex 1 PROFERRIN ES 2 PROFERRIN-FORTE 2 VENOFER 2 ANTIHEMORRHAGIC AGENTS ADVATE 2 QL ALPHANATE/VWF COMPLEX/HUMAN 2 QL

ALPHANINE SD 2 QL aminocaproic acid 1, 2



Nivel del

medicamento


BENEFIX 2 GELFILM 2 GELFOAM SPONGE 2 HEMOFIL M 2 QL KCENTRA 2 KOGENATE FS 2 QL NOVOSEVEN RT 2 PHENOL 2 QL PRAXBIND 4 PROFILNINE 4 QL PROTAMINE SULFATE 1 RECOTHROM 2 THROMBIN-JMI 2 tranexamic acid 1 XYNTHA 2 QL ANTITHROMBOTIC AGENTS ACD-A NOCLOT-50 2 ACTIVASE 2 anagrelide hcl 1 ANGIOMAX 2 argatroban 1, 2 ASPIRIN-DIPYRIDAMOLE ER 1 BRILINTA 2 clopidogrel bisulfate 1 EFFIENT 2 heparin (porcine) in sodium chloride 1, 2 heparin sod (porcine) in d5w 1 heparin sodium (porcine) 1 heparin sodium (porcine) lock flush 1 INTEGRILIN 4 LOVENOX 2 QL PRADAXA 2 PROFILNINE 4 REOPRO 2 THROMBATE III 2 TNKASE 2 warfarin sodium 1, 2 HEMATOPOIETIC AGENTS LEUKINE 4 QL NEUMEGA 4 NEUPOGEN 4 QL PROCRIT 2 QL PROMACTA 4 QL ZARXIO 2 QL


Nivel del

medicamento


HEMORRHEOLOGIC AGENTS pentoxifylline 1 CARDIOVASCULAR DRUGS ALPHA-ADRENERGIC BLOCKING AGENTS doxazosin mesylate 1 prazosin hcl 1 tamsulosin hcl 1 terazosin hcl 1 ANTILIPEMIC AGENTS atorvastatin calcium 1 cholestyramine 1 cholestyramine light 1 colestipol hcl 1 CRESTOR 2 fenofibrate 1 gemfibrozil 1 lovastatin 1 metoprolol succinate 1 pravastatin sodium 1 simvastatin 1 BETA-ADRENERGIC BLOCKING AGENTS atenolol 1 atenolol & chlorthalidone 1 bisoprolol & hydrochlorothiazide 1 bisoprolol fumarate 1 BREVIBLOC IN NACL 2 carvedilol 1 esmolol hcl 1 labetalol hcl 1 metoprolol & hydrochlorothiazide 1 metoprolol succinate 1 metoprolol tartrate 1 nadolol 1 propranolol hcl 1 sotalol hcl 1 sotalol hcl (afib/afl) 1 CALCIUM-CHANNEL BLOCKING AGENTS amlodipine besylate 1 CARDENE IV 2 CLEVIPREX 2 diltiazem hcl 1 diltiazem hcl coated beads 1 nicardipine hcl 1 nifedipine 1 nimodipine 1 verapamil hcl 1



Nivel del

medicamento


CARDIAC DRUGS adenosine 1 amiodarone hcl 1 digoxin 1, 2 disopyramide phosphate 1, 2 flecainide acetate 1 ibutilide fumarate 1 lidocaine hcl (cardiac) 1, 2 lidocaine in d5w 1 mexiletine hcl 1 milrinone in dextrose 1 milrinone lactate 1 PROCAINAMIDE HCL 2 propafenone hcl 1 quinidine gluconate 1, 2 QUINIDINE SULFATE 1, 2 TIKOSYN 2 HYPOTENSIVE AGENTS clonidine hcl 1 hydralazine hcl 1 methyldopa 1 METHYLDOPATE HCL 2 minoxidil 1 NITROPRESS 2 PROGLYCEM 4 RESERPINE 2 RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITORS benazepril hcl 1 captopril 1 enalaprilat 1 ENTRESTO 2 lisinopril 1 lisinopril & hydrochlorothiazide 1 losartan potassium 1 losartan potassium & hydrochlorothiazide 1 ramipril 1 spironolactone 1 spironolactone & hydrochlorothiazide 1 valsartan 1 valsartan-hydrochlorothiazide 1 SCLEROSING AGENTS ETHAMOLIN 2 SOTRADECOL 2


Nivel del

medicamento


VASODILATING AGENTS alprostadil 1 CAVERJECT 2 QL dipyridamole 1 dipyridamole (diagnostic) 1 isosorbide dinitrate 1, 2 isosorbide mononitrate 1 LETAIRIS 4 LD LEVITRA 2 QL nitroglycerin 1, 2 nitroglycerin in d5w 1, 2 papaverine hcl 1 REMODULIN 4 LD sildenafil citrate (pulmonary hypertension)

1 QL

TRACLEER 4 QL, LD TYVASO 2 QL, LD VENTAVIS 4 QL, LD CENTRAL NERVOUS SYSTEM AGENTS ANALGESICS AND ANTIPYRETICS acetaminophen w/ codeine 1 alfentanil 1 buprenorphine hcl 1 buprenorphine hcl-naloxone hcl dihydrate 1 QL

butorphanol tartrate 1 choline & mag salicylate 1 CODEINE SULFATE 1, 2 etodolac 1 fentanyl 1 QL fentanyl citrate 1, 2 hydrocodone-acetaminophen 1, 2 hydromorphone hcl 1, 2 ibuprofen 1 indomethacin 1, 2 INDOMETHACIN SODIUM 1 INFUMORPH 200 2 ketorolac tromethamine 1 MECLOFENAMATE SODIUM 2 mefenamic acid 1 meloxicam 1 meperidine hcl 1



Nivel del

medicamento


methadone hcl 1, 2 morphine sulfate 1, 2 nabumetone 1 nalbuphine hcl 1 naproxen 1 naproxen sodium 1 NEOPROFEN 2 OFIRMEV 2 OPANA 2 oxycodone hcl 1 oxycodone w/ acetaminophen 1 pentazocine w/ naloxone 1 salsalate 1 sufentanil citrate 1 sulindac 1 tramadol hcl 1 tramadol-acetaminophen 1 ULTIVA 2 ANOREXIGENIC AGENTS AND RESPIRATORY AND CEREBRAL STIMULANTS amphetamine-dextroamphetamine 1, 2 caffeine citrate 1 dexmethylphenidate hcl 1 dextroamphetamine sulfate 1 methylphenidate hcl 1, 2 VYVANSE 2 ANTICONVULSANTS BANZEL 4 carbamazepine 1, 2 CELONTIN 2 clonazepam 1 divalproex sodium 1 EQUETRO 2 ethosuximide 1 felbamate 1 fosphenytoin sodium 1 gabapentin 1 lamotrigine 1, 2 levetiracetam 1 LEVETIRACETAM IN NACL 2 magnesium sulfate 1, 2 oxcarbazepine 1


Nivel del

medicamento


phenytoin 1 phenytoin sodium 1 phenytoin sodium extended 1, 2 primidone 1 SABRIL 4 QL, LD topiramate 1 valproate sodium 1 valproic acid 1 ANTIMANIC AGENTS LITHIUM 2 lithium carbonate 1 ANTIMIGRAINE AGENTS ERGOLOID MESYLATES 1 ergotamine w/ caffeine 1, 2 isometheptene-dichloralphenazone-acetaminophen

1

naratriptan hcl 1 rizatriptan benzoate 1 sumatriptan 1 sumatriptan succinate 1 ANTIPARKINSONIAN AGENTS amantadine hcl 1 APOKYN 4 QL AZILECT 2 benztropine mesylate 1 bromocriptine mesylate 1 cabergoline 1 carbidopa-levodopa 1, 4 CARBIDOPA-LEVODOPA-ENTACAPONE

2

entacapone 1 LODOSYN 2 pramipexole dihydrochloride 1 ropinirole hydrochloride 1 selegiline hcl 1 trihexyphenidyl hcl 1 ANXIOLYTICS, SEDATIVES, AND HYPNOTICS alprazolam 1 buspirone hcl 1 BUTISOL SODIUM 2 chlordiazepoxide hcl 1 clorazepate dipotassium 1 DIASTAT ACUDIAL 2



Nivel del

medicamento


diazepam 1, 2 droperidol 1 hydroxyzine hcl 1, 2 hydroxyzine pamoate 1, 2 lorazepam 1 midazolam hcl 1 NEMBUTAL 2 oxazepam 1 phenobarbital 1, 2 PHENOBARBITAL SODIUM 2 PRECEDEX 2 temazepam 1 zolpidem tartrate 1 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS acamprosate calcium 1 flumazenil 1 memantine hcl 1, 2 riluzole 1 selegiline hcl 1 GENERAL ANESTHETICS BREVITAL SODIUM 2 etomidate 1 FORANE 2 ketamine hcl 1 propofol 1 MULTIPLE SCLEROSIS AGENTS AVONEX 4 QL EXTAVIA 2 QL glatiramer acetate 1 QL TYSABRI 4 OPIATE ANTAGONISTS naloxone hcl 1, 2 naltrexone hcl 1, 2 PSYCHOTHERAPEUTIC AGENTS amitriptyline hcl 1 AMOXAPINE 2 aripiprazole 1 bupropion hcl 1 chlorpromazine hcl 1, 2 citalopram hydrobromide 1 clomipramine hcl 1 clozapine 1 desipramine hcl 1 doxepin hcl 1, 2 duloxetine hcl 1 escitalopram oxalate 1 fluoxetine hcl 1


Nivel del

medicamento


fluphenazine decanoate 1 fluphenazine hcl 1, 2 fluvoxamine maleate 1 haloperidol 1 haloperidol decanoate 1 haloperidol lactate 1 imipramine hcl 1 loxapine succinate 1 MAPROTILINE HCL 2 mirtazapine 1 nefazodone hcl 1, 2 nortriptyline hcl 1, 2 olanzapine 1 ORAP 2 paroxetine hcl 1 perphenazine 1 PERPHENAZINE-AMITRIPTYLINE 2 phenelzine sulfate 1 prochlorperazine 1 prochlorperazine edisylate 1 prochlorperazine maleate 1 protriptyline hcl 1 quetiapine fumarate 1 risperidone 1 sertraline hcl 1 SURMONTIL 2 thioridazine hcl 1 thiothixene 1 tranylcypromine sulfate 1 trazodone hcl 1 trifluoperazine hcl 1 venlafaxine hcl 1 ziprasidone hcl 1 CONTRACEPTIVES (FOAMS, DEVICES) CONTRACEPTIVES (FOAMS, DEVICES) levonorgestrel & eth estradiol 1 ORTHO DIAPHRAGM ALL-FLEX 2 WIDE-SEAL DIAPHRAGM 60 2 DEVICES DEVICES AEROCHAMBER Z-STAT PLUS 2 AEROTRACH PLUS 2



Nivel del

medicamento


BAYER BREEZE 2 CONTROL 2 BD INSULIN SYR ULTRAFINE II 2 BD LANCET DEVICE 2 BD LANCET ULTRAFINE 33G 2 BD LUER-LOK SYRINGE 2 BD PEN NEEDLE MINI U/F 2 BD SAFETYGLIDE SYRINGE/NEEDLE 2 DISPOSABLE POWER 2 ONETOUCH ULTRA MINI 2 PEDIATRIC SMALL MASK 2 PENLET II BLOOD SAMPLER 2 TRUZONE PEAK FLOW METER 2 DIAGNOSTIC AGENTS DIAGNOSTIC AGENTS ACETEST 2 adenosine (diagnostic) 1 ALBUSTIX 2 CHEMSTRIP 9 2 CHIRHOSTIM 2 CLINITEST 2 CONRAY 2 CORTROSYN 2 CREON 2 CYSTOGRAFIN 2 D-XYLOSE 2 DIASTIX 2 E-Z-CAT DRY 2 EOVIST 2 fluorescein sodium injection 1 fluorescein sodium topical 1 fluorescein w/ benoxinate 1 GADAVIST 2 GASTROGRAFIN 2 INDIGO CARMINE 2 KETO-DIASTIX 2 LEXISCAN 2 LUMASON 2


Nivel del

medicamento


MAGNEVIST 2 METOPIRONE 2 MULTIHANCE 2 OMNIPAQUE 2 ONETOUCH ULTRA BLUE 2 THYROGEN 2 TUBERSOL 2 ELECTROLYTIC, CALORIC, AND WATER BALANCE ACIDIFYING AGENTS AMMONIUM CHLORIDE 2 ALKALINIZING AGENTS pot & sod citrates w/citric ac 1 potassium citrate (alkalinizer) 1 potassium citrate-citric acid 1 sodium acetate 1 sodium bicarbonate 1, 2 sodium citrate & citric acid 1 THAM 2 AMMONIA DETOXICANTS lactulose 1 lactulose (encephalopathy) 1 LITHOSTAT 2 sodium phenylbutyrate 1, 4 QL CALORIC AGENTS amino acid electrolyte infusion 1, 2 amino acid infusion 1, 2 CLINIMIX E/DEXTROSE (2.75/10)

2

CLINIMIX E/DEXTROSE (2.75/5) 2 CLINIMIX E/DEXTROSE (4.25/25)

2

CLINIMIX E/DEXTROSE (5/15) 2 CLINIMIX E/DEXTROSE (5/20) 2 CLINIMIX/DEXTROSE (2.75/5) 2 CLINIMIX/DEXTROSE 2



Nivel del

medicamento


(4.25/10) CLINIMIX/DEXTROSE (4.25/20) 2 CLINIMIX/DEXTROSE (4.25/25) 2 CLINIMIX/DEXTROSE (5/15) 2 dextrose 1, 2 fat emulsion 1, 2 PHENEX-1 2 DIURETICS amiloride & hydrochlorothiazide 1 bumetanide 1 chlorthalidone 1, 2 DYRENIUM 2 EDECRIN 2 furosemide 1, 2 hydrochlorothiazide 1 indapamide 1 mannitol 1 metolazone 1 SODIUM EDECRIN 2 torsemide 1 triamterene & hydrochlorothiazide 1 ION-REMOVING AGENTS RENVELA 2 sodium polystyrene sulfonate 1 IRRIGATING SOLUTIONS acetic acid 1 DIANEAL LOW CALCIUM/4.25% DEX 2 lactated ringer's (irrigation) 1 ringer's irrigation 1 sodium chloride (gu irrigant) 1 water for irrigation, sterile 1 REPLACEMENT PREPARATIONS calcium acetate (phosphate binder) 1, 2 calcium chloride (dihydrate) 1 calcium gluconate 1 CHROMIC CHLORIDE 2 COPPER CHLORIDE 2 COPPER SULFATE 2


Nivel del

medicamento


DEXTROSE 5%/ELECTROLYTE #48

2

dextrose in lactated ringers 1 dextrose in ringers 1 dextrose w/ sodium chloride 1, 2 hetastarch in sodium chloride 1 HEXTEND 2 HYPERLYTE-CR 2 K-PHOS 2 KCL-LACTATED RINGERS-D5W 2 lactated ringer's 1 LMD IN D5W 2 LMD IN NACL 2 M.T.E.-5 CONCENTRATE 2 MAGNESIUM SULFATE IN D5W 2 MANGANESE CHLORIDE 2 PLASMA-LYTE A 2 potassium acetate 1 potassium bicarbonate 1 potassium chloride 1, 2 potassium chloride in dextrose 1 potassium chloride in dextrose & sodium chloride

1, 2

potassium chloride in nacl 1 potassium chloride microencapsulated crystals cr

1

potassium phosphate dibasic 1 potassium phosphates 1 ringer's 1 saline, bacteriostatic 1 SELENIUM 2 sodium chloride 1 sodium chloride flush 1 sodium phosphate 1 trace minerals (cr-cu-mn-zn) 1, 2 zinc sulfate 1, 2



Nivel del

medicamento


ZINC TRACE METAL 2 URICOSURIC AGENTS colchicine w/ probenecid 1 probenecid 1 ENZYMES ENZYMES ALDURAZYME 4 CEREZYME 4 ELAPRASE 4 ELITEK 4 FABRAZYME 4 HYLENEX 2 MYOZYME 4 NAGLAZYME 4 PROLASTIN-C 2 LD PULMOZYME 4 STRENSIQ 4 QL VIMIZIM 4 VORAXAZE 4 VPRIV 4 EYE, EAR, NOSE, AND THROAT (EENT) PREPARATIONS ANTI-INFECTIVES BACITRACIN 2 bacitracin-polymyxin b (ophth) 1 chlorhexidine gluconate (mouth-throat)

