2016 Formul Ary oF Covered PresCriPtion drugs … SH Formulary...VNSNY CHOICE SelectHealth Formulary January 2016 Foreword MedImpact is a Pharmacy Benefit Manager for VNSNY CHOICE

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2016 FormulAry oF Covered

PresCriPtion drugs selectHealth

© 2016 VNSNY ChoiCe

VNSNY CHOICE SelectHealth FormularyJanuary 2016

ForewordMedImpact is a Pharmacy Benefit Manager for VNSNY CHOICE SelectHealth. This document represents

the efforts of the MedImpact Healthcare Systems Pharmacy and Therapeutics (P & T) and Formulary

Committees to provide physicians and pharmacists with a method to evaluate the safety, efficacy and cost-

effectiveness of commercially available drug products. A structured approach to the drug selection process is

essential in ensuring continuing patient access to rational drug therapies.

This is accomplished through the auspices of the MedImpact P & T and Formulary Committees. These

committees meet quarterly and more often as warranted to ensure clinical relevancy of the Formulary. To

accommodate changes to this document, updates are made accessible as necessary.

Access to the most current version of the VNSNY CHOICE SelectHealth Formulary can be obtained by visiting www.vnsnychoice.org

The MedImpact P & T and Formulary Committees use the following criteria in the evaluation of drug

selection for VNSNY CHOICE SelectHealth Formulary:

● Drug safety profile

● Drug efficacy

● Comparison of relevant therapeutic benefits to current formulary agents of similar use, and to minimize

therapeutic duplication where possible

● Cost-effectiveness relative to comparable therapies

How to Use the FormularyThe Formulary is a list of medications available to VNSNY CHOICE SelectHealth members under their

pharmacy benefit. All drugs are listed by their generic names and most common proprietary (branded) name.

The Formulary may be accessed by using the index, either by generic or proprietary name and by therapeutic

drug category. In situations where an FDA approved generic equivalent is available, brand names are listed for reference purposes only, and do not denote coverage for the brand, unless specifically noted.

All drugs are listed in each category in alphabetical order by generic name. Where an FDA approved generic

is available for the listed generic name, the generic name is bolded.

For certain agents within the Formulary, a recommended prescribing guideline may apply. These are denoted

throughout the document using the following symbols:

AGE Age Edit Coverage may depend on patient age

G Gender Edit Coverage may depend on patient gender

PA Prior Authorization Requires specific physician request process

QL Quantity Limit Coverage may be limited to specific quantities

per prescription and/or time period

ST Step Therapy Coverage may depend on previous use of another drug

Please refer to the prescribing guideline appendix within this document for details regarding specific agents.

VNSNY Page 1 of 73

Benefit Coverage and LimitationsThis printed Formulary does not provide information regarding the specific coverage and limitations an

individual member may be subject to. Many members have specific benefit inclusions, exclusions, copays,

or a lack of coverage, which are not reflected in the Formulary.

The Formulary applies only to outpatient drugs provided to members, and does not apply to medications used

in inpatient settings. If a member has any specific questions regarding their coverage, they should contact

VNSNY CHOICE SelectHealth Member Services at 1-866-469-7774 Monday through Friday, 8:00 am to

6:00 pm. TTY users call 711.

Depending upon a member’s specific benefit parameters, the following topics may apply: 1. Generic Substitution

When available, FDA approved generic drugs are to be used in all situations, regardless of the brand

name indicated. The generic names are bolded in the formulary listing wherever an FDA approved

generic drug product is available. Greater economy is realized through the use of generic equivalents.

This policy is not meant to preclude or supplant any state statutes that may exist. All drugs that are or

become available generically are subject to review by MedImpact’s Pharmacy and Therapeutics

Committee. MedImpact approves such multi-source drugs for addition to the MAC list based on the

following criteria:

● A multi-source drug product manufactured by at least one (1) nationally marketed company.

● At least one (1) of the generic manufacturer’s products must have an “A” rating or the generic product

has been determined to be unassociated with efficacy, safety or bioequivalence concerns by the

MedImpact P & T Committee.

● Drug product will be approved for generic substitution by the MedImpact P & T Committee.

This list is reviewed and updated periodically based on the clinical literature and pharmacokinetic

characteristics of currently available versions of these drug products.

If a member or physician requests a brand name product in lieu of an approved generic, and physician

determines that there is a documented medical need for the brand equivalent, a request for coverage may

be made using the medication request process at 1-888-678-7741, 24 hours a day, and 7 days a week.

2. Tier Benefit DesignThe Formulary may be applied to a tier benefit design, where the member shares the cost of prescription

drug therapy based on the drug’s tier and copayment or coinsurance. In most instances, generically

available drugs will be covered in a separate lower tier (low copay), preferred branded drugs listed on the

Formulary will be covered under a higher tier, and branded drugs not on the Formulary will be covered

under a separate non-preferred branded drug copay tier. Essential health benefit/preventative

medications, if available on your plans formulary (applies to new and non-grandfathered plans), will be

covered without cost sharing (zero copay).

TIER DEFINITIONS:

TIER 1: Preferred generic medications (formulary agents)

TIER 2: Preferred brand medications (formulary agents)

TIER 3: Non-preferred medications (non-formulary agents)

TIER 4: Zero Copay/Preventative medications

TIER 5: Over the Counter (OTC)

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3. Medication Request ProcessDepending upon plan benefit design, a medication request process may apply as follows:

A. Coverage Exceptions:

Drugs that are listed in the Formulary with associated Prior Authorization (PA) require evaluation, per

MedImpact P & T Committee Prior Authorization guidelines prior to dispensing at a network

pharmacy. Each request will be reviewed on an individual patient need basis. If the request does not

meet the guidelines established by the P & T Committee, the request will not be approved and

alternative therapy may be recommended.

B. Obtaining CoverageCoverage, questions or information regarding the medication request or formulary process may be

obtained by:

1. Faxing a completed Medication Request Form to MedImpactat 1-858-790-7100.

2. Contacting MedImpact at 1-888-678-7741and providing all necessary information requested.

MedImpact will provide an authorization number, specific for the medical need, for all approved

requests. Non-approved requests may be appealed. The prescriber must provide information to

support the appeal on the basis of medical necessity. Prior Authorization is generally not available for

drugs that are specifically excluded by benefit design.

4. General ExclusionsA. Drugs specifically listed as not covered.

B. Any drug products used for cosmetic purposes.

C. Experimental drug products or any drug product used in an experimental manner.

D. Replacement of lost or stolen medication.

E. Non-self-administered injectable drug products unless otherwise specified in the Formulary listing.

F. Foreign sourced drugs or drugs not approved by the United States Food & Drug Administration,

except in certain cases of drug shortage, when allowed under the individual’s pharmacy benefit.

The P & T and Formulary Committees recognize that not all medical needs can be met with this

document and encourage inquiries about alternative therapies.

5. Pharmacist and Physician CommunicationThe Formulary is a tool to promote cost-effective prescription drug use. The P & T and Formulary

Committees have made every attempt to create a document that meets all therapeutic needs; however, the

art of medicine makes this a formidable task. MedImpact welcomes the participation of physicians,

pharmacists, and ancillary medical providers, in this dynamic process. Physicians and pharmacists are

encouraged to direct any suggestions, comments or formulary additions to MedImpact at the following

address:

Chairperson, Pharmacy & Therapeutics Committee

MedImpact Healthcare Systems, Inc.

10181 Scripps Gateway Court

San Diego, CA 92131

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Medication Request Form (MRF)MedImpact Healthcare Systems, Inc.

DO NOT WRITE IN BLOCKED AREASFOR INTERNAL USE ONLY

Attn: Prior Authorization Department

DO NOT WRITE IN BLOCKED AREASFOR INTERNAL USE ONLY

Contacted: 10181 Scripps Gateway Court San Diego, CA 92131

Approved:

Physician: Phone 1-888-678-7741 Denied:

Pharmacy: Phone: 1-888-678-7741 Returned:

Patient: Fax: 858-790-7100 PA #:

Instructions:This form is to be used by participating physicians and providers to obtain coverage for a non-formulary drug

for which there is no suitable alternative available. Please complete this form and fax to MedImpact

Healthcare Systems, Inc. at 1-858 790-7100 or please call 1-888-678-7741 with this information. If you have

any questions regarding this process, please contact MedImpact’s Customer Service at 1-888-678-7741), 24

hours a day, 7 days a week.

Review Criteria:The following guidelines are used in reviewing medication requests:

1. The use of Formulary Drug Products is contraindicated in the patient.

2. The patient has failed an appropriate trial of Formulary or related agents.

3. The choices available in the Formulary are not suited for the present patient care need and the drug

selected is required for patient safety.

4. The use of a Formulary Drug Product may provoke an underlying medical condition, which would be

detrimental to patient care

VNSNY Page 4 of 73

Medication Request Information (please complete each section of this form prior to transmittal):

Patient Name (required):

Patient’s Health Plan (required):

Patient ID # (required): Physician Name/Specialty:

Physician ID#/DEA#:

Patient DOB (required):

Physician Area Code and Telephone Number:

( ) -

Diagnosis (required):

Physician Area Code and Fax Number (required):

( ) -

Pharmacy used by Member:

Pharmacy Area Code and Telephone Number:

( ) -

Drug Requested:

Quantity (per month):

Dose:

Length of Treatment (please be specific):

Strength:

Dosage Form (e.g., Oral, Injection):

Reason for Medication Request (please be specific, give detail):

Other Medications Tried and/or Failed (please be specific, give detail including reason for failure):

Other Pertinent History (relative or pertaining to this request):

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Formulario de VNSNY CHOICE SelectHealthEnero de 2016

PrólogoMedImpact es un administrador del beneficio de farmacia para VNSNY CHOICE SelectHealth. Este documento representa los esfuerzos de los Comités de Farmacia y Terapéutica de MedImpact Healthcare Systems (Pharmacy and Therapeutics, P & T) y el Formulario para proporcionar a los médicos y farmacéuticos un método para evaluar la seguridad, eficacia y rentabilidad de los productos medicinales disponibles comercialmente. Un enfoque estructurado al proceso de selección del medicamento es esencial para asegurar el acceso continuo del paciente a las terapias racionales de medicamentos. Esto se lleva a cabo a través de los auspicios de los Comités de P & T y la Lista de medicamentos de MedImpact. Estos comités se reúnen trimestralmente y con más frecuencia si es necesario para asegurar la relevancia clínica de la lista de medicamentos. Para adaptar los cambios a este documento, las actualizaciones se encuentran accesibles según sea necesario. El acceso a la versión más actualizada del Formulario de VNSNY CHOICE SelectHealth se puede obtener visitando www.vnsnychoice.org Los Comités de P & T y de la Lista de medicamentos de MedImpact usan los siguientes criterios en la evaluación de selección de medicamentos para la Lista de medicamentos de VNSNY CHOICE SelectHealth:

• Perfil de seguridad del medicamento• Eficacia del medicamento• Comparación de beneficios terapéuticos relevantes con agentes actuales de uso similar de la Lista de

medicamentos, y para minimizar duplicidad terapéutica cuando sea posible• Costo-efectividad en relación a terapias comparables

Cómo usar la Lista de medicamentosLa Lista de medicamentos es un listado de medicamentos disponibles para los afiliados de VNSNY CHOICE SelectHealth bajo su beneficio de farmacia. Todos los medicamentos están listados por sus nombres genéricos y nombre comercial más común (marca). Puede obtener acceso a la Lista de medicamentos usando el índice, ya sea por nombre genérico o comercial y por categoría terapéutica del medicamento. En situaciones en las que un genérico equivalente aprobado por la FDA esté disponible, los nombres de marca se encuentran listados únicamente por motivos de referencia y no denotan cobertura de la marca, a menos que se especifique. Todos los medicamentos se encuentran listados en cada categoría en orden alfabético por nombre genérico. Cuando un medicamento genérico aprobado por la FDA está disponible para el nombre genérico listado, el nombre genérico se encuentra en negrita. Para ciertos agentes dentro de la Lista de medicamentos, puede aplicar un lineamiento de prescripción recomendada. Estos se indican en todo el documento usando los siguientes símbolos: EDAD Editar la edad La cobertura puede depender de la edad del paciente

G Editar el género La cobertura puede depender del género del paciente

PA Autorización previa Requiere de un proceso específico de solicitud del médico

QL Límite de cantidad La cobertura puede estar limitada a cantidades específicas

por receta médica o por período de tiempo

ST Terapia de pasos La cobertura puede depender del uso previo de otro medicamento

Consulte el apéndice de lineamientos de recetas en este documento para obtener detalles sobre agentes específicos.Cobertura de beneficios y limitacionesEste formulario impreso no proporciona información relacionada con la cobertura y limitaciones específicas a las que un afiliado individual puede estar sujeto. Muchos afiliados tienen inclusiones de beneficios, exclusiones, copagos específicos o falta de cobertura, los cuales no se reflejan en la Lista de medicamentos. La Lista de medicamentos aplica únicamente a los medicamentos para pacientes ambulatorios proporcionados a afiliados y no aplica a los medicamentos que se usan en entornos para pacientes hospitalizados. Si un afiliado tiene preguntas específicas en relación a su cobertura, deberá comunicarse a Servicios del afiliado de VNSNY CHOICE SelectHealth al 1-866-469-7774, de lunes a viernes de 8:00 a. m. a 6:00 p. m. Los usuarios de TTY deben llamar al 711.

VNSNY Page 6 of 73

Dependiendo de los parámetros de beneficios específicos del afiliado, los siguientes temas pueden aplicar: 1. Sustitución de genéricos

Cuando se encuentren disponibles, los medicamentos genéricos aprobados por la FDA se usarán en todos los casos, independientemente del nombre de marca indicado. Los nombres genéricos se encuentran en negrita en la lista de medicamentos donde se encuentre un producto medicinal genérico aprobado por la FDA que esté disponible. Se obtiene mayor ahorro con el uso de equivalentes genéricos. Esta política no tiene el propósito de excluir o reemplazar los estatutos del estado que puedan existir. Todos los medicamentos que se encuentran o lleguen a estar disponibles como genéricos están sujetos a revisión por parte del Comité de farmacia y terapéutica de MedImpact. MedImpact aprueba dichos medicamentos de múltiples fuentes para agregarlos a la lista MAC con base en los siguientes criterios:

• Producto medicinal de múltiple fuente fabricado por al menos una (1) empresa comercializada a nivel nacional.

• Al menos uno (1) de los productos genéricos del fabricante debe tener una calificación “A” o que se haya determinado que el producto genérico no está asociado con problemas de eficacia, seguridad o bioequivalencia por parte del Comité de P & T de MedImpact.

• El producto medicinal será aprobado para sustitución genérica por parte del Comité de P & T de MedImpact.

Esta lista se revisa y actualiza periódicamente con base en la literatura clínica y características farmacocinéticas de las versiones disponibles actualmente de estos productos medicinales.

Si un afiliado o médico solicita un producto de marca en lugar de un genérico aprobado, y el médico determina que existe una necesidad médica documentada de la marca equivalente, se puede realizar una solicitud de cobertura usando el proceso de solicitud de medicamentos al 1-888-678-7741, las 24 horas del día, los 7 días de la semana.

2. Diseño de beneficios por nivelLa Lista de medicamentos se puede aplicar a un diseño de beneficios por niveles, donde el afiliado comparte el costo de la terapia con medicamentos con receta médica con base en el nivel del medicamento, copago o coaseguro. En la mayoría de los casos, los medicamentos genéricos disponibles serán cubiertos en un nivel más bajo por separado (copago bajo), los medicamentos preferidos de marca listados en la Lista de medicamentos serán cubiertos bajo un nivel más alto, y los medicamentos de marca que no se encuentran en el formulario serán cubiertos bajo un nivel de copago de medicamento de marca no preferida por separado. Los medicamentos esenciales para la salud de beneficio o preventiva, si están disponibles en el formulario de sus planes (aplica a planes nuevos y que no cuentan con derechos adquiridos), serán cubiertos sin costo compartido (cero copago).

VNSNY Page 7 of 73

DEFINICIONES DE LOS NIVELES: NIVEL 1: Medicamentos genéricos preferidos (agentes de la Lista de medicamentos) NIVEL 2: Medicamentos de marca preferidos (agentes de la Lista de medicamentos) NIVEL 3: Medicamentos no preferidos (agentes que no son de la Lista de medicamentos) NIVEL 4: Medicamentos con cero copago o de prevenciónNIVEL 5: De venta libre (OTC)

3. Proceso de solicitud de medicamentosDependiendo del diseño de beneficios del plan, puede aplicar un proceso de solicitud de medicamentos de la siguiente forma:

A. Excepciones de cobertura:Los medicamentos que se listan en el formulario de autorización previa asociado (PA) requieren evaluación, según las pautas de autorización previa del Comité de P & T de MedImpact antes de su distribución en una farmacia de la red. Cada solicitud será revisada en base a la necesidad individual del paciente. Si la solicitud no cumple con los lineamientos establecidos por el Comité de P & T, la solicitud no será aprobada y puede que se recomiende terapia alternativa. B. Obtención de coberturaLa cobertura, preguntas o información con respecto a la solicitud de medicamentos o proceso del formulario pueden obtenerse:

1. Enviando por fax un Formulario de solicitud de medicamentos a MedImpact al 1-858-790-7100.2. Comunicándose a MedImpact al 1-888-678-7741 y proporcionando toda la información necesaria que

se le solicite. MedImpact le proporcionará un número de autorización, especifico para la necesidad médica, para todas las solicitudes aprobadas. Las solicitudes no aprobadas pueden ser apeladas. La persona que escribe las recetas debe proporcionar información para apoyar la apelación basándose en la necesidad médica. La autorización previa generalmente no está disponible para medicamentos que están excluidos específicamente por el diseño de los beneficios. 4. Exclusiones generales

A. Medicamentos específicamente listados como no cubiertos.B. Cualquier producto medicinal usado para propósitos cosméticos.C. Productos medicinales experimentales o cualquier producto medicinal usado de forma experimental.D. Reposición de medicamento perdido o robado.E. Productos medicinales inyectables no autoadministrables, a menos que se especifique de otra manera

en la Lista de medicamentos.F. Medicamentos de fuentes extranjeras o medicamentos no aprobados por la Administración de

Alimentos y Medicamentos de los Estados Unidos, excepto en ciertos casos de escasez de medicamentos, cuando sea permitido bajo beneficio de la farmacia de la persona.

Los Comités de P & T y de la Lista de medicamentos reconocen que no todas las necesidades médicas se pueden cubrir con este documento y fomentan las investigaciones sobre terapias alternativas.

VNSNY Page 8 of 73

5. Comunicación del farmacéutico y el médicoLa Lista de medicamentos es una herramienta para promover que el uso de medicamentos con receta médica sea rentable. Los Comités de P & T y de la Lista de medicamentos han realizado todos los esfuerzos para crear un documento que cumpla con todas las necesidades terapéuticas; sin embargo, el arte de la medicina hace de esto una tarea enorme. MedImpact da la bienvenida a la participación de médicos, farmacéuticos y proveedores de servicios médicos auxiliares, en este proceso dinámico. Exhortamos a los médicos y farmacéuticos a dirigir cualquier sugerencia, comentarios o adiciones a la Lista de medicamentos a MedImpact a la siguiente dirección:

Chairperson, Pharmacy & Therapeutics Committee MedImpact Healthcare Systems, Inc.10181 Scripps Gateway Court San Diego, CA 92131

Formulario de Solicitud de Medicamentos (MRF) de MedImpact Healthcare Systems, Inc. NO ESCRIBA EN LAS ÁREAS BLOQUEADAS ÚNICAMENTE PARA USO INTERNO

Attn: Prior AuthorizationDepartment

NO ESCRIBA EN LAS ÁREAS BLOQUEADASÚNICAMENTE PARA USO INTERNO

Contactado: 10181 Scripps Gateway Court San Diego, CA 92131

Aprobado:

Médico: Teléfono 1-888-678-7741 Denegado:

Farmacia: Teléfono: 1-888-678-7741 Devuelto:

Paciente: Fax: 858-790-7100 N.º de PA:

Instrucciones:Esta lista de medicamentos es para el uso de los médicos y proveedores participantes para obtener cobertura para un medicamento que no se encuentre en la lista de medicamentos para el cual no existe una alternativa adecuada disponible. Llene este formulario y envíelo por fax a MedImpact Healthcare Systems, Inc. al 1- 858-790-7100 o llame al 1-888-678-7741 con esta información. Si tiene preguntas en relación a este proceso, comuníquese a Servicio al Cliente de MedImpact al 1-888-678-7741, las 24 horas del día, los 7 días de la semana. Criterios de revisión:Los siguientes lineamientos se usan al revisar las solicitudes de medicamentos:1. El uso de los productos medicinales de la lista de medicamentos está contraindicado para el paciente.2. El paciente ha fallado una prueba adecuada de los agentes de la lista de medicamentos o agentes

relacionados.3. Las opciones disponibles en la Lista de medicamentos no son adecuadas para las necesidades de atención

presentes del paciente y el medicamento elegido se requiere por seguridad del paciente.4. El uso del producto medicinal de la lista de medicamentos puede provocar una condición médica

subyacente, que sería en detrimento de la atención al paciente.

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Información de solicitud de medicación (por favor, llene cada sección de este formulario previo a su transmisión): Nombre del paciente (obligatorio): Plan de salud del paciente (obligatorio):

N.º de Id. del paciente (obligatorio): Nombre del médico/especialidad:

N.° de Id. del médico /N.° de DEA:

Fecha de nacimiento del paciente (requerida): Código de área y número telefónico del médico: ( )

Diagnóstico (obligatorio): Código de área y número de fax del médico (obligatorio): ( )

Farmacia que usa el afiliado: Código de área y número telefónico de la farmacia: ( )

Medicamento solicitado: Cantidad (por mes):

Dosis: Duración del tratamiento (especifique):

Concentración: Presentación (por ejemplo: oral, inyección):

Motivo de la solicitud del medicamento (especifique, proporcione detalles):

Otros medicamentos que se hayan probado o hayan fallado (especifique, dé detalles incluyendo la razóndel fallo): Otros pertinentes a la historia (relacionados o pertenecientes a esta solicitud):

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Antivirals, Hiv-specific, Non-nucleoside, RtiT1 nevirapine NEVIRAPINE ER

ALLERGY2nd Gen Antihistamine & Decongestant

CombinationsT5 cetirizine

hcl/pseudoephedrineCETIRIZINE-PSEUDOEPHEDRINEER(OTC)

T1 fexofenadine/pseudoephedrine

ALLERGY RELIEF-D(OTC)

T5 loratadine/pseudoephedrine

CLARITIN-D 12HOUR(OTC)

T5 loratadine/pseudoephedrine

CLARITIN-D 24HOUR(OTC)

Allergenic Extracts, TherapeuticsT2 gr pol-orc/sw

ver/rye/kent/timORALAIR PA

T2 grass pollen-timothy, std GRASTEK PAT2 weed pollen-short

ragweedRAGWITEK PA

Antihistamines - 1st GenerationT1 brompheniramine

maleateJ-TAN PD(OTC)

T4 carbinoxamine maleate CARBINOXAMINEMALEATE(LIQUID)

T1 carbinoxamine maleate CARBINOXAMINEMALEATE(TAB)

T4 chlorpheniraminemaleate

ALLERGY(OTC)

T4 clemastine fumarate CLEMASTINEFUMARATE

T1 clemastine fumarate CLEMASTINEFUMARATE(OTC)

T1 cyproheptadine hcl CYPROHEPTADINEHCL

T4 diphenhydramine hcl DIPHENHYDRAMINEHCL(CAP)(OTC)

T5 diphenhydramine hcl DIPHENHYDRAMINEHCL(ELIXIR)(OTC)

T4 diphenhydramine hcl DIPHENHYDRAMINEHCL(LIQUID)(OTC)

T4 diphenhydramine hcl DIPHENHYDRAMINEHCL(SYRUP)(OTC)

T4 diphenhydramine hcl DIPHENHYDRAMINEHCL(TAB)(OTC)

T4 hydroxyzine hcl HYDROXYZINE HCLT4 hydroxyzine pamoate HYDROXYZINE

PAMOATET4 hydroxyzine pamoate VISTARILT4 promethazine hcl PHENERGANT1 promethazine hcl PROMETHAZINE HCL

Antihistamines - 2nd GenerationT1 cetirizine hcl CETIRIZINE HCLT1 cetirizine hcl CETIRIZINE

HCL(OTC)T1 desloratadine DESLORATADINE QLT1 fexofenadine hcl FEXOFENADINE HCL

T1 fexofenadine hcl FEXOFENADINEHCL(OTC)

T1 levocetirizinedihydrochloride

LEVOCETIRIZINEDIHYDROCHLORIDE(SOLUTION)

QL, ST

T1 levocetirizinedihydrochloride

LEVOCETIRIZINEDIHYDROCHLORIDE(TAB)

T5 loratadine CLARITIN(OTC)T5 loratadine LORATADINE(OTC)

Nasal AntihistamineT1 azelastine hcl AZELASTINE HCL QLT1 olopatadine hcl OLOPATADINE HCL QL, ST

Nasal Anti-inflammatory SteroidsT2 beclomethasone

dipropionateQNASL QL, ST

T1 flunisolide FLUNISOLIDE QLT1 fluticasone propionate FLUTICASONE

PROPIONATEQL

T1 fluticasone propionate FLUTICASONEPROPIONATE(OTC)

QL

T2 mometasone furoate NASONEX QL

ANTIEMESIS/ANTIVERTIGOAntiemetic/antivertigo AgentsT2 aprepitant EMEND(CAP DS PK) QLT2 aprepitant EMEND(CAP)(125 MG)QLT2 aprepitant EMEND(CAP)(40 MG) QLT2 aprepitant EMEND(CAP)(80 MG) QLT5 dimenhydrinate MOTION

SICKNESS(OTC)T1 dronabinol DRONABINOL QL, STT1 granisetron hcl GRANISETRON HCL QL, STT1 meclizine hcl MECLIZINE HCLT1 meclizine hcl MECLIZINE HCL(OTC)T2 netupitant/palonosetron

hclAKYNZEO QL

T1 ondansetron ONDANSETRON ODTT1 ondansetron hcl ONDANSETRON

HCL(SOLUTION)QL

T1 ondansetron hcl ONDANSETRONHCL(TAB)

T1 prochlorperazine PROCHLORPERAZINET1 prochlorperazine

maleatePROCHLORPERAZINEMALEATE

T1 promethazine hcl PROMETHEGANT1 trimethobenzamide hcl TRIMETHOBENZAMI

DE HCL

ASTHMA AND COPDAdrenergic Agents,catecholaminesT1 epinephrine EPINEPHRINE

Beta-adrenergic AgentsT1 albuterol sulfate ALBUTEROL

SULFATET2 albuterol sulfate VENTOLIN HFAT2 formoterol fumarate PERFOROMIST QLT1 levalbuterol hcl LEVALBUTEROL HCL

VNSNY Page 11 of 73

T1 metaproterenol sulfate METAPROTERENOLSULFATE

T2 olodaterol hcl STRIVERDIRESPIMAT

QL

T1 terbutaline sulfate TERBUTALINESULFATE

Beta-adrenergic And Anticholinergic CombinationsT2 ipratropium/albuterol

sulfateCOMBIVENTRESPIMAT

T1 ipratropium/albuterolsulfate

IPRATROPIUM-ALBUTEROL

T2 tiotropium br/olodaterolhcl

STIOLTO RESPIMAT QL

T2 umeclidiniumbrm/vilanterol tr

ANORO ELLIPTA QL

Beta-adrenergic And Glucocorticoid CombinationsT2 fluticasone/salmeterol ADVAIR DISKUS QLT2 fluticasone/salmeterol ADVAIR HFA QLT2 fluticasone/vilanterol BREO ELLIPTA QLT2 mometasone/formoterol DULERA QL

General Bronchodilator AgentsT2 ipratropium bromide ATROVENT HFA QLT1 ipratropium bromide IPRATROPIUM

BROMIDET2 tiotropium bromide SPIRIVA RESPIMAT QLT2 umeclidinium bromide INCRUSE ELLIPTA QL

Glucocorticoids, Orally InhaledT1 budesonide BUDESONIDE(AMPUL

-NEB)(0.25MG/2ML)QL

T1 budesonide BUDESONIDE(AMPUL-NEB)(0.5 MG/2ML)

QL

T1 budesonide BUDESONIDE(AMPUL-NEB)(1 MG/2 ML)

QL

T2 flunisolide AEROSPAN QL

Leukotriene Receptor AntagonistsT1 montelukast sodium MONTELUKAST

SODIUMT1 zafirlukast ZAFIRLUKAST

Mast Cell StabilizersT1 cromolyn sodium CROMOLYN SODIUM

Phosphodiesterase-4 (pde4) InhibitorsT2 roflumilast DALIRESP QL, ST

Respiratory Aids,devices,equipmentT1 compressor, for nebulizerDEVILBISS

COMPACT(OTC)T1 compressor, for nebulizerDEVILBISS PULMO-

AIDET1 compressor, for nebulizerDEVILBISS PULMO-

AIDE(OTC)T1 compressor, for nebulizerDEVILBISS

PULMOMATE(OTC)T1 compressor, for nebulizerPULMO-AIDET1 compressor, for nebulizerPULMO-AIDE(OTC)T1 compressor, for nebulizerSUNRISE

COMPRESSOR-NEBULIZER

T1 inhaler, assist devices ACE AEROSOLCLOUD ENHANCER

T1 inhaler, assist devices AEROCHAMBER MINIT1 inhaler, assist devices AEROCHAMBER MVT1 inhaler, assist devices AEROCHAMBER

PLUS FLOW-VUT1 inhaler, assist devices AEROCHAMBER

WITH FLOWSIGNALT1 inhaler, assist devices AEROCHAMBER Z-

STAT PLUST1 inhaler, assist devices AEROTRACH PLUST1 inhaler, assist devices BREATHERITET1 inhaler, assist devices BREATHRITET1 inhaler, assist devices EASIVENTT1 inhaler, assist devices E-Z SPACERT1 inhaler, assist devices LITEAIRET1 inhaler, assist devices MICROCHAMBERT1 inhaler, assist devices MICROSPACERT1 inhaler, assist devices POCKET CHAMBERT1 inhaler, assist devices PRIMEAIRET1 inhaler, assist devices PROCHAMBERT1 inhaler, assist devices RITEFLOT1 inhaler, assist devices VORTEXT1 inhaler, assist devices VORTEX VHC FROG

MASKT1 inhaler, assist devices VORTEX VHC

LADYBUG MASKT1 inhaler,assist

device,accesoryEASIVENT

T1 inhaler,assistdevice,accesory

LITETOUCH


MOUTHPIECE(OTC)


ONE WAYMOUTHPIECE(OTC)


OPTICHAMBER


OPTICHAMBERDIAMOND


PANDA MASK(OTC)


PEDIATRIC PANDAMASK(OTC)


SIDESTREAMPEDIATRIC(OTC)


SILICONE MASK


SILICONEMASK(OTC)

T1 mucus clearing device FLUTTERT1 mucus clearing device QUAKET5 nasal airflow strips BREATHE

RIGHT(OTC)T5 nasal airflow strips NASAL STRIPS(OTC)T1 nebulizer AEROECLIPSE IIT1 nebulizer AIRS DISPOSABLE

NEBULIZER(OTC)T1 nebulizer ALTERA NEBULIZERT1 nebulizer BABY NEBULIZERT1 nebulizer COMPACT

COMPRESSORNEBULIZER(OTC)

VNSNY Page 12 of 73

T1 nebulizer COMPACTULTRASONICNEBULIZER(OTC)

T1 nebulizer COMPMISTCOMPRESSORNEBULIZER(OTC)

T1 nebulizer DEVILBISSDISPOSABLENEBULIZER(OTC)

T1 nebulizer ERAPID NEBULIZERT1 nebulizer INSPIRATIONT1 nebulizer LC D NEBULIZER SETT1 nebulizer LC PLUST1 nebulizer LC SPRINT

NEBULIZERT1 nebulizer MICRO AIR(OTC)T1 nebulizer MICRO PLUST1 nebulizer MINI PLUS

NEBULIZERT1 nebulizer MINICOMP

COMPRESSORNEBULIZER(OTC)

T1 nebulizer PARI LC SPRINTSINUS

T1 nebulizer PRODIGY MINI-MISTT1 nebulizer SIDESTREAMT1 nebulizer SIDESTREAM

NEBULIZERT1 nebulizer SIDESTREAM PLUST1 nebulizer/compressor COMP-AIR ELITE

COMPRESSOR SYSTT1 nebulizer/compressor COMP-AIR ELITE

COMPRESSORSYST(OTC)

T1 nebulizer/compressor COMP-AIRNEBULIZERCOMPRESSOR

T1 nebulizer/compressor COMP-AIRNEBULIZERCOMPRESSOR(OTC)

T1 nebulizer/compressor DEVILBISSTRAVELER

T1 nebulizer/compressor INNOSPIREELEGANCE

T1 nebulizer/compressor INNOSPIRE ESSENCET1 nebulizer/compressor INSPIRATION ELITET1 nebulizer/compressor MICRO ELITET1 nebulizer/compressor MINIELITET1 nebulizer/compressor PARI SINUS AEROSOL

SYSTEMT1 nebulizer/compressor PRONEB ULTRA IIT1 nebulizer/compressor PULMONEB LT

COMPRESSORNEBUL(OTC)

T1 nebulizer/compressor SAMI THE SEALT1 nebulizer/compressor TREK S COMBO PACKT1 nebulizer/compressor TREK S COMPACT

COMPRESSORT1 nebulizer/compressor VIOS AEROSOL

DELIVERY SYSTEMT1 peak flow meter AIRZONE PEAK FLOW

METER(OTC)T1 peak flow meter ASSESS(OTC)

T1 peak flow meter ASTHMACHECK(OTC)

T1 peak flow meter ASTHMAMENTOR(OTC)

T1 peak flow meter IN-CHECK NASALWITH MASK(OTC)

T1 peak flow meter IN-CHECKORAL(OTC)

T1 peak flow meter MICROLIFE PEAKFLOW(OTC)

T1 peak flow meter MINI-WRIGHT PEAKFLOW METER

T1 peak flow meter PEAK-AIR(OTC)T1 peak flow meter PERSONAL

BEST(OTC)T1 peak flow meter PIKO 1(OTC)T1 peak flow meter POCKET PEAK(OTC)T1 peak flow meter TRUZONE PEAK

FLOW METERT1 peak flow meter/inh asst

devAEROGEAR ASTHMAACTION KIT

T1 peak flow meter/inh asstdev

ASTHMAPACKCHILDREN'S

T1 spirometers andaccessories

IN-CHECK DIAL(OTC)


PFLEX TRAINER


THRESHOLD IMT


THRESHOLD PEP


WINDMILLTRAINER(OTC)

T1 vaporizer VAPORIZER(OTC)T1 vaporizer VICKS WARM STEAM

VAPORIZER(OTC)T1 vaporizer WARM STEAM

VAPORIZER(OTC)T1 vaporizer-humidifier

supplyVAPORIZERCLEANINGTABLETS(OTC)

T1 vaporizer-humidifiersupply

VAPORIZERINHALANT(OTC)

XanthinesT1 caffeine citrated CAFFEINE CITRATET2 theophylline anhydrous THEO-24T1 theophylline anhydrous THEOPHYLLINE

ANHYDROUS

AUTONOMIC NERVOUS SYSTEM

DISORDERSAlzheimer's Therapy, Nmda Receptor AntagonistsT1 memantine hcl MEMANTINE

HCL(SOLUTION)QL

T1 memantine hcl MEMANTINEHCL(TAB DS PK)

QL

T1 memantine hcl MEMANTINEHCL(TAB)

QL

T2 memantine hcl NAMENDA XR(CAP 24DSPK)

QL

VNSNY Page 13 of 73

T2 memantine hcl NAMENDA XR(CAPSPR 24)

QL

Alzheimer's Thx,nmda Recept Antag & Cholines

InhibT2 memantine hcl/donepezil

hclNAMZARIC QL, ST

Cholinesterase InhibitorsT1 donepezil hcl DONEPEZIL HCLT1 galantamine hbr GALANTAMINE

HBR(CAP24H PEL)QL

T1 galantamine hbr GALANTAMINEHBR(TAB)

QL

T2 pyridostigmine bromide MESTINONT1 pyridostigmine bromidePYRIDOSTIGMINE

BROMIDET1 rivastigmine RIVASTIGMINE QLT1 rivastigmine tartrate RIVASTIGMINE

BEHAVIORAL HEALTH -

ANTIDEPRESSANTSAlpha-2 Receptor Antagonist AntidepressantsT4 mirtazapine MIRTAZAPINET4 mirtazapine REMERON

Maois - Non-selective & IrreversibleT4 isocarboxazid MARPLANT4 phenelzine sulfate PHENELZINE

SULFATET4 tranylcypromine sulfatePARNATE

Norepinephrine And Dopamine Reuptake InhibT4 bupropion hbr APLENZIN QL, ST

Selective Serotonin Reuptake InhibitorT4 citalopram

hydrobromideCELEXA

T4 citalopramhydrobromide

CITALOPRAM HBR

T4 escitalopram oxalate ESCITALOPRAMOXALATE

T4 escitalopram oxalate LEXAPROT4 fluoxetine hcl FLUOXETINE HCLT4 fluoxetine hcl PROZACT4 fluoxetine hcl SARAFEMT4 fluvoxamine maleate FLUVOXAMINE

MALEATET4 paroxetine hcl PAXILT4 paroxetine hcl PAXIL CRT4 paroxetine mesylate BRISDELLE QL, STT4 paroxetine mesylate PEXEVA QL, STT4 sertraline hcl SERTRALINE HCL

Serotonin-2 Antagonist/reuptake InhibitorsT4 nefazodone hcl NEFAZODONE HCLT4 trazodone hcl OLEPTRO ER QL, STT4 trazodone hcl TRAZODONE HCL

Serotonin-norepinephrine Reuptake-inhibT4 desvenlafaxine DESVENLAFAXINE

ERQL, ST

T4 desvenlafaxine KHEDEZLA QL, STT4 desvenlafaxine fumarate DESVENLAFAXINE

FUMARATE ERQL, ST

T4 desvenlafaxine succinate PRISTIQ ER QL, STT4 duloxetine hcl CYMBALTA QLT4 duloxetine hcl DULOXETINE HCL QLT4 levomilnacipran

hydrochlorideFETZIMA QL, ST

T4 venlafaxine hcl VENLAFAXINE HCLER

Ssri & 5ht1a Partial Agonist AntidepressantT4 vilazodone hydrochlorideVIIBRYD QL, ST

Ssri & Serotonin Receptor Modulator

AntidepressantT4 vortioxetine

hydrobromideBRINTELLIX QL, ST

Tricyclic Antidepressant/benzodiazepine

CombinatnsT4 amitrip

hcl/chlordiazepoxideCHLORDIAZEPOXIDE-AMITRIPTYLINE

Tricyclic Antidepressant/phenothiazine CombinatnsT4 perphenazine/amitripty

line hclPERPHENAZINE-AMITRIPTYLINE

Tricyclic Antidepressants & Rel. Non-sel. Ru-inhibT4 amitriptyline hcl AMITRIPTYLINE HCLT4 amoxapine AMOXAPINET4 clomipramine hcl ANAFRANILT4 desipramine hcl NORPRAMINT4 doxepin hcl DOXEPIN HCLT4 imipramine hcl IMIPRAMINE HCLT4 imipramine pamoate TOFRANIL-PMT4 maprotiline hcl MAPROTILINE HCLT4 nortriptyline hcl NORTRIPTYLINE HCLT4 nortriptyline hcl PAMELORT4 protriptyline hcl PROTRIPTYLINE HCLT4 trimipramine maleate SURMONTILT4 trimipramine maleate TRIMIPRAMINE

MALEATE

BEHAVIORAL HEALTH - OTHERAdrenergics, Aromatic, Non-catecholamineT1 dextroamphetamine

sulfateDEXTROAMPHETAMINESULFATE(SOLUTION)

QL

T1 dextroamphetaminesulfate

DEXTROAMPHETAMINE SULFATE(TAB)(10MG)

QL


DEXTROAMPHETAMINE SULFATE(TAB)(5MG)

QL


ZENZEDI QL, ST

VNSNY Page 14 of 73

T1 dextroamphetamine/amphetamine

DEXTROAMPHETAMINE-AMPHETAMINE

QL

T2 lisdexamfetaminedimesylate

VYVANSE QL, ST

T1 methamphetamine hcl METHAMPHETAMINEHCL

QL

Anti-alcoholic PreparationsT1 disulfiram DISULFIRAMT2 naltrexone microspheres VIVITROL

Anti-anxiety DrugsT4 alprazolam ALPRAZOLAMT4 alprazolam ALPRAZOLAM

INTENSOLT4 buspirone hcl BUSPIRONE HCLT4 chlordiazepoxide hcl CHLORDIAZEPOXIDE

HCLT4 clorazepate

dipotassiumCLORAZEPATEDIPOTASSIUM

T4 clorazepatedipotassium

TRANXENE T-TAB

T4 diazepam DIAZEPAMT4 lorazepam ATIVANT4 lorazepam LORAZEPAMT4 meprobamate MEPROBAMATET4 oxazepam OXAZEPAM

Anti-mania DrugsT4 carbamazepine EQUETROT4 lithium carbonate LITHIUM

CARBONATET4 lithium carbonate LITHOBIDT4 lithium citrate LITHIUM

Antipsych,dopamine

Antag.,diphenylbutylpiperidinesT4 pimozide ORAP

Antipsychotics, Atyp, D2 Partial Agonist/5ht MixedT4 aripiprazole ABILIFY QL, STT2 aripiprazole ABILIFY MAINTENAT4 aripiprazole ARIPIPRAZOLE QL, ST

Antipsychotics, Dopamine & Serotonin AntagonistsT2 loxapine ADASUVET4 loxapine succinate LOXAPINE

Antipsychotics,atypical,dopamine,& Serotonin

AntagT4 asenapine maleate SAPHRIS QL, STT4 clozapine CLOZAPINE QLT4 clozapine CLOZARIL QLT4 clozapine VERSACLOZ QL, STT4 iloperidone FANAPT(TAB DS PK) QL, STT4 iloperidone FANAPT(TAB) QL, STT4 lurasidone hcl LATUDA(TAB)(120

MG)QL, ST

T4 lurasidone hcl LATUDA(TAB)(20 MG) QL, STT4 lurasidone hcl LATUDA(TAB)(40 MG) QL, STT4 lurasidone hcl LATUDA(TAB)(60 MG) QL, STT4 lurasidone hcl LATUDA(TAB)(80 MG) QL, ST

T4 olanzapine ZYPREXA QLT2 olanzapine pamoate ZYPREXA RELPREVVT4 paliperidone INVEGA(TAB ER

24H)(1.5 MG)QL, ST

T4 paliperidone INVEGA(TAB ER24H)(3 MG)

QL, ST


QL, ST


QL, ST

T2 paliperidone palmitate INVEGA SUSTENNAT4 quetiapine fumarate SEROQUEL QLT4 quetiapine fumarate SEROQUEL XR QL, STT4 risperidone RISPERDAL(SOLUTIO

N)QL

T4 risperidone RISPERDAL(TAB) QLT2 risperidone microspheres RISPERDAL CONSTAT4 ziprasidone hcl GEODON QLT4 ziprasidone mesylate GEODON

Antipsychotics,dopamine Antagonists,

ThioxanthenesT4 thiothixene THIOTHIXENE

Antipsychotics,dopamine

Antagonists,butyrophenonesT4 haloperidol HALOPERIDOLT4 haloperidol decanoate HALDOL

DECANOATE 50T4 haloperidol decanoate HALOPERIDOL

DECANOATET4 haloperidol lactate HALOPERIDOL

LACTATE

Anti-psychotics,phenothiazinesT4 chlorpromazine hcl CHLORPROMAZINE

HCLT4 fluphenazine decanoate FLUPHENAZINE

DECANOATET4 fluphenazine hcl FLUPHENAZINE HCLT4 perphenazine PERPHENAZINET4 thioridazine hcl THIORIDAZINE HCLT4 trifluoperazine hcl TRIFLUOPERAZINE

HCL

BarbituratesT4 butabarbital sodium BUTISOL SODIUMT4 phenobarbital PHENOBARBITALT4 secobarbital sodium SECONAL SODIUM

Hypnotics, Melatonin Mt1/mt2 Receptor AgonistsT4 ramelteon ROZEREM QL, STT4 tasimelteon HETLIOZ PA

Monoamine Oxidase(mao) InhibitorsT4 selegiline EMSAM QL

Narcolepsy And Sleep Disorder Therapy AgentsT1 modafinil MODAFINIL PA

Narcotic AntagonistsT1 naloxone hcl NALOXONE HCL

VNSNY Page 15 of 73

T1 naltrexone hcl NALTREXONE HCL

Sedative-hypnotics,non-barbiturateT4 diphenhydramine hcl NIGHTTIME SLEEP

AID(OTC)T4 diphenhydramine hcl ZZZQUIL(OTC)T4 doxepin hcl SILENOR QL, STT4 estazolam ESTAZOLAMT4 eszopiclone LUNESTA QLT4 flurazepam hcl FLURAZEPAM HCLT1 midazolam hcl MIDAZOLAM HCLT4 suvorexant BELSOMRA QL, STT4 temazepam RESTORILT4 triazolam TRIAZOLAMT4 zaleplon SONATA QLT4 zolpidem tartrate EDLUAR QL, STT4 zolpidem tartrate INTERMEZZO QL, STT4 zolpidem tartrate ZOLPIDEM TARTRATEQLT4 zolpidem tartrate ZOLPIMIST QL, ST

Ssri &antipsych,atyp,dopamine&serotonin Antag

CombT4 olanzapine/fluoxetine

hclOLANZAPINE-FLUOXETINE HCL

QL

T4 olanzapine/fluoxetinehcl

SYMBYAX QL

Tx For Adhd - Selective Alpha-2a Receptor AgonistT1 clonidine hcl CLONIDINE HCL ER QLT1 guanfacine hcl GUANFACINE HCL ER QL

Tx For Attention Deficit-hyperact(adhd)/narcolepsyT1 dexmethylphenidate hclDEXMETHYLPHENID

ATE HCL ERAGE,QL

T2 dexmethylphenidate hcl FOCALIN XR AGE,QL

T1 methylphenidate hcl METHYLPHENIDATEER(CPBP 50-50)(20MG)

AGE,QL


AGE,QL


AGE,QL

T1 methylphenidate hcl METHYLPHENIDATEER(TAB ER 24H)(18MG)

AGE,QL


AGE,QL


AGE,QL


AGE,QL

T1 methylphenidate hcl METHYLPHENIDATEER(TAB ER)(10 MG)

AGE,QL

T1 methylphenidate hcl METHYLPHENIDATEER(TAB ER)(20 MG)

AGE,QL

T2 methylphenidate hcl RITALIN LA AGE,QL

Tx For Attention Deficit-hyperact.(adhd), Nri-typeT2 atomoxetine hcl STRATTERA(CAP)(10

MG)QL

T2 atomoxetine hcl STRATTERA(CAP)(100MG)

QL


QL


QL


QL


QL


QL

CARDIOVASCULAR DISEASE -

ARRHYTHMIAAntiarrhythmicsT1 amiodarone hcl AMIODARONE HCLT1 disopyramide

phosphateDISOPYRAMIDEPHOSPHATE

T2 disopyramide phosphate NORPACE CRT2 dofetilide TIKOSYNT2 dronedarone hcl MULTAQT1 flecainide acetate FLECAINIDE

ACETATET1 mexiletine hcl MEXILETINE HCLT1 propafenone hcl PROPAFENONE HCLT1 quinidine gluconate QUINIDINE

GLUCONATET1 quinidine sulfate QUINIDINE SULFATE


CARDIAC STIMULANTDigitalis GlycosidesT2 digoxin DIGOXIN(SOLUTION)T1 digoxin DIGOXIN(TAB)


HYPERTENSIONAce Inhibitor/calcium Channel Blocker

CombinationT1 amlodipine

besylate/benazeprilAMLODIPINEBESYLATE-BENAZEPRIL

T1 trandolapril/verapamilhcl

TRANDOLAPRIL-VERAPAMIL ER

Ace Inhibitor/thiazide & Thiazide-like DiureticT1 benazepril/hydrochloro

thiazideBENAZEPRIL-HYDROCHLOROTHIAZIDE

VNSNY Page 16 of 73

T1 captopril/hydrochlorothiazide

CAPTOPRIL-HYDROCHLOROTHIAZIDE

T1 enalapril/hydrochlorothiazide

ENALAPRIL-HYDROCHLOROTHIAZIDE

T1 fosinopril/hydrochlorothiazide

FOSINOPRIL-HYDROCHLOROTHIAZIDE

T1 lisinopril/hydrochlorothiazide

LISINOPRIL-HYDROCHLOROTHIAZIDE

T1 moexipril/hydrochlorothiazide

MOEXIPRIL-HYDROCHLOROTHIAZIDE

T1 quinapril/hydrochlorothiazide

QUINAPRIL-HYDROCHLOROTHIAZIDE

Alpha/beta-adrenergic Blocking AgentsT1 carvedilol CARVEDILOLT2 carvedilol phosphate COREG CRT1 labetalol hcl LABETALOL HCL

