Post on 03-Jul-2020
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Preferred Drug List The Premium Hybrid Formulary includes a list of generic drugs covered by your prescription benefit. Preferred Drug List Medication Locator Instructions: 1. With the PDF open, click on the Edit menu, then click Find 2. In the Find box type the name of the medication you want to locate 3. Click the Next button until you find the medication(s) you are looking for
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Drug Name Drug Tier
Requirements/ Limits
ADHD/ANTI-NARCOLEPSY/ANTI- OBESITY/ANOREXIANTS - Drugs to Treat ADHD, Sleep and Eating Disorders
Anorexiants Non-Amphetamine
ADIPEX-P TABS (Use Phentermine HCl) 1
BONTRIL PDM TABS (Use Phendimetrazine Tartrate) 1
phendimetrazine tartrate tabs 1
phentermine hcl tabs 1
ALTERNATIVE MEDICINES
Alternative Medicine - A's
ALPHA LIPOIC ACID CAPS 1
alpha-lipoic acid (thioctic acid) caps 1
Alternative Medicine - B's
black cohosh (cimicifuga racemosa) caps 1
Alternative Medicine - C's
coenzyme q10 (ubidecarenone) caps 1
COLOSTRUM CAPS 1
Alternative Medicine - F's
BIO-FLAX CAPS (Use Flaxseed (Linseed)) 1
flaxseed (linseed) caps 1
Alternative Medicine - G's
glucosamine sulfate caps 1
Alternative Medicine - M's
melatonin caps or 10 mg 1
melatonin subl sl 10 mg 1
MELATONIN SUBL SL 10 MG (Use Melatonin) 1
MELATONIN SUBL SL 3 MG 1
3
Drug Name Drug Tier
Requirements/ Limits
melatonin tabs or 3 mg, 1 mg, 5 mg 1
Alternative Medicine Combinations
AZO CRANBERRY TABS 1
FLAX + DHA CAPS 1
flaxseed oil-fish oil-borage oil caps 1
glucosamine-chondroitin-vit c-manganese caps 1
GNP TRIPLE OMEGA COMPLEX CPDR 1
HM OMEGA-3-6-9 FATTY ACIDS CAPS 1
melatonin-pyridoxine tabs 1
melatonin-pyridoxine tbcr 1
OMEGA 3-6-9 COMPLEX CAPS 1
OMEGA-3 & OMEGA-6 FISH OIL CAPS 1
OMEGA-3-6-9 CAPS 1
RA OMEGA 3-6-9 CAPS 1
SM OMEGA-3 CAPS 1
SM OMEGA-3-6-9 FATTY ACIDS CAPS 1
SUPER OMEGA-3 CAPS 1
TRIPLE OMEGA COMPLEX CPDR 1
TRIPLE OMEGA-3-6-9 CAPS 1
ANALGESICS - ANTI-INFLAMMATORY - Drugs to Treat Pain, Swelling, Muscle and Joint Conditions
Nonsteroidal Anti-inflammatory Agents (NSAIDs)
ADVIL CAPS (Use Ibuprofen) 1
ADVIL MIGRAINE CAPS (Use Ibuprofen) 1
4
Drug Name Drug Tier
Requirements/ Limits
ADVIL TABS (Use Ibuprofen)
1
ALEVE ARTHRITIS TABS (Use Naproxen Sodium)
1
ALEVE TABS (Use Naproxen Sodium)
1
diclofenac sodium tbec 1
EC-NAPROSYN TBEC (Use Naproxen)
1
flurbiprofen tabs 1
ibuprofen caps 1
ibuprofen tabs 1
indomethacin caps 1
meloxicam tabs 15 mg 1 QL(1 ea per fill retail)
meloxicam tabs 7.5 mg 1 QL(2 ea per fill retail)
MOBIC TABS 15 MG (Use Meloxicam)
1 QL(1 ea per fill retail)
MOBIC TABS 7.5 MG (Use Meloxicam)
1 QL(2 ea per fill retail)
nabumetone tabs 500 mg 1 QL(4 ea per fill retail)
nabumetone tabs 750 mg 1 QL(3 ea per fill retail)
NAPROSYN TABS (Use Naproxen)
1
naproxen sodium tabs 1
naproxen tabs 1
naproxen tbec 1
sulindac tabs 1
ANALGESICS - NonNarcotic - Drugs to Treat Pain, Muscle and Joint Conditions
Analgesic Combinations
DOLOGESIC TABS 1
DOLOREX TABS 1
Drug Name Drug Tier
Requirements/ Limits
RELAGESIC TABS 1
Analgesics Other
acetaminophen tabs 1
acetaminophen tbcr 1
TYLENOL 8 HOUR ARTHRITISPAIN TBCR (Use Acetaminophen)
1
TYLENOL 8 HOUR TBCR (Use Acetaminophen)
1
TYLENOL EXTRA STRENGTH TABS (Use Acetaminophen)
1
TYLENOL TABS (Use Acetaminophen)
1
Salicylates
aspirin chew 1
aspirin tabs 1
aspirin tbec 1
ECOTRIN REGULAR STRENGTH TBEC (Use Aspirin)
1
ANALGESICS - OPIOID - Drugs to Treat Pain, Muscle and Joint Conditions
Opioid Agonists
tramadol hcl tabs 1 QL(8 ea per fill retail)
ULTRAM TABS (Use Tramadol HCl)
1 QL(8 ea per fill retail)
Opioid Combinations
acetaminophen w/ codeine soln
1
acetaminophen w/ codeine tabs
1
hydrocodone- acetaminophen tabs
1 QL(240 ea per fill retail)
NORCO TABS (Use Hydrocodone- Acetaminophen)
1 QL(240 ea per fill retail)
oxycodone w/ acetaminophen tabs
1
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Drug Name Drug Tier
Requirements/ Limits
PERCOCET TABS (Use Oxycodone w/ Acetaminophen)
1
tramadol-acetaminophen tabs 1
TYLENOL/CODEINE #3 TABS (Use Acetaminophen w/ Codeine)
1
TYLENOL/CODEINE #4 TABS (Use Acetaminophen w/ Codeine)
1
ULTRACET TABS (Use Tramadol-Acetaminophen) 1
ANORECTAL AGENTS - Rectal Drugs to Treat Pain, Swelling and Itching
Rectal Local Anesthetics
dibucaine (rectal) oint 1
NUPERCAINAL OINT (Use Dibucaine (Rectal)) 1
ANTACIDS - Ulcer and Stomach Acid Drugs
Antacids - Bicarbonate
sodium bicarbonate (antacid) tabs 1
Antacids - Calcium Salts
calcium carbonate (antacid) chew 1
TUMS CHEW (Use Calcium Carbonate (Antacid))
1
TUMS CHEWY BITES CHEW (Use Calcium Carbonate (Antacid))
1
TUMS E-X 750 CHEW (Use Calcium Carbonate (Antacid))
1
TUMS EXTRA STRENGTH 750 CHEW (Use Calcium Carbonate (Antacid))
1
TUMS KIDS CHEW (Use Calcium Carbonate (Antacid))
1
TUMS LASTING EFFECTS CHEW (Use Calcium Carbonate (Antacid))
1
Drug Name Drug Tier
Requirements/ Limits
TUMS SMOOTHIES CHEW (Use Calcium Carbonate (Antacid))
1
Antacids - Magnesium Salts
magnesium oxide tabs 1
ANTHELMINTICS - Drugs to Treat Worm Infections
Anthelmintics
pyrantel pamoate susp 1
ANTI-INFECTIVE AGENTS - MISC. - Drugs to Treat Bacterial Infections
Anti-infective Agents - Misc.
FLAGYL TABS (Use Metronidazole) 1
metronidazole tabs 1
Anti-infective Misc. - Combinations
BACTRIM DS TABS (Use Sulfamethoxazole- Trimethoprim)
1
BACTRIM TABS (Use Sulfamethoxazole- Trimethoprim)
1
sulfamethoxazole- trimethoprim susp 1
sulfamethoxazole- trimethoprim tabs 1
Lincosamides
CLEOCIN CAPS (Use Clindamycin HCl) 1
clindamycin hcl caps 1
ANTIANGINAL AGENTS - Drugs to Treat Chest Pain
Nitrates
isosorbide mononitrate tb24 1
ANTIANXIETY AGENTS - Drugs to Treat Anxiety
Antianxiety Agents - Misc.
buspirone hcl tabs 1
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Drug Name Drug Tier
Requirements/ Limits
hydroxyzine hcl syrp 1
hydroxyzine hcl tabs 1
hydroxyzine pamoate caps 1
VISTARIL CAPS (Use Hydroxyzine Pamoate) 1
Benzodiazepines
alprazolam tabs 1
ATIVAN TABS (Use Lorazepam) 1
chlordiazepoxide hcl caps 1
diazepam tabs 1
lorazepam tabs 1
VALIUM TABS (Use Diazepam) 1
XANAX TABS (Use Alprazolam) 1
ANTIARRHYTHMICS - Drugs to treat abnormal heart rhythms
Antiarrhythmics Type I-C
propafenone hcl tabs 1 QL(6 ea daily)
RYTHMOL TABS (Use Propafenone HCl) 1 QL(6 ea daily)
Antiarrhythmics Type III
amiodarone hcl tabs 1
CORDARONE TABS (Use Amiodarone HCl) 1
ANTIASTHMATIC AND BRONCHODILATOR AGENTS - Drugs to Treat Lung Conditions
Bronchodilators - Anticholinergics
ipratropium bromide soln 1
Leukotriene Modulators
montelukast sodium chew 1 QL(1 ea daily)
montelukast sodium tabs 1 QL(1 ea daily)
Drug Name Drug Tier
Requirements/ Limits
SINGULAIR CHEW (Use Montelukast Sodium) 1 QL(1 ea daily)
SINGULAIR TABS (Use Montelukast Sodium) 1 QL(1 ea daily)
Sympathomimetics
albuterol sulfate nebu 1
albuterol sulfate syrp 1
ipratropium-albuterol soln 1
ANTICOAGULANTS - Blood Thinners
Coumarin Anticoagulants
COUMADIN TABS (Use Warfarin Sodium) 1
warfarin sodium tabs 1
ANTICONVULSANTS - Drugs to Treat Seizures
Anticonvulsants - Benzodiazepines
clonazepam tabs 1
KLONOPIN TABS (Use Clonazepam) 1
Anticonvulsants - Misc.
gabapentin caps 1
gabapentin tabs 1
KEPPRA SOLN (Use Levetiracetam) 1
KEPPRA TABS (Use Levetiracetam) 1
LAMICTAL CHEWABLE DISPERSIBLE CHEW (Use Lamotrigine)
1
LAMICTAL TABS (Use Lamotrigine) 1
lamotrigine chew 1
lamotrigine tabs 1
levetiracetam soln 1
levetiracetam tabs 1
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Drug Name Drug Tier
Requirements/ Limits
MYSOLINE TABS (Use Primidone) 1
NEURONTIN CAPS (Use Gabapentin) 1
NEURONTIN TABS (Use Gabapentin) 1
oxcarbazepine tabs 1
primidone tabs 1
TOPAMAX TABS (Use Topiramate) 1
topiramate tabs 1
TRILEPTAL TABS (Use Oxcarbazepine) 1
Hydantoins
DILANTIN CAPS (Use Phenytoin Sodium Extended)
1
phenytoin sodium extended caps 1
Valproic Acid
DEPAKENE CAPS (Use Valproic Acid) 1
DEPAKOTE TBEC (Use Divalproex Sodium) 1
divalproex sodium tbec 1
valproic acid caps 1
ANTIDEPRESSANTS - Drugs to Treat Depression
Alpha-2 Receptor Antagonists (Tetracyclics)
mirtazapine tabs 1
REMERON TABS (Use Mirtazapine) 1
Antidepressants - Misc.
