eocco pharmacy formulary - moda health — provider of ... · pdf fileeocco pharmacy...

EOCCO Pharmacy Formulary

Effective 5/7/2018

Medications that are new to the market are not included within your pharmacy

benefit until reviewed by the Pharmacy and Therapeutics Committee. Please

contact Moda Health Customer Service if you are taking a medication that is

new to the market. Please note that this list is subject to change at any time.

Questions?

Call Pharmacy Customer Service at 888-474-8539.

2

How to read your pharmacy formulary

Refer to the chart below for a list of prescription medications covered by Moda Health. Medications that are new to the market are

subject to a review period. Please contact us if you are taking a medication that is new to the market.

To find out more information about the restrictions below, please refer to “Medications requiring authorization” at

eocco.com/members/pharmacy.shtml.

This document is provided for informational purposes only and is intended as a quick reference. For cost and further details of

the coverage, including exclusions, prior authorization requirements, any reduction or limitations and the terms under which

the policy may be continued in force, contact your producer or Moda Health.

Key

Bold Italic

Font Brand name medications

Regular

Font Generic medications

SP

Speciality medications – Certain prescription medications are defined as specialty products. Specialty medications are often used

to treat complex chronic health conditions. Specialty treatments often require special handling techniques, careful administration

and a unique ordering process. You must access specialty medications through the exclusive specialty pharmacy. All specialty

medications require a prior authorization before they can be dispensed. To enroll with Ardon Health Specialty Pharmacy, call toll-

free at 855-425-4085.

PA Prior authorization required – Your healthcare provider must work directly with Moda Health to obtain approval before we can

process payment for a specific medication.

ST Step therapy required – You must try one or more “first line” medications before you can get this step therapy medication.

QL Quantity limits – Some medications have limits to how much you can get per prescription or refill.

A Age limits – Some medications are limited to certain ages based on FDA recommendation or plan benefit limitations.

Bold Italic = Brand name; Regular Font = Generic; SP = Specialty medications; PA = Prior authorization required;

ST = Step therapy required; QL = Quantity limits; A = Age limits

2018.2 (5/7/2018).

For prior effective dates, please contact EOCCO. 3 eocco.com

Medication Name Dosage Form SP PA ST QL A

12 Hour Cold Relief (NDC 50428-4658-05) Tablet ER

12 Hour Decongestant Tablet ER

1st Choice Lancets Each

1st Tier Unifine Pentips Dis Needle

1st Tier Unifine Pentips Plus Dis Needle

1st Tier Unilet Comfortouch (Lancets) Each

24hour Allergy Tablet

2tek (Control Solution) Each

8 Hour Tablet ER

8 Hour Pain Relief Tablet ER

8 Hour Pain Reliever Tablet ER

Abacavir Tablet

Abacavir Solution

Abacavir-Lamivudine Tablet

Abacavir-Lamivudine-Zidovudine Tablet

Acarbose Tablet �

Accu-Chek (Lancets) Each

Accu-Chek (Lancing Device/Lancets) Kit

Accu-Chek Compact Plus Control Each

Accu-Chek Fastclix (Lancets) Each

Accu-Chek Fastclix (Lancing Device/Lancets Kit

Accu-Chek Guide Control Soln Each

Accu-Chek Safe-T-Pro (Lancets) Each

Accu-Chek Safe-T-Pro Plus (Lancets) Each

Accu-Chek Smartview (Control Solution) Each

Accu-Chek Softclix (Lancets) Each

Accu-Chek Softclix (Lancing Device/Lancets) Kit

Accutrend Glucose (Control Solution) Each

Acebutolol HCl Capsule

Acephen (325mg) Supp.Rect

Acerola C Tab Chew

Acerola C (NDC 43292-0555-74) Wafer

Acetadryl Tablet

Acetaminophen Solution

Acetaminophen Elixir

Acetaminophen Oral Susp

Acetaminophen Liquid

Acetaminophen Tab Chew

Acetaminophen Tablet

Acetaminophen 8 Hour Tablet ER

Acetaminophen ER Tablet ER

Acetaminophen Extra Strength Tablet

Acetaminophen PM Tablet



2018.2 (5/7/2018).



Acetaminophen PM Xtra Strength Tablet

Acetaminophen-Codeine Tablet �

Acetaminophen-Codeine Solution �

Acetaminophen-Diphenhydramine Tablet

Acetasol HC Drops

Acetazolamide Tablet

Acetazolamide Capsule ER

Acetic Acid Solution

Acetylcysteine Vial

Acid Controller (10mg) Tablet

Acid Reducer (Famotidine 10mg) Tablet

Acitretin Capsule

Acti-Lance (Lancets) Each

Actimmune Vial � �

Actoplus Met XR Tbmp 24hr � �

Acyclovir Capsule

Acyclovir Tablet

Acyclovir Oint. (G)

Acyclovir Oral Susp

Adacel Tdap Vial

Adacel Tdap Syringe

Added Strength Headache Tablet

Added Strength Pain Reliever Tablet

Adefovir Dipivoxil Tablet �

Adjustable Lancing Device Each

Admelog Vial � �

Admelog Solostar Insuln Pen � �

Adult Low Dose Aspirin EC Tablet Dr

Adult Robitussin Peak Cold Dm Liquid

Adult Tussin Cough Congest Dm Liquid

Adult Tussin Dm Syrup

Adult Wal-Tussin Dm Syrup

Advair Diskus Blst W/Dev �

Advair HFA HFA Aer Ad �

Advanced Antacid Oral Susp

Advanced Antacid-Antigas Oral Susp

Advanced Lancing Device Kit

Advanced Travel Lancets Each

Advate Vial � �

Advocate Control Solution Each

Advocate Lancet Each

Advocate Lancets Each

Advocate Pen Needles Dis Needle



2018.2 (5/7/2018).



Advocate Rapid-Safe (Lancing Device) Each

Advocate Redi-Code+ Ctrl Soln Each

Advocate Syringes Disp Syrin

Afeditab CR Tablet ER

Afluria 2017-2018 Syringe

Afluria 2017-2018 Vial

Afluria Quad 2017-2018 Syringe

Afluria Quad 2017-2018 Vial

Afstyla Vial � �

Aftera Tablet

Agamatrix Control (Control Solution) Each

Ak-Poly-Bac Oint. (G)

Ala-Cort Cream (G)

Ala-Scalp Lotion

Alavert Tab Rapdis

Albenza Tablet

Albuterol Sulfate Syrup

Albuterol Sulfate Tablet

Albuterol Sulfate Tab ER 12h

Albuterol Sulfate Vial-Neb

Albuterol Sulfate Solution

Alclometasone Dipropionate Cream (G)

Alclometasone Dipropionate Oint. (G)

Alecensa Capsule � � �

Alendronate Sodium Tablet

Alendronate Sodium Solution

Aler-Caps Capsule

Aleve Tablet

Alferon N Vial � �

Alfuzosin HCl ER Tab ER 24h �

Algal Omega-3 DHA Capsule

Alka-Seltzer Plus Allergy Tablet

All Day Allergy Tablet

All Day Allergy Relief Tablet

All Day Pain Relief Tablet

All Day Relief Tablet

Aller-Chlor Tablet

Aller-Chlor Syrup

Allerclear Tablet

Aller-G-Time Tablet

Allergy Tablet

Allergy Capsule

Allergy Liquid



2018.2 (5/7/2018).



Allergy 4-Hour Tablet

Allergy Medication Tablet

Allergy Medication Capsule

Allergy Medicine Tablet

Allergy Medicine Capsule

Allergy Medicine Liquid

Allergy Relief Liquid

Allergy Relief Tab Rapdis

Allergy Relief (Diphenhydramine HCl 25mg) Capsule

Allergy Relief (Loratadine 10mg) Tablet

Allergy Relief (Loratadine 5 mg/5ml) Solution

Allergy-Time Tablet

Aller-Tec Tablet

Allopurinol Tablet

Almacone Oral Susp

Almacone-2 Oral Susp

Alophen Pills Tablet Dr

Alosetron HCl Tablet

Alphagan P (0.10%) Drops

Alrex Drops Susp

Altabax Oint. (G)

Altachlore Drops

Altachlore Oint. (G)

Altamist Spray

Altavera Tablet

Alternate Site Lancets Each

Alternate Site Lancing Device Each

Alunbrig Tablet � �

Alyacen Tablet

Amabelz Tablet

Amantadine Solution

Amantadine Tablet

Amantadine Capsule

Amcinonide Cream (G)

Amcinonide Oint. (G)

Amcinonide Lotion

Amethia Tbdspk 3mo �

Amethia Lo Tbdspk 3mo �

Amicar Tablet � �

Amicar Solution � �

Amiloride HCl Tablet

Amiloride-Hydrochlorothiazide Tablet

Amiodarone HCl Tablet



2018.2 (5/7/2018).



Amitiza Capsule

Amlodipine Besylate Tablet

Amlodipine Besylate-Benazepril Capsule

Ammonium Lactate Cream (G)

Amoxicillin Tablet

Amoxicillin Tab Chew

Amoxicillin Capsule

Amoxicillin Susp Recon

Amoxicillin ER Tbmp 24hr

Amoxicillin-Clavulanate Pot ER Tab ER 12h

Amoxicillin-Clavulanate Potass Tab Chew

Amoxicillin-Clavulanate Potass Tablet

Amoxicillin-Clavulanate Potass Susp Recon

Ampicillin Trihydrate Capsule

Ampicillin Trihydrate Susp Recon

Amyl Nitrite Ampul

Anacaine Oint. (G)

Anadrol-50 Tablet �

Analpram HC Lotion

Anastrozole Tablet

Androxy Tablet �

Anodyne Lpt Kit

Antacid & Antigas Oral Susp

Antacid & Gas Relief Oral Susp

Antacid (Calcium Carbonate) Tab Chew

Antacid (Mag Hydrox/Aluminum Hyd/Simeth) Oral Susp

Antacid Anti-Gas Double Str Oral Susp

Antacid Calcium Tab Chew

Antacid Extra Strength Oral Susp

Antacid Extra Strength (300mg (750) & 400(1000)) Tab Chew

Antacid M Oral Susp

Antacid Maximum Strength Oral Susp

Antacid Plus Anti-Gas Oral Susp

Antacid Ultra Strength Tab Chew

Antacid With Simethicone Oral Susp

Antacid-Antigas (400-400-20 & 400-400-40) Oral Susp

Antibiotic Oint. (G)

Anti-Diarrheal Oral Susp

Anti-Diarrheal Liquid

Antifungal Cream Cream (G)

Anti-Fungal Cream Cream (G)

Antihist Elixir

Antihistamine Capsule



2018.2 (5/7/2018).



Antihistamine Tablet

Anti-Itch (Hydrocortisone) Cream (G)

Antipyrine-Benzocaine Drops

Antitussive Dm Syrup

Anzemet Tablet � �

Apidra Vial �

Apidra Solostar Insuln Pen � �

Apokyn Cartridge � �

Apraclonidine HCl Drops

Aprepitant Cap Ds Pk

Aprepitant (80 mg) Capsule

Apri Tablet

Apriso Cap ER 24h

Aptivus Solution

Aptivus Capsule

Aqua Lance Lancing Device Each

Aralast Np Vial � �

Aranelle Tablet

Aranesp Vial � �

Aranesp Syringe � �

Arbinoxa Tablet

Arbinoxa Liquid

Arcalyst Vial � �

Arnuity Ellipta Blst W/Dev �

Arthritis Pain Tablet ER

Arthritis Pain Relief Tablet ER

Arthritis Pain Reliever Tablet ER

Artificial Tears Drops

Asa-Butalb-Caffeine-Codeine Capsule

Ascomp With Codeine Capsule

Ascorbic Acid Tablet

Ascorbic Acid With Rh Tablet

Ashlyna Tbdspk 3mo �

Aspir 81 Tablet Dr

Aspirin Tab Chew

Aspirin (325mg) Tablet

Aspirin Buffered Tablet

Aspirin EC (81mg & 325mg) Tablet Dr

Aspirin-Caffeine-Dihydrocodein Capsule �

Aspirin-Dipyridamole ER Cpmp 12hr

Aspir-Low Tablet Dr

Aspir-Trin Tablet Dr

Assure 4 (Control Solution) Combo. Pkg



2018.2 (5/7/2018).



Assure Dose (Control Solution) Each

Assure Haemolance Plus (Lancets) Each

Assure Id Insulin Safety Disp Syrin

Assure Lance (Lancets) Each

Assure Lance Plus (Lancets) Each

Assure Prism (Control Solution) Each

Atabex DHA 200 Capsule

Atazanavir Sulfate Capsule

Atenolol Tablet

Atenolol-Chlorthalidone Tablet

Athenol Tablet

Athlete's Foot (Tolnaftate) Cream (G)

Athlete's Foot Cream Cream (G)

Atorvastatin Calcium Tablet

Atovaquone Oral Susp

Atovaquone-Proguanil HCl Tablet

Atripla Tablet

Atropine Sulfate Drops

Atropine Sulfate Oint. (G)

Atrovent HFA HFA Aer Ad

Aubagio Tablet � � �

Aubra Tablet

Augmentin (125-31.25/) Susp Recon

Auro Drops

Auroguard Drops

Austedo Tablet � � �

Autoject 2 Insuln Pen

Auto-Lancet Mini (Lancing Device/Lancets) Each

Autolet Impression (Lancing Device/Lancets) Kit

Autolet Lancing Device Each

Autolet Plus (Lancing Device) Each

Autopen Insuln Pen

Autoshield Duo Pen Needle Dis Needle

Autoshield Pen Needle Dis Needle

Avc Cream/Appl

Aviane Tablet

Avonex Kit � � �

Avonex Syringekit � � �

Avonex Syringe � � �

Avonex Pen Pen Injctr � � �

Avonex Pen Pen Ij Kit � � �

Ayr Saline Spray

Azasan Tablet



2018.2 (5/7/2018).



Azasite Drops

Azathioprine Tablet

Azelastine HCl Drops

Azithromycin Susp Recon

Azithromycin Tablet

Azithromycin Packet

Azopt Drops Susp

Azurette Tablet

B-12 (500 mcg) Tablet

B-12 Dots Tablet

Bacitracin Oint. (G)

Bacitracin Zinc Oint. (G)

Bacitracin-Polymyxin (NDC 24208-0555-55) Oint. (G)

Bacitraycin Plus Oint. (G)

Baclofen Tablet

Balsalazide Disodium Capsule

Balziva Tablet

Ban-Acid Tab Chew

Banophen Liquid

Banophen Capsule

Banophen Tablet

Baraclude Solution �

Bayer Migraine Tablet

Baza Antifungal Cream (G)

Bd Microtainer Lancets Each

Bd Ultra-Fine (Lancets) Each

Bd Ultra-Fine II (Lancets) Each

Bd Ultra-Fine Pen Needle Dis Needle

Bee-Zee Tablet

Bekyree Tablet

Belladonna-Opium Supp.Rect

Belladonna-Phenobarbital (NDC 00143-1140-01) Tablet

Benadryl Allergy Tablet

Benazepril HCl Tablet

Benazepril-Hydrochlorothiazide Tablet

Benznidazole Tablet �

Benzonatate (100mg & 200mg) Capsule

Benztropine Mesylate Tablet

Betamethasone Dipropionate Cream (G)

Betamethasone Dipropionate Oint. (G)

Betamethasone Dipropionate Lotion

Betamethasone Dipropionate Gel (Gram)

Betamethasone Valerate Oint. (G)



2018.2 (5/7/2018).