1

ciprofloxacin hcl (ophth) 1 erythromycin (ophth) 1 gentamicin sulfate (ophth) 1 MITOSOL 2 neomycin-bacitracin zn-polymyxin 1 neomycin-polymyxin-gramicidin 1 ofloxacin (ophth) 1 ofloxacin (otic) 1 polymyxin b-trimethoprim 1 sulfacetamide sodium (ophth) 1 tobramycin (ophth) 1, 2 trifluridine 1 ZYMAXID 2 ANTI-INFLAMMATORY AGENTS


Nivel del

medicamento


CIPRODEX 2 COLY-MYCIN S 2 DEXAMETHASONE SODIUM PHOSPHATE

1

diclofenac sodium (ophth) 1 flunisolide (nasal) 1 fluorometholone (ophth) 1, 2 flurbiprofen sodium 1 fluticasone propionate (nasal) 1 ketorolac tromethamine (ophth) 1 neomycin-polymy-dexameth 1 neomycin-polymyxin-hc (otic) 1 OZURDEX 4 prednisolone acetate (ophth) 1, 2 PREDNISOLONE SODIUM PHOSPHATE

2

RESTASIS 2 RETISERT 2 sulfacetamide sod-prednisolone 1, 2 TOBRADEX 2 VEXOL 2 ANTIALLERGIC AGENTS ALOCRIL 2 azelastine hcl 1 cromolyn sodium (ophth) 1 olopatadine hcl 1 ANTIGLAUCOMA AGENTS acetazolamide 1, 2 acetazolamide sodium 1 betaxolol hcl (ophth) 1 brimonidine tartrate 1 dorzolamide hcl 1 dorzolamide hcl-timolol maleate 1 latanoprost 1 levobunolol hcl 1, 2 LUMIGAN 2 methazolamide 1 MIOCHOL-E 2



Nivel del

medicamento


MIOSTAT 2 PHOSPHOLINE IODIDE 2 pilocarpine hcl 1 timolol maleate (ophth) 1 EENT DRUGS, MISCELLANEOUS acetic acid (otic) 1 ACETIC ACID-ALUMINUM ACETATE 1 apraclonidine hcl 1, 2 EYLEA 2 HEALON5 2 JETREA 2 LACRISERT 2 LUCENTIS 2 LD MACUGEN 2 ophthalmic irrigation solution - intraocular 1, 2 VISUDYNE 2 LOCAL ANESTHETICS AKTEN 2 COCAINE HCL 2 lidocaine hcl (mouth-throat) 1 proparacaine hcl 1, 2 tetracaine hcl (ophth) 1 MYDRIATICS atropine sulfate (ophthalmic) 1, 2 CYCLOMYDRIL 2 cyclopentolate hcl 1, 2 homatropine hbr 1 tropicamide 1 VASOCONSTRICTORS NAPHAZOLINE HCL 2 phenylephrine hcl (ophth) 1 GASTROINTESTINAL DRUGS ANTI-INFLAMMATORY AGENTS balsalazide disodium 1 mesalamine 1, 2 ANTIDIARRHEA AGENTS diphenoxylate w/ atropine 1, 2 PAREGORIC 2 ANTIEMETICS dronabinol 1 EMEND 2 QL meclizine hcl 1 ondansetron 1


Nivel del

medicamento


ondansetron hcl 1 TRANSDERM-SCOP (1.5 MG) 2 ANTIULCER AGENTS AND ACID SUPPRESSANTS cimetidine hcl 1 famotidine 1 FAMOTIDINE PREMIXED 2 misoprostol 1 omeprazole 1 pantoprazole sodium 1, 2 ranitidine hcl 1 sucralfate 1, 2 CATHARTICS AND LAXATIVES AMITIZA 2 CASCARA SAGRADA 2 peg 3350-kcl-sod bicarb-sod chloride-sod sulfate

1

SORBITOL 2 CHOLELITHOLYTIC AGENTS ursodiol 1, 2 DIGESTANTS CREON 2 PROKINETIC AGENTS metoclopramide hcl 1 GOLD COMPOUNDS GOLD COMPOUNDS RIDAURA 2 HEAVY METAL ANTAGONISTS HEAVY METAL ANTAGONISTS BAL IN OIL 2 CHEMET 4 deferoxamine mesylate 1 DEPEN TITRATABS 4 EXJADE 4 QL PENTETATE CALCIUM TRISODIUM 2 PENTETATE ZINC TRISODIUM 2 sodium thiosulfate 1, 2 HORMONES AND SYNTHETIC SUBSTITUTES ADRENALS A-HYDROCORT 1, 2 ARISTOSPAN INTRA-ARTICULAR 2 ASMANEX 120 METERED DOSES 2



Nivel del

medicamento


betamethasone sod phosphate & acetate 1 budesonide 1 budesonide (inhalation) 1, 2 CORTISONE ACETATE 2 dexamethasone 1, 2 dexamethasone sodium phosphate 1 FLOVENT HFA 2 fludrocortisone acetate 1 hydrocortisone 1 KENALOG 2 methylprednisolone 1, 2 methylprednisolone acetate 1 methylprednisolone sod succ 1, 2 prednisolone 1, 2 prednisolone sodium phosphate 1 prednisone 1, 2 QVAR 2 ANDROGENS ANDRODERM 1, 2 ANDROID 2 ANDROXY 2 danazol 1 oxandrolone 1 testosterone cypionate 1, 2 testosterone enanthate 1 ANTIDIABETIC AGENTS acarbose 1 BYDUREON 2 glimepiride 1 glipizide 1 glipizide-metformin hcl 1 glyburide 1 HUMALOG 2 HUMALOG MIX 50/50 2 HUMULIN 70/30 2 HUMULIN N 2 HUMULIN R 2 JARDIANCE 2 LANTUS 2 metformin hcl 1 pioglitazone hcl 1 TOLBUTAMIDE 2 TRADJENTA 2 ANTIHYPOGLYCEMIC AGENTS


Nivel del

medicamento


GLUCAGEN DIAGNOSTIC 2 GLUCAGEN HYPOKIT 2 GLUCAGON EMERGENCY 2 CONTRACEPTIVES desogestrel & ethinyl estradiol 1 drospirenone-ethinyl estradiol 1 ELLA 2 ethynodiol diacet & eth estrad 1, 2 levonorgestrel & eth estradiol 1 levonorgestrel (emergency oc) 1 levonorgestrel-eth estradiol (triphasic) 1 MIRENA (52 MG) 2 NECON 1/50 (28) 2 NECON 10/11 (28) 2 NEXPLANON 2 norethin acet & estrad-fe 1 norethindrone & eth estradiol 1 norethindrone (contraceptive) 1 norethindrone acet & eth estra 1 norethindrone-eth estradiol (triphasic) 1 norgestimate-ethinyl estradiol 1 norgestimate-ethinyl estradiol (triphasic) 1 norgestrel & ethinyl estradiol 1, 2 NUVARING 2 XULANE 2 ESTROGENS AND ESTROGEN AGONISTS-ANTAGONISTS clomiphene citrate 1 DEPO-ESTRADIOL 2 esterified estrogens & methyltestosterone 1 ESTRACE 2 estradiol 1, 2 estradiol valerate 1, 2



Nivel del

medicamento


PREMARIN 2 raloxifene hcl 1 GONADOTROPINS BRAVELLE 2 chorionic gonadotropin 1 MENOPUR 2 SYNAREL 4 PARATHYROID FORTEO 4 QL FORTICAL 2 PITUITARY desmopressin acetate 1, 4 desmopressin acetate refrigerated 1 desmopressin acetate spray 1 desmopressin acetate spray refrigerated 1 HP ACTHAR 2 LD vasopressin 1 PROGESTINS DEPO-PROVERA 2 ENDOMETRIN 2 medroxyprogesterone acetate 1 medroxyprogesterone acetate (contraceptive) 1 norethindrone acetate 1 progesterone 1 progesterone micronized 1 SOMATROPIN AGONISTS-ANTAGONISTS MAKENA 2 QL NORDITROPIN FLEXPRO 2, 4 QL

SEROSTIM 4 QL THYROID AND ANTITHYROID AGENTS levothyroxine sodium 1, 2 liothyronine sodium 1 methimazole 1 propylthiouracil 1 SSKI 2 IMMUNOLOGICAL AGENTS ANTIRHEUMATIC AGENTS ENBREL 4 QL HUMIRA 4 QL KINERET 4 QL, LD leflunomide 1 ORENCIA 4 QL OTEZLA 4 QL


Nivel del

medicamento


RASUVO 2 REMICADE 4 IMMUNE SUPPRESSANTS ATGAM 2 azathioprine 1 cyclosporine modified (for microemulsion) 1, 2 mycophenolate mofetil 1 SANDIMMUNE 2 sirolimus 1, 2 tacrolimus 1, 2 LOCAL ANESTHETICS LOCAL ANESTHETICS bupivacaine hcl 1 bupivacaine in dextrose 1 bupivacaine w/ epinephrine 1, 2 chloroprocaine hcl 1, 2 lidocaine hcl (cardiac) 1 lidocaine hcl (local anesth.) 1 lidocaine w/ epinephrine 1, 2 mepivacaine hcl 1 NAROPIN 2 TETRACAINE HCL 2 MISCELLANEOUS THERAPEUTIC AGENTS MISCELLANEOUS THERAPEUTIC AGENTS acetylcysteine 1 acetylcysteine (antidote) 1 ACTIMMUNE 4 QL, LD alendronate sodium 1, 2 allopurinol 1 amifostine crystalline 1 BOTOX 2 BOTOX COSMETIC 2 BRIDION 2 CERDELGA 4 QL CINRYZE 4 QL COLCHICINE 2 CYSTADANE 4 QL, LD CYSTAGON 2 QL, LD dexrazoxane 1 disulfiram 1, 2 ELMIRON 2 ETIDRONATE DISODIUM 2 finasteride 1



Nivel del

medicamento


FIRAZYR 4 QL FLUOR-A-DAY 2 FUSILEV 2 GRASTEK 2 HUMIRA 2 QL KALYDECO 4 QL leucovorin calcium 1 levocarnitine (metabolic modifiers) 1 mesna 1, 2 QL methylene blue (antidote) 1 MYOBLOC 2 octreotide acetate 1, 4 pamidronate disodium 1, 2 RIMSO-50 2 SENSIPAR 4 sodium fluoride 1, 2 sodium fluoride (dental) 1, 2 SOLIRIS 2 THALOMID 4 QL THIOLA 2 LD TRI-CHLOR 2 water for injection, sterile 1 XELJANZ 4 QL zoledronic acid 1 OXYTOCICS OXYTOCICS CERVIDIL 2 HEMABATE 2 methylergonovine maleate 1 MIFEPREX 2 oxytocin 1 PHARMACEUTICAL AIDS PHARMACEUTICAL AIDS ALOE VERA 2 ALPROSTADIL 2 ATROPINE SULFATE MONOHYDRATE 2 BACLOFEN 2 BACTERIOSTATIC WATER(BENZ ALC) 2 BIOTIN-D 2 BORIC ACID 2 CANTHARIDIN 2 CARBAMAZEPINE 2 CHLOROFORM 2


Nivel del

medicamento


CHLORPROMAZINE HCL 2 CHOLESTEROL ACETATE 2 CLINDAMYCIN HCL 2 CLOBETASOL PROPIONATE 2 CLONIDINE HCL 2 CLOTRIMAZOLE 2 COAL TAR 2 COLLODION FLEXIBLE 2 CYSTEAMINE HCL 2 DEXAMETHASONE 2 DILTIAZEM HCL 2 DIPHENYLCYCLOPROPENONE 2 ESTRADIOL 2 GABAPENTIN 2 GLYCERIN 2 GLYCOPYRROLATE 2 HALOPERIDOL 2 HYDROCORTISONE 2 HYDROPHILIC 2 HYDROXOCOBALAMIN 2 HYDROXYPROGESTERONE CAPROATE 2 INDOMETHACIN 2 ISOSORBIDE 2 KETAMINE HCL 2 KETOPROFEN 2 L-ARGININE 2 L-CITRULLINE 2 L-ISOLEUCINE 2 L-PROLINE 2 L-VALINE 2 LACTIC ACID 2 LACTOSE 2 LACTOSE MONOHYDRATE 2 LIDOCAINE HCL 2 METHADONE HCL 2 METOCLOPRAMIDE HCL MONOHYDRATE 2 METRONIDAZOLE 2 MORPHINE SULFATE 2 NEOMYCIN SULFATE 2 PAPAVERINE HCL 2 PHENOBARBITAL 2



Nivel del

medicamento


PHENTOLAMINE MESYLATE 2 PLURONIC F127 2 PODOPHYLLUM RESIN 2 POLYETHYLENE GLYCOL 400 2 POLYETHYLENE GLYCOL 8000 2 PROGESTERONE MICRONIZED 2 PROGESTERONE WETTABLE 2 PROPYLENE GLYCOL 2 QUINACRINE HCL 2 SALICYLIC ACID 2 SODIUM BENZOATE 2 SORBITOL 2 SQUARIC ACID DIBUTYLESTER 2 SULFUR PRECIPITATED 2 TESTOSTERONE PROPIONATE 2 THYMOL 2 TRANEXAMIC ACID 2 TRIAMCINOLONE ACETONIDE 2 UREA 2 VERAPAMIL HCL 2 water for injection, sterile 1 ZINC SULFATE 2 RESPIRATORY TRACT AGENTS ANTI-INFLAMMATORY AGENTS COMBIVENT RESPIMAT 2 CROMOLYN SODIUM 1 cromolyn sodium (mastocytosis) 1 DULERA 2 montelukast sodium 1 ANTITUSSIVES benzonatate 1 guaifenesin-codeine 1 hydrocodone w/ homatropine 1 phenylephrine-chlorphen-dm 1


Nivel del

medicamento


PHENYLHISTINE DH 2 promethazine w/codeine 1 promethazine-dm 1 pseudoephedrine w/ codeine-gg 1 MUCOLYTIC AGENTS sodium chloride (inhalant) 1 PULMONARY SURFACTANTS CUROSURF 2 SURVANTA 2 RESPIRATORY AGENTS, MISCELLANEOUS ORKAMBI 4 QL XOLAIR 4 QL, LD VASODILATING OPSUMIT 4 QL, LD SERUMS, TOXOIDS, AND VACCINES SERUMS ANTIVENIN LATRODECTUS MACTANS

2

CARIMUNE NF 2 CROFAB 2 CYTOGAM 2 DIGIFAB 2 GAMASTAN S/D 2 GAMMAGARD 2 HIZENTRA 4 QL HYPERRAB S/D 2 HYPERRHO S/D 2 HYPERTET S/D 2 NABI-HB 2 VARIZIG 2 TOXOIDS ADACEL 2 DIPHTHERIA-TETANUS TOXOIDS DT

2

INFANRIX 2 TETANUS-DIPHTHERIA TOXOIDS TD

2

VACCINES ACTHIB 2 AFLURIA 2 AFLURIA PRESERVATIVE FREE

2

BEXSERO 2



Nivel del

medicamento


ENGERIX-B 2 FLUARIX QUADRIVALENT 2 FLUBLOK 2 FLUCELVAX 2 FLUMIST QUADRIVALENT 2 FLUVIRIN 2 FLUVIRIN PRESERVATIVE FREE

2

FLUZONE HIGH-DOSE 2 GARDASIL 2 GARDASIL 9 2 HAVRIX 2 IMOVAX RABIES 2 IPOL 2 IXIARO 2 KINRIX 2 M-M-R II 2 MENOMUNE 2 MENVEO 2 PEDIARIX 2 PNEUMOVAX 23 2 PREVNAR 13 2 PROQUAD 2 RABAVERT 2 ROTARIX 2 ROTATEQ 2 THERACYS 2 TWINRIX 2 TYPHIM VI 2 VARIVAX 2 VIVOTIF 2 YF-VAX 2 ZOSTAVAX 2 SKIN AND MUCOUS MEMBRANE AGENTS ANTI-INFECTIVES benzoyl peroxide-erythromycin 1, 2 clindamycin phosphate (topical) 1 clindamycin phosphate vaginal 1 clindamycin phosphate-benzoyl peroxide

1

clindamycin phosphate-benzoyl 1


Nivel del

medicamento


peroxide (refrigerate) clotrimazole 1 dakin's solution 1, 2 erythromycin (acne aid) 1, 2 GENTAMICIN SULFATE 1, 2 iodoquinol-hc 1 ketoconazole (topical) 1 malathion 1 metronidazole (topical) 1 metronidazole vaginal 1 mupirocin 1 neomycin/polymyxin b gu 1 nystatin (topical) 1 permethrin 1, 2 selenium sulfide 1 silver sulfadiazine 1 SULFAMYLON 2 ANTI-INFLAMMATORY AGENTS alclometasone dipropionate 1 betamethasone dipropionate (topical) 1 betamethasone dipropionate augmented