Alpha-adrenergic Blocking AgentsT1 doxazosin mesylate DOXAZOSIN

MESYLATET1 phenoxybenzamine hcl phenoxybenzamine hclT1 prazosin hcl PRAZOSIN HCLT1 terazosin hcl TERAZOSIN HCL

Angioten.receptr Antag./cal.chanl Blkr/thiazide CbT1 amlodipine/valsartan/h

cthiazidAMLODIPINE-VALSARTAN-HCTZ

ST

Angiotensin Receptor Antag./thiazide Diuretic

CombT1 irbesartan/hydrochlorot

hiazideIRBESARTAN-HYDROCHLOROTHIAZIDE

T1 losartan/hydrochlorothiazide

LOSARTAN-HYDROCHLOROTHIAZIDE

T2 olmesartan/hydrochlorothiazide

BENICAR HCT ST

T1 valsartan/hydrochlorothiazide

VALSARTAN-HYDROCHLOROTHIAZIDE

Angiotensin Receptor Antgnst & Calc.channel

BlockrT1 amlodipine/valsartan AMLODIPINE-

VALSARTANST

Antihypertensives, Ace InhibitorsT1 benazepril hcl BENAZEPRIL HCLT1 enalapril maleate ENALAPRIL

MALEATET1 fosinopril sodium FOSINOPRIL SODIUMT1 lisinopril LISINOPRILT1 moexipril hcl MOEXIPRIL HCL

T1 perindopril erbumine PERINDOPRILERBUMINE

T1 quinapril hcl QUINAPRIL HCLT1 ramipril RAMIPRILT1 trandolapril TRANDOLAPRIL

Antihypertensives, Angiotensin Receptor

AntagonistT1 irbesartan IRBESARTANT1 losartan potassium LOSARTAN

POTASSIUMT2 olmesartan medoxomil BENICAR STT1 telmisartan TELMISARTANT1 valsartan VALSARTAN

Antihypertensives, SympatholyticT1 clonidine CLONIDINET1 clonidine hcl CLONIDINE HCLT1 clonidine

hcl/chlorthalidoneCLORPRES

T1 guanfacine hcl GUANFACINE HCLT1 methyldopa METHYLDOPAT1 methyldopa/hydrochlor

othiazideMETHYLDOPA-HYDROCHLOROTHIAZIDE

T1 reserpine RESERPINE

Antihypertensives, VasodilatorsT1 hydralazine hcl HYDRALAZINE HCLT1 minoxidil MINOXIDIL

Beta-adrenergic Blocking AgentsT1 acebutolol hcl ACEBUTOLOL HCLT1 atenolol ATENOLOLT1 betaxolol hcl BETAXOLOL HCLT1 bisoprolol fumarate BISOPROLOL

FUMARATET1 metoprolol succinate METOPROLOL

SUCCINATET1 metoprolol tartrate METOPROLOL

TARTRATET2 nebivolol hcl BYSTOLICT1 pindolol PINDOLOLT1 propranolol hcl PROPRANOLOL HCLT1 sotalol hcl SOTALOLT1 timolol maleate TIMOLOL MALEATE

Beta-adrenergic Blocking Agents/thiazide &

RelatedT1 atenolol/chlorthalidone ATENOLOL-

CHLORTHALIDONET1 bisoprolol

fumarate/hctzBISOPROLOL-HYDROCHLOROTHIAZIDE

T1 metoprolol/hydrochlorothiazide

METOPROLOL-HYDROCHLOROTHIAZIDE

T1 nadolol/bendroflumethiazide

NADOLOL-BENDROFLUMETHIAZIDE

VNSNY Page 17 of 73

T1 propranolol/hydrochlorothiazid

PROPRANOLOL-HYDROCHLOROTHIAZID

Calcium Channel Blocking AgentsT1 amlodipine besylate AMLODIPINE

BESYLATET1 diltiazem hcl CARTIA XTT1 felodipine FELODIPINE ERT1 isradipine ISRADIPINET1 nicardipine hcl NICARDIPINE HCLT1 nifedipine NIFEDIPINE ERT1 nimodipine NIMODIPINET2 nimodipine NYMALIZE PAT1 verapamil hcl VERAPAMIL ER

Loop DiureticsT1 bumetanide BUMETANIDET1 furosemide FUROSEMIDET1 torsemide TORSEMIDE

Potassium Sparing DiureticsT1 amiloride hcl AMILORIDE HCLT1 spironolactone SPIRONOLACTONE

Potassium Sparing Diuretics In CombinationT1 amiloride/hydrochlorot

hiazideAMILORIDE-HYDROCHLOROTHIAZIDE

T1 spironolact/hydrochlorothiazid

SPIRONOLACTONE-HCTZ

T1 triamterene/hydrochlorothiazid

TRIAMTERENE-HYDROCHLOROTHIAZID

Pulm Anti-htn,soluble Guanylate Cyclase

StimulatorT2 riociguat ADEMPAS PA

Pulm.anti-htn,sel.c-gmp Phosphodiesterase T5

InhibT2 sildenafil citrate REVATIO PAT1 sildenafil citrate SILDENAFIL PAT2 tadalafil ADCIRCA PA

Pulmonary Anti-htn, Endothelin Receptor

AntagonistT2 ambrisentan LETAIRIS PAT2 bosentan TRACLEER PAT2 macitentan OPSUMIT PA

Pulmonary Antihypertensives, Prostacyclin-typeT2 iloprost tromethamine VENTAVIS PAT2 treprostinil TYVASO PAT2 treprostinil diolamine ORENITRAM ER PAT2 treprostinil sodium REMODULIN PAT2 treprostinil/neb

accessoriesTYVASO PA

T2 treprostinil/nebulizer/accesor

TYVASO PA

Thiazide And Related DiureticsT1 chlorothiazide CHLOROTHIAZIDET1 chlorthalidone CHLORTHALIDONET1 hydrochlorothiazide HYDROCHLOROTHIA

ZIDET1 indapamide INDAPAMIDET1 methyclothiazide METHYCLOTHIAZIDET1 metolazone METOLAZONE

Vasodilators, CombinationT2 isosorb dinit/hydralazine

hclBIDIL

CARDIOVASCULAR DISEASE - LIPID

IRREGULARITYAntihyperlipidemic - Apo B-100 Synthesis InhibitorT2 mipomersen sodium KYNAMRO PA

Antihyperlipidemic - Hmg Coa Reductase

InhibitorsT1 atorvastatin calcium ATORVASTATIN

CALCIUMT1 lovastatin LOVASTATINT1 pravastatin sodium PRAVASTATIN

SODIUMT2 rosuvastatin calcium CRESTOR(TAB)(10

MG)QL, ST

T2 rosuvastatin calcium CRESTOR(TAB)(20MG)

QL, ST

T2 rosuvastatin calcium CRESTOR(TAB)(40MG)

QL, ST

T2 rosuvastatin calcium CRESTOR(TAB)(5 MG) QL, STT1 simvastatin SIMVASTATIN(TAB)

(10 MG)T1 simvastatin SIMVASTATIN(TAB)

(20 MG)T1 simvastatin SIMVASTATIN(TAB)

(40 MG)T1 simvastatin SIMVASTATIN(TAB)(5

MG)T1 simvastatin SIMVASTATIN(TAB)

(80 MG)ST

Antihyperlipidemic - Mtp InhibitorT2 lomitapide mesylate JUXTAPID PA, QL

Antihyperlipidemic-hmg Coa Reductase

Inhib.&niacinT2 niacin/simvastatin SIMCOR(TBMP

24HR)(1000-20MG)QL, ST

T2 niacin/simvastatin SIMCOR(TBMP24HR)(1000-40 MG)

QL, ST

T2 niacin/simvastatin SIMCOR(TBMP24HR)(500MG-20MG)

QL, ST


QL, ST


QL, ST

VNSNY Page 18 of 73

Bile Salt SequestrantsT1 cholestyramine (with

sugar)CHOLESTYRAMINE

T1 cholestyramine/aspartame

PREVALITE

T2 colesevelam hcl WELCHOLT1 colestipol hcl COLESTIPOL HCL

LipotropicsT2 ezetimibe ZETIA QLT1 fenofibrate FENOFIBRATET1 fenofibrate

nanocrystallizedFENOFIBRATE

T2 fenofibratenanocrystallized

TRIGLIDE ST

T1 fenofibrate,micronized FENOFIBRATET1 fenofibric acid FENOFIBRIC ACIDT1 fenofibric acid (choline) FENOFIBRIC ACIDT1 gemfibrozil GEMFIBROZILT2 icosapent ethyl VASCEPA QLT1 niacin NIACIN ER STT1 omega-3 acid ethyl

estersOMEGA-3 ACIDETHYL ESTERS

QL

Niacin PreparationsT1 niacin NIACIN(OTC)


MISCELLANEOUS AGENTSAdrenergic Vasopressor AgentsT2 droxidopa NORTHERA PAT1 midodrine hcl MIDODRINE HCL

Antianginal & Anti-ischemic Agents,non-

hemodynamicT2 ranolazine RANEXA(TAB ER

12H)(1000 MG)QL

T2 ranolazine RANEXA(TAB ER12H)(500 MG)

QL

Antihyperlip - Hmg-coa&calcium Channel Blocker

CbT1 amlodipine/atorvastatinAMLODIPINE-

ATORVASTATINQL


VASODILATIONVasodilators,coronaryT1 amyl nitrite AMYL NITRITET2 isosorbide dinitrate ISORDILT1 isosorbide dinitrate ISOSORBIDE

DINITRATET1 isosorbide mononitrate ISOSORBIDE

MONONITRATE ERT2 nitroglycerin NITRO-BIDT2 nitroglycerin NITRO-DUR

T1 nitroglycerin NITROGLYCERINPATCH

T2 nitroglycerin NITROSTAT

Vasodilators,peripheralT1 ergoloid mesylates ERGOLOID

MESYLATEST1 isoxsuprine hcl ISOXSUPRINE HCLT1 papaverine hcl PAPAVERINE HCL

CONTRACEPTION/OXYTOCICSContraceptives, Intravaginal, SystemicT4 etonogestrel/ethinyl

estradiolNUVARING QL

Contraceptives,injectableT4 medroxyprogesterone

acetateDEPO-PROVERA QL

T4 medroxyprogesteroneacetate

DEPO-SUBQPROVERA 104

QL

Contraceptives,oralT4 desog-

e.estradiol/e.estradiolAZURETTE

T4 desogestrel-ethinylestradiol

APRI

T4 drospir/ethestra/levomefol ca

BEYAZ ST

T4 drospir/ethestra/levomefol ca

SAFYRAL ST

T4 estradiolvalerate/dienogest

NATAZIA

T4 ethinylestradiol/drospirenone

OCELLA ST

T4 ethynodiol d-ethinylestradiol

KELNOR 1-35

T4 levonorgestrel MY WAY(OTC)T4 levonorgestrel-ethin

estradiolAMETHYST

T4 levonorgestrel-ethinestradiol

LEVORA-28

T4 l-norgest/e.estradion-e.estrad

CAMRESE QL

T4 l-norgest/e.estradion-e.estrad

QUARTETTE

T4 noreth-ethinylestradiol/iron

GENERESS FE

T4 norethindrone NORA-BET4 norethindrone ac-eth

estradiolLOESTRIN

T4 norethindrone ac-ethestradiol

MICROGESTIN

T4 norethindrone-e.estradiol-iron

LO LOESTRIN FE


MICROGESTIN FE


MINASTRIN 24 FE

T4 norethindrone-ethinylestrad

NECON

T4 norethindrone-ethinylestrad

ORTHO-NOVUM

VNSNY Page 19 of 73

T4 norethindrone-mestranol

NORINYL 1+50

T4 norgestimate-ethinylestradiol

ORTHO TRI-CYCLENLO

T4 norgestimate-ethinylestradiol

SPRINTEC

T4 norgestrel-ethinylestradiol

CRYSELLE

T4 ulipristal acetate ELLA

Contraceptives,transdermalT4 norelgestromin/ethin.es

tradiolORTHO EVRA QL

Diaphragms/cervical CapT4 diaphragms, wide seal WIDE SEAL

DIAPHRAGM

OxytocicsT1 methylergonovine

maleateMETHYLERGONOVINE MALEATE

COUGH AND COLD1st Gen Antihistamine & Decongestant

CombinationsT1 phenylephrine

hcl/prometh hclPROMETHAZINE VC

T1 pseudoephedrine/triprolidine

APRODINE(OTC)

Analgesic, Non-sal.- 1st Generation AntihistamineT1 acetaminophen/phenylt

olxDOLOGESIC(OTC)

Antitussives,non-narcoticT1 benzonatate BENZONATATE

Decongestants, OralT5 pseudoephedrine hcl WAL-PHED D(OTC)

ExpectorantsT5 guaifenesin Q-TUSSIN(OTC)

Narcotic Antituss-1st Gen. Antihistamine-decongestT1 bromphenira/pseudoep

hed/codeinMAR-COF BP(OTC)

T1 promethazine/phenyleph/codeine

PROMETHAZINE VC-CODEINE

T1 pseudoephed/hydrocodone/cpm

HYDROCOD-CPM-PSEUDOEPHEDRINE

Narcotic Antituss-decongestant-expectorant CombT1 p-ephed

hcl/codeine/guaifenCHERATUSSINDAC(OTC)

Narcotic Antitussive-1st Generation AntihistamineT1 hydrocodone/chlorphen

p-stirexHYDROCODONE-CHLORPHENIRAMNEER

T1 promethazinehcl/codeine

PROMETHAZINE-CODEINE

Narcotic Antitussive-anticholinergic Comb.T1 hydrocodone

bit/homatrop me-brHYDROMET

Narcotic Antitussive-expectorant CombinationT1 guaifenesin/codeine

phosphateCHERATUSSINAC(OTC)

Non-narc Antituss-1st Gen. Antihistamine-

decongestT1 brompheniram/phenyle

phrine/dmNIVA-HIST DM(OTC)

T1 dm/phenyleph/chlorpheniramine

NOHIST-DM(OTC)

T1 d-methorphan hb/p-epdhcl/bpm

BROMPHENIRAMINE-PSEUDOEPHED-DM

Non-narc Antitussive-1st Gen Antihistamine Comb.T1 promethazine/dextrome

thorphanPROMETHAZINE-DM

Non-narcotic Antitussive And Expectorant Comb.T5 guaifenesin/dextrometh

orphanQ-TUSSIN DM(OTC)

Nose Preparations, VasoconstrictorsT5 oxymetazoline hcl NASAL

DECONGESTANT(OTC)

Sympathomimetic AgentsT5 pseudoephedrine hcl NEXAFED(OTC)T5 pseudoephedrine hcl SUDOGEST(TAB

ER)(OTC)T5 pseudoephedrine hcl SUDOGEST(TAB)(30

MG)(OTC)T1 pseudoephedrine hcl SUDOGEST(TAB)(60

MG)(OTC)

DERMATOLOGY - ACNEAcne Agents,systemicT1 isotretinoin CLARAVIS

Acne Agents,topicalT1 clindamycin

phos/benzoyl peroxCLINDAMYCIN-BENZOYL PEROXIDE

AstringentsT5 aluminum acetate ALUMINUM

ACETATE(OTC)

Rosacea Agents, TopicalT1 metronidazole METRONIDAZOLE

Topical Preparations,antibacterialsT1 benzalkonium chloride REVITADERM(OTC)T1 chloroxylenol PERICLEAN(OTC)T1 hydrocortisone/iodoqui

nolHYDROCORTISONE-IODOQUINOL

T1 iodine/potassium iodide IODINE(OTC)

VNSNY Page 20 of 73

T1 methylbenzethoniumchloride

BEDSIDE-CARE(OTC)

T5 silver SILVASORB(OTC)T5 silver SILVERMED(OTC)T1 silver chloride SILVER GEL(OTC)T1 silver nitrate SILVER NITRATET5 silver/sodium alginate ARGLAES(OTC)

DERMATOLOGY - ANTIINFECTIVETopical AntibioticsT5 bacitracin BACITRACIN(OTC)T5 bacitracin zinc BACITRACIN

ZINC(OTC)T1 bacitracin/polymyxin b

sulfateBACITRACIN-POLYMYXIN(OTC)

T1 clindamycin phosphate CLINDAMYCINPHOSPHATE

T1 erythromycinbase/ethanol

ERYTHROMYCIN

T2 erythromycin/benzoylperoxide

BENZAMYCINPAK

T1 erythromycin/benzoylperoxide

ERYTHROMYCIN-BENZOYL PEROXIDE

T1 gentamicin sulfate GENTAMICINSULFATE

T1 mupirocin MUPIROCINT1 mupirocin calcium MUPIROCINT1 neomycn/baci zn/pmyx

bs/pramoxTRIPLE ANTIBIOTICPLUS(OTC)

Topical Antifungal/antiinflammatory,steriod AgentT1 clotrimazole/betametha

sone dipCLOTRIMAZOLE-BETAMETHASONE

Topical AntifungalsT1 ciclopirox CICLOPIROXT1 ciclopirox olamine CICLOPIROXT1 ciclopirox/ure/camph/m

enth/eucCICLOPIROX

T1 clotrimazole CLOTRIMAZOLET1 clotrimazole CLOTRIMAZOLE(OT

C)T1 econazole nitrate ECONAZOLE

NITRATET1 gentian viol/brlnt

grn/proflavTRIPLE DYE

T1 ketoconazole KETOCONAZOLET1 miconazole nitrate MICONAZOLE

NITRATE(OTC)T1 naftifine hcl NAFTIFINE HCLT2 naftifine hcl NAFTINT1 nystatin NYSTATINT1 nystatin/triamcin NYSTATIN-

TRIAMCINOLONET1 sodium thiosulfate/sal

acidEXODERM

T2 sulconazole nitrate EXELDERMT2 terbinafine hcl LAMISIL(OTC)T5 tolnaftate TOLNAFTATE(OTC)

Topical AntiparasiticsT2 crotamiton EURAXT1 lindane LINDANE

T1 permethrin PERMETHRINT5 permethrin PERMETHRIN(OTC)T5 piperonyl

butoxide/pyrethrinsLICE KILLING(OTC)

Topical AntiviralsT1 acyclovir ACYCLOVIRT2 acyclovir ZOVIRAXT5 docosanol ABREVA(OTC)

Topical SulfonamidesT1 mafenide acetate MAFENIDE ACETATET1 silver sulfadiazine SILVER

SULFADIAZINE

DERMATOLOGY -

ANTIINFLAMMATORYTopical Antibiotics/antiinflammatory,steroidalT2 neomycin/bacitra/polymy

xin/hcCORTISPORIN

T2 neomycin/polymyxin bsulf/hc

CORTISPORIN

Topical Anti-inflammatory SteroidalT1 alclometasone

dipropionateALCLOMETASONEDIPROPIONATE

T1 amcinonide AMCINONIDET1 betamethasone

dipropionateBETAMETHASONEDIPROPIONATE

T1 betamethasone valerate BETAMETHASONEVALERATE

T1 betamethasone/propylene glyc

BETAMETHASONEDIPROPIONATE

T1 clobetasol propionate CLOBETASOLPROPIONATE

T1 clobetasolpropionate/emoll

CLOBETASOLEMOLLIENT

T1 clocortolone pivalate CLOCORTOLONEPIVALATE

T1 desonide DESONIDET1 desoximetasone DESOXIMETASONET2 diflorasone

diacetate/emollAPEXICON E

T1 fluocinolone acetonide FLUOCINOLONEACETONIDE

T1 fluocinolone/shower capFLUOCINOLONEACETONIDE

T1 fluocinonide FLUOCINONIDET1 fluocinonide/emollient

baseFLUOCINONIDE-E

T2 flurandrenolide CORDRANT1 fluticasone propionate FLUTICASONE

PROPIONATET1 halobetasol propionate HALOBETASOL

PROPIONATET1 hc/mineral

oil/petrolat,whtHYDROCORTISONE

T2 hydrocort/salacid/sulf/shmp#1

SCALACORT DK

T1 hydrocortisone HYDROCORTISONET5 hydrocortisone HYDROCORTISONE(O

TC)

VNSNY Page 21 of 73

T2 hydrocortisone TEXACORTT5 hydrocortisone acetate HYDROCORTISONE

ACETATE(OTC)T1 hydrocortisone

acetate/ureaU-CORT

T1 hydrocortisonebutyrate

HYDROCORTISONEBUTYRATE

T2 hydrocortisone probutate PANDELT1 hydrocortisone valerate HYDROCORTISONE

VALERATET5 hydrocortisone/aloe

veraHYDROCORTISONE-ALOE(OTC)

T5 hydrocortisone/aloe/vit.e/a/d

ANTI-ITCHCREME(OTC)

T5 hydrocortisone/oatmeal/aloe/e

AVEENO(OTC)

T1 mometasone furoate MOMETASONEFUROATE

T1 prednicarbate PREDNICARBATET1 triamcinolone acetonideTRIAMCINOLONE

ACETONIDE

Topical Anti-inflammatory, NsaidsT1 diclofenac sodium DICLOFENAC

SODIUMT2 diclofenac sodium VOLTAREN

DERMATOLOGY - MISCELLANEOUSAntiseborrheic AgentsT1 emollient combination

no.43TL TRISEB

T1 emollient combinationno.85

LOUTREX

T1 selenium sulfide SELENIUM SULFIDET1 sulfacetamide sodium SODIUM

SULFACETAMIDE

Antiseptics,generalT1 alcohol antiseptic pads ALCOHOL PADS(OTC)T1 alcohol antiseptic pads ALCOHOL PREP

PADS(OTC)T2 alcohol antiseptic pads ALCOHOL PREP

SWABS(OTC)T1 alcohol antiseptic pads ALCOHOL

SWAB(OTC)T1 alcohol antiseptic pads ALCOHOL

SWABS(OTC)T1 alcohol antiseptic pads ALCOHOL

WIPES(OTC)T1 alcohol antiseptic pads CURITY ALCOHOL

PREPS(OTC)T1 alcohol antiseptic pads EASY TOUCH

ALCOHOL PREPPADS(OTC)

T2 alcohol antiseptic pads IV ANTISEPTICWIPES(OTC)

T2 alcohol antiseptic pads IV PREP WIPES(OTC)T1 alcohol antiseptic pads SINGLE USE

SWAB(OTC)T2 alcohol antiseptic pads SURE COMFORT

ALCOHOL(OTC)

T1 alcohol antiseptic pads SURE-PREPALCOHOL PREPPADS(OTC)

T1 alcohol antiseptic pads ULTILET ALCOHOLSWAB(OTC)

T1 alcohol antiseptic pads WEBCOL(OTC)

DeodorantsT5 ostomy supply FRESHNET(OTC)T5 ostomy supply HEX-ON LIGHT(OTC)T5 ostomy supply ODOR ELIMINATOR

DROPS(OTC)T5 ostomy supply ULTRA-FRESH(OTC)T1 sodium citrate M9(OTC)

EmollientsT1 aloe vera/collagen ALOE VESTA

CLEANSING(OTC)T1 aloe vera/collagen ALOE VESTA(OTC)T1 aloe vera/collagen PERISCENT(OTC)T1 aloe vera/collagen SENSI-CARE(OTC)T1 aloe/la/ceramide/silicone

&tapeSILICONE SCAR(OTC)

T1 aloe/lac ac/ceramides3,3b,6,1

HYPER-HEAL(OTC)

T1 ammonium lactate AMMONIUMLACTATE

T1 ammonium lactate AMMONIUMLACTATE(OTC)

T1 emol53/namgfs/ha/nahypochlorit

MB HYDROGEL

T1 emollient #56/hyaluronicacid

DERMAPLEX(OTC)


PRUTECT


EMULSION SB


PRUMYX


RESTORE SKINCONDITIONING(OTC)


HPR PLUS


ATRAPRO HYDROGEL

T1 emollient combo no.47 &no.60

ATRAPRO CP

T1 glycerin/dimethicone SENSITIVE SKINMOISTURE(OTC)

T1 lactic acid LACTIC ACIDT1 lanolin

alcohol/mo/w.pet/ceresDRY SKINTHERAPY(OTC)

T1 lanolin/aloe vera/propgly

SOOTHE & COOLPERINEALWASH(OTC)

T1 mineral oil/lan oil/propgly

BALNEOL(OTC)

T1 mineraloil/petrolatum,white

HYDROCERIN(OTC)

T1 pantothenic acid/aloevera

EXCEL-GEL(OTC)

T1 petrolatum,white SECURAPROTECTIVE(OTC)

T1 silicones/adhesive tape SILICONE DISC(OTC)

VNSNY Page 22 of 73

T1 silicones/adhesive tape SILICONE ROLL(OTC)T1 silicones/adhesive tape SILICONE

SHEET(OTC)T1 silicones/adhesive tape SILICONE TAPE(OTC)T1 vitamin e VITAMIN E(OTC)T1 vitamin e/aloe vera WOUND GEL(OTC)T1 vite

ac/grape/hyaluronicacid

PRUCLAIR

IrrigantsT1 acetic acid ACETIC ACIDT1 mannitol/sorbitol

solutionSORBITOL-MANNITOL

T1 nacl irrigat/decylglucoside

SEA-CLENS(OTC)

T1 neomycin su/polymyx bsulf

NEOMYCIN-POLYMYXIN B

T1 ringers solution RINGERS IRRIGATIONT1 sodium chloride irrig

solutionSODIUM CHLORIDE

T1 sorbitol solution SORBITOLT1 water for

irrigation,sterileWATER

Irritants/counter-irritantsT1 methyl salicylate METHYL

SALICYLATE(OTC)T1 methyl

salicylate/isopropanolISOPROPYL-WINTERGREEN(OTC)

KeratolyticsT5 benzoyl peroxide ACNE

MEDICATION(OTC)T1 benzoyl peroxide BENZOYL

PEROXIDE(CLEANSER)(OTC)

T5 benzoyl peroxide BENZOYLPEROXIDE(GEL)(10%)(OTC)

T1 benzoyl peroxide BENZOYLPEROXIDE(GEL)(2.5%)(OTC)

T5 benzoyl peroxide BENZOYLPEROXIDE(LOTION)(OTC)

T2 podofilox CONDYLOXT1 podofilox PODOFILOXT1 podophyllum resin PODOCON-25T1 potassium hydroxide POTASSIUM

HYDROXIDET1 salicylic acid SALICYLIC ACIDT1 salicylic acid/ceramide

cmb #1SALICYLIC ACID

T1 silver nitrate applicator SILVER NITRATEAPPLICATOR

T1 urea UREAT1 urea/hyaluronate

sodiumUREA

T1 urea/lactic ac/znundecylenate

BP-50% UREA

T1 urea/lactic acid/salicylicac

LATRIX

Oxidizing AgentsT1 hydrogen peroxide HYDROGEN

PEROXIDE(OTC)

ProtectivesT1 benzethonium chloride NEW SKIN(OTC)T1 benzoin BENZOIN(OTC)T1 carbit/equis

xt/ethan/chit/msmGENADUR

T1 dimethicone ONE STEPPERINEAL(OTC)

T1 hyaluronsod/allantoin/aloe xt

RADIAPLEXRX

T1 hyaluronate sodium BIONECTT1 petrolatum,white WHITE

PETROLATUM(OTC)T1 protect cmb2/ceramide

1,3,6-11PR CREAM

T1 zincacetate/meadowsweet/oak

AMERIGEL(OTC)

Shampoos/lotionT1 soap GRX RINSE-

FREE(OTC)

Topical Agents,miscellaneousT1 urea CARB-O-PHILIC

Topical Anti-inflammatory Steroid-local AnestheticT2 hydrocortisone/pramoxin

eANALPRAM HC

T1 hydrocortisone/pramoxine

HYDROCORTISONE-PRAMOXINE HCL


PRAMOSONE

T1 lidocaine/hydrocortisone ac

LIDOCAINE-HYDROCORTISONE

Topical Antineoplastic & Premalignant Lesion

AgntsT2 bexarotene TARGRETIN PAT1 diclofenac sodium DICLOFENAC

SODIUMPA, QL

T1 fluorouracil FLUOROURACILT2 ingenol mebutate PICATO(GEL)(0.015 %) QLT2 ingenol mebutate PICATO(GEL)(0.05 %) QLT2 mechlorethamine hcl VALCHLOR PA

Topical Local AnestheticsT1 cocaine hcl COCAINE HCLT1 dyclonine

hcl/benzethonium clLIQUIDBANDAGE(OTC)

T1 ethyl chloride ETHYL CHLORIDET1 lidocaine LIDOCAINET1 lidocaine hcl LIDOCAINE HCLT1 lidocaine hcl/collagen REGENECARET1 lidocaine/prilocaine LIDOCAINE-

PRILOCAINET1 vit e/lidocain/alo

ver/colagnREGENECARE

VNSNY Page 23 of 73

Topical Preparations,miscellaneousT1 benzethonium chloride BEDSIDE-CARE

PERINEAL(OTC)T1 calcium carbonate/na

hypochlorNAIL SCRUB(OTC)

T1 honey MEDIHONEY(OTC)T1 povidone-iodine BETADINE(OTC)T1 povidone-iodine POVIDONE-

IODINE(OTC)T1 skin cleanser comb no.34 PROSHIELD FOAM &

SPRAY(OTC)

Topical/mucous Membr./subcut. EnzymesT1 trypsin/balsam

peru/castor oilGRANULEX

DERMATOLOGY - PIGMENTATION

DISORDERSHypopigmentation AgentsT1 hydroquinone HYDROQUINONET1 hydroquinone

microspheresHYDROQUINONE

T1 hydroquinone/ferricoxide

MELPAQUE HP

T1 oxybenzone/octinox/h-quinone

ALPHAQUIN HP

Topical Hyperpigmentation AgentsT2 methoxsalen OXSORALEN

DERMATOLOGY -

PSORIASIS/ECZEMAAntipsoriatic Agents,systemicT2 methoxsalen 8-MOPT1 methoxsalen, rapid METHOXSALENT2 secukinumab COSENTYX (2

SYRINGES)PA

T2 secukinumab COSENTYX PEN PAT2 secukinumab COSENTYX PEN (2

PENS)PA

T2 secukinumab COSENTYX SYRINGE PA

Antipsoriatics AgentsT2 anthralin DRITHOCREME HP STT1 calcipotriene CALCIPOTRIENE STT1 calcitriol CALCITRIOL STT2 tazarotene TAZORAC

Topical Agents,miscellaneousT1 collagen,bovine TRIPLE HELIX

COLLAGEN(OTC)T1 skin cleanser PERIANAL

CLEANSING(OTC)T1 skin cleanser PERIFRESH(OTC)T1 skin cleanser comb no.20 RESTORE SKIN

CLEANSER(OTC)T1 skin cleanser comb no.21 RESTORE WOUND

CLEANSER(OTC)

Topical Immunosuppressive AgentsT1 tacrolimus TACROLIMUS AGE,

ST

Topical Vit D Analog/antiinflammatory, SteroidalT1 calcipotriene/betametha

soneCALCIPOTRIENE-BETAMETHASONE DP

ST

DIABETESAntihypergly, (dpp-4) Inhibitor & Biguanide Comb.T2 linagliptin/metformin hcl JENTADUETO QLT2 sitagliptin

phos/metformin hclJANUMET QL

T2 sitagliptinphos/metformin hcl

JANUMET XR(TBMP24HR)(100-1000MG)

QL


JANUMET XR(TBMP24HR)(50-1000 MG)

QL


JANUMET XR(TBMP24HR)(50MG-500MG)

QL

Antihypergly,incretin MimeticT2 albiglutide TANZEUM QL, STT2 dulaglutide TRULICITY QL, ST

Antihyperglycemc-sod/gluc

Cotransport2(sglt2)inhibT2 canagliflozin INVOKANA QL, STT2 empagliflozin JARDIANCE QL, ST

Antihyperglycemic, Alpha-glucosidase InhibT1 acarbose ACARBOSE

Antihyperglycemic, Amylin Analog-typeT2 pramlintide acetate SYMLINPEN 120T2 pramlintide acetate SYMLINPEN 60

Antihyperglycemic, Dpp-4 InhibitorsT2 linagliptin TRADJENTA QLT2 sitagliptin phosphate JANUVIA QL

Antihyperglycemic, Insulin-release Stimulant TypeT1 chlorpropamide CHLORPROPAMIDET1 glimepiride GLIMEPIRIDET1 glipizide GLIPIZIDET2 glyburide DIABETAT1 glyburide GLYBURIDET1 glyburide,micronized GLYBURIDE

MICRONIZEDT1 nateglinide NATEGLINIDET1 repaglinide REPAGLINIDET1 tolazamide TOLAZAMIDET1 tolbutamide TOLBUTAMIDE

Antihyperglycemic, Insulin-response EnhancerT1 pioglitazone hcl PIOGLITAZONE HCL

Antihyperglycemic, Sglt-2 & Dpp-4 Inhibitor Comb.T2 empagliflozin/linagliptin GLYXAMBI QL, ST

Antihyperglycemic,biguanide TypeT1 metformin hcl METFORMIN HCL

VNSNY Page 24 of 73

T2 metformin hcl RIOMET

Antihyperglycemic,insulin-rel Stim.& Biguanide

CmbT1 glipizide/metformin hcl GLIPIZIDE-

METFORMINT1 glyburide/metformin

hclGLYBURIDE-METFORMIN HCL

T1 repaglinide/metforminhcl

REPAGLINIDE-METFORMIN HCL

Antihyperglycemic-glucocorticoid Receptor BlockerT2 mifepristone KORLYM PA, QL

Antihyperglycemic-sglt2 Inhibitor & Biguanide

CombT2 canagliflozin/metformin

hclINVOKAMET QL, ST

T2 empagliflozin/metforminhcl

SYNJARDY QL, ST

Antihyperglycm,insul-resp.enhancer & Biguanide

CmbT2 pioglitazone

hcl/metformin hclACTOPLUS MET XR ST

T1 pioglitazonehcl/metformin hcl

PIOGLITAZONE-METFORMIN

ST

Blood Sugar DiagnosticsT2 blood sugar diagnostic TRUE METRIX

GLUCOSE TESTSTRIP(OTC)

T2 blood sugar diagnostic TRUETEST TESTSTRIPS(OTC)

T2 blood sugar diagnostic TRUETRACK TESTSTRIP(OTC)

Diabetic SuppliesT1 blood glucose ctl

high,nml&lowMYGLUCOHEALTHCONTROLSOLUTION(OTC)

T2 blood glucose ctlhigh,nml&low

ON CALL EXPRESSCONTROL SOLN(OTC)

T1 blood-gluctransmitter/sensor

PARADIGM REAL-TIME

T5 blood-gluc.meter& wristbp mon

ADVOCATE REDI-CODE DUO(OTC)

T1 blood-glucose & ketonectl nml

NOVAMAX PLUSGLU-KET(OTC)

T5 blood-glucose meter EVENCARE MINIMONITORSYSTEM(OTC)

T2 blood-glucose meter TRUE METRIXBLOOD GLUCOSEMTR(OTC)

T2 blood-glucose meter TRUE2GO BLOODGLUCOSESYSTEM(OTC)

T2 blood-glucose meter TRUERESULT BLOODGLUCOSESYSTM(OTC)

T2 blood-glucose meter TRUETRACK SMARTSYSTEM(OTC)

T1 blood-glucose transmitterMINILINK REAL-TIME TRANSMITTER

T1 infusion set for insulinpump

COMFORT


CONTACT DETACHINFUSION SET


MINIMED


MIO INFUSION SET


QUICK-SETPARADIGM


SURE-T PARADIGM

T5 lancing device ADJUSTABLELANCINGDEVICE(OTC)

T5 lancing device ADVOCATE LANCINGDEVICE(OTC)

T5 lancing device ADVOCATE RAPID-SAFE(OTC)

T5 lancing device ALTERNATE SITELANCINGDEVICE(OTC)

T5 lancing device AQUA LANCELANCINGDEVICE(OTC)

T5 lancing device AUTO-LANCETMINI(OTC)

T5 lancing device AUTOLET LANCINGDEVICE(OTC)

T5 lancing device CARELANCE ULTLANCINGDEVICE(OTC)

T5 lancing device CAREONE(OTC)T5 lancing device CARESENS PREM

LANCINGDEVICE(OTC)

T5 lancing device DROPLET LANCINGDEVICE(OTC)

T5 lancing device EASY CLICK(OTC)T5 lancing device EASY TOUCH

LANCINGDEVICE(OTC)

T5 lancing device FORA LANCINGDEVICE(OTC)

T5 lancing device GLUCOLET 2(OTC)T5 lancing device GMATE LANCING

DEVICE(OTC)T5 lancing device HEALTHY ACCENTS

AUTOLET(OTC)T5 lancing device INCONTROL

LANCINGDEVICE(OTC)

T5 lancing device LANCETDEVICE(OTC)

T5 lancing device LANCINGDEVICE(OTC)

T5 lancing device LANCINGSYSTEM(OTC)

T5 lancing device LITE TOUCH(OTC)

VNSNY Page 25 of 73

T5 lancing device MINI LANCINGDEVICE(OTC)

T5 lancing device ON CALL LANCINGDEVICE(OTC)

T5 lancing device ON CALL PLUSLANCINGDEVICE(OTC)

T5 lancing device PRODIGY LANCINGDEVICE(OTC)

T5 lancing device RELIAMED MINILANCINGDEVICE(OTC)

T5 lancing device RIGHTESTGD500(OTC)

T5 lancing device SMARTDIABETESVANTAGE(OTC)

T5 lancing device SOFTCLIX(OTC)T5 lancing device SURE COMFORT

LANCING PEN(OTC)T5 lancing device SUREFLEX(OTC)T5 lancing device SURE-PEN(OTC)T5 lancing device TRUEDRAW(OTC)T5 lancing device ULTI-LANCE(OTC)T5 lancing device/lancets ACCU-CHEK

FASTCLIX(OTC)T5 lancing device/lancets ACCU-CHEK

SOFTCLIX(OTC)T5 lancing device/lancets ACCU-CHEK(OTC)T5 lancing device/lancets ADVANCED LANCING

DEVICE(OTC)T5 lancing device/lancets AUTOLET

IMPRESSION(OTC)T5 lancing device/lancets GLUCOLET 2(OTC)T5 lancing device/lancets HYPOLANCE(OTC)T5 lancing device/lancets LANCING

DEVICE(OTC)T5 lancing device/lancets LANZO(OTC)T5 lancing device/lancets MICROLET 2(OTC)T5 lancing device/lancets ONETOUCH

DELICA(OTC)T5 lancing device/lancets ONETOUCH

SURESOFT(OTC)T5 lancing device/lancets PENLET PLUS BLOOD

SAMPLER(OTC)T5 lancing device/lancets SOLUS V2 LANCING

DEVICE(OTC)T5 lancing device/lancets SUREFLEX(OTC)T5 lancing device/lancets ULTI-LANCE(OTC)T5 lancing device/lancets UNISTIK 2

EXTRA(OTC)T2 lancing device/lancets UNISTIK 2 NORMALT5 lancing device/lancets UNISTIK 2

NORMAL(OTC)T5 lancing device/lancets UNISTIK 2(OTC)T5 lancing device/lancets UNISTIK 3

COMFORT(OTC)T5 lancing device/lancets UNISTIK 3

NEONATAL(OTC)T5 lancing device/lancets UNISTIK 3(OTC)T1 subcutaneous insulin

pumpANIMAS 2020

T1 subcutaneous insulinpump

INSULIN PUMP


OMNIPOD


ONETOUCH PING


REVELPROGRAMMABLEPUMP

T1 sub-q insulin device, 20unit

VGO 20


VGO 30


VGO 40

Diabetic Ulcer Preparations,topicalT2 becaplermin REGRANEX

HyperglycemicsT5 dextrose GLUCOSE(OTC)T5 dextrose/dextrin/maltos

eINSTA-GLUCOSE(OTC)

T2 glucagon,humanrecombinant

GLUCAGONEMERGENCY KIT

InsulinsT2 insulin

glargine,hum.rec.anlogLANTUS QL

T2 insulinglargine,hum.rec.anlog

LANTUS SOLOSTAR QL

T2 insulinglargine,hum.rec.anlog

TOUJEO SOLOSTAR QL

T2 insulin lispro HUMALOG KWIKPENU-100

QL

T2 insulin lispro HUMALOG KWIKPENU-200

QL

T2 insulin lispro HUMALOG(CARTRIDGE)

QL

T2 insulin lispro HUMALOG(VIAL) QLT5 insulin nph hum/reg

insulin hmHUMULIN 70/30KWIKPEN(OTC)

QL

T5 insulin nph hum/reginsulin hm

HUMULIN 70-30(OTC) QL

T5 insulin nph humanisophane

HUMULIN NKWIKPEN(OTC)

QL

T5 insulin nph humanisophane

HUMULIN N(OTC) QL

T2 insulin npl/insulin lispro HUMALOG MIX 50-50 QLT2 insulin npl/insulin lispro HUMALOG MIX 50-50

KWIKPENQL

T2 insulin npl/insulin lispro HUMALOG MIX 75-25 QLT2 insulin npl/insulin lispro HUMALOG MIX 75-25

KWIKPENQL

T5 insulin regular, human HUMULIN R U-500 QLT5 insulin regular, human HUMULIN R(OTC) QL

Urine Glucose Test AidsT1 urine glucose test,strip DIASTIX

REAGENT(OTC)T1 urine glucose test,tablet CLINITEST

REAGENT(OTC)

Urine Glucose/acetone Test Aids,stripsT1 urine gluc-acet

comb.tst,stripCHEMSTRIPUGK(OTC)

VNSNY Page 26 of 73

T1 urine gluc-acetcomb.tst,strip

KETO-DIASTIXREAGENT(OTC)

EAR - GENERAL DISORDERSEar Preparations Anti-inflammatoryT1 fluocinolone acetonide

oilFLUOCINOLONEACETONIDE OIL

Ear Preparations, Misc. Anti-infectivesT1 acetic acid ACETIC ACIDT1 acetic acid/aluminum

acetateACETIC ACID-ALUMINUM

T1 aceticacid/hydrocortisone

HYDROCORTISONE-ACETIC ACID

T1 hc/pramox hcl/cl-xylenol/water

CORTANE-B

T1 hc/pramoxinehcl/chloroxylenol

OTO-END 10

Ear Preparations,antibioticsT1 ciprofloxacin hcl CIPROFLOXACIN HCLT1 neomycin/polymyxin b

sulf/hcNEOMYCIN-POLYMYXIN-HC

Ear Preparations,local AnestheticsT1 antipyrine/benzocaine ANTIPYRINE-

BENZOCAINET1 benzocaine PINNACAINE

Otic Preparations,anti-inflammatory-antibioticsT2 ciprofloxacin

hcl/dexamethCIPRODEX

Otic,antiinfective-local Anesthetic CombinationsT1 chloroxylenol/pramoxin

e hclOTICIN

ELECTROLYTE REGULATIONElectrolyte DepletersT1 calcium acetate CALCIUM ACETATET1 calcium carbonate/mag

carb/faMAGNEBIND 400 RX

T2 sevelamer carbonate RENVELAT2 sevelamer hcl RENAGELT1 sodium polystyrene

sulfonateKIONEX

Potassium ReplacementT1 pot chloride/pot

bicarb/cit acPOTASSIUMCHLORIDE

T1 potassiumbicarbonate/cit ac

K EFFERVESCENT

T1 potassium chloride POTASSIUMCHLORIDE

Sodium/saline PreparationsT1 0.9 % sodium chloride NORMAL SALINE

FLUSHT1 normal saline NORMAL SALINE

FLUSHT1 sodium chloride 0.45 % SODIUM CHLORIDE

ENDOCRINE DISORDER - OTHERAntidiuretic And Vasopressor HormonesT1 desmopressin

(nonrefrigerated)DESMOPRESSINACETATE

T1 desmopressin acetate DDAVPT1 desmopressin acetate DESMOPRESSIN

ACETATE

Antineoplastic Lhrh(gnrh) Agonist,pituitary Suppr.T2 leuprolide acetate ELIGARD PAT1 leuprolide acetate LEUPROLIDE

ACETATE

Bone Formation Stim. Agents - Parathyroid

HormoneT2 teriparatide FORTEO QL

Bone Resorption Inhibitor & Vitamin D

CombinationsT2 alendronate

sodium/vitamin d3FOSAMAX PLUS D

Bone Resorption InhibitorsT1 alendronate sodium ALENDRONATE

SODIUM(SOLUTION)QL

T1 alendronate sodium ALENDRONATESODIUM(TAB)

T1 calcitonin,salmon,synthetic

CALCITONIN-SALMON

T1 etidronate disodium ETIDRONATEDISODIUM

T1 ibandronate sodium IBANDRONATESODIUM

T1 raloxifene hcl RALOXIFENE HCL PA, QL

Growth HormonesT2 somatropin GENOTROPIN PAT2 somatropin HUMATROPE PAT2 somatropin NORDITROPIN

FLEXPROPA

T2 somatropin NORDITROPINNORDIFLEX

PA

T2 somatropin NUTROPIN AQ PAT2 somatropin NUTROPIN AQ

NUSPINPA

T2 somatropin OMNITROPE PAT2 somatropin SAIZEN PAT2 somatropin SEROSTIM PAT2 somatropin ZOMACTON PAT2 somatropin ZORBTIVE PA

Hyperparathyroid Tx Agents - Vitamin D Analog-

typeT1 doxercalciferol DOXERCALCIFEROLT1 paricalcitol PARICALCITOL

Insulin-like Growth Factor-1 (igf-1) HormonesT2 mecasermin INCRELEX PA

VNSNY Page 27 of 73

Leptin Hormone AnalogsT2 metreleptin MYALEPT QL

Pituitary Suppressive AgentsT1 cabergoline CABERGOLINET1 danazol DANAZOL

ENDOCRINE DISORDER - THYROIDAntithyroid PreparationsT1 methimazole METHIMAZOLET1 propylthiouracil PROPYLTHIOURACIL

Iodine Containing AgentsT1 potassium iodide SSKIT1 potassium iodide/iodine STRONG IODINE

Thyroid HormonesT1 levothyroxine sodium LEVOTHYROXINE

SODIUMT1 liothyronine sodium LIOTHYRONINE

SODIUMT2 thyroid,pork ARMOUR THYROIDT1 thyroid,pork NATURE-THROID

EYE - GENERAL DISORDERSEye Antibiotic-corticoid CombinationsT1 neo/polymyx b

sulf/dexamethNEOMYCIN-POLYMYXIN-DEXAMETH

T1 neomycin su/bacizn/poly/hc

NEOMYCIN-BACITRACIN-POLY-HC

T2 tobramycin/dexamethasone

TOBRADEX

T1 tobramycin/dexamethasone

TOBRAMYCIN-DEXAMETHASONE

T2 tobramycin/lotepred etab ZYLET

Eye AntihistaminesT1 azelastine hcl AZELASTINE HCLT1 epinastine hcl EPINASTINE HCLT2 olopatadine hcl PATADAYT2 olopatadine hcl PATANOL

Eye Antiinflammatory AgentsT1 dexamethasone sod

phosphateDEXAMETHASONESODIUM PHOSPHATE

T1 diclofenac sodium DICLOFENACSODIUM

T2 difluprednate DUREZOLT1 fluorometholone FLUOROMETHOLONET2 fluorometholone FML FORTET2 fluorometholone FML S.O.P.T2 fluorometholone acetate FLAREXT1 flurbiprofen sodium FLURBIPROFEN

SODIUMT1 ketorolac tromethamineKETOROLAC

TROMETHAMINET2 loteprednol etabonate ALREXT2 loteprednol etabonate LOTEMAXT2 nepafenac ILEVRO

T2 nepafenac NEVANACT2 prednisolone acetate PRED MILDT1 prednisolone acetate PREDNISOLONE

ACETATET1 prednisolone sod

phosphatePREDNISOLONESODIUM PHOSPHATE

Eye AntiviralsT2 ganciclovir ZIRGANT1 trifluridine TRIFLURIDINE

Eye Local AnestheticsT1 benoxinate

hcl/fluorescein naALTAFLUOR

T1 proparacaine hcl PROPARACAINE HCLT1 proparacaine/fluorescei

n sodFLUCAINE

T1 tetracaine hcl TETRACAINE HCLT1 tetracaine hcl/pf TETRACAINE HCL

Eye SulfonamidesT1 sulfacetamide sodium SULFACETAMIDE

SODIUMT1 sulfacetamide/prednisol

one spSULFACETAMIDE-PREDNISOLONE

T2 sulfacetm na/prednisol acBLEPHAMIDET2 sulfacetm na/prednisol acBLEPHAMIDE S.O.P.