bupropion hcl tb12 1
WELLBUTRIN SR TB12 (Use Bupropion HCl) 1
Selective Serotonin Reuptake Inhibitors (SSRIs)
Drug Name Drug Tier
Requirements/ Limits
CELEXA TABS 10 MG (Use Citalopram Hydrobromide)
1 QL(4 ea per fill retail)
CELEXA TABS 20 MG (Use Citalopram Hydrobromide)
1 QL(2 ea per fill retail)
CELEXA TABS 40 MG (Use Citalopram Hydrobromide)
1 QL(1 ea per fill retail)
citalopram hydrobromide tabs 10 mg 1
QL(4 ea per fill retail)
citalopram hydrobromide tabs 20 mg 1
QL(2 ea per fill retail)
citalopram hydrobromide tabs 40 mg 1
QL(1 ea per fill retail)
escitalopram oxalate tabs 1
fluoxetine hcl caps 1
fluvoxamine maleate tabs 1
LEXAPRO TABS (Use Escitalopram Oxalate) 1
paroxetine hcl tabs 1
PAXIL TABS (Use Paroxetine HCl) 1
PROZAC CAPS (Use Fluoxetine HCl) 1
sertraline hcl tabs 1
ZOLOFT TABS (Use Sertraline HCl) 1
Serotonin Modulators
trazodone hcl tabs 1
Serotonin-Norepinephrine Reuptake Inhibitors
EFFEXOR XR CP24 150 MG (Use Venlafaxine HCl) 1
QL(2 ea per fill retail)
EFFEXOR XR CP24 37.5 MG, 75 MG (Use Venlafaxine HCl)
1 QL(1 ea per fill retail)
venlafaxine hcl cp24 150 mg
1 QL(2 ea per fill retail)
venlafaxine hcl cp24 75 mg, 37.5 mg
1 QL(1 ea per fill retail)
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Drug Name Drug Tier
Requirements/ Limits
venlafaxine hcl tabs 75 mg 1
Tricyclic Agents
amitriptyline hcl tabs 1
ELAVIL TABS (Use Amitriptyline HCl) 1
imipramine hcl tabs 1
nortriptyline hcl caps 1
PAMELOR CAPS (Use Nortriptyline HCl) 1
TOFRANIL TABS (Use Imipramine HCl) 1
ANTIDIABETICS - Drugs to Regulate Blood Sugar
Antidiabetic Combinations
GLUCOVANCE TABS (Use Glyburide-Metformin) 1
glyburide-metformin tabs 1
Biguanides
GLUCOPHAGE TABS (Use Metformin HCl) 1
GLUCOPHAGE XR TB24 (Use Metformin HCl) 1
metformin hcl tabs 1
metformin hcl tb24 1
Insulin Sensitizing Agents
ACTOS TABS (Use Pioglitazone HCl) 1
pioglitazone hcl tabs 1
Sulfonylureas
AMARYL TABS (Use Glimepiride) 1
DIABETA TABS 1
glimepiride tabs 1
glipizide tabs 1
Drug Name Drug Tier
Requirements/ Limits
glipizide tb24 1
GLUCOTROL TABS (Use Glipizide) 1
GLUCOTROL XL TB24 (Use Glipizide) 1
glyburide micronized tabs 1
glyburide tabs 1
GLYNASE TABS (Use Glyburide Micronized) 1
ANTIDIARRHEALS - Drugs to Treat Diarrhea
Antidiarrheal Agents - Misc.
ACIDOPHILUS CAPS 1
ACIDOPHILUS HIGH- POTENCY CAPS 1
ACIDOPHILUS PEARLS CAPS 1
ACIDOPHILUS PROBIOTIC BLEND CAPS 1
ACIDOPHILUS SUPER PROBIOTIC CAPS 1
ACIDOPHILUS/GOAT MILK CAPS 1
ADVANCED PROBIOTIC 10 CAPS 1
ADVANCED PROBIOTIC CAPS 1
ALIGN CAPS 1
bismuth subsalicylate chew 1
bismuth subsalicylate tabs 1
CHILDRENS PROBIOTIC PEARLS CAPS 1
CULTURELLE ADVANCED IMMUNE DEFENSE CAPS
1
CULTURELLE PRO-WELL CAPS 1
CVS ADULT 50+ PROBIOTIC CAPS 1
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Drug Name Drug Tier
Requirements/ Limits
CVS ADULT PROBIOTIC CAPS 1
CVS DIGESTIVE PROBIOTIC CAPS 1
CVS PROBIOTIC CAPS 1
CVS PROBIOTIC MAXIMUM STRENGTH CAPS
1
CVS PROBIOTIC PEARLS EXTRA STRENGTH CAPS 1
CVS SENIOR PROBIOTIC CAPS 1
DAILY PROBIOTIC CAPS 1
DIFF-STAT CAPS 1
DIGESTIVE ADVANTAGE CAPS 1
DIGESTIVE ADVANTAGE LACTOSE DEFENSE FORMULA CAPS
1
EQ PROBIOTIC DIGESTIVE SYSTEM SUPPORT CAPS
1
EQL ACIDOPHILUS EXTRA STRENGTH CAPS 1
EQL DAILY PROBIOTIC CAPS 1
EQL PROBIOTIC COLON SUPPORT CAPS 1
FLORA VANCE CAPS 1
FLORA-Q 2 CAPS 1
FLORA-Q CAPS 1
FLORAJEN ACIDOPHILUS CAPS 1
FLORAJEN BIFIDOBLEND CAPS 1
FLORAJEN3 CAPS 1
FLORAJEN4KIDS CAPS 1
FORTIFY DAILY PROBIOTIC CAPS 1
Drug Name Drug Tier
Requirements/ Limits
GNP ACIDOPHILUS HIGH POTENCY CAPS 1
GNP PROBIOTIC COLON SUPPORT CAPS 1
HM ACIDOPHILUS CAPS 1
LACTO-PECTIN CAPS 1
lactobacillus caps 1
MEGA PROBIOTIC CAPS 1
META BIOTIC/BIO- ACTIVE 12 CAPS 1
NATRUL PROBIOTIC CAPS 1
PEARLS IC CAPS 1
PEPTO BISMOL TABS (Use Bismuth Subsalicylate)
1
PEPTO-BISMOL CHEW (Use Bismuth Subsalicylate)
1
PEPTO-BISMOL INSTACOOL CHEW (Use Bismuth Subsalicylate)
1
PEPTO-BISMOL TO-GO CHEW (Use Bismuth Subsalicylate)
1
PHILLIPS COLON HEALTH CAPS 1
PREORBOTIC CAPS 1
PRO-BIOTIC BLEND CAPS 1
PRO-FLORA IMMUNE CAPS 1
PROBIOMAX DAILY DF CAPS 1
PROBIOTIC & ACIDOPHILUS FORMULA EXTRA STRENGTH CAPS
1
PROBIOTIC + OMEGA-3 CAPS 1
10
Drug Name Drug Tier
Requirements/ Limits
PROBIOTIC ACIDOPHILUS BEADS CAPS
1
PROBIOTIC ACIDOPHILUS CAPS 1
PROBIOTIC ADVANCED ULTRAPOTENCY CAPS 1
PROBIOTIC CAPS 1
PROBIOTIC COLON SUPPORT CAPS 1
PROBIOTIC COMPLEX/ACIDOPHILUS CAPS
1
PROBIOTIC DAILY CAPS 1
PROBIOTIC GOLD EXTRA STRENGTH CAPS 1
PROBIOTIC MATURE ADULT CAPS 1
PROBIOTIC PEARLS ADVANTAGE CAPS 1
PROBIOTIC PEARLS CAPS 1
PROBIOTIC-10 CAPS 1
PROBIOTIC-10 ULTIMATE CAPS 1
RA PROBIOTIC COLON CARE CAPS 1
RA PROBIOTIC COMPLEX CAPS 1
REPHRESH PRO-B CAPS 1
RESTORA CAPS 1
RISAQUAD CAPS 1
RISAQUAD-2 CAPS 1
SM ACIDOPHILUS PEARLS CAPS 1
SUPER PROBIOTIC CAPS 1
SUPER PROBIOTIC DIGESTIVE SUPPORT CAPS
1
Drug Name Drug Tier
Requirements/ Limits
TRUBIOTICS CAPS 1
TRUNATURE DIGESTIVE PROBIOTIC CAPS
1
ULTRAFLORA IMMUNE HEALTH CAPS
1
VISBIOME PROBIOTIC HIGH POTENCY CAPS
1
VSL#3 CAPS 1
Antiperistaltic Agents
IMODIUM A-D TABS (Use Loperamide HCl) 1
loperamide hcl tabs 1
ANTIEMETICS - Drugs to Treat Nausea and Vomiting
5-HT3 Receptor Antagonists
ondansetron hcl soln ij 40 mg/20ml, 4 mg/2ml
1
ondansetron hcl tabs or 4 mg
1 QL(20 ea per fill retail)
ZOFRAN TABS (Use Ondansetron HCl)
1 QL(20 ea per fill retail)
Antiemetics - Anticholinergic
dimenhydrinate tabs 1
DRAMAMINE TABS (Use Dimenhydrinate)
1
meclizine hcl chew 25 mg 1
meclizine hcl tabs 25 mg, 12.5 mg
1 RX/OTC
ANTIFUNGALS - Drugs to Treat Fungal Infections
Antifungals
LAMISIL TABS (Use Terbinafine HCl)
1 QL(365 ea per 90 days retail)
terbinafine hcl tabs 1 QL(365 ea per 90 days retail)
ANTIHISTAMINES - Drugs to Treat Allergies
Antihistamines - Alkylamines
11
Drug Name Drug Tier
Requirements/ Limits
CHLOR-TRIMETON TABS (Use Chlorpheniramine Maleate)
1
chlorpheniramine maleate tabs
1
Antihistamines - Ethanolamines
BENADRYL ALLERGY CAPS (Use Diphenhydramine HCl)
1
BENADRYL ALLERGY CHILDRENS LIQD (Use Diphenhydramine HCl)
1
BENADRYL ALLERGY TABS (Use Diphenhydramine HCl)
1
diphenhydramine hcl caps 25 mg
1
diphenhydramine hcl caps 50 mg
1 RX/OTC
diphenhydramine hcl liqd 50 mg/20ml, 12.5 mg/5ml, 25 mg/10ml
1
diphenhydramine hcl tabs 25 mg
1
Antihistamines - Non-Sedating
ALLEGRA ALLERGY TABS (Use Fexofenadine HCl)
1
cetirizine hcl soln 5 mg/5ml, 1 mg/ml
1 RX/OTC
cetirizine hcl syrp 1 mg/ml, 5 mg/5ml
1 RX/OTC
cetirizine hcl tabs 10 mg, 5 mg
1
CLARITIN REDITABS TBDP (Use Loratadine)
1
CLARITIN SYRP (Use Loratadine)
1
CLARITIN TABS (Use Loratadine)
1
fexofenadine hcl tabs 1
levocetirizine dihydrochloride tabs
1 QL(1 ea daily); RX/OTC
loratadine soln 1
Drug Name Drug Tier
Requirements/ Limits
loratadine syrp 1
loratadine tabs 1
loratadine tbdp 1
XYZAL ALLERGY 24HR TABS (Use Levocetirizine Dihydrochloride)
1 QL(1 ea daily); RX/OTC
XYZAL TABS (Use Levocetirizine Dihydrochloride)
1 QL(1 ea daily); RX/OTC
ZYRTEC ALLERGY TABS (Use Cetirizine HCl)
1
ZYRTEC CHILDRENS ALLERGY SYRP (Use Cetirizine HCl)
1 RX/OTC
Antihistamines - Phenothiazines
promethazine hcl soln 1
promethazine hcl syrp 1
promethazine hcl tabs 1
ANTIHYPERLIPIDEMICS - Drugs to Treat High Cholesterol
Fibric Acid Derivatives
gemfibrozil tabs 1
LOPID TABS (Use Gemfibrozil)
1
HMG CoA Reductase Inhibitors
atorvastatin calcium tabs 1 QL(1 ea daily)
CRESTOR TABS (Use Rosuvastatin Calcium)
1 QL(1 ea daily)
LIPITOR TABS (Use Atorvastatin Calcium)
1 QL(1 ea daily)
lovastatin tabs 1
MEVACOR TABS (Use Lovastatin)
1
rosuvastatin calcium tabs 1 QL(1 ea daily)
simvastatin tabs 1 QL(1 ea daily)
10
Drug Name Drug Tier
Requirements/ Limits
ZOCOR TABS (Use Simvastatin)
1 QL(1 ea daily)
ANTIHYPERTENSIVES - Drugs to Treat High Blood Pressure
ACE Inhibitors
ACCUPRIL TABS (Use Quinapril HCl)
1
ALTACE CAPS (Use Ramipril)
1 QL(2 ea daily)
benazepril hcl tabs 1
enalapril maleate tabs 1 QL(2 ea daily)
fosinopril sodium tabs 1
lisinopril tabs 1
LOTENSIN TABS (Use Benazepril HCl)
1
MAVIK TABS (Use Trandolapril)
1
PRINIVIL TABS (Use Lisinopril)
1
quinapril hcl tabs 1
ramipril caps 1 QL(2 ea daily)
trandolapril tabs 1
VASOTEC TABS (Use Enalapril Maleate)
1 QL(2 ea daily)
ZESTRIL TABS (Use Lisinopril)
1
Angiotensin II Receptor Antagonists
AVAPRO TABS (Use Irbesartan)
1
COZAAR TABS (Use Losartan Potassium)
1
irbesartan tabs 1
losartan potassium tabs 1
Antiadrenergic Antihypertensives
CATAPRES TABS (Use Clonidine HCl)
1
Drug Name Drug Tier