Betamethasone Valerate Cream (G)

Betamethasone Valerate Lotion

Betatemp Oral Susp

Betaxolol HCl Tablet

Betaxolol HCl Drops

Bethanechol Chloride Tablet

Bethkis Ampul-Neb � � �

Betimol Drops

Betoptic S Drops Susp

Bexsero Syringe

Bicalutamide Tablet

Biktarvy Tablet

Bimatoprost Drops

Biocotron Liquid

Bisac-Evac Supp.Rect

Bisacodyl Tablet Dr

Bisacodyl Supp.Rect

Bisa-Lax Tablet Dr

Biscolax Supp.Rect

Bismatrol Tab Chew

Bismatrol (262mg/15ml) Oral Susp

Bismuth Tab Chew

Bismuth Oral Susp

Bisoprolol Fumarate Tablet

Bisoprolol-Hydrochlorothiazide Tablet

Bivigam Vial � �

Bleph-10 Drops

Blephamide Drops Susp

Blephamide S.O.P. Oint. (G)

Blisovi 24 Fe Tablet

Blisovi Fe Tablet

Blood Glucose Control (Control Solution) Each

Blood Lancets Each

Blood-Glucose Control (Control Solution) Each

Boostrix Tdap Vial

Boostrix Tdap Syringe

Bosulif Tablet � � �

Breeze 2 (Control Solution) Each

Brevicon Tablet

Briellyn Tablet

Brimonidine Tartrate Drops

Briviact Tablet � �

Bromocriptine Mesylate Tablet



2018.2 (5/7/2018).



Bromocriptine Mesylate Capsule

Budesonide Ampul-Neb

Budesonide EC Capdr - ER

Buffered Aspirin Tablet

Bufferin Tablet

Bullseye Mini Safety Lancets Each

Bumetanide Tablet

Bunavail Film �

Buphenyl Tablet � �

Buprenorphine HCl Tab Subl

Buprenorphine-Naloxone Tab Subl

Buproban Tab ER 12h �

Bupropion HCl Sr (Zyban) Tab ER 12h �

Butalb-Acetaminoph-Caff-Codein Capsule �

Butalb-Caff-Acetaminoph-Codein Capsule �

Butalbital Compound-Codeine Capsule

Butalbital-Acetaminophen (50mg-325mg) Tablet

Butalbital-Acetaminophen-Caffe Tablet

Butalbital-Acetaminophen-Caffe (50-300-40) Capsule �

Butalbital-Acetaminophen-Caffe (50-325-40) Capsule

Butalbital-Aspirin-Caffeine Capsule

Bystolic (2.5mg, 5mg, & 10mg) Tablet �

C-500 Tablet

C-500 Tab Chew

Cabergoline Tablet �

Caffeine Citrate Solution

Calcipotriene Solution

Calcipotriene Cream (G)

Calcipotriene Oint. (G)

Calcitonin-Salmon Spray/Pump

Calcitrene Oint. (G)

Calcitriol Capsule

Calcium (600 mg) Tablet

Calcium 600-Vit D3 Tablet

Calcium Acetate Capsule

Calcium Acetate (667mg) Tablet

Calcium Antacid (200(500)mg, 215(500)mg, 300mg (750),

320mg(750),& 400(1000)) Tab Chew

Calcium Carbonate (200(500)mg, 300mg(750), &

400(1000)) Tab Chew

Calcium Carbonate (260mg(648) & 600 mg) Tablet

Calcium Citrate Tablet

Calcium Citrate - Vitamin D Tablet

Calcium Citrate - Vitamin D3 Tablet



2018.2 (5/7/2018).



Calcium Citrate-D Tablet

Calcium Citrate-Vit D Tablet

Calcium Citrate-Vitamin D (NDC 50428-0280-46) Tablet

Calcium Citrate-Vitamin D3 Tablet

Calcium Polycarbophil Tablet

Cal-Gest Tab Chew

Calquence Capsule � � �

Camila Tablet

Camrese Tbdspk 3mo �

Camrese Lo Tbdspk 3mo �

Canasa Supp.Rect

Candesartan Cilexetil Tablet �

Candesartan-Hydrochlorothiazid Tablet �

Cantil Tablet

Capacet Capsule

Capecitabine Tablet �

Capex Shampoo Shampoo

Capital W-Codeine Oral Susp �

Capsaicin (0.03%) Cream (G)

Captopril Tablet

Captopril-Hydrochlorothiazide Tablet

Carafate Oral Susp

Carbamazepine Tablet

Carbamazepine Tab Chew

Carbamazepine Oral Susp

Carbamazepine ER Cpmp 12hr

Carbamazepine ER Tab ER 12h

Carbamoxide Drops

Carbidopa Tablet

Carbidopa-Levodopa Tablet

Carbidopa-Levodopa Tab Rapdis

Carbidopa-Levodopa ER Tablet ER

Carbidopa-Levodopa-Entacapone Tablet

Carbinoxamine Maleate Tablet

Carbinoxamine Maleate Liquid

Cardura Xl Tab ER 24

Careone (Lancing Device) Each

Caresens (Control Solution) Each

Caretouch Twist Lancet Each

Carisoprodol Tablet

Carisoprodol Compound Tablet

Carisoprodol Compound-Codeine Tablet

Carisoprodol-Aspirin Tablet



2018.2 (5/7/2018).



Carisoprodol-Aspirin-Codeine Tablet

Carteolol HCl Drops

Cartia XT Cap ER 24h

Carvedilol Tablet

Caya Contoured Diaphragm

Caziant Tablet

Cefaclor Capsule

Cefaclor Susp Recon

Cefaclor ER Tab ER 12h

Cefadroxil Capsule

Cefadroxil Tablet

Cefadroxil Susp Recon

Cefdinir Capsule

Cefdinir Susp Recon

Cefditoren Pivoxil (200 mg) Tablet

Cefixime Susp Recon

Cefpodoxime Proxetil Tablet

Cefpodoxime Proxetil Susp Recon

Cefprozil Susp Recon

Cefprozil Tablet

Ceftibuten Susp Recon

Ceftibuten Capsule

Ceftin Susp Recon

Cefuroxime Tablet

Celecoxib Capsule � �

Celontin Capsule

Centamin Liquid

Central Vite For Seniors Tablet

Centravites 50 Plus Tablet

Cephalexin Tablet

Cephalexin Capsule

Cephalexin Susp Recon

Cerovite Liquid

Cerovite Advanced Formula Tablet

Cerovite Senior Tablet

Certavite-Antioxidant Liquid

Cervarix Syringe �

Cesamet Capsule �

Cetacaine Anesthetic Liquid

Cetirizine HCl (1 mg/Ml) Solution

Cetirizine HCl (10mg) Tablet

Cevimeline HCl Capsule

Chantix Tablet �



2018.2 (5/7/2018).



Chantix Tab Ds Pk �

Chateal Tablet

Child Ibuprofen Oral Susp

Children's Acetaminophen Tab Chew

Children's Acetaminophen Oral Susp

Children's Allergy Liquid

Children's Allergy Tab Rapdis

Children's Allergy Elixir

Children's Allergy (Loratadine) Solution

Children's Allergy Rapid Melts Tab Chew

Children's Allergy Relief Liquid

Children's Allergy Relief Tab Rapdis

Children's Allergy Relief (Loratadine) Solution

Children's Aspirin Tab Chew

Children's Complete Allergy Tab Rapdis

Children's Ferrous Sulfate Drops

Children's Ibuprofen Oral Susp

Children's Iron Drops

Children's Loratadine Solution

Children's Non-Aspirin Oral Susp

Children's Non-Aspirin Tab Chew

Children's Non-Aspirin Elixir

Children's Non-Aspirin Drops

Children's Pain & Fever Tab Chew

Children's Pain And Fever Liquid

Children's Pain Relief Oral Susp

Children's Pain Relief Liquid

Children's Pain Reliever Tab Chew

Children's Pain Reliever Oral Susp

Children's Pain-Fever Oral Susp

Children's Profen Ib Oral Susp

Children's Profenib Oral Susp

Children's Q-Pap Oral Susp

Children's Saline Nasal Spray Spray

Children's Silapap Liquid

Children's Tactinal Tab Chew

Children's Wal-Dryl Allergy Liquid

Children's Wal-Dryl Allergy Tab Rapdis

Chlordiazepoxide-Clidinium Capsule

Chlorhexidine Gluconate Mouthwash

Chlorhist Tablet

Chloroquine Phosphate Tablet

Chlorothiazide Tablet



2018.2 (5/7/2018).



Chlorpheniramine Maleate Tablet

Chlorpropamide Tablet

Chlortabs Tablet

Chlorthalidone Tablet

Chlorzoxazone Tablet

Choicedm Clarus Control Soln Each

Cholbam Capsule � �

Cholestyramine Powder

Cholestyramine Powd Pack

Cholestyramine Light Powder

Cholestyramine Light Powd Pack

Ciclopirox Suspension

Ciclopirox Gel (Gram)

Ciclopirox Cream (G)

Ciclopirox Solution

Cilostazol Tablet

Ciloxan Oint. (G)

Cimduo Tablet

Cimetidine Solution

Cimetidine Tablet

Cipro HC Drops Susp

Ciprodex Drops Susp

Ciprofloxacin Sus Mc Rec

Ciprofloxacin ER Tbmp 24hr

Ciprofloxacin HCl Tablet

Ciprofloxacin HCl Drops

Ciprofloxacin HCl Droperette

Citracal + D Maximum Tablet

Citrate Of Magnesia Solution

Citroma Solution

Citrus Calcium + D Tablet

Clarithromycin Tablet

Clarithromycin Susp Recon

Clarithromycin ER Tab ER 24h

Claritin Tablet

Clemastine Fumarate Tablet

Clemastine Fumarate Syrup

Cleocin Supp.Vag

Clever Chek Lancets Each

Clever Choice Control Solution Each

Clickfine Dis Needle

Climara Pro Patch Tdwk

Clindamycin HCl Capsule



2018.2 (5/7/2018).



Clindamycin Palmitate HCl Soln Recon

Clindamycin Pediatric Soln Recon

Clindamycin Phosphate Solution

Clindamycin Phosphate Gel (Gram)

Clindamycin Phosphate Lotion

Clindamycin Phosphate Cream/Appl

Clindamycin Phosphate Med. Swab

Clindesse Crm ER (G)

Clobetasol Emollient Cream (G)

Clobetasol Emollient Foam

Clobetasol Propionate Oint. (G)

Clobetasol Propionate Cream (G)

Clobetasol Propionate Solution

Clobetasol Propionate Gel (Gram)

Clobetasol Propionate Shampoo

Clobetasol Propionate Lotion

Clobetasol Propionate Spray

Clobetasol Propionate Foam

Clocortolone Pivalate Cream (G)

Clonazepam Tablet

Clonazepam Tab Rapdis

Clonidine Patch Tdwk �

Clonidine HCl Tablet

Clopidogrel Tablet

Clorpres Tablet

Clotrimazole Troche

Clotrimazole Cream/Appl

Clotrimazole Solution

Clotrimazole Cream (G)

Clotrimazole 3 Cream/Appl

Clotrimazole-7 Cream/Appl

Clotrimazole-Betamethasone Cream (G)

Clotrimazole-Betamethasone Lotion

C-Nate DHA Capsule

Coaguchek (Lancets) Each

Cocaine HCl Solution

Codeine Sulfate Tablet

Colchicine Capsule

Colchicine Tablet

Colestipol HCl Tablet

Colestipol HCl Packet

Colestipol HCl Granules

Colocort Enema



2018.2 (5/7/2018).



Color Lancets Each

Col-Rite (100mg & 250mg) Capsule

Combigan Drops

Combipatch Patch Tdsw

Combivent Respimat Mist Inhal �

Comfort EZ Disp Syrin

Comfort EZ (Lancets) Each

Comfort EZ Dis Needle

Comfort Gel Oral Susp

Comfort Lancets Each

Complera Tablet �

Complete Allergy Capsule

Complete Allergy Tablet

Complete Allergy Liquid

Complete Natal DHA Combo. Pkg

Complete Senior Tablet

Completenate Tab Chew

Compoz Tablet

Compro Supp.Rect

Constulose Solution

Contour (Control Solution) Each

Contour Next Control Solution Each

Control Solution Each

Cool Control Solution Each

Cordran Med. Tape

Cormax Solution

Cortaid Cream (G)

Cortifoam Foam/Appl

Cortisone Cream (G)

Cortisone Acetate Tablet

Cortisporin Oint. (G)

Cortisporin Cream (G)

Cortizone-10 Cream (G)

Cortizone-10 Plus Cream (G)

Cough Syrup

Cough Control Dm Liquid

Cough Control Dm Syrup

Cough Syrup Dm Syrup

Creon Capsule Dr �

Cresemba Capsule �

Crinone (4%) Gel/Pf App

Crixivan Capsule

Cromolyn Sodium Ampul-Neb



2018.2 (5/7/2018).



Cryselle Tablet

Cuvitru Vial � �

Cyclafem Tablet

Cyclobenzaprine HCl (5mg & 10mg) Tablet

Cyclomydril Drops

Cyclopentolate HCl Drops

Cyclophosphamide Capsule

Cycloserine Capsule

Cyclosporine Solution

Cyclosporine Capsule

Cyclosporine Modified Capsule

Cyproheptadine HCl Tablet

Cyproheptadine HCl Syrup

Cyred Tablet

Cystadane Powder � �

Cystagon Capsule �

Cytra-2 Solution

Cytra-3 Solution

Cytra-K Solution

Daily Fiber Powder

Daily Fiber Capsule

Daily Multiple Vitamin Tablet

Daily Multivitamin With Iron Tablet

Daily Value Tablet

Daily Vitamin + Iron Tablet

Daily Vitamin Formula Tablet

Daily Vitamin Formula-Minerals Tablet

Daily Vite Tablet

Daily Vite With Iron Tablet

Daklinza Tablet � � �

Danazol Capsule

Dantrolene Sodium Capsule

Dapsone Tablet

Daraprim Tablet

Dasetta Tablet

Daysee Tbdspk 3mo �

Deblitane Tablet

Debrox Drops

Deep Sea Spray

Deltasone Tablet

Delyla Tablet

Delzicol Cap(Drtab) �

Delzicol Capsule Dr �



2018.2 (5/7/2018).