Eye VasoconstrictorsT1 naphazoline hcl NAPHAZOLINE HCLT1 phenylephrine hcl PHENYLEPHRINE

HCL

Ophthalmic AntibioticsT1 bacitracin/polymyxin b

sulfateAK-POLY-BAC

T2 besifloxacin hcl BESIVANCET2 ciprofloxacin hcl CILOXANT1 ciprofloxacin hcl CIPROFLOXACIN HCLT1 erythromycin base ERYTHROMYCINT1 gatifloxacin GATIFLOXACINT1 gentamicin sulfate GENTAMICIN

SULFATET1 levofloxacin LEVOFLOXACINT2 moxifloxacin hcl MOXEZAT2 moxifloxacin hcl VIGAMOXT1 neomycin

su/bacitra/polymyxinNEOMYCIN-BACITRACIN-POLYMYXIN

T1 neomycin/polymyxnb/gramicidin

NEOMYCIN-POLYMYXIN-GRAMICIDIN

T1 ofloxacin OFLOXACINT1 polymyxin b

sulf/trimethoprimPOLYMYXIN B SUL-TRIMETHOPRIM

T1 tobramycin TOBRAMYCINT2 tobramycin TOBREX

Ophthalmic Anti-inflammatory Immunomodulator-

typeT2 cyclosporine RESTASIS QL

VNSNY Page 28 of 73

Ophthalmic Mast Cell StabilizersT1 cromolyn sodium CROMOLYN SODIUMT2 lodoxamide

tromethamineALOMIDE

T2 nedocromil sodium ALOCRIL

Ophthalmic Preparations, MiscellaneousT5 sodium chloride SODIUM

CHLORIDE(OTC)

EYE - GLAUCOMACarbonic Anhydrase InhibitorsT1 acetazolamide ACETAZOLAMIDE

Miotics/other Intraoc. Pressure ReducersT1 apraclonidine hcl APRACLONIDINE

HCLT1 betaxolol hcl BETAXOLOL HCLT2 betaxolol hcl BETOPTIC ST1 bimatoprost BIMATOPROST QLT2 bimatoprost LUMIGAN QLT2 brimonidine tartrate ALPHAGAN PT1 brimonidine tartrate BRIMONIDINE

TARTRATET2 brimonidine

tartrate/timololCOMBIGAN

T2 brinzolamide AZOPTT2 brinzolamide/brimonidin

e tartSIMBRINZA

T1 carteolol hcl CARTEOLOL HCLT1 dorzolamide hcl DORZOLAMIDE HCLT1 dorzolamide hcl/timolol

maleatDORZOLAMIDE-TIMOLOL

T1 latanoprost LATANOPROSTT1 levobunolol hcl LEVOBUNOLOL HCLT1 metipranolol METIPRANOLOLT1 pilocarpine hcl PILOCARPINE HCLT2 timolol BETIMOLT1 timolol maleate TIMOLOL MALEATET2 travoprost TRAVATAN Z QLT1 travoprost

(benzalkonium)TRAVOPROST QL

MydriaticsT1 atropine sulfate ATROPINE SULFATET2 cyclopentolate hcl CYCLOGYLT1 cyclopentolate hcl CYCLOPENTOLATE

HCLT1 homatropine hbr HOMATROPAIRET1 tropicamide TROPICAMIDE

EYE - MISCELLANEOUSArtificial TearsT5 dextran

70/hypromelloseARTIFICIALTEARS(OTC)

T5 dextran70/hypromellose/pf

ARTIFICIALTEARS(OTC)

T5 dextran70/hypromellose/pf

BION TEARS(OTC)

T5 dextran/hypromellose/glycerin

TEARS NATURALEFORTE(OTC)

T5 glycerin/propyleneglycol


T5 hypromellose NATURAL BALANCETEARS(OTC)

T5 petrolat,wht/min oil/sodchl

NIGHTTIMERELIEF(OTC)

T5 polyvinyl alcohol ARTIFICIALTEARS(OTC)

T5 polyvinylalcohol/povidone


Eye Diagnostic AgentsT1 fluorescein sodium BIOGLO

Eye IrrigationsT1 balanced salt soln non-

surg #6EYE WASH(OTC)

Eye Preparations, MiscellaneousT5 eyelid cleanser

combination #5CLEANSING EYELIDPADS(OTC)

T5 eyelid cleansercombination #5

CLEANSING EYELIDWIPES(OTC)

T5 eyelid cleansercombination #6

EYELID WIPES(OTC)

T5 lanolin/minoil/petrolat,wht

AKWA TEARS(OTC)




REFRESH LACRI-LUBE(OTC)


REFRESH P.M.(OTC)

Ophthalmic Cystine Depleting AgentsT2 cysteamine hcl CYSTARAN PA

GOUT AND RELATED DISEASESColchicineT1 colchicine COLCHICINE QLT1 colchicine/probenecid PROBENECID-

COLCHICINE

Hyperuricemia Tx - Purine InhibitorsT1 allopurinol ALLOPURINOLT2 febuxostat ULORIC QL

Uricosuric AgentsT1 probenecid PROBENECID

HEMATOLOGICAL DISORDERSAnticoagulants,coumarin TypeT1 warfarin sodium WARFARIN SODIUM

Antifibrinolytic AgentsT1 aminocaproic acid AMINOCAPROIC

ACIDT1 tranexamic acid TRANEXAMIC ACID

Citrates As AnticoagulantsT1 citrate phosphate

dextros solnCITRATE PHOSPHATEDEXTROSE

VNSNY Page 29 of 73

T1 sodium citrate SODIUM CITRATE

Direct Factor Xa InhibitorsT2 apixaban ELIQUIS(TAB)(2.5 MG)QLT2 apixaban ELIQUIS(TAB)(5 MG) QLT2 rivaroxaban XARELTO(TAB DS PK)QLT2 rivaroxaban XARELTO(TAB)(10

MG)QL

T2 rivaroxaban XARELTO(TAB)(15MG)

QL

T2 rivaroxaban XARELTO(TAB)(20MG)

QL

Factor Ix PreparationsT2 factor ix ALPHANINE SDT2 factor ix human

recombinantBENEFIX

Hematinics,otherT2 epoetin alfa PROCRIT PA

Hemorrheologic AgentsT1 pentoxifylline PENTOXIFYLLINE

Heparin And Related PreparationsT2 dalteparin

sodium,porcineFRAGMIN(SYRINGE)(10000/ML)

QL

T2 dalteparinsodium,porcine

FRAGMIN(SYRINGE)(12500/0.5)

QL



QL



QL


FRAGMIN(SYRINGE)(2500/0.2ML)

QL



QL



QL


FRAGMIN(VIAL) QL

T1 enoxaparin sodium ENOXAPARINSODIUM(SYRINGE)(100 MG/ML)

QL

T1 enoxaparin sodium ENOXAPARINSODIUM(SYRINGE)(120MG/.8ML)

QL

T1 enoxaparin sodium ENOXAPARINSODIUM(SYRINGE)(150 MG/ML)

QL

T1 enoxaparin sodium ENOXAPARINSODIUM(SYRINGE)(30MG/0.3ML)

QL


QL


QL


QL

T1 enoxaparin sodium ENOXAPARINSODIUM(VIAL)

QL

T1 fondaparinux sodium FONDAPARINUXSODIUM(SYRINGE)(10MG/0.8ML)

QL

T1 fondaparinux sodium FONDAPARINUXSODIUM(SYRINGE)(2.5 MG/0.5)

QL

T1 fondaparinux sodium FONDAPARINUXSODIUM(SYRINGE)(5MG/0.4ML)

QL

T1 fondaparinux sodium FONDAPARINUXSODIUM(SYRINGE)(7.5MG/0.6)

QL

T1 heparin sod,porcine/0.9% nacl

HEPARIN FLUSH

T1 heparin sodium,porcine HEPARIN SODIUMT1 heparin

sodium,porcine/d5wHEPARIN SODIUM-D5W

T1 heparinsodium,porcine/ns/pf

HEPARIN SODIUM-0.9% NACL

T1 heparinsodium,porcine/pf

HEPARIN FLUSH

Leukocyte (wbc) StimulantsT2 filgrastim NEUPOGEN PAT2 pegfilgrastim NEULASTA PAT2 sargramostim LEUKINE PAT2 tbo-filgrastim GRANIX PA

Platelet Aggregation InhibitorsT1 cilostazol CILOSTAZOLT1 clopidogrel bisulfate CLOPIDOGREL(TAB)

(300 MG)QL

T1 clopidogrel bisulfate CLOPIDOGREL(TAB)(75 MG)

T1 dipyridamole DIPYRIDAMOLET2 prasugrel hcl EFFIENT QLT2 ticagrelor BRILINTA QLT1 ticlopidine hcl TICLOPIDINE HCL

Platelet Reducing AgentsT1 anagrelide hcl ANAGRELIDE HCL

Thrombin Inhibitors,sel.,direct,&rev.-hirudin TypeT2 desirudin IPRIVASK PA, QL

Thrombopoietin Receptor AgonistsT2 eltrombopag olamine PROMACTA PA, QL

Topical HemostaticsT1 thrombin (bovine) THROMBIN-JMI

Vitamin K PreparationsT2 phytonadione MEPHYTONT1 phytonadione VITAMIN K1

HORMONAL DEFICIENCYAndrogenic AgentsT1 fluoxymesterone ANDROXY QLT2 methyltestosterone METHITESTT1 methyltestosterone METHYLTESTOSTERO

NET1 oxandrolone OXANDROLONE PA

VNSNY Page 30 of 73

T1 testosterone ANDROGEL(GEL MDPMP)(1.25G (1%))

PA, QL

T2 testosterone ANDROGEL(GEL MDPMP)(20.25/1.25)

PA, QL

T2 testosterone ANDROGEL(GELPACKET)(1.25G-1.62)

PA, QL

T2 testosterone ANDROGEL(GELPACKET)(2.5G-1.62%)

PA, QL

T1 testosterone ANDROGEL(GELPACKET)(25MG(1%))

PA, QL

T1 testosterone ANDROGEL(GELPACKET)(50 MG (1%))

PA, QL

T2 testosterone AXIRON PA, QLT1 testosterone TESTOSTERONE(GEL

MD PMP)PA, QL

T1 testosterone TESTOSTERONE(GEL) PA, QLT1 testosterone cypionate TESTOSTERONE

CYPIONATEPA, QL

T1 testosterone enanthate TESTOSTERONEENANTHATE

PA, QL

Estrogen & Selective Estrogen Recept

Mod(serm)combT2 estrogens,conj/bazedoxif

eneDUAVEE

Estrogen/androgen CombinationsT1 estrogen,ester/me-

testosteroneESTROGEN-METHYLTESTOSTERONE

Estrogenic AgentsT1 estradiol ESTRADIOL(PATCH

TDSW)QL

T1 estradiol ESTRADIOL(PATCHTDWK)

QL

T1 estradiol ESTRADIOL(TAB)T2 estradiol/norethindrone

acetCOMBIPATCH QL

T1 estradiol/norethindroneacet

ESTRADIOL-NORETHINDRONEACETAT

T2 estrogen,con/m-progestacet

PREMPHASE

T2 estrogen,con/m-progestacet

PREMPRO

T2 estrogens, conjugated PREMARINT2 estrogens,esterified MENESTT1 estropipate ESTROPIPATET1 norethindrone ac-eth

estradiolJINTELI

Progestational AgentsT1 medroxyprogesterone

acetateMEDROXYPROGESTERONE ACETATE

T1 norethindrone acetate NORETHINDRONEACETATE

T1 progesterone PROGESTERONET1 progesterone,micronize

dPROGESTERONE

IMMUNIZATIONAntiseraT2 igg/hyaluronidase,recom

binantHYQVIA PA

T2 immun glob g(igg)/gly/iga 50+

GAMMAGARDLIQUID

PA


GAMMAKED PA


GAMUNEX-C PA

T2 immun globg(igg)/pro/iga 0-50

HIZENTRA PA

IMMUNOSUPPRESSION/MODULATIO

NImmunomodulatorsT1 imiquimod IMIQUIMOD PA, QLT2 interferon alfa-

2b,recomb.INTRON A PA

ImmunosuppressivesT1 azathioprine AZATHIOPRINET1 cyclosporine CYCLOSPORINET2 cyclosporine SANDIMMUNET1 cyclosporine, modified GENGRAFT2 everolimus ZORTRESST1 mycophenolate mofetil MYCOPHENOLATE

MOFETILT1 mycophenolate sodium MYCOPHENOLIC

ACIDT2 sirolimus RAPAMUNET1 sirolimus SIROLIMUST2 tacrolimus ASTAGRAF XLT1 tacrolimus TACROLIMUS

INFECTIOUS DISEASE - BACTERIALAbsorbable SulfonamidesT1 sulfamethoxazole/trime

thoprimSULFAMETHOXAZOLE-TRIMETHOPRIM

BetalactamsT2 aztreonam lysine CAYSTON PA, QL

Cephalosporins - 1st GenerationT1 cefadroxil CEFADROXILT1 cephalexin CEPHALEXIN

Cephalosporins - 2nd GenerationT1 cefaclor CEFACLORT1 cefprozil CEFPROZILT2 cefuroxime axetil CEFTINT1 cefuroxime axetil CEFUROXIME

Cephalosporins - 3rd GenerationT1 cefdinir CEFDINIRT1 cefditoren pivoxil CEFDITOREN

PIVOXILT1 cefixime CEFIXIME

VNSNY Page 31 of 73

T2 cefixime SUPRAXT1 cefpodoxime proxetil CEFPODOXIME

PROXETILT1 ceftibuten CEFTIBUTEN

Chemotherapeutics, Antibacterial, Misc.T1 methen/m-blue/sal/na

phos/hyosUSTELL

T1 methen/sod phos/methblue/hyos

UROGESIC-BLUE

T1 methenam/meblue/ba/salicy/hyo

HYOPHEN

T2 methenam/meblue/ba/salicy/hyo

PROSED-DS

T1 methenamine hippurateMETHENAMINEHIPPURATE

T1 methenaminemandelate

METHENAMINEMANDELATE

T2 mth/me blue/sodphos/phen/hyos

PHOSPHASAL


URETRON D-S


URIN D.S.


URO-MP

T2 trimethoprim PRIMSOLT1 trimethoprim TRIMETHOPRIM

KetolidesT2 telithromycin KETEK

MacrolidesT1 azithromycin AZITHROMYCINT2 azithromycin ZMAXT1 clarithromycin CLARITHROMYCINT2 erythromycin base ERY-TABT1 erythromycin base ERYTHROMYCINT2 erythromycin base PCET1 erythromycin

ethylsuccinateE.E.S. 200

T2 erythromycinethylsuccinate

ERYPED 400

T1 erythromycin stearate ERYTHROCINSTEARATE

T2 fidaxomicin DIFICID QL, ST

Nitrofuran DerivativesT1 nitrofurantoin NITROFURANTOINT1 nitrofurantoin

macrocrystalNITROFURANTOIN

T1 nitrofurantoinmonohyd/m-cryst

NITROFURANTOINMONO-MACRO

OxazolidinonesT1 linezolid LINEZOLID PAT2 tedizolid phosphate SIVEXTRO PA

PenicillinsT1 amoxicillin AMOXICILLINT1 amoxicillin/potassium

clavAMOXICILLIN-CLAVULANATEPOTASS

T2 amoxicillin/potassiumclav

AUGMENTIN

T1 ampicillin trihydrate AMPICILLINTRIHYDRATE

T1 dicloxacillin sodium DICLOXACILLINSODIUM

T2 penicillin g benzathine BICILLIN L-AT1 penicillin v potassium PENICILLIN V

POTASSIUM

QuinolonesT1 ciprofloxacin CIPROFLOXACINT1 ciprofloxacin hcl CIPROFLOXACIN HCLT1 ciprofloxacin/ciprofloxa

hclCIPROFLOXACIN ER

T1 levofloxacin LEVOFLOXACINT1 moxifloxacin hcl MOXIFLOXACIN HCLT1 ofloxacin OFLOXACIN

TetracyclinesT1 demeclocycline hcl DEMECLOCYCLINE

HCLT2 doxycycline calcium VIBRAMYCINT1 doxycycline hyclate DOXYCYCLINE

HYCLATEQL, ST

T1 doxycyclinemonohydrate

DOXYCYCLINEMONOHYDRATE(CAP)

QL


DOXYCYCLINEMONOHYDRATE(SUSP RECON)


DOXYCYCLINEMONOHYDRATE(TAB)(100 MG)

QL, ST



QL



QL, ST



QL

T1 minocycline hcl MINOCYCLINE HCLT1 tetracycline hcl TETRACYCLINE HCL

INFECTIOUS DISEASE - FUNGALAntifungal AgentsT1 clotrimazole CLOTRIMAZOLET1 fluconazole FLUCONAZOLET1 flucytosine FLUCYTOSINET1 itraconazole ITRACONAZOLET2 itraconazole SPORANOXT1 ketoconazole KETOCONAZOLET2 terbinafine hcl LAMISILT1 terbinafine hcl TERBINAFINE HCLT1 voriconazole VORICONAZOLE

Antifungal AntibioticsT1 griseofulvin, microsize GRISEOFULVINT1 nystatin NYSTATIN

VNSNY Page 32 of 73

INFECTIOUS DISEASE -

MISCELLANEOUSAminoglycosidesT1 neomycin sulfate NEOMYCIN SULFATET2 tobramycin TOBI PODHALER PA, QLT1 tobramycin in 0.225%

naclTOBRAMYCIN PA, QL

Antibacterial Agents,miscellaneousT1 glycine urologic

solutionGLYCINE

AntileproticsT1 dapsone DAPSONET2 thalidomide THALOMID PA, QL

Anti-mycobacterium AgentsT4 aminosalicylic acid PASERT4 ethambutol hcl ETHAMBUTOL HCLT4 ethambutol hcl MYAMBUTOLT4 ethionamide TRECATORT4 isoniazid ISONIAZIDT4 pyrazinamide PYRAZINAMIDET4 rifabutin MYCOBUTIN

Antitubercular AntibioticsT4 bedaquiline fumarate SIRTURO PAT4 cycloserine CYCLOSERINET4 rifampin RIFAMPINT4 rifampin/isoniazid RIFAMATET4 rifapentine PRIFTIN

LincosamidesT1 clindamycin hcl CLINDAMYCIN HCLT1 clindamycin palmitate

hclCLINDAMYCINPALMITATE HCL

Rifamycins And Related Derivative AntibioticsT2 rifaximin XIFAXAN PA

Vancomycin And DerivativesT1 vancomycin hcl VANCOMYCIN HCL QL

INFECTIOUS DISEASE - PARASITIC2nd Gen. Anaerobic Antiprotozoal-antibacterialT1 tinidazole TINIDAZOLE

AmebacidesT1 paromomycin sulfate PAROMOMYCIN

SULFATE

Anaerobic Antiprotozoal-antibacterial AgentsT2 metronidazole FLAGYL ERT1 metronidazole METRONIDAZOLE

AnthelminticsT1 ivermectin IVERMECTINT2 praziquantel BILTRICIDE

Antimalarial DrugsT1 atovaquone/proguanil

hclATOVAQUONE-PROGUANIL HCL

T1 chloroquine phosphate CHLOROQUINEPHOSPHATE

T1 hydroxychloroquinesulfate

HYDROXYCHLOROQUINE SULFATE

T1 mefloquine hcl MEFLOQUINE HCLT2 primaquine phosphate PRIMAQUINET2 pyrimethamine DARAPRIM PAT1 quinine sulfate QUININE SULFATE

Antiprotozoal Drugs,miscellaneousT1 atovaquone ATOVAQUONET2 pentamidine isethionate NEBUPENT

INFECTIOUS DISEASE - VIRALAntiviral monoclonal antibodiesT2 palivizumab SYNAGIS PA

Antivirals, GeneralT1 acyclovir ACYCLOVIRT1 famciclovir FAMCICLOVIRT2 oseltamivir phosphate TAMIFLU(CAP)(30

MG)QL

T2 oseltamivir phosphate TAMIFLU(CAP)(45MG)

QL

T2 oseltamivir phosphate TAMIFLU(CAP)(75MG)

QL

T2 oseltamivir phosphate TAMIFLU(SUSPRECON)

QL

T2 ribavirin VIRAZOLET1 rimantadine hcl RIMANTADINE HCLT1 valacyclovir hcl VALACYCLOVIRT1 valganciclovir hcl VALGANCICLOVIR

HCL

Antivirals, Hiv-spec, Non-peptidic Protease InhibT2 darunavir ethanolate PREZISTA(ORAL

SUSP)QL

T2 darunavir ethanolate PREZISTA(TAB)(150MG)

QL


QL


QL


QL


QL

T2 darunavir/cobicistat PREZCOBIX QLT2 tipranavir APTIVUST2 tipranavir/vitamin e tpgs APTIVUS

Antivirals, Hiv-spec, Nucleoside-nucleotide AnalogT2 emtricitabine/tenofovir TRUVADA QL

Antivirals, Hiv-spec., Nucleoside Analog, Rti CombT2 abacavir

sulfate/lamivudineEPZICOM QL

VNSNY Page 33 of 73

T1 abacavir/lamivudine/zidovudine

ABACAVIR-LAMIVUDINE-ZIDOVUDINE

T1 lamivudine/zidovudine LAMIVUDINE-ZIDOVUDINE

QL

Antivirals, Hiv-specific, Ccr5 Co-receptor Antag.T2 maraviroc SELZENTRY

Antivirals, Hiv-specific, Fusion InhibitorsT2 enfuvirtide FUZEON QL

Antivirals, Hiv-specific, Non-nucleoside, RtiT2 delavirdine mesylate RESCRIPTORT2 efavirenz SUSTIVAT2 etravirine INTELENCET1 nevirapine NEVIRAPINE(ORAL

SUSP)QL

T1 nevirapine NEVIRAPINE(TAB) QLT2 rilpivirine hcl EDURANT

Antivirals, Hiv-specific, Nucleoside Analog, RtiT1 abacavir sulfate ABACAVIR QLT2 abacavir sulfate ZIAGEN QLT1 didanosine DIDANOSINE(CAP

DR)(125 MG)QL

T1 didanosine DIDANOSINE(CAPDR)(200 MG)

QL



T2 didanosine VIDEX QLT2 emtricitabine EMTRIVA(CAP) QLT2 emtricitabine EMTRIVA(SOLUTION) QLT1 lamivudine LAMIVUDINE(SOLUTI

ON)QL

T1 lamivudine LAMIVUDINE(TAB)(150 MG)

QL

T1 lamivudine LAMIVUDINE(TAB)(300 MG)

QL

T1 stavudine STAVUDINE(CAP) QLT1 stavudine STAVUDINE(SOLN

RECON)QL

T1 zidovudine ZIDOVUDINE(CAP) QLT1 zidovudine ZIDOVUDINE(SYRUP) QLT1 zidovudine ZIDOVUDINE(TAB) QL

Antivirals, Hiv-specific, Nucleotide Analog, RtiT2 tenofovir disoproxil

fumarateVIREAD(POWDER) QL

T2 tenofovir disoproxilfumarate

VIREAD(TAB) QL

Antivirals, Hiv-specific, Protease Inhibitor CombT2 lopinavir/ritonavir KALETRA(SOLUTIO

N)QL

T2 lopinavir/ritonavir KALETRA(TAB)(100MG-25MG)

QL

T2 lopinavir/ritonavir KALETRA(TAB)(200MG-50MG)

QL

Antivirals, Hiv-specific, Protease InhibitorsT2 atazanavir sulfate REYATAZ

T2 atazanavirsulfate/cobicistat

EVOTAZ QL

T2 fosamprenavir calcium LEXIVAT2 indinavir sulfate CRIXIVANT2 nelfinavir mesylate VIRACEPTT2 ritonavir NORVIR(CAP) QLT2 ritonavir NORVIR(SOLUTION) QLT2 ritonavir NORVIR(TAB) QLT2 saquinavir mesylate INVIRASE(CAP) QLT2 saquinavir mesylate INVIRASE(TAB) QL

Antivirals,hiv-1 Integrase Strand Transfer InhibtrT2 dolutegravir sodium TIVICAYT2 elvitegravir VITEKTA QLT2 raltegravir potassium ISENTRESS

Artv Cmb Nucleoside,nucleotide,&non-nucleoside

RtiT2 efavirenz/emtricitab/teno

fovirATRIPLA QL

T2 emtricitab/rilpivirine/tenofov

COMPLERA

Arv Cmb-nrti,n(t)rti, Integrase InhibitorT2 elvitegr/cobicist/emtric/te

nofSTRIBILD QL

Arv Comb-nrtis & Integrase InhibitorT2 abacavir/dolutegravir/lam

ivudiTRIUMEQ QL

Cytochrome P450 InhibitorsT2 cobicistat TYBOST PA

Hep C Virus - Ns5a & Ns5b Polymerase Inhib.

Combo.T2 ledipasvir/sofosbuvir HARVONI PA

Hep C Virus,nucleotide Analog Ns5b Polymerase

InhT2 sofosbuvir SOVALDI PA

Hepatitis B Treatment AgentsT2 lamivudine EPIVIR HBVT1 lamivudine LAMIVUDINE HBV

Hepatitis C Treatment AgentsT2 peginterferon alfa-2a PEGASYS PAT2 peginterferon alfa-2a PEGASYS PROCLICK PAT2 ribavirin REBETOLT1 ribavirin RIBASPHERE

INFLAMMATORY DISEASEAnti-arthritic And Chelating AgentsT2 penicillamine CUPRIMINET2 penicillamine DEPEN

Anti-arthritic, Folate Antagonist AgentsT2 methotrexate/pf OTREXUP QL, ST

VNSNY Page 34 of 73

T2 methotrexate/pf RASUVO(AUTOINJECT)(10MG/0.2ML)

QL, ST

T2 methotrexate/pf RASUVO(AUTOINJECT)(12.5/0.25)

QL, ST


QL, ST


QL, ST


QL, ST


QL, ST


QL, ST


QL, ST


QL, ST

T2 methotrexate/pf RASUVO(AUTOINJECT)(7.5MG/0.15)

QL, ST

Anti-inflammatory Tumor Necrosis Factor

InhibitorT2 golimumab SIMPONI PA, QL

Anti-inflammatory, Pyrimidine Synthesis InhibitorT1 leflunomide LEFLUNOMIDE

Anti-inflammatory,phosphodiesterase-4(pde4)

Inhib.T2 apremilast OTEZLA PA

Antinflammatory, Sel.costim.mod.,t-cell InhibitorT2 abatacept ORENCIA PA, QL

Bradykinin B2 Receptor AntagonistsT2 icatibant acetate FIRAZYR PA

C1 Esterase InhibitorsT2 c1 esterase inhibitor BERINERT PA, QLT2 c1 esterase inhibitor CINRYZE PAT2 c1 esterase inhibitor,

recombRUCONEST PA

GlucocorticoidsT1 budesonide BUDESONIDE ECT1 cortisone acetate CORTISONE ACETATET1 dexamethasone DEXAMETHASONET1 hydrocortisone HYDROCORTISONET2 methylprednisolone MEDROLT1 methylprednisolone METHYLPREDNISOL

ONET2 prednisolone MILLIPREDT2 prednisolone MILLIPRED DPT1 prednisolone PREDNISOLONET1 prednisolone sod

phosphatePREDNISOLONESODIUM PHOSPHATE

T1 prednisone PREDNISONET2 prednisone PREDNISONE

INTENSOL

Interleukin-6 (il-6) Receptor InhibitorsT2 tocilizumab ACTEMRA PA

Janus Kinase (jak) InhibitorsT2 tofacitinib citrate XELJANZ PA, QL

MineralocorticoidsT1 fludrocortisone acetate FLUDROCORTISONE

ACETATE

Nsaids, Cyclooxygenase 2 Inhibitor - TypeT1 celecoxib CELECOXIB

Nsaids, Cyclooxygenase Inhibitor-typeT1 diclofenac potassium DICLOFENAC

POTASSIUMT1 diclofenac sodium DICLOFENAC

SODIUMT1 etodolac ETODOLACT2 fenoprofen calcium FENOPROFEN

CALCIUM(CAP)T1 fenoprofen calcium FENOPROFEN

CALCIUM(TAB)T1 flurbiprofen FLURBIPROFENT5 ibuprofen CHILDREN'S

MOTRIN(OTC)T1 ibuprofen IBUPROFENT5 ibuprofen IBUPROFEN(OTC)T2 indomethacin INDOCINT1 indomethacin INDOMETHACINT1 ketoprofen KETOPROFENT1 ketorolac tromethamineKETOROLAC

TROMETHAMINET1 meclofenamate sodium MECLOFENAMATE

SODIUMT1 meloxicam MELOXICAMT1 nabumetone NABUMETONET1 naproxen NAPROXENT1 naproxen sodium NAPROXEN SODIUMT1 oxaprozin OXAPROZINT1 piroxicam PIROXICAMT1 sulindac SULINDACT1 tolmetin sodium TOLMETIN SODIUM

LOCAL ANESTHESIALocal AnestheticsT1 lidocaine hcl LIDOCAINE HCL

VISCOUS

LOWER GASTROINTESTINAL

DISORDERS - BOWEL INFLAMMATBowel Antiinflamatory AgentsT1 sulfadiazine SULFADIAZINE

Chronic Inflam. Colon Dx, 5-a-salicylat,rectal TxT2 mesalamine CANASAT1 mesalamine MESALAMINET1 mesalamine w/cleansing

wipesMESALAMINE

VNSNY Page 35 of 73

Drug Tx-chronic Inflam. Colon Dx,5-

aminosalicylatT1 balsalazide disodium BALSALAZIDE

DISODIUMT2 mesalamine APRISOT1 sulfasalazine SULFASALAZINE

Drugs To Tx Chronic Inflamm. Disease Of ColonT2 certolizumab pegol CIMZIA PA, QL

Hemorrhoidal Prep, Anti-infam Steroid/local

AnesthT1 hydrocort/pramoxin/em

ol/pram#1HYDROCORTISONE-PRAMOXINE

T1 hydrocortisone/lidocaine/aloe



ANALPRAMHC(CREAM/APPL)


ANALPRAMHC(LOTION)


HYDROCORTISONE-PRAMOXINE


PROCTOFOAM-HC

T1 lidocaine/hydrocortisone ac


Irritable Bowel Agents,guanylate Cylase-c AgonistT2 linaclotide LINZESS QL

Rectal PreparationsT1 hydrocortisone PROCTOZONE-HCT1 hydrocortisone acetate HYDROCORTISONE

ACETATE

Rectal/lower Bowel Prep.,glucocort.T1 hydrocortisone HYDROCORTISONE

LOWER GASTROINTESTINAL

DISORDERS - OTHERAmmonia InhibitorsT2 glycerol phenylbutyrate RAVICTI PAT1 lactulose GENERLAC

AntidiarrhealsT5 bismuth subsalicylate PEPTO-BISMOL TO-

GO(OTC)T5 bismuth subsalicylate PINK BISMUTH(OTC)T1 diphenoxylate

hcl/atropineDIPHENOXYLATE-ATROPINE

T1 loperamide hcl LOPERAMIDET1 loperamide hcl LOPERAMIDE(CAP)

(OTC)T5 loperamide hcl LOPERAMIDE(LIQUI

D)(OTC)T1 opium tincture OPIUM TINCTURET1 paregoric PAREGORIC

Bile SaltsT1 ursodiol URSODIOL

Laxatives And CatharticsT5 bisacodyl BISACODYL(OTC)T5 castor oil CASTOR OIL(OTC)T5 docusate sodium DOC-Q-LACE(OTC)T1 fos/maltodextrin FIBER-STAT(OTC)T1 fructooligosaccharides/p

olydexFIBER-STAT(OTC)

T2 lactulose KRISTALOSET1 lactulose LACTULOSET2 lubiprostone AMITIZA QLT5 magnesium hydroxide PHILLIPS' MILK OF

MAGNESIA(OTC)T5 methylcellulose CITRUCEL(OTC)T5 mineral oil MINERAL OIL(OTC)T1 peg 3350/na

sulf,bicarb,cl/kclGAVILYTE-C

T2 peg 3350/nasulf,bicarb,cl/kcl

GOLYTELY

T1 polyethylene glycol3350

POLYETHYLENEGLYCOL 3350

T1 polyethylene glycol3350

POLYETHYLENEGLYCOL 3350(OTC)

T5 psyllium husk KONSYL(OTC)T5 psyllium husk (with

sugar)METAMUCIL(OTC)

T5 psyllium husk (withsugar)

WAL-MUCIL(OTC)

T5 psyllium husk/aspartame METAMUCILMULTIHEALTHFIBER(OTC)

T5 psylliumhusk/aspartame

NATURAL DAILYFIBER(OTC)

T5 psyllium husk/aspartame WAL-MUCIL(OTC)T5 psyllium seed REGULOID(OTC)T5 psyllium seed (with

dextrose)NATURALFIBER(OTC)

T5 psyllium seed (withsugar)

REGULOID(OTC)

T5 psylliumseed/aspartame

NATURALFIBER(OTC)

T5 sennosides SENNA(OTC)T1 sodium

chloride/nahco3/kcl/pegGAVILYTE-N

Laxatives, Local/rectalT5 bisacodyl BISAC-EVAC(OTC)T5 docusate sodium ENEMEEZ(OTC)

Narcotic Antagonists, Peripherally-actingT2 naloxegol oxalate MOVANTIK QL

Sbs - Glucagon-like Peptide-2 (glp-2) AnalogsT2 teduglutide GATTEX PA, QL

MISCELLANEOUS AGENTSAnaphylaxis Therapy AgentsT1 epinephrine EPINEPHRINET2 epinephrine EPIPEN JR 2-PAK

VNSNY Page 36 of 73

Parasympathetic AgentsT1 bethanechol chloride BETHANECHOL

CHLORIDET1 guanidine hcl GUANIDINE HCLT1 pilocarpine hcl PILOCARPINE HCL

NEOPLASTIC DISEASEAlkylating AgentsT2 altretamine HEXALENT1 hydroxyurea HYDROXYUREAT2 melphalan ALKERANT1 temozolomide TEMOZOLOMIDE PA

Antiandrogenic AgentsT2 abiraterone acetate ZYTIGA PA, QLT1 bicalutamide BICALUTAMIDET2 enzalutamide XTANDI PA, QLT1 flutamide FLUTAMIDET2 nilutamide NILANDRON QL

AntimetabolitesT1 capecitabine CAPECITABINE(TAB)

(150 MG)PA, QL

T1 capecitabine CAPECITABINE(TAB)(500 MG)

PA, QL

T1 mercaptopurine MERCAPTOPURINET2 mercaptopurine PURIXAN STT1 methotrexate sodium METHOTREXATET2 methotrexate sodium TREXALLT1 methotrexate sodium/pfMETHOTREXATE

SODIUMT2 trifluridine/tipiracil hcl LONSURF PA

Antineoplastic Aromatase InhibitorsT1 anastrozole ANASTROZOLET1 exemestane EXEMESTANE PAT1 letrozole LETROZOLE

Antineoplastic - Hedgehog Pathway InhibitorT2 sonidegib phosphate ODOMZO PAT2 vismodegib ERIVEDGE PA, QL

Antineoplastic - Janus Kinase (jak) InhibitorsT2 ruxolitinib phosphate JAKAFI PA, QL

Antineoplastic - Mtor Kinase InhibitorsT2 everolimus AFINITOR DISPERZ PAT2 everolimus AFINITOR(TAB)(10

MG)PA, QL

T2 everolimus AFINITOR(TAB)(2.5MG)

PA, QL

T2 everolimus AFINITOR(TAB)(5 MG)PA, QLT2 everolimus AFINITOR(TAB)(7.5

MG)PA

Antineoplastic Immunomodulator AgentsT2 lenalidomide REVLIMID PA, QLT2 peginterferon alfa-2b SYLATRON QLT2 pomalidomide POMALYST PA

Antineoplastic Lhrh(gnrh) Antagonist,pituit.supprsT2 degarelix acetate FIRMAGON(VIAL)(120

MG)QL

T2 degarelix acetate FIRMAGON(VIAL)(80MG)

QL

Antineoplastic Systemic Enzyme InhibitorsT2 afatinib dimaleate GILOTRIF PAT2 axitinib INLYTA(TAB)(1 MG) PA, QLT2 axitinib INLYTA(TAB)(5 MG) PA, QLT2 bosutinib BOSULIF(TAB)(100

MG)PA, QL

T2 bosutinib BOSULIF(TAB)(500MG)

PA, QL

T2 cabozantinib s-malate COMETRIQ PA, QLT2 ceritinib ZYKADIA PAT2 crizotinib XALKORI PA, QLT2 dabrafenib mesylate TAFINLAR PAT2 dasatinib SPRYCEL(TAB)(100

MG)PA, QL

T2 dasatinib SPRYCEL(TAB)(140MG)

PA, QL


PA, QL


PA, QL


PA, QL


PA, QL

T2 erlotinib hcl TARCEVA PA, QLT2 gefitinib IRESSA PAT2 ibrutinib IMBRUVICA PAT2 idelalisib ZYDELIG PAT2 imatinib mesylate GLEEVEC PA, QLT2 lapatinib ditosylate TYKERB PAT2 lenvatinib mesylate LENVIMA PAT2 nilotinib hcl TASIGNA PA, QLT2 olaparib LYNPARZA PA, QLT2 palbociclib IBRANCE PAT2 pazopanib hcl VOTRIENT PA, QLT2 ponatinib hcl ICLUSIG(TAB)(15 MG) PA, QLT2 ponatinib hcl ICLUSIG(TAB)(45 MG) PA, QLT2 regorafenib STIVARGA PA, QLT2 sorafenib tosylate NEXAVAR PA, QLT2 sunitinib malate SUTENT PA, QLT2 trametinib dimethyl

sulfoxideMEKINIST PA

T2 vandetanib CAPRELSA(TAB)(100MG)

PA, QL

T2 vandetanib CAPRELSA(TAB)(300MG)

PA, QL

T2 vemurafenib ZELBORAF PA, QL

Antineoplastic,histone Deacetylase Inhibitors,hdisT2 panobinostat lactate FARYDAK PA

Antineoplastics,miscellaneousT1 etoposide ETOPOSIDET2 omacetaxine

mepesuccinateSYNRIBO PA

VNSNY Page 37 of 73

Chemotherapy Rescue/antidote AgentsT1 leucovorin calcium LEUCOVORIN

CALCIUM

Intrapleural Sclerosing Agents, Antineoplast. Adj.T1 talc STERILE TALC

Selective Estrogen Receptor ModulatorsT2 tamoxifen citrate SOLTAMOXT1 tamoxifen citrate TAMOXIFEN CITRATET2 toremifene citrate FARESTON PA

Selective Retinoid X Receptor AgonistsT1 bexarotene BEXAROTENE PA

Steroid AntineoplasticsT1 megestrol acetate MEGESTROL

ACETATE

NEUROLOGICAL DISEASE -

MISCELLANEOUSAgents To Treat Multiple SclerosisT2 dimethyl fumarate TECFIDERA PA, QLT2 fingolimod hcl GILENYA PA, QLT2 glatiramer acetate COPAXONE PAT1 glatiramer acetate GLATOPA PAT2 interferon beta-1a AVONEX PEN(PEN INJ

KIT)PA, QL

T2 interferon beta-1a AVONEX PEN(PENINJCTR)

PA, QL

T2 interferon beta-1a AVONEX(SYRINGEKIT)

PA, QL

T2 interferon beta-1a AVONEX(SYRINGE) PA, QLT2 interferon beta-

1a/albuminAVONEXADMINISTRATIONPACK

PA, QL

T2 interferon beta-1a/albumin

REBIF REBIDOSE(PENINJCTR)(22MCG/.5ML)

PA, QL


REBIF REBIDOSE(PENINJCTR)(44MCG/.5ML)

PA, QL


REBIF REBIDOSE(PENINJCTR)(8.8-22(6))

PA, QL


REBIF(SYRINGE)(22MCG/.5ML)

PA, QL


REBIF(SYRINGE)(44MCG/.5ML)

PA, QL


REBIF(SYRINGE)(8.8-22(6))

PA, QL

T2 teriflunomide AUBAGIO PA, QL

Agts Tx Neuromusc Transmission Dis,pot-chan

BlkrT2 dalfampridine AMPYRA PA

Fibromyalgia Agents,serotonin-norepineph Ru

InhibT2 milnacipran hcl SAVELLA

Movement DisordersT1 tetrabenazine TETRABENAZINE PA

ORAL/PHARYNGEAL DISORDERSDental Aids And PreparationsT1 chlorhexidine gluconateCHLORHEXIDINE

GLUCONATET1 triamcinolone acetonideTRIAMCINOLONE

ACETONIDE

Nose Preparations AntibioticsT2 mupirocin calcium BACTROBAN NASAL

Nose Preparations, MiscellaneousT1 ipratropium bromide IPRATROPIUM

BROMIDE

OTHER RESPIRATORY DISORDERSAntifibrotic Therapy - Pyridone AnalogsT2 pirfenidone ESBRIET PA

Cystic Fib.transmemb Conduct.reg.(cftr)potentiatorT2 ivacaftor KALYDECO PA, QL

Cystic Fibrosis-cftr Potentiator & Corrector Comb.T2 lumacaftor/ivacaftor ORKAMBI PA

MucolyticsT1 acetylcysteine ACETYLCYSTEINET2 dornase alfa PULMOZYME PA, QL

Pulmonary Fibrosis - Systemic Enzyme InhibitorsT2 nintedanib esylate OFEV PA

PAIN MANAGEMENT - ANALGESICSAnalgesic, Non-salicylate & Barbiturate Comb.T1 butalbital/acetaminoph

enBUTALBITAL-ACETAMINOPHEN

Analgesic, Salicylate, Barbiturate,& Xanthine CmbT1 butalbital/aspirin/caffei

neBUTALBITAL-ASPIRIN-CAFFEINE

Analgesic,non-salicylate,barbiturate,&xanthine

CmbT1 butalb/acetaminophen/c

affeineBUTALBITAL-ACETAMINOPHEN-CAFFE

Analgesic/antipyretics, SalicylatesT5 aspirin ASPIRIN EC(OTC) QLT5 aspirin/calcium

carbonate/magTRI-BUFFEREDASPIRIN(OTC)

T1 choline sal/magsalicylate

CHOLINE MAGTRISALICYLATE

T1 diflunisal DIFLUNISALT1 salsalate SALSALATE

VNSNY Page 38 of 73

Analgesic/antipyretics,non-salicylateT5 acetaminophen MAPAP(OTC)

Analgesics, Narcotic Agonist And Nsaid

CombinationT1 hydrocodone/ibuprofen HYDROCODONE-

IBUPROFENT1 ibuprofen/oxycodone

hclOXYCODONE HCL-IBUPROFEN

Analgesics,narcoticsT2 buprenorphine BUTRANS QLT1 butorphanol tartrate BUTORPHANOL

TARTRATET1 codeine sulfate CODEINE SULFATET1 codeine/carisoprodol/as

pirinCARISOPRODOLCOMPOUND-CODEINE

T1 dihydrocodeine/aspirin/caffein

ASPIRIN-CAFFEINE-DIHYDROCODEIN

T1 fentanyl FENTANYL PA, QLT1 fentanyl citrate FENTANYL CITRATE PA, QLT1 hydrocodone/acetamino

phenHYDROCODONE-ACETAMINOPHEN(SOLUTION)(10-325/15)

QL

T1 hydrocodone/acetaminophen

HYDROCODONE-ACETAMINOPHEN(SOLUTION)(5-163/7.5)

QL


HYDROCODONE-ACETAMINOPHEN(SOLUTION)(7.5-325/15)

QL


HYDROCODONE-ACETAMINOPHEN(TAB)(10MG-325MG)

QL


HYDROCODONE-ACETAMINOPHEN(TAB)(2.5-325MG)


HYDROCODONE-ACETAMINOPHEN(TAB)(5 MG-325MG)

QL


HYDROCODONE-ACETAMINOPHEN(TAB)(7.5-325MG)

QL

T1 hydromorphone hcl HYDROMORPHONEHCL

T1 hydromorphone hcl/pf HYDROMORPHONEHCL

T1 levorphanol tartrate LEVORPHANOLTARTRATE

T1 meperidine hcl MEPERIDINE HCLT1 methadone hcl METHADONE HCLT2 morphine sulfate MORPHINE SULFATET1 morphine sulfate MORPHINE SULFATE

ER(CAP ER PEL)QL

T1 morphine sulfate MORPHINE SULFATEER(CPMP 24HR)(120MG)

QL


QL


QL


QL


QL


QL

T1 morphine sulfate MORPHINE SULFATEER(TAB ER)

QL

T1 morphine sulfate/pf MORPHINE SULFATET1 nalbuphine hcl NALBUPHINE HCLT1 opium/belladonna

alkaloidsBELLADONNA-OPIUM

T1 oxycodone hcl OXYCODONE HCLT2 oxycodone hcl OXYCONTIN(TAB ER

12H)(10 MG)QL

T2 oxycodone hcl OXYCONTIN(TAB ER12H)(15 MG)

QL


QL


QL


QL


QL


QL

T1 oxycodonehcl/acetaminophen

OXYCODONE-ACETAMINOPHEN

QL

T1 oxycodone hcl/aspirin OXYCODONE HCL-ASPIRIN

T1 oxymorphone hcl OXYMORPHONE HCLT1 pentazocine

hcl/naloxone hclPENTAZOCINE-NALOXONE HCL

T2 tapentadol hcl NUCYNTA QLT2 tapentadol hcl NUCYNTA ER QLT1 tramadol hcl TRAMADOL HCLT1 tramadol

hcl/acetaminophenTRAMADOL HCL-ACETAMINOPHEN

Antimigraine PreparationsT1 dihydroergotamine

mesylateDIHYDROERGOTAMINEMESYLATE(AMPUL)

QL

T1 dihydroergotaminemesylate

DIHYDROERGOTAMINEMESYLATE(SPRAY/PUMP)

QL

T1 dihydroergotaminemesylate

DIHYDROERGOTAMINE MESYLATE(VIAL)

T2 ergotaminetartrate/caffeine

CAFERGOT QL

T1 isomethept/dichlphn/acetaminop

ISOMETHEPT-DICHLORALP-ACETAMIN

T1 rizatriptan benzoate RIZATRIPTAN QLT1 sumatriptan SUMATRIPTAN QL

VNSNY Page 39 of 73

T1 sumatriptan succinate SUMATRIPTANSUCCINATE(CARTRIDGE)

QL

T1 sumatriptan succinate SUMATRIPTANSUCCINATE(PENINJCTR)

QL

T1 sumatriptan succinate SUMATRIPTANSUCCINATE(TAB)

QL

T1 sumatriptan succinate SUMATRIPTANSUCCINATE(VIAL)

QL

T2 zolmitriptan ZOMIG(SPRAY)(2.5MG)

QL, ST

T2 zolmitriptan ZOMIG(SPRAY)(5 MG) QL, ST

Narc.& Non-sal.analgesic,barbiturate &xanthine

CmbT1 butalbit/acetamin/caff/c

odeineBUTALB-CAFF-ACETAMINOPH-CODEIN

Narcotic & Salicylate Analgesics, Barb.& XanthineT1 codeine/butalbital/asa/c

affeinBUTALBITALCOMPOUND-CODEINE

Narcotic Analgesic & Non-salicylate Analgesic

CombT1 acetaminophen with

codeineACETAMINOPHEN-CODEINE

T2 acetaminophen withcodeine

CAPITAL W-CODEINE

Narcotic Withdrawal Therapy AgentsT1 buprenorphine hcl BUPRENORPHINE

HCL(SYRINGE)T1 buprenorphine hcl BUPRENORPHINE

HCL(TAB SUBL)PA, QL

T1 buprenorphinehcl/naloxone hcl

BUPRENORPHINE-NALOXONE

PA, QL


SUBOXONE(FILM)(12MG-3 MG)

PA, QL


SUBOXONE(FILM)(2MG-0.5MG)

PA, QL


SUBOXONE(FILM)(4MG-1MG)

PA, QL


SUBOXONE(FILM)(8MG-2 MG)

PA, QL

PARKINSONS DISEASEAntiparkinsonism Drugs,anticholinergicT4 benztropine mesylate BENZTROPINE

MESYLATET4 trihexyphenidyl hcl TRIHEXYPHENIDYL

HCL

Antiparkinsonism Drugs,otherT1 amantadine hcl AMANTADINET2 apomorphine hcl APOKYN PA, QLT1 bromocriptine mesylate BROMOCRIPTINE

MESYLATE

T1 carbidopa/levodopa CARBIDOPA-LEVODOPA

T1 carbidopa/levodopa/entacapone

CARBIDOPA-LEVODOPA-ENTACAPONE

T1 entacapone ENTACAPONET1 pramipexole di-hcl PRAMIPEXOLE

DIHYDROCHLORIDET2 rasagiline mesylate AZILECT QLT1 ropinirole hcl ROPINIROLE HCLT2 rotigotine NEUPRO QL, STT1 selegiline hcl SELEGILINE HCL