1

betamethasone valerate 1 clobetasol propionate 1, 2 CORDRAN 2 CORTISPORIN 2 desoximetasone 1 fluocinolone acetonide 1 fluocinonide 1 fluticasone propionate 1 halobetasol propionate 1 hydrocortisone (intrarectal) 1 hydrocortisone (rectal) 1 hydrocortisone (topical) 1 hydrocortisone acetate (rectal) 1 mometasone furoate 1 nystatin-triamcinolone 1 pramoxine-hc 1, 2 PROCTOFOAM HC 2 triamcinolone acetonide (mouth) 1



Nivel del

medicamento


triamcinolone acetonide (topical) 1 ANTIPRURITICS AND LOCAL ANESTHETICS hydrocortisone acetate w/ pramoxine 1, 2 lidocaine 1 lidocaine hcl 1 lidocaine-prilocaine 1 PHENOL 2 ASTRINGENTS DRYSOL 2 XERAC AC 2 CELL STIMULANTS AND PROLIFERANTS KEPIVANCE 4 RETIN-A MICRO 2 tretinoin 1, 2 DEPIGMENTING AND PIGMENTING AGENTS 8-MOP 2 methoxsalen rapid 1, 2 OXSORALEN 2 KERATOLYTIC AGENTS KERALYT 2 sulfacetamide sodium w/ sulfur 1, 2 KERATOPLASTIC AGENTS ELTA TAR 2 SKIN AND MUCOUS MEMBRANE AGENTS, MISCELLANEOUS acitretin 1 AQUAPHOR 2 BENZOIN 2 BENZOIN COMPOUND 2 calcipotriene 1 COSENTYX 4 QL DESITIN 2 diclofenac sodium (topical) 1 DIFFERIN 2 DRITHO-CREME HP 2 ELIDEL 2 EPIDUO 2 fluorouracil (topical) 1, 2 imiquimod 1 isotretinoin 1 QL LEVULAN KERASTICK 2 PODOCON 2 podofilox 1, 2 SANTYL 2


Nivel del

medicamento


sodium chloride 1 STELARA 4 tacrolimus (topical) 1 TARGRETIN 4 QL TAZORAC 2 VECTICAL 2 SMOOTH MUSCLE RELAXANTS GENITOURINARY SMOOTH MUSCLE RELAXANTS oxybutynin chloride 1 OXYTROL 2 trospium chloride 1 RESPIRATORY SMOOTH MUSCLE RELAXANTS aminophylline 1 theophylline 1 theophylline in dextrose 1, 2 VITAMINS MULTIVITAMIN PREPARATIONS b-complex w/ c & folic acid 1 INFUVITE 2 INFUVITE PEDIATRIC 2 ped multivitamins w/fl & iron 1 pediatric multiple vitamin w/ c 1 pediatric multiple vitamins w/ iron 1 pediatric multivitamins w/fl 1 pediatric vitamins acd w/ fluoride 1 VITAMIN A AQUASOL A 2 VITAMIN B COMPLEX cyanocobalamin 1 FOLIC ACID 2 niacin 1, 2 POTABA 2 pyridoxine hcl 1 thiamine hcl 1 VITAMIN C ascorbic acid 1 VITAMIN D calcitriol 1 ergocalciferol 1 VITAMIN K ACTIVITY phytonadione 1, 2


Los medicamentos que figuran a continuación no están incluidos en la Lista de medicamentos aprobados del Plan. Si su médico de Kaiser Permanente determina por medio de un proceso de excepción que uno de estos medicamentos es necesario desde el punto de vista médico, el medicamento será cubierto como un medicamento de Nivel 4, con el costo compartido correspondiente.


ANTI-INFECTIVE AGENTS ANTIBACTERIALS

BETHKIS NEB 300/4ML DALVANCE SOL 500MG DIFICID TAB 200MG KITABIS PAK NEB 300/5ML LINEZOLID SOLN 2MG/ML ORBACTIV SOL 400MG SIVEXTRO INJ 200MG SIVEXTRO TAB 200MG TYGACIL INJ 50MG VANCOCIN HCL CAP 125MG VANCOCIN HCL CAP 250MG ZYVOX SOL 2MG/ML

ANTIFUNGALS ANCOBON CAP 250MG ANCOBON CAP 500MG CRESEMBA SOLR 372 MG CRESEMBA CAPS 186 MG MYCAMINE INJ 100MG MYCAMINE INJ 50MG NOXAFIL SUS 40MG/ML NOXAFIL SOLN 300 MG/16.7ML NOXAFIL TAB 100MG VFEND SUS 40MG/ML VFEND TAB 200MG VFEND TAB 50MG

ANTIMYCOBACTERIALS MYCOBUTIN CAP 150MG SIRTURO TAB 100MG

ANTIPROTOZOALS IMPAVIDO CAPS 50 MG MEPRON SUS

ANTIVIRALS BARACLUDE TAB 0.5MG BARACLUDE TAB 1MG DAKLINZA TABS 90 MG HEPSERA TAB 10MG


RAPIVAB SOLN 200 MG/20ML TYZEKA 600 MG TABLET VALCYTE TAB 450MG VISTIDE INJ 75MG/ML

ANTIHEPATITIS C AGENTS OLYSIO CAP 150MG TECHNIVIE TABS 12.5-75-50 MG VIEKIRA PAK TAB VIEKIRA XR TB24 200-8.33-50- 33.33 MG ZEPATIER TABS

ANTINEOPLASTIC AGENTS ANTINEOPLASTIC AGENTS

AFINITOR DISPERZ TAB 2MG AFINITOR DISPERZ TAB 3MG AFINITOR DISPERZ TAB 5MG ALIMTA SOLR 100 MG ARZERRA CON 100/5ML BELEODAQ INJ 500MG BOSULIF TAB 100MG BOSULIF TAB 500MG BUSULFEX INJ 6MG/ML CABOMETYX TABS COSMEGEN INJ 0.5MG DARZALEX SOLN 100 MG/5ML DARZALEX SOLN 400 MG/20ML DOCETAXEL (NON-ALCOHOL) SOLN ELOXATIN INJ 100MG ELOXATIN INJ 200MG ELOXATIN INJ 50MG EMPLICITI SOLR 300 MG EMPLICITI SOLR 400 MG EVOMELA SOLR 50 MG FARESTON 60 MG TABLET FARYDAK CAP 10MG FARYDAK CAP 15MG FARYDAK CAP 20MG GILOTRIF TAB 20MG GILOTRIF TAB 30MG GILOTRIF TAB 40MG HYCAMTIN 4 MG VIAL HYCAMTIN CAP 0.25MG HYCAMTIN CAP 1MG ICLUSIG TAB 15MG ICLUSIG TAB 45MG IMLYGIC SUSP 1000000 UNIT/ML



IMLYGIC SUSP 100000000 UNIT/ML INLYTA TAB 1MG INLYTA TAB 5MG INTRON-A KIT 10MU/ML INTRON-A INJ 10MU PEN INTRON-A INJ 3MU PEN INTRON-A INJ 5MU PEN KYPROLIS 30 MG VIAL LARTRUVO SOLN 500 MG/50ML LENVIMA PACK 4 (2) MG (8 MG DAILY DOSE) LENVIMA PACK 10 & 4 (2) MG (18 MG DAILY

DOSE) NIPENT INJ 10MG ODOMZO CAPS 200 MG ONIVYDE INJ 43 MG/10ML PORTRAZZA SOLN 800 MG/50ML PURINETHOL SUPPRELIN LA KIT 50 MG SYLATRON KIT 200MCG SYLATRON KIT 300MCG SYLATRON KIT 600MCG SYNRIBO INJ 3.5MG TAXOTERE INJ 80MG/4ML TEMODAR CAP 100MG TEMODAR CAP 140MG TEMODAR CAP 180MG TEMODAR CAP 20MG TEMODAR CAP 250MG TEMODAR CAP 5MG TEMODAR INJ 100MG TREANDA INJ 180MG TREANDA INJ 25MG TREANDA INJ 45MG TRELSTAR DEPOT MIXJECT INJ 3.75MG TRELSTAR LA MIXJECT INJ 11.25MG TRELSTAR MIXJECT INJ 22.5MG VALSTAR SOL 40MG/ML VANTAS KIT 50MG VECTIBIX INJ 100MG VECTIBIX INJ 400MG VENCLEXTA TABS YONDELIS SOLR 1 MG ZALTRAP INJ 100/4ML ZALTRAP INJ 200/8ML ZOLINZA CAP 100MG


AUTONOMIC DRUGS SYMPATHOMIMETIC (ADRENERGIC) AGENTS

NORTHERA CAP 100MG NORTHERA CAP 200MG NORTHERA CAP 300MG

BLOOD FORMATION, COAGULATION, AND THROMBOSIS

ANTIHEMORRHAGIC AGENTS BENEFIX SOLR

CYKLOKAPRON 100 MG/ML AMPUL PROFILNINE SD INJ RIXUBIS SOLR IXINITY SOLR

HEMATOPOIETIC AGENTS GRANIX INJ 300/0.5 GRANIX INJ 480/0.8 LEUKINE 500 MCG/ML VIAL MOZOBIL 20 MG/ML VIAL NEULASTA INJ 6MG/0.6M

CARDIAC DRUGS ANTILIPEMIC AGENTS

JUXTAPID CAP 10MG JUXTAPID CAP 20MG JUXTAPID CAP 30MG JUXTAPID CAP 40MG JUXTAPID CAP 5MG JUXTAPID CAP 60MG KYNAMRO INJ 200MG/ML PRALUENT SOSY 150 MG/ML PRALUENT SOSY 75 MG/ML REPATHA SOSY 140 MG/ML REPATHA SURECLICK SOAJ 140 MG/ML REPATHA PUSH INJ 420/3.5

HYPOTENSIVE AGENTS

VASODILATING AGENTS ADCIRCA TAB 20MG REVATIO INJ REVATIO TAB 20MG

CENTRAL NERVOUS SYSTEM AGENTS ANALGESICS AND ANTIPYRETICS

PROBUPHINE IMPLANT KIT IMPL 74.2 MG ILARIS INJ 180MG

ANTICONVULSANTS APTIOM TAB 200MG APTIOM TAB 400MG



APTIOM TAB 600MG APTIOM TAB 800MG BRIVIACT SOLN 10 MG/ML BRIVIACT TABS FELBATOL SUS 600/5ML FELBATOL TAB 400MG FELBATOL TAB 600MG SABRIL TAB 500MG SPRITAM TB3D

ANTIPARKINSONIAN AGENTS RYTARY TASMAR 100 MG TABLET

ANXIOLYTICS/SEDATIVES/HYPNOTICS HETLIOZ CAP 20MG

CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS

RILUTEK TAB 50MG XENAZINE TAB 12.5MG XENAZINE TAB 25MG XYREM SOL 500MG/ML

MULTIPLE SCLEROSIS AUBAGIO TAB 14MG AUBAGIO TAB 7MG COPAXONE INJ 40MG/ML GILENYA CAP 0.5MG PLEGRIDY INJ PLEGRIDY INJ PEN PLEGRIDY STARTER PACK INJ STARTER REBIF INJ 22/0.5 REBIF INJ 44/0.5 REBIF REBIDOSE INJ 22/0.5 REBIF REBIDOSE INJ 44/0.5 REBIF REBIDOSE TITRATION PACK SOL

TITRATN REBIF TITRATION PACK SOL PACK TECFIDERA CAP 120MG TECFIDERA CAP 240MG TECFIDERA STARTER PACK MIS STARTER

OPIATE AGENTS VIVITROL 380MG INJ

PSYCHOTHERAPEUTIC AGENTS INVEGA TB24 1.5 MG INVEGA TB24 3 MG INVEGA TB24 6 MG INVEGA TB24 9 MG


INVEGA SUSTENNA INJ 117/0.75 INVEGA SUSTENNA INJ 234/1.5 INVEGA SUSTENNA INJ 39/0.25 INVEGA SUSTENNA INJ 78/0.5ML REXULTI TABS VRAYLAR CAPS VRAYLAR CPPK 1.5 & 3 MG

ELECTROLYTIC, CALORIC, AND WATER BALANCE

AMMONIA DETOXICANTS BUPHENYL POW RAVICTI LIQ 1.1GM/ML

DIURETICS SAMSCA 15 MG TABLET SAMSCA 30 MG TABLET

ION-REMOVING AGENTS FOSRENOL CHW 1000MG FOSRENOL CHW 500MG FOSRENOL CHW 750MG FOSRENOL PACK 750 MG FOSRENOL PACK 1000 MG

EYE, EAR, NOSE, AND THROAT (EENT) PREPARATIONS

ANTI-INFLAMMATORY AGENTS ILUVIEN 0.19MG IMPLANT

ENZYMES ENZYMES

CEREZYME INJ 200UNIT ELELYSO INJ 200UNIT KANUMA SOLN 20 MG/10ML VIMIZIM INJ 5MG/5ML

GASTROINTESTINAL DRUGS ANTI-INFLAMMATORY AGENTS

DIPENTUM CAP 250MG LOTRONEX TAB 0.5MG LOTRONEX TAB 1MG

GI DRUGS, MISCELLANEOUS ENTYVIO INJ 300MG GATTEX KIT 5MG OCALIVA RELISTOR 12 MG/0.6 ML KIT RELISTOR SOLN 8 MG/0.4ML RELISTOR TABS 150 MG VIBERZI TABS 75 MG VIBERZI TABS 100 MG

HEAVY METAL ANTAGONISTS



HEAVY METAL ANTAGONISTS CUPRIMINE CAPS 250 MG FERRIPROX TAB 500MG FERRIPROX SOLN 100 MG/ML

HORMONES AND SYNTHETIC SUBSTITUTES ADRENALS

ENTOCORT EC CAP 3MG/24HR UCERIS TAB 9MG

DIABETIC AGENTS KORLYM TAB 300MG

PARATHYROID NATPARA CART 100 MCG NATPARA CART 25 MCG NATPARA CART 50 MCG NATPARA CART 75 MCG

PROGESTINS MAKENA INJ 250MG/ML

SOMATOTROPIN AGONISTS AND ANTAGONISTS

BETASERON KIT 0.3 MG EGRIFTA INJ 1MG EGRIFTA SOL 2MG GENOTROPIN INJ 12MG GENOTROPIN INJ 5MG GENOTROPIN MINIQUICK INJ 0.2MG GENOTROPIN MINIQUICK INJ 0.4MG GENOTROPIN MINIQUICK INJ 0.6MG GENOTROPIN MINIQUICK INJ 0.8MG GENOTROPIN MINIQUICK INJ 1.2MG GENOTROPIN MINIQUICK INJ 1.4MG GENOTROPIN MINIQUICK INJ 1.6MG GENOTROPIN MINIQUICK INJ 1.8MG GENOTROPIN MINIQUICK INJ 1MG GENOTROPIN MINIQUICK INJ 2MG HUMATROPE COMBO PACK INJ 5MG HUMATROPE INJ 12MG HUMATROPE INJ 24MG HUMATROPE INJ 6MG INCRELEX INJ 40MG/4ML NORDITROPIN FLEXPRO INJ 10/1.5ML NORDITROPIN FLEXPRO INJ 5/1.5ML NORDITROPIN NORDIFLEX PEN INJ 30/3ML NUTROPIN AQ INJ 10MG/2ML NUTROPIN AQ NUSPIN 5 INJ NUSPIN 5 NUTROPIN AQ NUSPIN 10 SOLN 10 MG/2ML NUTROPIN AQ NUSPIN 20 SOLN 20 MG/2ML


NUTROPIN AQ PEN INJ 10MG/2ML NUTROPIN AQ PEN INJ 20MG/2ML NUTROPIN INJ 10MG SAIZEN CLICK.EASY INJ 8.8MG SAIZEN SOLR 5 MG SIGNIFOR INJ 0.3MG/ML SIGNIFOR INJ 0.6MG/ML SIGNIFOR INJ 0.9MG/ML SIGNIFOR LAR INJ 20MG SIGNIFOR LAR INJ 40MG SIGNIFOR LAR INJ 60MG SOMAVERT INJ 10MG SOMAVERT INJ 15MG SOMAVERT INJ 20MG SOMAVERT INJ 25MG SOMAVERT INJ 30 ZOMACTON SOLR 5 MG ZOMACTON SOLR 10 MG ZORBTIVE INJ 8.8MG

IMMUNOLOGICAL AGENTS ANTIRHEUMATIC AGENTS

ACTEMRA INJ ACTEMRA INJ 162/0.9 ACTEMRA SOLN 80 MG/4ML ACTEMRA SOLN 400 MG/20ML ARAVA TAB 10MG ARAVA TAB 20MG CIMZIA KIT CIMZIA KIT 200MG/ML HUMIRA KIT 10MG/0.2 HUMIRA KIT 20MG/0.4 SIMPONI ARIA SOL 50MG/4ML SIMPONI INJ 100MG/ML SIMPONI INJ 50MG XELJANZ TAB 5MG XELJANZ XR TB24 11 MG