Demeclocycline HCl Tablet

Demser Capsule

Denta 5000 Plus Cream (G) �

Dentagel Gel (Gram) �

Depen Tablet

Depo-Provera Vial �

Depo-Subq Provera 104 Syringe �

Descovy Tablet

Desloratadine Tablet

Desmopressin Acetate Tablet �

Desmopressin Acetate Ampul �

Desmopressin Acetate Vial �

Desmopressin Acetate Spray/Pump �

Desmopressin Acetate Solution �

Desogestrel-Ethinyl Estradiol Tablet

Desogestr-Eth Estrad Eth Estra Tablet

Desonate Gel (Gram)

Desonide Oint. (G)

Desonide Lotion

Desonide Cream (G)

Desoximetasone Cream (G)

Desoximetasone Gel (Gram)

Desoximetasone (0.25%) Oint. (G)

Dex4 Glucose Gel (Gram)

Dexamethasone Solution

Dexamethasone Tablet

Dexamethasone Elixir

Dexamethasone Intensol Drops

Dexamethasone Sodium Phosphate Drops

Dexmethylphenidate HCl Tablet �

Dextroamphetamine Sulfate Tablet

Dextroamphetamine Sulfate Solution �

Dextroamphetamine Sulfate ER Capsule ER �

Dextroamphetamine-Amphet ER Cap ER 24h �

Dextroamphetamine-Amphetamine Tablet

Diabetic Siltussin-Dm Liquid

Diabetic Tussin Dm (100-10mg/5) Liquid

Diarrhea Relief Oral Susp

Diatrue (Control Solution) Each

Diazepam (2.5mg & 5-7.5-10mg) Kit �

Diclofenac Potassium Tablet

Diclofenac Sodium Tablet Dr

Diclofenac Sodium (0.10%) Drops



2018.2 (5/7/2018).



Diclofenac Sodium (1%) Gel (Gram) �

Diclofenac Sodium ER Tab ER 24h

Dicloxacillin Sodium Capsule

Dicyclomine HCl Capsule

Dicyclomine HCl Tablet

Dicyclomine HCl Solution

Didanosine Capsule Dr

Diflorasone Diacetate Oint. (G)

Diflorasone Diacetate Cream (G)

Diflunisal Tablet

Digestive Relief Oral Susp

Digestive Relief Tab Chew

Digitek Tablet

Digox Tablet

Digoxin Solution

Digoxin Tablet

Dilantin (30mg) Capsule

Diltiazem 12hr ER Cap ER 12h

Diltiazem 24hr Cd Cap ER 24h

Diltiazem 24hr ER Cap ER 24h

Diltiazem 24hr ER Capsule ER

Diltiazem 24hr ER Tab ER 24h

Diltiazem ER Cap ER Deg

Diltiazem HCl Tablet

Dilt-XR Cap ER Deg

Diocto Liquid

Diocto Syrup

Dioctyl Syrup

Diotame Tab Chew

Dipentum Capsule

Diphedryl Liquid

Diphedryl Capsule

Diphedryl Tablet

Diphedryl Allergy Liquid

Diphen Tablet

Diphenhist Liquid

Diphenhist Capsule

Diphenhist Tablet

Diphenhydramine HCl Capsule

Diphenhydramine HCl Tablet

Diphenhydramine HCl Elixir

Diphenhydramine HCl Syrup

Diphenhydramine HCl Liquid



2018.2 (5/7/2018).



Diphenoxylate-Atropine Liquid

Diphenoxylate-Atropine Tablet

Diphtheria-Tetanus Toxoids-Ped Vial

Dipyridamole Tablet

Disopyramide Phosphate Capsule

Disulfiram Tablet

Diuril Oral Susp

Divigel Gel Packet

Doc-Q-Lace Capsule

Doc-Q-Lax Tablet

Docu Liquid Liquid

Docusate Calcium Capsule

Docusate Sodium Liquid

Docusate Sodium Capsule

Docusate Sodium Syrup

Docusate Sodium-Senna Tablet

Docusil Capsule

Dofetilide Capsule

Dok Capsule

Dok Plus Tablet

Donepezil HCl (5 mg & 10mg) Tablet

Donepezil HCl Odt Tab Rapdis �

Dorzolamide HCl Drops

Dorzolamide-Timolol Drops

Doxazosin Mesylate Tablet

Doxycycline Monohydrate Tablet

Doxycycline Monohydrate Susp Recon

Doxycycline Monohydrate (50mg, 100mg & 150mg) Capsule

Drithocreme Hp Cream (G)

Dronabinol Capsule �

Droplet Lancets Each

Droplet Lancing Device Each

Drospirenone-Ethinyl Estradiol Tablet

Droxia Capsule

Dss Capsule

Ducodyl Tablet Dr

Dulcolax Stool Softener Capsule

Dulera HFA Aer Ad �

Durezol Drops

Dutasteride Capsule

Dyrenium Capsule

E.E.S. 200 Susp Recon

E.E.S. 400 Tablet



2018.2 (5/7/2018).



Ear Drops (Carbamide Peroxide) Drops

Ear System Drops

Ear Wax Removal Drops

Earwax Treatment Drops

Easy Click (Lancing Device) Each

Easy Comfort (Lancets) Each

Easy Comfort Insulin Syringe Disp Syrin

Easy Comfort Pen Needles Dis Needle

Easy Plus Ii (Control) Each

Easy Step (Control) Each

Easy Talk (Control) Each

Easy Touch (Lancets) Each

Easy Touch Disp Syrin

Easy Touch Control Solution Each

Easy Touch Insulin Safety Disp Syrin

Easy Touch Insulin Syringe Disp Syrin

Easy Touch Lancets Each

Easy Touch Lancing Device Each

Easy Touch Pen Needle Dis Needle

Easy Trak (Control Solution) Each

Easy Twist & Cap Lancets Each

Easygluco Plus Control Normal (Control Solution) Each

Easymax (Control Solution) Each

Easymax 15 (Control Solution) Each

Easy-Touch Insulin Syringe Disp Syrin

Eazzze The Pain Tablet

Eclipse Syringe Disp Syrin

Econazole Nitrate Cream (G)

Econtra EZ Tablet

Ecotrin (325mg) Tablet Dr

Ecpirin Tablet Dr

Eczema Anti-Itch Cream (G)

Ed Chlorped Jr Syrup

Ed-Apap Liquid

Ed-Chlortan Tablet

Ed-Spaz Tab Rapdis

Edurant Tablet

Efavirenz Capsule

Efavirenz Tablet

Effer-K (25 Meq) Tablet Eff

Element Compact Control Soln Each

Element Control Solution Each

Elestrin Gel Md Pmp



2018.2 (5/7/2018).



Elinest Tablet

Eliphos Tablet

Eliquis Tab Ds Pk

Eliquis Tablet

Elite Ob DHA Capsule

Elixophyllin Elixir

Ella Tablet

Elmiron Capsule �

Embrace (Lancets & Control) Each

Embrace Evo (Control Solution) Each

Embrace Glucose Control Soln Each

Embrace Pro (Control Solution) Each

Emcyt Capsule � �

Emend (40mg & 125mg) Capsule

Emoquette Tablet

Emtriva Capsule

Emtriva Solution

Enalapril Maleate Tablet

Enalapril-Hydrochlorothiazide Tablet

Enbrel Cartridge � �

Enbrel Vial � � �

Enbrel Syringe � � �

Enbrel Pen Injctr � � �

Endocet Tablet �

Endur-Acin Tablet ER

Enema (19g-7g/118) Enema

Enema Disposable Enema

Engerix-B Adult Vial

Engerix-B Adult Syringe

Engerix-B Pediatric-Adolescent Vial

Engerix-B Pediatric-Adolescent Syringe

Enjuvia Tablet

Enoxaparin Sodium Syringe

Enoxaparin Sodium Vial

Enpresse Tablet

Enskyce Tablet

Entacapone Tablet

Entecavir Tablet �

Entresto (49mg-51mg & 97mg-103mg) Tablet

Enulose Solution

Epclusa Tablet � � �

Epifoam Foam

Epinephrine Auto Injct �



2018.2 (5/7/2018).



Epitol Tablet

Epivir Hbv Solution �

Eplerenone Tablet �

Epogen Vial � �

Eprosartan Mesylate Tablet �

Errin Tablet

Ery Med. Swab

Eryped 400 Susp Recon

Ery-Tab Tablet Dr

Erythrocin Stearate Tablet

Erythromycin Solution

Erythromycin Gel (Gram)

Erythromycin Oint. (G)

Erythromycin Tablet

Erythromycin Capsule Dr

Erythromycin Med. Swab

Erythromycin Ethylsuccinate Tablet

Erythromycin Ethylsuccinate Susp Recon

Estarylla Tablet

Estradiol Cream/Appl

Estradiol Tablet

Estradiol Patch Tdwk

Estradiol Patch Tdsw

Estradiol-Norethindrone Acetat Tablet

Estrogel Gel Md Pmp �

Estropipate Tablet

Ethambutol HCl Tablet

Ethosuximide Solution

Ethosuximide Capsule

Ethynodiol-Ethinyl Estradiol Tablet

Etidronate Disodium Tablet

Etodolac Tablet

Etodolac Capsule

Etodolac ER Tab ER 24h

Etoposide Capsule � �

Eurax Cream (G)

Evac-U-Gen Tablet

Evamist Spray

Evencare (Lancets) Each

Evencare G2 (Control Solution) Each

Evencare G3 (Control Solution) Each

Evencare Mini Glucose Control Each

Evolution Control Solution Each



2018.2 (5/7/2018).



Evotaz Tablet

Excedrin Migraine Tablet

Exemestane Tablet �

Exjade Tab Disper � �

Exoderm Lotion

Expectorant Dm Syrup

Extra Action Cough Syrup

Extra Pain Relief Tablet

Extra Strength Non-Aspirin Tablet

Extraprin Tablet

E-Z Ject Lancets Each

EZ Nite Sleep Capsule

EZ Smart (Control Solution) Each

EZ Smart Lancets Each

E-Zject Lancets Each

Factive Tablet �

Fallback Solo Tablet

Falmina Tablet

Famciclovir Tablet �

Famotidine Oral Susp

Famotidine Tablet

Fareston Tablet � �

Farydak Capsule � � �

Fast Relief Laxative Supp.Rect

Fayosim Tbdspk 3mo

Fe C Plus Tablet

Feiba NF Vial � �

Felbamate Tablet

Felbamate Oral Susp

Felodipine ER Tab ER 24h

Femcap Each

Femynor Tablet

Fenofibrate Tablet

Fenofibrate Capsule

Fenofibric Acid Tablet

Fenoprofen Calcium Tablet

Fenoprofen Calcium (200 mg) Capsule

Fentanyl Patch Td72 � �

Feosol (325(65) mg) Tablet

Fer-Iron Drops

Ferosul Elixir

Ferosul Tablet

Ferrex 150 Capsule



2018.2 (5/7/2018).



Ferro-Time Tablet

Ferrous Sulfate Tablet

Ferrous Sulfate Solution

Ferrous Sulfate Elixir

Ferrous Sulfate Drops

Ferrousul Tablet

Fever Reducer-Pain Reliever Oral Susp

Feverall (80mg & 325mg) Supp.Rect

Fiasp Vial �

Fiber Powder

Fiber (0.52g) Capsule

Fiber (625mg) Tablet

Fiber Lax Tablet

Fiber Laxative Capsule

Fiber Laxative Powder

Fiber Laxative (625mg) Tablet

Fiber Smooth Powder

Fiber Tabs Tablet

Fiber Therapy Capsule

Fiber Therapy Powder

Fiber Therapy (625mg) Tablet

Fiber-Lax Tablet

Fiber-Tabs Tablet

Fifty50 Safety Seal Lancets Each

Finasteride (5mg) Tablet

Fine 30 Universal Lancets Each

Fingerstix (Lancets) Each

Firvanq Soln Recon

First Aid Antibiotic (3.5-400-5k) Oint. (G)

Fish Oil Capsule

Fish Oil (60 mg-90mg) Capsule Dr

Fish Oil Concentrate Capsule

Fish Oil Omega-3 (300-1000mg) Capsule

Flanax Oral Susp

Flanax Tablet

Flarex Drops Susp

Flavor Chews Antacid Tab Chew

Flavoxate HCl Tablet

Flecainide Acetate Tablet

Flovent Diskus Blst W/Dev

Flovent HFA Aer W/Adap

Fluad 2017-2018 Syringe

Flublok 2017-2018 Vial



2018.2 (5/7/2018).



Flublok Quad 2017-2018 Syringe

Flucelvax Quad 2017-2018 Syringe

Flucelvax Quad 2017-2018 Vial

Fluconazole Susp Recon

Fluconazole Tablet

Flucytosine Capsule

Fludrocortisone Acetate Tablet

Flulaval Quad 2017-2018 Syringe

Fluocinolone Acetonide Cream (G)

Fluocinolone Acetonide Solution

Fluocinolone Acetonide Oint. (G)

Fluocinonide Cream (G)

Fluocinonide Oint. (G)

Fluocinonide Solution

Fluocinonide Gel (Gram)

Fluocinonide-E Cream (G)

Fluorabon Drops �

Fluor-A-Day Drops �

Fluoride Tab Chew �

Fluoridex Daily Defense Gel (Gram) �

Fluoridex Sensitivity Relief Gel (Gram) �

Fluorometholone Drops Susp

Fluoroplex Cream (G)

Fluorouracil Cream (G)

Fluorouracil Solution

Flura-Drops Drops �

Flurandrenolide Lotion

Flurbiprofen Tablet

Flurbiprofen Sodium Drops

Flutamide Capsule

Fluticasone Propionate Cream (G)

Fluticasone Propionate Lotion

Fluticasone Propionate Oint. (G)

Fluticasone Propionate Spray Susp �

Fluvirin 2017-2018 Syringe

Fluvirin 2017-2018 Vial

Fluzone High-Dose 2017-2018 Syringe

Fluzone Intraderm Quad 2017-18 Syringe

Fluzone Quad 2017-2018 Vial

Fluzone Quad 2017-2018 Syringe

Fluzone Quad Pedi 2017-2018 Syringe

Fml Forte Drops Susp

Fml S.O.P. Oint. (G)



2018.2 (5/7/2018).