Requirements/ Limits
clonidine hcl tabs 1
methyldopa tabs 1
terazosin hcl caps 1
Antihypertensive Combinations
bisoprolol & hydrochlorothiazide tabs
1
DIOVAN HCT TABS (Use Valsartan- Hydrochlorothiazide)
1
enalapril maleate & hydrochlorothiazide tabs
1
HYZAAR TABS (Use Losartan Potassium & Hydrochlorothiazide)
1
lisinopril & hydrochlorothiazide tabs
1
losartan potassium & hydrochlorothiazide tabs
1
valsartan- hydrochlorothiazide tabs
1
VASERETIC TABS (Use Enalapril Maleate & Hydrochlorothiazide)
1
ZESTORETIC TABS (Use Lisinopril & Hydrochlorothiazide)
1
ZIAC TABS (Use Bisoprolol & Hydrochlorothiazide)
1
Vasodilators
hydralazine hcl tabs 1
ANTIMYCOBACTERIAL AGENTS - Drugs to Treat Tuberculosis (Bacterial Infections)
Antimycobacterial Agents
isoniazid tabs 1
ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES - Drugs to Treat Cancer
Antimetabolites
fluorouracil soln 1
Antineoplastic - Hormonal and Related Agents
11
Drug Name Drug Tier
Requirements/ Limits
FEMARA TABS (Use Letrozole)
1
letrozole tabs 1
MEGACE ORAL SUSP (Use Megestrol Acetate)
1
megestrol acetate susp 1
megestrol acetate tabs 1
ANTIPARKINSON AGENTS - Drugs to Treat Parkinson's Disease
Antiparkinson Anticholinergics
benztropine mesylate tabs 1
trihexyphenidyl hcl tabs 1
Antiparkinson Dopaminergics
carbidopa-levodopa tabs 1
carbidopa-levodopa tbcr 1
MIRAPEX TABS (Use Pramipexole Dihydrochloride)
1
pramipexole dihydrochloride tabs
1
REQUIP TABS (Use Ropinirole Hydrochloride)
1
ropinirole hydrochloride tabs
1
SINEMET CR TBCR (Use Carbidopa-Levodopa)
1
SINEMET TABS (Use Carbidopa-Levodopa)
1
ANTIPSYCHOTICS/ANTIMANIC AGENTS - Drugs to Treat Mood Disorders
Antimanic Agents
LITHIUM CARBONATE CAPS 600 MG, 150 MG (Use Lithium Carbonate)
1
lithium carbonate caps 600 mg, 300 mg, 150 mg
1
lithium carbonate tabs 300 mg
1
Drug Name Drug Tier
Requirements/ Limits
lithium carbonate tbcr 450 mg
1
Benzisoxazoles
RISPERDAL TABS (Use Risperidone)
1
risperidone tabs 1
Butyrophenones
haloperidol tabs 1
Dibenzapines
olanzapine tabs 1
quetiapine fumarate tabs 1
SEROQUEL TABS (Use Quetiapine Fumarate)
1
ZYPREXA TABS (Use Olanzapine)
1
Phenothiazines
prochlorperazine maleate tabs
1
thioridazine hcl tabs 1
ANTISEPTICS & DISINFECTANTS - Drugs to Prevent Bacterial Skin Infections
Antiseptic Combinations
BUCALSEP LIQD 1
ANTIVIRALS - Drugs to Treat Viral Infections
Herpes Agents
acyclovir caps 1
acyclovir tabs 1
ZOVIRAX CAPS (Use Acyclovir)
1
ZOVIRAX TABS (Use Acyclovir)
1
BETA BLOCKERS - Drugs to Treat High Blood Pressure
Alpha-Beta Blockers
carvedilol tabs 3.125 mg 1 QL(2 ea daily)
12
CEPHALOSPORINS - Drugs to Treat Bacterial Infections
Drug Name Drug Tier
Requirements/ Limits
carvedilol tabs 6.25 mg, 25 mg, 12.5 mg
1
COREG TABS 25 MG, 12.5 MG, 6.25 MG (Use Carvedilol)
1
COREG TABS 3.125 MG (Use Carvedilol)
1 QL(2 ea daily)
labetalol hcl tabs 1
Beta Blockers Cardio-Selective
atenolol tabs 1
LOPRESSOR TABS (Use Metoprolol Tartrate)
1
metoprolol tartrate tabs 1
TENORMIN TABS (Use Atenolol)
1
Beta Blockers Non-Selective
BETAPACE AF TABS (Use Sotalol HCl (AFIB/AFL))
1
BETAPACE TABS (Use Sotalol HCl)
1
propranolol hcl tabs 1
sotalol hcl (afib/afl) tabs 1
sotalol hcl tabs 1
CALCIUM CHANNEL BLOCKERS - Drugs to Treat High Blood Pressure
Calcium Channel Blockers
amlodipine besylate tabs 1 QL(2 ea daily)
CALAN TABS (Use Verapamil HCl)
1
CARDIZEM TABS (Use Diltiazem HCl)
1
diltiazem hcl tabs 1
NORVASC TABS (Use Amlodipine Besylate)
1 QL(2 ea daily)
verapamil hcl tabs 1
Drug Name Drug Tier
Requirements/ Limits
Cephalosporins - 1st Generation
cefadroxil caps 1
cephalexin caps 1
KEFLEX CAPS (Use Cephalexin)
1
CHEMICALS
Bulk Chemicals - T's
TEA TREE OIL OIL 1 RX/OTC
CORTICOSTEROIDS - Steroid Hormone Drugs to Treat Systemic Swelling Conditions
Glucocorticosteroids
CORTEF TABS (Use Hydrocortisone)
1
dexamethasone elix 0.5 mg/5ml
1
DEXAMETHASONE SOLN 0.5 MG/5ML
1
dexamethasone tabs 0.5 mg, 0.75 mg, 4 mg
1
hydrocortisone tabs 1
prednisolone sodium phosphate soln
1
prednisolone soln 1
prednisolone syrp 1
prednisone tabs 1 mg, 10 mg, 5 mg, 2.5 mg, 20 mg
1
PREDNISONE TABS 50 MG
1
COUGH/COLD/ALLERGY - Drugs to Treat Cough, Cold and Allergy Symptoms
Antitussives
benzonatate caps 1
TESSALON PERLES CAPS (Use Benzonatate)
1
Cough/Cold/Allergy Combinations
ACTICON SOLN 1
13
Drug Name Drug Tier
Requirements/ Limits
ACTICON TABS 1
ACTIDOGESIC TABS 1
ACTINEL LIQD 1
BIONEL LIQD 1
CONEX COLD/ALLERGY SOLN
1
CONEX COLD/ALLERGY TABS
1
DECON-A ELIX 1
DESPEC-TAB TABS 1
dextromethorphan- guaifenesin syrp
1
diphenhydramine- acetaminophen tabs
1
DOLOGEN TABS 1
DOLOGESIC TABS 1
DOLOGESIC-DF TABS 1
DOMETUSS- DA/CHILDREN LIQD
1
EXACTUSS LIQD (Use Phenylephrine w/ DM-GG)
1 RX/OTC
G-DOLOGEN TABS 1
G-TUSICOF LIQD 1
G-ZYNCOF SYRP 1
GILTUSS LIQD (Use Phenylephrine w/ DM-GG)
1 RX/OTC
PECGEN DMX LIQD 1
PERCOGESIC TABS (Use Diphenhydramine- Acetaminophen)
1
Drug Name Drug Tier
Requirements/ Limits
phenylephrine w/ dm-gg liqd 10mg/5ml-10mg/5ml- 100mg/5ml-100mg/5ml- 5mg/5ml-5mg/5ml, 10mg/5ml-100mg/5ml- 5mg/5ml, 10mg/5ml- 200mg/5ml-5mg/5ml
1
phenylephrine w/ dm-gg liqd 28mg/5ml-388mg/5ml- 10mg/5ml, 5mg/ml- 50mg/ml-2.5mg/ml, 7.5mg/ml-88mg/ml- 2.5mg/ml
1
RX/OTC
promethazine w/codeine syrp
1
pseudoephedrine w/ dm-gg liqd
1
pseudoephedrine w/ dm-gg tabs
1
pseudoephedrine- dexchlorpheniramine- chlophedianol liqd
1
ROBITUSSIN DM SYRP (Use Dextromethorphan- Guaifenesin)
1
ROBITUSSIN PEAK COLD DM SYRP (Use Dextromethorphan- Guaifenesin)
1
ROBITUSSIN PEAK COLD MULTI-SYMPTOM COLD LIQD (Use Phenylephrine w/ DM-GG)
1
ROBITUSSIN TO GO COUGH &COLD CF LIQD (Use Phenylephrine w/ DM- GG)
1
SORBUTUSS NR LIQD 1
TRISPEC DMX LIQD 1
TRISPEC DMX PEDIATRIC LIQD
1
TUSICOF LIQD 1
TUSNEL C SYRP 1
TUSNEL LIQD 1
14
Drug Name Drug Tier
Requirements/ Limits
ZYNCOF SYRP 1
Expectorants
guaifenesin tabs 1
Misc. Respiratory Inhalants
HYPERSAL NEBU 1
NEBUSAL NEBU 1
sodium chloride (inhalant) nebu
1
DERMATOLOGICALS - Drugs to Treat Skin Conditions
Acne Products
benzoyl peroxide gel 1 RX/OTC
Antibiotics - Topical
BACIGUENT OINT (Use Bacitracin (Topical))
1
bacitracin (topical) oint 1
bacitracin zinc oint 1
gentamicin sulfate (topical) crea
1
neomycin-bacitracin- polymyxin oint
1
neomycin-polymyxin w/ pramoxine crea
1
NEOSPORIN ORIGINAL OINT (Use Neomycin- Bacitracin-Polymyxin)
1
NEOSPORIN PLUS PAIN RELIEF MAXIMUM STRENGTH CREA (Use Neomycin-Polymyxin w/ Pramoxine)
1
Antifungals - Topical
ciclopirox olamine crea 1
clotrimazole (topical) crea 1 RX/OTC
FUNGI-NAIL SOLN 1
Drug Name Drug Tier
Requirements/ Limits
G-MYCO NAIL SOLN 1
GORDOCHOM SOLN 1
LAMISIL AT CREA (Use Terbinafine HCl (Topical))
1
LAMISIL AT JOCK ITCH CREA (Use Terbinafine HCl (Topical))
1
LOPROX CREA (Use Ciclopirox Olamine)
1
LOTRIMIN AF CREA (Use Clotrimazole (Topical))
1 RX/OTC
LOTRIMIN AF FOR HER CREA (Use Clotrimazole (Topical))
1 RX/OTC
LOTRIMIN AF JOCK ITCH CREA (Use Clotrimazole (Topical))
1 RX/OTC
MICATIN CREA (Use Miconazole Nitrate (Topical))
1
miconazole nitrate (topical) crea
1
MYCO NAIL A SOLN 1
MYCO NAIL SOLN 1
MYCO-NAIL SOLN 1
RA ANTI-FUNGAL FOOT CARE SOLN
1
terbinafine hcl (topical) crea 1
TINACTIN CREA (Use Tolnaftate)
1
TINACTIN JOCK ITCH CREA (Use Tolnaftate)
1
TINACTIN POWD (Use Tolnaftate)
1
tolnaftate crea 1
tolnaftate powd 1
Antihistamines-Topical
15
Drug Name Drug Tier
Requirements/ Limits
BENADRYL EXTRA STRENGTH CREA (Use Diphenhydramine-Zinc Acetate)
1
BENADRYL ITCH STOPPING CREA (Use Diphenhydramine-Zinc Acetate)
1
diphenhydramine-zinc acetate crea
1
Burn Products
SILVADENE CREA (Use Silver Sulfadiazine)
1
silver sulfadiazine crea 1
Corticosteroids - Topical
betamethasone dipropionate augmented crea
1
DIPROLENE AF CREA (Use Betamethasone Dipropionate Augmented)
1
ELOCON CREA (Use Mometasone Furoate)
1
ELOCON LOTN (Use Mometasone Furoate)
1
fluocinonide crea 1
hydrocortisone (topical) crea 0.5 %, 2.5 %
1
hydrocortisone (topical) crea 1%, 1 %
1 RX/OTC
hydrocortisone (topical) oint 1 %
1 RX/OTC
hydrocortisone (topical) oint 2.5 %
1
hydrocortisone-aloe vera crea
1
mometasone furoate crea 1
mometasone furoate soln 1
MONISTAT SOOTHING CARE ITCH RELIEF CREA (Use Hydrocortisone (Topical))
1
RX/OTC
Drug Name Drug Tier
Requirements/ Limits
triamcinolone acetonide (topical) crea
1
triamcinolone acetonide (topical) oint
1
Diaper Rash Products
diaper rash products oint 1
Emollient/Keratolytic Agents
ATRAC-TAIN CREA (Use Urea)
1
CARMOL 20 CREA (Use Urea)