MISCELLANEOUS THERAPEUTIC AGENTS MISCELLANEOUS THERAPEUTIC AGENTS

AMPYRA TAB 10MG ARCALYST INJ 220MG ASTAGRAF XL CP24 0.5 MG ASTAGRAF XL CAP 1MG ASTAGRAF XL CAP 5MG BERINERT INJ 500UNIT EXONDYS 51 SOLN



KUVAN POWDER KUVAN TAB 100MG LEMTRADA SOLN 12 MG/1.2ML MYALEPT INJ 11.3MG NULOJIX INJ 250MG ORFADIN CAP 10MG ORFADIN CAP 2MG ORFADIN CAP 5MG ORFADIN CAPS 20 MG ORFADIN SUS 4MG/ML PROCYSBI CAP 25MG PROCYSBI CAP 75MG RUCONEST INJ 2100UNIT SAXENDA SIMULECT INJ 10MG SIMULECT INJ 20MG SOMATULINE DEPOT INJ 120/.5ML SOMATULINE DEPOT INJ 60/0.2ML SOMATULINE DEPOT INJ 90/0.3ML THYMOGLOBULIN INJ 25MG VISTOGARD PACK 10 GM XEOMIN SOLR 200 UNIT XGEVA INJ XURIDEN PACK 2 GM ZAVESCA CAP 100MG ZINBRYTA INJ 150MG/ML ZORTRESS TAB 0.25MG ZORTRESS TAB 0.5MG ZORTRESS TAB 0.75MG

SYSTEMIC LUPUS ERYTHEMATOSUS BENLYSTA INJ 120MG BENLYSTA INJ 400MG

RESPIRATORY TRACT AGENTS ANTI-INFLAMMATORY AGENTS

CINQAIR SOLN 100 MG/10ML GASTROCROM 100 MG/5 ML CONC NUCALA SOLR 100 MG ZYFLO CR TAB 600MG ZYFLO TAB 600MG

RESPIRATORY AGENTS, MISCELLANEOUS ARALAST NP SOLR 500 MG ESBRIET CAP 267MG GLASSIA INJ OFEV CAP 100MG OFEV CAP 150MG


ZEMAIRA SOLR 1000 MG VASODILATING AGENTS

ADEMPAS TAB 0.5MG ADEMPAS TAB 1.5MG ADEMPAS TAB 1MG ADEMPAS TAB 2.5MG ADEMPAS TAB 2MG OPSUMIT TAB 10MG ORENITRAM TAB 0.125MG ORENITRAM TAB 0.25MG ORENITRAM TAB 1MG ORENITRAM TAB 2.5MG UPTRAVI TABS

SERUMS, TOXOIDS, AND VACCINES SERUMS

HYQVIA KIT 10 GM/100ML HYQVIA KIT 2.5 GM/25ML HYQVIA KIT 20 GM/200ML HYQVIA KIT 30 GM/300ML HYQVIA KIT 5 GM/50ML

SKIN AND MUCOUS MEMBRANE AGENTS ANTI-INFLAMMATORY AGENTS (SKIN AND

MUCOUS MEMBRANE) TACLONEX OIN TACLONEX SUSP 0.005-0.064 % ULTRAVATE LOTN 0.05 %

SKIN AND MUCOUS MEMBRANE AGENTS, MISCELLANEOUS

PANRETIN GEL 0.1% REGRANEX GEL 0.01% RYNODERM CREA 37.5 % SORIATANE CAP 10MG SORIATANE CAP 17.5MG SORIATANE CAP 25MG STELARA SOLN 130 MG/26ML TALTZ SOSY 80 MG/ML TALTZ SOAJ 80 MG/ML VALCHLOR GEL 0.016%


8 8-MOP ............................................................. 21

A abacavir sulfate .................................................. 4 abacavir sulfate-lamivudine-zidovudine ............. 4 ABELCET .......................................................... 5 ABRAXANE ....................................................... 6 acamprosate calcium ....................................... 12 acarbose .......................................................... 17 ACD-A NOCLOT-50 .......................................... 9 acetaminophen w/ codeine .............................. 10 acetazolamide.................................................. 15 acetazolamide sodium ..................................... 15 ACETEST ........................................................ 13 acetic acid .................................................. 14, 15 acetic acid (otic) ............................................... 15 ACETIC ACID-ALUMINUM ACETATE ............ 15 acetylcysteine .................................................. 18 acetylcysteine (antidote) .................................. 18 acitretin ............................................................ 21 ACTEMRA INJ ................................................. 26 ACTEMRA INJ 162/0.9 .................................... 26 ACTEMRA SOLN 400 MG/20ML ..................... 26 ACTEMRA SOLN 80 MG/4ML ......................... 26 ACTHIB ........................................................... 20 ACTIMMUNE ................................................... 18 ACTIVASE ......................................................... 9 acyclovir ............................................................. 6 acyclovir sodium ................................................ 6 ADACEL .......................................................... 20 ADCETRIS ........................................................ 6 ADCIRCA TAB 20MG ...................................... 24 adefovir dipivoxil ................................................ 6 ADEMPAS TAB 0.5MG.................................... 27 ADEMPAS TAB 1.5MG.................................... 27 ADEMPAS TAB 1MG ...................................... 27 ADEMPAS TAB 2.5MG.................................... 27 ADEMPAS TAB 2MG ...................................... 27 adenosine .................................................... 9, 13 adenosine (diagnostic) ..................................... 13 ADVAIR DISKUS ............................................... 8 ADVATE ............................................................ 8 AEROCHAMBER Z-STAT PLUS ..................... 12 AEROTRACH PLUS ........................................ 12 AFINITOR .................................................... 6, 23 AFINITOR DISPERZ TAB 2MG ....................... 23 AFINITOR DISPERZ TAB 3MG ....................... 23 AFINITOR DISPERZ TAB 5MG ....................... 23 AFLURIA ......................................................... 20

AFLURIA PRESERVATIVE FREE ................... 20 A-HYDROCORT .............................................. 16 AKTEN ............................................................. 15 ALBENZA .......................................................... 4 albumin, human ................................................. 8 ALBUSTIX ....................................................... 13 albuterol sulfate ................................................. 8 alclometasone dipropionate ............................. 21 ALDURAZYME ................................................ 14 ALECENSA ........................................................ 6 alendronate sodium ......................................... 18 alfentanil .......................................................... 10 ALIMTA ........................................................ 6, 23 ALIMTA SOLR 100 MG ................................... 23 ALINIA ............................................................... 5 ALKERAN .......................................................... 6 allopurinol ........................................................ 18 ALOCRIL ......................................................... 15 ALOE VERA .................................................... 19 ALPHANATE/VWF COMPLEX/HUMAN ............ 8 ALPHANINE SD ................................................ 8 alprazolam ....................................................... 11 alprostadil ........................................................ 10 ALPROSTADIL ................................................ 19 amantadine hcl ................................................ 11 AMBISOME ....................................................... 5 amifostine crystalline ........................................ 18 amikacin sulfate ................................................. 4 amiloride & hydrochlorothiazide ....................... 13 amino acid electrolyte infusion ......................... 13 amino acid infusion .......................................... 13 aminocaproic acid .............................................. 8 aminophylline ................................................... 22 amiodarone hcl .................................................. 9 AMITIZA........................................................... 16 amitriptyline hcl ................................................ 12 amlodipine besylate ........................................... 9 AMMONIUM CHLORIDE ................................. 13 AMOXAPINE ................................................... 12 amoxicillin .......................................................... 4 amoxicillin & pot clavulanate .............................. 4 amphetamine-dextroamphetamine .................. 11 AMPHOTERICIN B ............................................ 5 ampicillin ............................................................ 4 ampicillin & sulbactam sodium ........................... 4 ampicillin sodium ............................................... 4 AMPYRA TAB 10MG ....................................... 26 anagrelide hcl .................................................... 9 anastrozole ........................................................ 6 ANCOBON CAP 250MG .................................. 23 ANCOBON CAP 500MG .................................. 23 ANDRODERM ................................................. 16


ANDROID ........................................................ 16 ANDROXY ....................................................... 16 ANGIOMAX ....................................................... 9 ANTIVENIN LATRODECTUS MACTANS ........ 20 APOKYN .......................................................... 11 apraclonidine hcl .............................................. 15 APTIOM TAB 200MG ...................................... 24 APTIOM TAB 400MG ...................................... 24 APTIOM TAB 600MG ...................................... 24 APTIOM TAB 800MG ...................................... 24 APTIVUS ........................................................... 4 AQUAPHOR .................................................... 21 AQUASOL A .................................................... 22 ARALAST NP SOLR 500 MG .......................... 27 ARAVA TAB 10MG .......................................... 26 ARAVA TAB 20MG .......................................... 26 ARCALYST INJ 220MG ................................... 26 argatroban ......................................................... 9 aripiprazole ...................................................... 12 ARISTOSPAN INTRA-ARTICULAR ................. 16 ARRANON ......................................................... 6 ARZERRA CON 100/5ML ................................ 23 ascorbic acid .................................................... 22 ASMANEX 120 METERED DOSES ................ 16 ASPIRIN-DIPYRIDAMOLE ER .......................... 9 ASTAGRAF XL CAP 1MG ............................... 26 ASTAGRAF XL CAP 5MG ............................... 26 ASTAGRAF XL CP24 0.5 MG ......................... 26 atenolol .............................................................. 9 atenolol & chlorthalidone .................................... 9 ATGAM ............................................................ 18 atorvastatin calcium ........................................... 9 atovaquone ........................................................ 5 atovaquone-proguanil hcl ................................... 5 atracurium besylate ........................................... 8 ATRIPLA ............................................................ 4 atropine sulfate ............................................ 7, 16 atropine sulfate (ophthalmic) ............................ 16 ATROPINE SULFATE MONOHYDRATE ........ 19 ATROVENT HFA ............................................... 7 AUBAGIO TAB 14MG ...................................... 25 AUBAGIO TAB 7MG ........................................ 25 AVASTIN ........................................................... 6 AVELOX ............................................................ 4 AVONEX .......................................................... 12 azacitidine .......................................................... 6 AZACTAM IN DEXTROSE ................................ 4 azathioprine ..................................................... 18 azelastine hcl ................................................... 15 AZILECT .......................................................... 11 azithromycin ...................................................... 4 aztreonam .......................................................... 4

B bacitracin ..................................................... 4, 15

BACITRACIN ................................................... 15 bacitracin-polymyxin b (ophth) ......................... 15 baclofen ............................................................. 8 BACLOFEN ..................................................... 19 BACTERIOSTATIC WATER(BENZ ALC) ........ 19 BACTOCILL IN DEXTROSE .............................. 4 BAL IN OIL ....................................................... 16 balsalazide disodium ........................................ 16 BANZEL ........................................................... 11 BARACLUDE TAB 0.5MG ............................... 23 BARACLUDE TAB 1MG .................................. 23 BAYER BREEZE 2 CONTROL ........................ 12 b-complex w/ c & folic acid ............................... 22 BD INSULIN SYR ULTRAFINE II ..................... 12 BD LANCET DEVICE ...................................... 12 BD LANCET ULTRAFINE 33G ........................ 12 BD LUER-LOK SYRINGE ................................ 12 BD PEN NEEDLE MINI U/F ............................. 12 BD SAFETYGLIDE SYRINGE/NEEDLE .......... 12 BELEODAQ INJ 500MG .................................. 23 BELLADONNA ALKALOIDS-OPIUM ................. 7 benazepril hcl ................................................... 10 BENDEKA .......................................................... 6 BENEFIX ..................................................... 8, 24 BENEFIX SOLR ............................................... 24 BENLYSTA INJ 120MG ................................... 27 BENLYSTA INJ 400MG ................................... 27 BENZOIN ......................................................... 21 BENZOIN COMPOUND ................................... 21 benzonatate ..................................................... 20 benzoyl peroxide-erythromycin ........................ 21 benztropine mesylate ....................................... 11 BERINERT INJ 500UNIT ................................. 26 betamethasone dipropionate (topical) .............. 21 betamethasone dipropionate augmented ......... 21 betamethasone sod phosphate & acetate ........ 16 betamethasone valerate .................................. 21 BETASERON KIT 0.3 MG................................ 26 betaxolol hcl (ophth) ......................................... 15 bethanechol chloride .......................................... 8 BETHKIS NEB 300/4ML .................................. 23 BEXSERO ....................................................... 20 bicalutamide ....................................................... 6 BICILLIN L-A ...................................................... 4 BICNU ............................................................... 6 BILTRICIDE ....................................................... 4 BIOTIN-D ......................................................... 19 bisoprolol & hydrochlorothiazide ........................ 9 bisoprolol fumarate ............................................ 9 bleomycin sulfate ............................................... 6 BLINCYTO ......................................................... 6 BORIC ACID .................................................... 19 BOSULIF TAB 100MG ..................................... 23 BOSULIF TAB 500MG ..................................... 23 BOTOX ............................................................ 18


BOTOX COSMETIC ........................................ 18 BRAVELLE ...................................................... 17 BREVIBLOC IN NACL ....................................... 9 BREVITAL SODIUM ........................................ 12 BRIDION .......................................................... 18 BRILINTA .......................................................... 9 brimonidine tartrate .......................................... 15 BRIVIACT SOLN 10 MG/ML ............................ 25 BRIVIACT TABS .............................................. 25 bromocriptine mesylate .................................... 11 budesonide ...................................................... 16 budesonide (inhalation).................................... 16 bumetanide ...................................................... 13 BUPHENYL POW ............................................ 25 bupivacaine hcl ................................................ 18 bupivacaine in dextrose ................................... 18 bupivacaine w/ epinephrine ............................. 18 buprenorphine hcl ............................................ 10 buprenorphine hcl-naloxone hcl dihydrate ....... 10 bupropion hcl ................................................... 12 buspirone hcl ................................................... 11 BUSULFEX INJ 6MG/ML ................................. 23 BUTISOL SODIUM .......................................... 11 butorphanol tartrate ......................................... 10 BYDUREON .................................................... 17

C cabergoline ...................................................... 11 CABOMETYX TABS ........................................ 23 caffeine citrate ................................................. 11 calcipotriene .................................................... 21 calcitriol ............................................................ 22 calcium acetate (phosphate binder) ................. 14 calcium chloride (dihydrate) ............................. 14 calcium gluconate ............................................ 14 CAMPTOSAR .................................................... 6 CANCIDAS ........................................................ 5 CANTHARIDIN ................................................ 19 CAPASTAT SULFATE ....................................... 5 capecitabine ...................................................... 6 CAPRELSA ....................................................... 6 captopril ........................................................... 10 carbamazepine ................................................ 11 CARBAMAZEPINE .......................................... 19 carbidopa-levodopa ......................................... 11 CARBIDOPA-LEVODOPA-ENTACAPONE ..... 11 CARDENE IV ..................................................... 9 CARIMUNE NF ................................................ 20 carvedilol ........................................................... 9 CASCARA SAGRADA ..................................... 16 CAVERJECT ................................................... 10 CAYSTON ......................................................... 4 cefaclor .............................................................. 4 cefadroxil ........................................................... 4 cefazolin sodium ................................................ 4