Folbecal Tbmp 24hr

Folic Acid (0.8mg & 1mg) Tablet

Folinatal Plus B Tbmp 24hr

Fondaparinux Sodium Syringe

Fora Control Solution Each

Fora Lancets Each

Fora Lancing Device Each

Foracare Gdh (Control Solution) Each

Foracare Lancets Each

Forteo Pen Injctr � �

Fortiscare (Control Solution) Each

Fosamprenavir Calcium Tablet

Fosinopril Sodium Tablet

Fosinopril-Hydrochlorothiazide Tablet

Fosrenol Tab Chew

Fosrenol Powd Pack

Freestyle Control Solution Each

Freestyle Freedom Lite Kit

Freestyle Insulinx (Meter) Each

Freestyle Insulinx Strip �

Freestyle Insulinx Test Strips Strip �

Freestyle Lancets Each

Freestyle Lite Meter Kit

Freestyle Lite Strips Strip �

Freestyle Precision Disp Syrin

Freestyle Test Strips Strip �

Freestyle Unistik 2 (Lancets) Each

Fruit C-500 Tab Chew

Fulyzaq Tablet Dr � �

Fungoid-D Cream (G)

Furosemide Solution

Furosemide Tablet

Fyavolv Tablet

Gabapentin Tablet

Gabapentin Capsule

Gabapentin Solution

Galantamine ER Cap24h Pel � �

Galantamine Hbr Tablet � �

Galantamine Hydrobromide Solution �

Gardasil Vial �

Gardasil Syringe �

Gardasil 9 Vial �

Gardasil 9 Syringe �



2018.2 (5/7/2018).



Gas Relief Tab Chew

Gas Relief Drops Susp

Gas Relief 80 Tab Chew

Gatifloxacin Drops

Gavilyte-C Soln Recon

Gavilyte-G Soln Recon

Gavilyte-N Soln Recon

Ge100 Control Solution Normal Each

Gelusil Oral Susp

Gemfibrozil Tablet

Generlac Solution

Gengraf Capsule

Gengraf Solution

Genotropin Cartridge � �

Genotropin Syringe � �

Gentak Oint. (G)

Gentamicin Sulfate Oint. (G)

Gentamicin Sulfate Cream (G)

Gentamicin Sulfate Drops

Genteal Tears (0.1%-0.3%) Drops

Gentle Laxative Supp.Rect

Gentle Laxative Tablet Dr

Genvoya Tablet

Geri-Dryl Tablet

Geri-Dryl Capsule

Geri-Hydrolac Cream (G)

Geri-Kot Tablet

Geri-Lanta Oral Susp

Geri-Mucil Powder

Geri-Pectate Oral Susp

Geri-Tussin Dm Syrup

Gianvi Tablet

Gildagia Tablet

Gildess Tablet

Gildess 24 Fe Tablet

Gildess Fe Tablet

Glatiramer Acetate Syringe � �

Glatopa Syringe � � �

Gleostine Capsule � �

Glimepiride Tablet

Glipizide Tablet

Glipizide ER Tab ER 24

Glipizide Xl Tab ER 24



2018.2 (5/7/2018).



Glipizide-Metformin Tablet

Glucagon Emergency Kit Kit

Gluco Burst Gel (Gram)

Glucocard 01 Control (Control Solution) Each

Glucocard Expression (Control Solution) Each

Glucocard Shine (Control Solution) Each

Glucocom (Lancets) Each

Glucocom Control Solution Each

Glucocom Lancets Each

Glucolet 2 (Lancing Device) Each

Glucolet 2 (Lancing Device/Lancing) Kit

Glucose Tab Chew

Glucose Control Each

Glucose Control Solution Each

Glucose Gel Gel (Gram)

Glutose 15 Gel (Gram)

Glutose 45 Gel (Gram)

Glyburide Tablet

Glyburide Micronized Tablet

Glyburide-Metformin HCl Tablet

Glycerin (Pediatric) Supp.Rect

Glycopyrrolate Tablet

Gmate (Lancets) Each

Gmate Control Solution Each

Gmate Lancing Device Each

Golytely Powd Pack

Goody's Extra Strength Tablet

Goody's Migraine Relief Tablet

Granisetron HCl Tablet � �

Griseofulvin Oral Susp �

Grx Hicort 25 Supp.Rect

G-Tron Liquid

Guaiasorb DM Liquid

Guaifenesin-Dextromethorphan Syrup

Guanfacine HCl Tablet

Guanidine HCl Tablet

Hair Vitamin Tablet

Hair, Skin & Nails Tablet

Hair, Skin And Nails (3.3 mg-25) Tablet

Halobetasol Propionate Cream (G)

Halobetasol Propionate Oint. (G)

Halog Cream (G)

Halog Oint. (G)



2018.2 (5/7/2018).



Havrix Vial

Havrix Syringe

Headache Formula Tablet

Headache Pain Tablet

Headache PM Tablet

Headache PM Formula Tablet

Headache Relief Tablet

Healthpro Glucose Control Soln Each

Healthy Accents Autolet (Lancing Device) Each

Healthy Accents Unifine Pentip Dis Needle

Healthy Accents Unilet Lancet Each

Heartburn Prevention (10mg) Tablet

Heartburn Relief (Famotidine 10mg) Tablet

Heather Tablet

Helixate Fs Vial � �

Hemlibra Vial � �

Heplisav-B Vial

Hexalen Capsule � �

Homatropaire Drops

Homatropine Hydrobromide Drops

Humalog Vial �

Humalog Cartridge � �

Humalog Kwikpen U-100 Insuln Pen � �

Humalog Kwikpen U-200 Insuln Pen �

Humalog Mix 50-50 Vial �

Humalog Mix 50-50 Kwikpen Insuln Pen � �

Humalog Mix 75-25 Vial �

Humalog Mix 75-25 Kwikpen Insuln Pen � �

Humapen Luxura Hd Insuln Pen

Humatrope Vial � �

Humatrope Cartridge � �

Humira Syringekit � � �

Humira Pediatric Crohn's Syringekit � � �

Humira Pen Pen Ij Kit � � �

Humira Pen Crohn-Uc-Hs Starter Pen Ij Kit � � �

Humira Pen Psoriasis-Uveitis Pen Ij Kit � � �

Humulin 70/30 Kwikpen Insuln Pen � �

Humulin 70-30 Vial �

Humulin N Vial �

Humulin N Kwikpen Insuln Pen �

Humulin R Vial �

Humulin R U-500 Vial �

Humulin R U-500 Kwikpen Insuln Pen � �



2018.2 (5/7/2018).



Hycamtin Capsule

Hydralazine HCl Tablet

Hydrochlorothiazide Tablet

Hydrochlorothiazide Capsule

Hydrocil Instant Powder

Hydrocodone-Acetaminophen Solution �

Hydrocodone-Acetaminophen Tablet �

Hydrocodone-Ibuprofen Tablet

Hydrocortisone Tablet

Hydrocortisone Enema

Hydrocortisone Crm/Pe App

Hydrocortisone Cream (G)

Hydrocortisone Oint. (G)

Hydrocortisone (2.50%) Lotion

Hydrocortisone Acetate Supp.Rect

Hydrocortisone Butyrate Cream (G)

Hydrocortisone Butyrate Oint. (G)

Hydrocortisone Butyrate Solution

Hydrocortisone Valerate Cream (G)

Hydrocortisone Valerate Oint. (G)

Hydrocortisone-Acetic Acid Drops

Hydrocream Cream (G)

Hydromorphone HCl Tablet

Hydromorphone HCl Liquid

Hydromorphone HCl Supp.Rect

Hydroxychloroquine Sulfate Tablet

Hydroxyurea Capsule

Hydroxyzine HCl Tablet

Hydroxyzine HCl Solution

Hydroxyzine Pamoate Capsule

Hyoscyamine Sulfate Tablet

Hyoscyamine Sulfate Tab Rapdis

Hyoscyamine Sulfate Tab Subl

Hyoscyamine Sulfate Drops

Hyoscyamine Sulfate Elixir

Hyoscyamine Sulfate ER Tab ER 12h

Hyoscyamine Sulfate SR Tab ER 12h

Hypolance (Lancing Device/Lancets) Kit

Ibandronate Sodium Tablet �

Ibrance Capsule � � �

Ibuprofen Oral Susp

Ibuprofen (200mg, 400mg, 600mg, & 800mg) Tablet

Ibuprofen Ib Tablet



2018.2 (5/7/2018).



Icaps Plus Tablet

Icar-C Plus Tablet

Idelvion Vial � �

Iferex 150 Capsule

Imatinib Mesylate Tablet � �

Imbruvica Capsule � � �

Imbruvica Tablet � � �

Imiquimod Cream Pack �

Impavido Capsule � �

Inatal Advance Tablet

Inatal Ultra Tablet

Incontrol Lancing Device Each

Incontrol Pen Needle Dis Needle

Incontrol Super Thin Lancets Each

Incontrol Ultra Thin Lancets Each

Increlex Vial � �

Incruse Ellipta Blst W/Dev �

Indapamide Tablet

Indocin Oral Susp

Indocin Supp.Rect

Indomethacin Capsule

Indomethacin ER Capsule ER

Infant Fever-Pain Reliever Oral Susp

Infant Gas Relief Drops Susp

Infant Pain Relief Oral Susp

Infant Pain-Fever Oral Susp

Infants' Acetaminophen Oral Susp

Infants' Gas Relief Drops Susp

Infants' Pain Relief Oral Susp

Infant's Pain Relief Oral Susp

Infant's Pain Relief Drops Susp

Infants' Pain Reliever Oral Susp

Infants' Pain-Fever Oral Susp

Infinity Control Solution Each

Ingrezza Capsule � � �

Inject Ease Lancets Each

Innopran XL Cap ER 24h

Insta-Glucose Gel (Gram)

Insulin Pen Needle Dis Needle

Insulin Syringe Disp Syrin

Insupen Dis Needle

Integra Syringe Disp Syrin

Intelence Tablet



2018.2 (5/7/2018).



Intron A Vial � �

Introvale Tbdspk 3mo �

Invacare Lancets Each

Invirase Tablet

Invirase Capsule

Inzo Antifungal Cream (G)

Iophen DM-NR Liquid

Iopidine Droperette

Ipol Vial

Ipol Syringe

Ipratropium Bromide Solution

Ipratropium-Albuterol Ampul-Neb

I-Prin Tablet

Irbesartan Tablet

Irbesartan-Hydrochlorothiazide Tablet

Iressa Tablet � �

Iron Drops

Iron (325(65) mg) Tablet

Iron Supplement Tablet

Isentress Tablet

Isentress Tab Chew

Isentress Powd Pack

Isentress HD Tablet

Isibloom Tablet

Isomethept-Dichloralp-Acetamin Capsule

Isoniazid Tablet

Isoniazid Solution

Isordil Tablet

Isosorbide Dinitrate Tablet

Isosorbide Dinitrate Tablet ER

Isosorbide Mononitrate Tablet

Isosorbide Mononitrate ER Tab ER 24h

Isradipine Capsule

Istalol Drop Daily

Itraconazole Capsule

Ivermectin Tablet

I-Vite (1000-60-2) Tablet

Jadenu Tablet � �

Jantoven Tablet

Janumet Tablet � �

Janumet XR Tbmp 24hr � �

Januvia Tablet � �

Jardiance Tablet � �



2018.2 (5/7/2018).



Jencycla Tablet

Jinteli Tablet

Jolessa Tbdspk 3mo �

Jolivette Tablet

Juleber Tablet

Juluca Tablet

Junel Tablet

Junel Fe Tablet

Junel Fe 24 Tablet

Jynarque Tablet Seq � � �

K Effervescent Tablet Eff

Kadian (40mg & 200mg) Cap ER Pel

Kaletra Tablet

Kaopectate (262mg/15ml) Oral Susp

Kao-Tin Oral Susp

Kao-Tin Capsule

Kariva Tablet

Kelnor 1-35 Tablet

Ketek Tablet

Ketoconazole Cream (G)

Ketoconazole Tablet

Ketoconazole Shampoo

Ketoprofen Capsule

Ketoprofen Cap24h Pel

Ketorolac Tromethamine Tablet �

Ketorolac Tromethamine Drops

Keveyis Tablet � � �

Kimidess Tablet

Kineret Syringe � � �

Kinney Brand Lancets Each

Kionex Oral Susp

Kionex Powder

Kisqali Tablet � � �

Kisqali Femara Co-Pack Tablet � � �

Kitabis Pak Ampul-Neb � � �

Klor-Con (25 Meq) Packet

Klor-Con M10 Tab ER Prt



Klor-Con Sprinkle Capsule ER

Kogenate Fs Vial � �

Kombiglyze XR Tbmp 24hr � �

Konsyl Capsule



2018.2 (5/7/2018).



Konsyl Powder

Konsyl Fiber Tablet

Kovaltry Vial � �

K-Pec Oral Susp

K-Phos No.2 Tablet

K-Phos Original Tablet Sol

Kristalose Packet

Kurvelo Tablet

Kuvan Tablet Sol � �

Kuvan Powd Pack � �

Kynamro Syringe � �

Labetalol HCl Tablet

Lactulose Solution

Lamisil Gran Pack

Lamivudine Solution

Lamivudine (100mg) Tablet �

Lamivudine (150mg & 300mg) Tablet

Lamivudine Hbv Tablet �

Lamivudine-Zidovudine Tablet

Lancet Device Each

Lancets Each

Lancets Thin Each

Lancets Ultra Thin Each

Lancing Device Each

Lancing Device Kit

Lancing System Each

Lanoxin (62.5 mcg & 187.5 mcg) Tablet

Lansoprazol-Amoxicil-Clarithro Combo. Pkg

Lanthanum Carbonate Tab Chew

Lantus Vial �

Lantus Solostar Insuln Pen � �

Larin Tablet

Larin 24 Fe Tablet

Larin Fe Tablet

Larissia Tablet

Latanoprost Drops

Lax Stool Softener With Senna Tablet

Laxacin Tablet

Laxative Tablet Dr

Laxative Suppository Supp.Rect

Leena Tablet

Leflunomide Tablet

Lenvima Capsule � �



2018.2 (5/7/2018).