1
urea crea 1
Liniments
ASPERCREME/ALOE CREA (Use Trolamine Salicylate)
1
MOBISYL CREA (Use Trolamine Salicylate)
1
MYOFLEX CREA (Use Trolamine Salicylate)
1
SPORTSCREME CREA (Use Trolamine Salicylate)
1
trolamine salicylate crea 1
Local Anesthetics - Topical
capsaicin crea 1
lidocaine hcl gel 2 % 1 RX/OTC
lidocaine hcl soln 4 % 1
XYLOCAINE SOLN (Use Lidocaine HCl)
1
ZOSTRIX ARTHRITIS PAIN RELIEF CREA (Use Capsaicin)
1
Misc. Topical
AVEENO BABY SOOTHING RELIEF DIAPER RASH CREA
1
DRYSOL SOLN 1
XERAC AC SOLN 1
16
Drug Name Drug Tier
Requirements/ Limits
zinc oxide (topical) crea 1
zinc oxide (topical) oint 1
Wound Care Products
DUODERM HYDROACTIVE GEL GEL
1
DIETARY PRODUCTS/DIETARY MANAGEMENT PRODUCTS
Nutritional Supplements
ACAI WEIGHT CONTROL CAPS
1 RX/OTC
APP SLIM RMS CAPS 1 RX/OTC
CARB INTERCEPT/PHASE 2 CAPS
1 RX/OTC
DEXATRIM MAX COMPLEX 7 CAPS
1 RX/OTC
DIETERS DETOX CAPS 1 RX/OTC
DIETEX FORTE CAPS 1 RX/OTC
MINUS WEIGHT PLUS ENERGY CAPS
1 RX/OTC
ULTRA DIET AID CAPS 1 RX/OTC
DIGESTIVE AIDS - Drugs to Treat Low Digestive Enzymes
Digestive Enzymes
ABATRACE CAPS 1
DIGAZ CAPS 1
DIGEST II CAPS 1
DIGEST III CAPS 1
digestive enzymes caps 1
DIGESTIVE SUPPORT CAPS
1
GASTRACE DIGESTIVE SUPPORT CAPS
1
LACTAID FAST ACT CHEW (Use Lactase)
1
Drug Name Drug Tier
Requirements/ Limits
LACTAID FAST ACT TABS (Use Lactase)
1
lactase chew 1
lactase tabs 1
LIPASE CONCENTRATE- HP CAPS
1
TYLER SIMILASE JR CAPS
1
DIURETICS - Drugs to Treat Heart, Circulation Conditions and Blood Pressure
Diuretic Combinations
DYAZIDE CAPS (Use Triamterene & Hydrochlorothiazide)
1
MAXZIDE TABS (Use Triamterene & Hydrochlorothiazide)
1
MAXZIDE-25 TABS (Use Triamterene & Hydrochlorothiazide)
1
triamterene & hydrochlorothiazide caps
1
triamterene & hydrochlorothiazide tabs
1
Loop Diuretics
bumetanide tabs 1
BUMEX TABS (Use Bumetanide)
1
furosemide tabs 1
LASIX TABS (Use Furosemide)
1
Potassium Sparing Diuretics
ALDACTONE TABS (Use Spironolactone)
1
spironolactone tabs 1
Thiazides and Thiazide-Like Diuretics
hydrochlorothiazide caps 1
hydrochlorothiazide tabs 1
17
HEMATOPOIETIC AGENTS - Drugs to Treat Blood Disorders
Drug Name Drug Tier
Requirements/ Limits
MICROZIDE CAPS (Use Hydrochlorothiazide)
1
ESTROGENS - Hormone Replacement/Modifying Drugs
Estrogens
ESTRACE TABS (Use Estradiol)
1
estradiol tabs 1
FLUOROQUINOLONES - Drugs to Treat Bacterial Infections
Fluoroquinolones
CIPRO TABS (Use Ciprofloxacin HCl)
1
ciprofloxacin hcl tabs 1
LEVAQUIN TABS (Use Levofloxacin)
1 QL(14 ea per fill retail)
levofloxacin tabs 1 QL(14 ea per fill retail)
GASTROINTESTINAL AGENTS - MISC. - Miscellaneous Gastrointestinal Drugs
Antiflatulents
BICARSIM TABS 1
GAS-X CHEW (Use Simethicone)
1
GAS-X EXTRA STRENGTH CHEW (Use Simethicone)
1
MYLICON INFANTS GAS RELIEF SUSP (Use Simethicone)
1
MYLICON SUSP (Use Simethicone)
1
PHAZYME CAPS (Use Simethicone)
1
PHAZYME MAXIMUM STRENGTH CAPS
1
PHAZYME ULTRA STRENGTH CAPS (Use Simethicone)
1
simethicone caps 1
Drug Name Drug Tier
Requirements/ Limits
simethicone chew 1
simethicone liqd 1
simethicone susp 1
Gastrointestinal Stimulants
metoclopramide hcl soln 1
metoclopramide hcl tabs 1
REGLAN TABS (Use Metoclopramide HCl)
1
Inflammatory Bowel Agents
AZULFIDINE EN-TABS TBEC (Use Sulfasalazine)
1
AZULFIDINE TABS (Use Sulfasalazine)
1
sulfasalazine tabs 1
sulfasalazine tbec 1
GOUT AGENTS - Drugs to Treat Gout
Gout Agents
allopurinol tabs 1
ZYLOPRIM TABS (Use Allopurinol)
1
HEMATOLOGICAL AGENTS - MISC. - Drugs to Treat Blood Disorders
Hematorheologic Agents
pentoxifylline tbcr 1
Platelet Aggregation Inhibitors
cilostazol tabs 1 QL(2 ea per fill retail)
clopidogrel bisulfate tabs 1 QL(2 ea daily)
PLAVIX TABS (Use Clopidogrel Bisulfate)
1 QL(2 ea daily)
PLETAL TABS (Use Cilostazol)
1 QL(2 ea per fill retail)
18
Drug Name Drug Tier
Requirements/ Limits
Cobalamins
B-12 LOZG 1
B-12 TABS 1
cyanocobalamin subl 1
cyanocobalamin tabs 1
cyanocobalamin tbcr 1
methylcobalamin subl 1
VITAMIN B 12 LOZG 1
Folic Acid/Folates
folic acid tabs 1 mg 1 RX/OTC
folic acid tabs 400 mcg, 800 mcg
1
Hematopoietic Mixtures
ABANEU-SL SUBL 1
ABATREX TABS 1
B-12 1000 SUBL 1
B-12 SUBL 1
ferrous fumarate-fa-b complex-c-zn-mg-mn-cu tabs
1
ferrous fumarate-folic acid tabs
1
FOLGARD TABS 1
FOLIC + B12 TABS 1 RX/OTC
FOLINIC-PLUS TABS 1
FOLTRATE TABS 1 RX/OTC
HEMATRON-AF TABS (Use Iron-Docusate-B12- Folic Acid-Vit C-Vit E- Copper-Biotin)
1
RX/OTC
Drug Name Drug Tier
Requirements/ Limits
iron polysaccharide complex-vit b12-folic acid caps
1
iron-docusate-b12-folic acid-vit c-vit e-copper-biotin tabs
1 RX/OTC
MTX SUPPORT TABS 1 RX/OTC
NEURIN-SL SUBL 1
OPURITY B12/FOLIC ACID TABS
1 RX/OTC
VITAMIN B12/FOLIC ACID TABS
1 RX/OTC
Iron
FEOSOL TABS (Use Ferrous Sulfate Dried)
1
ferrous fumarate tabs 1
ferrous gluconate tabs 1
FERROUS GLUCONATE TABS
1
ferrous sulfate dried tabs 1
ferrous sulfate dried tbcr 1
ferrous sulfate elix 220 mg/5ml
1
ferrous sulfate tabs 65 mg, 325 mg
1
ferrous sulfate tbcr 50 mg 1
FERROUS SULFATE TBEC 324 MG
1
HEMOCYTE TABS (Use Ferrous Fumarate)
1
IRON TABS 1
polysaccharide iron complex caps
1
HYPNOTICS/SEDATIVES/SLEEP DISORDER AGENTS
Antihistamine Hypnotics
diphenhydramine- acetaminophen (sleep) tabs
1
19
Drug Name Drug Tier
Requirements/ Limits
doxylamine succinate (sleep) tabs
1
TYLENOL PM EXTRA STRENGTH TABS (Use Diphenhydramine- Acetaminophen (sleep))
1
UNISOM TABS (Use Doxylamine Succinate (Sleep))
1
Non-Barbiturate Hypnotics
AMBIEN TABS (Use Zolpidem Tartrate)
1 QL(1 ea per fill retail)
estazolam tabs 1
RESTORIL CAPS (Use Temazepam)
1
SONATA CAPS (Use Zaleplon)
1 QL(1 ea per fill retail)
temazepam caps 1
zaleplon caps 1 QL(1 ea per fill retail)
zolpidem tartrate tabs 1 QL(1 ea per fill retail)
LAXATIVES - Bowel Treatment Drugs
Bulk Laxatives
calcium polycarbophil tabs 1
FIBERCON TABS (Use Calcium Polycarbophil)
1
Laxative Combinations
sennosides-docusate sodium tabs
1
SENOKOT S TABS (Use Sennosides-Docusate Sodium)
1
Stimulant Laxatives
bisacodyl tbec 1
AL; At least 50 yrs old - Up to 74 yrs old
DULCOLAX TBEC (Use Bisacodyl)
1 AL; At least 50 yrs old - Up to 74 yrs old
sennosides tabs 1
Drug Name Drug Tier
Requirements/ Limits
SENOKOT TABS (Use Sennosides)
1
Surfactant Laxatives
COLACE CAPS (Use Docusate Sodium)
1
docusate calcium caps 1
docusate sodium caps 1
MEDICAL DEVICES AND SUPPLIES
Parenteral Therapy Supplies
3ML LUER LOCK SAFETY SYRINGES/3ML/21G X 1 1/2" MISC
1 RX/OTC
3ML LUER-LOK SYRINGE21G X 1-1/2" MISC
1 RX/OTC
3ML SYRINGE/21G X 1- 1/2"/LUER LOCK TIP MISC
1 RX/OTC
BD 3ML LUER-LOK SYRINGE/21G X 1-1/2" MISC
1 RX/OTC
BD INTEGRA 3ML SYRINGE W/RETRACTING NEEDLE/21G X 1-1/2" MISC
1
RX/OTC
EASY TOUCH FLIPLOCK SAFETY SYRINGES 3ML/21GX1-1/2" MISC
1 RX/OTC
EASY TOUCH SHEATHLOCK SAFETY SYRINGE 3ML/21GX1-1/2" MISC
1
RX/OTC
INSULIN SYRINGES-MISC 1
MONOJECT 3ML SYRINGE/STANDARD HYPODERMIC NEEDLE/21GX1-1/2" MISC
1
RX/OTC
MONOJECT MAGELLAN SYRINGE/SAFETY NEEDLE/3ML/21G X 1-1/2" MISC
1
RX/OTC
20
Drug Name Drug Tier
Requirements/ Limits
MONOJECT SAFETY SYRINGE/SHIELD/NEEDL E/3ML/21G X 1-1/2" MISC
1 RX/OTC
MONOJECT SYRINGE/LUER- LOCK/3ML/21G X 1-1/2" MISC
1
RX/OTC
PENTIPS/PEN NEEDLES MISC
1
SAFESNAP SYRINGE/NEEDLE/3ML/2 1G X 1-1/2" MISC
1 RX/OTC
SAFETY SYRINGES/NEEDLE 3ML/21GX1-1/2" MISC
1 RX/OTC
SAFETY-LOK SYRINGE/NEEDLE3ML LUER-LOK 21GX1-1/2" MISC
1
RX/OTC
SYRINGE/LUER LOCK/3ML/21G X 1-1/2" MISC
1 RX/OTC
SYRINGE/LUER LOCK/3ML/21GX1-1/2" MISC
1 RX/OTC
VANISHPOINT SAFETY SYRINGE/3ML/21GX1-1/2" MISC
1 RX/OTC
VANISHPOINT SYRINGE/3ML/21G X 1- 1/2" MISC
1 RX/OTC
MINERALS & ELECTROLYTES
Calcium
calcium carbonate tabs 1
calcium carbonate- cholecalciferol tabs
1
calcium carbonate-vitamin d tabs
1
calcium carbonate-vitamin d w/ minerals chew
1
calcium carbonate-vitamin d w/ minerals tabs
1
calcium citrate-vitamin d tabs
1
Drug Name Drug Tier
Requirements/ Limits
calcium-magnesium w/ vitamin d tb24
1
CALTRATE 600+D PLUS MINERALS CHEW (Use Calcium Carbonate-Vitamin D w/ Minerals)
1
CALTRATE 600+D PLUS MINERALS TABS (Use Calcium Carbonate-Vitamin D w/ Minerals)
1
CALTRATE 600+D TABS (Use Calcium Carbonate- Cholecalciferol)
1
CALTRATE 600+D3 SOFT CHEWS CHEW
1
CITRACAL + D3 MAXIMUM TABS (Use Calcium Citrate-Vitamin D)
1
CITRACAL CALCIUM+D SLOW RELEASE TB24 (Use Calcium-Magnesium w/ Vitamin D)
1
CITRACAL MAXIMUM TABS (Use Calcium Citrate-Vitamin D)
1
CORAL CALCIUM PLUS CAPS
1
Magnesium
magnesium oxide (mg supplement) tabs
1
