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Page of 231 1 Drug Name Dosage Form Drug Tier Requirements/ Limits Analgesics Non-opioid Analgesics ACUFLEX TABS 2 PA ali-flex TABS 2 PA ALPAIN TABS 2 PA amigesic TABS 1 anabar TABS 2 PA asp 300/200/20 CAPS 1 by-ache CAPS 2 PA c.m.t TABS 1 cafgesic CAPS 2 PA carisoprodol compound TABS 1 carisoprodol/aspirin TABS 1 CELEBREX CAPS 2 ST choline magnesium trisalicylate LIQD 1 choline magnesium trisalicylate TABS 1 cmt TABS 1 CYMBALTA CPEP 2 DOLOGESIC CAPS 2 PA DOLOGESIC LIQD 2 PA dologesic TABS 2 PA dolorex CAPS 2 PA dolorex TABS 2 PA DURABAC CAPS 2 PA DURAXIN CAPS 2 PA ed-flex CAPS 2 PA EQUAGESIC TABS 2 PA FLEXTRA DS TABS 2 PA FLEXTRA CAPS 2 PA FLEXTRA-650 TABS 2 PA genecar TABS 2 PA genedolorex CAPS 2 PA gene-r-gesic TABS 2 PA hyflex-650 TABS 2 PA hyflex-ds TABS 2 PA LAGESIC TBCR 2 PA LEVACET TABS 2 PA myophen TBCR 2 PA NEOPROFEN SOLN 2 PA NORGESIC FORTE TABS 2 PA novagesic TABS 2 PA orphenadrine /asa /caffeine TABS 1 orphenadrine compound ds TABS 1 orphenadrine compound TABS 1 orphenadrine/asa/caff TABS 1 orphengesic forte TABS 1 orphengesic TABS 1 pentazocine /acetaminophen TABS 1 pentazocine hcl/acetaminophen TABS 1 PRIALT SOLN 2 PA

Drug Name Dosage Form Drug Requirements/ Tier Limits ...Drug Name Dosage Form Drug Tier Requirements/ Limits Analgesics Non-opioid Analgesics ACUFLEX TABS 2 PA ali-flex TABS 2 PA ALPAIN

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Page of 231 1

Drug Name Dosage Form Drug Tier

Requirements/ Limits

Analgesics Non-opioid Analgesics ACUFLEX TABS 2 PA ali-flex TABS 2 PA ALPAIN TABS 2 PA amigesic TABS 1 anabar TABS 2 PA asp 300/200/20 CAPS 1 by-ache CAPS 2 PA c.m.t TABS 1 cafgesic CAPS 2 PA carisoprodol compound TABS 1 carisoprodol/aspirin TABS 1 CELEBREX CAPS 2 ST choline magnesium trisalicylate LIQD 1 choline magnesium trisalicylate TABS 1 cmt TABS 1 CYMBALTA CPEP 2 DOLOGESIC CAPS 2 PA DOLOGESIC LIQD 2 PA dologesic TABS 2 PA dolorex CAPS 2 PA dolorex TABS 2 PA DURABAC CAPS 2 PA DURAXIN CAPS 2 PA ed-flex CAPS 2 PA EQUAGESIC TABS 2 PA FLEXTRA DS TABS 2 PA FLEXTRA CAPS 2 PA FLEXTRA-650 TABS 2 PA genecar TABS 2 PA genedolorex CAPS 2 PA gene-r-gesic TABS 2 PA hyflex-650 TABS 2 PA hyflex-ds TABS 2 PA LAGESIC TBCR 2 PA LEVACET TABS 2 PA myophen TBCR 2 PA NEOPROFEN SOLN 2 PA NORGESIC FORTE TABS 2 PA novagesic TABS 2 PA orphenadrine /asa /caffeine TABS 1 orphenadrine compound ds TABS 1 orphenadrine compound TABS 1 orphenadrine/asa/caff TABS 1 orphengesic forte TABS 1 orphengesic TABS 1 pentazocine /acetaminophen TABS 1 pentazocine hcl/acetaminophen TABS 1 PRIALT SOLN 2 PA

Page of 231 2

Drug Name Dosage Form Drug Tier

Requirements/ Limits

RELAGESIC TABS 2 PA rhinoflex TABS 2 PA rhinoflex-650 TABS 2 PA salflex TABS 1 salsalate TABS 1 SOMA COMPOUND/CODEINE TABS 1 SOMA COMPOUND TABS 1 STAFLEX TABS 2 PA tricosal TABS 1 TRILISATE TABS 2 PA Opioid Analgesics, Long-acting astramorph SOLN 2 PA AVINZA CP24 2 PA B & O 15-A SUPPRETTE SUPP 1 B & O 16-A SUPPRETTE SUPP 1 belladonna alkaloids & opium SUPP 1 DEPODUR SUSP 2 PA DOLOPHINE HCL TABS 2 PA DOLOPHINE SOLN 2 PA DOLOPHINE TABS 2 PA DURAGESIC PT72 2 PA duramorph SOLN 2 PA fentanyl PT72 1 fentanyl PT72 1 QL INFUMORPH 200 SOLN 2 PA KADIAN CP24 2 LEVO DROMORAN SOLN 2 PA LEVO-DROMORAN TABS 2 PA levorphanol tartrate TABS 1 methadone hcl CONC 1 METHADONE HCL SOLN 1 methadone hcl TABS 1 METHADONE HCL SOLN 2 PA methadose TABS 1 morphine sulfate add-vantage SOLN 1 morphine sulfate dilute-a-jet SOLN 1 PA morphine sulfate er TB12 1 MORPHINE SULFATE IN DEXTROSE 5% SOLN 2 PA morphine sulfate stick-gard SOLN 1 PA MORPHINE SULFATE/D5W SOLN 2 PA MORPHINE SULFATE/NS SOLN 1 MORPHINE SULFATE SOLN 1 morphine sulfate SOLN 1 PA morphine sulfate SUPP 1 morphine sulfate TABS 1 MORPHINE/D5W SOLN 2 PA MS CONTIN TB12 2 PA ms/l SOLN 1 ORAMORPH SR TB12 1 oxycodone hcl cr TB12 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

oxycodone hcl cr TB12 1 PA oxycodone hcl er TB12 1 oxycodone hcl er TB12 1 PA OXYCONTIN TB12 2 PA RMS SUPP 1 ROXANOL SOLN 2 PA Opioid Analgesics, Short-acting acetaminophen /hydrocodone TABS 1 acetaminophen/codeine #2 TABS 1 acetaminophen/codeine #3 TABS 1 acetaminophen/codeine #4 TABS 1 acetaminophen/codeine SOLN 1 acetaminophen/codeine TABS 1 acetaminophen/oxycodone TABS 1 acetaminophen-codeine #4 TABS 1 ACTIQ LPOP 2 PA ALCET TABS 2 PA anexsia TABS 2 PA apap/hydrocodone bitartrate TABS 1 apap/oxycodone CAPS 1 apap/oxycodone TABS 1 aspirin/codeine #3 TABS 1 aspirin/codeine TABS 1 BALACET 325 TABS 2 PA BANCAP-HC CAPS 2 PA BUPRENEX SOLN 2 PA buprenorphine hcl SOLN 1 butalbital /apap /caffeine /codeine CAPS 1 butorphanol tartrate SOLN 1 butorphanol tartrate SOLN 1 PA CAPITAL/CODEINE SUSP 2 PA carisoprodol /aspirin /codeine TABS 1 CODEINE PHOSPHATE SOLN 1 codeine sulfate TABS 2 co-gesic TABS 2 PA COMBUNOX TABS 2 PA DARVOCET A500 TABS 2 PA DARVOCET-N 100 TABS 2 PA DARVOCET-N 50 TABS 2 PA DARVON COMPOUND-65 CAPS 2 PA DARVON CAPS 2 PA DARVON-N TABS 2 PA DEMEROL SOLN 2 PA DEMEROL SYRP 2 PA DEMEROL TABS 2 PA DILAUDID TABS 2 PA DILAUDID-5 LIQD 2 PA DILAUDID-HP SOLN 2 PA DILAUDID-HP SOLR 2 PA dolacet CAPS 2 PA

Page of 231 4

Drug Name Dosage Form Drug Tier

Requirements/ Limits

dolagesic CAPS 2 PA dolorex forte CAPS 2 PA endocet TABS 1 endodan TABS 1 eth-oxydose CONC 1 FENTANYL CITRATE ORAL TRANSMUCOSAL LPOP 1 fentanyl citrate SOLN 1 FENTORA TABS 2 PA FIORICET/CODEINE CAPS 1 HYCET SOLN 2 PA hydrocet CAPS 2 PA hydrocodone /acetaminophen SOLN 1 hydrocodone /acetaminophen TABS 1 hydrocodone /acetaminophen-hs TABS 1 hydrocodone bitartrate/acetaminophen TABS 1 hydrocodone bitartrate/apap TABS 1 hydrocodone/apap TABS 1 hydrocodone/ibuprofen TABS 1 hydrocodone-acetaminophen TABS 1 hydrocodone-apap TABS 1 hydromorphone hcl TABS 1 hydromorphone hcl SOLN 2 PA LORCET 10/650 TABS 2 PA LORCET PLUS TABS 2 PA lorcet-hd CAPS 2 PA LORTAB 10 TABS 2 PA LORTAB 2.5 TABS 2 PA LORTAB 5 TABS 1 LORTAB 7.5 TABS 2 PA LORTAB ELIX 2 PA margesic-h CAPS 2 PA MAXIDONE TABS 2 PA MEPERIDINE HCL SOLN 1 meperidine hcl SYRP 1 meperidine hcl TABS 1 meperidine hcl SOLN 2 PA meperitab TABS 1 nalbuphine hcl SOLN 1 naloxone/pentazocine TABS 1 narvox TABS 2 PA NORCO TABS 2 PA NUBAIN SOLN 2 PA NUMORPHAN SOLN 2 PA NUMORPHAN SUPP 2 PA OPANA ER TB12 2 PA OPANA TABS 2 PA oxycodone hcl CAPS 1 oxycodone hcl CONC 1 oxycodone hcl SOLN 1 oxycodone hcl TABS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

oxycodone/acetaminophen CAPS 1 oxycodone/acetaminophen TABS 1 oxycodone/apap TABS 1 oxycodone/aspirin TABS 1 oxycodone-apap TABS 1 oxyfast CONC 2 PA OXYIR CAPS 2 PA PANLOR DC CAPS 2 PA PANLOR SS TABS 2 PA pentazocine /acetaminophen TABS 1 pentazocine hcl/acetaminophen TABS 1 pentazocine/naloxone hcl TABS 1 PERCOCET TABS 2 PA PERCODAN TABS 2 PA percolone TABS 1 phrenilin w/caffeine/codeine CAPS 2 PA propoxacet TABS 2 PA propoxacet-n TABS 2 PA propoxyphene /acetaminophen TABS 1 PROPOXYPHENE COMPOUND CAPS 1 propoxyphene hcl CAPS 1 PROPOXYPHENE/ASA/CAFF CAPS 1 propoxyphene-n /acetaminophen TABS 1 REPREXAIN TABS 2 ROXICET SOLN 1 PA roxicet TABS 1 PA ROXICODONE INTENSOL CONC 2 PA ROXICODONE SOLN 1 ROXICODONE TABS 1 SOMA COMPOUND/CODEINE TABS 1 STADOL SOLN 2 PA STAGESIC-10 TABS 2 PA stagesic CAPS 2 PA SUBOXONE SUBL 2 PA SUBUTEX SUBL 2 PA TALACEN TABS 2 PA TALWIN NX TABS 2 PA TALWIN SOLN 2 PA tramadol hcl TABS 1 tramadol hydrochloride/acetaminophen TABS 1 TRYCET TABS 2 PA TYLENOL/CODEINE #3 TABS 2 PA TYLENOL/CODEINE #4 TABS 2 PA TYLOX CAPS 2 PA ULTRACET TABS 2 PA ULTRAM ER TB24 2 PA ULTRAM TABS 2 PA vanacet TABS 2 PA VICODIN ES TABS 2 PA vicodin hp TABS 2 PA

Page of 231 6

Drug Name Dosage Form Drug Tier

Requirements/ Limits

VICODIN TABS 2 PA VICOPROFEN TABS 2 PA VOPAC TABS 2 PA XODOL TABS 2 PA ZYDONE TABS 2 PA Anesthetics Local Anesthetics ALCAINE SOLN 2 PA antipyrine/benzocaine SOLN 1 BICILLIN C-R SUSP 2 PA EMLA/TEGADERM KIT 2 PA EMLA CREA 2 PA lidocaine hcl GEL 1 lidocaine hcl SOLN 1 lidocaine hcl SOLN 1 PA lidocaine hcl SOLN 2 PA lidocaine/prilocaine CREA 1 lidocaine OINT 1 LIDODERM PTCH 2 PA mydral SOLN 2 PA MYDRIACYL SOLN 2 PA parcaine SOLN 2 PA PENICILLIN G PROCAINE SUSP 1 phenazopyridine hcl TABS 1 proparacaine hcl SOLN 1 proparacaine hcl SOLN 2 PA TROLAMINE LIQD 2 PA tropicacyl SOLN 2 PA tropicamide SOLN 1 TYMPAGESIC DROPS SOLN 2 PA uni-otic LIQD 2 PA XYLOCAINE JELLY GEL 2 PA XYLOCAINE VISCOUS SOLN 2 PA XYLOCAINE SOLN 2 PA Antibacterials Amino Derivative Penicillins amoclan SUSR 2 PA amoxicillin/clavulanate potassium CHEW 1 amoxicillin/clavulanate potassium SUSR 1 amoxicillin/clavulanate potassium TABS 1 amoxicillin/potassium clavulanate CHEW 1 amoxicillin/potassium clavulanate SUSR 1 amoxicillin/potassium clavulanate TABS 1 amoxicillin CAPS 1 amoxicillin CHEW 1 amoxicillin SUSR 1 amoxicillin TABS 1 amoxil CAPS 2 PA AMOXIL CHEW 2 PA amoxil SUSR 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

AMOXIL TABS 2 PA ampicillin sodium SOLR 1 PA ampicillin CAPS 1 ampicillin SUSR 1 ampicillin-sulbactam SOLR 2 PA AUGMENTIN ES-600 SUSR 2 PA AUGMENTIN XR TB12 2 PA AUGMENTIN CHEW 2 PA AUGMENTIN SUSR 2 PA AUGMENTIN TABS 2 PA DISPERMOX TBSO 2 PA PREVPAC MISC 2 PA trimox CAPS 1 trimox SUSR 1 UNASYN ADD-VANTAGE SOLR 2 PA UNASYN BULK PACK SOLR 2 PA UNASYN PIGGYBACK UNIT SOLR 2 PA UNASYN SOLR 2 PA Aminoglycosides amikacin sulfate SOLN 1 AMIKIN SOLN 2 PA aurobiotic-hc SOLN 2 PA COLY-MYCIN S SUSP 2 PA COLY-MYCIN-S SUSP 2 PA CORTISPORIN CREA 2 PA CORTISPORIN OINT 2 PA CORTISPORIN SOLN 2 PA CORTISPORIN SUSP 2 PA CORTISPORIN-TC SUSP 2 PA cortomycin SOLN 1 cortomycin SUSP 1 dexasporin SUSP 2 PA GARAMYCIN SOLN 2 PA genoptic SOLN 2 PA gentacidin SOLN 2 PA gentak OINT 1 gentak SOLN 1 GENTAMICIN SULFATE/0.9% SODIUM CHLORIDE SOLN 1 gentamicin sulfate/0.9% sodium chloride SOLN 2 PA gentamicin sulfate/sodium chloride SOLN 2 PA gentamicin sulfate CREA 1 gentamicin sulfate OINT 1 gentamicin sulfate SOLN 1 gentamicin sulfate SOLN 1 PA gentamicin sulfate SOLN 2 PA HUMATIN CAPS 2 PA isotonic gentamicin SOLN 1 KANAMYCIN SULFATE SOLN 1 MAXITROL OINT 2 PA MAXITROL SUSP 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

NEBCIN MDV SOLN 2 PA NEBCIN SOLN 2 PA NEBCIN SOLR 2 PA neo/polymyxin/hc 5-10000-1 SUSP 1 NEO-FRADIN SOLN 2 PA neomycin /bacitracin /polymyxin /hydrocortisone OINT 1 neomycin /polymyxin /dexamethasone OINT 1 neomycin /polymyxin /dexamethasone SUSP 1 neomycin /polymyxin /gramicidin SOLN 1 neomycin /polymyxin /hydrocortisone SOLN 1 neomycin /polymyxin /hydrocortisone SUSP 1 neomycin sulfate TABS 1 neomycin/bacitracin zn/polymyx OINT 1 neomycin/polymyxin b/gramicidin SOLN 1 neomycin/polymyxin/hc SOLN 1 ocutricin SOLN 1 oticin hc SUSP 2 PA otimar SOLN 2 PA otimar SUSP 2 PA paromomycin sulfate CAPS 1 PEDIOTIC SUSP 2 PA poly-dex OINT 2 PA polymyxin /gramicidin /neomycin SOLN 1 POLY-PRED SUSP 2 PA PRED-G S.O.P. OINT 2 PA PRED-G SUSP 2 PA STREPTOMYCIN SULFATE SOLR 1 TOBI NEBU 2 PA TOBRADEX OINT 2 TOBRADEX SUSP 2 TOBRAMYCIN SULFATE ADD-VANTAGE SOLN 2 PA tobramycin sulfate fliptop SOLN 2 PA TOBRAMYCIN SULFATE/SODIUM CHLORIDE SOLN 1 tobramycin sulfate SOLN 1 tobramycin sulfate SOLN 1 PA tobramycin sulfate SOLN 2 PA tobramycin sulfate SOLR 2 PA tobrasol SOLN 2 PA TOBREX OINT 2 PA TOBREX SOLN 2 PA triple antibiotic OINT 1 triple antibiotic SOLN 1 ZYLET SUSP 2 PA Antifolate Antibacterials BACTRIM DS TABS 2 PA BACTRIM TABS 2 PA PRIMSOL SOLN 2 PA PROLOPRIM TABS 2 PA SEPTRA DS TABS 2 PA SEPTRA TABS 2 PA

Page of 231 9

Drug Name Dosage Form Drug Tier

Requirements/ Limits

smz-tmp ds TABS 1 sulfamethoxazole /trimethoprim SUSP 1 sulfatrim SUSP 1 trimethoprim TABS 1 Beta-lactam, Other AZACTAM IN DEXTROSE SOLN 2 PA AZACTAM SOLR 2 PA cefoxitin sodium SOLR 1 cefoxitin sodium SOLR 2 PA CEFOXITIN SOLR 1 INVANZ SOLR 2 PA LORABID CAPS 2 LORABID CAPS 2 PA LORABID SUSR 2 MEFOXIN ADD-VANTAGE SOLR 2 PA MEFOXIN IN DEXTROSE 2.2% SOLN 2 PA MEFOXIN IN DEXTROSE 3.9% SOLN 2 PA MEFOXIN SOLR 2 PA MERREM SOLR 2 PA PRIMAXIN I.M. SOLR 2 PA PRIMAXIN IV ADD-VANTAGE SOLR 2 PA PRIMAXIN IV SOLR 2 PA Cephalosporin Antibacterials, 1st Generation cefadroxil CAPS 1 cefadroxil SUSR 1 cefadroxil TABS 1 cefazolin sodium SOLR 1 PA CEFAZOLIN SODIUM SOLN 2 PA cefazolin sodium SOLR 2 PA CEFAZOLIN SODIUM-DEXTROSE SOLR 2 PA cephalexin CAPS 1 cephalexin SUSR 1 CEPHALEXIN TABS 1 DURICEF SUSR 2 PA KEFLEX CAPS 2 PA KEFLEX SUSR 2 PA PANIXINE DISPERDOSE TBSO 2 PA VELOSEF CAPS 2 PA Cephalosporin Antibacterials, 2nd Generation cefaclor er TB12 1 cefaclor CAPS 1 CEFACLOR SUSR 1 cefoxitin sodium SOLR 1 cefoxitin sodium SOLR 2 PA CEFOXITIN SOLR 1 cefprozil SUSR 1 cefprozil TABS 1 CEFTIN SUSR 2 PA CEFTIN TABS 2 PA cefuroxime axetil TABS 1

Page of 231 10

Drug Name Dosage Form Drug Tier

Requirements/ Limits

cefuroxime sodium SOLR 1 CEFUROXIME/DEXTROSE SOLR 1 PA CEFZIL SUSR 2 PA CEFZIL TABS 2 PA MANDOL/D5W SOLN 2 PA MEFOXIN ADD-VANTAGE SOLR 2 PA MEFOXIN IN DEXTROSE 2.2% SOLN 2 PA MEFOXIN IN DEXTROSE 3.9% SOLN 2 PA MEFOXIN SOLR 2 PA RANICLOR CHEW 2 PA ZINACEF IN ISO-OSMOTIC DEXTROSE SOLN 2 PA ZINACEF IN ISO-OSMOTIC DILUENT SOLN 2 PA ZINACEF/D5W SOLN 2 PA ZINACEF SOLR 2 PA Cephalosporin Antibacterials, 3rd Generation CEDAX CAPS 2 PA CEDAX SUSR 2 PA CEFIZOX IN DEXTROSE 5% SOLN 1 CEFIZOX SOLR 2 PA cefotaxime sodium SOLR 1 cefpodoxime proxetil TABS 1 CEFTAZIDIME SOLR 2 PA ceftriaxone in iso-osmotic dextrose SOLN 1 ceftriaxone sodium SOLR 1 CEFTRIAXONE/DEXTROSE SOLR 1 CLAFORAN INFUSION BOTTLES SOLR 2 PA CLAFORAN/D5W GALAXY SOLN 2 PA CLAFORAN SOLR 2 PA FORTAZ INFUSION PACK SOLR 2 PA FORTAZ SOLN 2 PA FORTAZ SOLR 2 PA OMNICEF CAPS 2 OMNICEF SUSR 2 OMNI-PAC CAPS 2 ROCEPHIN IN ISO-OSMOTIC DEXTROSE SOLN 2 PA ROCEPHIN SOLR 2 PA SPECTRACEF TABS 2 PA SUPRAX SUSR 2 PA TAZICEF SOLN 2 PA tazicef SOLR 2 PA VANTIN SUSR 2 PA VANTIN TABS 2 PA Cephalosporin Antibacterials, 4th Generation MAXIPIME SOLR 2 PA Erythromycins AKNE-MYCIN OINT 2 PA e.e.s. 200 SUSP 2 PA e.e.s. 400 SUSP 2 PA e.e.s. 400 TABS 2 PA E.E.S. GRANULES SUSR 2 PA

Page of 231 11

Drug Name Dosage Form Drug Tier

Requirements/ Limits

E-MYCIN TBEC 2 PA ERYC CPEP 2 PA eryderm SOLN 1 ERYGEL GEL 2 PA ERYPED 200 SUSR 2 PA ERYPED 400 SUSR 2 PA ERYPED SUSR 2 PA ERY-TAB TBEC 2 PA ERYTHROCIN LACTOBIONATE SOLR 1 erythrocin stearate TABS 2 PA ERYTHROCIN SOLR 2 PA erythromycin /sulfisoxazole SUSR 1 ERYTHROMYCIN BASE TABS 1 erythromycin ethylsuccinate SUSP 1 erythromycin ethylsuccinate SUSR 1 erythromycin ethylsuccinate TABS 2 PA ERYTHROMYCIN LACTOBIONATE SOLR 1 erythromycin stearate TABS 1 ERYTHROMYCIN CPEP 1 erythromycin GEL 1 erythromycin OINT 1 erythromycin PADS 1 erythromycin SOLN 1 ERYTHROMYCIN TBEC 1 PCE TBEC 2 PA PEDIAZOLE SUSR 2 PA Extended Spectrum Penicillins GEOCILLIN TABS 2 PA PIPERACILLIN SODIUM SOLR 2 PA PIPRACIL/D5W SOLN 2 PA TIMENTIN SOLN 2 PA TIMENTIN SOLR 2 PA ZOSYN SOLN 2 PA ZOSYN SOLR 2 PA Glycopeptide Antibacterials TYGACIL SOLR 2 PA VANCOCIN HCL ISO-OSMOTIC DEXTROSE SOLN 2 PA VANCOCIN HCL CAPS 2 PA VANCOCIN HCL SOLN 2 PA vancomycin hcl SOLR 1 PA Ketolides KETEK PAK TABS 2 PA KETEK TABS 2 KETEK TABS 2 QL Lincomycin Antibacterials CLEOCIN PEDIATRIC GRANULES SOLN 2 PA CLEOCIN PHOSPHATE SOLN 2 PA CLEOCIN CAPS 2 PA clindamycin hcl CAPS 1 clindamycin phosphate add-vantage SOLN 2 PA

Page of 231 12

Drug Name Dosage Form Drug Tier

Requirements/ Limits

clindamycin phosphate SOLN 2 PA LINCOCIN SOLN 2 PA ZIANA GEL 2 PA Macrolides (Non-erythromycins, Non-ketolides) AZASITE SOLN 2 PA AZITHROMYCIN PACK 1 azithromycin SOLR 1 azithromycin SUSR 1 azithromycin TABS 1 BIAXIN XL PAC TB24 2 BIAXIN XL TB24 2 BIAXIN SUSR 2 PA BIAXIN TABS 2 PA clarithromycin er TB24 1 clarithromycin SUSR 1 clarithromycin TABS 1 DYNABAC D5-PAK TBEC 2 PA PREVPAC MISC 2 PA ZITHROMAX TRI-PAK TABS 2 PA ZITHROMAX Z-PAK TABS 2 PA ZITHROMAX PACK 2 PA ZITHROMAX SOLR 2 PA ZITHROMAX SUSR 2 PA ZITHROMAX TABS 2 QL PA ZMAX SUSR 2 Miscellaneous Antibacterials acetic acid SOLN 1 acid jelly GEL 1 acidic vaginal jelly GEL 1 ak-poly-bac OINT 1 bac/poly/neomy/hc OINT 1 baciim SOLR 2 PA bacitracin /neomycin /polymyxin OINT 1 bacitracin/polymyxin b OINT 1 bacitracin OINT 1 BACITRACIN SOLR 1 PA BACTROBAN NASAL OINT 2 PA BACTROBAN CREA 2 PA BACTROBAN OINT 2 PA borofair SOLN 1 centany OINT 1 CHLORAMPHENICOL SODIUM SUCCINATE SOLR 1 CHLOROMYCETIN SOLR 2 PA colistimethate sodium SOLR 1 COLY-MYCIN-M SOLR 2 PA CRESYLATE SOLN 2 PA CUBICIN SOLR 2 PA FLAGYL ER TB24 2 PA FLAGYL CAPS 2 PA FLAGYL TABS 2 PA

Page of 231 13

Drug Name Dosage Form Drug Tier

Requirements/ Limits

HELIDAC MISC 2 PA HIPREX TABS 2 PA MANDELAMINE TABS 2 PA methenamine hippurate TABS 1 methenamine mandelate TABS 1 METRO IV SOLN 2 PA METROCREAM CREA 2 PA METROGEL VAGINAL GEL 2 PA METROGEL GEL 2 PA METROLOTION LOTN 2 PA metronidazole in nacl 0.79% SOLN 2 PA metronidazole vaginal GEL 1 metronidazole CAPS 1 metronidazole CREA 1 metronidazole TABS 1 MONUROL PACK 2 PA mupirocin OINT 1 neo/poly/bac/hc OINT 1 neocin OINT 2 PA neomycin /bacitracin /polymyxin /hydrocortisone OINT 1 neomycin /bacitracin /polymyxin OINT 1 neomycin /polymyxin /bacitracin OINT 1 neomycin/bacitracin zn/polymyx OINT 1 NORITATE CREA 2 PA ocumycin OINT 1 polymyxin b sulfate SOLR 1 POLYTRIM SOLN 2 PA PYLERA CAPS 2 PA ROZEX EMUL 2 PA SILVADENE CREA 2 PA silver sulfadiazine CREA 1 ssd af CREA 1 ssd CREA 1 SYNERCID SOLR 2 PA thermazene CREA 1 trimethoprim sulfate/polymyxin b sulfate SOLN 1 trimethoprim/polymyxin b SOLN 1 triple antibiotic OINT 1 uni-otic LIQD 2 PA UREX TABS 1 UROQID #2 TABS 2 PA vandazole GEL 2 PA XIFAXAN TABS 2 PA Natural Penicillins BICILLIN C-R SUSP 2 PA BICILLIN L-A SUSP 2 PA PENICILLIN G POTASSIUM IN ISO-OSMOTIC DEXTROSE SOLN 2 PA penicillin g potassium SOLR 1 PA PENICILLIN G PROCAINE SUSP 1 PENICILLIN G SODIUM SOLR 1

Page of 231 14

Drug Name Dosage Form Drug Tier

Requirements/ Limits

penicillin v potassium SOLR 1 penicillin v potassium TABS 1 penicillin vk TABS 1 pfizerpen-g SOLR 2 PA veetids SOLR 1 veetids TABS 1 Nitrofuran Antibacterials FURADANTIN SUSP 2 PA MACROBID CAPS 2 PA MACRODANTIN CAPS 2 PA nitrofurantoin macrocrystalline CAPS 1 nitrofurantoin monohydrate CAPS 1 nitrofurantoin CAPS 1 Oxazolidinone Antibacterials ZYVOX SOLN 2 PA ZYVOX SUSR 2 ZYVOX TABS 2 PA Penicillinase-resistant Penicillins BACTOCILL IN DEXTROSE SOLN 2 PA dicloxacillin sodium CAPS 1 NAFCILLIN SODIUM SOLR 1 NALLPEN ISO-OSMOTIC IN DEXTROSE SOLN 2 PA NALLPEN/DEXTROSE SOLN 2 PA OXACILLIN SODIUM SOLR 1 PA OXACILLIN SODIUM SOLR 2 PA Quinolones AVELOX ABC PACK TABS 2 PA AVELOX SOLN 2 PA AVELOX TABS 2 PA CILOXAN OINT 2 PA CILOXAN SOLN 2 PA CIPRO HC SUSP 2 PA CIPRO I.V. SOLN 2 PA CIPRO I.V.-IN D5W SOLN 2 PA CIPRO XR TB24 2 PA CIPRO SUSR 2 PA CIPRO TABS 2 PA CIPRODEX SUSP 2 ciprofloxacin er TB24 1 ciprofloxacin extended-release TB24 1 ciprofloxacin hcl SOLN 1 ciprofloxacin hcl TABS 1 ciprofloxacin SOLN 1 FACTIVE TABS 2 PA FLOXIN OTIC SINGLES SOLN 2 FLOXIN OTIC SOLN 2 FLOXIN TABS 2 PA LEVAQUIN LEVA-PAK TABS 2 LEVAQUIN PREMIX SOLN 2 PA LEVAQUIN SOLN 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

LEVAQUIN SOLN 2 PA LEVAQUIN TABS 2 NEGGRAM TABS 2 PA NOROXIN TABS 2 PA ofloxacin SOLN 1 ofloxacin TABS 1 ofloxacin TABS 1 QL PROQUIN XR TB24 2 PA QUIXIN SOLN 2 PA VIGAMOX SOLN 2 PA ZYMAR SOLN 2 PA Sulfonamides AZULFIDINE EN-TABS TBEC 2 PA AZULFIDINE TABS 2 PA BACTRIM DS TABS 2 PA BACTRIM TABS 2 PA BLEPH-10 SOLN 2 PA BLEPHAMIDE S.O.P. OINT 2 PA CARMOL SCALP TREATMENT KIT 2 PA CARMOL SCALP TREATMENT LOTN 2 PA erythromycin /sulfisoxazole SUSR 1 GANTRISIN PEDIATRIC SUSP 2 PA KLARON LOTN 2 PA PEDIAZOLE SUSR 2 PA prednisolone /sulfacetamide SOLN 1 PREDNISOLONE /SULFACETAMIDE SUSP 2 PA ROSULA NS PADS 2 PA ROSULA EMUL 1 ROSULA GEL 2 PA scalp treatment KIT 2 PA SEPTRA DS TABS 2 PA SEPTRA SUSP 2 PA SEPTRA TABS 2 PA smz-tmp ds TABS 1 sodium sulfacetamide LOTN 1 sodium sulfacetamide SOLN 1 sulf-10 SOLN 2 PA sulfac SOLN 2 PA SULFACETAMIDE SODIUM OINT 1 sulfacetamide sodium SOLN 1 sulfacetamide sodium LOTN 2 PA SULFADIAZINE TABS 1 SULFAMETHOXAZOLE /TRIMETHOPRIM SOLN 1 PA sulfamethoxazole /trimethoprim SUSP 1 sulfamethoxazole /trimethoprim TABS 1 sulfamethoxazole/trimethoprim ds TABS 1 SULFAMYLON CREA 2 PA SULFAMYLON PACK 2 PA sulfasalazine ec TBEC 1 sulfasalazine TABS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

sulfasalazine TBEC 1 sulfatol cleanser EMUL 2 PA sulfatol GEL 1 sulfatrim SUSP 1 SULFISOXAZOLE TABS 1 trimethoprim/sulfamethoxazole ds TABS 1 Tetracyclines ADOXA PAK 1/100 TABS 2 PA ADOXA PAK 1/150 TABS 2 PA ADOXA PAK 1/75 TABS 2 PA ADOXA PAK 2/100 TABS 2 PA ADOXA TABS 2 PA ARESTIN MISC 2 PA ATRIDOX KIT 2 PA DECLOMYCIN TABS 2 PA demeclocycline hcl TABS 1 DORYX CPEP 2 PA DORYX TBEC 2 PA doxy-caps CAPS 2 PA doxycycline hyclate CAPS 1 DOXYCYCLINE HYCLATE CPEP 1 doxycycline hyclate TABS 1 doxycycline hyclate SOLR 2 PA doxycycline monohydrate CAPS 1 doxycycline monohydrate TABS 1 dynacin CAPS 1 DYNACIN CAPS 2 PA DYNACIN TABS 2 PA MINOCIN PAC KIT 2 PA MINOCIN CAPS 2 PA minocycline hcl CAPS 1 minocycline hcl TABS 1 MONODOX CAPS 2 PA myrac TABS 2 PA ORACEA CPDR 2 PA PERIOSTAT TABS 2 PA SOLODYN TB24 2 PA SUMYCIN SYRP 2 PA SUMYCIN TABS 2 PA tetracycline hcl CAPS 1 VIBRAMYCIN CAPS 2 PA VIBRAMYCIN SUSR 2 PA VIBRAMYCIN SYRP 2 PA VIBRATAB TABS 2 PA Anticonvulsants Anticonvulsants (Other) carbamazepine CHEW 1 carbamazepine SUSP 1 carbamazepine TABS 1 CARBATROL CP12 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

EQUETRO CP12 2 PA KEPPRA SOLN 2 KEPPRA SOLN 2 PA KEPPRA TABS 2 KEPPRA TABS 2 PA MAGNESIUM SULFATE IN D5W SOLN 1 PA MAGNESIUM SULFATE SOLN 2 PA tis-u-sol viaflex SOLN 1 tis-u-sol SOLN 1 Calcium Channel Modifying Agents CELONTIN CAPS 2 PA ethosuximide CAPS 1 ethosuximide SOLN 1 LYRICA CAPS 2 ZARONTIN CAPS 2 PA ZARONTIN SOLN 2 PA Gamma-aminobutyric Acid (GABA) Augmenting Agents DEPACON SOLN 2 PA DEPAKENE CAPS 2 PA DEPAKENE SYRP 2 PA DEPAKOTE ER TB24 2 PA DEPAKOTE SPRINKLES CPSP 2 PA DEPAKOTE TBEC 2 gabapentin CAPS 1 gabapentin TABS 1 GABARONE TABS 2 PA GABITRIL TABS 2 GABITRIL TABS 2 PA MYSOLINE TABS 2 PA NEURONTIN CAPS 2 PA NEURONTIN SOLN 2 PA NEURONTIN TABS 2 PA primidone TABS 1 valproate sodium SOLN 1 valproic acid CAPS 1 VALPROIC ACID LIQD 1 valproic acid SYRP 1 ZONEGRAN CAPS 2 ZONEGRAN CAPS 2 PA zonisamide CAPS 1 Glutamate Reducing Agents FELBATOL SUSP 2 PA FELBATOL TABS 2 PA LAMICTAL CHEWABLE DISPERSIBLE TBDP 2 PA LAMICTAL STARTER/TAKING CARBAMAZEPINE/NOT TAKING VALPROATE

KIT 2

LAMICTAL STARTER/TAKING VALPROATE KIT 2 LAMICTAL TABS 2 lamotrigine chewable dispersible TBDP 1 TOPAMAX SPRINKLE CPSP 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

TOPAMAX TABS 2 TOPAMAX TABS 2 PA Sodium Channel Inhibitors carbamazepine CHEW 1 carbamazepine SUSP 1 carbamazepine TABS 1 CARBATROL CP12 2 PA DILANTIN INFATABS CHEW 2 DILANTIN-125 SUSP 1 DILANTIN CAPS 2 DILANTIN CAPS 2 PA DILANTIN SUSP 2 PA epitol TABS 1 EQUETRO CP12 2 PA PEGANONE TABS 2 PA PHENYTEK CAPS 2 phenytoin sodium extended CAPS 1 PHENYTOIN SODIUM PROMPT CAPS 1 phenytoin sodium SOLN 1 PA phenytoin SUSP 1 TEGRETOL CHEW 2 PA TEGRETOL SUSP 2 PA TEGRETOL TABS 2 PA TEGRETOL-XR TB12 2 TRILEPTAL SUSP 2 TRILEPTAL TABS 2 Antidementia Agents Antidementia Agents, Other ergoloid mesylates TABS 1 HYDERGINE TABS 2 PA Cholinesterase Inhibitors ARICEPT ODT TBDP 2 PA ARICEPT TABS 2 COGNEX CAPS 2 PA EXELON CAPS 2 EXELON SOLN 2 RAZADYNE ER CP24 2 PA RAZADYNE SOLN 2 PA RAZADYNE TABS 2 PA Glutamate Pathway Modifiers NAMENDA TITRATION PAK TABS 2 NAMENDA SOLN 2 NAMENDA TABS 2 Antidepressants Antidepressants, Other budeprion sr TB12 1 budeprion xl TB24 1 bupropion er TB12 1 bupropion hcl er TB12 1 bupropion hcl sr TB12 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

bupropion hcl TABS 1 bupropion hcl TB12 1 EFFEXOR XR CP24 2 EFFEXOR TABS 2 PA mirtazapine TABS 1 mirtazapine TBDP 1 nefazodone hcl TABS 1 REMERON SOLTAB TBDP 2 PA REMERON TABS 2 PA trazodone hcl dividose TABS 1 trazodone hcl TABS 1 venlafaxine hcl TABS 1 WELLBUTRIN SR TB12 2 PA WELLBUTRIN XL TB24 2 WELLBUTRIN TABS 2 PA Monoamine Oxidase (Type A) Inhibitors MARPLAN TABS 2 NARDIL TABS 2 PARNATE TABS 2 Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) CELEXA SOLN 2 PA CELEXA TABS 2 PA citalopram hydrobromide SOLN 1 citalopram hydrobromide TABS 1 CYMBALTA CPEP 2 fluoxetine hcl CAPS 1 fluoxetine hcl SOLN 1 fluoxetine hcl TABS 1 fluoxetine hcl TABS 2 PA fluvoxamine maleate TABS 1 LEXAPRO SOLN 2 LEXAPRO TABS 2 paroxetine hcl SUSP 1 paroxetine hcl TABS 1 PAXIL CR TB24 2 PAXIL SUSP 2 PA PAXIL TABS 2 PA PEXEVA TABS 2 PA PROZAC WEEKLY CPDR 2 PA PROZAC CAPS 2 PA PROZAC SOLN 2 PA PROZAC TABS 2 PA RAPIFLUX TABS 2 PA SARAFEM CAPS 2 PA sertraline hcl CONC 1 sertraline hcl TABS 1 sertraline hydrochloride CONC 1 SYMBYAX CAPS 2 ZOLOFT CONC 2 PA ZOLOFT TABS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

Tricyclics amitriptyline /chlordiazepoxide TABS 1 amitriptyline hcl TABS 1 AMOXAPINE TABS 1 ANAFRANIL CAPS 2 PA AVENTYL CAPS 2 PA chlordiazepoxide /amitriptyline TABS 1 clomipramine hcl CAPS 1 desipramine hcl TABS 1 doxepin hcl CAPS 1 doxepin hcl CONC 1 DUO-VIL TABS 2 PA imipramine hcl TABS 1 LIMBITROL DS TABS 2 PA LIMBITROL TABS 2 PA MAPROTILINE HCL TABS 1 NORPRAMIN TABS 2 PA nortriptyline hcl CAPS 1 nortriptyline hcl SOLN 1 PAMELOR CAPS 2 PA PAMELOR SOLN 2 PA PERPHENAZINE /AMITRIPTYLINE TABS 2 PA SURMONTIL CAPS 2 SURMONTIL CAPS 2 PA TOFRANIL TABS 2 PA TOFRANIL-PM CAPS 2 PA trimipramine maleate CAPS 1 VIVACTIL TABS 2 PA Antidotes, Deterrents, and Toxicologic Agents Alcohol Deterrents ANTABUSE TABS 2 PA CAMPRAL TBEC 2 PA depade TABS 2 PA REVIA TABS 2 PA VIVITROL SUSR 2 PA Antidotes, Deterrents, and Toxicologic Agents CHEMET CAPS 2 PA CUPRIMINE CAPS 2 DEPEN TITRATABS TABS 2 PA SYPRINE CAPS 2 PA Ion Exchange Resins FOSRENOL CHEW 2 KAYEXALATE POWD 2 PA kionex POWD 1 RENAGEL TABS 2 RENAGEL TABS 2 PA sodium polystyrene sulfonate SUSP 2 PA sps 30gm/120ml enema SUSP 1 sps SUSP 1 Opioid Antagonists

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

naloxone hcl SOLN 1 naloxone/pentazocine TABS 1 naltrexone hcl TABS 1 NARCAN SOLN 2 PA pentazocine/naloxone hcl TABS 1 REVEX SOLN 2 PA SUBOXONE SUBL 2 PA Smoking Cessation Agents buproban TB12 1 CHANTIX TABS 2 PA NICOTROL INHALER INHA 2 PA NICOTROL NS SOLN 2 PA ZYBAN TB12 2 PA Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists ALOXI SOLN 2 PA ANZEMET SOLN 2 PA ANZEMET TABS 2 PA KYTRIL SOLN 2 PA KYTRIL SOLN 2 QL PA KYTRIL TABS 2 QL PA ondansetron hcl SOLN 1 ondansetron hcl TABS 1 ondansetron odt TBDP 1 ZOFRAN ODT TBDP 2 PA ZOFRAN SOLN 2 ZOFRAN SOLN 2 PA ZOFRAN SOLN 2 QL PA ZOFRAN TABS 2 Antiemetics, Other CESAMET CAPS 2 PA chlorpromazine hcl TABS 1 compro SUPP 1 MARINOL CAPS 2 PA NICOTROL NS SOLN 2 PA phenadoz SUPP 1 PHENERGAN SOLN 2 PA promethazine hcl SOLN 1 PA promethazine hcl SUPP 1 promethazine hcl SYRP 1 promethazine hcl TABS 1 promethegan SUPP 1 TIGAN CAPS 2 PA TIGAN SOLN 2 PA trimethobenzamide hcl CAPS 1 trimethobenzamide hcl SOLN 1 Neurokinin 1 (NK1) Receptor Antagonists EMEND CAPS 2 EMEND MISC 2 Antifungals

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

Allylamine Antifungals LAMISIL SOLN 2 LAMISIL TABS 2 PA NAFTIN CREA 2 PA NAFTIN GEL 2 PA NAFTIN-MP CREA 2 PA Antifungals (Other) ANCOBON CAPS 2 ANCOBON CAPS 2 PA ciclopirox olamine CREA 1 ciclopirox SUSP 1 clotrimazole CREA 1 clotrimazole LOZG 1 clotrimazole SOLN 1 clotrimazole TROC 1 ERAXIS SOLR 2 PA GRIFULVIN V SUSP 1 GRIFULVIN V SUSP 2 PA GRIFULVIN V TABS 2 PA griseofulvin microsize SUSP 2 PA GRISEOFULVIN ULTRAMICROSIZE TABS 2 PA GRIS-PEG TABS 2 PA LOPROX SHAMPOO SHAM 2 PA LOPROX CREA 2 PA LOPROX GEL 2 PA LOPROX SUSP 2 PA LOTRISONE CREA 2 PA MENTAX CREA 2 PA MYCAMINE SOLR 2 PA MYCELEX TROC 2 PA PENLAC NAIL LACQUER SOLN 2 PA sb clotrimazole foot CREA 1 selenium sulfide SHAM 1 SELSEB SHAM 2 PA SPECTAZOLE CREA 2 PA versiclear LOTN 2 PA Azole Antifungals clotrimazole/betamethasone dipropionate CREA 1 clotrimazole/betamethasone dipropionate LOTN 1 DIFLUCAN IN ISO-OSMOTIC DEXTROSE SOLN 2 PA DIFLUCAN IN NACL SOLN 2 PA DIFLUCAN SUSR 2 PA DIFLUCAN TABS 2 PA econazole nitrate CREA 1 eq miconazole 3 combo pack KIT 1 EXELDERM CREA 2 PA EXELDERM SOLN 2 PA fluconazole in dextrose SOLN 2 PA fluconazole in nacl SOLN 1 fluconazole SUSR 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

fluconazole TABS 1 itraconazole CAPS 1 itraconazole CAPS 1 PA ketoconazole CREA 1 ketoconazole SHAM 1 ketoconazole TABS 1 kuric CREA 1 LOTRISONE LOTN 2 PA MICONAZOLE 3 SUPP 1 MONISTAT 3 SUPP 2 PA MONISTAT-DERM CREA 2 PA NIZORAL SHAM 2 PA NIZORAL TABS 2 PA NOXAFIL SUSP 2 PA OXISTAT CREA 2 PA OXISTAT LOTN 2 PA sb miconazole 3-day combo KIT 1 SPORANOX PULSEPAK CAPS 2 PA SPORANOX CAPS 2 PA SPORANOX KIT 2 PA SPORANOX SOLN 2 PA TERAZOL 3 CREA 1 TERAZOL 3 CREA 2 PA TERAZOL 3 SUPP 2 PA TERAZOL 7 CREA 2 PA terconazole CREA 1 VFEND IV SOLR 2 PA VFEND SUSR 2 VFEND TABS 2 XOLEGEL GEL 2 PA zazole CREA 2 PA zazole SUPP 2 PA Polyene Antifungals ABELCET SUSP 1 PA AMBISOME SUSR 2 PA amphocin SOLR 2 PA AMPHOTEC SUSR 2 PA amphotericin b SOLR 2 PA BIO-STATIN CAPS 2 PA FUNGIZONE SOLR 2 PA MYCOSTATIN CREA 2 PA MYCOSTATIN POWD 2 PA MYCOSTATIN SUSP 2 PA mytrex CREA 1 NATACYN SUSP 2 PA nyamyc POWD 1 nystatin/triamcinolone CREA 1 nystatin/triamcinolone OINT 1 nystatin CREA 1 nystatin OINT 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

nystatin POWD 1 nystatin SUSP 1 nystatin TABS 1 nystop POWD 1 pedi-dri POWD 1 triamcinolone/nystatin CREA 1 triamcinolone/nystatin OINT 1 Antigout Agents Antigout Agents (Non-renal Tubular Blocking Agents and Non-xanthine Inhibitors)

colchicine TABS 1 COLCHICINE SOLN 2 PA Renal Tubular Blocking Agents probenecid/colchicine TABS 1 probenecid TABS 1 Xanthine Oxidase Inhibitors allopurinol sodium SOLR 1 allopurinol TABS 1 ALOPRIM SOLR 2 PA ZYLOPRIM TABS 2 PA Anti-inflammatories Glucocorticoids CORTEF TABS 2 PA hydrocortisone TABS 1 Nonsteroidal Anti-inflammatory Drugs ANAPROX DS TABS 2 PA ANAPROX TABS 2 PA ANSAID TABS 2 PA ARTHROTEC 50 TABS 2 PA ARTHROTEC 75 TABS 2 PA CATAFLAM TABS 2 PA CELEBREX CAPS 2 CELEBREX CAPS 2 ST CLINORIL TABS 2 PA DAYPRO TABS 2 PA diclofenac potassium TABS 1 diclofenac sodium dr TBEC 1 diclofenac sodium ec TBEC 1 diclofenac sodium er TB24 1 diclofenac sodium sr TB24 1 diclofenac sodium xr TB24 1 diclofenac sodium TBEC 1 DIFLUNISAL TABS 1 DIFLUNISAL TABS 2 PA DOLOBID TABS 2 PA EC-NAPROSYN TBEC 2 PA etodolac er TB24 1 etodolac CAPS 1 etodolac TABS 1 FELDENE CAPS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

fenoprofen calcium TABS 1 flurbiprofen TABS 1 ibu TABS 1 ibuprofen SUSP 1 ibuprofen TABS 1 INDOCIN IV SOLR 2 PA INDOCIN SR CPCR 2 PA INDOCIN CAPS 2 PA INDOCIN SUSP 2 PA indomethacin cr CPCR 1 indomethacin er CPCR 1 indomethacin sa CPCR 1 indomethacin sr CPCR 1 indomethacin CAPS 1 KETOPROFEN ER CP24 1 ketoprofen CAPS 1 ketorolac tromethamine SOLN 1 ketorolac tromethamine TABS 1 ketorolac tromethamine SOLN 2 PA MECLOFENAMATE SODIUM CAPS 1 MELOXICAM SUSP 1 meloxicam TABS 1 MOBIC SUSP 2 PA MOBIC TABS 2 PA MOTRIN TABS 2 PA nabumetone TABS 1 NALFON CAPS 2 PA NAPRELAN TB24 2 PA NAPROSYN SUSP 2 PA NAPROSYN TABS 2 PA naproxen dr TBEC 1 naproxen ec TBEC 1 naproxen sodium TABS 1 naproxen sodium TB24 1 naproxen SUSP 1 naproxen TABS 1 NEOPROFEN SOLN 2 PA ORUDIS CAPS 2 PA ORUVAIL CP24 2 PA oxaprozin TABS 1 piroxicam CAPS 1 PONSTEL CAPS 2 PA PREVACID NAPRAPAC KIT 2 PA RELAFEN TABS 2 PA rufen TABS 2 PA sulindac TABS 1 TOLECTIN DS CAPS 2 tolmetin sodium CAPS 1 TOLMETIN SODIUM TABS 1 TORADOL ORAL TABS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

VOLTAREN TBEC 2 PA VOLTAREN-XR TB24 2 PA Antimigraine Agents Antimigraine Agents, Prophylactic (Non-beta-adrenergic Blocking Agents)

DEPAKOTE ER TB24 2 PA DEPAKOTE TBEC 2 TOPAMAX SPRINKLE CPSP 2 TOPAMAX TABS 2 TOPAMAX TABS 2 PA Beta-adrenergic Blocking Agents BLOCADREN TABS 2 PA INDERAL LA CP24 2 PA INDERAL TABS 2 PA INNOPRAN XL CP24 2 PA propranolol hcl er CP24 1 PROPRANOLOL HCL INTENSOL CONC 1 PROPRANOLOL HCL SOLN 1 propranolol hcl SOLN 1 PA propranolol hcl TABS 1 TIMOLOL MALEATE TABS 1 Ergot Alkaloids CAFERGOT TABS 2 PA D.H.E. 45 SOLN 2 PA dihydroergotamine mesylate SOLN 1 ERGOMAR SUBL 2 PA ergotamine tartrate/caffeine TABS 1 MIGERGOT SUPP 2 QL PA MIGRANAL SOLN 2 PA Triptans AMERGE TABS 2 QL PA AXERT TABS 2 QL PA FROVA TABS 2 PA IMITREX STATDOSE REFILL KIT 2 IMITREX STATDOSE SYSTEM KIT 2 IMITREX SOLN 2 IMITREX SOLN 2 QL IMITREX TABS 2 IMITREX TABS 2 QL MAXALT TABS 2 PA MAXALT-MLT TBDP 2 PA RELPAX TABS 2 ZOMIG ZMT TBDP 2 PA ZOMIG SOLN 2 ZOMIG TABS 2 ZOMIG TABS 2 QL Antimyasthenic Agents Parasympathomimetics bethanechol chloride TABS 1 GUANIDINE HCL TABS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

MESTINON TIMESPAN TBCR 2 PA MESTINON SOLN 2 PA MESTINON SYRP 2 PA MESTINON TABS 2 PA MYTELASE TABS 2 PA neostigmine methylsulfate SOLN 1 PHYSOSTIGMINE SALICYLATE SOLN 1 PROSTIGMIN SOLN 2 PA PROSTIGMIN TABS 2 PA pyridostigmine bromide TABS 1 REGONOL SOLN 2 PA URECHOLINE TABS 2 PA Antimycobacterials Antimycobacterials, Other DAPSONE TABS 1 MYCOBUTIN CAPS 2 Antituberculars amikacin sulfate SOLN 1 CAPASTAT SULFATE SOLR 2 PA ethambutol hcl TABS 1 isonarif CAPS 2 PA isoniazid TABS 1 ISONIAZID SYRP 2 PA KANAMYCIN SULFATE SOLN 1 MYAMBUTOL TABS 2 PA NYDRAZID SOLN 2 PA PRIFTIN TABS 2 PA pyrazinamide TABS 1 RIFADIN CAPS 2 PA RIFADIN SOLR 2 PA RIFAMATE CAPS 2 PA rifampin CAPS 1 rifampin SOLR 1 RIFATER TABS 2 PA rimactane CAPS 2 PA SEROMYCIN CAPS 2 PA STREPTOMYCIN SULFATE SOLR 1 TRECATOR TABS 2 PA TRECATOR-SC TABS 2 PA Antineoplastics Antineoplastics ABRAXANE SUSR 2 PA adriamycin SOLN 2 PA adriamycin SOLR 2 PA adrucil SOLN 2 PA ALIMTA SOLR 2 PA ALKERAN SOLR 2 PA ARRANON SOLN 2 PA AVASTIN SOLN 2 PA AZASAN TABS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