Lessina Tablet

Letairis Tablet � �

Letrozole Tablet

Leucovorin Calcium Tablet

Leukeran Tablet � �

Leuprolide Acetate Vial � �

Leuprolide Acetate Kit � �

Levalbuterol Concentrate Vial-Neb � �

Levalbuterol HCl Vial-Neb � �

Levalbuterol Tartrate HFA HFA Aer Ad � �

Levatol Tablet

Levemir Vial �

Levemir Flextouch Insuln Pen � �

Levetiracetam Solution

Levetiracetam Tablet

Levetiracetam ER Tab ER 24h

Levobunolol HCl Drops

Levocarnitine Solution

Levocarnitine Tablet

Levocetirizine Dihydrochloride Solution �

Levofloxacin Tablet

Levofloxacin Drops

Levofloxacin Solution

Levonest Tablet

Levonorgestrel Tablet

Levonorgestrel-Eth Estradiol Tablet

Levonorgestrel-Eth Estradiol Tbdspk 3mo �

Levonorg-Eth Estrad Eth Estrad Tbdspk 3mo �

Levora-28 Tablet

Levorphanol Tartrate Tablet

Levothyroxine Sodium Tablet

Levulan Sol W/Appl

Lexiva Oral Susp

Liberty Lev 1 Glucose Control (Control Solution) Each

Liberty Lev 2 Glucose Control (Control Solution) Each

Lice Cream Rinse Liquid

Lice Killing Liquid

Lice Treatment Liquid

Lidocaine HCl Jelly(Ml)

Lidocaine HCl (40 mg/Ml) Solution

Lidocaine-Hydrocortisone Cream (G)

Lidocaine-Prilocaine Cream (G)

Lidocaine-Prilocaine Kit



2018.2 (5/7/2018).



Liletta Iud

Lindane Lotion

Lindane Shampoo

Linzess Capsule �

Liothyronine Sodium Tablet

Liquid Antacid Oral Susp

Liquitears Drops

Lisinopril Tablet

Lisinopril-Hydrochlorothiazide Tablet

Lite Coat Aspirin Tablet

Lite Touch (Lancing Device) Each

Lite Touch Disp Syrin

Lite Touch Dis Needle

Lithostat Tablet

Little Remedies Fever-Pain Oral Susp

Little Remedies Stuffy Nose Spray

Locoid Lotion

Lo-Dose Aspirin EC Tablet Dr

Lomedia 24 FE Tablet

Long Acting Nasal Decongestant Tablet ER

Lonsurf Tablet � � �

Loperamide Capsule

Loperamide (1 mg/5 Ml) Liquid

Lopinavir-Ritonavir Solution

Lopreeza Tablet

Loradamed Tablet

Loratadine Tablet

Loratadine Solution

Loratadine Tab Rapdis

Loratadine Allergy Solution

Loratadine Hives Relief Solution

Lorcet Tablet �

Lorcet HD Tablet �

Lorcet Plus Tablet �

Loryna Tablet

Losartan Potassium Tablet

Losartan-Hydrochlorothiazide Tablet

Lotemax Drops Susp

Lotemax Drops Gel

Lovastatin Tablet

Low Dose Aspirin EC Tablet Dr

Low-Ogestrel Tablet

Lubricant Eye (1.40%) Drops



2018.2 (5/7/2018).



Lucentis Vial � �

Ludent Fluoride (0.5(1.1)mg) Tab Chew �

Luer-Lok Syringe Disp Syrin

Lumigan Drops

Lupron Depot Syringekit � �

Lupron Depot (Lupaneta) Syringekit � �

Lupron Depot-Ped Kit � �

Lutera Tablet

Lyrica Capsule � �

Lyrica Solution � �

Lysodren Tablet

Lyza Tablet

Maalox Advanced Oral Susp

Macugen Syringe � �

Mag Delay Tablet Dr

Mag64 Tablet Dr

Mag-Al Plus Oral Susp

Mag-Al Plus Xs Oral Susp

Magellan Insulin Safety Syrng Disp Syrin

Magellan Insulin Syringe Disp Syrin

Magic Bullet Supp.Rect

Maglox Oral Susp

Magnesium (400mg) Tablet

Magnesium Citrate Solution

Magnesium Oxide (400 mg) Tablet

Makena Auto Injt � �

Malathion Lotion

Mapap Tablet

Mapap Tab Chew

Mapap Oral Susp

Mapap (160 mg/5ml) Liquid

Mapap Arthritis Pain Tablet ER

Mapap PM Tablet

Margesic Capsule

Marlissa Tablet

Marten-Tab Tablet

Masanti Oral Susp

Masophen Tablet

Matulane Capsule � �

Matzim La Tab ER 24h

Mavyret Tablet � �

Maxepa Capsule

Maxi-Comfort Disp Syrin



2018.2 (5/7/2018).



Maxidex Drops Susp

Maxinate Tablet

Meclizine HCl Tablet

Meclofenamate Sodium Capsule

Medi-Laxx Tablet

Mediproxen Tablet

Medisense (Control Solution) Combo. Pkg

Medisense (Control Solution) Each

Medisense Control (Control Solution) Combo. Pkg

Medisense Glucose Ketone (Control Solution) Combo. Pkg

Medisense Glucose Ketone Contr (Control Solution) Each

Medisense Thin Lancets Each

Medlance Plus (Lancets) Each

Medlance Plus Special Blade Each

Medrol (2mg) Tablet

Medroxyprogesterone Acetate Tablet

Medroxyprogesterone Acetate Vial �

Medroxyprogesterone Acetate Syringe �

Mefenamic Acid Capsule �

Mefloquine HCl Tablet

Mega Multi W-Chelated Minerals Tablet

Mega Multivitamin With Mineral Tablet

Megestrol Acetate Tablet

Megestrol Acetate (400mg/10ml) Oral Susp

Melatin Tablet

Melatonin (3mg) Tab Rapdis

Melatonin (3mg, 3mg-500mcg, & 3 mg-10 mg) Tablet

Meloxicam Oral Susp

Meloxicam Tablet

Melphalan Tablet � �

Memantine HCl Solution �

Menactra Vial

Menest Tablet

Menomune-A-C-Y-W-135 Vial

Menostar Patch Tdwk

Men's Multi-Vitamin Tablet

Men's One Daily Tablet

Menveo A-C-Y-W-135-Dip Kit

Meperidine HCl Solution

Meperidine HCl Tablet

Mephyton Tablet

Mercaptopurine Tablet

Mesalamine Enema



2018.2 (5/7/2018).



Mesalamine Tablet Dr �

Mesnex Tablet � �

Metadate ER Tablet ER �

Metamucil (3.4g/5.8g) Powder

Metaproterenol Sulfate Syrup

Meter-Check (Control Solution) Each

Metformin HCl Tablet

Metformin HCl ER Tab ER 24h

Metformin HCl ER (500mg) Tab ER 24

Methadone HCl Oral Conc

Methadone HCl Solution

Methadone HCl Tablet

Methadone HCl Tablet Sol

Methadone Intensol Oral Conc

Methadose Tablet Sol

Methazolamide Tablet

Methimazole Tablet

Methitest Tablet �

Methocarbamol Tablet

Methotrexate Tablet

Methoxsalen Cap Lq Rap �

Methoxsalen (NDC 68682-0065-10) Cap Lq Rap

Methscopolamine Bromide Tablet

Methyclothiazide Tablet

Methyldopa Tablet

Methyldopa-Hydrochlorothiazide Tablet

Methylphenidate ER Cpbp 50-50 �

Methylphenidate ER Tab ER 24 �

Methylphenidate ER Tablet ER �

Methylphenidate HCl Tablet

Methylphenidate HCl Solution �

Methylphenidate HCl Tab Chew

Methylphenidate HCl CD (10mg, 20mg, 30mg & 40mg) Cpbp 30-70 �

Methylphenidate HCl CD (50mg & 60mg) Cpbp 30-70

Methylphenidate HCl ER (10mg, 20mg, 30mg & 40mg) Cpbp 30-70 �

Methylphenidate HCl ER (50mg & 60mg) Cpbp 30-70

Methylphenidate LA (10mg, 20mg, 30mg, & 40mg) Cpbp 50-50 �

Methylprednisolone Tablet

Methylprednisolone Tab Ds Pk

Methyltestosterone Capsule �

Metipranolol Drops

Metoclopramide HCl Tablet

Metoclopramide HCl Solution



2018.2 (5/7/2018).



Metolazone Tablet

Metoprolol Succinate Tab ER 24h

Metoprolol Tartrate Tablet

Metoprolol-Hydrochlorothiazide Tablet

Metronidazole Tablet

Metronidazole Gel W/Appl

Metronidazole Capsule

Mexiletine HCl Capsule

Mgo Tablet

Mi Acid Oral Susp

Mi-Acid Oral Susp

Mi-Acid Tab Chew

Mibelas 24 FE Tab Chew

Micatin Cream (G)

Miconazole 3 Supp.Vag

Miconazole 3 Cmb Pf Crm

Miconazole 3 Kit

Miconazole 7 Cream/Appl

Miconazole 7 Supp.Vag

Miconazole Nitrate Cream (G)

Miconazole Nitrate Cream/Appl

Miconazole Nitrate Supp.Vag

Micro Thin Lancets Each

Microdot (Control Solution) Each

Microgestin Tablet

Microgestin 24 Fe Tablet

Microgestin Fe Tablet

Microlet (Lancets) Each

Microlet 2 (Lancing Device/Lancets) Kit

Microtainer Lancets Each

Migergot Supp.Rect

Miglitol Tablet � �

Migragesic Ida Capsule

Migraine Formula Tablet

Migraine Pain-Reliever Tablet

Migraine Relief Tablet

Milk Of Magnesia (400 mg/5ml) Oral Susp

Millipred Tablet

Millipred Dp Tab Ds Pk

Mimvey Tablet

Mimvey Lo Tablet

Mini Lancing Device Each

Mini Ultra-Thin II Dis Needle



2018.2 (5/7/2018).



Minitran Patch Td24

Minocycline HCl Capsule

Minocycline HCl Tablet

Minocycline HCl ER Tab ER 24h

Minoxidil Tablet

Mintox Oral Susp

Mintox Maximum Strength Oral Susp

Mircera Syringe � �

Mirena Iud

Misoprostol Tablet

M-M-R Ii Vaccine Vial

Moexipril HCl Tablet

Moexipril-Hydrochlorothiazide Tablet

Mometasone Furoate Oint. (G)

Mometasone Furoate Cream (G)

Mometasone Furoate Solution

Monistat 7 Cream/Appl

Monoject Disp Syrin

Monoject Insulin Safety Syrng Disp Syrin

Monoject Insulin Syringe Disp Syrin

Monolet Lancets Each

Monolet Thin Lancets Each

Mono-Linyah Tablet

Mononessa Tablet

Montelukast Sodium Tablet �

Montelukast Sodium Tab Chew �

Montelukast Sodium Gran Pack �

Morphine Sulfate Tablet

Morphine Sulfate Solution

Morphine Sulfate Supp.Rect

Morphine Sulfate ER Cpmp 24hr �

Morphine Sulfate ER Tablet ER

Morphine Sulfate ER (10mg) Cap ER Pel

Moviprep Powd Pack

Moxifloxacin Drops

Moxifloxacin HCl Tablet

Multi-Day Plus Iron Tablet

Multiple Vitamin Tablet

Multiple Vitamins Tablet

Multivitamin And Fluoride Drops �

Multi-Vitamin Daily Tablet

Multi-Vitamin W-Fluoride Drops �

Multi-Vitamin W-Fluoride-Iron Drops �



2018.2 (5/7/2018).



Multivitamin With Fluoride Tab Chew �

Multivitamin With Fluoride Drops �

Multi-Vitamin With Fluoride Tab Chew �

Multi-Vitamin-Fluor-Iron Drops �

Multivitamin-Iron-Fluoride Drops �

Multivitamins Tablet

Multivitamins W-Fluoride-Iron Drops �

Multivitamins With Fluoride Drops �

Multivitamins With Fluoride Tab Chew �

Multivitamins With Iron Tablet

Multivitamins With Minerals Tablet

Multivitamins-A,B,D,E,K,Zn Drops

Multivitamins-A,B,D,E,K,Zn Tab Chew

Multivitamins-A,B,D,E,K,Zn Capsule

Mupirocin Oint. (G)

Mupirocin Cream (G)

Murine Ear Drops Drops

Murine Ear Wax Removal System Drops

Muro-128 Oint. (G)

Muro-128 (5%) Drops

Mvc-Fluoride Tab Chew �

M-Vit Tablet

Mvw Complete Formultn Multivit Capsule

My Way Tablet

Mycophenolate Mofetil Capsule

Mycophenolate Mofetil Tablet

Mycophenolate Mofetil Susp Recon

Mycophenolic Acid Tablet Dr

Myferon 150 Capsule

Myglucohealth Control Solution Each

Myglucohealth Lancets Each

Mykidz Iron Fl Oral Susp

Myleran Tablet � �

Mynatal Capsule

Mynatal Tablet

Mynatal Advance Tablet

Mynatal Plus Tablet

Mynatal-Z Tablet

Mynate 90 Plus Tablet ER

Mytab Gas Tab Chew

Mytab Gas Maximum Strength Tab Chew

Mytesi Tablet Dr � �

Myzilra Tablet



2018.2 (5/7/2018).



Nabumetone Tablet

Nadolol Tablet

Nadolol-Bendroflumethiazide Tablet

Naloxone HCl Vial

Naloxone HCl Syringe

Naltrexone Tablet

Naphazoline HCl Drops

Naprelan (750mg) Tbmp 24hr

Naproxen Tablet

Naproxen Tablet Dr

Naproxen Oral Susp

Naproxen Sodium Tablet

Naproxen Sodium Ds Tablet

Naratriptan Tablet �

Naratriptan HCl Tablet �

Narcan Spray

Nasal & Sinus Decongestant Tablet

Nasal Decon (Pseudoephedrine) Liquid

Nasal Decongestant Tablet ER

Nasal Decongestant (30mg) Tablet

Nasal Moisturizing Spray

Nasal Spray (Sodium Chloride 0.65%) Spray

Natacyn Drops Susp

Nateglinide Tablet

Natpara Cartridge � � �

Natural Balance Tears (0.1%-0.3%) Drops

Natural Daily Fiber Powder

Natural Fiber Capsule

Natural Fiber Powder

Natural Fiber Laxative (3.4 G/12 G) Powder

Natural Fiber Powder Powder

Natural Laxative (8.6mg) Tablet

Natural Psyllium Fiber Powder

Natural Senna Laxative Tablet

Natural Vegetable Laxative (8.6mg) Tablet

Natural Vegetable Powder Powder

Nature's Tears Drops

Nebupent Vial-Neb � �

Necon Tablet

Needles Dis Needle

Neomycin Sulfate Tablet

Neomycin-Bacitracin-Poly-HC Oint. (G)

Neomycin-Bacitracin-Polymyxin Oint. (G)



2018.2 (5/7/2018).