MAGOX 400 TABS (Use Magnesium Oxide (Mg Supplement))
1
Potassium
K-TAB TBCR (Use Potassium Chloride)
1
potassium chloride microencapsulated crystals er tbcr
1
potassium chloride tbcr 1
Trace Minerals
chromium picolinate caps 1
Zinc
21
Drug Name Drug Tier
Requirements/ Limits
zinc sulfate caps 1
MISCELLANEOUS THERAPEUTIC CLASSES
Homeopathic Products
ARNICARE GEL 1 RX/OTC
BIORX SPONIX NAIL GEL GEL
1 RX/OTC
CALENDULA GEL 1 RX/OTC
COLCIGEL GEL 1 RX/OTC
LICEFREEE GEL GEL 1 RX/OTC
NEURAGEN GEL 1 RX/OTC
PROSACEA GEL 1 RX/OTC
RAPID GEL RX GEL 1 RX/OTC
SPEEDGEL RX GEL 1 RX/OTC
STERYMINE GEL 1 RX/OTC
T-RELIEF PAIN ARNICA + 12 GEL
1 RX/OTC
TECNU EXTREME MEDICATED POISON IVY SCRUB GEL
1 RX/OTC
TRANZGEL GEL 1 RX/OTC
TRAUMEEL GEL 1 RX/OTC
MOUTH/THROAT/DENTAL AGENTS
Anesthetics Topical Oral
ACTISEP SOLN 1
G-BUCAL-C SOLN 1
GUMSOL LIQD 1
lidocaine hcl (mouth-throat) soln
1
ORASEP SOLN 1
Anti-infectives - Throat
Drug Name Drug Tier
Requirements/ Limits
nystatin (mouth-throat) susp
1
Antiseptics - Mouth/Throat
CHERACOL SORE THROAT LIQD (Use Phenol (Antiseptic))
1
PAIN-A-LAY LIQD (Use Phenol (Antiseptic))
1
phenol (antiseptic) liqd 1
MULTIVITAMINS
B-Complex Vitamins
b-complex vitamins caps 1
b-complex vitamins tabs 1
B-Complex w/ C
b complex w/ c caps 1
b complex w/ c tabs 1
B-Complex w/ Folic Acid
B-100 COMPLEX TABS 1
b-complex w/ folic acid tabs 1
b-complex w/biotin & folic acid tabs
1
b-complex w/biotin & folic acid tbcr
1
BIOTALAN CLEAR LIQD 1 RX/OTC
SUPERVITE LIQD 1 RX/OTC
B-Complex w/ Iron
APETIGEN-PLUS SOLN 1
SUPLEVIT LIQD 1
Bioflavonoid Products
bioflavonoid caps 1
bioflavonoid tabs 1
Multiple Vitamins w/ Calcium
22
Drug Name Drug Tier
Requirements/ Limits
HM ONE DAILY ESSENTIAL TABS
1
multiple vitamins w/ calcium tabs
1
ONE-A-DAY WOMENS FORMULA TABS (Use Multiple Vitamins w/ Calcium)
1
SM ONE DAILY ESSENTIAL TABS
1
Multiple Vitamins w/ Minerals
ACTIVITE EC TABS 1 RX/OTC
CENTRUM MULTIVITAMIN FLAVOR BURST DRINK PACK
1
EMERGEN-C BLUE PACK 1
EMERGEN-C FIVE PACK 1
EMERGEN-C HEART HEALTH PACK
1
EMERGEN-C IMMUNE PACK
1
EMERGEN-C IMMUNE PLUS PACK
1
EMERGEN-C IMMUNE+ WARMERS PACK
1
EMERGEN-C JOINT HEALTH PACK
1
EMERGEN-C KIDZ PACK 1
EMERGEN-C MSM LITE PACK
1
EMERGEN-C PINK PACK 1
EMERGEN-C SUPER FRUIT PACK
1
EMERGEN-C VITAMIN C LITE PACK
1
EMERGEN-C VITAMIN C PACK
1
EMERGEN-C VITAMIN D & CALCIUM PACK
1
ENERGY BOOSTER PACK
1
Drug Name Drug Tier
Requirements/ Limits
EQL SUPER ENERGY BOOSTER PACK
1
IMMUNE SUPPORT VITAMIN C PACK
1
MAXIMIN PACK PACK 1
MULTI FOR HER PACK 1
MULTI FOR HIM PACK 1
multivitamin/minerals cap 1
multivitamin/minerals liq 1
multivitamin/minerals tab 1
RA ESSENCE-C PACK 1
SKIN BEAUTY & WELLNESS PACK
1
UDAMIN SP TABS 1 RX/OTC
VITAMENT PACK 1
VITAMIN C EFFERVESCENT BLEND PACK
1
VITAMIN C/ELECTROLYTES PACK
1
Multivitamins
CARDENZ TABS (Use Multiple Vitamin)
1
DEKAS ESSENTIAL CAPS 1
multiple vitamin caps 1
multiple vitamin tabs 1
OMNICAP TABS 1
ONE-A-DAY ESSENTIAL TABS (Use Multiple Vitamin)
1
ONE-A-DAY MENS TABS (Use Multiple Vitamin)
1
QUINTABS TABS 1
23
Drug Name Drug Tier
Requirements/ Limits
THERA TABS 1
THERA/BETA-CAROTENE TABS
1
ZE-PLUS CAPS (Use Multiple Vitamin)
1
Prenatal Vitamins
CENTRUM SPECIALIST PRENATAL MISC
1
CLASSIC PRENATAL TABS
1
CVS PRENATAL MULTI+DHA CAPS
1
CVS PRENATAL TABS 1
ENFAMIL EXPECTA MISC 1
EQL PRENATAL FORMULA TABS
1
GNP PRENATAL TABS 1
GOODSENSE PRENATAL VITAMINS TABS
1
HM PRENATAL TABS 1
KP PRENATAL MULTIVITAMINS TABS
1
M-VIT TABS 1 RX/OTC
MULTI PRENATAL TABS 1
NAT-RUL PRENATAL VITAMINS TABS
1
NIVA-PLUS TABS 1 RX/OTC
O-CAL FA TABS 1 RX/OTC
PNV FOLIC ACID + IRON MULTIVITAMIN TABS
1 RX/OTC
PNV PRENATAL PLUS MULTIVITAMIN TABS
1 RX/OTC
PRENATAL FORMULA TABS
1
PRENATAL LOW IRON TABS
1
PRENATAL MULTI + DHA CAPS
1
Drug Name Drug Tier
Requirements/ Limits
PRENATAL MULTIVITAMIN + DHA MISC
1
PRENATAL MULTIVITAMIN PLUS DHA CAPS
1
PRENATAL MULTIVITAMIN TABS
1
PRENATAL ONE DAILY TABS
1
PRENATAL PLUS TABS 1 RX/OTC
PRENATAL TABS 22MG- 2MG-25MG-1.84MG- 200MG-27MG-4000UNIT- 20MG-3MG-12MCG- 400UNIT-1MG-10MG- 120MG
1
RX/OTC
PRENATAL TABS 30UNIT- 4000UNIT-25MG-1.8MG- 200MG-28MG-20MG- 1.7MG-8MCG-400UNIT- 0.8MG-2.6MG-120MG, 4000UNIT-30UNIT-25MG- 1.8MG-200MG-28MG- 20MG-1.7MG-8MCG- 400UNIT-800MCG-2.6MG- 120MG, 4000UNIT- 30UNIT-200MG-25MG- 1.8MG-28MG-20MG- 1.7MG-8MCG-400UNIT- 800MCG-2.6MG-120MG, 30UNIT-25MG-1.8MG- 200MG-28MG-20MG- 1.7MG-4000UNIT-8MCG- 400UNIT-800MCG-2.6MG- 120MG, 11UNIT-263MG- 25MG-1.5MG-27MG- 4000UNIT-18MG-1.7MG- 4MCG-400UNIT-0.8MG- 2.6MG-100MG, 30UNIT- 4000UNIT-25MG-1.8MG- 200MG-28MG-20MG- 1.7MG-8MCG-400UNIT- 800MCG-2.6MG-120MG, 160MG-11UNIT-200MG- 25MG-1.84MG-27MG- 4000UNIT-18MG-1.7MG- 4MCG-400UNIT-800MCG- 2.6MG-100MG
1
24
Drug Name Drug Tier
Requirements/ Limits
PRENATAL VITAMIN & MINERAL TABS
1
PRENATAL VITAMIN TABS
1
PRENATAL VITAMIN/IRON TABS
1
PRENATAL VITAMINS PLUS LOW IRON TABS
1 RX/OTC
PRENATAL VITAMINS TABS
1
PREPLUS TABS 1 RX/OTC
PX PRENATAL MULTIVITAMINS TABS
1
QC PRENATAL TABS 1
RA PRENATAL FORMULA/FOLICACID TABS
1
RA PRENATAL TABS 1
RIGHT STEP PRENATAL TABS
1
SIMILAC PRENATAL EARLY SHIELD MISC
1
SM PRENATAL VITAMINS TABS
1
THERANATAL CORE NUTRITION TABS
1 RX/OTC
TRICARE TABS 1 RX/OTC
VINATE M TABS 1
VOL-PLUS TABS 1 RX/OTC
Vitamins w/ Lipotropics
ACTIFLOVIT EAR HEALTH TABS
1
LIPOTRIAD TABS (Use Vitamins w/ Lipotropics)
1
vitamins w/ lipotropics tabs 1
MUSCULOSKELETAL THERAPY AGENTS - Drugs to Treat Spasms
Central Muscle Relaxants
Drug Name Drug Tier
Requirements/ Limits
baclofen tabs 1
carisoprodol tabs 1
chlorzoxazone tabs 1
cyclobenzaprine hcl tabs 1
methocarbamol tabs 1
PARAFON FORTE DSC TABS (Use Chlorzoxazone)
1
ROBAXIN TABS (Use Methocarbamol)
1
ROBAXIN-750 TABS (Use Methocarbamol)
1
SOMA TABS (Use Carisoprodol)
1
tizanidine hcl tabs 1
ZANAFLEX TABS (Use Tizanidine HCl)
1
NASAL AGENTS - SYSTEMIC AND TOPICAL - Drugs to treat the Nose or Sinus
Nasal Agents - Misc.
OCEAN NASAL SPRAY SOLN (Use Saline)
1
saline soln 1
Sympathomimetic Decongestants
AFRIN 12 HOUR SOLN (Use Oxymetazoline HCl)
1
AFRIN ALL NIGHT NODRIP SOLN (Use Oxymetazoline HCl)
1
AFRIN NASAL SPRAY SOLN (Use Oxymetazoline HCl)
1
AFRIN NODRIP EXTRA MOISTURIZING SOLN (Use Oxymetazoline HCl)
1
AFRIN NODRIP ORIGINAL SOLN (Use Oxymetazoline HCl)
1
AFRIN NODRIP SEVERE CONGESTION SOLN (Use Oxymetazoline HCl)
1
25
Drug Name Drug Tier
Requirements/ Limits
AFRIN NODRIP SINUS SOLN (Use Oxymetazoline HCl)
1
AFRIN SINUS SOLN (Use Oxymetazoline HCl)
1
AFRIN SOLN (Use Oxymetazoline HCl)
1
DRISTAN SPRAY SOLN (Use Oxymetazoline HCl)
1
DURATION 12 HOUR SOLN (Use Oxymetazoline HCl)
1
DURATION SPRAY SOLN (Use Oxymetazoline HCl)
1
NASAL DECONGESTANT SYRP
1
NEO-SYNEPHRINE 12 HOUR EXTRA MOISTURIZING SOLN (Use Oxymetazoline HCl)
1
oxymetazoline hcl soln 1
phenylephrine hcl (oral) tabs
1
pseudoephedrine hcl tabs 1
SUDAFED CONGESTION TABS (Use Pseudoephedrine HCl)
1
SUDAFED NASAL DECONGESTANT MAXIMUM STRENGTH TABS (Use Pseudoephedrine HCl)
1
SUDAFED PE CONGESTION TABS (Use Phenylephrine HCl (Oral))
1
VICKS SINEX 12 HOUR DECONGESTANT SOLN (Use Oxymetazoline HCl)
1
VICKS SINEX 12 HOUR DECONGESTANT ULTRA FINE MIST SOLN (Use Oxymetazoline HCl)
1
Drug Name Drug Tier
Requirements/ Limits
VICKS SINEX 12 HOUR DECONGESTANT ULTRA FINE MIST/MOISTURIZNG SOLN (Use Oxymetazoline HCl)
1
VICKS SINEX MOISTURIZING SOLN (Use Oxymetazoline HCl)
1
VICKS SINEX SEVERE NASALDECONGESTANT SOLN (Use Oxymetazoline HCl)
1
VICKS SINEX SOLN (Use Oxymetazoline HCl)
1
NUTRIENTS
Lipotropics
lecithin caps 1
Misc. Nutritional Substances
omega-3 fatty acids caps 1
Proteins
amino acids tabs 1
arginine tabs 1
DEQUASINE TABS (Use Amino Acids)
1
PHENYLADE PHEBLOC TABS
1
SUPER-AMINO 1600 TABS
1
TRIAMINO TABS 1
OPHTHALMIC AGENTS - Drugs to Treat the Eye
Artificial Tears and Lubricants
artificial tear solution soln 1
carboxymethylcellulose sodium (ophth) soln
1
GENTEAL TEARS MODERATEPF SOLN
1
polyvinyl alcohol-povidone (ophth) soln
1
26
TETRACYCLINES - Drugs to Treat Bacterial Infections
Drug Name Drug Tier
Requirements/ Limits
REFRESH LIQUIGEL SOLN
1
REFRESH SOLN (Use Polyvinyl Alcohol-Povidone (Ophth))
1
REFRESH TEARS SOLN (Use Carboxymethylcellulose Sodium (Ophth))
1
Ophthalmic Decongestants
naphazoline w/ pheniramine soln
1
OPCON-A SOLN (Use Naphazoline w/ Pheniramine)
1
tetrahydrozoline hcl (ophth) soln
1
VISINE EXTRA SOLN (Use Tetrahydrozoline HCl (Ophth))
1
VISINE SOLN (Use Tetrahydrozoline HCl (Ophth))
1
Ophthalmics - Misc.