AZATHIOPRINE SODIUM SOLR 1 azathioprine TABS 1 BEXXAR CONC 2 PA BICNU W/DILUENT ABSOLUTE ETHANOL SOLR 2 PA BLENOXANE SOLR 2 PA bleomycin sulfate SOLR 1 BUSULFEX SOLN 2 PA CAMPATH SOLN 2 PA CAMPTOSAR SOLN 2 PA carboplatin SOLN 2 PA carboplatin SOLR 2 PA CEENU CAPS 2 CERUBIDINE SOLR 2 PA cisplatin SOLN 2 PA cladribine SOLN 1 CLOLAR SOLN 2 PA COSMEGEN SOLR 2 PA cyclophosphamide TABS 1 cyclophosphamide SOLR 2 PA cytarabine aqueous SOLN 1 PA cytarabine SOLN 1 CYTARABINE SOLR 1 CYTOXAN SOLR 2 PA CYTOXAN TABS 2 PA DACARBAZINE SOLR 1 dacarbazine SOLR 1 PA DAUNORUBICIN HCL INJ 1 daunorubicin hcl SOLR 1 DAUNOXOME INJ 2 PA DOXIL INJ 2 PA doxorubicin hcl SOLN 1 doxorubicin hcl SOLR 1 DROXIA CAPS 2 PA DTIC-DOME SOLR 2 PA EFUDEX OCCLUSION PACK KIT 2 PA EFUDEX CREA 2 PA EFUDEX SOLN 2 PA ELITEK SOLR 2 PA ELLENCE SOLN 2 PA ELOXATIN SOLN 2 PA ELOXATIN SOLR 2 PA EPIRUBICIN HCL SOLR 1 PA ERBITUX SOLN 2 PA ETHYOL SOLR 2 PA ETOPOPHOS SOLR 2 PA etoposide SOLN 2 PA FASLODEX SOLN 2 PA floxuridine SOLR 1 FLUDARA SOLR 2 PA FLUDARABINE PHOSPHATE SOLN 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

fludarabine phosphate SOLR 1 FLUOROPLEX CREA 2 PA FLUOROPLEX SOLN 2 PA FLUOROURACIL SOLN 2 PA FUDR SOLR 2 PA GEMZAR SOLR 2 PA HERCEPTIN SOLR 2 PA HEXALEN CAPS 2 PA HYCAMTIN SOLR 2 PA HYDREA CAPS 2 PA hydroxyurea CAPS 1 IDAMYCIN PFS SOLN 2 PA idarubicin SOLN 2 PA IFEX/MESNEX COMBO PACK KIT 2 PA IFEX SOLR 2 PA ifosfamide/mesna KIT 2 PA ifosfamide SOLR 2 PA IMURAN TABS 2 PA LEUKERAN TABS 2 LEUSTATIN SOLN 2 PA LYSODREN TABS 2 MATULANE CAPS 2 PA mercaptopurine TABS 1 mesna SOLN 1 MESNEX SOLN 2 PA MESNEX TABS 2 PA mitomycin SOLR 2 PA MUSTARGEN SOLR 2 PA MUTAMYCIN SOLR 2 PA MYLOTARG SOLR 2 PA NAVELBINE SOLN 2 PA NEUMEGA SOLR 2 PA NIPENT SOLR 2 PA NOVANTRONE CONC 2 ONCASPAR SOLN 2 PA ONTAK SOLN 2 PA onxol CONC 2 PA paclitaxel CONC 2 PA PARAPLATIN SOLN 2 PA PARAPLATIN SOLR 2 PA PHOTOFRIN SOLR 2 PA PLATINOL AQ SOLN 2 PA PROLEUKIN SOLR 2 PA PURINETHOL TABS 2 PA QUADRAMET SOLN 2 PA RITUXAN CONC 2 PA TABLOID TABS 2 PA TAXOL CONC 2 PA TAXOTERE CONC 2 PA THERACYS SUSR 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

THIOTEPA SOLR 1 thiotepa SOLR 1 PA toposar SOLN 2 PA TORISEL SOLN 2 PA TYKERB TABS 2 PA VECTIBIX SOLN 2 PA VELCADE SOLR 2 PA VIDAZA SUSR 2 PA VINBLASTINE SULFATE SOLN 2 PA VINBLASTINE SULFATE SOLR 2 PA vincasar pfs SOLN 2 PA vincristine sulfate SOLN 2 PA vinorelbine tartrate SOLN 2 PA ZANOSAR SOLR 2 PA ZEVALIN IN-111 KIT 2 PA ZEVALIN Y-90 KIT 2 PA ZINECARD SOLR 2 PA ZOLINZA CAPS 2 PA Aromatase Inhibitors, 3rd Generation ARIMIDEX TABS 2 AROMASIN TABS 2 PA FEMARA TABS 2 Epidermal Growth Factor Receptor Kinase Inhibitors IRESSA TABS 2 PA TARCEVA TABS 2 TARCEVA TABS 2 PA Estrogen-nitrosoureas EMCYT CAPS 2 Multitargeted Kinase Inhibitors, Bcr-Abl/c-kit Receptor Tyrosine Kinases

NEXAVAR TABS 2 PA Multitargeted Kinase Inhibitors, Gastrointestinal Stromal Tumors GLEEVEC TABS 2 SPRYCEL TABS 2 PA SUTENT CAPS 2 PA Multitargeted Kinase Inhibitors, Renal Cell Carcinoma NEXAVAR TABS 2 PA Retinoids PANRETIN GEL 2 PA TARGRETIN CAPS 2 PA TARGRETIN GEL 2 PA VESANOID CAPS 2 PA Selective Estrogen Receptor Modulators, 1st Generation FARESTON TABS 2 PA SOLTAMOX SOLN 2 PA tamoxifen citrate TABS 1 Antiparasitics Anthelmintics ALBENZA TABS 2 PA BILTRICIDE TABS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

mebendazole CHEW 1 MINTEZOL CHEW 2 PA MINTEZOL SUSP 2 PA STROMECTOL TABS 2 PA VERMOX CHEW 2 PA Antimalarials ARALEN TABS 2 PA chloroquine phosphate TABS 1 DARAPRIM TABS 2 FANSIDAR TABS 2 PA hydroxychloroquine sulfate TABS 1 LARIAM TABS 2 PA MALARONE TABS 2 PA mefloquine hcl TABS 1 PLAQUENIL TABS 2 PA PRIMAQUINE PHOSPHATE TABS 1 QUALAQUIN CAPS 2 PA Antiprotozoals (Non-antimalarials) ALINIA SUSR 2 PA ALINIA TABS 2 PA HUMATIN CAPS 2 PA MALARONE TABS 2 PA MEPRON SUSP 2 NEBUPENT SOLR 2 PA paromomycin sulfate CAPS 1 PENTAM 300 SOLR 2 PA pentamidine isethionate SOLR 2 PA TINDAMAX TABS 2 PA YODOXIN TABS 2 PA Pediculicides/Scabicides acticin CREA 1 CAPITROL SHAM 2 PA ELIMITE CREA 2 PA EURAX CREA 2 PA EURAX LOTN 2 PA LINDANE LOTN 1 lindane SHAM 1 MALATHION LIQD 2 PA OVIDE LOTN 2 PA PERMETHRIN TECHNICAL LIQD 1 permethrin CREA 1 Antiparkinson Agents Anticholinergics AKINETON TABS 2 PA benztropine mesylate TABS 1 COGENTIN SOLN 2 PA KEMADRIN TABS 2 PA trihexyphenidyl hcl ELIX 1 trihexyphenidyl hcl TABS 1 Antiparkinson Agents, Other

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

amantadine hcl CAPS 1 amantadine hcl SYRP 1 AMANTADINE HCL TABS 1 APOKYN SOLN 2 PA AZILECT TABS 2 PA ELDEPRYL CAPS 2 PA EMSAM PT24 2 PA selegiline hcl CAPS 1 selegiline hcl TABS 1 SYMMETREL TABS 2 PA ZELAPAR TBDP 2 PA Catechol O-methyltransferase (COMT) Inhibitors COMTAN TABS 2 PA STALEVO 100 TABS 2 PA STALEVO 150 TABS 2 PA STALEVO 50 TABS 2 PA TASMAR TABS 2 Dopamine Agonists bromocriptine mesylate CAPS 1 bromocriptine mesylate TABS 1 cabergoline TABS 2 PA MIRAPEX TABS 2 PARLODEL CAPS 2 PA PARLODEL TABS 2 PA pergolide mesylate TABS 1 PERMAX TABS 2 PA REQUIP TABS 2 Dopamine Precursors atamet TABS 2 PA carbidopa/levodopa cr TBCR 1 carbidopa/levodopa er TBCR 1 carbidopa/levodopa sr TBCR 1 carbidopa/levodopa TABS 1 LODOSYN TABS 2 PA PARCOPA TBDP 2 PA SINEMET CR TBCR 2 PA SINEMET TABS 2 PA STALEVO 100 TABS 2 PA STALEVO 150 TABS 2 PA STALEVO 50 TABS 2 PA Antipsychotics Atypicals ABILIFY DISCMELT TBDP 2 ABILIFY SOLN 2 ABILIFY SOLN 2 PA ABILIFY TABS 2 CLOZAPINE TABS 1 CLOZARIL TABS 2 PA FAZACLO TBDP 2 PA GEODON CAPS 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

GEODON SOLR 2 PA INVEGA TB24 2 PA RISPERDAL CONSTA SUSR 2 PA RISPERDAL M-TAB TBDP 2 RISPERDAL M-TAB TBDP 2 PA RISPERDAL SOLN 2 RISPERDAL TABS 2 SEROQUEL XR TB24 2 SEROQUEL TABS 2 SYMBYAX CAPS 2 ZYPREXA ZYDIS TBDP 2 ZYPREXA SOLR 2 ZYPREXA TABS 2 Conventional CHLORPROMAZINE HCL SOLN 1 PA chlorpromazine hcl TABS 1 DUO-VIL TABS 2 PA fluphenazine decanoate SOLN 2 PA FLUPHENAZINE HCL CONC 1 FLUPHENAZINE HCL ELIX 1 fluphenazine hcl TABS 1 FLUPHENAZINE HCL SOLN 2 PA HALDOL DECANOATE 50 SOLN 2 PA HALDOL DECANOATE-100 SOLN 2 PA HALDOL DECANOATE-50 SOLN 2 PA HALDOL SOLN 2 PA haloperidol decanoate SOLN 2 PA haloperidol lactate SOLN 2 PA haloperidol CONC 1 haloperidol TABS 1 loxapine succinate CAPS 1 LOXITANE CAPS 2 PA MOBAN TABS 2 MOBAN TABS 2 PA NAVANE CAPS 2 PA ORAP TABS 2 PERPHENAZINE /AMITRIPTYLINE TABS 2 PA perphenazine TABS 1 prochlorperazine edisylate SOLN 2 PA prochlorperazine maleate TABS 1 prochlorperazine SUPP 1 thioridazine hcl TABS 1 thiothixene CAPS 1 trifluoperazine hcl TABS 1 VESPRIN SOLN 1 Antivirals Anti-cytomegalovirus (CMV) Agents CYTOVENE CAPS 2 PA CYTOVENE SOLR 2 PA foscarnet sodium SOLN 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

FOSCAVIR SOLN 2 PA GANCICLOVIR CAPS 1 GANCICLOVIR CAPS 1 PA VALCYTE TABS 2 PA VISTIDE SOLN 2 PA Antiherpetic Agents ACYCLOVIR SODIUM SOLN 1 acyclovir sodium SOLR 1 acyclovir CAPS 1 acyclovir SUSP 1 acyclovir TABS 1 DENAVIR CREA 2 FAMVIR TABS 2 foscarnet sodium SOLN 2 PA FOSCAVIR SOLN 2 PA trifluridine SOLN 1 VALTREX TABS 2 VIROPTIC SOLN 2 PA ZOVIRAX CAPS 2 PA ZOVIRAX CREA 2 PA ZOVIRAX OINT 2 PA ZOVIRAX SOLR 2 PA ZOVIRAX SUSP 2 PA ZOVIRAX TABS 2 PA Anti-HIV Agents, Non-nucleoside Reverse Transcriptase Inhibitors

ATRIPLA TABS 2 RESCRIPTOR TABS 2 SUSTIVA CAPS 2 SUSTIVA TABS 2 VIRAMUNE SUSP 2 VIRAMUNE TABS 2 Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

ATRIPLA TABS 2 COMBIVIR TABS 2 didanosine CPDR 1 EMTRIVA CAPS 2 EMTRIVA SOLN 2 EPIVIR HBV SOLN 2 EPIVIR HBV TABS 2 EPIVIR SOLN 2 EPIVIR TABS 2 EPZICOM TABS 2 RETROVIR IV INFUSION SOLN 2 RETROVIR CAPS 2 RETROVIR SYRP 2 RETROVIR TABS 2 TRIZIVIR TABS 2 TRUVADA TABS 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

VIDEX EC CPDR 2 VIDEX PEDIATRIC SOLR 2 VIREAD TABS 2 ZERIT CAPS 2 ZERIT SOLR 2 ZIAGEN SOLN 2 ZIAGEN TABS 2 zidovudine SYRP 1 zidovudine TABS 1 Anti-HIV Agents, Protease Inhibitors AGENERASE CAPS 2 AGENERASE SOLN 2 APTIVUS CAPS 2 CRIXIVAN CAPS 2 INVIRASE CAPS 2 INVIRASE TABS 2 KALETRA CAPS 2 KALETRA SOLN 2 KALETRA TABS 2 LEXIVA TABS 2 NORVIR CAPS 2 NORVIR SOLN 2 PREZISTA TABS 2 REYATAZ CAPS 2 VIRACEPT TABS 2 Anti-human Immunodeficiency Virus (HIV) Agents, Fusion Inhibitors

FUZEON KIT 2 PA Anti-influenza Agents amantadine hcl CAPS 1 amantadine hcl SYRP 1 AMANTADINE HCL TABS 1 FLUMADINE SYRP 2 PA FLUMADINE TABS 2 PA RELENZA DISKHALER AEPB 2 QL PA rimantadine hcl TABS 1 SYMMETREL TABS 2 PA TAMIFLU CAPS 2 QL PA TAMIFLU SUSR 2 Antivirals, Other BARACLUDE TABS 2 COPEGUS TABS 2 PA HEPSERA TABS 2 PA REBETOL CAPS 2 PA REBETOL SOLN 2 PA ribapak MISC 2 PA ribapak TABS 2 PA ribasphere CAPS 2 PA ribasphere TABS 2 PA ribatab MISC 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

ribatab TABS 2 PA ribavirin CAPS 2 PA ribavirin TABS 2 PA TYZEKA TABS 2 PA VIRAZOLE SOLR 2 PA Anxiolytics Antidepressants doxepin hcl CAPS 1 doxepin hcl CONC 1 LEXAPRO SOLN 2 LEXAPRO TABS 2 Anxiolytics, Other amitriptyline /chlordiazepoxide TABS 1 chlordiazepoxide /amitriptyline TABS 1 LIMBITROL DS TABS 2 PA LIMBITROL TABS 2 PA Bipolar Agents Bipolar Agents ABILIFY DISCMELT TBDP 2 ABILIFY SOLN 2 ABILIFY SOLN 2 PA ABILIFY TABS 2 carbamazepine CHEW 1 carbamazepine SUSP 1 carbamazepine TABS 1 CARBATROL CP12 2 PA DEPAKOTE ER TB24 2 PA DEPAKOTE SPRINKLES CPSP 2 PA DEPAKOTE TBEC 2 epitol TABS 1 EQUETRO CP12 2 PA ESKALITH CR TBCR 2 PA ESKALITH CAPS 2 PA GEODON CAPS 2 GEODON SOLR 2 PA LAMICTAL STARTER/NOT TAKING CARBAMAZEPINE KIT 2 lithium carbonate er TBCR 1 lithium carbonate CAPS 1 LITHIUM CARBONATE TABS 1 lithium citrate SOLN 1 lithium citrate SYRP 1 LITHOBID TBCR 2 PA RISPERDAL CONSTA SUSR 2 PA RISPERDAL M-TAB TBDP 2 RISPERDAL M-TAB TBDP 2 PA RISPERDAL SOLN 2 RISPERDAL TABS 2 SEROQUEL XR TB24 2 SEROQUEL TABS 2 SYMBYAX CAPS 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

TEGRETOL CHEW 2 PA TEGRETOL SUSP 2 PA TEGRETOL TABS 2 PA TEGRETOL-XR TB12 2 ZYPREXA ZYDIS TBDP 2 ZYPREXA SOLR 2 ZYPREXA TABS 2 Bipolar Agents DEPAKOTE TBEC 2 Blood Glucose Regulators Alpha Glucosidase Inhibitors GLYSET TABS 2 PA PRECOSE TABS 2 PRECOSE TABS 2 PA ST Amylinomimetics SYMLIN SOLN 2 PA Biguanides ACTOPLUS MET TABS 2 AVANDAMET TABS 2 AVANDAMET TABS 2 PA ST FORTAMET TB24 2 glipizide/metformin hcl TABS 1 GLUCOPHAGE XR TB24 2 PA GLUCOPHAGE TABS 2 PA GLUCOVANCE TABS 2 PA GLUMETZA TB24 2 PA glyburide/metformin hcl TABS 1 JANUMET TABS 2 PA METAGLIP TABS 2 PA metformin hcl er TB24 1 metformin hcl TABS 1 RIOMET SOLN 2 PA Glycemic Agents GLUCAGEN HYPOKIT SOLR 2 PA GLUCAGON EMERGENCY KIT KIT 2 PROGLYCEM SUSP 2 PA Incretin Mimetics BYETTA SOLN 2 PA Insulin Mixtures, Analogs HUMALOG MIX 50/50 PEN SUSP 2 HUMALOG MIX 50/50 SUSP 2 HUMALOG MIX 75/25 PEN SUSP 2 HUMALOG MIX 75/25 SUSP 2 NOVOLOG MIX 70/30 PENFILL SUSP 2 PA NOVOLOG MIX 70/30 PREFILLED FLEXPEN SUSP 2 PA NOVOLOG MIX 70/30 SUSP 2 PA Insulin Mixtures, Short-acting and Intermediate-acting HUMULIN 50/50 SUSP 2 HUMULIN 70/30 PEN SUSP 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

HUMULIN 70/30 SUSP 2 NOVOLIN 70/30 INNOLET SUSP 2 PA NOVOLIN 70/30 PENFILL SUSP 2 PA NOVOLIN 70/30 SUSP 1 Insulin, Intermediate-acting HUMULIN N U-100 PEN SUSP 2 HUMULIN N SUSP 2 NOVOLIN N INNOLET SUSP 2 PA NOVOLIN N U-100 PENFILL SUSP 2 PA NOVOLIN N U-100 SUSP 1 NOVOLIN N SUSP 1 RELION 70/30 INNOLET SUSP 2 PA RELION 70/30 SUSP 1 RELION N INNOLET SUSP 2 PA RELION N SUSP 1 Insulin, Long-acting LANTUS OPTICLIK SOLN 2 PA LANTUS SOLN 2 LEVEMIR SOLN 2 Insulin, Rapid-acting APIDRA SOLN 2 PA EXUBERA COMBINATION PACK 15 POWD 2 PA EXUBERA KIT POWD 2 PA HUMALOG PEN SOLN 2 HUMALOG SOLN 2 NOVOLOG PENFILL SOLN 2 PA NOVOLOG SOLN 2 PA RELION R SOLN 2 PA Insulin, Short-acting HUMULIN R U-500 (CONCENTRATED) SOLN 2 HUMULIN R SOLN 2 NOVOLIN R INNOLET SOLN 2 PA NOVOLIN R U-100 PENFILL SOLN 2 PA NOVOLIN R U-100 SOLN 2 PA NOVOLIN R SOLN 2 PA Meglitinides PRANDIN TABS 2 STARLIX TABS 2 STARLIX TABS 2 ST Sulfonylureas AMARYL TABS 2 PA AVANDARYL TABS 2 chlorpropamide TABS 1 DIABETA TABS 2 PA DIABINESE TABS 2 PA DUETACT TABS 2 ST glimepiride TABS 1 glipizide er TB24 1 glipizide xl TB24 1 glipizide/metformin hcl TABS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

glipizide TABS 1 GLUCOTROL XL TB24 2 PA GLUCOTROL TABS 2 PA GLUCOVANCE TABS 2 PA glyburide micronized TABS 1 glyburide/metformin hcl TABS 1 glyburide TABS 1 glycron TABS 2 PA GLYNASE TABS 2 PA METAGLIP TABS 2 PA MICRONASE TABS 2 PA tolazamide TABS 1 TOLAZAMIDE TABS 2 PA TOLBUTAMIDE TABS 1 TOLINASE TABS 2 PA Thiazolidinediones ACTOPLUS MET TABS 2 ACTOS TABS 2 AVANDAMET TABS 2 AVANDAMET TABS 2 PA ST AVANDARYL TABS 2 AVANDIA TABS 2 AVANDIA TABS 2 PA ST DUETACT TABS 2 ST Blood Glucose Regulators JANUVIA TABS 2 PA Blood Products/Modifiers/Volume Expanders Adenosine Diphosphate P2Y12 Inhibitors PLAVIX TABS 2 TICLID TABS 2 PA ticlopidine hcl TABS 1 Anticoagulants, Oral COUMADIN SOLR 2 PA COUMADIN TABS 2 PA jantoven TABS 2 jantoven TABS 2 PA warfarin sodium TABS 1 Blood Products/Modifiers/Volume Expanders HEPARIN SODIUM (PORCINE) POWD 1 HEPARIN SODIUM DCU SOLN 2 PA heparin sodium/d5w SOLN 2 PA HEPARIN SODIUM/NACL 0.45% SOLN 1 heparin sodium/nacl 0.9% SOLN 1 heparin sodium/nacl 0.9% SOLN 2 PA HEPARIN SODIUM/SODIUM CHLORIDE 0.9% SOLN 1 HEPARIN SODIUM SOLN 1 HEPARIN SODIUM SOLN 2 PA pentopak TBCR 2 PA pentoxifylline cr TBCR 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

pentoxifylline er TBCR 1 pentoxil TBCR 1 TRENTAL TBCR 2 PA Colony Stimulating Factors LEUKINE SOLN 2 PA LEUKINE SOLR 2 PA NEULASTA SOLN 2 PA NEUPOGEN SOLN 2 PA Cyclic Adenosine Monophosphate Reuptake Inhibitors AGGRENOX CP12 2 dipyridamole TABS 1 PERSANTINE TABS 2 PA Erythropoietins ARANESP ALBUMIN FREE SURECLICK SOLN 2 PA ARANESP ALBUMIN FREE SOLN 2 PA ARANESP SOLN 2 PA EPOGEN SOLN 2 PA PROCRIT SOLN 2 PA Factor Xa Inhibitors, Indirect ARIXTRA SOLN 2 PA Iron Overload Agents EXJADE TBSO 2 PA Low Molecular Weight Heparins FRAGMIN INJ 2 PA INNOHEP SOLN 2 PA LOVENOX SOLN 2 PA Phosphodiesterase III/Adenosine Uptake Inhibitors cilostazol TABS 1 PLETAL TABS 2 PA Blood Products/Modifiers/Volume Expanders AGRYLIN CAPS 2 PA anagrelide hydrochloride CAPS 1 Cardiovascular Agents 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) Reductase Inhibitors

ADVICOR TB24 2 ALTOPREV TB24 2 CADUET TABS 2 CRESTOR TABS 2 LESCOL XL TB24 2 LESCOL CAPS 2 LIPITOR TABS 2 lovastatin TABS 1 MEVACOR TABS 2 PA PRAVACHOL TABS 2 pravastatin sodium TABS 1 simvastatin TABS 1 VYTORIN TABS 2 ZOCOR TABS 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

Aldosterone Receptor Antagonists ALDACTAZIDE TABS 2 PA ALDACTONE TABS 2 PA INSPRA TABS 2 PA spironolactone /hydrochlorothiazide TABS 1 spironolactone TABS 1 Alpha-adrenergic Agonists ALDORIL D30 TABS 2 PA ALDORIL D50 TABS 2 PA ALDORIL-15 TABS 2 PA ALDORIL-25 TABS 2 PA CATAPRES TABS 2 PA CATAPRES-TTS 2 PTWK 2 PA CATAPRES-TTS-1 PTWK 2 CATAPRES-TTS-2 PTWK 2 PA CATAPRES-TTS-3 PTWK 2 PA clonidine hcl TABS 1 CLORPRES TABS 2 PA DURACLON SOLN 2 PA GUANABENZ ACETATE TABS 1 guanfacine hcl TABS 1 METHYLDOPA /HYDROCHLOROTHIAZIDE TABS 1 methyldopa TABS 1 METHYLDOPATE HCL SOLN 1 midodrine hcl TABS 1 PROAMATINE TABS 2 PA TENEX TABS 2 PA Alpha-adrenergic Blocking Agents CARDURA TABS 2 PA carvedilol TABS 1 doxazosin mesylate TABS 1 HYTRIN CAPS 2 PA MINIPRESS CAPS 2 PA MINIZIDE CAPS 2 PA prazosin hcl CAPS 1 RESERPINE TABS 1 terazosin hcl CAPS 1 Alpha-beta-adrenergic Blocking Agents carvedilol TABS 1 COREG CR CP24 2 COREG TABS 2 labetalol hcl TABS 1 labetalol hcl SOLN 2 PA PROPRANOLOL HCL ER CP24 1 TRANDATE IV SOLN 2 PA TRANDATE SOLN 2 PA TRANDATE TABS 2 PA Angiotensin II Receptor Antagonists ATACAND HCT TABS 2 PA ATACAND TABS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

AVALIDE TABS 2 PA AVAPRO TABS 2 PA BENICAR HCT TABS 2 BENICAR TABS 2 COZAAR TABS 2 DIOVAN HCT TABS 2 DIOVAN TABS 2 EXFORGE TABS 2 HYZAAR TABS 2 HYZAAR TABS 2 PA MICARDIS HCT TABS 2 PA MICARDIS TABS 2 PA TEVETEN HCT TABS 2 PA TEVETEN TABS 2 PA Angiotensin-converting Enzyme (ACE) Inhibitors ACCUPRIL TABS 2 PA ACCURETIC TABS 2 PA ACEON TABS 2 PA ALTACE CAPS 2 amlodipine besylate/benazepril hydrochloride CAPS 1 benazepril hcl/hydrochlorothiazide TABS 1 benazepril hcl TABS 1 CAPOTEN TABS 2 PA CAPOZIDE TABS 2 PA captopril /hydrochlorothiazide TABS 1 captopril TABS 1 enalapril maleate/hydrochlorothiazide TABS 1 enalapril maleate TABS 1 fosinopril sodium/hydrochlorothiazide TABS 1 fosinopril sodium TABS 1 fosinopril sodium TABS 2 PA LEXXEL TBCR 2 PA lisinopril /hydrochlorothiazide TABS 1 lisinopril TABS 1 LOTENSIN HCT TABS 2 PA LOTENSIN TABS 2 PA LOTREL CAPS 2 MAVIK TABS 2 PA moexipril hcl TABS 1 MONOPRIL HCT TABS 2 PA MONOPRIL TABS 2 PA PRINIVIL TABS 2 PA PRINZIDE TABS 2 PA quinapril /hydrochlorothiazide TABS 1 quinapril hcl TABS 1 quinapril/hctz TABS 1 quinapril TABS 1 quinaretic TABS 1 TARKA TBCR 2 PA trandolapril TABS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

UNIRETIC TABS 2 PA UNIVASC TABS 2 PA VASERETIC TABS 2 PA VASOTEC TABS 2 PA ZESTORETIC TABS 2 PA ZESTRIL TABS 2 PA Antiarrhythmics - Class Ia/II/III/IV pacerone TABS 2 PA PROCAINAMIDE HCL ER TBCR 1 procainamide hcl sr TBCR 1 procainamide hcl CAPS 1 PROCAINAMIDE HCL SOLN 1 PROCAINAMIDE HCL SOLN 2 PA PROCANBID TB12 2 PA PRONESTYL SR TBCR 2 PA PRONESTYL CAPS 1 PRONESTYL CAPS 2 PA PRONESTYL TABS 2 PA Antiarrhythmics - Class II/III BETAPACE AF TABS 2 PA BETAPACE TABS 2 PA sorine TABS 1 sotalol hcl (af) TABS 1 sotalol hcl TABS 1 Antiarrhythmics - Class II acebutolol hcl CAPS 1 BLOCADREN TABS 2 PA Antiarrhythmics - Class III amiodarone hcl SOLN 1 PA amiodarone hcl TABS 1 BETAPACE AF TABS 2 PA BETAPACE TABS 2 PA CORDARONE I.V. SOLN 2 PA CORDARONE TABS 2 PA Antiarrhythmics - Class II INDERAL LA CP24 2 PA INDERAL TABS 2 PA INNOPRAN XL CP24 2 PA Antiarrhythmics - Class III PACERONE TABS 2 PA sotalol hcl TABS 1 TIKOSYN CAPS 2 PA Antiarrhythmics - Class II nadolol TABS 1 pindolol TABS 1 propranolol hcl er CP24 1 PROPRANOLOL HCL INTENSOL CONC 1 PROPRANOLOL HCL SOLN 1 propranolol hcl SOLN 1 PA propranolol hcl TABS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

PROPRANOLOL HCL SOLN 2 PA SECTRAL CAPS 2 PA TIMOLIDE 10/25 TABS 2 PA TIMOLOL MALEATE TABS 1 Antiarrhythmics - Class IV CALAN SR TBCR 2 PA CALAN TABS 2 PA CARDIZEM CD CP24 2 PA CARDIZEM LA TB24 2 PA CARDIZEM SOLN 2 PA CARDIZEM TABS 2 PA cartia xt CP24 1 COVERA-HS TB24 2 PA DILACOR XR CP24 2 PA dilt-cd CP24 1 diltia xt CP24 1 diltiazem cd CP24 1 diltiazem hcl er CP12 1 diltiazem hcl er CP24 1 diltiazem hcl sr CP24 1 diltiazem hcl CP24 1 diltiazem hcl TABS 1 diltiazem hcl SOLN 2 PA DILTIAZEM HCL SOLR 2 PA diltiazem xr CP24 1 ISOPTIN SR TBCR 2 PA taztia xt CP24 1 TIAZAC CP24 2 PA verapamil hcl cr TBCR 1 verapamil hcl er CP24 1 verapamil hcl er TBCR 1 verapamil hcl sa TBCR 1 verapamil hcl sr CP24 1 verapamil hcl sr TBCR 1 verapamil hcl SOLN 1 PA verapamil hcl TABS 1 VERELAN PM CP24 2 PA VERELAN CP24 2 PA Antiarrhythmics - Classes IA, B, and C disopyramide phosphate er CP12 1 disopyramide phosphate CAPS 1 flecainide acetate TABS 1 MEXILETINE HCL CAPS 1 MEXITIL CAPS 2 PA NORPACE CR CP12 2 PA NORPACE CAPS 2 PA procainamide hcl CAPS 1 propafenone hcl TABS 1 quinidine gluconate cr TBCR 1 quinidine gluconate er TBCR 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

quinidine gluconate sa TBCR 1 QUINIDINE SULFATE ER TBCR 1 quinidine sulfate TABS 1 RYTHMOL SR CP12 2 PA RYTHMOL TABS 2 PA TAMBOCOR TABS 2 PA Antiarrhythmics (Other) MAGNESIUM SULFATE IN D5W SOLN 1 PA MAGNESIUM SULFATE SOLN 2 PA tis-u-sol viaflex SOLN 1 tis-u-sol SOLN 1 Bile Acid Sequestrants cholestyramine light PACK 1 cholestyramine light POWD 1 cholestyramine PACK 1 cholestyramine POWD 1 COLESTID FLAVORED GRAN 2 COLESTID FLAVORED PACK 2 COLESTID GRAN 2 COLESTID PACK 2 COLESTID TABS 2 colestipol hcl GRAN 1 colestipol hcl TABS 1 prevalite PACK 1 QUESTRAN LIGHT PACK 2 PA QUESTRAN LIGHT POWD 2 PA QUESTRAN PACK 2 PA QUESTRAN POWD 2 PA WELCHOL TABS 2 PA Calcium Channel Blocking Agents (Non-dihydropyridines) CALAN SR TBCR 2 PA CALAN TABS 2 PA CARDIZEM CD CP24 2 PA CARDIZEM LA TB24 2 PA CARDIZEM SOLN 2 PA CARDIZEM TABS 2 PA cartia xt CP24 1 COVERA-HS TB24 2 PA DILACOR XR CP24 2 PA dilt-cd CP24 1 diltia xt CP24 1 diltiazem cd CP24 1 diltiazem hcl er CP12 1 diltiazem hcl er CP24 1 diltiazem hcl sr CP24 1 diltiazem hcl CP24 1 diltiazem hcl TABS 1 diltiazem hcl SOLN 2 PA DILTIAZEM HCL SOLR 2 PA diltiazem xr CP24 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

dilt-xr CP24 1 ISOPTIN SR TBCR 2 PA TARKA TBCR 2 PA taztia xt CP24 1 TIAZAC CP24 2 PA verapamil hcl cr TBCR 1 verapamil hcl er CP24 1 verapamil hcl er TBCR 1 verapamil hcl sa TBCR 1 verapamil hcl sr CP24 1 verapamil hcl sr TBCR 1 verapamil hcl SOLN 1 PA verapamil hcl TABS 1 VERELAN PM CP24 2 PA VERELAN CP24 2 PA Carbonic Anhydrase Inhibitors ACETAZOLAMIDE SODIUM SOLR 1 acetazolamide TABS 1 DIAMOX CP12 2 PA methazolamide TABS 1 Cardioselective Beta-adrenergic Blocking Agents acebutolol hcl CAPS 1 atenolol/chlorthalidone TABS 1 atenolol TABS 1 betaxolol hcl TABS 1 bisoprolol fumarate/hydrochlorothiazide TABS 1 bisoprolol fumarate TABS 1 CORZIDE TABS 2 PA KERLONE TABS 1 KERLONE TABS 2 PA LOPRESSOR HCT TABS 2 PA LOPRESSOR SOLN 2 PA LOPRESSOR TABS 2 PA metoprolol /hydrochlorothiazide TABS 1 metoprolol succinate er TB24 1 metoprolol tartrate SOLN 1 PA metoprolol tartrate TABS 1 metoprolol tartrate TABS 1 PA SECTRAL CAPS 2 PA TENORMIN SOLN 2 PA TENORMIN TABS 2 PA TOPROL XL TB24 2 ZEBETA TABS 2 PA ZIAC TABS 2 PA Cardiovascular Agents INVERSINE TABS 2 PA TEKTURNA TABS 2 PA Cholesterol Absorption Inhibitors VYTORIN TABS 2 ZETIA TABS 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

Dihydropyridines ADALAT CC TB24 2 PA afeditab cr TB24 1 amlodipine besylate/benazepril hydrochloride CAPS 1 amlodipine besylate TABS 1 CADUET TABS 2 CARDENE I.V. SOLN 2 PA CARDENE SR CP12 2 PA CARDENE CAPS 2 PA DYNACIRC CR TB24 2 PA DYNACIRC CAPS 2 PA DYNACIRC-CR TB24 2 PA EXFORGE TABS 2 felodipine er TB24 1 isradipine CAPS 1 LEXXEL TBCR 2 PA LOTREL CAPS 2 nicardipine hcl CAPS 1 nifediac cc TB24 1 nifedical xl TB24 1 nifedipine er TB24 1 nifedipine CAPS 1 nifedipine TB24 1 NIMOTOP CAPS 2 PA NORVASC TABS 2 PLENDIL TB24 2 PA PROCARDIA XL TB24 2 PA PROCARDIA CAPS 2 PA SULAR TB24 2 Direct Cardiac Inotropics digitek TABS 1 DIGOXIN SOLN 1 digoxin TABS 1 digoxin SOLN 2 PA LANOXICAPS CAPS 2 PA LANOXIN SOLN 2 LANOXIN SOLN 2 PA LANOXIN TABS 2 PA Fibrates ANTARA CAPS 2 PA CLOFIBRATE LIQD 2 PA fenofibrate CAPS 1 gemfibrozil TABS 1 LOFIBRA CAPS 2 PA LOFIBRA TABS 2 PA LOPID TABS 2 PA TRICOR TABS 2 TRIGLIDE TABS 2 PA Loop Diuretics bumetanide TABS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

bumetanide SOLN 2 PA BUMEX SOLN 2 PA BUMEX TABS 2 PA DEMADEX SOLN 2 PA DEMADEX TABS 2 PA EDECRIN TABS 2 PA FUROSEMIDE SOLN 1 furosemide SOLN 1 PA furosemide TABS 1 furosemide SOLN 2 PA LASIX TABS 2 PA SODIUM EDECRIN SOLR 2 PA torsemide TABS 1 Nonselective Beta-adrenergic Blocking Agents CARTROL TABS 2 PA CORGARD TABS 2 PA INDERAL LA CP24 2 PA INDERAL TABS 2 PA INDERIDE 40/25 TABS 2 PA INNOPRAN XL CP24 2 PA LEVATOL TABS 2 PA nadolol TABS 1 propranolol /hydrochlorothiazide TABS 1 propranolol hcl er CP24 1 PROPRANOLOL HCL INTENSOL CONC 1 PROPRANOLOL HCL SOLN 1 propranolol hcl SOLN 1 PA propranolol hcl TABS 1 PROPRANOLOL HCL SOLN 2 PA TIMOLOL MALEATE TABS 1 Omega-3 Fatty Acids OMACOR CAPS 2 Osmotic Diuretics ISMOTIC SOLN 2 PA Partial Fatty Acid Oxidase Inhibitors RANEXA TB12 2 PA Potassium-sparing Diuretics ALDACTAZIDE TABS 2 PA ALDACTONE TABS 2 PA amiloride /hydrochlorothiazide TABS 1 AMILORIDE HCL TABS 1 DYAZIDE CAPS 2 PA DYRENIUM CAPS 2 PA INSPRA TABS 2 PA MAXZIDE-25 TABS 2 PA MAXZIDE TABS 2 PA MIDAMOR TABS 2 PA MODURETIC 5-50 TABS 2 PA spironolactone /hydrochlorothiazide TABS 1 spironolactone TABS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

triamterene /hydrochlorothiazide CAPS 1 triamterene /hydrochlorothiazide TABS 1 Thiazide Diuretics ALDACTAZIDE TABS 2 PA ALDORIL D30 TABS 2 PA ALDORIL D50 TABS 2 PA ALDORIL-15 TABS 2 PA ALDORIL-25 TABS 2 PA amiloride /hydrochlorothiazide TABS 1 ATACAND HCT TABS 2 PA benazepril hcl/hydrochlorothiazide TABS 1 bisoprolol fumarate/hydrochlorothiazide TABS 1 CAPOZIDE TABS 2 PA chlorothiazide TABS 1 chlorthalidone TABS 1 CLORPRES TABS 2 PA CORZIDE TABS 2 PA DIURIL IV SOLR 2 PA DIURIL SUSP 2 PA DYAZIDE CAPS 2 PA HYDRALAZINE /HYDROCHLOROTHIAZIDE CAPS 2 PA hydrochlorothiazide CAPS 1 hydrochlorothiazide TABS 1 HYDROCHLOROTHIAZIDE SOLN 2 PA indapamide TABS 1 INDERIDE 40/25 TABS 2 PA LOPRESSOR HCT TABS 2 PA LOZOL TABS 1 LOZOL TABS 2 PA MAXZIDE-25 TABS 2 PA MAXZIDE TABS 2 PA METHYCLOTHIAZIDE TABS 1 METHYLDOPA /HYDROCHLOROTHIAZIDE TABS 1 metolazone TABS 1 metoprolol /hydrochlorothiazide TABS 1 MICROZIDE CAPS 2 PA MINIZIDE CAPS 2 PA MODURETIC 5-50 TABS 2 PA NATURETIN TABS 2 PA propranolol /hydrochlorothiazide TABS 1 quinapril /hydrochlorothiazide TABS 1 quinapril/hctz TABS 1 quinaretic TABS 1 spironolactone /hydrochlorothiazide TABS 1 TENORETIC 100 TABS 2 PA TENORETIC 50 TABS 2 PA TEVETEN HCT TABS 2 PA THALITONE TABS 2 PA TIMOLIDE 10/25 TABS 2 PA triamterene /hydrochlorothiazide CAPS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

triamterene /hydrochlorothiazide TABS 1 VASERETIC TABS 2 PA ZAROXOLYN TABS 2 PA ZIAC TABS 2 PA Vasodilators, Direct-acting Arterial/Venous BIDIL TABS 2 PA DILATRATE SR CPCR 2 PA IMDUR TB24 2 PA ISMO TABS 2 PA isochron TBCR 2 PA ISORDIL TITRADOSE TABS 1 ISORDIL TITRADOSE TABS 2 PA isosorbide dinitrate er TBCR 1 isosorbide dinitrate sa TBCR 1 isosorbide dinitrate tr TBCR 1 isosorbide dinitrate SUBL 1 isosorbide dinitrate TABS 1 isosorbide mononitrate er TB24 1 isosorbide mononitrate TABS 1 minitran PT24 1 MONOKET TABS 1 MONOKET TABS 2 PA nitrek PT24 1 NITRO-BID OINT 2 PA NITRO-DUR PT24 1 NITRO-DUR PT24 2 PA NITROGARD TBCR 2 PA nitroglycerin cr CPCR 1 nitroglycerin er CPCR 1 nitroglycerin sr CPCR 1 nitroglycerin td CPCR 1 nitroglycerin transdermal PT24 1 NITROGLYCERIN OINT 1 nitroglycerin PT24 1 nitroglycerin SUBL 1 nitroglycerin SOLN 2 PA NITROLINGUAL PUMPSPRAY SOLN 2 PA nitroquick SUBL 1 NITROSTAT SUBL 1 nitro-time CPCR 1 Vasodilators, Direct-acting Arterial BIDIL TABS 2 PA HYDRALAZINE /HYDROCHLOROTHIAZIDE CAPS 2 PA hydralazine hcl TABS 1 hydralazine hcl SOLN 2 PA minoxidil TABS 1 papaverine hcl cr CPCR 1 papaverine hcl er CPCR 1 papaverine hcl SOLN 2 PA para-time CPCR 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

Vasodilators, Endothelin Receptor Antagonists LETAIRIS TABS 2 PA TRACLEER TABS 2 PA Cardiovascular Agents DEMSER CAPS 2 PA niacor TABS 2 NIASPAN TBCR 2 Central Nervous System Agents Amphetamines ADDERALL XR CP24 2 ADDERALL TABS 2 PA amphetamine /dextroamphetamine TABS 1 amphetamine salt combo TABS 1 amphetamine salts combo TABS 1 DESOXYN TABS 2 PA DEXEDRINE CP24 2 PA DEXEDRINE TABS 2 PA dextroamphetamine sulfate TABS 1 dextroamphetamine sulfatecr CP24 1 dextrostat TABS 1 methamphetamine hcl TABS 1 VYVANSE CAPS 2 PA Non-amphetamines CONCERTA TBCR 2 DAYTRANA PTCH 2 PA FOCALIN XR CP24 2 FOCALIN XR CP24 2 PA FOCALIN TABS 2 PA METADATE CD CPCR 2 PA METADATE ER TBCR 2 PA methylin er TBCR 1 methylin TABS 1 METHYLIN CHEW 2 PA METHYLIN SOLN 2 PA methylphenidate hcl er TBCR 1 methylphenidate hcl sr TBCR 1 methylphenidate hcl TABS 1 methylphenidate hcl TBCR 1 PROVIGIL TABS 2 PA RILUTEK TABS 2 PA RITALIN LA CP24 2 RITALIN SR TBCR 2 PA RITALIN TABS 2 PA STRATTERA CAPS 2 STRATTERA CAPS 2 PA XYREM SOLN 2 PA Dental and Oral Agents Dental and Oral Agents APHTHASOL PSTE 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

cavarest GEL 2 PA chlorhexadine gluconate oral rinse SOLN 1 CHLORHEXIDINE CONCENTRATE CONC 1 chlorhexidine gluconate SOLN 1 CHLORHEXIDINE GLUCONATE SOLN 2 PA KENALOG IN ORABASE PSTE 1 PERIDEX ORAL RINSE SOLN 2 PA PERIDEX SOLN 2 PA periogard SOLN 1 perisol SOLN 2 PA pilocarpine hcl TABS 1 pilocarpine hydrochloride TABS 1 SALAGEN TABS 2 PA triamcinolone dental PSTE 1 triamcinolone in orabase PSTE 1 Dermatological Agents Dermatological Anti-inflammatories ELOCON CREA 2 PA locoid OINT 2 PA LOTRISONE CREA 2 PA mometasone furoate CREA 1 SOLARAZE GEL 2 PA Dermatological Antipruritic Agents a/b otic SOLN 1 allergen SOLN 2 PA AMERICAINE OTIC SOLN 2 PA AMERICAINE GEL 2 PA ANACAINE OINT 2 PA antiben SOLN 2 PA antipyrine /benzocaine SOLN 1 antipyrine/benzocaine SOLN 1 aurodex SOLN 2 PA auroguard SOLN 2 PA auroto SOLN 2 PA balagan SOLN 2 PA benzotic SOLN 2 PA cefadroxil SUSR 1 cefadroxil TABS 1 dolotic SOLN 2 PA DURICEF CAPS 2 PA DURICEF TABS 2 PA ear drops SOLN 1 ear-gesic SOLN 1 omedia otic SOLN 2 PA oticaine otic SOLN 1 oticin hc SOLN 2 PA otocain SOLN 2 PA otogesic otic SOLN 2 PA otogesic SOLN 2 PA otra nr SOLN 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

pro-otic SOLN 2 PA prudoxin CREA 2 PA PYRIDIUM TABS 2 PA ZONALON CREA 2 PA Dermatological Caustic Agents BENSAL HP OINT 2 PA CONDYLOX W/APPLICATORS SOLN 2 PA CONDYLOX GEL 2 PA DICHLOROACETIC ACID LIQD 1 KERALYT GEL 2 PA podofilox SOLN 1 SALEX CREA 2 PA SALEX LOTN 2 PA Dermatological Emolients ammonium lactate CREA 1 ammonium lactate LOTN 1 AMMONIUM LACTATE SOLN 1 CARMOL-HC CREA 2 PA laccream CREA 2 PA LAC-HYDRIN CREA 2 PA LAC-HYDRIN LOTN 2 PA laclotion LOTN 2 PA Dermatological Immunomodulators ALDARA CREA 2 PA ELIDEL CREA 2 PA PROTOPIC OINT 2 Dermatological Mitotic Inhibitors anthralin CREA 2 PA DOVONEX CREA 2 PA DOVONEX OINT 2 PA DOVONEX SOLN 2 PA DRITHO-SCALP CREA 2 PA PSORIATEC CREA 2 PA TACLONEX OINT 2 PA Dermatological Photochemotherapy Agents 8-MOP CAPS 1 PA OXSORALEN ULTRA CAPS 2 PA OXSORALEN LOTN 2 PA UVADEX SOLN 2 PA Dermatological Retinoids ACCUTANE CAPS 2 PA amnesteem CAPS 2 PA claravis CAPS 2 PA isotretinoin CAPS 1 SORIATANE CAPS 2 PA sotret CAPS 2 PA TAZORAC CREA 2 TAZORAC GEL 2 tretinoin CREA 1 tretinoin GEL 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

ZIANA GEL 2 PA Dermatological Wound Care Agents ACCUZYME LIQD 2 ACCUZYME OINT 2 allanenzyme LIQD 2 PA allanenzyme OINT 2 PA ALLANFILLENZYME LIQD 2 PA allanfillenzyme OINT 2 PA ethezyme 830 OINT 2 PA ETHEZYME OINT 2 PA gladase OINT 1 gladase-c OINT 1 kovia 6.5 OINT 2 kovia OINT 1 PANAFIL LIQD 2 PA PANAFIL OINT 2 PA papain-urea-chlorophyllin OINT 1 pap-urea OINT 1 REGRANEX GEL 2 QL PA SANTYL OINT 2 PA SILVER NITRATE OINT 1 SILVER NITRATE SOLN 1 ziox 405 OINT 2 PA ziox OINT 1 Pigmenting Agents BENOQUIN CREA 2 PA Dermatological Agents AZELEX CREA 2 PA CARAC CREA 2 PA FINACEA GEL 2 PA Enzyme Replacements/Modifiers Enzyme Replacements/Modifiers ALDURAZYME SOLN 2 PA BUPHENYL TABS 2 PA CEREDASE SOLN 2 PA CEREZYME SOLR 2 PA CREON 5 CPEP 2 PA CREON 10 CPEP 2 PA CREON 20 CPEP 2 PA CYSTADANE POWD 2 PA CYSTAGON CAPS 2 PA DYGASE CAPS 2 PA ELAPRASE SOLN 2 PA ELSPAR SOLR 2 PA ENZYCAP CAPS 2 PA ENZYMAX TABS 2 PA FABRAZYME SOLR 2 PA KUTRASE CAPS 2 PA KU-ZYME HP CAPS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

KU-ZYME CAPS 2 PA LAPASE CAPS 2 PA LIPRAM 4500 CPEP 2 PA LIPRAM-CR10 CPEP 2 PA LIPRAM-CR20 CPEP 2 PA LIPRAM-CR5 CPEP 2 PA LIPRAM-PN10 CPEP 2 PA LIPRAM-PN16 CPEP 2 PA LIPRAM-PN20 CPEP 2 PA LIPRAM-UL12 CPEP 2 PA LIPRAM-UL18 CPEP 2 PA LIPRAM-UL20 CPEP 2 PA MYOZYME SOLR 2 PA NAGLAZYME SOLN 2 PA PALCAPS 10 CPEP 2 PA PALCAPS 20 CPEP 2 PA PALIPASE MT 16 CPEP 2 PA PALIPASE MT 20 CPEP 2 PA PALIPASE CPEP 2 PA PALPEON DR 10 CPEP 2 PA PALPEON DR 20 CPEP 2 PA PALPEON MT 20 CPEP 2 PA PALTRASE V8 TABS 2 PA PANCREASE MT 10 CPEP 2 PA PANCREASE MT 16 CPEP 2 PA PANCREASE MT 20 CPEP 2 PA PANCREASE MT 4 CPEP 2 PA PANCREASE CPEP 2 PA PANCRECARB MS-16 CPEP 2 PA PANCRECARB MS-4 CPEP 2 PA PANCRECARB MS-8 CPEP 2 PA PANCRELIPASE MST-16 CPEP 2 PA PANCRELIPASE CAPS 2 PA PANCRELIPASE CPEP 2 PA PANCRELIPASE TABS 2 PA PANCRON 10 CPEP 2 PA PANCRON 20 CPEP 2 PA PANGESTYME CN 10 CPEP 2 PA PANGESTYME CN 20 CPEP 2 PA PANGESTYME EC CPEP 2 PA PANGESTYME MT 16 CPEP 2 PA PANGESTYME UL 12 CPEP 2 PA PANGESTYME UL 18 CPEP 2 PA PANGESTYME UL 20 CPEP 2 PA PANOCAPS MT 16 CPEP 2 PA PANOCAPS MT 20 CPEP 2 PA PANOCAPS CPEP 2 PA PANOKASE-16 TABS 2 PA PANOKASE TABS 2 PA PLARETASE 8000 TABS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

PULMOZYME SOLN 2 PA SUCRAID SOLN 2 PA ULTRACAPS MT 20 CPEP 2 PA ULTRASE MT 12 CPEP 2 PA ULTRASE MT 18 CPEP 2 PA ULTRASE MT 20 CPEP 2 PA ULTRASE CPEP 2 PA VIOKASE 16 TABS 2 PA VIOKASE 8 TABS 2 PA ZAVESCA CAPS 2 PA Gastrointestinal Agents Antispasmodics, Gastrointestinal ANASPAZ TABS 2 PA a-spas SUBL 2 PA atreza TABS 2 PA atropine sulfate SOLN 1 PA ATROVENT SOLN 2 PA B & O 15-A SUPPRETTE SUPP 1 B & O 16-A SUPPRETTE SUPP 1 belladonna & opium SUPP 1 belladonna alkaloids & opium SUPP 1 BENTYL CAPS 2 PA BENTYL SOLN 2 PA BENTYL SYRP 2 PA BENTYL TABS 2 PA CANTIL TABS 2 PA colidrops pediatric SOLN 2 PA COLYTROL PEDIATRIC SOLN 2 PA COLYTROL SUSP 2 PA COLYTROL TABS 2 PA CYSTOSPAZ TABS 2 PA dicyclomine hcl CAPS 1 dicyclomine hcl SOLN 1 dicyclomine hcl TABS 1 dicyclomine hcl SOLN 2 PA diphenatol TABS 1 diphenoxylate/atropine TABS 1 dispas TBDP 2 PA ENLON-PLUS SOLN 2 PA glycopyrrolate TABS 1 glycopyrrolate SOLN 2 PA hyoscyamine sulfate ELIX 1 hyoscyamine sulfate SOLN 1 hyoscyamine sulfate SUBL 1 hyoscyamine sulfate TABS 1 hyoscyamine sulfate TBDP 1 hyoscyamine TABS 1 hyospaz TABS 1 hyosyne ELIX 2 PA hyosyne SOLN 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