CEFAZOLIN SODIUM-DEXTROSE ................... 4 cefdinir ............................................................... 4 cefepime hcl ....................................................... 4 CEFEPIME-DEXTROSE .................................... 4 cefotaxime sodium ............................................. 4 cefotetan disodium ............................................. 4 CEFOTETAN DISODIUM-DEXTROSE .............. 4 cefoxitin sodium ................................................. 4 CEFOXITIN SODIUM-DEXTROSE .................... 4 cefpodoxime proxetil .......................................... 4 ceftazidime ......................................................... 4 ceftriaxone sodium ............................................. 4 CEFTRIAXONE SODIUM IN DEXTROSE ......... 4 CEFTRIAXONE SODIUM-DEXTROSE ............. 4 cefuroxime axetil ................................................ 4 cefuroxime sodium ............................................. 4 CEFUROXIME SODIUM-DEXTROSE ............... 4 CELONTIN ....................................................... 11 cephalexin .......................................................... 4 CERDELGA ..................................................... 18 CEREZYME ............................................... 14, 25 CEREZYME INJ 200UNIT ............................... 25 CERVIDIL ........................................................ 18 CHANTIX ........................................................... 8 CHEMET.......................................................... 16 CHEMSTRIP 9 ................................................. 13 CHIRHOSTIM .................................................. 13 CHLORAMPHENICOL SOD SUCCINATE ........ 4 chlordiazepoxide hcl .................................... 7, 11 chlordiazepoxide hcl-clidinium bromide .............. 7 chlorhexidine gluconate (mouth-throat) ............ 15 CHLOROFORM ............................................... 19 chloroprocaine hcl ............................................ 18 chloroquine phosphate ....................................... 5 chlorpheniramine & phenylephrine ..................... 6 chlorpromazine hcl ........................................... 12 CHLORPROMAZINE HCL ............................... 19 chlorthalidone .................................................. 13 CHOLESTEROL ACETATE ............................. 19 cholestyramine ................................................... 9 cholestyramine light ........................................... 9 choline & mag salicylate .................................. 10 chorionic gonadotropin ..................................... 17 CHROMIC CHLORIDE .................................... 14 cidofovir ............................................................. 6 cimetidine hcl ................................................... 16 CIMZIA KIT ...................................................... 26 CIMZIA KIT 200MG/ML ................................... 26 CINQAIR SOLN 100 MG/10ML ........................ 27 CINRYZE ......................................................... 18 CIPRODEX ...................................................... 15 ciprofloxacin ................................................. 4, 15 ciprofloxacin hcl ........................................... 4, 15 ciprofloxacin hcl (ophth) ................................... 15 ciprofloxacin in d5w ............................................ 4


cisatracurium besylate ....................................... 8 cisplatin .............................................................. 6 citalopram hydrobromide ................................. 12 cladribine ........................................................... 6 clarithromycin..................................................... 4 CLEOCIN IN D5W ............................................. 4 CLEVIPREX ...................................................... 9 clindamycin hcl .................................................. 4 CLINDAMYCIN HCL ........................................ 19 clindamycin palmitate hydrochloride .................. 4 clindamycin phosphate ................................ 4, 21 clindamycin phosphate (topical) ....................... 21 clindamycin phosphate vaginal ........................ 21 clindamycin phosphate-benzoyl peroxide ........ 21 clindamycin phosphate-benzoyl peroxide

(refrigerate) ................................................... 21 CLINIMIX E/DEXTROSE (2.75/10) .................. 13 CLINIMIX E/DEXTROSE (2.75/5) .................... 13 CLINIMIX E/DEXTROSE (4.25/25) .................. 13 CLINIMIX E/DEXTROSE (5/15) ....................... 13 CLINIMIX E/DEXTROSE (5/20) ....................... 13 CLINIMIX/DEXTROSE (2.75/5) ....................... 13 CLINIMIX/DEXTROSE (4.25/10) ..................... 13 CLINIMIX/DEXTROSE (4.25/20) ..................... 13 CLINIMIX/DEXTROSE (4.25/25) ..................... 13 CLINIMIX/DEXTROSE (5/15) .......................... 13 CLINITEST ...................................................... 13 clobetasol propionate ....................................... 21 CLOBETASOL PROPIONATE ........................ 19 clomiphene citrate ............................................ 17 clomipramine hcl .............................................. 12 clonazepam ..................................................... 11 clonidine hcl ..................................................... 10 CLONIDINE HCL ............................................. 19 clopidogrel bisulfate ........................................... 9 clorazepate dipotassium .................................. 11 clotrimazole ..................................................... 21 CLOTRIMAZOLE ............................................. 19 clozapine ......................................................... 12 COAL TAR ....................................................... 19 COARTEM ......................................................... 5 COCAINE HCL ................................................ 15 CODEINE SULFATE ....................................... 10 COLCHICINE................................................... 18 colchicine w/ probenecid .................................. 14 colestipol hcl ...................................................... 9 COLLODION FLEXIBLE .................................. 19 COLY-MYCIN S ............................................... 15 COMBIVENT ............................................... 8, 20 COMBIVENT RESPIMAT ................................ 20 COMETRIQ (100 MG DAILY DOSE) ................. 6 COMPLERA ...................................................... 4 CONRAY ......................................................... 13 COPAXONE INJ 40MG/ML ............................. 25 COPPER CHLORIDE ...................................... 14

COPPER SULFATE ......................................... 14 CORDRAN ....................................................... 21 CORTISONE ACETATE .................................. 16 CORTISPORIN ................................................ 21 CORTROSYN .................................................. 13 COSENTYX ..................................................... 21 COSMEGEN ................................................ 6, 23 COSMEGEN INJ 0.5MG .................................. 23 COTELLIC ......................................................... 6 CREON ...................................................... 13, 16 CRESEMBA CAPS 186 MG ............................ 23 CRESEMBA SOLR 372 MG ............................ 23 CRESTOR ......................................................... 9 CRIXIVAN .......................................................... 4 CROFAB .......................................................... 20 CROMOLYN SODIUM ..................................... 20 cromolyn sodium (mastocytosis) ...................... 20 cromolyn sodium (ophth) ................................. 15 CUBICIN ............................................................ 4 CUPRIMINE CAPS 250 MG ............................ 25 CUROSURF .................................................... 20 cyanocobalamin ............................................... 22 cyclobenzaprine hcl ........................................... 8 CYCLOMYDRIL ............................................... 16 cyclopentolate hcl ............................................ 16 cyclophosphamide ............................................. 6 CYCLOSERINE ................................................. 5 cyclosporine modified (for microemulsion) ....... 18 CYKLOKAPRON 100 MG/ML AMPUL ............. 24 cyproheptadine hcl ............................................. 6 CYRAMZA ......................................................... 6 CYSTADANE ................................................... 18 CYSTAGON ..................................................... 18 CYSTEAMINE HCL ......................................... 19 CYSTOGRAFIN ............................................... 13 cytarabine .......................................................... 6 CYTOGAM ....................................................... 20

D dacarbazine ....................................................... 6 DACOGEN ......................................................... 6 DAKLINZA ................................................... 6, 23 DAKLINZA TABS 90 MG ................................. 23 DALVANCE SOL 500MG ................................. 23 danazol ............................................................ 16 dantrolene sodium ............................................. 8 dapsone ............................................................. 5 DARAPRIM ........................................................ 5 DARZALEX SOLN 100 MG/5ML ...................... 23 DARZALEX SOLN 400 MG/20ML .................... 23 daunorubicin hcl ................................................. 6 DAUNOXOME ................................................... 6 deferoxamine mesylate .................................... 16 demeclocycline hcl ............................................. 5 DEPEN TITRATABS ........................................ 16


DEPOCYT ......................................................... 6 DEPO-ESTRADIOL ......................................... 17 DEPO-PROVERA ............................................ 17 DESCOVY ......................................................... 6 desipramine hcl ................................................ 12 DESITIN .......................................................... 21 desmopressin acetate ...................................... 17 desmopressin acetate refrigerated ................... 17 desmopressin acetate spray ............................ 17 desmopressin acetate spray refrigerated ......... 17 desogestrel & ethinyl estradiol ......................... 17 desoximetasone ............................................... 21 dexamethasone ............................................... 16 DEXAMETHASONE .................................. 15, 19 dexamethasone sodium phosphate ................. 16 DEXAMETHASONE SODIUM PHOSPHATE .. 15 dexmethylphenidate hcl ................................... 11 dexrazoxane .................................................... 18 dextroamphetamine sulfate .............................. 11 dextrose ..................................................... 13, 14 DEXTROSE 5%/ELECTROLYTE #48 ............. 14 dextrose in lactated ringers .............................. 14 dextrose in ringers ........................................... 14 dextrose w/ sodium chloride ............................ 14 DIANEAL LOW CALCIUM/4.25% DEX ............ 14 DIASTAT ACUDIAL ......................................... 11 DIASTIX ........................................................... 13 diazepam ......................................................... 11 diclofenac sodium (ophth) ................................ 15 diclofenac sodium (topical) .............................. 21 dicloxacillin sodium ............................................ 5 dicyclomine hcl .................................................. 7 didanosine ......................................................... 4 DIFFERIN ........................................................ 21 DIFICID TAB 200MG ....................................... 23 DIGIFAB .......................................................... 20 digoxin ............................................................... 9 dihydroergotamine mesylate .............................. 8 diltiazem hcl ....................................................... 9 DILTIAZEM HCL .............................................. 19 diltiazem hcl coated beads ................................. 9 DIPENTUM CAP 250MG ................................. 25 diphenhydramine hcl .......................................... 6 diphenoxylate w/ atropine ................................ 16 DIPHENYLCYCLOPROPENONE .................... 19 DIPHTHERIA-TETANUS TOXOIDS DT .......... 20 dipyridamole .................................................... 10 dipyridamole (diagnostic) ................................. 10 disopyramide phosphate .................................... 9 DISPOSABLE POWER.................................... 12 disulfiram ......................................................... 18 divalproex sodium ............................................ 11 dobutamine hcl .................................................. 8 dobutamine in d5w ............................................. 8 DOCETAXEL ............................................... 6, 23

DOCETAXEL (NON-ALCOHOL) SOLN ........... 23 donepezil hydrochloride ..................................... 8 DONNATAL ....................................................... 7 dopamine hcl ..................................................... 8 dopamine in d5w ................................................ 8 dorzolamide hcl ................................................ 15 dorzolamide hcl-timolol maleate ....................... 15 doxazosin mesylate ........................................... 9 doxepin hcl ....................................................... 12 doxorubicin hcl ................................................... 6 doxorubicin hcl liposomal ................................... 6 doxycycline (monohydrate) ................................ 5 doxycycline hyclate ............................................ 5 DRITHO-CREME HP ....................................... 22 dronabinol ........................................................ 16 droperidol ......................................................... 11 drospirenone-ethinyl estradiol .......................... 17 DRYSOL .......................................................... 21 DULERA .......................................................... 20 duloxetine hcl ................................................... 12 D-XYLOSE ....................................................... 13 DYRENIUM ...................................................... 13

E EDECRIN ......................................................... 13 EDURANT ......................................................... 4 EFFIENT ............................................................ 9 EGRIFTA INJ 1MG .......................................... 26 EGRIFTA SOL 2MG ........................................ 26 ELAPRASE ...................................................... 14 ELELYSO INJ 200UNIT ................................... 25 ELIDEL ............................................................ 22 ELITEK ............................................................ 14 ELLA ................................................................ 17 ELMIRON ........................................................ 18 ELOXATIN INJ 100MG .................................... 23 ELOXATIN INJ 200MG .................................... 23 ELOXATIN INJ 50MG ...................................... 23 ELTA TAR ........................................................ 21 EMCYT .............................................................. 6 EMEND ............................................................ 16 EMPLICITI SOLR 300 MG ............................... 23 EMPLICITI SOLR 400 MG ............................... 23 EMTRIVA ........................................................... 4 enalaprilat ........................................................ 10 ENBREL .......................................................... 18 ENDOMETRIN ................................................. 17 ENGERIX-B ..................................................... 20 ENLON .............................................................. 8 entacapone ...................................................... 11 entecavir ............................................................ 6 ENTOCORT EC CAP 3MG/24HR .................... 26 ENTRESTO ..................................................... 10 ENTYVIO INJ 300MG ...................................... 25 EOVIST............................................................ 13


EPCLUSA .......................................................... 6 ephedrine sulfate (pressors) .............................. 8 EPIDUO ........................................................... 22 EPINEPHRINE .................................................. 8 epinephrine hcl .................................................. 8 EPZICOM .......................................................... 4 EQUETRO ....................................................... 11 ERBITUX ........................................................... 6 ergocalciferol ................................................... 22 ERGOLOID MESYLATES ............................... 11 ERGOMAR ........................................................ 8 ergotamine w/ caffeine ..................................... 11 ERIVEDGE ........................................................ 6 ERWINAZE ........................................................ 6 ERYTHROCIN LACTOBIONATE....................... 5 erythromycin (acne aid) ................................... 21 erythromycin (ophth) ........................................ 15 ESBRIET CAP 267MG .................................... 27 escitalopram oxalate ........................................ 12 esmolol hcl ......................................................... 9 esterified estrogens & methyltestosterone ....... 17 ESTRACE ........................................................ 17 estradiol ........................................................... 17 ESTRADIOL .................................................... 19 estradiol valerate ............................................. 17 ethambutol hcl ................................................... 5 ETHAMOLIN .................................................... 10 ethosuximide ................................................... 11 ethynodiol diacet & eth estrad .......................... 17 ETIDRONATE DISODIUM ............................... 18 etodolac ........................................................... 10 etomidate ......................................................... 12 etoposide ........................................................... 6 EVOMELA SOLR 50 MG ................................ 23 exemestane ....................................................... 6 EXJADE ........................................................... 16 EXONDYS 51 SOLN ....................................... 26 EXTAVIA ......................................................... 12 EYLEA ............................................................. 15 E-Z-CAT DRY .................................................. 13

F FABRAZYME ................................................... 14 famciclovir .......................................................... 6 famotidine ........................................................ 16 FAMOTIDINE PREMIXED ............................... 16 FARESTON 60 MG TABLET ........................... 23 FARYDAK CAP 10MG ..................................... 23 FARYDAK CAP 15MG ..................................... 23 FARYDAK CAP 20MG ..................................... 23 FASLODEX ....................................................... 6 fat emulsion ..................................................... 13 felbamate ......................................................... 11 FELBATOL SUS 600/5ML ............................... 25 FELBATOL TAB 400MG .................................. 25

FELBATOL TAB 600MG .................................. 25 fenofibrate .......................................................... 9 fentanyl ............................................................ 10 fentanyl citrate ................................................. 10 FERRIPROX SOLN 100 MG/ML ...................... 26 FERRIPROX TAB 500MG ............................... 26 finasteride ........................................................ 18 FIRAZYR ......................................................... 18 flecainide acetate ............................................... 9 FLOVENT HFA ................................................ 16 FLUARIX QUADRIVALENT ............................. 20 FLUBLOK ........................................................ 20 FLUCELVAX .................................................... 20 fluconazole ......................................................... 5 fluconazole in dextrose ...................................... 5 fluconazole in nacl ............................................. 5 FLUCONAZOLE IN SODIUM CHLORIDE ......... 5 flucytosine .......................................................... 5 fludarabine phosphate ....................................... 6 fludrocortisone acetate ..................................... 16 flumazenil ......................................................... 12 FLUMIST QUADRIVALENT ............................. 20 flunisolide (nasal) ............................................. 15 fluocinolone acetonide ..................................... 21 fluocinonide ...................................................... 21 FLUOR-A-DAY ................................................ 18 fluorescein sodium injection ............................. 13 fluorescein sodium topical ................................ 13 fluorescein w/ benoxinate ................................ 13 fluorometholone (ophth) ................................... 15 fluorouracil ................................................... 6, 22 fluorouracil (topical) .......................................... 22 fluoxetine hcl .................................................... 12 fluphenazine decanoate ................................... 12 fluphenazine hcl ............................................... 12 flurbiprofen sodium .......................................... 15 flutamide ............................................................ 6 fluticasone propionate ................................ 15, 21 fluticasone propionate (nasal) .......................... 15 FLUVIRIN ........................................................ 20 FLUVIRIN PRESERVATIVE FREE .................. 20 fluvoxamine maleate ........................................ 12 FLUZONE HIGH-DOSE ................................... 20 FOLIC ACID ..................................................... 22 FORANE .......................................................... 12 FORTAZ IN D5W ............................................... 5 FORTEO .......................................................... 17 FORTICAL ....................................................... 17 FOSCAVIR ........................................................ 6 fosphenytoin sodium ........................................ 11 FOSRENOL CHW 1000MG ............................. 25 FOSRENOL CHW 500MG ............................... 25 FOSRENOL CHW 750MG ............................... 25 FOSRENOL PACK 1000 MG ........................... 25 FOSRENOL PACK 750 MG ............................. 25


furosemide ....................................................... 13 FUSILEV .......................................................... 18 FUZEON ............................................................ 4