Decarboxylase InhibitorsT1 carbidopa CARBIDOPA

SEIZURE DISORDERAnticonvulsantsT1 carbamazepine CARBAMAZEPINE(CP

MP 12HR)T4 carbamazepine CARBAMAZEPINE(OR

AL SUSP)T4 carbamazepine CARBAMAZEPINE(TA

B CHEW)T4 carbamazepine CARBAMAZEPINE(TA

B)T4 carbamazepine CARBATROLT4 carbamazepine TEGRETOL XRT4 clobazam ONFI(ORAL SUSP) QL, STT4 clobazam ONFI(TAB) QL, STT4 clonazepam CLONAZEPAMT4 clonazepam KLONOPINT4 diazepam DIASTATT4 diazepam DIASTAT ACUDIALT4 diazepam DIAZEPAM QLT4 divalproex sodium DIVALPROEX

SODIUM ERT4 eslicarbazepine acetate APTIOM(TAB)(200

MG)QL, ST

T4 eslicarbazepine acetate APTIOM(TAB)(400MG)

QL, ST


QL, ST


QL, ST

T4 ethosuximide ETHOSUXIMIDET4 ethosuximide ZARONTINT4 ethotoin PEGANONET4 ezogabine POTIGA(TAB)(200 MG)QL, STT4 ezogabine POTIGA(TAB)(300 MG)QL, STT4 ezogabine POTIGA(TAB)(400 MG)QL, STT4 ezogabine POTIGA(TAB)(50 MG) QL, STT4 felbamate FELBAMATE(ORAL

SUSP)QL, ST

T4 felbamate FELBAMATE(TAB)(400MG)

QL, ST

T4 felbamate FELBAMATE(TAB)(600MG)

QL, ST

T4 gabapentin GABAPENTIN(CAP)T1 gabapentin GABAPENTIN(SOLUTI

ON)T4 gabapentin GABAPENTIN(TAB)T4 lacosamide VIMPAT(SOLUTION) QL, ST

VNSNY Page 40 of 73

T4 lacosamide VIMPAT(TAB) QL, STT4 lamotrigine LAMICTALT4 lamotrigine LAMICTAL (BLUE)T4 lamotrigine LAMICTAL (GREEN)T4 lamotrigine LAMICTAL (ORANGE)T4 lamotrigine LAMICTAL ODTT4 lamotrigine LAMICTAL ODT

(BLUE)T4 lamotrigine LAMICTAL ODT

(GREEN)T4 lamotrigine LAMICTAL ODT

(ORANGE)T4 lamotrigine LAMICTAL XR (BLUE)STT4 lamotrigine LAMICTAL XR

(GREEN)ST

T4 lamotrigine LAMICTAL XR(ORANGE)

ST

T4 lamotrigine LAMOTRIGINET4 levetiracetam KEPPRAT4 levetiracetam LEVETIRACETAMT4 methsuximide CELONTINT4 oxcarbazepine OXTELLAR XR(TAB

ER 24H)(150 MG)QL, ST

T4 oxcarbazepine OXTELLAR XR(TABER 24H)(300 MG)

QL, ST

T4 oxcarbazepine OXTELLAR XR(TABER 24H)(600 MG)

QL, ST

T4 oxcarbazepine TRILEPTALT4 perampanel FYCOMPA(TAB)(10

MG)QL, ST

T4 perampanel FYCOMPA(TAB)(12MG)

QL, ST


QL, ST


QL, ST


QL, ST


QL, ST

T4 phenytoin DILANTINT4 phenytoin DILANTIN-125T4 phenytoin PHENYTOINT4 phenytoin sodium

extendedDILANTIN

T4 phenytoin sodiumextended

PHENYTEK

T4 phenytoin sodiumextended

PHENYTOIN SODIUMEXTENDED

T4 pregabalin LYRICAT4 primidone MYSOLINET4 rufinamide BANZEL(ORAL SUSP) QL, STT4 rufinamide BANZEL(TAB)(200

MG)QL, ST

T4 rufinamide BANZEL(TAB)(400MG)

QL, ST

T4 tiagabine hcl GABITRIL(TAB)(12MG)

QL, ST

T4 tiagabine hcl GABITRIL(TAB)(16MG)

QL, ST

T4 tiagabine hcl GABITRIL(TAB)(2 MG)T4 tiagabine hcl GABITRIL(TAB)(4 MG)T4 tiagabine hcl TIAGABINE HCL QL, STT4 topiramate TOPAMAX

T4 topiramate TROKENDI XR(CAPER 24H)(100 MG)

QL, ST


QL, ST


QL, ST


QL, ST

T4 valproic acid VALPROIC ACIDT4 valproic acid (as

sodium salt)VALPROIC ACID

T4 vigabatrin SABRIL QLT4 zonisamide ZONEGRANT4 zonisamide ZONISAMIDE

SKELETAL MUSCLE DISORDERAgents To Tx Periodic Paralysis - Carbon Anhyd

InhT2 dichlorphenamide KEVEYIS PA

Skeletal Muscle RelaxantsT1 baclofen BACLOFENT1 carisoprodol CARISOPRODOLT1 carisoprodol/aspirin CARISOPRODOL-

ASPIRINT1 chlorzoxazone CHLORZOXAZONET1 cyclobenzaprine hcl CYCLOBENZAPRINE

HCLT1 dantrolene sodium DANTROLENE

SODIUMT1 methocarbamol METHOCARBAMOLT1 orphenadrine citrate ORPHENADRINE

CITRATET1 tizanidine hcl TIZANIDINE HCL

SMOKING CESSATIONSmoking Deterrent AgentsT5 nicotine NICODERM CQ(OTC)T5 nicotine polacrilex NICORETTE(OTC)

Smoking Deterrent-nicotinic Recept.partial AgonistT4 varenicline tartrate CHANTIX QL

Smoking Deterrents, OtherT4 bupropion hcl BUPROBAN

UPPER GASTROINTESTINAL

DISORDERS - DIGESTIVEGastric EnzymesT2 sacrosidase SUCRAID PA, QL

Pancreatic EnzymesT2 lipase/protease/amylase CREONT1 lipase/protease/amylase PANCRELIPASE 5,000T2 lipase/protease/amylase ZENPEP

VNSNY Page 41 of 73


DISORDERS - SPASTIC DISEASEAnticholinergics/antispasmodicsT1 dicyclomine hcl DICYCLOMINE HCL

Belladonna AlkaloidsT1 hyoscyamine sulfate HYOSCYAMINE

SULFATET1 methscopolamine

bromideMETHSCOPOLAMINEBROMIDE

T2 phenobarb/hyoscy/atropine/scop

DONNATAL

EmeticsT1 ipecac IPECAC(OTC)


DISORDERS - ULCER DISEASEAntacidsT5 aluminum hydroxide ALUMINUM

HYDROXIDE(OTC)T5 calcium carbonate ANTACID EXTRA

STRENGTH(OTC)T5 mag hydrox/al

hydrox/simethMI ACID(OTC)

T5 mgtrisilicate/alh/nahco3/aa

ANTACIDTABLET(OTC)

T5 sodium bicarbonate SODIUMBICARBONATE(OTC)

Anticholinergics,quaternary AmmoniumT1 chlordiazepoxide/clidini

um brCHLORDIAZEPOXIDE-CLIDINIUM

T1 glycopyrrolate GLYCOPYRROLATET1 propantheline bromide PROPANTHELINE

BROMIDE

Anti-ulcer PreparationsT1 misoprostol MISOPROSTOLT2 sucralfate CARAFATET1 sucralfate SUCRALFATE

Anti-ulcer-h.pylori AgentsT1 lansoprazole/amoxiciln/

clarithLANSOPRAZOL-AMOXICIL-CLARITHRO

QL

Histamine H2-receptor InhibitorsT1 cimetidine CIMETIDINET5 cimetidine CIMETIDINE(OTC)T1 cimetidine hcl CIMETIDINET1 famotidine FAMOTIDINET5 famotidine FAMOTIDINE(OTC)T1 nizatidine NIZATIDINET1 ranitidine hcl RANITIDINE HCLT5 ranitidine hcl RANITIDINE

HCL(OTC)

Intestinal Motility StimulantsT1 metoclopramide hcl METOCLOPRAMIDE

HCL

Proton-pump InhibitorsT1 esomeprazole

magnesiumESOMEPRAZOLEMAGNESIUM

QL, ST

T2 esomeprazolemagnesium

NEXIUM QL, ST

T1 lansoprazole LANSOPRAZOLET1 lansoprazole LANSOPRAZOLE(OT

C)T2 lansoprazole PREVACID STT1 omeprazole OMEPRAZOLET5 omeprazole OMEPRAZOLE(OTC)T1 pantoprazole sodium PANTOPRAZOLE

SODIUMT1 rabeprazole sodium RABEPRAZOLE

SODIUMQL

URINARY TRACT - FUNCTIONAL

DISORDERSBenign Prostatic Hypertrophy/micturition AgentsT1 alfuzosin hcl ALFUZOSIN HCL ERT1 dutasteride DUTASTERIDE G, STT1 finasteride FINASTERIDET1 tamsulosin hcl TAMSULOSIN HCL

BPH agents, 5-alpha-red Inh & Alpha-1-adr Antg

CmbT1 dutasteride/tamsulosin DUTASTERIDE/TAMS

ULOSING, ST

Kidney Stone AgentsT2 cysteamine bitartrate PROCYSBI PA

Urinary Ph ModifiersT1 citric acid/sodium

citrateSODIUM CITRATE &CITRIC ACID

T1 phosphorus #1 PHOSPHA 250NEUTRAL

T1 potassium citrate POTASSIUM CITRATEER

T1 potassium citrate/citricacid

CYTRA-K

T1 sod/pot/k cit/sod cit/citacid

CYTRA-3

Urinary Tract Analgesic AgentsT2 pentosan polysulfate

sodiumELMIRON

Urinary Tract Anesthetic/analgesic AgntT1 phenazopyridine hcl PHENAZOPYRIDINE

HCL

Urinary Tract Antispasmodic, M(3) Selective Antag.T2 solifenacin succinate VESICARE ST

VNSNY Page 42 of 73

Urinary Tract Antispasmodic/antiincontinence

AgentT2 fesoterodine fumarate TOVIAZ STT1 flavoxate hcl FLAVOXATE HCLT1 oxybutynin chloride OXYBUTYNIN

CHLORIDET1 tolterodine tartrate TOLTERODINE

TARTRATEST

VAGINAL DISORDERSVaginal AntibioticsT1 clindamycin phosphate CLINDAMYCIN

PHOSPHATET1 metronidazole METRONIDAZOLE

Vaginal AntifungalsT2 butoconazole nitrate GYNAZOLE 1T1 miconazole nitrate MICONAZOLE 3T5 miconazole nitrate MICONAZOLE 3(OTC)T5 miconazole nitrate MONISTAT 3(OTC)T1 terconazole TERCONAZOLE

Vaginal Estrogen PreparationsT2 estradiol ESTRACET2 estradiol VAGIFEMT2 estrogens, conjugated PREMARIN

Vaginal SulfonamidesT2 sulfanilamide AVC

VITAMIN AND/OR MINERAL

DEFICIENCYAntioxidant Multivitamin CombinationsT5 beta-carotene(a) w-c &

e/zn/cuVISION-VITE +ZINC(OTC)

T5 vit a,c &e/lutein/minerals

I-VITE(OTC)

T5 vit a/vit c/vite/zinc/copper

PRESERVISIONAREDS(OTC)

BioflavonoidsT5 bioflav,lemon/vit

bcomp,cRISANOID PLUS(OTC)

Calcium ReplacementT1 cal

carb/mgox/d3/b12/fa/b6/bor

TL G-FOL OS

T5 calcium carb&gluconate/vit d2

PARVA-CAL 500(OTC)

T5 calcium carbonate CALCIUM(OTC)T5 calcium

carbonate/vitamin d2OYSTER SHELLCALCIUM W-VITD(OTC)

T5 calciumcarbonate/vitamin d3

OYSTER SHELLCALCIUM W-VITD(OTC)

T5 calcium citrate CALCITRATE(OTC)

T5 calcium/multivitaminsw-iron

FOSFREE(OTC)

Fluoride PreparationsT1 sodium fluoride FLUORIDET2 sodium fluoride FLUORITABT2 sodium fluoride FLURA-DROPST1 sodium

fluoride/potassium nitFLUORIDEXSENSITIVITY RELIEF

T1 stannous fluoride GEL-KAM(OTC)

Folic Acid PreparationsT1 folic acid FOLIC ACIDT1 folic acid FOLIC ACID(OTC)T5 multivit-

min/fa/lycopene/lutBIOCEL(OTC)

Geriatric Vitamin PreparationsT5 multivitamin w/iron,

mineralsSPECTRAVITESENIOR(OTC)

T5 multivitamin withminerals

ONE DAILY 50PLUS(OTC)

T5 multivitamin w-minerals/lutein

CEROVITESENIOR(OTC)

T5 multivit-min/fa/lycopene/lut

CERTAVITE SENIOR-ANTIOXIDANT(OTC)

T5 mv, min#36/iron,carbonyl/fa

GERITOLCOMPLETE(OTC)

Iron ReplacementT1 fe

fumarate/cal/e/fa/multivit

VITAFOL

T1 fefumarate/doss/fa/bcomp,c

NEPHRON FA

T1 fe fumarate/vitc/b12/stomc

HEMATOGEN

T1 fe fumarate/vit c/b12-if/fa

FEROCON

T1 ferrous fumarate/folicacid

HEMATINIC WITHFOLIC ACID

T5 ferrous sulfate FER-IN-SOL(OTC)T5 ferrous sulfate FERROUS

SULFATE(OTC)T1 ferrous sulfate/vit c/fa FOLITAB 500(OTC)T1 iron ag&fum/c/fa/mv

cmb11/ca-tFERREX 28

T1 ironag/c/b12/ca/suc.acid/stom

MULTIGEN

T1 iron aspgly&pscmplx/c/sucac

FERREX 150PLUS(OTC)

T1 ironaspgly&ps/c/b12/fa/ca/suc

FERREX 150 FORTEPLUS

T1 iron aspgly/c/b12/fa/ca-th/suc

MULTIGEN FOLIC

T1 iron bg&ps/vitc/b12/fa/ca thr

TARON FORTE

T1 iron fum &ag/c/b12/fa/ca/succ

MULTIGEN PLUS

T1 iron fum & p/fa/vit b &c no.9

FOLIVANE-PLUS

VNSNY Page 43 of 73

T1 iron fum & pscmp/fa/vit c/b3

FOLIVANE-F

T1 ironfum&polysac#1/fa/mvno.18

SE-TAN PLUS

T1 iron fumarate/vit c/vitb12/fa

TRIGELS-F FORTE

T1 iron polysac/ironheme/fa/b12

HEMETAB

T5 iron polysaccharidecomplex

FERREX 150(OTC)

T1 iron ps cmplx/vit b12/fa POLY-IRON 150 FORTET1 iron, carb &

gluc/fa/b12/c/dssFE 90 PLUS

T1 iron, carbonyl/fa/c/b-6/b12/zn

CORVITA 150

T1 iron,carb/dss/b12if/fa/mv-mn

TL-HEM 150

T2 iron,carb/fa#6/mv, minno.41

CORVITE 150

T1 iron,carbonyl/vit c/vitb12/fa

IRON 100 PLUS(OTC)

T1 iron/fa/b12/c/docusatesodium

FERRAPLUS 90

T1 iron/fa/vitbcomp,c/minerals

HEMATINIC PLUS

T5 iron/liver ext/vitbcomp,c/min

SIDEROL(OTC)

T5 iron/multivits,stressformula

STRESS FORMULAWITH IRON(OTC)

T5 vit b comp/c/fa/ironsulf/vite


T5 vit b comp/c/fa/iron/vite


Magnesium Salts ReplacementT5 magnesium MAGNESIUM(OTC)T5 magnesium oxide MAGNESIUM

OXIDE(OTC)

Mineral Replacement,miscellaneousT1 minerals/protein

supplementPROVIMIN(OTC)

Multivitamin PreparationsT5 a/c/e/zinc/sod

selenate/copperPROSIGHT(OTC)

T1 amino acids/mv,th w-fe,mn

TYR COOLER(OTC)

T1 b complex with vitaminc

VITAMIN B-COMPLEXWITH VITC(CAP)(OTC)

T5 b complex with vitaminc

VITAMIN B-COMPLEXWITH VITC(TAB)(OTC)

T5 beta-carotene(a) w-c &e/min

OCUTABS(OTC)

T5 cal/mag/b comp/vitd3/hrb61

WOMEN'SCOMPLEX(OTC)

T5 fa/mv,ca,iron,min/lycopene/lut

MULTIVITAL(OTC)

T1 fe fumarate/fa/vitbcomp,c

DIALYVITE 800 WITHIRON

T5 folic acid/multivit-min/lutein

ESSENTIAL WOMAN50+(OTC)

T5 folic acid/multivit-minerals

ONE DAILYESSENTIAL(OTC)

T5 folic acid/mv,fe,othermin

ONE DAILYMAXIMUM(OTC)

T5 folic acid/mv,fe,othermin/lut

CERTA PLUS(OTC)

T5 multivit withcalcium,iron,min

MULTIVITAMINS W-CALCIUM-IRON(OTC)

T1 multivit, iron, min #5,fa

STROVITE FORTE

T1 multivit, mincmb#20/iron/fa

BACMIN

T5 multivit,ca,iron,min/fa/hrb146

DAILY ENERGY(OTC)

T5 multivit,ther iron,ca,fa& min

THERA-M(OTC)

T5 multivitamin TAB-A-VITE(OTC)T1 multivitamin no.44/vit

d3/kMULTIVITAMINS-A,B,D,E,K,ZN

T5 multivitamin w/iron,minerals

MULTILEX(OTC)

T5 multivitamin withminerals

MULTIVITAMINSWITHMINERALS(OTC)

T5 multivitamin w-minerals/herbs

MEN'SBIOMULTIPLE(OTC)

T5 multivitamin/iron/folicacid

CEROVITEADVANCEDFORMULA(OTC)

T5 multivitamins with iron TAB-A-VITE WITHIRON(OTC)

T1 multivitamins with minno.7/fa

V-C FORTE

T5 multivitamins,ther w-minerals

VITAMIN ANDMINERALS(OTC)

T5 multivitamins,therapeutic

THERA(OTC)

T5 multivitamins-min/fa/ginkgo

DAILYMULTIPLE(OTC)

T5 multivit-min/fa/lutein/zeaxant

ICAPS MV(OTC)


CENTRUM SILVERULTRA MEN'S(OTC)


CENTRUMSILVER(OTC)

T5 multivit-min/folicacid/vit k

TRUEPLUSMULTIVITAMIN(OTC)

T5 multivits w-fe,othermin/lut

THERATRUMCOMPLETE(OTC)

T5 multivits w-iron,hematinic

COMPLETE(OTC)

T5 multivits,ca,min/iron/fa/lycop

SPECTRAVITEMEN'S(OTC)

T5 multivits,ca,minerals/iron/fa

ONE-A-DAYWOMEN'S(OTC)

T5 multivits,ca,minerals/iron/fa

THERA-M(OTC)

T5 multivits,stress formula STRESSFORMULA(OTC)

T5 multivits,stressformula/zinc

STRESS FORMULAWITH ZINC(OTC)

VNSNY Page 44 of 73

T5 multivits,th w-ca,fe,othmin

THERAPEUTICM(OTC)

T5 multivits,th w-fe,othermin

THEREMS-M(OTC)

T1 multivits,therap w-fe,hematin

B-PLEX PLUS

T5 multivits-min/iron/fa/ginseng

CENTURY ENERGYMETABOLISM(OTC)

T5 multivits-min/iron/fa/lutein

CENTRUM SILVERWOMEN(OTC)

T5 multivits-min/iron/fa/lutein

SPECTRAVITE ULTRAWOMEN'S(OTC)

T5 multivits-minerals/fa/lycopene

ONE-A-DAYMEN'S(OTC)

T5 mv w-ca/iron/fa/lutein/hrb#179

MEGAMULTIVITAMIN(OTC)

T5 mv,ca,iron,min/fa/phytosterol

CENTRAL-VITECARDIO(OTC)

T5 mv,ca,iron,min/fa/phytosterol

CENTRUMSPECIALISTHEART(OTC)

T5 mv,ca,min/ironfum/fa/lyco/lut

COMPLETE(OTC)

T5 mv,ca,min/ironfum/fa/vit k

MULTI FOR HER(OTC)

T5 mv,ca,min/iron/fa/guarana/caff

ONE-A-DAYWOMEN'S(OTC)

T5 mv,ca,min/iron/fa/lyc/lut/phyt

SPECTRAVITECARDIOHEALTH(OTC)

T5 mv,fe,other min/gr tealfxt

DAILYMULTIPLE(OTC)

T5 mv,minerals/fa/lycopene/ginkgo

DAILYMULTIPLE(OTC)

T5 mv/gnk bi ex/k.ginsg CENTRAL VITE(OTC)T5 mv-min/iron

fum/fa/k/lyco/lutnSUNVITE(OTC)

T5 mv-mn/fa/lycopene/lut/hb#178

MEGA MULTI(OTC)

T1 om-3/ca carb/d3/fa/mvcmb 13

ADVANCED AM/PM

T1 om-3/dha/epa/b12/fa/b6/phytost

VIT 3

T5 vit a/vit c/vite/zinc/copper

ICAPS(OTC)

T5 vitb&c/iron fum/fa/vite/aa#16

STRESS FORMULAENERGY(OTC)

Pediatric Vitamin PreparationsT1 fluoride/iron/vit a,c&d TRI-VIT WITH

FLUORIDE-IRONT5 multivitamin w/iron,

mineralsLYSIPLEX PLUS(OTC)

T5 ped multivit #46/ironsulfate

POLYVITAMIN WITHIRON(OTC)

T1 ped mv a,c,d3 #21 w-fluoride

TRI-VITAMIN WITHFLUORIDE

T1 ped mv a,c,d3 #38 w-fluoride

TRI-VI-FLORO

T1 pedi m.vit no.17 withfluoride

MULTIVITAMIN WITHFLUORIDE

T1 pedi multivit #65/vitd3/vit k

MULTIVITAMINS-A,B,D,E,K,ZN

T1 pedi multivit no.2 w-fluoride

MULTIVITAMINSWITH FLUORIDE

T5 pedi multivits a,c,&d3no.21

TRI-VITAMIN(OTC)

T1 pedi mv#45/fluoride/iron

MULTIVITAMINS W-FLUORIDE-IRON

T1 pedi mv#75/fluoride/iron

MULTIVITAMINS W-FLUORIDE-IRON

T1 pedi mv no.83 withfluoride

QUFLORA

T1 pedi mv no.84 withfluoride

QUFLORA

T1 pedi mvi no.12/sodiumfluoride

MVC-FLUORIDE

T1 pedi mvi no.16 withfluoride


T1 pedi mvi no.82 withfluoride


T5 pediatric multivit combno.20

POLY-VITAMIN(OTC)

T5 vit a palmitate/vit c/vitd3

TRI-VI-SOL(OTC)

Prenatal Vitamin PreparationsT1 iron,carbonyl/vit c/vit

b12/faICAR-C PLUS

T1 pn vit.w-o ca #7,iron,fa,dha

ELITE OB DHA

T1 pn w-ca64/ironcb&gl/fa/dss/dh

PRENAISSANCE 90DHA

T1 pnv #14/ferrousfum/folic acid

COMPLETENATE

T1 pnv #19/ironps&heme/folic/dha

VP-HEME ONE

T1 pnv #8/iron pscmp&aspg/fa/dha

PAIRE OB PLUS DHA

T1 pnv #87/ironbisgly/fa/dha

TRI-TABS DHA

T1 pnv 11-iron fum-folicacid-om3

C-NATE DHA

T1 pnvcomb.no.44/iron/folicacid

VITASPIRE

T1 pnv combo#22/iron/fa/om3/dha

HEMENATAL OB +DHA

T1 pnv combo#47/iron/fa#1/dha

PNV-DHA

T1 pnv no.115/ironfumarate/fa

PRENATAL 19

T1 pnv no.118/ironfumarate/fa

PRENATAL 19(OTC)

T1 pnv no.15/iron fum &ps cmp/fa

FOLIVANE-OB

T1 pnv no.22/ironcbn&gluc/fa/dss

VINACAL

T1 pnvno.66/iron,carbonyl/fa/dha

R-NATAL OB

T1 pnv no10/ironfum&p/fa/omega-3

SE-TAN DHA

VNSNY Page 45 of 73

T1 pnvno12/iron,carb/fa/dss/om-3

OBSTETRIX DHA

T1 pnv w-ca #40/ironfum/fa cmb#1

PNV-SELECT

T1 pnv w-cano.37/iron/fa/omega-3

ULTIMATECARE ONE

T1 pnv w-ca8/iron/fa/lmefolate ca

PNV-IRON

T1 pnv with ca#68/iron/fa#1/dha

VIRT-PN PLUS

T1 pnv with ca no.65/ironpoly/fa

MARNATAL-F

T1 pnv withca#74/iron/folic acid

VOL-PLUS

T1 pnv withca,no.62/iron/fa/dha

TRIVEEN-ONE

T1 pnv withca,no.70/iron/fa/dha

CALCIUM PNV

T1 pnv withca,no.72/iron,carb/fa

PRENATAL PLUS

T1 pnv withca,no.72/iron/fa

PRENATAL PLUS

T1 pnv withca,no63/iron/fa/b6

TARON-BC

T1 pnv w-o ca no5/fefumarate/fa

PRENATAL-U

T1 pnv#16/iron fum &ps/fa/om-3

TARON-C DHA

T1 pnv#20/iron/fa/ds/fish/dha/epa

TL-CARE DHA

T1 pnv#21/iron ps& hemepolyp/fa

HEMENATAL OB

T1 pnv#64/iron/lmfolate/algal/soy

VINATE DHA RF

T1 pnv#79/iron/fa/lmfolateca/dha

VINATE DHA

T1 pnv,ca,no.35/iron/fa/ds/omeg-3

ULTIMATECARE ONENF

T1 pnv,ca42/iron/fa/lmefolca/dha

PNV-DHA PLUS

T1 pnv/ferrousfumarate/doss/fa

MYNATE 90 PLUS

T1 pnv/ferrousfumarate/fa/se

VINATE-M

T1 pnv/iron,carbonyl/docusate/fa

MYNATAL

T1 pnv100/ironedta&ps/fa/omega3

BAL-CARE DHAESSENTIAL

T1 pnv115/ironfumarate/fa/dss

PRENATAL 19

T1 pnv119/ironfumarate/fa/dss

SE-NATAL 19

T1 pnv17/iron/fa/fishoil/dha/om

ELITE-OB 400

T1 pnv19/iron bg hc&succ-p/fa/om3

PR NATAL 400 EC

T1 pnv22/ironcbn&gluc/fa/dss/dha

PRENAISSANCE DHA

T1 pnv34/iron,carbonyl/fa/dss/dha

VP-CH-PNV

T1 pnv38/ironcbn&gluc/fa/dss/dha

PRENAISSANCEPROMISE

T1 pnv39/ironfumarate/fa/dss/dha

TARON-PREXPRENATAL

T1 pnv53/iron b-g hcl-p/fa/omega3

TRIVEEN-DUO DHA

T1 pnv54/iron b-g hcl-p/fa/omega3

PR NATAL 430

T1 pnv55/iron bg hc&succ-p/fa/om3

PR NATAL 430 EC

T1 pnv59/iron,carb&fum/fa/dss/dha

INFANATE PLUS


VP-CH PLUS


VIRTPREX


PRENAISSANCE PLUS

T1 pnv7/fe aspgly/docusate/fa

VINATE PN CARE

T1 pnv77/sod iron edta&ps/fa/om3

VENATAL COMPLETEDHA


PRENAISSANCE

T1 pnv81/sod iron edta&ps/fa/om3

BAL-CARE DHA

T5 pnv95/ferrousfumarate/fa

PRENATAL(OTC)

T1 prenat vitcomb.10/iron/fa/dha

VITAFOL-OB+DHA

T1 prenatal#57/iron/fa/dss/dha

EXTRA-VIRT PLUSDHA

T1 prenatal combno.42/folic acid

PRENA1 CHEW

T1 prenatal no.13/ironps/fa cb#1

SELECT-OB

T1 prenatalno.52/iron/fa/dha

VP-PNV-DHA

T1 prenatalno.75/iron/folate #1

VITAFOL NANO

T1 prenatal vit#76/iron,carb/fa

VOL-TAB RX

T1 prenatal vit 15/ironcb/fa/dss

VIRT-ADVANCE


VIRT-VITE GT


INATAL ULTRA

T1 prenatal vitno.109/iron/fa

VINATE CARE


TRINATE


PRENATABS FA

T1 prenatal vit#4/iron fum&ps/fa

PUREFE OB PLUS

T1 prenatal vit#86/ironbisgly/fa

NEWGEN

T5 prenatal vit#96/ferrousfum/fa

PRENATAL(OTC)

T1 prenatal vit/ironbisglycin/fa

VINATE II

T5 prenatal vit/ironfumarate/fa

PRENATALVITAMINS(OTC)

T1 prenatalvit27&calcium/iron/fa

VINATE ONE

VNSNY Page 46 of 73

T1 prenatal vits#4/ironfum/fa

PUREFE PLUS

T1 pv w-o cal/iron pscplx/fa

SELECT-OB

Prenatal Vitamins Without IronT1 pnv w-o

iron/fa/calcium/b6/b12FOLBECAL

T1 pnv/fa/b6/calciumcarb/ginger

PRENAISSANCENEXT-B

T1 pnv/fa/b6/calciumphos/ginger

VP-GGR-B6

Vitamin A PreparationsT5 vitamin a VITAMIN A(OTC)T5 vitamin a palmitate VITAMIN A(OTC)

Vitamin B PreparationsT1 b cmplx 4/vit

d3/c/fa/zinc oxVITAL-D RX

T1 b complex & cno.20/folic acid

RENO CAPS

T1 b12/levomefolatecalcium/b-6

FOLBIC RF

T1 cyanocobalamin/fa/pyridoxine

FOLBIC

T5 fa/vit b complex &c/rice bran

VITAMIN B-COMPLEXWITH VIT C(OTC)

T1 fa/vit bcomp&c/se/minaa/zn

DIALYVITE 3000

T5 fa/vitbcomp,c/zinc/vitamin d3

DIALYVITE 800-ULTRA D(OTC)

T1 folic acid/b complex & cno.17

VIRT-VITE PLUS

T1 folic acid/vit bcomp,c DIALYVITET1 folic acid/vit

bcomp,c/cu/znoxFOLBEE PLUS CZ

T1 vit b cmplx 3/fa/vitc/biotin

RENA-VITE RX

T1 vit b cmplxno3/fa/c/biot/zinc

NEPHPLEX RX

T5 vit b complex 100 cmb#2/herbs

NATURAL BALANCEDB-100(OTC)

T5 vit b complex 100 cmb#3/herbs

BALANCED B-100(OTC)

T1 vit b cplx#11/fa/c/biot/zn ox

DIALYVITE ZINC

T1 vitamin b complex VITAMIN BCOMPLEX(CAP)(OTC)

T5 vitamin b complex VITAMIN BCOMPLEX(TAB)(OTC)

T5 vitamin bcomplex/minerals

STRESSFORMULA(OTC)

T1 vitamins b1,b2,b3,b5,&b6

B-COMPLEX

Vitamin B1 PreparationsT5 thiamine hcl VITAMIN B-1(OTC)T5 thiamine mononitrate VITAMIN B-1(OTC)

Vitamin B12 PreparationsT1 cyanocobalamin

(vitamin b-12)CYANOCOBALAMININJECTION

T1 cyanocobalamin/mecobalamin

NEURIN-SL

T1 hydroxocobalamin HYDROXOCOBALAMIN

Vitamin B6 PreparationsT5 pyridoxine hcl VITAMIN B-6(OTC)

Vitamin C PreparationsT5 ascorbic acid VITAMIN C(OTC)T5 ascorbic acid/ascorbate

sodiumACEROLA C(OTC)

Vitamin D PreparationsT1 calcitriol CALCITRIOLT5 cholecalciferol (vitamin

d3)VITAMIN D(OTC) AGE

T5 cholecalciferol (vitamind3)

VITAMIN D3(OTC) AGE

T1 ergocalciferol (vitamind2)

VITAMIN D2

Zinc ReplacementT1 zinc sulfate ZINC SULFATE(OTC)

VNSNY Page 47 of 73

AGE RESTRICTIONS • DEXMETHYLPHENIDATE HCLER <= 18 years• FOCALIN XR <= 18 years• METHYLPHENIDATE ER(CPBP50-50)(20 MG) <= 18 years• METHYLPHENIDATE ER(CPBP50-50)(30 MG) <= 18 years• METHYLPHENIDATE ER(CPBP50-50)(40 MG) <= 18 years• METHYLPHENIDATE ER(TABER 24H)(18 MG) <= 18 years• METHYLPHENIDATE ER(TABER 24H)(27 MG) <= 18 years• METHYLPHENIDATE ER(TABER 24H)(36 MG) <= 18 years• METHYLPHENIDATE ER(TABER 24H)(54 MG) <= 18 years• METHYLPHENIDATE ER(TABER)(10 MG) <= 18 years• METHYLPHENIDATE ER(TABER)(20 MG) <= 18 years• RITALIN LA <= 18 years• TACROLIMUS >= 2 years• VITAMIN D(OTC) >= 65 years• VITAMIN D3(OTC) >= 65 years

Preferred Drug List Medication Prescribing Limitations

VNSNY Page 48 of 73

QUANTITY RESTRICTIONS • ABACAVIR 60 units per 30 days• ABILIFY 1 unit per 1 day• ADVAIR DISKUS 60 units per 30 days• ADVAIR HFA 12 gm per 30 days• AEROSPAN 17.8 gm per 30 days• AFINITOR(TAB)(10 MG) 1 unit per 1 day• AFINITOR(TAB)(2.5 MG) 1 unit per 1 day• AFINITOR(TAB)(5 MG) 1 unit per 1 day• AKYNZEO 1 unit per 28 days• ALENDRONATESODIUM(SOLUTION) 75 ml per 7 days• AMITIZA 2 units per 1 day• AMLODIPINE-ATORVASTATIN 1 unit per 1 day• ANDROGEL(GEL MDPMP)(1.25G (1%)) 300 gm per 30 days• ANDROGEL(GEL MDPMP)(20.25/1.25) 5 gm per 1 day• ANDROGEL(GELPACKET)(1.25G-1.62) 1.25 gm per 1 day• ANDROGEL(GEL PACKET)(2.5G-1.62%) 5 gm per 1 day• ANDROGEL(GELPACKET)(25MG(1%)) 5 gm per 1 day• ANDROGEL(GEL PACKET)(50MG (1%)) 300 gm per 30 days• ANDROXY 120 units per 30 days• ANORO ELLIPTA 60 units per 30 days• APLENZIN 1 unit per 1 day• APOKYN 2 ml per 1 day• APTIOM(TAB)(200 MG) 1 unit per 1 day• APTIOM(TAB)(400 MG) 1 unit per 1 day• APTIOM(TAB)(600 MG) 2 units per 1 day• APTIOM(TAB)(800 MG) 2 units per 1 day• ARIPIPRAZOLE 30 ml per 1 day• ASPIRIN EC(OTC) 100 units per fill• ATRIPLA 30 units per 30 days• ATROVENT HFA 25.8 gm per 30 days• AUBAGIO 1 unit per 1 day• AVONEX ADMINISTRATIONPACK 1 unit per 7 days• AVONEX PEN(PEN INJ KIT) 1 unit per 28 days• AVONEX PEN(PEN INJCTR) 2 ml per 28 days• AVONEX(SYRINGE KIT) 1 unit per 28 days• AVONEX(SYRINGE) 2 ml per 28 days• AXIRON 6 ml per 1 day• AZELASTINE HCL 60 ml per 30 days• AZILECT 1 unit per 1 day• BANZEL(ORAL SUSP) 80 ml per 1 day• BANZEL(TAB)(200 MG) 16 units per 1 day• BANZEL(TAB)(400 MG) 8 units per 1 day• BELSOMRA 1 unit per 1 day• BERINERT 4 units per 365 days• BIMATOPROST 1 ml per 12 days• BOSULIF(TAB)(100 MG) 4 units per 1 day• BOSULIF(TAB)(500 MG) 1 unit per 1 day• BREO ELLIPTA 60 units per 30 days• BRILINTA 2 units per 1 day• BRINTELLIX 1 unit per 1 day• BRISDELLE 1 unit per 1 day• BUDESONIDE(AMPUL-NEB)(0.25MG/2ML) 120 ml per 30 days

• BUDESONIDE(AMPUL-NEB)(0.5MG/2ML) 120 ml per 30 days• BUDESONIDE(AMPUL-NEB)(1MG/2 ML) 60 ml per 30 days• BUPRENORPHINE HCL(TABSUBL) 3 units per 1 day• BUPRENORPHINE-NALOXONE 3 units per 1 day• BUTRANS 1 unit per 7 days• CAFERGOT 10 units per 7 days• CAMRESE 91 unit per 84 days• CAPECITABINE(TAB)(150 MG) 28 units per 21 day• CAPECITABINE(TAB)(500 MG) 112 units per 21 day• CAPRELSA(TAB)(100 MG) 2 units per 1 day• CAPRELSA(TAB)(300 MG) 1 unit per 1 day• CAYSTON 84 ml per 56 days• CHANTIX 2 units per 1 day• CIMZIA 1 unit per 28 days• CLONIDINE HCL ER 120 units per 30 days• CLOPIDOGREL(TAB)(300 MG) 4 units per 30 days• CLOZAPINE 3 units per 1 day• CLOZARIL 3 units per 1 day• COLCHICINE 4 units per 1 day• COMBIPATCH 2 units per 7 days• COMETRIQ 4 units per 1 day• CRESTOR(TAB)(10 MG) 1 unit per 1 day• CRESTOR(TAB)(20 MG) 1 unit per 1 day• CRESTOR(TAB)(40 MG) 1 unit per 1 day• CRESTOR(TAB)(5 MG) 1 unit per 1 day• CYMBALTA 2 units per 1 day• DALIRESP 1 unit per 1 day• DEPO-PROVERA 1 ml per 84 days• DEPO-SUBQ PROVERA 104 .65 ml per 84 days• DESLORATADINE 1 unit per 1 day• DESVENLAFAXINE ER 1 unit per 1 day• DESVENLAFAXINE FUMARATEER 1 unit per 1 day• DEXMETHYLPHENIDATE HCLER 1 unit per 1 day• DEXTROAMPHETAMINESULFATE(SOLUTION) 1800 ml per 30 days• DEXTROAMPHETAMINESULFATE(TAB)(10 MG) 180 units per 30 days• DEXTROAMPHETAMINESULFATE(TAB)(5 MG) 90 units per 30 days• DEXTROAMPHETAMINE-AMPHETAMINE 2 units per 1 day• DIAZEPAM 1 unit per fill• DICLOFENAC SODIUM 100 gm per fill• DIDANOSINE(CAP DR)(125 MG) 60 units per 30 days• DIDANOSINE(CAP DR)(200 MG) 60 units per 30 days• DIFICID 20 units per 30 days• DIHYDROERGOTAMINEMESYLATE(AMPUL) 15 ml per 14 days• DIHYDROERGOTAMINEMESYLATE(SPRAY/PUMP) 8 ml per 28 days• DOXYCYCLINE HYCLATE 2 units per 1 day• DOXYCYCLINEMONOHYDRATE(CAP) 2 units per 1 day• DOXYCYCLINEMONOHYDRATE(TAB)(100 MG) 2 units per 1 day• DOXYCYCLINEMONOHYDRATE(TAB)(150 MG) 2 units per 1 day


VNSNY Page 49 of 73

• DOXYCYCLINEMONOHYDRATE(TAB)(50 MG) 2 units per 1 day• DOXYCYCLINEMONOHYDRATE(TAB)(75 MG) 2 units per 1 day• DRONABINOL 2 units per 1 day• DULERA 13 gm per 30 days• DULOXETINE HCL 2 units per 1 day• EDLUAR 1 unit per 1 day• EFFIENT 1 unit per 1 day• ELIQUIS(TAB)(2.5 MG) 2 units per 1 day• ELIQUIS(TAB)(5 MG) 74 units per 30 days• EMEND(CAP DS PK) 3 units per 21 day• EMEND(CAP)(125 MG) 3 units per 21 day• EMEND(CAP)(40 MG) 1 unit per 28 days• EMEND(CAP)(80 MG) 2 units per 21 day• EMSAM 1 unit per 1 day• EMTRIVA(CAP) 30 units per 30 days• EMTRIVA(SOLUTION) 720 ml per 30 days• ENOXAPARINSODIUM(SYRINGE)(100 MG/ML) 20 ml per 30 days• ENOXAPARINSODIUM(SYRINGE)(120MG/.8ML) 16 ml per 30 days• ENOXAPARINSODIUM(SYRINGE)(150 MG/ML) 20 ml per 30 days• ENOXAPARINSODIUM(SYRINGE)(30MG/0.3ML) 6 ml per 30 days• ENOXAPARINSODIUM(SYRINGE)(40MG/0.4ML) 8 ml per 30 days• ENOXAPARINSODIUM(SYRINGE)(60MG/0.6ML) 12 ml per 30 days• ENOXAPARINSODIUM(SYRINGE)(80MG/0.8ML) 16 ml per 30 days• ENOXAPARIN SODIUM(VIAL) 30 ml per 30 days• EPZICOM 30 units per 30 days• ERIVEDGE 1 unit per 1 day• ESOMEPRAZOLE MAGNESIUM 1 unit per 1 day• ESTRADIOL(PATCH TDSW) 2 units per 7 days• ESTRADIOL(PATCH TDWK) 1 unit per 7 days• EVOTAZ 1 unit per 1 day• FANAPT(TAB DS PK) 8 units per 28 days• FANAPT(TAB) 2 units per 1 day• FELBAMATE(ORAL SUSP) 30 ml per 1 day• FELBAMATE(TAB)(400 MG) 9 units per 1 day• FELBAMATE(TAB)(600 MG) 6 units per 1 day• FENTANYL 1 unit per 3 days• FENTANYL CITRATE 4 units per 1 day• FETZIMA 1 unit per 1 day• FIRMAGON(VIAL)(120 MG) 2 units per 365 days• FIRMAGON(VIAL)(80 MG) 1 unit per 30 days• FLUNISOLIDE 25 ml per 30 days• FLUTICASONE PROPIONATE 16 gm per 30 days• FLUTICASONEPROPIONATE(OTC) 16 ml per 30 days• FOCALIN XR 1 unit per 1 day• FONDAPARINUXSODIUM(SYRINGE)(10MG/0.8ML) 8 ml per 30 days• FONDAPARINUXSODIUM(SYRINGE)(2.5 MG/0.5) 5 ml per 30 days• FONDAPARINUXSODIUM(SYRINGE)(5MG/0.4ML) 4 ml per 30 days• FONDAPARINUXSODIUM(SYRINGE)(7.5MG/0.6) 6 ml per 30 days• FORTEO 2.4 ml per 28 days• FRAGMIN(SYRINGE)(10000/ML) 10 ml per 30 days

• FRAGMIN(SYRINGE)(12500/0.5) 5 ml per 30 days• FRAGMIN(SYRINGE)(15000/0.6) 6 ml per 30 days• FRAGMIN(SYRINGE)(18000/0.72)7.2 ml per 30 days• FRAGMIN(SYRINGE)(2500/0.2ML) 2 ml per 30 days• FRAGMIN(SYRINGE)(5000/0.2ML) 2 ml per 30 days• FRAGMIN(SYRINGE)(7500/0.3ML) 3 ml per 30 days• FRAGMIN(VIAL) 7.6 ml per 30 days• FUZEON 60 units per 30 days• FYCOMPA(TAB)(10 MG) 30 units per 30 days• FYCOMPA(TAB)(12 MG) 30 units per 30 days• FYCOMPA(TAB)(2 MG) 120 units per 30 days• FYCOMPA(TAB)(4 MG) 60 units per 30 days• FYCOMPA(TAB)(6 MG) 60 units per 30 days• FYCOMPA(TAB)(8 MG) 30 units per 30 days• GABITRIL(TAB)(12 MG) 4 units per 1 day• GABITRIL(TAB)(16 MG) 3 units per 1 day• GALANTAMINE HBR(CAP24HPEL) 30 units per 30 days• GALANTAMINE HBR(TAB) 60 units per 30 days• GATTEX 1 unit per 30 days• GEODON 2 units per 1 day• GILENYA 1 unit per 1 day• GLEEVEC 2 units per 1 day• GLYXAMBI 1 unit per 1 day• GRANISETRON HCL 8 units per 30 days• GUANFACINE HCL ER 1 unit per 1 day• HUMALOG KWIKPEN U-100 30 ml per 28 days• HUMALOG KWIKPEN U-200 12 ml per 28 days• HUMALOG MIX 50-50 40 ml per 28 days• HUMALOG MIX 50-50 KWIKPEN30 ml per 28 days• HUMALOG MIX 75-25 40 ml per 28 days• HUMALOG MIX 75-25 KWIKPEN30 ml per 28 days• HUMALOG(CARTRIDGE) 30 ml per 28 days• HUMALOG(VIAL) 40 ml per 28 days• HUMULIN 70/30 KWIKPEN(OTC)30 ml per 28 days• HUMULIN 70-30(OTC) 40 ml per 28 days• HUMULIN N KWIKPEN(OTC) 30 ml per 28 days• HUMULIN N(OTC) 40 ml per 28 days• HUMULIN R U-500 40 ml per 28 days• HUMULIN R(OTC) 40 ml per 28 days• HYDROCODONE-ACETAMINOPHEN(SOLUTION)(10-325/15) 184 ml per 1 day• HYDROCODONE-ACETAMINOPHEN(SOLUTION)(5-163/7.5) 184 ml per 1 day• HYDROCODONE-ACETAMINOPHEN(SOLUTION)(7.5-325/15) 184 ml per 1 day• HYDROCODONE-ACETAMINOPHEN(TAB)(10MG-325MG) 12 units per 1 day• HYDROCODONE-ACETAMINOPHEN(TAB)(5 MG-325MG) 12 units per 1 day• HYDROCODONE-ACETAMINOPHEN(TAB)(7.5-325MG) 12 units per 1 day• ICLUSIG(TAB)(15 MG) 2 units per 1 day• ICLUSIG(TAB)(45 MG) 1 unit per 1 day• IMIQUIMOD 24 units per 30 days


VNSNY Page 50 of 73

• INCRUSE ELLIPTA 30 units per 30 days• INLYTA(TAB)(1 MG) 6 units per 1 day• INLYTA(TAB)(5 MG) 2 units per 1 day• INTERMEZZO 1 unit per 1 day• INVEGA(TAB ER 24H)(1.5 MG) 1 unit per 1 day• INVEGA(TAB ER 24H)(3 MG) 1 unit per 1 day• INVEGA(TAB ER 24H)(6 MG) 2 units per 1 day• INVEGA(TAB ER 24H)(9 MG) 1 unit per 1 day• INVIRASE(CAP) 300 units per 30 days• INVIRASE(TAB) 120 units per 30 days• INVOKAMET 2 units per 1 day• INVOKANA 30 units per 30 days• IPRIVASK 6 units per 30 days• JAKAFI 2 units per 1 day• JANUMET 2 units per 1 day• JANUMET XR(TBMP 24HR)(100-1000MG) 1 unit per 1 day• JANUMET XR(TBMP 24HR)(50-1000 MG) 2 units per 1 day• JANUMET XR(TBMP24HR)(50MG-500MG) 2 units per 1 day• JANUVIA 1 unit per 1 day• JARDIANCE 1 unit per 1 day• JENTADUETO 2 units per 1 day• JUXTAPID 1 unit per 1 day• KALETRA(SOLUTION) 390 ml per 30 days• KALETRA(TAB)(100MG-25MG) 300 units per 30 days• KALETRA(TAB)(200MG-50MG) 120 units per 30 days• KALYDECO 2 units per 1 day• KHEDEZLA 1 unit per 1 day• KORLYM 4 units per 1 day• LAMIVUDINE(SOLUTION) 900 ml per 30 days• LAMIVUDINE(TAB)(150 MG) 60 units per 30 days• LAMIVUDINE(TAB)(300 MG) 30 units per 30 days• LAMIVUDINE-ZIDOVUDINE 60 units per 30 days• LANSOPRAZOL-AMOXICIL-CLARITHRO 112 units per 10 days• LANTUS 40 ml per 28 days• LANTUS SOLOSTAR 30 ml per 28 days• LATUDA(TAB)(120 MG) 30 units per 30 days• LATUDA(TAB)(20 MG) 30 units per 30 days• LATUDA(TAB)(40 MG) 30 units per 30 days• LATUDA(TAB)(60 MG) 30 units per 30 days• LATUDA(TAB)(80 MG) 60 units per 30 days• LEVOCETIRIZINEDIHYDROCHLORIDE(SOLUTION) 10 ml per 1 day• LINZESS 1 unit per 1 day• LUMIGAN 1 ml per 12 days• LUNESTA 1 unit per 1 day• LYNPARZA 16 units per 1 day• MEMANTINE HCL(SOLUTION) 300 ml per 30 days• MEMANTINE HCL(TAB DS PK) 49 units per 28 days• MEMANTINE HCL(TAB) 60 units per 30 days• METHAMPHETAMINE HCL 150 units per 30 days• METHYLPHENIDATE ER(CPBP50-50)(20 MG) 1 unit per 1 day• METHYLPHENIDATE ER(CPBP50-50)(30 MG) 2 units per 1 day• METHYLPHENIDATE ER(CPBP50-50)(40 MG) 1 unit per 1 day• METHYLPHENIDATE ER(TABER 24H)(18 MG) 1 unit per 1 day• METHYLPHENIDATE ER(TABER 24H)(27 MG) 1 unit per 1 day