Neomycin-Polymyxin-Dexameth Drops Susp

Neomycin-Polymyxin-Dexameth Oint. (G)

Neomycin-Polymyxin-Gramicidin Drops

Neomycin-Polymyxin-HC Drops Susp

Neomycin-Polymyxin-Hydrocort Solution

Neo-Polycin Oint. (G)

Neo-Polycin HC Oint. (G)

Neosporin Oint. (G)

Neosporin Cream (G)

Neo-Tuss Liquid

Neulasta Syringe � � �

Neulasta Syr W/ Inj � � �

Neumega Vial � � �

Neupro (2 mg/24 Hr, 4 mg/24 Hr, & 6 mg/24 Hr) Patch Td24

Nevanac Drops Susp

Nevirapine Oral Susp

Nevirapine Tablet

Nevirapine ER Tab ER 24h �

Nexavar Tablet � �

Nexplanon Implant �

Next Choice One Dose Tablet

Niacin (250mg, 500mg & 750mg) Tablet ER

Niacor Tablet

Nicardipine HCl Capsule

Nicoderm Cq (21 mg/24hr) Patch Td24

Nicorelief Gum

Nicotine Gum Gum

Nicotine Lozenge Lozenge

Nicotine Patch Patch Td24

Nicotrol Cartridge � �

Nicotrol Ns Spray � �

Nifedical Xl Tab ER 24

Nifedipine Capsule

Nifedipine ER Tab ER 24

Nifedipine ER Tablet ER

Night Time Pain Medicine Tablet

Nighttime Allergy Relief Tablet

Nighttime Sleep Aid Tablet

Nighttime Sleep Aid Capsule

Nighttime Sleep Gel Capsule

Nikki Tablet

Nilutamide Tablet � �

Nimodipine Capsule



2018.2 (5/7/2018).



Nisoldipine Tab ER 24h

Nitro-Bid Oint. (G)

Nitrofurantoin Capsule

Nitrofurantoin Oral Susp

Nitrofurantoin Mono-Macro Capsule

Nitroglycerin Capsule ER

Nitroglycerin Tab Subl

Nitroglycerin Patch Patch Td24

Nizatidine Capsule

Nizatidine Solution

Noble Formula HC Cream (G)

Non-Aspirin Tab Chew

Non-Aspirin Tablet

Non-Aspirin Elixir

Non-Aspirin Oral Susp

Non-Aspirin 8 Hour Tablet ER

Non-Aspirin Extra Strength Tablet

Non-Aspirin Pain Relief Tablet

Non-Aspirin PM Tablet

Non-Aspirin PM Ex-Strength Tablet

Non-Aspirin Sleep Aid Tablet

Non-Drowsy Allergy Tablet

Nora-Be Tablet

Norditropin Flexpro Pen Injctr � �

Norethindrone Tablet

Norethindrone Ac (Lupaneta) Tablet

Norethindrone Acetate Tablet

Norethindron-Ethinyl Estradiol Tablet

Norethin-Eth Estra-Ferrous Fum Tablet

Norethin-Eth Estra-Ferrous Fum (1mg-20(24)) Tab Chew

Norgestimate-Ethinyl Estradiol Tablet

Norinyl 1-35 Tablet

Norlyda Tablet

Norlyroc Tablet

Norpace CR (100mg) Capsule ER

Nortemp Oral Susp

Nortrel Tablet

Norvir Solution

Norvir Capsule

Nova Max Glucose Control Soln Each

Nova Safety Lancets Each

Nova Sureflex Each

Novamax Plus Glu-Ket Each



2018.2 (5/7/2018).



Novofine Dis Needle

Novofine 32 Dis Needle

Novofine Autocover Dis Needle

Novolin 70-30 Vial �

Novolin N Vial �

Novolin R Vial �

Novolog Cartridge � �

Novolog Vial �

Novolog Flexpen Insuln Pen � �

Novolog Mix 70-30 Vial �

Novolog Mix 70-30 Flexpen Insuln Pen � �

Novopen Echo Insuln Pen

Novotwist Dis Needle

Noxafil Oral Susp �

Noxafil Tablet Dr �

Nts Patch Td24

Nu-Iron 150 Capsule

Nu-Mag Tablet Dr

Nuplazid Tablet � �

Nutropin Aq Cartridge � �

Nutropin Aq Nuspin Pen Injctr � �

Nuvaring Vag Ring �

Nuwiq Vial � �

Nyamyc Powder

Nyata Powder

Nystatin Tablet

Nystatin Oral Susp

Nystatin Oint. (G)

Nystatin Cream (G)

Nystatin Powder(Ea)

Nystatin Powder

Nystatin-Triamcinolone Cream (G)

Nystatin-Triamcinolone Oint. (G)

Nystop Powder

Nytol Quickcaps Tablet

Nyt-Time Sleep Tablet

Obstetrix DHA Cmbpkgdrcp

Obstetrix EC Tablet Dr

O-Cal Fa Tablet

O-Cal Prenatal Tablet

Ocaliva Tablet � �

Ocean Spray

Ocella Tablet



2018.2 (5/7/2018).



Octreotide Acetate Vial � �

Octreotide Acetate Ampul � �

Octreotide Acetate Syringe � �

Odefsey Tablet

Ofloxacin Drops

Ofloxacin Tablet

Ogestrel Tablet

Omega 3 Capsule

Omega-3 Fish Oil (300-1000mg) Capsule

Omeprazole Tablet Dr �

Omeprazole (10mg) Capsule Dr �

Omeprazole (20mg & 40mg) Capsule Dr

Omeprazole Magnesium Capsule Dr

Omeprazole-Sodium Bicarbonate Packet �

Omeprazole-Sodium Bicarbonate Capsule �

Omnitrope Cartridge � �

Omnitrope Vial � �

On Call Express Control Soln Each

On Call Lancet Each

On Call Lancing Device Each

On Call Plus Control (Control Solution) Each

On Call Plus Lancet Each

On Call Plus Lancing Device Each

On Call Vivid Control (Control Solution) Each

Onccor Tablet

Once Daily Tablet

Oncovite Tablet

Ondansetron HCl Solution �

Ondansetron HCl Tablet �

Ondansetron ODT Tab Rapdis �

One Daily Tablet

One Daily Complete Tablet

One Daily Energy Tablet

One Daily Essential Tablet

One Daily Multivitamin Tablet

One Daily Plus Iron Tablet

One Daily Plus Minerals Tablet

One Daily With Iron Tablet

One Touch Delica (Lancets) Each

One-A-Day Essential Tablet

One-A-Day Maximum Formula Tablet

One-A-Day Men's Tablet

One-A-Day Teen Advantage Tablet



2018.2 (5/7/2018).



One-Piece Sharps Collectors Each

Onetouch Delica (Lancets) Each

Onetouch Delica (Lancing Device/Lancets) Kit

Onetouch Finepoint Lancets Each

Onetouch Lancets Each

Onetouch Suresoft (Lancing Device/Lancets) Kit

Onetouch Suresoft (Lancets) Each

Onetouch Ultra Control Soln Each

Onetouch Verio (Control Solution) Each

On-The-Go (Lancets) Each

Opcicon One-Step Tablet

Opium Tincture Tincture

Opsumit Tablet � �

Option 2 Tablet

Opti-Vitamin Tablet

Optumrx (Control Solutions) Each

Opurity Multivitamin Tab Chew

Oracit Solution

Oralone Paste (G)

Oralyte Solution

Orencia Syringe � � �

Orencia Clickject Auto Injct � � �

Orkambi Tablet � �

Ormir Capsule

Orphenadrine Citrate Tablet ER

Orsythia Tablet

Oscimin Tablet

Oscimin Tab Rapdis

Oscimin Sl Tab Subl

Oscimin Sr Tab ER 12h

Oseltamivir Phosphate Capsule �

Oseltamivir Phosphate Susp Recon �

Osmoprep Tablet

Oticin Drops

Otovel Vial

Oxandrolone Tablet �

Oxaprozin Tablet

Oxcarbazepine Tablet

Oxcarbazepine Oral Susp

Oxtellar XR Tab ER 24h

Oxybutynin Chloride Syrup �

Oxybutynin Chloride Tablet �

Oxybutynin Chloride ER (15mg) Tab ER 24



2018.2 (5/7/2018).



Oxybutynin Chloride ER (5mg & 10mg) Tab ER 24 �

Oxycodone HCl Solution �

Oxycodone HCl Oral Conc

Oxycodone HCl Tablet �

Oxycodone HCl Capsule �

Oxycodone HCl Syringe �

Oxycodone HCl ER Tab ER 12h � �

Oxycodone HCl-Aspirin Tablet

Oxycodone HCl-Ibuprofen Tablet

Oxycodone-Acetaminophen Tablet �

Oxycodone-Acetaminophen Solution �

Oxycontin (15mg, 30mg & 60mg) Tab ER 12h � �

Oxymorphone HCl Tablet

Oxymorphone HCl ER Tab ER 12h � �

Oxytrol Patch Tdsw �

Pacerone Tablet

Pain & Fever Tablet

Pain & Sleep Tablet

Pain Ease Spray

Pain Relief Tablet ER

Pain Relief Liquid

Pain Relief (325mg & 500mg) Tablet

Pain Relief Extra Strength Tablet

Pain Relief PM Tablet

Pain Reliever (325mg, 500mg & 250-250-65) Tablet

Pain Reliever Plus Tablet

Pain Reliever PM Tablet

Pain-Off Tablet

Pamprin Max Tablet

Pancrelipase 5,000 Capsule Dr

Pandel Cream (G)

Panretin Gel (Gram)

Pantoprazole Sodium Tablet Dr �

Paragard T 380-A Iud � �

Paregoric Liquid

Paremyd Drops

Paricalcitol Capsule �

Paroex Mouthwash

Paromomycin Sulfate Capsule

Paser Granpkt Dr

Pce Tab Part

P-Col Rite Tablet

Pediacare Fever Reducer Oral Susp



2018.2 (5/7/2018).



Pedia-Lax Supp.Rect

Pediatric Electrolyte Solution

Pediatric Enema Enema

Pediatric Freezer Pops Solution

Peg 3350-Electrolyte Soln Recon

Peg-3350 And Electrolytes Soln Recon

Peganone Tablet

Pegasys Vial � �

Pegasys Syringe � � �

Pegintron Kit � �

Pegintron Redipen Pen Ij Kit � � �

Pen Needle Dis Needle

Pen Needles Dis Needle

Penicillin V Potassium Tablet

Penicillin V Potassium Soln Recon

Penlet Plus Blood Sampler (Lancing Device/Lancets) Kit

Pentacel Dtap-Ipv Component Vial

Pentasa Capsule ER

Pentazocine-Naloxone HCl Tablet

Pentoxifylline Tablet ER

Peptic Relief Tab Chew

Peptic Relief Oral Susp

Pep-T-Med Tab Chew

Peri-Colace Tablet

Periogard Mouthwash

Permethrin Cream (G)

Permethrin Liquid

Pharbechlor Tablet

Pharbedryl Capsule

Pharbetol Tablet

Pharmacist Favorite Multi-Vite Tablet

Phenadoz Supp.Rect

Phenazopyridine HCl Tablet

Phenobarbital Tablet

Phenylephrine HCl Drops

Phenytoin Tab Chew

Phenytoin Oral Susp

Phenytoin Sodium Extended Capsule

Philith Tablet

Phillips' Laxative Capsule

Phospha 250 Neutral Tablet

Phosphate Enema Enema

Phospholine Iodide Drops



2018.2 (5/7/2018).



Pilocarpine HCl Tablet

Pilocarpine HCl Drops

Pimtrea Tablet

Pindolol Tablet

Pink Bismuth Tab Chew

Pink Bismuth (262mg/15ml) Oral Susp

Pinnacaine Drops

Pioglitazone HCl Tablet �

Pioglitazone-Glimepiride Tablet � �

Pioglitazone-Metformin Tablet � �

Pirmella Tablet

Piroxicam Capsule

Pneumovax 23 Syringe

Pneumovax 23 Vial

Pnv-Vp-U Capsule

Polycin Oint. (G)

Polyethylene Glycol 3350 Powder

Polyethylene Glycol 3350 Powd Pack

Poly-Iron Capsule

Polymyxin B Sul-Trimethoprim Drops

Polyvinyl Alcohol Drops

Poly-Vita Drops

Poly-Vita With Iron Drops

Poly-Vitamin Drops

Polyvitamin With Iron Drops

Pomalyst Capsule � � �

Portia Tablet

Potass Cit-Sod Cit-Citric Acid Solution

Potassium Bicarbonate Tablet Eff

Potassium Chloride Liquid

Potassium Chloride Tablet ER

Potassium Chloride Capsule ER

Potassium Chloride Packet

Potassium Chloride Tablet Eff

Potassium Chloride Tab ER Prt

Potassium Citrate ER Tablet ER

Potassium Citrate-Citric Acid Solution

Pr Natal 400 Combo. Pkg

Pr Natal 400 EC Cmbpkgdrcp

Pr Natal 430 Combo. Pkg

Pr Natal 430 EC Cmbpkgdrcp

Pradaxa Capsule

Praluent Pen Pen Injctr � �



2018.2 (5/7/2018).



Praluent Syringe Syringe � �

Pramipexole Dihydrochloride Tablet

Pramosone Lotion

Pramosone (1 %-1 %) Oint. (G)

Pravastatin Sodium Tablet

Praziquantel Tablet

Prazosin HCl Capsule

Precision (Control Solution) Combo. Pkg

Precision Glucose Control (Control Solution) Combo. Pkg

Precision Xtra Strip �

Precision Xtra (Meter) Each

Pred Mild Drops Susp

Pred-G Oint. (G)

Pred-G Drops Susp

Prednicarbate Oint. (G)

Prednicarbate Cream (G)

Prednisolone Solution

Prednisolone Acetate Drops Susp

Prednisolone Sodium Phos Odt Tab Rapdis

Prednisolone Sodium Phosphate Drops

Prednisolone Sodium Phosphate (5 mg/5 Ml, 15 mg/5 Ml,

& 25 mg/5 Ml) Solution

Prednisone Tablet

Prednisone Solution

Prednisone Tab Ds Pk

Prednisone Intensol Oral Conc

Prefest Tablet

Premarin Tablet

Premphase Tablet

Prempro Tablet

Prenatabs Rx Tablet

Prenatal DHA Capsule

Prenatal Plus Tablet

Prenatal Vitamin Plus Low Iron Tablet

Prenatal-U Capsule

Preparation H Cream (G)

Preplus Tablet

Preservision Areds Capsule

Pressure Activated Lancets Each

Prevalite Powder

Prevalite Powd Pack

Prevident Paste (Ml) �

Prevident 5000 Gel (Ml) �



2018.2 (5/7/2018).