EYEAID IRRIGATING SOLUTION SOLN (Use Ophthalmic Irrigation Solution)
1
ophthalmic irrigation solution soln
1
OTIC AGENTS - Drugs to Treat the Ear
Otic Agents - Miscellaneous
carbamide peroxide (otic) soln
1
DEBROX SOLN (Use Carbamide Peroxide (Otic))
1
isopropyl alcohol (otic) liqd 1
SWIM EAR LIQD (Use Isopropyl Alcohol (Otic))
1
PENICILLINS - Drugs to Treat Bacterial Infections
Aminopenicillins
amoxicillin caps 1
Drug Name Drug Tier
Requirements/ Limits
amoxicillin tabs 1
ampicillin caps 250 mg, 500 mg
1
AMPICILLIN CAPS 500 MG
1
Natural Penicillins
penicillin v potassium tabs 1
PHARMACEUTICAL ADJUVANTS
Liquid Vehicles
BACTERIOSTATIC WATER FORINJECTION/BENZYL ALCOHOL SOLN
1
Pharmaceutical Excipients
LACTOSE ANHYDROUS POWD
1 RX/OTC
LACTOSE HYDROUS POWD
1 RX/OTC
LACTOSE POWD 1 RX/OTC
Semi Solid Vehicles
white petrolatum gel 1 RX/OTC
PROGESTINS - Hormone Replacement/Modifying Drugs
Progestins
medroxyprogesterone acetate tabs
1
PROVERA TABS (Use Medroxyprogesterone Acetate)
1
PSYCHOTHERAPEUTIC AND NEUROLOGICAL AGENTS - MISC. - Drugs to Treat Mental and Emotional Conditions
Antidementia Agents
ARICEPT TABS (Use Donepezil Hydrochloride)
1
donepezil hydrochloride tabs
1
27
Drug Name Drug Tier
Requirements/ Limits
Tetracyclines
doxycycline (monohydrate) caps
1
MINOCIN CAPS (Use Minocycline HCl)
1
minocycline hcl caps 1
THYROID AGENTS - Drugs to Regulate Thyroid Hormones
Antithyroid Agents
methimazole tabs 1
TAPAZOLE TABS (Use Methimazole)
1
Thyroid Hormones
ARMOUR THYROID TABS (Use Thyroid)
1
levothyroxine sodium tabs 1
NATURE-THROID TABS 1
SYNTHROID TABS (Use Levothyroxine Sodium)
1
thyroid tabs 1
WESTHROID TABS 1
WP THYROID TABS 1
ULCER DRUGS - Drugs to Treat Bowel, Intestine and Stomach Conditions
Antispasmodics
ANASPAZ TBDP (Use Hyoscyamine Sulfate)
1
BENTYL CAPS (Use Dicyclomine HCl)
1
BENTYL TABS (Use Dicyclomine HCl)
1
dicyclomine hcl caps 1
dicyclomine hcl soln 1
dicyclomine hcl tabs 1
hyoscyamine sulfate subl 1
Drug Name Drug Tier
Requirements/ Limits
hyoscyamine sulfate tabs 1
hyoscyamine sulfate tbdp 1
LEVSIN TABS (Use Hyoscyamine Sulfate)
1
LEVSIN/SL SUBL (Use Hyoscyamine Sulfate)
1
H-2 Antagonists
cimetidine hcl soln 1
cimetidine tabs 1
famotidine tabs 10 mg 1
famotidine tabs 20 mg 1 QL(4 ea daily); RX/OTC
famotidine tabs 40 mg 1 QL(2 ea daily)
PEPCID AC MAXIMUM STRENGTH TABS (Use Famotidine)
1 QL(4 ea daily); RX/OTC
PEPCID AC TABS (Use Famotidine)
1
PEPCID TABS 20 MG (Use Famotidine)
1 QL(4 ea daily); RX/OTC
PEPCID TABS 40 MG (Use Famotidine)
1 QL(2 ea daily)
ranitidine hcl syrp 15 mg/ml, 150 mg/10ml, 75 mg/5ml
1
ranitidine hcl tabs 150 mg 1 RX/OTC
ranitidine hcl tabs 75 mg, 300 mg
1
ZANTAC 150 MAXIMUM STRENGTH TABS (Use Ranitidine HCl)
1 RX/OTC
ZANTAC 75 TABS (Use Ranitidine HCl)
1
ZANTAC TABS 150 MG (Use Ranitidine HCl)
1 RX/OTC
ZANTAC TABS 300 MG (Use Ranitidine HCl)
1
Misc. Anti-Ulcer
CARAFATE TABS (Use Sucralfate)
1
28
Drug Name Drug Tier
Requirements/ Limits
sucralfate tabs 1
Proton Pump Inhibitors
omeprazole cpdr 1
pantoprazole sodium tbec 1
PRILOSEC CPDR (Use Omeprazole)
1
PROTONIX TBEC (Use Pantoprazole Sodium)
1
VAGINAL PRODUCTS - Drugs to Treat Vaginal Infections and Low Hormones
Miscellaneous Vaginal Products
REPLENS VAGINAL MOISTURIZER GEL (Use Vaginal Lubricant)
1
vaginal lubricant gel 1
Vaginal Anti-infectives
clotrimazole vaginal crea 1
GYNE-LOTRIMIN CREA (Use Clotrimazole Vaginal)
1
miconazole nitrate vaginal crea
1
MONISTAT 7 SIMPLY CURE CREA (Use Miconazole Nitrate Vaginal)
1
VITAMINS
Misc. Nutritional Factors
BIOFLONEX TABS (Use Hesperidin-Diosmin)
1
hesperidin-diosmin tabs 1
Oil Soluble Vitamins
cholecalciferol caps 1
cholecalciferol tabs 1
DRISDOL CAPS (Use Ergocalciferol)
1
ergocalciferol caps 1
Drug Name Drug Tier
Requirements/ Limits
vitamin a caps 1
VITAMIN D2 TABS 1
VITAMIN D3 TABS 1
vitamin e caps 1
Water Soluble Vitamins
ascorbic acid tabs 1
biotin tabs 1
niacin tabs 1
pyridoxine hcl tabs 1
thiamine hcl tabs 1
Index 1
Index 3ML LUER LOCK SAFETY SYRINGES/3ML/21G X 1 1/2"
ALEVE ARTHRITIS 2
ALIGN 6
BACIGUENT 14 bacitracin (topical) 14
3ML LUER-LOK 19
SYRINGE21G X ALLEGRA ALLERGY 9 bacitracin zinc 14
1-1/2" 19 3ML SYRINGE/21G X 1- 1/2"/LUER LOCK TIP 19 ABANEU-SL 18
ABATRACE 16
ABATREX 18
ACAI WEIGHT CONTROL 16
ACCUPRIL 10
acetaminophen 2
acetaminophen w/ codeine 2
ACIDOPHILUS 6 ACIDOPHILUS HIGH- POTENCY 6 ACIDOPHILUS PEARLS 6 ACIDOPHILUS PROBIOTIC BLEND 6 ACIDOPHILUS SUPER PROBIOTIC 6 ACIDOPHILUS/GOAT MILK 6
ACTICON 12
ACTIDOGESIC 13
ACTIFLOVIT EAR HEALTH 24
ACTINEL 13
ACTISEP 21
ACTIVITE EC 22
ACTOS 6
acyclovir 11
ADIPEX-P 1
ADVANCED PROBIOTIC 6
ADVANCED PROBIOTIC 10 6
ADVIL 1
ADVIL MIGRAINE 1
AFRIN 25
AFRIN 12 HOUR 24
AFRIN ALL NIGHT NODRIP 24
AFRIN NASAL SPRAY 24 AFRIN NODRIP EXTRA MOISTURIZING 24 AFRIN NODRIP ORIGINAL 24 AFRIN NODRIP SEVERE CONGESTION 24 AFRIN NODRIP SINUS 25
AFRIN SINUS 25
albuterol sulfate 4
ALDACTONE 16
ALEVE
2
allopurinol 17
ALPHA LIPOIC ACID 1 alpha-lipoic acid (thioctic acid) 1 alprazolam 4
ALTACE 10
AMARYL 6
AMBIEN 19
amino acids 25
amiodarone hcl 4
amitriptyline hcl 6
amlodipine besylate 12
amoxicillin 26
ampicillin 26
AMPICILLIN 26
ANASPAZ 27
APETIGEN-PLUS 21
APP SLIM RMS 16
arginine 25
ARICEPT 26
ARMOUR THYROID 27
ARNICARE 21
artificial tear solution 25 ascorbic
acid 28
ASPERCREME/ALOE 15
aspirin 2
atenolol 12
ATIVAN 4
atorvastatin calcium 9
ATRAC-TAIN 15
AVAPRO 10 AVEENO BABY SOOTHING RELIEF DIAPER RASH 15 AZO CRANBERRY 1
AZULFIDINE 17
AZULFIDINE EN-TABS 17
b complex w/ c 21 B-
100 COMPLEX 21 B-
12 18 B-
12 1000 18
b-complex vitamins 21 b-
complex w/ folic acid 21 b-complex w/biotin & folic acid 21
Index 2
baclofen 24 BACTERIOSTATIC WATER FORINJECTION/BENZYL ALCOHOL 26 BACTRIM 3
BACTRIM DS 3 BD 3ML LUER-LOK SYRINGE/21G X 1-1/2" 19 BD INTEGRA 3ML SYRINGE W/RETRACTING NEEDLE/21G X 1-1/2" 19 BENADRYL ALLERGY 9 BENADRYL ALLERGY CHILDRENS 9 BENADRYL EXTRA STRENGTH 15 BENADRYL ITCH STOPPING 15 benazepril hcl
10 BENTYL
27
benzonatate
12 benzoyl peroxide
14 benztropine mesylate
11 betamethasone dipropionate augmented 15 BETAPACE
12 BETAPACE AF
12 BICARSIM
17 BIO-FLAX 1
bioflavonoid caps
21 bioflavonoid tabs
21 BIOFLONEX
28 BIONEL
13 BIORX SPONIX NAIL
GEL 21 BIOTALAN CLEAR
21
biotin
28 bisacodyl
19 bismuth subsalicylate
6 bisoprolol & hydrochlorothiazide 10 black cohosh (cimicifuga racemosa) 1 BONTRIL PDM 1
BUCALSEP 11
bumetanide
16 BUMEX
16
bupropion hcl 5
Index 3
buspirone hcl 3
CALAN 12
calcium carbonate 20
calcium carbonate (antacid) 3 calcium carbonate- cholecalciferol 20 calcium carbonate-vitamin d 20 calcium carbonate-vitamin d w/ minerals 20 calcium citrate-vitamin d 20
calcium polycarbophil 19 calcium-magnesium w/ vitamin d 20 CALENDULA 21
CALTRATE 600+D 20 CALTRATE 600+D PLUS MINERALS 20 CALTRATE 600+D3 SOFT CHEWS 20 capsaicin 15 CARAFATE 27 CARB INTERCEPT/PHASE 2 16 carbamide peroxide (otic) 26
carbidopa-levodopa 11 carboxymethylcellulose sodium (ophth) 25 CARDENZ 22
CARDIZEM 12
carisoprodol 24
CARMOL 20 15
carvedilol 11,12
CATAPRES 10
cefadroxil 12
CELEXA 5 CENTRUM MULTIVITAMIN FLAVOR BURST DRINK 22 CENTRUM SPECIALIST PRENATAL 23 cephalexin 12 cetirizine hcl 9 CHERACOL SORE THROAT 21 CHILDRENS PROBIOTIC PEARLS 6 CHLOR-TRIMETON 9
chlordiazepoxide hcl 4
chlorpheniramine maleate 9
chlorzoxazone 24
cholecalciferol 28
chromium picolinate 20
ciclopirox olamine 14
cilostazol 17