• METHYLPHENIDATE ER(TABER 24H)(36 MG) 2 units per 1 day• METHYLPHENIDATE ER(TABER 24H)(54 MG) 1 unit per 1 day• METHYLPHENIDATE ER(TABER)(10 MG) 3 units per 1 day• METHYLPHENIDATE ER(TABER)(20 MG) 90 units per 30 days• MORPHINE SULFATE ER(CAPER PEL) 2 units per 1 day• MORPHINE SULFATE ER(CPMP24HR)(120 MG) 2 units per 1 day• MORPHINE SULFATE ER(CPMP24HR)(30 MG) 1 unit per 1 day• MORPHINE SULFATE ER(CPMP24HR)(45 MG) 1 unit per 1 day• MORPHINE SULFATE ER(CPMP24HR)(60 MG) 1 unit per 1 day• MORPHINE SULFATE ER(CPMP24HR)(75 MG) 1 unit per 1 day• MORPHINE SULFATE ER(CPMP24HR)(90 MG) 1 unit per 1 day• MORPHINE SULFATE ER(TABER) 3 units per 1 day• MOVANTIK 1 unit per 1 day• MYALEPT 1 unit per 1 day• NAMENDA XR(CAP 24 DSPK) 28 units per 28 days• NAMENDA XR(CAP SPR 24) 30 units per 30 days• NAMZARIC 1 unit per 1 day• NASONEX 17 gm per 30 days• NEUPRO 1 unit per 1 day• NEVIRAPINE(ORAL SUSP) 1200 ml per 30 days• NEVIRAPINE(TAB) 60 units per 30 days• NEXAVAR 4 units per 1 day• NEXIUM 1 unit per 1 day• NILANDRON 150 units after 30 days• NORVIR(CAP) 360 units per 30 days• NORVIR(SOLUTION) 450 ml per 30 days• NORVIR(TAB) 360 units per 30 days• NUCYNTA 6 units per 1 day• NUCYNTA ER 2 units per 1 day• NUVARING 1 unit per 28 days• OLANZAPINE-FLUOXETINEHCL 1 unit per 1 day• OLEPTRO ER 3 units per 2 days• OLOPATADINE HCL 30.5 gm per 30 days• OMEGA-3 ACID ETHYL ESTERS 4 units per 1 day• ONDANSETRONHCL(SOLUTION) 50 ml per 15 days• ONFI(ORAL SUSP) 480 ml per 30 days• ONFI(TAB) 2 units per 1 day• ORENCIA 1 ml per 7 days• ORTHO EVRA 3 units per 28 days• OTREXUP 1.6 ml per 28 days• OXTELLAR XR(TAB ER 24H)(150MG) 1 unit per 1 day• OXTELLAR XR(TAB ER 24H)(300MG) 1 unit per 1 day• OXTELLAR XR(TAB ER 24H)(600MG) 4 units per 1 day• OXYCODONE-ACETAMINOPHEN 12 units per 1 day• OXYCONTIN(TAB ER 12H)(10MG) 2 units per 1 day


VNSNY Page 51 of 73

• OXYCONTIN(TAB ER 12H)(15MG) 2 units per 1 day• OXYCONTIN(TAB ER 12H)(20MG) 2 units per 1 day• OXYCONTIN(TAB ER 12H)(30MG) 2 units per 1 day• OXYCONTIN(TAB ER 12H)(40MG) 2 units per 1 day• OXYCONTIN(TAB ER 12H)(60MG) 2 units per 1 day• OXYCONTIN(TAB ER 12H)(80MG) 4 units per 1 day• PERFOROMIST 120 ml per 30 days• PEXEVA 1 unit per 1 day• PICATO(GEL)(0.015 %) 3 units per 28 days• PICATO(GEL)(0.05 %) 2 units per 28 days• POTIGA(TAB)(200 MG) 3 units per 1 day• POTIGA(TAB)(300 MG) 3 units per 1 day• POTIGA(TAB)(400 MG) 3 units per 1 day• POTIGA(TAB)(50 MG) 9 units per 1 day• PREZCOBIX 1 unit per 1 day• PREZISTA(ORAL SUSP) 240 ml per 30 days• PREZISTA(TAB)(150 MG) 240 units per 30 days• PREZISTA(TAB)(400 MG) 60 units per 30 days• PREZISTA(TAB)(600 MG) 60 units per 30 days• PREZISTA(TAB)(75 MG) 480 units per 30 days• PREZISTA(TAB)(800 MG) 30 units per 30 days• PRISTIQ ER 1 unit per 1 day• PROMACTA 1 unit per 1 day• PULMOZYME 5 ml per 1 day• QNASL 8.7 gm per 30 days• RABEPRAZOLE SODIUM 1 unit per 1 day• RALOXIFENE HCL 1 unit per 1 day• RANEXA(TAB ER 12H)(1000 MG)60 units per 30 days• RANEXA(TAB ER 12H)(500 MG) 120 units per 30 days• RASUVO(AUTOINJECT)(10MG/0.2ML) .8 ml per 28 days• RASUVO(AUTOINJECT)(12.5/0.25) 1 ml per 28 days• RASUVO(AUTOINJECT)(15MG/0.3ML) 1.2 ml per 28 days• RASUVO(AUTOINJECT)(17.5/0.35) 1.4 ml per 28 days• RASUVO(AUTOINJECT)(20MG/0.4ML) 1.6 ml per 28 days• RASUVO(AUTOINJECT)(22.5/0.45) 1.8 ml per 28 days• RASUVO(AUTOINJECT)(25MG/0.5ML) 2 ml per 28 days• RASUVO(AUTOINJECT)(27.5/0.55) 2.2 ml per 28 days• RASUVO(AUTOINJECT)(30MG/0.6ML) 2.4 ml per 28 days• RASUVO(AUTOINJECT)(7.5MG/0.15) .6 ml per 28 days• REBIF REBIDOSE(PENINJCTR)(22MCG/.5ML) 6 ml per 28 days• REBIF REBIDOSE(PENINJCTR)(44MCG/.5ML) 6 ml per 28 days• REBIF REBIDOSE(PENINJCTR)(8.8-22(6)) 4.2 ml per 28 days• REBIF(SYRINGE)(22MCG/.5ML) 6 ml per 28 days• REBIF(SYRINGE)(44MCG/.5ML) 6 ml per 28 days• REBIF(SYRINGE)(8.8-22(6)) 4.2 ml per 28 days

• RESTASIS 64 units per 30 days• REVLIMID 1 unit per 1 day• RISPERDAL(SOLUTION) 8 ml per 1 day• RISPERDAL(TAB) 2 units per 1 day• RITALIN LA 1 unit per 1 day• RIVASTIGMINE 30 units per 30 days• RIZATRIPTAN 3 units per 5 days• ROZEREM 1 unit per 1 day• SABRIL 6 units per 1 day• SAPHRIS 2 units per 1 day• SEROQUEL 3 units per 1 day• SEROQUEL XR 1 unit per 1 day• SILENOR 1 unit per 1 day• SIMCOR(TBMP 24HR)(1000-20MG) 2 units per 1 day• SIMCOR(TBMP 24HR)(1000-40MG) 1 unit per 1 day• SIMCOR(TBMP 24HR)(500MG-20MG) 1 unit per 1 day• SIMCOR(TBMP 24HR)(500MG-40MG) 1 unit per 1 day• SIMCOR(TBMP 24HR)(750MG-20MG) 2 units per 1 day• SIMPONI .5 ml per 30 days• SONATA 1 unit per 1 day• SPIRIVA RESPIMAT 4 gm per 30 days• SPRYCEL(TAB)(100 MG) 1 unit per 1 day• SPRYCEL(TAB)(140 MG) 1 unit per 1 day• SPRYCEL(TAB)(20 MG) 2 units per 1 day• SPRYCEL(TAB)(50 MG) 1 unit per 1 day• SPRYCEL(TAB)(70 MG) 1 unit per 1 day• SPRYCEL(TAB)(80 MG) 1 unit per 1 day• STAVUDINE(CAP) 60 units per 30 days• STAVUDINE(SOLN RECON) 2400 ml per 30 days• STIOLTO RESPIMAT 4 gm per 30 days• STIVARGA 3 units per 1 day• STRATTERA(CAP)(10 MG) 60 units per 30 days• STRATTERA(CAP)(100 MG) 30 units per 30 days• STRATTERA(CAP)(18 MG) 60 units per 30 days• STRATTERA(CAP)(25 MG) 60 units per 30 days• STRATTERA(CAP)(40 MG) 60 units per 30 days• STRATTERA(CAP)(60 MG) 30 units per 30 days• STRATTERA(CAP)(80 MG) 30 units per 30 days• STRIBILD 30 units per 30 days• STRIVERDI RESPIMAT 4 gm per 30 days• SUBOXONE(FILM)(12 MG-3 MG) 2 units per 1 day• SUBOXONE(FILM)(2 MG-0.5MG) 3 units per 1 day• SUBOXONE(FILM)(4MG-1MG) 3 units per 1 day• SUBOXONE(FILM)(8 MG-2 MG) 3 units per 1 day• SUCRAID 8 ml per 1 day• SUMATRIPTAN 6 units per 15 days• SUMATRIPTANSUCCINATE(CARTRIDGE) 1 ml per 14 days• SUMATRIPTAN SUCCINATE(PENINJCTR) 1 ml per 14 days• SUMATRIPTANSUCCINATE(TAB) 3 units per 5 days• SUMATRIPTANSUCCINATE(VIAL) 1 ml per 14 days• SUTENT 1 unit per 1 day• SYLATRON 1 unit per 28 days• SYMBYAX 1 unit per 1 day• SYNJARDY 2 units per 1 day• TAMIFLU(CAP)(30 MG) 40 units per 183 days


VNSNY Page 52 of 73

• TAMIFLU(CAP)(45 MG) 20 units per 183 days• TAMIFLU(CAP)(75 MG) 20 units per 183 days• TAMIFLU(SUSP RECON) 360 ml per 183 days• TANZEUM 4 units per 28 days• TARCEVA 1 unit per 1 day• TASIGNA 4 units per 1 day• TECFIDERA 2 units per 1 day• TESTOSTERONE CYPIONATE 10 ml per 30 days• TESTOSTERONE ENANTHATE 5 ml per 30 days• TESTOSTERONE(GEL MD PMP) 4 gm per 1 day• TESTOSTERONE(GEL) 300 gm per 30 days• THALOMID 2 units per 1 day• TIAGABINE HCL 4 units per 1 day• TOBI PODHALER 8 units per 1 day• TOBRAMYCIN 5 ml per 1 day• TOUJEO SOLOSTAR 7.5 ml per 28 days• TRADJENTA 1 unit per 1 day• TRAVATAN Z 1 ml per 12 days• TRAVOPROST 1 ml per 12 days• TRIUMEQ 1 unit per 1 day• TROKENDI XR(CAP ER 24H)(100MG) 1 unit per 1 day• TROKENDI XR(CAP ER 24H)(200MG) 2 units per 1 day• TROKENDI XR(CAP ER 24H)(25MG) 1 unit per 1 day• TROKENDI XR(CAP ER 24H)(50MG) 1 unit per 1 day• TRULICITY 2 ml per 28 days• TRUVADA 30 units per 30 days• ULORIC 30 units per 30 days• VANCOMYCIN HCL 40 units per 30 days• VASCEPA 4 units per 1 day• VERSACLOZ 18 ml per 1 day• VIDEX 1200 ml per 30 days• VIIBRYD 1 unit per 1 day• VIMPAT(SOLUTION) 1200 ml per 30 days• VIMPAT(TAB) 2 units per 1 day• VIREAD(POWDER) 225 gm per 30 days• VIREAD(TAB) 30 units per 30 days• VITEKTA 1 unit per 1 day• VOTRIENT 4 units per 1 day• VYVANSE 1 unit per 1 day• XALKORI 2 units per 1 day• XARELTO(TAB DS PK) 51 unit per 30 days• XARELTO(TAB)(10 MG) 1 unit per 1 day• XARELTO(TAB)(15 MG) 42 tablets for the first 21

days; followed by 30tablets per 30 days

• XARELTO(TAB)(20 MG) 1 unit per 1 day• XELJANZ 2 units per 1 day• XTANDI 4 units per 1 day• ZELBORAF 8 units per 1 day• ZENZEDI 90 units per 30 days• ZETIA 1 unit per 1 day• ZIAGEN 900 ml per 30 days• ZIDOVUDINE(CAP) 180 units per 30 days• ZIDOVUDINE(SYRUP) 1800 ml per 30 days• ZIDOVUDINE(TAB) 60 units per 30 days• ZOLPIDEM TARTRATE 1 unit per 1 day• ZOLPIMIST 7.7 ml per 30 days• ZOMIG(SPRAY)(2.5 MG) 12 units per 30 days• ZOMIG(SPRAY)(5 MG) 6 units per 15 days• ZYPREXA 1 unit per 1 day

• ZYTIGA 4 units per 1 day


VNSNY Page 53 of 73

STEP THERAPY EDITS • ABILIFY Trial of two of the following: olanzapine/ODT, quetiapine IR, risperidone/ODT,

ziprasidone, sertraline, fluoxetine, venlafaxine, paroxetine, citalopram, orescitalopram within the past 365 days

• ACTOPLUS MET XR Trial of metformin, metformin ER, sulfonylurea (e.g., glyburide, glipizide) orpioglitazone within the past 120 days

• AMLODIPINE-VALSARTAN Trial of ACE or ACE combination (benazepril,captopril, enalapril, fosinopril,lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril, amlodipinebesylate/benazepril, fosinopril/hctz, enalapril/hctz, captopril/hctz, quinapril/hctz,benazepril/hctz, lisinopril/hctz, moexipril/hctz, trandolapril/verapamil) OR ACEcombination or formulary generic ARB or ARB combination (irbesartan, losartan,losartan/hctz, irbesartan/hctz, valsartan/hctz) within the past 120 days

• AMLODIPINE-VALSARTAN-HCTZ Trial of ACE or ACE combination (benazepril,captopril, enalapril, fosinopril,lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril, amlodipinebesylate/benazepril, fosinopril/hctz, enalapril/hctz, captopril/hctz, quinapril/hctz,benazepril/hctz, lisinopril/hctz, moexipril/hctz, trandolapril/verapamil) OR ACEcombination or formulary generic ARB or ARB combination (irbesartan, losartan,losartan/hctz, irbesartan/hctz, valsartan/hctz) within the past 120 days

• APLENZIN Trial of bupropion hcl SR or XL within the past 120 days• APTIOM(TAB)(200 MG) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetam

IR or ER, oxcarbazepine, valproic acid or divalproex, topiramate, or zonisamiderequired within the past 365 days

• APTIOM(TAB)(400 MG) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetamIR or ER, oxcarbazepine, valproic acid or divalproex, topiramate, or zonisamiderequired within the past 365 days



• ARIPIPRAZOLE Trial of two of the following: olanzapine/ODT, quetiapine IR, risperidone/ODT,ziprasidone, sertraline, fluoxetine, venlafaxine, paroxetine, citalopram, orescitalopram within the past 365 days

• BANZEL(ORAL SUSP) Trial of lamotrigine, valproic acid or topiramate within the past 120 days• BANZEL(TAB)(200 MG) Trial of lamotrigine, valproic acid or topiramate within the past 120 days• BANZEL(TAB)(400 MG) Trial of lamotrigine, valproic acid or topiramate within the past 120 days• BELSOMRA Trial of zolpidem IR, zaleplon or eszopiclone within the past 120 days• BENICAR Trial of ACE or ACE combination (benazepril,captopril, enalapril, fosinopril,

lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril, amlodipinebesylate/benazepril, fosinopril/hctz, enalapril/hctz, captopril/hctz, quinapril/hctz,benazepril/hctz, lisinopril/hctz, moexipril/hctz, trandolapril/verapamil) OR ACEcombination or formulary generic ARB or ARB combination (irbesartan, losartan,losartan/hctz, irbesartan/hctz, valsartan/hctz) within the past 120 days

• BENICAR HCT Trial of ACE or ACE combination (benazepril,captopril, enalapril, fosinopril,lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril, amlodipinebesylate/benazepril, fosinopril/hctz, enalapril/hctz, captopril/hctz, quinapril/hctz,benazepril/hctz, lisinopril/hctz, moexipril/hctz, trandolapril/verapamil) OR ACEcombination or formulary generic ARB or ARB combination (irbesartan, losartan,losartan/hctz, irbesartan/hctz, valsartan/hctz) within the past 120 days

• BEYAZ Trial of two different non-drospirenone oral contraceptives (containinglevonorgestrel, norethindrone, norgestimate, norgestrel, desogestrel, or ethinynodiolace.) within the past 365 days

• BRINTELLIX Trial of two of the following: generic paroxetine, fluoxetine, citalopram, sertraline,escitalopram, venlafaxine IR, venlafaxine ER, mirtazapine, or bupropion within thepast 365 days

• BRISDELLE Trial of paroxetine or venlafaxine within the past 120 days• CALCIPOTRIENE Trial of a topical corticosteroid within the past 120 days• CALCIPOTRIENE-BETAMETHASONEDP Trial of a topical corticosteroid within the past 120 days• CALCITRIOL Trial of a topical corticosteroid within the past 120 days• CRESTOR(TAB)(10 MG) Trial of atorvastatin 40mg or atorvastatin 80mg within the past 120 days• CRESTOR(TAB)(20 MG) Trial of atorvastatin 40mg or atorvastatin 80mg within the past 120 days


VNSNY Page 54 of 73

• CRESTOR(TAB)(40 MG) Trial of atorvastatin 40mg or atorvastatin 80mg within the past 120 days• CRESTOR(TAB)(5 MG) Trial of two of the following: atorvastatin, lovastatin, pravastatin or simvastatin

within the past 365 days• DALIRESP Trial of Spiriva, Incruse, Striverdi, Breo Ellipta, Advair Diskus or Dulera required

within the past 120 days• DESVENLAFAXINE ER Trial of two of the following: generic paroxetine, fluoxetine, citalopram, sertraline,

escitalopram, venlafaxine IR, venlafaxine ER, mirtazapine, or bupropion within thepast 365 days

• DESVENLAFAXINE FUMARATE ER Trial of two of the following: generic paroxetine, fluoxetine, citalopram, sertraline,escitalopram, venlafaxine IR, venlafaxine ER, mirtazapine, or bupropion within thepast 365 days

• DIFICID Trial of vancomycin capsules within the past 120 days• DOXYCYCLINE HYCLATE Trial of doxycycline monohydrate within the past 120 days• DOXYCYCLINEMONOHYDRATE(TAB)(100 MG) Trial of generic doxycycline monohydrate 100mg capsules within the past 120 days• DOXYCYCLINEMONOHYDRATE(TAB)(50 MG) Trial of generic doxycycline monohydrate 50mg capsules within the past 120 days• DRITHOCREME HP Trial of a topical corticosteroid within the past 120 days• DRONABINOL Trial of ondansetron, corticosteroids and Emend within the past 365 days• DUTASTERIDE Trial of Proscar, alfuzosin, doxazosin, prazosin, silodosin, tamsulosin or terazosin

within the past 120 days• DUTASTERIDE/TAMSULOSIN Trial of Proscar, alfuzosin, doxazosin, prazosin, silodosin, tamsulosin or terazosin

within the past 120 days• EDLUAR Trial of zolpidem IR/ER (Ambien) within the past 180 days• ESOMEPRAZOLE MAGNESIUM Trial of omeprazole, lansoprazole or pantoprazole within the past 120 days• FANAPT(TAB DS PK) Trial of two generic atypical antipsychotics: olanzapine/ODT, quetiapine IR,

risperidone/ODT or ziprasidone within the past 365 days• FANAPT(TAB) Trial of two generic atypical antipsychotics: olanzapine/ODT, quetiapine IR,

risperidone/ODT or ziprasidone within the past 365 days• FELBAMATE(ORAL SUSP) Trial of lamotrigine or topiramate within the past 120 days• FELBAMATE(TAB)(400 MG) Trial of lamotrigine or topiramate within the past 120 days• FELBAMATE(TAB)(600 MG) Trial of lamotrigine or topiramate within the past 120 days• FETZIMA Trial of two of the following: generic paroxetine, fluoxetine, citalopram, sertraline,


• FYCOMPA(TAB)(10 MG) Trial of two of the following: carbamzepine, gabapentin, lamotrigine, levetiracetamIR or ER, oxcarbazepine, valproic acid or divalproex, topiramate, or zonisamidewithin the past 365 days






• GABITRIL(TAB)(12 MG) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetamIR or ER, oxcarbazepine, valproic acid, divalproex, topiramate or zonisamide withinthe past 365 days

• GABITRIL(TAB)(16 MG) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetamIR or ER, oxcarbazepine, valproic acid, divalproex, topiramate or zonisamide withinthe past 365 days

• GLYXAMBI Trial of metformin/metformin combination OR formulary sulfonylurea ORpioglitazone/pioglitazone combination in the past 120 days.

• GRANISETRON HCL Trial of ondansetron tablets or ODT within the past 120 days• INTERMEZZO Trial of zolpidem IR (Ambien) within the past 120 days


VNSNY Page 55 of 73

• INVEGA(TAB ER 24H)(1.5 MG) Trial of two generic atypical antipsychotics: olanzapine/ODT, quetiapine IR,risperidone/ODT or ziprasidone within the past 365 days

• INVEGA(TAB ER 24H)(3 MG) Trial of two generic atypical antipsychotics: olanzapine/ODT, quetiapine IR,risperidone/ODT or ziprasidone within the past 365 days



• INVOKAMET Trial of metformin/metformin combination OR formulary sulfonylurea ORpioglitazone/pioglitazone combination in the past 120 days.

• INVOKANA Trial of metformin/metformin combination OR formulary sulfonylurea ORpioglitazone/pioglitazone combination in the past 120 days.

• JARDIANCE Trial of metformin/metformin combination OR formulary sulfonylurea ORpioglitazone/pioglitazone combination in the past 120 days.

• KHEDEZLA Trial of two of the following: generic paroxetine, fluoxetine, citalopram, sertraline,escitalopram, venlafaxine IR, venlafaxine ER, mirtazapine, or bupropion within thepast 365 days

• LAMICTAL XR (BLUE) Trial of lamotrigine IR within the past 120 days• LAMICTAL XR (GREEN) Trial of lamotrigine IR within the past 120 days• LAMICTAL XR (ORANGE) Trial of lamotrigine IR within the past 120 days• LATUDA(TAB)(120 MG) Trial of two generic atypical antipsychotics: olanzapine/ODT, quetiapine IR,

risperidone/ODT or ziprasidone within the past 365 days• LATUDA(TAB)(20 MG) Trial of two generic atypical antipsychotics: olanzapine/ODT, quetiapine IR,




risperidone/ODT or ziprasidone within the past 365 days• LEVOCETIRIZINEDIHYDROCHLORIDE(SOLUTION) Trial of desloratadine or levocetirizine tablet within the past 120 days• NAMZARIC Trial of donepezil and memantine within the past 365 days• NEUPRO Trial of pramipexole IR or ropinirole IR within the past 120 days• NEXIUM Trial of omeprazole, lansoprazole or pantoprazole within the past 120 days• NIACIN ER Trial of two of the following: generic/multisource statin (atorvastatin, lovastatin,

pravastatin or simvastatin), gemfibrozil or genofibrate within the past 365 days• OCELLA Trial of two different non-drospirenone oral contraceptives (containing

levonorgestrel, norethindrone, norgestimate, norgestrel, desogestrel, or ethinynodiolace.) within the past 365 days

• OLEPTRO ER Trial of immediate release trazodone within the past 120 days• OLOPATADINE HCL Trial of Astelin (azelastine) within the past 120 days• ONFI(ORAL SUSP) Trial of lamotrigine or topiramate within the past 120 days• ONFI(TAB) Trial of lamotrigine or topiramate within the past 120 days• OTREXUP Trial of Rasuvo and either methotrexate tablet or solution for injection within the past

365 days• OXTELLAR XR(TAB ER 24H)(150 MG) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetam

IR or ER, oxcarbazepine, valproic acid, divalproex, topiramate or zonisamide withinthe past 365 days

• OXTELLAR XR(TAB ER 24H)(300 MG) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetamIR or ER, oxcarbazepine, valproic acid, divalproex, topiramate or zonisamide withinthe past 365 days

• OXTELLAR XR(TAB ER 24H)(600 MG) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetamIR or ER, oxcarbazepine, valproic acid, divalproex, topiramate or zonisamide withinthe past 365 days

• PEXEVA Trial of paroxetine HCL IR within the past 120 days• PIOGLITAZONE-METFORMIN Trial of metformin, metformin ER, sulfonylurea (e.g., glyburide, glipizide) or

pioglitazone within the past 120 days• POTIGA(TAB)(200 MG) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetam


• POTIGA(TAB)(300 MG) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetamIR or ER, oxcarbazepine, valproic acid, divalproex, topiramate or zonisamide withinthe past 365 days


VNSNY Page 56 of 73



• PREVACID Trial of omeprazole, lansoprazole or pantoprazole within the past 120 days• PRISTIQ ER Trial of two of the following: generic paroxetine, fluoxetine, citalopram, sertraline,


• PURIXAN Trial of mercaptopurine tablet within the past 120 days• QNASL Trial of fluticasone or flunisolide within the past 365 days• RASUVO(AUTO INJECT)(10MG/0.2ML) Trial of methotrexate tablet or solution for injection within the past 120 days• RASUVO(AUTO INJECT)(12.5/0.25) Trial of methotrexate tablet or solution for injection within the past 120 days• RASUVO(AUTO INJECT)(15MG/0.3ML) Trial of methotrexate tablet or solution for injection within the past 120 days• RASUVO(AUTO INJECT)(17.5/0.35) Trial of methotrexate tablet or solution for injection within the past 120 days• RASUVO(AUTO INJECT)(20MG/0.4ML) Trial of methotrexate tablet or solution for injection within the past 120 days• RASUVO(AUTO INJECT)(22.5/0.45) Trial of methotrexate tablet or solution for injection within the past 120 days• RASUVO(AUTO INJECT)(25MG/0.5ML) Trial of methotrexate tablet or solution for injection within the past 120 days• RASUVO(AUTO INJECT)(27.5/0.55) Trial of methotrexate tablet or solution for injection within the past 120 days• RASUVO(AUTO INJECT)(30MG/0.6ML) Trial of methotrexate tablet or solution for injection within the past 120 days• RASUVO(AUTO INJECT)(7.5MG/0.15) Trial of methotrexate tablet or solution for injection within the past 120 days• ROZEREM Trial of one of the following: eszopiclone(Lunesta), zolpidem IR (Ambien) or

zaleplon (Sonata) within the past 120 days• SAFYRAL Trial of two different non-drospirenone oral contraceptives (containing

levonorgestrel, norethindrone, norgestimate, norgestrel, desogestrel, or ethinynodiolace.) within the past 365 days

• SAPHRIS Trial of two generic atypical antipsychotics: olanzapine/ODT, quetiapine IR,risperidone/ODT or ziprasidone within the past 365 days

• SEROQUEL XR Trial of two of the following: olanzapine/ODT, quetiapine IR, risperidone/ODT,ziprasidone, sertraline, fluoxetine, venlafaxine, paroxetine, citalopram, orescitalopram within the past 365 days

• SILENOR Trial of one of the following: eszopiclone(Lunesta), zolpidem IR (Ambien) orzaleplon (Sonata) within the past 120 days

• SIMCOR(TBMP 24HR)(1000-20MG) Trial of two of the following: atorvastatin, lovastatin, pravastatin or simvastatinwithin the past 365 days

• SIMCOR(TBMP 24HR)(1000-40 MG) Trial of two of the following: atorvastatin, lovastatin, pravastatin or simvastatinwithin the past 365 days

• SIMCOR(TBMP 24HR)(500MG-20MG) Trial of two of the following: atorvastatin, lovastatin, pravastatin or simvastatinwithin the past 365 days



• SIMVASTATIN(TAB)(80 MG) Trial of simvastatin 80mg or Vytorin 10/80mg within the past 120 days• SYNJARDY Trial of metformin, metformin ER, sulfonylurea (e.g., glyburide, glipizide),

pioglitazone or a combination product containing any two of the threeaforementioned agents within the past 120 days

• TACROLIMUS Trial of a topical corticosteroid within the past 120 days• TANZEUM Trial of metformin/metformin combination OR formulary sulfonylurea OR

pioglitazone/pioglitazone combination in the past 120 days.• TIAGABINE HCL Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetam


• TOLTERODINE TARTRATE Trial of oxybutynin IR or obybutynin XL within the past 120 days• TOVIAZ Trial of oxybutynin or oxybutynin ER within the past 120 days• TRIGLIDE Trial of gemifibrozil or generic fenofibrate within the past 120 days• TROKENDI XR(CAP ER 24H)(100 MG) Trial of topiramate IR within the past 120 days• TROKENDI XR(CAP ER 24H)(200 MG) Trial of topiramate IR within the past 120 days• TROKENDI XR(CAP ER 24H)(25 MG) Trial of topiramate IR within the past 120 days• TROKENDI XR(CAP ER 24H)(50 MG) Trial of topiramate IR within the past 120 days• TRULICITY Trial of metformin/metformin combination OR formulary sulfonylurea OR

pioglitazone/pioglitazone combination in the past 120 days.


VNSNY Page 57 of 73

• VERSACLOZ Trial of two generic atypical antipsychotics: olanzapine/ODT, quetiapine IR,risperidone/ODT or ziprasidone within the past 365 days

• VESICARE Trial of oxybutynin or oxybutynin ER within the past 120 days• VIIBRYD Trial of two of the following: generic paroxetine, fluoxetine, citalopram, sertraline,

escitalopram, mirtazapine or bupropion, or venlafaxine IR/ER within the past 365days

• VIMPAT(SOLUTION) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetamIR or ER, oxcarbazepine, valproic acid, divalproex, topiramate or zonisamide withinthe past 365 days

• VIMPAT(TAB) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetamIR or ER, oxcarbazepine, valproic acid, divalproex, topiramate or zonisamide withinthe past 365 days

• VYVANSE Trial of one of the following: SSRI, topiramate, generic/multisource mixedamphetamine salts (Adderall IR/XR), or methylphenidate (IR, ER, LA, CD) withinthe past 120 days

• ZENZEDI Trial of a multisource dextroamphetamine sulfate tablet or dextroamphetaminesolution within the past 120 days

• ZOLPIMIST Trial of zolpidem IR (Ambien) within the past 120 days• ZOMIG(SPRAY)(2.5 MG) Trial of sumatriptan or rizatriptan within the past 180 days• ZOMIG(SPRAY)(5 MG) Trial of sumatriptan or rizatriptan within the past 180 days


VNSNY Page 58 of 73

PRIOR AUTHORIZATION RESTRICTIONS • ACTEMRA• ADCIRCA• ADEMPAS• AFINITOR DISPERZ• AFINITOR(TAB)(10 MG)• AFINITOR(TAB)(2.5 MG)• AFINITOR(TAB)(5 MG)• AFINITOR(TAB)(7.5 MG)• AMPYRA• ANDROGEL(GEL MD PMP)(1.25G (1%))• ANDROGEL(GEL MD PMP)(20.25/1.25)• ANDROGEL(GEL PACKET)(1.25G-1.62)• ANDROGEL(GEL PACKET)(2.5G-1.62%)• ANDROGEL(GEL PACKET)(25MG(1%))• ANDROGEL(GEL PACKET)(50 MG (1%))• APOKYN• AUBAGIO• AVONEX ADMINISTRATION PACK• AVONEX PEN(PEN INJ KIT)• AVONEX PEN(PEN INJCTR)• AVONEX(SYRINGE KIT)• AVONEX(SYRINGE)• AXIRON• BERINERT• BEXAROTENE• BOSULIF(TAB)(100 MG)• BOSULIF(TAB)(500 MG)• BUPRENORPHINE HCL(TAB SUBL)• BUPRENORPHINE-NALOXONE• CAPECITABINE(TAB)(150 MG)• CAPECITABINE(TAB)(500 MG)• CAPRELSA(TAB)(100 MG)• CAPRELSA(TAB)(300 MG)• CAYSTON• CIMZIA• CINRYZE• COMETRIQ• COPAXONE• COSENTYX (2 SYRINGES)• COSENTYX PEN• COSENTYX PEN (2 PENS)• COSENTYX SYRINGE• CYSTARAN• DARAPRIM• DICLOFENAC SODIUM• ELIGARD• ERIVEDGE• ESBRIET• EXEMESTANE• FARESTON• FARYDAK• FENTANYL• FENTANYL CITRATE• FIRAZYR• GAMMAGARD LIQUID• GAMMAKED• GAMUNEX-C• GATTEX• GENOTROPIN• GILENYA• GILOTRIF• GLATOPA

• GLEEVEC• GRANIX• GRASTEK• HARVONI• HETLIOZ• HIZENTRA• HUMATROPE• HYQVIA• IBRANCE• ICLUSIG(TAB)(15 MG)• ICLUSIG(TAB)(45 MG)• IMBRUVICA• IMIQUIMOD• INCRELEX• INLYTA(TAB)(1 MG)• INLYTA(TAB)(5 MG)• INTRON A• IPRIVASK• IRESSA• JAKAFI• JUXTAPID• KALYDECO• KEVEYIS• KORLYM• KYNAMRO• LENVIMA• LETAIRIS• LEUKINE• LINEZOLID• LONSURF• LYNPARZA• MEKINIST• MODAFINIL• NEULASTA• NEUPOGEN• NEXAVAR• NORDITROPIN FLEXPRO• NORDITROPIN NORDIFLEX• NORTHERA• NUTROPIN AQ• NUTROPIN AQ NUSPIN• NYMALIZE• ODOMZO• OFEV• OMNITROPE• OPSUMIT• ORALAIR• ORENCIA• ORENITRAM ER• ORKAMBI• OTEZLA• OXANDROLONE• PEGASYS• PEGASYS PROCLICK• POMALYST• PROCRIT• PROCYSBI• PROMACTA• PULMOZYME• RAGWITEK• RALOXIFENE HCL• RAVICTI


VNSNY Page 59 of 73

• REBIF REBIDOSE(PEN INJCTR)(22MCG/.5ML)• REBIF REBIDOSE(PEN INJCTR)(44MCG/.5ML)• REBIF REBIDOSE(PEN INJCTR)(8.8-22(6))• REBIF(SYRINGE)(22MCG/.5ML)• REBIF(SYRINGE)(44MCG/.5ML)• REBIF(SYRINGE)(8.8-22(6))• REMODULIN• REVATIO• REVLIMID• RUCONEST• SAIZEN• SEROSTIM• SILDENAFIL• SIMPONI• SIRTURO• SIVEXTRO• SOVALDI• SPRYCEL(TAB)(100 MG)• SPRYCEL(TAB)(140 MG)• SPRYCEL(TAB)(20 MG)• SPRYCEL(TAB)(50 MG)• SPRYCEL(TAB)(70 MG)• SPRYCEL(TAB)(80 MG)• STIVARGA• SUBOXONE(FILM)(12 MG-3 MG)• SUBOXONE(FILM)(2 MG-0.5MG)• SUBOXONE(FILM)(4MG-1MG)• SUBOXONE(FILM)(8 MG-2 MG)• SUCRAID• SUTENT• SYNAGIS• SYNRIBO• TAFINLAR• TARCEVA• TARGRETIN• TASIGNA• TECFIDERA• TEMOZOLOMIDE• TESTOSTERONE CYPIONATE• TESTOSTERONE ENANTHATE• TESTOSTERONE(GEL MD PMP)• TESTOSTERONE(GEL)• TETRABENAZINE• THALOMID• TOBI PODHALER• TOBRAMYCIN• TRACLEER• TYBOST• TYKERB• TYVASO• VALCHLOR• VENTAVIS• VOTRIENT• XALKORI• XELJANZ• XIFAXAN• XTANDI• ZELBORAF• ZOMACTON• ZORBTIVE• ZYDELIG• ZYKADIA• ZYTIGA


VNSNY Page 60 of 73

GENDER LIMITS • DUTASTERIDE Male Only• DUTASTERIDE/TAMSULOSIN Male Only


VNSNY Page 61 of 73

- # -0.9 % SODIUM CHLORIDE............................................ 278-MOP............................................................................... 24- A -A/C/E/ZINC/SOD SELENATE/COPPER.........................44ABACAVIR................................................................. 34, 49ABACAVIR SULFATE..................................................... 34ABACAVIR SULFATE/LAMIVUDINE...........................33ABACAVIR/DOLUTEGRAVIR/LAMIVUDI.................. 34ABACAVIR/LAMIVUDINE/ZIDOVUDINE...................34ABACAVIR-LAMIVUDINE-ZIDOVUDINE.................. 34ABATACEPT.....................................................................35ABILIFY................................................................15, 49, 54ABILIFY MAINTENA..................................................... 15ABIRATERONE ACETATE............................................. 37ABREVA(OTC).................................................................21ACARBOSE...................................................................... 24ACCU-CHEK FASTCLIX(OTC)......................................26ACCU-CHEK SOFTCLIX(OTC)......................................26ACCU-CHEK(OTC)..........................................................26ACE AEROSOL CLOUD ENHANCER...........................12ACEBUTOLOL HCL........................................................17ACEROLA C(OTC)...........................................................47ACETAMINOPHEN......................................................... 39ACETAMINOPHEN WITH CODEINE........................... 40ACETAMINOPHEN/PHENYLTOLX.............................. 20ACETAMINOPHEN-CODEINE.......................................40ACETAZOLAMIDE..........................................................29ACETIC ACID............................................................ 23, 27ACETIC ACID/ALUMINUM ACETATE.........................27ACETIC ACID/HYDROCORTISONE............................. 27ACETIC ACID-ALUMINUM...........................................27ACETYLCYSTEINE........................................................ 38ACNE MEDICATION(OTC)............................................ 23ACTEMRA..................................................................35, 59ACTOPLUS MET XR.................................................25, 54ACYCLOVIR.............................................................. 21, 33ADASUVE........................................................................ 15ADCIRCA................................................................... 18, 59ADEMPAS...................................................................18, 59ADJUSTABLE LANCING DEVICE(OTC)..................... 25ADVAIR DISKUS....................................................... 12, 49ADVAIR HFA..............................................................12, 49ADVANCED AM/PM....................................................... 45ADVANCED LANCING DEVICE(OTC)........................ 26ADVOCATE LANCING DEVICE(OTC).........................25ADVOCATE RAPID-SAFE(OTC)................................... 25ADVOCATE REDI-CODE DUO(OTC)........................... 25AEROCHAMBER MINI...................................................12AEROCHAMBER MV..................................................... 12AEROCHAMBER PLUS FLOW-VU............................... 12AEROCHAMBER WITH FLOWSIGNAL.......................12AEROCHAMBER Z-STAT PLUS.................................... 12AEROECLIPSE II............................................................. 12AEROGEAR ASTHMA ACTION KIT............................ 13AEROSPAN.................................................................12, 49AEROTRACH PLUS.........................................................12AFATINIB DIMALEATE................................................. 37AFINITOR DISPERZ................................................. 37, 59AFINITOR(TAB)(10 MG).................................... 37, 49, 59AFINITOR(TAB)(2.5 MG)................................... 37, 49, 59AFINITOR(TAB)(5 MG)...................................... 37, 49, 59AFINITOR(TAB)(7.5 MG)......................................... 37, 59AIRS DISPOSABLE NEBULIZER(OTC)....................... 12AIRZONE PEAK FLOW METER(OTC)......................... 13AK-POLY-BAC................................................................. 28AKWA TEARS(OTC)....................................................... 29AKYNZEO.................................................................. 11, 49ALBIGLUTIDE.................................................................24ALBUTEROL SULFATE..................................................11ALCLOMETASONE DIPROPIONATE........................... 21ALCOHOL ANTISEPTIC PADS..................................... 22ALCOHOL PADS(OTC)...................................................22ALCOHOL PREP PADS(OTC)........................................ 22ALCOHOL PREP SWABS(OTC).....................................22ALCOHOL SWAB(OTC)..................................................22ALCOHOL SWABS(OTC)............................................... 22ALCOHOL WIPES(OTC).................................................22ALENDRONATE SODIUM............................................. 27ALENDRONATE SODIUM(SOLUTION).................27, 49ALENDRONATE SODIUM(TAB)................................... 27ALENDRONATE SODIUM/VITAMIN D3......................27ALFUZOSIN HCL............................................................ 42ALFUZOSIN HCL ER...................................................... 42ALKERAN........................................................................ 37ALLERGY RELIEF-D(OTC)........................................... 11ALLERGY(OTC).............................................................. 11ALLOPURINOL............................................................... 29ALOCRIL.......................................................................... 29ALOE VERA/COLLAGEN.............................................. 22ALOE VESTA CLEANSING(OTC)................................. 22ALOE VESTA(OTC).........................................................22

ALOE/LA/CERAMIDE/SILICONE&TAPE.................... 22ALOE/LAC AC/CERAMIDES 3,3B,6,1.......................... 22ALOMIDE.........................................................................29ALPHAGAN P.................................................................. 29ALPHANINE SD.............................................................. 30ALPHAQUIN HP.............................................................. 24ALPRAZOLAM................................................................ 15ALPRAZOLAM INTENSOL........................................... 15ALREX.............................................................................. 28ALTAFLUOR.................................................................... 28ALTERA NEBULIZER.....................................................12ALTERNATE SITE LANCING DEVICE(OTC).............. 25ALTRETAMINE................................................................37ALUMINUM ACETATE...................................................20ALUMINUM ACETATE(OTC)........................................ 20ALUMINUM HYDROXIDE............................................ 42ALUMINUM HYDROXIDE(OTC)..................................42AMANTADINE.................................................................40AMANTADINE HCL........................................................40AMBRISENTAN...............................................................18AMCINONIDE..................................................................21AMERIGEL(OTC)............................................................ 23AMETHYST......................................................................19AMILORIDE HCL............................................................18AMILORIDE/HYDROCHLOROTHIAZIDE...................18AMILORIDE-HYDROCHLOROTHIAZIDE...................18AMINO ACIDS/MV,TH W-FE,MN..................................44AMINOCAPROIC ACID.................................................. 29AMINOSALICYLIC ACID.............................................. 33AMIODARONE HCL....................................................... 16AMITIZA.................................................................... 36, 49AMITRIP HCL/CHLORDIAZEPOXIDE.........................14AMITRIPTYLINE HCL................................................... 14AMLODIPINE BESYLATE............................................. 18AMLODIPINE BESYLATE/BENAZEPRIL.................... 16AMLODIPINE BESYLATE-BENAZEPRIL....................16AMLODIPINE/ATORVASTATIN.....................................19AMLODIPINE/VALSARTAN.......................................... 17AMLODIPINE/VALSARTAN/HCTHIAZID................... 17AMLODIPINE-ATORVASTATIN.............................. 19, 49AMLODIPINE-VALSARTAN.................................... 17, 54AMLODIPINE-VALSARTAN-HCTZ........................ 17, 54AMMONIUM LACTATE..................................................22AMMONIUM LACTATE(OTC)....................................... 22AMOXAPINE................................................................... 14AMOXICILLIN.................................................................32AMOXICILLIN/POTASSIUM CLAV.............................. 32AMOXICILLIN-CLAVULANATE POTASS................... 32AMPICILLIN TRIHYDRATE.......................................... 32AMPYRA.................................................................... 38, 59AMYL NITRITE............................................................... 19ANAFRANIL.................................................................... 14ANAGRELIDE HCL.........................................................30ANALPRAM HC.............................................................. 23ANALPRAM HC(CREAM/APPL)...................................36ANALPRAM HC(LOTION)............................................. 36ANASTROZOLE.............................................................. 37ANDROGEL(GEL MD PMP)(1.25G (1%))......... 31, 49, 59ANDROGEL(GEL MD PMP)(20.25/1.25)...........31, 49, 59ANDROGEL(GEL PACKET)(1.25G-1.62).......... 31, 49, 59ANDROGEL(GEL PACKET)(2.5G-1.62%).........31, 49, 59ANDROGEL(GEL PACKET)(25MG(1%))..........31, 49, 59ANDROGEL(GEL PACKET)(50 MG (1%))........31, 49, 59ANDROXY..................................................................30, 49ANIMAS 2020...................................................................26ANORO ELLIPTA...................................................... 12, 49ANTACID EXTRA STRENGTH(OTC)........................... 42ANTACID TABLET(OTC)............................................... 42ANTHRALIN.................................................................... 24ANTI-ITCH CREME(OTC)..............................................22ANTIPYRINE/BENZOCAINE.........................................27ANTIPYRINE-BENZOCAINE........................................ 27APEXICON E....................................................................21APIXABAN.......................................................................30APLENZIN............................................................14, 49, 54APOKYN...............................................................40, 49, 59APOMORPHINE HCL..................................................... 40APRACLONIDINE HCL.................................................. 29APREMILAST.................................................................. 35APREPITANT................................................................... 11APRI.................................................................................. 19APRISO............................................................................. 36APRODINE(OTC).............................................................20APTIOM(TAB)(200 MG)......................................40, 49, 54APTIOM(TAB)(400 MG)......................................40, 49, 54APTIOM(TAB)(600 MG)......................................40, 49, 54APTIOM(TAB)(800 MG)......................................40, 49, 54APTIVUS.......................................................................... 33AQUA LANCE LANCING DEVICE(OTC).....................25ARGLAES(OTC).............................................................. 21ARIPIPRAZOLE...................................................15, 49, 54ARMOUR THYROID.......................................................28

ARTIFICIAL TEARS(OTC)............................................. 29ASCORBIC ACID.............................................................47ASCORBIC ACID/ASCORBATE SODIUM....................47ASENAPINE MALEATE..................................................15ASPIRIN............................................................................38ASPIRIN EC(OTC)..................................................... 38, 49ASPIRIN/CALCIUM CARBONATE/MAG..................... 38ASPIRIN-CAFFEINE-DIHYDROCODEIN.....................39ASSESS(OTC)...................................................................13ASTAGRAF XL................................................................ 31ASTHMA CHECK(OTC)................................................. 13ASTHMAMENTOR(OTC)............................................... 13ASTHMAPACK CHILDREN'S........................................ 13ATAZANAVIR SULFATE.................................................34ATAZANAVIR SULFATE/COBICISTAT.........................34ATENOLOL...................................................................... 17ATENOLOL/CHLORTHALIDONE.................................17ATENOLOL-CHLORTHALIDONE.................................17ATIVAN............................................................................. 15ATOMOXETINE HCL......................................................16ATORVASTATIN CALCIUM........................................... 18ATOVAQUONE.................................................................33ATOVAQUONE/PROGUANIL HCL................................33ATOVAQUONE-PROGUANIL HCL................................33ATRAPRO CP................................................................... 22ATRAPRO HYDROGEL.................................................. 22ATRIPLA.....................................................................34, 49ATROPINE SULFATE...................................................... 29ATROVENT HFA........................................................12, 49AUBAGIO............................................................. 38, 49, 59AUGMENTIN................................................................... 32AUTO-LANCET MINI(OTC)...........................................25AUTOLET IMPRESSION(OTC)......................................26AUTOLET LANCING DEVICE(OTC)............................ 25AVC................................................................................... 43AVEENO(OTC).................................................................22AVONEX ADMINISTRATION PACK.................38, 49, 59AVONEX PEN(PEN INJ KIT)..............................38, 49, 59AVONEX PEN(PEN INJCTR)..............................38, 49, 59AVONEX(SYRINGE KIT)................................... 38, 49, 59AVONEX(SYRINGE)........................................... 38, 49, 59AXIRON................................................................31, 49, 59AXITINIB..........................................................................37AZATHIOPRINE.............................................................. 31AZELASTINE HCL..............................................11, 28, 49AZILECT.....................................................................40, 49AZITHROMYCIN.............................................................32AZOPT.............................................................................. 29AZTREONAM LYSINE....................................................31AZURETTE.......................................................................19- B -B CMPLX 4/VIT D3/C/FA/ZINC OX.............................. 47B COMPLEX & C NO.20/FOLIC ACID..........................47B COMPLEX WITH VITAMIN C................................... 44B12/LEVOMEFOLATE CALCIUM/B-6..........................47BABY NEBULIZER......................................................... 12BACITRACIN................................................................... 21BACITRACIN ZINC......................................................... 21BACITRACIN ZINC(OTC).............................................. 21BACITRACIN(OTC).........................................................21BACITRACIN/POLYMYXIN B SULFATE............... 21, 28BACITRACIN-POLYMYXIN(OTC)................................21BACLOFEN...................................................................... 41BACMIN............................................................................44BACTROBAN NASAL..................................................... 38BALANCED B-100(OTC)................................................ 47BALANCED SALT SOLN NON-SURG #6.....................29BAL-CARE DHA..............................................................46BAL-CARE DHA ESSENTIAL....................................... 46BALNEOL(OTC).............................................................. 22BALSALAZIDE DISODIUM...........................................36BANZEL(ORAL SUSP)........................................41, 49, 54BANZEL(TAB)(200 MG)..................................... 41, 49, 54BANZEL(TAB)(400 MG)..................................... 41, 49, 54B-COMPLEX.................................................................... 47BECAPLERMIN............................................................... 26BECLOMETHASONE DIPROPIONATE........................ 11BEDAQUILINE FUMARATE.......................................... 33BEDSIDE-CARE PERINEAL(OTC)................................24BEDSIDE-CARE(OTC)....................................................21BELLADONNA-OPIUM..................................................39BELSOMRA..........................................................16, 49, 54BENAZEPRIL HCL.......................................................... 17BENAZEPRIL/HYDROCHLOROTHIAZIDE................. 16BENAZEPRIL-HYDROCHLOROTHIAZIDE.................16BENEFIX.......................................................................... 30BENICAR....................................................................17, 54BENICAR HCT...........................................................17, 54BENOXINATE HCL/FLUORESCEIN NA...................... 28BENZALKONIUM CHLORIDE...................................... 20BENZAMYCINPAK......................................................... 21BENZETHONIUM CHLORIDE................................ 23, 24