IB-STAT AERS 2 PA LEVSIN/SL SUBL 2 PA LEVSIN ELIX 2 PA LEVSIN SOLN 2 PA LEVSIN TABS 2 PA LOMOTIL LIQD 2 PA LOMOTIL TABS 2 PA maldemar TABS 2 PA MAR-SPAS TBDP 2 PA methscopolamine bromide TABS 1 MOTOFEN TABS 2 PA neosol TBDP 2 PA NULEV TBDP 2 PA PAMINE FORTE TABS 2 PA PAMINE TABS 2 PA PRO-BANTHINE TABS 2 PA PROPANTHELINE BROMIDE TABS 1 PROSED/DS (ATROPINE FREE) TABS 2 PA ROBINUL FORTE TABS 2 PA ROBINUL SOLN 2 PA ROBINUL TABS 2 PA SAL-TROPINE TABS 2 PA SCOPACE TABS 2 PA SCOPOLAMINE HYDROBROMIDE SOLN 1 SIMETYL ELIX 2 PA SIMETYL TABS 2 PA spasdel ELIX 2 PA spasdel SOLN 2 PA spasdel TABS 2 PA symax fastabs TBDP 2 PA symax-sl SUBL 2 PA TRANSDERM-SCOP PT72 2 PA Gastrointestinal Agents, Other ACTIGALL CAPS 2 PA AMITIZA CAPS 2 PA COLYTE SOLR 1 COLYTE-FLAVOR PACKS SOLR 1 constulose SOLN 1 di-atro TABS 1 DIPENTUM CAPS 2 diphenatol TABS 1 diphenoxylate/atropine LIQD 1 diphenoxylate/atropine TABS 1 enulose SOLN 1 GASTROCROM CONC 2 PA generlac SOLN 1 glycolax PACK 1 glycolax POWD 1 GOLYTELY SOLR 2 PA KRISTALOSE PACK 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

LACTULOSE SOLN 1 lofene TABS 1 LOMOTIL LIQD 2 PA LOMOTIL TABS 2 PA lonox TABS 2 PA loperamide hcl CAPS 1 metoclopramide hcl SOLN 1 metoclopramide hcl TABS 1 MOVIPREP SOLR 2 PA NULYTELY SOLR 2 PA OSMOPREP TABS 2 PA peg 3350/electrolytes SOLR 1 polyethylene glycol 3350 PACK 1 POLYETHYLENE GLYCOL 3350 POWD 1 PYLERA CAPS 2 PA REGLAN SOLN 2 PA REGLAN TABS 2 PA URSO 250 TABS 2 PA URSO FORTE TABS 2 PA ursodiol CAPS 1 XENICAL CAPS 2 PA Histamine2 (H2) Blocking Agents AXID CAPS 2 PA AXID SOLN 2 PA cimetidine hcl SOLN 1 cimetidine TABS 1 famotidine premixed SOLN 2 PA famotidine TABS 1 famotidine SOLN 2 PA nizatidine CAPS 1 PEPCID I.V. SOLN 2 PA PEPCID PREMIXED SOLN 2 PA PEPCID SUSR 2 PA PEPCID TABS 2 PA ranitidine hcl CAPS 1 ranitidine hcl SOLN 1 PA ranitidine hcl SYRP 1 ranitidine hcl TABS 1 TAGAMET TABS 1 TAGAMET TABS 2 PA TALADINE CAPS 2 PA ZANTAC CAPS 2 PA ZANTAC PACK 2 PA ZANTAC SOLN 2 PA ZANTAC SYRP 2 PA ZANTAC TABS 2 PA ZANTAC TBEF 2 PA Irritable Bowel Syndrome Agents LOTRONEX TABS 2 PA Protectants

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

ARTHROTEC 50 TABS 2 PA ARTHROTEC 75 TABS 2 PA CARAFATE SUSP 2 PA CARAFATE TABS 2 PA CYTOTEC TABS 2 PA misoprostol TABS 1 sucralfate TABS 1 SUCRALFATE SUSP 2 PA Proton Pump Inhibitors ACIPHEX TBEC 2 PA ST NEXIUM I.V. SOLR 2 PA NEXIUM CPDR 2 NEXIUM PACK 2 PA omeprazole CPDR 1 PREVACID NAPRAPAC KIT 2 PA PREVACID SOLUTAB TBDP 2 PREVACID SOLUTAB TBDP 2 PA ST PREVACID CPDR 2 PREVACID PACK 2 PREVACID PACK 2 ST PREVPAC MISC 2 PA PRILOSEC CPDR 2 PA PROTONIX SOLR 2 PA PROTONIX TBEC 2 PA PROTONIX TBEC 2 PA ST ZEGERID CAPS 2 PA ZEGERID PACK 2 PA Genitourinary Agents 5 Alpha-reductase Inhibitors AVODART CAPS 2 PROSCAR TABS 2 Alpha1-adrenergic Blocking Agents CARDURA TABS 2 PA doxazosin mesylate TABS 1 FLOMAX CP24 2 PA HYTRIN CAPS 2 PA prazosin hcl CAPS 1 terazosin hcl CAPS 1 UROXATRAL TB24 2 PA Antispasmodics, Urinary DETROL LA CP24 2 DETROL TABS 2 DITROPAN XL TB24 2 PA DITROPAN SYRP 2 PA DITROPAN TABS 2 PA ENABLEX TB24 1 oxybutynin chloride er TB24 1 oxybutynin chloride SYRP 1 oxybutynin chloride TABS 1 OXYTROL PTTW 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

SANCTURA TABS 2 PA SIMETHICONE LIQD 1 URISPAS TABS 2 PA VESICARE TABS 2 Genitourinary Agents ELMIRON CAPS 2 PA THIOLA TABS 2 PA URELLE TABS 2 PA UTIRA TBEC 1 Oxytocics oxytocin SOLN 1 PITOCIN SOLN 2 PA Phosphate Binders FOSRENOL CHEW 2 FOSRENOL CHEW 2 PA PHOSLO CAPS 2 RENAGEL TABS 2 RENAGEL TABS 2 PA Genitourinary Agents URECHOLINE TABS 2 PA Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids ADVAIR DISKUS MISC 2 a-methapred SOLR 2 PA ARISTOSPAN INTRA-ARTICULAR SUSP 2 PA ARISTOSPAN INTRALESIONAL SUSP 2 PA CELESTONE SOLN 2 PA CORTEF TABS 2 PA cortisone acetate TABS 1 DECADRON TABS 2 PA deltasone TABS 2 PA DEPO-MEDROL SUSP 2 PA DEXAMETHASONE INTENSOL CONC 2 PA dexamethasone sodium phosphate SOLN 1 dexamethasone sodium phosphate SOLN 2 PA DEXAMETHASONE ELIX 1 DEXAMETHASONE SOLN 1 dexamethasone TABS 1 DEXPAK 13 DAY TABS 2 PA KENALOG-10 MDV SUSP 2 PA KENALOG-10 SUSP 2 PA KENALOG-40 SUSP 2 PA KEY-PRED SUSP 2 PA LOTRISONE CREA 2 PA MEDROL DOSEPAK TABS 2 PA MEDROL TABS 2 PA methylprednisolone acetate SUSP 1 methylprednisolone sodiumsuccinate SOLR 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

methylprednisolone TABS 1 neomycin /polymyxin /dexamethasone SUSP 1 ORAPRED ODT TBDP 2 PA ORAPRED SOLN 2 PA PEDIAPRED LIQD 2 PA prednisolone acetate SUSP 1 prednisolone sodium phosphate LIQD 1 prednisolone sodium phosphate SOLN 1 prednisolone SYRP 1 prednisolone TABS 1 PREDNISONE INTENSOL CONC 2 PA PREDNISONE SOLN 1 PREDNISONE TABS 1 PRELONE SYRP 2 PA SOLU-CORTEF SOLR 2 PA SOLU-MEDROL ACT-O-VIAL SOLR 2 PA SOLU-MEDROL SOLR 2 PA SOLUREX LA SUSP 2 PA STERAPRED 12 DAY TABS 1 STERAPRED DS 12 DAY TABS 1 STERAPRED DS TABS 1 STERAPRED TABS 1 Glucocorticoids-Topical-High Potency alclometasone dipropionate CREA 1 amcinonide CREA 1 AMCINONIDE LOTN 1 amcinonide OINT 1 ARISTOCORT A CREA 2 PA ARISTOCORT A OINT 2 PA ARISTOCORT TABS 2 PA augmented betamethasone dipropionate CREA 1 augmented betamethasone dipropionate GEL 1 betamethasone dipropionate CREA 1 betamethasone dipropionate GEL 1 betamethasone dipropionate LOTN 1 betamethasone dipropionate OINT 1 clotrimazole/betamethasone dipropionate CREA 1 clotrimazole/betamethasone dipropionate LOTN 1 CYCLOCORT CREA 2 PA CYCLOCORT LOTN 2 PA CYCLOCORT OINT 2 PA del-beta LOTN 2 PA DESONATE GEL 2 PA desoximetasone CREA 1 desoximetasone GEL 1 desoximetasone OINT 2 PA DIPROLENE AF CREA 2 PA DIPROLENE GEL 2 PA DIPROLENE LOTN 2 PA DIPROLENE OINT 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

fluocinolone acetonide CREA 1 fluocinolone acetonide OINT 1 fluocinolone acetonide SOLN 1 fluocinonide emollient base CREA 1 fluocinonide CREA 1 fluocinonide GEL 1 fluocinonide OINT 1 fluocinonide SOLN 1 fluocinonide-e CREA 1 HALOG CREA 2 PA HALOG OINT 2 PA HALOG SOLN 2 PA KENALOG AERS 2 PA KENALOG CREA 2 PA LIDEX CREA 2 PA LIDEX GEL 2 PA LIDEX OINT 2 PA LIDEX SOLN 2 PA LIDEX-E CREA 2 PA LOTRISONE CREA 2 PA LOTRISONE LOTN 2 PA mytrex CREA 1 nystatin/triamcinolone CREA 1 nystatin/triamcinolone OINT 1 TACLONEX OINT 2 PA TOPICORT CREA 2 PA TOPICORT GEL 2 PA TOPICORT OINT 2 PA triamcinolone acetonide CREA 1 triamcinolone acetonide OINT 1 VANOS CREA 2 PA Glucocorticoids-Topical-Low Potency ACLOVATE CREA 2 PA ACLOVATE OINT 2 PA ala-cort CREA 2 PA ala-cort LOTN 2 PA ALA-SCALP LOTN 2 PA alclometasone dipropionate OINT 1 ANUSOL-HC CREA 1 CARMOL-HC CREA 2 PA cetacort LOTN 2 PA CLODERM CREA 2 PA CORTIFOAM FOAM 2 PA CORTISPORIN CREA 2 PA CORTISPORIN OINT 2 PA desonide OINT 1 hc cream CREA 1 hydrocortisone in absorbase OINT 1 hydrocortisone CREA 1 hydrocortisone LOTN 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

hydrocortisone OINT 1 HYTONE LOTN 1 HYTONE CREA 2 PA keratol hc CREA 2 PA lacticare-hc LOTN 2 PA nutracort LOTN 1 nystatin/triamcinolone OINT 1 proctocare-hc CREA 2 PA PROCTOCORT CREA 2 PA proctocream-hc CREA 2 PA procto-kit CREA 2 PA procto-pak CREA 1 proctosol hc CREA 2 PA proctozone-hc CREA 1 SYNALAR SOLN 2 PA texacort SOLN 1 TEXACORT SOLN 2 PA triamcinolone/nystatin CREA 1 triamcinolone/nystatin OINT 1 TRIDESILON CREA 2 PA TRIDESILON OINT 2 PA u-cort CREA 2 PA VERDESO FOAM 2 PA Glucocorticoids-Topical-Medium Potency betamethasone valerate CREA 1 betamethasone valerate LOTN 1 betamethasone valerate OINT 1 beta-val CREA 1 beta-val LOTN 1 CAPEX SHAM 2 PA CORDRAN SP CREA 2 PA CORDRAN TAPE TAPE 2 PA CORDRAN LOTN 2 PA CORDRAN OINT 2 PA CUTIVATE CREA 2 PA CUTIVATE LOTN 2 PA CUTIVATE OINT 2 PA DERMA-SMOOTHE/FS BODY OIL OIL 2 PA DERMA-SMOOTHE/FS SCALP OIL OIL 2 PA DERMATOP CREA 2 PA DERMATOP OINT 2 PA desonide CREA 1 desonide LOTN 1 DESOWEN OINT 1 DESOWEN CREA 2 PA DESOWEN LOTN 2 PA desoximetasone CREA 1 ELOCON CREA 2 PA ELOCON LOTN 2 PA ELOCON OINT 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

fluocinolone acetonide CREA 1 fluocinolone acetonide SOLN 1 fluticasone propionate CREA 1 fluticasone propionate OINT 1 hydrocortisone butyrate CREA 1 hydrocortisone butyrate OINT 1 hydrocortisone butyrate SOLN 1 hydrocortisone valerate CREA 1 hydrocortisone valerate OINT 1 KENALOG CREA 2 PA KENALOG LOTN 2 PA KENALOG OINT 2 PA LOCOID LIPOCREAM CREA 2 PA locoid CREA 2 PA locoid OINT 2 PA locoid SOLN 2 PA lokara LOTN 1 LUXIQ FOAM 2 PA mometasone furoate CREA 1 mometasone furoate OINT 1 mometasone furoate SOLN 1 PANDEL CREA 2 PA prednicarbate CREA 1 SYNALAR CREA 2 PA SYNALAR OINT 2 PA TEMOVATE SOLN 2 PA TOPICORT LP CREA 2 PA TRIAMCINOLONE ACETONIDE IN ABSORBASE OINT 2 PA triamcinolone acetonide CREA 1 triamcinolone acetonide LOTN 1 triamcinolone acetonide OINT 1 triamcinolone acetonide PSTE 1 triderm CREA 2 PA triderm OINT 2 PA WESTCORT CREA 2 PA WESTCORT OINT 2 PA Glucocorticoids-Topical-Very High Potency alphatrex GEL 2 PA apexicon e CREA 1 apexicon OINT 2 PA augmented betamethasone dipropionate OINT 1 clobetasol propionate e CREA 1 clobetasol propionate emollient CREA 1 clobetasol propionate CREA 1 clobetasol propionate GEL 1 clobetasol propionate OINT 1 clobetasol propionate SOLN 1 clobevate GEL 2 PA CLOBEX LIQD 2 PA CLOBEX LOTN 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

CLOBEX SHAM 2 PA cormax CREA 1 cormax OINT 1 cormax SOLN 1 diflorasone diacetate CREA 1 diflorasone diacetate OINT 1 embeline e CREA 1 embeline CREA 1 embeline GEL 1 embeline OINT 1 embeline SOLN 1 halobetasol propionate CREA 1 halobetasol propionate OINT 1 isovate CREA 2 PA MAXIFLOR CREA 1 MAXIFLOR OINT 1 OLUX FOAM 2 PA OLUX-E FOAM 2 PA PSORCON E CREA 2 PA PSORCON E OINT 2 PA TEMOVATE E CREA 2 PA TEMOVATE CREA 2 PA TEMOVATE GEL 2 PA TEMOVATE OINT 2 PA ULTRAVATE CREA 2 PA ULTRAVATE OINT 2 PA Mineralocorticoids FLORINEF TABS 2 PA fludrocortisone acetate TABS 1 Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Oral ACTONEL WITH CALCIUM TABS 2 ACTONEL TABS 2 BONIVA TABS 2 PA DIDRONEL TABS 2 etidronate disodium TABS 1 FOSAMAX PLUS D TABS 2 FOSAMAX SOLN 2 FOSAMAX TABS 2 SKELID TABS 2 PA Bisphosphonates, Parenteral AREDIA SOLR 2 PA BONIVA KIT 2 PA DIDRONEL IV SOLN 2 PA pamidronate disodium SOLN 2 PA pamidronate disodium SOLR 2 PA RECLAST SOLN 2 PA ZOMETA CONC 2 PA Calcium Regulating Hormones

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

FORTEO SOLN 2 PA fortical SOLN 2 PA MIACALCIN SOLN 2 MIACALCIN SOLN 2 PA Parathyroid Hormone Analogs FORTEO SOLN 2 PA Vitamin D-related Agents/Metabolic Bone Disease Agents CALCIJEX SOLN 2 PA calcitriol CAPS 1 calcitriol SOLN 1 PA DHT INTENSOL SOLN 2 PA DHT TABS 2 PA HECTOROL CAPS 2 HECTOROL CAPS 2 PA HECTOROL SOLN 2 PA ROCALTROL CAPS 2 PA ROCALTROL SOLN 2 PA ZEMPLAR CAPS 2 PA ZEMPLAR SOLN 2 PA Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary) DDAVP SOLN 2 PA DDAVP TABS 2 PA desmopressin acetate SOLN 1 desmopressin acetate TABS 1 desmopressin acetate SOLN 2 PA GENOTROPIN MINIQUICK SOLR 2 PA GENOTROPIN SOLR 2 PA HUMATROPE COMBO PACK SOLR 2 PA HUMATROPE SOLR 2 PA minirin SOLN 2 PA NORDITROPIN CARTRIDGE SOLN 2 PA NORDITROPIN NORDIFLEX PEN SOLN 2 PA NORDITROPIN NORDIFLEX SOLN 2 PA NUTROPIN AQ PEN SOLN 2 PA NUTROPIN AQ SOLN 2 PA NUTROPIN SOLR 2 PA SAIZEN CLICK.EASY SOLR 2 PA SAIZEN SOLR 2 PA SEROSTIM SOLR 2 PA SOMAVERT SOLR 2 PA STIMATE SOLN 2 PA TEV-TROPIN SOLR 2 PA ZORBTIVE SOLR 2 PA Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

INCRELEX SOLN 2 PA Hormonal Agents, Stimulant/Replacement/Modifying (Sex

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

Hormones/Modifiers) Androgens/Anabolic Steroids ANADROL-50 TABS 2 PA ANDRODERM PT24 2 ANDRODERM PT24 2 PA ANDROGEL GEL 2 PA ANDROID CAPS 2 PA ANDROXY TABS 2 danazol CAPS 1 danazol CAPS 1 PA DEPO-TESTOSTERONE OIL 2 PA NANDROLONE DECANOATE OIL 2 PA OXANDRIN TABS 2 PA oxandrolone TABS 1 STRIANT MISC 2 PA TESLAC TABS 2 PA TESTIM GEL 1 PA testosterone cypionate OIL 1 PA testosterone enanthate OIL 1 PA TESTOSTERONE PROPIONATE OIL 1 PA TESTOSTERONE SUSP 1 PA TESTRED CAPS 2 PA Contraceptives ALESSE-28 TABS 2 PA ALESSE TABS 2 PA apri TABS 2 PA aranelle TABS 2 PA aviane TABS 2 PA balziva TABS 1 BREVICON-28 TABS 2 PA camila TABS 2 PA cesia TABS 2 PA cryselle-28 TABS 2 PA CYCLESSA TABS 2 PA DEMULEN 1/35-28 TABS 2 PA DEMULEN 1/50-28 TABS 2 PA DESOGEN TABS 2 PA enpresse-28 TABS 1 errin TABS 2 PA ESTROSTEP FE TABS 1 FEMCON FE CHEW 2 PA jolessa TABS 1 jolivette TABS 2 PA junel 1.5/30 TABS 1 junel 1/20 TABS 1 junel fe 1.5/30 TABS 1 junel fe 1/20 TABS 1 kariva TABS 2 PA kelnor 1/35 TABS 2 PA leena TABS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

lessina-28 TABS 2 PA LEVLEN CONTRACT PACK TABS 2 PA LEVLEN-28 TABS 2 PA LEVLITE-28 TABS 2 PA levora 0.15/30-28 TABS 2 PA LO/OVRAL-28 TABS 2 PA LO/OVRAL TABS 2 PA LOESTRIN 1.5/30-21 TABS 2 PA LOESTRIN 1/20-21 TABS 2 PA LOESTRIN 24 FE TABS 2 PA LOESTRIN FE 1.5/30 TABS 2 PA LOESTRIN FE 1/20 TABS 2 PA low-ogestrel TABS 2 PA lutera TABS 2 PA LYBREL TABS 2 PA microgestin 1.5/30 TABS 2 PA microgestin 1/20 TABS 2 PA microgestin fe 1.5/30 TABS 2 PA microgestin fe TABS 2 PA MODICON-28 TABS 2 PA mononessa TABS 2 PA necon 0.5/35-28 TABS 1 necon 1/35-28 TABS 1 necon 1/50-28 TABS 1 NECON 10/11-28 TABS 1 necon 7/7/7 TABS 1 nora-be TABS 2 PA NORDETTE-28 TABS 2 PA NORDETTE TABS 2 PA NORINYL 1+35 TABS 2 PA NORINYL 1+50 TABS 2 PA NOR-QD TABS 2 PA nortrel 0.5/35 (28) TABS 2 PA nortrel 1/35 (21) TABS 2 PA nortrel 1/35 (28) TABS 2 PA nortrel 7/7/7 TABS 2 PA NUVARING RING 2 PA OGESTREL TABS 2 PA ORTHO EVRA PTWK 2 PA ORTHO MICRONOR TABS 2 PA ORTHO TRI-CYCLEN LO TABS 2 PA ORTHO TRI-CYCLEN TABS 2 PA ORTHO-CEPT-28 TABS 2 PA ORTHO-CEPT TABS 2 PA ORTHO-CYCLEN-28 TABS 2 PA ORTHO-NOVUM 1/35-28 TABS 2 PA ORTHO-NOVUM 1/50-28 TABS 2 PA ORTHO-NOVUM 10/11-28 TABS 2 PA ORTHO-NOVUM 7/7/7-28 TABS 2 PA OVCON-35 TABS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

OVCON-50 28 TABS 2 PA PLAN B TABS 2 portia-28 TABS 1 previfem TABS 2 PA quasense TABS 1 reclipsen TABS 2 PA SEASONALE TABS 2 PA SEASONIQUE TABS 2 PA solia TABS 2 PA sprintec 28 TABS 2 PA TRI-LEVLEN CONTRACT PACK TABS 2 PA TRI-LEVLEN TABS 2 PA trinessa TABS 2 PA TRI-NORINYL 28 TABS 2 PA TRIPHASIL 28 TABS 2 PA tri-previfem TABS 2 PA tri-sprintec TABS 2 PA trivora-28 TABS 2 PA velivet TABS 2 PA YASMIN 28 TABS 2 PA YAZ TABS 2 PA zovia 1/35e TABS 1 zovia 1/50e TABS 1 Estrogens ALORA PTTW 1 ANGELIQ TABS 2 PA CENESTIN TABS 2 PA CLIMARA PRO PTWK 2 PA CLIMARA PTWK 2 CLIMARA PTWK 2 PA COMBIPATCH PTTW 2 PA DELESTROGEN OIL 2 PA DEPO-ESTRADIOL OIL 2 PA DIVIGEL GEL 2 PA ELESTRIN GEL 2 PA ESCLIM PTTW 2 PA ESTRACE TABS 1 ESTRACE CREA 2 PA ESTRACE TABS 2 PA ESTRADERM PTTW 2 PA estradiol PTWK 1 estradiol TABS 1 ESTRASORB EMUL 2 PA ESTRING RING 2 PA estro-5 SUSP 2 PA ESTROGEL GEL 2 PA estropipate TABS 1 FEMHRT 1/5 TABS 2 PA FEMHRT LOW DOSE TABS 2 PA FEMRING RING 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

FEMTRACE TABS 2 PA GYNODIOL TABS 2 PA junel 1.5/30 TABS 1 kestrone 5 SUSP 2 PA MENEST TABS 2 PA MENOSTAR PTWK 2 PA MIRCETTE TABS 2 PA OGEN TABS 2 PA ORTHO-CEPT-28 TABS 2 PA ortho-est TABS 2 PA OVCON-50 28 TABS 2 PA OVCON-50/28 TABS 2 PA PREFEST TABS 2 PA PREMARIN W/APPLICATOR CREA 2 PREMARIN SOLR 2 PA PREMARIN TABS 2 PREMPHASE TABS 2 PREMPRO TABS 2 VAGIFEM TABS 2 PA VIVELLE PTTW 1 VIVELLE-DOT PTTW 1 VIVELLE-DOT PTTW 2 PA Progestins ANGELIQ TABS 2 PA AYGESTIN TABS 1 COMBIPATCH PTTW 2 PA CRINONE GEL 2 PA DEPO-PROVERA CONTRACEPTIVE SUSP 2 PA DEPO-PROVERA SUSP 2 PA DEPO-SUBQ PROVERA 104 SUSP 2 PA medroxyprogesterone acetate TABS 1 medroxyprogesterone acetate SUSP 2 PA MEGACE ES SUSP 2 MEGACE ORAL SUSP 2 PA megestrol acetate SUSP 1 megestrol acetate TABS 1 norethindrone acetate TABS 1 PREMPHASE TABS 2 PREMPRO TABS 2 PROCHIEVE GEL 2 PA PROMETRIUM CAPS 2 PA PROVERA TABS 2 PA Selective Estrogen Receptor Modifying Agents EVISTA TABS 2 Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid) ARMOUR THYROID TABS 2 PA CYTOMEL TABS 2 levothroid TABS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

levothroid TABS 1 PA levothyroxine sodium TABS 1 levothyroxine sodium SOLR 2 PA levoxyl TABS 1 nature-throid TABS 1 SYNTHROID TABS 1 SYNTHROID TABS 2 PA thyroid TABS 1 THYROLAR-1/2 TABS 2 PA THYROLAR-1/4 TABS 2 PA THYROLAR-1 TABS 2 PA THYROLAR-2 TABS 2 THYROLAR-3 TABS 2 PA TRIOSTAT SOLN 2 PA unithroid TABS 1 westhroid light blue sugar coated TABS 2 PA westhroid tan compressed TABS 2 PA westhroid TABS 2 PA Hormonal Agents, Suppressant (Adrenal) Hormonal Agents, Suppressant (Adrenal) CYTADREN TABS 2 Hormonal Agents, Suppressant (Parathyroid) Calcimimetics SENSIPAR TABS 2 PA Hormonal Agents, Suppressant (Pituitary) Dopamine Agonists DOSTINEX TABS 2 PA pergolide mesylate TABS 1 Somatostatin Analogs octreotide acetate SOLN 2 PA SANDOSTATIN LAR DEPOT KIT 2 PA SANDOSTATIN SOLN 2 PA Hormonal Agents, Suppressant (Sex Hormones/Modifiers) Antiandrogens AVODART CAPS 2 CASODEX TABS 2 ELIGARD KIT 2 PA flutamide CAPS 1 leuprolide acetate KIT 2 PA leuprolide acetate SOLN 2 PA LUPRON 2 WEEK SUPPLY KIT 2 PA LUPRON 6-PACK SOLN 2 PA LUPRON DEPOT KIT 2 PA LUPRON DEPOT-PED KIT 2 PA NILANDRON TABS 2 PA SYNAREL SOLN 2 PA TRELSTAR DEPOT SUSR 2 PA TRELSTAR LA SUSR 2 PA VANTAS KIT 2 PA VIADUR KIT 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

ZOLADEX IMPL 2 PA Hormonal Agents, Suppressant (Thyroid) Hormonal Agents, Suppressant (Thyroid) liothyronine sodium SOLN 1 methimazole TABS 1 propylthiouracil TABS 1 TAPAZOLE TABS 2 PA Immunological Agents Immune Suppressants (Non-TNF Inhibitors) AMEVIVE SOLR 2 PA azathioprine TABS 1 CELLCEPT INTRAVENOUS SOLR 2 PA CELLCEPT CAPS 2 CELLCEPT SUSR 2 CELLCEPT TABS 2 cyclosporine modified CAPS 1 cyclosporine modified SOLN 1 CYCLOSPORINE MODIFIED CAPS 2 PA cyclosporine CAPS 1 cyclosporine SOLN 1 cyclosporine SOLN 2 PA gengraf CAPS 1 gengraf CAPS 1 PA gengraf SOLN 1 methotrexate sodium SOLN 2 PA methotrexate sodium SOLR 2 PA methotrexate TABS 1 MYFORTIC TBEC 2 NEORAL CAPS 2 PA NEORAL SOLN 2 PA PROGRAF CAPS 2 PROGRAF SOLN 2 PA RAPAMUNE SOLN 2 PA RAPAMUNE TABS 2 PA RAPTIVA KIT 2 PA RESTASIS EMUL 2 PA RHEUMATREX TABS 2 PA SANDIMMUNE CAPS 2 PA SANDIMMUNE SOLN 2 PA SIMULECT SOLR 2 PA TREXALL TABS 2 PA ZENAPAX CONC 2 PA Immunomodulators, Other ARAVA TABS 2 ARAVA TABS 2 PA CARIMUNE NANOFILTERED SOLR 2 PA COPAXONE KIT 2 PA KINERET SOLN 2 PA leflunomide TABS 1 REVLIMID CAPS 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

RIDAURA CAPS 2 PA THALOMID CAPS 2 PA TYSABRI CONC 2 PA Interferons, Alfa ALFERON N SOLN 2 PA INFERGEN INJ 2 PA INTRON-A W/DILUENT SOLR 2 PA INTRON-A KIT 2 PA INTRON-A SOLN 2 PA PEGASYS KIT 2 PA PEGASYS SOLN 2 PA PEG-INTRON REDIPEN PAK 4 KIT 2 PA PEG-INTRON REDIPEN KIT 2 PA PEG-INTRON KIT 2 PA REBETRON KIT 2 PA ROFERON-A KIT 2 PA Interferons, Beta AVONEX KIT 2 PA BETASERON SOLR 2 PA REBIF TITRATION PACK SOLN 2 PA REBIF SOLN 2 PA Interferons, Gamma ACTIMMUNE SOLN 2 PA Tumor Necrosis Factor (TNF) Inhibitors ENBREL SURECLICK SOLN 2 PA ENBREL KIT 2 PA ENBREL SOLN 2 PA HUMIRA PEN KIT 2 PA HUMIRA KIT 2 PA ORENCIA SOLR 2 PA REMICADE SOLR 2 PA Vaccines ACTHIB SOLR 2 PA ADACEL SUSP 2 PA ATTENUVAX INJ 2 PA BOOSTRIX SUSP 2 PA CARIMUNE NANOFILTERED SOLR 2 PA CARIMUNE SOLR 2 PA COMVAX SUSP 2 PA DAPTACEL SUSP 2 PA DECAVAC INJ 2 PA DIPTHERIA/TETANUS TOXOID PEDIATRIC INJ 2 PA ENGERIX-B SDV SUSP 2 PA ENGERIX-B INJ 2 PA ENGERIX-B SUSP 2 PA FLEBOGAMMA INJ 2 PA GAMASTAN S/D INJ 2 PA GAMMAGARD LIQUID SOLN 2 PA GAMMAGARD S/D SOLR 2 PA gammar-p i.v. SOLR 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

GAMUNEX INJ 2 PA GARDASIL SUSP 2 PA HAVRIX SUSP 2 PA HIBTITER SOLN 2 PA IMMUNE GLOBULIN INJ 2 PA INFANRIX SUSP 2 PA IPOL INACTIVATED IPV INJ 2 PA IVEEGAM EN SOLR 2 PA MENACTRA INJ 2 PA MENOMUNE-A/C/Y/W-135 INJ 2 PA MERUVAX II W/DILUENT 1 DOSE INJ 2 PA MERUVAX II W/DILUENT 10 DOSE INJ 2 PA M-M-R II 1 DOSE INJ 2 PA M-M-R II W/DILUENT 1 DOSE INJ 2 PA M-M-R II W/DILUENT 10 DOSE INJ 2 PA M-M-R II INJ 2 PA M-R-VAX II INJ 2 PA MUMPSVAX W/DILUENT 1 DOSE INJ 2 PA MUMPSVAX W/DILUENT 10 DOSE INJ 2 PA OCTAGAM SOLN 2 PA PANGLOBULIN NF SOLR 2 PA PANGLOBULIN. SOLR 2 PA PANGLOBULIN SOLR 2 PA PEDIARIX SUSP 2 PA PEDVAX HIB SOLN 2 PA POLYGAM S/D SOLR 2 PA PROQUAD INJ 2 PA RECOMBIVAX HB INJ 2 PA RECOMBIVAX HB SUSP 2 PA ROTATEQ SUSP 2 PA TETANUS TOXOID ADSORBED SOLN 2 PA TETANUS TOXOID SOLN 1 PA TETANUS/DIPHTHERIA TOXOID-ADULT INJ 2 PA TETANUS/DIPHTHERIA TOXOIDS-ABSORBED ADULT SUSP 2 PA TICE BCG SUSR 2 PA TRIHIBIT KIT 2 PA TRIPEDIA SUSP 2 PA TWINRIX SUSP 2 PA VAQTA INJ 2 PA VARIVAX INJ 2 PA VENOGLOBULIN-S INJ 2 PA VIVAGLOBIN SOLN 2 PA ZOSTAVAX SOLR 2 PA Inflammatory Bowel Disease Agents Glucocorticoids colocort ENEM 1 ENTOCORT EC CP24 2 PA hydrocortisone ENEM 1 Salicylates ASACOL TBEC 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

CANASA SUPP 2 PA COLAZAL CAPS 2 PA LIALDA TBEC 2 PA mesalamine ENEM 1 PENTASA CPCR 2 PA ROWASA ENEM 2 PA Insulin Administration Supplies Insulin Administration Supplies ALCOHOL SWABS PADS 1 DIABETIC SUPPLIES, MISC SYRP 1 emcin clear PADS 2 PA GAUZE PADS 2"X2" PADS 1 KMART VALU PLUS INSULIN SYRINGE/0.3ML/30G MISC 1 KMART VALU PLUS INSULIN SYRINGE/0.5ML/29G MISC 1 KMART VALU PLUS INSULIN SYRINGE/1ML/29G MISC 1 pen needles, insulin disposable NOT

APPLICABLE 1

UNIFINE PENTIPS/12MM MISC 1 Ophthalmic Agents Alpha-adrenergic Agonists, Ophthalmic ALPHAGAN P SOLN 2 brimonidine tartrate SOLN 1 dipivefrin hcl SOLN 1 IOPIDINE SOLN 2 PROPINE SOLN 2 PA Beta-adrenergic Blocking Agents, Ophthalmic BETAGAN C CAP QD SOLN 1 BETAGAN WITHOUT C CAP SOLN 2 PA BETAGAN SOLN 1 BETAGAN SOLN 2 PA BETAXOLOL HCL SOLN 2 PA BETIMOL SOLN 2 PA BETOPTIC-S SUSP 2 PA carteolol hcl SOLN 1 COSOPT SOLN 2 ISTALOL SOLN 1 levobunolol hcl SOLN 1 metipranolol SOLN 2 PA OPTIPRANOLOL SOLN 2 PA timolol maleate ophthalmic gel forming SOLG 1 timolol maleate SOLG 1 timolol maleate SOLN 1 TIMOPTIC OCUDOSE SOLN 2 PA TIMOPTIC SOLN 2 PA TIMOPTIC-XE SOLG 2 PA Carbonic Anhydrase Inhibitors, Ophthalmic ACETAZOLAMIDE SODIUM SOLR 1 acetazolamide TABS 1 AZOPT SUSP 2 PA COSOPT SOLN 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

DIAMOX CP12 2 PA methazolamide TABS 1 TRUSOPT SOLN 2 Glucocorticoids, Ophthalmic ALREX SUSP 2 PA bac/poly/neomy/hc OINT 1 BLEPHAMIDE LIQUIFILM SUSP 2 PA BLEPHAMIDE S.O.P. OINT 2 PA BLEPHAMIDE SUSP 2 PA CORTISPORIN SUSP 2 PA dexamethasone sodium phosphate SOLN 1 dexasol SOLN 2 PA dexasporin SUSP 2 PA ECONOPRED PLUS SUSP 1 FLAREX SUSP 2 PA fluorometholone SUSP 1 fluor-op SUSP 1 FML FORTE SUSP 2 FML LIQUIFILM SUSP 2 FML S.O.P. OINT 2 FML-S LIQUIFILM SUSP 2 INFLAMASE FORTE SOLN 2 PA INFLAMASE MILD SOLN 2 PA LOTEMAX SUSP 2 PA MAXIDEX SUSP 2 PA MAXITROL OINT 2 PA MAXITROL SUSP 2 PA neo/poly/bac/hc OINT 1 neomycin /bacitracin /polymyxin /hydrocortisone OINT 1 neomycin /polymyxin /dexamethasone OINT 1 neomycin /polymyxin /dexamethasone SUSP 1 neomycin /polymyxin /hydrocortisone SUSP 1 poly-dex OINT 2 PA poly-dex SUSP 2 PA POLY-PRED SUSP 2 PA PRED FORTE SUSP 2 PA PRED MILD SUSP 2 PA PRED-G S.O.P. OINT 2 PA PRED-G SUSP 2 PA prednisol SOLN 2 PA prednisolone /sulfacetamide SOLN 1 PREDNISOLONE /SULFACETAMIDE SUSP 2 PA prednisolone acetate SUSP 1 prednisolone sodium phosphate SOLN 1 SULFACETAMIDE /PREDNISOLONE SUSP 2 PA sulfacetamide sodium/prednisolone sodium phosphate SOLN 1 TOBRADEX OINT 2 TOBRADEX SUSP 2 triple antibiotic OINT 1 VEXOL SUSP 2 PA

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

ZYLET SUSP 2 PA Miotics, Ophthalmic carbastat SOLN 2 PA ISOPTO CARPINE SOLN 1 ISOPTO CARPINE SOLN 2 PA MIOSTAT SOLN 2 PA PHOSPHOLINE IODIDE SOLR 2 pilocar SOLN 2 pilocar SOLN 2 PA pilocarpine hcl SOLN 1 PILOPINE HS GEL 2 PA piloptic-1/2 SOLN 1 piloptic-1 SOLN 1 piloptic-2 SOLN 2 PA piloptic-3 SOLN 2 PA piloptic-4 SOLN 2 PA piloptic-6 SOLN 2 PA Nonsteroidal Anti-inflammatory Drugs, Ophthalmic ACULAR LS SOLN 2 ACULAR PF SOLN 2 ACULAR SOLN 2 flurbiprofen sodium SOLN 1 NEVANAC SUSP 2 PA OCUFEN SOLN 2 PA VOLTAREN SOLN 2 PA XIBROM SOLN 2 PA Ocular Surface Agents LACRISERT INST 2 Ophthalmic Agents, Other ak-con SOLN 1 allersol SOLN 2 PA atropine sulfate OINT 1 atropine sulfate SOLN 1 atropine-care SOLN 2 PA AZASITE SOLN 2 PA homatropaire SOLN 1 ISOPTO ATROPINE SOLN 2 PA ISOPTO HOMATROPINE SOLN 1 naphazole SOLN 1 naphazoline hcl SOLN 1 OCUFLOX SOLN 2 PA POLYSPORIN OINT 1 triple antibiotic OINT 1 Ophthalmic Anti-allergy Agents ALAMAST SOLN 2 PA ALOCRIL SOLN 2 PA ALOMIDE SOLN 2 PA CROLOM SOLN 1 cromolyn sodium SOLN 1 ELESTAT SOLN 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

EMADINE SOLN 2 PA ketotifen fumarate SOLN 1 OPTIVAR SOLN 2 PATADAY SOLN 2 PATANOL SOLN 2 Prostaglandins, Ophthalmic LUMIGAN SOLN 2 TRAVATAN Z SOLN 2 PA TRAVATAN SOLN 2 XALATAN SOLN 2 Ophthalmic Agents ak-tob SOLN 1 gentasol SOLN 2 PA ocusulf-10 SOLN 2 PA polycin b OINT 2 PA polymyxin b sulfate/trimethoprim sulfate SOLN 1 romycin OINT 2 PA Otic Agents Otic Anti-inflammatories acetasol hc SOLN 1 acetic acid/aluminum acetate SOLN 1 acetic acid/hydrocortisone SOLN 1 antibiotic ear SOLN 1 antibiotic ear SUSP 1 aurobiotic-hc SOLN 2 PA CIPRO HC SUSP 2 PA CIPRODEX SUSP 2 COLY-MYCIN S SUSP 2 PA COLY-MYCIN-S SUSP 2 PA CORTISPORIN SOLN 2 PA CORTISPORIN SUSP 2 PA CORTISPORIN-TC SUSP 2 PA cortomycin SOLN 1 cortomycin SUSP 1 CRESYLATE SOLN 2 PA DERMOTIC OIL 2 PA neo/polymyxin/hc 5-10000-1 SUSP 1 neomycin /polymyxin /hydrocortisone SOLN 1 neomycin /polymyxin /hydrocortisone SUSP 1 neomycin/polymyxin/hc SOLN 1 oticin hc SOLN 2 PA oticin hc SUSP 2 PA otimar SOLN 2 PA otimar SUSP 2 PA PEDIOTIC SUSP 2 PA Respiratory Tract Agents Bronchodilators, Anticholinergic ALBUTEROL SULFATE/IPRATROPIUM BROMIDE SOLN 1 ATROVENT HFA AERS 2

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

ATROVENT SOLN 2 PA COMBIVENT AERO 2 DUONEB SOLN 2 PA ENLON-PLUS SOLN 2 PA ipratropium bromide SOLN 1 Bronchodilators, Anti-inflammatories ADVAIR DISKUS MISC 2 ADVAIR HFA AERO 2 AEROBID AERS 2 PA AEROBID-M AERS 2 PA ASMANEX 120 METERED DOSES AEPB 2 PA ASMANEX 14 METERED DOSES AEPB 2 PA ASMANEX 30 METERED DOSES AEPB 2 PA ASMANEX 60 METERED DOSES AEPB 2 PA AZMACORT AERS 2 PA FLOVENT HFA AERO 2 PA FLOVENT AERO 2 PULMICORT TURBUHALER AEPB 2 PA PULMICORT SUSP 2 PA QVAR AERS 2 SYMBICORT AERO 2 PA Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines) aminophylline SOLN 1 PA aminophylline TABS 1 ELIXOPHYLLIN ELIX 2 PA LUFYLLIN TABS 2 PA QUIBRON-T/SR TB12 2 PA QUIBRON-T TABS 2 PA SLO-BID GYROCAPS CP12 2 PA THEO-24 CP24 2 PA theocap CP12 2 PA theochron TB12 1 theophylline anhydrous cr TB12 1 theophylline cr TB12 1 theophylline er CP12 1 theophylline er TB12 1 theophylline sr TB12 1 theophylline td TB12 1 UNIPHYL TB24 2 PA Bronchodilators, Sympathomimetic ACCUNEB NEBU 2 PA ADRENALIN SOLN 2 PA ADVAIR DISKUS MISC 2 ADVAIR HFA AERO 2 airet NEBU 2 PA alavert allergy/sinus TB12 1 ALBUTEROL SULFATE/IPRATROPIUM BROMIDE SOLN 1 albuterol sulfate NEBU 1 albuterol sulfate SYRP 1 albuterol sulfate TABS 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

albuterol AERS 1 ALLEGRA-D 12 HOUR TB12 2 QL PA ST ALLEGRA-D 24 HOUR TB24 2 PA ST ALUPENT AERP 2 PA BRETHINE SOLN 2 PA BRETHINE TABS 2 PA BROVANA NEBU 2 PA CLARINEX-D 12 HOUR TB12 2 PA CLARINEX-D 24 HOUR TB24 2 PA COMBIVENT AERO 2 epinephrine hcl SOLN 2 PA EPIPEN 2-PAK DEVI 2 PA EPIPEN-JR 2-PAK DEVI 2 PA FORADIL AEROLIZER CAPS 2 ISUPREL SOLN 2 PA MAXAIR AUTOHALER AERB 2 PA metaproterenol sulfate NEBU 1 metaproterenol sulfate SYRP 1 METAPROTERENOL SULFATE TABS 1 PROAIR HFA AERS 1 PROVENTIL HFA AERS 2 PROVENTIL NEBU 1 PROVENTIL AERS 2 PA PROVENTIL NEBU 2 PA SEREVENT DISKUS AEPB 2 SYMBICORT AERO 2 PA terbutaline sulfate SOLN 1 PA terbutaline sulfate TABS 1 VENTOLIN HFA AERS 2 VENTOLIN NEBU 2 PA VOSPIRE ER TB12 2 PA XOPENEX CONCENTRATE NEBU 2 PA XOPENEX HFA AERO 2 PA XOPENEX NEBU 2 PA H1 Blocking Agents, Sedating ANTIVERT TABS 2 PA ATARAX SYRP 2 PA BENADRYL CAPS 1 cyproheptadine hcl SYRP 1 cyproheptadine hcl TABS 1 DEXCHLORPHENIRAMINE MALEATE SYRP 1 diphenhydramine hcl CAPS 1 diphenhydramine hcl ELIX 1 diphenhydramine hcl SOLN 2 PA hydroxyzine hcl SYRP 1 hydroxyzine hcl TABS 1 hydroxyzine hcl SOLN 2 PA hydroxyzine pamoate CAPS 1 hyzine SOLN 2 PA meclizine hcl CHEW 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

meclizine hcl TABS 1 PHENERGAN SUPP 2 PA promethazine /phenylephrine SYRP 1 promethazine hcl plain SYRP 1 promethazine hcl SOLN 1 PA promethazine hcl TABS 1 univert TABS 2 PA vertin-32 TABS 2 PA VISTARIL CAPS 2 PA VISTARIL SUSP 2 PA Histamine1 (H1) Blocking Agents, Mildly/Non-sedating alavert allergy/sinus TB12 1 ALLEGRA SUSP 2 ST ALLEGRA TABS 2 ALLEGRA-D 12 HOUR TB12 2 ALLEGRA-D 12 HOUR TB12 2 QL PA ST ALLEGRA-D 24 HOUR TB24 2 PA ST allergy relief for kids SYRP 1 ASTELIN SOLN 2 CLARINEX REDITABS TBDP 2 PA CLARINEX SYRP 2 PA CLARINEX TABS 2 PA CLARINEX-D 12 HOUR TB12 2 PA CLARINEX-D 24 HOUR TB24 2 PA fexofenadine hcl TABS 1 loratadine TABS 1 ZYRTEC CHEW 2 PA ZYRTEC SYRP 2 PA ST ZYRTEC TABS 2 PA ZYRTEC-D TB12 2 QL PA ST Mast Cell Stabilizers cromolyn sodium NEBU 1 INTAL 112 AERS 2 INTAL 200 AERS 2 INTAL INHALER AERS 2 INTAL NEBU 2 TILADE AERS 2 PA Receptor Antagonists ACCOLATE TABS 2 PA SINGULAIR CHEW 2 SINGULAIR PACK 2 SINGULAIR TABS 2 Respiratory Tract Agents, Other acetylcysteine SOLN 1 ARALAST SOLR 2 PA BECONASE AQ SUSP 2 PA FLONASE SUSP 2 flunisolide SOLN 1 fluticasone propionate SUSP 1 ipratropium bromide SOLN 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

LETAIRIS TABS 2 PA MUCOMYST-10 SOLN 2 PA NASACORT AQ AERS 2 NASAREL SOLN 2 PA NASONEX SUSP 2 PROLASTIN SOLR 2 PA PROLASTIN SUSR 2 PA REVATIO TABS 2 PA RHINOCORT AQUA SUSP 2 TRACLEER TABS 2 PA TYZINE PEDIATRIC NASAL DROPS SOLN 2 PA TYZINE SOLN 2 PA VERAMYST SUSP 2 PA XOLAIR SOLR 2 PA ZEMAIRA SOLR 2 PA Synthesis Inhibitors ZYFLO TABS 2 PA Sedatives/Hypnotics Sedatives/Hypnotics AMBIEN CR TBCR 2 AMBIEN TABS 2 AQUACHLORAL SUPP 2 PA ATARAX SYRP 2 PA BUSPAR TABS 2 PA buspirone hcl TABS 1 butalbital /apap /caffeine /codeine CAPS 1 CHLORAL HYDRATE SUPP 1 PA chloral hydrate SYRP 1 EQUAGESIC TABS 2 PA hydroxyzine hcl SYRP 1 hydroxyzine hcl TABS 1 hydroxyzine hcl SOLN 2 PA hydroxyzine pamoate CAPS 1 hyzine SOLN 2 PA LUNESTA TABS 2 PA MEPROBAMATE TABS 1 PHENERGAN SUPP 2 PA phrenilin w/caffeine/codeine CAPS 2 PA promethazine hcl plain SYRP 1 promethazine hcl SOLN 1 PA promethazine hcl TABS 1 ROZEREM TABS 2 SOMNOTE CAPS 2 PA SONATA CAPS 2 PA VANSPAR TABS 2 PA VISTARIL CAPS 2 PA VISTARIL SUSP 2 PA zolpidem tartrate TABS 1 Skeletal Muscle Relaxants Skeletal Muscle Relaxants

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

AMRIX CP24 2 PA baclofen TABS 1 carisoprodol /aspirin /codeine TABS 1 carisoprodol compound TABS 1 carisoprodol/aspirin TABS 1 carisoprodol TABS 1 chlorzoxazone TABS 1 cyclobenzaprine hcl TABS 1 DANTRIUM CAPS 2 PA dantrolene sodium CAPS 1 FLEXERIL TABS 2 PA methocarbamol TABS 1 NORFLEX SOLN 2 PA NORGESIC FORTE TABS 2 PA orphenadrine /asa /caffeine TABS 1 orphenadrine citrate cr TB12 1 orphenadrine citrate er TB12 1 orphenadrine citrate SOLN 2 PA orphenadrine compound ds TABS 1 orphenadrine compound TABS 1 orphenadrine/asa/caff TABS 1 orphengesic forte TABS 1 orphengesic TABS 1 PARAFON FORTE DSC TABS 2 PA ROBAXIN SOLN 2 PA ROBAXIN TABS 2 PA ROBAXIN-750 TABS 2 PA SKELAXIN TABS 2 PA SOMA COMPOUND/CODEINE TABS 1 SOMA COMPOUND TABS 1 SOMA TABS 2 PA tizanidine hcl TABS 1 ZANAFLEX CAPS 2 PA ZANAFLEX TABS 2 PA Sulfonamides sulfazine ec TBEC 1 sulfazine TABS 1 Therapeutic Nutrients/Minerals/Electrolytes Electrolytes/Minerals ALCOHOL 10%/DEXTROSE 5% SOLN 1 AMINESS SOLN 2 PA calcium gluconate SOLN 1 CITROLITH TABS 2 PA COLYTE-FLAVOR PACKS SOLR 1 delflex-lc/1.5% dextrose SOLN 1 delflex-lc/2.5% dextrose SOLN 1 delflex-lc/4.25% dextrose SOLN 1 delflex-lm/1.5% dextrose SOLN 1 delflex-lm/2.5% dextrose SOLN 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

delflex-lm/4.25% dextrose SOLN 1 delflex-sm/1.5% dextrose SOLN 1 delflex-sm/2.5% dextrose SOLN 1 DELFLEX-SM/4.25% DEXTROSE SOLN 1 DEXTROSE 10%/NACL 0.45% SOLN 2 PA dextrose 2.5% lactated ringer's 1/2 strength SOLN 1 dextrose 2.5% lactated ringers 1/2st SOLN 1 dextrose 2.5%/lactated ringer's 1/2 strength SOLN 1 DEXTROSE 2.5% SOLN 2 PA dextrose 5% /electrolyte #48 viaflex SOLN 1 dextrose 5% /electrolyte #75 viaflex SOLN 1 dextrose 10% flex container SOLN 2 PA dextrose 10%/nacl 0.2% SOLN 2 PA DEXTROSE 10%/NACL 0.225% SOLN 2 PA dextrose 10%/nacl 0.9% SOLN 2 PA dextrose 10%/sodium chloride 0.9% SOLN 2 PA dextrose 2.5%/nacl 0.45% SOLN 2 PA dextrose 2.5%/sodium chloride 0.45% SOLN 2 PA dextrose 5%/lactated ringer's SOLN 1 dextrose 5%/nacl 0.2% SOLN 2 PA DEXTROSE 5%/NACL 0.225% SOLN 2 PA DEXTROSE 5%/NACL 0.3% SOLN 2 PA dextrose 5%/nacl 0.33% SOLN 2 PA dextrose 5%/nacl 0.45% SOLN 2 PA dextrose 5%/nacl 0.9% SOLN 2 PA DEXTROSE 5%/POTASSIUM CHLORIDE 0.075% SOLN 2 PA dextrose 5%/potassium chloride 0.15% SOLN 2 PA dextrose 5%/ringer's SOLN 1 dextrose 5%/sodium chloride 0.2% SOLN 2 PA dextrose 5%/sodium chloride 0.33% SOLN 2 PA dextrose 5%/sodium chloride 0.45% SOLN 2 PA dextrose 5%/sodium chloride 0.9% SOLN 2 PA dextrose 5% SOLN 2 PA DEXTROSE 50% /ELECTROLYTES A PARTIAL FILL SOLN 1 dialyte/1.5% dextrose pattern lm SOLN 2 PA dialyte/2.5% dextrose pattern lm SOLN 2 PA dialyte/4.25% dextrose pattern lm SOLN 2 PA DIANEAL PD-2/3.5% DEXTROSE SOLN 2 PA ed k+10 TBCR 2 PA effer-k TBEF 1 fluoridex daily defense GEL 1 FREAMINE III 3% SOLN 2 PA GOLYTELY SOLR 2 PA inpersol/dextrose SOLN 1 inpersol-lm/1.5% dextrose SOLN 1 inpersol-lm/2.5% dextrose SOLN 1 inpersol-lm/4.25% dextrose SOLN 1 IONOSOL-B/DEXTROSE 5% SOLN 1 IONOSOL-MB/DEXTROSE 5% SOLN 1 IONOSOL-T/DEXTROSE 5% SOLN 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

k+ potassium PACK 1 kaochlor LIQD 2 PA KAON ELIX 2 PA kaon-cl-10 TBCR 2 PA KAON-CL LIQD 2 PA kay ciel PACK 2 PA kcl 0.075%/d5w/nacl 0.2% SOLN 2 PA KCL 0.075%/D5W/NACL 0.225 SOLN 2 PA kcl 0.075%/d5w/nacl 0.45% SOLN 2 PA KCL 0.15%/D10W/NACL 0.2% SOLN 2 PA kcl 0.15%/d5w/ nacl 0.3% SOLN 2 PA KCL 0.15%/D5W/LR SOLN 1 kcl 0.15%/d5w/nacl 0.2% SOLN 2 PA kcl 0.15%/d5w/nacl 0.225% SOLN 2 PA kcl 0.15%/d5w/nacl 0.45% SOLN 2 PA kcl 0.15%/d5w/nacl 0.9% SOLN 2 PA kcl 0.22%/d5w/nacl 0.2% SOLN 2 PA kcl 0.224%/d5w/nacl 0.2% SOLN 2 PA KCL 0.224%/D5W/NACL 0.225 SOLN 2 PA kcl 0.224%/d5w/nacl 0.45% SOLN 2 PA KCL 0.3%/D5W/LR IV LAC RING SOLN 1 KCL 0.3%/D5W/LR SOLN 1 kcl 0.3%/d5w/nacl 0.2% SOLN 2 PA KCL 0.3%/D5W/NACL 0.225% SOLN 2 PA KCL 0.3%/D5W/NACL 0.33% SOLN 2 PA kcl 0.3%/d5w/nacl 0.45% SOLN 2 PA KCL 0.3%/D5W/NACL 0.9% SOLN 2 PA K-DUR TBCR 2 PA k-effervescent TBEF 1 K-LOR PACK 2 PA klor-con 10 TBCR 1 KLOR-CON 25 PACK 2 PA klor-con 8 TBCR 1 klor-con m10 TBCR 2 PA KLOR-CON M15 TBCR 2 PA klor-con m20 TBCR 1 klor-con/ef TBEF 1 klor-con PACK 1 klotrix TBCR 1 K-LYTE DS TBEF 2 PA K-LYTE TBEF 1 K-PHOS MF TABS 2 PA K-PHOS NEUTRAL TABS 1 K-PHOS NO 2 TABS 2 PA K-PHOS TABS 2 PA K-TABS TBCR 1 k-vescent TBEF 1 k-vescent PACK 2 PA lactated ringer's dextrose 5% viaflex SOLN 1 lactated ringer's irrigation SOLN 1