cimetidine 27
cimetidine hcl 27
CIPRO 17
ciprofloxacin hcl 17 citalopram hydrobromide 5 CITRACAL + D3 MAXIMUM 20 CITRACAL CALCIUM+D SLOW RELEASE 20 CITRACAL MAXIMUM 20
CLARITIN 9
CLARITIN REDITABS 9
CLASSIC PRENATAL 23
CLEOCIN 3
clindamycin hcl 3
clonazepam 4
clonidine hcl 10
clopidogrel bisulfate 17
clotrimazole (topical) 14
clotrimazole vaginal 28 coenzyme q10 (ubidecarenone) 1 COLACE 19
COLCIGEL 21
COLOSTRUM 1
CONEX COLD/ALLERGY 13
CORAL CALCIUM PLUS 20
CORDARONE 4
COREG 12
CORTEF 12
COUMADIN 4
COZAAR 10
CRESTOR 9 CULTURELLE ADVANCED IMMUNE DEFENSE 6 CULTURELLE PRO-WELL 6 CVS ADULT 50+ PROBIOTIC 6 CVS ADULT PROBIOTIC 7 CVS DIGESTIVE PROBIOTIC 7 CVS PRENATAL 23 CVS PRENATAL MULTI+DHA 23 CVS PROBIOTIC 7 CVS PROBIOTIC MAXIMUM STRENGTH 7
CVS PROBIOTIC PEARLS EXTRA STRENGTH 7 CVS SENIOR PROBIOTIC 7
cyanocobalamin 18
cyclobenzaprine hcl 24
DAILY PROBIOTIC 7
DEBROX 26
DECON-A 13
DEKAS ESSENTIAL 22
DEPAKENE 5
DEPAKOTE 5
DEQUASINE 25
DESPEC-TAB 13
dexamethasone 12
DEXAMETHASONE 12
dexamethasone 12 DEXATRIM MAX COMPLEX 7 16 dextromethorphan-guaifenesin 13 DIABETA 6
diaper rash products 15
diazepam 4
dibucaine (rectal) 3
diclofenac sodium 2
dicyclomine hcl 27
DIETERS DETOX 16
DIETEX FORTE 16
DIFF-STAT 7
DIGAZ 16
DIGEST II 16
DIGEST III 16
DIGESTIVE ADVANTAGE 7 DIGESTIVE ADVANTAGE LACTOSE DEFENSE FORMULA 7 digestive enzymes 16
DIGESTIVE SUPPORT 16
DILANTIN 5
diltiazem hcl 12
dimenhydrinate 8
DIOVAN HCT 10
diphenhydramine hcl 9 diphenhydramine-acetaminophen 13 diphenhydramine-acetaminophen (sleep) 18 diphenhydramine-zinc acetate 15
Index 4
DIPROLENE AF 15
divalproex sodium 5
docusate calcium 19
docusate sodium 19
DOLOGEN 13
DOLOGESIC 2
DOLOGESIC-DF 13
DOLOREX 2 DOMETUSS-DA/CHILDREN 13 donepezil hydrochloride 26 doxycycline (monohydrate) 27 doxylamine succinate (sleep) 19 DRAMAMINE 8
DRISDOL 28
DRISTAN SPRAY 25
DRYSOL 15
DULCOLAX 19 DUODERM HYDROACTIVE GEL 16 DURATION 12 HOUR 25
DURATION SPRAY 25
DYAZIDE 16 EASY TOUCH FLIPLOCK SAFETY SYRINGES 3ML/21GX1-1/2" 19 EASY TOUCH SHEATHLOCK SAFETY SYRINGE 3ML/21GX1- 1/2" 19 EC-NAPROSYN 2 ECOTRIN REGULAR STRENGTH 2 EFFEXOR XR 5
ELAVIL 6
ELOCON 15
EMERGEN-C BLUE 22
EMERGEN-C FIVE 22 EMERGEN-C HEART HEALTH 22 EMERGEN-C IMMUNE 22 EMERGEN-C IMMUNE PLUS 22 EMERGEN-C IMMUNE+ WARMERS 22 EMERGEN-C JOINT
EMERGEN-C SUPER FRUIT 22 EMERGEN-C VITAMIN C 22 EMERGEN-C VITAMIN C LITE 22 EMERGEN-C VITAMIN D & CALCIUM 22 enalapril maleate 10 enalapril maleate & hydrochlorothiazide 10 ENERGY BOOSTER 22
ENFAMIL EXPECTA 23 EQ PROBIOTIC DIGESTIVE SYSTEM SUPPORT 7 EQL ACIDOPHILUS EXTRA STRENGTH 7 EQL DAILY PROBIOTIC 7 EQL PRENATAL FORMULA 23 EQL PROBIOTIC COLON SUPPORT 7 EQL SUPER ENERGY BOOSTER 22 ergocalciferol 28
escitalopram oxalate 5
estazolam 19
ESTRACE 17
estradiol 17
EXACTUSS 13 EYEAID IRRIGATING SOLUTION 26 famotidine 27
FEMARA 11
FEOSOL 18
ferrous fumarate 18 ferrous fumarate-fa-b complex- c-zn-mg-mn-cu 18 ferrous fumarate-folic acid 18
ferrous gluconate 18
FERROUS GLUCONATE 18
ferrous sulfate 18
FERROUS SULFATE 18
ferrous sulfate dried 18
fexofenadine hcl 9
FIBERCON 19
FLAGYL 3 FLAX + DHA 1
FLORA-Q 7
FLORA-Q 2 7
FLORAJEN ACIDOPHILUS 7
FLORAJEN BIFIDOBLEND 7
FLORAJEN3 7
FLORAJEN4KIDS 7
fluocinonide 15
fluorouracil 10
fluoxetine hcl 5
flurbiprofen 2
fluvoxamine maleate 5
FOLGARD 18
FOLIC + B12 18
folic acid 18
FOLINIC-PLUS 18
FOLTRATE 18
FORTIFY DAILY PROBIOTIC 7
fosinopril sodium 10
FUNGI-NAIL 14
furosemide 16
G-BUCAL-C 21
G-DOLOGEN 13
G-MYCO NAIL 14
G-TUSICOF 13
G-ZYNCOF 13
gabapentin 4
GAS-X 17
GAS-X EXTRA STRENGTH 17 GASTRACE DIGESTIVE SUPPORT 16 gemfibrozil 9
gentamicin sulfate (topical) 14 GENTEAL TEARS MODERATEPF 25 GILTUSS 13
glimepiride 6
glipizide 6
GLUCOPHAGE 6
GLUCOPHAGE XR 6
glucosamine sulfate 1 glucosamine-chondroitin-vit c- manganese 1 GLUCOTROL 6
HEALTH 22 EMERGEN-C KIDZ 22 flaxseed (linseed) 1 flaxseed oil-fish oil-borage
GLUCOTROL XL 6
GLUCOVANCE 6
EMERGEN-C MSM LITE 22 EMERGEN-C PINK 22 oil 1
FLORA VANCE 7
glyburide 6
glyburide micronized 6
Index 5
glyburide-metformin 6
GLYNASE 6 GNP ACIDOPHILUS HIGH POTENCY 7 GNP PRENATAL 23 GNP PROBIOTIC COLON SUPPORT 7 GNP TRIPLE OMEGA COMPLEX 1 GOODSENSE PRENATAL VITAMINS 23 GORDOCHOM 14
guaifenesin 14
GUMSOL 21
GYNE-LOTRIMIN 28
haloperidol 11
HEMATRON-AF 18
HEMOCYTE 18
hesperidin-diosmin 28
HM ACIDOPHILUS 7 HM OMEGA-3-6-9 FATTY ACIDS 1 HM ONE DAILY ESSENTIAL 22 HM PRENATAL 23
hydralazine hcl 10
hydrochlorothiazide 16
hydrocodone-acetaminophen 2
hydrocortisone 12
hydrocortisone (topical) 15
hydrocortisone-aloe vera 15
hydroxyzine hcl 4
hydroxyzine pamoate 4
hyoscyamine sulfate 27
HYPERSAL 14
HYZAAR 10
ibuprofen 2
imipramine hcl 6 IMMUNE SUPPORT VITAMIN C 22 IMODIUM A-D 8
indomethacin 2
INSULIN SYRINGES-MISC 19
ipratropium bromide 4
ipratropium-albuterol 4
irbesartan 10
IRON 18 iron polysaccharide complex-vit b12-folic acid 18
iron-docusate-b12-folic acid-vit c-vit e-copper-biotin 18 isoniazid 10
isopropyl alcohol (otic) 26
isosorbide mononitrate 3 K-
TAB 20
KEFLEX 12
KEPPRA 4
KLONOPIN 4 KP PRENATAL MULTIVITAMINS 23 labetalol hcl 12
LACTAID FAST ACT 16
lactase 16
LACTO-PECTIN 7
lactobacillus 7
LACTOSE 26
LACTOSE ANHYDROUS 26
LACTOSE HYDROUS 26
LAMICTAL 4 LAMICTAL CHEWABLE DISPERSIBLE 4 LAMISIL 8
LAMISIL AT 14
LAMISIL AT JOCK ITCH 14
lamotrigine 4
LASIX 16
lecithin 25
letrozole 11
LEVAQUIN 17
levetiracetam 4 levocetirizine dihydrochloride 9 levofloxacin 17
levothyroxine sodium 27
LEVSIN 27
LEVSIN/SL 27
LEXAPRO 5
LICEFREEE GEL 21
lidocaine hcl 15 lidocaine hcl (mouth- throat) 21 LIPASE CONCENTRATE- HP 16 LIPITOR 9
LIPOTRIAD 24
lisinopril 10 lisinopril & hydrochlorothiazide 10
LITHIUM CARBONATE 11
lithium carbonate 11
loperamide hcl 8
LOPID 9
LOPRESSOR 12
LOPROX 14
loratadine 9
lorazepam 4
losartan potassium 10 losartan potassium & hydrochlorothiazide 10 LOTENSIN 10
LOTRIMIN AF 14
LOTRIMIN AF FOR HER 14
LOTRIMIN AF JOCK ITCH 14
lovastatin 9
M-VIT 23
magnesium oxide 3 magnesium oxide (mg supplement) 20 MAGOX 400 20
MAVIK 10
MAXIMIN PACK 22
MAXZIDE 16
MAXZIDE-25 16
meclizine hcl 8 medroxyprogesterone acetate 26 MEGA PROBIOTIC 7
MEGACE ORAL 11
megestrol acetate 11
melatonin 1
MELATONIN 1
melatonin 1
melatonin-pyridoxine 1
meloxicam 2
META BIOTIC/BIO-ACTIVE 12 7 metformin hcl 6
methimazole 27
methocarbamol 24
methylcobalamin 18
methyldopa 10
metoclopramide hcl 17
metoprolol tartrate 12
metronidazole 3
MEVACOR 9
MICATIN 14
Index 6
miconazole nitrate (topical) 14
miconazole nitrate vaginal 28
MICROZIDE 17
MINOCIN 27
minocycline hcl 27 MINUS WEIGHT PLUS ENERGY 16 MIRAPEX 11
mirtazapine 5
MOBIC 2
MOBISYL 15
mometasone furoate 15 MONISTAT 7 SIMPLY CURE 28 MONISTAT SOOTHING CARE ITCH RELIEF 15 MONOJECT 3ML SYRINGE/STANDARD HYPODERMIC NEEDLE/21GX1- 1/2" 19 MONOJECT MAGELLAN SYRINGE/SAFETY NEEDLE/3ML/21G X 1-1/2" 19 MONOJECT SAFETY SYRINGE/SHIELD/NEEDLE/3ML /21G X 1-1/2" 20 MONOJECT SYRINGE/LUER- LOCK/3ML/21G X 1-1/2" 20 montelukast sodium 4
MTX SUPPORT 18
MULTI FOR HER 22
MULTI FOR HIM 22
MULTI PRENATAL 23 multiple vitamin 22
naproxen sodium 2
NASAL DECONGESTANT 25 NAT-RUL PRENATAL VITAMINS 23 NATRUL PROBIOTIC 7
NATURE-THROID 27
NEBUSAL 14 NEO-SYNEPHRINE 12 HOUR EXTRA MOISTURIZING 25 neomycin-bacitracin-polymyxin 14 neomycin-polymyxin w/ pramoxine 14 NEOSPORIN ORIGINAL 14 NEOSPORIN PLUS PAIN RELIEF MAXIMUM STRENGTH 14 NEURAGEN 21
NEURIN-SL 18
NEURONTIN 5
niacin 28