VNSNY Page 62 of 73

Index

BENZOCAINE..................................................................27BENZOIN..........................................................................23BENZOIN(OTC)............................................................... 23BENZONATATE............................................................... 20BENZOYL PEROXIDE.................................................... 23BENZOYL PEROXIDE(CLEANSER)(OTC)...................23BENZOYL PEROXIDE(GEL)(10 %)(OTC).................... 23BENZOYL PEROXIDE(GEL)(2.5 %)(OTC)................... 23BENZOYL PEROXIDE(LOTION)(OTC)........................ 23BENZTROPINE MESYLATE.......................................... 40BERINERT............................................................ 35, 49, 59BESIFLOXACIN HCL......................................................28BESIVANCE..................................................................... 28BETA-CAROTENE(A) W-C & E/MIN............................ 44BETA-CAROTENE(A) W-C & E/ZN/CU........................ 43BETADINE(OTC)............................................................. 24BETAMETHASONE DIPROPIONATE........................... 21BETAMETHASONE VALERATE................................... 21BETAMETHASONE/PROPYLENE GLYC..................... 21BETAXOLOL HCL.....................................................17, 29BETHANECHOL CHLORIDE.........................................37BETIMOL..........................................................................29BETOPTIC S..................................................................... 29BEXAROTENE..................................................... 23, 38, 59BEYAZ........................................................................ 19, 54BICALUTAMIDE............................................................. 37BICILLIN L-A...................................................................32BIDIL.................................................................................18BILTRICIDE..................................................................... 33BIMATOPROST..........................................................29, 49BIOCEL(OTC).................................................................. 43BIOFLAV,LEMON/VIT BCOMP,C..................................43BIOGLO............................................................................ 29BION TEARS(OTC)......................................................... 29BIONECT.......................................................................... 23BISAC-EVAC(OTC)..........................................................36BISACODYL.....................................................................36BISACODYL(OTC).......................................................... 36BISMUTH SUBSALICYLATE........................................ 36BISOPROLOL FUMARATE............................................ 17BISOPROLOL FUMARATE/HCTZ.................................17BISOPROLOL-HYDROCHLOROTHIAZIDE.................17BLEPHAMIDE..................................................................28BLEPHAMIDE S.O.P........................................................28BLOOD GLUCOSE CTL HIGH,NML&LOW.................25BLOOD SUGAR DIAGNOSTIC......................................25BLOOD-GLUC TRANSMITTER/SENSOR....................25BLOOD-GLUC.METER& WRIST BP MON.................. 25BLOOD-GLUCOSE & KETONE CTL NML.................. 25BLOOD-GLUCOSE METER........................................... 25BLOOD-GLUCOSE TRANSMITTER.............................25BOSENTAN...................................................................... 18BOSULIF(TAB)(100 MG).................................... 37, 49, 59BOSULIF(TAB)(500 MG).................................... 37, 49, 59BOSUTINIB...................................................................... 37BP-50% UREA..................................................................23B-PLEX PLUS...................................................................45BREATHE RIGHT(OTC)..................................................12BREATHERITE................................................................ 12BREATHRITE...................................................................12BREO ELLIPTA..........................................................12, 49BRILINTA................................................................... 30, 49BRIMONIDINE TARTRATE............................................29BRIMONIDINE TARTRATE/TIMOLOL........................ 29BRINTELLIX........................................................14, 49, 54BRINZOLAMIDE.............................................................29BRINZOLAMIDE/BRIMONIDINE TART...................... 29BRISDELLE..........................................................14, 49, 54BROMOCRIPTINE MESYLATE.....................................40BROMPHENIRA/PSEUDOEPHED/CODEIN.................20BROMPHENIRAM/PHENYLEPHRINE/DM................. 20BROMPHENIRAMINE MALEATE................................ 11BROMPHENIRAMINE-PSEUDOEPHED-DM...............20BUDESONIDE............................................................12, 35BUDESONIDE EC............................................................35BUDESONIDE(AMPUL-NEB)(0.25MG/2ML).........12, 49BUDESONIDE(AMPUL-NEB)(0.5 MG/2ML)..........12, 49BUDESONIDE(AMPUL-NEB)(1 MG/2 ML)............12, 49BUMETANIDE................................................................. 18BUPRENORPHINE.......................................................... 39BUPRENORPHINE HCL................................................. 40BUPRENORPHINE HCL(SYRINGE)............................. 40BUPRENORPHINE HCL(TAB SUBL)................40, 49, 59BUPRENORPHINE HCL/NALOXONE HCL................. 40BUPRENORPHINE-NALOXONE....................... 40, 49, 59BUPROBAN......................................................................41BUPROPION HBR............................................................14BUPROPION HCL............................................................41BUSPIRONE HCL............................................................ 15BUTABARBITAL SODIUM.............................................15BUTALB/ACETAMINOPHEN/CAFFEINE.................... 38BUTALB-CAFF-ACETAMINOPH-CODEIN.................. 40

BUTALBIT/ACETAMIN/CAFF/CODEINE.................... 40BUTALBITAL COMPOUND-CODEINE........................ 40BUTALBITAL/ACETAMINOPHEN................................ 38BUTALBITAL/ASPIRIN/CAFFEINE.............................. 38BUTALBITAL-ACETAMINOPHEN................................38BUTALBITAL-ACETAMINOPHEN-CAFFE.................. 38BUTALBITAL-ASPIRIN-CAFFEINE..............................38BUTISOL SODIUM..........................................................15BUTOCONAZOLE NITRATE......................................... 43BUTORPHANOL TARTRATE.........................................39BUTRANS...................................................................39, 49BYSTOLIC........................................................................17- C -C1 ESTERASE INHIBITOR............................................ 35C1 ESTERASE INHIBITOR, RECOMB..........................35CABERGOLINE............................................................... 28CABOZANTINIB S-MALATE.........................................37CAFERGOT................................................................ 39, 49CAFFEINE CITRATE.......................................................13CAFFEINE CITRATED....................................................13CAL CARB/MGOX/D3/B12/FA/B6/BOR....................... 43CAL/MAG/B COMP/VIT D3/HRB61..............................44CALCIPOTRIENE...................................................... 24, 54CALCIPOTRIENE/BETAMETHASONE........................ 24CALCIPOTRIENE-BETAMETHASONE DP............ 24, 54CALCITONIN,SALMON,SYNTHETIC..........................27CALCITONIN-SALMON.................................................27CALCITRATE(OTC)........................................................ 43CALCITRIOL........................................................24, 47, 54CALCIUM ACETATE.......................................................27CALCIUM CARB &GLUCONATE/VIT D2................... 43CALCIUM CARBONATE.......................................... 42, 43CALCIUM CARBONATE/MAG CARB/FA....................27CALCIUM CARBONATE/NA HYPOCHLOR................24CALCIUM CARBONATE/VITAMIN D2........................ 43CALCIUM CARBONATE/VITAMIN D3........................ 43CALCIUM CITRATE....................................................... 43CALCIUM PNV................................................................46CALCIUM(OTC).............................................................. 43CALCIUM/MULTIVITAMINS W-IRON.........................43CAMRESE.................................................................. 19, 49CANAGLIFLOZIN........................................................... 24CANAGLIFLOZIN/METFORMIN HCL......................... 25CANASA........................................................................... 35CAPECITABINE...............................................................37CAPECITABINE(TAB)(150 MG)........................ 37, 49, 59CAPECITABINE(TAB)(500 MG)........................ 37, 49, 59CAPITAL W-CODEINE................................................... 40CAPRELSA(TAB)(100 MG)................................ 37, 49, 59CAPRELSA(TAB)(300 MG)................................ 37, 49, 59CAPTOPRIL/HYDROCHLOROTHIAZIDE....................17CAPTOPRIL-HYDROCHLOROTHIAZIDE................... 17CARAFATE.......................................................................42CARBAMAZEPINE................................................... 15, 40CARBAMAZEPINE(CPMP 12HR)..................................40CARBAMAZEPINE(ORAL SUSP)................................. 40CARBAMAZEPINE(TAB CHEW).................................. 40CARBAMAZEPINE(TAB)............................................... 40CARBATROL....................................................................40CARBIDOPA.....................................................................40CARBIDOPA/LEVODOPA.............................................. 40CARBIDOPA/LEVODOPA/ENTACAPONE................... 40CARBIDOPA-LEVODOPA.............................................. 40CARBIDOPA-LEVODOPA-ENTACAPONE...................40CARBINOXAMINE MALEATE......................................11CARBINOXAMINE MALEATE(LIQUID)..................... 11CARBINOXAMINE MALEATE(TAB)............................11CARBIT/EQUIS XT/ETHAN/CHIT/MSM......................23CARB-O-PHILIC.............................................................. 23CARELANCE ULT LANCING DEVICE(OTC)..............25CAREONE(OTC)..............................................................25CARESENS PREM LANCING DEVICE(OTC)..............25CARISOPRODOL.............................................................41CARISOPRODOL COMPOUND-CODEINE.................. 39CARISOPRODOL/ASPIRIN............................................ 41CARISOPRODOL-ASPIRIN............................................41CARTEOLOL HCL...........................................................29CARTIA XT...................................................................... 18CARVEDILOL.................................................................. 17CARVEDILOL PHOSPHATE.......................................... 17CASTOR OIL....................................................................36CASTOR OIL(OTC)......................................................... 36CAYSTON.............................................................31, 49, 59CEFACLOR.......................................................................31CEFADROXIL...................................................................31CEFDINIR.........................................................................31CEFDITOREN PIVOXIL..................................................31CEFIXIME.................................................................. 31, 32CEFPODOXIME PROXETIL........................................... 32CEFPROZIL...................................................................... 31CEFTIBUTEN...................................................................32CEFTIN............................................................................. 31

CEFUROXIME..................................................................31CEFUROXIME AXETIL.................................................. 31CELECOXIB..................................................................... 35CELEXA............................................................................14CELONTIN....................................................................... 41CENTRAL VITE(OTC).................................................... 45CENTRAL-VITE CARDIO(OTC)....................................45CENTRUM SILVER ULTRA MEN'S(OTC).................... 44CENTRUM SILVER WOMEN(OTC).............................. 45CENTRUM SILVER(OTC)...............................................44CENTRUM SPECIALIST HEART(OTC)........................ 45CENTURY ENERGY METABOLISM(OTC)..................45CEPHALEXIN.................................................................. 31CERITINIB........................................................................37CEROVITE ADVANCED FORMULA(OTC).................. 44CEROVITE SENIOR(OTC)..............................................43CERTA PLUS(OTC)..........................................................44CERTAVITE SENIOR-ANTIOXIDANT(OTC)................43CERTOLIZUMAB PEGOL.............................................. 36CETIRIZINE HCL............................................................ 11CETIRIZINE HCL(OTC)..................................................11CETIRIZINE HCL/PSEUDOEPHEDRINE..................... 11CETIRIZINE-PSEUDOEPHEDRINE ER(OTC)..............11CHANTIX................................................................... 41, 49CHEMSTRIP UGK(OTC).................................................26CHERATUSSIN AC(OTC)............................................... 20CHERATUSSIN DAC(OTC).............................................20CHILDREN'S MOTRIN(OTC)......................................... 35CHLORDIAZEPOXIDE HCL.......................................... 15CHLORDIAZEPOXIDE/CLIDINIUM BR...................... 42CHLORDIAZEPOXIDE-AMITRIPTYLINE................... 14CHLORDIAZEPOXIDE-CLIDINIUM.............................42CHLORHEXIDINE GLUCONATE..................................38CHLOROQUINE PHOSPHATE....................................... 33CHLOROTHIAZIDE.........................................................18CHLOROXYLENOL........................................................ 20CHLOROXYLENOL/PRAMOXINE HCL.......................27CHLORPHENIRAMINE MALEATE...............................11CHLORPROMAZINE HCL..............................................15CHLORPROPAMIDE....................................................... 24CHLORTHALIDONE.......................................................18CHLORZOXAZONE........................................................ 41CHOLECALCIFEROL (VITAMIN D3)........................... 47CHOLESTYRAMINE.......................................................19CHOLESTYRAMINE (WITH SUGAR).......................... 19CHOLESTYRAMINE/ASPARTAME.............................. 19CHOLINE MAG TRISALICYLATE................................38CHOLINE SAL/MAG SALICYLATE..............................38CICLOPIROX....................................................................21CICLOPIROX OLAMINE................................................ 21CICLOPIROX/URE/CAMPH/MENTH/EUC...................21CILOSTAZOL................................................................... 30CILOXAN......................................................................... 28CIMETIDINE.................................................................... 42CIMETIDINE HCL........................................................... 42CIMETIDINE(OTC)......................................................... 42CIMZIA................................................................. 36, 49, 59CINRYZE.................................................................... 35, 59CIPRODEX....................................................................... 27CIPROFLOXACIN............................................................32CIPROFLOXACIN ER......................................................32CIPROFLOXACIN HCL.......................................27, 28, 32CIPROFLOXACIN HCL/DEXAMETH........................... 27CIPROFLOXACIN/CIPROFLOXA HCL.........................32CITALOPRAM HBR........................................................ 14CITALOPRAM HYDROBROMIDE................................ 14CITRATE PHOSPHATE DEXTROS SOLN.................... 29CITRATE PHOSPHATE DEXTROSE............................. 29CITRIC ACID/SODIUM CITRATE................................. 42CITRUCEL(OTC)............................................................. 36CLARAVIS........................................................................20CLARITHROMYCIN....................................................... 32CLARITIN(OTC).............................................................. 11CLARITIN-D 12 HOUR(OTC).........................................11CLARITIN-D 24 HOUR(OTC).........................................11CLEANSING EYELID PADS(OTC)................................29CLEANSING EYELID WIPES(OTC)..............................29CLEMASTINE FUMARATE........................................... 11CLEMASTINE FUMARATE(OTC).................................11CLINDAMYCIN HCL...................................................... 33CLINDAMYCIN PALMITATE HCL................................33CLINDAMYCIN PHOS/BENZOYL PEROX.................. 20CLINDAMYCIN PHOSPHATE................................. 21, 43CLINDAMYCIN-BENZOYL PEROXIDE.......................20CLINITEST REAGENT(OTC)......................................... 26CLOBAZAM..................................................................... 40CLOBETASOL EMOLLIENT..........................................21CLOBETASOL PROPIONATE.........................................21CLOBETASOL PROPIONATE/EMOLL..........................21CLOCORTOLONE PIVALATE........................................21CLOMIPRAMINE HCL................................................... 14CLONAZEPAM................................................................ 40

VNSNY Page 63 of 73

Index

CLONIDINE......................................................................17CLONIDINE HCL.......................................................16, 17CLONIDINE HCL ER................................................ 16, 49CLONIDINE HCL/CHLORTHALIDONE....................... 17CLOPIDOGREL BISULFATE..........................................30CLOPIDOGREL(TAB)(300 MG)............................... 30, 49CLOPIDOGREL(TAB)(75 MG)....................................... 30CLORAZEPATE DIPOTASSIUM.................................... 15CLORPRES....................................................................... 17CLOTRIMAZOLE...................................................... 21, 32CLOTRIMAZOLE(OTC)..................................................21CLOTRIMAZOLE/BETAMETHASONE DIP................. 21CLOTRIMAZOLE-BETAMETHASONE........................ 21CLOZAPINE............................................................... 15, 49CLOZARIL..................................................................15, 49C-NATE DHA....................................................................45COBICISTAT.....................................................................34COCAINE HCL.................................................................23CODEINE SULFATE........................................................39CODEINE/BUTALBITAL/ASA/CAFFEIN..................... 40CODEINE/CARISOPRODOL/ASPIRIN......................... 39COLCHICINE............................................................. 29, 49COLCHICINE/PROBENECID......................................... 29COLESEVELAM HCL..................................................... 19COLESTIPOL HCL.......................................................... 19COLLAGEN,BOVINE...................................................... 24COMBIGAN......................................................................29COMBIPATCH............................................................31, 49COMBIVENT RESPIMAT............................................... 12COMETRIQ.......................................................... 37, 49, 59COMFORT........................................................................ 25COMPACT COMPRESSOR NEBULIZER(OTC)........... 12COMPACT ULTRASONIC NEBULIZER(OTC).............13COMP-AIR ELITE COMPRESSOR SYST..................... 13COMP-AIR ELITE COMPRESSOR SYST(OTC)...........13COMP-AIR NEBULIZER COMPRESSOR..................... 13COMP-AIR NEBULIZER COMPRESSOR(OTC)...........13COMPLERA......................................................................34COMPLETE(OTC)......................................................44, 45COMPLETENATE............................................................ 45COMPMIST COMPRESSOR NEBULIZER(OTC)......... 13COMPRESSOR, FOR NEBULIZER................................12CONDYLOX..................................................................... 23CONTACT DETACH INFUSION SET............................ 25COPAXONE................................................................38, 59CORDRAN........................................................................21COREG CR....................................................................... 17CORTANE-B..................................................................... 27CORTISONE ACETATE...................................................35CORTISPORIN................................................................. 21CORVITA 150................................................................... 44CORVITE 150................................................................... 44COSENTYX (2 SYRINGES)......................................24, 59COSENTYX PEN....................................................... 24, 59COSENTYX PEN (2 PENS)....................................... 24, 59COSENTYX SYRINGE..............................................24, 59CREON..............................................................................41CRESTOR(TAB)(10 MG)..................................... 18, 49, 54CRESTOR(TAB)(20 MG)..................................... 18, 49, 54CRESTOR(TAB)(40 MG)..................................... 18, 49, 55CRESTOR(TAB)(5 MG)....................................... 18, 49, 55CRIXIVAN........................................................................ 34CRIZOTINIB.....................................................................37CROMOLYN SODIUM.............................................. 12, 29CROTAMITON................................................................. 21CRYSELLE....................................................................... 20CUPRIMINE..................................................................... 34CURITY ALCOHOL PREPS(OTC)................................. 22CYANOCOBALAMIN (VITAMIN B-12)........................47CYANOCOBALAMIN INJECTION................................ 47CYANOCOBALAMIN/FA/PYRIDOXINE...................... 47CYANOCOBALAMIN/MECOBALAMIN...................... 47CYCLOBENZAPRINE HCL............................................41CYCLOGYL......................................................................29CYCLOPENTOLATE HCL.............................................. 29CYCLOSERINE................................................................33CYCLOSPORINE....................................................... 28, 31CYCLOSPORINE, MODIFIED........................................31CYMBALTA................................................................14, 49CYPROHEPTADINE HCL............................................... 11CYSTARAN................................................................ 29, 59CYSTEAMINE BITARTRATE.........................................42CYSTEAMINE HCL.........................................................29CYTRA-3.......................................................................... 42CYTRA-K..........................................................................42- D -DABRAFENIB MESYLATE............................................ 37DAILY ENERGY(OTC)....................................................44DAILY MULTIPLE(OTC)...........................................44, 45DALFAMPRIDINE........................................................... 38DALIRESP............................................................ 12, 49, 55DALTEPARIN SODIUM,PORCINE................................ 30

DANAZOL........................................................................ 28DANTROLENE SODIUM................................................ 41DAPSONE......................................................................... 33DARAPRIM................................................................ 33, 59DARUNAVIR ETHANOLATE......................................... 33DARUNAVIR/COBICISTAT............................................ 33DASATINIB...................................................................... 37DDAVP.............................................................................. 27DEGARELIX ACETATE.................................................. 37DELAVIRDINE MESYLATE...........................................34DEMECLOCYCLINE HCL..............................................32DEPEN.............................................................................. 34DEPO-PROVERA....................................................... 19, 49DEPO-SUBQ PROVERA 104.....................................19, 49DERMAPLEX(OTC)........................................................ 22DESIPRAMINE HCL....................................................... 14DESIRUDIN......................................................................30DESLORATADINE.....................................................11, 49DESMOPRESSIN (NONREFRIGERATED)................... 27DESMOPRESSIN ACETATE........................................... 27DESOG-E.ESTRADIOL/E.ESTRADIOL........................ 19DESOGESTREL-ETHINYL ESTRADIOL..................... 19DESONIDE....................................................................... 21DESOXIMETASONE....................................................... 21DESVENLAFAXINE........................................................14DESVENLAFAXINE ER......................................14, 49, 55DESVENLAFAXINE FUMARATE................................. 14DESVENLAFAXINE FUMARATE ER............... 14, 49, 55DESVENLAFAXINE SUCCINATE................................. 14DEVILBISS COMPACT(OTC).........................................12DEVILBISS DISPOSABLE NEBULIZER(OTC)............ 13DEVILBISS PULMO-AIDE............................................. 12DEVILBISS PULMO-AIDE(OTC).................................. 12DEVILBISS PULMOMATE(OTC).................................. 12DEVILBISS TRAVELER..................................................13DEXAMETHASONE........................................................35DEXAMETHASONE SOD PHOSPHATE.......................28DEXAMETHASONE SODIUM PHOSPHATE............... 28DEXMETHYLPHENIDATE HCL....................................16DEXMETHYLPHENIDATE HCL ER................. 16, 48, 49DEXTRAN 70/HYPROMELLOSE.................................. 29DEXTRAN 70/HYPROMELLOSE/PF.............................29DEXTRAN/HYPROMELLOSE/GLYCERIN.................. 29DEXTROAMPHETAMINE SULFATE............................ 14DEXTROAMPHETAMINE SULFATE(SOLUTION)......14, 49DEXTROAMPHETAMINE SULFATE(TAB)(10 MG)......14, 49DEXTROAMPHETAMINE SULFATE(TAB)(5 MG)......14, 49DEXTROAMPHETAMINE/AMPHETAMINE................15DEXTROAMPHETAMINE-AMPHETAMINE..........15, 49DEXTROSE.......................................................................26DEXTROSE/DEXTRIN/MALTOSE................................ 26DIABETA.......................................................................... 24DIALYVITE...................................................................... 47DIALYVITE 3000............................................................. 47DIALYVITE 800 WITH IRON......................................... 44DIALYVITE 800-ULTRA D(OTC).................................. 47DIALYVITE ZINC............................................................47DIAPHRAGMS, WIDE SEAL..........................................20DIASTAT........................................................................... 40DIASTAT ACUDIAL........................................................ 40DIASTIX REAGENT(OTC)............................................. 26DIAZEPAM........................................................... 15, 40, 49DICHLORPHENAMIDE.................................................. 41DICLOFENAC POTASSIUM........................................... 35DICLOFENAC SODIUM................... 22, 23, 28, 35, 49, 59DICLOXACILLIN SODIUM............................................32DICYCLOMINE HCL...................................................... 42DIDANOSINE...................................................................34DIDANOSINE(CAP DR)(125 MG)............................34, 49DIDANOSINE(CAP DR)(200 MG)............................34, 49DIDANOSINE(CAP DR)(250 MG)..................................34DIDANOSINE(CAP DR)(400 MG)..................................34DIFICID.................................................................32, 49, 55DIFLORASONE DIACETATE/EMOLL.......................... 21DIFLUNISAL....................................................................38DIFLUPREDNATE........................................................... 28DIGOXIN.......................................................................... 16DIGOXIN(SOLUTION)....................................................16DIGOXIN(TAB)................................................................ 16DIHYDROCODEINE/ASPIRIN/CAFFEIN..................... 39DIHYDROERGOTAMINE MESYLATE......................... 39DIHYDROERGOTAMINE MESYLATE(AMPUL)...... 39,49DIHYDROERGOTAMINE MESYLATE(SPRAY/PUMP)..................................................................................... 39, 49DIHYDROERGOTAMINE MESYLATE(VIAL)............. 39DILANTIN........................................................................ 41DILANTIN-125.................................................................41DILTIAZEM HCL.............................................................18

DIMENHYDRINATE....................................................... 11DIMETHICONE................................................................23DIMETHYL FUMARATE................................................38DIPHENHYDRAMINE HCL..................................... 11, 16DIPHENHYDRAMINE HCL(CAP)(OTC)...................... 11DIPHENHYDRAMINE HCL(ELIXIR)(OTC).................11DIPHENHYDRAMINE HCL(LIQUID)(OTC)................ 11DIPHENHYDRAMINE HCL(SYRUP)(OTC)................. 11DIPHENHYDRAMINE HCL(TAB)(OTC)...................... 11DIPHENOXYLATE HCL/ATROPINE............................. 36DIPHENOXYLATE-ATROPINE......................................36DIPYRIDAMOLE............................................................. 30DISOPYRAMIDE PHOSPHATE..................................... 16DISULFIRAM...................................................................15DIVALPROEX SODIUM..................................................40DIVALPROEX SODIUM ER............................................40DM/PHENYLEPH/CHLORPHENIRAMINE.................. 20D-METHORPHAN HB/P-EPD HCL/BPM...................... 20DOCOSANOL...................................................................21DOC-Q-LACE(OTC).........................................................36DOCUSATE SODIUM......................................................36DOFETILIDE.................................................................... 16DOLOGESIC(OTC).......................................................... 20DOLUTEGRAVIR SODIUM............................................34DONEPEZIL HCL............................................................ 14DONNATAL...................................................................... 42DORNASE ALFA............................................................. 38DORZOLAMIDE HCL..................................................... 29DORZOLAMIDE HCL/TIMOLOL MALEAT.................29DORZOLAMIDE-TIMOLOL...........................................29DOXAZOSIN MESYLATE.............................................. 17DOXEPIN HCL...........................................................14, 16DOXERCALCIFEROL..................................................... 27DOXYCYCLINE CALCIUM........................................... 32DOXYCYCLINE HYCLATE............................... 32, 49, 55DOXYCYCLINE MONOHYDRATE...............................32DOXYCYCLINE MONOHYDRATE(CAP).............. 32, 49DOXYCYCLINE MONOHYDRATE(SUSP RECON)......32DOXYCYCLINE MONOHYDRATE(TAB)(100 MG)......32, 49, 55DOXYCYCLINE MONOHYDRATE(TAB)(150 MG)......32, 49DOXYCYCLINE MONOHYDRATE(TAB)(50 MG)......32, 50, 55DOXYCYCLINE MONOHYDRATE(TAB)(75 MG)......32, 50DRITHOCREME HP.................................................. 24, 55DRONABINOL..................................................... 11, 50, 55DRONEDARONE HCL.................................................... 16DROPLET LANCING DEVICE(OTC)............................ 25DROSPIR/ETH ESTRA/LEVOMEFOL CA.................... 19DROXIDOPA.................................................................... 19DRY SKIN THERAPY(OTC)...........................................22DUAVEE............................................................................31DULAGLUTIDE............................................................... 24DULERA..................................................................... 12, 50DULOXETINE HCL...................................................14, 50DUREZOL.........................................................................28DUTASTERIDE.................................................... 42, 55, 61DUTASTERIDE/TAMSULOSIN..........................42, 55, 61DYCLONINE HCL/BENZETHONIUM CL.................... 23- E -E.E.S. 200.......................................................................... 32EASIVENT........................................................................12EASY CLICK(OTC)......................................................... 25EASY TOUCH ALCOHOL PREP PADS(OTC).............. 22EASY TOUCH LANCING DEVICE(OTC)..................... 25ECONAZOLE NITRATE..................................................21EDLUAR............................................................... 16, 50, 55EDURANT........................................................................ 34EFAVIRENZ......................................................................34EFAVIRENZ/EMTRICITAB/TENOFOVIR..................... 34EFFIENT..................................................................... 30, 50ELIGARD....................................................................27, 59ELIQUIS(TAB)(2.5 MG)............................................ 30, 50ELIQUIS(TAB)(5 MG)............................................... 30, 50ELITE OB DHA................................................................ 45ELITE-OB 400.................................................................. 46ELLA................................................................................. 20ELMIRON......................................................................... 42ELTROMBOPAG OLAMINE...........................................30ELVITEGR/COBICIST/EMTRIC/TENOF.......................34ELVITEGRAVIR...............................................................34EMEND(CAP DS PK)................................................ 11, 50EMEND(CAP)(125 MG).............................................11, 50EMEND(CAP)(40 MG)...............................................11, 50EMEND(CAP)(80 MG)...............................................11, 50EMOL53/NAMGFS/HA/NAHYPOCHLORIT................ 22EMOLLIENT #56/HYALURONIC ACID........................22EMOLLIENT COMBINATION NO.10............................22EMOLLIENT COMBINATION NO.32............................22

VNSNY Page 64 of 73

Index

EMOLLIENT COMBINATION NO.35............................22EMOLLIENT COMBINATION NO.36............................22EMOLLIENT COMBINATION NO.43............................22EMOLLIENT COMBINATION NO.53............................22EMOLLIENT COMBINATION NO.60............................22EMOLLIENT COMBINATION NO.85............................22EMOLLIENT COMBO NO.47 & NO.60......................... 22EMPAGLIFLOZIN............................................................24EMPAGLIFLOZIN/LINAGLIPTIN..................................24EMPAGLIFLOZIN/METFORMIN HCL..........................25EMSAM.......................................................................15, 50EMTRICITAB/RILPIVIRINE/TENOFOV....................... 34EMTRICITABINE.............................................................34EMTRICITABINE/TENOFOVIR..................................... 33EMTRIVA(CAP)......................................................... 34, 50EMTRIVA(SOLUTION)............................................. 34, 50EMULSION SB.................................................................22ENALAPRIL MALEATE..................................................17ENALAPRIL/HYDROCHLOROTHIAZIDE................... 17ENALAPRIL-HYDROCHLOROTHIAZIDE................... 17ENEMEEZ(OTC).............................................................. 36ENFUVIRTIDE................................................................. 34ENOXAPARIN SODIUM................................................. 30ENOXAPARIN SODIUM(SYRINGE)(100 MG/ML)......30, 50ENOXAPARIN SODIUM(SYRINGE)(120MG/.8ML)......30, 50ENOXAPARIN SODIUM(SYRINGE)(150 MG/ML)......30, 50ENOXAPARIN SODIUM(SYRINGE)(30MG/0.3ML)......30, 50ENOXAPARIN SODIUM(SYRINGE)(40MG/0.4ML)......30, 50ENOXAPARIN SODIUM(SYRINGE)(60MG/0.6ML)......30, 50ENOXAPARIN SODIUM(SYRINGE)(80MG/0.8ML)......30, 50ENOXAPARIN SODIUM(VIAL)...............................30, 50ENTACAPONE................................................................. 40ENZALUTAMIDE............................................................ 37EPINASTINE HCL........................................................... 28EPINEPHRINE............................................................11, 36EPIPEN JR 2-PAK.............................................................36EPIVIR HBV..................................................................... 34EPOETIN ALFA............................................................... 30EPZICOM....................................................................33, 50EQUETRO.........................................................................15ERAPID NEBULIZER......................................................13ERGOCALCIFEROL (VITAMIN D2)............................. 47ERGOLOID MESYLATES...............................................19ERGOTAMINE TARTRATE/CAFFEINE........................ 39ERIVEDGE........................................................... 37, 50, 59ERLOTINIB HCL............................................................. 37ERYPED 400..................................................................... 32ERY-TAB........................................................................... 32ERYTHROCIN STEARATE.............................................32ERYTHROMYCIN................................................21, 28, 32ERYTHROMYCIN BASE.......................................... 28, 32ERYTHROMYCIN BASE/ETHANOL............................ 21ERYTHROMYCIN ETHYLSUCCINATE........................32ERYTHROMYCIN STEARATE.......................................32ERYTHROMYCIN/BENZOYL PEROXIDE................... 21ERYTHROMYCIN-BENZOYL PEROXIDE................... 21ESBRIET..................................................................... 38, 59ESCITALOPRAM OXALATE..........................................14ESLICARBAZEPINE ACETATE..................................... 40ESOMEPRAZOLE MAGNESIUM...................... 42, 50, 55ESSENTIAL WOMAN 50+(OTC)................................... 44ESTAZOLAM................................................................... 16ESTRACE..........................................................................43ESTRADIOL............................................................... 31, 43ESTRADIOL VALERATE/DIENOGEST........................ 19ESTRADIOL(PATCH TDSW)....................................31, 50ESTRADIOL(PATCH TDWK)................................... 31, 50ESTRADIOL(TAB)...........................................................31ESTRADIOL/NORETHINDRONE ACET.......................31ESTRADIOL-NORETHINDRONE ACETAT..................31ESTROGEN,CON/M-PROGEST ACET.......................... 31ESTROGEN,ESTER/ME-TESTOSTERONE...................31ESTROGEN-METHYLTESTOSTERONE.......................31ESTROGENS, CONJUGATED.................................. 31, 43ESTROGENS,CONJ/BAZEDOXIFENE.......................... 31ESTROGENS,ESTERIFIED.............................................31ESTROPIPATE.................................................................. 31ESZOPICLONE................................................................ 16ETHAMBUTOL HCL.......................................................33ETHINYL ESTRADIOL/DROSPIRENONE................... 19ETHIONAMIDE............................................................... 33ETHOSUXIMIDE............................................................. 40ETHOTOIN....................................................................... 40ETHYL CHLORIDE......................................................... 23ETHYNODIOL D-ETHINYL ESTRADIOL....................19

ETIDRONATE DISODIUM..............................................27ETODOLAC...................................................................... 35ETONOGESTREL/ETHINYL ESTRADIOL...................19ETOPOSIDE......................................................................37ETRAVIRINE....................................................................34EURAX..............................................................................21EVENCARE MINI MONITOR SYSTEM(OTC)............. 25EVEROLIMUS............................................................31, 37EVOTAZ...................................................................... 34, 50EXCEL-GEL(OTC)...........................................................22EXELDERM......................................................................21EXEMESTANE........................................................... 37, 59EXODERM........................................................................21EXTRA-VIRT PLUS DHA............................................... 46EYE WASH(OTC).............................................................29EYELID CLEANSER COMBINATION #5..................... 29EYELID CLEANSER COMBINATION #6..................... 29EYELID WIPES(OTC)..................................................... 29E-Z SPACER..................................................................... 12EZETIMIBE...................................................................... 19EZOGABINE.................................................................... 40- F -FA/MV,CA,IRON,MIN/LYCOPENE/LUT....................... 44FA/VIT B COMPLEX & C/RICE BRAN.........................47FA/VIT BCOMP&C/SE/MIN AA/ZN.............................. 47FA/VIT BCOMP,C/ZINC/VITAMIN D3.......................... 47FACTOR IX.......................................................................30FACTOR IX HUMAN RECOMBINANT.........................30FAMCICLOVIR................................................................ 33FAMOTIDINE...................................................................42FAMOTIDINE(OTC)........................................................ 42FANAPT(TAB DS PK)..........................................15, 50, 55FANAPT(TAB)......................................................15, 50, 55FARESTON................................................................. 38, 59FARYDAK...................................................................37, 59FE 90 PLUS.......................................................................44FE FUMARATE/CAL/E/FA/MULTIVIT......................... 43FE FUMARATE/DOSS/FA/BCOMP,C............................ 43FE FUMARATE/FA/VIT BCOMP,C................................ 44FE FUMARATE/VIT C/B12/STOMC.............................. 43FE FUMARATE/VIT C/B12-IF/FA.................................. 43FEBUXOSTAT.................................................................. 29FELBAMATE....................................................................40FELBAMATE(ORAL SUSP)................................40, 50, 55FELBAMATE(TAB)(400 MG)............................. 40, 50, 55FELBAMATE(TAB)(600 MG)............................. 40, 50, 55FELODIPINE.................................................................... 18FELODIPINE ER.............................................................. 18FENOFIBRATE.................................................................19FENOFIBRATE NANOCRYSTALLIZED....................... 19FENOFIBRATE,MICRONIZED.......................................19FENOFIBRIC ACID......................................................... 19FENOFIBRIC ACID (CHOLINE).................................... 19FENOPROFEN CALCIUM.............................................. 35FENOPROFEN CALCIUM(CAP)....................................35FENOPROFEN CALCIUM(TAB)....................................35FENTANYL...........................................................39, 50, 59FENTANYL CITRATE......................................... 39, 50, 59FER-IN-SOL(OTC)........................................................... 43FEROCON.........................................................................43FERRAPLUS 90................................................................44FERREX 150 FORTE PLUS.............................................43FERREX 150 PLUS(OTC)................................................43FERREX 150(OTC).......................................................... 44FERREX 28....................................................................... 43FERROUS FUMARATE/FOLIC ACID............................43FERROUS SULFATE........................................................43FERROUS SULFATE(OTC)............................................. 43FERROUS SULFATE/VIT C/FA...................................... 43FESOTERODINE FUMARATE....................................... 43FETZIMA.............................................................. 14, 50, 55FEXOFENADINE HCL.................................................... 11FEXOFENADINE HCL(OTC)......................................... 11FEXOFENADINE/PSEUDOEPHEDRINE...................... 11FIBER-STAT(OTC)...........................................................36FIDAXOMICIN.................................................................32FILGRASTIM................................................................... 30FINASTERIDE..................................................................42FINGOLIMOD HCL......................................................... 38FIRAZYR.................................................................... 35, 59FIRMAGON(VIAL)(120 MG)....................................37, 50FIRMAGON(VIAL)(80 MG)......................................37, 50FLAGYL ER......................................................................33FLAREX............................................................................28FLAVOXATE HCL............................................................43FLECAINIDE ACETATE..................................................16FLUCAINE........................................................................28FLUCONAZOLE.............................................................. 32FLUCYTOSINE................................................................ 32FLUDROCORTISONE ACETATE................................... 35FLUNISOLIDE..................................................... 11, 12, 50FLUOCINOLONE ACETONIDE.....................................21

FLUOCINOLONE ACETONIDE OIL............................. 27FLUOCINOLONE/SHOWER CAP..................................21FLUOCINONIDE..............................................................21FLUOCINONIDE/EMOLLIENT BASE.......................... 21FLUOCINONIDE-E..........................................................21FLUORESCEIN SODIUM............................................... 29FLUORIDE........................................................................43FLUORIDE/IRON/VIT A,C&D....................................... 45FLUORIDEX SENSITIVITY RELIEF.............................43FLUORITAB..................................................................... 43FLUOROMETHOLONE...................................................28FLUOROMETHOLONE ACETATE................................ 28FLUOROURACIL.............................................................23FLUOXETINE HCL..........................................................14FLUOXYMESTERONE................................................... 30FLUPHENAZINE DECANOATE.....................................15FLUPHENAZINE HCL.................................................... 15FLURA-DROPS................................................................ 43FLURANDRENOLIDE.................................................... 21FLURAZEPAM HCL........................................................ 16FLURBIPROFEN..............................................................35FLURBIPROFEN SODIUM............................................. 28FLUTAMIDE.....................................................................37FLUTICASONE PROPIONATE...........................11, 21, 50FLUTICASONE PROPIONATE(OTC)...................... 11, 50FLUTICASONE/SALMETEROL.....................................12FLUTICASONE/VILANTEROL......................................12FLUTTER..........................................................................12FLUVOXAMINE MALEATE...........................................14FML FORTE......................................................................28FML S.O.P......................................................................... 28FOCALIN XR....................................................... 16, 48, 50FOLBECAL.......................................................................47FOLBEE PLUS CZ........................................................... 47FOLBIC............................................................................. 47FOLBIC RF....................................................................... 47FOLIC ACID..................................................................... 43FOLIC ACID(OTC)...........................................................43FOLIC ACID/B COMPLEX & C NO.17..........................47FOLIC ACID/MULTIVIT-MIN/LUTEIN.........................44FOLIC ACID/MULTIVIT-MINERALS............................44FOLIC ACID/MV,FE,OTHER MIN................................. 44FOLIC ACID/MV,FE,OTHER MIN/LUT.........................44FOLIC ACID/VIT BCOMP,C........................................... 47FOLIC ACID/VIT BCOMP,C/CU/ZNOX........................ 47FOLITAB 500(OTC)......................................................... 43FOLIVANE-F.................................................................... 44FOLIVANE-OB................................................................. 45FOLIVANE-PLUS.............................................................43FONDAPARINUX SODIUM............................................30FONDAPARINUX SODIUM(SYRINGE)(10MG/0.8ML)..................................................................................... 30, 50FONDAPARINUX SODIUM(SYRINGE)(2.5 MG/0.5)..................................................................................... 30, 50FONDAPARINUX SODIUM(SYRINGE)(5MG/0.4ML)..................................................................................... 30, 50FONDAPARINUX SODIUM(SYRINGE)(7.5MG/0.6)......30, 50FORA LANCING DEVICE(OTC)................................... 25FORMOTEROL FUMARATE.......................................... 11FORTEO...................................................................... 27, 50FOS/MALTODEXTRIN....................................................36FOSAMAX PLUS D......................................................... 27FOSAMPRENAVIR CALCIUM.......................................34FOSFREE(OTC)................................................................43FOSINOPRIL SODIUM................................................... 17FOSINOPRIL/HYDROCHLOROTHIAZIDE.................. 17FOSINOPRIL-HYDROCHLOROTHIAZIDE.................. 17FRAGMIN(SYRINGE)(10000/ML)........................... 30, 50FRAGMIN(SYRINGE)(12500/0.5)............................ 30, 50FRAGMIN(SYRINGE)(15000/0.6)............................ 30, 50FRAGMIN(SYRINGE)(18000/0.72).......................... 30, 50FRAGMIN(SYRINGE)(2500/0.2ML)........................ 30, 50FRAGMIN(SYRINGE)(5000/0.2ML)........................ 30, 50FRAGMIN(SYRINGE)(7500/0.3ML)........................ 30, 50FRAGMIN(VIAL).......................................................30, 50FRESHNET(OTC).............................................................22FRUCTOOLIGOSACCHARIDES/POLYDEX................ 36FUROSEMIDE..................................................................18FUZEON......................................................................34, 50FYCOMPA(TAB)(10 MG)....................................41, 50, 55FYCOMPA(TAB)(12 MG)....................................41, 50, 55FYCOMPA(TAB)(2 MG)......................................41, 50, 55FYCOMPA(TAB)(4 MG)......................................41, 50, 55FYCOMPA(TAB)(6 MG)......................................41, 50, 55FYCOMPA(TAB)(8 MG)......................................41, 50, 55- G -GABAPENTIN..................................................................40GABAPENTIN(CAP)....................................................... 40GABAPENTIN(SOLUTION)........................................... 40GABAPENTIN(TAB)........................................................40GABITRIL(TAB)(12 MG).................................... 41, 50, 55

VNSNY Page 65 of 73

Index

GABITRIL(TAB)(16 MG).................................... 41, 50, 55GABITRIL(TAB)(2 MG).................................................. 41GABITRIL(TAB)(4 MG).................................................. 41GALANTAMINE HBR.....................................................14GALANTAMINE HBR(CAP24H PEL)..................... 14, 50GALANTAMINE HBR(TAB).....................................14, 50GAMMAGARD LIQUID............................................31, 59GAMMAKED............................................................. 31, 59GAMUNEX-C.............................................................31, 59GANCICLOVIR................................................................ 28GATIFLOXACIN.............................................................. 28GATTEX................................................................36, 50, 59GAVILYTE-C.................................................................... 36GAVILYTE-N....................................................................36GEFITINIB........................................................................37GEL-KAM(OTC).............................................................. 43GEMFIBROZIL.................................................................19GENADUR........................................................................23GENERESS FE................................................................. 19GENERLAC...................................................................... 36GENGRAF........................................................................ 31GENOTROPIN............................................................ 27, 59GENTAMICIN SULFATE...........................................21, 28GENTIAN VIOL/BRLNT GRN/PROFLAV.....................21GEODON.................................................................... 15, 50GERITOL COMPLETE(OTC)..........................................43GILENYA.............................................................. 38, 50, 59GILOTRIF................................................................... 37, 59GLATIRAMER ACETATE............................................... 38GLATOPA....................................................................38, 59GLEEVEC............................................................. 37, 50, 59GLIMEPIRIDE..................................................................24GLIPIZIDE........................................................................ 24GLIPIZIDE/METFORMIN HCL......................................25GLIPIZIDE-METFORMIN...............................................25GLUCAGON EMERGENCY KIT................................... 26GLUCAGON,HUMAN RECOMBINANT.......................26GLUCOLET 2(OTC)...................................................25, 26GLUCOSE(OTC).............................................................. 26GLYBURIDE.....................................................................24GLYBURIDE MICRONIZED...........................................24GLYBURIDE,MICRONIZED...........................................24GLYBURIDE/METFORMIN HCL...................................25GLYBURIDE-METFORMIN HCL.................................. 25GLYCERIN/DIMETHICONE...........................................22GLYCERIN/PROPYLENE GLYCOL...............................29GLYCEROL PHENYLBUTYRATE.................................36GLYCINE.......................................................................... 33GLYCINE UROLOGIC SOLUTION................................33GLYCOPYRROLATE....................................................... 42GLYXAMBI.......................................................... 24, 50, 55GMATE LANCING DEVICE(OTC)................................ 25GOLIMUMAB.................................................................. 35GOLYTELY.......................................................................36GR POL-ORC/SW VER/RYE/KENT/TIM...................... 11GRANISETRON HCL.......................................... 11, 50, 55GRANIX......................................................................30, 59GRANULEX..................................................................... 24GRASS POLLEN-TIMOTHY, STD................................. 11GRASTEK...................................................................11, 59GRISEOFULVIN...............................................................32GRISEOFULVIN, MICROSIZE....................................... 32GRX RINSE-FREE(OTC).................................................23GUAIFENESIN................................................................. 20GUAIFENESIN/CODEINE PHOSPHATE.......................20GUAIFENESIN/DEXTROMETHORPHAN.................... 20GUANFACINE HCL...................................................16, 17GUANFACINE HCL ER.............................................16, 50GUANIDINE HCL............................................................ 37GYNAZOLE 1...................................................................43- H -HALDOL DECANOATE 50............................................. 15HALOBETASOL PROPIONATE..................................... 21HALOPERIDOL............................................................... 15HALOPERIDOL DECANOATE...................................... 15HALOPERIDOL LACTATE............................................. 15HARVONI................................................................... 34, 59HC/MINERAL OIL/PETROLAT,WHT............................ 21HC/PRAMOX HCL/CL-XYLENOL/WATER..................27HC/PRAMOXINE HCL/CHLOROXYLENOL................27HEALTHY ACCENTS AUTOLET(OTC) ........................ 25HEMATINIC PLUS...........................................................44HEMATINIC WITH FOLIC ACID...................................43HEMATOGEN.................................................................. 43HEMENATAL OB.............................................................46HEMENATAL OB + DHA................................................45HEMETAB........................................................................ 44HEPARIN FLUSH.............................................................30HEPARIN SOD,PORCINE/0.9 % NACL......................... 30HEPARIN SODIUM..........................................................30HEPARIN SODIUM,PORCINE....................................... 30HEPARIN SODIUM,PORCINE/D5W..............................30