G gabapentin ....................................................... 11 GABAPENTIN.................................................. 19 GADAVIST ...................................................... 13 galantamine hydrobromide ................................ 8 GAMASTAN S/D .............................................. 20 GAMMAGARD ................................................. 20 ganciclovir sodium ............................................. 6 GARDASIL ...................................................... 20 GARDASIL 9 ................................................... 20 GASTROCROM 100 MG/5 ML CONC ............. 27 GASTROGRAFIN ............................................ 13 GATTEX KIT 5MG ........................................... 25 GAZYVA ............................................................ 6 GELFILM ........................................................... 8 GELFOAM SPONGE ......................................... 8 gemcitabine hcl .................................................. 6 gemfibrozil ......................................................... 9 GENOTROPIN INJ 12MG ................................ 26 GENOTROPIN INJ 5MG .................................. 26 GENOTROPIN MINIQUICK INJ 0.2MG ........... 26 GENOTROPIN MINIQUICK INJ 0.4MG ........... 26 GENOTROPIN MINIQUICK INJ 0.6MG ........... 26 GENOTROPIN MINIQUICK INJ 0.8MG ........... 26 GENOTROPIN MINIQUICK INJ 1.2MG ........... 26 GENOTROPIN MINIQUICK INJ 1.4MG ........... 26 GENOTROPIN MINIQUICK INJ 1.6MG ........... 26 GENOTROPIN MINIQUICK INJ 1.8MG ........... 26 GENOTROPIN MINIQUICK INJ 1MG .............. 26 GENOTROPIN MINIQUICK INJ 2MG .............. 26 gentamicin in saline ........................................... 5 gentamicin sulfate ........................................ 5, 15 GENTAMICIN SULFATE ................................. 21 gentamicin sulfate (ophth) ................................ 15 GENVOYA ......................................................... 6 GILENYA CAP 0.5MG ..................................... 25 GILOTRIF TAB 20MG ..................................... 23 GILOTRIF TAB 30MG ..................................... 23 GILOTRIF TAB 40MG ..................................... 23 GLASSIA INJ ................................................... 27 glatiramer acetate ............................................ 12 GLEEVEC .......................................................... 7 GLEOSTINE ...................................................... 7 glimepiride ....................................................... 17 glipizide ............................................................ 17 glipizide-metformin hcl ..................................... 17 GLUCAGEN DIAGNOSTIC ............................. 17 GLUCAGEN HYPOKIT .................................... 17 GLUCAGON EMERGENCY ............................ 17 glyburide .......................................................... 17 GLYCERIN ...................................................... 19

glycopyrrolate .................................................... 7 GLYCOPYRROLATE ....................................... 19 GRANIX INJ 300/0.5 ........................................ 24 GRANIX INJ 480/0.8 ........................................ 24 GRASTEK ........................................................ 18 griseofulvin microsize ......................................... 5 griseofulvin ultramicrosize .................................. 5 guaifenesin-codeine ......................................... 20 guanfacine hcl .................................................... 8 GUANIDINE HCL ............................................... 8

H HALAVEN .......................................................... 7 halobetasol propionate ..................................... 21 haloperidol ....................................................... 12 HALOPERIDOL ............................................... 19 haloperidol decanoate ...................................... 12 haloperidol lactate ............................................ 12 HARVONI .......................................................... 5 HAVRIX ........................................................... 20 HEALON5 ........................................................ 15 HEMABATE ..................................................... 18 HEMOFIL M ....................................................... 8 heparin (porcine) in sodium chloride .................. 9 heparin sod (porcine) in d5w .............................. 9 heparin sodium (porcine) ................................... 9 heparin sodium (porcine) lock flush ................... 9 HEPSERA TAB 10MG ..................................... 23 HERCEPTIN ...................................................... 7 hetastarch in sodium chloride .......................... 14 HETLIOZ CAP 20MG ....................................... 25 HEXALEN .......................................................... 7 HEXTEND ........................................................ 14 HIZENTRA ....................................................... 20 homatropine hbr ............................................... 16 HP ACTHAR .................................................... 17 HUMALOG ....................................................... 17 HUMALOG MIX 50/50 ..................................... 17 HUMATROPE COMBO PACK INJ 5MG .......... 26 HUMATROPE INJ 12MG ................................. 26 HUMATROPE INJ 24MG ................................. 26 HUMATROPE INJ 6MG ................................... 26 HUMIRA..................................................... 18, 26 HUMIRA KIT 10MG/0.2 ................................... 26 HUMIRA KIT 20MG/0.4 ................................... 26 HUMULIN 70/30 .............................................. 17 HUMULIN N ..................................................... 17 HUMULIN R ..................................................... 17 HYCAMTIN 4 MG VIAL .................................... 23 HYCAMTIN CAP 0.25MG ................................ 23 HYCAMTIN CAP 1MG ..................................... 23 hydralazine hcl ................................................. 10 hydrochlorothiazide .......................................... 13 hydrocodone w/ homatropine ........................... 20 hydrocodone-acetaminophen........................... 10


hydrocortisone ........................................... 16, 21 HYDROCORTISONE ...................................... 19 hydrocortisone (intrarectal) .............................. 21 hydrocortisone (rectal) ..................................... 21 hydrocortisone (topical).................................... 21 hydrocortisone acetate (rectal) ........................ 21 hydrocortisone acetate w/ pramoxine .............. 21 hydromorphone hcl .......................................... 10 HYDROPHILIC ................................................ 19 HYDROXOCOBALAMIN .................................. 19 hydroxychloroquine sulfate ................................ 5 HYDROXYPROGESTERONE CAPROATE .... 19 hydroxyurea ....................................................... 7 hydroxyzine hcl ................................................ 11 hydroxyzine pamoate ....................................... 11 HYLENEX ........................................................ 14 hyoscyamine sulfate .......................................... 7 HYPERLYTE-CR ............................................. 14 HYPERRAB S/D .............................................. 20 HYPERRHO S/D ............................................. 20 HYPERTET S/D ............................................... 20 HYQVIA KIT 10 GM/100ML ............................. 27 HYQVIA KIT 2.5 GM/25ML .............................. 27 HYQVIA KIT 20 GM/200ML ............................. 27 HYQVIA KIT 30 GM/300ML ............................. 27 HYQVIA KIT 5 GM/50ML ................................. 27

I IBRANCE ........................................................... 7 ibuprofen .......................................................... 10 ibutilide fumarate ............................................... 9 ICLUSIG TAB 15MG ........................................ 23 ICLUSIG TAB 45MG ........................................ 23 idarubicin hcl ...................................................... 7 ifosfamide .......................................................... 7 IFOSFAMIDE-MESNA ....................................... 7 ILARIS INJ 180MG .......................................... 24 ILUVIEN 0.19MG IMPLANT ............................. 25 IMBRUVICA ....................................................... 7 imipramine hcl.................................................. 12 imiquimod ........................................................ 22 IMLYGIC SUSP 1000000 UNIT/ML ................. 23 IMLYGIC SUSP 100000000 UNIT/ML ............. 23 IMOVAX RABIES ............................................. 20 IMPAVIDO CAPS 50 MG ................................. 23 INCRELEX INJ 40MG/4ML .............................. 26 indapamide ...................................................... 13 INDIGO CARMINE .......................................... 13 indomethacin ................................................... 10 INDOMETHACIN ....................................... 10, 19 INDOMETHACIN SODIUM .............................. 10 INFANRIX ........................................................ 20 INFED ................................................................ 8 INFERGEN ........................................................ 5 INFUMORPH 200 ............................................ 10

INFUVITE ........................................................ 22 INFUVITE PEDIATRIC .................................... 22 INLYTA TAB 1MG............................................ 23 INLYTA TAB 5MG............................................ 24 INTEGRILIN ....................................................... 9 INTELENCE ....................................................... 4 INTRON A .......................................................... 7 INTRON-A KIT 10MU/ML............................. 24 INTRON-A INJ 10MU PEN .............................. 24 INTRON-A INJ 3MU PEN ................................ 24 INTRON-A INJ 5MU PEN ................................ 24 INVANZ.............................................................. 5 INVEGA SUSTENNA INJ 117/0.75 .................. 25 INVEGA SUSTENNA INJ 234/1.5 .................... 25 INVEGA SUSTENNA INJ 39/0.25 .................... 25 INVEGA SUSTENNA INJ 78/0.5ML ................. 25 INVEGA TB24 1.5 MG ..................................... 25 INVEGA TB24 3 MG ........................................ 25 INVEGA TB24 6 MG ........................................ 25 INVEGA TB24 9 MG ........................................ 25 INVIRASE .......................................................... 4 iodoquinol-hc ................................................... 21 IPOL ................................................................ 20 ipratropium bromide ....................................... 7, 8 ipratropium bromide (nasal) ............................... 8 IRESSA ............................................................. 7 ISENTRESS ...................................................... 4 isometheptene-dichloralphenazone-

acetaminophen ............................................. 11 isoniazid ............................................................. 5 isoproterenol hcl ................................................ 8 ISOSORBIDE .................................................. 19 isosorbide dinitrate ........................................... 10 isosorbide mononitrate ..................................... 10 isotretinoin ....................................................... 22 ISTODAX ........................................................... 7 itraconazole ....................................................... 5 ivermectin .......................................................... 4 IXEMPRA KIT .................................................... 7 IXIARO ............................................................ 20 IXINITY SOLR ................................................. 24

J JAKAFI .............................................................. 7 JARDIANCE .................................................... 17 JETREA ........................................................... 15 JEVTANA ........................................................... 7 JUXTAPID CAP 10MG .................................... 24 JUXTAPID CAP 20MG .................................... 24 JUXTAPID CAP 30MG .................................... 24 JUXTAPID CAP 40MG .................................... 24 JUXTAPID CAP 5MG ...................................... 24 JUXTAPID CAP 60MG .................................... 24


K KADCYLA .......................................................... 7 KALETRA .......................................................... 4 KALYDECO ..................................................... 18 KANUMA SOLN 20 MG/10ML ......................... 25 KCENTRA ......................................................... 8 KCL-LACTATED RINGERS-D5W .................... 14 KENALOG ....................................................... 16 KEPIVANCE .................................................... 21 KERALYT ........................................................ 21 ketamine hcl .................................................... 12 KETAMINE HCL .............................................. 19 ketoconazole ............................................... 5, 21 ketoconazole (topical) ...................................... 21 KETO-DIASTIX ................................................ 13 KETOPROFEN ................................................ 19 ketorolac tromethamine ............................. 10, 15 ketorolac tromethamine (ophth) ....................... 15 KEYTRUDA ....................................................... 7 KINERET ......................................................... 18 KINRIX ............................................................. 20 KITABIS PAK NEB 300/5ML ............................ 23 KOGENATE FS ................................................. 8 KORLYM TAB 300MG ..................................... 26 K-PHOS ........................................................... 14 KUVAN POWDER ........................................... 26 KUVAN TAB 100MG ........................................ 26 KYNAMRO INJ 200MG/ML .............................. 24 KYPROLIS ................................................... 7, 24 KYPROLIS 30 MG VIAL .................................. 24

L labetalol hcl ........................................................ 9 LACRISERT .................................................... 15 lactated ringer's ............................................... 14 lactated ringer's (irrigation) .............................. 14 LACTIC ACID .................................................. 19 LACTOSE ........................................................ 19 LACTOSE MONOHYDRATE ........................... 19 lactulose .......................................................... 13 lactulose (encephalopathy) .............................. 13 lamivudine ..................................................... 4, 6 lamivudine (hbv) ................................................ 6 lamivudine-zidovudine ....................................... 4 lamotrigine ....................................................... 11 LANTUS .......................................................... 17 L-ARGININE .................................................... 19 LARTRUVO SOLN 500 MG/50ML ................... 24 latanoprost ....................................................... 15 L-CITRULLINE ................................................. 19 leflunomide ...................................................... 18 LEMTRADA SOLN 12 MG/1.2ML .................... 27 LENVIMA ..................................................... 7, 24 LENVIMA 10 MG DAILY DOSE ......................... 7

LENVIMA PACK 10 & 4 (2) MG (18 MG DAILY DOSE) .......................................................... 24

LENVIMA PACK 4 (2) MG (8 MG DAILY DOSE) ..................................................................... 24

LETAIRIS ......................................................... 10 letrozole ............................................................. 7 leucovorin calcium ........................................... 18 LEUKERAN ....................................................... 7 LEUKINE ..................................................... 9, 24 LEUKINE 500 MCG/ML VIAL ........................... 24 leuprolide acetate .............................................. 7 levetiracetam ................................................... 11 LEVETIRACETAM IN NACL ............................ 11 LEVITRA .......................................................... 10 levobunolol hcl ................................................. 15 levocarnitine (metabolic modifiers) ................... 18 levofloxacin ........................................................ 5 levofloxacin in d5w ............................................. 5 levonorgestrel & eth estradiol ..................... 12, 17 levonorgestrel (emergency oc) ......................... 17 levonorgestrel-eth estradiol (triphasic) ............. 17 levothyroxine sodium ....................................... 18 LEVULAN KERASTICK ................................... 22 LEXISCAN ....................................................... 13 LEXIVA .............................................................. 4 lidocaine........................................... 9, 15, 18, 21 lidocaine hcl ..................................... 9, 15, 18, 21 LIDOCAINE HCL ............................................. 19 lidocaine hcl (cardiac) .................................. 9, 18 lidocaine hcl (local anesth.) .............................. 18 lidocaine hcl (mouth-throat).............................. 15 lidocaine in d5w ................................................. 9 lidocaine w/ epinephrine .................................. 18 lidocaine-prilocaine .......................................... 21 linezolid .............................................................. 5 LINEZOLID SOLN 2MG/ML ............................. 23 liothyronine sodium .......................................... 18 lisinopril ............................................................ 10 lisinopril & hydrochlorothiazide ......................... 10 L-ISOLEUCINE ................................................ 19 LITHIUM .......................................................... 11 lithium carbonate ............................................. 11 LITHOSTAT ..................................................... 13 LMD IN D5W .................................................... 14 LMD IN NACL .................................................. 14 LODOSYN ....................................................... 11 LONSURF .......................................................... 7 lorazepam ........................................................ 11 losartan potassium ........................................... 10 losartan potassium & hydrochlorothiazide ........ 10 LOTRONEX TAB 0.5MG ................................. 25 LOTRONEX TAB 1MG .................................... 25 lovastatin............................................................ 9 LOVENOX ......................................................... 9 loxapine succinate ........................................... 12


L-PROLINE ...................................................... 19 LUCENTIS ....................................................... 15 LUMASON ....................................................... 13 LUMIGAN ........................................................ 15 LUPRON DEPOT .............................................. 7 LUPRON DEPOT-PED ...................................... 7 L-VALINE ......................................................... 19 LYNPARZA ........................................................ 7 LYSODREN ....................................................... 7

M M.T.E.-5 CONCENTRATE ............................... 14 MACUGEN ...................................................... 15 magnesium sulfate ........................................... 11 MAGNESIUM SULFATE IN D5W .................... 14 MAGNEVIST.................................................... 13 MAKENA ................................................... 18, 26 MAKENA INJ 250MG/ML ................................. 26 malathion ......................................................... 21 MANGANESE CHLORIDE .............................. 14 mannitol ........................................................... 13 MAPROTILINE HCL ........................................ 12 MARQIBO .......................................................... 7 MATULANE ....................................................... 7 meclizine hcl .................................................... 16 MECLOFENAMATE SODIUM ......................... 10 medroxyprogesterone acetate ......................... 17 medroxyprogesterone acetate (contraceptive) . 17 mefenamic acid ................................................ 10 mefloquine hcl.................................................... 6 megestrol acetate .............................................. 7 MEKINIST .......................................................... 7 meloxicam ....................................................... 10 melphalan hcl..................................................... 7 memantine hcl ................................................. 12 MENOMUNE ................................................... 20 MENOPUR ...................................................... 17 MENVEO ......................................................... 20 meperidine hcl ................................................. 10 mepivacaine hcl ............................................... 18 MEPRON SUS ................................................. 23 mercaptopurine .................................................. 7 meropenem ....................................................... 5 mesalamine ..................................................... 16 mesna .............................................................. 18 METAPROTERENOL SULFATE ....................... 8 metformin hcl ................................................... 17 methadone hcl ................................................. 10 METHADONE HCL .......................................... 19 methazolamide ................................................ 15 methenamine hippurate ..................................... 6 methimazole .................................................... 18 methocarbamol .................................................. 8 methotrexate sodium ......................................... 7 methoxsalen rapid ........................................... 21

methyldopa ...................................................... 10 METHYLDOPATE HCL ................................... 10 methylene blue (antidote) ................................ 18 methylergonovine maleate ............................... 18 methylphenidate hcl ......................................... 11 methylprednisolone .......................................... 16 methylprednisolone acetate ............................. 16 methylprednisolone sod succ ........................... 16 metoclopramide hcl .......................................... 16 METOCLOPRAMIDE HCL MONOHYDRATE .. 19 metolazone ...................................................... 14 METOPIRONE ................................................. 13 metoprolol & hydrochlorothiazide ....................... 9 metoprolol succinate .......................................... 9 metoprolol tartrate .............................................. 9 metronidazole .............................................. 6, 21 METRONIDAZOLE .......................................... 19 metronidazole (topical) ..................................... 21 metronidazole in nacl ......................................... 6 metronidazole vaginal ...................................... 21 mexiletine hcl ..................................................... 9 midazolam hcl .................................................. 11 midodrine hcl ..................................................... 8 MIFEPREX ...................................................... 19 milrinone in dextrose .......................................... 9 milrinone lactate ............................................... 10 minocycline hcl .................................................. 5 minoxidil ........................................................... 10 MIOCHOL-E .................................................... 15 MIOSTAT ......................................................... 15 MIRENA (52 MG) ............................................. 17 mirtazapine ...................................................... 12 misoprostol ...................................................... 16 mitomycin ........................................................... 7 MITOSOL ......................................................... 15 mitoxantrone hcl ................................................ 7 M-M-R II ........................................................... 20 mometasone furoate ........................................ 21 montelukast sodium ......................................... 20 morphine sulfate .............................................. 10 MORPHINE SULFATE .................................... 19 moxifloxacin hcl ................................................. 5 MOZOBIL 20 MG/ML VIAL .............................. 24 MULTIHANCE ................................................. 13 mupirocin ......................................................... 21 MUSTARGEN .................................................... 7 MYALEPT INJ 11.3MG .................................... 27 MYCAMINE INJ 100MG .................................. 23 MYCAMINE INJ 50MG .................................... 23 MYCOBUTIN CAP 150MG .............................. 23 mycophenolate mofetil ..................................... 18 MYLERAN ......................................................... 7 MYOBLOC ....................................................... 18 MYOZYME ....................................................... 14