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Drug Name Dosage Form Drug Tier

Requirements/ Limits

lactated ringer's viaflex SOLN 1 lactated ringer's SOLN 1 leucovorin calcium TABS 1 leucovorin calcium SOLN 2 PA leucovorin calcium SOLR 2 PA MICRO-K CPCR 1 MICRO-K CPCR 2 PA NACL 0.9%/DEXTROSE 0.2% SOLN 2 PA phospha 250 neutral TABS 1 poly-vitamin/fluoride SOLN 1 potassium acetate SOLN 1 POTASSIUM BICARBONATE CAPS 1 potassium bicarbonate TBEF 1 potassium chloride 0.075%/d5w/nacl 0.225% SOLN 2 PA POTASSIUM CHLORIDE 0.15% /NACL 0.45% VIAFLEX SOLN 2 PA potassium chloride 0.15% d5w/nacl 0.33% SOLN 2 PA potassium chloride 0.15% d5w/nacl 0.45% viaflex SOLN 2 PA potassium chloride 0.15% w/nacl 0.9% viaflex SOLN 2 PA potassium chloride 0.15%/d5w SOLN 2 PA POTASSIUM CHLORIDE 0.15%/NACL 0.9% SOLN 2 PA potassium chloride 0.22% d5w/nacl 0.45% SOLN 2 PA potassium chloride 0.224%/d5w/nacl 0.45% SOLN 2 PA potassium chloride 0.224%/d5w SOLN 2 PA POTASSIUM CHLORIDE 0.224%D5W/NACL 0.33% SOLN 2 PA POTASSIUM CHLORIDE 0.3%/ NACL 0.9% SOLN 2 PA potassium chloride 0.3%/d5w SOLN 2 PA potassium chloride 0.3%/nacl 0.9%/viaflex SOLN 2 PA potassium chloride cr TBCR 1 potassium chloride er CPCR 1 potassium chloride er TBCR 1 potassium chloride mini-vial SOLN 1 PA potassium chloride sa TBCR 1 potassium chloride sr TBCR 1 potassium chloride LIQD 1 POTASSIUM CHLORIDE PACK 1 POTASSIUM CHLORIDE SOLN 1 PA potassium effervescent TBEF 1 potassium phosphate SOLN 1 QUICK-K TABS 2 PA RENAMIN SOLN 2 ringer's injection SOLN 1 ringer's irrigation SOLN 1 RUM-K LIQD 2 PA sodium acetate SOLN 1 sodium bicarbonate partial fill SOLN 1 PA sodium bicarbonate stick-gard SOLN 1 PA sodium bicarbonate SOLN 1 sodium bicarbonate SOLN 1 PA sodium chloride 0.9% SOLN 1 PA sodium chloride 0.45% viaflex SOLN 1 PA

Page of 231 87

Drug Name Dosage Form Drug Tier

Requirements/ Limits

sodium chloride 0.45% SOLN 1 PA sodium chloride 0.9% SOLN 1 sodium chloride bacteriostatic SOLN 1 PA sodium chloride SOLN 1 sodium chloride SOLN 1 PA tis-u-sol viaflex SOLN 1 tis-u-sol SOLN 1 tpn electrolytes ftv CONC 2 PA tpn electrolytes ftv SOLN 2 PA tpn electrolytes ii SOLN 2 PA travert 10%/electrolyte 2 SOLN 1 travert 5%/electrolyte #2 SOLN 1 trilyte SOLR 1 trinate TABS 2 PA ULTRABAG/DIANEAL LOW CALCIUM/1.5% DEXTROSE SOLN 2 PA ULTRABAG/DIANEAL LOW CALCIUM/2.5% DEXTROSE SOLN 2 PA ULTRABAG/DIANEAL LOW CALCIUM/4.25% DEXTROSE SOLN 2 PA ULTRABAG/DIANEAL PD-2/1.5% DEXTROSE SOLN 2 PA ULTRABAG/DIANEAL PD-2/2.5% DEXTROSE SOLN 2 PA ULTRABAG/DIANEAL PD-2/4.25% DEXTROSE SOLN 2 PA UROCIT-K 10 TBCR 2 PA UROCIT-K 5 TBCR 2 PA URO-KP-NEUTRAL TABS 2 VISICOL TABS 2 PA ZANTAC SOLN 2 PA Parenteral Nutrition aminosyn 8.5%/electrolytes SOLN 1 PA DIANEAL LOW CALCIUM/4.25%DEXTROSE SOLN 2 PA FREAMINE HBC 6.9% SOLN 2 PA intralipid 20% EMUL 2 intralipid EMUL 2 LIPOSYN II EMUL 2 liposyn iii EMUL 2 Prenatal Vitamins advanced natalcare TABS 2 PA advanced-rf natalcare TABS 2 PA ANEMAGEN OB CAPS 2 PA ATABEX PRENATAL TABS 2 PA BRIGHT BEGINNINGS PRENATAL BAR BAR 1 BRIGHT BEGINNINGS PRENATAL BAR BAR 2 PA cal-nate TABS 1 CENOGEN ULTRA CAPS 2 PA CITRACAL PRENATAL + DHA MISC 2 PA CITRACAL PRENATAL RX TABS 2 PA co-natal fa TABS 2 PA DUET DHA EC MISC 2 PA DUET DHA MISC 2 PA DUET CHEW 2 PA DUET TABS 2 PA ICAR PRENATAL COMBO PACK MISC 2 PA

Page of 231 88

Drug Name Dosage Form Drug Tier

Requirements/ Limits

inatal advance TABS 1 inatal gt TABS 2 PA inatal ultra TABS 2 PA maternity TABS 1 maternity-90 TABS 2 PA multiple vitamins/fluoride SOLN 1 mynatal advance TABS 2 PA mynatal plus TABS 2 PA mynatal ultracaplet TABS 2 PA MYNATAL CAPS 2 PA mynatal-z TABS 2 PA mynate 90 plus TBCR 2 PA natacaps CAPS 2 PA NATACHEW CHEW 2 PA natafolic-pn TABS 2 PA NATAFORT TABS 2 PA natalcare cfe 60 TABS 2 PA natalcare glosstabs TABS 2 PA natalcare pic forte TABS 2 PA natalcare pic TABS 1 natalcare plus TABS 1 natalcare plus TABS 2 PA natalcare rx TABS 1 natalcare three TABS 2 PA NATALVIT TABS 2 PA natamar rx TABS 2 PA natatab cfe TABS 2 PA natatab fa TABS 2 PA natatab rx TABS 2 PA NATELLE C TABS 2 PA NATELLE EZ TABS 2 PA NATELLE PREFER TABS 2 PA NATELLE TABS 2 PA NESTABS CBF TABS 2 PA NESTABS FA TABS 2 PA NESTABS RX TABS 2 PA niferex-pn forte TABS 2 PA NOVANATAL TABS 2 PA NOVASTART TABS 2 PA nu-natal advanced TABS 2 PA nutrinate CHEW 2 PA obstetrix ec TABS 2 PA OBTREX TABS 2 PA O-CAL PRENATAL TABS 2 PA PRECARE CONCEIVE TABS 2 PA PRECARE PRENATAL TABS 2 PA PRECARE CHEW 2 PA PREMESIS RX TABS 1 PRENA-CAP CAPS 2 PA prenafirst TABS 2 PA

Page of 231 89

Drug Name Dosage Form Drug Tier

Requirements/ Limits

prenatabs cbf TABS 1 prenatabs fa TABS 2 PA prenatabs obn TABS 2 PA prenatabs rx TABS 2 PA prenatal 1 + iron TABS 1 prenatal 1 plus 1 TABS 2 PA prenatal 1+1 TABS 1 PRENATAL 19 TABS 2 PA prenatal ad TABS 2 PA prenatal advantage TABS 1 prenatal formula 3 TABS 1 prenatal formula TABS 1 prenatal low iron TABS 1 prenatal mr 90 fe TBCR 2 PA prenatal mtr/selenium TABS 1 prenatal multivitamin-ultra TABS 1 prenatal plus nf TABS 2 PA prenatal plus/27mg iron TABS 1 prenatal plus/betacarotene TABS 1 prenatal plus/iron TABS 1 prenatal plus TABS 1 prenatal rx 1 TABS 1 prenatal rx/beta-carotene TABS 1 prenatal rx TABS 1 prenatal rx TABS 2 PA prenatal start TABS 2 PA prenatal z TABS 2 PA prenatal/folic acid TABS 1 prenatal-h CAPS 1 prenatal-u CAPS 2 PA PRENATE GT TABS 2 PA PRIMACARE MISC 2 PA SELECT-OB CHEW 2 PA STRONGSTART CHEW 2 PA STRONGSTART TABS 2 PA STUARTNATAL PLUS 3 TABS 2 PA ultra natal TABS 2 PA ultra natalcare TABS 2 PA ultra-natal TABS 2 PA vinatal forte TABS 2 PA vinate 90 TBCR 2 PA vinate advanced TABS 2 PA vinate good start CHEW 2 PA vinate gt TABS 1 vinate ii TABS 2 PA vinate m TABS 2 PA vinate ultra TABS 2 PA VITAFOL-OB TABS 2 PA vynatal fa TABS 2 PA Unclassified

Page of 231 90

Drug Name Dosage Form Drug Tier

Requirements/ Limits

Unclassified ALCOHOL 5%/DEXTROSE 5% SOLN 1 ANTIZOL SOLN 2 PA BOTOX SOLR 2 PA CARNITOR TABS 2 PA dexrazoxane SOLR 1 dexrazoxane SOLR 1 PA DIANEAL LOW CALCIUM/1.5% DEXTROSE SOLN 2 PA DIANEAL LOW CALCIUM/2.5% DEXTROSE SOLN 2 PA DIANEAL PD-2/1.5% DEXTROSE SOLN 2 PA DIANEAL PD-2/2.5% DEXTROSE SOLN 2 PA DIANEAL PD-2/4.25% DEXTROSE SOLN 2 PA gold sodium thiomalate SOLN 2 PA levocarnitine TABS 1 LITHOSTAT TABS 2 PA MYOBLOC SOLN 2 PA MYOCHRYSINE SOLN 2 PA SALEX SHAM 2 PA ZINECARD SOLR 2 PA Unclassified No Classification ACTIVELLA TABS 2 PA ACTONEL TABS 2 allergy relief/nasal decongestant TB24 1 amlodipine besylate/benazepril hydrochloride CAPS 1 BARACLUDE SOLN 2 BARACLUDE TABS 2 CLARITIN SYRP 2 PA CLARITIN TABS 2 PA CLARITIN-D 12 HOUR TB12 2 PA CLARITIN-D 24 HOUR TB24 2 PA flunisolide SOLN 2 PA PAMIDRONATE DISODIUM SOLN 2 PA PRILOSEC OTC TBEC 1 RELPAX TABS 2 SPIRIVA HANDIHALER CAPS 2

Page of 231 91

Index Drug Name Class Category Class Name Page #

8-MOP Dermatological Agents Dermatological Photochemotherapy Agents

53

a/b otic Dermatological Agents Dermatological Antipruritic Agents

52

ABELCET Antifungals Polyene Antifungals 23 ABILIFY DISCMELT Antipsychotics Atypicals 32 ABILIFY DISCMELT Bipolar Agents Bipolar Agents 36 ABILIFY Antipsychotics Atypicals 32 ABILIFY Antipsychotics Atypicals 32 ABILIFY Antipsychotics Atypicals 32 ABILIFY Bipolar Agents Bipolar Agents 36 ABILIFY Bipolar Agents Bipolar Agents 36 ABILIFY Bipolar Agents Bipolar Agents 36 ABRAXANE Antineoplastics Antineoplastics 27 ACCOLATE Respiratory Tract Agents Receptor Antagonists 81 ACCUNEB Respiratory Tract Agents Bronchodilators,

Sympathomimetic 79

ACCUPRIL Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

ACCURETIC Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

ACCUTANE Dermatological Agents Dermatological Retinoids 53 ACCUZYME Dermatological Agents Dermatological Wound Care

Agents 54

ACCUZYME Dermatological Agents Dermatological Wound Care Agents

54

acebutolol hcl Cardiovascular Agents Antiarrhythmics - Class II 43 acebutolol hcl Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

ACEON Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

acetaminophen /hydrocodone Analgesics Opioid Analgesics, Short-acting 3 acetaminophen/codeine #2 Analgesics Opioid Analgesics, Short-acting 3 acetaminophen/codeine #3 Analgesics Opioid Analgesics, Short-acting 3 acetaminophen/codeine #4 Analgesics Opioid Analgesics, Short-acting 3 acetaminophen/codeine Analgesics Opioid Analgesics, Short-acting 3 acetaminophen/codeine Analgesics Opioid Analgesics, Short-acting 3 acetaminophen/oxycodone Analgesics Opioid Analgesics, Short-acting 3 acetaminophen-codeine #4 Analgesics Opioid Analgesics, Short-acting 3 acetasol hc Otic Agents Otic Anti-inflammatories 78 ACETAZOLAMIDE SODIUM Cardiovascular Agents Carbonic Anhydrase Inhibitors 46 ACETAZOLAMIDE SODIUM Ophthalmic Agents Carbonic Anhydrase Inhibitors,

Ophthalmic 75

acetazolamide Cardiovascular Agents Carbonic Anhydrase Inhibitors 46 acetazolamide Ophthalmic Agents Carbonic Anhydrase Inhibitors,

Ophthalmic 75

acetic acid/aluminum acetate Otic Agents Otic Anti-inflammatories 78

Page of 231 92

Drug Name Class Category Class Name Page #acetic acid/hydrocortisone Otic Agents Otic Anti-inflammatories 78 acetic acid Antibacterials Miscellaneous Antibacterials 12 acetylcysteine Respiratory Tract Agents Respiratory Tract Agents, Other 81 acid jelly Antibacterials Miscellaneous Antibacterials 12 acidic vaginal jelly Antibacterials Miscellaneous Antibacterials 12 ACIPHEX Gastrointestinal Agents Proton Pump Inhibitors 59 ACLOVATE Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

ACLOVATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

ACTHIB Immunological Agents Vaccines 73 acticin Antiparasitics Pediculicides/Scabicides 31 ACTIGALL Gastrointestinal Agents Gastrointestinal Agents, Other 57 ACTIMMUNE Immunological Agents Interferons, Gamma 73 ACTIQ Analgesics Opioid Analgesics, Short-acting 3 ACTIVELLA Unclassified No Classification 90 ACTONEL WITH CALCIUM Hormonal Agents,

Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Oral 65

ACTONEL Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Oral 65

ACTONEL Unclassified No Classification 90 ACTOPLUS MET Blood Glucose Regulators Biguanides 37 ACTOPLUS MET Blood Glucose Regulators Thiazolidinediones 39 ACTOS Blood Glucose Regulators Thiazolidinediones 39 ACUFLEX Analgesics Non-opioid Analgesics 1 ACULAR LS Ophthalmic Agents Nonsteroidal Anti-inflammatory

Drugs, Ophthalmic 77

ACULAR PF Ophthalmic Agents Nonsteroidal Anti-inflammatory Drugs, Ophthalmic

77

ACULAR Ophthalmic Agents Nonsteroidal Anti-inflammatory Drugs, Ophthalmic

77

ACYCLOVIR SODIUM Antivirals Antiherpetic Agents 34 acyclovir sodium Antivirals Antiherpetic Agents 34 acyclovir Antivirals Antiherpetic Agents 34 acyclovir Antivirals Antiherpetic Agents 34 acyclovir Antivirals Antiherpetic Agents 34 ADACEL Immunological Agents Vaccines 73 ADALAT CC Cardiovascular Agents Dihydropyridines 47 ADDERALL XR Central Nervous System

Agents Amphetamines 51

ADDERALL Central Nervous System Agents

Amphetamines 51

ADOXA PAK 1/100 Antibacterials Tetracyclines 16 ADOXA PAK 1/150 Antibacterials Tetracyclines 16 ADOXA PAK 1/75 Antibacterials Tetracyclines 16

Page of 231 93

Drug Name Class Category Class Name Page #ADOXA PAK 2/100 Antibacterials Tetracyclines 16 ADOXA Antibacterials Tetracyclines 16 ADRENALIN Respiratory Tract Agents Bronchodilators,

Sympathomimetic 79

adriamycin Antineoplastics Antineoplastics 27 adriamycin Antineoplastics Antineoplastics 27 adrucil Antineoplastics Antineoplastics 27 ADVAIR DISKUS Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

ADVAIR DISKUS Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

ADVAIR DISKUS Respiratory Tract Agents Bronchodilators, Sympathomimetic

79

ADVAIR HFA Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

ADVAIR HFA Respiratory Tract Agents Bronchodilators, Sympathomimetic

79

advanced natalcare Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

advanced-rf natalcare Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

ADVICOR Cardiovascular Agents 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) Reductase Inhibitors

40

AEROBID-M Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

AEROBID Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

afeditab cr Cardiovascular Agents Dihydropyridines 47 AGENERASE Antivirals Anti-HIV Agents, Protease

Inhibitors 35

AGENERASE Antivirals Anti-HIV Agents, Protease Inhibitors

35

AGGRENOX Blood Products/Modifiers/Volume Expanders

Cyclic Adenosine Monophosphate Reuptake Inhibitors

40

AGRYLIN Blood Products/Modifiers/Volume Expanders

40

airet Respiratory Tract Agents Bronchodilators, Sympathomimetic

79

ak-con Ophthalmic Agents Ophthalmic Agents, Other 77 AKINETON Antiparkinson Agents Anticholinergics 31 AKNE-MYCIN Antibacterials Erythromycins 10 ak-poly-bac Antibacterials Miscellaneous Antibacterials 12 ak-tob Ophthalmic Agents 78 ala-cort Hormonal Agents,

Stimulant/Replacement/ModifyGlucocorticoids-Topical-Low Potency

62

Page of 231 94

Drug Name Class Category Class Name Page #ing (Adrenal)

ala-cort Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

ALAMAST Ophthalmic Agents Ophthalmic Anti-allergy Agents 77 ALA-SCALP Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

alavert allergy/sinus Respiratory Tract Agents Bronchodilators, Sympathomimetic

79

alavert allergy/sinus Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

ALBENZA Antiparasitics Anthelmintics 30 ALBUTEROL SULFATE/IPRATROPIUM BROMIDE

Respiratory Tract Agents Bronchodilators, Anticholinergic 78

ALBUTEROL SULFATE/IPRATROPIUM BROMIDE

Respiratory Tract Agents Bronchodilators, Sympathomimetic

79

albuterol sulfate Respiratory Tract Agents Bronchodilators, Sympathomimetic

79

albuterol sulfate Respiratory Tract Agents Bronchodilators, Sympathomimetic

79

albuterol sulfate Respiratory Tract Agents Bronchodilators, Sympathomimetic

79

albuterol Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

ALCAINE Anesthetics Local Anesthetics 6 ALCET Analgesics Opioid Analgesics, Short-acting 3 alclometasone dipropionate Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

alclometasone dipropionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

ALCOHOL 10%/DEXTROSE 5%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 83

ALCOHOL 5%/DEXTROSE 5% Unclassified Unclassified 90 ALCOHOL SWABS Insulin Administration

Supplies Insulin Administration Supplies 75

ALDACTAZIDE Cardiovascular Agents Aldosterone Receptor Antagonists

41

ALDACTAZIDE Cardiovascular Agents Potassium-sparing Diuretics 48 ALDACTAZIDE Cardiovascular Agents Thiazide Diuretics 49 ALDACTONE Cardiovascular Agents Aldosterone Receptor

Antagonists 41

ALDACTONE Cardiovascular Agents Potassium-sparing Diuretics 48 ALDARA Dermatological Agents Dermatological

Immunomodulators 53

ALDORIL D30 Cardiovascular Agents Alpha-adrenergic Agonists 41

Page of 231 95

Drug Name Class Category Class Name Page #ALDORIL D30 Cardiovascular Agents Thiazide Diuretics 49 ALDORIL D50 Cardiovascular Agents Alpha-adrenergic Agonists 41 ALDORIL D50 Cardiovascular Agents Thiazide Diuretics 49 ALDORIL-15 Cardiovascular Agents Alpha-adrenergic Agonists 41 ALDORIL-15 Cardiovascular Agents Thiazide Diuretics 49 ALDORIL-25 Cardiovascular Agents Alpha-adrenergic Agonists 41 ALDORIL-25 Cardiovascular Agents Thiazide Diuretics 49 ALDURAZYME Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

54

ALESSE-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

ALESSE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

ALFERON N Immunological Agents Interferons, Alfa 73 ali-flex Analgesics Non-opioid Analgesics 1 ALIMTA Antineoplastics Antineoplastics 27 ALINIA Antiparasitics Antiprotozoals (Non-

antimalarials) 31

ALINIA Antiparasitics Antiprotozoals (Non-antimalarials)

31

ALKERAN Antineoplastics Antineoplastics 27 allanenzyme Dermatological Agents Dermatological Wound Care

Agents 54

allanenzyme Dermatological Agents Dermatological Wound Care Agents

54

ALLANFILLENZYME Dermatological Agents Dermatological Wound Care Agents

54

allanfillenzyme Dermatological Agents Dermatological Wound Care Agents

54

ALLEGRA-D 12 HOUR Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

ALLEGRA-D 12 HOUR Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

ALLEGRA-D 12 HOUR Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

ALLEGRA-D 24 HOUR Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

ALLEGRA-D 24 HOUR Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

ALLEGRA Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

ALLEGRA Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

allergen Dermatological Agents Dermatological Antipruritic Agents

52

allergy relief for kids Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

allergy relief/nasal decongestant

Unclassified No Classification 90

Page of 231 96

Drug Name Class Category Class Name Page #allersol Ophthalmic Agents Ophthalmic Agents, Other 77 allopurinol sodium Antigout Agents Xanthine Oxidase Inhibitors 24 allopurinol Antigout Agents Xanthine Oxidase Inhibitors 24 ALOCRIL Ophthalmic Agents Ophthalmic Anti-allergy Agents 77 ALOMIDE Ophthalmic Agents Ophthalmic Anti-allergy Agents 77 ALOPRIM Antigout Agents Xanthine Oxidase Inhibitors 24 ALORA Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

ALOXI Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

ALPAIN Analgesics Non-opioid Analgesics 1 ALPHAGAN P Ophthalmic Agents Alpha-adrenergic Agonists,

Ophthalmic 75

alphatrex Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

ALREX Ophthalmic Agents Glucocorticoids, Ophthalmic 76 ALTACE Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 42

ALTOPREV Cardiovascular Agents 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) Reductase Inhibitors

40

ALUPENT Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

amantadine hcl Antiparkinson Agents Antiparkinson Agents, Other 32 amantadine hcl Antiparkinson Agents Antiparkinson Agents, Other 32 AMANTADINE HCL Antiparkinson Agents Antiparkinson Agents, Other 32 amantadine hcl Antivirals Anti-influenza Agents 35 amantadine hcl Antivirals Anti-influenza Agents 35 AMANTADINE HCL Antivirals Anti-influenza Agents 35 AMARYL Blood Glucose Regulators Sulfonylureas 38 AMBIEN CR Sedatives/Hypnotics Sedatives/Hypnotics 82 AMBIEN Sedatives/Hypnotics Sedatives/Hypnotics 82 AMBISOME Antifungals Polyene Antifungals 23 amcinonide Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

AMCINONIDE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

amcinonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

AMERGE Antimigraine Agents Triptans 26 AMERICAINE OTIC Dermatological Agents Dermatological Antipruritic

Agents 52

AMERICAINE Dermatological Agents Dermatological Antipruritic Agents

52

a-methapred Hormonal Agents, Stimulant/Replacement/Modify

Glucocorticoids 60

Page of 231 97

Drug Name Class Category Class Name Page #ing (Adrenal)

AMEVIVE Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

amigesic Analgesics Non-opioid Analgesics 1 amikacin sulfate Antibacterials Aminoglycosides 7 amikacin sulfate Antimycobacterials Antituberculars 27 AMIKIN Antibacterials Aminoglycosides 7 amiloride /hydrochlorothiazide Cardiovascular Agents Potassium-sparing Diuretics 48 amiloride /hydrochlorothiazide Cardiovascular Agents Thiazide Diuretics 49 AMILORIDE HCL Cardiovascular Agents Potassium-sparing Diuretics 48 AMINESS Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 83

aminophylline Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

aminophylline Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

aminosyn 8.5%/electrolytes Therapeutic Nutrients/Minerals/Electrolytes

Parenteral Nutrition 87

amiodarone hcl Cardiovascular Agents Antiarrhythmics - Class III 43 amiodarone hcl Cardiovascular Agents Antiarrhythmics - Class III 43 AMITIZA Gastrointestinal Agents Gastrointestinal Agents, Other 57 amitriptyline /chlordiazepoxide Antidepressants Tricyclics 20 amitriptyline /chlordiazepoxide Anxiolytics Anxiolytics, Other 36 amitriptyline hcl Antidepressants Tricyclics 20 amlodipine besylate/benazepril hydrochloride

Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

amlodipine besylate/benazepril hydrochloride

Cardiovascular Agents Dihydropyridines 47

amlodipine besylate/benazepril hydrochloride

Unclassified No Classification 90

amlodipine besylate Cardiovascular Agents Dihydropyridines 47 ammonium lactate Dermatological Agents Dermatological Emolients 53 ammonium lactate Dermatological Agents Dermatological Emolients 53 AMMONIUM LACTATE Dermatological Agents Dermatological Emolients 53 amnesteem Dermatological Agents Dermatological Retinoids 53 amoclan Antibacterials Amino Derivative Penicillins 6 AMOXAPINE Antidepressants Tricyclics 20 amoxicillin/clavulanate potassium

Antibacterials Amino Derivative Penicillins 6

amoxicillin/clavulanate potassium

Antibacterials Amino Derivative Penicillins 6

amoxicillin/clavulanate potassium

Antibacterials Amino Derivative Penicillins 6

amoxicillin/potassium clavulanate

Antibacterials Amino Derivative Penicillins 6

amoxicillin/potassium clavulanate

Antibacterials Amino Derivative Penicillins 6

Page of 231 98

Drug Name Class Category Class Name Page #amoxicillin/potassium clavulanate

Antibacterials Amino Derivative Penicillins 6

amoxicillin Antibacterials Amino Derivative Penicillins 6 amoxicillin Antibacterials Amino Derivative Penicillins 6 amoxicillin Antibacterials Amino Derivative Penicillins 6 amoxicillin Antibacterials Amino Derivative Penicillins 6 amoxil Antibacterials Amino Derivative Penicillins 6 AMOXIL Antibacterials Amino Derivative Penicillins 6 amoxil Antibacterials Amino Derivative Penicillins 6 AMOXIL Antibacterials Amino Derivative Penicillins 7 amphetamine /dextroamphetamine

Central Nervous System Agents

Amphetamines 51

amphetamine salt combo Central Nervous System Agents

Amphetamines 51

amphetamine salts combo Central Nervous System Agents

Amphetamines 51

amphocin Antifungals Polyene Antifungals 23 AMPHOTEC Antifungals Polyene Antifungals 23 amphotericin b Antifungals Polyene Antifungals 23 ampicillin sodium Antibacterials Amino Derivative Penicillins 7 ampicillin Antibacterials Amino Derivative Penicillins 7 ampicillin Antibacterials Amino Derivative Penicillins 7 ampicillin-sulbactam Antibacterials Amino Derivative Penicillins 7 AMRIX Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 anabar Analgesics Non-opioid Analgesics 1 ANACAINE Dermatological Agents Dermatological Antipruritic

Agents 52

ANADROL-50 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

ANAFRANIL Antidepressants Tricyclics 20 anagrelide hydrochloride Blood

Products/Modifiers/Volume Expanders

40

ANAPROX DS Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

ANAPROX Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

ANASPAZ Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 ANCOBON Antifungals Antifungals (Other) 22 ANCOBON Antifungals Antifungals (Other) 22 ANDRODERM Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

ANDRODERM Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

ANDROGEL Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

ANDROID Hormonal Agents, Androgens/Anabolic Steroids 67

Page of 231 99

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

ANDROXY Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

ANEMAGEN OB Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

anexsia Analgesics Opioid Analgesics, Short-acting 3 ANGELIQ Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

ANGELIQ Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

ANSAID Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

ANTABUSE Antidotes, Deterrents, and Toxicologic Agents

Alcohol Deterrents 20

ANTARA Cardiovascular Agents Fibrates 47 anthralin Dermatological Agents Dermatological Mitotic Inhibitors 53 antiben Dermatological Agents Dermatological Antipruritic

Agents 52

antibiotic ear Otic Agents Otic Anti-inflammatories 78 antibiotic ear Otic Agents Otic Anti-inflammatories 78 antipyrine /benzocaine Dermatological Agents Dermatological Antipruritic

Agents 52

antipyrine/benzocaine Anesthetics Local Anesthetics 6 antipyrine/benzocaine Dermatological Agents Dermatological Antipruritic

Agents 52

ANTIVERT Respiratory Tract Agents H1 Blocking Agents, Sedating 80 ANTIZOL Unclassified Unclassified 90 ANUSOL-HC Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

ANZEMET Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

ANZEMET Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

apap/hydrocodone bitartrate Analgesics Opioid Analgesics, Short-acting 3 apap/oxycodone Analgesics Opioid Analgesics, Short-acting 3 apap/oxycodone Analgesics Opioid Analgesics, Short-acting 3 apexicon e Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

apexicon Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

APHTHASOL Dental and Oral Agents Dental and Oral Agents 51 APIDRA Blood Glucose Regulators Insulin, Rapid-acting 38 APOKYN Antiparkinson Agents Antiparkinson Agents, Other 32

Page of 231 100

Drug Name Class Category Class Name Page #apri Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

APTIVUS Antivirals Anti-HIV Agents, Protease Inhibitors

35

AQUACHLORAL Sedatives/Hypnotics Sedatives/Hypnotics 82 ARALAST Respiratory Tract Agents Respiratory Tract Agents, Other 81 ARALEN Antiparasitics Antimalarials 31 aranelle Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

ARANESP ALBUMIN FREE SURECLICK

Blood Products/Modifiers/Volume Expanders

Erythropoietins 40

ARANESP ALBUMIN FREE Blood Products/Modifiers/Volume Expanders

Erythropoietins 40

ARANESP Blood Products/Modifiers/Volume Expanders

Erythropoietins 40

ARAVA Immunological Agents Immunomodulators, Other 72 ARAVA Immunological Agents Immunomodulators, Other 72 AREDIA Hormonal Agents,

Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Parenteral 65

ARESTIN Antibacterials Tetracyclines 16 ARICEPT ODT Antidementia Agents Cholinesterase Inhibitors 18 ARICEPT Antidementia Agents Cholinesterase Inhibitors 18 ARIMIDEX Antineoplastics Aromatase Inhibitors, 3rd

Generation 30

ARISTOCORT A Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

ARISTOCORT A Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

ARISTOCORT Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

ARISTOSPAN INTRA-ARTICULAR

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

ARISTOSPAN INTRALESIONAL

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

ARIXTRA Blood Products/Modifiers/Volume Expanders

Factor Xa Inhibitors, Indirect 40

ARMOUR THYROID Hormonal Agents, Stimulant/Replacement/Modify

Hormonal Agents, Stimulant/Replacement/Modifyin

70

Page of 231 101

Drug Name Class Category Class Name Page #ing (Thyroid) g (Thyroid)

AROMASIN Antineoplastics Aromatase Inhibitors, 3rd Generation

30

ARRANON Antineoplastics Antineoplastics 27 ARTHROTEC 50 Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 24

ARTHROTEC 50 Gastrointestinal Agents Protectants 59 ARTHROTEC 75 Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 24

ARTHROTEC 75 Gastrointestinal Agents Protectants 59 ASACOL Inflammatory Bowel Disease

Agents Salicylates 74

ASMANEX 120 METERED DOSES

Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

ASMANEX 14 METERED DOSES

Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

ASMANEX 30 METERED DOSES

Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

ASMANEX 60 METERED DOSES

Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

asp 300/200/20 Analgesics Non-opioid Analgesics 1 a-spas Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 aspirin/codeine #3 Analgesics Opioid Analgesics, Short-acting 3 aspirin/codeine Analgesics Opioid Analgesics, Short-acting 3 ASTELIN Respiratory Tract Agents Histamine1 (H1) Blocking

Agents, Mildly/Non-sedating 81

astramorph Analgesics Opioid Analgesics, Long-acting 2 ATABEX PRENATAL Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

ATACAND HCT Cardiovascular Agents Angiotensin II Receptor Antagonists

41

ATACAND HCT Cardiovascular Agents Thiazide Diuretics 49 ATACAND Cardiovascular Agents Angiotensin II Receptor

Antagonists 41

atamet Antiparkinson Agents Dopamine Precursors 32 ATARAX Respiratory Tract Agents H1 Blocking Agents, Sedating 80 ATARAX Sedatives/Hypnotics Sedatives/Hypnotics 82 atenolol/chlorthalidone Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

atenolol Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

atreza Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 ATRIDOX Antibacterials Tetracyclines 16 ATRIPLA Antivirals Anti-HIV Agents, Non-

nucleoside Reverse Transcriptase Inhibitors

34

ATRIPLA Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

atropine sulfate Gastrointestinal Agents Antispasmodics, Gastrointestinal 56

Page of 231 102

Drug Name Class Category Class Name Page #atropine sulfate Ophthalmic Agents Ophthalmic Agents, Other 77 atropine sulfate Ophthalmic Agents Ophthalmic Agents, Other 77 atropine-care Ophthalmic Agents Ophthalmic Agents, Other 77 ATROVENT HFA Respiratory Tract Agents Bronchodilators, Anticholinergic 78 ATROVENT Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 ATROVENT Respiratory Tract Agents Bronchodilators, Anticholinergic 79 ATTENUVAX Immunological Agents Vaccines 73 augmented betamethasone dipropionate

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

augmented betamethasone dipropionate

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

augmented betamethasone dipropionate

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

AUGMENTIN ES-600 Antibacterials Amino Derivative Penicillins 7 AUGMENTIN XR Antibacterials Amino Derivative Penicillins 7 AUGMENTIN Antibacterials Amino Derivative Penicillins 7 AUGMENTIN Antibacterials Amino Derivative Penicillins 7 AUGMENTIN Antibacterials Amino Derivative Penicillins 7 aurobiotic-hc Antibacterials Aminoglycosides 7 aurobiotic-hc Otic Agents Otic Anti-inflammatories 78 aurodex Dermatological Agents Dermatological Antipruritic

Agents 52

auroguard Dermatological Agents Dermatological Antipruritic Agents

52

auroto Dermatological Agents Dermatological Antipruritic Agents

52

AVALIDE Cardiovascular Agents Angiotensin II Receptor Antagonists

42

AVANDAMET Blood Glucose Regulators Biguanides 37 AVANDAMET Blood Glucose Regulators Biguanides 37 AVANDAMET Blood Glucose Regulators Thiazolidinediones 39 AVANDAMET Blood Glucose Regulators Thiazolidinediones 39 AVANDARYL Blood Glucose Regulators Sulfonylureas 38 AVANDARYL Blood Glucose Regulators Thiazolidinediones 39 AVANDIA Blood Glucose Regulators Thiazolidinediones 39 AVANDIA Blood Glucose Regulators Thiazolidinediones 39 AVAPRO Cardiovascular Agents Angiotensin II Receptor

Antagonists 42

AVASTIN Antineoplastics Antineoplastics 27 AVELOX ABC PACK Antibacterials Quinolones 14 AVELOX Antibacterials Quinolones 14 AVELOX Antibacterials Quinolones 14 AVENTYL Antidepressants Tricyclics 20 aviane Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

AVINZA Analgesics Opioid Analgesics, Long-acting 2 AVODART Genitourinary Agents 5 Alpha-reductase Inhibitors 59

Page of 231 103

Drug Name Class Category Class Name Page #AVODART Hormonal Agents,

Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

AVONEX Immunological Agents Interferons, Beta 73 AXERT Antimigraine Agents Triptans 26 AXID Gastrointestinal Agents Histamine2 (H2) Blocking

Agents 58

AXID Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

AYGESTIN Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

AZACTAM IN DEXTROSE Antibacterials Beta-lactam, Other 9 AZACTAM Antibacterials Beta-lactam, Other 9 AZASAN Antineoplastics Antineoplastics 27 AZASITE Antibacterials Macrolides (Non-erythromycins,

Non-ketolides) 12

AZASITE Ophthalmic Agents Ophthalmic Agents, Other 77 AZATHIOPRINE SODIUM Antineoplastics Antineoplastics 28 azathioprine Antineoplastics Antineoplastics 28 azathioprine Immunological Agents Immune Suppressants (Non-

TNF Inhibitors) 72

AZELEX Dermatological Agents 54 AZILECT Antiparkinson Agents Antiparkinson Agents, Other 32 AZITHROMYCIN Antibacterials Macrolides (Non-erythromycins,

Non-ketolides) 12

azithromycin Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

azithromycin Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

azithromycin Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

AZMACORT Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

AZOPT Ophthalmic Agents Carbonic Anhydrase Inhibitors, Ophthalmic

75

AZULFIDINE EN-TABS Antibacterials Sulfonamides 15 AZULFIDINE Antibacterials Sulfonamides 15 B & O 15-A SUPPRETTE Analgesics Opioid Analgesics, Long-acting 2 B & O 15-A SUPPRETTE Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 B & O 16-A SUPPRETTE Analgesics Opioid Analgesics, Long-acting 2 B & O 16-A SUPPRETTE Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 bac/poly/neomy/hc Antibacterials Miscellaneous Antibacterials 12 bac/poly/neomy/hc Ophthalmic Agents Glucocorticoids, Ophthalmic 76 baciim Antibacterials Miscellaneous Antibacterials 12 bacitracin /neomycin /polymyxin Antibacterials Miscellaneous Antibacterials 12 bacitracin/polymyxin b Antibacterials Miscellaneous Antibacterials 12 bacitracin Antibacterials Miscellaneous Antibacterials 12 BACITRACIN Antibacterials Miscellaneous Antibacterials 12 baclofen Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 BACTOCILL IN DEXTROSE Antibacterials Penicillinase-resistant Penicillins 14

Page of 231 104

Drug Name Class Category Class Name Page #BACTRIM DS Antibacterials Antifolate Antibacterials 8 BACTRIM DS Antibacterials Sulfonamides 15 BACTRIM Antibacterials Antifolate Antibacterials 8 BACTRIM Antibacterials Sulfonamides 15 BACTROBAN NASAL Antibacterials Miscellaneous Antibacterials 12 BACTROBAN Antibacterials Miscellaneous Antibacterials 12 BACTROBAN Antibacterials Miscellaneous Antibacterials 12 BALACET 325 Analgesics Opioid Analgesics, Short-acting 3 balagan Dermatological Agents Dermatological Antipruritic

Agents 52

balziva Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

BANCAP-HC Analgesics Opioid Analgesics, Short-acting 3 BARACLUDE Antivirals Antivirals, Other 35 BARACLUDE Unclassified No Classification 90 BARACLUDE Unclassified No Classification 90 BECONASE AQ Respiratory Tract Agents Respiratory Tract Agents, Other 81 belladonna & opium Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 belladonna alkaloids & opium Analgesics Opioid Analgesics, Long-acting 2 belladonna alkaloids & opium Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 BENADRYL Respiratory Tract Agents H1 Blocking Agents, Sedating 80 benazepril hcl/hydrochlorothiazide

Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

benazepril hcl/hydrochlorothiazide

Cardiovascular Agents Thiazide Diuretics 49

benazepril hcl Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

BENICAR HCT Cardiovascular Agents Angiotensin II Receptor Antagonists

42

BENICAR Cardiovascular Agents Angiotensin II Receptor Antagonists

42

BENOQUIN Dermatological Agents Pigmenting Agents 54 BENSAL HP Dermatological Agents Dermatological Caustic Agents 53 BENTYL Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 BENTYL Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 BENTYL Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 BENTYL Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 benzotic Dermatological Agents Dermatological Antipruritic

Agents 52

benztropine mesylate Antiparkinson Agents Anticholinergics 31 BETAGAN C CAP QD Ophthalmic Agents Beta-adrenergic Blocking

Agents, Ophthalmic 75

BETAGAN WITHOUT C CAP Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

BETAGAN Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

BETAGAN Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

betamethasone dipropionate Hormonal Agents, Stimulant/Replacement/Modify

Glucocorticoids-Topical-High Potency

61

Page of 231 105

Drug Name Class Category Class Name Page #ing (Adrenal)

betamethasone dipropionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

betamethasone dipropionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

betamethasone dipropionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

betamethasone valerate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

betamethasone valerate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

betamethasone valerate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

BETAPACE AF Cardiovascular Agents Antiarrhythmics - Class II/III 43 BETAPACE AF Cardiovascular Agents Antiarrhythmics - Class III 43 BETAPACE Cardiovascular Agents Antiarrhythmics - Class II/III 43 BETAPACE Cardiovascular Agents Antiarrhythmics - Class III 43 BETASERON Immunological Agents Interferons, Beta 73 beta-val Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

beta-val Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

betaxolol hcl Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

BETAXOLOL HCL Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

bethanechol chloride Antimyasthenic Agents Parasympathomimetics 26 BETIMOL Ophthalmic Agents Beta-adrenergic Blocking

Agents, Ophthalmic 75

BETOPTIC-S Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

BEXXAR Antineoplastics Antineoplastics 28 BIAXIN XL PAC Antibacterials Macrolides (Non-erythromycins,

Non-ketolides) 12

BIAXIN XL Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

BIAXIN Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

BIAXIN Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

BICILLIN C-R Anesthetics Local Anesthetics 6 BICILLIN C-R Antibacterials Natural Penicillins 13 BICILLIN L-A Antibacterials Natural Penicillins 13

Page of 231 106

Drug Name Class Category Class Name Page #BICNU W/DILUENT ABSOLUTE ETHANOL

Antineoplastics Antineoplastics 28

BIDIL Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

BIDIL Cardiovascular Agents Vasodilators, Direct-acting Arterial

50

BILTRICIDE Antiparasitics Anthelmintics 30 BIO-STATIN Antifungals Polyene Antifungals 23 bisoprolol fumarate/hydrochlorothiazide

Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

bisoprolol fumarate/hydrochlorothiazide

Cardiovascular Agents Thiazide Diuretics 49

bisoprolol fumarate Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

BLENOXANE Antineoplastics Antineoplastics 28 bleomycin sulfate Antineoplastics Antineoplastics 28 BLEPH-10 Antibacterials Sulfonamides 15 BLEPHAMIDE LIQUIFILM Ophthalmic Agents Glucocorticoids, Ophthalmic 76 BLEPHAMIDE S.O.P. Antibacterials Sulfonamides 15 BLEPHAMIDE S.O.P. Ophthalmic Agents Glucocorticoids, Ophthalmic 76 BLEPHAMIDE Ophthalmic Agents Glucocorticoids, Ophthalmic 76 BLOCADREN Antimigraine Agents Beta-adrenergic Blocking Agents 26 BLOCADREN Cardiovascular Agents Antiarrhythmics - Class II 43 BONIVA Hormonal Agents,

Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Oral 65

BONIVA Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Parenteral 65

BOOSTRIX Immunological Agents Vaccines 73 borofair Antibacterials Miscellaneous Antibacterials 12 BOTOX Unclassified Unclassified 90 BRETHINE Respiratory Tract Agents Bronchodilators,

Sympathomimetic 80

BRETHINE Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

BREVICON-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

BRIGHT BEGINNINGS PRENATAL BAR

Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

BRIGHT BEGINNINGS PRENATAL BAR

Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

brimonidine tartrate Ophthalmic Agents Alpha-adrenergic Agonists, Ophthalmic

75

bromocriptine mesylate Antiparkinson Agents Dopamine Agonists 32 bromocriptine mesylate Antiparkinson Agents Dopamine Agonists 32

Page of 231 107

Drug Name Class Category Class Name Page #BROVANA Respiratory Tract Agents Bronchodilators,

Sympathomimetic 80

budeprion sr Antidepressants Antidepressants, Other 18 budeprion xl Antidepressants Antidepressants, Other 18 bumetanide Cardiovascular Agents Loop Diuretics 47 bumetanide Cardiovascular Agents Loop Diuretics 48 BUMEX Cardiovascular Agents Loop Diuretics 48 BUMEX Cardiovascular Agents Loop Diuretics 48 BUPHENYL Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

54

BUPRENEX Analgesics Opioid Analgesics, Short-acting 3 buprenorphine hcl Analgesics Opioid Analgesics, Short-acting 3 buproban Antidotes, Deterrents, and

Toxicologic Agents Smoking Cessation Agents 21

bupropion er Antidepressants Antidepressants, Other 18 bupropion hcl er Antidepressants Antidepressants, Other 18 bupropion hcl sr Antidepressants Antidepressants, Other 18 bupropion hcl Antidepressants Antidepressants, Other 19 bupropion hcl Antidepressants Antidepressants, Other 19 BUSPAR Sedatives/Hypnotics Sedatives/Hypnotics 82 buspirone hcl Sedatives/Hypnotics Sedatives/Hypnotics 82 BUSULFEX Antineoplastics Antineoplastics 28 butalbital /apap /caffeine /codeine

Analgesics Opioid Analgesics, Short-acting 3

butalbital /apap /caffeine /codeine

Sedatives/Hypnotics Sedatives/Hypnotics 82

butorphanol tartrate Analgesics Opioid Analgesics, Short-acting 3 butorphanol tartrate Analgesics Opioid Analgesics, Short-acting 3 by-ache Analgesics Non-opioid Analgesics 1 BYETTA Blood Glucose Regulators Incretin Mimetics 37 c.m.t Analgesics Non-opioid Analgesics 1 cabergoline Antiparkinson Agents Dopamine Agonists 32 CADUET Cardiovascular Agents 3-hydroxy-3-methylglutaryl

coenzyme A (HMG CoA) Reductase Inhibitors

40

CADUET Cardiovascular Agents Dihydropyridines 47 CAFERGOT Antimigraine Agents Ergot Alkaloids 26 cafgesic Analgesics Non-opioid Analgesics 1 CALAN SR Cardiovascular Agents Antiarrhythmics - Class IV 44 CALAN SR Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

CALAN Cardiovascular Agents Antiarrhythmics - Class IV 44 CALAN Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

CALCIJEX Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

calcitriol Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

Page of 231 108

Drug Name Class Category Class Name Page #Bone Disease Agents)

calcitriol Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

calcium gluconate Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 83

cal-nate Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

camila Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

CAMPATH Antineoplastics Antineoplastics 28 CAMPRAL Antidotes, Deterrents, and

Toxicologic Agents Alcohol Deterrents 20

CAMPTOSAR Antineoplastics Antineoplastics 28 CANASA Inflammatory Bowel Disease

Agents Salicylates 75

CANTIL Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 CAPASTAT SULFATE Antimycobacterials Antituberculars 27 CAPEX Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

CAPITAL/CODEINE Analgesics Opioid Analgesics, Short-acting 3 CAPITROL Antiparasitics Pediculicides/Scabicides 31 CAPOTEN Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 42

CAPOZIDE Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

CAPOZIDE Cardiovascular Agents Thiazide Diuretics 49 captopril /hydrochlorothiazide Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 42

captopril Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

CARAC Dermatological Agents 54 CARAFATE Gastrointestinal Agents Protectants 59 CARAFATE Gastrointestinal Agents Protectants 59 carbamazepine Anticonvulsants Anticonvulsants (Other) 16 carbamazepine Anticonvulsants Anticonvulsants (Other) 16 carbamazepine Anticonvulsants Anticonvulsants (Other) 16 carbamazepine Anticonvulsants Sodium Channel Inhibitors 18 carbamazepine Anticonvulsants Sodium Channel Inhibitors 18 carbamazepine Anticonvulsants Sodium Channel Inhibitors 18 carbamazepine Bipolar Agents Bipolar Agents 36 carbamazepine Bipolar Agents Bipolar Agents 36 carbamazepine Bipolar Agents Bipolar Agents 36 carbastat Ophthalmic Agents Miotics, Ophthalmic 77 CARBATROL Anticonvulsants Anticonvulsants (Other) 16 CARBATROL Anticonvulsants Sodium Channel Inhibitors 18

Page of 231 109

Drug Name Class Category Class Name Page #CARBATROL Bipolar Agents Bipolar Agents 36 carbidopa/levodopa cr Antiparkinson Agents Dopamine Precursors 32 carbidopa/levodopa er Antiparkinson Agents Dopamine Precursors 32 carbidopa/levodopa sr Antiparkinson Agents Dopamine Precursors 32 carbidopa/levodopa Antiparkinson Agents Dopamine Precursors 32 carboplatin Antineoplastics Antineoplastics 28 carboplatin Antineoplastics Antineoplastics 28 CARDENE I.V. Cardiovascular Agents Dihydropyridines 47 CARDENE SR Cardiovascular Agents Dihydropyridines 47 CARDENE Cardiovascular Agents Dihydropyridines 47 CARDIZEM CD Cardiovascular Agents Antiarrhythmics - Class IV 44 CARDIZEM CD Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

CARDIZEM LA Cardiovascular Agents Antiarrhythmics - Class IV 44 CARDIZEM LA Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

CARDIZEM Cardiovascular Agents Antiarrhythmics - Class IV 44 CARDIZEM Cardiovascular Agents Antiarrhythmics - Class IV 44 CARDIZEM Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

CARDIZEM Cardiovascular Agents Calcium Channel Blocking Agents (Non-dihydropyridines)

45

CARDURA Cardiovascular Agents Alpha-adrenergic Blocking Agents

41

CARDURA Genitourinary Agents Alpha1-adrenergic Blocking Agents

59

CARIMUNE NANOFILTERED Immunological Agents Immunomodulators, Other 72 CARIMUNE NANOFILTERED Immunological Agents Vaccines 73 CARIMUNE Immunological Agents Vaccines 73 carisoprodol /aspirin /codeine Analgesics Opioid Analgesics, Short-acting 3 carisoprodol /aspirin /codeine Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 carisoprodol compound Analgesics Non-opioid Analgesics 1 carisoprodol compound Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 carisoprodol/aspirin Analgesics Non-opioid Analgesics 1 carisoprodol/aspirin Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 carisoprodol Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 CARMOL SCALP TREATMENT

Antibacterials Sulfonamides 15

CARMOL SCALP TREATMENT

Antibacterials Sulfonamides 15

CARMOL-HC Dermatological Agents Dermatological Emolients 53 CARMOL-HC Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

CARNITOR Unclassified Unclassified 90 carteolol hcl Ophthalmic Agents Beta-adrenergic Blocking

Agents, Ophthalmic 75

cartia xt Cardiovascular Agents Antiarrhythmics - Class IV 44 cartia xt Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

CARTROL Cardiovascular Agents Nonselective Beta-adrenergic 48

Page of 231 110

Drug Name Class Category Class Name Page #Blocking Agents

carvedilol Cardiovascular Agents Alpha-adrenergic Blocking Agents

41

carvedilol Cardiovascular Agents Alpha-beta-adrenergic Blocking Agents

41

CASODEX Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

CATAFLAM Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

CATAPRES Cardiovascular Agents Alpha-adrenergic Agonists 41 CATAPRES-TTS 2 Cardiovascular Agents Alpha-adrenergic Agonists 41 CATAPRES-TTS-1 Cardiovascular Agents Alpha-adrenergic Agonists 41 CATAPRES-TTS-2 Cardiovascular Agents Alpha-adrenergic Agonists 41 CATAPRES-TTS-3 Cardiovascular Agents Alpha-adrenergic Agonists 41 cavarest Dental and Oral Agents Dental and Oral Agents 52 CEDAX Antibacterials Cephalosporin Antibacterials,

3rd Generation 10

CEDAX Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

CEENU Antineoplastics Antineoplastics 28 cefaclor er Antibacterials Cephalosporin Antibacterials,