NIVA-PLUS 23
NORCO 2
nortriptyline hcl 6
NORVASC 12
NUPERCAINAL 3
nystatin (mouth-throat) 21 O-
CAL FA 23
OCEAN NASAL SPRAY 24
olanzapine 11
OMEGA 3-6-9 COMPLEX 1 OMEGA-3 & OMEGA-6 FISH
oxymetazoline hcl 25
PAIN-A-LAY 21
PAMELOR 6
pantoprazole sodium 28
PARAFON FORTE DSC 24
paroxetine hcl 5
PAXIL 5
PEARLS IC 7
PECGEN DMX 13
penicillin v potassium 26 PENTIPS/PEN NEEDLES MISC 20 pentoxifylline 17
PEPCID 27
PEPCID AC 27 PEPCID AC MAXIMUM STRENGTH 27 PEPTO BISMOL 7 PEPTO-BISMOL 7 PEPTO-BISMOL INSTACOOL 7 PEPTO-BISMOL TO-GO 7
PERCOCET 3
PERCOGESIC 13
PHAZYME 17 PHAZYME MAXIMUM STRENGTH 17 PHAZYME ULTRA STRENGTH 17 phendimetrazine tartrate 1
phenol (antiseptic) 21 phentermine hcl 1
multiple vitamins w/ calcium 22 OIL 1 omega-3 fatty acids 25 PHENYLADE PHEBLOC 25
multivitamin/minerals cap 22
multivitamin/minerals liq 22
multivitamin/minerals tab 22
MYCO NAIL 14
MYCO NAIL A 14
MYCO-NAIL 14
MYLICON 17 MYLICON INFANTS GAS RELIEF 17 MYOFLEX 15
MYSOLINE 5
nabumetone 2
naphazoline w/ pheniramine 26
NAPROSYN 2
naproxen 2
OMEGA-3-6-9 1
omeprazole 28
OMNICAP 22
ondansetron hcl 8
ONE-A-DAY ESSENTIAL 22
ONE-A-DAY MENS 22 ONE-A-DAY WOMENS FORMULA 22 OPCON-A 26 ophthalmic irrigation solution 26 OPURITY B12/FOLIC ACID 18 ORASEP 21
oxcarbazepine 5
Index 7
oxycodone w/ acetaminophen 2
phenylephrine hcl (oral) 25
phenylephrine w/ dm-gg 13
phenytoin sodium
extended 5 PHILLIPS
COLON HEALTH 7
pioglitazone hcl
6 PLAVIX
17 PLETAL
17 PNV FOLIC ACID + IRON MULTIVITAMIN 23 PNV PRENATAL PLUS MULTIVITAMIN 23 polysaccharide iron complex 18 polyvinyl alcohol-povidone (ophth) 25 potassium chloride 20
Index 8
potassium chloride microencapsulated crystals er 20 pramipexole dihydrochloride 11
prednisolone 12 prednisolone sodium phosphate 12 prednisone 12
PREDNISONE 12
PRENATAL 23
PRENATAL FORMULA 23
PRENATAL LOW IRON 23
PRENATAL MULTI + DHA 23
PRENATAL MULTIVITAMIN 23 PRENATAL MULTIVITAMIN + DHA 23 PRENATAL MULTIVITAMIN 23
PROBIOTIC MATURE ADULT 8 PROBIOTIC PEARLS 8 PROBIOTIC PEARLS ADVANTAGE 8 PROBIOTIC-10 8
PROBIOTIC-10 ULTIMATE 8
prochlorperazine maleate 11
promethazine hcl 9
promethazine w/codeine 13
propafenone hcl 4
propranolol hcl 12
PROSACEA 21
PROTONIX 28
PROVERA 26
PROZAC 5 pseudoephedrine hcl 25
REPLENS VAGINAL MOISTURIZER 28 REQUIP 11
RESTORA 8
RESTORIL 19
RIGHT STEP PRENATAL 24
RISAQUAD 8
RISAQUAD-2 8
RISPERDAL 11
risperidone 11
ROBAXIN 24
ROBAXIN-750 24
ROBITUSSIN DM 13 ROBITUSSIN PEAK COLD DM 13 ROBITUSSIN PEAK COLD MULTI-SYMPTOM COLD 13
PLUS DHA ONE DAILY 23 pseudoephedrine w/ dm- ROBITUSSIN TO GO COUGH
PRENATAL
PRENATAL PLUS 23
PRENATAL VITAMIN 24 PRENATAL VITAMIN & MINERAL 24 PRENATAL VITAMIN/IRON 24
PRENATAL VITAMINS 24 PRENATAL VITAMINS PLUS LOW IRON 24 PREORBOTIC 7
PREPLUS 24
PRILOSEC 28
primidone 5
PRINIVIL 10
PRO-BIOTIC BLEND 7
PRO-FLORA IMMUNE 7
PROBIOMAX DAILY DF 7
PROBIOTIC 8 PROBIOTIC & ACIDOPHILUS FORMULA EXTRA STRENGTH 7 PROBIOTIC + OMEGA-3 7
PROBIOTIC ACIDOPHILUS 8 PROBIOTIC ACIDOPHILUS BEADS 8 PROBIOTIC ADVANCED ULTRAPOTENCY 8 PROBIOTIC COLON SUPPORT 8 PROBIOTIC COMPLEX/ACIDOPHILUS 8 PROBIOTIC DAILY 8
PROBIOTIC GOLD EXTRA STRENGTH 8
gg 13 pseudoephedrine- dexchlorpheniramine- chlophedianol 13 PX PRENATAL MULTIVITAMINS 24 pyrantel pamoate 3
pyridoxine hcl 28
QC PRENATAL 24
quetiapine fumarate 11
quinapril hcl 10
QUINTABS 22 RA ANTI-FUNGAL FOOT CARE 14 RA ESSENCE-C 22
RA OMEGA 3-6-9 1
RA PRENATAL 24 RA PRENATAL FORMULA/FOLICACID 24 RA PROBIOTIC COLON CARE 8 RA PROBIOTIC COMPLEX 8
ramipril 10
ranitidine hcl 27
RAPID GEL RX 21
REFRESH 26
REFRESH LIQUIGEL 26
REFRESH TEARS 26
REGLAN 17
RELAGESIC 2
Index 9
REMERON 5
REPHRESH PRO-B 8
&COLD CF 13 ropinirole hydrochloride 11
rosuvastatin calcium
9 RYTHMOL
4 SAFESNAP SYRINGE/NEEDLE/3ML/21G X 1-1/2" 20 SAFETY SYRINGES/NEEDLE 3ML/21GX1-1/2" 20 SAFETY-LOK SYRINGE/NEEDLE3ML LUER- LOK 21GX1-1/2" 20 saline 24 sennosides 19 sennosides-docusate sodium 19 SENOKOT
19 SENOKOT S
19 SEROQUEL
11
sertraline hcl
5 SILVADENE
15
silver sulfadiazine
15 simethicone
17 SIMILAC PRENATAL EARLY SHIELD 24 simvastatin
9
SINEMET 11
SINEMET CR 11
SINGULAIR 4 SKIN BEAUTY & WELLNESS 22 SM ACIDOPHILUS PEARLS 8
SM OMEGA-3 1
Index 10
SM OMEGA-3-6-9 FATTY ACIDS 1 SM ONE DAILY ESSENTIAL22
SM PRENATAL VITAMINS 24 sodium bicarbonate (antacid) 3
TESSALON PERLES 12 tetrahydrozoline hcl (ophth) 26 THERA 23 THERA/BETA-CAROTENE
TUSICOF 13
TUSNEL 13
TUSNEL C 13
TYLENOL 2
TYLENOL 8 HOUR 2
sodium chloride (inhalant) 14 23 THERANATAL CORE TYLENOL 8 HOUR
SOMA 24
SONATA 19
SORBUTUSS NR 13
sotalol hcl 12
sotalol hcl (afib/afl) 12
SPEEDGEL RX 21
spironolactone 16
SPORTSCREME 15
STERYMINE 21
sucralfate 28
SUDAFED CONGESTION 25 SUDAFED NASAL DECONGESTANT MAXIMUM STRENGTH 25 SUDAFED PE CONGESTION 25 sulfamethoxazole- trimethoprim 3 sulfasalazine 17
sulindac 2
NUTRITION 24 thiamine hcl 28
thioridazine hcl 11
thyroid 27
TINACTIN 14
TINACTIN JOCK ITCH 14
tizanidine hcl 24
TOFRANIL 6
tolnaftate 14
TOPAMAX 5
topiramate 5
tramadol hcl 2
tramadol-acetaminophen 3
trandolapril 10
TRANZGEL 21
TRAUMEEL 21
trazodone hcl 5 triamcinolone acetonide (topical) 15
ARTHRITISPAIN 2 TYLENOL EXTRA STRENGTH 2 TYLENOL PM EXTRA STRENGTH 19 TYLENOL/CODEINE #3 3
TYLENOL/CODEINE #4 3
TYLER SIMILASE JR 16
UDAMIN SP 22
ULTRA DIET AID 16
ULTRACET 3 ULTRAFLORA IMMUNE HEALTH 8 ULTRAM 2
UNISOM 19
urea 15
vaginal lubricant 28
VALIUM 4
valproic acid 5 valsartan-hydrochlorothiazide
SUPER OMEGA-3 1 TRIAMINO 25 10 VANISHPOINT SAFETY
SUPER PROBIOTIC 8 SUPER PROBIOTIC DIGESTIVE SUPPORT 8 SUPER-AMINO 1600 25
SUPERVITE 21
SUPLEVIT 21
SWIM EAR 26
SYNTHROID 27 SYRINGE/LUER LOCK/3ML/21G X 1-1/2" 20 SYRINGE/LUER LOCK/3ML/21GX1-1/2" 20 T-RELIEF PAIN ARNICA + 12 21 TAPAZOLE 27
TEA TREE OIL 12 TECNU EXTREME MEDICATED POISON IVY SCRUB 21 temazepam 19
TENORMIN 12
terazosin hcl 10
terbinafine hcl 8
terbinafine hcl (topical)
14
triamterene & hydrochlorothiazide 16 TRICARE 24
trihexyphenidyl hcl 11 TRILEPTAL 5 TRIPLE OMEGA COMPLEX 1 TRIPLE OMEGA-3-6-9 1 TRISPEC DMX 13 TRISPEC DMX PEDIATRIC 13 trolamine salicylate 15
TRUBIOTICS 8 TRUNATURE DIGESTIVE PROBIOTIC 8 TUMS 3
TUMS CHEWY BITES 3 TUMS E-
X 750 3 TUMS EXTRA STRENGTH 750 3 TUMS KIDS 3
TUMS LASTING EFFECTS 3
TUMS SMOOTHIES 3
Index 11
SYRINGE/3ML/21GX1-1/2" 20 VANISHPOINT SYRINGE/3ML/21G X 1-1/2" 20 VASERETIC 10
VASOTEC 10
venlafaxine hcl
5,
6 verapamil hcl
1
2 VICKS SINEX
2
5 VICKS SINEX 12 HOUR DECONGESTANT 25 VICKS SINEX 12 HOUR DECONGESTANT ULTRA FINE MIST 25 VICKS SINEX 12 HOUR DECONGESTANT ULTRA FINE MIST/MOISTURIZNG 25 VICKS SINEX MOISTURIZING 25 VICKS SINEX SEVERE NASALDECONGESTANT 25 VINATE M 24 VISBIOME PROBIOTIC HIGH POTENCY 8 VISINE 26
Index 12
VISINE EXTRA 26
VISTARIL 4
VITAMENT 22
vitamin a 28
VITAMIN B 12 18
VITAMIN B12/FOLIC ACID 18 VITAMIN C EFFERVESCENT BLEND 22 VITAMIN C/ELECTROLYTES 22 VITAMIN D2 28
VITAMIN D3 28
vitamin e 28
vitamins w/ lipotropics 24 VOL-
PLUS 24
VSL#3 8
warfarin sodium 4
WELLBUTRIN SR 5
WESTHROID 27
white petrolatum 26
WP THYROID 27
XANAX 4
XERAC AC 15
XYLOCAINE 15
XYZAL 9
XYZAL ALLERGY 24HR 9
zaleplon 19
ZANAFLEX 24
ZANTAC 27 ZANTAC 150 MAXIMUM STRENGTH 27 ZANTAC 75 27
ZE-PLUS 23
ZESTORETIC 10
ZESTRIL 10
ZIAC 10
zinc oxide (topical) 16
zinc sulfate 21
ZOCOR 10
ZOFRAN 8
ZOLOFT 5
zolpidem tartrate 19 ZOSTRIX ARTHRITIS PAIN RELIEF 15 ZOVIRAX 11
ZYLOPRIM 17
ZYNCOF 14
ZYPREXA 11
ZYRTEC ALLERGY 9 ZYRTEC CHILDRENS ALLERGY 9