HEPARIN SODIUM,PORCINE/NS/PF............................30HEPARIN SODIUM,PORCINE/PF..................................30HEPARIN SODIUM-0.9% NACL.................................... 30HEPARIN SODIUM-D5W................................................30HETLIOZ.................................................................... 15, 59HEXALEN........................................................................ 37HEX-ON LIGHT(OTC).................................................... 22HIZENTRA................................................................. 31, 59HOMATROPAIRE............................................................ 29HOMATROPINE HBR......................................................29HONEY............................................................................. 24HPR PLUS.........................................................................22HUMALOG KWIKPEN U-100.................................. 26, 50HUMALOG KWIKPEN U-200.................................. 26, 50HUMALOG MIX 50-50..............................................26, 50HUMALOG MIX 50-50 KWIKPEN.......................... 26, 50HUMALOG MIX 75-25..............................................26, 50HUMALOG MIX 75-25 KWIKPEN.......................... 26, 50HUMALOG(CARTRIDGE)........................................26, 50HUMALOG(VIAL).....................................................26, 50HUMATROPE............................................................. 27, 59HUMULIN 70/30 KWIKPEN(OTC).......................... 26, 50HUMULIN 70-30(OTC)..............................................26, 50HUMULIN N KWIKPEN(OTC).................................26, 50HUMULIN N(OTC).................................................... 26, 50HUMULIN R U-500....................................................26, 50HUMULIN R(OTC).................................................... 26, 50HYALURON SOD/ALLANTOIN/ALOE XT.................. 23HYALURONATE SODIUM..............................................23HYDRALAZINE HCL......................................................17HYDROCERIN(OTC).......................................................22HYDROCHLOROTHIAZIDE.......................................... 18HYDROCOD-CPM-PSEUDOEPHEDRINE....................20HYDROCODONE BIT/HOMATROP ME-BR.................20HYDROCODONE/ACETAMINOPHEN..........................39HYDROCODONE/CHLORPHEN P-STIREX.................20HYDROCODONE/IBUPROFEN..................................... 39HYDROCODONE-ACETAMINOPHEN(SOLUTION)(10-325/15).........................................................................39, 50HYDROCODONE-ACETAMINOPHEN(SOLUTION)(5-163/7.5)........................................................................39, 50HYDROCODONE-ACETAMINOPHEN(SOLUTION)(7.5-325/15).........39, 50HYDROCODONE-ACETAMINOPHEN(TAB)(10MG-325MG)........................................................................39, 50HYDROCODONE-ACETAMINOPHEN(TAB)(2.5-325MG)..............................................................................39HYDROCODONE-ACETAMINOPHEN(TAB)(5 MG-325MG)........................................................................39, 50HYDROCODONE-ACETAMINOPHEN(TAB)(7.5-325MG)........................................................................39, 50HYDROCODONE-CHLORPHENIRAMNE ER............. 20HYDROCODONE-IBUPROFEN..................................... 39HYDROCORT/PRAMOXIN/EMOL/PRAM#1................36HYDROCORT/SAL ACID/SULF/SHMP#1.....................21HYDROCORTISONE..................................... 21, 22, 35, 36HYDROCORTISONE ACETATE...............................22, 36HYDROCORTISONE ACETATE(OTC).......................... 22HYDROCORTISONE ACETATE/UREA.........................22HYDROCORTISONE BUTYRATE................................. 22HYDROCORTISONE PROBUTATE............................... 22HYDROCORTISONE VALERATE..................................22HYDROCORTISONE(OTC).............................................21HYDROCORTISONE/ALOE VERA............................... 22HYDROCORTISONE/ALOE/VIT.E/A/D........................ 22HYDROCORTISONE/IODOQUINOL.............................20HYDROCORTISONE/LIDOCAINE/ALOE.................... 36HYDROCORTISONE/OATMEAL/ALOE/E....................22HYDROCORTISONE/PRAMOXINE........................ 23, 36HYDROCORTISONE-ACETIC ACID.............................27HYDROCORTISONE-ALOE(OTC).................................22HYDROCORTISONE-IODOQUINOL............................ 20HYDROCORTISONE-PRAMOXINE.............................. 36HYDROCORTISONE-PRAMOXINE HCL..................... 23HYDROGEN PEROXIDE.................................................23HYDROGEN PEROXIDE(OTC)...................................... 23HYDROMET.....................................................................20HYDROMORPHONE HCL..............................................39HYDROMORPHONE HCL/PF........................................ 39HYDROQUINONE........................................................... 24HYDROQUINONE MICROSPHERES............................ 24HYDROQUINONE/FERRIC OXIDE...............................24HYDROXOCOBALAMIN................................................47HYDROXYCHLOROQUINE SULFATE......................... 33HYDROXYUREA.............................................................37HYDROXYZINE HCL......................................................11HYDROXYZINE PAMOATE........................................... 11HYOPHEN........................................................................ 32HYOSCYAMINE SULFATE.............................................42HYPER-HEAL(OTC)........................................................22HYPOLANCE(OTC).........................................................26HYPROMELLOSE........................................................... 29

HYQVIA......................................................................31, 59- I -IBANDRONATE SODIUM...............................................27IBRANCE....................................................................37, 59IBRUTINIB....................................................................... 37IBUPROFEN..................................................................... 35IBUPROFEN(OTC)...........................................................35IBUPROFEN/OXYCODONE HCL.................................. 39ICAPS MV(OTC).............................................................. 44ICAPS(OTC)..................................................................... 45ICAR-C PLUS................................................................... 45ICATIBANT ACETATE.................................................... 35ICLUSIG(TAB)(15 MG)....................................... 37, 50, 59ICLUSIG(TAB)(45 MG)....................................... 37, 50, 59ICOSAPENT ETHYL....................................................... 19IDELALISIB..................................................................... 37IGG/HYALURONIDASE,RECOMBINANT................... 31ILEVRO.............................................................................28ILOPERIDONE.................................................................15ILOPROST TROMETHAMINE....................................... 18IMATINIB MESYLATE................................................... 37IMBRUVICA...............................................................37, 59IMIPRAMINE HCL.......................................................... 14IMIPRAMINE PAMOATE................................................14IMIQUIMOD.........................................................31, 50, 59IMMUN GLOB G (IGG)/GLY/IGA 50+.......................... 31IMMUN GLOB G(IGG)/PRO/IGA 0-50.......................... 31INATAL ULTRA............................................................... 46IN-CHECK DIAL(OTC)................................................... 13IN-CHECK NASAL WITH MASK(OTC)........................13IN-CHECK ORAL(OTC)..................................................13INCONTROL LANCING DEVICE(OTC)....................... 25INCRELEX..................................................................27, 59INCRUSE ELLIPTA....................................................12, 51INDAPAMIDE...................................................................18INDINAVIR SULFATE..................................................... 34INDOCIN.......................................................................... 35INDOMETHACIN............................................................ 35INFANATE PLUS............................................................. 46INFUSION SET FOR INSULIN PUMP...........................25INGENOL MEBUTATE....................................................23INHALER, ASSIST DEVICES.........................................12INHALER,ASSIST DEVICE,ACCESORY......................12INLYTA(TAB)(1 MG)...........................................37, 51, 59INLYTA(TAB)(5 MG)...........................................37, 51, 59INNOSPIRE ELEGANCE................................................ 13INNOSPIRE ESSENCE.................................................... 13INSPIRATION...................................................................13INSPIRATION ELITE.......................................................13INSTA-GLUCOSE(OTC)..................................................26INSULIN GLARGINE,HUM.REC.ANLOG....................26INSULIN LISPRO.............................................................26INSULIN NPH HUM/REG INSULIN HM...................... 26INSULIN NPH HUMAN ISOPHANE............................. 26INSULIN NPL/INSULIN LISPRO................................... 26INSULIN PUMP............................................................... 26INSULIN REGULAR, HUMAN...................................... 26INTELENCE..................................................................... 34INTERFERON ALFA-2B,RECOMB................................31INTERFERON BETA-1A................................................. 38INTERFERON BETA-1A/ALBUMIN..............................38INTERMEZZO......................................................16, 51, 55INTRON A.................................................................. 31, 59INVEGA SUSTENNA...................................................... 15INVEGA(TAB ER 24H)(1.5 MG).........................15, 51, 56INVEGA(TAB ER 24H)(3 MG)............................15, 51, 56INVEGA(TAB ER 24H)(6 MG)............................15, 51, 56INVEGA(TAB ER 24H)(9 MG)............................15, 51, 56INVIRASE(CAP)........................................................ 34, 51INVIRASE(TAB)........................................................ 34, 51INVOKAMET....................................................... 25, 51, 56INVOKANA.......................................................... 24, 51, 56IODINE(OTC)................................................................... 20IODINE/POTASSIUM IODIDE........................................20IPECAC............................................................................. 42IPECAC(OTC)...................................................................42IPRATROPIUM BROMIDE........................................12, 38IPRATROPIUM/ALBUTEROL SULFATE...................... 12IPRATROPIUM-ALBUTEROL........................................12IPRIVASK............................................................. 30, 51, 59IRBESARTAN...................................................................17IRBESARTAN/HYDROCHLOROTHIAZIDE.................17IRBESARTAN-HYDROCHLOROTHIAZIDE.................17IRESSA........................................................................37, 59IRON 100 PLUS(OTC)..................................................... 44IRON AG&FUM/C/FA/MV CMB11/CA-T......................43IRON AG/C/B12/CA/SUC.ACID/STOM......................... 43IRON ASPGLY&PS CMPLX/C/SUCAC......................... 43IRON ASPGLY&PS/C/B12/FA/CA/SUC.........................43IRON ASPGLY/C/B12/FA/CA-TH/SUC..........................43IRON BG&PS/VIT C/B12/FA/CA THR...........................43IRON FUM & AG/C/B12/FA/CA/SUCC..........................43

VNSNY Page 66 of 73

Index

IRON FUM & P/FA/VIT B & C NO.9..............................43IRON FUM & PS CMP/FA/VIT C/B3..............................44IRON FUM&POLYSAC#1/FA/MV NO.18...................... 44IRON FUMARATE/VIT C/VIT B12/FA.......................... 44IRON POLYSAC/IRON HEME/FA/B12.......................... 44IRON POLYSACCHARIDE COMPLEX......................... 44IRON PS CMPLX/VIT B12/FA........................................ 44IRON, CARB & GLUC/FA/B12/C/DSS...........................44IRON, CARBONYL/FA/C/B-6/B12/ZN...........................44IRON,CARB/DSS/B12IF/FA/MV-MN............................. 44IRON,CARB/FA#6/MV, MIN NO.41............................... 44IRON,CARBONYL/VIT C/VIT B12/FA....................44, 45IRON/FA/B12/C/DOCUSATE SODIUM......................... 44IRON/FA/VIT BCOMP,C/MINERALS............................ 44IRON/LIVER EXT/VIT BCOMP,C/MIN......................... 44IRON/MULTIVITS,STRESS FORMULA........................44ISENTRESS...................................................................... 34ISOCARBOXAZID...........................................................14ISOMETHEPT/DICHLPHN/ACETAMINOP.................. 39ISOMETHEPT-DICHLORALP-ACETAMIN.................. 39ISONIAZID....................................................................... 33ISOPROPYL-WINTERGREEN(OTC)............................. 23ISORDIL............................................................................19ISOSORB DINIT/HYDRALAZINE HCL........................18ISOSORBIDE DINITRATE..............................................19ISOSORBIDE MONONITRATE......................................19ISOSORBIDE MONONITRATE ER................................19ISOTRETINOIN................................................................20ISOXSUPRINE HCL........................................................ 19ISRADIPINE..................................................................... 18ITRACONAZOLE.............................................................32IV ANTISEPTIC WIPES(OTC)........................................22IV PREP WIPES(OTC)..................................................... 22IVACAFTOR..................................................................... 38IVERMECTIN...................................................................33I-VITE(OTC)..................................................................... 43- J -JAKAFI..................................................................37, 51, 59JANUMET...................................................................24, 51JANUMET XR(TBMP 24HR)(100-1000MG)............24, 51JANUMET XR(TBMP 24HR)(50-1000 MG).............24, 51JANUMET XR(TBMP 24HR)(50MG-500MG)......... 24, 51JANUVIA.................................................................... 24, 51JARDIANCE......................................................... 24, 51, 56JENTADUETO............................................................ 24, 51JINTELI.............................................................................31J-TAN PD(OTC)................................................................ 11JUXTAPID.............................................................18, 51, 59- K -K EFFERVESCENT..........................................................27KALETRA(SOLUTION)............................................ 34, 51KALETRA(TAB)(100MG-25MG)............................. 34, 51KALETRA(TAB)(200MG-50MG)............................. 34, 51KALYDECO..........................................................38, 51, 59KELNOR 1-35...................................................................19KEPPRA............................................................................ 41KETEK.............................................................................. 32KETOCONAZOLE..................................................... 21, 32KETO-DIASTIX REAGENT(OTC)................................. 27KETOPROFEN..................................................................35KETOROLAC TROMETHAMINE............................ 28, 35KEVEYIS.................................................................... 41, 59KHEDEZLA.......................................................... 14, 51, 56KIONEX............................................................................ 27KLONOPIN.......................................................................40KONSYL(OTC).................................................................36KORLYM.............................................................. 25, 51, 59KRISTALOSE................................................................... 36KYNAMRO.................................................................18, 59- L -LABETALOL HCL........................................................... 17LACOSAMIDE........................................................... 40, 41LACTIC ACID.................................................................. 22LACTULOSE.................................................................... 36LAMICTAL....................................................................... 41LAMICTAL (BLUE).........................................................41LAMICTAL (GREEN)...................................................... 41LAMICTAL (ORANGE)...................................................41LAMICTAL ODT..............................................................41LAMICTAL ODT (BLUE)................................................41LAMICTAL ODT (GREEN).............................................41LAMICTAL ODT (ORANGE)......................................... 41LAMICTAL XR (BLUE)............................................ 41, 56LAMICTAL XR (GREEN)......................................... 41, 56LAMICTAL XR (ORANGE)...................................... 41, 56LAMISIL........................................................................... 32LAMISIL(OTC).................................................................21LAMIVUDINE..................................................................34LAMIVUDINE HBV........................................................ 34LAMIVUDINE(SOLUTION)..................................... 34, 51LAMIVUDINE(TAB)(150 MG)................................. 34, 51LAMIVUDINE(TAB)(300 MG)................................. 34, 51

LAMIVUDINE/ZIDOVUDINE........................................ 34LAMIVUDINE-ZIDOVUDINE..................................34, 51LAMOTRIGINE................................................................41LANCET DEVICE(OTC)................................................. 25LANCING DEVICE....................................................25, 26LANCING DEVICE(OTC)......................................... 25, 26LANCING DEVICE/LANCETS.......................................26LANCING SYSTEM(OTC).............................................. 25LANOLIN ALCOHOL/MO/W.PET/CERES....................22LANOLIN/ALOE VERA/PROP GLY.............................. 22LANOLIN/MIN OIL/PETROLAT,WHT.......................... 29LANSOPRAZOL-AMOXICIL-CLARITHRO........... 42, 51LANSOPRAZOLE............................................................ 42LANSOPRAZOLE(OTC)................................................. 42LANSOPRAZOLE/AMOXICILN/CLARITH..................42LANTUS......................................................................26, 51LANTUS SOLOSTAR................................................ 26, 51LANZO(OTC)................................................................... 26LAPATINIB DITOSYLATE..............................................37LATANOPROST............................................................... 29LATRIX............................................................................. 23LATUDA(TAB)(120 MG)..................................... 15, 51, 56LATUDA(TAB)(20 MG)....................................... 15, 51, 56LATUDA(TAB)(40 MG)....................................... 15, 51, 56LATUDA(TAB)(60 MG)....................................... 15, 51, 56LATUDA(TAB)(80 MG)....................................... 15, 51, 56LC D NEBULIZER SET................................................... 13LC PLUS........................................................................... 13LC SPRINT NEBULIZER................................................ 13LEDIPASVIR/SOFOSBUVIR.......................................... 34LEFLUNOMIDE...............................................................35LENALIDOMIDE............................................................. 37LENVATINIB MESYLATE.............................................. 37LENVIMA...................................................................37, 59LETAIRIS....................................................................18, 59LETROZOLE.................................................................... 37LEUCOVORIN CALCIUM.............................................. 38LEUKINE.................................................................... 30, 59LEUPROLIDE ACETATE.................................................27LEVALBUTEROL HCL................................................... 11LEVETIRACETAM.......................................................... 41LEVOBUNOLOL HCL.....................................................29LEVOCETIRIZINE DIHYDROCHLORIDE................... 11LEVOCETIRIZINE DIHYDROCHLORIDE(SOLUTION)............................................................................... 11, 51, 56LEVOCETIRIZINE DIHYDROCHLORIDE(TAB)......... 11LEVOFLOXACIN.......................................................28, 32LEVOMILNACIPRAN HYDROCHLORIDE.................. 14LEVONORGESTREL.......................................................19LEVONORGESTREL-ETHIN ESTRADIOL.................. 19LEVORA-28......................................................................19LEVORPHANOL TARTRATE......................................... 39LEVOTHYROXINE SODIUM......................................... 28LEXAPRO......................................................................... 14LEXIVA............................................................................. 34LICE KILLING(OTC).......................................................21LIDOCAINE......................................................................23LIDOCAINE HCL.......................................................23, 35LIDOCAINE HCL VISCOUS.......................................... 35LIDOCAINE HCL/COLLAGEN...................................... 23LIDOCAINE/HYDROCORTISONE AC....................23, 36LIDOCAINE/PRILOCAINE.............................................23LIDOCAINE-HYDROCORTISONE..........................23, 36LIDOCAINE-PRILOCAINE............................................ 23LINACLOTIDE................................................................. 36LINAGLIPTIN.................................................................. 24LINAGLIPTIN/METFORMIN HCL................................ 24LINDANE..........................................................................21LINEZOLID................................................................ 32, 59LINZESS..................................................................... 36, 51LIOTHYRONINE SODIUM.............................................28LIPASE/PROTEASE/AMYLASE.....................................41LIQUID BANDAGE(OTC)............................................... 23LISDEXAMFETAMINE DIMESYLATE.........................15LISINOPRIL......................................................................17LISINOPRIL/HYDROCHLOROTHIAZIDE....................17LISINOPRIL-HYDROCHLOROTHIAZIDE................... 17LITE TOUCH(OTC)......................................................... 25LITEAIRE......................................................................... 12LITETOUCH.....................................................................12LITHIUM.......................................................................... 15LITHIUM CARBONATE..................................................15LITHIUM CITRATE......................................................... 15LITHOBID........................................................................ 15L-NORGEST/E.ESTRADION-E.ESTRAD......................19LO LOESTRIN FE............................................................ 19LODOXAMIDE TROMETHAMINE............................... 29LOESTRIN........................................................................ 19LOMITAPIDE MESYLATE............................................. 18LONSURF................................................................... 37, 59LOPERAMIDE..................................................................36LOPERAMIDE HCL.........................................................36

LOPERAMIDE(CAP)(OTC).............................................36LOPERAMIDE(LIQUID)(OTC).......................................36LOPINAVIR/RITONAVIR................................................ 34LORATADINE.................................................................. 11LORATADINE(OTC)........................................................11LORATADINE/PSEUDOEPHEDRINE........................... 11LORAZEPAM................................................................... 15LOSARTAN POTASSIUM............................................... 17LOSARTAN/HYDROCHLOROTHIAZIDE.....................17LOSARTAN-HYDROCHLOROTHIAZIDE.................... 17LOTEMAX........................................................................28LOTEPREDNOL ETABONATE.......................................28LOUTREX.........................................................................22LOVASTATIN....................................................................18LOXAPINE....................................................................... 15LOXAPINE SUCCINATE.................................................15LUBIPROSTONE..............................................................36LUMACAFTOR/IVACAFTOR.........................................38LUMIGAN.................................................................. 29, 51LUNESTA................................................................... 16, 51LURASIDONE HCL.........................................................15LYNPARZA...........................................................37, 51, 59LYRICA.............................................................................41LYSIPLEX PLUS(OTC)....................................................45- M -M9(OTC)........................................................................... 22MACITENTAN................................................................. 18MAFENIDE ACETATE.................................................... 21MAG HYDROX/AL HYDROX/SIMETH........................ 42MAGNEBIND 400 RX..................................................... 27MAGNESIUM...................................................................44MAGNESIUM HYDROXIDE.......................................... 36MAGNESIUM OXIDE......................................................44MAGNESIUM OXIDE(OTC)........................................... 44MAGNESIUM(OTC)........................................................ 44MANNITOL/SORBITOL SOLUTION............................ 23MAPAP(OTC)................................................................... 39MAPROTILINE HCL........................................................14MARAVIROC....................................................................34MAR-COF BP(OTC).........................................................20MARNATAL-F.................................................................. 46MARPLAN........................................................................14MB HYDROGEL.............................................................. 22MECASERMIN.................................................................27MECHLORETHAMINE HCL..........................................23MECLIZINE HCL.............................................................11MECLIZINE HCL(OTC).................................................. 11MECLOFENAMATE SODIUM....................................... 35MEDIHONEY(OTC).........................................................24MEDROL...........................................................................35MEDROXYPROGESTERONE ACETATE................ 19, 31MEFLOQUINE HCL........................................................ 33MEGA MULTI(OTC)........................................................45MEGA MULTIVITAMIN(OTC).......................................45MEGESTROL ACETATE................................................. 38MEKINIST.................................................................. 37, 59MELOXICAM...................................................................35MELPAQUE HP................................................................ 24MELPHALAN...................................................................37MEMANTINE HCL....................................................13, 14MEMANTINE HCL(SOLUTION)............................. 13, 51MEMANTINE HCL(TAB DS PK)............................. 13, 51MEMANTINE HCL(TAB)..........................................13, 51MEMANTINE HCL/DONEPEZIL HCL..........................14MENEST........................................................................... 31MEN'S BIOMULTIPLE(OTC)..........................................44MEPERIDINE HCL.......................................................... 39MEPHYTON..................................................................... 30MEPROBAMATE............................................................. 15MERCAPTOPURINE....................................................... 37MESALAMINE...........................................................35, 36MESALAMINE W/CLEANSING WIPES....................... 35MESTINON.......................................................................14METAMUCIL MULTIHEALTH FIBER(OTC)................36METAMUCIL(OTC)......................................................... 36METAPROTERENOL SULFATE.....................................12METFORMIN HCL.................................................... 24, 25METHADONE HCL......................................................... 39METHAMPHETAMINE HCL....................................15, 51METHEN/M-BLUE/SAL/NA PHOS/HYOS....................32METHEN/SOD PHOS/METH BLUE/HYOS...................32METHENAM/ME BLUE/BA/SALICY/HYO.................. 32METHENAMINE HIPPURATE....................................... 32METHENAMINE MANDELATE.................................... 32METHIMAZOLE.............................................................. 28METHITEST..................................................................... 30METHOCARBAMOL.......................................................41METHOTREXATE........................................................... 37METHOTREXATE SODIUM...........................................37METHOTREXATE SODIUM/PF..................................... 37METHOTREXATE/PF................................................34, 35METHOXSALEN............................................................. 24

VNSNY Page 67 of 73

Index

METHOXSALEN, RAPID............................................... 24METHSCOPOLAMINE BROMIDE................................ 42METHSUXIMIDE............................................................ 41METHYCLOTHIAZIDE...................................................18METHYL SALICYLATE................................................. 23METHYL SALICYLATE(OTC).......................................23METHYL SALICYLATE/ISOPROPANOL..................... 23METHYLBENZETHONIUM CHLORIDE......................21METHYLCELLULOSE....................................................36METHYLDOPA................................................................ 17METHYLDOPA/HYDROCHLOROTHIAZIDE.............. 17METHYLDOPA-HYDROCHLOROTHIAZIDE..............17METHYLERGONOVINE MALEATE............................. 20METHYLPHENIDATE ER(CPBP 50-50)(20 MG)...... 16,48, 51METHYLPHENIDATE ER(CPBP 50-50)(30 MG)...... 16,48, 51METHYLPHENIDATE ER(CPBP 50-50)(40 MG)...... 16,48, 51METHYLPHENIDATE ER(TAB ER 24H)(18 MG)...... 16,48, 51METHYLPHENIDATE ER(TAB ER 24H)(27 MG)...... 16,48, 51METHYLPHENIDATE ER(TAB ER 24H)(36 MG)...... 16,48, 51METHYLPHENIDATE ER(TAB ER 24H)(54 MG)...... 16,48, 51METHYLPHENIDATE ER(TAB ER)(10 MG)...... 16, 48,51METHYLPHENIDATE ER(TAB ER)(20 MG)...... 16, 48,51METHYLPHENIDATE HCL............................................16METHYLPREDNISOLONE............................................ 35METHYLTESTOSTERONE.............................................30METIPRANOLOL............................................................ 29METOCLOPRAMIDE HCL............................................. 42METOLAZONE................................................................ 18METOPROLOL SUCCINATE..........................................17METOPROLOL TARTRATE............................................17METOPROLOL/HYDROCHLOROTHIAZIDE...............17METOPROLOL-HYDROCHLOROTHIAZIDE.............. 17METRELEPTIN................................................................ 28METRONIDAZOLE............................................. 20, 33, 43MEXILETINE HCL.......................................................... 16MG TRISILICATE/ALH/NAHCO3/AA...........................42MI ACID(OTC)................................................................. 42MICONAZOLE 3.............................................................. 43MICONAZOLE 3(OTC)................................................... 43MICONAZOLE NITRATE......................................... 21, 43MICONAZOLE NITRATE(OTC).....................................21MICRO AIR(OTC)............................................................ 13MICRO ELITE.................................................................. 13MICRO PLUS....................................................................13MICROCHAMBER...........................................................12MICROGESTIN................................................................ 19MICROGESTIN FE.......................................................... 19MICROLET 2(OTC)..........................................................26MICROLIFE PEAK FLOW(OTC)....................................13MICROSPACER................................................................12MIDAZOLAM HCL..........................................................16MIDODRINE HCL........................................................... 19MIFEPRISTONE...............................................................25MILLIPRED...................................................................... 35MILLIPRED DP................................................................35MILNACIPRAN HCL.......................................................38MINASTRIN 24 FE...........................................................19MINERAL OIL................................................................. 36MINERAL OIL(OTC).......................................................36MINERAL OIL/LAN OIL/PROP GLY.............................22MINERAL OIL/PETROLATUM,WHITE.................. 22, 29MINERALS/PROTEIN SUPPLEMENT.......................... 44MINI LANCING DEVICE(OTC)..................................... 26MINI PLUS NEBULIZER................................................ 13MINICOMP COMPRESSOR NEBULIZER(OTC)..........13MINIELITE....................................................................... 13MINILINK REAL-TIME TRANSMITTER..................... 25MINIMED......................................................................... 25MINI-WRIGHT PEAK FLOW METER...........................13MINOCYCLINE HCL...................................................... 32MINOXIDIL......................................................................17MIO INFUSION SET........................................................25MIPOMERSEN SODIUM................................................ 18MIRTAZAPINE.................................................................14MISOPROSTOL................................................................42MODAFINIL............................................................... 15, 59MOEXIPRIL HCL.............................................................17MOEXIPRIL/HYDROCHLOROTHIAZIDE....................17MOEXIPRIL-HYDROCHLOROTHIAZIDE................... 17MOMETASONE FUROATE.......................................11, 22MOMETASONE/FORMOTEROL....................................12MONISTAT 3(OTC).......................................................... 43MONTELUKAST SODIUM.............................................12

MORPHINE SULFATE.....................................................39MORPHINE SULFATE ER(CAP ER PEL)................39, 51MORPHINE SULFATE ER(CPMP 24HR)(120 MG)......39, 51MORPHINE SULFATE ER(CPMP 24HR)(30 MG)...... 39,51MORPHINE SULFATE ER(CPMP 24HR)(45 MG)...... 39,51MORPHINE SULFATE ER(CPMP 24HR)(60 MG)...... 39,51MORPHINE SULFATE ER(CPMP 24HR)(75 MG)...... 39,51MORPHINE SULFATE ER(CPMP 24HR)(90 MG)...... 39,51MORPHINE SULFATE ER(TAB ER)........................ 39, 51MORPHINE SULFATE/PF............................................... 39MOTION SICKNESS(OTC)............................................. 11MOUTHPIECE(OTC)....................................................... 12MOVANTIK................................................................ 36, 51MOXEZA.......................................................................... 28MOXIFLOXACIN HCL..............................................28, 32MTH/ME BLUE/SOD PHOS/PHEN/HYOS.................... 32MUCUS CLEARING DEVICE........................................ 12MULTAQ........................................................................... 16MULTI FOR HER(OTC)...................................................45MULTIGEN.......................................................................43MULTIGEN FOLIC.......................................................... 43MULTIGEN PLUS............................................................ 43MULTILEX(OTC).............................................................44MULTIVIT WITH CALCIUM,IRON,MIN...................... 44MULTIVIT, IRON, MIN #5, FA....................................... 44MULTIVIT, MIN CMB#20/IRON/FA.............................. 44MULTIVIT,CA,IRON,MIN/FA/HRB146......................... 44MULTIVIT,THER IRON,CA,FA & MIN......................... 44MULTIVITAL(OTC).........................................................44MULTIVITAMIN.............................................................. 44MULTIVITAMIN NO.44/VIT D3/K.................................44MULTIVITAMIN W/IRON, MINERALS...................43-45MULTIVITAMIN WITH FLUORIDE..............................45MULTIVITAMIN WITH MINERALS....................... 43, 44MULTIVITAMIN W-MINERALS/HERBS......................44MULTIVITAMIN W-MINERALS/LUTEIN.................... 43MULTIVITAMIN/IRON/FOLIC ACID............................ 44MULTIVITAMINS W-CALCIUM-IRON(OTC).............. 44MULTIVITAMINS W-FLUORIDE-IRON....................... 45MULTIVITAMINS WITH FLUORIDE............................45MULTIVITAMINS WITH IRON......................................44MULTIVITAMINS WITH MIN NO.7/FA........................44MULTIVITAMINS WITH MINERALS(OTC)................ 44MULTIVITAMINS,THER W-MINERALS...................... 44MULTIVITAMINS,THERAPEUTIC............................... 44MULTIVITAMINS-A,B,D,E,K,ZN............................ 44, 45MULTIVITAMINS-MIN/FA/GINKGO............................44MULTIVIT-MIN/FA/LUTEIN/ZEAXANT...................... 44MULTIVIT-MIN/FA/LYCOPENE/LUT..................... 43, 44MULTIVIT-MIN/FOLIC ACID/VIT K.............................44MULTIVITS W-FE,OTHER MIN/LUT............................44MULTIVITS W-IRON,HEMATINIC................................44MULTIVITS,CA,MIN/IRON/FA/LYCOP........................ 44MULTIVITS,CA,MINERALS/IRON/FA......................... 44MULTIVITS,STRESS FORMULA.................................. 44MULTIVITS,STRESS FORMULA/ZINC........................44MULTIVITS,TH W-CA,FE,OTH MIN.............................45MULTIVITS,TH W-FE,OTHER MIN.............................. 45MULTIVITS,THERAP W-FE,HEMATIN........................ 45MULTIVITS-MIN/IRON/FA/GINSENG..........................45MULTIVITS-MIN/IRON/FA/LUTEIN.............................45MULTIVITS-MINERALS/FA/LYCOPENE.....................45MUPIROCIN..................................................................... 21MUPIROCIN CALCIUM............................................21, 38MV W-CA/IRON/FA/LUTEIN/HRB#179........................45MV, MIN #36/IRON,CARBONYL/FA.............................43MV,CA,IRON,MIN/FA/PHYTOSTEROL........................ 45MV,CA,MIN/IRON FUM/FA/LYCO/LUT....................... 45MV,CA,MIN/IRON FUM/FA/VIT K................................ 45MV,CA,MIN/IRON/FA/GUARANA/CAFF..................... 45MV,CA,MIN/IRON/FA/LYC/LUT/PHYT........................ 45MV,FE,OTHER MIN/GR TEA LFXT.............................. 45MV,MINERALS/FA/LYCOPENE/GINKGO....................45MV/GNK BI EX/K.GINSG...............................................45MVC-FLUORIDE............................................................. 45MV-MIN/IRON FUM/FA/K/LYCO/LUTN...................... 45MV-MN/FA/LYCOPENE/LUT/HB#178.......................... 45MY WAY(OTC).................................................................19MYALEPT...................................................................28, 51MYAMBUTOL..................................................................33MYCOBUTIN................................................................... 33MYCOPHENOLATE MOFETIL......................................31MYCOPHENOLATE SODIUM....................................... 31MYCOPHENOLIC ACID.................................................31MYGLUCOHEALTH CONTROL SOLUTION(OTC)......25

MYNATAL........................................................................ 46MYNATE 90 PLUS........................................................... 46MYSOLINE.......................................................................41- N -NABUMETONE................................................................35NACL IRRIGAT/DECYL GLUCOSIDE..........................23NADOLOL/BENDROFLUMETHIAZIDE.......................17NADOLOL-BENDROFLUMETHIAZIDE...................... 17NAFTIFINE HCL..............................................................21NAFTIN.............................................................................21NAIL SCRUB(OTC)......................................................... 24NALBUPHINE HCL.........................................................39NALOXEGOL OXALATE................................................36NALOXONE HCL............................................................ 15NALTREXONE HCL........................................................16NALTREXONE MICROSPHERES..................................15NAMENDA XR(CAP 24 DSPK)................................13, 51NAMENDA XR(CAP SPR 24)................................... 14, 51NAMZARIC.......................................................... 14, 51, 56NAPHAZOLINE HCL...................................................... 28NAPROXEN...................................................................... 35NAPROXEN SODIUM..................................................... 35NASAL AIRFLOW STRIPS.............................................12NASAL DECONGESTANT(OTC)................................... 20NASAL STRIPS(OTC)..................................................... 12NASONEX.................................................................. 11, 51NATAZIA.......................................................................... 19NATEGLINIDE................................................................. 24NATURAL BALANCE TEARS(OTC).............................29NATURAL BALANCED B-100(OTC).............................47NATURAL DAILY FIBER(OTC)..................................... 36NATURAL FIBER(OTC)..................................................36NATURE-THROID........................................................... 28NEBIVOLOL HCL............................................................17NEBULIZER............................................................... 12, 13NEBULIZER/COMPRESSOR..........................................13NEBUPENT...................................................................... 33NECON..............................................................................19NEDOCROMIL SODIUM................................................ 29NEFAZODONE HCL........................................................14NELFINAVIR MESYLATE.............................................. 34NEO/POLYMYX B SULF/DEXAMETH.........................28NEOMYCIN SU/BACI ZN/POLY/HC............................. 28NEOMYCIN SU/BACITRA/POLYMYXIN.....................28NEOMYCIN SU/POLYMYX B SULF.............................23NEOMYCIN SULFATE....................................................33NEOMYCIN/BACITRA/POLYMYXIN/HC.................... 21NEOMYCIN/POLYMYXIN B SULF/HC..................21, 27NEOMYCIN/POLYMYXN B/GRAMICIDIN................. 28NEOMYCIN-BACITRACIN-POLY-HC...........................28NEOMYCIN-BACITRACIN-POLYMYXIN....................28NEOMYCIN-POLYMYXIN B......................................... 23NEOMYCIN-POLYMYXIN-DEXAMETH..................... 28NEOMYCIN-POLYMYXIN-GRAMICIDIN................... 28NEOMYCIN-POLYMYXIN-HC......................................27NEOMYCN/BACI ZN/PMYX BS/PRAMOX..................21NEPAFENAC.................................................................... 28NEPHPLEX RX................................................................ 47NEPHRON FA...................................................................43NETUPITANT/PALONOSETRON HCL......................... 11NEULASTA.................................................................30, 59NEUPOGEN................................................................30, 59NEUPRO............................................................... 40, 51, 56NEURIN-SL...................................................................... 47NEVANAC.........................................................................28NEVIRAPINE............................................................. 11, 34NEVIRAPINE ER............................................................. 11NEVIRAPINE(ORAL SUSP)..................................... 34, 51NEVIRAPINE(TAB)................................................... 34, 51NEW SKIN(OTC)............................................................. 23NEWGEN.......................................................................... 46NEXAFED(OTC).............................................................. 20NEXAVAR.............................................................37, 51, 59NEXIUM............................................................... 42, 51, 56NIACIN............................................................................. 19NIACIN ER................................................................. 19, 56NIACIN(OTC)................................................................... 19NIACIN/SIMVASTATIN...................................................18NICARDIPINE HCL.........................................................18NICODERM CQ(OTC).....................................................41NICORETTE(OTC)...........................................................41NICOTINE.........................................................................41NICOTINE POLACRILEX...............................................41NIFEDIPINE..................................................................... 18NIFEDIPINE ER............................................................... 18NIGHTTIME RELIEF(OTC)............................................ 29NIGHTTIME SLEEP AID(OTC)......................................16NILANDRON..............................................................37, 51NILOTINIB HCL.............................................................. 37NILUTAMIDE...................................................................37NIMODIPINE....................................................................18NINTEDANIB ESYLATE................................................ 38

VNSNY Page 68 of 73

Index

NITRO-BID....................................................................... 19NITRO-DUR..................................................................... 19NITROFURANTOIN........................................................ 32NITROFURANTOIN MACROCRYSTAL....................... 32NITROFURANTOIN MONOHYD/M-CRYST................32NITROFURANTOIN MONO-MACRO........................... 32NITROGLYCERIN........................................................... 19NITROGLYCERIN PATCH.............................................. 19NITROSTAT...................................................................... 19NIVA-HIST DM(OTC)......................................................20NIZATIDINE.....................................................................42NOHIST-DM(OTC)...........................................................20NORA-BE..........................................................................19NORDITROPIN FLEXPRO........................................27, 59NORDITROPIN NORDIFLEX...................................27, 59NORELGESTROMIN/ETHIN.ESTRADIOL.................. 20NORETH-ETHINYL ESTRADIOL/IRON...................... 19NORETHINDRONE......................................................... 19NORETHINDRONE ACETATE....................................... 31NORETHINDRONE AC-ETH ESTRADIOL.............19, 31NORETHINDRONE-E.ESTRADIOL-IRON................... 19NORETHINDRONE-ETHINYL ESTRAD...................... 19NORETHINDRONE-MESTRANOL............................... 20NORGESTIMATE-ETHINYL ESTRADIOL...................20NORGESTREL-ETHINYL ESTRADIOL....................... 20NORINYL 1+50................................................................ 20NORMAL SALINE...........................................................27NORMAL SALINE FLUSH............................................. 27NORPACE CR...................................................................16NORPRAMIN................................................................... 14NORTHERA................................................................19, 59NORTRIPTYLINE HCL................................................... 14NORVIR(CAP)............................................................34, 51NORVIR(SOLUTION)................................................34, 51NORVIR(TAB)............................................................ 34, 51NOVAMAX PLUS GLU-KET(OTC)................................25NUCYNTA.................................................................. 39, 51NUCYNTA ER............................................................ 39, 51NUTROPIN AQ...........................................................27, 59NUTROPIN AQ NUSPIN........................................... 27, 59NUVARING.................................................................19, 51NYMALIZE................................................................ 18, 59NYSTATIN.................................................................. 21, 32NYSTATIN/TRIAMCIN................................................... 21NYSTATIN-TRIAMCINOLONE..................................... 21- O -OBSTETRIX DHA............................................................46OCELLA......................................................................19, 56OCUTABS(OTC)...............................................................44ODOMZO....................................................................37, 59ODOR ELIMINATOR DROPS(OTC)...............................22OFEV...........................................................................38, 59OFLOXACIN...............................................................28, 32OLANZAPINE.................................................................. 15OLANZAPINE PAMOATE...............................................15OLANZAPINE/FLUOXETINE HCL............................... 16OLANZAPINE-FLUOXETINE HCL.........................16, 51OLAPARIB........................................................................37OLEPTRO ER....................................................... 14, 51, 56OLMESARTAN MEDOXOMIL.......................................17OLMESARTAN/HYDROCHLOROTHIAZIDE...............17OLODATEROL HCL........................................................ 12OLOPATADINE HCL..................................... 11, 28, 51, 56OM-3/CA CARB/D3/FA/MV CMB 13.............................45OM-3/DHA/EPA/B12/FA/B6/PHYTOST.........................45OMACETAXINE MEPESUCCINATE............................. 37OMEGA-3 ACID ETHYL ESTERS........................... 19, 51OMEPRAZOLE................................................................ 42OMEPRAZOLE(OTC)......................................................42OMNIPOD.........................................................................26OMNITROPE.............................................................. 27, 59ON CALL EXPRESS CONTROL SOLN(OTC).............. 25ON CALL LANCING DEVICE(OTC).............................26ON CALL PLUS LANCING DEVICE(OTC).................. 26ONDANSETRON..............................................................11ONDANSETRON HCL.....................................................11ONDANSETRON HCL(SOLUTION)........................ 11, 51ONDANSETRON HCL(TAB).......................................... 11ONDANSETRON ODT.................................................... 11ONE DAILY 50 PLUS(OTC)............................................43ONE DAILY ESSENTIAL(OTC)..................................... 44ONE DAILY MAXIMUM(OTC)...................................... 44ONE STEP PERINEAL(OTC)..........................................23ONE WAY MOUTHPIECE(OTC).................................... 12ONE-A-DAY MEN'S(OTC).............................................. 45ONE-A-DAY WOMEN'S(OTC)................................. 44, 45ONETOUCH DELICA(OTC)........................................... 26ONETOUCH PING........................................................... 26ONETOUCH SURESOFT(OTC)......................................26ONFI(ORAL SUSP)..............................................40, 51, 56ONFI(TAB)............................................................40, 51, 56OPIUM TINCTURE..........................................................36

OPIUM/BELLADONNA ALKALOIDS.......................... 39OPSUMIT....................................................................18, 59OPTICHAMBER...............................................................12OPTICHAMBER DIAMOND.......................................... 12ORALAIR....................................................................11, 59ORAP.................................................................................15ORENCIA..............................................................35, 51, 59ORENITRAM ER....................................................... 18, 59ORKAMBI.................................................................. 38, 59ORPHENADRINE CITRATE...........................................41ORTHO EVRA............................................................20, 51ORTHO TRI-CYCLEN LO...............................................20ORTHO-NOVUM..............................................................19OSELTAMIVIR PHOSPHATE......................................... 33OSTOMY SUPPLY........................................................... 22OTEZLA......................................................................35, 59OTICIN..............................................................................27OTO-END 10.....................................................................27OTREXUP............................................................. 34, 51, 56OXANDROLONE....................................................... 30, 59OXAPROZIN.....................................................................35OXAZEPAM......................................................................15OXCARBAZEPINE.......................................................... 41OXSORALEN................................................................... 24OXTELLAR XR(TAB ER 24H)(150 MG)........... 41, 51, 56OXTELLAR XR(TAB ER 24H)(300 MG)........... 41, 51, 56OXTELLAR XR(TAB ER 24H)(600 MG)........... 41, 51, 56OXYBENZONE/OCTINOX/H-QUINONE......................24OXYBUTYNIN CHLORIDE............................................43OXYCODONE HCL......................................................... 39OXYCODONE HCL/ACETAMINOPHEN...................... 39OXYCODONE HCL/ASPIRIN........................................ 39OXYCODONE HCL-ASPIRIN........................................ 39OXYCODONE HCL-IBUPROFEN..................................39OXYCODONE-ACETAMINOPHEN.........................39, 51OXYCONTIN(TAB ER 12H)(10 MG)....................... 39, 51OXYCONTIN(TAB ER 12H)(15 MG)....................... 39, 52OXYCONTIN(TAB ER 12H)(20 MG)....................... 39, 52OXYCONTIN(TAB ER 12H)(30 MG)....................... 39, 52OXYCONTIN(TAB ER 12H)(40 MG)....................... 39, 52OXYCONTIN(TAB ER 12H)(60 MG)....................... 39, 52OXYCONTIN(TAB ER 12H)(80 MG)....................... 39, 52OXYMETAZOLINE HCL................................................ 20OXYMORPHONE HCL................................................... 39OYSTER SHELL CALCIUM W-VIT D(OTC)................ 43- P -PAIRE OB PLUS DHA..................................................... 45PALBOCICLIB................................................................. 37PALIPERIDONE............................................................... 15PALIPERIDONE PALMITATE.........................................15PALIVIZUMAB................................................................ 33PAMELOR.........................................................................14PANCRELIPASE 5,000.....................................................41PANDA MASK(OTC)....................................................... 12PANDEL............................................................................22PANOBINOSTAT LACTATE............................................37PANTOPRAZOLE SODIUM............................................42PANTOTHENIC ACID/ALOE VERA..............................22PAPAVERINE HCL...........................................................19PARADIGM REAL-TIME................................................25PAREGORIC..................................................................... 36PARI LC SPRINT SINUS................................................. 13PARI SINUS AEROSOL SYSTEM..................................13PARICALCITOL...............................................................27PARNATE..........................................................................14PAROMOMYCIN SULFATE............................................33PAROXETINE HCL..........................................................14PAROXETINE MESYLATE............................................. 14PARVA-CAL 500(OTC).................................................... 43PASER............................................................................... 33PATADAY.......................................................................... 28PATANOL..........................................................................28PAXIL................................................................................14PAXIL CR..........................................................................14PAZOPANIB HCL.............................................................37PCE.................................................................................... 32PEAK FLOW METER...................................................... 13PEAK FLOW METER/INH ASST DEV..........................13PEAK-AIR(OTC).............................................................. 13PED MULTIVIT #46/IRON SULFATE............................ 45PED MV A,C,D3 #21 W-FLUORIDE.............................. 45PED MV A,C,D3 #38 W-FLUORIDE.............................. 45PEDI M.VIT NO.17 WITH FLUORIDE.......................... 45PEDI MULTIVIT #65/VIT D3/VIT K.............................. 45PEDI MULTIVIT NO.2 W-FLUORIDE........................... 45PEDI MULTIVITS A,C,&D3 NO.21................................45PEDI MV #45/FLUORIDE/IRON.................................... 45PEDI MV #75/FLUORIDE/IRON.................................... 45PEDI MV NO.83 WITH FLUORIDE............................... 45PEDI MV NO.84 WITH FLUORIDE............................... 45PEDI MVI NO.12/SODIUM FLUORIDE........................ 45PEDI MVI NO.16 WITH FLUORIDE..............................45

PEDI MVI NO.82 WITH FLUORIDE..............................45PEDIATRIC MULTIVIT COMB NO.20.......................... 45PEDIATRIC PANDA MASK(OTC)..................................12PEG 3350/NA SULF,BICARB,CL/KCL.......................... 36PEGANONE......................................................................40PEGASYS....................................................................34, 59PEGASYS PROCLICK...............................................34, 59PEGFILGRASTIM............................................................30PEGINTERFERON ALFA-2A..........................................34PEGINTERFERON ALFA-2B..........................................37PENICILLAMINE............................................................ 34PENICILLIN G BENZATHINE........................................32PENICILLIN V POTASSIUM.......................................... 32PENLET PLUS BLOOD SAMPLER(OTC).....................26PENTAMIDINE ISETHIONATE......................................33PENTAZOCINE HCL/NALOXONE HCL....................... 39PENTAZOCINE-NALOXONE HCL................................39PENTOSAN POLYSULFATE SODIUM..........................42PENTOXIFYLLINE..........................................................30P-EPHED HCL/CODEINE/GUAIFEN.............................20PEPTO-BISMOL TO-GO(OTC).......................................36PERAMPANEL................................................................. 41PERFOROMIST..........................................................11, 52PERIANAL CLEANSING(OTC)..................................... 24PERICLEAN(OTC)...........................................................20PERIFRESH(OTC)............................................................24PERINDOPRIL ERBUMINE........................................... 17PERISCENT(OTC)........................................................... 22PERMETHRIN..................................................................21PERMETHRIN(OTC)....................................................... 21PERPHENAZINE..............................................................15PERPHENAZINE/AMITRIPTYLINE HCL.....................14PERPHENAZINE-AMITRIPTYLINE............................. 14PERSONAL BEST(OTC)................................................. 13PETROLAT,WHT/MIN OIL/SOD CHL........................... 29PETROLATUM,WHITE............................................. 22, 23PEXEVA................................................................ 14, 52, 56PFLEX TRAINER.............................................................13PHENAZOPYRIDINE HCL............................................. 42PHENELZINE SULFATE................................................. 14PHENERGAN................................................................... 11PHENOBARB/HYOSCY/ATROPINE/SCOP.................. 42PHENOBARBITAL.......................................................... 15PHENOXYBENZAMINE HCL........................................17PHENYLEPHRINE HCL..................................................28PHENYLEPHRINE HCL/PROMETH HCL.....................20PHENYTEK...................................................................... 41PHENYTOIN.................................................................... 41PHENYTOIN SODIUM EXTENDED............................. 41PHILLIPS' MILK OF MAGNESIA(OTC)........................36PHOSPHA 250 NEUTRAL.............................................. 42PHOSPHASAL..................................................................32PHOSPHORUS #1............................................................ 42PHYTONADIONE............................................................ 30PICATO(GEL)(0.015 %).............................................23, 52PICATO(GEL)(0.05 %)...............................................23, 52PIKO 1(OTC).....................................................................13PILOCARPINE HCL.................................................. 29, 37PIMOZIDE........................................................................ 15PINDOLOL....................................................................... 17PINK BISMUTH(OTC).................................................... 36PINNACAINE................................................................... 27PIOGLITAZONE HCL......................................................24PIOGLITAZONE HCL/METFORMIN HCL................... 25PIOGLITAZONE-METFORMIN............................... 25, 56PIPERONYL BUTOXIDE/PYRETHRINS.......................21PIRFENIDONE................................................................. 38PIROXICAM..................................................................... 35PN VIT.W-O CA #7, IRON,FA,DHA............................... 45PN W-CA64/IRON CB&GL/FA/DSS/DH........................ 45PNV #14/FERROUS FUM/FOLIC ACID........................ 45PNV #19/IRON PS&HEME/FOLIC/DHA....................... 45PNV #8/IRON PS CMP&ASPG/FA/DHA........................45PNV #87/IRON BISGLY/FA/DHA...................................45PNV 11-IRON FUM-FOLIC ACID-OM3........................ 45PNV COMB.NO.44/IRON/FOLIC ACID.........................45PNV COMBO #22/IRON/FA/OM3/DHA.........................45PNV COMBO#47/IRON/FA #1/DHA.............................. 45PNV NO.115/IRON FUMARATE/FA.............................. 45PNV NO.118/IRON FUMARATE/FA.............................. 45PNV NO.15/IRON FUM & PS CMP/FA.......................... 45PNV NO.22/IRON CBN&GLUC/FA/DSS....................... 45PNV NO.66/IRON,CARBONYL/FA/DHA...................... 45PNV NO10/IRON FUM&P/FA/OMEGA-3......................45PNV NO12/IRON,CARB/FA/DSS/OM-3.........................46PNV W-CA #40/IRON FUM/FA CMB#1.........................46PNV W-CA NO.37/IRON/FA/OMEGA-3........................ 46PNV W-CA8/IRON/FA/LMEFOLATE CA...................... 46PNV WITH CA #68/IRON/FA#1/DHA............................46PNV WITH CA NO.65/IRON POLY/FA..........................46PNV WITH CA#74/IRON/FOLIC ACID......................... 46PNV WITH CA,NO.62/IRON/FA/DHA........................... 46