Prevident 5000 Enamel Protect Paste (Ml) �

Prevident 5000 Sensitive Paste (Ml) �

Previfem Tablet

Prevnar 13 Syringe �

Prezcobix Tablet

Prezista Oral Susp

Prezista (75mg, 150mg, 400mg & 600mg) Tablet

Prezista (800mg) Tablet �

Prialt Vial � �

Priftin Tablet

Prilosec Suspdr Pkt �

Prilosec Otc Tablet Dr �

Primaquine Tablet

Primidone Tablet

Pro Comfort Lancet Each

Pro Comfort Lancets Each

Probenecid Tablet

Probenecid-Colchicine Tablet

Prochlorperazine Supp.Rect

Prochlorperazine Maleate Tablet

Procrit Vial � �

Proctofoam-HC Foam

Procto-Med HC Crm/Pe App

Procto-Pak Crm/Pe App

Proctosol-HC Crm/Pe App

Proctozone-HC Crm/Pe App

Prodigy Control Solution Each

Prodigy Insulin Syringe Disp Syrin

Prodigy Lancets Each

Prodigy Lancing Device Each

Prodigy Twist Top Lancet Each

Progesterone Capsule

Proglycem Oral Susp

Prolastin C Vial � �

Promethazine HCl Tablet

Promethazine HCl Syrup

Promethazine HCl Supp.Rect

Promethegan Supp.Rect

Propafenone HCl Tablet

Propafenone HCl ER Cap ER 12h

Propantheline Bromide Tablet

Propranolol HCl Solution

Propranolol HCl Tablet



2018.2 (5/7/2018).



Propranolol HCl ER Cap Sa 24h

Propranolol-Hydrochlorothiazid Tablet

Propylthiouracil Tablet

Proquad Vial

Prosight Tablet

Provil Tablet

Pseudoephedrine ER Tablet ER

Pseudoephedrine HCl Tablet

Pseudoephedrine HCl Liquid

Psyllium Fiber Capsule

Pulmicort Flexhaler Aer Pow Ba �

Pulmozyme Solution � �

Pure & Gentle Saline Enema Enema

Purixan Oral Susp

Push Button Safety Lancets Each

Pyrazinamide Tablet

Pyridostigmine Bromide Tablet

Pyridostigmine Bromide ER Tablet ER

Pyridoxine HCl (25mg, 50mg & 100mg) Tablet

Q-Dryl Capsule

Q-Dryl Liquid

Q-Pap Tablet

Q-Pap Drops

Q-Pap Liquid

Q-Pap Extra Strength Tablet

Q-Tussin Dm Syrup

Quadracel Dtap-Ipv Vial

Quasense Tbdspk 3mo �

Quenalin Syrup

Quillichew ER Tab Cbp24h � �

Quillivant XR Su ER Rc24 � � �

Quinapril HCl Tablet

Quinapril-Hydrochlorothiazide Tablet

Quinidine Gluconate Tablet ER

Quinidine Sulfate Tablet ER

Quinidine Sulfate Tablet

Quinine Sulfate Capsule

Quit 2 Gum

Quit 2 Lozenge

Quit 4 Gum

Quit 4 Lozenge

Qvar Aer W/Adap �

Qvar Redihaler Hfa Aeroba �



2018.2 (5/7/2018).



Raloxifene HCl Tablet

Ramipril Capsule

Ranitidine HCl Syrup

Ranitidine HCl Capsule

Ranitidine HCl Tablet

Rapamune Solution

Rasagiline Mesylate Tablet

React Tablet

Readylance Safety Lancets Each

Rebif Syringe � � �

Rebif Rebidose Pen Injctr � �

Reclipsen Tablet

Recombinate Vial � �

Recombivax Hb Syringe

Recombivax Hb Vial

Recort Plus Cream (G)

Refresh Classic Droperette

Refresh Lacri-Lube Oint. (G)

Refresh Liquigel Drp Lq Gel

Refuah Plus Glucose Control (Control Solution) Each

Reguloid Powder

Reguloid (0.52g) Capsule

Relenza Blst W/Dev �

Reliamed (Lancets) Each

Reliamed Mini Lancing Device Each

Reliamed Safety Seal Lancets Each

Relion Pen Needles Dis Needle

Relion Thin (Lancets) Each

Relnate DHA Capsule

Remedy Antifungal Cream(Ml)

Remodulin Vial � �

Renagel Tablet

Repaglinide Tablet �

Repaglinide-Metformin HCl Tablet �

Repatha Pushtronex Wear Injct � �

Repatha Sureclick Pen Injctr � �

Repatha Syringe Syringe � �

Reprexain (5mg-200mg & 10mg-200mg) Tablet

Rescriptor Tab Disper

Rescriptor Tablet

Reserpine Tablet

Rest Simply Tablet

Restfully Sleep Tablet



2018.2 (5/7/2018).



Revlimid Capsule � �

Reyataz Capsule

Reyataz Powd Pack

Ribasphere Capsule � �

Ribasphere Tablet � �

Ribavirin Tablet � �

Ribavirin Capsule � �

Ribavirin Vial-Neb � �

Ridaura Capsule

Rifabutin Capsule

Rifampin Capsule

Rifater Tablet

Ri-Gel Oral Susp

Ri-Gel Ii Oral Susp

Rightest Control Solution Each

Rightest Gc250s Control Soln Each

Rightest Gd500 (Lancing Device) Each

Rightest Gl300 Lancets Each

Riluzole Tablet � � �

Rimantadine HCl Tablet

Ritalin LA (10mg) Cpbp 50-50 �

Ritonavir Tablet

Ri-Tussin Dm Syrup

Rivastigmine Capsule

Rivastigmine Patch Td24 �

Rizatriptan Tablet �

Rizatriptan Tab Rapdis �

Robafen Dm Cough Liquid

Robafen Dm Cough-Chest Congest Syrup

Robafen-Dm Syrup

Ropinirole ER (2mg, 4mg, 8mg & 12mg) Tab ER 24h

Ropinirole HCl Tablet

Rubraca Tablet � � �

Rydapt Capsule � �

Safesnap Insulin Syringe Disp Syrin

Safetussin Dm Liquid

Safety Lancets Each

Safety Seal Lancets Each

Safetyglide Insulin Syringe Disp Syrin

Safetyglide Syringe Disp Syrin

Safety-Let (Lancets) Each

Saizen Vial � �

Saizen Cartridge � �



2018.2 (5/7/2018).



Saizen-Saizenprep Cartridge � �

Saline Enema Enema

Saline Mist Spray

Saline Nasal Spray Spray

Saline Nose Spray Spray

Salmon Oil-1000 Capsule

Salsalate Tablet

Sani-Supp (Pediatric) Supp.Rect

Savaysa Tablet

Scopolamine Patch Td 3

Sea Soft Spray

Sea-Omega Capsule

Sea-Omega 30 Capsule

Secura Antifungal Cream (G)

Seebri Neohaler Cap W/Dev

Select-Ob Tab Chew

Selegiline HCl Tablet

Selegiline HCl Capsule

Selzentry Tablet

Selzentry Solution

Se-Natal 19 Tablet

Se-Natal 19 Tab Chew

Senexon Tablet

Senexon-S Tablet

Senna Tablet

Senna Lax Tablet

Senna Laxative (8.6mg & 8.6mg-50mg) Tablet

Senna Plus Tablet

Senna S Tablet

Sennalax-S Tablet

Senna-S Tablet

Senna-Time S Tablet

Senno Tablet

Sennosides-Docusate Sodium Tablet

Senokot-S Tablet

Sen-O-Tab Tablet

Sentry (18mg-0.4mg) Tablet

Serevent Diskus Blst W/Dev �

Serostim Vial � �

Setlakin Tbdspk 3mo �

Sf Gel (Gram) �

Sf 5000 Plus Cream (G) �

Shake That Ache Tablet



2018.2 (5/7/2018).



Sharobel Tablet

Sharps Collector Each

Sharps Container Each

Shingrix Kit � �

Shingrix Ge Antigen Component Vial � �

Shingrix Adjuvant Component Vial � �

Shohl's Modified Solution

Silace Syrup

Silace Liquid

Siladryl Liquid

Silapap Drops

Silphen Syrup

Siltussin Dm Syrup

Siltussin Dm Das Cough Formula Liquid

Silver Sulfadiazine Cream (G)

Simethicone Drops Susp

Simethicone Tab Chew

Simponi Syringe � � �

Simponi Pen Injctr � �

Simvastatin (40mg) Tablet �

Simvastatin (5mg, 10mg, & 20mg) Tablet

Simvastatin (80mg) Tablet � �

Single-Let (Lancets) Each

Sinus & Allergy Tablet ER

Sinus 12 Hour Tablet ER

Sinus 12-Hour Tablet ER

Sirolimus Tablet

Skyla Iud

Sleep Aid Capsule

Sleep Aid (Diphenhydramine HCl) Tablet

Sleep Ii Tablet

Sleep Tablet Tablet

Sleep Tabs Tablet

Sleep-Aid Capsule

Sleepgels Capsule

Sleeping Capsule

Smart Sense (Lancets) Each

Smart Sense Lancets Each

Smartdiabetes Vantage (Lancing Device) Each

Smartest (Control Solution) Each

Smartest Lancet Each

Smooth Antacid Tab Chew

Smooth Dissolving Antacid Tab Chew



2018.2 (5/7/2018).



Sochlor Drops

Sochlor Oint. (G)

Sodium Bicarbonate Tablet

Sodium Chloride Drops

Sodium Chloride Oint. (G)

Sodium Chloride Vial-Neb

Sodium Citrate-Citric Acid Solution

Sodium Fluoride Drops �

Sodium Fluoride Solution �

Sodium Fluoride Tab Chew �

Sodium Polystyrene Sulfonate Enema

Sodium Polystyrene Sulfonate Oral Susp

Sodium Polystyrene Sulfonate Powder

Soft Touch (Lancets) Each

Soltamox Solution �

Solus V2 (Lancets) Each

Solus V2 Control Solution Each

Solus V2 Lancets Each

Solus V2 Lancing Device Kit

Somatuline Depot Syringe � �

Somavert Vial � �

Soothe Oral Susp

Soothe Tab Chew

Soothing Care Cream (G)

Soothing Pureway-C Tablet

Sorbugen NR Liquid

Sorine Tablet

Sotalol Tablet

Sotalol AF Tablet

Sovaldi Tablet � � �

Spectravite Adult 50+ Tablet

Spectravite Advanced Formula Tablet

Spectravite Senior Tablet

Spinosad Suspension

Spiriva Cap W/Dev �

Spiriva Respimat Mist Inhal �

Spironolactone Tablet

Spironolactone-HCTZ Tablet

Sporanox Solution

Spray And Stretch Spray

Sprintec Tablet

Sprycel Tablet � �

Sps Oral Susp



2018.2 (5/7/2018).



Sronyx Tablet

SSD Cream (G)

SSKI Solution

St. Joseph Aspirin Tab Chew

St. Joseph Aspirin Tablet Dr

Stavudine Capsule

Stavudine Soln Recon

Stelara Syringe � �

Sterilance TL (Lancets) Each

Stimate Spray/Pump �

Stimulant Laxative Plus Tablet

Stivarga Tablet � � �

Stomach Relief Tab Chew

Stomach Relief (262mg/15ml) Oral Susp

Stomach Relief Original Oral Susp

Stool Softener Tablet

Stool Softener Liquid

Stool Softener Syrup

Stool Softener (8.6mg-50mg, 100mg, 240mg & 250mg) Capsule

Stool Softener-Laxative Tablet

Stool Softener-Stimulant Lax Tablet

Stop Smoking Aid Lozenge

Strensiq Vial � � �

Stribild Tablet �

Strong Iodine Solution

Suboxone Film

Sucralfate Tablet

Sudafed Tablet

Sudafed 12-Hour Tablet ER

Sudogest Tablet

Sudogest Tablet ER

Sulfacetamide Sodium Oint. (G)

Sulfacetamide Sodium Drops

Sulfacetamide-Prednisolone Drops

Sulfadiazine Tablet

Sulfamethoxazole-Trimethoprim Tablet

Sulfamethoxazole-Trimethoprim Oral Susp

Sulfasalazine Tablet

Sulfasalazine DR Tablet Dr

Sulfatrim Oral Susp

Sulindac Tablet

Sumatriptan Spray �

Sumatriptan Succinate Tablet �



2018.2 (5/7/2018).



Super B-50 Complex Capsule

Super Calcium Tablet

Super Multivitamin Tablet

Super Pain Relief Tablet

Super Thin Lancets Each

Suphedrin Tablet

Suphedrin Liquid

Suphedrin 12-Hour Tablet ER

Suphedrine Tablet

Suphedrine 12-Hour Tablet ER

Suphedrine Sinus Congestion Tablet

Suprax Tab Chew

Suprax Capsule

Suprax (500 mg/5ml) Susp Recon

Sure Comfort Disp Syrin

Sure Comfort Dis Needle

Sure Comfort Lancets Each

Sure Comfort Lancing Pen Each

Sure-Fine Pen Needles Dis Needle

Sureflex (Lancing Device) Each

Sureflex (Lancing Device/Lancets) Kit

Sure-Ject Insulin Syringe Disp Syrin

Sure-Lance (Lancets) Each

Sure-Pen (Lancing Device) Each

Sure-Test Easyplus Mini (Control Solution) Each

Sure-Touch (Lancets) Each

Sutent Capsule � �

Syeda Tablet

Sylatron Kit � �

Symbicort HFA Aer Ad �

Symfi Tablet

Symfi Lo Tablet

Symlinpen 120 Pen Injctr �

Symlinpen 60 Pen Injctr �

Synagis Vial � �

Synarel Spray � �

Synera M.Ht Patch

Synribo Vial � �

Tab-A-Vite Tablet

Tab-A-Vite With Iron Tablet

Tab-A-Vite-Minerals Tablet

Tabloid Tablet � �

Tacrolimus Capsule



2018.2 (5/7/2018).



Tactinal Tablet

Taltz Autoinjector Auto Injct � �

Taltz Autoinjector (2 Pack) Auto Injct � �

Taltz Autoinjector (3 Pack) Auto Injct � �

Taltz Syringe Syringe � �

Taltz Syringe (2 Pack) Syringe � �

Taltz Syringe (3 Pack) Syringe � �

Tamoxifen Citrate Tablet

Tamsulosin HCl Cap ER 24h

Tanzeum Pen Injctr � �

Tarceva Tablet � �

Targretin Gel (Gram) � �

Tarina Fe Tablet

Taron-Prex Prenatal Capsule

Tasigna Capsule � � �

Tazarotene Cream (G) �

Tazorac Gel (Gram) �

Tazorac (0.05%) Cream (G) �

Taztia Xt Capsule ER

Td Gold Level 1 Control Sol Each



Tears Again Drops

Tears Pure Drops

Tecfidera Capsule Dr � � �

Techlite Lancets Each

Telcare (Lancets) Each

Telcare Control Solution Each

Temazepam (15mg & 30mg) Capsule

Temozolomide Capsule � �

Tencon Tablet

Tenivac Vial

Tenivac Syringe

Tenofovir Disoproxil Fumarate Tablet

Terazosin HCl Capsule

Terbinafine HCl Tablet �

Terbutaline Sulfate Tablet

Terconazole Cream/Appl �

Terconazole Supp.Vag �

Terumo Insulin Syringe Disp Syrin

Testosterone Cypionate Vial �

Testosterone Enanthate Vial �

Tetanus Diphtheria Toxoids Vial



2018.2 (5/7/2018).