2nd Generation 9

cefaclor Antibacterials Cephalosporin Antibacterials, 2nd Generation

9

CEFACLOR Antibacterials Cephalosporin Antibacterials, 2nd Generation

9

cefadroxil Antibacterials Cephalosporin Antibacterials, 1st Generation

9

cefadroxil Antibacterials Cephalosporin Antibacterials, 1st Generation

9

cefadroxil Antibacterials Cephalosporin Antibacterials, 1st Generation

9

cefadroxil Dermatological Agents Dermatological Antipruritic Agents

52

cefadroxil Dermatological Agents Dermatological Antipruritic Agents

52

cefazolin sodium Antibacterials Cephalosporin Antibacterials, 1st Generation

9

CEFAZOLIN SODIUM Antibacterials Cephalosporin Antibacterials, 1st Generation

9

cefazolin sodium Antibacterials Cephalosporin Antibacterials, 1st Generation

9

CEFAZOLIN SODIUM-DEXTROSE

Antibacterials Cephalosporin Antibacterials, 1st Generation

9

CEFIZOX IN DEXTROSE 5% Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

CEFIZOX Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

cefotaxime sodium Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

Page of 231 111

Drug Name Class Category Class Name Page #cefoxitin sodium Antibacterials Beta-lactam, Other 9 cefoxitin sodium Antibacterials Beta-lactam, Other 9 cefoxitin sodium Antibacterials Cephalosporin Antibacterials,

2nd Generation 9

cefoxitin sodium Antibacterials Cephalosporin Antibacterials, 2nd Generation

9

CEFOXITIN Antibacterials Beta-lactam, Other 9 CEFOXITIN Antibacterials Cephalosporin Antibacterials,

2nd Generation 9

cefpodoxime proxetil Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

cefprozil Antibacterials Cephalosporin Antibacterials, 2nd Generation

9

cefprozil Antibacterials Cephalosporin Antibacterials, 2nd Generation

9

CEFTAZIDIME Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

CEFTIN Antibacterials Cephalosporin Antibacterials, 2nd Generation

9

CEFTIN Antibacterials Cephalosporin Antibacterials, 2nd Generation

9

ceftriaxone in iso-osmotic dextrose

Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

ceftriaxone sodium Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

CEFTRIAXONE/DEXTROSE Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

cefuroxime axetil Antibacterials Cephalosporin Antibacterials, 2nd Generation

9

cefuroxime sodium Antibacterials Cephalosporin Antibacterials, 2nd Generation

10

CEFUROXIME/DEXTROSE Antibacterials Cephalosporin Antibacterials, 2nd Generation

10

CEFZIL Antibacterials Cephalosporin Antibacterials, 2nd Generation

10

CEFZIL Antibacterials Cephalosporin Antibacterials, 2nd Generation

10

CELEBREX Analgesics Non-opioid Analgesics 1 CELEBREX Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 24

CELEBREX Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

CELESTONE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

CELEXA Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

CELEXA Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

CELLCEPT INTRAVENOUS Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

Page of 231 112

Drug Name Class Category Class Name Page #CELLCEPT Immunological Agents Immune Suppressants (Non-

TNF Inhibitors) 72

CELLCEPT Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

CELLCEPT Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

CELONTIN Anticonvulsants Calcium Channel Modifying Agents

17

CENESTIN Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

CENOGEN ULTRA Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

centany Antibacterials Miscellaneous Antibacterials 12 cephalexin Antibacterials Cephalosporin Antibacterials,

1st Generation 9

cephalexin Antibacterials Cephalosporin Antibacterials, 1st Generation

9

CEPHALEXIN Antibacterials Cephalosporin Antibacterials, 1st Generation

9

CEREDASE Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

54

CEREZYME Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

54

CERUBIDINE Antineoplastics Antineoplastics 28 CESAMET Antiemetics Antiemetics, Other 21 cesia Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

cetacort Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

CHANTIX Antidotes, Deterrents, and Toxicologic Agents

Smoking Cessation Agents 21

CHEMET Antidotes, Deterrents, and Toxicologic Agents

Antidotes, Deterrents, and Toxicologic Agents

20

CHLORAL HYDRATE Sedatives/Hypnotics Sedatives/Hypnotics 82 chloral hydrate Sedatives/Hypnotics Sedatives/Hypnotics 82 CHLORAMPHENICOL SODIUM SUCCINATE

Antibacterials Miscellaneous Antibacterials 12

chlordiazepoxide /amitriptyline Antidepressants Tricyclics 20 chlordiazepoxide /amitriptyline Anxiolytics Anxiolytics, Other 36 chlorhexadine gluconate oral rinse

Dental and Oral Agents Dental and Oral Agents 52

CHLORHEXIDINE CONCENTRATE

Dental and Oral Agents Dental and Oral Agents 52

chlorhexidine gluconate Dental and Oral Agents Dental and Oral Agents 52 CHLORHEXIDINE GLUCONATE

Dental and Oral Agents Dental and Oral Agents 52

CHLOROMYCETIN Antibacterials Miscellaneous Antibacterials 12

Page of 231 113

Drug Name Class Category Class Name Page #chloroquine phosphate Antiparasitics Antimalarials 31 chlorothiazide Cardiovascular Agents Thiazide Diuretics 49 chlorpromazine hcl Antiemetics Antiemetics, Other 21 CHLORPROMAZINE HCL Antipsychotics Conventional 33 chlorpromazine hcl Antipsychotics Conventional 33 chlorpropamide Blood Glucose Regulators Sulfonylureas 38 chlorthalidone Cardiovascular Agents Thiazide Diuretics 49 chlorzoxazone Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 cholestyramine light Cardiovascular Agents Bile Acid Sequestrants 45 cholestyramine light Cardiovascular Agents Bile Acid Sequestrants 45 cholestyramine Cardiovascular Agents Bile Acid Sequestrants 45 cholestyramine Cardiovascular Agents Bile Acid Sequestrants 45 choline magnesium trisalicylate Analgesics Non-opioid Analgesics 1 choline magnesium trisalicylate Analgesics Non-opioid Analgesics 1 ciclopirox olamine Antifungals Antifungals (Other) 22 ciclopirox Antifungals Antifungals (Other) 22 cilostazol Blood

Products/Modifiers/Volume Expanders

Phosphodiesterase III/Adenosine Uptake Inhibitors

40

CILOXAN Antibacterials Quinolones 14 CILOXAN Antibacterials Quinolones 14 cimetidine hcl Gastrointestinal Agents Histamine2 (H2) Blocking

Agents 58

cimetidine Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

CIPRO HC Antibacterials Quinolones 14 CIPRO HC Otic Agents Otic Anti-inflammatories 78 CIPRO I.V. Antibacterials Quinolones 14 CIPRO I.V.-IN D5W Antibacterials Quinolones 14 CIPRO XR Antibacterials Quinolones 14 CIPRO Antibacterials Quinolones 14 CIPRO Antibacterials Quinolones 14 CIPRODEX Antibacterials Quinolones 14 CIPRODEX Otic Agents Otic Anti-inflammatories 78 ciprofloxacin er Antibacterials Quinolones 14 ciprofloxacin extended-release Antibacterials Quinolones 14 ciprofloxacin hcl Antibacterials Quinolones 14 ciprofloxacin hcl Antibacterials Quinolones 14 ciprofloxacin Antibacterials Quinolones 14 cisplatin Antineoplastics Antineoplastics 28 citalopram hydrobromide Antidepressants Serotonin and Norepinephrine

Reuptake Inhibitors (SNRIs) 19

citalopram hydrobromide Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

CITRACAL PRENATAL + DHA Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

CITRACAL PRENATAL RX Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

CITROLITH Therapeutic Electrolytes/Minerals 83

Page of 231 114

Drug Name Class Category Class Name Page #Nutrients/Minerals/Electrolytes

cladribine Antineoplastics Antineoplastics 28 CLAFORAN INFUSION BOTTLES

Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

CLAFORAN/D5W GALAXY Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

CLAFORAN Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

claravis Dermatological Agents Dermatological Retinoids 53 CLARINEX REDITABS Respiratory Tract Agents Histamine1 (H1) Blocking

Agents, Mildly/Non-sedating 81

CLARINEX-D 12 HOUR Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

CLARINEX-D 12 HOUR Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

CLARINEX-D 24 HOUR Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

CLARINEX-D 24 HOUR Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

CLARINEX Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

CLARINEX Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

clarithromycin er Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

clarithromycin Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

clarithromycin Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

CLARITIN-D 12 HOUR Unclassified No Classification 90 CLARITIN-D 24 HOUR Unclassified No Classification 90 CLARITIN Unclassified No Classification 90 CLARITIN Unclassified No Classification 90 CLEOCIN PEDIATRIC GRANULES

Antibacterials Lincomycin Antibacterials 11

CLEOCIN PHOSPHATE Antibacterials Lincomycin Antibacterials 11 CLEOCIN Antibacterials Lincomycin Antibacterials 11 CLIMARA PRO Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

CLIMARA Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

CLIMARA Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

clindamycin hcl Antibacterials Lincomycin Antibacterials 11 clindamycin phosphate add-vantage

Antibacterials Lincomycin Antibacterials 11

clindamycin phosphate Antibacterials Lincomycin Antibacterials 12

Page of 231 115

Drug Name Class Category Class Name Page #CLINORIL Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 24

clobetasol propionate e Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

clobetasol propionate emollient Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

clobetasol propionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

clobetasol propionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

clobetasol propionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

clobetasol propionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

clobevate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

CLOBEX Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

CLOBEX Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

64

CLOBEX Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

CLODERM Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

CLOFIBRATE Cardiovascular Agents Fibrates 47 CLOLAR Antineoplastics Antineoplastics 28 clomipramine hcl Antidepressants Tricyclics 20 clonidine hcl Cardiovascular Agents Alpha-adrenergic Agonists 41 CLORPRES Cardiovascular Agents Alpha-adrenergic Agonists 41 CLORPRES Cardiovascular Agents Thiazide Diuretics 49 clotrimazole/betamethasone dipropionate

Antifungals Azole Antifungals 22

clotrimazole/betamethasone dipropionate

Antifungals Azole Antifungals 22

clotrimazole/betamethasone dipropionate

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

clotrimazole/betamethasone dipropionate

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

Page of 231 116

Drug Name Class Category Class Name Page #clotrimazole Antifungals Antifungals (Other) 22 clotrimazole Antifungals Antifungals (Other) 22 clotrimazole Antifungals Antifungals (Other) 22 clotrimazole Antifungals Antifungals (Other) 22 CLOZAPINE Antipsychotics Atypicals 32 CLOZARIL Antipsychotics Atypicals 32 cmt Analgesics Non-opioid Analgesics 1 CODEINE PHOSPHATE Analgesics Opioid Analgesics, Short-acting 3 codeine sulfate Analgesics Opioid Analgesics, Short-acting 3 COGENTIN Antiparkinson Agents Anticholinergics 31 co-gesic Analgesics Opioid Analgesics, Short-acting 3 COGNEX Antidementia Agents Cholinesterase Inhibitors 18 COLAZAL Inflammatory Bowel Disease

Agents Salicylates 75

colchicine Antigout Agents Antigout Agents (Non-renal Tubular Blocking Agents and Non-xanthine Inhibitors)

24

COLCHICINE Antigout Agents Antigout Agents (Non-renal Tubular Blocking Agents and Non-xanthine Inhibitors)

24

COLESTID FLAVORED Cardiovascular Agents Bile Acid Sequestrants 45 COLESTID FLAVORED Cardiovascular Agents Bile Acid Sequestrants 45 COLESTID Cardiovascular Agents Bile Acid Sequestrants 45 COLESTID Cardiovascular Agents Bile Acid Sequestrants 45 COLESTID Cardiovascular Agents Bile Acid Sequestrants 45 colestipol hcl Cardiovascular Agents Bile Acid Sequestrants 45 colestipol hcl Cardiovascular Agents Bile Acid Sequestrants 45 colidrops pediatric Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 colistimethate sodium Antibacterials Miscellaneous Antibacterials 12 colocort Inflammatory Bowel Disease

Agents Glucocorticoids 74

COLY-MYCIN S Antibacterials Aminoglycosides 7 COLY-MYCIN S Otic Agents Otic Anti-inflammatories 78 COLY-MYCIN-M Antibacterials Miscellaneous Antibacterials 12 COLY-MYCIN-S Antibacterials Aminoglycosides 7 COLY-MYCIN-S Otic Agents Otic Anti-inflammatories 78 COLYTE-FLAVOR PACKS Gastrointestinal Agents Gastrointestinal Agents, Other 57 COLYTE-FLAVOR PACKS Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 83

COLYTE Gastrointestinal Agents Gastrointestinal Agents, Other 57 COLYTROL PEDIATRIC Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 COLYTROL Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 COLYTROL Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 COMBIPATCH Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

COMBIPATCH Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

COMBIVENT Respiratory Tract Agents Bronchodilators, Anticholinergic 79

Page of 231 117

Drug Name Class Category Class Name Page #COMBIVENT Respiratory Tract Agents Bronchodilators,

Sympathomimetic 80

COMBIVIR Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

COMBUNOX Analgesics Opioid Analgesics, Short-acting 3 compro Antiemetics Antiemetics, Other 21 COMTAN Antiparkinson Agents Catechol O-methyltransferase

(COMT) Inhibitors 32

COMVAX Immunological Agents Vaccines 73 co-natal fa Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

CONCERTA Central Nervous System Agents

Non-amphetamines 51

CONDYLOX W/APPLICATORS Dermatological Agents Dermatological Caustic Agents 53 CONDYLOX Dermatological Agents Dermatological Caustic Agents 53 constulose Gastrointestinal Agents Gastrointestinal Agents, Other 57 COPAXONE Immunological Agents Immunomodulators, Other 72 COPEGUS Antivirals Antivirals, Other 35 CORDARONE I.V. Cardiovascular Agents Antiarrhythmics - Class III 43 CORDARONE Cardiovascular Agents Antiarrhythmics - Class III 43 CORDRAN SP Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

CORDRAN TAPE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

CORDRAN Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

CORDRAN Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

COREG CR Cardiovascular Agents Alpha-beta-adrenergic Blocking Agents

41

COREG Cardiovascular Agents Alpha-beta-adrenergic Blocking Agents

41

CORGARD Cardiovascular Agents Nonselective Beta-adrenergic Blocking Agents

48

cormax Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

cormax Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

cormax Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

CORTEF Anti-inflammatories Glucocorticoids 24 CORTEF Hormonal Agents, Glucocorticoids 60

Page of 231 118

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Adrenal)

CORTIFOAM Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

cortisone acetate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

CORTISPORIN Antibacterials Aminoglycosides 7 CORTISPORIN Antibacterials Aminoglycosides 7 CORTISPORIN Antibacterials Aminoglycosides 7 CORTISPORIN Antibacterials Aminoglycosides 7 CORTISPORIN Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

CORTISPORIN Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

CORTISPORIN Ophthalmic Agents Glucocorticoids, Ophthalmic 76 CORTISPORIN Otic Agents Otic Anti-inflammatories 78 CORTISPORIN Otic Agents Otic Anti-inflammatories 78 CORTISPORIN-TC Antibacterials Aminoglycosides 7 CORTISPORIN-TC Otic Agents Otic Anti-inflammatories 78 cortomycin Antibacterials Aminoglycosides 7 cortomycin Antibacterials Aminoglycosides 7 cortomycin Otic Agents Otic Anti-inflammatories 78 cortomycin Otic Agents Otic Anti-inflammatories 78 CORZIDE Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

CORZIDE Cardiovascular Agents Thiazide Diuretics 49 COSMEGEN Antineoplastics Antineoplastics 28 COSOPT Ophthalmic Agents Beta-adrenergic Blocking

Agents, Ophthalmic 75

COSOPT Ophthalmic Agents Carbonic Anhydrase Inhibitors, Ophthalmic

75

COUMADIN Blood Products/Modifiers/Volume Expanders

Anticoagulants, Oral 39

COUMADIN Blood Products/Modifiers/Volume Expanders

Anticoagulants, Oral 39

COVERA-HS Cardiovascular Agents Antiarrhythmics - Class IV 44 COVERA-HS Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

COZAAR Cardiovascular Agents Angiotensin II Receptor Antagonists

42

CREON 5 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

54

CREON 10 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

54

CREON 20 Enzyme Enzyme 54

Page of 231 119

Drug Name Class Category Class Name Page #Replacements/Modifiers Replacements/Modifiers

CRESTOR Cardiovascular Agents 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) Reductase Inhibitors

40

CRESYLATE Antibacterials Miscellaneous Antibacterials 12 CRESYLATE Otic Agents Otic Anti-inflammatories 78 CRINONE Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

CRIXIVAN Antivirals Anti-HIV Agents, Protease Inhibitors

35

CROLOM Ophthalmic Agents Ophthalmic Anti-allergy Agents 77 cromolyn sodium Ophthalmic Agents Ophthalmic Anti-allergy Agents 77 cromolyn sodium Respiratory Tract Agents Mast Cell Stabilizers 81 cryselle-28 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

CUBICIN Antibacterials Miscellaneous Antibacterials 12 CUPRIMINE Antidotes, Deterrents, and

Toxicologic Agents Antidotes, Deterrents, and Toxicologic Agents

20

CUTIVATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

CUTIVATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

CUTIVATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

CYCLESSA Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

cyclobenzaprine hcl Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 CYCLOCORT Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

CYCLOCORT Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

CYCLOCORT Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

cyclophosphamide Antineoplastics Antineoplastics 28 cyclophosphamide Antineoplastics Antineoplastics 28 cyclosporine modified Immunological Agents Immune Suppressants (Non-

TNF Inhibitors) 72

cyclosporine modified Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

CYCLOSPORINE MODIFIED Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

cyclosporine Immunological Agents Immune Suppressants (Non- 72

Page of 231 120

Drug Name Class Category Class Name Page #TNF Inhibitors)

cyclosporine Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

cyclosporine Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

CYMBALTA Analgesics Non-opioid Analgesics 1 CYMBALTA Antidepressants Serotonin and Norepinephrine

Reuptake Inhibitors (SNRIs) 19

cyproheptadine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 80 cyproheptadine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 80 CYSTADANE Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

54

CYSTAGON Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

54

CYSTOSPAZ Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 CYTADREN Hormonal Agents,

Suppressant (Adrenal) Hormonal Agents, Suppressant (Adrenal)

71

cytarabine aqueous Antineoplastics Antineoplastics 28 cytarabine Antineoplastics Antineoplastics 28 CYTARABINE Antineoplastics Antineoplastics 28 CYTOMEL Hormonal Agents,

Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

70

CYTOTEC Gastrointestinal Agents Protectants 59 CYTOVENE Antivirals Anti-cytomegalovirus (CMV)

Agents 33

CYTOVENE Antivirals Anti-cytomegalovirus (CMV) Agents

33

CYTOXAN Antineoplastics Antineoplastics 28 CYTOXAN Antineoplastics Antineoplastics 28 D.H.E. 45 Antimigraine Agents Ergot Alkaloids 26 DACARBAZINE Antineoplastics Antineoplastics 28 dacarbazine Antineoplastics Antineoplastics 28 danazol Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

danazol Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

DANTRIUM Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 dantrolene sodium Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 DAPSONE Antimycobacterials Antimycobacterials, Other 27 DAPTACEL Immunological Agents Vaccines 73 DARAPRIM Antiparasitics Antimalarials 31 DARVOCET A500 Analgesics Opioid Analgesics, Short-acting 3 DARVOCET-N 100 Analgesics Opioid Analgesics, Short-acting 3 DARVOCET-N 50 Analgesics Opioid Analgesics, Short-acting 3 DARVON COMPOUND-65 Analgesics Opioid Analgesics, Short-acting 3 DARVON Analgesics Opioid Analgesics, Short-acting 3 DARVON-N Analgesics Opioid Analgesics, Short-acting 3 DAUNORUBICIN HCL Antineoplastics Antineoplastics 28

Page of 231 121

Drug Name Class Category Class Name Page #daunorubicin hcl Antineoplastics Antineoplastics 28 DAUNOXOME Antineoplastics Antineoplastics 28 DAYPRO Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 24

DAYTRANA Central Nervous System Agents

Non-amphetamines 51

DDAVP Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

DDAVP Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

DECADRON Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

DECAVAC Immunological Agents Vaccines 73 DECLOMYCIN Antibacterials Tetracyclines 16 del-beta Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

DELESTROGEN Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

delflex-lc/1.5% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 83

delflex-lc/2.5% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 83

delflex-lc/4.25% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 83

delflex-lm/1.5% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 83

delflex-lm/2.5% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 83

delflex-lm/4.25% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

delflex-sm/1.5% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

delflex-sm/2.5% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

DELFLEX-SM/4.25% DEXTROSE

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

deltasone Hormonal Agents, Glucocorticoids 60

Page of 231 122

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Adrenal)

DEMADEX Cardiovascular Agents Loop Diuretics 48 DEMADEX Cardiovascular Agents Loop Diuretics 48 demeclocycline hcl Antibacterials Tetracyclines 16 DEMEROL Analgesics Opioid Analgesics, Short-acting 3 DEMEROL Analgesics Opioid Analgesics, Short-acting 3 DEMEROL Analgesics Opioid Analgesics, Short-acting 3 DEMSER Cardiovascular Agents 51 DEMULEN 1/35-28 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

DEMULEN 1/50-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

DENAVIR Antivirals Antiherpetic Agents 34 DEPACON Anticonvulsants Gamma-aminobutyric Acid

(GABA) Augmenting Agents 17

depade Antidotes, Deterrents, and Toxicologic Agents

Alcohol Deterrents 20

DEPAKENE Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

DEPAKENE Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

DEPAKOTE ER Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

DEPAKOTE ER Antimigraine Agents Antimigraine Agents, Prophylactic (Non-beta-adrenergic Blocking Agents)

26

DEPAKOTE ER Bipolar Agents Bipolar Agents 36 DEPAKOTE SPRINKLES Anticonvulsants Gamma-aminobutyric Acid

(GABA) Augmenting Agents 17

DEPAKOTE SPRINKLES Bipolar Agents Bipolar Agents 36 DEPAKOTE Anticonvulsants Gamma-aminobutyric Acid

(GABA) Augmenting Agents 17

DEPAKOTE Antimigraine Agents Antimigraine Agents, Prophylactic (Non-beta-adrenergic Blocking Agents)

26

DEPAKOTE Bipolar Agents Bipolar Agents 36 DEPAKOTE Bipolar Agents 37 DEPEN TITRATABS Antidotes, Deterrents, and

Toxicologic Agents Antidotes, Deterrents, and Toxicologic Agents

20

DEPODUR Analgesics Opioid Analgesics, Long-acting 2 DEPO-ESTRADIOL Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

DEPO-MEDROL Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

DEPO-PROVERA CONTRACEPTIVE

Hormonal Agents, Stimulant/Replacement/Modify

Progestins 70

Page of 231 123

Drug Name Class Category Class Name Page #ing (Sex Hormones/Modifiers)

DEPO-PROVERA Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

DEPO-SUBQ PROVERA 104 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

DEPO-TESTOSTERONE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

DERMA-SMOOTHE/FS BODY OIL

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

DERMA-SMOOTHE/FS SCALP OIL

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

DERMATOP Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

DERMATOP Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

DERMOTIC Otic Agents Otic Anti-inflammatories 78 desipramine hcl Antidepressants Tricyclics 20 desmopressin acetate Hormonal Agents,

Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

desmopressin acetate Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

desmopressin acetate Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

DESOGEN Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

DESONATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

desonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

desonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

desonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

DESOWEN Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

Page of 231 124

Drug Name Class Category Class Name Page #DESOWEN Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

DESOWEN Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

desoximetasone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

desoximetasone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

desoximetasone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

desoximetasone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

DESOXYN Central Nervous System Agents

Amphetamines 51

DETROL LA Genitourinary Agents Antispasmodics, Urinary 59 DETROL Genitourinary Agents Antispasmodics, Urinary 59 DEXAMETHASONE INTENSOL

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

dexamethasone sodium phosphate

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

dexamethasone sodium phosphate

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

dexamethasone sodium phosphate

Ophthalmic Agents Glucocorticoids, Ophthalmic 76

DEXAMETHASONE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

DEXAMETHASONE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

dexamethasone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

dexasol Ophthalmic Agents Glucocorticoids, Ophthalmic 76 dexasporin Antibacterials Aminoglycosides 7 dexasporin Ophthalmic Agents Glucocorticoids, Ophthalmic 76 DEXCHLORPHENIRAMINE MALEATE

Respiratory Tract Agents H1 Blocking Agents, Sedating 80

DEXEDRINE Central Nervous System Agents

Amphetamines 51

DEXEDRINE Central Nervous System Agents

Amphetamines 51

Page of 231 125

Drug Name Class Category Class Name Page #DEXPAK 13 DAY Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

dexrazoxane Unclassified Unclassified 90 dexrazoxane Unclassified Unclassified 90 dextroamphetamine sulfate Central Nervous System

Agents Amphetamines 51

dextroamphetamine sulfatecr Central Nervous System Agents

Amphetamines 51

DEXTROSE 10%/NACL 0.45% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 2.5% lactated ringer's 1/2 strength

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 2.5% lactated ringers 1/2st

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 2.5%/lactated ringer's 1/2 strength

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

DEXTROSE 2.5% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5% /electrolyte #48 viaflex

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5% /electrolyte #75 viaflex

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 10% flex container Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 10%/nacl 0.2% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

DEXTROSE 10%/NACL 0.225%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 10%/nacl 0.9% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 10%/sodium chloride 0.9%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 2.5%/nacl 0.45% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 2.5%/sodium chloride 0.45%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

Page of 231 126

Drug Name Class Category Class Name Page #dextrose 5%/lactated ringer's Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5%/nacl 0.2% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

DEXTROSE 5%/NACL 0.225% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

DEXTROSE 5%/NACL 0.3% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5%/nacl 0.33% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5%/nacl 0.45% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5%/nacl 0.9% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

DEXTROSE 5%/POTASSIUM CHLORIDE 0.075%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5%/potassium chloride 0.15%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5%/ringer's Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5%/sodium chloride 0.2%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5%/sodium chloride 0.33%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5%/sodium chloride 0.45%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5%/sodium chloride 0.9%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrose 5% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

DEXTROSE 50% /ELECTROLYTES A PARTIAL FILL

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dextrostat Central Nervous System Agents

Amphetamines 51

DHT INTENSOL Hormonal Agents, Vitamin D-related 66

Page of 231 127

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Agents/Metabolic Bone Disease Agents

DHT Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

DIABETA Blood Glucose Regulators Sulfonylureas 38 DIABETIC SUPPLIES, MISC Insulin Administration

Supplies Insulin Administration Supplies 75

DIABINESE Blood Glucose Regulators Sulfonylureas 38 dialyte/1.5% dextrose pattern lm

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dialyte/2.5% dextrose pattern lm

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

dialyte/4.25% dextrose pattern lm

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

DIAMOX Cardiovascular Agents Carbonic Anhydrase Inhibitors 46 DIAMOX Ophthalmic Agents Carbonic Anhydrase Inhibitors,

Ophthalmic 76

DIANEAL LOW CALCIUM/1.5% DEXTROSE

Unclassified Unclassified 90

DIANEAL LOW CALCIUM/2.5% DEXTROSE

Unclassified Unclassified 90

DIANEAL LOW CALCIUM/4.25%DEXTROSE

Therapeutic Nutrients/Minerals/Electrolytes

Parenteral Nutrition 87

DIANEAL PD-2/1.5% DEXTROSE

Unclassified Unclassified 90

DIANEAL PD-2/2.5% DEXTROSE

Unclassified Unclassified 90

DIANEAL PD-2/3.5% DEXTROSE

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

DIANEAL PD-2/4.25% DEXTROSE

Unclassified Unclassified 90

di-atro Gastrointestinal Agents Gastrointestinal Agents, Other 57 DICHLOROACETIC ACID Dermatological Agents Dermatological Caustic Agents 53 diclofenac potassium Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 24

diclofenac sodium dr Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

diclofenac sodium ec Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

diclofenac sodium er Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

diclofenac sodium sr Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

Page of 231 128

Drug Name Class Category Class Name Page #diclofenac sodium xr Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 24

diclofenac sodium Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

dicloxacillin sodium Antibacterials Penicillinase-resistant Penicillins 14 dicyclomine hcl Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 dicyclomine hcl Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 dicyclomine hcl Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 dicyclomine hcl Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 didanosine Antivirals Anti-HIV Agents, Nucleoside and

Nucleotide Reverse Transcriptase Inhibitors

34

DIDRONEL IV Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Parenteral 65

DIDRONEL Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Oral 65

diflorasone diacetate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

diflorasone diacetate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

DIFLUCAN IN ISO-OSMOTIC DEXTROSE

Antifungals Azole Antifungals 22

DIFLUCAN IN NACL Antifungals Azole Antifungals 22 DIFLUCAN Antifungals Azole Antifungals 22 DIFLUCAN Antifungals Azole Antifungals 22 DIFLUNISAL Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 24

DIFLUNISAL Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

digitek Cardiovascular Agents Direct Cardiac Inotropics 47 DIGOXIN Cardiovascular Agents Direct Cardiac Inotropics 47 digoxin Cardiovascular Agents Direct Cardiac Inotropics 47 digoxin Cardiovascular Agents Direct Cardiac Inotropics 47 dihydroergotamine mesylate Antimigraine Agents Ergot Alkaloids 26 DILACOR XR Cardiovascular Agents Antiarrhythmics - Class IV 44 DILACOR XR Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

DILANTIN INFATABS Anticonvulsants Sodium Channel Inhibitors 18 DILANTIN-125 Anticonvulsants Sodium Channel Inhibitors 18 DILANTIN Anticonvulsants Sodium Channel Inhibitors 18 DILANTIN Anticonvulsants Sodium Channel Inhibitors 18 DILANTIN Anticonvulsants Sodium Channel Inhibitors 18 DILATRATE SR Cardiovascular Agents Vasodilators, Direct-acting

Arterial/Venous 50

DILAUDID-5 Analgesics Opioid Analgesics, Short-acting 3

Page of 231 129

Drug Name Class Category Class Name Page #DILAUDID Analgesics Opioid Analgesics, Short-acting 3 DILAUDID-HP Analgesics Opioid Analgesics, Short-acting 3 DILAUDID-HP Analgesics Opioid Analgesics, Short-acting 3 dilt-cd Cardiovascular Agents Antiarrhythmics - Class IV 44 dilt-cd Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

diltia xt Cardiovascular Agents Antiarrhythmics - Class IV 44 diltia xt Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

diltiazem cd Cardiovascular Agents Antiarrhythmics - Class IV 44 diltiazem cd Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

diltiazem hcl er Cardiovascular Agents Antiarrhythmics - Class IV 44 diltiazem hcl er Cardiovascular Agents Antiarrhythmics - Class IV 44 diltiazem hcl er Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

diltiazem hcl er Cardiovascular Agents Calcium Channel Blocking Agents (Non-dihydropyridines)

45

diltiazem hcl sr Cardiovascular Agents Antiarrhythmics - Class IV 44 diltiazem hcl sr Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

diltiazem hcl Cardiovascular Agents Antiarrhythmics - Class IV 44 diltiazem hcl Cardiovascular Agents Antiarrhythmics - Class IV 44 diltiazem hcl Cardiovascular Agents Antiarrhythmics - Class IV 44 DILTIAZEM HCL Cardiovascular Agents Antiarrhythmics - Class IV 44 diltiazem hcl Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

diltiazem hcl Cardiovascular Agents Calcium Channel Blocking Agents (Non-dihydropyridines)

45

diltiazem hcl Cardiovascular Agents Calcium Channel Blocking Agents (Non-dihydropyridines)

45

DILTIAZEM HCL Cardiovascular Agents Calcium Channel Blocking Agents (Non-dihydropyridines)

45

diltiazem xr Cardiovascular Agents Antiarrhythmics - Class IV 44 diltiazem xr Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 45

dilt-xr Cardiovascular Agents Calcium Channel Blocking Agents (Non-dihydropyridines)

46

DIOVAN HCT Cardiovascular Agents Angiotensin II Receptor Antagonists

42

DIOVAN Cardiovascular Agents Angiotensin II Receptor Antagonists

42

DIPENTUM Gastrointestinal Agents Gastrointestinal Agents, Other 57 diphenatol Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 diphenatol Gastrointestinal Agents Gastrointestinal Agents, Other 57 diphenhydramine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 80 diphenhydramine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 80 diphenhydramine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 80 diphenoxylate/atropine Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 diphenoxylate/atropine Gastrointestinal Agents Gastrointestinal Agents, Other 57 diphenoxylate/atropine Gastrointestinal Agents Gastrointestinal Agents, Other 57

Page of 231 130

Drug Name Class Category Class Name Page #dipivefrin hcl Ophthalmic Agents Alpha-adrenergic Agonists,

Ophthalmic 75

DIPROLENE AF Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

DIPROLENE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

DIPROLENE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

DIPROLENE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

61

DIPTHERIA/TETANUS TOXOID PEDIATRIC

Immunological Agents Vaccines 73

dipyridamole Blood Products/Modifiers/Volume Expanders

Cyclic Adenosine Monophosphate Reuptake Inhibitors

40

disopyramide phosphate er Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

44

disopyramide phosphate Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

44

dispas Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 DISPERMOX Antibacterials Amino Derivative Penicillins 7 DITROPAN XL Genitourinary Agents Antispasmodics, Urinary 59 DITROPAN Genitourinary Agents Antispasmodics, Urinary 59 DITROPAN Genitourinary Agents Antispasmodics, Urinary 59 DIURIL IV Cardiovascular Agents Thiazide Diuretics 49 DIURIL Cardiovascular Agents Thiazide Diuretics 49 DIVIGEL Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

dolacet Analgesics Opioid Analgesics, Short-acting 3 dolagesic Analgesics Opioid Analgesics, Short-acting 4 DOLOBID Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 24

DOLOGESIC Analgesics Non-opioid Analgesics 1 DOLOGESIC Analgesics Non-opioid Analgesics 1 dologesic Analgesics Non-opioid Analgesics 1 DOLOPHINE HCL Analgesics Opioid Analgesics, Long-acting 2 DOLOPHINE Analgesics Opioid Analgesics, Long-acting 2 DOLOPHINE Analgesics Opioid Analgesics, Long-acting 2 dolorex forte Analgesics Opioid Analgesics, Short-acting 4 dolorex Analgesics Non-opioid Analgesics 1 dolorex Analgesics Non-opioid Analgesics 1 dolotic Dermatological Agents Dermatological Antipruritic

Agents 52

DORYX Antibacterials Tetracyclines 16 DORYX Antibacterials Tetracyclines 16 DOSTINEX Hormonal Agents, Dopamine Agonists 71

Page of 231 131

Drug Name Class Category Class Name Page #Suppressant (Pituitary)

DOVONEX Dermatological Agents Dermatological Mitotic Inhibitors 53 DOVONEX Dermatological Agents Dermatological Mitotic Inhibitors 53 DOVONEX Dermatological Agents Dermatological Mitotic Inhibitors 53 doxazosin mesylate Cardiovascular Agents Alpha-adrenergic Blocking

Agents 41

doxazosin mesylate Genitourinary Agents Alpha1-adrenergic Blocking Agents

59

doxepin hcl Antidepressants Tricyclics 20 doxepin hcl Antidepressants Tricyclics 20 doxepin hcl Anxiolytics Antidepressants 36 doxepin hcl Anxiolytics Antidepressants 36 DOXIL Antineoplastics Antineoplastics 28 doxorubicin hcl Antineoplastics Antineoplastics 28 doxorubicin hcl Antineoplastics Antineoplastics 28 doxy-caps Antibacterials Tetracyclines 16 doxycycline hyclate Antibacterials Tetracyclines 16 DOXYCYCLINE HYCLATE Antibacterials Tetracyclines 16 doxycycline hyclate Antibacterials Tetracyclines 16 doxycycline hyclate Antibacterials Tetracyclines 16 doxycycline monohydrate Antibacterials Tetracyclines 16 doxycycline monohydrate Antibacterials Tetracyclines 16 DRITHO-SCALP Dermatological Agents Dermatological Mitotic Inhibitors 53 DROXIA Antineoplastics Antineoplastics 28 DTIC-DOME Antineoplastics Antineoplastics 28 DUET DHA EC Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

DUET DHA Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

DUETACT Blood Glucose Regulators Sulfonylureas 38 DUETACT Blood Glucose Regulators Thiazolidinediones 39 DUET Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

DUET Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

DUONEB Respiratory Tract Agents Bronchodilators, Anticholinergic 79 DUO-VIL Antidepressants Tricyclics 20 DUO-VIL Antipsychotics Conventional 33 DURABAC Analgesics Non-opioid Analgesics 1 DURACLON Cardiovascular Agents Alpha-adrenergic Agonists 41 DURAGESIC Analgesics Opioid Analgesics, Long-acting 2 duramorph Analgesics Opioid Analgesics, Long-acting 2 DURAXIN Analgesics Non-opioid Analgesics 1 DURICEF Antibacterials Cephalosporin Antibacterials,

1st Generation 9

DURICEF Dermatological Agents Dermatological Antipruritic Agents

52

Page of 231 132

Drug Name Class Category Class Name Page #DURICEF Dermatological Agents Dermatological Antipruritic

Agents 52

DYAZIDE Cardiovascular Agents Potassium-sparing Diuretics 48 DYAZIDE Cardiovascular Agents Thiazide Diuretics 49 DYGASE Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

54

DYNABAC D5-PAK Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

dynacin Antibacterials Tetracyclines 16 DYNACIN Antibacterials Tetracyclines 16 DYNACIN Antibacterials Tetracyclines 16 DYNACIRC CR Cardiovascular Agents Dihydropyridines 47 DYNACIRC Cardiovascular Agents Dihydropyridines 47 DYNACIRC-CR Cardiovascular Agents Dihydropyridines 47 DYRENIUM Cardiovascular Agents Potassium-sparing Diuretics 48 e.e.s. 200 Antibacterials Erythromycins 10 e.e.s. 400 Antibacterials Erythromycins 10 e.e.s. 400 Antibacterials Erythromycins 10 E.E.S. GRANULES Antibacterials Erythromycins 10 ear drops Dermatological Agents Dermatological Antipruritic

Agents 52

ear-gesic Dermatological Agents Dermatological Antipruritic Agents

52

EC-NAPROSYN Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

econazole nitrate Antifungals Azole Antifungals 22 ECONOPRED PLUS Ophthalmic Agents Glucocorticoids, Ophthalmic 76 ed k+10 Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

EDECRIN Cardiovascular Agents Loop Diuretics 48 ed-flex Analgesics Non-opioid Analgesics 1 effer-k Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

EFFEXOR XR Antidepressants Antidepressants, Other 19 EFFEXOR Antidepressants Antidepressants, Other 19 EFUDEX OCCLUSION PACK Antineoplastics Antineoplastics 28 EFUDEX Antineoplastics Antineoplastics 28 EFUDEX Antineoplastics Antineoplastics 28 ELAPRASE Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

54

ELDEPRYL Antiparkinson Agents Antiparkinson Agents, Other 32 ELESTAT Ophthalmic Agents Ophthalmic Anti-allergy Agents 77 ELESTRIN Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

ELIDEL Dermatological Agents Dermatological Immunomodulators

53

ELIGARD Hormonal Agents, Suppressant (Sex

Antiandrogens 71

Page of 231 133

Drug Name Class Category Class Name Page #Hormones/Modifiers)

ELIMITE Antiparasitics Pediculicides/Scabicides 31 ELITEK Antineoplastics Antineoplastics 28 ELIXOPHYLLIN Respiratory Tract Agents Bronchodilators,

Phosphodiesterase 2 Inhibitors (Xanthines)

79

ELLENCE Antineoplastics Antineoplastics 28 ELMIRON Genitourinary Agents Genitourinary Agents 60 ELOCON Dermatological Agents Dermatological Anti-

inflammatories 52

ELOCON Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

ELOCON Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

ELOCON Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

63

ELOXATIN Antineoplastics Antineoplastics 28 ELOXATIN Antineoplastics Antineoplastics 28 ELSPAR Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

54

EMADINE Ophthalmic Agents Ophthalmic Anti-allergy Agents 78 embeline e Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

embeline Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

embeline Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

embeline Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

embeline Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

emcin clear Insulin Administration Supplies

Insulin Administration Supplies 75

EMCYT Antineoplastics Estrogen-nitrosoureas 30 EMEND Antiemetics Neurokinin 1 (NK1) Receptor

Antagonists 21

EMEND Antiemetics Neurokinin 1 (NK1) Receptor Antagonists

21

EMLA/TEGADERM Anesthetics Local Anesthetics 6 EMLA Anesthetics Local Anesthetics 6 EMSAM Antiparkinson Agents Antiparkinson Agents, Other 32 EMTRIVA Antivirals Anti-HIV Agents, Nucleoside and

Nucleotide Reverse 34

Page of 231 134

Drug Name Class Category Class Name Page #Transcriptase Inhibitors

EMTRIVA Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

E-MYCIN Antibacterials Erythromycins 11 ENABLEX Genitourinary Agents Antispasmodics, Urinary 59 enalapril maleate/hydrochlorothiazide

Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

enalapril maleate Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

ENBREL SURECLICK Immunological Agents Tumor Necrosis Factor (TNF) Inhibitors

73

ENBREL Immunological Agents Tumor Necrosis Factor (TNF) Inhibitors

73

ENBREL Immunological Agents Tumor Necrosis Factor (TNF) Inhibitors

73

endocet Analgesics Opioid Analgesics, Short-acting 4 endodan Analgesics Opioid Analgesics, Short-acting 4 ENGERIX-B SDV Immunological Agents Vaccines 73 ENGERIX-B Immunological Agents Vaccines 73 ENGERIX-B Immunological Agents Vaccines 73 ENLON-PLUS Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 ENLON-PLUS Respiratory Tract Agents Bronchodilators, Anticholinergic 79 enpresse-28 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

ENTOCORT EC Inflammatory Bowel Disease Agents

Glucocorticoids 74

enulose Gastrointestinal Agents Gastrointestinal Agents, Other 57 ENZYCAP Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

54

ENZYMAX Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

54

epinephrine hcl Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

EPIPEN 2-PAK Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

EPIPEN-JR 2-PAK Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

EPIRUBICIN HCL Antineoplastics Antineoplastics 28 epitol Anticonvulsants Sodium Channel Inhibitors 18 epitol Bipolar Agents Bipolar Agents 36 EPIVIR HBV Antivirals Anti-HIV Agents, Nucleoside and

Nucleotide Reverse Transcriptase Inhibitors

34

EPIVIR HBV Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

EPIVIR Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

Page of 231 135

Drug Name Class Category Class Name Page #EPIVIR Antivirals Anti-HIV Agents, Nucleoside and

Nucleotide Reverse Transcriptase Inhibitors

34

EPOGEN Blood Products/Modifiers/Volume Expanders

Erythropoietins 40

EPZICOM Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

eq miconazole 3 combo pack Antifungals Azole Antifungals 22 EQUAGESIC Analgesics Non-opioid Analgesics 1 EQUAGESIC Sedatives/Hypnotics Sedatives/Hypnotics 82 EQUETRO Anticonvulsants Anticonvulsants (Other) 17 EQUETRO Anticonvulsants Sodium Channel Inhibitors 18 EQUETRO Bipolar Agents Bipolar Agents 36 ERAXIS Antifungals Antifungals (Other) 22 ERBITUX Antineoplastics Antineoplastics 28 ergoloid mesylates Antidementia Agents Antidementia Agents, Other 18 ERGOMAR Antimigraine Agents Ergot Alkaloids 26 ergotamine tartrate/caffeine Antimigraine Agents Ergot Alkaloids 26 errin Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

ERYC Antibacterials Erythromycins 11 eryderm Antibacterials Erythromycins 11 ERYGEL Antibacterials Erythromycins 11 ERYPED 200 Antibacterials Erythromycins 11 ERYPED 400 Antibacterials Erythromycins 11 ERYPED Antibacterials Erythromycins 11 ERY-TAB Antibacterials Erythromycins 11 ERYTHROCIN LACTOBIONATE

Antibacterials Erythromycins 11

erythrocin stearate Antibacterials Erythromycins 11 ERYTHROCIN Antibacterials Erythromycins 11 erythromycin /sulfisoxazole Antibacterials Erythromycins 11 erythromycin /sulfisoxazole Antibacterials Sulfonamides 15 ERYTHROMYCIN BASE Antibacterials Erythromycins 11 erythromycin ethylsuccinate Antibacterials Erythromycins 11 erythromycin ethylsuccinate Antibacterials Erythromycins 11 erythromycin ethylsuccinate Antibacterials Erythromycins 11 ERYTHROMYCIN LACTOBIONATE

Antibacterials Erythromycins 11

erythromycin stearate Antibacterials Erythromycins 11 ERYTHROMYCIN Antibacterials Erythromycins 11 erythromycin Antibacterials Erythromycins 11 erythromycin Antibacterials Erythromycins 11 erythromycin Antibacterials Erythromycins 11 erythromycin Antibacterials Erythromycins 11 ERYTHROMYCIN Antibacterials Erythromycins 11 ESCLIM Hormonal Agents,

Stimulant/Replacement/ModifyEstrogens 69

Page of 231 136

Drug Name Class Category Class Name Page #ing (Sex Hormones/Modifiers)

ESKALITH CR Bipolar Agents Bipolar Agents 36 ESKALITH Bipolar Agents Bipolar Agents 36 ESTRACE Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

ESTRACE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

ESTRACE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

ESTRADERM Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

estradiol Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

estradiol Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

ESTRASORB Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

ESTRING Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

estro-5 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

ESTROGEL Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

estropipate Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

ESTROSTEP FE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

ethambutol hcl Antimycobacterials Antituberculars 27 ethezyme 830 Dermatological Agents Dermatological Wound Care

Agents 54

ETHEZYME Dermatological Agents Dermatological Wound Care Agents

54

ethosuximide Anticonvulsants Calcium Channel Modifying Agents

17

ethosuximide Anticonvulsants Calcium Channel Modifying Agents

17

eth-oxydose Analgesics Opioid Analgesics, Short-acting 4 ETHYOL Antineoplastics Antineoplastics 28 etidronate disodium Hormonal Agents, Bisphosphonates, Oral 65

Page of 231 137

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

etodolac er Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

etodolac Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

etodolac Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

24

ETOPOPHOS Antineoplastics Antineoplastics 28 etoposide Antineoplastics Antineoplastics 28 EURAX Antiparasitics Pediculicides/Scabicides 31 EURAX Antiparasitics Pediculicides/Scabicides 31 EVISTA Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Selective Estrogen Receptor Modifying Agents

70

EXELDERM Antifungals Azole Antifungals 22 EXELDERM Antifungals Azole Antifungals 22 EXELON Antidementia Agents Cholinesterase Inhibitors 18 EXELON Antidementia Agents Cholinesterase Inhibitors 18 EXFORGE Cardiovascular Agents Angiotensin II Receptor

Antagonists 42

EXFORGE Cardiovascular Agents Dihydropyridines 47 EXJADE Blood

Products/Modifiers/Volume Expanders

Iron Overload Agents 40

EXUBERA COMBINATION PACK 15

Blood Glucose Regulators Insulin, Rapid-acting 38

EXUBERA KIT Blood Glucose Regulators Insulin, Rapid-acting 38 FABRAZYME Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

54

FACTIVE Antibacterials Quinolones 14 famotidine premixed Gastrointestinal Agents Histamine2 (H2) Blocking

Agents 58

famotidine Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

famotidine Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

FAMVIR Antivirals Antiherpetic Agents 34 FANSIDAR Antiparasitics Antimalarials 31 FARESTON Antineoplastics Selective Estrogen Receptor

Modulators, 1st Generation 30

FASLODEX Antineoplastics Antineoplastics 28 FAZACLO Antipsychotics Atypicals 32 FELBATOL Anticonvulsants Glutamate Reducing Agents 17 FELBATOL Anticonvulsants Glutamate Reducing Agents 17 FELDENE Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 24

felodipine er Cardiovascular Agents Dihydropyridines 47 FEMARA Antineoplastics Aromatase Inhibitors, 3rd

Generation 30

Page of 231 138

Drug Name Class Category Class Name Page #FEMCON FE Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

FEMHRT 1/5 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

FEMHRT LOW DOSE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

FEMRING Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 69

FEMTRACE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

fenofibrate Cardiovascular Agents Fibrates 47 fenoprofen calcium Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

FENTANYL CITRATE ORAL TRANSMUCOSAL

Analgesics Opioid Analgesics, Short-acting 4

fentanyl citrate Analgesics Opioid Analgesics, Short-acting 4 fentanyl Analgesics Opioid Analgesics, Long-acting 2 fentanyl Analgesics Opioid Analgesics, Long-acting 2 FENTORA Analgesics Opioid Analgesics, Short-acting 4 fexofenadine hcl Respiratory Tract Agents Histamine1 (H1) Blocking

Agents, Mildly/Non-sedating 81

FINACEA Dermatological Agents 54 FIORICET/CODEINE Analgesics Opioid Analgesics, Short-acting 4 FLAGYL ER Antibacterials Miscellaneous Antibacterials 12 FLAGYL Antibacterials Miscellaneous Antibacterials 12 FLAGYL Antibacterials Miscellaneous Antibacterials 12 FLAREX Ophthalmic Agents Glucocorticoids, Ophthalmic 76 FLEBOGAMMA Immunological Agents Vaccines 73 flecainide acetate Cardiovascular Agents Antiarrhythmics - Classes IA, B,

and C 44

FLEXERIL Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 FLEXTRA DS Analgesics Non-opioid Analgesics 1 FLEXTRA-650 Analgesics Non-opioid Analgesics 1 FLEXTRA Analgesics Non-opioid Analgesics 1 FLOMAX Genitourinary Agents Alpha1-adrenergic Blocking

Agents 59

FLONASE Respiratory Tract Agents Respiratory Tract Agents, Other 81 FLORINEF Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Mineralocorticoids 65

FLOVENT HFA Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

FLOVENT Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

FLOXIN OTIC SINGLES Antibacterials Quinolones 14 FLOXIN OTIC Antibacterials Quinolones 14

Page of 231 139

Drug Name Class Category Class Name Page #FLOXIN Antibacterials Quinolones 14 floxuridine Antineoplastics Antineoplastics 28 fluconazole in dextrose Antifungals Azole Antifungals 22 fluconazole in nacl Antifungals Azole Antifungals 22 fluconazole Antifungals Azole Antifungals 22 fluconazole Antifungals Azole Antifungals 23 FLUDARA Antineoplastics Antineoplastics 28 FLUDARABINE PHOSPHATE Antineoplastics Antineoplastics 28 fludarabine phosphate Antineoplastics Antineoplastics 29 fludrocortisone acetate Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Mineralocorticoids 65

FLUMADINE Antivirals Anti-influenza Agents 35 FLUMADINE Antivirals Anti-influenza Agents 35 flunisolide Respiratory Tract Agents Respiratory Tract Agents, Other 81 flunisolide Unclassified No Classification 90 fluocinolone acetonide Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

fluocinolone acetonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

fluocinolone acetonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

fluocinolone acetonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

fluocinolone acetonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

fluocinonide emollient base Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

fluocinonide-e Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

fluocinonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

fluocinonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

fluocinonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

fluocinonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

fluoridex daily defense Therapeutic Nutrients/Minerals/Electrolyte

Electrolytes/Minerals 84

Page of 231 140

Drug Name Class Category Class Name Page #s

fluorometholone Ophthalmic Agents Glucocorticoids, Ophthalmic 76 FLUOROPLEX Antineoplastics Antineoplastics 29 FLUOROPLEX Antineoplastics Antineoplastics 29 fluor-op Ophthalmic Agents Glucocorticoids, Ophthalmic 76 FLUOROURACIL Antineoplastics Antineoplastics 29 fluoxetine hcl Antidepressants Serotonin and Norepinephrine

Reuptake Inhibitors (SNRIs) 19

fluoxetine hcl Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

fluoxetine hcl Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

fluoxetine hcl Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

fluphenazine decanoate Antipsychotics Conventional 33 FLUPHENAZINE HCL Antipsychotics Conventional 33 FLUPHENAZINE HCL Antipsychotics Conventional 33 fluphenazine hcl Antipsychotics Conventional 33 FLUPHENAZINE HCL Antipsychotics Conventional 33 flurbiprofen sodium Ophthalmic Agents Nonsteroidal Anti-inflammatory

Drugs, Ophthalmic 77

flurbiprofen Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

flutamide Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

fluticasone propionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

fluticasone propionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

fluticasone propionate Respiratory Tract Agents Respiratory Tract Agents, Other 81 fluvoxamine maleate Antidepressants Serotonin and Norepinephrine

Reuptake Inhibitors (SNRIs) 19

FML FORTE Ophthalmic Agents Glucocorticoids, Ophthalmic 76 FML LIQUIFILM Ophthalmic Agents Glucocorticoids, Ophthalmic 76 FML S.O.P. Ophthalmic Agents Glucocorticoids, Ophthalmic 76 FML-S LIQUIFILM Ophthalmic Agents Glucocorticoids, Ophthalmic 76 FOCALIN XR Central Nervous System

Agents Non-amphetamines 51

FOCALIN XR Central Nervous System Agents

Non-amphetamines 51

FOCALIN Central Nervous System Agents

Non-amphetamines 51

FORADIL AEROLIZER Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

FORTAMET Blood Glucose Regulators Biguanides 37 FORTAZ INFUSION PACK Antibacterials Cephalosporin Antibacterials,

3rd Generation 10

FORTAZ Antibacterials Cephalosporin Antibacterials, 10

Page of 231 141

Drug Name Class Category Class Name Page #3rd Generation

FORTAZ Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

FORTEO Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Calcium Regulating Hormones 66

FORTEO Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Parathyroid Hormone Analogs 66

fortical Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Calcium Regulating Hormones 66

FOSAMAX PLUS D Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Oral 65

FOSAMAX Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Oral 65

FOSAMAX Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Oral 65

foscarnet sodium Antivirals Anti-cytomegalovirus (CMV) Agents

33

foscarnet sodium Antivirals Antiherpetic Agents 34 FOSCAVIR Antivirals Anti-cytomegalovirus (CMV)

Agents 34

FOSCAVIR Antivirals Antiherpetic Agents 34 fosinopril sodium/hydrochlorothiazide

Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

fosinopril sodium Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

fosinopril sodium Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

FOSRENOL Antidotes, Deterrents, and Toxicologic Agents

Ion Exchange Resins 20

FOSRENOL Genitourinary Agents Phosphate Binders 60 FOSRENOL Genitourinary Agents Phosphate Binders 60 FRAGMIN Blood