VNSNY Page 69 of 73

Index

PNV WITH CA,NO.70/IRON/FA/DHA........................... 46PNV WITH CA,NO.72/IRON,CARB/FA......................... 46PNV WITH CA,NO.72/IRON/FA.....................................46PNV WITH CA,NO63/IRON/FA/B6................................ 46PNV W-O CA NO5/FE FUMARATE/FA......................... 46PNV W-O IRON/FA/CALCIUM/B6/B12.........................47PNV#16/IRON FUM & PS/FA/OM-3...............................46PNV#20/IRON/FA/DS/FISH/DHA/EPA...........................46PNV#21/IRON PS& HEME POLYP/FA.......................... 46PNV#64/IRON/LMFOLATE/ALGAL/SOY..................... 46PNV#79/IRON/FA/LMFOLATE CA/DHA...................... 46PNV,CA,NO.35/IRON/FA/DS/OMEG-3.......................... 46PNV,CA42/IRON/FA/LMEFOL CA/DHA....................... 46PNV/FA/B6/CALCIUM CARB/GINGER........................47PNV/FA/B6/CALCIUM PHOS/GINGER.........................47PNV/FERROUS FUMARATE/DOSS/FA.........................46PNV/FERROUS FUMARATE/FA/SE.............................. 46PNV/IRON,CARBONYL/DOCUSATE/FA......................46PNV100/IRON EDTA&PS/FA/OMEGA3........................ 46PNV115/IRON FUMARATE/FA/DSS..............................46PNV119/IRON FUMARATE/FA/DSS..............................46PNV17/IRON/FA/FISH OIL/DHA/OM............................46PNV19/IRON BG HC&SUCC-P/FA/OM3.......................46PNV22/IRON CBN&GLUC/FA/DSS/DHA..................... 46PNV34/IRON,CARBONYL/FA/DSS/DHA..................... 46PNV38/IRON CBN&GLUC/FA/DSS/DHA..................... 46PNV39/IRON FUMARATE/FA/DSS/DHA......................46PNV53/IRON B-G HCL-P/FA/OMEGA3........................ 46PNV54/IRON B-G HCL-P/FA/OMEGA3........................ 46PNV55/IRON BG HC&SUCC-P/FA/OM3.......................46PNV59/IRON,CARB&FUM/FA/DSS/DHA.....................46PNV59/IRON,CARBONYL/FA/DSS/DHA..................... 46PNV66/IRON FUMARATE/FA/DSS/DHA......................46PNV69/IRON,CARBONYL/FA/DSS/DHA..................... 46PNV7/FE ASP GLY/DOCUSATE/FA.............................. 46PNV77/SOD IRON EDTA& PS/FA/OM3........................ 46PNV80/IRON FUMARATE/FA/DSS/DHA......................46PNV81/SOD IRON EDTA& PS/FA/OM3........................ 46PNV95/FERROUS FUMARATE/FA................................46PNV-DHA..........................................................................45PNV-DHA PLUS...............................................................46PNV-IRON.........................................................................46PNV-SELECT....................................................................46POCKET CHAMBER....................................................... 12POCKET PEAK(OTC)......................................................13PODOCON-25...................................................................23PODOFILOX.....................................................................23PODOPHYLLUM RESIN.................................................23POLYETHYLENE GLYCOL 3350...................................36POLYETHYLENE GLYCOL 3350(OTC)........................ 36POLY-IRON 150 FORTE.................................................. 44POLYMYXIN B SULF/TRIMETHOPRIM......................28POLYMYXIN B SUL-TRIMETHOPRIM........................28POLYVINYL ALCOHOL.................................................29POLYVINYL ALCOHOL/POVIDONE........................... 29POLYVITAMIN WITH IRON(OTC)................................45POLY-VITAMIN(OTC).....................................................45POMALIDOMIDE............................................................ 37POMALYST................................................................ 37, 59PONATINIB HCL............................................................. 37POT CHLORIDE/POT BICARB/CIT AC........................ 27POTASSIUM BICARBONATE/CIT AC.......................... 27POTASSIUM CHLORIDE................................................27POTASSIUM CITRATE....................................................42POTASSIUM CITRATE ER..............................................42POTASSIUM CITRATE/CITRIC ACID...........................42POTASSIUM HYDROXIDE.............................................23POTASSIUM IODIDE...................................................... 28POTASSIUM IODIDE/IODINE........................................28POTIGA(TAB)(200 MG)...................................... 40, 52, 56POTIGA(TAB)(300 MG)...................................... 40, 52, 56POTIGA(TAB)(400 MG)...................................... 40, 52, 57POTIGA(TAB)(50 MG)........................................ 40, 52, 57POVIDONE-IODINE........................................................ 24POVIDONE-IODINE(OTC)............................................. 24PR CREAM....................................................................... 23PR NATAL 400 EC............................................................46PR NATAL 430..................................................................46PR NATAL 430 EC............................................................46PRAMIPEXOLE DI-HCL.................................................40PRAMIPEXOLE DIHYDROCHLORIDE........................40PRAMLINTIDE ACETATE.............................................. 24PRAMOSONE...................................................................23PRASUGREL HCL........................................................... 30PRAVASTATIN SODIUM.................................................18PRAZIQUANTEL............................................................. 33PRAZOSIN HCL...............................................................17PRED MILD......................................................................28PREDNICARBATE...........................................................22PREDNISOLONE............................................................. 35PREDNISOLONE ACETATE...........................................28PREDNISOLONE SOD PHOSPHATE...................... 28, 35

PREDNISOLONE SODIUM PHOSPHATE...............28, 35PREDNISONE.................................................................. 35PREDNISONE INTENSOL..............................................35PREGABALIN.................................................................. 41PREMARIN.................................................................31, 43PREMPHASE....................................................................31PREMPRO.........................................................................31PRENA1 CHEW................................................................46PRENAISSANCE..............................................................46PRENAISSANCE 90 DHA............................................... 45PRENAISSANCE DHA.................................................... 46PRENAISSANCE NEXT-B.............................................. 47PRENAISSANCE PLUS...................................................46PRENAISSANCE PROMISE........................................... 46PRENAT VIT COMB.10/IRON/FA/DHA........................ 46PRENATABS FA............................................................... 46PRENATAL #57/IRON/FA/DSS/DHA............................. 46PRENATAL 19............................................................ 45, 46PRENATAL 19(OTC)........................................................45PRENATAL COMB NO.42/FOLIC ACID........................46PRENATAL NO.13/IRON PS/FA CB#1........................... 46PRENATAL NO.52/IRON/FA/DHA................................. 46PRENATAL NO.75/IRON/FOLATE #1............................46PRENATAL PLUS.............................................................46PRENATAL VIT #76/IRON,CARB/FA............................ 46PRENATAL VIT 15/IRON CB/FA/DSS........................... 46PRENATAL VIT 16/IRON CB/FA/DSS........................... 46PRENATAL VIT 18/IRON CB/FA/DSS........................... 46PRENATAL VIT NO.109/IRON/FA................................. 46PRENATAL VIT NO.73/IRON/FA................................... 46PRENATAL VIT NO.78/IRON/FA................................... 46PRENATAL VIT#4/IRON FUM &PS/FA.........................46PRENATAL VIT#86/IRON BISGLY/FA.......................... 46PRENATAL VIT#96/FERROUS FUM/FA....................... 46PRENATAL VIT/IRON BISGLYCIN/FA......................... 46PRENATAL VIT/IRON FUMARATE/FA........................ 46PRENATAL VIT27&CALCIUM/IRON/FA..................... 46PRENATAL VITAMINS(OTC).........................................46PRENATAL VITS#4/IRON FUM/FA............................... 47PRENATAL(OTC).............................................................46PRENATAL-U................................................................... 46PRESERVISION AREDS(OTC).......................................43PREVACID.................................................................. 42, 57PREVALITE...................................................................... 19PREZCOBIX............................................................... 33, 52PREZISTA(ORAL SUSP)...........................................33, 52PREZISTA(TAB)(150 MG).........................................33, 52PREZISTA(TAB)(400 MG).........................................33, 52PREZISTA(TAB)(600 MG).........................................33, 52PREZISTA(TAB)(75 MG)...........................................33, 52PREZISTA(TAB)(800 MG).........................................33, 52PRIFTIN............................................................................ 33PRIMAQUINE.................................................................. 33PRIMAQUINE PHOSPHATE...........................................33PRIMEAIRE......................................................................12PRIMIDONE..................................................................... 41PRIMSOL.......................................................................... 32PRISTIQ ER.......................................................... 14, 52, 57PROBENECID.................................................................. 29PROBENECID-COLCHICINE.........................................29PROCHAMBER................................................................12PROCHLORPERAZINE...................................................11PROCHLORPERAZINE MALEATE............................... 11PROCRIT.....................................................................30, 59PROCTOFOAM-HC......................................................... 36PROCTOZONE-HC.......................................................... 36PROCYSBI..................................................................42, 59PRODIGY LANCING DEVICE(OTC).............................26PRODIGY MINI-MIST.....................................................13PROGESTERONE.............................................................31PROGESTERONE,MICRONIZED...................................31PROMACTA..........................................................30, 52, 59PROMETHAZINE HCL................................................... 11PROMETHAZINE HCL/CODEINE.................................20PROMETHAZINE VC......................................................20PROMETHAZINE VC-CODEINE...................................20PROMETHAZINE/DEXTROMETHORPHAN............... 20PROMETHAZINE/PHENYLEPH/CODEINE................. 20PROMETHAZINE-CODEINE......................................... 20PROMETHAZINE-DM.....................................................20PROMETHEGAN............................................................. 11PRONEB ULTRA II.......................................................... 13PROPAFENONE HCL...................................................... 16PROPANTHELINE BROMIDE........................................42PROPARACAINE HCL.................................................... 28PROPARACAINE/FLUORESCEIN SOD........................ 28PROPRANOLOL HCL..................................................... 17PROPRANOLOL/HYDROCHLOROTHIAZID...............18PROPRANOLOL-HYDROCHLOROTHIAZID...............18PROPYLTHIOURACIL.................................................... 28PROSED-DS......................................................................32PROSHIELD FOAM & SPRAY(OTC)............................. 24

PROSIGHT(OTC)............................................................. 44PROTECT CMB2/CERAMIDE 1,3,6-11..........................23PROTRIPTYLINE HCL....................................................14PROVIMIN(OTC)............................................................. 44PROZAC............................................................................14PRUCLAIR........................................................................23PRUMYX.......................................................................... 22PRUTECT..........................................................................22PSEUDOEPHED/HYDROCODONE/CPM..................... 20PSEUDOEPHEDRINE HCL.............................................20PSEUDOEPHEDRINE/TRIPROLIDINE......................... 20PSYLLIUM HUSK........................................................... 36PSYLLIUM HUSK (WITH SUGAR)...............................36PSYLLIUM HUSK/ASPARTAME................................... 36PSYLLIUM SEED............................................................ 36PSYLLIUM SEED (WITH DEXTROSE)........................ 36PSYLLIUM SEED (WITH SUGAR)................................36PSYLLIUM SEED/ASPARTAME....................................36PULMO-AIDE.................................................................. 12PULMO-AIDE(OTC)........................................................12PULMONEB LT COMPRESSOR NEBUL(OTC)............13PULMOZYME...................................................... 38, 52, 59PUREFE OB PLUS........................................................... 46PUREFE PLUS..................................................................47PURIXAN....................................................................37, 57PV W-O CAL/IRON PS CPLX/FA................................... 47PYRAZINAMIDE............................................................. 33PYRIDOSTIGMINE BROMIDE...................................... 14PYRIDOXINE HCL.......................................................... 47PYRIMETHAMINE..........................................................33- Q -QNASL.................................................................. 11, 52, 57Q-TUSSIN DM(OTC)....................................................... 20Q-TUSSIN(OTC)...............................................................20QUAKE..............................................................................12QUARTETTE.................................................................... 19QUETIAPINE FUMARATE............................................. 15QUFLORA........................................................................ 45QUICK-SET PARADIGM................................................ 25QUINAPRIL HCL.............................................................17QUINAPRIL/HYDROCHLOROTHIAZIDE.................... 17QUINAPRIL-HYDROCHLOROTHIAZIDE....................17QUINIDINE GLUCONATE..............................................16QUINIDINE SULFATE.....................................................16QUININE SULFATE.........................................................33- R -RABEPRAZOLE SODIUM........................................42, 52RADIAPLEXRX............................................................... 23RAGWITEK................................................................ 11, 59RALOXIFENE HCL............................................. 27, 52, 59RALTEGRAVIR POTASSIUM.........................................34RAMELTEON................................................................... 15RAMIPRIL........................................................................ 17RANEXA(TAB ER 12H)(1000 MG).......................... 19, 52RANEXA(TAB ER 12H)(500 MG)............................ 19, 52RANITIDINE HCL........................................................... 42RANITIDINE HCL(OTC).................................................42RANOLAZINE..................................................................19RAPAMUNE..................................................................... 31RASAGILINE MESYLATE..............................................40RASUVO(AUTO INJECT)(10MG/0.2ML).......... 35, 52, 57RASUVO(AUTO INJECT)(12.5/0.25)................. 35, 52, 57RASUVO(AUTO INJECT)(15MG/0.3ML).......... 35, 52, 57RASUVO(AUTO INJECT)(17.5/0.35)................. 35, 52, 57RASUVO(AUTO INJECT)(20MG/0.4ML).......... 35, 52, 57RASUVO(AUTO INJECT)(22.5/0.45)................. 35, 52, 57RASUVO(AUTO INJECT)(25MG/0.5ML).......... 35, 52, 57RASUVO(AUTO INJECT)(27.5/0.55)................. 35, 52, 57RASUVO(AUTO INJECT)(30MG/0.6ML).......... 35, 52, 57RASUVO(AUTO INJECT)(7.5MG/0.15)............. 35, 52, 57RAVICTI......................................................................36, 59REBETOL......................................................................... 34REBIF REBIDOSE(PEN INJCTR)(22MCG/.5ML)...... 38,52, 60REBIF REBIDOSE(PEN INJCTR)(44MCG/.5ML)...... 38,52, 60REBIF REBIDOSE(PEN INJCTR)(8.8-22(6))...... 38, 52,60REBIF(SYRINGE)(22MCG/.5ML)...................... 38, 52, 60REBIF(SYRINGE)(44MCG/.5ML)...................... 38, 52, 60REBIF(SYRINGE)(8.8-22(6)).............................. 38, 52, 60REFRESH LACRI-LUBE(OTC).......................................29REFRESH P.M.(OTC).......................................................29REGENECARE.................................................................23REGORAFENIB............................................................... 37REGRANEX......................................................................26REGULOID(OTC)............................................................ 36RELIAMED MINI LANCING DEVICE(OTC)............... 26REMERON........................................................................14REMODULIN............................................................. 18, 60RENAGEL.........................................................................27RENA-VITE RX................................................................47

VNSNY Page 70 of 73

Index

RENO CAPS..................................................................... 47RENVELA.........................................................................27REPAGLINIDE................................................................. 24REPAGLINIDE/METFORMIN HCL............................... 25REPAGLINIDE-METFORMIN HCL............................... 25RESCRIPTOR................................................................... 34RESERPINE...................................................................... 17RESTASIS................................................................... 28, 52RESTORE SKIN CLEANSER(OTC)............................... 24RESTORE SKIN CONDITIONING(OTC)...................... 22RESTORE WOUND CLEANSER(OTC)......................... 24RESTORIL........................................................................ 16REVATIO.....................................................................18, 60REVEL PROGRAMMABLE PUMP................................26REVITADERM(OTC)....................................................... 20REVLIMID............................................................37, 52, 60REYATAZ..........................................................................34RIBASPHERE................................................................... 34RIBAVIRIN................................................................. 33, 34RIFABUTIN...................................................................... 33RIFAMATE........................................................................33RIFAMPIN........................................................................ 33RIFAMPIN/ISONIAZID................................................... 33RIFAPENTINE..................................................................33RIFAXIMIN...................................................................... 33RIGHTEST GD500(OTC).................................................26RILPIVIRINE HCL...........................................................34RIMANTADINE HCL...................................................... 33RINGERS IRRIGATION.................................................. 23RINGERS SOLUTION..................................................... 23RIOCIGUAT......................................................................18RIOMET............................................................................ 25RISANOID PLUS(OTC)...................................................43RISPERDAL CONSTA..................................................... 15RISPERDAL(SOLUTION)......................................... 15, 52RISPERDAL(TAB)..................................................... 15, 52RISPERIDONE................................................................. 15RISPERIDONE MICROSPHERES.................................. 15RITALIN LA......................................................... 16, 48, 52RITEFLO...........................................................................12RITONAVIR...................................................................... 34RIVAROXABAN...............................................................30RIVASTIGMINE......................................................... 14, 52RIVASTIGMINE TARTRATE.......................................... 14RIZATRIPTAN............................................................39, 52RIZATRIPTAN BENZOATE............................................ 39R-NATAL OB.................................................................... 45ROFLUMILAST............................................................... 12ROPINIROLE HCL...........................................................40ROSUVASTATIN CALCIUM...........................................18ROTIGOTINE....................................................................40ROZEREM............................................................ 15, 52, 57RUCONEST................................................................ 35, 60RUFINAMIDE.................................................................. 41RUXOLITINIB PHOSPHATE.......................................... 37- S -SABRIL....................................................................... 41, 52SACROSIDASE................................................................ 41SAFYRAL................................................................... 19, 57SAIZEN....................................................................... 27, 60SALICYLIC ACID............................................................23SALICYLIC ACID/CERAMIDE CMB #1.......................23SALSALATE.....................................................................38SAMI THE SEAL..............................................................13SANDIMMUNE................................................................31SAPHRIS...............................................................15, 52, 57SAQUINAVIR MESYLATE............................................. 34SARAFEM........................................................................ 14SARGRAMOSTIM........................................................... 30SAVELLA..........................................................................38SCALACORT DK............................................................. 21SEA-CLENS(OTC)........................................................... 23SECOBARBITAL SODIUM.............................................15SECONAL SODIUM........................................................ 15SECUKINUMAB.............................................................. 24SECURA PROTECTIVE(OTC)........................................22SELECT-OB................................................................ 46, 47SELEGILINE.................................................................... 15SELEGILINE HCL........................................................... 40SELENIUM SULFIDE......................................................22SELZENTRY.....................................................................34SE-NATAL 19....................................................................46SENNA(OTC)....................................................................36SENNOSIDES...................................................................36SENSI-CARE(OTC)..........................................................22SENSITIVE SKIN MOISTURE(OTC).............................22SEROQUEL.................................................................15, 52SEROQUEL XR.................................................... 15, 52, 57SEROSTIM..................................................................27, 60SERTRALINE HCL.......................................................... 14SE-TAN DHA....................................................................45SE-TAN PLUS...................................................................44

SEVELAMER CARBONATE.......................................... 27SEVELAMER HCL.......................................................... 27SIDEROL(OTC)................................................................ 44SIDESTREAM.................................................................. 13SIDESTREAM NEBULIZER........................................... 13SIDESTREAM PEDIATRIC(OTC).................................. 12SIDESTREAM PLUS....................................................... 13SILDENAFIL.............................................................. 18, 60SILDENAFIL CITRATE...................................................18SILENOR.............................................................. 16, 52, 57SILICONE DISC(OTC).................................................... 22SILICONE MASK.............................................................12SILICONE MASK(OTC).................................................. 12SILICONE ROLL(OTC)................................................... 23SILICONE SCAR(OTC)................................................... 22SILICONE SHEET(OTC)................................................. 23SILICONE TAPE(OTC).................................................... 23SILICONES/ADHESIVE TAPE................................. 22, 23SILVASORB(OTC)............................................................21SILVER..............................................................................21SILVER CHLORIDE........................................................ 21SILVER GEL(OTC).......................................................... 21SILVER NITRATE............................................................ 21SILVER NITRATE APPLICATOR...................................23SILVER SULFADIAZINE................................................ 21SILVER/SODIUM ALGINATE........................................ 21SILVERMED(OTC).......................................................... 21SIMBRINZA..................................................................... 29SIMCOR(TBMP 24HR)(1000-20MG)................. 18, 52, 57SIMCOR(TBMP 24HR)(1000-40 MG)................ 18, 52, 57SIMCOR(TBMP 24HR)(500MG-20MG)............. 18, 52, 57SIMCOR(TBMP 24HR)(500MG-40MG)............. 18, 52, 57SIMCOR(TBMP 24HR)(750MG-20MG)............. 18, 52, 57SIMPONI...............................................................35, 52, 60SIMVASTATIN..................................................................18SIMVASTATIN(TAB)(10 MG)......................................... 18SIMVASTATIN(TAB)(20 MG)......................................... 18SIMVASTATIN(TAB)(40 MG)......................................... 18SIMVASTATIN(TAB)(5 MG)........................................... 18SIMVASTATIN(TAB)(80 MG)................................... 18, 57SINGLE USE SWAB(OTC)..............................................22SIROLIMUS......................................................................31SIRTURO.....................................................................33, 60SITAGLIPTIN PHOS/METFORMIN HCL...................... 24SITAGLIPTIN PHOSPHATE............................................24SIVEXTRO..................................................................32, 60SKIN CLEANSER............................................................ 24SKIN CLEANSER COMB NO.20....................................24SKIN CLEANSER COMB NO.21....................................24SKIN CLEANSER COMB NO.34....................................24SMARTDIABETES VANTAGE(OTC).............................26SOAP................................................................................. 23SOD/POT/K CIT/SOD CIT/CIT ACID.............................42SODIUM BICARBONATE...............................................42SODIUM BICARBONATE(OTC).................................... 42SODIUM CHLORIDE.......................................... 23, 27, 29SODIUM CHLORIDE 0.45 %.......................................... 27SODIUM CHLORIDE IRRIG SOLUTION..................... 23SODIUM CHLORIDE(OTC)............................................29SODIUM CHLORIDE/NAHCO3/KCL/PEG................... 36SODIUM CITRATE.................................................... 22, 30SODIUM CITRATE & CITRIC ACID............................. 42SODIUM FLUORIDE.......................................................43SODIUM FLUORIDE/POTASSIUM NIT........................43SODIUM POLYSTYRENE SULFONATE.......................27SODIUM SULFACETAMIDE.......................................... 22SODIUM THIOSULFATE/SAL ACID.............................21SOFOSBUVIR.................................................................. 34SOFTCLIX(OTC)..............................................................26SOLIFENACIN SUCCINATE...........................................42SOLTAMOX...................................................................... 38SOLUS V2 LANCING DEVICE(OTC)............................26SOMATROPIN..................................................................27SONATA...................................................................... 16, 52SONIDEGIB PHOSPHATE.............................................. 37SOOTHE & COOL PERINEAL WASH(OTC).................22SORAFENIB TOSYLATE................................................37SORBITOL........................................................................23SORBITOL SOLUTION...................................................23SORBITOL-MANNITOL................................................. 23SOTALOL..........................................................................17SOTALOL HCL.................................................................17SOVALDI.................................................................... 34, 60SPECTRAVITE CARDIO HEALTH(OTC)......................45SPECTRAVITE MEN'S(OTC)..........................................44SPECTRAVITE SENIOR(OTC)....................................... 43SPECTRAVITE ULTRA WOMEN'S(OTC)..................... 45SPIRIVA RESPIMAT.................................................. 12, 52SPIROMETERS AND ACCESSORIES........................... 13SPIRONOLACT/HYDROCHLOROTHIAZID.................18SPIRONOLACTONE........................................................18SPIRONOLACTONE-HCTZ............................................ 18

SPORANOX......................................................................32SPRINTEC........................................................................ 20SPRYCEL(TAB)(100 MG)....................................37, 52, 60SPRYCEL(TAB)(140 MG)....................................37, 52, 60SPRYCEL(TAB)(20 MG)......................................37, 52, 60SPRYCEL(TAB)(50 MG)......................................37, 52, 60SPRYCEL(TAB)(70 MG)......................................37, 52, 60SPRYCEL(TAB)(80 MG)......................................37, 52, 60SSKI...................................................................................28STANNOUS FLUORIDE..................................................43STAVUDINE..................................................................... 34STAVUDINE(CAP).....................................................34, 52STAVUDINE(SOLN RECON)....................................34, 52STERILE TALC................................................................ 38STIOLTO RESPIMAT.................................................12, 52STIVARGA............................................................37, 52, 60STRATTERA(CAP)(10 MG)...................................... 16, 52STRATTERA(CAP)(100 MG).................................... 16, 52STRATTERA(CAP)(18 MG)...................................... 16, 52STRATTERA(CAP)(25 MG)...................................... 16, 52STRATTERA(CAP)(40 MG)...................................... 16, 52STRATTERA(CAP)(60 MG)...................................... 16, 52STRATTERA(CAP)(80 MG)...................................... 16, 52STRESS FORMULA ENERGY(OTC).............................45STRESS FORMULA WITH IRON(OTC)........................ 44STRESS FORMULA WITH ZINC(OTC)........................ 44STRESS FORMULA(OTC)........................................ 44, 47STRIBILD................................................................... 34, 52STRIVERDI RESPIMAT............................................ 12, 52STRONG IODINE.............................................................28STROVITE FORTE...........................................................44SUBCUTANEOUS INSULIN PUMP...............................26SUBOXONE(FILM)(12 MG-3 MG).....................40, 52, 60SUBOXONE(FILM)(2 MG-0.5MG).....................40, 52, 60SUBOXONE(FILM)(4MG-1MG).........................40, 52, 60SUBOXONE(FILM)(8 MG-2 MG).......................40, 52, 60SUB-Q INSULIN DEVICE, 20 UNIT.............................. 26SUB-Q INSULIN DEVICE, 30 UNIT.............................. 26SUB-Q INSULIN DEVICE, 40 UNIT.............................. 26SUCRAID..............................................................41, 52, 60SUCRALFATE.................................................................. 42SUDOGEST(TAB ER)(OTC)............................................20SUDOGEST(TAB)(30 MG)(OTC)....................................20SUDOGEST(TAB)(60 MG)(OTC)....................................20SULCONAZOLE NITRATE.............................................21SULFACETAMIDE SODIUM.................................... 22, 28SULFACETAMIDE/PREDNISOLONE SP...................... 28SULFACETAMIDE-PREDNISOLONE........................... 28SULFACETM NA/PREDNISOL AC................................28SULFADIAZINE...............................................................35SULFAMETHOXAZOLE/TRIMETHOPRIM................. 31SULFAMETHOXAZOLE-TRIMETHOPRIM................. 31SULFANILAMIDE........................................................... 43SULFASALAZINE........................................................... 36SULINDAC....................................................................... 35SUMATRIPTAN..........................................................39, 52SUMATRIPTAN SUCCINATE.........................................40SUMATRIPTAN SUCCINATE(CARTRIDGE)..........40, 52SUMATRIPTAN SUCCINATE(PEN INJCTR).......... 40, 52SUMATRIPTAN SUCCINATE(TAB).........................40, 52SUMATRIPTAN SUCCINATE(VIAL).......................40, 52SUNITINIB MALATE...................................................... 37SUNRISE COMPRESSOR-NEBULIZER........................12SUNVITE(OTC)................................................................45SUPRAX............................................................................32SURE COMFORT ALCOHOL(OTC).............................. 22SURE COMFORT LANCING PEN(OTC).......................26SUREFLEX(OTC).............................................................26SURE-PEN(OTC)..............................................................26SURE-PREP ALCOHOL PREP PADS(OTC).................. 22SURE-T PARADIGM....................................................... 25SURMONTIL.................................................................... 14SUSTIVA........................................................................... 34SUTENT................................................................ 37, 52, 60SUVOREXANT................................................................ 16SYLATRON.................................................................37, 52SYMBYAX..................................................................16, 52SYMLINPEN 120............................................................. 24SYMLINPEN 60............................................................... 24SYNAGIS.................................................................... 33, 60SYNJARDY...........................................................25, 52, 57SYNRIBO....................................................................37, 60- T -TAB-A-VITE WITH IRON(OTC).................................... 44TAB-A-VITE(OTC)...........................................................44TACROLIMUS................................................ 24, 31, 48, 57TADALAFIL..................................................................... 18TAFINLAR..................................................................37, 60TALC................................................................................. 38TAMIFLU(CAP)(30 MG)........................................... 33, 52TAMIFLU(CAP)(45 MG)........................................... 33, 53TAMIFLU(CAP)(75 MG)........................................... 33, 53

VNSNY Page 71 of 73

Index

TAMIFLU(SUSP RECON)......................................... 33, 53TAMOXIFEN CITRATE...................................................38TAMSULOSIN HCL.........................................................42TANZEUM............................................................ 24, 53, 57TAPENTADOL HCL.........................................................39TARCEVA............................................................. 37, 53, 60TARGRETIN............................................................... 23, 60TARON FORTE.................................................................43TARON-BC....................................................................... 46TARON-C DHA................................................................ 46TARON-PREX PRENATAL..............................................46TASIGNA.............................................................. 37, 53, 60TASIMELTEON................................................................ 15TAZAROTENE..................................................................24TAZORAC.........................................................................24TBO-FILGRASTIM.......................................................... 30TEARS NATURALE FORTE(OTC).................................29TECFIDERA......................................................... 38, 53, 60TEDIZOLID PHOSPHATE...............................................32TEDUGLUTIDE............................................................... 36TEGRETOL XR................................................................ 40TELITHROMYCIN...........................................................32TELMISARTAN................................................................17TEMAZEPAM...................................................................16TEMOZOLOMIDE..................................................... 37, 60TENOFOVIR DISOPROXIL FUMARATE......................34TERAZOSIN HCL............................................................ 17TERBINAFINE HCL.................................................. 21, 32TERBUTALINE SULFATE.............................................. 12TERCONAZOLE.............................................................. 43TERIFLUNOMIDE...........................................................38TERIPARATIDE............................................................... 27TESTOSTERONE............................................................. 31TESTOSTERONE CYPIONATE.......................... 31, 53, 60TESTOSTERONE ENANTHATE........................ 31, 53, 60TESTOSTERONE(GEL MD PMP)...................... 31, 53, 60TESTOSTERONE(GEL).......................................31, 53, 60TETRABENAZINE.....................................................38, 60TETRACAINE HCL......................................................... 28TETRACAINE HCL/PF....................................................28TETRACYCLINE HCL.................................................... 32TEXACORT...................................................................... 22THALIDOMIDE............................................................... 33THALOMID.......................................................... 33, 53, 60THEO-24........................................................................... 13THEOPHYLLINE ANHYDROUS................................... 13THERA(OTC)................................................................... 44THERA-M(OTC)...............................................................44THERAPEUTIC M(OTC).................................................45THERATRUM COMPLETE(OTC).................................. 44THEREMS-M(OTC)......................................................... 45THIAMINE HCL...............................................................47THIAMINE MONONITRATE..........................................47THIORIDAZINE HCL...................................................... 15THIOTHIXENE.................................................................15THRESHOLD IMT........................................................... 13THRESHOLD PEP............................................................13THROMBIN (BOVINE)....................................................30THROMBIN-JMI.............................................................. 30THYROID,PORK..............................................................28TIAGABINE HCL.................................................41, 53, 57TICAGRELOR.................................................................. 30TICLOPIDINE HCL......................................................... 30TIKOSYN..........................................................................16TIMOLOL......................................................................... 29TIMOLOL MALEATE................................................17, 29TINIDAZOLE................................................................... 33TIOTROPIUM BR/OLODATEROL HCL........................ 12TIOTROPIUM BROMIDE................................................12TIPRANAVIR....................................................................33TIPRANAVIR/VITAMIN E TPGS................................... 33TIVICAY........................................................................... 34TIZANIDINE HCL........................................................... 41TL G-FOL OS....................................................................43TL TRISEB........................................................................22TL-CARE DHA.................................................................46TL-HEM 150..................................................................... 44TOBI PODHALER................................................33, 53, 60TOBRADEX......................................................................28TOBRAMYCIN.............................................. 28, 33, 53, 60TOBRAMYCIN IN 0.225% NACL.................................. 33TOBRAMYCIN/DEXAMETHASONE............................28TOBRAMYCIN/LOTEPRED ETAB................................ 28TOBRAMYCIN-DEXAMETHASONE........................... 28TOBREX........................................................................... 28TOCILIZUMAB................................................................35TOFACITINIB CITRATE................................................. 35TOFRANIL-PM................................................................ 14TOLAZAMIDE................................................................. 24TOLBUTAMIDE...............................................................24TOLMETIN SODIUM...................................................... 35TOLNAFTATE.................................................................. 21

TOLNAFTATE(OTC)........................................................21TOLTERODINE TARTRATE..................................... 43, 57TOPAMAX........................................................................ 41TOPIRAMATE.................................................................. 41TOREMIFENE CITRATE.................................................38TORSEMIDE.................................................................... 18TOUJEO SOLOSTAR................................................. 26, 53TOVIAZ.......................................................................43, 57TRACLEER.................................................................18, 60TRADJENTA...............................................................24, 53TRAMADOL HCL............................................................39TRAMADOL HCL/ACETAMINOPHEN.........................39TRAMADOL HCL-ACETAMINOPHEN........................ 39TRAMETINIB DIMETHYL SULFOXIDE......................37TRANDOLAPRIL.............................................................17TRANDOLAPRIL/VERAPAMIL HCL............................16TRANDOLAPRIL-VERAPAMIL ER.............................. 16TRANEXAMIC ACID...................................................... 29TRANXENE T-TAB..........................................................15TRANYLCYPROMINE SULFATE..................................14TRAVATAN Z..............................................................29, 53TRAVOPROST............................................................29, 53TRAVOPROST (BENZALKONIUM).............................. 29TRAZODONE HCL..........................................................14TRECATOR.......................................................................33TREK S COMBO PACK...................................................13TREK S COMPACT COMPRESSOR.............................. 13TREPROSTINIL............................................................... 18TREPROSTINIL DIOLAMINE........................................18TREPROSTINIL SODIUM...............................................18TREPROSTINIL/NEB ACCESSORIES...........................18TREPROSTINIL/NEBULIZER/ACCESOR.....................18TREXALL......................................................................... 37TRIAMCINOLONE ACETONIDE............................ 22, 38TRIAMTERENE/HYDROCHLOROTHIAZID................18TRIAMTERENE-HYDROCHLOROTHIAZID............... 18TRIAZOLAM....................................................................16TRI-BUFFERED ASPIRIN(OTC).................................... 38TRIFLUOPERAZINE HCL.............................................. 15TRIFLURIDINE................................................................28TRIFLURIDINE/TIPIRACIL HCL.................................. 37TRIGELS-F FORTE..........................................................44TRIGLIDE...................................................................19, 57TRIHEXYPHENIDYL HCL............................................. 40TRILEPTAL...................................................................... 41TRIMETHOBENZAMIDE HCL...................................... 11TRIMETHOPRIM.............................................................32TRIMIPRAMINE MALEATE.......................................... 14TRINATE...........................................................................46TRIPLE ANTIBIOTIC PLUS(OTC).................................21TRIPLE DYE.....................................................................21TRIPLE HELIX COLLAGEN(OTC)................................24TRI-TABS DHA................................................................ 45TRIUMEQ................................................................... 34, 53TRIVEEN-DUO DHA.......................................................46TRIVEEN-ONE.................................................................46TRI-VI-FLORO................................................................. 45TRI-VI-SOL(OTC)............................................................45TRI-VIT WITH FLUORIDE-IRON..................................45TRI-VITAMIN WITH FLUORIDE.................................. 45TRI-VITAMIN(OTC)........................................................ 45TROKENDI XR(CAP ER 24H)(100 MG)............41, 53, 57TROKENDI XR(CAP ER 24H)(200 MG)............41, 53, 57TROKENDI XR(CAP ER 24H)(25 MG)..............41, 53, 57TROKENDI XR(CAP ER 24H)(50 MG)..............41, 53, 57TROPICAMIDE................................................................ 29TRUE METRIX BLOOD GLUCOSE MTR(OTC).......... 25TRUE METRIX GLUCOSE TEST STRIP(OTC)............ 25TRUE2GO BLOOD GLUCOSE SYSTEM(OTC)............25TRUEDRAW(OTC)...........................................................26TRUEPLUS MULTIVITAMIN(OTC).............................. 44TRUERESULT BLOOD GLUCOSE SYSTM(OTC)....... 25TRUETEST TEST STRIPS(OTC).................................... 25TRUETRACK SMART SYSTEM(OTC)..........................25TRUETRACK TEST STRIP(OTC)...................................25TRULICITY.......................................................... 24, 53, 57TRUVADA...................................................................33, 53TRUZONE PEAK FLOW METER...................................13TRYPSIN/BALSAM PERU/CASTOR OIL......................24TYBOST......................................................................34, 60TYKERB..................................................................... 37, 60TYR COOLER(OTC)........................................................44TYVASO......................................................................18, 60- U -U-CORT.............................................................................22ULIPRISTAL ACETATE...................................................20ULORIC...................................................................... 29, 53ULTI-LANCE(OTC)......................................................... 26ULTILET ALCOHOL SWAB(OTC).................................22ULTIMATECARE ONE....................................................46ULTIMATECARE ONE NF..............................................46ULTRA-FRESH(OTC)...................................................... 22

UMECLIDINIUM BRM/VILANTEROL TR...................12UMECLIDINIUM BROMIDE..........................................12UNISTIK 2 EXTRA(OTC)............................................... 26UNISTIK 2 NORMAL...................................................... 26UNISTIK 2 NORMAL(OTC)........................................... 26UNISTIK 2(OTC)..............................................................26UNISTIK 3 COMFORT(OTC)..........................................26UNISTIK 3 NEONATAL(OTC)........................................ 26UNISTIK 3(OTC)..............................................................26UREA................................................................................ 23UREA/HYALURONATE SODIUM..................................23UREA/LACTIC AC/ZN UNDECYLENATE....................23UREA/LACTIC ACID/SALICYLIC AC.......................... 23URETRON D-S................................................................. 32URIN D.S.......................................................................... 32URINE GLUC-ACET COMB.TST,STRIP................. 26, 27URINE GLUCOSE TEST,STRIP..................................... 26URINE GLUCOSE TEST,TABLET................................. 26UROGESIC-BLUE............................................................32URO-MP............................................................................32URSODIOL....................................................................... 36USTELL............................................................................ 32- V -VAGIFEM..........................................................................43VALACYCLOVIR.............................................................33VALACYCLOVIR HCL....................................................33VALCHLOR................................................................ 23, 60VALGANCICLOVIR HCL............................................... 33VALPROIC ACID............................................................. 41VALPROIC ACID (AS SODIUM SALT)......................... 41VALSARTAN.................................................................... 17VALSARTAN/HYDROCHLOROTHIAZIDE.................. 17VALSARTAN-HYDROCHLOROTHIAZIDE.................. 17VANCOMYCIN HCL................................................. 33, 53VANDETANIB.................................................................. 37VAPORIZER..................................................................... 13VAPORIZER CLEANING TABLETS(OTC)................... 13VAPORIZER INHALANT(OTC)..................................... 13VAPORIZER(OTC)...........................................................13VAPORIZER-HUMIDIFIER SUPPLY............................. 13VARENICLINE TARTRATE............................................ 41VASCEPA.................................................................... 19, 53V-C FORTE....................................................................... 44VEMURAFENIB.............................................................. 37VENATAL COMPLETE DHA..........................................46VENLAFAXINE HCL...................................................... 14VENLAFAXINE HCL ER................................................ 14VENTAVIS.................................................................. 18, 60VENTOLIN HFA.............................................................. 11VERAPAMIL ER.............................................................. 18VERAPAMIL HCL........................................................... 18VERSACLOZ........................................................15, 53, 58VESICARE..................................................................42, 58VGO 20..............................................................................26VGO 30..............................................................................26VGO 40..............................................................................26VIBRAMYCIN..................................................................32VICKS WARM STEAM VAPORIZER(OTC)..................13VIDEX.........................................................................34, 53VIGABATRIN................................................................... 41VIGAMOX........................................................................ 28VIIBRYD...............................................................14, 53, 58VILAZODONE HYDROCHLORIDE.............................. 14VIMPAT(SOLUTION).......................................... 40, 53, 58VIMPAT(TAB)...................................................... 41, 53, 58VINACAL..........................................................................45VINATE CARE................................................................. 46VINATE DHA................................................................... 46VINATE DHA RF............................................................. 46VINATE II......................................................................... 46VINATE ONE....................................................................46VINATE PN CARE........................................................... 46VINATE-M........................................................................ 46VIOS AEROSOL DELIVERY SYSTEM......................... 13VIRACEPT........................................................................34VIRAZOLE....................................................................... 33VIREAD(POWDER)...................................................34, 53VIREAD(TAB)............................................................34, 53VIRT-ADVANCE.............................................................. 46VIRT-PN PLUS................................................................. 46VIRTPREX........................................................................ 46VIRT-VITE GT..................................................................46VIRT-VITE PLUS............................................................. 47VISION-VITE + ZINC(OTC)........................................... 43VISMODEGIB.................................................................. 37VISTARIL......................................................................... 11VIT 3..................................................................................45VIT A PALMITATE/VIT C/VIT D3................................. 45VIT A,C & E/LUTEIN/MINERALS................................ 43VIT A/VIT C/VIT E/ZINC/COPPER......................... 43, 45VIT B CMPLX 3/FA/VIT C/BIOTIN............................... 47VIT B CMPLX NO3/FA/C/BIOT/ZINC........................... 47

VNSNY Page 72 of 73

Index

VIT B COMP/C/FA/IRON SULF/VITE........................... 44VIT B COMP/C/FA/IRON/VIT E..................................... 44VIT B COMPLEX 100 CMB #2/HERBS......................... 47VIT B COMPLEX 100 CMB #3/HERBS......................... 47VIT B CPLX #11/FA/C/BIOT/ZN OX..............................47VIT E/LIDOCAIN/ALO VER/COLAGN.........................23VITAFOL...........................................................................43VITAFOL NANO.............................................................. 46VITAFOL-OB+DHA.........................................................46VITAL-D RX.....................................................................47VITAMIN A...................................................................... 47VITAMIN A PALMITATE................................................ 47VITAMIN A(OTC)............................................................ 47VITAMIN AND MINERALS(OTC).................................44VITAMIN B COMPLEX...................................................47VITAMIN B COMPLEX(CAP)(OTC)..............................47VITAMIN B COMPLEX(TAB)(OTC)..............................47VITAMIN B COMPLEX/MINERALS............................. 47VITAMIN B-1(OTC).........................................................47VITAMIN B-6(OTC).........................................................47VITAMIN B-COMPLEX WITH VIT C(CAP)(OTC).......44VITAMIN B-COMPLEX WITH VIT C(OTC)................. 47VITAMIN B-COMPLEX WITH VIT C(TAB)(OTC).......44VITAMIN C(OTC)............................................................ 47VITAMIN D(OTC)...................................................... 47, 48VITAMIN D2.................................................................... 47VITAMIN D3(OTC).................................................... 47, 48VITAMIN E.......................................................................23VITAMIN E(OTC)............................................................ 23VITAMIN E/ALOE VERA............................................... 23VITAMIN K1.................................................................... 30VITAMINS B1,B2,B3,B5,& B6........................................47VITASPIRE....................................................................... 45VITB&C/IRON FUM/FA/VIT E/AA#16..........................45VITE AC/GRAPE/HYALURONIC ACID........................ 23VITEKTA.................................................................... 34, 53VIVITROL.........................................................................15VOL-PLUS........................................................................ 46VOL-TAB RX....................................................................46VOLTAREN.......................................................................22VORICONAZOLE............................................................ 32VORTEX........................................................................... 12VORTEX VHC FROG MASK.......................................... 12VORTEX VHC LADYBUG MASK................................. 12VORTIOXETINE HYDROBROMIDE............................. 14VOTRIENT............................................................37, 53, 60VP-CH PLUS.....................................................................46VP-CH-PNV...................................................................... 46VP-GGR-B6...................................................................... 47VP-HEME ONE................................................................ 45VP-PNV-DHA................................................................... 46VYVANSE.............................................................15, 53, 58- W -WAL-MUCIL(OTC).......................................................... 36WAL-PHED D(OTC).........................................................20WARFARIN SODIUM...................................................... 29WARM STEAM VAPORIZER(OTC)...............................13WATER.............................................................................. 23WATER FOR IRRIGATION,STERILE............................ 23WEBCOL(OTC)................................................................22WEED POLLEN-SHORT RAGWEED............................ 11WELCHOL........................................................................19WHITE PETROLATUM(OTC).........................................23WIDE SEAL DIAPHRAGM.............................................20WINDMILL TRAINER(OTC)..........................................13WOMEN'S COMPLEX(OTC).......................................... 44WOUND GEL(OTC).........................................................23- X -XALKORI............................................................. 37, 53, 60XARELTO(TAB DS PK).............................................30, 53XARELTO(TAB)(10 MG)...........................................30, 53XARELTO(TAB)(15 MG)...........................................30, 53XARELTO(TAB)(20 MG)...........................................30, 53XELJANZ.............................................................. 35, 53, 60XIFAXAN....................................................................33, 60XTANDI................................................................ 37, 53, 60- Z -ZAFIRLUKAST................................................................ 12ZALEPLON.......................................................................16ZARONTIN....................................................................... 40ZELBORAF...........................................................37, 53, 60ZENPEP.............................................................................41ZENZEDI.............................................................. 14, 53, 58ZETIA..........................................................................19, 53ZIAGEN.......................................................................34, 53ZIDOVUDINE...................................................................34ZIDOVUDINE(CAP).................................................. 34, 53ZIDOVUDINE(SYRUP)............................................. 34, 53ZIDOVUDINE(TAB).................................................. 34, 53ZINC ACETATE/MEADOWSWEET/OAK..................... 23ZINC SULFATE................................................................ 47ZINC SULFATE(OTC)......................................................47

ZIPRASIDONE HCL........................................................ 15ZIPRASIDONE MESYLATE........................................... 15ZIRGAN............................................................................ 28ZMAX................................................................................32ZOLMITRIPTAN.............................................................. 40ZOLPIDEM TARTRATE............................................ 16, 53ZOLPIMIST.......................................................... 16, 53, 58ZOMACTON...............................................................27, 60ZOMIG(SPRAY)(2.5 MG).................................... 40, 53, 58ZOMIG(SPRAY)(5 MG)....................................... 40, 53, 58ZONEGRAN..................................................................... 41ZONISAMIDE.................................................................. 41ZORBTIVE..................................................................27, 60ZORTRESS........................................................................31ZOVIRAX..........................................................................21ZYDELIG.................................................................... 37, 60ZYKADIA................................................................... 37, 60ZYLET...............................................................................28ZYPREXA...................................................................15, 53ZYPREXA RELPREVV................................................... 15ZYTIGA................................................................ 37, 53, 60ZZZQUIL(OTC)................................................................ 16

VNSNY Page 73 of 73

Index

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