N NABI-HB .......................................................... 20 nabumetone ..................................................... 10 nadolol ............................................................... 9 nafcillin sodium .................................................. 5 NAFCILLIN SODIUM IN DEXTROSE ................ 5 NAGLAZYME................................................... 14 nalbuphine hcl.................................................. 10 naloxone hcl .................................................... 12 naltrexone hcl .................................................. 12 NAPHAZOLINE HCL ....................................... 16 naproxen .......................................................... 10 naproxen sodium ............................................. 10 naratriptan hcl .................................................. 11 NAROPIN ........................................................ 18 NATPARA CART 100 MCG ............................. 26 NATPARA CART 25 MCG ............................... 26 NATPARA CART 50 MCG ............................... 26 NATPARA CART 75 MCG ............................... 26 NEBUPENT ....................................................... 6 NECON 1/50 (28) ............................................ 17 NECON 10/11 (28) .......................................... 17 nefazodone hcl ................................................ 12 NEMBUTAL ..................................................... 11 neomycin sulfate ................................................ 5 NEOMYCIN SULFATE .................................... 19 neomycin/polymyxin b gu ................................. 21 neomycin-bacitracin zn-polymyxin ................... 15 neomycin-polymy-dexameth ............................ 15 neomycin-polymyxin-gramicidin ....................... 15 neomycin-polymyxin-hc (otic) .......................... 15 NEOPROFEN .................................................. 10 neostigmine methylsulfate ................................. 8 NEULASTA INJ 6MG/0.6M .............................. 24 NEUMEGA ........................................................ 9 NEUPOGEN ...................................................... 9 nevirapine .......................................................... 4 NEXAVAR ......................................................... 7 NEXPLANON................................................... 17 niacin ............................................................... 22 nicardipine hcl .................................................... 9 nicotine .............................................................. 8 nicotine polacrilex .............................................. 8 nifedipine ........................................................... 9 nimodipine ......................................................... 9 NINLARO ........................................................... 7 NIPENT INJ 10MG .......................................... 24 nitrofurantoin ...................................................... 6 nitrofurantoin macrocrystal ................................. 6 nitrofurantoin monohyd macro ........................... 6 nitroglycerin ..................................................... 10 nitroglycerin in d5w .......................................... 10 NITROPRESS ................................................. 10 NORDITROPIN FLEXPRO ........................ 18, 26 NORDITROPIN FLEXPRO INJ 10/1.5ML ........ 26

NORDITROPIN FLEXPRO INJ 5/1.5ML .......... 26 NORDITROPIN NORDIFLEX PEN INJ 30/3ML 26 norepinephrine bitartrate .................................... 8 norethin acet & estrad-fe .................................. 17 norethindrone & eth estradiol ........................... 17 norethindrone (contraceptive) .......................... 17 norethindrone acet & eth estra ......................... 17 norethindrone acetate ...................................... 17 norethindrone-eth estradiol (triphasic).............. 17 norgestimate-ethinyl estradiol .......................... 17 norgestimate-ethinyl estradiol (triphasic) .......... 17 norgestrel & ethinyl estradiol ............................ 17 NORTHERA CAP 100MG ................................ 24 NORTHERA CAP 200MG ................................ 24 NORTHERA CAP 300MG ................................ 24 nortriptyline hcl ................................................. 12 NORVIR ............................................................. 4 NOVOSEVEN RT .............................................. 8 NOXAFIL SOLN 300 MG/16.7ML .................... 23 NOXAFIL SUS 40MG/ML ................................ 23 NOXAFIL TAB 100MG ..................................... 23 NUCALA SOLR 100 MG .................................. 27 NULOJIX INJ 250MG ....................................... 27 NUTROPIN AQ INJ 10MG/2ML ....................... 26 NUTROPIN AQ NUSPIN 10 SOLN 10 MG/2ML

..................................................................... 26 NUTROPIN AQ NUSPIN 20 SOLN 20 MG/2ML

..................................................................... 26 NUTROPIN AQ NUSPIN 5 INJ NUSPIN 5 ....... 26 NUTROPIN AQ PEN INJ 10MG/2ML ............... 26 NUTROPIN AQ PEN INJ 20MG/2ML ............... 26 NUTROPIN INJ 10MG ..................................... 26 NUVARING ...................................................... 17 nystatin ........................................................ 5, 21 nystatin (mouth-throat) ....................................... 5 nystatin (topical) ............................................... 21 nystatin-triamcinolone ...................................... 21

O OCALIVA ......................................................... 25 octreotide acetate ............................................ 18 ODEFSEY .......................................................... 6 ODOMZO CAPS 200 MG ................................ 24 OFEV CAP 100MG .......................................... 27 OFEV CAP 150MG .......................................... 27 OFIRMEV ........................................................ 10 ofloxacin (ophth) .............................................. 15 ofloxacin (otic) .................................................. 15 olanzapine ....................................................... 12 olopatadine hcl ................................................. 15 OLYSIO CAP 150MG ...................................... 23 omeprazole ...................................................... 16 OMNIPAQUE ................................................... 13 ONCASPAR ....................................................... 7 ondansetron ..................................................... 16


ondansetron hcl ............................................... 16 ONETOUCH ULTRA BLUE ............................. 13 ONETOUCH ULTRA MINI ............................... 12 ONIVYDE INJ 43 MG/10ML ............................. 24 OPANA ............................................................ 10 OPDIVO ............................................................. 7 ophthalmic irrigation solution - intraocular ........ 15 OPSUMIT .................................................. 20, 27 OPSUMIT TAB 10MG ...................................... 27 ORAP .............................................................. 12 ORBACTIV SOL 400MG.................................. 23 ORENCIA ........................................................ 18 ORENITRAM TAB 0.125MG ............................ 27 ORENITRAM TAB 0.25MG .............................. 27 ORENITRAM TAB 1MG ................................... 27 ORENITRAM TAB 2.5MG ................................ 27 ORFADIN SUS 4MG/ML ............................. 27 ORFADIN CAP 10MG ..................................... 27 ORFADIN CAP 2MG ....................................... 27 ORFADIN CAP 5MG ....................................... 27 ORFADIN CAPS 20 MG .................................. 27 ORKAMBI ........................................................ 20 ORTHO DIAPHRAGM ALL-FLEX .................... 12 OTEZLA ........................................................... 18 oxacillin sodium ................................................. 5 oxaliplatin ........................................................... 7 oxandrolone ..................................................... 16 oxazepam ........................................................ 11 oxcarbazepine ................................................. 11 OXSORALEN .................................................. 21 oxybutynin chloride .......................................... 22 oxycodone hcl .................................................. 10 oxycodone w/ acetaminophen ......................... 10 oxytocin ........................................................... 19 OXYTROL ....................................................... 22 OZURDEX ....................................................... 15

P paclitaxel ............................................................ 7 pamidronate disodium ..................................... 18 pancuronium bromide ........................................ 8 PANRETIN GEL 0.1% ..................................... 27 pantoprazole sodium ....................................... 16 papaverine hcl ................................................. 10 PAPAVERINE HCL .......................................... 19 PAREGORIC ................................................... 16 paromomycin sulfate .......................................... 6 paroxetine hcl .................................................. 12 ped multivitamins w/fl & iron ............................ 22 PEDIARIX ........................................................ 20 pediatric multiple vitamin w/ c .......................... 22 pediatric multiple vitamins w/ iron .................... 22 pediatric multivitamins w/fl ............................... 22 PEDIATRIC SMALL MASK .............................. 12 pediatric vitamins acd w/ fluoride ..................... 22

peg 3350-kcl-sod bicarb-sod chloride-sod sulfate ..................................................................... 16

PEGASYS .......................................................... 5 PEG-INTRON REDIPEN ................................... 5 PENICILLIN G POT IN DEXTROSE .................. 5 penicillin g potassium ......................................... 5 PENICILLIN G PROCAINE ................................ 5 PENICILLIN G SODIUM .................................... 5 penicillin v potassium ......................................... 5 PENLET II BLOOD SAMPLER ........................ 13 pentazocine w/ naloxone ................................. 10 PENTETATE CALCIUM TRISODIUM .............. 16 PENTETATE ZINC TRISODIUM ..................... 16 pentostatin ......................................................... 7 pentoxifylline ...................................................... 9 PERJETA ........................................................... 7 permethrin ........................................................ 21 perphenazine ................................................... 12 PERPHENAZINE-AMITRIPTYLINE ................. 12 phenelzine sulfate ............................................ 12 PHENEX-1 ....................................................... 13 phenobarbital ................................................... 11 PHENOBARBITAL ..................................... 11, 19 PHENOBARBITAL SODIUM ............................ 11 PHENOL ...................................................... 8, 21 phenoxybenzamine hcl ...................................... 8 PHENTOLAMINE MESYLATE ..................... 8, 19 phenylephrine hcl (ophth) ................................ 16 phenylephrine hcl (pressors) .............................. 8 phenylephrine-chlorphen-dm ........................... 20 PHENYLHISTINE DH ...................................... 20 phenytoin ......................................................... 11 phenytoin sodium ............................................. 11 phenytoin sodium extended ............................. 11 PHOSPHOLINE IODIDE .................................. 15 PHYSOSTIGMINE SALICYLATE ...................... 8 phytonadione ................................................... 22 pilocarpine hcl .............................................. 8, 15 pilocarpine hcl (oral) ........................................... 8 pioglitazone hcl ................................................ 17 piperacillin sodium-tazobactam sodium ............. 5 PLASMA-LYTE A ............................................. 14 PLASMANATE ................................................... 8 PLEGRIDY INJ ................................................ 25 PLEGRIDY INJ PEN ........................................ 25 PLEGRIDY STARTER PACK INJ STARTER... 25 PLURONIC F127 ............................................. 19 PNEUMOVAX 23 ............................................. 20 PODOCON ...................................................... 22 podofilox .......................................................... 22 PODOPHYLLUM RESIN ................................. 19 POLYETHYLENE GLYCOL 400 ...................... 19 POLYETHYLENE GLYCOL 8000 .................... 19 polymyxin b-trimethoprim ................................. 15 polysaccharide iron complex .............................. 8


POMALYST ....................................................... 7 PORTRAZZA SOLN 800 MG/50ML ................. 24 pot & sod citrates w/citric ac ............................ 13 POTABA .......................................................... 22 potassium acetate ............................................ 14 potassium bicarbonate ..................................... 14 potassium chloride ........................................... 14 potassium chloride in dextrose ........................ 14 potassium chloride in dextrose & sodium chloride

..................................................................... 14 potassium chloride in nacl ................................ 14 potassium chloride microencapsulated crystals cr

..................................................................... 14 potassium citrate (alkalinizer) .......................... 13 potassium citrate-citric acid .............................. 13 potassium phosphate dibasic ........................... 14 potassium phosphates ..................................... 14 PRADAXA ......................................................... 9 PRALUENT SOSY 150 MG/ML ....................... 24 PRALUENT SOSY 75 MG/ML ......................... 24 pramipexole dihydrochloride ............................ 11 pramoxine-hc ................................................... 21 pravastatin sodium ............................................. 9 PRAXBIND ........................................................ 8 prazosin hcl ....................................................... 9 PRECEDEX ..................................................... 11 prednisolone .............................................. 15, 16 prednisolone acetate (ophth) ........................... 15 prednisolone sodium phosphate ...................... 16 PREDNISOLONE SODIUM PHOSPHATE ...... 15 prednisone ....................................................... 16 PREMARIN ...................................................... 17 PREVNAR 13 .................................................. 20 PREZCOBIX ...................................................... 4 PREZISTA ......................................................... 4 PRIFTIN ............................................................. 5 PRIMAQUINE PHOSPHATE ............................. 6 PRIMAXIN IV ..................................................... 5 primidone ......................................................... 11 PRIMSOL .......................................................... 5 probenecid ....................................................... 14 PROBUPHINE IMPLANT KIT IMPL 74.2 MG .. 24 PROCAINAMIDE HCL ..................................... 10 prochlorperazine .............................................. 12 prochlorperazine edisylate ............................... 12 prochlorperazine maleate ................................ 12 PROCRIT .......................................................... 9 PROCTOFOAM HC ......................................... 21 PROCYSBI CAP 25MG ................................... 27 PROCYSBI CAP 75MG ................................... 27 PROFERRIN ES ................................................ 8 PROFERRIN-FORTE ........................................ 8 PROFILNINE ........................................... 8, 9, 24 PROFILNINE SD INJ ....................................... 24 progesterone ................................................... 17

progesterone micronized ................................. 17 PROGESTERONE MICRONIZED ................... 19 PROGESTERONE WETTABLE ...................... 19 PROGLYCEM .................................................. 10 PROLASTIN-C ................................................. 14 PROLEUKIN ...................................................... 7 PROMACTA ...................................................... 9 promethazine hcl ............................................... 6 promethazine w/codeine .................................. 20 promethazine-dm ............................................. 20 propafenone hcl ............................................... 10 PROPANTHELINE BROMIDE ........................... 8 proparacaine hcl .............................................. 15 propofol ............................................................ 12 propranolol hcl ................................................... 9 PROPYLENE GLYCOL ................................... 19 propylthiouracil ................................................. 18 PROQUAD ....................................................... 20 PROSTIGMIN .................................................... 8 PROTAMINE SULFATE .................................... 9 protriptyline hcl ................................................. 12 pseudoephedrine w/ codeine-gg ...................... 20 PULMOZYME .................................................. 14 PURINETHOL .................................................. 24 pyrazinamide ..................................................... 5 pyridostigmine bromide ...................................... 8 pyridoxine hcl ................................................... 22

Q QUELICIN .......................................................... 8 quetiapine fumarate ......................................... 12 QUINACRINE HCL .......................................... 19 quinidine gluconate .......................................... 10 QUINIDINE SULFATE ..................................... 10 QVAR .............................................................. 16

R RABAVERT ..................................................... 20 raloxifene hcl .................................................... 17 ramipril ............................................................. 10 ranitidine hcl ..................................................... 16 RAPIVAB SOLN 200 MG/20ML ....................... 23 RASUVO.......................................................... 18 RAVICTI LIQ 1.1GM/ML .................................. 25 REBIF INJ 22/0.5 ............................................. 25 REBIF INJ 44/0.5 ............................................. 25 REBIF REBIDOSE INJ 22/0.5 .......................... 25 REBIF REBIDOSE INJ 44/0.5 .......................... 25 REBIF REBIDOSE TITRATION PACK SOL

TITRATN ...................................................... 25 REBIF TITRATION PACK SOL PACK ............. 25 RECOTHROM ................................................... 9 REGRANEX GEL 0.01% ................................. 27 RELENZA DISKHALER ..................................... 6


RELISTOR 12 MG/0.6 ML KIT ......................... 25 RELISTOR SOLN 8 MG/0.4ML ....................... 25 RELISTOR TABS 150 MG ............................... 25 REMICADE ...................................................... 18 REMODULIN ................................................... 10 RENVELA ........................................................ 14 REOPRO ........................................................... 9 REPATHA PUSH INJ 420/3.5 .......................... 24 REPATHA SOSY 140 MG/ML ......................... 24 REPATHA SURECLICK SOAJ 140 MG/ML ..... 24 RESCRIPTOR ................................................... 4 RESERPINE .................................................... 10 RESTASIS ....................................................... 15 RETIN-A MICRO ............................................. 21 RETISERT ....................................................... 15 REVATIO INJ................................................... 24 REVATIO TAB 20MG ...................................... 24 REVLIMID .......................................................... 7 REXULTI TABS ............................................... 25 REYATAZ .......................................................... 4 ribavirin (hepatitis c) ........................................... 5 RIDAURA ........................................................ 16 rifabutin .............................................................. 5 RIFAMATE ........................................................ 5 rifampin .............................................................. 5 RILUTEK TAB 50MG ....................................... 25 riluzole ............................................................. 12 rimantadine hydrochloride .................................. 6 RIMSO-50 ........................................................ 18 risperidone ....................................................... 12 RITUXAN ........................................................... 7 RIXUBIS SOLR ................................................ 24 rizatriptan benzoate ......................................... 11 rocuronium bromide ........................................... 8 ropinirole hydrochloride.................................... 11 ROTARIX ......................................................... 20 ROTATEQ ....................................................... 20 RUCONEST INJ 2100UNIT ............................. 27 RYNODERM CREA 37.5 % ............................. 27 RYTARY .......................................................... 25