Products/Modifiers/Volume Expanders

Low Molecular Weight Heparins 40

FREAMINE HBC 6.9% Therapeutic Nutrients/Minerals/Electrolytes

Parenteral Nutrition 87

FREAMINE III 3% Therapeutic Nutrients/Minerals/Electrolyte

Electrolytes/Minerals 84

Page of 231 142

Drug Name Class Category Class Name Page #s

FROVA Antimigraine Agents Triptans 26 FUDR Antineoplastics Antineoplastics 29 FUNGIZONE Antifungals Polyene Antifungals 23 FURADANTIN Antibacterials Nitrofuran Antibacterials 14 FUROSEMIDE Cardiovascular Agents Loop Diuretics 48 furosemide Cardiovascular Agents Loop Diuretics 48 furosemide Cardiovascular Agents Loop Diuretics 48 furosemide Cardiovascular Agents Loop Diuretics 48 FUZEON Antivirals Anti-human Immunodeficiency

Virus (HIV) Agents, Fusion Inhibitors

35

gabapentin Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

gabapentin Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

GABARONE Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

GABITRIL Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

GABITRIL Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

GAMASTAN S/D Immunological Agents Vaccines 73 GAMMAGARD LIQUID Immunological Agents Vaccines 73 GAMMAGARD S/D Immunological Agents Vaccines 73 gammar-p i.v. Immunological Agents Vaccines 73 GAMUNEX Immunological Agents Vaccines 74 GANCICLOVIR Antivirals Anti-cytomegalovirus (CMV)

Agents 34

GANCICLOVIR Antivirals Anti-cytomegalovirus (CMV) Agents

34

GANTRISIN PEDIATRIC Antibacterials Sulfonamides 15 GARAMYCIN Antibacterials Aminoglycosides 7 GARDASIL Immunological Agents Vaccines 74 GASTROCROM Gastrointestinal Agents Gastrointestinal Agents, Other 57 GAUZE PADS 2"X2" Insulin Administration

Supplies Insulin Administration Supplies 75

gemfibrozil Cardiovascular Agents Fibrates 47 GEMZAR Antineoplastics Antineoplastics 29 genecar Analgesics Non-opioid Analgesics 1 genedolorex Analgesics Non-opioid Analgesics 1 gene-r-gesic Analgesics Non-opioid Analgesics 1 generlac Gastrointestinal Agents Gastrointestinal Agents, Other 57 gengraf Immunological Agents Immune Suppressants (Non-

TNF Inhibitors) 72

gengraf Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

gengraf Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

genoptic Antibacterials Aminoglycosides 7 GENOTROPIN MINIQUICK Hormonal Agents, Hormonal Agents, 66

Page of 231 143

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Pituitary)

Stimulant/Replacement/Modifying (Pituitary)

GENOTROPIN Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

gentacidin Antibacterials Aminoglycosides 7 gentak Antibacterials Aminoglycosides 7 gentak Antibacterials Aminoglycosides 7 GENTAMICIN SULFATE/0.9% SODIUM CHLORIDE

Antibacterials Aminoglycosides 7

gentamicin sulfate/0.9% sodium chloride

Antibacterials Aminoglycosides 7

gentamicin sulfate/sodium chloride

Antibacterials Aminoglycosides 7

gentamicin sulfate Antibacterials Aminoglycosides 7 gentamicin sulfate Antibacterials Aminoglycosides 7 gentamicin sulfate Antibacterials Aminoglycosides 7 gentamicin sulfate Antibacterials Aminoglycosides 7 gentamicin sulfate Antibacterials Aminoglycosides 7 gentasol Ophthalmic Agents 78 GEOCILLIN Antibacterials Extended Spectrum Penicillins 11 GEODON Antipsychotics Atypicals 32 GEODON Antipsychotics Atypicals 33 GEODON Bipolar Agents Bipolar Agents 36 GEODON Bipolar Agents Bipolar Agents 36 gladase-c Dermatological Agents Dermatological Wound Care

Agents 54

gladase Dermatological Agents Dermatological Wound Care Agents

54

GLEEVEC Antineoplastics Multitargeted Kinase Inhibitors, Gastrointestinal Stromal Tumors

30

glimepiride Blood Glucose Regulators Sulfonylureas 38 glipizide er Blood Glucose Regulators Sulfonylureas 38 glipizide xl Blood Glucose Regulators Sulfonylureas 38 glipizide/metformin hcl Blood Glucose Regulators Biguanides 37 glipizide/metformin hcl Blood Glucose Regulators Sulfonylureas 38 glipizide Blood Glucose Regulators Sulfonylureas 39 GLUCAGEN HYPOKIT Blood Glucose Regulators Glycemic Agents 37 GLUCAGON EMERGENCY KIT

Blood Glucose Regulators Glycemic Agents 37

GLUCOPHAGE XR Blood Glucose Regulators Biguanides 37 GLUCOPHAGE Blood Glucose Regulators Biguanides 37 GLUCOTROL XL Blood Glucose Regulators Sulfonylureas 39 GLUCOTROL Blood Glucose Regulators Sulfonylureas 39 GLUCOVANCE Blood Glucose Regulators Biguanides 37 GLUCOVANCE Blood Glucose Regulators Sulfonylureas 39 GLUMETZA Blood Glucose Regulators Biguanides 37 glyburide micronized Blood Glucose Regulators Sulfonylureas 39 glyburide/metformin hcl Blood Glucose Regulators Biguanides 37 glyburide/metformin hcl Blood Glucose Regulators Sulfonylureas 39 glyburide Blood Glucose Regulators Sulfonylureas 39

Page of 231 144

Drug Name Class Category Class Name Page #glycolax Gastrointestinal Agents Gastrointestinal Agents, Other 57 glycolax Gastrointestinal Agents Gastrointestinal Agents, Other 57 glycopyrrolate Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 glycopyrrolate Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 glycron Blood Glucose Regulators Sulfonylureas 39 GLYNASE Blood Glucose Regulators Sulfonylureas 39 GLYSET Blood Glucose Regulators Alpha Glucosidase Inhibitors 37 gold sodium thiomalate Unclassified Unclassified 90 GOLYTELY Gastrointestinal Agents Gastrointestinal Agents, Other 57 GOLYTELY Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

GRIFULVIN V Antifungals Antifungals (Other) 22 GRIFULVIN V Antifungals Antifungals (Other) 22 GRIFULVIN V Antifungals Antifungals (Other) 22 griseofulvin microsize Antifungals Antifungals (Other) 22 GRISEOFULVIN ULTRAMICROSIZE

Antifungals Antifungals (Other) 22

GRIS-PEG Antifungals Antifungals (Other) 22 GUANABENZ ACETATE Cardiovascular Agents Alpha-adrenergic Agonists 41 guanfacine hcl Cardiovascular Agents Alpha-adrenergic Agonists 41 GUANIDINE HCL Antimyasthenic Agents Parasympathomimetics 26 GYNODIOL Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

HALDOL DECANOATE 50 Antipsychotics Conventional 33 HALDOL DECANOATE-100 Antipsychotics Conventional 33 HALDOL DECANOATE-50 Antipsychotics Conventional 33 HALDOL Antipsychotics Conventional 33 halobetasol propionate Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

halobetasol propionate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

HALOG Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

HALOG Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

HALOG Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

haloperidol decanoate Antipsychotics Conventional 33 haloperidol lactate Antipsychotics Conventional 33 haloperidol Antipsychotics Conventional 33 haloperidol Antipsychotics Conventional 33 HAVRIX Immunological Agents Vaccines 74 hc cream Hormonal Agents,

Stimulant/Replacement/ModifyGlucocorticoids-Topical-Low Potency

62

Page of 231 145

Drug Name Class Category Class Name Page #ing (Adrenal)

HECTOROL Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

HECTOROL Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

HECTOROL Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

HELIDAC Antibacterials Miscellaneous Antibacterials 13 HEPARIN SODIUM (PORCINE)

Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

HEPARIN SODIUM DCU Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

heparin sodium/d5w Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

HEPARIN SODIUM/NACL 0.45%

Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

heparin sodium/nacl 0.9% Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

heparin sodium/nacl 0.9% Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

HEPARIN SODIUM/SODIUM CHLORIDE 0.9%

Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

HEPARIN SODIUM Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

HEPARIN SODIUM Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

HEPSERA Antivirals Antivirals, Other 35 HERCEPTIN Antineoplastics Antineoplastics 29 HEXALEN Antineoplastics Antineoplastics 29 HIBTITER Immunological Agents Vaccines 74 HIPREX Antibacterials Miscellaneous Antibacterials 13 homatropaire Ophthalmic Agents Ophthalmic Agents, Other 77 HUMALOG MIX 50/50 PEN Blood Glucose Regulators Insulin Mixtures, Analogs 37 HUMALOG MIX 50/50 Blood Glucose Regulators Insulin Mixtures, Analogs 37 HUMALOG MIX 75/25 PEN Blood Glucose Regulators Insulin Mixtures, Analogs 37 HUMALOG MIX 75/25 Blood Glucose Regulators Insulin Mixtures, Analogs 37

Page of 231 146

Drug Name Class Category Class Name Page #HUMALOG PEN Blood Glucose Regulators Insulin, Rapid-acting 38 HUMALOG Blood Glucose Regulators Insulin, Rapid-acting 38 HUMATIN Antibacterials Aminoglycosides 7 HUMATIN Antiparasitics Antiprotozoals (Non-

antimalarials) 31

HUMATROPE COMBO PACK Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

HUMATROPE Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

HUMIRA PEN Immunological Agents Tumor Necrosis Factor (TNF) Inhibitors

73

HUMIRA Immunological Agents Tumor Necrosis Factor (TNF) Inhibitors

73

HUMULIN 50/50 Blood Glucose Regulators Insulin Mixtures, Short-acting and Intermediate-acting

37

HUMULIN 70/30 PEN Blood Glucose Regulators Insulin Mixtures, Short-acting and Intermediate-acting

37

HUMULIN 70/30 Blood Glucose Regulators Insulin Mixtures, Short-acting and Intermediate-acting

38

HUMULIN N U-100 PEN Blood Glucose Regulators Insulin, Intermediate-acting 38 HUMULIN N Blood Glucose Regulators Insulin, Intermediate-acting 38 HUMULIN R U-500 (CONCENTRATED)

Blood Glucose Regulators Insulin, Short-acting 38

HUMULIN R Blood Glucose Regulators Insulin, Short-acting 38 HYCAMTIN Antineoplastics Antineoplastics 29 HYCET Analgesics Opioid Analgesics, Short-acting 4 HYDERGINE Antidementia Agents Antidementia Agents, Other 18 HYDRALAZINE /HYDROCHLOROTHIAZIDE

Cardiovascular Agents Thiazide Diuretics 49

HYDRALAZINE /HYDROCHLOROTHIAZIDE

Cardiovascular Agents Vasodilators, Direct-acting Arterial

50

hydralazine hcl Cardiovascular Agents Vasodilators, Direct-acting Arterial

50

hydralazine hcl Cardiovascular Agents Vasodilators, Direct-acting Arterial

50

HYDREA Antineoplastics Antineoplastics 29 hydrocet Analgesics Opioid Analgesics, Short-acting 4 hydrochlorothiazide Cardiovascular Agents Thiazide Diuretics 49 hydrochlorothiazide Cardiovascular Agents Thiazide Diuretics 49 HYDROCHLOROTHIAZIDE Cardiovascular Agents Thiazide Diuretics 49 hydrocodone /acetaminophen Analgesics Opioid Analgesics, Short-acting 4 hydrocodone /acetaminophen Analgesics Opioid Analgesics, Short-acting 4 hydrocodone /acetaminophen-hs

Analgesics Opioid Analgesics, Short-acting 4

hydrocodone bitartrate/acetaminophen

Analgesics Opioid Analgesics, Short-acting 4

hydrocodone bitartrate/apap Analgesics Opioid Analgesics, Short-acting 4 hydrocodone/apap Analgesics Opioid Analgesics, Short-acting 4 hydrocodone/ibuprofen Analgesics Opioid Analgesics, Short-acting 4

Page of 231 147

Drug Name Class Category Class Name Page #hydrocodone-acetaminophen Analgesics Opioid Analgesics, Short-acting 4 hydrocodone-apap Analgesics Opioid Analgesics, Short-acting 4 hydrocortisone butyrate Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

hydrocortisone butyrate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

hydrocortisone butyrate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

hydrocortisone in absorbase Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

hydrocortisone valerate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

hydrocortisone valerate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

hydrocortisone Anti-inflammatories Glucocorticoids 24 hydrocortisone Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

hydrocortisone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

62

hydrocortisone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

hydrocortisone Inflammatory Bowel Disease Agents

Glucocorticoids 74

hydromorphone hcl Analgesics Opioid Analgesics, Short-acting 4 hydromorphone hcl Analgesics Opioid Analgesics, Short-acting 4 hydroxychloroquine sulfate Antiparasitics Antimalarials 31 hydroxyurea Antineoplastics Antineoplastics 29 hydroxyzine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 80 hydroxyzine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 80 hydroxyzine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 80 hydroxyzine hcl Sedatives/Hypnotics Sedatives/Hypnotics 82 hydroxyzine hcl Sedatives/Hypnotics Sedatives/Hypnotics 82 hydroxyzine hcl Sedatives/Hypnotics Sedatives/Hypnotics 82 hydroxyzine pamoate Respiratory Tract Agents H1 Blocking Agents, Sedating 80 hydroxyzine pamoate Sedatives/Hypnotics Sedatives/Hypnotics 82 hyflex-650 Analgesics Non-opioid Analgesics 1 hyflex-ds Analgesics Non-opioid Analgesics 1 hyoscyamine sulfate Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 hyoscyamine sulfate Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 hyoscyamine sulfate Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 hyoscyamine sulfate Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 hyoscyamine sulfate Gastrointestinal Agents Antispasmodics, Gastrointestinal 56

Page of 231 148

Drug Name Class Category Class Name Page #hyoscyamine Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 hyospaz Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 hyosyne Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 hyosyne Gastrointestinal Agents Antispasmodics, Gastrointestinal 56 HYTONE Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

HYTONE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

HYTRIN Cardiovascular Agents Alpha-adrenergic Blocking Agents

41

HYTRIN Genitourinary Agents Alpha1-adrenergic Blocking Agents

59

HYZAAR Cardiovascular Agents Angiotensin II Receptor Antagonists

42

HYZAAR Cardiovascular Agents Angiotensin II Receptor Antagonists

42

hyzine Respiratory Tract Agents H1 Blocking Agents, Sedating 80 hyzine Sedatives/Hypnotics Sedatives/Hypnotics 82 IB-STAT Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 ibu Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

ibuprofen Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

ibuprofen Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

ICAR PRENATAL COMBO PACK

Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 87

IDAMYCIN PFS Antineoplastics Antineoplastics 29 idarubicin Antineoplastics Antineoplastics 29 IFEX/MESNEX COMBO PACK Antineoplastics Antineoplastics 29 IFEX Antineoplastics Antineoplastics 29 ifosfamide/mesna Antineoplastics Antineoplastics 29 ifosfamide Antineoplastics Antineoplastics 29 IMDUR Cardiovascular Agents Vasodilators, Direct-acting

Arterial/Venous 50

imipramine hcl Antidepressants Tricyclics 20 IMITREX STATDOSE REFILL Antimigraine Agents Triptans 26 IMITREX STATDOSE SYSTEM Antimigraine Agents Triptans 26 IMITREX Antimigraine Agents Triptans 26 IMITREX Antimigraine Agents Triptans 26 IMITREX Antimigraine Agents Triptans 26 IMITREX Antimigraine Agents Triptans 26 IMMUNE GLOBULIN Immunological Agents Vaccines 74 IMURAN Antineoplastics Antineoplastics 29 inatal advance Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

inatal gt Therapeutic Prenatal Vitamins 88

Page of 231 149

Drug Name Class Category Class Name Page #Nutrients/Minerals/Electrolytes

inatal ultra Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

INCRELEX Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

indapamide Cardiovascular Agents Thiazide Diuretics 49 INDERAL LA Antimigraine Agents Beta-adrenergic Blocking Agents 26 INDERAL LA Cardiovascular Agents Antiarrhythmics - Class II 43 INDERAL LA Cardiovascular Agents Nonselective Beta-adrenergic

Blocking Agents 48

INDERAL Antimigraine Agents Beta-adrenergic Blocking Agents 26 INDERAL Cardiovascular Agents Antiarrhythmics - Class II 43 INDERAL Cardiovascular Agents Nonselective Beta-adrenergic

Blocking Agents 48

INDERIDE 40/25 Cardiovascular Agents Nonselective Beta-adrenergic Blocking Agents

48

INDERIDE 40/25 Cardiovascular Agents Thiazide Diuretics 49 INDOCIN IV Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

INDOCIN SR Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

INDOCIN Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

INDOCIN Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

indomethacin cr Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

indomethacin er Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

indomethacin sa Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

indomethacin sr Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

indomethacin Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

INFANRIX Immunological Agents Vaccines 74 INFERGEN Immunological Agents Interferons, Alfa 73 INFLAMASE FORTE Ophthalmic Agents Glucocorticoids, Ophthalmic 76 INFLAMASE MILD Ophthalmic Agents Glucocorticoids, Ophthalmic 76 INFUMORPH 200 Analgesics Opioid Analgesics, Long-acting 2 INNOHEP Blood

Products/Modifiers/Volume Expanders

Low Molecular Weight Heparins 40

INNOPRAN XL Antimigraine Agents Beta-adrenergic Blocking Agents 26 INNOPRAN XL Cardiovascular Agents Antiarrhythmics - Class II 43 INNOPRAN XL Cardiovascular Agents Nonselective Beta-adrenergic

Blocking Agents 48

inpersol/dextrose Therapeutic Electrolytes/Minerals 84

Page of 231 150

Drug Name Class Category Class Name Page #Nutrients/Minerals/Electrolytes

inpersol-lm/1.5% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

inpersol-lm/2.5% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

inpersol-lm/4.25% dextrose Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

INSPRA Cardiovascular Agents Aldosterone Receptor Antagonists

41

INSPRA Cardiovascular Agents Potassium-sparing Diuretics 48 INTAL 112 Respiratory Tract Agents Mast Cell Stabilizers 81 INTAL 200 Respiratory Tract Agents Mast Cell Stabilizers 81 INTAL INHALER Respiratory Tract Agents Mast Cell Stabilizers 81 INTAL Respiratory Tract Agents Mast Cell Stabilizers 81 intralipid 20% Therapeutic

Nutrients/Minerals/Electrolytes

Parenteral Nutrition 87

intralipid Therapeutic Nutrients/Minerals/Electrolytes

Parenteral Nutrition 87

INTRON-A W/DILUENT Immunological Agents Interferons, Alfa 73 INTRON-A Immunological Agents Interferons, Alfa 73 INTRON-A Immunological Agents Interferons, Alfa 73 INVANZ Antibacterials Beta-lactam, Other 9 INVEGA Antipsychotics Atypicals 33 INVERSINE Cardiovascular Agents Cardiovascular Agents 46 INVIRASE Antivirals Anti-HIV Agents, Protease

Inhibitors 35

INVIRASE Antivirals Anti-HIV Agents, Protease Inhibitors

35

IONOSOL-B/DEXTROSE 5% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

IONOSOL-MB/DEXTROSE 5% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

IONOSOL-T/DEXTROSE 5% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 84

IOPIDINE Ophthalmic Agents Alpha-adrenergic Agonists, Ophthalmic

75

IPOL INACTIVATED IPV Immunological Agents Vaccines 74 ipratropium bromide Respiratory Tract Agents Bronchodilators, Anticholinergic 79 ipratropium bromide Respiratory Tract Agents Respiratory Tract Agents, Other 81 IRESSA Antineoplastics Epidermal Growth Factor

Receptor Kinase Inhibitors 30

ISMO Cardiovascular Agents Vasodilators, Direct-acting 50

Page of 231 151

Drug Name Class Category Class Name Page #Arterial/Venous

ISMOTIC Cardiovascular Agents Osmotic Diuretics 48 isochron Cardiovascular Agents Vasodilators, Direct-acting

Arterial/Venous 50

isonarif Antimycobacterials Antituberculars 27 isoniazid Antimycobacterials Antituberculars 27 ISONIAZID Antimycobacterials Antituberculars 27 ISOPTIN SR Cardiovascular Agents Antiarrhythmics - Class IV 44 ISOPTIN SR Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 46

ISOPTO ATROPINE Ophthalmic Agents Ophthalmic Agents, Other 77 ISOPTO CARPINE Ophthalmic Agents Miotics, Ophthalmic 77 ISOPTO CARPINE Ophthalmic Agents Miotics, Ophthalmic 77 ISOPTO HOMATROPINE Ophthalmic Agents Ophthalmic Agents, Other 77 ISORDIL TITRADOSE Cardiovascular Agents Vasodilators, Direct-acting

Arterial/Venous 50

ISORDIL TITRADOSE Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

isosorbide dinitrate er Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

isosorbide dinitrate sa Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

isosorbide dinitrate tr Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

isosorbide dinitrate Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

isosorbide dinitrate Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

isosorbide mononitrate er Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

isosorbide mononitrate Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

isotonic gentamicin Antibacterials Aminoglycosides 7 isotretinoin Dermatological Agents Dermatological Retinoids 53 isovate Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

isradipine Cardiovascular Agents Dihydropyridines 47 ISTALOL Ophthalmic Agents Beta-adrenergic Blocking

Agents, Ophthalmic 75

ISUPREL Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

itraconazole Antifungals Azole Antifungals 23 itraconazole Antifungals Azole Antifungals 23 IVEEGAM EN Immunological Agents Vaccines 74 jantoven Blood

Products/Modifiers/Volume Expanders

Anticoagulants, Oral 39

jantoven Blood Products/Modifiers/Volume Expanders

Anticoagulants, Oral 39

Page of 231 152

Drug Name Class Category Class Name Page #JANUMET Blood Glucose Regulators Biguanides 37 JANUVIA Blood Glucose Regulators 39 jolessa Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

jolivette Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

junel 1.5/30 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

junel 1.5/30 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

junel 1/20 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

junel fe 1.5/30 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

junel fe 1/20 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

k+ potassium Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KADIAN Analgesics Opioid Analgesics, Long-acting 2 KALETRA Antivirals Anti-HIV Agents, Protease

Inhibitors 35

KALETRA Antivirals Anti-HIV Agents, Protease Inhibitors

35

KALETRA Antivirals Anti-HIV Agents, Protease Inhibitors

35

KANAMYCIN SULFATE Antibacterials Aminoglycosides 7 KANAMYCIN SULFATE Antimycobacterials Antituberculars 27 kaochlor Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kaon-cl-10 Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KAON-CL Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KAON Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kariva Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

kay ciel Therapeutic Electrolytes/Minerals 85

Page of 231 153

Drug Name Class Category Class Name Page #Nutrients/Minerals/Electrolytes

KAYEXALATE Antidotes, Deterrents, and Toxicologic Agents

Ion Exchange Resins 20

kcl 0.075%/d5w/nacl 0.2% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KCL 0.075%/D5W/NACL 0.225 Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kcl 0.075%/d5w/nacl 0.45% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KCL 0.15%/D10W/NACL 0.2% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kcl 0.15%/d5w/ nacl 0.3% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KCL 0.15%/D5W/LR Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kcl 0.15%/d5w/nacl 0.2% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kcl 0.15%/d5w/nacl 0.225% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kcl 0.15%/d5w/nacl 0.45% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kcl 0.15%/d5w/nacl 0.9% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kcl 0.22%/d5w/nacl 0.2% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kcl 0.224%/d5w/nacl 0.2% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KCL 0.224%/D5W/NACL 0.225 Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kcl 0.224%/d5w/nacl 0.45% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KCL 0.3%/D5W/LR IV LAC RING

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KCL 0.3%/D5W/LR Therapeutic Nutrients/Minerals/Electrolyte

Electrolytes/Minerals 85

Page of 231 154

Drug Name Class Category Class Name Page #s

kcl 0.3%/d5w/nacl 0.2% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KCL 0.3%/D5W/NACL 0.225% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KCL 0.3%/D5W/NACL 0.33% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kcl 0.3%/d5w/nacl 0.45% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KCL 0.3%/D5W/NACL 0.9% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

K-DUR Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

k-effervescent Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KEFLEX Antibacterials Cephalosporin Antibacterials, 1st Generation

9

KEFLEX Antibacterials Cephalosporin Antibacterials, 1st Generation

9

kelnor 1/35 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

KEMADRIN Antiparkinson Agents Anticholinergics 31 KENALOG IN ORABASE Dental and Oral Agents Dental and Oral Agents 52 KENALOG-10 MDV Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

KENALOG-10 Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

KENALOG-40 Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

KENALOG Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

KENALOG Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

KENALOG Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

KENALOG Hormonal Agents, Stimulant/Replacement/Modify

Glucocorticoids-Topical-Medium Potency

64

Page of 231 155

Drug Name Class Category Class Name Page #ing (Adrenal)

KENALOG Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

KEPPRA Anticonvulsants Anticonvulsants (Other) 17 KEPPRA Anticonvulsants Anticonvulsants (Other) 17 KEPPRA Anticonvulsants Anticonvulsants (Other) 17 KEPPRA Anticonvulsants Anticonvulsants (Other) 17 KERALYT Dermatological Agents Dermatological Caustic Agents 53 keratol hc Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

KERLONE Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

KERLONE Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

kestrone 5 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

KETEK PAK Antibacterials Ketolides 11 KETEK Antibacterials Ketolides 11 KETEK Antibacterials Ketolides 11 ketoconazole Antifungals Azole Antifungals 23 ketoconazole Antifungals Azole Antifungals 23 ketoconazole Antifungals Azole Antifungals 23 KETOPROFEN ER Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

ketoprofen Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

ketorolac tromethamine Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

ketorolac tromethamine Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

ketorolac tromethamine Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

ketotifen fumarate Ophthalmic Agents Ophthalmic Anti-allergy Agents 78 KEY-PRED Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

KINERET Immunological Agents Immunomodulators, Other 72 kionex Antidotes, Deterrents, and

Toxicologic Agents Ion Exchange Resins 20

KLARON Antibacterials Sulfonamides 15 klor-con 10 Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KLOR-CON 25 Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

klor-con 8 Therapeutic Nutrients/Minerals/Electrolyte

Electrolytes/Minerals 85

Page of 231 156

Drug Name Class Category Class Name Page #s

klor-con m10 Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KLOR-CON M15 Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

klor-con m20 Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

klor-con/ef Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

klor-con Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

K-LOR Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

klotrix Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

K-LYTE DS Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

K-LYTE Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KMART VALU PLUS INSULIN SYRINGE/0.3ML/30G

Insulin Administration Supplies

Insulin Administration Supplies 75

KMART VALU PLUS INSULIN SYRINGE/0.5ML/29G

Insulin Administration Supplies

Insulin Administration Supplies 75

KMART VALU PLUS INSULIN SYRINGE/1ML/29G

Insulin Administration Supplies

Insulin Administration Supplies 75

kovia 6.5 Dermatological Agents Dermatological Wound Care Agents

54

kovia Dermatological Agents Dermatological Wound Care Agents

54

K-PHOS MF Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

K-PHOS NEUTRAL Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

K-PHOS NO 2 Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

K-PHOS Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KRISTALOSE Gastrointestinal Agents Gastrointestinal Agents, Other 57

Page of 231 157

Drug Name Class Category Class Name Page #K-TABS Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

kuric Antifungals Azole Antifungals 23 KUTRASE Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

54

KU-ZYME HP Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

54

KU-ZYME Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

k-vescent Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

k-vescent Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

KYTRIL Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

KYTRIL Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

KYTRIL Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

labetalol hcl Cardiovascular Agents Alpha-beta-adrenergic Blocking Agents

41

labetalol hcl Cardiovascular Agents Alpha-beta-adrenergic Blocking Agents

41

laccream Dermatological Agents Dermatological Emolients 53 LAC-HYDRIN Dermatological Agents Dermatological Emolients 53 LAC-HYDRIN Dermatological Agents Dermatological Emolients 53 laclotion Dermatological Agents Dermatological Emolients 53 LACRISERT Ophthalmic Agents Ocular Surface Agents 77 lactated ringer's dextrose 5% viaflex

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

lactated ringer's irrigation Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 85

lactated ringer's viaflex Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

lactated ringer's Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

lacticare-hc Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

LACTULOSE Gastrointestinal Agents Gastrointestinal Agents, Other 58 LAGESIC Analgesics Non-opioid Analgesics 1 LAMICTAL CHEWABLE DISPERSIBLE

Anticonvulsants Glutamate Reducing Agents 17

LAMICTAL STARTER/NOT Bipolar Agents Bipolar Agents 36

Page of 231 158

Drug Name Class Category Class Name Page #TAKING CARBAMAZEPINE LAMICTAL STARTER/TAKING CARBAMAZEPINE/NOT TAKING VALPROATE

Anticonvulsants Glutamate Reducing Agents 17

LAMICTAL STARTER/TAKING VALPROATE

Anticonvulsants Glutamate Reducing Agents 17

LAMICTAL Anticonvulsants Glutamate Reducing Agents 17 LAMISIL Antifungals Allylamine Antifungals 22 LAMISIL Antifungals Allylamine Antifungals 22 lamotrigine chewable dispersible

Anticonvulsants Glutamate Reducing Agents 17

LANOXICAPS Cardiovascular Agents Direct Cardiac Inotropics 47 LANOXIN Cardiovascular Agents Direct Cardiac Inotropics 47 LANOXIN Cardiovascular Agents Direct Cardiac Inotropics 47 LANOXIN Cardiovascular Agents Direct Cardiac Inotropics 47 LANTUS OPTICLIK Blood Glucose Regulators Insulin, Long-acting 38 LANTUS Blood Glucose Regulators Insulin, Long-acting 38 LAPASE Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

55

LARIAM Antiparasitics Antimalarials 31 LASIX Cardiovascular Agents Loop Diuretics 48 leena Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 67

leflunomide Immunological Agents Immunomodulators, Other 72 LESCOL XL Cardiovascular Agents 3-hydroxy-3-methylglutaryl

coenzyme A (HMG CoA) Reductase Inhibitors

40

LESCOL Cardiovascular Agents 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) Reductase Inhibitors

40

lessina-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LETAIRIS Cardiovascular Agents Vasodilators, Endothelin Receptor Antagonists

51

LETAIRIS Respiratory Tract Agents Respiratory Tract Agents, Other 82 leucovorin calcium Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

leucovorin calcium Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

leucovorin calcium Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

LEUKERAN Antineoplastics Antineoplastics 29 LEUKINE Blood

Products/Modifiers/Volume Expanders

Colony Stimulating Factors 40

LEUKINE Blood Colony Stimulating Factors 40

Page of 231 159

Drug Name Class Category Class Name Page #Products/Modifiers/Volume Expanders

leuprolide acetate Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

leuprolide acetate Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

LEUSTATIN Antineoplastics Antineoplastics 29 LEVACET Analgesics Non-opioid Analgesics 1 LEVAQUIN LEVA-PAK Antibacterials Quinolones 14 LEVAQUIN PREMIX Antibacterials Quinolones 14 LEVAQUIN Antibacterials Quinolones 14 LEVAQUIN Antibacterials Quinolones 15 LEVAQUIN Antibacterials Quinolones 15 LEVATOL Cardiovascular Agents Nonselective Beta-adrenergic

Blocking Agents 48

LEVEMIR Blood Glucose Regulators Insulin, Long-acting 38 LEVLEN CONTRACT PACK Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LEVLEN-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LEVLITE-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LEVO DROMORAN Analgesics Opioid Analgesics, Long-acting 2 levobunolol hcl Ophthalmic Agents Beta-adrenergic Blocking

Agents, Ophthalmic 75

levocarnitine Unclassified Unclassified 90 LEVO-DROMORAN Analgesics Opioid Analgesics, Long-acting 2 levora 0.15/30-28 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

levorphanol tartrate Analgesics Opioid Analgesics, Long-acting 2 levothroid Hormonal Agents,

Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

70

levothroid Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

levothyroxine sodium Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

levothyroxine sodium Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

levoxyl Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

Page of 231 160

Drug Name Class Category Class Name Page #LEVSIN/SL Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 LEVSIN Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 LEVSIN Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 LEVSIN Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 LEXAPRO Antidepressants Serotonin and Norepinephrine

Reuptake Inhibitors (SNRIs) 19

LEXAPRO Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

LEXAPRO Anxiolytics Antidepressants 36 LEXAPRO Anxiolytics Antidepressants 36 LEXIVA Antivirals Anti-HIV Agents, Protease

Inhibitors 35

LEXXEL Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

LEXXEL Cardiovascular Agents Dihydropyridines 47 LIALDA Inflammatory Bowel Disease

Agents Salicylates 75

LIDEX-E Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

LIDEX Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

LIDEX Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

LIDEX Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

LIDEX Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

lidocaine hcl Anesthetics Local Anesthetics 6 lidocaine hcl Anesthetics Local Anesthetics 6 lidocaine hcl Anesthetics Local Anesthetics 6 lidocaine hcl Anesthetics Local Anesthetics 6 lidocaine/prilocaine Anesthetics Local Anesthetics 6 lidocaine Anesthetics Local Anesthetics 6 LIDODERM Anesthetics Local Anesthetics 6 LIMBITROL DS Antidepressants Tricyclics 20 LIMBITROL DS Anxiolytics Anxiolytics, Other 36 LIMBITROL Antidepressants Tricyclics 20 LIMBITROL Anxiolytics Anxiolytics, Other 36 LINCOCIN Antibacterials Lincomycin Antibacterials 12 LINDANE Antiparasitics Pediculicides/Scabicides 31 lindane Antiparasitics Pediculicides/Scabicides 31 liothyronine sodium Hormonal Agents,

Suppressant (Thyroid) Hormonal Agents, Suppressant (Thyroid)

72

LIPITOR Cardiovascular Agents 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) Reductase Inhibitors

40

Page of 231 161

Drug Name Class Category Class Name Page #liposyn iii Therapeutic

Nutrients/Minerals/Electrolytes

Parenteral Nutrition 87

LIPOSYN II Therapeutic Nutrients/Minerals/Electrolytes

Parenteral Nutrition 87

LIPRAM 4500 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

LIPRAM-CR10 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

LIPRAM-CR20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

LIPRAM-CR5 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

LIPRAM-PN10 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

LIPRAM-PN16 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

LIPRAM-PN20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

LIPRAM-UL12 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

LIPRAM-UL18 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

LIPRAM-UL20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

lisinopril /hydrochlorothiazide Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

lisinopril Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

lithium carbonate er Bipolar Agents Bipolar Agents 36 lithium carbonate Bipolar Agents Bipolar Agents 36 LITHIUM CARBONATE Bipolar Agents Bipolar Agents 36 lithium citrate Bipolar Agents Bipolar Agents 36 lithium citrate Bipolar Agents Bipolar Agents 36 LITHOBID Bipolar Agents Bipolar Agents 36 LITHOSTAT Unclassified Unclassified 90 LO/OVRAL-28 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LO/OVRAL Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LOCOID LIPOCREAM Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

locoid Dermatological Agents Dermatological Anti-inflammatories

52

locoid Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

Page of 231 162

Drug Name Class Category Class Name Page #locoid Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

locoid Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

LODOSYN Antiparkinson Agents Dopamine Precursors 32 LOESTRIN 1.5/30-21 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LOESTRIN 1/20-21 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LOESTRIN 24 FE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LOESTRIN FE 1.5/30 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LOESTRIN FE 1/20 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

lofene Gastrointestinal Agents Gastrointestinal Agents, Other 58 LOFIBRA Cardiovascular Agents Fibrates 47 LOFIBRA Cardiovascular Agents Fibrates 47 lokara Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

LOMOTIL Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 LOMOTIL Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 LOMOTIL Gastrointestinal Agents Gastrointestinal Agents, Other 58 LOMOTIL Gastrointestinal Agents Gastrointestinal Agents, Other 58 lonox Gastrointestinal Agents Gastrointestinal Agents, Other 58 loperamide hcl Gastrointestinal Agents Gastrointestinal Agents, Other 58 LOPID Cardiovascular Agents Fibrates 47 LOPRESSOR HCT Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

LOPRESSOR HCT Cardiovascular Agents Thiazide Diuretics 49 LOPRESSOR Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

LOPRESSOR Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

LOPROX SHAMPOO Antifungals Antifungals (Other) 22 LOPROX Antifungals Antifungals (Other) 22 LOPROX Antifungals Antifungals (Other) 22 LOPROX Antifungals Antifungals (Other) 22 LORABID Antibacterials Beta-lactam, Other 9 LORABID Antibacterials Beta-lactam, Other 9 LORABID Antibacterials Beta-lactam, Other 9 loratadine Respiratory Tract Agents Histamine1 (H1) Blocking

Agents, Mildly/Non-sedating 81

Page of 231 163

Drug Name Class Category Class Name Page #LORCET 10/650 Analgesics Opioid Analgesics, Short-acting 4 LORCET PLUS Analgesics Opioid Analgesics, Short-acting 4 lorcet-hd Analgesics Opioid Analgesics, Short-acting 4 LORTAB 10 Analgesics Opioid Analgesics, Short-acting 4 LORTAB 2.5 Analgesics Opioid Analgesics, Short-acting 4 LORTAB 5 Analgesics Opioid Analgesics, Short-acting 4 LORTAB 7.5 Analgesics Opioid Analgesics, Short-acting 4 LORTAB Analgesics Opioid Analgesics, Short-acting 4 LOTEMAX Ophthalmic Agents Glucocorticoids, Ophthalmic 76 LOTENSIN HCT Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 42

LOTENSIN Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

LOTREL Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

LOTREL Cardiovascular Agents Dihydropyridines 47 LOTRISONE Antifungals Antifungals (Other) 22 LOTRISONE Antifungals Azole Antifungals 23 LOTRISONE Dermatological Agents Dermatological Anti-

inflammatories 52

LOTRISONE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

LOTRISONE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

LOTRISONE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

LOTRONEX Gastrointestinal Agents Irritable Bowel Syndrome Agents 58 lovastatin Cardiovascular Agents 3-hydroxy-3-methylglutaryl

coenzyme A (HMG CoA) Reductase Inhibitors

40

LOVENOX Blood Products/Modifiers/Volume Expanders

Low Molecular Weight Heparins 40

low-ogestrel Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

loxapine succinate Antipsychotics Conventional 33 LOXITANE Antipsychotics Conventional 33 LOZOL Cardiovascular Agents Thiazide Diuretics 49 LOZOL Cardiovascular Agents Thiazide Diuretics 49 LUFYLLIN Respiratory Tract Agents Bronchodilators,

Phosphodiesterase 2 Inhibitors (Xanthines)

79

LUMIGAN Ophthalmic Agents Prostaglandins, Ophthalmic 78 LUNESTA Sedatives/Hypnotics Sedatives/Hypnotics 82 LUPRON 2 WEEK SUPPLY Hormonal Agents,

Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

Page of 231 164

Drug Name Class Category Class Name Page #LUPRON 6-PACK Hormonal Agents,

Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

LUPRON DEPOT Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

LUPRON DEPOT-PED Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

lutera Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LUXIQ Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

LYBREL Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

LYRICA Anticonvulsants Calcium Channel Modifying Agents

17

LYSODREN Antineoplastics Antineoplastics 29 MACROBID Antibacterials Nitrofuran Antibacterials 14 MACRODANTIN Antibacterials Nitrofuran Antibacterials 14 MAGNESIUM SULFATE IN D5W

Anticonvulsants Anticonvulsants (Other) 17

MAGNESIUM SULFATE IN D5W

Cardiovascular Agents Antiarrhythmics (Other) 45

MAGNESIUM SULFATE Anticonvulsants Anticonvulsants (Other) 17 MAGNESIUM SULFATE Cardiovascular Agents Antiarrhythmics (Other) 45 MALARONE Antiparasitics Antimalarials 31 MALARONE Antiparasitics Antiprotozoals (Non-

antimalarials) 31

MALATHION Antiparasitics Pediculicides/Scabicides 31 maldemar Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 MANDELAMINE Antibacterials Miscellaneous Antibacterials 13 MANDOL/D5W Antibacterials Cephalosporin Antibacterials,

2nd Generation 10

MAPROTILINE HCL Antidepressants Tricyclics 20 margesic-h Analgesics Opioid Analgesics, Short-acting 4 MARINOL Antiemetics Antiemetics, Other 21 MARPLAN Antidepressants Monoamine Oxidase (Type A)

Inhibitors 19

MAR-SPAS Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 maternity-90 Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

maternity Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

MATULANE Antineoplastics Antineoplastics 29 MAVIK Cardiovascular Agents Angiotensin-converting Enzyme 42

Page of 231 165

Drug Name Class Category Class Name Page #(ACE) Inhibitors

MAXAIR AUTOHALER Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

MAXALT Antimigraine Agents Triptans 26 MAXALT-MLT Antimigraine Agents Triptans 26 MAXIDEX Ophthalmic Agents Glucocorticoids, Ophthalmic 76 MAXIDONE Analgesics Opioid Analgesics, Short-acting 4 MAXIFLOR Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

MAXIFLOR Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

MAXIPIME Antibacterials Cephalosporin Antibacterials, 4th Generation

10

MAXITROL Antibacterials Aminoglycosides 7 MAXITROL Antibacterials Aminoglycosides 7 MAXITROL Ophthalmic Agents Glucocorticoids, Ophthalmic 76 MAXITROL Ophthalmic Agents Glucocorticoids, Ophthalmic 76 MAXZIDE-25 Cardiovascular Agents Potassium-sparing Diuretics 48 MAXZIDE-25 Cardiovascular Agents Thiazide Diuretics 49 MAXZIDE Cardiovascular Agents Potassium-sparing Diuretics 48 MAXZIDE Cardiovascular Agents Thiazide Diuretics 49 mebendazole Antiparasitics Anthelmintics 31 meclizine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 80 meclizine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 81 MECLOFENAMATE SODIUM Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

MEDROL DOSEPAK Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

MEDROL Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

medroxyprogesterone acetate Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

medroxyprogesterone acetate Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

mefloquine hcl Antiparasitics Antimalarials 31 MEFOXIN ADD-VANTAGE Antibacterials Beta-lactam, Other 9 MEFOXIN ADD-VANTAGE Antibacterials Cephalosporin Antibacterials,

2nd Generation 10

MEFOXIN IN DEXTROSE 2.2%

Antibacterials Beta-lactam, Other 9

MEFOXIN IN DEXTROSE 2.2%

Antibacterials Cephalosporin Antibacterials, 2nd Generation

10

MEFOXIN IN DEXTROSE 3.9%

Antibacterials Beta-lactam, Other 9

MEFOXIN IN DEXTROSE Antibacterials Cephalosporin Antibacterials, 10

Page of 231 166

Drug Name Class Category Class Name Page #3.9% 2nd Generation MEFOXIN Antibacterials Beta-lactam, Other 9 MEFOXIN Antibacterials Cephalosporin Antibacterials,

2nd Generation 10

MEGACE ES Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

MEGACE ORAL Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

megestrol acetate Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

megestrol acetate Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

MELOXICAM Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

meloxicam Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

MENACTRA Immunological Agents Vaccines 74 MENEST Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

MENOMUNE-A/C/Y/W-135 Immunological Agents Vaccines 74 MENOSTAR Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

MENTAX Antifungals Antifungals (Other) 22 MEPERIDINE HCL Analgesics Opioid Analgesics, Short-acting 4 meperidine hcl Analgesics Opioid Analgesics, Short-acting 4 meperidine hcl Analgesics Opioid Analgesics, Short-acting 4 meperidine hcl Analgesics Opioid Analgesics, Short-acting 4 meperitab Analgesics Opioid Analgesics, Short-acting 4 MEPROBAMATE Sedatives/Hypnotics Sedatives/Hypnotics 82 MEPRON Antiparasitics Antiprotozoals (Non-

antimalarials) 31

mercaptopurine Antineoplastics Antineoplastics 29 MERREM Antibacterials Beta-lactam, Other 9 MERUVAX II W/DILUENT 1 DOSE

Immunological Agents Vaccines 74

MERUVAX II W/DILUENT 10 DOSE

Immunological Agents Vaccines 74

mesalamine Inflammatory Bowel Disease Agents

Salicylates 75

mesna Antineoplastics Antineoplastics 29 MESNEX Antineoplastics Antineoplastics 29 MESNEX Antineoplastics Antineoplastics 29 MESTINON TIMESPAN Antimyasthenic Agents Parasympathomimetics 27 MESTINON Antimyasthenic Agents Parasympathomimetics 27 MESTINON Antimyasthenic Agents Parasympathomimetics 27

Page of 231 167

Drug Name Class Category Class Name Page #MESTINON Antimyasthenic Agents Parasympathomimetics 27 METADATE CD Central Nervous System

Agents Non-amphetamines 51

METADATE ER Central Nervous System Agents

Non-amphetamines 51

METAGLIP Blood Glucose Regulators Biguanides 37 METAGLIP Blood Glucose Regulators Sulfonylureas 39 metaproterenol sulfate Respiratory Tract Agents Bronchodilators,

Sympathomimetic 80

metaproterenol sulfate Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

METAPROTERENOL SULFATE

Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

metformin hcl er Blood Glucose Regulators Biguanides 37 metformin hcl Blood Glucose Regulators Biguanides 37 methadone hcl Analgesics Opioid Analgesics, Long-acting 2 METHADONE HCL Analgesics Opioid Analgesics, Long-acting 2 methadone hcl Analgesics Opioid Analgesics, Long-acting 2 METHADONE HCL Analgesics Opioid Analgesics, Long-acting 2 methadose Analgesics Opioid Analgesics, Long-acting 2 methamphetamine hcl Central Nervous System

Agents Amphetamines 51

methazolamide Cardiovascular Agents Carbonic Anhydrase Inhibitors 46 methazolamide Ophthalmic Agents Carbonic Anhydrase Inhibitors,

Ophthalmic 76

methenamine hippurate Antibacterials Miscellaneous Antibacterials 13 methenamine mandelate Antibacterials Miscellaneous Antibacterials 13 methimazole Hormonal Agents,

Suppressant (Thyroid) Hormonal Agents, Suppressant (Thyroid)

72

methocarbamol Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 methotrexate sodium Immunological Agents Immune Suppressants (Non-

TNF Inhibitors) 72

methotrexate sodium Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

methotrexate Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

methscopolamine bromide Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 METHYCLOTHIAZIDE Cardiovascular Agents Thiazide Diuretics 49 METHYLDOPA /HYDROCHLOROTHIAZIDE

Cardiovascular Agents Alpha-adrenergic Agonists 41

METHYLDOPA /HYDROCHLOROTHIAZIDE

Cardiovascular Agents Thiazide Diuretics 49

methyldopa Cardiovascular Agents Alpha-adrenergic Agonists 41 METHYLDOPATE HCL Cardiovascular Agents Alpha-adrenergic Agonists 41 methylin er Central Nervous System

Agents Non-amphetamines 51

methylin Central Nervous System Agents

Non-amphetamines 51

METHYLIN Central Nervous System Agents

Non-amphetamines 51

METHYLIN Central Nervous System Non-amphetamines 51

Page of 231 168

Drug Name Class Category Class Name Page #Agents

methylphenidate hcl er Central Nervous System Agents

Non-amphetamines 51

methylphenidate hcl sr Central Nervous System Agents

Non-amphetamines 51

methylphenidate hcl Central Nervous System Agents

Non-amphetamines 51

methylphenidate hcl Central Nervous System Agents

Non-amphetamines 51

methylprednisolone acetate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

methylprednisolone sodiumsuccinate

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 60

methylprednisolone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

metipranolol Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

metoclopramide hcl Gastrointestinal Agents Gastrointestinal Agents, Other 58 metoclopramide hcl Gastrointestinal Agents Gastrointestinal Agents, Other 58 metolazone Cardiovascular Agents Thiazide Diuretics 49 metoprolol /hydrochlorothiazide Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

metoprolol /hydrochlorothiazide Cardiovascular Agents Thiazide Diuretics 49 metoprolol succinate er Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

metoprolol tartrate Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

metoprolol tartrate Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

metoprolol tartrate Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

METRO IV Antibacterials Miscellaneous Antibacterials 13 METROCREAM Antibacterials Miscellaneous Antibacterials 13 METROGEL VAGINAL Antibacterials Miscellaneous Antibacterials 13 METROGEL Antibacterials Miscellaneous Antibacterials 13 METROLOTION Antibacterials Miscellaneous Antibacterials 13 metronidazole in nacl 0.79% Antibacterials Miscellaneous Antibacterials 13 metronidazole vaginal Antibacterials Miscellaneous Antibacterials 13 metronidazole Antibacterials Miscellaneous Antibacterials 13 metronidazole Antibacterials Miscellaneous Antibacterials 13 metronidazole Antibacterials Miscellaneous Antibacterials 13 MEVACOR Cardiovascular Agents 3-hydroxy-3-methylglutaryl

coenzyme A (HMG CoA) Reductase Inhibitors

40

MEXILETINE HCL Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

44

MEXITIL Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

44

Page of 231 169

Drug Name Class Category Class Name Page #MIACALCIN Hormonal Agents,

Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Calcium Regulating Hormones 66

MIACALCIN Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Calcium Regulating Hormones 66

MICARDIS HCT Cardiovascular Agents Angiotensin II Receptor Antagonists

42

MICARDIS Cardiovascular Agents Angiotensin II Receptor Antagonists

42

MICONAZOLE 3 Antifungals Azole Antifungals 23 microgestin 1.5/30 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

microgestin 1/20 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

microgestin fe 1.5/30 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

microgestin fe Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

MICRO-K Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

MICRO-K Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

MICRONASE Blood Glucose Regulators Sulfonylureas 39 MICROZIDE Cardiovascular Agents Thiazide Diuretics 49 MIDAMOR Cardiovascular Agents Potassium-sparing Diuretics 48 midodrine hcl Cardiovascular Agents Alpha-adrenergic Agonists 41 MIGERGOT Antimigraine Agents Ergot Alkaloids 26 MIGRANAL Antimigraine Agents Ergot Alkaloids 26 MINIPRESS Cardiovascular Agents Alpha-adrenergic Blocking

Agents 41

minirin Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

minitran Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

MINIZIDE Cardiovascular Agents Alpha-adrenergic Blocking Agents

41

MINIZIDE Cardiovascular Agents Thiazide Diuretics 49 MINOCIN PAC Antibacterials Tetracyclines 16 MINOCIN Antibacterials Tetracyclines 16 minocycline hcl Antibacterials Tetracyclines 16 minocycline hcl Antibacterials Tetracyclines 16

Page of 231 170

Drug Name Class Category Class Name Page #minoxidil Cardiovascular Agents Vasodilators, Direct-acting

Arterial 50

MINTEZOL Antiparasitics Anthelmintics 31 MINTEZOL Antiparasitics Anthelmintics 31 MIOSTAT Ophthalmic Agents Miotics, Ophthalmic 77 MIRAPEX Antiparkinson Agents Dopamine Agonists 32 MIRCETTE Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

mirtazapine Antidepressants Antidepressants, Other 19 mirtazapine Antidepressants Antidepressants, Other 19 misoprostol Gastrointestinal Agents Protectants 59 mitomycin Antineoplastics Antineoplastics 29 M-M-R II 1 DOSE Immunological Agents Vaccines 74 M-M-R II W/DILUENT 1 DOSE Immunological Agents Vaccines 74 M-M-R II W/DILUENT 10 DOSE

Immunological Agents Vaccines 74

M-M-R II Immunological Agents Vaccines 74 MOBAN Antipsychotics Conventional 33 MOBAN Antipsychotics Conventional 33 MOBIC Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

MOBIC Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

MODICON-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

MODURETIC 5-50 Cardiovascular Agents Potassium-sparing Diuretics 48 MODURETIC 5-50 Cardiovascular Agents Thiazide Diuretics 49 moexipril hcl Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 42

mometasone furoate Dermatological Agents Dermatological Anti-inflammatories

52

mometasone furoate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

mometasone furoate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

mometasone furoate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

MONISTAT 3 Antifungals Azole Antifungals 23 MONISTAT-DERM Antifungals Azole Antifungals 23 MONODOX Antibacterials Tetracyclines 16 MONOKET Cardiovascular Agents Vasodilators, Direct-acting

Arterial/Venous 50

MONOKET Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

mononessa Hormonal Agents, Stimulant/Replacement/Modify

Contraceptives 68

Page of 231 171

Drug Name Class Category Class Name Page #ing (Sex Hormones/Modifiers)

MONOPRIL HCT Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

MONOPRIL Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

MONUROL Antibacterials Miscellaneous Antibacterials 13 morphine sulfate add-vantage Analgesics Opioid Analgesics, Long-acting 2 morphine sulfate dilute-a-jet Analgesics Opioid Analgesics, Long-acting 2 morphine sulfate er Analgesics Opioid Analgesics, Long-acting 2 MORPHINE SULFATE IN DEXTROSE 5%

Analgesics Opioid Analgesics, Long-acting 2

morphine sulfate stick-gard Analgesics Opioid Analgesics, Long-acting 2 MORPHINE SULFATE/D5W Analgesics Opioid Analgesics, Long-acting 2 MORPHINE SULFATE/NS Analgesics Opioid Analgesics, Long-acting 2 MORPHINE SULFATE Analgesics Opioid Analgesics, Long-acting 2 morphine sulfate Analgesics Opioid Analgesics, Long-acting 2 morphine sulfate Analgesics Opioid Analgesics, Long-acting 2 morphine sulfate Analgesics Opioid Analgesics, Long-acting 2 MORPHINE/D5W Analgesics Opioid Analgesics, Long-acting 2 MOTOFEN Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 MOTRIN Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

MOVIPREP Gastrointestinal Agents Gastrointestinal Agents, Other 58 M-R-VAX II Immunological Agents Vaccines 74 MS CONTIN Analgesics Opioid Analgesics, Long-acting 2 ms/l Analgesics Opioid Analgesics, Long-acting 2 MUCOMYST-10 Respiratory Tract Agents Respiratory Tract Agents, Other 82 multiple vitamins/fluoride Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

MUMPSVAX W/DILUENT 1 DOSE

Immunological Agents Vaccines 74

MUMPSVAX W/DILUENT 10 DOSE

Immunological Agents Vaccines 74

mupirocin Antibacterials Miscellaneous Antibacterials 13 MUSTARGEN Antineoplastics Antineoplastics 29 MUTAMYCIN Antineoplastics Antineoplastics 29 MYAMBUTOL Antimycobacterials Antituberculars 27 MYCAMINE Antifungals Antifungals (Other) 22 MYCELEX Antifungals Antifungals (Other) 22 MYCOBUTIN Antimycobacterials Antimycobacterials, Other 27 MYCOSTATIN Antifungals Polyene Antifungals 23 MYCOSTATIN Antifungals Polyene Antifungals 23 MYCOSTATIN Antifungals Polyene Antifungals 23 mydral Anesthetics Local Anesthetics 6 MYDRIACYL Anesthetics Local Anesthetics 6 MYFORTIC Immunological Agents Immune Suppressants (Non-