Tetracycline HCl Capsule

Texacort Solution

Thalomid Capsule � �

Theo-24 Cap ER 24h

Theochron Tab ER 12h

Theophylline Solution

Theophylline Tab ER 24h

Theophylline Anhydrous Tab ER 12h

Thera Tablet

Thera M Plus Tablet

Theradex M Tablet

Thera-M Tablet

Therapeutic M (27mg-0.4mg) Tablet

Thera-Tabs Tablet

Thera-Tabs M Tablet

Theratrum Complete 50 Plus Tablet

Therems Tablet

Therems-M Tablet

Thin Lancets Each

Thinpro Insulin Syringe Disp Syrin

Thiola Tablet �

Thrivite 19 Tablet

Thyrolar-1 Tablet

Thyrolar-1/2 Tablet

Thyrolar-1/4 Tablet

Thyrolar-2 Tablet

Thyrolar-3 Tablet

Tiagabine HCl Tablet

Ticlopidine HCl Tablet

Tilia Fe Tablet

Timolol Maleate Tablet

Timolol Maleate Drops

Timolol Maleate Sol-Gel

Timoptic Ocudose Droperette

Tinidazole Tablet

Tivicay (50mg) Tablet �

Tizanidine HCl Tablet

Tobi Podhaler Capsule � � �

Tobi Podhaler Cap W/Dev � � �

Tobradex Oint. (G)

Tobramycin Drops

Tobramycin Ampul-Neb � � �

Tobramycin-Dexamethasone Drops Susp



2018.2 (5/7/2018).



Tobrex Oint. (G)

Tolazamide Tablet

Tolbutamide Tablet

Tolcapone Tablet

Tolmetin Sodium Capsule

Tolmetin Sodium Tablet

Tolnaftate Cream (G)

Tolterodine Tartrate Tablet �

Topcare Clickfine Dis Needle

Topcare Ultra Comfort Disp Syrin

Topcare Universal1 Lancet Each

Topcare Universal1 Thin Lancet Each

Topiramate Tablet

Topiramate Cap Sprink

Torsemide Tablet

Total Allergy Tablet

Tracleer Tablet � �

Tradjenta Tablet � �

Tramadol HCl Tablet

Tramadol HCl ER Tab ER 24h � �

Tramadol HCl-Acetaminophen Tablet �

Trandolapril Tablet

Trandolapril-Verapamil ER Tab Bp 24h

Tranexamic Acid Tablet �

Travoprost Drops �

Trecator Tablet

Trelegy Ellipta Blst W/Dev � �

Tretinoin Capsule

Trexall Tablet

Tri Femynor Tablet

Triadvance Tablet

Triamcinolone Acetonide Cream (G)

Triamcinolone Acetonide Oint. (G)

Triamcinolone Acetonide Lotion

Triamcinolone Acetonide Paste (G)

Triamcinolone Acetonide Aerosol

Triamterene-Hydrochlorothiazid Tablet

Triamterene-Hydrochlorothiazid Capsule

Trianex Oint. (G)

Tri-Buffered Aspirin Tablet

Tricitrates Solution

Triderm Cream (G)

Tridesilon Cream (G)



2018.2 (5/7/2018).



Tri-Estarylla Tablet

Trifluridine Drops

Trihexyphenidyl HCl Elixir

Trihexyphenidyl HCl Tablet

Tri-Legest Fe Tablet

Tri-Linyah Tablet

Tri-Lo-Estarylla Tablet

Tri-Lo-Marzia Tablet

Tri-Lo-Sprintec Tablet

Trilyte With Flavor Packets Soln Recon

Trimethobenzamide HCl Capsule

Trinatal Gt Tablet

Trinessa Tablet

Trinessa Lo Tablet

Triple Antibiotic Oint. (G)

Triple Antibiotic Oint Pack

Triple Antibiotic Plus Oint. (G)

Triple Dye Med. Swab

Triple-Vitamin W-Fluoride Drops �

Tri-Previfem Tablet

Tri-Sprintec Tablet

Triumeq Tablet

Triveen-Duo DHA Combo. Pkg

Tri-Vi-Sol Drops

Tri-Vit With Fluoride-Iron Drops �

Tri-Vitamin Drops

Tri-Vitamin With Fluoride Drops �

Trivora-28 Tablet

Trixaicin Cream (G)

Tropicamide Drops

Trospium Chloride Tablet �

Trospium Chloride ER Cap ER 24h �

True Metrix (Control Solution) Each

Truecontrol (Control Solution) Each

Truedraw (Lancing Device) Each

Trueplus Insulin Syringe Disp Syrin

Trueplus Lancets Each

Truetest Glucose Control Each

Trumenba Syringe

Trust Natal DHA Combo. Pkg

Truvada Tablet

Tudorza Pressair Aer Pow Ba �

Tusnel Diabetic Liquid



2018.2 (5/7/2018).



Tussin Cough (100-10mg/5) Liquid

Tussin Cough Dm Liquid

Tussin Cough-Chest Congestion Liquid

Tussin Dm Liquid

Tussin Dm (100-10mg/5) Syrup

Tussin Dm Clear Syrup

Tussin Dm Cough Syrup

Tussin Dm Cough & Chest Syrup

Tussin Dm Cough-Chest Congest Syrup

Tussin Dm Cough-Chest Congest Liquid

Tussin Dm Max (100-10mg/5) Liquid

Twinrix Vial

Twinrix Syringe

Tybost Tablet

Tydemy Tablet

Tykerb Tablet � �

Tylenol PM Extra Strength Tablet

Tymlos Pen Injctr � �

Tyzeka Tablet

U-Cort Cream (G)

Ulticare Syringe

Ulticare Disp Syrin

Ulticare Pen Needle Dis Needle

Ulti-Lance (Lancing Device/Lancets) Kit

Ulti-Lance (Lancing Device) Each

Ultilet Basic (Lancets) Each

Ultilet Classic (Lancets) Each

Ultilet Insulin Syringe Disp Syrin

Ultilet Lancets Each

Ultilet Pen Needle Dis Needle

Ultilet Safety (Lancets) Each

Ultimatecare One Capsule

Ultimatecare One NF Capsule

Ultra Comfort Disp Syrin

Ultra Dm Free & Clear Liquid

Ultra Omega-3 Capsule

Ultra Saline Spray

Ultra Strength Antacid Tab Chew

Ultra Thin Lancets Each

Ultra Thin Plus Each

Ultra Thin Plus Lancets Each

Ultra Tuss Syrup

Ultralance Each



2018.2 (5/7/2018).



Ultra-Thin Ii Disp Syrin

Ultra-Thin Ii Dis Needle

Ultra-Thin Ii Each

Ultratlc Lancets Each

Ultratrak (Control) Each

Ultratrak Ultimate (Control) Each

Unifine Pentips Dis Needle

Unifine Pentips Plus Dis Needle

Unilet Comfortouch (Lancets) Each

Unilet Excelite (Lancets) Each

Unilet Excelite II (Lancets) Each

Unilet Gp Lancet Each

Unilet Lancet Each

Unilet Lancets Each

Unisom Capsule

Unistik 2 (Lancing Device/Lancets) Kit

Unistik 2 Extra (Lancing Device/Lancets) Kit

Unistik 2 Normal (Lancing Device/Lancets) Kit

Unistik 3 (Lancing Device/Lancets) Kit

Unistik 3 (Lancing Device/Lancets) Each

Unistik 3 Comfort (Lancing Device/Lancets) Kit

Unistik 3 Extra (Lancets) Each

Unistik 3 Neonatal (Lancing Device/Lancets) Kit

Unistik CZT (Lancets) Each

Unistik Safety (Lancets) Each

Unistik Touch (Lancets) Each

Unistrip (Control Solution) Each

Universal 1 (Lancets) Each

Uptravi Tablet � �

Uptravi Tab Ds Pk � �

Uroqid-Acid No.2 Tablet

Ursodiol Tablet

Ursodiol Capsule

Utibron Neohaler Cap W/Dev

Vagistat-3 Kit

Valacyclovir Tablet

Valganciclovir HCl Tablet

Valsartan Tablet

Valsartan-Hydrochlorothiazide Tablet

Valu-Dryl Tab Chew

Valu-Dryl Elixir

Valu-Dryl Allergy Medicine Tablet

Vancomycin HCl Vial



2018.2 (5/7/2018).



Vancomycin HCl Vial Port

Vancomycin HCl Capsule �

Vanishpoint Disp Syrin

Vaqta Syringe

Vaqta Vial

Varivax Vaccine Vial

V-C Forte Capsule

Vegetable Laxative Tablet

Velivet Tablet

Velphoro Tab Chew

Veltassa Powd Pack

Vemlidy Tablet � � �

Venclexta Tablet � �

Venclexta Starting Pack Tab Ds Pk � �

Ventolin HFA HFA Aer Ad �

Verapamil ER Tablet ER

Verapamil ER Cap24h Pel

Verapamil ER PM Cap24h Pct

Verapamil HCl Tablet

Verapamil HCl Cap24h Pel

Verapamil Sr Cap24h Pel

Verdeso Foam

Veregen Oint. (G) �

Verzenio Tablet � � �

Vestura Tablet

Vexol Drops Susp

Viberzi Tablet

Vibramycin Syrup

Vic-Forte Capsule

Vicks Qlearquil Allergy Tablet

Vicks Qlearquil Nighttime Tablet

Vicodin Tablet �

Vicodin ES Tablet �

Vicodin HP Tablet �

Victoza 2-Pak Pen Injctr � �

Victoza 3-Pak Pen Injctr � �

Videx Soln Recon

Vienva Tablet

Vinacal Tablet

Vinate Care Tab Chew

Vinate GT Tablet

Vinate II Tablet

Vinate One Tablet



2018.2 (5/7/2018).



Vinate PN Care Tablet

Vinate Ultra Tablet

Vinate-M Tablet

Viorele Tablet

Viracept Tablet

Viread Powder

Virt-Advance Tablet

Virt-Nate DHA Capsule

Virt-Phos 250 Neutral Tablet

Virtrate-2 Solution

Virtrate-3 Solution

Virtrate-K Solution

Virt-Vite GT Tablet

Vistogard Gran Pack � �

Vitafol-Ob+DHA Combo. Pkg

Vitamin B Complex Capsule

Vitamin B-12 (500 mcg & 1000mcg) Tablet

Vitamin B-6 (25mg, 50mg & 100mg) Tablet

Vitamin C Wafer

Vitamin C (250mg & 500mg) Tablet

Vitamin C (500mg) Tab Chew

Vitamin C With Rose Hips (500mg) Tablet

Vitamin D2 Capsule

Vitamin E (200 Unit & 400 Unit) Capsule

Vitamins A,C,D And Fluoride Drops �

Vitamins For Hair Tablet

Vitekta Tablet

Viva DHA Capsule

Vivitrol Sus ER Rec �

Vocal Point Glucose Control (Control Solution) Each

Vocalpoint Glucose Control (Control Solution) Each

Vonvendi Vial � �

Voriconazole Tablet �

Voriconazole Susp Recon �

Vosevi Tablet � �

Vyfemla Tablet

Vyvanse Capsule � �

Vyvanse Tab Chew � �

Wal-Dryl Capsule

Wal-Dryl Tablet

Wal-Dryl Allergy Liquid

Wal-Dryl Allergy Tablet

Wal-Finate Tablet



2018.2 (5/7/2018).



Wal-Itin Solution

Wal-Itin Tablet

Wal-Itin Tab Rapdis

Wal-Mucil Capsule

Wal-Mucil (3.4g/5.8g) Powder

Wal-Mucil Natural Fiber Lax Powder

Wal-Nadol PM Tablet

Wal-Phed (30mg) Tablet

Wal-Phed 12 Hour Tablet ER

Wal-Phed D Tablet ER

Wal-Profen (200mg) Tablet

Wal-Proxen Tablet

Wal-Sleep Z Capsule

Wal-Sleep Z Tab Rapdis

Wal-Som Capsule

Wal-Som Tab Rapdis

Wal-Tussin Dm Syrup

Wal-Zan 75 Tablet

Wal-Zyr Tablet

Warfarin Sodium Tablet

Wavesense Control Solution Each

Wera Tablet

Wide Seal Diaphragm Diaphragm

Woman's Laxative Tablet Dr

Women's Gentle Laxative Tablet Dr

Women's Laxative Tablet Dr

Womens Stool Softener Capsule

Xarelto Tablet �

Xarelto Tab Ds Pk �

Xeljanz Tablet � � �

Xeljanz XR Tab ER 24h � � �

Xifaxan Tablet � �

Xolair Vial � �

Xtandi Capsule � � �

Xulane Patch Tdwk

Xuriden Gran Pack � �

Xylon 10 Tablet

Xyrem Solution � �

Zaleplon Capsule �

Zantac 75 Tablet

Zarah Tablet

Zarxio Syringe � � �

Zavesca Capsule � �



2018.2 (5/7/2018).



Zebutal Capsule

Zelapar Tab Rapdis

Zemaira Vial � �

Zenchent Tablet

Zenpep (40k-136k, 10-34-55k, 15-51-82k, 40-126-168,

20-63-84K, 5K-17K-24K, 25-79-105K, 10-32-42k and

20-68-109k)

Capsule DR

Zenzedi (5mg and 10mg) Tablet

Zepatier Tablet � � �

Zephrex-D Tablet

Zidovudine Tablet

Zidovudine Capsule

Zidovudine Syrup

Zinbryta Syringe � �

Zinc Oxide (20%) Oint. (G)

Zinc Sulfate Capsule

Zinc-220 Capsule

Zmax Sus ER Rec

Zoladex Implant � �

Zolinza Capsule

Zolmitriptan Tablet �

Zolmitriptan ODT Tab Rapdis �

Zolpidem Tablet �

Zolpidem Tartrate Tablet �

Zolpidem Tartrate ER Tab Mphase � �

Zomacton Vial � �

Zonisamide Capsule

Zontivity Tablet �

Zorbtive Vial � �

Zostavax Vial �

Zostrix Cream (G)

Zovia 1-35e Tablet

Zovia 1-50e Tablet

Z-Sleep Capsule

Zurampic Tablet � �

Zykadia Capsule � � �

Zylet Drops Susp

Health plans in Oregon provided by Moda Health Plan, Inc. Dental plans in Oregon provided by Oregon Dental Service, dba Delta Dental Plan

of Oregon.

eocco pharmacy formulary - moda health — provider of ... · pdf fileeocco pharmacy...

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