S SABRIL ...................................................... 11, 25 SABRIL TAB 500MG ....................................... 25 SAIZEN CLICK.EASY INJ 8.8MG .................... 26 SAIZEN SOLR 5 MG ....................................... 26 SALICYLIC ACID ............................................. 19 saline, bacteriostatic ........................................ 14 salsalate .......................................................... 11 SAMSCA 15 MG TABLET ............................... 25 SAMSCA 30 MG TABLET ............................... 25 SANDIMMUNE ................................................ 18 SANTYL ........................................................... 22 SAXENDA ....................................................... 27 SCOPOLAMINE HBR ........................................ 8

selegiline hcl .............................................. 11, 12 SELENIUM ...................................................... 14 selenium sulfide ............................................... 21 SELZENTRY ...................................................... 4 SENSIPAR ....................................................... 18 SEREVENT DISKUS ......................................... 8 SEROSTIM ...................................................... 18 sertraline hcl .................................................... 12 SIGNIFOR INJ 0.3MG/ML ............................... 26 SIGNIFOR INJ 0.6MG/ML ............................... 26 SIGNIFOR INJ 0.9MG/ML ............................... 26 SIGNIFOR LAR INJ 20MG............................... 26 SIGNIFOR LAR INJ 40MG............................... 26 SIGNIFOR LAR INJ 60MG............................... 26 sildenafil citrate (pulmonary hypertension) ....... 10 silver sulfadiazine............................................. 21 SIMPONI ARIA SOL 50MG/4ML ...................... 26 SIMPONI INJ 100MG/ML ................................. 26 SIMPONI INJ 50MG ......................................... 26 SIMULECT INJ 10MG ...................................... 27 SIMULECT INJ 20MG ...................................... 27 simvastatin ......................................................... 9 sirolimus........................................................... 18 SIRTURO TAB 100MG .................................... 23 SIVEXTRO INJ 200MG .................................... 23 SIVEXTRO TAB 200MG .................................. 23 sodium acetate ................................................ 13 SODIUM BENZOATE ...................................... 19 sodium bicarbonate .......................................... 13 sodium chloride .................................... 14, 20, 22 sodium chloride (gu irrigant)............................. 14 sodium chloride (inhalant) ................................ 20 sodium chloride flush ....................................... 14 sodium citrate & citric acid ............................... 13 SODIUM EDECRIN ......................................... 14 sodium fluoride ................................................ 18 sodium fluoride (dental) ................................... 18 sodium phenylbutyrate ..................................... 13 sodium phosphate............................................ 14 sodium polystyrene sulfonate ........................... 14 sodium thiosulfate ............................................ 16 SOLIRIS........................................................... 18 SOMATULINE DEPOT INJ 120/.5ML .............. 27 SOMATULINE DEPOT INJ 60/0.2ML .............. 27 SOMATULINE DEPOT INJ 90/0.3ML .............. 27 SOMAVERT INJ 10MG .................................... 26 SOMAVERT INJ 15MG .................................... 26 SOMAVERT INJ 20MG .................................... 26 SOMAVERT INJ 25MG .................................... 26 SOMAVERT INJ 30 ......................................... 26 SORBITOL ................................................. 16, 19 SORIATANE CAP 10MG ................................. 27 SORIATANE CAP 17.5MG .............................. 27 SORIATANE CAP 25MG ................................. 27 sotalol hcl ........................................................... 9


sotalol hcl (afib/afl) ............................................. 9 SOTRADECOL ................................................ 10 SOVALDI ........................................................... 5 SPIRIVA RESPIMAT ......................................... 8 spironolactone ................................................. 10 spironolactone & hydrochlorothiazide .............. 10 SPRITAM TB3D ............................................... 25 SPRYCEL .......................................................... 7 SQUARIC ACID DIBUTYLESTER ................... 19 SSKI ................................................................ 18 stavudine ........................................................... 4 STELARA .................................................. 22, 27 STELARA SOLN 130 MG/26ML ...................... 27 STIOLTO RESPIMAT ........................................ 8 STIVARGA ........................................................ 7 STRENSIQ ...................................................... 14 STREPTOMYCIN SULFATE ............................. 5 STRIBILD .......................................................... 4 STRIVERDI RESPIMAT .................................... 8 sucralfate ......................................................... 16 sufentanil citrate ............................................... 11 sulfacetamide sodium (ophth) .......................... 15 sulfacetamide sodium w/ sulfur ........................ 21 sulfacetamide sod-prednisolone ...................... 15 SULFADIAZINE ................................................. 5 sulfamethoxazole-trimethoprim .......................... 5 SULFAMYLON ................................................ 21 sulfasalazine ...................................................... 5 SULFUR PRECIPITATED ............................... 19 sulindac ........................................................... 11 sumatriptan ...................................................... 11 sumatriptan succinate ...................................... 11 SUPPRELIN LA KIT 50 MG ............................. 24 SUPRAX ............................................................ 5 SURMONTIL.................................................... 12 SURVANTA ..................................................... 20 SUSTIVA ........................................................... 4 SUTENT ............................................................ 7 SYLATRON KIT 296MCG ................................ 24 SYLATRON KIT 444MCG ................................ 24 SYLATRON KIT 888MCG ................................ 24 SYLVANT .......................................................... 7 SYNAGIS ........................................................... 6 SYNAREL ........................................................ 17 SYNERCID ........................................................ 5 SYNRIBO INJ 3.5MG ...................................... 24

T TABLOID ........................................................... 7 TACLONEX OIN .............................................. 27 TACLONEX SUSP 0.005-0.064 % ................... 27 tacrolimus .................................................. 18, 22 tacrolimus (topical) ........................................... 22 TAFINLAR ......................................................... 7 TAGRISSO ........................................................ 7

TALTZ SOAJ 80 MG/ML .................................. 27 TALTZ SOSY 80 MG/ML ................................. 27 TAMIFLU ........................................................... 6 tamoxifen citrate ................................................ 7 tamsulosin hcl .................................................... 9 TARCEVA .......................................................... 7 TARGRETIN ................................................ 7, 22 TASIGNA ........................................................... 7 TASMAR 100 MG TABLET .............................. 25 TAXOTERE ..................................................... 24 TAXOTERE INJ 80MG/4ML ............................. 24 TAZORAC ........................................................ 22 TECENTRIQ ...................................................... 7 TECFIDERA CAP 120MG................................ 25 TECFIDERA CAP 240MG................................ 25 TECFIDERA STARTER PACK MIS STARTER 25 TECHNIVIE TABS 12.5-75-50 MG .................. 23 temazepam ...................................................... 11 TEMODAR CAP 100MG .................................. 24 TEMODAR CAP 140MG .................................. 24 TEMODAR CAP 180MG .................................. 24 TEMODAR CAP 20MG .................................... 24 TEMODAR CAP 250MG .................................. 24 TEMODAR CAP 5MG ...................................... 24 TEMODAR INJ 100MG .................................... 24 temozolomide .................................................... 7 TENIPOSIDE ..................................................... 7 terazosin hcl ....................................................... 9 terbinafine hcl .................................................... 5 terbutaline sulfate .............................................. 8 testosterone cypionate ..................................... 17 testosterone enanthate .................................... 17 TESTOSTERONE PROPIONATE ................... 19 TETANUS-DIPHTHERIA TOXOIDS TD ........... 20 TETRACAINE HCL .......................................... 18 tetracaine hcl (ophth) ....................................... 15 TETRACYCLINE HCL ....................................... 5 THALOMID ...................................................... 18 THAM .............................................................. 13 theophylline ...................................................... 22 theophylline in dextrose ................................... 22 THERACYS ..................................................... 20 thiamine hcl ...................................................... 22 THIOLA ............................................................ 18 thioridazine hcl ................................................. 12 THIOTEPA ......................................................... 7 thiothixene ....................................................... 12 THROMBATE III ................................................ 9 THROMBIN-JMI ................................................. 9 THYMOGLOBULIN INJ 25MG ......................... 27 THYMOL .......................................................... 19 THYROGEN .................................................... 13 TIKOSYN ......................................................... 10 timolol maleate (ophth) .................................... 15 TIVICAY ......................................................... 4, 6


tizanidine hcl ...................................................... 8 TNKASE ............................................................ 9 TOBRADEX ..................................................... 15 tobramycin ................................................... 5, 15 tobramycin (ophth) ........................................... 15 tobramycin sulfate .............................................. 5 TOLBUTAMIDE ............................................... 17 topiramate ........................................................ 11 topotecan hcl ..................................................... 7 TORISEL ........................................................... 7 torsemide ......................................................... 14 trace minerals (cr-cu-mn-zn) ............................ 14 TRACLEER ..................................................... 10 TRADJENTA.................................................... 17 tramadol hcl ..................................................... 11 tramadol-acetaminophen ................................. 11 tranexamic acid .................................................. 9 TRANEXAMIC ACID ........................................ 19 TRANSDERM-SCOP (1.5 MG) ........................ 16 tranylcypromine sulfate .................................... 12 trazodone hcl ................................................... 12 TREANDA ....................................................... 24 TREANDA INJ 180MG..................................... 24 TREANDA INJ 25MG ...................................... 24 TREANDA INJ 45MG ...................................... 24 TRECATOR ....................................................... 5 TRELSTAR DEPOT MIXJECT INJ 3.75MG ..... 24 TRELSTAR LA MIXJECT INJ 11.25MG .......... 24 TRELSTAR MIXJECT INJ 22.5MG .................. 24 tretinoin ........................................................ 7, 21 tretinoin (chemotherapy) .................................... 7 TRIAMCINOLONE ACETONIDE ..................... 19 triamcinolone acetonide (mouth) ...................... 21 triamcinolone acetonide (topical) ..................... 21 triamterene & hydrochlorothiazide ................... 14 TRI-CHLOR ..................................................... 18 trifluoperazine hcl ............................................. 12 trifluridine ......................................................... 15 trihexyphenidyl hcl ........................................... 11 trimethoprim ....................................................... 6 TRISENOX ........................................................ 7 TRIUMEQ .......................................................... 4 tropicamide ...................................................... 16 trospium chloride ............................................. 22 TRUVADA ..................................................... 4, 6 TRUZONE PEAK FLOW METER .................... 13 TUBERSOL ..................................................... 13 TWINRIX ......................................................... 20 TYGACIL INJ 50MG ........................................ 23 TYKERB ............................................................ 7 TYPHIM VI ....................................................... 20 TYSABRI ......................................................... 12 TYVASO .......................................................... 10 TYZEKA 600 MG TABLET ............................... 23

U UCERIS TAB 9MG ........................................... 26 ULTIVA ............................................................ 11 ULTRAVATE LOTN 0.05 % ............................. 27 UNITUXIN .......................................................... 7 UPTRAVI TABS ............................................... 27 UREA ............................................................... 19 ursodiol ............................................................ 16

V valacyclovir hcl ................................................... 6 VALCHLOR GEL 0.016% ................................ 27 VALCYTE TAB 450MG .................................... 23 valganciclovir hcl ................................................ 6 valproate sodium ............................................. 11 valproic acid ..................................................... 11 valsartan .......................................................... 10 valsartan-hydrochlorothiazide .......................... 10 VALSTAR SOL 40MG/ML ................................ 24 VANCOCIN HCL CAP 125MG ......................... 23 VANCOCIN HCL CAP 250MG ......................... 23 vancomycin hcl .................................................. 5 VANCOMYCIN HCL IN DEXTROSE ................. 5 VANTAS KIT 50MG ......................................... 24 VARIVAX ......................................................... 20 VARIZIG .......................................................... 20 vasopressin ...................................................... 17 VECAMYL TAB 2.5MG .................................... 24 VECTIBIX INJ 100MG ..................................... 24 VECTIBIX INJ 400MG ..................................... 24 VECTICAL ....................................................... 22 vecuronium bromide .......................................... 8 VELCADE .......................................................... 7 VENCLEXTA TABS ......................................... 24 venlafaxine hcl ................................................. 12 VENOFER ......................................................... 8 VENTAVIS ....................................................... 10 verapamil hcl ...................................................... 9 VERAPAMIL HCL ............................................ 19 VEXOL ............................................................. 15 VFEND SUS 40MG/ML .................................... 23 VFEND TAB 200MG ........................................ 23 VFEND TAB 50MG .......................................... 23 VIBERZI TABS 100 MG ................................... 25 VIBERZI TABS 75 MG ..................................... 25 VIEKIRA PAK TAB........................................... 23 VIEKIRA XR TB24 200-8.33-50- 33.33 MG ..... 23 VIMIZIM ..................................................... 14, 25 VIMIZIM INJ 5MG/5ML .................................... 25 VINBLASTINE SULFATE .................................. 7 vincristine sulfate ............................................... 7 vinorelbine tartrate ............................................. 7 VIRACEPT ......................................................... 4 VIRAZOLE ......................................................... 6


VIREAD ............................................................. 4 VISTIDE INJ 75MG/ML .................................... 23 VISTOGARD PACK 10 GM ............................. 27 VISUDYNE ...................................................... 15 VIVITROL 380MG INJ ..................................... 25 VIVOTIF ........................................................... 20 VORAXAZE ..................................................... 14 voriconazole .................................................. 5, 6 VOTRIENT ........................................................ 7 VPRIV .............................................................. 14 VRAYLAR CAPS ............................................. 25 VRAYLAR CPPK 1.5 & 3 MG .......................... 25 VYVANSE ........................................................ 11

W warfarin sodium ................................................. 9 water for injection, sterile ........................... 18, 19 water for irrigation, sterile ................................. 14 WIDE-SEAL DIAPHRAGM 60 ......................... 12

X XALKORI ........................................................... 7 XELJANZ ................................................... 18, 26 XELJANZ TAB 5MG ........................................ 26 XELJANZ XR TB24 11 MG .............................. 26 XENAZINE TAB 12.5MG ................................. 25 XENAZINE TAB 25MG .................................... 25 XEOMIN SOLR 200 UNIT ................................ 27 XERAC AC ...................................................... 21 XGEVA INJ ...................................................... 27 XIFAXAN ........................................................... 5 XOLAIR ........................................................... 20 XTANDI ............................................................. 7 XULANE .......................................................... 17 XURIDEN PACK 2 GM .................................... 27 XYNTHA ............................................................ 9 XYREM SOL 500MG/ML ................................. 25

Y YERVOY ............................................................ 7

YF-VAX ............................................................ 20 YODOXIN .......................................................... 6 YONDELIS SOLR 1 MG .................................. 24

Z ZALTRAP INJ 100/4ML ................................... 24 ZALTRAP INJ 200/8ML ................................... 24 ZANOSAR ......................................................... 7 ZARXIO ............................................................. 9 ZAVESCA CAP 100MG ................................... 27 ZELBORAF ........................................................ 7 ZEMAIRA SOLR 1000 MG............................... 27 ZEPATIER TABS ............................................. 23 zidovudine .......................................................... 4 ZINACEF IN STERILE WATER ......................... 5 ZINBRYTA INJ 150MG/ML .......................... 27 zinc sulfate ....................................................... 14 ZINC SULFATE ............................................... 19 ZINC TRACE METAL ...................................... 14 ziprasidone hcl ................................................. 12 zoledronic acid ................................................. 18 ZOLINZA CAP 100MG ..................................... 24 zolpidem tartrate .............................................. 11 ZOMACTON SOLR 10 MG .............................. 26 ZOMACTON SOLR 5 MG ................................ 26 ZORBTIVE INJ 8.8MG ..................................... 26 ZORTRESS TAB 0.25MG ................................ 27 ZORTRESS TAB 0.5MG .................................. 27 ZORTRESS TAB 0.75MG ................................ 27 ZOSTAVAX ...................................................... 20 ZOSYN .............................................................. 5 ZYDELIG ........................................................... 7 ZYFLO CR TAB 600MG .................................. 27 ZYFLO TAB 600MG ......................................... 27 ZYKADIA ........................................................... 7 ZYMAXID ......................................................... 15 ZYTIGA .............................................................. 7 ZYVOX SOL 2MG/ML ...................................... 23

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