TNF Inhibitors) 72

MYLOTARG Antineoplastics Antineoplastics 29 mynatal advance Therapeutic

Nutrients/Minerals/ElectrolytePrenatal Vitamins 88

Page of 231 172

Drug Name Class Category Class Name Page #s

mynatal plus Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

mynatal ultracaplet Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

MYNATAL Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

mynatal-z Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

mynate 90 plus Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

MYOBLOC Unclassified Unclassified 90 MYOCHRYSINE Unclassified Unclassified 90 myophen Analgesics Non-opioid Analgesics 1 MYOZYME Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

55

myrac Antibacterials Tetracyclines 16 MYSOLINE Anticonvulsants Gamma-aminobutyric Acid

(GABA) Augmenting Agents 17

MYTELASE Antimyasthenic Agents Parasympathomimetics 27 mytrex Antifungals Polyene Antifungals 23 mytrex Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

nabumetone Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

NACL 0.9%/DEXTROSE 0.2% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

nadolol Cardiovascular Agents Antiarrhythmics - Class II 43 nadolol Cardiovascular Agents Nonselective Beta-adrenergic

Blocking Agents 48

NAFCILLIN SODIUM Antibacterials Penicillinase-resistant Penicillins 14 NAFTIN Antifungals Allylamine Antifungals 22 NAFTIN Antifungals Allylamine Antifungals 22 NAFTIN-MP Antifungals Allylamine Antifungals 22 NAGLAZYME Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

55

nalbuphine hcl Analgesics Opioid Analgesics, Short-acting 4 NALFON Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

NALLPEN ISO-OSMOTIC IN DEXTROSE

Antibacterials Penicillinase-resistant Penicillins 14

NALLPEN/DEXTROSE Antibacterials Penicillinase-resistant Penicillins 14 naloxone hcl Antidotes, Deterrents, and

Toxicologic Agents Opioid Antagonists 21

Page of 231 173

Drug Name Class Category Class Name Page #naloxone/pentazocine Analgesics Opioid Analgesics, Short-acting 4 naloxone/pentazocine Antidotes, Deterrents, and

Toxicologic Agents Opioid Antagonists 21

naltrexone hcl Antidotes, Deterrents, and Toxicologic Agents

Opioid Antagonists 21

NAMENDA TITRATION PAK Antidementia Agents Glutamate Pathway Modifiers 18 NAMENDA Antidementia Agents Glutamate Pathway Modifiers 18 NAMENDA Antidementia Agents Glutamate Pathway Modifiers 18 NANDROLONE DECANOATE Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

naphazole Ophthalmic Agents Ophthalmic Agents, Other 77 naphazoline hcl Ophthalmic Agents Ophthalmic Agents, Other 77 NAPRELAN Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

NAPROSYN Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

NAPROSYN Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

naproxen dr Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

naproxen ec Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

naproxen sodium Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

naproxen sodium Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

naproxen Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

naproxen Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

NARCAN Antidotes, Deterrents, and Toxicologic Agents

Opioid Antagonists 21

NARDIL Antidepressants Monoamine Oxidase (Type A) Inhibitors

19

narvox Analgesics Opioid Analgesics, Short-acting 4 NASACORT AQ Respiratory Tract Agents Respiratory Tract Agents, Other 82 NASAREL Respiratory Tract Agents Respiratory Tract Agents, Other 82 NASONEX Respiratory Tract Agents Respiratory Tract Agents, Other 82 natacaps Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NATACHEW Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NATACYN Antifungals Polyene Antifungals 23 natafolic-pn Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NATAFORT Therapeutic Nutrients/Minerals/Electrolyte

Prenatal Vitamins 88

Page of 231 174

Drug Name Class Category Class Name Page #s

natalcare cfe 60 Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natalcare glosstabs Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natalcare pic forte Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natalcare pic Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natalcare plus Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natalcare plus Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natalcare rx Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natalcare three Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NATALVIT Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natamar rx Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natatab cfe Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natatab fa Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

natatab rx Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NATELLE C Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NATELLE EZ Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NATELLE PREFER Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NATELLE Therapeutic Nutrients/Minerals/Electrolyte

Prenatal Vitamins 88

Page of 231 175

Drug Name Class Category Class Name Page #s

nature-throid Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

NATURETIN Cardiovascular Agents Thiazide Diuretics 49 NAVANE Antipsychotics Conventional 33 NAVELBINE Antineoplastics Antineoplastics 29 NEBCIN MDV Antibacterials Aminoglycosides 8 NEBCIN Antibacterials Aminoglycosides 8 NEBCIN Antibacterials Aminoglycosides 8 NEBUPENT Antiparasitics Antiprotozoals (Non-

antimalarials) 31

necon 0.5/35-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

necon 1/35-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

necon 1/50-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

NECON 10/11-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

necon 7/7/7 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

nefazodone hcl Antidepressants Antidepressants, Other 19 NEGGRAM Antibacterials Quinolones 15 neo/poly/bac/hc Antibacterials Miscellaneous Antibacterials 13 neo/poly/bac/hc Ophthalmic Agents Glucocorticoids, Ophthalmic 76 neo/polymyxin/hc 5-10000-1 Antibacterials Aminoglycosides 8 neo/polymyxin/hc 5-10000-1 Otic Agents Otic Anti-inflammatories 78 neocin Antibacterials Miscellaneous Antibacterials 13 NEO-FRADIN Antibacterials Aminoglycosides 8 neomycin /bacitracin /polymyxin /hydrocortisone

Antibacterials Aminoglycosides 8

neomycin /bacitracin /polymyxin /hydrocortisone

Antibacterials Miscellaneous Antibacterials 13

neomycin /bacitracin /polymyxin /hydrocortisone

Ophthalmic Agents Glucocorticoids, Ophthalmic 76

neomycin /bacitracin /polymyxin Antibacterials Miscellaneous Antibacterials 13 neomycin /polymyxin /bacitracin Antibacterials Miscellaneous Antibacterials 13 neomycin /polymyxin /dexamethasone

Antibacterials Aminoglycosides 8

neomycin /polymyxin /dexamethasone

Antibacterials Aminoglycosides 8

neomycin /polymyxin /dexamethasone

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

neomycin /polymyxin Ophthalmic Agents Glucocorticoids, Ophthalmic 76

Page of 231 176

Drug Name Class Category Class Name Page #/dexamethasone neomycin /polymyxin /dexamethasone

Ophthalmic Agents Glucocorticoids, Ophthalmic 76

neomycin /polymyxin /gramicidin

Antibacterials Aminoglycosides 8

neomycin /polymyxin /hydrocortisone

Antibacterials Aminoglycosides 8

neomycin /polymyxin /hydrocortisone

Antibacterials Aminoglycosides 8

neomycin /polymyxin /hydrocortisone

Ophthalmic Agents Glucocorticoids, Ophthalmic 76

neomycin /polymyxin /hydrocortisone

Otic Agents Otic Anti-inflammatories 78

neomycin /polymyxin /hydrocortisone

Otic Agents Otic Anti-inflammatories 78

neomycin sulfate Antibacterials Aminoglycosides 8 neomycin/bacitracin zn/polymyx Antibacterials Aminoglycosides 8 neomycin/bacitracin zn/polymyx Antibacterials Miscellaneous Antibacterials 13 neomycin/polymyxin b/gramicidin

Antibacterials Aminoglycosides 8

neomycin/polymyxin/hc Antibacterials Aminoglycosides 8 neomycin/polymyxin/hc Otic Agents Otic Anti-inflammatories 78 NEOPROFEN Analgesics Non-opioid Analgesics 1 NEOPROFEN Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

NEORAL Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

NEORAL Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

neosol Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 neostigmine methylsulfate Antimyasthenic Agents Parasympathomimetics 27 NESTABS CBF Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NESTABS FA Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NESTABS RX Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NEULASTA Blood Products/Modifiers/Volume Expanders

Colony Stimulating Factors 40

NEUMEGA Antineoplastics Antineoplastics 29 NEUPOGEN Blood

Products/Modifiers/Volume Expanders

Colony Stimulating Factors 40

NEURONTIN Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

NEURONTIN Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

Page of 231 177

Drug Name Class Category Class Name Page #NEURONTIN Anticonvulsants Gamma-aminobutyric Acid

(GABA) Augmenting Agents 17

NEVANAC Ophthalmic Agents Nonsteroidal Anti-inflammatory Drugs, Ophthalmic

77

NEXAVAR Antineoplastics Multitargeted Kinase Inhibitors, Bcr-Abl/c-kit Receptor Tyrosine Kinases

30

NEXAVAR Antineoplastics Multitargeted Kinase Inhibitors, Renal Cell Carcinoma

30

NEXIUM I.V. Gastrointestinal Agents Proton Pump Inhibitors 59 NEXIUM Gastrointestinal Agents Proton Pump Inhibitors 59 NEXIUM Gastrointestinal Agents Proton Pump Inhibitors 59 niacor Cardiovascular Agents 51 NIASPAN Cardiovascular Agents 51 nicardipine hcl Cardiovascular Agents Dihydropyridines 47 NICOTROL INHALER Antidotes, Deterrents, and

Toxicologic Agents Smoking Cessation Agents 21

NICOTROL NS Antidotes, Deterrents, and Toxicologic Agents

Smoking Cessation Agents 21

NICOTROL NS Antiemetics Antiemetics, Other 21 nifediac cc Cardiovascular Agents Dihydropyridines 47 nifedical xl Cardiovascular Agents Dihydropyridines 47 nifedipine er Cardiovascular Agents Dihydropyridines 47 nifedipine Cardiovascular Agents Dihydropyridines 47 nifedipine Cardiovascular Agents Dihydropyridines 47 niferex-pn forte Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NILANDRON Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

NIMOTOP Cardiovascular Agents Dihydropyridines 47 NIPENT Antineoplastics Antineoplastics 29 nitrek Cardiovascular Agents Vasodilators, Direct-acting

Arterial/Venous 50

NITRO-BID Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

NITRO-DUR Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

NITRO-DUR Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

nitrofurantoin macrocrystalline Antibacterials Nitrofuran Antibacterials 14 nitrofurantoin monohydrate Antibacterials Nitrofuran Antibacterials 14 nitrofurantoin Antibacterials Nitrofuran Antibacterials 14 NITROGARD Cardiovascular Agents Vasodilators, Direct-acting

Arterial/Venous 50

nitroglycerin cr Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

nitroglycerin er Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

nitroglycerin sr Cardiovascular Agents Vasodilators, Direct-acting 50

Page of 231 178

Drug Name Class Category Class Name Page #Arterial/Venous

nitroglycerin td Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

nitroglycerin transdermal Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

NITROGLYCERIN Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

nitroglycerin Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

nitroglycerin Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

nitroglycerin Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

NITROLINGUAL PUMPSPRAY Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

nitroquick Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

NITROSTAT Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

nitro-time Cardiovascular Agents Vasodilators, Direct-acting Arterial/Venous

50

nizatidine Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

NIZORAL Antifungals Azole Antifungals 23 NIZORAL Antifungals Azole Antifungals 23 nora-be Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

NORCO Analgesics Opioid Analgesics, Short-acting 4 NORDETTE-28 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

NORDETTE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

NORDITROPIN CARTRIDGE Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

NORDITROPIN NORDIFLEX PEN

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

NORDITROPIN NORDIFLEX Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

norethindrone acetate Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

NORFLEX Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 NORGESIC FORTE Analgesics Non-opioid Analgesics 1 NORGESIC FORTE Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 NORINYL 1+35 Hormonal Agents, Contraceptives 68

Page of 231 179

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

NORINYL 1+50 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

NORITATE Antibacterials Miscellaneous Antibacterials 13 NOROXIN Antibacterials Quinolones 15 NORPACE CR Cardiovascular Agents Antiarrhythmics - Classes IA, B,

and C 44

NORPACE Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

44

NORPRAMIN Antidepressants Tricyclics 20 NOR-QD Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

nortrel 0.5/35 (28) Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

nortrel 1/35 (21) Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

nortrel 1/35 (28) Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

nortrel 7/7/7 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

nortriptyline hcl Antidepressants Tricyclics 20 nortriptyline hcl Antidepressants Tricyclics 20 NORVASC Cardiovascular Agents Dihydropyridines 47 NORVIR Antivirals Anti-HIV Agents, Protease

Inhibitors 35

NORVIR Antivirals Anti-HIV Agents, Protease Inhibitors

35

novagesic Analgesics Non-opioid Analgesics 1 NOVANATAL Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NOVANTRONE Antineoplastics Antineoplastics 29 NOVASTART Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NOVOLIN 70/30 INNOLET Blood Glucose Regulators Insulin Mixtures, Short-acting and Intermediate-acting

38

NOVOLIN 70/30 PENFILL Blood Glucose Regulators Insulin Mixtures, Short-acting and Intermediate-acting

38

NOVOLIN 70/30 Blood Glucose Regulators Insulin Mixtures, Short-acting and Intermediate-acting

38

NOVOLIN N INNOLET Blood Glucose Regulators Insulin, Intermediate-acting 38 NOVOLIN N U-100 PENFILL Blood Glucose Regulators Insulin, Intermediate-acting 38 NOVOLIN N U-100 Blood Glucose Regulators Insulin, Intermediate-acting 38

Page of 231 180

Drug Name Class Category Class Name Page #NOVOLIN N Blood Glucose Regulators Insulin, Intermediate-acting 38 NOVOLIN R INNOLET Blood Glucose Regulators Insulin, Short-acting 38 NOVOLIN R U-100 PENFILL Blood Glucose Regulators Insulin, Short-acting 38 NOVOLIN R U-100 Blood Glucose Regulators Insulin, Short-acting 38 NOVOLIN R Blood Glucose Regulators Insulin, Short-acting 38 NOVOLOG MIX 70/30 PENFILL

Blood Glucose Regulators Insulin Mixtures, Analogs 37

NOVOLOG MIX 70/30 PREFILLED FLEXPEN

Blood Glucose Regulators Insulin Mixtures, Analogs 37

NOVOLOG MIX 70/30 Blood Glucose Regulators Insulin Mixtures, Analogs 37 NOVOLOG PENFILL Blood Glucose Regulators Insulin, Rapid-acting 38 NOVOLOG Blood Glucose Regulators Insulin, Rapid-acting 38 NOXAFIL Antifungals Azole Antifungals 23 NUBAIN Analgesics Opioid Analgesics, Short-acting 4 NULEV Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 NULYTELY Gastrointestinal Agents Gastrointestinal Agents, Other 58 NUMORPHAN Analgesics Opioid Analgesics, Short-acting 4 NUMORPHAN Analgesics Opioid Analgesics, Short-acting 4 nu-natal advanced Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

nutracort Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

nutrinate Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

NUTROPIN AQ PEN Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

NUTROPIN AQ Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

NUTROPIN Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

NUVARING Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

nyamyc Antifungals Polyene Antifungals 23 NYDRAZID Antimycobacterials Antituberculars 27 nystatin/triamcinolone Antifungals Polyene Antifungals 23 nystatin/triamcinolone Antifungals Polyene Antifungals 23 nystatin/triamcinolone Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

nystatin/triamcinolone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

nystatin/triamcinolone Hormonal Agents, Stimulant/Replacement/Modify

Glucocorticoids-Topical-Low Potency

63

Page of 231 181

Drug Name Class Category Class Name Page #ing (Adrenal)

nystatin Antifungals Polyene Antifungals 23 nystatin Antifungals Polyene Antifungals 23 nystatin Antifungals Polyene Antifungals 24 nystatin Antifungals Polyene Antifungals 24 nystatin Antifungals Polyene Antifungals 24 nystop Antifungals Polyene Antifungals 24 obstetrix ec Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

OBTREX Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

O-CAL PRENATAL Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

OCTAGAM Immunological Agents Vaccines 74 octreotide acetate Hormonal Agents,

Suppressant (Pituitary) Somatostatin Analogs 71

OCUFEN Ophthalmic Agents Nonsteroidal Anti-inflammatory Drugs, Ophthalmic

77

OCUFLOX Ophthalmic Agents Ophthalmic Agents, Other 77 ocumycin Antibacterials Miscellaneous Antibacterials 13 ocusulf-10 Ophthalmic Agents 78 ocutricin Antibacterials Aminoglycosides 8 ofloxacin Antibacterials Quinolones 15 ofloxacin Antibacterials Quinolones 15 ofloxacin Antibacterials Quinolones 15 OGEN Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

OGESTREL Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

OLUX-E Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

OLUX Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

OMACOR Cardiovascular Agents Omega-3 Fatty Acids 48 omedia otic Dermatological Agents Dermatological Antipruritic

Agents 52

omeprazole Gastrointestinal Agents Proton Pump Inhibitors 59 OMNICEF Antibacterials Cephalosporin Antibacterials,

3rd Generation 10

OMNICEF Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

OMNI-PAC Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

ONCASPAR Antineoplastics Antineoplastics 29

Page of 231 182

Drug Name Class Category Class Name Page #ondansetron hcl Antiemetics 5-Hydroxytryptamine 3 (5-HT3)

Antagonists 21

ondansetron hcl Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

ondansetron odt Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

ONTAK Antineoplastics Antineoplastics 29 onxol Antineoplastics Antineoplastics 29 OPANA ER Analgesics Opioid Analgesics, Short-acting 4 OPANA Analgesics Opioid Analgesics, Short-acting 4 OPTIPRANOLOL Ophthalmic Agents Beta-adrenergic Blocking

Agents, Ophthalmic 75

OPTIVAR Ophthalmic Agents Ophthalmic Anti-allergy Agents 78 ORACEA Antibacterials Tetracyclines 16 ORAMORPH SR Analgesics Opioid Analgesics, Long-acting 2 ORAP Antipsychotics Conventional 33 ORAPRED ODT Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

ORAPRED Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

ORENCIA Immunological Agents Tumor Necrosis Factor (TNF) Inhibitors

73

orphenadrine /asa /caffeine Analgesics Non-opioid Analgesics 1 orphenadrine /asa /caffeine Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 orphenadrine citrate cr Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 orphenadrine citrate er Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 orphenadrine citrate Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 orphenadrine compound ds Analgesics Non-opioid Analgesics 1 orphenadrine compound ds Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 orphenadrine compound Analgesics Non-opioid Analgesics 1 orphenadrine compound Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 orphenadrine/asa/caff Analgesics Non-opioid Analgesics 1 orphenadrine/asa/caff Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 orphengesic forte Analgesics Non-opioid Analgesics 1 orphengesic forte Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 orphengesic Analgesics Non-opioid Analgesics 1 orphengesic Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 ORTHO EVRA Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

ORTHO MICRONOR Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

ORTHO TRI-CYCLEN LO Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

ORTHO TRI-CYCLEN Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

Page of 231 183

Drug Name Class Category Class Name Page #ORTHO-CEPT-28 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

ORTHO-CEPT-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

ORTHO-CEPT Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

ORTHO-CYCLEN-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

ortho-est Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

ORTHO-NOVUM 1/35-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

ORTHO-NOVUM 1/50-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

ORTHO-NOVUM 10/11-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

ORTHO-NOVUM 7/7/7-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

ORUDIS Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

ORUVAIL Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

OSMOPREP Gastrointestinal Agents Gastrointestinal Agents, Other 58 oticaine otic Dermatological Agents Dermatological Antipruritic

Agents 52

oticin hc Antibacterials Aminoglycosides 8 oticin hc Dermatological Agents Dermatological Antipruritic

Agents 52

oticin hc Otic Agents Otic Anti-inflammatories 78 oticin hc Otic Agents Otic Anti-inflammatories 78 otimar Antibacterials Aminoglycosides 8 otimar Antibacterials Aminoglycosides 8 otimar Otic Agents Otic Anti-inflammatories 78 otimar Otic Agents Otic Anti-inflammatories 78 otocain Dermatological Agents Dermatological Antipruritic

Agents 52

otogesic otic Dermatological Agents Dermatological Antipruritic Agents

52

otogesic Dermatological Agents Dermatological Antipruritic Agents

52

otra nr Dermatological Agents Dermatological Antipruritic Agents

52

Page of 231 184

Drug Name Class Category Class Name Page #OVCON-35 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 68

OVCON-50 28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

OVCON-50 28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

OVCON-50/28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

OVIDE Antiparasitics Pediculicides/Scabicides 31 OXACILLIN SODIUM Antibacterials Penicillinase-resistant Penicillins 14 OXACILLIN SODIUM Antibacterials Penicillinase-resistant Penicillins 14 OXANDRIN Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

oxandrolone Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

oxaprozin Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

OXISTAT Antifungals Azole Antifungals 23 OXISTAT Antifungals Azole Antifungals 23 OXSORALEN ULTRA Dermatological Agents Dermatological

Photochemotherapy Agents 53

OXSORALEN Dermatological Agents Dermatological Photochemotherapy Agents

53

oxybutynin chloride er Genitourinary Agents Antispasmodics, Urinary 59 oxybutynin chloride Genitourinary Agents Antispasmodics, Urinary 59 oxybutynin chloride Genitourinary Agents Antispasmodics, Urinary 59 oxycodone hcl cr Analgesics Opioid Analgesics, Long-acting 2 oxycodone hcl cr Analgesics Opioid Analgesics, Long-acting 3 oxycodone hcl er Analgesics Opioid Analgesics, Long-acting 3 oxycodone hcl er Analgesics Opioid Analgesics, Long-acting 3 oxycodone hcl Analgesics Opioid Analgesics, Short-acting 4 oxycodone hcl Analgesics Opioid Analgesics, Short-acting 4 oxycodone hcl Analgesics Opioid Analgesics, Short-acting 4 oxycodone hcl Analgesics Opioid Analgesics, Short-acting 4 oxycodone/acetaminophen Analgesics Opioid Analgesics, Short-acting 5 oxycodone/acetaminophen Analgesics Opioid Analgesics, Short-acting 5 oxycodone/apap Analgesics Opioid Analgesics, Short-acting 5 oxycodone/aspirin Analgesics Opioid Analgesics, Short-acting 5 oxycodone-apap Analgesics Opioid Analgesics, Short-acting 5 OXYCONTIN Analgesics Opioid Analgesics, Long-acting 3 oxyfast Analgesics Opioid Analgesics, Short-acting 5 OXYIR Analgesics Opioid Analgesics, Short-acting 5 oxytocin Genitourinary Agents Oxytocics 60 OXYTROL Genitourinary Agents Antispasmodics, Urinary 59 pacerone Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43

Page of 231 185

Drug Name Class Category Class Name Page #PACERONE Cardiovascular Agents Antiarrhythmics - Class III 43 paclitaxel Antineoplastics Antineoplastics 29 PALCAPS 10 Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

55

PALCAPS 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PALIPASE MT 16 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PALIPASE MT 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PALIPASE Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PALPEON DR 10 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PALPEON DR 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PALPEON MT 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PALTRASE V8 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PAMELOR Antidepressants Tricyclics 20 PAMELOR Antidepressants Tricyclics 20 pamidronate disodium Hormonal Agents,

Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Parenteral 65

pamidronate disodium Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Parenteral 65

PAMIDRONATE DISODIUM Unclassified No Classification 90 PAMINE FORTE Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 PAMINE Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 PANAFIL Dermatological Agents Dermatological Wound Care

Agents 54

PANAFIL Dermatological Agents Dermatological Wound Care Agents

54

PANCREASE MT 10 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCREASE MT 16 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCREASE MT 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCREASE MT 4 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCREASE Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCRECARB MS-16 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCRECARB MS-4 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

Page of 231 186

Drug Name Class Category Class Name Page #PANCRECARB MS-8 Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

55

PANCRELIPASE MST-16 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCRELIPASE Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCRELIPASE Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCRELIPASE Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCRON 10 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANCRON 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANDEL Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

PANGESTYME CN 10 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANGESTYME CN 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANGESTYME EC Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANGESTYME MT 16 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANGESTYME UL 12 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANGESTYME UL 18 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANGESTYME UL 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANGLOBULIN NF Immunological Agents Vaccines 74 PANGLOBULIN. Immunological Agents Vaccines 74 PANGLOBULIN Immunological Agents Vaccines 74 PANIXINE DISPERDOSE Antibacterials Cephalosporin Antibacterials,

1st Generation 9

PANLOR DC Analgesics Opioid Analgesics, Short-acting 5 PANLOR SS Analgesics Opioid Analgesics, Short-acting 5 PANOCAPS MT 16 Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

55

PANOCAPS MT 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANOCAPS Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANOKASE-16 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANOKASE Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

55

PANRETIN Antineoplastics Retinoids 30 papain-urea-chlorophyllin Dermatological Agents Dermatological Wound Care

Agents 54

Page of 231 187

Drug Name Class Category Class Name Page #papaverine hcl cr Cardiovascular Agents Vasodilators, Direct-acting

Arterial 50

papaverine hcl er Cardiovascular Agents Vasodilators, Direct-acting Arterial

50

papaverine hcl Cardiovascular Agents Vasodilators, Direct-acting Arterial

50

pap-urea Dermatological Agents Dermatological Wound Care Agents

54

PARAFON FORTE DSC Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 PARAPLATIN Antineoplastics Antineoplastics 29 PARAPLATIN Antineoplastics Antineoplastics 29 para-time Cardiovascular Agents Vasodilators, Direct-acting

Arterial 50

parcaine Anesthetics Local Anesthetics 6 PARCOPA Antiparkinson Agents Dopamine Precursors 32 PARLODEL Antiparkinson Agents Dopamine Agonists 32 PARLODEL Antiparkinson Agents Dopamine Agonists 32 PARNATE Antidepressants Monoamine Oxidase (Type A)

Inhibitors 19

paromomycin sulfate Antibacterials Aminoglycosides 8 paromomycin sulfate Antiparasitics Antiprotozoals (Non-

antimalarials) 31

paroxetine hcl Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

paroxetine hcl Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

PATADAY Ophthalmic Agents Ophthalmic Anti-allergy Agents 78 PATANOL Ophthalmic Agents Ophthalmic Anti-allergy Agents 78 PAXIL CR Antidepressants Serotonin and Norepinephrine

Reuptake Inhibitors (SNRIs) 19

PAXIL Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

PAXIL Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

PCE Antibacterials Erythromycins 11 PEDIAPRED Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

PEDIARIX Immunological Agents Vaccines 74 PEDIAZOLE Antibacterials Erythromycins 11 PEDIAZOLE Antibacterials Sulfonamides 15 pedi-dri Antifungals Polyene Antifungals 24 PEDIOTIC Antibacterials Aminoglycosides 8 PEDIOTIC Otic Agents Otic Anti-inflammatories 78 PEDVAX HIB Immunological Agents Vaccines 74 peg 3350/electrolytes Gastrointestinal Agents Gastrointestinal Agents, Other 58 PEGANONE Anticonvulsants Sodium Channel Inhibitors 18 PEGASYS Immunological Agents Interferons, Alfa 73 PEGASYS Immunological Agents Interferons, Alfa 73 PEG-INTRON REDIPEN PAK 4 Immunological Agents Interferons, Alfa 73 PEG-INTRON REDIPEN Immunological Agents Interferons, Alfa 73

Page of 231 188

Drug Name Class Category Class Name Page #PEG-INTRON Immunological Agents Interferons, Alfa 73 pen needles, insulin disposable Insulin Administration

Supplies Insulin Administration Supplies 75

PENICILLIN G POTASSIUM IN ISO-OSMOTIC DEXTROSE

Antibacterials Natural Penicillins 13

penicillin g potassium Antibacterials Natural Penicillins 13 PENICILLIN G PROCAINE Anesthetics Local Anesthetics 6 PENICILLIN G PROCAINE Antibacterials Natural Penicillins 13 PENICILLIN G SODIUM Antibacterials Natural Penicillins 13 penicillin v potassium Antibacterials Natural Penicillins 14 penicillin v potassium Antibacterials Natural Penicillins 14 penicillin vk Antibacterials Natural Penicillins 14 PENLAC NAIL LACQUER Antifungals Antifungals (Other) 22 PENTAM 300 Antiparasitics Antiprotozoals (Non-

antimalarials) 31

pentamidine isethionate Antiparasitics Antiprotozoals (Non-antimalarials)

31

PENTASA Inflammatory Bowel Disease Agents

Salicylates 75

pentazocine /acetaminophen Analgesics Non-opioid Analgesics 1 pentazocine /acetaminophen Analgesics Opioid Analgesics, Short-acting 5 pentazocine hcl/acetaminophen Analgesics Non-opioid Analgesics 1 pentazocine hcl/acetaminophen Analgesics Opioid Analgesics, Short-acting 5 pentazocine/naloxone hcl Analgesics Opioid Analgesics, Short-acting 5 pentazocine/naloxone hcl Antidotes, Deterrents, and

Toxicologic Agents Opioid Antagonists 21

pentopak Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

pentoxifylline cr Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

39

pentoxifylline er Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

40

pentoxil Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

40

PEPCID I.V. Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

PEPCID PREMIXED Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

PEPCID Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

PEPCID Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

PERCOCET Analgesics Opioid Analgesics, Short-acting 5 PERCODAN Analgesics Opioid Analgesics, Short-acting 5 percolone Analgesics Opioid Analgesics, Short-acting 5 pergolide mesylate Antiparkinson Agents Dopamine Agonists 32 pergolide mesylate Hormonal Agents, Dopamine Agonists 71

Page of 231 189

Drug Name Class Category Class Name Page #Suppressant (Pituitary)

PERIDEX ORAL RINSE Dental and Oral Agents Dental and Oral Agents 52 PERIDEX Dental and Oral Agents Dental and Oral Agents 52 periogard Dental and Oral Agents Dental and Oral Agents 52 PERIOSTAT Antibacterials Tetracyclines 16 perisol Dental and Oral Agents Dental and Oral Agents 52 PERMAX Antiparkinson Agents Dopamine Agonists 32 PERMETHRIN TECHNICAL Antiparasitics Pediculicides/Scabicides 31 permethrin Antiparasitics Pediculicides/Scabicides 31 PERPHENAZINE /AMITRIPTYLINE

Antidepressants Tricyclics 20

PERPHENAZINE /AMITRIPTYLINE

Antipsychotics Conventional 33

perphenazine Antipsychotics Conventional 33 PERSANTINE Blood

Products/Modifiers/Volume Expanders

Cyclic Adenosine Monophosphate Reuptake Inhibitors

40

PEXEVA Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

pfizerpen-g Antibacterials Natural Penicillins 14 phenadoz Antiemetics Antiemetics, Other 21 phenazopyridine hcl Anesthetics Local Anesthetics 6 PHENERGAN Antiemetics Antiemetics, Other 21 PHENERGAN Respiratory Tract Agents H1 Blocking Agents, Sedating 81 PHENERGAN Sedatives/Hypnotics Sedatives/Hypnotics 82 PHENYTEK Anticonvulsants Sodium Channel Inhibitors 18 phenytoin sodium extended Anticonvulsants Sodium Channel Inhibitors 18 PHENYTOIN SODIUM PROMPT

Anticonvulsants Sodium Channel Inhibitors 18

phenytoin sodium Anticonvulsants Sodium Channel Inhibitors 18 phenytoin Anticonvulsants Sodium Channel Inhibitors 18 PHOSLO Genitourinary Agents Phosphate Binders 60 phospha 250 neutral Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

PHOSPHOLINE IODIDE Ophthalmic Agents Miotics, Ophthalmic 77 PHOTOFRIN Antineoplastics Antineoplastics 29 phrenilin w/caffeine/codeine Analgesics Opioid Analgesics, Short-acting 5 phrenilin w/caffeine/codeine Sedatives/Hypnotics Sedatives/Hypnotics 82 PHYSOSTIGMINE SALICYLATE

Antimyasthenic Agents Parasympathomimetics 27

pilocar Ophthalmic Agents Miotics, Ophthalmic 77 pilocar Ophthalmic Agents Miotics, Ophthalmic 77 pilocarpine hcl Dental and Oral Agents Dental and Oral Agents 52 pilocarpine hcl Ophthalmic Agents Miotics, Ophthalmic 77 pilocarpine hydrochloride Dental and Oral Agents Dental and Oral Agents 52 PILOPINE HS Ophthalmic Agents Miotics, Ophthalmic 77 piloptic-1/2 Ophthalmic Agents Miotics, Ophthalmic 77 piloptic-1 Ophthalmic Agents Miotics, Ophthalmic 77 piloptic-2 Ophthalmic Agents Miotics, Ophthalmic 77 piloptic-3 Ophthalmic Agents Miotics, Ophthalmic 77

Page of 231 190

Drug Name Class Category Class Name Page #piloptic-4 Ophthalmic Agents Miotics, Ophthalmic 77 piloptic-6 Ophthalmic Agents Miotics, Ophthalmic 77 pindolol Cardiovascular Agents Antiarrhythmics - Class II 43 PIPERACILLIN SODIUM Antibacterials Extended Spectrum Penicillins 11 PIPRACIL/D5W Antibacterials Extended Spectrum Penicillins 11 piroxicam Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

PITOCIN Genitourinary Agents Oxytocics 60 PLAN B Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

PLAQUENIL Antiparasitics Antimalarials 31 PLARETASE 8000 Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

55

PLATINOL AQ Antineoplastics Antineoplastics 29 PLAVIX Blood

Products/Modifiers/Volume Expanders

Adenosine Diphosphate P2Y12 Inhibitors

39

PLENDIL Cardiovascular Agents Dihydropyridines 47 PLETAL Blood

Products/Modifiers/Volume Expanders

Phosphodiesterase III/Adenosine Uptake Inhibitors

40

podofilox Dermatological Agents Dermatological Caustic Agents 53 polycin b Ophthalmic Agents 78 poly-dex Antibacterials Aminoglycosides 8 poly-dex Ophthalmic Agents Glucocorticoids, Ophthalmic 76 poly-dex Ophthalmic Agents Glucocorticoids, Ophthalmic 76 polyethylene glycol 3350 Gastrointestinal Agents Gastrointestinal Agents, Other 58 POLYETHYLENE GLYCOL 3350

Gastrointestinal Agents Gastrointestinal Agents, Other 58

POLYGAM S/D Immunological Agents Vaccines 74 polymyxin /gramicidin /neomycin

Antibacterials Aminoglycosides 8

polymyxin b sulfate/trimethoprim sulfate

Ophthalmic Agents 78

polymyxin b sulfate Antibacterials Miscellaneous Antibacterials 13 POLY-PRED Antibacterials Aminoglycosides 8 POLY-PRED Ophthalmic Agents Glucocorticoids, Ophthalmic 76 POLYSPORIN Ophthalmic Agents Ophthalmic Agents, Other 77 POLYTRIM Antibacterials Miscellaneous Antibacterials 13 poly-vitamin/fluoride Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

PONSTEL Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

portia-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

potassium acetate Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

Page of 231 191

Drug Name Class Category Class Name Page #POTASSIUM BICARBONATE Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium bicarbonate Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride 0.075%/d5w/nacl 0.225%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

POTASSIUM CHLORIDE 0.15% /NACL 0.45% VIAFLEX

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride 0.15% d5w/nacl 0.33%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride 0.15% d5w/nacl 0.45% viaflex

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride 0.15% w/nacl 0.9% viaflex

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride 0.15%/d5w Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

POTASSIUM CHLORIDE 0.15%/NACL 0.9%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride 0.22% d5w/nacl 0.45%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride 0.224%/d5w/nacl 0.45%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride 0.224%/d5w Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

POTASSIUM CHLORIDE 0.224%D5W/NACL 0.33%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

POTASSIUM CHLORIDE 0.3%/ NACL 0.9%

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride 0.3%/d5w Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride 0.3%/nacl 0.9%/viaflex

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride cr Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

Page of 231 192

Drug Name Class Category Class Name Page #potassium chloride er Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride er Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride mini-vial Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride sa Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride sr Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium chloride Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

POTASSIUM CHLORIDE Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

POTASSIUM CHLORIDE Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium effervescent Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

potassium phosphate Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

PRANDIN Blood Glucose Regulators Meglitinides 38 PRAVACHOL Cardiovascular Agents 3-hydroxy-3-methylglutaryl

coenzyme A (HMG CoA) Reductase Inhibitors

40

pravastatin sodium Cardiovascular Agents 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) Reductase Inhibitors

40

prazosin hcl Cardiovascular Agents Alpha-adrenergic Blocking Agents

41

prazosin hcl Genitourinary Agents Alpha1-adrenergic Blocking Agents

59

PRECARE CONCEIVE Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

PRECARE PRENATAL Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

PRECARE Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

PRECOSE Blood Glucose Regulators Alpha Glucosidase Inhibitors 37

Page of 231 193

Drug Name Class Category Class Name Page #PRECOSE Blood Glucose Regulators Alpha Glucosidase Inhibitors 37 PRED FORTE Ophthalmic Agents Glucocorticoids, Ophthalmic 76 PRED MILD Ophthalmic Agents Glucocorticoids, Ophthalmic 76 PRED-G S.O.P. Antibacterials Aminoglycosides 8 PRED-G S.O.P. Ophthalmic Agents Glucocorticoids, Ophthalmic 76 PRED-G Antibacterials Aminoglycosides 8 PRED-G Ophthalmic Agents Glucocorticoids, Ophthalmic 76 prednicarbate Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

prednisolone /sulfacetamide Antibacterials Sulfonamides 15 PREDNISOLONE /SULFACETAMIDE

Antibacterials Sulfonamides 15

prednisolone /sulfacetamide Ophthalmic Agents Glucocorticoids, Ophthalmic 76 PREDNISOLONE /SULFACETAMIDE

Ophthalmic Agents Glucocorticoids, Ophthalmic 76

prednisolone acetate Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

prednisolone acetate Ophthalmic Agents Glucocorticoids, Ophthalmic 76 prednisolone sodium phosphate

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

prednisolone sodium phosphate

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

prednisolone sodium phosphate

Ophthalmic Agents Glucocorticoids, Ophthalmic 76

prednisolone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

prednisolone Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

prednisol Ophthalmic Agents Glucocorticoids, Ophthalmic 76 PREDNISONE INTENSOL Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

PREDNISONE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

PREDNISONE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

PREFEST Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

PRELONE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

PREMARIN W/APPLICATOR Hormonal Agents, Estrogens 70

Page of 231 194

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

PREMARIN Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

PREMARIN Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

PREMESIS RX Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

PREMPHASE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

PREMPHASE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

PREMPRO Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

PREMPRO Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

PRENA-CAP Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

prenafirst Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 88

prenatabs cbf Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatabs fa Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatabs obn Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatabs rx Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal 1 + iron Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal 1 plus 1 Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal 1+1 Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

PRENATAL 19 Therapeutic Prenatal Vitamins 89

Page of 231 195

Drug Name Class Category Class Name Page #Nutrients/Minerals/Electrolytes

prenatal ad Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal advantage Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal formula 3 Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal formula Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal low iron Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal mr 90 fe Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal mtr/selenium Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal multivitamin-ultra Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal plus nf Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal plus/27mg iron Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal plus/betacarotene Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal plus/iron Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal plus Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal rx 1 Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal rx/beta-carotene Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal rx Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal rx Therapeutic Prenatal Vitamins 89

Page of 231 196

Drug Name Class Category Class Name Page #Nutrients/Minerals/Electrolytes

prenatal start Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal z Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal/folic acid Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal-h Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

prenatal-u Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

PRENATE GT Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

PREVACID NAPRAPAC Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

PREVACID NAPRAPAC Gastrointestinal Agents Proton Pump Inhibitors 59 PREVACID SOLUTAB Gastrointestinal Agents Proton Pump Inhibitors 59 PREVACID SOLUTAB Gastrointestinal Agents Proton Pump Inhibitors 59 PREVACID Gastrointestinal Agents Proton Pump Inhibitors 59 PREVACID Gastrointestinal Agents Proton Pump Inhibitors 59 PREVACID Gastrointestinal Agents Proton Pump Inhibitors 59 prevalite Cardiovascular Agents Bile Acid Sequestrants 45 previfem Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

PREVPAC Antibacterials Amino Derivative Penicillins 7 PREVPAC Antibacterials Macrolides (Non-erythromycins,

Non-ketolides) 12

PREVPAC Gastrointestinal Agents Proton Pump Inhibitors 59 PREZISTA Antivirals Anti-HIV Agents, Protease

Inhibitors 35

PRIALT Analgesics Non-opioid Analgesics 1 PRIFTIN Antimycobacterials Antituberculars 27 PRILOSEC OTC Unclassified No Classification 90 PRILOSEC Gastrointestinal Agents Proton Pump Inhibitors 59 PRIMACARE Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

PRIMAQUINE PHOSPHATE Antiparasitics Antimalarials 31 PRIMAXIN I.M. Antibacterials Beta-lactam, Other 9 PRIMAXIN IV ADD-VANTAGE Antibacterials Beta-lactam, Other 9 PRIMAXIN IV Antibacterials Beta-lactam, Other 9 primidone Anticonvulsants Gamma-aminobutyric Acid

(GABA) Augmenting Agents 17

Page of 231 197

Drug Name Class Category Class Name Page #PRIMSOL Antibacterials Antifolate Antibacterials 8 PRINIVIL Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 42

PRINZIDE Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

PROAIR HFA Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

PROAMATINE Cardiovascular Agents Alpha-adrenergic Agonists 41 PRO-BANTHINE Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 probenecid/colchicine Antigout Agents Renal Tubular Blocking Agents 24 probenecid Antigout Agents Renal Tubular Blocking Agents 24 PROCAINAMIDE HCL ER Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43 procainamide hcl sr Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43 procainamide hcl Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43 PROCAINAMIDE HCL Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43 PROCAINAMIDE HCL Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43 procainamide hcl Cardiovascular Agents Antiarrhythmics - Classes IA, B,

and C 44

PROCANBID Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43 PROCARDIA XL Cardiovascular Agents Dihydropyridines 47 PROCARDIA Cardiovascular Agents Dihydropyridines 47 PROCHIEVE Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

prochlorperazine edisylate Antipsychotics Conventional 33 prochlorperazine maleate Antipsychotics Conventional 33 prochlorperazine Antipsychotics Conventional 33 PROCRIT Blood

Products/Modifiers/Volume Expanders

Erythropoietins 40

proctocare-hc Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

PROCTOCORT Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

proctocream-hc Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

procto-kit Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

procto-pak Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

proctosol hc Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

proctozone-hc Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

Page of 231 198

Drug Name Class Category Class Name Page #PROGLYCEM Blood Glucose Regulators Glycemic Agents 37 PROGRAF Immunological Agents Immune Suppressants (Non-

TNF Inhibitors) 72

PROGRAF Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

PROLASTIN Respiratory Tract Agents Respiratory Tract Agents, Other 82 PROLASTIN Respiratory Tract Agents Respiratory Tract Agents, Other 82 PROLEUKIN Antineoplastics Antineoplastics 29 PROLOPRIM Antibacterials Antifolate Antibacterials 8 promethazine /phenylephrine Respiratory Tract Agents H1 Blocking Agents, Sedating 81 promethazine hcl plain Respiratory Tract Agents H1 Blocking Agents, Sedating 81 promethazine hcl plain Sedatives/Hypnotics Sedatives/Hypnotics 82 promethazine hcl Antiemetics Antiemetics, Other 21 promethazine hcl Antiemetics Antiemetics, Other 21 promethazine hcl Antiemetics Antiemetics, Other 21 promethazine hcl Antiemetics Antiemetics, Other 21 promethazine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 81 promethazine hcl Respiratory Tract Agents H1 Blocking Agents, Sedating 81 promethazine hcl Sedatives/Hypnotics Sedatives/Hypnotics 82 promethazine hcl Sedatives/Hypnotics Sedatives/Hypnotics 82 promethegan Antiemetics Antiemetics, Other 21 PROMETRIUM Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

PRONESTYL SR Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43 PRONESTYL Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43 PRONESTYL Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43 PRONESTYL Cardiovascular Agents Antiarrhythmics - Class Ia/II/III/IV 43 pro-otic Dermatological Agents Dermatological Antipruritic

Agents 53

propafenone hcl Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

44

PROPANTHELINE BROMIDE Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 proparacaine hcl Anesthetics Local Anesthetics 6 proparacaine hcl Anesthetics Local Anesthetics 6 PROPINE Ophthalmic Agents Alpha-adrenergic Agonists,

Ophthalmic 75

propoxacet Analgesics Opioid Analgesics, Short-acting 5 propoxacet-n Analgesics Opioid Analgesics, Short-acting 5 propoxyphene /acetaminophen Analgesics Opioid Analgesics, Short-acting 5 PROPOXYPHENE COMPOUND

Analgesics Opioid Analgesics, Short-acting 5

propoxyphene hcl Analgesics Opioid Analgesics, Short-acting 5 PROPOXYPHENE/ASA/CAFF Analgesics Opioid Analgesics, Short-acting 5 propoxyphene-n /acetaminophen

Analgesics Opioid Analgesics, Short-acting 5

propranolol /hydrochlorothiazide

Cardiovascular Agents Nonselective Beta-adrenergic Blocking Agents

48

propranolol /hydrochlorothiazide

Cardiovascular Agents Thiazide Diuretics 49

propranolol hcl er Antimigraine Agents Beta-adrenergic Blocking Agents 26

Page of 231 199

Drug Name Class Category Class Name Page #PROPRANOLOL HCL ER Cardiovascular Agents Alpha-beta-adrenergic Blocking

Agents 41

propranolol hcl er Cardiovascular Agents Antiarrhythmics - Class II 43 propranolol hcl er Cardiovascular Agents Nonselective Beta-adrenergic

Blocking Agents 48

PROPRANOLOL HCL INTENSOL

Antimigraine Agents Beta-adrenergic Blocking Agents 26

PROPRANOLOL HCL INTENSOL

Cardiovascular Agents Antiarrhythmics - Class II 43

PROPRANOLOL HCL INTENSOL

Cardiovascular Agents Nonselective Beta-adrenergic Blocking Agents

48

PROPRANOLOL HCL Antimigraine Agents Beta-adrenergic Blocking Agents 26 propranolol hcl Antimigraine Agents Beta-adrenergic Blocking Agents 26 propranolol hcl Antimigraine Agents Beta-adrenergic Blocking Agents 26 PROPRANOLOL HCL Cardiovascular Agents Antiarrhythmics - Class II 43 propranolol hcl Cardiovascular Agents Antiarrhythmics - Class II 43 propranolol hcl Cardiovascular Agents Antiarrhythmics - Class II 43 PROPRANOLOL HCL Cardiovascular Agents Antiarrhythmics - Class II 44 PROPRANOLOL HCL Cardiovascular Agents Nonselective Beta-adrenergic

Blocking Agents 48

propranolol hcl Cardiovascular Agents Nonselective Beta-adrenergic Blocking Agents

48

propranolol hcl Cardiovascular Agents Nonselective Beta-adrenergic Blocking Agents

48

PROPRANOLOL HCL Cardiovascular Agents Nonselective Beta-adrenergic Blocking Agents

48

propylthiouracil Hormonal Agents, Suppressant (Thyroid)

Hormonal Agents, Suppressant (Thyroid)

72

PROQUAD Immunological Agents Vaccines 74 PROQUIN XR Antibacterials Quinolones 15 PROSCAR Genitourinary Agents 5 Alpha-reductase Inhibitors 59 PROSED/DS (ATROPINE FREE)

Gastrointestinal Agents Antispasmodics, Gastrointestinal 57

PROSTIGMIN Antimyasthenic Agents Parasympathomimetics 27 PROSTIGMIN Antimyasthenic Agents Parasympathomimetics 27 PROTONIX Gastrointestinal Agents Proton Pump Inhibitors 59 PROTONIX Gastrointestinal Agents Proton Pump Inhibitors 59 PROTONIX Gastrointestinal Agents Proton Pump Inhibitors 59 PROTOPIC Dermatological Agents Dermatological

Immunomodulators 53

PROVENTIL HFA Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

PROVENTIL Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

PROVENTIL Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

PROVENTIL Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

PROVERA Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Progestins 70

Page of 231 200

Drug Name Class Category Class Name Page #PROVIGIL Central Nervous System

Agents Non-amphetamines 51

PROZAC WEEKLY Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

PROZAC Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

PROZAC Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

PROZAC Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

prudoxin Dermatological Agents Dermatological Antipruritic Agents

53

PSORCON E Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

PSORCON E Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

PSORIATEC Dermatological Agents Dermatological Mitotic Inhibitors 53 PULMICORT TURBUHALER Respiratory Tract Agents Bronchodilators, Anti-

inflammatories 79

PULMICORT Respiratory Tract Agents Bronchodilators, Anti-inflammatories

79

PULMOZYME Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

56

PURINETHOL Antineoplastics Antineoplastics 29 PYLERA Antibacterials Miscellaneous Antibacterials 13 PYLERA Gastrointestinal Agents Gastrointestinal Agents, Other 58 pyrazinamide Antimycobacterials Antituberculars 27 PYRIDIUM Dermatological Agents Dermatological Antipruritic

Agents 53

pyridostigmine bromide Antimyasthenic Agents Parasympathomimetics 27 QUADRAMET Antineoplastics Antineoplastics 29 QUALAQUIN Antiparasitics Antimalarials 31 quasense Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

QUESTRAN LIGHT Cardiovascular Agents Bile Acid Sequestrants 45 QUESTRAN LIGHT Cardiovascular Agents Bile Acid Sequestrants 45 QUESTRAN Cardiovascular Agents Bile Acid Sequestrants 45 QUESTRAN Cardiovascular Agents Bile Acid Sequestrants 45 QUIBRON-T/SR Respiratory Tract Agents Bronchodilators,

Phosphodiesterase 2 Inhibitors (Xanthines)

79

QUIBRON-T Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

QUICK-K Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

quinapril /hydrochlorothiazide Cardiovascular Agents Angiotensin-converting Enzyme 42

Page of 231 201

Drug Name Class Category Class Name Page #(ACE) Inhibitors

quinapril /hydrochlorothiazide Cardiovascular Agents Thiazide Diuretics 49 quinapril hcl Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 42

quinapril/hctz Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

quinapril/hctz Cardiovascular Agents Thiazide Diuretics 49 quinapril Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 42

quinaretic Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

quinaretic Cardiovascular Agents Thiazide Diuretics 49 quinidine gluconate cr Cardiovascular Agents Antiarrhythmics - Classes IA, B,

and C 44

quinidine gluconate er Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

44

quinidine gluconate sa Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

45

QUINIDINE SULFATE ER Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

45

quinidine sulfate Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

45

QUIXIN Antibacterials Quinolones 15 QVAR Respiratory Tract Agents Bronchodilators, Anti-

inflammatories 79

RANEXA Cardiovascular Agents Partial Fatty Acid Oxidase Inhibitors

48

RANICLOR Antibacterials Cephalosporin Antibacterials, 2nd Generation

10

ranitidine hcl Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

ranitidine hcl Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

ranitidine hcl Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

ranitidine hcl Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

RAPAMUNE Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

RAPAMUNE Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

RAPIFLUX Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

RAPTIVA Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

RAZADYNE ER Antidementia Agents Cholinesterase Inhibitors 18 RAZADYNE Antidementia Agents Cholinesterase Inhibitors 18 RAZADYNE Antidementia Agents Cholinesterase Inhibitors 18 REBETOL Antivirals Antivirals, Other 35 REBETOL Antivirals Antivirals, Other 35 REBETRON Immunological Agents Interferons, Alfa 73

Page of 231 202

Drug Name Class Category Class Name Page #REBIF TITRATION PACK Immunological Agents Interferons, Beta 73 REBIF Immunological Agents Interferons, Beta 73 RECLAST Hormonal Agents,

Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Parenteral 65

reclipsen Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

RECOMBIVAX HB Immunological Agents Vaccines 74 RECOMBIVAX HB Immunological Agents Vaccines 74 REGLAN Gastrointestinal Agents Gastrointestinal Agents, Other 58 REGLAN Gastrointestinal Agents Gastrointestinal Agents, Other 58 REGONOL Antimyasthenic Agents Parasympathomimetics 27 REGRANEX Dermatological Agents Dermatological Wound Care

Agents 54

RELAFEN Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

RELAGESIC Analgesics Non-opioid Analgesics 2 RELENZA DISKHALER Antivirals Anti-influenza Agents 35 RELION 70/30 INNOLET Blood Glucose Regulators Insulin, Intermediate-acting 38 RELION 70/30 Blood Glucose Regulators Insulin, Intermediate-acting 38 RELION N INNOLET Blood Glucose Regulators Insulin, Intermediate-acting 38 RELION N Blood Glucose Regulators Insulin, Intermediate-acting 38 RELION R Blood Glucose Regulators Insulin, Rapid-acting 38 RELPAX Antimigraine Agents Triptans 26 RELPAX Unclassified No Classification 90 REMERON SOLTAB Antidepressants Antidepressants, Other 19 REMERON Antidepressants Antidepressants, Other 19 REMICADE Immunological Agents Tumor Necrosis Factor (TNF)

Inhibitors 73

RENAGEL Antidotes, Deterrents, and Toxicologic Agents

Ion Exchange Resins 20

RENAGEL Antidotes, Deterrents, and Toxicologic Agents

Ion Exchange Resins 20

RENAGEL Genitourinary Agents Phosphate Binders 60 RENAGEL Genitourinary Agents Phosphate Binders 60 RENAMIN Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

REPREXAIN Analgesics Opioid Analgesics, Short-acting 5 REQUIP Antiparkinson Agents Dopamine Agonists 32 RESCRIPTOR Antivirals Anti-HIV Agents, Non-

nucleoside Reverse Transcriptase Inhibitors

34

RESERPINE Cardiovascular Agents Alpha-adrenergic Blocking Agents

41

RESTASIS Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

RETROVIR IV INFUSION Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse

34

Page of 231 203

Drug Name Class Category Class Name Page #Transcriptase Inhibitors

RETROVIR Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

RETROVIR Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

RETROVIR Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

REVATIO Respiratory Tract Agents Respiratory Tract Agents, Other 82 REVEX Antidotes, Deterrents, and

Toxicologic Agents Opioid Antagonists 21

REVIA Antidotes, Deterrents, and Toxicologic Agents

Alcohol Deterrents 20

REVLIMID Immunological Agents Immunomodulators, Other 72 REYATAZ Antivirals Anti-HIV Agents, Protease

Inhibitors 35

RHEUMATREX Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

RHINOCORT AQUA Respiratory Tract Agents Respiratory Tract Agents, Other 82 rhinoflex-650 Analgesics Non-opioid Analgesics 2 rhinoflex Analgesics Non-opioid Analgesics 2 ribapak Antivirals Antivirals, Other 35 ribapak Antivirals Antivirals, Other 35 ribasphere Antivirals Antivirals, Other 35 ribasphere Antivirals Antivirals, Other 35 ribatab Antivirals Antivirals, Other 35 ribatab Antivirals Antivirals, Other 36 ribavirin Antivirals Antivirals, Other 36 ribavirin Antivirals Antivirals, Other 36 RIDAURA Immunological Agents Immunomodulators, Other 73 RIFADIN Antimycobacterials Antituberculars 27 RIFADIN Antimycobacterials Antituberculars 27 RIFAMATE Antimycobacterials Antituberculars 27 rifampin Antimycobacterials Antituberculars 27 rifampin Antimycobacterials Antituberculars 27 RIFATER Antimycobacterials Antituberculars 27 RILUTEK Central Nervous System

Agents Non-amphetamines 51

rimactane Antimycobacterials Antituberculars 27 rimantadine hcl Antivirals Anti-influenza Agents 35 ringer's injection Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

ringer's irrigation Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

RIOMET Blood Glucose Regulators Biguanides 37 RISPERDAL CONSTA Antipsychotics Atypicals 33 RISPERDAL CONSTA Bipolar Agents Bipolar Agents 36

Page of 231 204

Drug Name Class Category Class Name Page #RISPERDAL M-TAB Antipsychotics Atypicals 33 RISPERDAL M-TAB Antipsychotics Atypicals 33 RISPERDAL M-TAB Bipolar Agents Bipolar Agents 36 RISPERDAL M-TAB Bipolar Agents Bipolar Agents 36 RISPERDAL Antipsychotics Atypicals 33 RISPERDAL Antipsychotics Atypicals 33 RISPERDAL Bipolar Agents Bipolar Agents 36 RISPERDAL Bipolar Agents Bipolar Agents 36 RITALIN LA Central Nervous System

Agents Non-amphetamines 51

RITALIN SR Central Nervous System Agents

Non-amphetamines 51

RITALIN Central Nervous System Agents

Non-amphetamines 51

RITUXAN Antineoplastics Antineoplastics 29 RMS Analgesics Opioid Analgesics, Long-acting 3 ROBAXIN-750 Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 ROBAXIN Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 ROBAXIN Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 ROBINUL FORTE Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 ROBINUL Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 ROBINUL Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 ROCALTROL Hormonal Agents,

Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

ROCALTROL Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

ROCEPHIN IN ISO-OSMOTIC DEXTROSE

Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

ROCEPHIN Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

ROFERON-A Immunological Agents Interferons, Alfa 73 romycin Ophthalmic Agents 78 ROSULA NS Antibacterials Sulfonamides 15 ROSULA Antibacterials Sulfonamides 15 ROSULA Antibacterials Sulfonamides 15 ROTATEQ Immunological Agents Vaccines 74 ROWASA Inflammatory Bowel Disease

Agents Salicylates 75

ROXANOL Analgesics Opioid Analgesics, Long-acting 3 ROXICET Analgesics Opioid Analgesics, Short-acting 5 roxicet Analgesics Opioid Analgesics, Short-acting 5 ROXICODONE INTENSOL Analgesics Opioid Analgesics, Short-acting 5 ROXICODONE Analgesics Opioid Analgesics, Short-acting 5 ROXICODONE Analgesics Opioid Analgesics, Short-acting 5 ROZEREM Sedatives/Hypnotics Sedatives/Hypnotics 82 ROZEX Antibacterials Miscellaneous Antibacterials 13 rufen Anti-inflammatories Nonsteroidal Anti-inflammatory 25

Page of 231 205

Drug Name Class Category Class Name Page #Drugs

RUM-K Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

RYTHMOL SR Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

45

RYTHMOL Cardiovascular Agents Antiarrhythmics - Classes IA, B, and C

45

SAIZEN CLICK.EASY Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

SAIZEN Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

SALAGEN Dental and Oral Agents Dental and Oral Agents 52 SALEX Dermatological Agents Dermatological Caustic Agents 53 SALEX Dermatological Agents Dermatological Caustic Agents 53 SALEX Unclassified Unclassified 90 salflex Analgesics Non-opioid Analgesics 2 salsalate Analgesics Non-opioid Analgesics 2 SAL-TROPINE Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 SANCTURA Genitourinary Agents Antispasmodics, Urinary 60 SANDIMMUNE Immunological Agents Immune Suppressants (Non-

TNF Inhibitors) 72

SANDIMMUNE Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

SANDOSTATIN LAR DEPOT Hormonal Agents, Suppressant (Pituitary)

Somatostatin Analogs 71

SANDOSTATIN Hormonal Agents, Suppressant (Pituitary)

Somatostatin Analogs 71

SANTYL Dermatological Agents Dermatological Wound Care Agents

54

SARAFEM Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

sb clotrimazole foot Antifungals Antifungals (Other) 22 sb miconazole 3-day combo Antifungals Azole Antifungals 23 scalp treatment Antibacterials Sulfonamides 15 SCOPACE Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 SCOPOLAMINE HYDROBROMIDE

Gastrointestinal Agents Antispasmodics, Gastrointestinal 57

SEASONALE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

SEASONIQUE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

SECTRAL Cardiovascular Agents Antiarrhythmics - Class II 44 SECTRAL Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

SELECT-OB Therapeutic Nutrients/Minerals/Electrolyte

Prenatal Vitamins 89

Page of 231 206

Drug Name Class Category Class Name Page #s

selegiline hcl Antiparkinson Agents Antiparkinson Agents, Other 32 selegiline hcl Antiparkinson Agents Antiparkinson Agents, Other 32 selenium sulfide Antifungals Antifungals (Other) 22 SELSEB Antifungals Antifungals (Other) 22 SENSIPAR Hormonal Agents,

Suppressant (Parathyroid) Calcimimetics 71

SEPTRA DS Antibacterials Antifolate Antibacterials 8 SEPTRA DS Antibacterials Sulfonamides 15 SEPTRA Antibacterials Antifolate Antibacterials 8 SEPTRA Antibacterials Sulfonamides 15 SEPTRA Antibacterials Sulfonamides 15 SEREVENT DISKUS Respiratory Tract Agents Bronchodilators,

Sympathomimetic 80

SEROMYCIN Antimycobacterials Antituberculars 27 SEROQUEL XR Antipsychotics Atypicals 33 SEROQUEL XR Bipolar Agents Bipolar Agents 36 SEROQUEL Antipsychotics Atypicals 33 SEROQUEL Bipolar Agents Bipolar Agents 36 SEROSTIM Hormonal Agents,

Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

sertraline hcl Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

sertraline hcl Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

sertraline hydrochloride Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

SILVADENE Antibacterials Miscellaneous Antibacterials 13 SILVER NITRATE Dermatological Agents Dermatological Wound Care

Agents 54

SILVER NITRATE Dermatological Agents Dermatological Wound Care Agents

54

silver sulfadiazine Antibacterials Miscellaneous Antibacterials 13 SIMETHICONE Genitourinary Agents Antispasmodics, Urinary 60 SIMETYL Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 SIMETYL Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 SIMULECT Immunological Agents Immune Suppressants (Non-

TNF Inhibitors) 72

simvastatin Cardiovascular Agents 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) Reductase Inhibitors

40

SINEMET CR Antiparkinson Agents Dopamine Precursors 32 SINEMET Antiparkinson Agents Dopamine Precursors 32 SINGULAIR Respiratory Tract Agents Receptor Antagonists 81 SINGULAIR Respiratory Tract Agents Receptor Antagonists 81 SINGULAIR Respiratory Tract Agents Receptor Antagonists 81 SKELAXIN Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 SKELID Hormonal Agents,

Stimulant/Replacement/Modifying (Parathyroid/Metabolic

Bisphosphonates, Oral 65

Page of 231 207

Drug Name Class Category Class Name Page #Bone Disease Agents)

SLO-BID GYROCAPS Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

smz-tmp ds Antibacterials Antifolate Antibacterials 9 smz-tmp ds Antibacterials Sulfonamides 15 sodium acetate Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

sodium bicarbonate partial fill Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

sodium bicarbonate stick-gard Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

sodium bicarbonate Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

sodium bicarbonate Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

sodium chloride 0.9% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

sodium chloride 0.45% viaflex Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 86

sodium chloride 0.45% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

sodium chloride 0.9% Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

sodium chloride bacteriostatic Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

sodium chloride Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

sodium chloride Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

SODIUM EDECRIN Cardiovascular Agents Loop Diuretics 48 sodium polystyrene sulfonate Antidotes, Deterrents, and

Toxicologic Agents Ion Exchange Resins 20

sodium sulfacetamide Antibacterials Sulfonamides 15 sodium sulfacetamide Antibacterials Sulfonamides 15 SOLARAZE Dermatological Agents Dermatological Anti-

inflammatories 52

solia Hormonal Agents, Stimulant/Replacement/Modify

Contraceptives 69

Page of 231 208

Drug Name Class Category Class Name Page #ing (Sex Hormones/Modifiers)

SOLODYN Antibacterials Tetracyclines 16 SOLTAMOX Antineoplastics Selective Estrogen Receptor

Modulators, 1st Generation 30

SOLU-CORTEF Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

SOLU-MEDROL ACT-O-VIAL Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

SOLU-MEDROL Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

SOLUREX LA Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

SOMA COMPOUND/CODEINE Analgesics Non-opioid Analgesics 2 SOMA COMPOUND/CODEINE Analgesics Opioid Analgesics, Short-acting 5 SOMA COMPOUND/CODEINE Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 SOMA COMPOUND Analgesics Non-opioid Analgesics 2 SOMA COMPOUND Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 SOMA Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 SOMAVERT Hormonal Agents,

Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

SOMNOTE Sedatives/Hypnotics Sedatives/Hypnotics 82 SONATA Sedatives/Hypnotics Sedatives/Hypnotics 82 SORIATANE Dermatological Agents Dermatological Retinoids 53 sorine Cardiovascular Agents Antiarrhythmics - Class II/III 43 sotalol hcl (af) Cardiovascular Agents Antiarrhythmics - Class II/III 43 sotalol hcl Cardiovascular Agents Antiarrhythmics - Class II/III 43 sotalol hcl Cardiovascular Agents Antiarrhythmics - Class III 43 sotret Dermatological Agents Dermatological Retinoids 53 spasdel Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 spasdel Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 spasdel Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 SPECTAZOLE Antifungals Antifungals (Other) 22 SPECTRACEF Antibacterials Cephalosporin Antibacterials,

3rd Generation 10

SPIRIVA HANDIHALER Unclassified No Classification 90 spironolactone /hydrochlorothiazide

Cardiovascular Agents Aldosterone Receptor Antagonists

41

spironolactone /hydrochlorothiazide

Cardiovascular Agents Potassium-sparing Diuretics 48

spironolactone /hydrochlorothiazide

Cardiovascular Agents Thiazide Diuretics 49

spironolactone Cardiovascular Agents Aldosterone Receptor Antagonists

41

spironolactone Cardiovascular Agents Potassium-sparing Diuretics 48 SPORANOX PULSEPAK Antifungals Azole Antifungals 23 SPORANOX Antifungals Azole Antifungals 23

Page of 231 209

Drug Name Class Category Class Name Page #SPORANOX Antifungals Azole Antifungals 23 SPORANOX Antifungals Azole Antifungals 23 sprintec 28 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

SPRYCEL Antineoplastics Multitargeted Kinase Inhibitors, Gastrointestinal Stromal Tumors

30

sps 30gm/120ml enema Antidotes, Deterrents, and Toxicologic Agents

Ion Exchange Resins 20

sps Antidotes, Deterrents, and Toxicologic Agents

Ion Exchange Resins 20

ssd af Antibacterials Miscellaneous Antibacterials 13 ssd Antibacterials Miscellaneous Antibacterials 13 STADOL Analgesics Opioid Analgesics, Short-acting 5 STAFLEX Analgesics Non-opioid Analgesics 2 STAGESIC-10 Analgesics Opioid Analgesics, Short-acting 5 stagesic Analgesics Opioid Analgesics, Short-acting 5 STALEVO 100 Antiparkinson Agents Catechol O-methyltransferase

(COMT) Inhibitors 32

STALEVO 100 Antiparkinson Agents Dopamine Precursors 32 STALEVO 150 Antiparkinson Agents Catechol O-methyltransferase

(COMT) Inhibitors 32

STALEVO 150 Antiparkinson Agents Dopamine Precursors 32 STALEVO 50 Antiparkinson Agents Catechol O-methyltransferase

(COMT) Inhibitors 32

STALEVO 50 Antiparkinson Agents Dopamine Precursors 32 STARLIX Blood Glucose Regulators Meglitinides 38 STARLIX Blood Glucose Regulators Meglitinides 38 STERAPRED 12 DAY Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

STERAPRED DS 12 DAY Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

STERAPRED DS Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

STERAPRED Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids 61

STIMATE Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

STRATTERA Central Nervous System Agents

Non-amphetamines 51

STRATTERA Central Nervous System Agents

Non-amphetamines 51

STREPTOMYCIN SULFATE Antibacterials Aminoglycosides 8 STREPTOMYCIN SULFATE Antimycobacterials Antituberculars 27 STRIANT Hormonal Agents,

Stimulant/Replacement/ModifyAndrogens/Anabolic Steroids 67

Page of 231 210

Drug Name Class Category Class Name Page #ing (Sex Hormones/Modifiers)

STROMECTOL Antiparasitics Anthelmintics 31 STRONGSTART Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

STRONGSTART Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

STUARTNATAL PLUS 3 Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

SUBOXONE Analgesics Opioid Analgesics, Short-acting 5 SUBOXONE Antidotes, Deterrents, and

Toxicologic Agents Opioid Antagonists 21

SUBUTEX Analgesics Opioid Analgesics, Short-acting 5 SUCRAID Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

56

sucralfate Gastrointestinal Agents Protectants 59 SUCRALFATE Gastrointestinal Agents Protectants 59 SULAR Cardiovascular Agents Dihydropyridines 47 sulf-10 Antibacterials Sulfonamides 15 sulfac Antibacterials Sulfonamides 15 SULFACETAMIDE /PREDNISOLONE

Ophthalmic Agents Glucocorticoids, Ophthalmic 76

sulfacetamide sodium/prednisolone sodium phosphate

Ophthalmic Agents Glucocorticoids, Ophthalmic 76

SULFACETAMIDE SODIUM Antibacterials Sulfonamides 15 sulfacetamide sodium Antibacterials Sulfonamides 15 sulfacetamide sodium Antibacterials Sulfonamides 15 SULFADIAZINE Antibacterials Sulfonamides 15 sulfamethoxazole /trimethoprim Antibacterials Antifolate Antibacterials 9 SULFAMETHOXAZOLE /TRIMETHOPRIM

Antibacterials Sulfonamides 15

sulfamethoxazole /trimethoprim Antibacterials Sulfonamides 15 sulfamethoxazole /trimethoprim Antibacterials Sulfonamides 15 sulfamethoxazole/trimethoprim ds

Antibacterials Sulfonamides 15

SULFAMYLON Antibacterials Sulfonamides 15 SULFAMYLON Antibacterials Sulfonamides 15 sulfasalazine ec Antibacterials Sulfonamides 15 sulfasalazine Antibacterials Sulfonamides 15 sulfasalazine Antibacterials Sulfonamides 16 sulfatol cleanser Antibacterials Sulfonamides 16 sulfatol Antibacterials Sulfonamides 16 sulfatrim Antibacterials Antifolate Antibacterials 9 sulfatrim Antibacterials Sulfonamides 16 sulfazine ec Sulfonamides 83 sulfazine Sulfonamides 83 SULFISOXAZOLE Antibacterials Sulfonamides 16 sulindac Anti-inflammatories Nonsteroidal Anti-inflammatory 25

Page of 231 211

Drug Name Class Category Class Name Page #Drugs

SUMYCIN Antibacterials Tetracyclines 16 SUMYCIN Antibacterials Tetracyclines 16 SUPRAX Antibacterials Cephalosporin Antibacterials,

3rd Generation 10

SURMONTIL Antidepressants Tricyclics 20 SURMONTIL Antidepressants Tricyclics 20 SUSTIVA Antivirals Anti-HIV Agents, Non-

nucleoside Reverse Transcriptase Inhibitors

34

SUSTIVA Antivirals Anti-HIV Agents, Non-nucleoside Reverse Transcriptase Inhibitors

34

SUTENT Antineoplastics Multitargeted Kinase Inhibitors, Gastrointestinal Stromal Tumors

30

symax fastabs Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 symax-sl Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 SYMBICORT Respiratory Tract Agents Bronchodilators, Anti-

inflammatories 79

SYMBICORT Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

SYMBYAX Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

SYMBYAX Antipsychotics Atypicals 33 SYMBYAX Bipolar Agents Bipolar Agents 36 SYMLIN Blood Glucose Regulators Amylinomimetics 37 SYMMETREL Antiparkinson Agents Antiparkinson Agents, Other 32 SYMMETREL Antivirals Anti-influenza Agents 35 SYNALAR Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

SYNALAR Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

SYNALAR Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

SYNAREL Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

SYNERCID Antibacterials Miscellaneous Antibacterials 13 SYNTHROID Hormonal Agents,

Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

SYNTHROID Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

SYPRINE Antidotes, Deterrents, and Toxicologic Agents

Antidotes, Deterrents, and Toxicologic Agents

20

TABLOID Antineoplastics Antineoplastics 29 TACLONEX Dermatological Agents Dermatological Mitotic Inhibitors 53

Page of 231 212

Drug Name Class Category Class Name Page #TACLONEX Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

TAGAMET Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

TAGAMET Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

TALACEN Analgesics Opioid Analgesics, Short-acting 5 TALADINE Gastrointestinal Agents Histamine2 (H2) Blocking

Agents 58

TALWIN NX Analgesics Opioid Analgesics, Short-acting 5 TALWIN Analgesics Opioid Analgesics, Short-acting 5 TAMBOCOR Cardiovascular Agents Antiarrhythmics - Classes IA, B,

and C 45

TAMIFLU Antivirals Anti-influenza Agents 35 TAMIFLU Antivirals Anti-influenza Agents 35 tamoxifen citrate Antineoplastics Selective Estrogen Receptor

Modulators, 1st Generation 30

TAPAZOLE Hormonal Agents, Suppressant (Thyroid)

Hormonal Agents, Suppressant (Thyroid)

72

TARCEVA Antineoplastics Epidermal Growth Factor Receptor Kinase Inhibitors

30

TARCEVA Antineoplastics Epidermal Growth Factor Receptor Kinase Inhibitors

30

TARGRETIN Antineoplastics Retinoids 30 TARGRETIN Antineoplastics Retinoids 30 TARKA Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 42

TARKA Cardiovascular Agents Calcium Channel Blocking Agents (Non-dihydropyridines)

46

TASMAR Antiparkinson Agents Catechol O-methyltransferase (COMT) Inhibitors

32

TAXOL Antineoplastics Antineoplastics 29 TAXOTERE Antineoplastics Antineoplastics 29 TAZICEF Antibacterials Cephalosporin Antibacterials,

3rd Generation 10

tazicef Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

TAZORAC Dermatological Agents Dermatological Retinoids 53 TAZORAC Dermatological Agents Dermatological Retinoids 53 taztia xt Cardiovascular Agents Antiarrhythmics - Class IV 44 taztia xt Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 46

TEGRETOL Anticonvulsants Sodium Channel Inhibitors 18 TEGRETOL Anticonvulsants Sodium Channel Inhibitors 18 TEGRETOL Anticonvulsants Sodium Channel Inhibitors 18 TEGRETOL Bipolar Agents Bipolar Agents 37 TEGRETOL Bipolar Agents Bipolar Agents 37 TEGRETOL Bipolar Agents Bipolar Agents 37 TEGRETOL-XR Anticonvulsants Sodium Channel Inhibitors 18 TEGRETOL-XR Bipolar Agents Bipolar Agents 37

Page of 231 213

Drug Name Class Category Class Name Page #TEKTURNA Cardiovascular Agents Cardiovascular Agents 46 TEMOVATE E Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

TEMOVATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

TEMOVATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

TEMOVATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

TEMOVATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

TENEX Cardiovascular Agents Alpha-adrenergic Agonists 41 TENORETIC 100 Cardiovascular Agents Thiazide Diuretics 49 TENORETIC 50 Cardiovascular Agents Thiazide Diuretics 49 TENORMIN Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

TENORMIN Cardiovascular Agents Cardioselective Beta-adrenergic Blocking Agents

46

TERAZOL 3 Antifungals Azole Antifungals 23 TERAZOL 3 Antifungals Azole Antifungals 23 TERAZOL 3 Antifungals Azole Antifungals 23 TERAZOL 7 Antifungals Azole Antifungals 23 terazosin hcl Cardiovascular Agents Alpha-adrenergic Blocking

Agents 41

terazosin hcl Genitourinary Agents Alpha1-adrenergic Blocking Agents

59

terbutaline sulfate Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

terbutaline sulfate Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

terconazole Antifungals Azole Antifungals 23 TESLAC Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

TESTIM Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

testosterone cypionate Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

testosterone enanthate Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

TESTOSTERONE PROPIONATE

Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

Page of 231 214

Drug Name Class Category Class Name Page #TESTOSTERONE Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

TESTRED Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Androgens/Anabolic Steroids 67

TETANUS TOXOID ADSORBED

Immunological Agents Vaccines 74

TETANUS TOXOID Immunological Agents Vaccines 74 TETANUS/DIPHTHERIA TOXOID-ADULT

Immunological Agents Vaccines 74

TETANUS/DIPHTHERIA TOXOIDS-ABSORBED ADULT

Immunological Agents Vaccines 74

tetracycline hcl Antibacterials Tetracyclines 16 TEVETEN HCT Cardiovascular Agents Angiotensin II Receptor

Antagonists 42

TEVETEN HCT Cardiovascular Agents Thiazide Diuretics 49 TEVETEN Cardiovascular Agents Angiotensin II Receptor

Antagonists 42

TEV-TROPIN Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

texacort Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

TEXACORT Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

THALITONE Cardiovascular Agents Thiazide Diuretics 49 THALOMID Immunological Agents Immunomodulators, Other 73 THEO-24 Respiratory Tract Agents Bronchodilators,

Phosphodiesterase 2 Inhibitors (Xanthines)

79

theocap Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

theochron Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

theophylline anhydrous cr Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

theophylline cr Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

theophylline er Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

theophylline er Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

Page of 231 215

Drug Name Class Category Class Name Page #theophylline sr Respiratory Tract Agents Bronchodilators,

Phosphodiesterase 2 Inhibitors (Xanthines)

79

theophylline td Respiratory Tract Agents Bronchodilators, Phosphodiesterase 2 Inhibitors (Xanthines)

79

THERACYS Antineoplastics Antineoplastics 29 thermazene Antibacterials Miscellaneous Antibacterials 13 THIOLA Genitourinary Agents Genitourinary Agents 60 thioridazine hcl Antipsychotics Conventional 33 THIOTEPA Antineoplastics Antineoplastics 30 thiotepa Antineoplastics Antineoplastics 30 thiothixene Antipsychotics Conventional 33 thyroid Hormonal Agents,

Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

THYROLAR-1/2 Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

THYROLAR-1/4 Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

THYROLAR-1 Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

THYROLAR-2 Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

THYROLAR-3 Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

TIAZAC Cardiovascular Agents Antiarrhythmics - Class IV 44 TIAZAC Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 46

TICE BCG Immunological Agents Vaccines 74 TICLID Blood

Products/Modifiers/Volume Expanders

Adenosine Diphosphate P2Y12 Inhibitors

39

ticlopidine hcl Blood Products/Modifiers/Volume Expanders

Adenosine Diphosphate P2Y12 Inhibitors

39

TIGAN Antiemetics Antiemetics, Other 21 TIGAN Antiemetics Antiemetics, Other 21 TIKOSYN Cardiovascular Agents Antiarrhythmics - Class III 43 TILADE Respiratory Tract Agents Mast Cell Stabilizers 81 TIMENTIN Antibacterials Extended Spectrum Penicillins 11 TIMENTIN Antibacterials Extended Spectrum Penicillins 11 TIMOLIDE 10/25 Cardiovascular Agents Antiarrhythmics - Class II 44 TIMOLIDE 10/25 Cardiovascular Agents Thiazide Diuretics 49 timolol maleate ophthalmic gel forming

Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

Page of 231 216

Drug Name Class Category Class Name Page #TIMOLOL MALEATE Antimigraine Agents Beta-adrenergic Blocking Agents 26 TIMOLOL MALEATE Cardiovascular Agents Antiarrhythmics - Class II 44 TIMOLOL MALEATE Cardiovascular Agents Nonselective Beta-adrenergic

Blocking Agents 48

timolol maleate Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

timolol maleate Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

TIMOPTIC OCUDOSE Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

TIMOPTIC Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

TIMOPTIC-XE Ophthalmic Agents Beta-adrenergic Blocking Agents, Ophthalmic

75

TINDAMAX Antiparasitics Antiprotozoals (Non-antimalarials)

31

tis-u-sol viaflex Anticonvulsants Anticonvulsants (Other) 17 tis-u-sol viaflex Cardiovascular Agents Antiarrhythmics (Other) 45 tis-u-sol viaflex Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

tis-u-sol Anticonvulsants Anticonvulsants (Other) 17 tis-u-sol Cardiovascular Agents Antiarrhythmics (Other) 45 tis-u-sol Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

tizanidine hcl Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 TOBI Antibacterials Aminoglycosides 8 TOBRADEX Antibacterials Aminoglycosides 8 TOBRADEX Antibacterials Aminoglycosides 8 TOBRADEX Ophthalmic Agents Glucocorticoids, Ophthalmic 76 TOBRADEX Ophthalmic Agents Glucocorticoids, Ophthalmic 76 TOBRAMYCIN SULFATE ADD-VANTAGE

Antibacterials Aminoglycosides 8

tobramycin sulfate fliptop Antibacterials Aminoglycosides 8 TOBRAMYCIN SULFATE/SODIUM CHLORIDE

Antibacterials Aminoglycosides 8

tobramycin sulfate Antibacterials Aminoglycosides 8 tobramycin sulfate Antibacterials Aminoglycosides 8 tobramycin sulfate Antibacterials Aminoglycosides 8 tobramycin sulfate Antibacterials Aminoglycosides 8 tobrasol Antibacterials Aminoglycosides 8 TOBREX Antibacterials Aminoglycosides 8 TOBREX Antibacterials Aminoglycosides 8 TOFRANIL Antidepressants Tricyclics 20 TOFRANIL-PM Antidepressants Tricyclics 20 tolazamide Blood Glucose Regulators Sulfonylureas 39 TOLAZAMIDE Blood Glucose Regulators Sulfonylureas 39 TOLBUTAMIDE Blood Glucose Regulators Sulfonylureas 39 TOLECTIN DS Anti-inflammatories Nonsteroidal Anti-inflammatory 25

Page of 231 217

Drug Name Class Category Class Name Page #Drugs

TOLINASE Blood Glucose Regulators Sulfonylureas 39 tolmetin sodium Anti-inflammatories Nonsteroidal Anti-inflammatory

Drugs 25

TOLMETIN SODIUM Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

TOPAMAX SPRINKLE Anticonvulsants Glutamate Reducing Agents 17 TOPAMAX SPRINKLE Antimigraine Agents Antimigraine Agents,

Prophylactic (Non-beta-adrenergic Blocking Agents)

26

TOPAMAX Anticonvulsants Glutamate Reducing Agents 18 TOPAMAX Anticonvulsants Glutamate Reducing Agents 18 TOPAMAX Antimigraine Agents Antimigraine Agents,

Prophylactic (Non-beta-adrenergic Blocking Agents)

26

TOPAMAX Antimigraine Agents Antimigraine Agents, Prophylactic (Non-beta-adrenergic Blocking Agents)

26

TOPICORT LP Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

TOPICORT Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

TOPICORT Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

TOPICORT Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

toposar Antineoplastics Antineoplastics 30 TOPROL XL Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

TORADOL ORAL Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

25

TORISEL Antineoplastics Antineoplastics 30 torsemide Cardiovascular Agents Loop Diuretics 48 tpn electrolytes ftv Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

tpn electrolytes ftv Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

tpn electrolytes ii Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

TRACLEER Cardiovascular Agents Vasodilators, Endothelin Receptor Antagonists

51

TRACLEER Respiratory Tract Agents Respiratory Tract Agents, Other 82 tramadol hcl Analgesics Opioid Analgesics, Short-acting 5 tramadol Analgesics Opioid Analgesics, Short-acting 5

Page of 231 218

Drug Name Class Category Class Name Page #hydrochloride/acetaminophen TRANDATE IV Cardiovascular Agents Alpha-beta-adrenergic Blocking

Agents 41

TRANDATE Cardiovascular Agents Alpha-beta-adrenergic Blocking Agents

41

TRANDATE Cardiovascular Agents Alpha-beta-adrenergic Blocking Agents

41

trandolapril Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

42

TRANSDERM-SCOP Gastrointestinal Agents Antispasmodics, Gastrointestinal 57 TRAVATAN Z Ophthalmic Agents Prostaglandins, Ophthalmic 78 TRAVATAN Ophthalmic Agents Prostaglandins, Ophthalmic 78 travert 10%/electrolyte 2 Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

travert 5%/electrolyte #2 Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

trazodone hcl dividose Antidepressants Antidepressants, Other 19 trazodone hcl Antidepressants Antidepressants, Other 19 TRECATOR Antimycobacterials Antituberculars 27 TRECATOR-SC Antimycobacterials Antituberculars 27 TRELSTAR DEPOT Hormonal Agents,

Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

TRELSTAR LA Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

TRENTAL Blood Products/Modifiers/Volume Expanders

Blood Products/Modifiers/Volume Expanders

40

tretinoin Dermatological Agents Dermatological Retinoids 53 tretinoin Dermatological Agents Dermatological Retinoids 53 TREXALL Immunological Agents Immune Suppressants (Non-

TNF Inhibitors) 72

TRIAMCINOLONE ACETONIDE IN ABSORBASE

Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

triamcinolone acetonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

triamcinolone acetonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

triamcinolone acetonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

triamcinolone acetonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

triamcinolone acetonide Hormonal Agents, Glucocorticoids-Topical-Medium 64

Page of 231 219

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Adrenal)

Potency

triamcinolone acetonide Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

triamcinolone dental Dental and Oral Agents Dental and Oral Agents 52 triamcinolone in orabase Dental and Oral Agents Dental and Oral Agents 52 triamcinolone/nystatin Antifungals Polyene Antifungals 24 triamcinolone/nystatin Antifungals Polyene Antifungals 24 triamcinolone/nystatin Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

triamcinolone/nystatin Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

triamterene /hydrochlorothiazide

Cardiovascular Agents Potassium-sparing Diuretics 49

triamterene /hydrochlorothiazide

Cardiovascular Agents Potassium-sparing Diuretics 49

triamterene /hydrochlorothiazide

Cardiovascular Agents Thiazide Diuretics 49

triamterene /hydrochlorothiazide

Cardiovascular Agents Thiazide Diuretics 50

TRICOR Cardiovascular Agents Fibrates 47 tricosal Analgesics Non-opioid Analgesics 2 triderm Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

triderm Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

TRIDESILON Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

TRIDESILON Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

trifluoperazine hcl Antipsychotics Conventional 33 trifluridine Antivirals Antiherpetic Agents 34 TRIGLIDE Cardiovascular Agents Fibrates 47 trihexyphenidyl hcl Antiparkinson Agents Anticholinergics 31 trihexyphenidyl hcl Antiparkinson Agents Anticholinergics 31 TRIHIBIT Immunological Agents Vaccines 74 TRILEPTAL Anticonvulsants Sodium Channel Inhibitors 18 TRILEPTAL Anticonvulsants Sodium Channel Inhibitors 18 TRI-LEVLEN CONTRACT PACK

Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

TRI-LEVLEN Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

Page of 231 220

Drug Name Class Category Class Name Page #TRILISATE Analgesics Non-opioid Analgesics 2 trilyte Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

trimethobenzamide hcl Antiemetics Antiemetics, Other 21 trimethobenzamide hcl Antiemetics Antiemetics, Other 21 trimethoprim sulfate/polymyxin b sulfate

Antibacterials Miscellaneous Antibacterials 13

trimethoprim/polymyxin b Antibacterials Miscellaneous Antibacterials 13 trimethoprim/sulfamethoxazole ds

Antibacterials Sulfonamides 16

trimethoprim Antibacterials Antifolate Antibacterials 9 trimipramine maleate Antidepressants Tricyclics 20 trimox Antibacterials Amino Derivative Penicillins 7 trimox Antibacterials Amino Derivative Penicillins 7 trinate Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

trinessa Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

TRI-NORINYL 28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

TRIOSTAT Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

TRIPEDIA Immunological Agents Vaccines 74 TRIPHASIL 28 Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

triple antibiotic Antibacterials Aminoglycosides 8 triple antibiotic Antibacterials Aminoglycosides 8 triple antibiotic Antibacterials Miscellaneous Antibacterials 13 triple antibiotic Ophthalmic Agents Glucocorticoids, Ophthalmic 76 triple antibiotic Ophthalmic Agents Ophthalmic Agents, Other 77 tri-previfem Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

tri-sprintec Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

trivora-28 Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

TRIZIVIR Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

TROLAMINE Anesthetics Local Anesthetics 6 tropicacyl Anesthetics Local Anesthetics 6 tropicamide Anesthetics Local Anesthetics 6

Page of 231 221

Drug Name Class Category Class Name Page #TRUSOPT Ophthalmic Agents Carbonic Anhydrase Inhibitors,

Ophthalmic 76

TRUVADA Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

34

TRYCET Analgesics Opioid Analgesics, Short-acting 5 TWINRIX Immunological Agents Vaccines 74 TYGACIL Antibacterials Glycopeptide Antibacterials 11 TYKERB Antineoplastics Antineoplastics 30 TYLENOL/CODEINE #3 Analgesics Opioid Analgesics, Short-acting 5 TYLENOL/CODEINE #4 Analgesics Opioid Analgesics, Short-acting 5 TYLOX Analgesics Opioid Analgesics, Short-acting 5 TYMPAGESIC DROPS Anesthetics Local Anesthetics 6 TYSABRI Immunological Agents Immunomodulators, Other 73 TYZEKA Antivirals Antivirals, Other 36 TYZINE PEDIATRIC NASAL DROPS

Respiratory Tract Agents Respiratory Tract Agents, Other 82

TYZINE Respiratory Tract Agents Respiratory Tract Agents, Other 82 u-cort Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

ultra natalcare Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

ultra natal Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

ULTRABAG/DIANEAL LOW CALCIUM/1.5% DEXTROSE

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

ULTRABAG/DIANEAL LOW CALCIUM/2.5% DEXTROSE

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

ULTRABAG/DIANEAL LOW CALCIUM/4.25% DEXTROSE

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

ULTRABAG/DIANEAL PD-2/1.5% DEXTROSE

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

ULTRABAG/DIANEAL PD-2/2.5% DEXTROSE

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

ULTRABAG/DIANEAL PD-2/4.25% DEXTROSE

Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

ULTRACAPS MT 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

56

ULTRACET Analgesics Opioid Analgesics, Short-acting 5 ULTRAM ER Analgesics Opioid Analgesics, Short-acting 5 ULTRAM Analgesics Opioid Analgesics, Short-acting 5 ultra-natal Therapeutic Prenatal Vitamins 89

Page of 231 222

Drug Name Class Category Class Name Page #Nutrients/Minerals/Electrolytes

ULTRASE MT 12 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

56

ULTRASE MT 18 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

56

ULTRASE MT 20 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

56

ULTRASE Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

56

ULTRAVATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

ULTRAVATE Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Very High Potency

65

UNASYN ADD-VANTAGE Antibacterials Amino Derivative Penicillins 7 UNASYN BULK PACK Antibacterials Amino Derivative Penicillins 7 UNASYN PIGGYBACK UNIT Antibacterials Amino Derivative Penicillins 7 UNASYN Antibacterials Amino Derivative Penicillins 7 UNIFINE PENTIPS/12MM Insulin Administration

Supplies Insulin Administration Supplies 75

uni-otic Anesthetics Local Anesthetics 6 uni-otic Antibacterials Miscellaneous Antibacterials 13 UNIPHYL Respiratory Tract Agents Bronchodilators,

Phosphodiesterase 2 Inhibitors (Xanthines)

79

UNIRETIC Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

43

unithroid Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

UNIVASC Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

43

univert Respiratory Tract Agents H1 Blocking Agents, Sedating 81 URECHOLINE Antimyasthenic Agents Parasympathomimetics 27 URECHOLINE Genitourinary Agents 60 URELLE Genitourinary Agents Genitourinary Agents 60 UREX Antibacterials Miscellaneous Antibacterials 13 URISPAS Genitourinary Agents Antispasmodics, Urinary 60 UROCIT-K 10 Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

UROCIT-K 5 Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

URO-KP-NEUTRAL Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

UROQID #2 Antibacterials Miscellaneous Antibacterials 13 UROXATRAL Genitourinary Agents Alpha1-adrenergic Blocking 59

Page of 231 223

Drug Name Class Category Class Name Page #Agents

URSO 250 Gastrointestinal Agents Gastrointestinal Agents, Other 58 URSO FORTE Gastrointestinal Agents Gastrointestinal Agents, Other 58 ursodiol Gastrointestinal Agents Gastrointestinal Agents, Other 58 UTIRA Genitourinary Agents Genitourinary Agents 60 UVADEX Dermatological Agents Dermatological

Photochemotherapy Agents 53

VAGIFEM Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

VALCYTE Antivirals Anti-cytomegalovirus (CMV) Agents

34

valproate sodium Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

valproic acid Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

VALPROIC ACID Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

valproic acid Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

VALTREX Antivirals Antiherpetic Agents 34 vanacet Analgesics Opioid Analgesics, Short-acting 5 VANCOCIN HCL ISO-OSMOTIC DEXTROSE

Antibacterials Glycopeptide Antibacterials 11

VANCOCIN HCL Antibacterials Glycopeptide Antibacterials 11 VANCOCIN HCL Antibacterials Glycopeptide Antibacterials 11 vancomycin hcl Antibacterials Glycopeptide Antibacterials 11 vandazole Antibacterials Miscellaneous Antibacterials 13 VANOS Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-High Potency

62

VANSPAR Sedatives/Hypnotics Sedatives/Hypnotics 82 VANTAS Hormonal Agents,

Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

VANTIN Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

VANTIN Antibacterials Cephalosporin Antibacterials, 3rd Generation

10

VAQTA Immunological Agents Vaccines 74 VARIVAX Immunological Agents Vaccines 74 VASERETIC Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 43

VASERETIC Cardiovascular Agents Thiazide Diuretics 50 VASOTEC Cardiovascular Agents Angiotensin-converting Enzyme

(ACE) Inhibitors 43

VECTIBIX Antineoplastics Antineoplastics 30 veetids Antibacterials Natural Penicillins 14 veetids Antibacterials Natural Penicillins 14 VELCADE Antineoplastics Antineoplastics 30 velivet Hormonal Agents, Contraceptives 69

Page of 231 224

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

VELOSEF Antibacterials Cephalosporin Antibacterials, 1st Generation

9

venlafaxine hcl Antidepressants Antidepressants, Other 19 VENOGLOBULIN-S Immunological Agents Vaccines 74 VENTOLIN HFA Respiratory Tract Agents Bronchodilators,

Sympathomimetic 80

VENTOLIN Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

VERAMYST Respiratory Tract Agents Respiratory Tract Agents, Other 82 verapamil hcl cr Cardiovascular Agents Antiarrhythmics - Class IV 44 verapamil hcl cr Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 46

verapamil hcl er Cardiovascular Agents Antiarrhythmics - Class IV 44 verapamil hcl er Cardiovascular Agents Antiarrhythmics - Class IV 44 verapamil hcl er Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 46

verapamil hcl er Cardiovascular Agents Calcium Channel Blocking Agents (Non-dihydropyridines)

46

verapamil hcl sa Cardiovascular Agents Antiarrhythmics - Class IV 44 verapamil hcl sa Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 46

verapamil hcl sr Cardiovascular Agents Antiarrhythmics - Class IV 44 verapamil hcl sr Cardiovascular Agents Antiarrhythmics - Class IV 44 verapamil hcl sr Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 46

verapamil hcl sr Cardiovascular Agents Calcium Channel Blocking Agents (Non-dihydropyridines)

46

verapamil hcl Cardiovascular Agents Antiarrhythmics - Class IV 44 verapamil hcl Cardiovascular Agents Antiarrhythmics - Class IV 44 verapamil hcl Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 46

verapamil hcl Cardiovascular Agents Calcium Channel Blocking Agents (Non-dihydropyridines)

46

VERDESO Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Low Potency

63

VERELAN PM Cardiovascular Agents Antiarrhythmics - Class IV 44 VERELAN PM Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 46

VERELAN Cardiovascular Agents Antiarrhythmics - Class IV 44 VERELAN Cardiovascular Agents Calcium Channel Blocking

Agents (Non-dihydropyridines) 46

VERMOX Antiparasitics Anthelmintics 31 versiclear Antifungals Antifungals (Other) 22 vertin-32 Respiratory Tract Agents H1 Blocking Agents, Sedating 81 VESANOID Antineoplastics Retinoids 30 VESICARE Genitourinary Agents Antispasmodics, Urinary 60 VESPRIN Antipsychotics Conventional 33 VEXOL Ophthalmic Agents Glucocorticoids, Ophthalmic 76

Page of 231 225

Drug Name Class Category Class Name Page #VFEND IV Antifungals Azole Antifungals 23 VFEND Antifungals Azole Antifungals 23 VFEND Antifungals Azole Antifungals 23 VIADUR Hormonal Agents,

Suppressant (Sex Hormones/Modifiers)

Antiandrogens 71

VIBRAMYCIN Antibacterials Tetracyclines 16 VIBRAMYCIN Antibacterials Tetracyclines 16 VIBRAMYCIN Antibacterials Tetracyclines 16 VIBRATAB Antibacterials Tetracyclines 16 VICODIN ES Analgesics Opioid Analgesics, Short-acting 5 vicodin hp Analgesics Opioid Analgesics, Short-acting 5 VICODIN Analgesics Opioid Analgesics, Short-acting 6 VICOPROFEN Analgesics Opioid Analgesics, Short-acting 6 VIDAZA Antineoplastics Antineoplastics 30 VIDEX EC Antivirals Anti-HIV Agents, Nucleoside and

Nucleotide Reverse Transcriptase Inhibitors

35

VIDEX PEDIATRIC Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

35

VIGAMOX Antibacterials Quinolones 15 vinatal forte Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

vinate 90 Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

vinate advanced Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

vinate good start Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

vinate gt Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

vinate ii Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

vinate m Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

vinate ultra Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

VINBLASTINE SULFATE Antineoplastics Antineoplastics 30 VINBLASTINE SULFATE Antineoplastics Antineoplastics 30 vincasar pfs Antineoplastics Antineoplastics 30 vincristine sulfate Antineoplastics Antineoplastics 30 vinorelbine tartrate Antineoplastics Antineoplastics 30

Page of 231 226

Drug Name Class Category Class Name Page #VIOKASE 16 Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

56

VIOKASE 8 Enzyme Replacements/Modifiers

Enzyme Replacements/Modifiers

56

VIRACEPT Antivirals Anti-HIV Agents, Protease Inhibitors

35

VIRAMUNE Antivirals Anti-HIV Agents, Non-nucleoside Reverse Transcriptase Inhibitors

34

VIRAMUNE Antivirals Anti-HIV Agents, Non-nucleoside Reverse Transcriptase Inhibitors

34

VIRAZOLE Antivirals Antivirals, Other 36 VIREAD Antivirals Anti-HIV Agents, Nucleoside and

Nucleotide Reverse Transcriptase Inhibitors

35

VIROPTIC Antivirals Antiherpetic Agents 34 VISICOL Therapeutic

Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

VISTARIL Respiratory Tract Agents H1 Blocking Agents, Sedating 81 VISTARIL Respiratory Tract Agents H1 Blocking Agents, Sedating 81 VISTARIL Sedatives/Hypnotics Sedatives/Hypnotics 82 VISTARIL Sedatives/Hypnotics Sedatives/Hypnotics 82 VISTIDE Antivirals Anti-cytomegalovirus (CMV)

Agents 34

VITAFOL-OB Therapeutic Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

VIVACTIL Antidepressants Tricyclics 20 VIVAGLOBIN Immunological Agents Vaccines 74 VIVELLE-DOT Hormonal Agents,

Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

VIVELLE-DOT Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

VIVELLE Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Estrogens 70

VIVITROL Antidotes, Deterrents, and Toxicologic Agents

Alcohol Deterrents 20

VOLTAREN Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

26

VOLTAREN Ophthalmic Agents Nonsteroidal Anti-inflammatory Drugs, Ophthalmic

77

VOLTAREN-XR Anti-inflammatories Nonsteroidal Anti-inflammatory Drugs

26

VOPAC Analgesics Opioid Analgesics, Short-acting 6 VOSPIRE ER Respiratory Tract Agents Bronchodilators,

Sympathomimetic 80

Page of 231 227

Drug Name Class Category Class Name Page #vynatal fa Therapeutic

Nutrients/Minerals/Electrolytes

Prenatal Vitamins 89

VYTORIN Cardiovascular Agents 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) Reductase Inhibitors

40

VYTORIN Cardiovascular Agents Cholesterol Absorption Inhibitors 46 VYVANSE Central Nervous System

Agents Amphetamines 51

warfarin sodium Blood Products/Modifiers/Volume Expanders

Anticoagulants, Oral 39

WELCHOL Cardiovascular Agents Bile Acid Sequestrants 45 WELLBUTRIN SR Antidepressants Antidepressants, Other 19 WELLBUTRIN XL Antidepressants Antidepressants, Other 19 WELLBUTRIN Antidepressants Antidepressants, Other 19 WESTCORT Hormonal Agents,

Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

WESTCORT Hormonal Agents, Stimulant/Replacement/Modifying (Adrenal)

Glucocorticoids-Topical-Medium Potency

64

westhroid light blue sugar coated

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

westhroid tan compressed Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

westhroid Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

71

XALATAN Ophthalmic Agents Prostaglandins, Ophthalmic 78 XENICAL Gastrointestinal Agents Gastrointestinal Agents, Other 58 XIBROM Ophthalmic Agents Nonsteroidal Anti-inflammatory

Drugs, Ophthalmic 77

XIFAXAN Antibacterials Miscellaneous Antibacterials 13 XODOL Analgesics Opioid Analgesics, Short-acting 6 XOLAIR Respiratory Tract Agents Respiratory Tract Agents, Other 82 XOLEGEL Antifungals Azole Antifungals 23 XOPENEX CONCENTRATE Respiratory Tract Agents Bronchodilators,

Sympathomimetic 80

XOPENEX HFA Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

XOPENEX Respiratory Tract Agents Bronchodilators, Sympathomimetic

80

XYLOCAINE JELLY Anesthetics Local Anesthetics 6 XYLOCAINE VISCOUS Anesthetics Local Anesthetics 6 XYLOCAINE Anesthetics Local Anesthetics 6 XYREM Central Nervous System

Agents Non-amphetamines 51

YASMIN 28 Hormonal Agents, Contraceptives 69

Page of 231 228

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

YAZ Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

YODOXIN Antiparasitics Antiprotozoals (Non-antimalarials)

31

ZANAFLEX Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 ZANAFLEX Skeletal Muscle Relaxants Skeletal Muscle Relaxants 83 ZANOSAR Antineoplastics Antineoplastics 30 ZANTAC Gastrointestinal Agents Histamine2 (H2) Blocking

Agents 58

ZANTAC Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

ZANTAC Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

ZANTAC Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

ZANTAC Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

ZANTAC Gastrointestinal Agents Histamine2 (H2) Blocking Agents

58

ZANTAC Therapeutic Nutrients/Minerals/Electrolytes

Electrolytes/Minerals 87

ZARONTIN Anticonvulsants Calcium Channel Modifying Agents

17

ZARONTIN Anticonvulsants Calcium Channel Modifying Agents

17

ZAROXOLYN Cardiovascular Agents Thiazide Diuretics 50 ZAVESCA Enzyme

Replacements/Modifiers Enzyme Replacements/Modifiers

56

zazole Antifungals Azole Antifungals 23 zazole Antifungals Azole Antifungals 23 ZEBETA Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

ZEGERID Gastrointestinal Agents Proton Pump Inhibitors 59 ZEGERID Gastrointestinal Agents Proton Pump Inhibitors 59 ZELAPAR Antiparkinson Agents Antiparkinson Agents, Other 32 ZEMAIRA Respiratory Tract Agents Respiratory Tract Agents, Other 82 ZEMPLAR Hormonal Agents,

Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

ZEMPLAR Hormonal Agents, Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Vitamin D-related Agents/Metabolic Bone Disease Agents

66

ZENAPAX Immunological Agents Immune Suppressants (Non-TNF Inhibitors)

72

ZERIT Antivirals Anti-HIV Agents, Nucleoside and 35

Page of 231 229

Drug Name Class Category Class Name Page #Nucleotide Reverse Transcriptase Inhibitors

ZERIT Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

35

ZESTORETIC Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

43

ZESTRIL Cardiovascular Agents Angiotensin-converting Enzyme (ACE) Inhibitors

43

ZETIA Cardiovascular Agents Cholesterol Absorption Inhibitors 46 ZEVALIN IN-111 Antineoplastics Antineoplastics 30 ZEVALIN Y-90 Antineoplastics Antineoplastics 30 ZIAC Cardiovascular Agents Cardioselective Beta-adrenergic

Blocking Agents 46

ZIAC Cardiovascular Agents Thiazide Diuretics 50 ZIAGEN Antivirals Anti-HIV Agents, Nucleoside and

Nucleotide Reverse Transcriptase Inhibitors

35

ZIAGEN Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

35

ZIANA Antibacterials Lincomycin Antibacterials 12 ZIANA Dermatological Agents Dermatological Retinoids 54 zidovudine Antivirals Anti-HIV Agents, Nucleoside and

Nucleotide Reverse Transcriptase Inhibitors

35

zidovudine Antivirals Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors

35

ZINACEF IN ISO-OSMOTIC DEXTROSE

Antibacterials Cephalosporin Antibacterials, 2nd Generation

10

ZINACEF IN ISO-OSMOTIC DILUENT

Antibacterials Cephalosporin Antibacterials, 2nd Generation

10

ZINACEF/D5W Antibacterials Cephalosporin Antibacterials, 2nd Generation

10

ZINACEF Antibacterials Cephalosporin Antibacterials, 2nd Generation

10

ZINECARD Antineoplastics Antineoplastics 30 ZINECARD Unclassified Unclassified 90 ziox 405 Dermatological Agents Dermatological Wound Care

Agents 54

ziox Dermatological Agents Dermatological Wound Care Agents

54

ZITHROMAX TRI-PAK Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

ZITHROMAX Z-PAK Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

ZITHROMAX Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

ZITHROMAX Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

Page of 231 230

Drug Name Class Category Class Name Page #ZITHROMAX Antibacterials Macrolides (Non-erythromycins,

Non-ketolides) 12

ZITHROMAX Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

ZMAX Antibacterials Macrolides (Non-erythromycins, Non-ketolides)

12

ZOCOR Cardiovascular Agents 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) Reductase Inhibitors

40

ZOFRAN ODT Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

ZOFRAN Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

ZOFRAN Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

ZOFRAN Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

ZOFRAN Antiemetics 5-Hydroxytryptamine 3 (5-HT3) Antagonists

21

ZOLADEX Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogens 72

ZOLINZA Antineoplastics Antineoplastics 30 ZOLOFT Antidepressants Serotonin and Norepinephrine

Reuptake Inhibitors (SNRIs) 19

ZOLOFT Antidepressants Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

19

zolpidem tartrate Sedatives/Hypnotics Sedatives/Hypnotics 82 ZOMETA Hormonal Agents,

Stimulant/Replacement/Modifying (Parathyroid/Metabolic Bone Disease Agents)

Bisphosphonates, Parenteral 65

ZOMIG ZMT Antimigraine Agents Triptans 26 ZOMIG Antimigraine Agents Triptans 26 ZOMIG Antimigraine Agents Triptans 26 ZOMIG Antimigraine Agents Triptans 26 ZONALON Dermatological Agents Dermatological Antipruritic

Agents 53

ZONEGRAN Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

ZONEGRAN Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

zonisamide Anticonvulsants Gamma-aminobutyric Acid (GABA) Augmenting Agents

17

ZORBTIVE Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

66

ZOSTAVAX Immunological Agents Vaccines 74 ZOSYN Antibacterials Extended Spectrum Penicillins 11 ZOSYN Antibacterials Extended Spectrum Penicillins 11 zovia 1/35e Hormonal Agents, Contraceptives 69

Page of 231 231

Drug Name Class Category Class Name Page #Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

zovia 1/50e Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

Contraceptives 69

ZOVIRAX Antivirals Antiherpetic Agents 34 ZOVIRAX Antivirals Antiherpetic Agents 34 ZOVIRAX Antivirals Antiherpetic Agents 34 ZOVIRAX Antivirals Antiherpetic Agents 34 ZOVIRAX Antivirals Antiherpetic Agents 34 ZOVIRAX Antivirals Antiherpetic Agents 34 ZYBAN Antidotes, Deterrents, and

Toxicologic Agents Smoking Cessation Agents 21

ZYDONE Analgesics Opioid Analgesics, Short-acting 6 ZYFLO Respiratory Tract Agents Synthesis Inhibitors 82 ZYLET Antibacterials Aminoglycosides 8 ZYLET Ophthalmic Agents Glucocorticoids, Ophthalmic 77 ZYLOPRIM Antigout Agents Xanthine Oxidase Inhibitors 24 ZYMAR Antibacterials Quinolones 15 ZYPREXA ZYDIS Antipsychotics Atypicals 33 ZYPREXA ZYDIS Bipolar Agents Bipolar Agents 37 ZYPREXA Antipsychotics Atypicals 33 ZYPREXA Antipsychotics Atypicals 33 ZYPREXA Bipolar Agents Bipolar Agents 37 ZYPREXA Bipolar Agents Bipolar Agents 37 ZYRTEC-D Respiratory Tract Agents Histamine1 (H1) Blocking

Agents, Mildly/Non-sedating 81

ZYRTEC Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

ZYRTEC Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

ZYRTEC Respiratory Tract Agents Histamine1 (H1) Blocking Agents, Mildly/Non-sedating

81

ZYVOX Antibacterials Oxazolidinone Antibacterials 14 ZYVOX Antibacterials Oxazolidinone Antibacterials 14 ZYVOX Antibacterials Oxazolidinone Antibacterials 14